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The study of tribological applications requires measuring various parameters, including RPMs, friction, and wear. The useful information is sometimes not readily available in a measurement and requires further postprocessing to extract that information. In this research, a production engine test rig has been developed to study a direct-acting valvetrain’s tribological performance for various operating conditions. The measurement of the drive torque is carried out by using a shaft-to-shaft torque transducer. The total drive torque is a combination of geometric torque and frictional torque. The geometric torque is not affected by changes in parameters such as surface modification or lubricant chemistry but the frictional torque changes. We need to extract the frictional torque from the total drive torque to study the effect of any parameter or operating condition change on friction. As variation in frictional torque helps the tribologists to compare the performance of different parameter changes. This paper explains the complete procedure of measuring the experimental frictional torque from drive torque data. In this study, the frictional torque variation between an untextured and a textured tappet shim is studied for a direct acting cam tappet contact of a real production engine.

Imaging plays a central role in neuro-oncology including primary diagnosis, treatment planning, and surveillance of tumors. The emergence of quantitative imaging and radiomics provided an uprecedented opportunity to compile mineable databases that can be utilized in a variety of applications. In this review, we aim to summarize the current state of conventional and advanced imaging techniques, standardization efforts, fast protocols, contrast and sedation in pediatric neuro-oncologic imaging, radiomics-radiogenomics, multi-omics and molecular imaging approaches. We will also address the existing challenges and discuss future directions.

Abstract The inter-arterial watershed zone in neonates is a geographic area without discernible anatomic boundaries and difficult to demarcate and usually not featured in atlases. Schematics currently used to depict the areas are not based on any prior anatomic mapping, compared to adults. Magnetic resonance imaging (MRI) of neonates in the acute to subacute phase with suspected hypoxic-ischaemic injury (HII) can demonstrate signal abnormality and restricted diffusion in the cortical and subcortical parenchyma of the watershed regions. In the chronic stage of partial-prolonged hypoxic-ischaemic injury, atrophy and ulegyria can make the watershed zone more conspicuous as a region. Our aim is to use images extracted from a sizable medicolegal database (approximately 2000 cases), of delayed MRI scans in children with cerebral palsy, to demonstrate the watershed region. To achieve this, we have selected cases diagnosed on imaging as having sustained a term pattern of partial-prolonged HII affecting the hemispheric cortex, based on the presence of bilateral, symmetric atrophy with ulegyria. From these, we have identified those patients demonstrating injury along the whole watershed continuum as well as those demonstrating selective anterior or posterior watershed predominant injury for demonstration. Recognition of this zone is essential for diagnosing partial-prolonged hypoxic-ischaemic injury sustained in term neonates. The images presented in this pictorial review provide a template for identifying the cortical watershed distribution when there is milder regional (anterior, parasagittal, peri-Sylvian and posterior) watershed injury and for more severe injury where multiple regions are injured in combination or as a continuum.

Abstract Meckel’s cave is a dural recess in the posteromedial portion of the middle cranial fossa that acts as a conduit for the trigeminal nerve between the prepontine cistern and the cavernous sinus, and houses the Gasserian ganglion and proximal rootlets of the trigeminal nerve. It serves as a major pathway in perineural spread of pathologies such as head and neck neoplasms, automatically upstaging tumours, and is a key structure to assess in cases of trigeminal neuralgia. The purpose of this pictorial review is threefold: (1) to review the normal anatomy of Meckel’s cave; (2) to describe imaging findings that identify disease involving Meckel’s cave; (3) to present case examples of trigeminal and non-trigeminal processes affecting Meckel’s cave. Teaching points • Meckel’s cave contains the trigeminal nerve between prepontine cistern and cavernous sinus. • Assessment is essential for perineural spread of disease and trigeminal neuralgia. • Key imaging: neural enhancement, enlargement, perineural fat/CSF effacement, skull base foraminal changes.

Various rapid propagation strategies have been discovered, which has facilitated large-scale plant reproduction and cultivar development. These methods, in many plant species, are used to rapidly generate large quantities (900 mini-tubers/m2) of high-quality propagule (free from contamination) at a relatively low cost in a small space. They are also used for plant preservation. This review article aims to provide potential applications for regeneration and clonal propagation. Plant propagation using advanced agrotechnology, such as aeroponics, is becoming increasingly popular among academics and industrialists. The advancement of asexual aeroponic propagation has been achieved through advancements in monitoring and control systems using IoT and smart sensor technology. New sensor technology systems have gained substantial interest in agriculture in recent years. It is used in agriculture to precisely arrange various operations and objectives while harnessing limited resources with minimal human intervention. Modern intelligent technologies and control systems simplify sensor data collection, making it more efficient than manual data collection, which can be slow and prone to errors. Specific ambient variables like temperature, humidity, light intensity, stock solution concentrations (nutrient water), EC (electrical conductivity), pH values, CO2 content, and atomization parameters (frequency and interval) are collected more effectively through these systems. The use of intelligent technologies provides complete control over the system. When combined with IoT, it aids in boosting crop quality and yield while also lowering production costs and providing data directly to tablets and smartphones in aeroponic propagation systems. It can potentially increase the system's productivity and usefulness compared to the older manual monitoring and operating methods. [ABSTRACT FROM AUTHOR]

The need to mitigate carbon dioxide has motivated an influx of interest in innovative technologies, and microfluidic systems have emerged as a promising forefront in this endeavor. This short review analyzes CO2 reduction within microfluidic platforms, thoroughly investigating existing methodologies, challenges, and novel perspectives. This work commences with a detailed exposition of the fundamental principles governing microfluidic electrolyzers, elucidating the interaction of microchannels and electrodes. We show the electrochemical reactions supporting CO2 reduction, detailing the processes at the cathode. The use of microfluidic systems encompasses precise control over reaction conditions, efficient mass transport, reduced energy consumption, high throughput screening capabilities, integration with analytical tools, and portability. Catalyst selection for optimal CO2 reduction products, technical complexities, integration of renewable energy sources, and cost‐effectiveness are notable challenges on the horizon. A perspective on potential pathways to resolution is delineated, with each impediment succinctly but insightfully addressed. Moreover, this review extends beyond a looking‐back analysis, propounding innovative perspectives. It posits the concept of microfluidic fuel cells directly fueled by CO2. This work seeks to inspire new researchers and innovation in the field by comparing the present state‐of‐the‐art with prospective avenues of exploration. [ABSTRACT FROM AUTHOR]

Reduced wear and friction are directly related to longer component service lives and increased energy efficiency. The mechanisms used to achieve this goal in mechanical systems include the study of lubricant chemistry, surface coating, and surface modification. Significant research has been conducted on friction reduction of valve trains of internal combustion engines using surface modifications such as coatings and surface texturing. Here, an experimental approach has been adopted to investigate the effect of micro surface texturing on Thermo-Elastohydrodynamically Lubricated cam/tappet contact in a direct-acting valve train. A commercial vehicle valve train has been instrumented to study the effect of varying surface texture area density on friction under realistic engine operating conditions. Fiber laser surface texturing has been used to microtexture three samples of tappet shims with texture densities of 5%, 8%, and 10%. The tests have been run at four engine speeds—300, 500, 700, and 900 RPM—and three temperatures—30 °C, 60 °C, and 90 °C. The experimental results show a significant friction reduction of up to 18.33% for textured shims at the temperature of 90 °C. The friction reduction performance of the 8% textured shim has been optimum for all RPMs at the higher temperatures. [ABSTRACT FROM AUTHOR]

Pulse oximeters are widely used in hospitals and homes for measurement of blood oxygen saturation level (SpO2) and heart rate (HR). Concern has been raised regarding a possible bias in obtaining pulse oximeter measurements from different fingertips and the potential effect of skin pigmentation (white, brown, and dark). In this study, we obtained 600 SpO2 measurements from 20 volunteers using three UK NHS-approved commercial pulse oximeters alongside our custom-developed sensor, and used the Munsell colour system (5YR and 7.5YR cards) to classify the participants' skin pigmentation into three distinct categories (white, brown, and dark). The statistical analysis using ANOVA post hoc tests (Bonferroni correction), a Bland–Altman plot, and a correlation test were then carried out to determine if there was clinical significance in measuring the SpO2 from different fingertips and to highlight if skin pigmentation affects the accuracy of SpO2 measurement. The results indicate that although the three commercial pulse oximeters had different means and standard deviations, these differences had no clinical significance. [ABSTRACT FROM AUTHOR]

This study investigates the friction-reducing potential of "micro surface texturing" on H-13 steel metal surfaces. Tribological tests were performed on a ball-on-plate reciprocating tribometer using SAE30 oil. Circular micro textures with a 0.1 mm diameter and 5-8 µm depth were applied at varying area densities (5%, 10%, and 15%). The results were compared to identify the most effective area density for the micro textures. A friction reduction of 37.95% was observed compared to the untextured sample at 15% area density. The average friction for all the textures is reduced, which shows the effectiveness of laser surface texturing on tribological performance. [ABSTRACT FROM AUTHOR]

Objective: To determine the efficacy of preoperative Tranexamic Acid (TXA) in reducing perioperative allogenic blood transfusion frequency in patients with intertrochanteric fractures treated with Dynamic Hip Screw (DHS). Methods: We conducted this placebo controlled double-blinded randomized trial in Orthopaedics & Traumatolgy Division Lady Reading Hospital, Peshawar from 1st January 2020 to 25th December 2022. All patients with intertrochanteric hip fractures fulfilling the inclusion criteria were treated with Dynamic Hip Screw (DHS) and were randomly divided into two equal groups. One group was administered single dose IV Tranexamic Acid (TXA) in a dose of 15mg/kg body weight in 100ml of saline while the other group (Placebo) was given 100 ml normal saline preoperatively. Postoperative Hemoglobin was measured on first, second and third day. The frequency of allogenic blood transfusions in the perioperative period was determined in both groups based upon the transfusion trigger (Hemoglobin 9g/dl). Categorical variables were compared with Chi-square test and mean with Independent sample t-test. P value of <0.05 was considered significant. Results: The total number of patients in our trial were 200 which were equally but randomly allocated into TXA group and Placebo group each containing 100 patients. The mean age of the patients in TXA group was 48.16±1.75 years and the age of patients in the Placebo group was 48.35±1.60. The baseline demographic and clinical variables of both groups were identical (p< 0.05). The average preoperative hemoglobin was 11.5±4.2 g/dl in TXA group and 11.3±2.4g/ dl in the Placebo group (p>0.05). The frequency of allogenic blood transfusion was significantly lower (p<0.05) in TXA group (13%, n=13) than in the Placebo group (41%, n=41). Conclusion: Tranexamic acid (TXA) significantly reduces the frequency of peri operative allogenic blood transfusion in patients undergoing Dynamic Hip Screw (DHS) for intertrochanteric fractures. [ABSTRACT FROM AUTHOR]

Reduction in friction ensures fuel economy, control on emissions and durability of components in internal combustion engines. A modern gasoline internal combustion engine was instrumented to determine the friction values at the cam–roller interface considering the effects of surface treatment and engine operating state. A series of tests under different operating speeds and lubricant inlet temperatures were undertaken using both an original surface roller and a Wonder Process Craft (WPC) surface-treated engine roller. The results clearly revealed a substantial reduction in friction magnitude for the WPC surface-treated engine roller in comparison to the original roller while operating under similar conditions, indicating their strong potential for employment in engines. An increase in friction with the rise in temperature was also observed for both types of rollers, whereas increased lubricant entraining velocity due to higher operating speed had the opposite impact. A considerable reduction in frictional drive torque ranging from 8% to 28% was observed by employing the WPC-treated roller in comparison to original/untreated roller at various operating conditions, which signifies the strong potential for employment of WPC surface treatment in the roller/follower valve train engines. [ABSTRACT FROM AUTHOR]

Rice (Oryza sativa L.) is an important crop that is grown worldwide to supply the world's expanding food demand. In the current study, the effects of plant growth-promoting rhizobacteria (PGPR) and Arbuscular mycorrhizal fungi (AMF) on soil fertility and rice growth were explored. Rice plants were inoculated to evaluate how AMF fungi and PGPR affect various aspects of soil and plants, implicating abiotic stress tolerances. The experiment was carried out in a completely randomized design with three replicates under the controlled conditions. Results depicted that the plants that were inoculated with a mixture of AMF and PGPR had better yields and nutritional concentrations, while both AMF and PGPR lowered soil pH and organic matter differently. Similarly, AMF and PGPR treatments significantly increased the amount of N, P, K, and B in the post-harvest soil. The PGPR-inoculated plants had a 10–40% higher buildup of N in their tissues. Similarly, when they were compared with non-infected plants, AMF-inoculated treatments demonstrated a greater N accumulation in the rice tissue. The maximum P content in plant tissues was 0.149% in PGPR5-infected plants, either alone or in combination with AMF. In T12, AMF + PGPR5 inoculated rice plants, the maximum K uptake was 1.98%, which was 54% higher than the control treatment. The sole application of AMF raised K buildup in rice tissues by 38% compared with the control treatment. The improved productivity of plants with AMF and PGPR (especially with PGPR5) was attributed to the increased availability of nutrients in the soil. As a result, rice plant growth, yield, and essential element uptakes were boosted significantly. The present study's results suggested using the combined application of AMF + PGPR5 for improving the rice yield and for sustaining the soil health. [ABSTRACT FROM AUTHOR]

Insect-vectored plant viruses pose a serious threat to sustainable production of economically important crops worldwide. This demands a continuous search for environmentally-friendly, sustainable and efficient approaches based on biological agents to address the mounting challenges of viral disease management. To date, the efficacy of actinomycetes bacteria against DNA plant viruses remains unknown. Here, through comparative analyses, we demonstrate that the RFS-23 strain of Streptomyces cellulase possesses protective activity as it positively regulated the plant growth and development. and diminished the severity, of disease symptoms, together with reduced accumulation of Tomato yellow leaf curl virus (TYLCV) DNA. The RFS-23 strain maintained relative chlorophyll contents by promoting the expression of genes (CLH1, HEMA1 and PORA) associated with chlorophyll biogenesis. As compared to another strain, CTF-20, the RSF-23 induced a significantly higher expression of plant defense-related genes (NbCIS and NbNCED) associated with biogenesis and accumulation of salicylic acid and abscisic acid. Additionally, the activity of antioxidant enzymes (SOD, CAT, POD and MDA) was significantly enhanced by RSF-23 treatment, despite the presence of viral infection. These findings suggest that RSF-23 is a novel biocontrol agent with protective activity, and it could be a potential candidate for the management of plant viral infections. [ABSTRACT FROM AUTHOR]

In the present study, a method for the determination of residues of the neonicotinoid insecticides thiamethoxam and imidacloprid in the stingless bee Melipona scutellaris Latreille (1811) was optimized through a factorial design, tested using green metrics, and then applied to exposed bees. It combines the extraction with a modified quick, easy, cheap, effective, rugged, and safe method and the determination by liquid chromatography–tandem mass spectrometry analysis. Different parameters such as the mass of the sample, dispersive sorbents, and elution solvents were assessed. Method validation parameters were checked and include sensitivity, specificity, and linearity. The limit of quantification of 0.0025 μg g–1 was obtained for both insecticides, where accuracy was 94%–100% with satisfactory intraday and interday precisions (relative standard deviation <10%). The qualified method was applied to orally and topically exposed bee samples, and the results indicated that it is suitable for the determination and quantification of neonicotinoid pesticide residues in this species. Moreover, green analytical metrics like the National Environmental Methods Index, Eco Scale score, high‐performance liquid chromatography with an environmental assessment tool (HPLC‐EAT), waste generation, and amount of sample were compared with methods described in the literature involving neonicotinoid analysis in honeybees. As a result, the present study displayed the highest Eco Scale score and HPLC‐EAT score and the second smallest amount of sample and waste generated. Thus, the method meets green analytical metrics more than other methods. In this sense, besides the application, the multicriteria decision analysis tool employed suggests that this is a good option as a green analytical method. Environ Toxicol Chem 2022;41:2365–2374. © 2022 SETAC [ABSTRACT FROM AUTHOR]

Background: Narcissism is a personality disorder that has an impact on interpersonal relationship with friends, family and colleagues. These individuals can be more shy, arrogant or over-sensitive. These traits are also present among normal individual. A lot of features of behaviour are still unknown. Objective: To observe the narcissism score among medical and allied health students and the association of narcissism with their academic performance. Study type, settings & duration: This cross-sectional study was conducted at Fatima Memorial College of Medicine & Dentistry, Lahore from March 2019 to October 2019. Methodology: In this cross-sectional study of six months duration the "Narcissistic Personality Inventory (NPI40)" tool was administrated to 385 medical and allied health undergraduates. NPI scores were calculated. Comparative analysis was carried out. Multiple linear regression was also performed to observe the dependence of NPI score on demographic variables. Results: NPI score of males were found to be higher (18.27) than females scores (14.66). The odds for NPI were 21.98 times higher in males as compared to females. Similarly, hostilities were 3.42 times at more risk of narcissism. Last exam percentage was significantly associated with narcissism score. (0.024) Conclusion: Students of Allied health sciences exhibit more narcissistic traits than MBBS undergraduates. Institutes should encourage student counseling & mentoring sessions and they should have taught to overcome negative personality characteristics. [ABSTRACT FROM AUTHOR]

A Tuneable Microwave Photonics Gain Filter (TMWPF) is proposed based on Stimulated Brillouin Scattering (SBS). The TMWPF configuration exhibits a gain of $ \simeq $ 70 dBm and tuneable bandwidth control which makes it attractive for applications requiring high gain and bandwidth variations with high precision. The proposed TMWPF configuration employs a tuneable laser, an Erbium-Doped Fibre Amplifiers (EDFA), Radio Frequency (RF) mixers, an RF Amplifier (RFA), Single Mode Fibre (SMF) and Gallium Arsenide (GaAs) I-Q Dual parallel Mach-Zehnder Modulator (DPMZM). The modulation scheme performed by I-Q DPMZM is controlled by a voltage bias controller. The performance of the filter is compared whilst using LiNbO3 Phase Modulators (PMs) and Intensity Modulators (IMs) instead of GaAs I-Q DPMZM. The TMWPF delivers 44 dBm, 57 dBm & 44 dBm of gain for I-Q DPMZM, PM, and IM, respectively. The use of RFA resulted in a total gain of 62 dBm, 69 dBm & 52 dBm for I-Q DPMZM, PM and Amplitude Modulators (AM), respectively. This configuration exhibits high Q, tuneable bandwidth by employing stokes SBS gain, RF mixer and RFA. The bandwidth of the filter is varied from 20 MHz to 40 MHz. The operation principle of the TMWPF is based on SBS stokes gain. By controlling the bias point of the I-Q DPMZM, the operating point can be varied between PM and IM allowing 6 dBm gain control and the choice of PM or IM for specific applications. This gives improved filter performance. The full control of TMWFP's gain is obtained by using EDFA. The EDFA controls the power of the tuneable laser pump. The control challenges of the proposed TMWPF along with improvement enhancements are reported. The proposed TMWPF exhibits tuneability of 32 GHz in RF domain, and 40 GHz in optical domain. To the best of our knowledge, this TMWPF exhibits the highest reported gain. [ABSTRACT FROM AUTHOR]

This study aims to solve water constraints in today's agricultural industry, as well as decreasing soil conditions and growing food demand. The primary goal of current research is to find a substitute for conventional farming practices that could conserve water, fertilizer and generate more sustainable food vertically and horizontally. Two treatments were performed, each with two replications. The treatments included hydroponic (soil-less) and geoponic (soil) spinach seed cultivation. The seed was initially grown in a seedling tray before being transferred onto a prepared plot and a hydroponic model, respectively. All the standard materials (made of plastic) needed for a perfect low-cost hydroponic model, obtained from local markets, were combined accordingly to achieve the results of set goals. A total of 9680.00 PKR was the approximate expense of the manually manufactured hydroponic model. The field under geoponic cultivation was maintained equal to the manufactured hydroponic model (4'x 4'). Full-Spectrum Light-emitting diode (LED) grow light was used to meet the plants' light requirements. The stock solution (a combination of water and nutrients) was used to feed the transplanted plants during hydroponic cultivation. On average, relative to water use under geoponic agriculture, the hydroponic model's productivity was 97.42 percent. The growth efficiency of the hydroponic spinach crop was much higher than that of geoponic cultivation. On average, the leaf area was 24 percent, height 25 percent, and steam scale 24 percent greater than geoponic. Statistically, there was a substantial (p<0.05) variation in the leaf area, height, and steam scale of plants, suggesting that hydroponic technology could also increase crop yields by up to 25 percent. It is inferred from this analysis that hydroponic cultivation is successful in saving water and fertilizer and increasing crop yields at the desirable limit. To enhance yield, the hydroponic model should be equipped with sensors and artificial intelligence technologies to handle difficulties related with food supplies. The hydroponic growing technology should be introduced to cities. At the time, such as when challenged with Covid-19 and the locust attack. [ABSTRACT FROM AUTHOR]

Objectives: To determine the clinical and radiological outcome of proximal femur shaft fractures in school going children treated with locking compression plates (LCP). Methods: This descriptive study was conducted in Orthopaedic Division Lady Ready Reading Hospital Peshawar from 25th June 2018 to 25th September 2020. Children of either gender and age 6 to 12 years old with subtrochanteric and proximal one third femur factures fulfilling the inclusion criteria were enrolled in this study. Open reduction and internal fixation with 4.5 mm narrow locking compression plates (LCP) were done in all. Post operative clinical outcome was evaluated by using Flynn scoring system and graded as excellent, satisfactory and poo results. Radiological assessment of fracture union was done through anteroposterior (AP) and lateral X-ray radiographs. Results: A total of 60 children with mean age 9.01?1.61 SD (range 6 to 12 years) were included in our study. Oblique fractures were present in 23(38.3%) children, spiral in 20(33.3%), transverse in 11(18.3%) and comminuted in 6 (10%) children. The radiological union time was 13.3?1.2 weeks (range 9.4 to 18 weeks). Majority (88.3%, n=53) of children had excellent clinical outcome according to Flynn's scoring system while satisfactory outcome was noted in 7(11.6%) children. No cases of delayed union, mal union, nonunion and implant failure was reported. Conclusion: The results of our study indicated that proximal femoral shaft fractures in school going children treated with locking compression plates had excellent clinical and radiological outcome. We therefore recommend locking compression plate as the implant of choice to fix proximal femoral shaft fractures in school going children. [ABSTRACT FROM AUTHOR]

In this paper, we have focused on machine learning (ML) feature selection (FS) algorithms for identifying and diagnosing multidrug-resistant (MDR) tuberculosis (TB). MDR-TB is a universal public health problem, and its early detection has been one of the burning issues. The present study has been conducted in the Malakand Division of Khyber Pakhtunkhwa, Pakistan, to further add to the knowledge on the disease and to deal with the issues of identification and early detection of MDR-TB by ML algorithms. These models also identify the most important factors causing MDR-TB infection whose study gives additional insights into the matter. ML algorithms such as random forest, k-nearest neighbors, support vector machine, logistic regression, leaset absolute shrinkage and selection operator (LASSO), artificial neural networks (ANNs), and decision trees are applied to analyse the case-control dataset. This study reveals that close contacts of MDR-TB patients, smoking, depression, previous TB history, improper treatment, and interruption in first-line TB treatment have a great impact on the status of MDR. Accordingly, weight loss, chest pain, hemoptysis, and fatigue are important symptoms. Based on accuracy, sensitivity, and specificity, SVM and RF are the suggested models to be used for patients' classifications. [ABSTRACT FROM AUTHOR]

Cellulosic fibers provide a favorable substrate for nucleation and growth of the nanoparticles. Manganese ferrite nanoparticles can serve as catalysts for various purposes. Here, sonosynthesis of manganese ferrite nanoparticles on cotton fabric was carried out through sonochemical processing by using iron chloride and manganese chloride salts at different temperatures and times in alkaline media. Also, the central composite design based on the response surface methodology was used to optimize the production conditions such as temperature and time. The formation of synthesized nanoparticles on cotton was evaluated by X-ray diffraction (XRD), Fourier transform infrared (FTIR), field emission scanning electron microscopy (FESEM), energy-dispersive X-ray spectroscopy (EDX), and elemental mapping tests. FESEM images confirmed the spherical manganese ferrite nanoparticles with an average size of 48 nm on cotton fabric. The photocatalytic activities, washing and lightfastness, and magnetic, mechanical, and colorimetric properties of the modified fabrics were investigated. The nanocomposites boosted methylene blue photodegradation under sunlight. In addition, the vibrating sample magnetometer (VSM) test indicated the paramagnetic nature of the manganese ferrite nanoparticles with a magnetic saturation of 1.32 emu/g. The treated fabrics with the proper magnetic properties are suitable for use in diverse applications such as supercapacitors.

Objectives: To determine the frequency of recurrent shoulder dislocation after first time traumatic anterior shoulder dislocation treated non operatively. Study Design: Prospective observational cohort study. Setting: Department of Orthopedics and Traumatology Lady Reading Hospital Peshawar. Period: 25th May 2011 to 25th December 2018. Material & Methods: Patients of all ages and both gender with first time traumatic anterior shoulder dislocation meeting the inclusion criteria were included in the study. In the included subjects shoulder joint was relocated under general anesthesia and immobilized in a poly sling for four weeks followed by supervised physiotherapy and rehabilitation program without any surgical stabilization of the shoulder joint. All these patients were instructed for follow up at monthly interval or before if recurrence occurred. Results: A total of 52 patients with mean age 35±9.4 years (range 16-55 years) were enrolled in our study. Male patients were 43(82.6%) while female patients were 9(17.3%). Right sided dislocation was noted in 38(73%) and left in 14(26.9%). Recurrent shoulder dislocation was reported in 32(61.5%) patients during a minimal follow up period of three years. Most (46.8%, n=15) of the patients with recurrent shoulder dislocation were 30 years of age or below. Conclusion: First time traumatic anterior shoulder dislocation treated non operatively not always result in recurrent shoulder dislocation in all patients. However a large number of patients and particularly younger patients suffered recurrence. [ABSTRACT FROM AUTHOR]

Objectives: To find out awareness regarding Diabetes Mellitus and its management amongst patients admitted to a tertiary care teaching hospital of Peshawar Material and Method: The study was conducted at Khyber Teaching Hospital and completed in 06 months' time. Non-Random Consecutive sampling technique was used for the collection of data. The survey was conducted as a cross-sectional study using questionnaires to guide the interview-based data collection from the patients. A pre tested questionnaire was used for data collection. Verbal consent was taken from the patients and data collected while respecting the anonymity of the individual participants. According to the recent data of prevalence of diabetes in Pakistan, the sample size was calculated to be 275 for the study. For the analysis of data SPSS version 23.0 was used. The Chi square test was used for significance testing of variables. Results: A total of 275 interviews were conducted. Out of 275 who responded, 87.6% of the patients were suffering from Type 2 Diabetes Mellitus while 10.5% and 1.8% of the patients were suffering from Type 1 Diabetes Mellitus and Gestational Diabetes Mellitus respectively. Around 55% of the patients had poor knowledge about the disease. Almost 50.9% participants were unaware about the importance of regular glycemic monitoring, 27.3% knew about HbA1c and its importance while 64.7% and 72.7% of the patient were unaware of recommended fasting and random blood glucose levels respectively. Approximately 48.7% of the participants were of the view that insulin is the end stage drug for diabetics and it in itself damages vital organs of the body. Conclusion: The awareness of Diabetes and its complications is very low among the diabetic patients of Peshawar. Their awareness is crucial for us to control the increasing trends of the disease and its complications. [ABSTRACT FROM AUTHOR]

The organizations utilizing the cloud computing services are required to select suitable Information Security Controls (ISCs) to maintain data security and privacy. Many organizations bought popular products or traditional tools to select ISCs. However, selecting the wrong information security control without keeping in view severity of the risk, budgetary constraints, measures cost, and implementation and mitigation time may lead to leakage of data and resultantly, organizations may lose their user's information, face financial implications, even reputation of the organization may be damaged. Therefore, the organizations should evaluate each control based on certain criteria like implementation time, mitigation time, exploitation time, risk, budgetary constraints, and previous effectiveness of the control under review. In this article, the authors utilized the methodologies of the Multi Criteria Decision Making (MCDM), Analytic Hierarchy Process (AHP) and Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) to help the cloud organizations in the prioritization and selection of the best information security control. Furthermore, a numerical example is also given, depicting the step by step utilization of the method in cloud organizations for the prioritization of the information security controls. [ABSTRACT FROM AUTHOR]

Fuzzy logic has wide adoption in every field of study due to its immense advantages and techniques. In cloud computing, there are many challenges that can be resolved with the help of fuzzy logic. The core objective of this paper is to analyze the application of fuzzy logic in most demanding research areas of cloud computing. We also analyzed the fuzzy methods that were used in the solving of problems relates to cloud computing. A systematic literature review was conducted to enlist the all the challenging areas of research relates to cloud computing, categorized the most critical and challenging areas of cloud research, studied existing problem-solving techniques of each challenging cloud area, and finally studied the application of fuzzy logic in each aforementioned areas to redress different problems. The authors concluded that fuzzy logic can be used in every area of research including cloud computing to solve the problems and optimized the performance, as well as fuzzy logic techniques, were opted by many cloud computing researchers to conduct their study to optimize the performance of the system. [ABSTRACT FROM AUTHOR]

BACKGROUND: Osmotic pretreatment is an effective processing unit for improving the textural quality of dried fruit and vegetable snacks, whereas nutrition loss and high calorie after impregnation is still a noteworthy shortcoming of sugar‐immersed products. Therefore, the use of apple juice concentrate as a clean label solution to improve the qualities of instant controlled pressure drop (DIC)‐dried carrot chips was investigated. RESULTS: Apple juice concentrate impregnation substantially enhanced the physical properties of the carrot chips, including hardness (38.28 N), crispness (2.01 mm), porosity (66.72%) and homogeneous microstructure, comparable to chips obtained using sucrose and maltiltol based osmotic solutions. Additionally, compared to the sucrose and maltiltol impregnated chips, a higher retention of carotenoids (302.81 μg g–1, dry basis), a higher multiplicity of phenolic compounds, stronger antioxidant activities and a superior sensory score were observed in the chips pretreated with apple juice concentrate. CONCLUSION: Apple juice concentrate could be used as a clean label osmotic solution to enhance the organoleptic attributes and fortify the nutritional properties of DIC‐dried carrot snacks. © 2019 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Objective: To analyze the contents and format of peer review proforma of Medical journals of Pakistan. Methods: This descriptive study was conducted in the Department of Orthopaedics and Traumatology Lady reading Hospital Peshawar Pakistan from 3rd August 2018 to 9th February 2019. An email was sent to the chief editors of all the medical journals listed on the official website (www.pmdc.org.pk) of Pakistan Medical and Dental Council (PM&DC). They were requested to send peer review proformas of their journals. The received proformas were analyzed for major contents and format or style. The proforma had a structured format when each portion of the manuscript i.e, title, abstract, key words, methodology, results, discussion, conclusion and references were individually sectioned for evaluation. Whereas in the unstructured proformas the reviewer was asked to assess the manuscript as a whole. Results: We received 41 proformas via emails. Majority (82.9%) of the proformas were structured while 17% were unstructured. A scoring or rating system for the manuscript was present in 31.7% of the proformas while 43.9% of the proformas were without any scoring system. Guidelines for the peer reviewers were given in 58.5% of the proformas. The peer review policy (closed or open) was mentioned in only 7.3%. About 9.7% of the proformas asked the reviewers to disclose conflict of interests. Conclusion: A spectrum of contents and format of peer review proformas of medical journals were observed. We found structured peer review proforma with a scoring scale comprehensive and more appropriate for peer review. [ABSTRACT FROM AUTHOR]

Objectives: To compare the frequency of surgical site wound complication rate between the skin closure with staples and polypropylene suture after elective hip surgery. Study Design: Prospective Randomized trial. Place and Duration of the Study: Orthopaedic & Traumatology Department Lady Reading Hospital from 13/03/2016 to 25/12/2017. Material and Methods: All patients of either gender or age with intertrochanteric fractures fulfilling the inclusion criteria and fixed with dynamic hip screw (DHS) were randomly divided into two groups. Group A surgical site skin wounds were closed with metallic skin staples while Group B wounds were closed with polypropylene sutures. Wounds were examined for inflammation, necrosis, dehiscence, discharge and abscess on 3rd day, 2nd week, 4th, and 8th weeks in both groups and compared. P value was considered significant if < 0.05. Results: Surgical site skin closure of 100 patients were done with staples (group A, 50 patients) and interrupted polypropylene suture (group B, 50 patients). Baseline parameters of both groups had no significant differences. Mean age of group A and B patients were 61.6±SD 17.1 and 61.02±SD 19.2 respectively. Surgical site wound complications were reported in 9(18%) patients with staples closure and 8(16%) patients with suture closure (p > 0.05). Conclusion: We found no significance difference in surgical site complication rates of staples and suture closure in elective hip surgery patients. The operating surgeon can use closure material of his own choice. [ABSTRACT FROM AUTHOR]

The effects of instant controlled pressure drop (DIC) drying, and blanching-assisted DIC (B + DIC) on texture, volume ratio (VR), colour, microstructures of different tissues, and cell-morphology of fruit and vegetable chips was examined. Results revealed that B + DIC had a significant effect on fruits and vegetable chips as compared with DIC treated. The DIC dried mango chips were observed to have low hardness (26.12 N) and maximum crispness (10.43) that were also observed in mango chips under B + DIC treated (14.66), exhibiting a puffy structure and crispy texture. Well expanded structure which reflected by VR was found in the mango (0.46 mL) and king oyster mushroom (KOM) (0.36 mL) chips under both treatments. The maximum total colour changes (∆E) were also obtained in the mango (30.40) and carrot (42.87) chips under B + DIC. The microstructures of the apple, carrot, KOM and potato chips products, which corresponded to its well expanded appearances, showed a honeycomb-like pores structure, observed for DIC treated apple, fresh potato, B + DIC dried KOM as well as in sweet potato. In addition, the B + DIC-treated carrot chips, pores size, increased the cell wall and expanded. Moreover, the mushroom chips mostly were shrunken after hot water blanching. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate and compare the radiological and functional outcome of interlocking nail femur in dynamized with static mode. STUDY DESIGN: Prospective Randomized trial. PLACE AND DURATION: Orthopaedic and Traumatology Department Lady Reading Hospital from 3rd February 2014 to 10th January 2018. METHODOLOGY: Transverse and oblique fractures shaft of femur meeting the inclusion criteria were randomly divided into two equal groups. Group I was treated with reamed antegrade interlocking nail in dynamized mode while group II in static mode. Both groups were followed for two years. Radiologically union time, delayed union,non union and implant failure was assessed and compare in both groups. Functional evaluation was assessed with Thorensen's criteria as excellent, good, fair and poor. P value was considered significant if < 0.05. RESULTS: Both group I and II had 50 patients each. Mean age of group I and II was 36.1±SD 11.41 and 37.4±SD11.24 years respectively. Dynamic nails were associated with early fracture healing(15th week) than static nailing(22nd week).Excellent functional results were achieved in 84% patients in group I and 22% patients in group II.( P value < 0.05) Delayed union was noted in 8% patients in group I and 26% in group II(P value < 0.05) while non union in 2% patient in group I and 16% patients in group II( P value < 0.05) CONCLUSION: Dynamic interlocking nail femur for oblique and transverse shaft fractures results in excellent radiological and functional outcome in majority of patients than static interlocking nails. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the outcome of retrograde flexible intramedullary nails in treatment of paedriatic diaphyseal fractures in comparison with the traditional treatment of immediate hip spica cast. Hypothesis: We hypothesised that in children with femur fracture who are managed with flexible intramedullary nails have better outcome in comparison to those managed with immediate hip spica cast. Study Design: Randomized control trail. Place & Duration of Study: Lady Reading Hospital, Peshawar from June 2016 to October 2017. Methods: A group of forty-eight children aged 6-12 were randomly allocated either elastic intramedullary nail or immediate hip spica casting and were followed up to six months. Fracture alignment (coronal and sagittal angulation, leg length discrepancy), time for fracture union, recovery mile stones (time to start weight bearing with aids, independent walking, knee range of movement) and the presence of complications including surgical site infection were recorded and compared between two groups. Results: Children treated with elastic intramedullary nails in comparison with those treated with immediate hip spica had early union (p<0.001), shorter time to start weight bearing with support or independently (p<0.001). Leg Length discrepancy (p<0.001), coronal and sagittal angulation (p<0.001 and p=0.02) was significantly higher in hip spica group. Difference observed between the two groups regarding knee range of movement (p=0.085) and surgical site infection (p=0.076) was not significant. Conclusion: Children aged 6-12 years treated with elastic intramedullary nail for femoral diaphyseal fracture had earlier union, reduced rate of shortening, malunion and allowed earlier rehabilitation. [ABSTRACT FROM AUTHOR]

Background: Polytrauma is the result of high energy trauma and presents itself as damage to multiple systems of the body. Since fractures frequently exist, the presence of femoral and pelvic fractures is alarming and presents a great challenge to trauma surgeons. There are two different schools of thought regarding the timing of definitive surgical involvement in polytrauma patients i.e. early total care and the damage controlled orthopaedics. Each approach has its merits and demerits. The clinical status of the patient determines the appropriate orthopaedic approach, which should aim at the survival of the patient. Objective: To assess the best possible orthopaedic approach in a patient with blunt multiple injuries. Patients and Methods: This is a retrospective study that include 40 patients of multiple trauma with associated fractures of femur or pelvis during the period of 2013 at KTH Peshawar. The patients' age was 20-60 years and the spectrum of injuries varied. All patients has deranged one or more vital functions. Road traffic accident is the main cause of multiple injuries in our series. Early total care (ETC) or damage control had orthopaedics policy was followed. We tried to find out the best possible orthopaedic approach by studying the incidence, of acute respiratory distress syndrome (ARDS), multiple organs dysfunction syndrome (MODS), pneumonia, pulmonary embolism, death rate as well as the length of ICU and hospital stay. Postoperatively patients received antibiotics and low molecular weight heparin (clexane 40 mg S/C). The effect of early total care/damage control orthopaedics (DCO) on surgical fixation is also studied. Bilateral femoral fractures were excluded from the study. They represent separate entity with different Results: The mean patients age is 38.61±10.28 (range 20-60 years). We followed Rape classification to group the patients on the basis of their clinical status. There are derangement of one or more vital functions along with fracture of femur or pelvis. We targeted to achieve control of bleeding, haemodynamics and ventilation. Subsequently the clinical status of the patient guided us to follow the policy of ETC or DCO. In our series ETC is carried out on 33 patients after resuscitation. 9 of them deteriorated after surgical stabilization of femur/pelvis. Early total care is effective in 27 stable patients (75%). Damage control orthopaedics is followed in 4 unstable patients (11.11%) 9 borderline cases in our study developed ARDS after ETC (19.4%). The mean follow-up period is 10.08+1.11 (range 9-12 months). Bony union is achieved in all cases. Conclusion: The results of our series of multiple trauma patients indicate that the best orthopaedic approach cannot be predetermined definitely at the time of presentation of patient to emergency room. Early total care is indicated in a stable patient within 24-48 hours after injury. Damage control orthopaedics is adopted in unstable patients preferably between 5th-10th days. Effectiveness of resuscitation plays important role. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the result of percutaneous pinning in displaced supracondylar fracture of humerus with two crossed K wires in children and to compare the results with the published literature. Study design: This is a descriptive observational study. Place and duration: This study is conducted at Orthopaedic unit KTH Peshawar, from June 2010 to June 2013 on 80 patients with displaced supracondylar fracture of humerus. Material & Methods: Eighty patients with closed supracondylar humerus fractures admitted through emergency were included in this study. Patients above the age of 12 years, open fracture, poly trauma and undisplaced type I fracture were excluded while patients with closed supracondylar humerus type II and III fractures below the age of 12 years were included in the study. All fractures were treated with close reduction and percutaneous pinning with two crossed K wires under general anesthesia. Follow up was done for one year with assessment of radiological healing and clinical outcome that is union, joint movement, deformity neurovascular injurias. Results: Among 80 patients. 50(62.5%) were male and 30(37.5%) female. Left side involved in 35(43.75%) patients and right side in 45 (56.25%) patients. The mean age at the time of presentation was 6.5 years.Among 80 patients 25 were type II and 55 were type III according to Gartland's classification. Union was achieved in all patients within 3 to 5 weeks. The mean period or fracture union was 4.8 weeks. All patients got union in an acceptable position. 1 patients (1%) developed compartment syndrome. Pin site infection was the common complication and was noted in 12% patients. No deep infection was noted in these cases, and they were treated with oral antibiotics and dressing. All recovered after removal of pins. Neuro-pyrexia of the ulnar nerve was noted in 2%. No iatrogenic vascular injury was noted. Complete range of movement was achieved after 4 to 6 week. None of the patients developed loss of fixation or cubitus varus deformity. Excellent results were in 60%, good results in 39% patients, poor results in only two (2%) patient. Conclusion: Closed reduction with two cross K wires pinning is a safe and effective method for treating supracondylar fracture of humerus and gives excellent results regarding healing and function. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical and radiological outcome between minimally invasive plate osteosynthesis, open reduction and internal fixation in distal tibial fractures. Methods: This randomized controlled trail study was conducted in the department of Orthopedics KTH hospital Peshawar from March 2012 to Sep 2014, 22 patients presenting with closed, displaced, distal tibial fractures without ankle involvement were divided into two groups using lottery method. Group-A underwent open reduction and internal fixation (ORIF) and Group-B underwent minimally invasive plate Osteosynthesis (MIPO). A written informed consent is taken from every patient. Results: The mean age of the patients is 42.45 ± 8.25 years in Group-A and 41.35 ± 19.56 years in Group-B (p=.699). Mean operative time was insignificantly higher in Group-B (73.90 ± 5.1 5 vs. 70.75 ± 6.10 minutes; p=086) as compared to Group-A. Mean VAS score for post-operative pain (6.40 ± 1.05 vs. 4.45 ± .95; p=.000) and mean length of hospital stay (4.35±1.04 vs. 2.70 ± .73 days; p=000 was significantly higher in Group-A as compared to Group-B. Ten patients in Group-A developed flap necrosis compared to 3 in Group-B (30% vs. 0%; p=.008). Five Patients in Group-A. developed wound infection in 2nd post-operative week compared to only 3 patient in Group-B ;25% vs. 5%, p-.077). On 12th postoperative week, radiological union is evident in all the patients (21%) of Group-B compared to 19 patients (80%) of Group-A, and this difference is significant (p=.035). Conclusion: We concluded that MIPO offers the advantage of solid tissue protection thus minimizing infection and the complications without any compromise in radiological healing of distal tibial fractures.. [ABSTRACT FROM AUTHOR]

Side effects of high concentration of drug, related to high initial burst release still are major challenges of pharmacotherapy. This field demands novel drug release control methods. In this research, cellulose nanocrystals were modified via physical adsorption of polyamidoamine and used as an additive into electrospun cellulose acetate matrix. Characterizations confirmed successful modification of CNC, intactness of crystallinity, and perfect antibacterial activity. Zeta potential of the nanoparticles shifted from -12 eV to +23 eV. The modified CNC demonstrated 17800 cm−1 Stocks shift. The addition of modified CNC to cellulose acetate reduced the nanofiber diameter up to 75% and improved mechanical properties. Electrospun cellulose acetate containing modified CNC perfectly controlled the release rate of tranexamic acid and improved the ultimate release amount of the gatifloxacin. The results of this work pave the way for preparing safe clinically applicable antibacterial bioscaffolds with controlled drug release, without needing any toxic reagent and chemical reaction.

Objectives: To determine the frequency of lag screw cut out in intertrochanteric fractures fixed with dynamic hip screw and to identify the possible contributing factors for screw cut out. Study Design: Descriptive case series. Place and Duration of the Study: Orthopaedic & Traumatology Unit"A" Lady. Reading Hospital Peshawar from January 2014 to January 2017. Material and Methods: Patients of either gender or age with intertrochanteric fractures fulfilling the inclusion and exclusion criteria were fixed with dynamic hip screw (DHS). Post operatively fracture reduction, position of screw in head of femur and tip apex distance were calculated on anterio posterior and lateral radiographs. All the patients were reviewed fortnightly for two month and then monthly for six months for lag screw cut out on radiographs. Results: Total 110 patients mean age 72(range 22 to 98 years) years were fixed with dynamic hip screw. Lag screw cut out was noted in 12(10.9%) patients with 4(33.3%) male and 8(66.6%) female patients. The mean age was 62 years. Right side was involved in two (16.6%) patients while left in ten (83.3%) patients. Radiographically fracture reduction was poor in most (50%, n=6)) patients. The mean tip apex distance (TAD) was 32mm (range 24 to 40 mm). Majority (75%, n=9) of cut out screw were in superior portion of the head of femur. Four (33.3%) patients had screw cut out at 8th week postoperatively while eight (66.6%) patients had screw cut out at 12th week. Conclusion: Lag screw cut out wasthe most common mechanical complication after fixation of intertrochanteric fractures and all of the cut out patients were elderly with inadequately reduced fracture, superiorly placed lag screw and longer tip apex distance. [ABSTRACT FROM AUTHOR]