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Electron and photon beams demonstrate extraordinary characteristics useful for the treatment of cancer. These characteristics are essential to analyze before the calibration of the linear accelerator with dual energies. This study focused on the dosimetric characteristics of the different energies of electron beam for different field sizes. The basic objective of this work was to calculate the dosimetric parameters and characteristics of the electron beam, especially depth dose characteristics along the central axis. In this work, 6 MeV, 9 MeV, 12 MeV, 15 MeV and 18 MeV of electron beam and 6 MV and 15 MV of photon beam with different field sizes were used. The characteristics of the depth dose of electron and photon beams in water were analyzed to optimize the radiation quality for radiation treatment planning. The different beam characteristics are due to different interactions that occur between electron beams giving them a definite range, whereas photon beams are attenuated leading to dose deposition and a much larger range with no definite end. Depth dose characteristics of electron and photon beams are not similar since the interaction of these beams with matter depends on their quality. Attenuation and penetration factors change with changing dosimetric parameters. A complete analysis of the dosimetric characteristics of electron and photon beams helps to choose the more accurate beam for the treatment of cancer. This work helps to increase accuracy in the treatment of cancer with radiotherapy. Copyright(c) The Authors

Soy isoflavones (SI) have strong estrogenic effect in tissues by binding to estrogen receptors and might be beneficial for women with polycystic ovarian syndrome (PCOS) by reduction in testosterone, cholesterol, insulin, weight gain, inflammatory markers, and oxidative stress. The study was planned to examine the effect of various levels of SI on nutrient intake, digestibility, lipid profile, insulin, and reproductive hormones of estradiol valerate (4 mg/rat/IM) PCOS induced rat models. Thirty‐six Wistar 45 days old rats weighing 95 ± 5 g were divided into 4 groups, each having 9 rats: C (control: without SF), SF10 (SF 0.10 g/kg BW), SF15 (SF 0.15 g/kg BW), and SF20 (SF 0.20 g/kg BW). SF was given through the oral gavage. Food and water were offered ad libitum, and intake was recorded daily. During last week of trial, collected feces by total collection method and blood samples were used to calculate nutrient digestibility and biochemical analysis, respectively. Estrogen, progesterone, and prolactin were (p, The objective of this study was to investigate the effect of different levels of soy isoflavones on blood insulin, lipid, and reproductive hormones profile of the female rats with PCOS.

Objective: The study investigates the association between perceived primary parenting styles and attachment styles between single parent children and children living with both parents. Methods: A correlational research study was carried out on a sample of 200 children, 100single parent children (Boys=50; Girls=50) taken from single parent families living in child protection and welfare bureau and 100 children living with both parents (Boys=50; Girls=50) enrolled in different grades taken from a private school of Lahore, through purposive sampling strategy. The study was carried out at Lahore Garrison University from September 2017 to march 2017.After obtaining permission from authorities, children were given Parental Authority Questionnaireand the Urdu version of Inventory of Parental and Peer attachment. Results:The results showed that there was a significant negative correlation between permissive parenting styles with mother’scommunication (*p

Purpose: To find out if we can use topical anesthetic eye drops among different patients for one month after opening the bottle without any risk of causing corneal or conjunctival infections and endophthalmitis.Study Design: Experimental studyPlace and duration of study: Department of Ophthalmology DHQ Teaching Hospital, Gujranwala from 22nd May 2018 to 22nd June 2018.Materials and Methods: This was an experimental study in which topical anesthetic eye drops containing proparacaine hydrochloride 0.5% were tested daily to see if any bacterial/fungal growth occurs in the bottle containing eye drops or not. Same bottle was used in patients presenting in outdoor and indoor departments. Samples taken from the bottle contents were cultured on different media to see growth of fungi or bacteria if any.Results: After 1 month of daily culturing on agar plates, no micro-organism growth was seen.Conclusion: Topical anesthetic eye drops containing proparacaine hydrochloride as the main ingredient and benzalkonium chloride as the preservative (Alcaine®) can be used safely for 1 month after opening in different patients without any risk of causing infectious keratitis, conjunctivitis or endophthalmitis.Keywords: Topical anesthetic, Culture medium, Risk factor, Endophthalmitis

We present a case of23 year old female, who presented with history of decreased central vision in the right eye for 3 months. Best corrected visual acuity was 6/36 OD and 6/9 OS. Anterior segment was normal OU. Fundus examination revealed a yellowish white peripapillary lesion extending up to the macula in the right eye. A similar lesion was seen in the left eye. OCT macula showed central macular thickness of 193 – 323 µm with cystoid spaces and 290 – 436 µm with serous retinal detachment in the right and left eye respectively. CT scan showed a hyper dense opacity similar to the bony tissue OU. All lab investigations were normal. The patient was diagnosed as a case of bilateral choroidal osteoma. After 6 months no progression or complication was noted. Key Words: Choroid, Osteoma, Choroidal Neoplasm.

Background showers triggered by hadrons represent over 99.9% of all particles arriving at ground-based gamma-ray observatories. An important stage in the data analysis of these observatories, therefore, is the removal of hadron-triggered showers. Currently, the High-Altitude Water Cherenkov (HAWC) gamma-ray observatory employs an algorithm based on a single cut in two variables, unlike other ground-based gamma-ray observatories (e.g. H.E.S.S., VERITAS), which employ a large number of variables to separate the primary particles. In this work, we explore machine learning techniques (Boosted Decision Trees and Neural Networks) to identify the primary particles detected by HAWC. Our new gamma/hadron separation techniques were tested on data from the Crab nebula, the standard reference in Very High Energy astronomy, showing an improvement compared to the standard HAWC background rejection method., Comment: Presented at the 37th International Cosmic Ray Conference (ICRC2021), Berlin, Germany - Online

Purpose: To compare the efficacy of local anesthesia during Dacryocystorhinostomy using xylocaine with1:200,000 adrenaline versus 1:50,000 adrenaline.Study Design: Quasi experimental study.Place and Duration of Study: DHQ Hospital, Dera Ismail Khan, from January to December 2019.Material and Methods: We compared two different formulations of local anesthesia duringDacryocystorhinostomy in terms of efficacy of per-operative pain, bleeding and effectiveness of anesthesia. 50patients fulfilling our inclusion criteria were divided in two groups each containing 25 patients. In group A patientsunderwent Dacryocystorhinostomy under local anesthesia using Bupivacaine and the commercially availablexylocaine with 1:200,000 adrenaline while patients in the group B underwent surgery using Bupivacaine,Xylocaine with 1:50,000 adrenaline. Per-operative pain, bleeding and effectiveness of anesthesia were measuredon a numeric scale. Means of pain score, bleeding score and anesthesia effectiveness score were computed andwere compared.Results: In group A, 84% patients were females and 16% were male. In group B, 80% were females and 20%were males. Mean age of patients was 41.04 ± 6.84 and 40.80 ± 8.563 years in group A and B respectively. Meanpain score in group A was 2.20 while in group B was 1.72. Mean bleeding score in Group A was 1.84 while ingroup B was 1.24. Mean Anesthesia effectiveness score in group A was 2.08 while in group B was 2.76.Conclusion: Local anesthesia with concentrated adrenaline (in patients with no cardiac disease or other majorco-morbidity) provides a better control of per-operative pain, bleeding and better anesthesia

Sleep Apnea is a mutual disorder of sleep caused by obstructing airflow due to collapse of the soft tissue surrounding the upper airway of mouth or throat, and normal breathing would start again with a loud snort or choking sound. A traditional identification process of Sleep Apnea is polysomnography, which can only be accompanied in sleep centre with specific announcements, thus it is costly and problematic. In addition, it is utilized for understanding the conditions, without treatment work. Supplementary detecting techniques are Electrocardiogram (ECG), Pulse Oximeter, microphone or taking a video. A few strategies or gadgets have been created to lighten Sleep Apnea, such as; Continuous Positive Airway Pressure(CPAP), APAP (Automatic Positive Airway Pressure), BiPAP(Bilevel Positive Airway Pressure), intraoral mandibular advancement device and surgery. There are some parameters which help lower the chance of Sleep Apnea are; Surgery(uvulopalatopharyngoplasty), Intra-oral mandibular advancement, use of anti-snore pillows, weight control, sleeping in sideways position (Night Balance) and positional Therapy. In this paper, we propose and implement IoT based real time auto adjustable smart pillow system, we targeted only obstructive Sleep Apnea, initially it detects the attack and adjust the pillow accordingly if patient does not recover due to high Apnea attack it produces an alarm, so that the person lying beside the patient would awake to cater the situation and doctor would also be notified through IoT. Likened with current analysis or usage devices, the pillow is comfortable, non-invasive, inexpensive and portable, which can be used at home or during travelling.

Iliopsoas abscess (IPA) is rare in children but exceptional in neonates. Fewer than 30 cases have been reported in literature. We present a case of 11-day neonate who was brought with left inguinal swelling along with significantly raised white cell count and positive C-reactive protein (CRP). Ultrasound and CT scan confirmed the diagnosis of IPA. Drainage of abscess was done by open method through extraperitoneal approach. Systemic antibiotics, according to culture and sensitivity, were given and the neonate recovered well and was sent home. IPA can be primary or secondary. Primary IPA is more common in neonates unlike adults, who have secondary IPA in majority of the cases. Primary IPA spreads by hematogenous route from distant occult source in the body. Staphylococcus aureus is the causative organism in most cases of primary IPA. Septic arthritis of hip joint is among important differentials. Ultrasound and CT scan are helpful in diagnosis in the presence of raised white cell count and positive CRP. Drainage of pus by open method and through extraperitoneal approach is preferred method although ultrasound-guided percutaneous drainage has also been done with successful outcome. In conclusion, neonatal IPA is extremely rare entity and can easily be overlooked. High index of suspicion is required for its diagnosis in cases where a neonate presents with groin swelling, limited or painful motion of leg and fever.

Purpose: To determine the risk of ocular infections due to topical multi-dose anaesthetic eye drops in patients one month after opening the bottle. Study Design: Quasi experimental study. Place and duration of study: Department of Ophthalmology DHQ Teaching Hospital, Gujranwala from 22nd May 2018 to 22nd June 2018. Materials and Methods: In this study topical anaesthetic eye drops containing proparacaine hydrochloride 0.5% as main ingredient and benzalkonium choride as preservative (Alcaine�) were tested daily to see if any bacterial/fungal growth occurs in the bottle containing eye drops or not. Same bottle was used in patients presenting in outdoor and indoor departments. Samples taken from the bottle contents were cultured on different media to see growth of fungi or bacteria. Patients who already had keratitis, conjunctivitis, corneal opacities, thin corneas and having dry eyes which were prone to get infected were excluded from this study. Results: There were 60 patients included in our study and they were divided in two groups. Group A included those who presented in the outdoor department and group B comprised of those admitted for various operative procedures. There were 30 patients in each group. All patients were adults (18-60 years). After 1 month of daily culturing on agar plates, no micro-organism growth was seen in both groups. Conclusion: Topical anaesthetic eye drops can be used safely for 1 month in different patients after opening the bottle without any risk of causing infectious keratitis, conjunctivitis or endophthalmitis. Keywords: Proparacaine, Culture medium, Endophthalmitis.

The research was carried out with the end goal to give a detailed survey of current research to use Algae in order to remove nutrients such as Phosphorus (P) and Nitrogen (N) and also to determine treatment of synthetic waste water by using Algae. In this study, a Photobioreactor was fabricated on the basis of utilization of minimum space and suitable materials to maintain the quality and objective of this project. Total numbers of tank in Photobioreactor were 5 and total volume of water was 60 liters. Synthetic wastewater was produced using different quantities of Dextrin, Yeast extra, Sodium Carbonate, Soluble Starch, Sodium Dihydrogen Phosphate, Washing Powder, Potassium Sulfate, Settled sewage, Shampoo etc since the domestic wastewater contains a number of unwanted constituents. The Photobioreactor helped in storing synthetic waste water, providing growth medium for algae, settle down the sediments, filter out the remaining sediments and finally storing the clean water. The results obtained from the study showed considerable decrease in pH, Chemical oxygen demand (COD), biochemical oxygen demand (BOD), phosphates, sulfates and nitrates. The initial pH was determined to be 7.8 whereas after treatment it reduced to 7.5. BOD reduced from 22 mg/L to 15.5 mg/L, COD reduced from 15 mg/L to 9.5 mg/L, Nitrates reduced from 39.5 mg/L to 20 mg/L, Sulfates reduced from 14.5 mg/L to 10 mg/L and Phosphates reduced from 12 mg/L to 7 mg/L. Thus the reduction in various numbers of nutrients indicated that wastewater treatment using Algae is quite favorable in terms of economic and ecological point of view. Water collected at the end of the process was clean enough to be used in daily life routines.The research was carried out with the end goal to give a detailed survey of current research to use Algae in order to remove nutrients such as Phosphorus (P) and Nitrogen (N) and also to determine treatment of synthetic waste water by using Algae. In this study, a Photobioreactor was fabricated on the basis of utilization of minimum space and suitable materials to maintain the quality and objective of this project. Total numbers of tank in Photobioreactor were 5 and total volume of water was 60 liters. Synthetic wastewater was produced using different quantities of Dextrin, Yeast extra, Sodium Carbonate, Soluble Starch, Sodium Dihydrogen Phosphate, Washing Powder, Potassium Sulfate, Settled sewage, Shampoo etc since the domestic wastewater contains a number of unwanted constituents. The Photobioreactor helped in storing synthetic waste water, providing growth medium for algae, settle down the sediments, filter out the remaining sediments and finally storing the clean water. The results obtained from the s...

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Nurses who are educationally prepared can make a difference in the outcome of health care. It is a consensus that nurses need to possess advanced up-to-date knowledge that enable them to analyze complex problems, take critical decisions, and move on to appropriate actions. The objective of this study was to identify, the demographic profile of the selected respondents and the barriers to higher education in nursing as perceived by the respondents selected from private and public hospitals.

In contrast to females, male faecal incontinence has received little attention. We investigate its pattern and management at a large UK teaching hospital.Men presenting with faecal incontinence between January 2006 and December 2008 were identified from a gastrointestinal physiology database and classified into faecal leakage or faecal incontinence on the basis of symptomatology. Demographics, Cleveland Clinic incontinence score (CCIS), aetiological factors, investigations and treatments were collected by case note review and compared to clinical outcomes.Forty-three symptomatic patients were identified with faecal incontinence, in which 33 were classified as having faecal leakage (FL) and ten as faecal incontinence (FI). The mean CCIS was 10.7 (range, 4-14) and 14.2 (8-20) for FL and FI, respectively. The FL group had normal anal sphincter pressures, whilst the FI group had significantly lower mean resting pressure, 45 mmHg (8-90 mmHg), and mean squeeze pressure, 62.1 mmHg (18-110 mmHg). Thirteen out of 33 patients in the FL group and seven out of ten in the FI group had undergone previous anorectal surgery and had demonstrable sphincter defects whilst in the remainder, no definite aetiological factor could be identified. All patients in the FL group improved with lifestyle changes (28/33) or biofeedback (5/33). Six patients in the FI group required surgical intervention (3/6, collagen injection; 1/6, graciloplasty; 1/6, sacral nerve stimulation; 1/6, rectopexy).Patients presenting with FL characteristically have normal anorectal physiology and respond to non-operative measures, as compared to patients with FI who tend to have weakened anal sphincters, previous history of anorectal surgery, and more often require surgical intervention.