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Hydrogen sulphide (H2S) is considered an immunotoxicant, and its presence in the water can influence the mucosal barrier functions of fish. However, there is a significant knowledge gap on how fish mucosa responds to low environmental H2S levels. The present study investigated the consequences of prolonged exposure to sub-lethal levels of H2S on the mucosal defences of Atlantic salmon (Salmo salar). Fish were continuously exposed to two levels of H2S (low: 0.05 µM; and high: 0.12 µM) for 12 days. Unexposed fish served as control. Molecular and histological profiling focused on the changes in the skin, gills and olfactory rosette. In addition, metabolomics and proteomics were performed on the skin and gill mucus. The gene expression profile indicated that the gills and olfactory rosette were more sensitive to H2S than the skin. The olfactory rosette showed a dose-dependent response, but not the gills. Genes related to stress responses were triggered at mucosal sites by H2S. Moreover, H2S elicited strong inflammatory responses, particularly in the gills. All mucosal organs demonstrated the key molecular repertoire for sulphide detoxification, but their temporal and spatial expression was not substantially affected by sub-lethal H2S levels. Mucosal barrier integrity was not considerably affected by H2S. Mucus metabolomes of the skin and gills were unaffected, but a matrix-dependent response was identified. Comparing the high-concentration group's skin and gills mucus metabolomes identified altered amino acid biosynthesis and metabolism pathways. The skin and gill mucus exhibited distinct proteomic profiles. Enrichment analysis revealed that proteins related to immunity and metabolism were affected in both mucus matrices. The present study expands our knowledge of the defence mechanisms against H2S at mucosal sites in Atlantic salmon. The findings offer insights into the health and welfare consequences of sub-lethal H2S, which can be incorporated into the risk assessment protocols in salmon land-based farms.

OBJECTIVES This study aimed to determine patient satisfaction with the pre-operative anaesthetist visit. METHODOLOGY A cross-sectional study was conducted from March to September 2023. All consecutive elective patients operated under anaesthesia during the study period were interviewed 24 hours after the operation. Data were collected by the Leiden peri-operative patient satisfaction questionnaire (LPPSq) within 24 hours postoperatively. SPSS 26 version was used for data analysis. The chi-square test was used to compare pre-operative visits and patient satisfaction. RESULTS 230 elective patients were operated upon under anaesthesia during the study period. Among all sections, the Fear and concern factor has the highest Cronbach alpha, 0.942. almost half of the patients aged 26-35 (42.2%) were female (56.3%), Class I in ASA physical status (50.2%), and living in a rural area (64.9%). For occupation, the majority of respondents were unemployed (89.2%). In addition, more than half of the respondents received general anaesthesia (60.6%). The most frequent procedure type was the gynaecology procedure (38%). Regarding an anaesthetist's visit, most respondents received a pre-operative anaesthetist visit (89.6%) and an anaesthetist approach (73.6%). However, the majority didn't receive adequate information, didn’t have a chance to choose the type of anaesthesia, and didn’t have an opportunity to ask a question, with percentages of 68%, 90%, and 95.2%, respectively. A significant and strong association existed between patient satisfaction and pre-operative anaesthetist visits (P

The relevance of the work. In modern society, the problem of reducing the consumption of primary energy is becoming more acute. Scientists around the world are solving problems related to global energy efficiency. At the same time, issues of environmental protection, reducing energy costs, ensuring energy security and many others are considered. Construction, as one of the largest energy consumers on the planet, cannot stay away from this problem. The search for energy-efficient solutions in construction has been going on for a long time. However, at the same time, the main attention is paid to the engineering equipment of construction objects and the creation of shells impermeable from a heat engineering point of view. In the context of the gradual exhaustion of opportunities for further improving energy efficiency in construction using traditional methods, this work aims to draw attention to the influence of the constructive solution of buildings on their energy consumption. It can be assumed that the optimization of the supporting structures of buildings will become a new driver for the development of the energy efficiency of buildings and structures.

Idiopathic third-degree atrioventricular (AV) block in a relatively young patient is an uncommon phenomenon. Even more rare is when the third-degree heart block is alternating with the first- and second-degree AV blocks. In this case, we present a 39-year-old man with varying degrees of AV block, alternating the third-degree, second-degree, and first-degree AV blocks. The patient underwent an extensive workup for underlying etiologies, and results were inconclusive. A pacemaker was implanted and set for physiologic pacing via left bundle branch area pacing (LBBAP). This case will discuss potential genetic abnormalities associated with AV block and highlight LBBAP as an emerging technique for physiologic pacing.

Piscine orthoreovirus (PRV-1) infection causes heart and skeletal muscle inflammation (HSMI) in farmed Atlantic salmon (Salmo salar). The virus is also associated with focal melanized changes in white skeletal muscle where PRV-1 infection of macrophages appears to be important. In this study, we studied the macrophage polarization into M1 (pro-inflammatory) and M2 (anti-inflammatory) phenotypes during experimentally induced HSMI. The immune response in heart with HSMI lesions was characterized by CD8+ and MHC-I expressing cells and not by polarized macrophages. Fluorescent in situ hybridization (FISH) assays revealed localization of PRV-1 in a few M1 macrophages in both heart and skeletal muscle. M2 type macrophages were widely scattered in the heart and were more abundant in heart compared to the skeletal muscle. However, the M2 macrophages did not co-stain for PRV-1. There was a strong cellular immune response to the infection in the heart compared to that of the skeletal muscle, seen as increased MHC-I expression, partly in cells also containing PRV-1 RNA, and a high number of cytotoxic CD8+ granzyme producing cells that targeted PRV-1. In skeletal muscle, MHC-I expressing cells and CD8+ cells were dispersed between myocytes, but these cells did not stain for PRV-1. Gene expression analysis by RT-qPCR complied with the FISH results and confirmed a drop in level of PRV-1 following the cell mediated immune response. Overall, the results indicated that M1 macrophages do not contribute to the initial development of HSMI. However, large numbers of M2 macrophages reside in the heart and may contribute to the subsequent fast recovery following clearance of PRV-1 infection.

Melanized focal changes in white skeletal muscle of farmed Atlantic salmon, “black spots”, is a quality problem affecting on average 20% of slaughtered fish. The spots appear initially as “red spots” characterized by hemorrhages and acute inflammation and progress into black spots characterized by chronic inflammation and abundant pigmented cells. Piscine orthoreovirus 1 (PRV-1) was previously found to be associated with macrophages and melano-macrophages in red and black spots. Here we have addressed the inflammatory microenvironment of red and black spots by studying the polarization status of the macrophages and cell mediated immune responses in spots, in both PRV-1 infected and non-infected fish. Samples that had been collected at regular intervals through the seawater production phase in a commercial farm were analyzed by multiplex fluorescent in situ hybridization (FISH) and RT-qPCR methods. Detection of abundant inducible nitric oxide synthase (iNOS2) expressing M1-polarized macrophages in red spots demonstrated a pro-inflammatory microenvironment. There was an almost perfect co-localization with the iNOS2 expression and PRV-1 infection. Black spots, on the other side, had few iNOS2 expressing cells, but a relatively high number of arginase-2 expressing anti-inflammatory M2-polarized macrophages containing melanin. The numerous M2-polarized melano-macrophages in black spots indicate an ongoing healing phase. Co-localization of PRV-1 and cells expressing CD8+ and MHC-I suggests a targeted immune response taking place in the spots. Altogether, this study indicates that PRV-1 induces a pro-inflammatory environment that is important for the pathogenesis of the spots. We do not have indication that infection of PRV-1 is the initial causative agent of this condition.

Background: Serious burn prompts to a condition of hyper catabolism, bringing about fast muscle damage and long term disability. As life expectancy from severe burn are enhancing, early restoration is vital to boost functional recovery. The prevalence of burn in 2004 was 11 million worldwide. Objective of Study: To assess the effects of active range of motion exercises in combination with stretching exercises on burn patients. Methodology: It was aquasi-experimental study. The study was conducted in Burn and Plastic Surgery Department, Mayo Hospital, Lahore. The study was completed in five months from September 2015 to February 2016 after the approval of synopsis.There was two groups and each group was allocated with 20 patients. Non-probability convenient sampling technique was used. Group 1 received active range of motion and stretching exercises while group 2 received active range of motion exercises alone for three sessions a week for 4 weeks. Demographics data, pain intensity on visual analogue scale (VAS), functional status of affected region on burn functional assessment scale (BFAS) and range of motion through Goniometer were recorded before and after the treatment. Data were entered and analyzed through Statistical Package of Social Sciences (SPSS) version 16.0. Results: Baseline measurements for pain intensity on VAS for group 1 was 7.04+1.46 that changed to 1.71+0.56 and for group 2 it was changed from 6.684+1.25 to 2.63+0.76. Burn Functional Assessment Score for group 1 and 2 were 29.23+5.03 and 29.94+4.65 and that were changed to 8.86+2.69 and 12.42+2.06 respectively. Conclusion: Active range of motion along with stretching exercises was more effective than the active range of motion alone in reducing pain intensity, functional activities and range of motion of involved limb for treatment of burn patients. Key words: Burn patients, stretching, active range of motion

Heart and skeletal muscle inflammation (HSMI), caused by infection with Piscine orthoreovirus-1 (PRV-1), is a common disease in farmed Atlantic salmon (Salmo salar). Both an inactivated whole virus vaccine and a DNA vaccine have previously been tested experimentally against HSMI and demonstrated to give partial but not full protection. To understand the mechanisms involved in protection against HSMI and evaluate the potential of live attenuated vaccine strategies, we set up a cross-protection experiment using PRV genotypes not associated with disease development in Atlantic salmon. The three known genotypes of PRV differ in their preference of salmonid host species. The main target species for PRV-1 is Atlantic salmon. Coho salmon (Oncorhynchus kisutch) is the target species for PRV-2, where the infection may induce erythrocytic inclusion body syndrome (EIBS). PRV-3 is associated with heart pathology and anemia in rainbow trout, but brown trout (S. trutta) is the likely natural main host species. Here, we tested if primary infection with PRV-2 or PRV-3 in Atlantic salmon could induce protection against secondary PRV-1 infection, in comparison with an adjuvanted, inactivated PRV-1 vaccine. Viral kinetics, production of cross-reactive antibodies, and protection against HSMI were studied. PRV-3, and to a low extent PRV-2, induced antibodies cross-reacting with the PRV-1 σ1 protein, whereas no specific antibodies were detected after vaccination with inactivated PRV-1. Ten weeks after immunization, the fish were challenged through cohabitation with PRV-1-infected shedder fish. A primary PRV-3 infection completely blocked PRV-1 infection, while PRV-2 only reduced PRV-1 infection levels and the severity of HSMI pathology in a few individuals. This study indicates that infection with non-pathogenic, replicating PRV could be a future strategy to protect farmed salmon from HSMI.

Background: Cervical radiculopathy is a condition of pain and sensorimotor deficits due to cervical nerve root compression. The symptoms may include weakness, tingling, numbness and pain. C6, C7 nerve roots are most involved in cervical radiculopathy. Various modalities and therapeutic interventions are used and recommended for management of cervical radiculopathy including cervical collars, immobilization, manipulation, cervical traction TENS and therapeutic exercises.The aimof this study is to evaluate the efficacy of neurodynamics in comparison to manual traction in the management of cervical radiculopathy. Methods: An Interventional research was performed in the Department of Physiotherapy, Mayo hospital Lahore, Pakistan. 40 subjects aged between 18-60 years participated in the study. They were divided into two groups namely Group A and Group B with 20 subjects in each group. The duration of the study was 4 weeks with 4 sessions per week. GroupA received neurodynamics along with strengthening exercises while Group B received manual traction along with strengthening exercises. Neck Disability Index (NDI) scale was used as an outcome measure andpaired sample t-test was used for statistical analysis. Results: A significant improvement was found in both neurodynamics group and manual traction group for pain and functional status with p value< 0.05. Conclusion: This study concluded that the treatment techniques, neurodynamics and manual traction were effective in alleviating the symptoms associated with cervical radiculopathy in terms of decreasing pain intensity, increasing ranges of motion and improving functional capacity.

Ultraviolet (UV)-induced cationic frontal polymerization has emerged as a novel technique that allows rapid curing of various epoxy monomers upon UV irradiation within a few seconds. In the presence of a diaryliodonium salt photoinitiator together with a thermal radical initiator, the cationic ring opening polymerization of an epoxide monomer is auto-accelerated in the form of a self-propagating front upon UV irradiation. This hot propagating front generates the required enthalpy to sustain curing reaction throughout the resin formulation without further need for UV irradiation. This unique reaction pathway makes the cationic frontal polymerization a promising route towards the efficient curing of epoxy-based thermosetting resins and related composite structures. This review represents a comprehensive overview of the mechanism and progress of UV-induced cationic frontal polymerization of epoxy monomers that have been reported so far in literature. At the same time, this review covers important aspects on the frontal polymerization of various epoxide monomers involving the chemistry of the initiators, the effect of appropriate sensitizers, diluents and fillers.

Piscine orthoreovirus-1 (PRV-1) can cause heart and skeletal muscle inflammation (HSMI) in farmed Atlantic salmon (Salmo salar), but the line of events from infection, pathologic change, and regeneration has not been thoroughly described. In this study, the cellular localization and variation of PRV-1 RNA and protein levels were analyzed at different times post-exposure in experimentally infected Atlantic salmon. Immunohistochemistry, flow cytometry, and Western blot were used for assessment of the presence of the PRV-1 σ1 protein, while RT-qPCR and in situ hybridization were performed for viral RNA. Histopathologic evaluation demonstrated that PRV-1 infection induced heart lesions typical of HSMI, such as severe epicarditis and myocarditis with degeneration of cardiomyocytes, necrosis, and diffuse cellular infiltration. PRV-1 infection of erythrocytes and the peak viral plasma level preceded virus presence in cardiomyocytes and hepatocytes. Arginase-2-positive, macrophage-like cells observed in the heart indicated possible polarization to M2 macrophages and the onset of regenerative processes, which may contribute to the recovery from HSMI. The virus was cleared from regenerating heart tissue and from hepatocytes, but persisted in erythrocytes.

Piscine orthoreovirus (PRV-1) can cause heart and skeletal muscle inflammation (HSMI) in farmed Atlantic salmon (Salmo salar). The virus targets erythrocytes in the acute peak phase, followed by cardiomyocytes, before the infection subsides into persistence. The persistent phase is characterized by high level of viral RNA, but low level of viral protein. The origin and nature of persistent PRV-1 are not clear. Here, we analyzed for viral persistence and activity in various tissues and cell types in experimentally infected Atlantic salmon. Plasma contained PRV-1 genomic dsRNA throughout an 18-week long infection trial, indicating that viral particles are continuously produced and released. The highest level of PRV-1 RNA in the persistent phase was found in kidney. The level of PRV-1 ssRNA transcripts in kidney was significantly higher than that of blood cells in the persistent phase. In-situ hybridization assays confirmed that PRV-1 RNA was present in erythroid progenitor cells, erythrocytes, macrophages, melano-macrophages and in some additional un-characterized cells in kidney. These results show that PRV-1 establishes a productive, persistent infection in Atlantic salmon and that erythrocyte progenitor cells are PRV target cells.

Background: Cervical pain is a common condition and almost two thirds of population suffers with this condition. Cervical region is the commonest region for non-traumatic neck pain. Neck pain generates many muscular disturbances in the neck region and may result in tightness of muscles of cervical region. Stretching is considered as an effective mean of treating cervical pain. Isometric exercise is used to enhance the performance of muscles because it provides strength required to perform dynamic exercise. Both of the regimens either separately or combined are used in clinical settings to treat nonspecific cervical pain. This study aims to compare the results of cervical isometrics with and without stretching exercises in reducing non-specific cervical pain Methods: A randomized controlled trial research was performed at physiotherapy department of Mayo Hospital Lahore, Pakistan. A convenience sample of 40 participants was divided into two groups. The cervical isometric exercise was applied to group A and stretching plus isometric exercise to group B for 3 weeks. Nonspecific neck pain was analyzed by using visual analogue scale and goniometry for pre and post treatment assessment. Results: Isometric exercises play an effective role in relieving pain (p value is 0.03) and minimizing inability of the body to perform functional activities (p value is 0.004) in contrast to the patients of group A. Isometric exercises were applied to the patients of group A (Level of pain: pain value is 0.172) and (physical inability to perform functional activities has P value 0.201). Conclusion: The result showed that the patients with the complain of non-specific neck discomfort who were treated by cervical isometric alone, showed less improvement in pain relief in contrast to the patients who were treated by the cervical isometric long with stretching.

Background: Diabetes has become a very common disease all over the world since last few decades and is now perceived as a global health disorder. Diabetes mellitus is identified on the basis of constant high concentration of blood glucose level and it mainly occurs due to deficiency of the pancreatic hormone insulin. High-intensity interval training (HIIT) is an improved form of interval trainings, and exercise strategies which alternate the periods of small intense anaerobic exercise by less-intense regaining periods. The study aimed to compare the hematological parameters associated with diabetes and muscle activity between healthy humans and diabetic type-1 patients when subjected to HIIT and regular aerobic exercises. Methods: A convenience sample of total 60 participants was taken it comprised of thirty healthy individuals taken from the department of Physical Therapy, University of Sargodha, Lahore campus and thirty diabetic type-1 individuals of age 15-30 years taken from Akhuwat health services clinic Township, Lahore. Participants were divided into four groups of fifteen individuals each. Group one was the diabetic HIIT (DH) group with diabetic type-1 patients subjected to HIIT. Group two was the diabetic aerobic (DA) group with diabetic type-1 patients subjected to regular aerobic exercises. Group three was control High intensity interval training (HH) that consisted of fifteen healthy individuals to be subjected to High intensity interval training exercises (HIIT). Group four (HA) was the control aerobic group with fifteen healthy individuals of average lifestyles subjected to regular aerobic exercises. Results: Aerobic exercise was found to be more effective in reducing glucose level, lowering exogenous insulin and glycated hemoglobin, however HIIT proved to be more effective in lowering blood cholesterol level and decrease LDL level and increase HDL level. Conclusion: It was concluded that aerobic exercise program in comparison to high intensity interval training showed better results in lowering blood glucose levels and HbA1c levels. So we may suggest aerobic exercise program along with drugs as a synergic therapy to control diabetes and its complications.

Background: Froze shoulder in other words adhesive capsulitis is a condition characterized by progressive loss of shoulder mobility with general symptoms of pain, limited range of motion and altered scapula thoracic rhythm. The condition is mostly treated by using traditional physical therapy measures the study was conducted with the aim to determine the efficacy of routine physical therapy treatment with and without Kaltenborn mobilization in reducing pain and increasing shoulder mobility in frozen shoulder patients. Methods: The study was conducted in the department of Physiotherapy mayo Hospital Lahore. A sample of 60 patients was collected by using non-probability, convenience sampling without any discrimination regarding, social economic status, education, out of which there were 8 drop outs. Sample was distributed in two groups (26 participants each) i.e. experimental group receiving routine physical therapy and Kaltenborn Mobilization technique and control group receiving the routine physical therapy only. Participants were recruited based on the inclusion and exclusion criteria. Demographic data and data regarding pain relief was collected using self-made questionnaire and penn shoulder scale questionnaire respectively. Results: Results were evaluated by using SPSS version 19.1 it was seen that range of motion of cervical region was greater for the experimental group than control group. The maximum PENN score achieved in control group were 51 however for experimental group the value was 64. Conclusion: It was concluded that kaltenborn mobilization is an effective means of treating frozen shoulder and when combined with routine physical therapy gives better results.

Background: Urinary incontinence is a common condition among females and it is estimated that 20-40% females of age under 60 years suffer with urinary incontinence however for the females above 60 years the percentage is 30-50%. Keegal exercises are used to strengthen pelvic floor muscles which ultimately treats and reduces urinary incontinence. It is pretty definite that women with diabetes mellitus at advanced phases of age suffer with urine incontinence, but the severity of matter has yet been considered enough to put forth the cautionary measures to evade such concerns. Purpose of the study is to analyze the effect of pelvic floor exercises on the urinary incontinence in diabetic women. Methods: To evaluate the effect of Keegeal exercises (pelvic floor muscle exercises), quantitative research approach has been opted, in which patient were advised to perform the keegeal exercise for 3weekswith 4 weeks follow up. 45 diabetic women were recruited to analyze the effect of keegal exercises to minimize the risk of urine incontinence. In due course, three types of keegeal exercises have been proposed to analyze their effect on urine incontinence i.e. adductor strengthening, pelvic bridging, and draw in maneuver with a follow up of 4 weeks. Results: Reliability test was performed to evaluate the dependency between independent and dependent variable. Through ANOVA with Friedman's Test, it was observed that the data of correlation between the suggestive variables is highly significant. Cronbach’s Alpha test was performed which has concluded the results to 0.753 which is quite significant in context of research hypothesis and approving the fact the with keegeal exercise, urine incontinence can be reduced. Conclusion: With subjective research it was concluded that if the patient efficiently performs the exercise the urine incontinence can be improved.

Background: Upper cross syndrome is becoming more prevalent in today’s population. The syndrome is expressed as a postural disorder presenting with over active pectoralis musculature and upper trapezius musculature. Also there is inhibition of lower and middle trapezius musculature, which results in winging of scapula, elevated and abducted scapula. This scapulardyskinesia there by resulted inrounding of shoulders. The syndrome is often associated with bad posture in routine life oroccupation of a person.The purpose of the study is to determine the prevalence of upper cross syndrome in medical students of Lahore. Methods: A convenience sample of 384 medical students was selected from university of Lahore, based on inclusion and exclusion criteria. Medical students of age between 17 to 2 years with sound physical and mental state were included. Students with any trauma, recent injury, recent fracture or surgery and any serious underlying pathology that may interfere with mobility of upper limb were excluded from the study. The research was a cross sectional observational study and self-administered questionnaires were circulated among participants and the data was analyzed using SPSS version 21. Reed-co scale was used to analyze the proper alignment of head, neck and shoulder; where as wall push test was used to assess the abnormal protrusion of scapula. Results: The study have revealed that48.7% population of the students haveneck pain;and the results have concluded that high prevalence of upper cross syndrome in medical students of university of Lahore and a 66.8% of population was found to have poor studying posture. Conclusion: In this study relation between upper cross syndrome and bad posture were seen and it was found that the individuals suffering with upper cross syndrome were somehow related to bad posture or indulge in activities which make individual to adopt a posture of high physiologic cost there by leading to muscular imbalance that will yield upper cross syndrome and prevalence of upper cross syndrome in medical students of University of Lahore was found to be 37.1%.

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