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Submerged spillways with large capacity outlets are generally provided below the dam crest to perform the dual functions of flood disposal and sediment flushing. Flood water passing through these spillways exhibits turbulent behavior. Moreover; hydraulic analysis of such turbulent flows is a challenging task. Therefore, the present study aims to use numerical simulations to examine the hydraulic behavior of submerged spillways constructed at Mangla Dam, Pakistan. Besides, the hydraulic performance of aerator was also evaluated at different operating conditions. Computational fluid dynamics code FLOW 3D was used to numerically model the flows of Mangla Spillway. Reynolds-averaged Navier–Stokes equations are used in FLOW 3D to numerically model the turbulent flows. The study results indicated that the developed model can simulate the submerged spillway flows as it computed the flow parameters with an acceptable error of up to 6%. Moreover, air concentration computed by model near spillway chute bed was 3% which raised to more than 6% after the installation of ramp on aerator which showed that developed model is also capable of evaluating the performance of submerged spillway aerator.

Aim: To assess level of awareness in nurses regarding risk factors related to carcinoma breast at a tertiary care public hospital Lahore Methods: It was a descriptive study. This study took place at Mayo Hospital Lahore. The nurses of different departments especially the oncology department were recruited. A sample of n=300 was recruited through random probability sampling methods. An adopted close ended questionnaire was applied. The data was interpreted and analyzed by SPSS version 25. The data was analyzed in the form of tables and graphs. Results: Of the participants nurses 67% knew that smoking is a risk factor for carcinoma breast. It was also found that 59% agreed that exposure to another person’s cigarettes smoke also can cause breast carcinoma. Results also suggest that 88% agreed that drinking more than one glass of alcohol a day also can cause breast cancer. Moreover results suggest 71% agreed that being overweight (BMI>25) also can cause breast carcinoma. Results also suggest that 54% agreed that being over 70 years old can lead to breast cancer. Conclusion: Overall knowledge related to risk factors of breast carcinoma among nurses was satisfactory. Top rating risk factors were, smoking cigarettes and family history. Moreover, nurses knowledge regarding breast carcinoma symptoms and signs was also good among participants MeSH: Carcinoma Breast, Awareness, Risk Factor

Objective: To determine the depression in end stage renal disease patients on hemodialysis at Liaquat University Hospital. Study Design: Cross sectional study. Settings: Department of Medicine & Nephrology at Liaquat University Hospital Hyderabad Pakistan. Duration: Six months from February 2015 to January 2016. Methodology: All the Male or Female of age 14-70 years having ESRD patients on maintenance hemodialysis for >3 months period were included. Questionnaire proforma was filled and patient who score 5 or more on depression scale were labeled as positive for depression. An informed written consent for the study was obtained from the patients and their relatives. All the data was recorded on a pre-designed proforma. Data was analyzed by using SPSS version 20. Results: The mean age of patients was 52.21±7.90 years. There were 69.9% males and 30.1% female patients. Out of all 35.8% patients were employed while 64.2% patients were unemployed. Most of the patients 92.3% were married and 7.7% were unmarried. The depression in patients with end stage renal disease was found in 47.2%patients. Conclusion: The frequency of depression in end stage renal disease patients on hemodialysis at Liaquat University Hospital was found to be higher as 47.2%. However, there is need to involve the expert Psychiatrists to cope with this higher problem of depression to improve their quality of life by giving them additional anti-depressant along with hemodialysis.

Objectives: To describe the pattern of thoracic surgical diseases at a tertiary care hospital in South-Punjab Pakistan. Study Design: Descriptive, cross-sectional study. Setting: Nishtar Medical University hospital Multan, Pakistan. Period: From 01-01-2018 to 31-12-2018. Material & Methods: All the patients who were admitted through the out-patient department or referred from other units, over the year 2018, were analyzed. Variables under consideration included mode of admission, patient’s diagnosis, a surgical procedure performed, type of anesthesia-induced and the mortality. Data were analyzed using IBM SPSS statistics version 20. Mean and percentages were used for numerical data. Data were presented using descriptive statistics. Results: A total of 634 patients (370 females and 264 males) were admitted during the study period, out of which 566 came through the out-patient department while the remaining were referrals from other wards. In total, 697 surgeries were performed with esophagoscopy and dilation being the most frequent (38.7%), followed by tracheostomy (16.3%). Corrosive intake (49.8%) accounted as the cause for the highest number of admissions followed by empyema thoracis (11.4%). Conclusion: Local study on the topic of Thoracic Surgery audit, in terms of surgeries performed and variation of cases presented has become an absolute necessity for better health care planning of Pakistan. The pattern of thoracic surgical diseases varies considerably in different regions and populations. The evaluation of these disease patterns can help to adopt appropriate preventive measures to reduce the incidence of these diseases. Furthermore, it can significantly improve our health system.

We aimed to investigate the interventions of remdesivir in both diabetic and nondiabetic individuals who were suffering from a severe infection of novel coronavirus disease (COVID‐19). In this study, we aimed to explore the relationship between therapeutic effectiveness of remdesivir and complications of diabetes mellitus by observing the recovery period among diabetic and nondiabetic patients associated with COVID‐19 infection. A total of 850 COVID‐19 patients were recruited for this study, out of which 48% were diabetic and 52% were nondiabetics. The results of this study indicated that nondiabetic individuals administered with remdesivir recovered from COVID‐19 within 10 days showing a 95% confidence interval (p, Highlights 1.Remdesivir can be considered as possible therapeutic agent for the treatment of COVID‐192.COVID‐19 patients having diabetes mellitus showed a delayed recovery when treated with remdesivir as compared to non‐diabetic COVID‐19 patients.3.Non‐diabetic patients treated with remdesivir showed a faster recovery as compared with that of diabetic COVID‐19 patients.

Calcium (Ca) is a macronutrient and work as a modulator to mitigate oxidative stress induced by heavy metals. Present work was conducted to elucidate the role of Ca in modulating growth, physio-biochemical traits, and cellular antioxidant defense system in Zea mays L. seedlings under Cd stress. The experiment was designed in a complete randomized design with two levels of Cd (0 and 150 µM) and six levels of Ca (0, 0.5, 1, 2.5, 5 and 10 mM). Maize seedlings exposed to Cd at150 µM concentration showed a notable decrease in growth, biomass, anthocyanins, chlorophylls, and antioxidant enzymes activities. Higher level of Cd (150 µm) also caused an upsurge in oxidative damage observed as higher electrolyte leakage (increased membrane permeability), H2O2 production and MDA accumulation. Supplementation of Ca notably improved growth traits, photosynthetic pigments, cellular antioxidants (APX, POD and ascorbic acid), anthocyanins and level of osmolytes. The significant improvement in the osmolytes (proteins and amino acids), and enzymatic antioxidative defense system enhanced the membrane stability and mitigated the damaging effects of Cd. The present results concluded that exogenously applied Ca can potentially improve growth by regulating antioxidants and enable maize plants to withstand the Cd toxicity.

Background Multiple sclerosis (MS), as a neurodegenerative disorder, exhibits inflammation and oxidative stress hallmarks. Objective The research aims to know any disturbances in haematological parameters and antioxidant system of relapsing-remitting multiple sclerosis (RRMS) patients in the Kurdish population. Methods A case-control research meeting following the McDonald criterion was conducted on 100 RRMS patients and 100 controls. Results Lipid peroxidation products of malondialdehyde (MDA), erythrocyte sedimentation rate (ESR), and total leucocyte counts (TLCs) were increased significantly, but copper (Cu+2) and superoxide dismutase (SOD) were decreased significantly while nitric oxide metabolites (NOx) and lymphocyte were not changed significantly if compared with that of controls. Conclusion Findings from our study revealed that some defects were detected in haematological profiles in the Kurdish population and disturbance of immunological parameters. In addition, the utilization of Cu+2 supplement as an effective modality for RRMS patients may be beneficial.

Background: Hepatitis B virus (HBV) is the aetiological agent of transfusion-transmitted hepatitis globally. Beta thalassaemia major individuals are at greater risk of contracting HBV infection due to multiple blood transfusions required for the medical management of these patients. Based on HBV genetic variability, it is divided into 10 genotypes. The determination of HBV genotypes has significant implications for clinical management and treatment regimens. Aim: This study was performed to assess the HBV epidemiology and circulating genotypes in multi-transfused β-thalassemia major patients with the aim to be considered while formulating the treatment pattern taking into account particular needs of thalassaemia patients. Materials and Methods: This study was performed from September 2018 to June 2019, at the Department of Pathology and Transfusion Medicine, Shaheed Zulfiqar Ali Bhutto (SZAB) Medical University, Islamabad. A total of 2,260 thalassaemia patients were enrolled in the study. The study was endorsed by the Ethics Committee of the SZAB Medical University, Islamabad. The samples were serologically screened for HBsAg on the LIAISON® XL Murex HBsAg Quant assay (DiaSorin S.p.A., Italy) a chemiluminescence based immunoassay (CLIA). HBV quantitative PCR kit was used to measure the HBV DNA in serum samples. The HBV genotypes were determined using universal primers targeting the P1 and S1 region amplification. Results: Of 2,260 thalassaemia patients, 64.6% were males while 35.4% were females. The HBsAg was identified in 98 individuals (4.33%). The PCR analysis was done for these 98 patients and in this cohort, genotype D was 59.18% (n = 58), genotype A was 21.42% (n = 21) while genotype C was 19.38% (n = 19). Conclusion: The determination of HBV genotypes in the multi-transfused patients is key to the effective management of chronic HBV patients as the severity and course of the disease is dependent on a specific type of genotypes. Quality assured screening of donated blood will prevent the incidence of HBV in thalassaemia patients.

This paper presents a novel patient-specific seizure detection approach using wavelet decomposition of multi-channel EEG data and hand-engineered features extracted from the decomposed data. EEG data of all channels of each patient are segmented into four second segment lengths, and these segments are decomposed using discrete wavelet transform into four frequency bands corresponding to the δ, θ, α and β EEG rhythms. Three features are then extracted from each of these bands, which are used to classify the seizure and non-seizure segments. The proposed approach does not require any feature processing, or any post-processing for obtaining the seizure detection results. The CHB-MIT database with data of 23 pediatric patients is used for validation of the proposed seizure detection approach using five classifiers, and accuracy, sensitivity and specificity values of 99.6%, 99.8% and 99.6% respectively, averaged over all 23 patients, are obtained using five-fold cross-validation method. The obtained seizure detection results are compared with the results of other studies using the same database, and shown to out-perform the state-of-the-art. Furthermore, the obtained results are consistent over the data of all the patients, thereby demonstrating the robustness of the approach. The computational efficiency of the proposed approach, which is another highlight of the approach, is also illustrated in the form of metrics. The suitability of the approach for seizure detection in long-term multi-channel EEG recordings is also discussed.

Mitochondria are considered the power house of cells where ATP is generated for cellular metabolism, and they also act as a crucial regulator of the intrinsic apoptosis pathway. During ATP synthesis, reactive oxygen species (ROS) are produced as secondary products. Overproduction of ROS can promote mitochondrial DNA mutation, dysfunction and depolarization of the mitochondrial membrane, ultimately resulting in cell death. Therefore, the destruction of mitochondria would be an effective therapeutic approach to kill malignant tumors. Herein, we formulated a PEGylated α-TOS polymeric micellar system loaded with 10-hydroxycamptothecin (HCPT) drug to inhibit the nuclear topoisomerase I enzyme and disrupt the mitochondrial membrane to induce apoptosis. In addition, tumor-penetrating CRGDK peptide-functionalized TPGS2k specifically bound to the Nrp-1 receptor to facilitate higher cell uptake of polymeric micelles by tumor cells. Experimental studies confirmed that HCPT-loaded and peptide-functionalized TPGS2k-TOS micelles (HLPFTTM) showed an enhanced anti-cancer effect in A549 cancer cells.

Introduction Previous neuroimaging studies of Parkinson's disease (PD) patients have shown changes in whole-brain functional connectivity networks. Whether connectivity changes can be detected in the early stages (first 3 years) of PD by resting-state functional magnetic resonance imaging (fMRI) remains elusive. Research infrastructure including MRI and analytic capabilities is required to investigate this issue. The National Institutes of Health/National Institute of General Medical Sciences Center for Biomedical Research Excellence awards support infrastructure to advance research goals. Methods Static and dynamic functional connectivity analyses were conducted on early stage never-medicated PD subjects (N = 18) and matched healthy controls (N = 18) from the Parkinson's Progression Markers Initiative. Results Altered static and altered dynamic functional connectivity patterns were found in early PD resting-state fMRI data. Most static networks (with the exception of the default mode network) had a reduction in frequency and energy in specific low-frequency bands. Changes in dynamic networks in PD were associated with a decreased switching rate of brain states. Discussion This study demonstrates that in early PD, resting-state fMRI networks show spatial and temporal differences of fMRI signal characteristics. However, the default mode network was not associated with any measurable changes. Furthermore, by incorporating an optimum window size in a dynamic functional connectivity analysis, we found altered whole-brain temporal features in early PD, showing that PD subjects spend significantly more time than healthy controls in a specific brain state. These findings may help in improving diagnosis of early never-medicated PD patients. These key observations emerged in a Center for Biomedical Research Excellence–supported research environment.

Recently, there is increasing evidence that coronavirus disease 2019 (COVID-19) causes men to experience more serious symptoms and have a higher mortality rate than women, but the association between sex and immune response stays unknown till now, and weather patient’s prognosis associated with sex or not is another vague in COVID-19. In this study, the SARS-CoV-2-specific antibody titer test was performed for 727 patients who were a positive RT-PCR result for COVID-19 and we determined the difference in immune response in both genders. Patients were divided into two groups based on their genders, which were 383 males and 344 females. Plasma was collected from the patients after 17 days of diagnosis with COVID-19, and the concentrations of specific antibodies (IgG and IgM) was measured by multiparametric immunoassay system (VIDAS). Results demonstrated that there was no significant difference in both IgM and IgG production in male participants compared to women. Moreover, despite there was a weak significant positive association between age and IgM in male patients, while there was no significant correlation between IgG and age for the same gender. On the other hand, a slight positive correlation between IgM and IgG with age was observed in female participants. Finally, it concluded that there was no sex biases in patients with COVID-19 in Erbil, Iraq. So, these findings are crucial to treat and care male and female’s patients infected with COVID-19 at hospitals.

Background: The anterior cruciate ligament (ACL) stabilizes the joint during hyperextension and prevents anterior translation over femur. The objective of this study was to determine the diagnostic accuracy of magnetic resonance imaging (MRI) in detecting ACL injury by taking arthroscopy as gold standard in patients with traumatic knee injury.Methods: Patients fulfilling the study criteria were treated with clinical examination, MRI and then arthroscopy at the Department of Orthopedics and Spine in the Ghurki Trust Teaching Hospital, Lahore. The accuracy, sensitivity and specificity of MRI in diagnosing the anterior cruciate ligament injury were calculated based on arthroscopic findings. All the data were analyzed using SPSS 17.0 version.Results: A total 185 patients were included. 91.1% were males and 8.9% were females with Mean age of 28.25±0.433. The accuracy of MRI in diagnosing the anterior cruciate ligament was 91.89%, with sensitivity of 93.33%, specificity of 85.71%, positive predictive value of 96.55% and the negative predictive value of 75%.Conclusion: MRI is accurate and non-invasive modality for the assessment of ligamentous injuries. It can be used as a first line investigation to patients with suspicion of ACL injury.

Recent results discovered the protective roles of methane (CH4) against oxidative stress in animals. However, the possible physiological roles of CH4 in plants are still unknown. By using physiological, histochemical and molecular approaches, the beneficial role of CH4 in germinating alfalfa seeds upon copper (Cu) stress was evaluated. Endogenous production of CH4 was significantly increased in Cu-stressed alfalfa seeds, which was mimicked by 0.39 mM CH4. The pretreatment with CH4 significantly alleviated the inhibition of seed germination and seedling growth induced by Cu stress. Cu accumulation was obviously blocked as well. Meanwhile, α/β amylase activities and sugar contents were increased, all of which were consistent with the alleviation of seed germination inhibition triggered by CH4. The Cu-triggered oxidative stress was also mitigated, which was confirmed by the decrease of lipid peroxidation and reduction of Cu-induced loss of plasma membrane integrity in CH4-pretreated alfalfa seedlings. The results of antioxidant enzymes, including ascorbate peroxidase (APX), superoxide dismutase (SOD), catalase (CAT), and guaiacol peroxidase (POD) total or isozymatic activities, and corresponding transcripts (APX1/2, Cu/Zn SOD and Mn-SOD), indicated that CH4 reestablished cellular redox homeostasis. Further, Cu-induced proline accumulation was partly impaired by CH4, which was supported by the alternation of proline metabolism. Together, these results indicated that CH4 performs an advantageous effect on the alleviation of seed germination inhibition caused by Cu stress, and reestablishment of redox homeostasis mainly via increasing antioxidant defence.

Objective To assess the effect of intravenous dexmedetomidine on subarachnoid anesthesia with the help of hyperbaric bupivacaine when administered as a bolus or as an infusion. Materials and methods This randomized control trial was conducted at the Department of Anesthesia, Nishtar Hospital, Multan, Pakistan, from January 2017 to December 2018. Seventy patients were enrolled in the study. Patients were segregated into three groups. At the T10 level, a sensory blockade was noted. The motor blockade was also periodically measured until a modified Bromage score of three was achieved. The depth of sedation was measured with the help of the Ramsay Sedation Scale score. Oxygen saturation and other factors were also measured and recorded. Nausea, vomiting, diarrhea, and pruritus were the adverse effects noted during the study. To check and compare the statistical differences among the variables from different groups, the Chi-square test and analysis of variance test were performed. A probability (p) value of 2 (i.e., 3 or 4) in five patients from Group B, 19 from Group BDexB, and 17 from the group receiving intrathecal bupivacaine plus dexmedetomidine as an infusion (Group BDexI). Between these groups, a statistically significant difference was found (p

Excessive use of synthetic chemicals for the treatment of different diseases is associated with several adverse health effects. Because of this, scientists are searching for natural sources of therapeutic agents and other substances which protect the body from various ailments and disease. A diverse group of bioactive compounds from plants can be extracted and may be used for health purposes. Use of bioactive compounds is an appropriate alternative to synthetic medicines. Flavonoids are polyphenolic secondary metabolite phytochemicals which can be effectively used as nutraceutical agents. In order to shed light on the importance of flavonoids, this chapter will focus on the potential use of flavonoids against different diseases such as diabetes, cancer, hepatitis, osteoporosis, as well as other microbial, and viral infections. The possible mechanism of action of flavonoids will also be discussed. This chapter will also focus on the sources of these flavonoids, their extraction from these sources, and their usage in different food products as nutraceutical ingredients. The pharmacological importance of flavonoids which may be supplemented in staple food to develop different nutraceutical products will also be reviewed.

Flavonoids are polyphenolic phytochemicals generally found in vegetables, fruits, flowers, nuts, seeds, tea, honey and propolis. In the past plants containing these compounds have been used to cure different diseases. Seeking usage of plants for curing diseases many researchers carried out studies to analyze the antibacterial, antifungal, antiviral, anti-inflammatory and antioxidant properties of extract of different plants containing flavonoids. Similarly, synergistic relationship was found between chemotherapeutics and flavonoids. Cancer is a serious disease due to its high mortality rate. Anticancer mechanism of flavonoids has been described by elucidating its point of intervention in cancer cell cycle. Flavonoids act as bactericidal and bacteriostatic by damaging cytoplasmic membrane, inhibiting energy metabolism and inhibiting synthesis of nucleic acids against different microorganisms. Viral infections are more difficult to control as compared to bacterial. So antiviral drugs are least available, since flavonoids possess antiviral properties, so individual flavonoid compound having antiviral properties may be concentrated or their structure may be modified to enhance their antiviral activity. Phosphorylation of protein by cytokines II is inhibited by flavonoids which help in the cell arrestation of HIV at integration traction phage of virus. Structure activity relationship of flavonoids and human immune deficiency virus (HIV) has also been discussed.

Comparison of oral health status, dental needs and dietary habits of children with autism and their healthy siblings. In this cross-sectional study, oral hygiene measures, sugar consumption and dental examination of 58 Pakistani children with autism spectrum disorder were assessed and compared to 27 of their siblings without autism spectrum disorder. Questionnaires were distributed to their parents regarding oral hygiene measures, dietary habits and past dental experiences. Clinical examination for the presence of dental caries, periodontal disease or parafunctional habits was carried out and findings were associated with the mother’s education. Children with autism had a higher incidence of caries (50%) as compared to their healthy siblings (22.2%). Significant differences were observed between the groups regarding frequency of brushing and independent brushing. Dental plaque was observed on anterior teeth in 24% children with autism spectrum disorder as compared to 14% in the control group. Trauma due to self-injurious behaviour and bruxism was also recorded and compliance during clinical examination was noted in children with autism spectrum disorder. There was no significant difference in sugar consumption between children with autism spectrum disorder and their healthy siblings. Children with autism had greater dental needs and were more prone to developing dental problems as compared to their healthy siblings.

Clomiphene citrate(an anti-estrogen) has the abilities for the secretion of gondaotropin from the anterior pituitary gland. The present study was designed to investigate the effects of CC and hCG on female sex hormones (FSH, Estrogen) and serum biochemical constituents in pre-pubertal Sahiwal heifers. The twelve animals were randomly divided into a) treatment and b) control groups. These animals were grouped on the basis of reproductive status of heifers. The animals in treatment group were fed clomiphene citrate with dose of 300mg/ animal for 9 days. On 10thday of experiment, hCG (IVF-C 5000 iu (hCG) LG Life Sciences, Korea) was injected I/V to both groups. For the serum biochemical constituent’s evaluation and oxidative stress (MDA), blood on day 0, 14 and 28 was collected. Similarly, for hormones evaluation three blood samples per week (on alternate days) for 9 days were collected. The concentrations of both hormones were assessed by ELISA. For the comparison of variables, student t-test was applied. Analysis of data revealed that levels of hormones were higher in treated animals as compared to control. There was significant (p less than 0.05) increase in total cholesterol, triglycerides total protein and sugar.But there was nonsignificant(p> 0.05) effect on liver enzymes (ALT and AST) and MDA. It was concluded that use of CC and hCG increase the FSH and estrogen and few alterations in serum biochemical constituents in the pre-pubertal Sahiwal heifers.

c-Myc is a highly pleiotropic transcription factor known to control cell cycle progression, apoptosis, and cellular transformation. Normally, ectopic expression of c-Myc is associated with promoting cell proliferation or triggering cell death via activating p53. However, it is not clear how the levels of c-Myc lead to different cellular responses. Here, we generated a series of stable RPE cell clones expressing c-Myc at different levels, and found that consistent low level of c-Myc induced cellular senescence by activating AP4 in post-confluent RPE cells, while the cells underwent cell death at high level of c-Myc. In addition, high level of c-Myc could override the effect of AP4 on cellular senescence. Further knockdown of AP4 abrogated senescence-like phenotype in cells expressing low level of c-Myc, and accelerated cell death in cells with medium level of c-Myc, indicating that AP4 was required for cellular senescence induced by low level of c-Myc.

Migraine is a common neurological disorder, prevalent in almost all over the world population and being considered as the 13th major medical disorder among other major disorders across the globe, generally characterized with unilateral or bilateral headache, nausea and vomiting. In developing world, countries like Pakistan, most of the patients are not well aware of migraine headaches, as usually taken for simple headache due to no proper awareness. Usually it is not a contagious condition and most of the time it is recoded as episodic in nature. To assess the migraine, its frequency, symptoms, usual triggers and patients’ perceptions, the present study was conducted. For this purpose a prospective study was carried out based on properly designed questionnaire. The data were collected from 7 educational institutes, including students of Islamia College Peshawar, University of Peshawar, Khyber Medical College, Engineering University Peshawar, Fatima Jinnah College Peshawar, Commerce College Peshawar and Agriculture University Peshawar. Part of data was also collected from patients visiting Khyber Teaching Hospital Peshawar for their headache problems. A total of 270 questionnaires were filled up. About 81 (30.00%) headache cases were recorded, fulfilling the International criteria of Headache. Out of 81 recorded cases, 31 (38.3%) patients were of migraine with aura and 50 (61.7%) were of migraine without aura condition. The prevalence of migraine in the study population was found to be 30.00%. The frequency of female migraine patients was higher i.e. 31 (34.1%) than the male sufferers 50 (27.9%). The present study clearly showed that the higher frequency (65.0%) of migraine exists in the age group of above 30 years age. The most prevalent trigger was found to be tension, which was in parallel followed by the lack of sleep or oversleeping. A family history for migraine was found in migraine patients. Usually the condition was found to limit the routine activities of patients. The present study recorded that most of the migraine patients (40.2%) did not visit doctors at hospital and preferably go for self-medication, which really needs a public awareness in order to properly cope this neurological disorder, which may pose future medical complications as well.

The present study aimed to estimate the prevalence of iron deficiency anemia (IDA) in school-going children. Both Iron deficiency and iron deficiency anemia have considerable adverse effect on human health. Among the different negative health concerns, including stunt development, less developed immunity, lower IQ level, no proper physical work capacity, more fatigue, maternal mortality rates, young ones born with low birth weight, birth complications and infant mortality rates are some of the remarkable health concerns posed by iron deficiency level. Our study sample was consisting of 420 school age children of both genders. The blood samples were collected in EDTA (Ethylenediaminetetraacetic acid) tubes from different school and health maternity centres by trained and veteran persons. Questionnaires were utilised for the data collection, at the time of blood samples collection. Hemoglobin (Hb), hematocrite (Hct), Mean Corpuscular Volume (MCV), Mean Corpuscular hemoglobin concentration (MCHC), white blood cell and red blood cell (RBC) were determine by automatic hematological analyzer model Symex Ks-21 having two reagents, cell pack and Stromatolyser-wwt 500 ml. The total percentage of anemia recorded in school age children was 34.0%. In tehsil Banda Daud Shah, the incidence of anemia was high up to 43.6% while in tehsil Takhti Nasrati and Karak was 32.1% and 26.4% respectively. The percentage was higher in girls (38.9%) than in boys (31.0%). The anemia percentage was recorded high (55.8%) in lower socioeconomic family children, than middle class (32.2%) and upper class (17%). The percentage of anemic children was also high (40%) in age group of 10 - 12 years. Pale skin was the most common symptom of anemia.

Purpose: We studied the drug resistance of different microbes from clinical isolates. The morphological characteristics of bacteria were observed through culture characteristics and by carrying out gram staining techniques while the biochemical characteristics of bacteria were carried out by biochemical test. Methods: A total of 324 samples were collected from suspected patients visiting different hospitals at district Peshawar. For morphological identification, samples of clinical isolates were analyzed by blood agar, MacConkey agar and Eosine Methylene Blue, identified by gram staining and characterized by different biochemical tests. Antibiotic Sensitivity test by Modified Kirby-Bauer Disc diffusion method was used to test the in-vitro susceptibility of the identified isolates to different antibiotics such as Ceftazidime, Ceftazidime, Ceftriaxone, Cefepime and Imipenem. Results: These resistant non-lactose fermenting gram negative bacteria were isolated from samples of pus/wound (33.30%, n = 108/324), blood (33.30%, n = 108/324), urine (23.30%, n = 75/324) and from ascetic/pleural fluids (10.20%, n = 33/324). The study revealed that the percentage of non-fermenting bacterial infection was higher in females (53%) as compared to males (47%) along with higher infection observed in the age group of 11 - 30 years. Pseudomonas aeroginosa showed high resistance against Cefepime (88.80%), followed by Cefoperazone (55.50%), Ceftazidime (48.10%), Ceftriaxone (33.30%). Imipenem was active with low resistance (7.40%). More resistance was seen in Morganella morganii against Imipenem (66.70%) followed by Cefoperazone (55.50%), Ceftriaxone (55.50%). Cefepime showed low resistance (11%). Multi-drug resistant Proteus mirabillis was highly resistance to Ceftriaxone (74.07%), followed by Cefepime (59.20%), Cefoperazone (44.40%) and low resistance for Imipenem (25.90%). Salmonella typhi demonstrated high resistance against Imipenem (74.07%), followed by Ceftriaxone (40.70%), Ceftazidime (37.03%). Cefepime showed low resistance (3.70%), hence it is more active against S. typhi. Conclusions: The different species of non-lactose fermenting gram negative bacteria have shown a different resistivity pattern in the present study. Therefore identification of non-lactose fermenting gram negative bacteria and looking after their resistivity/susceptibility pattern are important for suitable management of the infections caused by them.

Purpose: The present studied was performed in order to investigate the drug resistance of different non-lactose fermenting gram negative bacteria from clinical isolates. The bacteria were morphologically characterized through culturing and gram staining techniques were used for the identification of different bacterial strains. Methods: A total of 324 samples were collected from patients, after they were diagnosed by physicians at different hospitals at district Peshawar. Samples were morphologically identified by blood agar, MacConkey agar and Eosine Methylene Blue, identified by gram staining techniques. Modified Kirby-Bauer Disc diffusion method was used to test the in-vitro susceptibility of the identified isolates to different antibiotics. Results: The non-lactose fermenting gram negative bacteria were isolated from samples of blood (33.30%), pus/ wound (33.30%), urine (23.30%) and from ascetic/pleural fluids (10.20%). The study revealed that Pseudomonas aeroginosa showed high resistance against Gentamicin (74%) and Aztreonam (74%), followed by Ciprofloxacin (59.20%) and Amikacin (33.30). Tazocin was active as low resistance (18.50%) is shown. More resistance was seen in Morganella morganii against Aztreonam (77.7%) followed by Gentamicin (62.90%), Ciprofloxacin (40.70%). Tazocin show low resistance (3.70%). Multidrug resistant Proteus mirabillis was highly resistance to Gentamicin (66.60%), followed by Aztreonam (62.90%), Amikacin (55.50%), Ciprofloxacin (40.20%) and low resistance to Tazocin was (22.20%). Salmonella typhi demonstrated high resistance against Amikacin (62.90%), followed by Aztreonam (48.10%), Tazocin (40.70%). Gentamicin showed low resistance (29.60%), and hence it is more active against S. typhi. Conclusions: It can be concluded from the present study that different species of non-lactose fermenting gram negative bacteria have shown a different resistivity pattern. This study is a gate way for better and suitable management strategy for the infections caused by non-Lactose fermenting bacteria in the sampling region.

To find the best option to treat White Spot Lesion in existing caries treatments, and to identify the selected articles discussing etiology of caries along with White spot lesion. Null hypothesis was that "Only anticariogenic agent can cure White Spot Lesion". PRISMA guidelines were used to conduct the systematic analysis. An electronic customized search was performed using mesh terminologies on PubMed database based on inclusion criteria that included studies with; any treatment option that can treat or prevent WSL; and minimally invasive treatment options that may be altered to treat WSL. While exclusion criteria comprised studies with treatment of rampant caries, severe early childhood caries and root caries. Inclusion criteria for etiological factors incorporated studies with factors that lead to white spot lesion or carious lesion. Finally, therapeutic agents of dental caries were analyzed. Only the use of anti-cariogenic agent cannot cure White Spot Lesion. Hence study fails to prove the null hypothesis. Although combination of anti-cariogenic agents with a re-mineralizing agent can provide additional options for the treatment or prevention of WSL.

Electrocoagulation (EC) technique is applied for the treatment of wastewater containing heavy metals ions such as nickle (Ni), lead (Pb) and cadmium (Cd) by using sacrificial anodes corrode to release active coagulant flocs usually alumin- ium or iron cations into the solution. During electrolytic reactions hydrogen gas evolve at the cathode. All the experiments were carried out in Batch mode. The tank was filled with synthetic wastewater containing heavy metals and efficiency of electro- coagulation in combination with aluminum and iron electrodes were investigated for removal of such metals. Several parameters, such as contact time, pH, electro-coagulant concentration, and current density were optimized to achieve maximum removal efficiency (%). The concentrations of heavy metals were determined by using Atomic Absorption Spectroscopy (AAS). It is found that the electro-coagulation process has potential to be utilized for the cost-effective removal of heavy metals from wastewater specially using iron electrodes in terms of high removal efficiencies and operating cost.

Background: Lateral condyle fractures in children are the second most common fracture about the elbow. The problem arises in those cases which are difficult to treat by pop cast or by close reduction with percutaneous pin fixation. Late presentation is another challenge. We selected surgical treatment for such cases up to 12 weeks to evaluate our results. Objective: To study the usefulness of open reduction and K-wire fixation of displaced, unstable with or without rotation of fractures lateral condyle of the humerus in children presenting up to 12 weeks post injury Design: Prospective. Setting: Three teaching orthopaedic units Independent Medical College / Punjab Medical College, and University Medical College Faisalabad. Period: From January 2008 to December 2010. Method: In this prospective study a series of 22 patients were treated using technique of open reduction and internal fixation with k-wires. The results were assessed by criteria of Agarwal et al with little modification after follow-up for 1 year. Results: Excellent to good results were observed in all the12 patients presenting at 1–4 weeks post injury. In 5 patients presenting at 5–8 weeks, the results were excellent in one, good in 2, fair in1 and poor in one patient. In 5 patients presenting at 9-12 weeks good in 1 fair in 2 and poor in 2 patients. Conclusions: Open reduction and internal fixation is an effective treatment in all cases of displaced fractures of the lateral condyle of the humerus presenting up to 12 weeks post injury on the basis of low surgical complications and high union rate.

Objective The objective of the work described in this paper is the development of a computationally efficient methodology for patient-specific automatic seizure detection in long-term multi-channel EEG recordings. Approach A novel patient-specific seizure detection approach based on a signal-derived empirical mode decomposition (EMD)-based dictionary approach is proposed. For this purpose, we use an empirical framework for EMD-based dictionary creation and learning, inspired by traditional dictionary learning methods, in which the EMD-based dictionary is learned from the multi-channel EEG data being analyzed for automatic seizure detection. We present the algorithm for dictionary creation and learning, whose purpose is to learn dictionaries with a small number of atoms. Using training signals belonging to seizure and non-seizure classes, an initial dictionary, termed as the raw dictionary, is formed. The atoms of the raw dictionary are composed of intrinsic mode functions obtained after decomposition of the training signals using the empirical mode decomposition algorithm. The raw dictionary is then trained using a learning algorithm, resulting in a substantial decrease in the number of atoms in the trained dictionary. The trained dictionary is then used for automatic seizure detection, such that coefficients of orthogonal projections of test signals against the trained dictionary form the features used for classification of test signals into seizure and non-seizure classes. Thus no hand-engineered features have to be extracted from the data as in traditional seizure detection approaches. Main results The performance of the proposed approach is validated using the CHB-MIT benchmark database, and averaged accuracy, sensitivity and specificity values of 92.9%, 94.3% and 91.5%, respectively, are obtained using support vector machine classifier and five-fold cross-validation method. These results are compared with other approaches using the same database, and the suitability of the approach for seizure detection in long-term multi-channel EEG recordings is discussed. Significance The proposed approach describes a computationally efficient method for automatic seizure detection in long-term multi-channel EEG recordings. The method does not rely on hand-engineered features, as are required in traditional approaches. Furthermore, the approach is suitable for scenarios where the dictionary once formed and trained can be used for automatic seizure detection of newly recorded data, making the approach suitable for long-term multi-channel EEG recordings.