Search

The paper aims to understand the combination of biomimicry and the BREEAM category of energy to identify innovative solutions for sustainable architecture and sustainable urbanism. It purposes to find similarities between biomimicry and the BREEAM category of energy by selecting and analyzing literature. The study aims to indicate potential applications of biomimicry, and the BREEAM category of energy focused on building design. The main question of this research is to discover how biomimicry and the BREEAM category of energy could combine to identify innovative solutions to address sustainable architecture and sustainable urbanism? The research required a systematic literature review for identifying, collecting, and analyzing relevant studies. JSTOR, Science Direct, and Microsoft Academic were used as repositories and led to the identification of 3855 studies. After screening, eligibility, and inclusion, 39 studies were included in the systematic literature review. More studies discussed sustainable architecture and required classification through subthemes: biomimetic design and associated principles; building skin; integrated framework; designing with BREEAM. The paper provides insight into biomimetic design approaches and energy management combining to ensure sustainability ranging from a building to an urban environment. The chosen research method causes the research results to lack generalizability since it does not associate with other BREEAM categories such as health and wellbeing, innovation, land use, materials, management, pollution, transport, waste, and water. The research fulfills the need to study the combination of biomimicry and one of the BREEAM categories to identify innovative solutions for sustainable architecture and sustainable urbanism.

Glaucoma is a primary cause of irreversible blindness worldwide, it kills the vision silently, having a financial burden on society regarding therapy expenses and loss of valuable hours of the day. Objective: To compare the choroidal filling time and grade the status and pattern of optic nerve head (ONH) perfusion by fundus fluorescein angiography (FFA) in glaucoma patients Methods: Patients with various types of glaucoma were enrolled and compared them with healthy volunteers with no history and findings of glaucoma. Perfusion status using FFA was studied and analyzed corresponding visual fields (VF) and optical coherence tomography (OCT) findings Results: There were 70 participants in the study, including 48 glaucoma patients and 22 healthy controls. Choroidal filling time (CFT) was 9-12, 13-17, 15-22, and 20-33 seconds in healthy individuals and patients with ocular hypertension (OH), primary open-angle glaucoma (POAG), and normal-tension glaucoma (NTG), respectively. In OH, inferonasal and inferotemporal hypofluorescence pattern of ONH perfusion was noted, whereas POAG showed an inferonasal, patchy, and undefined pattern of hypofluorescence. In contrast with the healthy volunteers that showed uniform fluorescence, patients with NTG showed inferonasal hypofluorescence. CFT was significantly delayed in NTG patients (p

Glaucoma is characterized by an optic neuropathy associated with raised intraocular pressure (IOP) and visual field defect Objective: To determine the efficacy and outcome of trabeculectomy augmented with anti-metabolite mitomycin-C in children with childhood glaucoma. Methods: A total of 40 eyes of 22 diagnosed cases of congenital glaucoma were studied. All these children underwent mitomycin-C augmented trabeculectomy from July 2017 to August 2020. The primary outcome was control of postoperative intraocular pressure (IOP) at the end of one year. A target pressure of

Purpose: To describe long term clinical outcome of simple Limbal epithelial transplantation(SLET). Design: Single center prospective interventional case series. Participants: This study include 21 patients, 12 adults and 9 children, who developed unilateral Limbal stem cell deficiency (LSCD) after ocular surface burn and underwent SLET between 2019 and 2021. Method: A 3.5 mm to 4 mm Limbal biopsy sample was harvested from unaffected eye. The recipient eye was surgically prepared and the autologous donor tissue was divided into small pieces and transplanted in mid periphery of the recipient cornea 360 around, using amniotic membrane, sutured with 10/0 nylon. Results: The study Includes of 21 patients, 12 adults and 9 children, with unilateral LSCD suffering from 0cular surface burn. Total LSCD (12 Clock hours) was seen in the affected eye in 11(91.66%) adults and 6 (66.66%) children and partial LSCD (less than 6 Clock hours) was seen 1(8.33%) adult and 3 (33.33%) children. Males were more common among adults, 7(58.33%) than children 5 (55.55%; p=.098) and adult female,5(41.66%) than female children, 4(44.44%). Accidental pressure cooker blast,3(33.33%) and lime burn,2(22.22%) were the most common causes of LSCD in children, whereas in adults causes include industrial alkali,4(33.33%) and lime burn, 3(33.33%). At the final follow up visit after SLET, 18 of 21 eyes in adults (91.66%) and children (77.77%) maintained a successfully regenerated stable corneal surface. Among patients with total LSCD, successful outcome was observed in 90% adults and 83% children and with partial LSCD success rate was 92% in adults and 83% in children respectively. There was a significant improvement in best corrected visual acuity (BCVA) after SLET compared with the base line in all age groups. In group 1, 14(66.66%) patients had pre-operative visual acuity of hand moment or perception of light with 0% visual acuity postoperatively. In group 2 ,07(33.33%) and 04(19.04%) patients had BCVA between 1/60 to 6/60, pre-operative and post-operative respectively. In group 3, none of the patient had pre-operative VA better than 6/60. Seventeen (80.95%) patients had recovered BCVA better than 6/60 with 95% Confidence interval and p value 0.000. Conclusion: Autologous SLET is an effective, reliable and replicable technique for long-lasting corneal regeneration and vision restoration in unilateral chronic ocular surface burns. Simple limbal epithelial transplantation is probably preferable to other techniques of limbal stem cell transplantation, particularly where cell cultivation facilities are unavailable.

Complex societal problems cannot be resolved without transdisciplinary research (TDR). Currently, there is no focused communication platform or commonly shared research framework for conducting TDR. The current study is a continuation of the exploration of collaborations in multidisciplinary, interdisciplinary, and TDR to identify ideas that could contribute to developing and testing a general framework for conducting TDR. The systematic literature review in this study discovered three main themes (TDR initiation, TDR management, and transdisciplinary knowledge exchange). These themes formed three phases of a general framework for conducting TDR. The novelty of the presented phased general framework for conducting TDR relates to the type of learning and outputs that are required at the end of each related action of all associated stages of the three phases to enable all participants to participate in TDR. The logical sequence of these actions and associated stages and phases were verified through a survey of academics and industry professionals internationally. The findings evidenced that improved communication between academics and industry professionals can respond to complex societal problems such as sustainable development, global environmental change, and environmental crises. The findings of the current research will enable the development of a transdisciplinary collaboration framework (TCF) for the nature-based design (NBD) of sustainable buildings aligned with the Royal Institute of British Architects (RIBA) Plan of Work.

Multidisciplinary, interdisciplinary, and transdisciplinary collaboration (TDC) continue to address complex societal problems such as sustainable development, global environmental change, and public health challenges. Nature-based design (NBD) methods including biomimicry, biomorphism, biophilia, bio-utilization and zoomorphism are essential for the design of the sustainable built environment (SBE). Currently, there is no transdisciplinary collaboration framework (TCF) to support the NBD of the SBE. The first step to fill this gap is through systematically exploring the applications of multidisciplinary research (MDR) in building design and by conducting a case study on the challenges to the MDR in the application of NBD methods for the SBE in the Faculty of Engineering and the Faculty of Science at the University of Strathclyde, Glasgow, UK. The systematic literature review and the survey results of academics on MDR collaboration showed a lack of transdisciplinary research (TDR) due to limited communication between disciplines. The research findings showed a lack of communication between academia and the Architecture, Engineering, and Construction (AEC) industry to advance NBD innovations for the SBE. The findings indicated that a TCF for research on NBD is needed to support knowledge exchange within academia and with industry for reducing the negative impacts of the building industry. Findings from the current research and future research will be used to develop and test a general TCF and then to develop a TCF for the NBD of the SBE aligned with the RIBA Plan of Work.

Objective: We aimed to compare the effectiveness of external dacryocystorhinostomy (EXT-DCR) with the intraoperative application and without intraoperative application of mitomycin-C (MMC) among chronic dacryocystitis patients. Material and method: The research design was a randomized controlled trial and it was conducted at Sir Ganga Ram Hospital, Lahore. The timeframe of research span from January 2017 to October 2017 (Ten Months). The research sample consisted of a total of 200 patients and these patients were also randomly allocated Group – I & II. Both male and female patients of (20 – 70) years of age who underwent EXT-DCR were made a part of this research. Patients also gave informed consent and we also secured ethical approval from the hospital management. Results: Both the groups showed a success rate of 96% (Group – I) and 85% for (Group – II) patients. Both the groups also showed a significant success rate difference with a significant P-Value of (0.014). Female were more in number in both groups. The researcher also applied SPSS software and Chi-Square test for statistical analysis. Conclusion: The application of intraoperative MMC with EXT-DCR is effective in comparison to the absence of application of MMC in EXT-DCR. Keywords: External Dacryocystorhinostomy (EXT-DCR), Chronic Dacryocystitis, Nasolacrimal Duct Obstruction and Mitomycin-C (MMC).

Objective: This research aimed to evaluate the effectiveness of metformin for PCOS (Polycystic Ovarian Syndrome) second line monotherapy of the patients. Methodology: This case series was conducted on a total of one hundred patients at Jinnah Hospital, Lahore (February to December 2017). We calculated the research sample with Confidence Interval (95%), expected metformin efficacy (29%) and freedom degree (7%) [6]. We included confirmed PCOS patients with clomiphene citrate treatment and any BMI range. Whereas, we did not include the patients with an intake of other than clomiphene citrate and any other known systemic disease. Physical examination history and second menstrual cycle hormonal profile (serum LH, FSH, testosterone, Prolactin and mid-luteal phase progesterone) along with ultrasound of pelvis were also carried out for every patient. Patients started receiving monotherapy of Metformin through an oral dose of (500 mg) per day for a period of one week and for another week the intake of the dose was (1500 mg) every day for a period of six months by non-obese females. We maintained a dose of (200 mg) among two groups obese female groups. During follow up visits after three weeks the researcher assessed the level of Serum Progesterone. Research documented the ovulation after a period of six months of metformin administration. Metformin was effective in the ovulation was at mid-luteal phase on the 21st day along with an indication of ovulation having progesterone more than (25 ng/ml). We documented every outcome on a designated proforma and statistical analysis with the help of SPSS software. Results: The research was carried out on one hundred patients who were selected in the age bracket of (20 – 40) years with an average age of (29.47 ± 6.23) years. Further distribution of age bracket was such as 57 patients were in the age bracket of (20 – 30) years and 43 patients were in the age bracket of (31 – 40) years. Metformin effectiveness in PCOS was reported in 63 women: whereas, 37 women reported no effect of metformin. Metformin effectiveness in terms of BMI was such that 12 out of 32 patients were obese (37.5%) and 51 out of 68 patients were non-obese (75%). Conclusion: We conclude that PCOS management is effectively possible by metformin; however, higher efficacy is significant in the PCOS non-obese women. Keywords: Metformin, PCOS (Polycystic Ovarian Syndrome), Effectiveness, Obese and Non-Obese.

Objective By 6 years, typically developing children have adequate reading/ reading comprehension, and writing skills. Per evidence-based research, phonological development is a pre-requisite to literacy skills as shown in the growth of receptive/expressive language modalities. Hypothetically, children develop phonological skills mainly through listening unlike children with congenital hearing impairment (HI), who lacks language and acquisition of phonological skills prior to literacy. This study aims to establish a computer- based program called Articulation, Language and Literacy Program (ALLP), following Aural-Oral Approach in children with HI to develop literacy. Method Phonological skills were introduced through the program to 10 children with sensorineural hearing loss targeting areas of articulation, language, and literacy skills, all of whom received early intervention through binaural hearing-aids or monaural cochlear implant. This program facilitated sound-word associations required for reading, simultaneously correcting production of speech, and developing lexical skills. Auditory training was mandatory through all stages of literacy development. Verbal responses and listening skills for speech sounds were recorded on weekly basis with individually tailored assessment tools. Generalization of therapeutic skills was facilitated through handouts given to parents. Conclusion This study reveals that early intervention is critical to language development and literacy skills, leading to academic success of children with hearing impairment in the mainstream academic environment.

To investigate whether urologists in UK utilise and adhere to recently published renal trauma guidelines. A one-page anonymous questionnaire was created based on recently published guidelines. Thirteen questions were used to investigate the current patterns of practice. The questionnaire was posted to 500 consultants in UK. Out of 500 questionnaires, 152 (30%) were returned; 109 (70%) respondents saw an estimated five or less cases of renal trauma per year; 104 (71%) respondents used guidelines but these differed; 79 (52%) respondents believed that the published guidelines were appropriate for UK practice; 8 (5%) did not feel that they were appropriate and 48 (32%) were unsure, and 30 (20%) used local guidelines. In stable patients with dipstick hematuria, 121 (80%) respondents requested imaging with ultrasound (76) the most popular. In stable patients with gross hematuria, all respondents requested imaging with CT scanning (126) the most popular. In stable children with suspected renal trauma, all respondents who managed pediatric cases would request imaging. Re-imaging following initial ultrasound was common. Imaging was described as easy or possible to obtain during regular working hours by 147 (97%) respondents. This fell to 131 (86%) out of hours with 14 (9%) respondents having difficulty with obtaining imaging. Only 27 (18%) respondents had interdepartmental protocols to facilitate the imaging process in suspected renal trauma. Only 74 (50%) responding urologists utilized the recently published guidelines in the management of renal trauma, and adherence to the recommendations – by those urologists who claimed to use the guidelines – was very variable. To facilitate the best practice in the management of renal trauma, it would be ideal if urologists and trauma surgeons were encouraged to adhere to established guidelines. As diagnostic imaging has a crucial role in the majority of cases, informed discussion with the local radiology department would probably help in achieving the standards required.

Dysphagia is an unusual presentation of pleural mesothelioma and carries a grim prognosis. A case of an elderly patient is presented herein, in whom the diagnosis was confirmed histologically, and the patient was still surviving 6 months after palliation.

The paper aims to explore and understand the ideas that contribute to the design of prosthetic architecture. The objectives to achieve the aim were: (1) to investigate "prosthetic building design" through previously published research, and (2) to design prosthetic architecture in an academic environment. The research opted for a systematic literature review assessing all accessible research related to prosthetic building design. It was complemented by the conceptualization and prosthetic architectural design of a Graduate design studio presented through various drawing techniques. The paper provides empirical insights such as achieving the design of prosthetic architecture by using representative qualities that are objectively proportionate to existing building elements but simultaneously reinforce their novel character. Due to the chosen research method, the research results may lack generalizability to other types of buildings requiring a prosthetic hence researchers are encouraged to test the proposed outcomes further. The research fulfils an identified need to study how prosthetic architecture can be designed.