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Nature is the best teacher and reconnects the mechanically lost man with originality. Considering the fundamental role of nature in the nurture of mankind, this study aims to emphasise the need for green spaces within the urban metropolis for improved lifestyles and a sustainable environment. The conditions of the United Nation Sustainable Development Goals (UN-SDG) necessitate a cleaner environment, clean air, water and sanitation. The quantitative research proposes jogging track, artificial forest implementation and recreational facilities along with the treated Malir river water sections. For this research, a questionnaire-based analysis is conducted. This study proposes a notion of urban forest recreation for the citizens, dwellers and monetary contribution for maintaining such facilities based on the quantitative analysis of the collected data. As a result, the analytics of the survey reveals that people would welcome the use of such options for recreation. According to the data received, the respondents ponder that these green places could enhance their quality of life with a preference for sharing green space with their family and friends and also increase some soothing hobbies in urban areas. Most respondents prefer urban forestry supporting water sports, boating and fishing areas in Karachi. The feasibility of the proposed model is ensured with critical analysis and assessment of public income for Tax, preferences of green places assessment, use of recreational areas, and willingness to pay for entry in the green area.

This study aims to check the effect of job demands on employees' burnout and job resources on employees' work engagement with the moderating role of psychological ownership. Moreover, the direct and mediating role of burnout and work engagement in adaptive job performance. Data were collected through a survey questionnaire from a total of 311 four and five-star hotel employees and structural equational modeling was employed to test the hypotheses. The findings demonstrate the positive relation of job demands with burnout and job resources with work engagement. Furthermore, burnout has a direct negative as well as mediating relation with adaptive job performance whereas, work engagement has a direct positive as well as mediating relation with adaptive job performance. Lastly, the study has also found that psychological ownership weakens the relationship of job demands and employees’ burnout whereas, it strengthens the relationship among job resources and employees’ work engagement. Theoretical and practical implications are also discussed.

This paper introduces an abridgment of solid waste conditions and their management issues in Karachi. Approach that can be usedto reduce the municipal waste and the management of solid waste produced by the residents of Karachi city is Zero Waste Strategy. Zero waste strategy is a focused approach of conserving all the resources. This approach is beneficial by means of responsible production, valuable consumption, reuse and recovery of product, packaging and materials without burning and with the least discharge to air, water or land that cause an adverse effect on our environment and human health. The budget allocated by governmental bodies for solid waste management is adequate but not allocated properly to the local bodies. Bin services are provided throughout the city is enough but the locations selected for this purpose are not appropriate. Zero waste strategy (ZWS) helps to reduce the solid waste by providing a proper route, with an appropriate recycling plan, adequate management of resources, and public behavior related to solid waste. The research concludes by proposing zero waste strategy (ZWS) as an effective solution of highlighted issues for the management of solid waste in Karachi city. The current research is entirely unique and could affect the society in value-added manner.

This paper presents the development of low-cost and robust industrial IoT based data acquisition system primarily focused on domestic manufacturing industries striving to achieve goals and benefits of “Industrial 4.0”. This proposes aims to promote DAQ System integration in traditional manufacturing process of the small and mid-sized industries of Pakistan with limited capacity of investment. Proposed method comprises of Arduino and it’s IoT features for Data Collection, along with a self-developed PC based Centralized Software for Collection of Data, Graphical User Display and Storing collected Data in Local SQL Database. PC based Software replaces requirement of multiple software in case of traditional low-cost DAQ systems, like OPC Software for collecting data from industrial hardware, Java or PHP based any GUI and SQL Data storage. The analysis of work is done with the help of the Message Queue Telemetry Transport (MQTT) protocol. This project will be in further stages evaluated to add features of Supervisory Control, along with Data Acquisition hardware with minimum increase in cost and further upgrading PC Software to add more features of Industry 4.0, as compared to costly commercial solutions available in the market. A machine learning algorithm, k-nearest neighbors algorithm has been used to classify sensitive and non-sensitive data for improvising cloud security. K-Nearest Neighbors is also called KNN algorithm which is supervised machine learning classifier.

This paper aims to transform tidal energy into rotation energy for electricity generation and in the course evaluating sea parameters. This is accomplished by integrating the Internet of Things with tidal energy off the coast (and in a home environment), which further enhances the capabilities of this prototype project to remotely monitor sea-like parameters to enable energy production using tidal energy. As South Korea is transducing tidal energy with a total installed tidal power capacity of above 500MW, Pakistan and Middle Eastern countries can benefit from its vast coastal line. This paper proposes a sustainable design that makes the turbine rotate at high speed. A vertical design is chosen, which is bi-directional. The design of the turbine consists of 3 blades, each occupying a 2 square feet area supported by an iron-rod frame. During the experimentation, an average voltage of 5V was generated, whereas the speed of the turbine generated was 75 RPM. It is the first known attempt of its kind supported by indigenous resources. It is proposed that this type of prototype can be scaled, to the coast to produce electrical energy to meet the energy production needs of the region.

This is a review paper on the idea of cloud computing which is evolved from the era of internetworking. Subsequently the highlight includes classification of cloud computing, comparison of public versus private cloud infrastructure. We further the concept of SaaS and PaaS where we set in note for future work. We finally conclude with some of the salient characteristics of networks on the cloud.

Conventional buildings consume large amounts of energy and are the source of greenhouse gas emissions contributing to climate change. The shortage of green buildings in Pakistan have been said to be due to shortage of knowledge of the benefits of essential green building materials and the absence of a regulatory framework. The study is qualitative and quantitative and is divided into two parts. This review paper focuses on awareness in the Pakistan's local construction market concerning green buildings through a survey questionnaire. Data collection procedure consists of 60 questionnaires related to green building construction awareness and priorities within Karachi's construction sector. Also, a focus group and personal interviews conducted with at least 5 professionals working in local construction projects are analyzed. The research questions formed from detailed literature review were analyzed and found that energy conservation, environmental/resource conservation and improving indoor environmental quality are major driving factors for green building development. Similarly, there is a lack of knowledge of green construction methods and regulations and lack of support from the government. This has been found as the major barrier in going towards green construction. We recommend policy directions towards this end and elaborate points of concern to the authorities.

Background All scoring systems used in Alopecia Areata (AA) focus mainly on scalp and cannot assess the severity or treatment response when AA involves the beard hair, eyebrows, or eyelashes. Aim This study describes and assesses the reliability of a new scoring system "Alopecia Areata Severity Index" (AASI) for measuring the severity of AA of scalp, beard, and upper face. Methods Scalp hair, beard hair, upper face (eyebrows and eyelashes) were individually assessed and the severity of AA was scored from 0 to 100 (0-50 in case of upper face). AASI score was then calculated as a sum of all these individual scores as AASI = AASI (scalp) + AASI (upper face) + AASI (beard)+. To test the inter-observer reliability of AASI score, 25 patients with varying severity of AA were scored by 4 trained dermatologists. Repeat scoring was performed after one week to test for intra-observer reliability. Results Excellent inter-rater, as well as intra-observer reliability, was observed with Chronbach's alpha value of 0.999 (CI = 0.989-1.000). The intra-observer correlation coefficient with average measure was 0.999 (CI = 0.990-1.000) with statistically significant F test Conclusion AASI score is a reliable scoring system to assess the severity of AA in patients with involvement of one or more areas of the body. Limitations Sample population belonged to single ethnic group.

Melasma is a common dermatosis, presenting as ill-defined light to dark brown pigmentation of photo-exposed areas, most commonly the face. Its exact prevalence is unknown, but it is commoner in intermediate skin phototypes and women of reproductive age. Its treatment and monitoring have significance due to its chronic recalcitrant history and psychosocial impact. Various indices and tools like the melasma area and severity Index (MASI), melasma severity index (MSI), and Melasma Quality of Life Scale (MELASQoL) have been formulated for measuring severity and treatment response. In this review, particular emphasis has been laid on melasma's epidemiological and clinical aspects and its assessment and scoring.

Topical steroid damaged face (TSDF) is an entity caused by unsupervised and prolonged use of topical corticosteroids (TC) on the face. There is currently no definite treatment that can partially or completely reverse the changes seen in the facial skin in TSDF. Platelet rich plasma (PRP) is a biological product that is obtained from autologous centrifuged blood and it contains multiple growth factors for the skin and other body tissues. PRP has been employed as a treatment option in patients with steroid induced rosacea. We hereby report the results from 34 cases of TSDF who had been treated with PRP at our institute. Retrospective analysis of the data and digital photographs of these cases was carried out in October 2021 and the data analysis revealed a significant therapeutic benefit in most of the cases with excellent results in 76% (26/34) cases. Improvement was noticed after the first session only in majority of cases and in all the clinical parameters in the study patients. No adverse effects were reported in any patient in this series.

Vaccination for COVID19 infection is in full swing all around the world and while the vaccines are considered overall safe, many cutaneous and extracutaneous adverse effects have been reported after their use. Local injection‐site reactions are the commonest adverse effect described with the use of these vaccines. We describe a case of Sweet syndrome in an elderly female after the first dose of Oxford‐AstraZeneca COVID‐19 vaccine (AZD1222).

Over several decades, topical corticosteroids (TCs) have been used in the treatment of various dermatoses such as psoriasis, contact dermatitis, and eczema, among others. The TCs act by reducing inflammation and irritation after topical application. The therapeutic effect of TCs is bestowed through their diverse biologic properties such as anti-inflammatory, antiproliferative, vasoconstrictive, and antimitotic activity, and its role in the reduction of lymphocyte reactivity, modulation of Langerhans cell expression, cellular and lysosomal membrane stabilization, reduction of recruitment of neutrophils and monocytes, reduction of mast cell density and reactivity, and sensitization of immunoglobulin E. Clobetasol propionate (CP) 0.025% is a class I TC available as a cream formulation. The cream formulation contains half the concentration of conventional CP (0.025%), without the loss of therapeutic potency. The lack of additives such as penetration enhancers (propylene glycol) further prevents cutaneous microbiome alteration. This comprehensive case series covers the potent efficacy and safety of ImpoyzTM (CP) Cream 0.025% in the management of various dermatological disorders.

Objective: Polycystic ovary syndrome (PCOS) is one of the most common reproductive, endocrine and metabolic disorders in premenopausal women. Even though the pathophysiology of PCOS is complex and obscure, the disorder is prominently considered as the syndrome of hyperandrogenism. C-Terminal binding protein 1 antisense (CTBP1-AS) acts as a novel Androgen Receptor regulating long noncoding RNA (lncRNA). Therefore, the present study was aimed to establish the possible association of androgen receptor regulating long noncoding RNA CTBP1-AS with PCOS.Methods: A total of 178 subjects including 105 PCOS cases and 73 age-matched healthy controls were recruited for the study. The anthropometric, hormonal and biochemical parameters of all subjects were analysed. Total RNA was isolated from peripheral venous blood and expression analysis was done by quantitative real time PCR (qRT-PCR). The correlation analysis was performed to evaluate the association between and various clinical parameters and lncRNA CTBP1-AS expression.Results and conclusion: the mean expression level of CTBP1-AS was found to be significantly higher in the PCOS women than in the healthy controls (-lnCTBP1-AS, 4.23 ± 1.68 versus 1.24 ± 0.29 p

Excimer light (EL) and targeted UVB (TUVB) devices have been used successfully in repigmenting vitiligo. To compare the repigmenting efficacy and safety of EL with TUVB device in vitiligo. The study was conducted retrospectively on patients of vitiligo who had received either EL (Group A) or TUVB (Group B) from year 2015 to 2020. Data pertaining to 40 such age and sex matched patients from each group was retrieved with almost similar sites of involvement. Only patients whose phototherapy sessions had been given twice weekly for minimum of 30 sessions or until 90%-100% repigmentation were included in the study. The study was retrospective in nature and the principles outlined in the Declaration of Helsinki were followed during the study. The primary endpoint compared between the two groups was the extent of repigmentation achieved on different sites of body and adverse effects from treatment. Secondary endpoints compared included total number of doses, cumulative dose needed for complete repigmentation and number of doses needed for onset of repigmentation. There were 82.6% responders in Group A and 76.3% in Group B who had achieved at least 50% repigmentation. Excellent response (75%-100% repigmentation) was achieved in 68.1% lesions in Group A and 46.4% lesions in Group B. Patients in Group A needed less number of doses (13.75 vs. 19.37) and less cumulative dose (6.14 vs. 7.69 J/cm2 ) to achieve complete or near complete repigmentation. Adverse effects were negligible in both groups. Targeted phototherapy with EL demonstrated better repigmenting efficacy than TUVB in vitiligo.

The ability to sustain communication between nodes as per Industry 4.0 standard within the waterways is still not mature enough. It is prudent to make use of natural resources that are abundantly found in the form of strong wind (wind energy) and underwater tidal waves generation (tidal energy). Climate change and environmental sustainability are now becoming more important for a sustainable smart world. This is discussed in detail along with the decentralized mode of crop management. In this chapter, it is shown that energy efficiency can lead to the selection of different system models for the internet of underwater things (IoUT) where systems are sustainable and can tap previously unexplored resources. This resource is useful as a reference to further explore IoUT and green energy harvesting techniques.

Segmental vitiligo (SV) is considered to be relatively less responsive form of vitiligo to medical treatment. While excimer light (EL) has shown great promise in treating localized vitiligo especially on face and neck, its efficacy in SV is not reported so commonly. We conducted a retrospective study on patients of childhood SV who had received EL therapy from January 2016 to December 2018 at our institute. Data of all such cases who had received at least 10 doses of EL treatment or achieved complete repigmentation were selected for analysis. Records of 26 children with SV satisfied the selection criteria. Excellent response (75% repigmentation) was documented in 65.4% (17/26) patients with 7.7% (2/26) patients showing partial (50%-75%) repigmentation. Response to treatment was seen to correlate inversely with the duration of SV. Patients with SV of6 months reported better results with all 10 cases achieving complete or near complete (75%) repigmentation. In contrast, only 44% patients (7/16) with disease duration of6 months were seen to have achieved75% repigmentation.

The delivery of healthcare in remote rural areas is a global phenomenon. Using digital governance, a discretized cluster of node relaying time-sensitive, and reliable data, life-critical health services can be ensured. Here tactile internet-based internet of things (IoT) and its variant internet of medical things (IoMT), as well as tactile internet, is introduced. Its relationship with 5G is explored. A model for e-health implementation using unmanned autonomous vehicles (UAVs) in the backhaul is presented. The link is analyzed over fiber optics, satellite, and 5G network in terms of latency and reliability: the crucial metrics for robotic surgery. It is also shown that 5G implemented in Italy, Zimbabwe, and Cooks Island have supported mobile hospitals in rural regions. Hence, induction of 5G networks is a feasible approach. Finally, a critical review of expected future technologies including telematics is presented. Hence, tactile internet-based robotic surgery can reduce the digital divide.

Melasma is a notorious dermatosis, often resistant to treatment. Chemical peeling constitutes an acceptable option of management of melasma (of any type and duration). In this article, as a group of experts from Pigmentary Disorders Society (PDS) in collaboration with South Asian Pigmentary Forum (SPF), we have tried to elaborate the various chemical peeling agents for the treatment of melasma. Besides, we have reviewed the indications, mechanism of action, rationality and the detailed procedure of peeling. The evidence in favor of various peeling agents have been summarized as well.

Laser hair removal since its availability has been primarily used for aesthetic purposes. Over the years, it has emerged as an important therapeutic modality in various dermatological and surgical disorders, both as an adjuvant and as a monotherapy. Depending on the skin type, all laser hair removal systems have been used with good results and minimal complications. We hereby review the diverse range of unconventional indications of laser hair removal.

There are limited treatment options available to control the progression of vitiligo and most of these treatment options carry the risk of both short-term as well as long-term adverse effects. Apremilast has emerged as a promising treatment option in psoriasis and many other cutaneous disorders. We report herein the successful use of oral apremilast therapy in controlling the progression of adult onset vitiligo in 13 patients. The patients had not responded to other systemic treatments earlier. In addition to the control of progression, eight patients (61.5%) showed some evidence of repigmentation after apremilast therapy. Gastrointestinal adverse effects and headache were the commonest adverse effects reported that led to cessation of treatment in two cases.