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Introduction: Obesity and income (wage) distribution have emerged as one of the most serious public health concerns but in this research, the study is continued under body mass index (BMI) and body shape and size index (BSSI) among children and adults in Pakistan. Methods: This cross-sectional study investigated the health-related behaviors and outcomes of 2,223 children and adults aged 2 to 19 years from Multan, Pakistan, including both males and females, providing a comprehensive understanding of the health status in this population. Data about gender, weight, height, age, family income and other demographic measures are recorded. For the measurement of BMI and BSSI, the latest formulas and methods were used. Different variables were applied through statistical description understudy. To check out the wage distribution in BSSI and BMI, the comparative approach was used and performed a role in making charts for BSSI and BMI against family income, age group and gender. Results: The mean BMI and BSSI for complete data are 18.00 and 0.23 for the age group of 2 to 5 years of children with family income less than 10,000. Similarly, these figures are 20.59 and 0.29 for the family income greater than 50,000. Conclusion: Most important things have been observed by this study, that income greatly affected the rate of obesity. BMI and BSSI increased by increasing the family income of children and adults in Pakistan. BMI and BSSI show high figures for female respondents as compared to male ones, observed by this research.

Introduction: In the current study, we construct growth charts of body surface area (BSA) for adults using the quantile regression (QR) approach and growth charts of different Gaussian Percentiles ( Z -scores) against age. Methods: A cross-sectional data consisting of 3,473 individuals aged 5 or more, both males and females were taken from Multan city. Quantile regression (QR) was used to construct BSA growth charts. Growth charts for different Z -scores were also constructed. Results: For our data set, the mean BSA is 0.48750. The BSA percentiles show a trending higher after the age of 5 until the age of 22, then decrease between age 22 and 35, and then finally increase after age 35. The Z -score curve increases slightly after age 5 and then proceeds higher until age 22. After age 22 and before 35 it plateaus and then increases slightly after age 35. Conclusion: Since the use of empirical BSA percentiles and Z -scores with grouped age provides a discrete approximation for the population percentiles and Z -scores, it is more accurate to use continuous BSA percentile and Z -score, curves against given ages while using quantile regression and Z -score approach. Furthermore, this approach can also be adopted to construct many other growth charts for physiological and medical sciences.

Food security as a major social concern and a global threat, requires better policy decisions based on empirical studies. This work presents a comparative statistical analysis of different methods to forecast wheat area, productivity, production, and population growth rate in Pakistan. Time series data from 1950 to 2020 were analyzed using various methods such as ARIMA, the compound growth exponential regression model (CGREM), Cuddy Della Valle instability index (CDVI), and decomposition analysis. The results show that CGREM performs better than other models. Periodic compound growth rates indicate that wheat area and yield decrease by about 67.0% and 40.0%, while the population decreases by 31.7%. For the period 2001-2020, the compound growth reaches the level of 0.60% for wheat area, 1.21% for yield, while it is high for the population and amounts to 2.22%. The overall compound growth rate for wheat area and yield (about 1.207%, 2.326%) is lower compared to the population (about 2.839%). The paper presents forecasts for wheat area, yield, and population in Pakistan will rise: 12.7%, 25.5%, 31.8% in 2030 and 43%, 97.8%, and 129% in 2050. The results of this study provide empirical evidence for the necessity of policy decisions addressing the problem of food security in Pakistan.

Objective: To emphasize the importance of antenatal diagnosis of the morbidly adherent placenta, employ management options accordingly and their impact on the patient’s outcome. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Okara Pakistan, Jan 2018 to Aug 2020. Methodology: One hundred and twenty-four patients were enrolled in the study. Diagnosed morbidly adherent placenta was made through trans-abdominal ultrasound, and a Doppler study in selected cases of posterior placenta previa magnetic resonance imaging (MRI) was performed. The surgical approach was either a high transverse placenta sparing or a classical incision on the uterus. After delivery of baby, conservative management included resection of part of uterus with adherent placenta followed by reconstruction of the lower uterine segment, segmental resection of myometrial tissue and hemostatic sutures, and over sewing of placental bed. The requirement of blood transfusion, intensive care unit stay, post-operative recovery, and day of discharge, along with all demographic and surgical details, was noted. Results: In 87(70%) patients, high transverse or placental sparing incision was made to assess the baby. Over sewing of the placental bed was done in 37(29.8%) patients, and myometrial segment resection was done in 57(46%) patients. An obstetrical hysterectomy was carried out in 30 patients. Blood transfusion of > 4 units RCCs was required in 92(74%) patients. 16% the patients required intensive care management. Conclusion: Antenatal diagnosis of morbidly adherent placenta through useful imaging modality allowed for a planned surgical approach and minimized......

Objective: To study efficacy of Magnesium Sulphate in reducing maternal morbidity and mortality in patients presenting with eclampsia. Study Design: Prospective observational study. Place and Duration of Study: Gynae/Obs Department, Combined Military Hospital Bannu, from Jan 2018 Sep 2019. Methodology: A total of 134 patients fulfilling inclusion criteria were included in the study. Patient management was multidisciplinary. Convulsions were controlled by 4gram magnesium sulphate intravenously over 20 minutes as a loading dose, followed by 1gram per hour of maintenance infusion. Blood pressure was controlled with injection Labetalol 10 milligram followed by injection Hydralazine repeated after every 20 minutes till the blood pressure was controlled. Results: A total of 134 patients had eclampsia constituting 6.8% of obstetric admissions. Case fatality was 14 (10.4%) while 120 (89.55%) of the cases responded well to treatment and survived the event. Mean age of patients was 22 years. Thirty patients 22.4% were booked and 104 patients 77.6% were un-booked. Mostly patients 122 (91%) came from rural area and only 12 (9%) were from urban areas with booked pregnancies having regular antenatal visits. One hundred and twenty six (94%) patients with eclampsia presented in antenatal period and only 8 (6%) presented in post natal period. Mode of delivery was cesarean section in 87 (64.9%) and 47 (35.1%) delivered vaginally. Frequency of patient requiring ventilator support, acute renal failure, disseminated intravascular coagulation, adult respiratory distress syndrome, HELLP (hemolysis, elevated liver enzymes, low platelet) syndrome was 11 (8.2%), 46 (34.3%), 43 (32.1%), 35 (26.1%), 7 (5.2%) respectively..........

Objective: To compare the safety and efficacy of post partum intrauterine contraceptive device with interval intrauterine contraceptive device, to avoid unplanned pregnancies. Study Design: Quasi-experimental study. Place and Duration of Study: Gynaecology and Obstetrics Department, Combined Military Hospital (CMH) Okara, from Aug 2019 to Jul 2020 Methodology: One hundred patients were included in the study. Divided in 2 groups, group A (post partum intrauterine contraceptive device, n=50) patients underwent cesarean section under spinal anesthesia, after removal of placenta and membranes contraceptive device was placed near fundus with fingers and incision was closed. In group B (interval intrauterine contraceptive device, n=50) and intrauterine contraceptive device was placed 6 weeks postpartum. Post insertion follow up was at 6 weeks and then 6 months. Efficacy was assessed by the continuation rate and safety, by presence or otherwise of heavy menstrual bleeding, lost threads, abnormal vaginal discharge and pain abdomen on follow up visits. Results: Efficacy in group A was 46 (92%) and in group B 40 (80%). Safety that is heavy menstrual bleeding 3 (6%) and 5 (10%), lost threads 3 (6%) and 1 (2%), abnormal vaginal discharge 2 (4%), and 3 (6%), and pain abdomen 1 (2%) and 2 (4%) in groups A and B respectively. Conclusion: Postpartum intrauterine contraceptive device insertion was found to be effective and safe method as compared to interval intrauterine contraceptive device. Successful placement, continuation and retention rate were significantly higher in post placental intra uterine contraceptive device insertion.

Corona virus is a new disease. Its contagiousness, course of disease and treatment are unfolding with time. Health care systems all across the world have evolved to cope up with this crisis. Pakistan reported its first case on 26th February. Since then, with the increasing influx of patients our health care system has been greatly impacted. Significant numbers of patients require Intensive care services. Therefore, development of dedicated Intensive care units amid compromised resources has been our priority. Infrastructure development and modification, training of staff, Infection Prevention and Control (IPC) measures and staff well being are the main challenges faced. However, with meticulous planning and judicious use of limited resources our establishment has successfully developed Intensive care units that not only provide efficient patient care but also prioritizes on safety of its health care workers.

Objective: To compare the impact of early versus delayed oral feeding on postoperative hospital stay and patient satisfaction after an uncomplicated cesarean section under regional anesthesia. Study Design: Comparative prospective study. Place and Duration of Study: Gynecology and Obstetrics department Combined Military Hospital Bannu, from Dec 2017 to Dec 2018 Methodology: Initially 215 patients were enrolled; who were planned for cesarean section under spinal anesthesia but in 8 patients spinal was converted to general anesthesia, while 7 patients refused to participate in trial. Patients were randomly allocated by lottery method to each group. Women in the early feeding group were allowed to start oral sips of fluids 2 hours post operatively while in delayed feeding group oral fluids were started after 12 hours. Primary outcome measures were hospital stay and patient satisfaction. Secondary outcome measures were nausea, vomiting, passage of flatus, and return of bowel sounds. Results: Hospital stay was short in early feeding group being 19 ± 1.95 hours versus 29 ± 6.7 hours (p-value 0.03) in delayed feeding group. Early feeding group has higher level of satisfaction 80% as compared to 49% in delayed feeding group (p-value

Machine learning algorithms are rapidly deploying and have made manifold breakthroughs in various fields. The optimization of algorithms got abundant attention of researchers being a core component for deploying the machine learning model (MLM) abled to learn the parameters in significant ways for the given data. Modeling crop productivity through innumerable agronomical constraints has become a crucial task for evolving sustainable agricultural policies. The cross-sectional datasets of 26430 (D1) crop-cut experiments are taken by 2nd-stage area frame sampling, collected from crop reporting service. This research is taken as follows: firstly three more effective numerical optimized datasets are generated (D1, D2, and D3) from D1 by taking the centroid points of features which decrease the sample size; secondly MLM is integrated with the traditional statistical models (TSMs) for multiple linear regression (MLR), and thirdly decision tree regression (DTR) and random forest regression (RFR) are deployed to get the optimized models able to predict the wheat productivity well with 75% datasets to train and 25% to test the model using the evaluation metrics (R2, RMSE), information criterion (AIC) with weights (AICW), evidence ration (E.R), and decompositions of prediction error. The MLR outperformed for MLM than TSM. The performance capability of MLM and TSM got upswing for generated datasets. RFR got optimized and superperformed for D1, D2, D3, and D4. This study demonstrated strong evidences for deploying MLM for prediction of wheat productivity as an alternative of traditional statistical modeling.

Background: Obesity leads to other fatal diseases like diabetes, cardiovascular diseases, depression, and some forms of cancer. Still, the well-known tool to measure obesity is the body mass index. But it usually failed in the measurement of adipose tissues. So, we present a novel anthropometric measure, called body shape and size index which is developed by the combination of major anthropometric determinants: body surface area, body mass index, weight, and height. Methods: This study is based on cross-sectional data consisting of 7224 individuals that were taken from the city Multan, Punjab, Pakistan. All the individuals, both males, and females, of age 2 years and above were included in the study except the pregnant women. The variables included in this study are gender, area (urban and rural), age (years), weight (kg), and height (meters). Growth charts of quantile regression are used for the inferential analysis of data. Comparison of proposed body shape and size index at different obesity levels has also been made to access the relationship of proposed body shape and size index with obesity. Results: The results show that the proposed body shape and size index has a great association with body surface area, body mass index, weight, height, and age. The proposed body shape and size index has a high negative association with body surface area, moderate negative association with body mass index and weight, and low negative association with height and age. According to growth charts of body shape and size index, after the age of 25 years, body shape and size index curves go upward while it smoothly goes downward at the age of 50 years but decreases in earlier ages. Body shape and size index showed a significant association with body shape and body size (body development) at the same time. Conclusion: Body shape and size index is found, generally linear with age, and increased with decreasing body mass index and body surface area. The proposed index has an indirect relationship with obesity. Body shape and size index with low values indicates a high risk of obesity. While, however, body shape and size index with high values indicates a low risk of obesity. Applications of the proposed body shape and size index are also presented in statistical modeling.

Strongly balanced repeated measurements designs are useful to balance out the residual effects. These designs are widely used in medicine, pharmacology, animal sciences and psychology. The situations where minimal strongly balanced repeated measurements designs cannot be constructed, strongly partially-balanced repeated measurements designs are preferred. This paper deals with the construction of circular strongly partially-balanced repeated measurements designs through method of cyclic shifts. MSC: 05B05, 62K10, 62K05, Keywords: Circular strongly balanced repeated measurements designs, Circular strongly partially-balanced repeated measurements designs, Method of cyclic shifts, Repeated measurements designs, Residual effects

LLDPE is a less crystalline polymer with vast industrial and domestic applications. It is imperative to understand the synthesis, processing conditions, and thermal degradation mechanism of the co- as well as terpolymers. This paper reports the in-situ synthesis and thermal degradation studies of the ethylene-propylene copolymer and ethylene-propylene-1-hexene terpolymer and its nanocomposite with ZnAL LDH sheets. The 1-hexene dosing during the in-situ process influenced the product yield and immensely affected the thermal stability of the resultant polymer. One milliliter 1-hexene in-situ addition increased the product yield by 170 percent, while the temperature at 10 percent weight loss in TGA was dropped by about 60 °C. While only 0.3 weight percent ZnAL LDH addition in the terpolymer improved the thermal stability by 10 °C. A master plot technique and combined kinetics analysis (CKA) were deployed to access the thermal degradation mechanism of the synthesized polymers.

Circular regular graph designs play an important role in the design of experiments where most of the balanced incomplete block designs require a large number of blocks. In this article, circular regular graph designs are constructed in blocks of size four through cyclic shifts. Without studying the complete design, some standard properties of the designs can be observed only through the sets of shifts. Therefore, method of cyclic shifts has an edge over existing methods.

Objective: To compare the technique of paramedian with midline approach of subarachnoid block in terms of number of attempts and frequency of success rate in elderly patients undergoing elective lower body surgeries. Study Design: Randomized controlled trial. Place and Duration of Study: This study was carried out at Anaesthesia department of Combined Military Hospital Lahore. Six months from Jan 2014 to Jun 2014. Material and Methods: One hundred and seventy elderly patients were scheduled for lower body surgery, using spinal anaesthesia. They were randomized to either Midline approach (n=85) or Paramedian approach (n=85) by lottery method. The outcome measures number of attempts and success rate were noted in both groups and analyzed using SPSS version 18. Results: The successful block in first attempt was 95.3% in Paramedian group and 58.8% in Midline group. Mean number of attempts in paramedian group was 1.24 ± 0.52 as compared to 1.95 ± 0.97 in midline group. A p-value

Neighbor balanced designs are useful to balance out the neighbor effects in field of agriculture, serology, agro forestry, industry, etc. In most of the agriculture experiments blocks are formed in a line and therefore, neighbor balanced designs are required in linear blocks. In this article some classes of first order neighbor balanced designs are presented in linear blocks of size three and four. A method to construct the second order neighbor balanced designs through two minimal first order neighbor balanced designs in linear binary blocks of size three is also developed here. Keywords: Neighbor effects, Linear blocks, First order neighbor balanced designs, Second order neighbor balanced designs, Minimal designs, MSC (2000): 05B05, 62K10

Neighbor balanced designs are robust to neighbor effects, therefore, these designs are used to balance out the neighbor effects. If a large number of experimental material is required for combinatorial neighbor balance then partially neighbor balanced designs should be recommended. In this study, some useful generators are developed to obtain the partially neighbor balanced designs in linear blocks of sizes 3–7. Keywords: Linear block, Neighbor effects, Neighbor balanced designs, Partially neighbor balanced designs

Neighbor balanced designs are more useful to remove the neighbor effects in experiments where the performance of a treatment is affected by the treatments applied to its adjacent plots. These designs ensure that treatment comparisons will be less affected by neighbor effects as possible. In literature, these designs are available in circular blocks of size 3, 5, 6, 8, 9. In this article, neighbor balanced designs are constructed in circular binary blocks of size ten. A catalog of these designs is also compiled.

Optimization is a key factor in almost all the topics of operations research / management science and economics.The road networks can be optimized within different constraints like time, distance, cost and traffic running onthe roads.This study is based on optimization of real road network by means of distances. Two main objectives arepursued in this research: 1) road distances among different routes are composed in detail; 2) two standardalgorithms (Dijkstra and Floyd-Warshall algoritms) are applied to optimize/minimize these distances for bothsingle-source and all-pairs shortest path problems.

Accurate estimation of parameters of a probability distribution is of immense importance in statistics. Biased and imprecise estimation of parameters can lead to erroneous results. Our focus is to estimate the parameter of Power function distribution accurately because this density is now widely used for modelling various types of data. In this study, L-moments, TL-moments, LL-moments and LH-moments of power function distribution are derived. In addition, the coefficient of variation, skewness and kurtosis are obtained by method of moments, L-moments and TL-moments. Parameters of the density are estimated using linear moments and compared with method of moments and MLE on the basis of bias, root mean square error and coefficients through simulation study. L-moments proved to be superior for the parameter estimation and this conclusion is equally true for different parametric values and sample size.