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Objective: To determine the role of angiography for the assessment the type of patent ductus arteriosus in children under 18 years. Study Design: Observational Retrospective study. Setting: Children’s Hospital Lahore. Period: October 2021 to February 2022. Material & Methods: The sample size calculated was 245 but, at the end of the period of four months only 120 patients fulfilled the criteria and were included in this study convenient sampling technique was used to collect the data. Patients with patent ductus arteriosus were included in this study. Patients with other congenital heart diseases were excluded. Essential measurements included Types of Patent Ductus Arteriosus (PDA), (PDA) Size, Ampulla Size, Aortic and Pulmonary systolic and diastolic pressures. Results: In this study 120 patients with PDA were included. Out of 120, 38 (31.7%) patients were male and 82 (68.3%) patients were female. The age range of the patients was 8 months to 18 years (mean;5.44 ± 3.972 years). The weight range of the patients was 5.3 to 41 Kg (mean;16.05 ± 8.38Kg). The mean PDA size was 4.01 ± 1.80. The mean Ampulla size was 9.92 ± 3.13. The types of PDA detected by angiography were Type A 59(49%), Type B 15(12.5%), Type C 20(16.7%), Type D 20(16.7%), Type E 5(4%), Type F 1(0.8%). The mean Aortic systolic pressure was 105.5±18.99 and diastolic pressure was 57.2 ±14.4. The mean Pulmonary Artery systolic pressure was 47.4 ± 23.3 and diastolic pressure was 27.7 ±14.2. Conclusion: Angiography was found more accurate for the assessment of all the anatomical types of PDA especially TYPE B, C, D and F. More precise measurements of the ampulla and PDA sizes were obtained using angiography. We may conclude that Angiography is a much better and good modality than other modalities for the assessment of the types of PDA.

Higher education plays an important role in human life by creating new information, transferring it to students and bringing up revolution. Standards of teaching are very important for academic achievements of students in higher education. Bringing up the standard of teaching requires advanced learning organizations to ensure that the education they offer meets to the students’ desires both today and for the next. Collaborative learning is an instructional way of learning and teaching in which a group of students cooperate to tackle an issue, accomplish a piece of work, and generate new thoughts. In the condition of collaborative learning, socially and spiritually characteristics are tested as they hear alternative points of view, and are required to verbalize and protect their thoughts. In this manner, students start to generate their own theoretical ideas and do not depend on specialists and books structure. Despite of the effectiveness of collaborative learning in teaching leaning process a very limited research work is organized to highlight the obstacles that effect collaborative learning manipulation for projection of related to its for reaching influences of the collaborative learning. In collaborative learning, the students have an opportunity to speak with companions, generate their own thoughts, share believes and other structure. The study entitled “Effect of collaborative learning on the academic achievements of post-graduate students” was conducted at University of Agriculture Faisalabad. The post graduate students of faculty of education were the target population of this study. The total students of M.Sc. education (2nd and 4th) semesters were 160. The sample size of 113 students was selected by using online software www.surveysystem.com with confidence interval five percent and confidence level ninety-five percent. Simple random sampling technique was used for sample selection. For data collection, a well-developed questionnaire was used for this study. For analyzing the data collection, SPSS (Statistical Package for Social Sciences) was used. The result indicated major facilitating factors and inhabiting factors . The facilitating factors were using A.V aids in classroom, each member of group participate with preparation, and relaxed environment. Inhabiting factors were competition, diverse personality of members, and no-weightage of group members’ effort.

Formulations of metronidazole M1, M2, M3, M4, and M5 with the polymer ethyl cellulose and M1*, M2*, M3*, M4* and M5* with the polymer Eudragit RS100 at varying concentrations were prepared and characterized by Zeta sizer, SEM, DSC, FTIR and XRD. The gel was evaluated for its spreadability, skin irritancy, entrapment efficiency and drug release. Size in M5* was 292.2 nm with PDI of 1.00 and in M2, 371.8 nm with PDI of 0.809 was observed. The entrapment efficiency and production yield with M5* was observed to be 68.40 % and 66.9 % respectively. While the EE and PY with M2 were 66.70 % and 58 % respectively. FTIR did not reveal any incompatibility between the polymer and the drugs and by SEM results, the shape of nanosponges appeared to be spherical and porous. 10% of the drug was released from nanosponges in Ist hour and almost 70 % in 8 hours.

Fetal growth retardation is described as infants whose weights are much less than expected. Population based norms are used to categorize abnormal growths. The objective of the study was to determine the frequency of intrauterine growth retardation on antenatal ultrasound scan. It was an observational descriptive study conducted at the Radiology Department of Fatima Memorial Hospital, Shadman Lahore. Patients visited the Ultrasound Department for Obstetric scan. The study was conducted in 6 months from January to June in 2022. The sample size of 87 was calculated for study with expected rate of 9% of pregnancies resulted in intrauterine growth retardation at 5% level of significance at 5% margin of error. The study included pregnant females in third trimesters of pregnancy. The data was analyzed using SPSS version 20. A total of 87 obstetric ultrasounds were performed during the study period. The mean age of the patients was 28.69 ±4.46 years with age range 20-42. The 87 included patients showed mean gestational age 35.29 ±2.50 weeks. The mean biparietal diameter was 8.69±0.57 cm and abdominal circumference was 29.72±3.03 cm. The mean fetal body weight is 2.52±0.59 kg. The frequency of intrauterine growth retardation was 10.3%. Fetal biometry, biophysical profile and Doppler studies were helpful in the diagnosis of intrauterine growth retardation and evaluation of ultrasound parameters in third trimester.

Objective: To find out the better adjunct in bier’s block. Study Design: Comparative, Qualitative. Setting: Aziz Fatima Hospital and Faisal Hospital. Period: August 2021 to May 2022. Material & Methods: This study was carried out in Faisal Hospital and Aziz Fatima Hospital Faisalabad. Patients electively undergoing hand and forearm surgery with expected duration less than or equal to one hour had been selected and randomly divided in three groups, group 1 LK means lignocaine and ketamine, group 2 LN means lignocaine and nalbuphine and group 3 LO that is lignocain and ondeansetron. All patients selected were ASA 1,2 between 22 to 60 yrs of age. An informed consent was taken. Patients were monitored with standard non-invasive monitoring like pulse oximeter, NIBP and ECG. Onset of sensory block was assessed by pin prick and motor by movement at 0, 1, 2 minutes of drug given. Pain was assessed by using Numeric Rating Scale (NRS 0-10) Post-operative pain as well as systemic effects of drugs administered at 10,20,30 and 60 minutes recorded. Patients then shifted to parent ward and need for systemic analgesia recorded for 24 hours. Results: Ketamine is more effective drug in terms of providing longer duration and improving quality of anesthesia with little side effects. Conclusion: The results of this study showed that ketamine is a better adjunct in Bier,s block as compared to nelbuphine and ondansetron. The least effective drug is ondansetron in terms of prolonging duration of anesthesia and post operative analgesia. But all three do not have many systemic side effects.

Implementasi program CSR merupakan komitmen perusahaan untuk wilayah di sekitar perusahaan. Pertamina Gas memiliki sebuah Program CSR yang dinamakan Desa Seirama (Sejuk Indah Ramah Lingkungan) yang terletak di Desa Cambai, Kecamatan Cambai, Kota Prabumulih, Sumatera Selatan. Program CSR diisi dengan kegiatan seperti pelatihan, pemberian infrastruktur, serta pemberdayaan masyarakat. Program ini bertujuan untuk memberikan daya, keterampilan, dan kemampuan perusahaan bagi masyarakat. Metode yang digunakan dalam pelaksanaan program dan kegiatan CSR yakni perencanaan berdasarkan kajian Pemetaan Sosial lalu melakukan diskusi bersama dengan masyarakat guna memastikan potensi dan masalah yang ada di masyarakat. Setelah melakukan hal tersebut ada beberapa program yang dapat dikembangkan lalu dilakukan implementasi program serta melakukan monitoring dan evaluasi. Program tersebut berupa pengembangan budidaya ikan air tawar, pakan alternatif maggot, hidroponik, dan pengelolaan sampah. Capaian dari budidaya ikan air tawar kelompok mendapatkan peningkatan kapasitas dalam pengelolaan budidaya ikan serta meningkatkan kualitas ikan, penggunaan pakan alternatif yang mampu menekan biaya pakan hingga 50%. Pengembangan budidaya maggot BSF ini juga dapat membantu pegurangan sampah organik yang ada di masyarakat, serta hasil panen maggot yang dapat menambah pendapatan kelompok. Hasil dari kegiatan hidroponik juga dapat menjadikan salah satu pendapatan tambahan bagi kelompok. Kegiatan pengelolaan sampah saat ini sudah menjalin kerjasama dengan perumahan untuk melakukan layanan pengambilan sampah, selain itu juga sampah botol plastik yang kelompok dapatkan dibuat menjadi filter Ipal yang sudah berkerjasama dengan Dinas Permukiman Kota Prabumulih. Hasil dari penjualan filter Ipal memberikan pendapatan tambahan bagi kelompok. Program yang direncanakan hingga tahun 2023 diharapkan mampu membuat masyarakat lebih mandiri.

The education sector in Pakistan is facing various challenges, one of which is the under-representation of women in positions of educational management. Underrepresentation of women in positions of educational leadership has been all around as perceived in the writing of the United States and Europe (Lopez, 2008) just as in Asian settings (Shamsodin, Saeed & Shahla, 2012). This socio-culturalcation level. Further settings his study also explored the internal and external barriers faced by women within their cultures and environments. The objectives of the study were to: examine the role of gender in shaping female perception for pursuing educational management position, explore the nature of household responsibilities being performed by women working in educational management, identify the influence of work environment on the performance of female managers, inspect the influence of socioeconomic background and socio cultural beliefs to women pursuing educational management related posts. This study utilized a mixed method approach. All the females on managerial position in Islamabad (International Islamic University Islamabad) and Rawalpindi (Fatima Jinnah Women University Rawalpindi) was identified as population /sample size and universal sampling technique was used. In this study, the researcher administered self-developed questionnaire and semi structured interview guide for collecting data from the participants. Researcher personally visited all the selected universities for data collection. Frequency and percentages was used to analyse the data collected from the questionnaire. Qualitative data were analysed through thematic analysis. It is concluded that need-based regular training program for improvement of women leadership.

Objective: To determine the prevalence and morbidity associated with high order caesarean section (HOCS). Study Design: Descriptive Study. Setting: Department of Obstetrics & Gynaecology, Nishtar Hospital Multan, Pakistan. Period: January 1, 2018 to December 31, 2019. Material & Methods: A prospective study of all the patients who underwent four or more C-section were included. Maternal morbidity was the primary study objective. The data was collected and analyzed by using SPSS version 19. Results: A total of 7390 caesarean sections were performed, out of these 240 patients (3.24%) underwent HOCS. Two women had their 6th caesarean, while 12 women had their fifth caesarean. There was no maternal death. Most common complications were postpartum haemorrhage requiring blood transfusion (25.8%), obstetric hysterectomy (6.25%), bladder injury requiring repair (5%) and wound dehiscence and wound infection (2.5%). Conclusion: HOCS is associated with increased maternalMmorbidity although there was no mortality. Indications for primary caesarean section should be reviewed to reduce repeat caesarean sections. Moreover, counselling on different methods of contraception during visits to antenatal clinics should be done to limit family size.

The goal of this paper is to extend the concept of complex-valued fuzzy metric space to complex-valued fuzzy b -metric spaces and to discuss various existence results for fixed points to ensure their existence and uniqueness. To demonstrate the viability of the proposed strategies, a nontrivial example is used. Finally, applications to integral equations and initial value problems in mechanical engineering are discussed to demonstrate the superiority of the obtained results.

A cross sectional analytical study was conducted from September 26 to December 28 2018 at Shifa Tameer-e-Millat University Islamabad with 111 undergraduate students aged 17-26 years as participants. The aim of the study was to establish the normative values of cervical joint positioning error (CJPE) and its association with cervical spine mechanics. Neck discomfort was measured using the neck portion of the “student specific Cornell Musculoskeletal Discomfort Questionnaire” (ssCMDQ) and CJPE was measured via cervico-cephalic relocation test using a goniometer. Non-parametric tests of significance were used because the data was not normally distributed in terms of normality testing. Normative values of CJPE were noted to be highest in flexion (9o±9o), rotation towards left (9o±6o) and right (8o±7o), extension (6o±8o), and lastly lateral flexion towards left (5o±7o) and right (5o±5o). Higher CJPE in all movements was observed among females; however, no significant statistical differences were observed (p>0.05). ---Continue

Objective: To compare the effect of adding buprenorphine with small dose of isobaric bupivacaine on hemodynamics and duration of analgesia with bupivacaine alone in spinal anesthesia. Study Design: Randomised Controlled Trial. Setting: Allied and Abwa Hospital Faisalabad. Period: September 2019 to March 2020. Material & Methods: Sixty elderly pts. ASA III or IV undergoing hip surgery were selected randomly and divided into two groups A and B. pts received either small dose of isobaric bupivacaine 3.5 mg along with 120 micrograms buprenophine or 10 mg isobaric bupivacaine alone. Pts. were given 250 ml normal saline prior to spinal anesthesia administration. Level of block noted. Blood pressure, Heart rate, respiratory rate, Spo2, ECG monitored. BP and HR every 5 min recorded comparison done at 5 min of block and 20 min after block. Duration of postoperative analgesia noted for 24 hrs. Results: Comparing the two groups showed that 50% pts. in group B had a drop in systolic Bp at 5 minutes after block while none had in group A. (p value 0.000) agter 20 min. 43.3 % pts had a drop in systolic BP in group B while only 3.3 % had it in group A. (p value 0.005). Duration of postoperative analgesia was upto 18 hrs in group A with minimum till 12 hrs. While in group B it was maximum 8 hrs with minimum 5 hrs. Conclusion: Addition of buprenorphine with small dose bupivacaine results in stable hemoynamics and prolonged post-operative analgesia compared to large dose of bupivacaine alone.

BACKGROUND & OBJECTIVE: Neutrophil to lymphocyte ratio has an important role to predict the outcome of diabetic foot syndrome. The aim is to evaluate NTL ratio as a prognostic factor in diabetic foot syndrome and its importance in diabetic wounds. METHODOLOGY: Descriptive cross-sectional study was to evaluate NTL ratio for prognosis of DFS. All cases were assessed for smoking, body mass index, presence of wound, glycated hemoglobin level, peripheral limb ischemia and infection. Patients were examined for a period of 12 months to assess wound if it resulted in minor amputation (below the level of ankle), major amputations (below/above knee amputation), chronic wound or completely healed wound. Chi-Square test was applied for categorical data. RESULTS: Total 100 patients were included and 61% were smokers. Average BMI was 31.7 and 34.5 in males and females. Complete wound healing found in 18% cases after debridement and chronic wounds in 15% patients. Subjects had to undergo major (above ankle) 16% and minor (below ankle) 51% amputations. Mean NTL count was 3.5 in fully healed wounds, 4.3 in chronic wounds, 6.9 in major amputations, and 5.2 in minor amputations. As the p-value indicates, there is a significant relationship between healed wounds, minor amputations, Chronic wounds and major amputations and the NTL ratio. CONCLUSION: Results revealed NTL ratio has independent prognosis in DFS for anticipating wound upshot. NTL ratio has a significant link with healed wounds, minor amputations, and major amputations, as indicated by p-value.

This study was conducted to explore students’ use of E-resources in the E-libraries of the Punjab by using Unified Theory of Acceptance and Use of Technology (UTAUT) model. The use of e-resources included; performance expectancy, effort expectancy, social influence, facilitating condition, and behavioral intention to use the e-resources. Students’ access to e- collection, ease of access, frequency of using resources, and problems associated with access to e-resources was also explored. A quantitative survey was conducted using a descriptive research design. All 20 e-libraries of the Punjab were the population of this research. Six e-libraries were selected randomly as a sample. The sample was selected from the list of users registered in each library using a proportionate sampling technique. The total number of participants was 250. A self-developed questionnaire with 26 items and a checklist having 8 items, was used to collect the data. To analyze the data descriptive statistics was used. The findings of this study showed that students agreed that they were getting advantages from these e-libraries and these e-libraries were very helpful in their study. They could easily and more efficiently do their work by using and accessing e-library resources. These e-libraries were especially beneficial for those students who did not afford laptops. It is suggested that the government should increase the number of these e-libraries and these libraries should be established in all big cities of Pakistan. The library staff should focus on resolving the problems which students are facing, like a shortage of computers and off-library access.

Bananas are one of the largest horticultural commodities in Indonesia because in each region of Indonesia there are different types of bananas. Bananas are climacteric because they will feel the experience even though they have been harvested. Currently, the introduction of banana ripeness is still done in a conventional way by utilizing sight and smell. However, this method is not effective in determining fruit maturity because we cannot distinguish between ripe bananas and bananas that are in the early stages because they have almost the same color and aroma. So a system is designed that resembles the human sense of smell to accurately identify the level of ripeness of the fruit. The system is named Electronic Nose or abbreviated as e-Nose. The design of the e-Nose will be done using the Artificial Neural Network Backpropagation method. The results obtained from the application of E-Nose to detect the level of ripeness of bananas with the Artificial Neural Network Backpropagation method, which is a tool capable of predicting the ripeness condition of the bananas being tested so that accurate predictions are obtained and the prediction results are displayed on the website. The accuracy results obtained from the use of the Backpropagation Neural Network method for 3 categories (immature bananas, ripe bananas, and rotten bananas) are 100%, with an epoch of 2000.

Objective: To compare the efficacy of catheter drainage with incision and drainage in children having soft tissue abscess. Study Design: Randomized Control Trial. Setting: Department of Paediatric Surgery, Allied Hospital Faisalabad. Period: January 2016 to June 2017. Material & Methods: After taking approval from the hospital ethical committee, 160 patients coming through OPD of the department who fulfilled the inclusion criteria were enrolled, and informed consent was taken from them. The patients were randomly divided into two groups using a computer-generated random number table. In group A, patients underwent catheter drainage method, and in group B, patients underwent incision and drainage method. Results: Out of 160 cases (80 in each group), 60% (n=48) in Group-A and 67.5% (n=54) in Group-B were between 1-6 years while 40% (n=32) in Group-A and 32.5% (n=26) in Group-B were 7-12 years of age. 70% (n=56) in Group-A and 67.5% (n=54) in Group-B were males. On efficacy comparison, it was shown that 73.75% (n=59) in Group-A and 47.5% (n=38) in Group-B had efficacy; the p-value was calculated as 0.0007, showing a significant difference. Conclusion: We concluded that catheter drainage is better than incision and drainage in children having soft tissue abscess in terms of length of hospital stay ˂ 24 hours.

Ibrahim Jalees’ reportage “Sheher” is a masterpiece of non-fictional literature. The cultural and traditional life of Bombay city is the main subject. The writer has tried to represent the helpless and miserable urban life probing from its artificial brightness. Also, it is the sorrowful lamentation of the valuelessness of ancient literature, culture, values and social life in the artificial glittering capitalist civilization. All the above issues have been addressed with a literary spell and beauty. The struggle for livelihood can be observed in this reportage. This “Reportage” is a literary and historical document about the multicultural civilization and society’s representation of the city’s development.

Objective: To compare the levels of serum zinc, serum calcium and serum magnesium between preeclamptic patients and normal pregnant women. Study Design: Retrospective/ Comparative study. Setting: Department of Obs & Gynae, Social Security Landhi Hospital Karachi. Period: March 2019 to October 2019. Material & Methods: 90 pregnant women were included for this research. Patients were divided into two groups randomly, Group-A (Pre-eclampsia) and Group-B (Normal pregnancies). 45 patients were included in each group. At the time of antenatal booking, in Group-A patients we advised CBC, LFT`s, Urine for Albumin, HbS. Ag, Anti HCV Antibody, Fasting blood sugar, serum zinc, serum calcium, serum magnesium level and ultra sound for fetal wellbeing while in Group-B patients only CBC, Fasting blood Sugar, Urine D/R, HbS Ag, Anti HCV antibody, serum calcium, serum zinc and serum magnesium level and ultra sound for fetal wellbeing. Compared mean age and B.M.I. of patients, mean gestational age, mean systolic and diastolic blood pressure, mean of serum zinc level, serum calcium level and serum magnesium level in both groups. Results: Serum Zinc, Serum Calcium and Serum Magnesium levels were significantly low in pre-eclamptic patients as compared with normal pregnant women. Conclusion: Mean serum zinc, calcium and magnesium level were low in pre-eclamptic patients.

At this time the development of the era is much influenced by technology. This development has an impact on various aspects and fields in the expected life in the field of employment. Al-Azhar 32 Padang Islamic Elementary School is one of the private schools located in the city of Padang, West Sumatra. Al-Azhar schools have staff such as principals, teachers and administration so that the data entered is quite a lot.The staffing system at the Al-Azhar school is still manual by inputting it with excel. To take attendance at the employee using fingerprints and some use the attendance form. However, errors often occur during scanning because the scanner cannot detect someone's finger when the scanner is dirty. So that many employees update attendance by filling out the attendance update form. Given the problems above, it is possible to propose a mobile-based personnel application system. This staffing application has various features that can be used for taking attendance, leave forms, attendance history, school information, and employee profiles. This Android-based attendance can only be taken around the school or less than 20 meters from the school distance. To find out the distance between th0e user and the school, this attendance application uses the haversine algorithm to measure the distance between the user and the school

Musyarakah Mutanaqishah adalah bentuk kerjasama antara dua pihak atau lebih untuk kepemilikan suatu barang atau aset.Perpindahan kepemilikan akan terjadi dengan mekanisme pembayaran atas hak kepemilikan yang lain. Pembiayaan properti yang berlandaskan akad MMQ dapat dikatakan sebagai kerjasama yang mana atas kepemilikan aset (suatu barang tertentu). Tujuan dari penelitian ini adalahpenerapan objek syirkah menjadi jaminan hak tanggungan pada pembiayaan perumahan melalui akad musyarakah mutanaqishah. Penelitian ini menggunakan penelitian yuridis normatif (legal research), dengan melakukan penelitian kepustakaan atau studi dokumen yang dilakukan atau ditujukan hanya pada peraturan-peraturan yang tertulis atau bahan hukum yang lain dan pendekatan normatif

Objective: To ascertain the vaginal birth rate following the trial of uterine scar and its outcomes. Study Design: Cross-sectional Observational study. Setting: Department of Gynecology Bakhtawar Amin Trust Teaching Hospital Multan. Period: 6th August 2020 to 6th August 2021. Material & Methods: After passing through selection criteria, all enrolled women underwent serial ultrasound including pelvis ultrasound to access scar thickness up to thirty-six gestation weeks. All women were evaluated for baseline investigations, clinical history, and underwent cardiotocography (CTG) which was then followed by a trial of labor (TOL). Women who experienced spontaneous labor after TOL were observed through partogram and intrapartum CTG. All maternal and fetal outcomes were observed. Results: Out of these 80 women, 51 (63.7%) had successfully given birth through the vaginal route while 29 (36.2%) underwent emergency CS following TOL. The majority of enrolled women, 62 (77.5%) had age less than 35 years, 45 (56.2%) had parity 1-4, and 74 (92.5%) had gestation age >36 weeks. 3 (5.8%) women had a history of VBAC and all had parity >4. Among the women with successful VBAC, the majority were younger than 35 years (88.2%), parity less than 4 (62.7%), and all were positive for previous successful VBAC. Postpartum hemorrhage was the most reported maternal complication (3.9%). Three (4.4%) experienced intra-uterine deaths which were the major fetal complications. Conclusion: Trial of vaginal birth following cesarean section could be a preferable option given its association with low fetal and maternal complications and considerable success rate.

This door security system is created to monitor the environment around the range of this tool. This system works by using the ultrasonic signal reflection from the distance sensor. This sensor is connected to the database server and recorded in the User Android app. This system uses Arduino Mega, Wemos D1 R2, distance sensor, camera VC0706, selonoid doorlock, and buzzer. The work of this tool is the sensor will send a ultrasonic signal continuously and then the ultrasonic reflection will be re-received by the sensor. The distance sensor will be received in Arduino Mega and sent to Wemos D1 R2 using serial software that the data will be sent to the database using the Internet network connected in Wemos.

Data mining and Machine learning are the emerging technologies that are rapidly spreading in every field of life due to their beneficial aspects. The financial sector also makes use of these technologies. Many research studies regarding banking data analysis have been performed using machine learning techniques. These research studies also have many Problems as the main focus of these studies was to achieve high accuracy and some of them only perform comparative analysis of different classifier's performance. Another major drawback of these studies was that they do not identify any optimal parameters and their impact. In this research, we have identified optimal parameters. These parameters are valuable for performing the credit scoring process and might also be used to predict credit card defaulters. We also find their impact on the results. We have used feature selection and classification techniques to identify optimal parameters and their impact on credit card defaulters identification. We have introduced three classifiers which are Kstar, SMO and Multilayer perceptron and repeat the process of classification and feature selection for every classifier. First, we apply feature selection techniques to our dataset with each classifier to find out possible optimal parameters and In the next phase, we use classification to find the impact of possible optimal parameters and proved our findings. In each round of classification, we have used different parameters available in the dataset every time we include and exclude some parameters and noted the results of each run of classification with each classifier and in this way, we identify the optimal parameters and their impact on the results Whereas we also analyze the performance of classifiers. To perform this research study, we use the “credit card defaults” dataset which we obtained from UCI Machine learning online repository. We use two feature selection techniques that include ranker approach and evolutionary search method and after that, we also apply classification techniques on the dataset. This research can help to reduce the complexities of the credit scoring process. Through this study, we identify up to six optimal parameters and also find their impact on the performance of classifiers. Further We also identify that multilayer perceptron was the best performing classifier out of three. This research work can also be extended to other fields in the future where we use this mechanism to find out optimal parameters and their impact can help us to predict the results.

BACKGROUND & OBJECTIVE: Post operative nausea and vomiting (PONV) is an important concern in laparoscopic surgeries. Aim of this study is to identify the role of metoclopramide dexamethasone combination for prophylactic management of post laparoscopic cholecystectomy nausea and vomiting in comparison to metoclopramide alone. METHODOLOGY: The study group comprised of 150 patients. These were the patients with symptomatic gallstones for whom elective laparoscopic cholecystectomy was planned. Study was conducted from 15-04-2018 to 15-07-2019. Non-probability consecutive sampling technique was used.Two groups were generated by simple random method. Group M was given injection metoclopramide only, whereas patients in Group D+M were injected with both dexamethasone and metoclopramide, intravenously, before induction of anesthesia. Parameters observed for 24 hours during postoperative period included; nausea, episodes of vomiting, requirement for rescue antiemetic drugs and total duration of hospital stay after the surgical procedure. RESULTS: In Group D+M (dexamethasone+metoclopramide), out of total 75 patients, 8% developed nausea while 5.33% had both nausea along with emesis. While in group M (metoclopramide), 16% out of the total 75 patients had nausea only but 18.7% patients had complaints of nausea and emesis. Three patients out of 75, that is 4% from group (D+M) had extended duration of in hospital admission (> 24 hours), while in groupM, this percentage was 13.33% (n=10) patients. CONCLUSION: A combination of metoclopramide with dexamethasone for prophylaxis against PONV in laparoscopic cholecystectomy patients is preferred to metoclopramide alone.

Unpleasant smell and pollution are the side effects during the cattle ranch activities. That is the reason why the cattle ranch is placed far from the housing residents. The cattle ranch areas are usually not covered by the internet network, but it is also important to monitoring the pollutant in the cattle ranch. The pollutant gases are also produced during the cattle ranch activities such as hydrogen, oxygen, methane, and carbon dioxide. To classify the odor or unpleasant smell in the air, the electronic Nose (e-Nose) become an effective system to monitor and classify the odor in real time. This research, we proposed an e-Nose system that able to classify the odor in cattle ranch. The Backpropagation method is selected to create the e-Nose model. This e-Nose system is able to transmit data to server without the internet network. The Lora Network has been applied by using point to point method. The web application is also made to display the real time data monitoring and prediction of the odor. Based on our test, the e-Nose accuracy is 99% in real time prediction.

Hyaluronan is a biodegradable, biopolymer that represents a major part of the extracellular matrix and has the potential to be fabricated in a fibrous form conjugated with other polymers via electrospinning. Unique physicochemical features such as viscoelasticity, conductivity, and biological activity mainly affected by molecular weight attracted the attention of biomedical researchers to utilize hyaluronan for designing novel HA-based nano-devices. Particularly HA-based nanofibers get focused on a diverse range of applications in medical like tissue implants for regeneration of damaged tissue or organ repair, wound dressings, and drug delivery carriers to treat various disorders. Currently, electrospinning represents an effective available method for designing highly porous, 3D, HA-based nanofibers with features similar to that of the extra-cellular matrix making them a promising candidate for designing advanced regenerative medicines. This review highlights the structural and physicochemical features of HA, recently cited protocols in literature for HA production via microbial fermentation with particular focus on electrospun fabrication of HA-based nanofibers and parameters affecting its synthesis, current progress in medical applications of these electrospun HA-based nanofibers, their limitations and future perspective about the potential of these HA-based nanofibers in medical field.

To investigate the psychosocial factors having an impact on persons with a stuttering problem.The correlation study was conducted from October 2016 to February 2018 at hospitals, speech clinics and educational institutes of Lahore. The sample comprised of young adults aged 16-30 years of either gender with stuttering problem. Data was collected using Stuttering Severity Instrument-4, Social Interaction Anxiety Scale-Urdu, Big Five Measure-20, Overall Assessment of the Speaker's Experience of Stuttering and the Urdu version of the shortened form of the Coping Orientation to Problems Experienced inventory. Data was analysed using SPSS 23.Of the 78 subjects, 66(84.6 %) were males and 12 (15.4 %) were females. There were 21(27%) subjects aged 16-19 years and 57(73%) with age range of 20-30 years. The overall mean age was 21.96±3.89 years. Mean age of onset was 4.59±1.29 years, while gradual onset and progressive stuttering was reported by 74(94.9 %). The Bilingual users 49(63%) reported to have frequent stuttering. Among the 43(55.1%) who had received treatment, 30(38%) received speech therapy and 26(33.3%) reported dissatisfaction. Stuttering severity and social anxiety were significantly positively correlated with all domains of impact of stuttering (p0.05). Age, and duration were negatively correlated with day-to-day communication (p0.05) and previous speech treatment showed negative association with impact on general knowledge about stuttering (p0.05). Avoidance coping strategy had a significant relationship with all domains of impact (p0.05).Severity of stuttering and social anxiety were found to have repercussions on people who stuttered, while avoidance coping was practised more to deal with the negative impact on reactions toward stuttering and quality of life.

To find out the prevalence and associated factors of undernutrition in a semi-rural setting.The community-based cross-sectional study was conducted in Tehsil Battagram of Khyber Pakhtunkhwa province, Pakistan, in January and February 2020 after approval from the ethics review committee of Nanjing Medical University, Jiangsu, China, and comprised children aged 6-59 months who had no physical or mental disability. Data was collected using a structured questionnaire. Anthropometric data was analysed using the World Health Organisation Anthro software. Multivariate logistic regression analysis was used to find out the association between dependent variables, like wasting, underweight and stunting, and independent variables, like socioeconomic, child, maternal and environmental characteristics. Data was analysed using SPSS 21.Of the 504 children, 257(51%) were girls and 247(49%) were boys. The largest group was aged 36-47 months 127(25.2%), while the smallest group was aged 6-11 months 56(11.1%). Overall, 94(18.7%) children were wasted, 167(33.1%) were underweight and 248(49.2%) were stunted. Children whose family income was high had low odds for being wasted (odds ratio: 0.59, 95% confidence interval: 0.25-0.71), underweight (odds ratio: 0.30, 95% confidence interval: 0.08-0.72) and stunted (odds ratio: 0.54, 95% confidence interval: 0.30-0.80). Similarly, those children who were exclusively breastfed had low odds of being wasted were (odds ratio: 0.45, 95% confidence interval: 0.32-0.53), underweight (odds ratio: 0.56, 95% confidence interval: 0.42-0.78) and stunted (odds ratio: 0.62, 95% confidence interval: 0.51-0.97). Children who were not immunised had higher odds of wasting (odds ratio: 4.16, 95% confidence interval: 2.18-7.93), underweight (odds ratio: 4.45, 95% confidence interval: 2.77-7.14) and stunted (odds ratio: 4.36, 95% confidence interval: 2.32-8.71). Children of mothers who did not have antenatal care visits had higher odds of being wasted (odds ratio: 1.91, 95% confidence interval: 1.13-3.22), underweight (odds ratio: 1.32, 95% confidence interval: 1.22-2.13) and stunted (odds ratio: 1.48, 95% confidence interval: 1.32-2.62). Children who did not have a latrine facility had higher odds of being wasted (odds ratio: 1.63, 95% confidence interval: 1.29-1.58), underweight (odds ratio: 1.76, 95% confidence interval: 1.36-3.84) and stunted (odds ratio: 1.45, 95% confidence interval: 1.22-2.12).Undernutrition among children aged 6-59 months was widespread. Nutrition awareness, interventions and multi-sectoral approaches were found to be needed to cope with the problem in the study area.

To determine the frequency of use of various psychoactive drugs among medical students in an urban setting, and to assess the risk category and intervention needs.The descriptive cross-sectional study was conducted from January to June 2018 at four medical education institutions of Karachi; 2 each randomly selected from registered public and private sectors. From the clinical classes of each institution, fourth year was randomly chosen by lottery method. Data was collected using the Alcohol, Smoking and Substance Involvement Screening Test version 3.0. Data was analysed using SPSS 20.Of the 445 respondents, 270(60.7%) were male and 175(39.3%) were females. The overall mean age was 21.3±1.7 years (range: 17-27 years). Of the total, 273(61.3%) had never used any psychoactive substance, 97(21.8%) had used at least one, 34(7.6%) at least two, 23(5.2%) three, while 18(4%) had tried four or more psychoactive drugs in their lifetime. The most commonly used drug was tobacco, reportedly used by 117(26.3%) respondents, and, among them, 40(34%) were in low risk/no intervention category, 71(60.6%) in moderate risk/brief intervention category and 6(5.1%) in high risk/intensive treatment category. The use of psychoactive drug was significantly more in male compared to female students(p0.05).Tobacco was the most commonly used psychoactive drug among medical students though the use of cocaine, cannabis, alcohol, amphetamine, inhalants and sedatives was also significant. Psychoactive drug use was more common in males compared to females.

The paper aims to examine the interplay of consent and coercion in the play A Doll’s House through the perspective of Althusser’s theory the ideological state apparatus and oppressive state apparatus. The problem of research is to find the systematic exploitation of women through ideological tool and oppressive tool by men. The research is qualitative based and content analysis is used as tool in this research. The objectives of the research are to explore the use of consent and coercion by male on the female and to examine the interplay of consent and coercion tools as systematic exploitation of women. There occurs the interplay of consent and coercion. According to theory both ideological and oppressive tools are used in the novel. So, personal freedom should be valued. In order to avoid silent exploitation balance should be exercised in the society.

Objective: To study the moderating role of perceived group normative support on the effect of group identification on scepticism and advocacy domains of attitude towards polio vaccination. Method: The cross-sectional analytical study was conducted at the National Institute of Psychology, Quaid-i-Azam University, Islamabad, Pakistan, in June 2020, and comprised adult residents of Pakistan who were approached through online platform Psytoolkit. Data was collected by means of Attitude towards Polio Vaccination Scale, Group Identification Scale, and a measure of Perceived Group Normative Support for Polio Vaccination. Data was analysed using SPSS 21. Results: Of the 310 participants, 69(22.3%) were men and 240(77.4%) were women. The overall mean age was 25.62+/-8.47 years (range: 18-72 years). Further, 242(78.1%) participants were single and 62 (19.7%) were married, 166(53.45%) were from Punjab, 80(25.8%) from the federally-administered tribal areas, 26(8.3%) from Khyber Pakhtunkhwa, 7(2.2%) from Sindh and 7(1.93%) from Balochistan. Group identification significantly increased advocacy (p

Currently, nanobiotechnology represents a leading research area that primarily focuses on the safe, eco-friendly synthesis of biocompatible metal oxide nanoparticles. Among these, biosynthesized cerium oxide nanoparticles have particularly received attention in medical science as their unique surface chemistry and dual oxidation state make them excellent antioxidants and freeradical scavengers. Currently, plant extracts are widely explored and employed for the biosynthesis of CeO2NPs. Other biological sources such as marine oyster shell extract, egg-white, biopolymers, e.g., chitosan, agarose, alginate, and others, have also been successfully used for the fabrication of CeO2NPs. This review highlights the recent progress in the biosynthesis of CeO2NPs and the investigation of their medical use as biocompatible anticancer, antibacterial, antifungal, antioxidant, antidiabetic, and wound healing agents. Furthermore, prospects associated with the use of biogenic CeO2NPs in developing novel products in the medical sector are also highlighted.

Objective: To compare the effect of Pakistani and American almonds on serum concentration of liver enzymes in coronary artery disease patients. Methods: The randomised controlled trial was conducted at the Cardiology Clinics of Aga Khan University Hospital, Karachi, from February to July, 2012, and comprised patients who were randomised into intervention PA and AA groups and the control NI groups. Subjects in the intervention groups were provided Pakistani and American varieties of almonds 10g/day respectively with instructions to soak them overnight, remove the skin and eat them before breakfast for 12 weeks. The control group underwent no intervention. Serum concentrations of aspartate transaminase, Alanine transaminase and gamma-glutamyl transferase were analysed and compared. Results: Of the 150 subjects, 110(73.3%) completed the study. Of them, there were 38(34.5%) in PA group, 41(37.3%) in AA, and 31(28.2%) in the NI group. Dietary almonds significantly reduced serum concentrations of aspartate transaminase, alanine transaminase and gamma-glutamyl transferase in the two intervention groups compared to the controls group (p

BACKGROUND & OBJECTIVE: One of the most common challenging complications after nasal surgeries is maintaining airways. The study aimed to use an alternative technique instead of nasal packing in the immediate postoperative period undergoing different nasal surgery under general anesthesia regarding airway management. METHODOLOGY: An interventional study was conducted at Aziz Fatimah Trust Hospital, Faisalabad, from March 20, 2018, to January 31, 2019. A total of 100 participants were enrolled in the study divided into two groups (A & B), 50 each. Group A patients were treated postoperatively with a modified nasal airway devised with a Nelton catheter and Group B patients with traditional nasal packing. The participants were assessed on different parameters which were statistically compared and analyzed. RESULTS: Group Descriptive statistics revealed that the Mean±SD of the age of group A and group B patients was 24.28±9.72 and 26.68±11.09 respectively, which had no significant difference between them {p-value (0.008)}. The postoperative parameters such as patient's comfort and sleep, surgeon satisfaction, ease of suction through Nelton catheter, and oxygen saturation were evaluated as significant variables in the evaluation of the study. p-value ≤0.05 and ≤0.005 were considered as significant and highly significant respectively. CONCLUSION: This modified nasal airway has proven to be easily replicable and reliable, and a cost-effective measure elucidated as a potential and exclusive outcome of the present study.

In today’s turbulent environment, we have observed a considerable increase in the volume of E-business and E-commerce locally and globally. These two factors have changed the whole business spectrum. The purpose of this research is to identify the factors that can improve firm’s performance in the present IToriented scenario. This study explains how firm’s performance is dependent on IT. The factors of E-business capabilities are IT infrastructure, IT expertise, strategic IT alignment, market orientation, and business process. The literature review provides the framework for the research model and hypotheses. Data was gathered from the services and manufacturing sectors through a questionnaire consisting of 31 items. This research is especially designed for firms. 400 questionnaires were distributed among managers. Data from 310 respondents were used to estimate the proposed model. Regression analysis was carried out for testing hypotheses. This study acknowledges the appropriate description of E-business capabilities for firm’s performance, that is, how IT resources affect the firm’s performance in the service and manufacturing sectors. This study has practical implications that could be beneficial for the services and manufacturing sectors to enhance their firm’s performance

OBJECTIVE: Vitamin D deficiency in chronically diseased individuals is an important cause of morbidity in addition to their chronic ailment. As it is an important component for bone mineralization and calcium homeostasis. Vitamin 25(0H) D is produced in skin in the presence of sunlight. The main objective of the study conducted is to observe the percentage of vitamin D deficiency in population with chronic diseases such as Diabetes and Hypertension in city of Lahore. METHODS: Data collected from patients visiting Medicine clinic in Bahria International Hospital, Lahore from June 2017 to March 2018. RESULTS: Retrospectively 115 patients were analyzed. Patients with level

Objective: To evaluate the sources of occupational stress related to workload among registered staff nurses. Methods: A cross-sectional study was conducted among 100 staff nurses. "Hospital consultants, job stress & satisfaction questionnaire (HCJSSQ)" was applied for data collection purpose. The questionnaire was formulated by an appropriate selection of questions and validated by 5 experts (one general administrator, two physicians, one nursing superintendent, and one human resource man- ager). The study was carried out during February-July 2016. The questionnaire consisted of 08 questions on sources of stress related to workload. Results: All the invited nurses agreed to participate. The mean age of the selected sample was 32.29 years and SD ± 7.025. The analysis of the data revealed that 'having an inadequate staff to do the job' was the biggest stressor followed by 'being on on-call and 'providing patient care within multidisciplinary teams as 2nd and 3rd stressors. 'Feeling under pressure to meet deadlines', 'too great magnitude of overall work', 'having inadequate equipment to do job properly', 'disturbance of home life due to long hours duty' and 'being unable to cure patients' were identified as 4th, 5th, 6th, 7th, and 8th number stressors respectively. Conclusion: Nurses are facing various types of stressors, which may affect organizational culture and a factor for low-quality care for patients as well as the individual wellbeing of a staff nurse. These stressors should be handled carefully on a priority basis by proper workload management, availability of facilities, good pay scale, reward system, initiate occupational health education or support to continue education.

Purpose: The study is an effort to identify the effects of strategic innovation on performance of small and medium enterprises of Pakistan. The study evaluated the effects of product innovation, process innovation and market innovation on performance of small and medium enterprises of Pakistan. Design/Methodology/Approach: The sample was drawn from the 102 small and medium enterprises which were operating in the Pakistan. Data was collected from employees of the small and medium size enterprises operating in Pakistan. Structured questionnaire was used to collect the data. Data was analyzed through SPSS software. Findings: The findings of the study show a positive relationship between innovation and performance. Results proved that introducing new products helps the small and medium size enterprises to increase their performance, or enhancement of current product also helps small and medium size enterprises to increase the performance. Implications/Originality/Value: The study concludes that in current competitive business environment, it is necessary for firm to be innovative in their products, processes and market to enhance their performance. Study findings conclude that strategic innovation is one of the most important factors of the firm for their performance

Keterampilan berbicara merupakan salah satu keterampilan berbahasa yang sangat penting dalam kehidupan sehari-hari sebab berbicara merupakan dasar utama dalam berkomunikasi dan berinteraksi di lingkungan. agar interaksi terjalin dengan baik maka perlu adanya komunkasi yang baik pula. karena berkomunikasi bukan hanya sekedar mengucapkan kata demi kata, namun bagaimana seseorang terampil dalam berkomunikasi dengan tujuan agar pendengar mudah memahami dan mengerti apa yang sedang dibicarakan agar tidak terjadi kesalah pahaman. Dengan demikian, keterampilan berbicara sebaiknya lebih ditingkatkan dalam proses pembelajaran disekolah. untuk itu peran guru dalam mengemas perangkat pembelajaran agar tujuan yang ingin dicapai berhasil, salah satu perangkat pembelajaran yaitu pengunaan model pembelajaran yang sesuai dengan materi pembelajaran, khususnya dalam memilih model pembelajaran untuk meningkatkan keterampilan berbicara. Mengapa pemilihan model pembelajaran sangatlah penting, karena keberhasilan seorang guru dalam proses pembelajaran ketika ia kreatif dalam memilih model yang sesuai dengan materi yang akan di ajarkan, nah untuk itu dalam meningkatkan keterampilan bericara dipilihlah salah satu model pembelajaran yang sesuai dengan keterampilan berbicara yaitu model kooperatif dengan tipe kooperatif script yang lebih mengarahkan siswa agar lebih terampil dalam berbicara. Tujuan penulisan yaitu untuk meningkatkan keterampilan berbicara menggunakan model pembelajaran kooperatif script. pada pembahasan akan dibahas bagaimana keterampilan berbicara serta bagaimana model pembelajaran kooperatif script dan peranananya dalam meningkatkan keterampilan berbicara.