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Aim: To determine the effect of COVID-19 on eye sight due to increase screen time in undergraduate students of medical school. Study design: Cross-sectional study. Place and duration of study: This survey was carried out from October 2022 to December 2022 in Army Medical College Rawalpindi. Questionnaires were filled in person and also online-based platform was used to distribute the e-questionnaire, developed using the Google Form. The participants were asked to share the e-questionnaire with their friends using Facebook and Messenger. Methods: Participants were selected for the study using non-probability consecutive sampling. College students of 20-25 years were included in the study. Sample size was 400 according to a study done internationally. Participants with comorbidities (cataract, glaucoma) were excluded from study. Participants having (trouble concentrating on things such as reading the newspaper, books or watching television) were included in the study. Digital eye strain was calculated using validated computer vision syndrome (CVS-Q) questionnaire to measure the symptoms such as eye fatigue, headache, blurred vision, double vision, itching eyes, dryness, tears, eye redness and pain, excessive blinking, feeling of a foreign body, burning or irritation, difficulty in focusing for near vision, feeling of sight worsening, and sensitivity to light. Qualitative data was analyzed using Chi square test. Results A total number of 470 responses were recorded, out of which 257 (54.7%) were males and 213(45.3%) were females. In our study, the most common symptom was headache, affecting 58.1% of the population before COVID 19 which has increased to 83.2% and the P value is less than 0.001.Theother symptoms which also showed P value less than 0.001 were blurred vision while using digital device, irritated or burning eyes, dry eyes and sensitivity to bright light. Conclusion The practical implication of the study is to create awareness among general population about COVID, that eye sight is Bull`s Target to be affected by it and simple preventing measures can be taken. The purpose of this study is to limelight the importance that during COVID 19 lockdown the excessive use of digital devices and their cons on the ocular health among future health care workers. Key words: Eye sight, Undergraduate students, computer vision syndrome, video display terminals

Pakistan-India relations are mired in power politics making the two countries as rivals with competing identities and interests. By the logic of power politics, the two neighbouring countries survive in a condition of security dilemma and are locked in patterns of enduring rivalry, militarised geopolitics and antagonistic national security paradigms. Despite the enduring rivalry, the India-Pakistan relations are also marked by contexts of cooperation where the two sides have exhibited orderly relations and given way for negotiations. In order to give meaning to this oscillating state-to-state relationship, the present study looks into the variable of threat perception whether it is an objective phenomenon or a subjective phenomenon. To this end, the study aims at demystifying Pakistan-India relations from the lens of Stephen Walt’s Balance of Threat Theory. By bringing up the ideational component of ‘aggressive intentions’ in his model, Walt conceptualises threat perception as a subjective phenomenon, which allows for an emancipatory framework of meaning and action that goes beyond the orthodox and regressive logic of traditional power politics to understand Pakistan-India relations. The present study argues that the state elites of the two countries can dial down their tensions by transforming their will and intentions towards more peaceful behaviours and outcomes.

Natural language processing technologies have become more widely available in recent years, making them more useful in everyday situations. Machine learning systems that employ accessible datasets and corporate work to serve the whole spectrum of problems addressed in computational linguistics have lately yielded a number of promising breakthroughs. These methods were particularly advantageous for regional languages, as they were provided with cutting-edge language processing tools as soon as the requisite corporate information was generated. The bulk of modern people are unconcerned about the importance of reading. Reading aloud, on the other hand, is an effective technique for nourishing feelings as well as a necessary skill in the learning process. This paper proposed a novel approach for speech recognition based on neural networks. The attention mechanism is first utilized to determine the speech accuracy and fluency assessments, with the spectrum map as the feature extraction input. To increase phoneme identification accuracy, reading precision, for example, employs a new type of deep speech. It makes use of the exportchapter tool, which provides a corpus, as well as the TensorFlow framework in the experimental setting. The experimental findings reveal that the suggested model can more effectively assess spoken speech accuracy and reading fluency than the old model, and its evaluation model’s score outcomes are more accurate.

Significant scarcity of a donor pool exists for heart transplantation (HT) as the prevalence of patients with end-stage refractory heart failure is increasing exceptionally. With the discovery of effective direct-acting antiviral and favorable short-term outcomes following HT, the hearts from hepatitis C virus (HCV) patient are being utilized to increase the donor pool. Short-term outcomes with regards to graft function, coronary artery vasculopathy, and kidney and liver disease is comparable in HCV-negative recipients undergoing HT from HCV-positive donors compared to HCV-negative donors. A significant high incidence of donor-derived HCV transmission was observed with great success of achieving sustained viral response with the use of direct-acting antivirals. By accepting HCV-positive organs, the donor pool has expanded with younger donors, a shorter waitlist time, and a reduction in waitlist mortality. However, the long-term outcomes and impact of specific HCV genotypes remains to be seen. We reviewed the current literature on HT from HCV-positive donors.

In this work, a modified square photonic crystal fiber (MS-PCF) architecture is exposed with ultra-high negative dispersion for communication window. The validation of the model is successfully performed by applying an efficient full-vector finite element method (FV-FEM) with anisotropic perfectly matched layers (PMLs) for precise simulation of PCFs. Additionally, waveguide dispersion engineering is accomplished by tuning the structural parameters of the MS-PCF. From the numerical investigation, negative dispersion behavior permits remarkable suppression rather than positive dispersion. It offers the high negative dispersion of −2357.54 ps/nm/km and Kerr nonlinearity (γ) of 74.68 W−1 km−1 simultaneously at the operating wavelength, λ = 1550 nm. Nevertheless, the designed fiber ensures the mono mode operation in the entire band of interest from λ = 1340 nm to λ = 1580 nm. MS-PCF with these outstanding optical performances has distinguished potency to be practiced as a dispersion compensating fiber in optical communication systems.

Opioids are commonly used as analgesics to relieve chronic pain and have high abuse potential. Due to their strong potency and trace concentration in plasma, a robust analytical method is necessary for quantification in forensic and pharmacology fields. Hence, this study developed and validated a simple, rapid, and robust method for the simultaneous determination of 12 opioids and metabolites which were available legally by prescription or abused for non-medical purposes, in plasma samples by simple liquid extraction and high-performance liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS). We compared the extraction recovery of our sample pre-treatment to two other sample pre-treatments (namely QuEChERS and simplified QuEChERS) and showed that the method used in our study gave the highest recoveries. The method validation followed the European Medicines Agency guidelines, including selectivity, carryover, accuracy and precision, dilution integrity, matrix effect and freeze/thaw stability. This method's accuracy ranged from 85% to 115% with a precision less than 15%, within the acceptable range of the validation protocol. The lower limit of quantification of the method ranged between 0.05 μg L

The most common neurological symptom is a headache, which may be a sign of something dangerous like a brain tumor or something relatively harmless like a migraine or tension headache. Although migraine is more common and more debilitating, most of population suffer from it. Since most of population are continuously under pressure, it was important to assess the prevalence of migraine headaches among this population. Lack of research concentrating on migraine headache among population encouraged this study.

Introduction: Self-medication is regarded as the system of taking medicines without the consultation of licensed medical practitioner. Self-medication leads to irrational use of medical drugs which is hazardous for health. The prevalence of this crucial issue is rapidly increasing worldwide. The present study was aimed to access the pattern of self-medication trends in healthcare students and non-healthcare students of Lahore, Pakistan. Methods: A cross-sectional survey based observational study has been conducted to access the knowledge along with the attitude of medical and non-medical students regarding self-medication. The study settings included different universities and medical colleges of Lahore, Pakistan. A total of 301 students from medical department and other departments were included in the study. A validated self-medication assessment questionnaire was used to access the knowledge along with attitude pattern of self-medication among healthcare students as well as non-healthcare students. Results: The findings of the present study presented that medical students are more aware of the potential side effects and adverse reactions of the self-medicated drug as compared to the non-medical students. Whereas, trends of self-medication was observed to be slightly higher in healthcare students as compared to the non-healthcare students. Moreover, the frequency of antibiotic use was comparatively more frequent in medical students as compared to the non-medical graduates. Whereas, the use of painkillers without prescription was more prevalent in non-medical students as compare to the medical graduates. Conclusion: There has been a significant difference in knowledge of healthcare students and non-healthcare students of Lahore, Pakistan. Although both healthcare and non-healthcare students have high prevalence of self-medication but differences have been observed in case of drugs taken. Healthcare students practice self-medication more as compared to the non-health-care students. Peer Review History: Received: 10 November 2022; Revised: 18 December; Accepted: 5 January 2023, Available online: 15 January 2023 Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, asia_abdullah65@yahoo.com Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. A.A. Mgbahurike, University of Port Harcourt, Nigeria, amaka_mgbahurike@yahoo.com Prof. Hassan A.H. Al-Shamahy, Sana'a University, Yemen, shmahe@yemen.net.ye Similar Articles: ANTIMICROBIALS SELF MEDICATION AMONG PARAMEDICAL STUDENTS IN A NIGERIAN UNIVERSITY ANTIBIOTICS KNOWLEDGE AND THEIR USES AGAINST VARIOUS DISEASES AMONG THE DORMITORY STUDENTS OF A RESIDENTIAL UNIVERSITY IN BANGLADESH: A PILOT STUDY

The goal of this study is to see if there's a link between age, gender, and risk factors including having a smoking parent, allergic rhinitis, skin allergies, food allergies, and a family history of atopy with the diagnosis of childhood asthma. The goal is also to evaluate the prevalence of asthma in the study's pediatric sample, as well as the prevalence of other symptoms and complications in this group. A link was discovered between childhood asthma and age, allergic rhinitis, skin allergies, food allergies, and atopy in the family. In most areas of this investigation, the findings are consistent with earlier studies conducted at various periods and in other places for almost identical aims.

Evidence shows that patients having testicular torsion usually present to the emergency department to apply immediate interventions. Immediate manual detorsion has been validated among different investigations as a productive technique for the initial management of testicular torsion. In the present literature review, we have elaborated on the success of manual detorsion for patients with torsion according to findings from previous relevant studies. Our findings indicate the favorable events that can be obtained after using manual detorsion. However, some studies reported that the success rate for the modality is not very high. In addition, it has been reported to reduce the time of ischemia as a temporary measure until surgery is prepared. Evidence also shows that the approach's efficacy is superior to that of surgical exploration and should be used since the time of diagnosis to prevent further deterioration of the affected case and enhance perfusion. However, the current evidence is based on a limited number of investigations that validated the efficacy of manual detorsion among a small population. Accordingly, we encourage further studies to be conducted in this context further to validate the current evidence with more adequate sample sizes.

In recent decades, testosterone therapy has gained the attention of many researchers due to the increased demand for this modality worldwide, the increased average age of the different populations, and increased awareness of the potential uses of the modality in clinical settings. Using testosterone therapy aims to treat erectile dysfunction, libido disorders, and potentially enhance physical strength and general body functions. It should be noted that the administration of this treatment modality has been reported with various adverse outcomes despite the remarkable efficacy and wide rates of administration among the different populations. In the present literature review, we have discussed the potential local and systemic complications of applying local testosterone patches and gel. The main advesre events that were reported for both formulas have been skin reactions at the site of application. However, these reactions are not usually serious, and only a few patients discontinued the therapy due to these reactions. In general, evidence indicates that the exogenous administration of testosterone has been associated with many systemic complications as cardiovascular diseases, prostate cancer, obstructive sleep apnea, and elevated hematocrite value. However, evidence regarding this association is still controversial, and additional studies are needed for verfication.

This article introduced a double guided ring-based spiral photonic crystal fiber (S-PCF) supporting both the orbital angular momentum (OAM) and linear polarization (LP) mode simultaneously with the efficient transmission. The outcomes exhibition that the designed S-PCF have good optical features such as less confinement loss (4.05342 × 10−12 dB/m for the EH9,1 mode), better mode quality and ISO (up to 98.87% and 126 dB, respectively), supported a decent amount of modes which is numerically 64 OAM and 6 LP modes, maintaining the large refractive index differences (> 10 - 4 ) of all the eigenmodes, and a relatively flat dispersion variation (0.0743 ps/km-nm for the EH1,1 mode). Also, we obtained the crosstalk less than −12 dB and the power fraction is approximately 93%-99% of the S-PCF. All the optimizing properties are obtained using the full-vector finite element method (FEM) and also the perfectly matched layer (PML) as a boundary condition. Thus, the above mentioned optimizing propagation characteristic based S-PCF has effective applications like reliable long-distance communication into the space division multiplexing (SDM) process of the large-capacity fiber communication systems.

In developing countries, the patriarchal social construct, unsatisfactory legal protection, and underlying cultural bias against women have resulted in increasing intimate partner violence, which largely goes unaddressed, undocumented, and unreported in healthcare settings. This case study presents a common scenario of intimate partner violence and carefully analyzes its ethical implications in an emergency case at a tertiary care hospital in Karachi, Pakistan. In this study, basic ethical principles are used to discuss important ethical challenges faced daily by healthcare workers in the medical, social, and legal context. It further highlights the dire need of patient education, safety, and a solid framework for addressing, documenting, and reporting intimate partner violence for healthcare workers.

Type 2 diabetes mellitus is a multifactorial illness triggered by a complicated interplay of various genetic variants with various environmental variables. The quantity of replicated common genetic variants associated with type 2 diabetes mellitus has increased rapidly with the recent genome-wide association (GWA) research. Major health issue in the public are type 2 diabetes mellitus (T2DM) is common throughout the world. Diabetes mellitus incidence is growing and is anticipated to affect 300 million individuals by 2025. Diabetes has been suggested to alter patterns of cytokine expression as an immune-dependent illness. Insulin resistance (IR) is a disease that results in less than anticipated biological impact of a specified insulin concentration. Insulin resistance and insulin secretion decreased are both defined pathophysiology of T2DM. One of the most alarming health issues of the 21st century is the spread of diabetes around the globe. Our goal in this study was to identify the role of IL-10 polymorphism in T2DM patients. The average age of 60 median patients with type 2 diabetes mellitus (31 males and 29 females) +-SD (45.91667 +-16.08799), fasting blood sugar (FBS) is +-SD (184.25 +-57.76387), hypertension (35 positive/25 negative) and 60 non-diabetic controls (32 males and 28 females) is +- SD (47.31667 +-15.13722). The group (T2DM patients and their control) had not a substantial distinction (P=0.33) and in each group (CC, TT, CT) there was a comparison between IL-10 gene polymorphism. T2DM patients and healthy individuals are not associated with the polymorphism of the gene IL-10 (SNP rs 3021097 (C/T). Keywords: Insulin, Diabetes Mellitis Type 2, Polymorphism, Interleukin-10, Genotype frequencies.

Background Diabetes is the leading cause of chronic kidney disease worldwide. Diabetic kidney disease is one of the microvascular complications of diabetes and it involves changes in glomerular hemodynamics, interstitial fibrosis, and tubular atrophy. Early detection and management of Diabetic kidney disease (DKD) help to reduce morbidity and mortality. This study aims to assess the prevalence of nephropathy and albuminuria in the diabetic population attending an Irish tertiary care center. Methods Retrospective data collection and analysis of patients diagnosed with Type 1 diabetes mellitus (T1DM) and Type 2 diabetes mellitus (T2DM) through the Development and Integration of Accurate Mathematical Operations in Numerical Data-Processing (DIAMOND) database in a single Irish tertiary care center. An audit tool was used to collect patients' information including gender, age, type of diabetes, serum creatinine, urinary albumin excretion, albumin creatinine ratio (ACR), body mass index, and last available glycated hemoglobin (HbA1c). Results Out of 7394 subjects with T2DM, 3139 (42%) were identified with chronic kidney disease (CKD). There were 1866 subjects with positive ACR out of 3139 subjects with CKD in the T2DM cohort. This shows that 25% of subjects have diabetic kidney disease and 17% have CKD of undetermined etiology. In the T1DM cohort with 1166 subjects, 209 (18%) were identified with CKD. Out of these 209 subjects with CKD, 164 (14%) were ACR-positive. The prevalence of CKD and albuminuria were related to age in both T1DM and T2DM populations. Albuminuria showed a linear relationship with age in subjects with no known CKD, which shows that age causally relates to albuminuria independent of type and duration of diabetes. Conclusion CKD is more prevalent in patients with T2DM as compared to T1DM, whereas the prevalence of albuminuria is higher in the T1DM population.

This century has introduced very deadly, dangerous, and infectious diseases to humankind such as the influenza virus, Ebola virus, Zika virus, and the most infectious SARS-CoV-2 commonly known as COVID-19 and have caused epidemics and pandemics across the globe. For some of these diseases, proper medications, and vaccinations are missing and the early detection of these viruses will be critical to saving the patients. And even the vaccines are available for COVID-19, the new variants of COVID-19 such as Delta, and Omicron are spreading at large. The available virus detection techniques take a long time, are costly, and complex and some of them generates false negative or false positive that might cost patients their lives. The biosensor technique is one of the best qualified to address this difficult challenge. In this systematic review, we have summarized recent advancements in biosensor-based detection of these pandemic viruses including COVID-19. Biosensors are emerging as efficient and economical analytical diagnostic instruments for early-stage illness detection. They are highly suitable for applications related to healthcare, wearable electronics, safety, environment, military, and agriculture. We strongly believe that these insights will aid in the study and development of a new generation of adaptable virus biosensors for fellow researchers.

UNSTRUCTURED Cutaneous reactions have been commonly associated with the Moderna mRNA Covid-19 vaccine. Of the reported cutaneous side effects, there have not been any associations reported yet of keratoacanthoma after Covid-19 mRNA vaccination. We report a novel case of an 86 year old man who had an eruption of multiple keratoacanthomas 2 weeks after inoculation with the Moderna mRNA-1273 vaccine that resolved following treatment with intralesional 5-fluorouracil.

Background: When it happens in a child or adolescent, an intracapsular femoral neck fracture can be very challenging to heal. Hip fractures are expected to rise from 1.26 million in 1990 to 2.6 million in 2025 and 4.5 million by the middle of this century, according to the latest estimates. 1 After a fixation, problems might occur for a number of various reasons, including those listed above. The initial displacement and the time and accuracy of the reduction are the most essential factors in determining the final output. Objective: To compare the frequency of fracture consolidation in two versus three cannulated screws for osteosynthesis of femoral neck fractures. Subjects and Method: In Karachi, the Al Mumtaz hospital complex hosted a total of eighty patients who met the study's eligibility criteria and agreed to participate. After being informed of the technique, patients agreed to participate. Each patient's name, age, gender, address, and phone number were entered into a database. utilizing a lottery technique, each patient was placed in one of two groups, A or B. 80 chits (40 for group A and 40 for group B) sealed in opaque envelope was put in a jar and patient was asked to pick one chit from jar and that patient was assigned to that particular group written on that chit. In group A, 40 patients were undergo osteosynthesis by using two cannulated screws, while in group B, 40 patients were undergo osteosynthesis by using three cannulated screws. All procedures were done under general anesthesia and by same surgeon’s team having minimum 5 years post qualification surgical experience. After surgery, patients were shifted to ward and was discharged. Then patients were followed-up in OPD for 3 months after surgery for assessment of fracture consolidation. Final assessment was made at 3rd month. Data was entered and analyzed through SPSS version 20. Results: In total, there were eighty people that took part in this research. Two cannulated screws were inserted into forty patients, whereas another forty patients received three screws. Patients with ages ranging from 18 to 55 were included in the study. Patients in Group 1 were on average 32.4 years old plus 8.13 years, while patients in Group 2 were on average 35.9 years old plus 9.01 years. Patients who were treated with two cannulated screws achieved fracture consolidation in 35 (87.5% of cases), but patients who were treated with three cannulated screws only experienced fracture consolidation in 20 (50%) of their instances, which is a significant difference. Conclusion: In conclusion, fracture consolidation with two cannulated screws is an effective approach for the treatment of osteosynthesis of femoral neck fractures. Keywords: Femoral neck fractures, Osteosynthesis, two cannulated screws, three cannulated screws.

In this report, a novel D-shaped long-range surface plasmon resonance (LRSPR) fiber base sensor has been introduced. The demonstration of proposed sensor involves two D-shaped silver-coated models to study the sensitivity responses. The entire study with the constructed models is based on a single-mode fiber. The models are multilayered consisting of metal, dielectric, and analyte as separate layers. Silver (Ag) and magnesium fluoride (MgF2) strips are used as metal and dielectric layers respectively. The constituency of analyte as an interface excellently standardized the models for sensitivity detection. In this report, a large range of analyte refractive indices (RI) which varies from 1.33 to 1.38 is appraised for the proposed models to characterize the sensitivity. The entire context is encompassed by the wavelength region from 450 to 850 nm with an interval of 20 nm. Sensitivities in this report are measured based on the analyte position from the core and metal for both models. For each of the two models, the analyte is placed as the top layer. RIs of the applied metal (Ag) are measured using the Drude-Lorentz formula. The simulated sensitivities for model-1 and model-2 vary from 6.3 × 103 nm/RIU to 8.7 × 103 nm/RIU.

Hadoop is a distributed system used exclusively for BigData analysis and processing that is Hadoop distinguished itself through its high performance and a solid availability. Hadoop cluster is available for use at any time and this is one of Hadoop’s solid attributes that make it popularly known in data analysis and sciences. However, there are a several factors impacting Hadoop cluster, causing it to be inaccessible. One of these factors is BigData in small files whereby Hadoop’s availability shortage accrued when a massive amount of small files dataset is pushed toward a Hadoop cluster. This will harm the cluster’s performance, making it unavailable for access and use. This negative factor affects the Namenode itself as the Namenode is a single point of failure. Hence, once it crashes, the whole cluster will be out of service and need to jump again manually. This paper will introduce the elastic Namenode in lieu of the current traditional one. The elastic Namenode has an ability to adapt to the frequent negative factors that are affecting the whole cluster, causing it to become unavailable. The elastic Namenode will adopt the vertical elasticity manner, this type of elasticity will add more memory resources to the Namenode based on a direction from a script that traces the Namenode memory itself. The result will be a cloud elastic Namenode that can be expanded and shrunk upon request, which allows Hadoop cluster to treat BigData in small files without any negative factor or issue.