Search

Objectives: Analyze how children with GBS manage in the clinic. Materials and methods: From 2015 to 2020, researchers at the Department of Neurosurgery at LRH and HMC Hospital peshawar analyzed data from 67 children (younger than 14) hospitalized at the hospitals with AFP. the Multicenter study in All patients had standard examinations, with most also undergoing [CSF examination], nerve conduction studies (NCS), and electromyography (EMG), depending on available resources. Supportive care, intravenous immunoglobulin (IVIG), and plasmapheresis were employed as treatment options, with the choice of modality determined by clinical need and accessibility to the respective procedures. Results: Sixty-nine percent (60) of the AFP cases were determined to be GBS. The average kid with GBS was six years old, and the male-to-female ratio was 1.06 to 1. Sixty-eight percent of patients had a previous medical history, seventy-two percent had sensory complaints, and sixty-two percent had autonomic dysfunction. There were ninety-three percent of patients with classical GBS (symmetrical ascending paralysis), two percent with descending paralysis, four percent with relapsing variation, and one with chronic inflammatory demyelinating polyneuropathy. A third of patients had the demyelinating type, another third had demyelinating with axonal involvement, and another twenty-one percent were classed as unclassified based on their electrophysiological investigations. Mechanical ventilation was necessary for 28 patients (44%). Mechanical breathing was necessary for 36% of those with axonal type and 24% with demyelinating type. Of the 28 patients given IVIG, 18 exhibited improvement, five did not, and plasmapheresis was performed on them. Conclusion: The majority of cases of AFP can be attributed to exposure to GBS. IVIG is an effective therapeutic strategy for children with GBS, and GBS with axonal involvement is more severe than demyelinating kind. Keywords: Children with Acute Flaccid Paralysis, Guillain-Barre Syndrome

The purpose of this study is to investigate the contributions of public libraries to the satisfaction of the intellectual needs of rural inhabitants in West Bengal, India. The study applied a quantitative survey method with the help of a well-structured questionnaire. Questionnaires were distributed among to the users (students, officers/professionals, self-employed individuals, businessmen, jobseekers, retired persons, and housewives) of 45 rural public libraries in five selected districts of West Bengal. The study found that the largest group of respondents belonged to the students and jobseekers categories, who visit the rural public libraries for seeking academic and job-related information. Many students from humble backgrounds were solely dependent on public libraries because they have procured some textbooks from middle school up to graduation level. Jobseekers were mostly consulting the Career Guidance Section of the library to prepare for various competitive exams. The study also revealed that public libraries have been trying to satisfy the intellectual and informational needs of the rural inhabitants by providing various services and facilities. Respondents have further reported that public libraries should adopt modern technologies and provide ICT-based library services as well. The outcome of this study would help to develop and upgrade the public library collection, services, and facilities in developing countries in a way that reflects patrons’ stated needs.

Nowadays, accidental explosions in residential and factory buildings are common owing to poor maintenance and mishandling of fuel gas and chemical explosive appliances leading to grievous injuries and infrastructure damages. Contact blast on slabs using explosives is noticed as a simpler act of subversion as compared to other components of the building and is more damaging than a close-in blast. In general, damage caused by contact blast is localized in the form of concrete cratering, scabbing, and rupture of the reinforcement. A recently published state-of-the-art review on the performance of reinforced concrete (RC) slabs under contact and close-in explosion loading scenario by the authors (Anas et al., 2021b) reveals the common perception for the location of contact blast to cause maximum damage is the centroid of the slab. It develops a curiosity with sufficient interest to investigate the effect of the location of contact explosive charge on the damage response of the slab. Several numerical techniques such as empirical, ConWEP (semi-empirical), Smooth Particle Hydrodynamics (mesh-free method), and Coupled-Eulerian-Lagrangian (CEL) are in use for simulation of blast loading on structures. Current literature reveals that the CEL is the most advanced and realistic blast modeling technique. This study applies Coupled-Eulerian–Lagrangian (CEL) formulation with finite element method (FEM) using the dynamic computer code ABAQUS/Explicit-v.6.15 to investigate the performance of singly reinforced one-way spanning concrete slab subjected to concentric contact blast loading. The numerical model is validated with the experiment results in the open literature. The validated model is then employed to investigate whether or not the maximum damage is really caused by the central location of the contact blast. For this purpose, one-quarter of the slab with nine symmetrical points (or locations) of contact blast of explosive charge, which reflect the coverage of the entire slab, in contact with the top face of the slab is considered in the study. Two constitutive material models, Concrete Damage Plasticity and Johnson–Cook, with strain rate effects are used to simulate the non-linear behavior of the concrete and steel, respectively. The results reveal that the most critical location of maximum damage to the slab is along the line of symmetry parallel to the supports at an eccentricity of B/4 from the centroid of the slab, where “B” is the width of the one-way slab.

Objectives: To determine the frequency of severely elevated blood pressure on admission in known hypertensive patients presenting with acute hemorrhagic stroke. Methodology: This cross-sectional Study conducted at Neurology Department, Lady Reading Hospital, Peshawar, the duration of study is 6 months from 2/12/2020 to 2/5/2021. In the present study a total of 90 patients 20 to 70 years old patients of either sex with a known history of hypertension (HTN) who present with acute hemorrhagic stroke were included in the study. The blood pressure of these patients was measured at the time of admission. The weight of the patient in kilograms was measured with the help of a digital electronic scale and height was measured with the help of a stadio-meter. Results: In the present study mean age was 53 years with standard deviation (SD) ± 10.02. Sixty two percent patients were male and 38% patients were female. Mean body mass index (BMI) was 26 kg/m2 with SD ± 3.31. Mean duration of hypertension was 3 years with SD ± 3.14. Eighty eight percent patients had use of antihypertensive medications while 12% patients’ did not had use of antihypertensive medications. Eighty percent patients had compliance with antihypertensive medications while 20% patients didn’t had compliance with antihypertensive medications. More over 18% patients had extremely raised blood pressure while 82% patients’ didn’t had very high blood pressure. Conclusion: Our study concludes that the frequency of severely elevated blood pressure was 18% on admission in known hypertensive patients presenting with acute hemorrhagic stroke.

Background: Trigeminal Neuralgia (TN) consist of brief periodic but severe and chronic facial pain in acial region in single or multiple branches of the trigeminal nerve. Objective: The objective of this study was to find the prevalence of TN in patients with chronic facial pain. Methodology: This cross sectional observational study was conducted at Department of Neurology OPD Lady Reading Hospital, Peshawar. 46 patients with chronic facial pain were selected for the study. All data was taken on a structured Performa and was entered and analyzed using SPSS version 21. Using non probability consecutive sampling after taking approval from Ethical Committee of the hospital, study duration was 10 months from 25-1-2019 to 25-10-2019. Results: Out of 46 patients, there were 18 (39.1%) males and 28 (60.9%) females. The mean age of the patients was 50.67, the Standard Deviation recorded was 11.56. Minimum age was 21 and maximum age was 67. 23. Out of 31 patients diagnosed with TN had history of tooth extraction and 8 had no extraction. Out of 31 patients presented with TN, right side was involved in 24 (52.2%) patients and left side was involved in 7 (15.2%) patients. Mandibular never was more common in the patients with TN which was 37% followed by maxillary nerve 21.7%, and ophthalmic nerve at 8.7%. Majority of the patients 28 (75.7%) belonged to the age group of 40 to 67. Females having TGN were 78% and males were 50%. Right side (52.2%) was more involved than left side. Mandibular division (37%) was more involved than maxillary and ophthalmic division. Conclusion: We conclude that females are more at risk of developing TN than males. Increasing age has a higher chance of developing TN. Right side is more involved than left. Mandibular division is more involved than maxillary and ophthalmic.

Background: Thyroid surgeries are commonly done nowadays for benign and malignant conditions. Recurrent laryngeal nerve palsy (RLNP) is an important and potentially catastrophic complication of thyroid surgery. The purpose of the study was to determine the impact of rigid endoscopy (Hopkins rod-lens telescope) performed at different time intervals on the diagnosis of RLNP in post-thyroid surgery patients. Aims and Objectives: To assess Proper Timing of Laryngoscopy in Post-thyroid Surgery patients to Detect RLN Injury. Materials and Methods: Rigid endoscopy was performed postoperatively at day 0 (T0), at 2nd day post-op (T1), and day 14 (T2). For patients with RLNP, repeated examinations were performed at 2 months (T3), 6 months (T4), and 12 months (T5). Results: The study included 50 patients of thyroid swelling with different diagnoses. Overall, 35 patients appeared for postoperative laryngoscopic examination of the vocal folds at our center, providing 61 nerves at risk. RLNP rate was 8.1% at T0, 11.5% at T1, 9.8% at T2, 8.1% at T3, 4.9% at T4, and 3.3% at T5. T1 was significantly superior to all other time intervals in terms of diagnosis of RLNP but statistically not significant. Conclusion: Rigid endoscopy is essential for the detection of vocal cord paralysis after thyroidectomy. We report different time evaluation criteria of vocal cord morbidity with great and significant variability of results. Second day post-op inspection of the larynx (T1) is suggested.

This paper presents a study in which triaxial tests were performed on loess soil reinforced with natural roots. Triaxial compression tests were performed on soil specimens with root biomass of 0.25, 0.5, 1.0, and 1.25% and subsequently consolidated at various confining stresses under drained and undrained conditions. The results are presented in terms of monotonic stress–strain behavior, volumetric behavior, failure envelope, and shear strength parameters. The test results showed that the inclusion of roots required higher confining stress to prevent failure. The reinforced specimen showed continued mobilization of dilatancy in drained and undrained conditions and resulted in exhibiting higher peak deviator stress compared to the unreinforced specimen. The specimen with the lowest root biomass exhibited the least increments in the hardening response, while the specimen with the largest root biomass showed the highest hardening response. The addition of roots decreased the contractancy of soil in both drained and undrained condition. Under the same root content and confining pressure, the shear strength in an undrained condition is much higher as compared to drained conditions. The largest improvement in soil's mechanical behavior was observed at smaller confining pressure, i.e., 100 kPa in both drained and undrained conditions. The addition of roots also increases the initial yielding of the soil, which is the function of roots biomass. The output of this research will provide a foundation for the future development of the predictive constitutive model for soil–root composite and its applications to slope stability.

Weak political systems and poor governance in certain developing countries are found to have a war-like environment where structures are being targeted by blasts and bombs. Industrial blasts due to frail know-how and mishandlings are also quite common. Recent accidental explosions like that occurred at the Beirut Port, Lebanon (August 2020); ammunition depot in the outskirt of the Ryazan City of Russia (November 2020) are of concern for the safety of adjacent building infrastructure and their users. Such intense loading events cause damage to certain elements of a structure which may result in disproportionate or progressive collapse. It necessitates a clear understanding of the phenomenon of the blast and extreme loads induced out of it, and response of the target structure under such loadings. In this study, the state of research on air-blast and ground shockwave parameters, shallow underground blasting, and on the ground and buried shallow blast-resistant shelters are presented. The phenomenon of the self-Mach-reflection of the explosion, loading parameters and empirical blast models available in the open literature followed by the damage criteria for the buildings subjected to the underground blasting and available peak particle velocity (PPV) prediction models have been discussed. To make the application of advanced materials such as fibrous concrete, ultra-high performance concrete, FRP composites, etc., it is important to comprehend the existing blast/shock-resistant shelters and their response under such loading. The shelters are primarily designed by incorporating features of the materials like high degree of deformability/ductility, use of the shock-isolation panels and the mechanism for controlling crack formations. Finally, conclusions and recommendations for future studies are summarised. This paper presents prospects to engineers, town planners, researchers, policymakers and members of the core drafting sectional committees to understand the phenomenon of the blast and extreme loads induced out of it.

The paper deals with detailed study on microstructure and mechanical properties of aluminum 7068 reinforced with fly ash and silicon carbide by powder metallurgy, aluminum 7068, silicon carbide and fly ash were taken in powder form of required size and mixed together in varying proportion according to specification and compacted with pressure of 400MPa using hydraulic press to make samples and then samples were sintered at 600°c for 2 hours, the samples were tested for density, compressive strength, hardness and microstructure was analyzed using scanning electron microscope, energy dispersive x-ray study was carried out in order to confirm presence of silicon carbide and fly ash in aluminum matrix.

Purpose CVST is a serious condition with a recent incidence of 13 million persons per year. (1) It has a highly variable presentation and may manifest itself with no recognizable risk factor, Magnetic resonance venography (MRV) is the investigation of choice for its diagnosis. However, since MRV is not readily available and is costly, this study tried to find the relationship between the levels of D-dimers as marker and duration of CVST. D-dimers are degraded fibrin products which are found to be raised in pulmonary embolism and deep venous thrombosis. Methods: Total 49 patients (male to female ratio 1:6) mean age 36.37 13years) with MRV proven CVST were included in the study. This descriptive cross-sectional study was conducted from January 2015-April 2017, on 49 confirmed patients of CVST, in Lady Reading Hospital. In patients suspected of CVST, magnetic resonance imaging of the brain with MRV was performed without delay on a 1.5 tesla MR scanner using T1, T2, flair, and diffusion weighted imaging sequences with a two-dimensional time of flight MRV. D-dimers were estimated by a rapid latex agglutination slide test technique using monoclonal antibodies. Data was analyzed using SPSS version 19. Frequencies, mean were calculated for quantitative data while Chi-square test was used for qualitative data. Sensitivity and specificity were calculated. Result: The duration of symptoms was 3-60 days (mean 22 days). The mean value of D-dimers levels recorded in micrograms were recorded as 1456 Conclusion: D-dimers levels were high in acute and subacute stage of CVST. However, there were cases in our study who despite having acute and subacute stage of CVST had normal D-dimers levels for unknown reasons.

Political rivalry among aspiring groups for power to rule turns the society hostile with trust deficit tends to instability and poor governance. Disgruntled groups take subversion as a tool to show their worth, and target government building infrastructures using explosives. Accidental explosions too damage the structures. Recent Beirut explosion of ammonium nitrate at the seaport is an example of an accidental large-scale explosion. Also, in the current prevailing political scenario, the need for blast-resistant shelter cannot be completely ruled out. With this concern, the double-roof on-ground RCC shelter, designed and tested by the Terminal Ballistics Research Laboratory, Ministry of Defence, Chandigarh, India, under the explosive loads of 10 and 30kg-TNT in free-air has been numerically analyzed in this study using the commercial FEM-based software program, ABAQUS/CAE version 6.14 equipped with concrete-damaged plasticity model. RCC Hume pipes with 25 mm thickness of 200 mm diameter spaced between the two roofs of the shelter act as energy absorption layer (EAL). The available test results and finite element analysis predictions, including maximum displacement and damage to the shelter, are presented and compared. The computed results are found in reasonable agreement with the experimental ones. To improve the shelter response, analysis has been extended replacing the EAL of the Hume pipes with the carbon-steel (CS) seamless pipes of grade Fe330 between the roofs of the shelter. The role of the RCC Hume pipes for dissipating the energy and the replaced CS pipes between the two roofs of the shelter is highlighted.

The current practice of the seismic design of buildings relies on a single event of earthquake having a specified intensity measure. Two-level earthquakes are used along with the specified design response spectrum for arriving at the seismic design forces. The seismic performance of the designed structure is evaluated using non-linear time history analysis for some specified ground motion or synthetically generated ground motion from the response spectrum. No consideration is paid to the aftershock event, which is commonly associated with any major shock. The present study investigates the adequacy of the current design practice to cater to the aftershock events using 11-storey RC frame subjected to a sequence of main- and aftershocks synthetically generated from the design response spectrum as specified in the IS code. Several seismic demand parameters, namely, transient and residual top displacements, maximum inter-storey drift, residual storey drift, base shear and a number of plastic hinges, are used to evaluate the seismic performance of the frame for each earthquake shock. The result of the study indicates that with the increase in the number of aftershocks, significant deterioration of strength and stiffness takes place, resulting in the residual demand parameters exceeding the permissible limit.

The blast-induced impulsive loads due to unabated accidental and man-made explosions on structures are receiving attention from structural designers. Recent devastating Beirut ammonium nitrate explosion and very recent blast at a chemical factory on the outskirts of Bangkok are examples of the accidental explosions. Such loading applies a high-intensity pressure over a very short duration (microsecond to the millisecond), is generally more damaging than quasi-static and other less intense dynamic loadings induced by wind, wave, or earthquake. The positive phase of the blast load is generally considered in the analysis neglecting the negative phase being less impulsive to cause significant damage to the structure. A number of available empirical relations predict blast wave parameters and each relation validates its experimental results, however, the proposed relations had not been vetted with different available experimental data. In this paper, several existing empirical equations proposed by various researchers for blast peak positive overpressure of spherical free-air and hemispherical surface-bursts, the arrival time of air-blast shockwave, and positive phase duration of the blast are presented and compared with the available experimental results and predictions of blast design manuals UFC 3–340-02(2008) and IS 4991:1968 for a span of scaled distances. The phenomenon of the blast is explained and a list of technical documents and required accessories to measure the experimental response is provided. The limitations of the empirical relationships are explored. This study is useful to structural engineers and researchers for the blast-resistant design of structures.

Emerging economies are characterised by a high proportion of family-owned businesses, significant political corruption, and a weak legal system which creates a more favourable environment for polit...

The explosion from bombshells develops an excessively high impulsive load on structures. Columns being important key load-bearing members of a structure are vital to providing strength and stability to the building. A circular column performs better than a square/rectangular column under blast loading. Following the validation of experimentally tested square RC column with seismic lateral reinforcement carrying 950kN axial load subjected to an explosive charge of 100kg ANFO (82kg-TNT equivalent) at a scaled distance of 1.00m/kg1/3 with 10mm mesh size using ABAQUS/EXPLICIT software equipped with concrete damage plasticity (CDP) model, an equivalent circular reinforced concrete (RC) column is considered. It is well known that the performance of the circular RC column with single helical transverse reinforcement is superior compared to circular lateral ties. To improve the blast-impact resistance of circular column provision for helical reinforcement mesh using six bars turning successive bars in opposite direction is attempted in this work. The performance of a column with equivalent helical mesh is compared with the column with single helical transverse reinforcement. Further, UHPFRC plaster, as well as CFRP wrapping, are considered on the two columns under the close-in blast loading. The thickness of UHPFRC plaster and CFRP wrapping considered in this study are 15mm and 2mm respectively. The effect of plaster and wrapping on the two columns in terms of confinement of concrete and stresses in longitudinal steel are investigated and compared. Maximum deflection and damage of the columns are predicted.

The research and innovation activities at higher education institutions (HEIs) are considered essential in driving forward sustainability in order to facilitate future decision-making. However, a systematic approach regarding sustainability research through administrative efforts is still lacking in HEIs worldwide. Therefore, this manuscript aimed to explore contradictions embedded in the activity systems that hamper the internalization of sustainability research in HEIs. The current study conducted semi-structured interviews with faculty members at a leading research university in Taiwan. The lens of activity theory was used to explore and analyze tensions rooted in the activity systems involved in research and innovation. We found that resources to undertake sustainability-related research have not been allocated in a desirable manner. Moreover, the stakeholders are lacking agency, motivation, and perceived urgency to play their roles in supporting sustainability-related research through their practices. The propositions concluded from this study would help the involved actors to reconfigure their activity systems to make a contribution toward sustainability. This study also serves as a fundamental step towards conducting future empirical studies in contextual theory building directed at co-creating value through sustainability-related research and innovation practices.

Rising fanaticism and rapid industrialization across the globe make the structures more vulnerable to direct threats generated from accidental and explosion-induced air-blast loads. Unlike the response of the reinforced concrete structure under quasi-static loading, it may respond in a brittle manner with highly localized failure like scabbing, cratering, spalling, and crushing of the concrete as well as rupturing of the reinforcement under the near field or contact detonations. Large deflection and high stresses could cause irreparable damage or result in the failure of critical structural elements. Besides, high-speed secondary fragmentation resulting from spalling of concrete may cause injuries to the occupants and other damages in the detonation area. It is therefore important to have a better understanding of the structural response/damage under air-blast loadings. This paper provides a comprehensive review of major (over twenty) publications addressing the blast response of the reinforced concrete slabs. First, the phenomenon of spall damage in the slab and the parameters affecting it are discussed. Then, available experimental investigations on slabs have been reviewed and different damage/failure modes of the slabs exposed to contact or close-in detonations are presented. The damage in the slabs has been observed in the form of spalling of concrete, the formation of punching crater, concrete scabbing/crushing, flexure-shear failure, flexural failure, bending-punching failure, and development of longitudinal, transverse, and radial cracks. Next, numerical modeling of the slabs using various material damage models available in different finite element programs has been discussed by reviewing the numerical /analytical investigations under air-blast loading. It is noted that the vast majority of the papers focused on improving the blast resistance of the slabs using different strengthening techniques. Finally, the major findings and other aspects that need to be considered for subsequent research are discussed.

This study traces the genesis of public libraries during the British period; the birth of National Library in India; the growth of public libraries in different districts of West Bengal; contributi...

This prospective study has been carried out to observe the outcomes of canal wall up (CWU) and canal wall down (CWD) Tympano-mastoidectomies in ears with cholesteatoma. Outcomes of the procedures have been done in terms of recurrence of cholesteatoma, complications, graft uptake rates and post-operative hearing gain. This study was carried out in the Department of Otorhinolaryngology of a reputed tertiary teaching hospital of North India from January 2016 to June 2020, with a mean follow-up of 32 months. The study included 100 patients of otitis media with cholesteatoma. In Canal Wall Up Tympano-mastoidectomy (CWUT) group, the number of males and females were 22 each. On the other hand, 36 males and 20 females underwent Canal Wall Down Tympano-mastoidectomy (CWDT). Each surgery was done as a single-staged and at the end of the surgical procedure angled oto-endoscopes were used for ensuring complete removal of the disease. Though there is no statistically significant difference in recurrence of cholesteatoma and complications rate in CWU and CWD Tympano-mastoidectomy techniques, but CWUT is superior to CWDT in terms of better graft uptake (p = 0.0156), and better average audiological gain (8.56 ± 0.93 dB) with p value = 0.0315. A diligent post-operative follow-up is must for assessing the outcomes of different types of mastoidectomies. This study shows no statistical difference in the disease recurrence and complication rates between Canal Wall Up and Down Tympano-mastoidectomies, though the anatomical changes and creation of the mastoid cavity in canal wall down procedure may affect the graft uptake and post-operative hearing gain. Use of Oto-endoscopes in cholesteatoma surgery helps in improving the outcomes of both techniques and thus recommended if the facility for the same is available.

The most challenging problem before the world is providing enough food for the gigantic leap in population. There are numerous reasons for the shortage of food and technological innovations in agriculture are required to overcome the shortages in food supply. Sustainable Development goals (SDGs) provides the futuristic vision and ICT along with other latest technologies will help achieve these development goals at a brisk speed. Recent technological developments as use of mobile-broadband access devices, Internet of Things (IoT), Specialized Robots, Drones, big data analytics and Artificial Intelligence has given farmers tools and technologies to scale agricultural production and marketing of their agricultural products. In this paper, we will discuss how Smart Agriculture is changing the face of agriculture in Budaun, a small city in Uttar Pradesh. Smart agriculture coupled with block chain technology is being used to achieve sustainability in agriculture growth. The production/yield has risen by over 20% and the profits have increased by over 30% with the new technology.

As there are changing trends in the microbiology of chronic otitis media, this study was carried out to look for the current aerobic microbes and their antimicrobial susceptibilities in patients of chronic otitis media from north Indian region. A total of 322 patients who met the inclusion criteria were studied and aerobic ear swab culture was done under aseptic conditions. Gram staining was performed and antibiotic susceptibility testing was done using Kirby–Bauer disc diffusion method on Mueller–Hinton Agar. A total of 341 culture positive results were obtained from 322 patients. The culture results revealed 10 different aerobic microbes. Gram-positive floras were seen in 152 (44.57%), and Gram-negative in 189(55.43%) isolates. Staphylococcus aureus was the most common isolate present in 131 samples (38.41%), followed by pseudomonas aeruginosa in 101 (29.62%) and proteus in 36 (10.56%). In overall susceptibility of antibiotics against Gram-positive culture isolates, Vancomycin was most effective (97.37%). For Gram-negative microbes, Piperacillin–Tazobactum combination was most effective with overall susceptibility of 79.37% susceptibility. Microbiological assessment of Chronic Otitis Media should be carried out in an area on regular intervals because of the changing patterns of bacteriology and their antimicrobial susceptibilities.