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In adhesive bonding, two different substrate materials are joined together, usually by forming chemical bonds. The adhesive can stick things together. The loading rate and deformation mode can easily change the mechanical properties of the adhesive material. Hence, a vital aim of the current study is to evaluate the strain rate effect on the damage response of adhesive joints for Mode I loading scenarios. The adherend material was aluminum AL6061-T6, and Araldite 2015 was the adherent material. This experiment for delamination had a prescribed adherend size of 200 mm × 25 mm × 3 mm and an adhesive thickness of 0.5 mm. In situations where the strain rate affects the failure mechanism, a displacement rate of 5, 50, or 500 mm/min is sufficient to attain the failure mechanism. A double cantilever beam (DCB) specimen was employed to construct the FE model geometry for simulation. A hybrid experimental–FE technique was utilized to extract the properties of the adhesive interface. FE simulation has proven to have an excellent correlation with the experimental findings. [ABSTRACT FROM AUTHOR]

Objective:The objective of the present study is to determine the frequency of delirium and the associated factors in patients undergoing open heart surgery. Study Design: Descriptive cross sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology and National Institute of Heart Disease, from October 2016 to December 2016. Materials and Methods:A descriptive cross sectional study was conducted on 328 patients, who underwent elective open heart surgery at intensive care unit of AFIC/NIHD, over 3 months spanning from October to December 2016. The patients who underwent elective coronary artery bypass graft (CABG) surgery during the specified study period are included in inclusion criteria and age of over 18 years. While patients with the history of psychiatric illness were excluded.Samplings were performed by non-probability consecutive sampling technique. Patients were assessed for delirium byusing the DSM IV Criteria for diagnosis of Delirium. Chi- square statistics and Pearson correlation were used as a test of significance. Results: The frequency of immediate post surgical delirium was found to be 5.0%. The patients mean age was found to be 55 (53±14) and most frequent age group was >50 yearsi.e. 200 (61.0%) while number of patients in <50 years were 128 (39.0%). Among these patients, 245 (72.0%) were male and 95 (28.0%) were females. Of these patients, 246 (72.0%) had coronary artery bypass graft (CABG) and 60 (18.0%) underwent valve replacement. Risk factors such as age, ventilator time, intra-aortic balloon pump, intensive care unit stay, need for ionotropes, arrhythmias, number of reopen procedure and mortality were positively correlated with delirium (p-value <0.05). Conclusion: Diagnosis of delirium is of greatest value; therefore, further studies are essential to clarify the risk factors because controlling them will help prevent delirium. [ABSTRACT FROM AUTHOR]

Objective:To determine the frequency of sepsis and to evaluate the morbidity and mortality of patients subjected to cardiac surgery that developed sepsis during the in-hospital postoperative period. Study Design: Descriptive cross sectional study. Place and Duration of Study:Armed Forces Institute of Cardiology, Intensive Care Unit of Rawalpindi, from Oct2016 to Dec2016. Material and Methods:Three hundred and twenty eight patients were included who underwent elective open heart surgery at intensive care unit of AFIC/NIHD. All the patients who were above 18 years of age and underwent elective coronary artery bypass graft (CABG) surgery during the specified study period were included. Patients with any infection and with infective endocarditis were excluded. Non-probability consecutive sampling technique was used. Results: The frequency of immediate post surgical sepsis was found to be 55(17.0%). The mean age of patients was found to be 55 (53±14) years. Among these patients, 29(9.0%) were males and 26(8.0%) were females. 38 (12.0%) had coronary artery bypass graft (CABG) and 17 (5.0%) underwent valve replacement. Mean ICU stay was found to be 14.5 ± 10.1 days in males & 17.3 ± 12.4 days in females, surgical site infection rate 8 (2.3%), cardiac support 19 (34.5%), likewise mechanical cardiac support in males 10 (18.0%) and in females 2 (4.0%), mean mechanical ventilation time was found to be (5.1±1.3 hours), post-op acute renal failure in males 6 (11.0%) and 1(2.0%) in females. Mortalityin males was found to be 5 (9.0%)and in females it was 6(11.0%). Haemocultures results of septic population showed that 15 patients were positive and of which 11 (73.0%) mainly comprised of the acinetobacter species. Conclusion:Sepsis that occurs in the cardiac surgery post-operative period significantly contributes to patients’ high morbidity and mortality. Moreover, further studies are essential to simplify the proper diagnosis, and risk factors that will help prevent sepsis. [ABSTRACT FROM AUTHOR]

Objective: The aim is to study frequency of hypoalbuminemia and examine factors associated with hypoalbuminemia in critically ill-children. Study Design: Descriptive cross sectional study. Place and Duration of Study: Armed Forces Institute of Cardiology & National Institute of Heart Diseases Rawalpindi, from Jan 2016 to Sep 2016. Material and Methods: This prospective study measured the serum albumin concentration of 153 children admitted to Peads intensive care unit after congenital heart disease surgery. Data was collected from PICU registry included demographic profile (age, sex, and weight), clinical findings and postoperative complications. Data was entered and analyzed in IBM SPSS Statistics 22 (statistical package for social sciences). Results: Mean albumin level was 31.8 mg/dl (Range 8-56 mg/dl). Patients with albumin more than 25 mg/dl were 132 (86%) and patients with albumin less than 25 mg/dl were 21 (14%). 13 (62%) patients with hypoalbuminemia were females. Average ICU stay of patients with hypoalbuminemia was 211 ± 458 hours. Average ventilation time of patients with hypoalbuminemia was 49 ± 103 hours. Conclusion: Hypoalbuminemia is the prominent factor in post operative congenital heart disease patients. It is strongly correlated with the type of defect, cyanosis and it effects the post operative complications like ICU stay, ventilation duration and urine output of the patients. [ABSTRACT FROM AUTHOR]

Objective: This study was conducted to determine the pattern of cutaneous malignancies among patients attending the skin out-patient department Hayatabad Medical Complex Peshawar. Methodology: This was descriptive analysis of skin cancers carried from January 2011 to December 2011. Histologically diagnosed skin cancers were reviewed and analyzed according to age, gender, site of distribution and histological types. Results: Hundred histologically diagnosed skin malignancies were reported during the period under review. Sixty cases (60%) were males and 40 cases (40%) females with a male to female ratio of 1.5:1. Age ranged from 22 years to 86 years. Mean age was 57.05+_11.39 SD. Mean duration of disease in months were 16.78+_ 9.07SD. Basal cell carcinoma (BCC) was the most common malignancy consisting of 32(32%) cases followed by Squamous cell carcinoma (SCC 18%) with 10 (10%) cases of melanoma and 9(9%) cases of Mycosis Fungoides. Actinic Keratosis, Kaposi's sarcoma, Bowen's disease, Dermatofibroma, Atypical fibroxanthoma constituted the remaining. Conclusion: The most common skin malignancy was BCC followed by SCC and melanoma. Larger studies should be conducted to ascertain the actual prevalence of skin tumors. [ABSTRACT FROM AUTHOR]

Background: Inadvertent coughing and desaturation are the most commonly faced and feared respiratory complications in post-anaesthesia period. The study was done to compare the efficacy of intravenous lignocaine versus sevoflurane in prevention of coughing and desaturation at extubation in children less than 6 years of age., Methods: This Randomized Control Trial was carried out from May 2013 to May 2016, at Combined Military Hospital Nowshera after obtaining approval from the hospital ethics committee (IREC-0003/5/13/Aneas). Children aged three months to six years undergoing surgical procedures requiring the placement of definitive airway were randomly assigned into two groups. Patients were anaesthetized by standardized balanced anaesthesia technique. In Group A (n=355), three minutes prior to extubation lignocaine 2% was used intravenously. In Group B (n=355), isoflurane was switched off, breathing circuit changed and sevoflurane started at minimum alveolar concentration (MAC 3-4%) for 3 minutes prior to extubation. Assessment for extubation was clinical. Oxygen saturation and severity of coughing were noted for 5 consecutive minutes, after extubation., Results: In group-A, 156 patients were less than 2 years of age while in group-B, 135 patients were less than 2 years old. In group-A, 199 and in group-B, 220 children were 2-6 years of age respectively. Post stratification the p-value for weight was 0.17 (p-value >0.05) and t-statistic was 1.36. Post stratification p-value for gender was 0.12 (p-value>0.05) and chi square statistic was 2.49. Group A had more eventful extubation with 270 cases of cough (76%) as compared to group-B where it was noted in 199 cases (56%). Similarly, desaturation was observed in 85 cases in group-A (24%) as compared to 28 cases (8%) in group-B. The difference between the groups was statistically significant., Conclusions: Sevoflurane based anaesthetic vapours mixture causes statistical significant prevention from events like coughing episodes and desaturation in post-extubation in children less than six years of age undergoing elective surgery.