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Background: Diaphyseal fractures of the tibia currently account for approximately 2% of all fractures presenting to orthopedic surgeons. Epidemiology has changed markedly during the last two decades with overcrowding and related to improved road safety. In comparison to young population majority of these fracture occur predominantly in females as compared to males in old population. Objectives: To determine the outcome of diaphysis fractures of tibia in elderly patients Methods: This study was carried out in department of orthopaedic Jinnah hospital Lahore from 2014-2017. One hundred and twenty patients both males and females in the age range of 65 to 80years, having diaphyseal fractures of tibia were included in the study. The patients with poly-trauma and with peri-prosthetic fractures were excluded from the study. After detailed medical history, clinical examination, the x-rays of tibia fibula AP and Lateral views including joint above and below were done to determine the configuration of the fracture. Each patient was followed at 1st, 2nd and at 6th week and then at 3rd month, 4th month, 6th month and later at 1 year. Data was entered and analyzed in SPSS ver: 21.0 and was presented and frequency and percentages. Cross tabulation was done for open and closed fracture for outcome and Chi Square test was used to assess statistical significance with p value of ≤0.05. Results: 62.5% were females and 37.5% were males with mean age of 72 + 5.45 years. The mode of injury in most of the patients was slip and fall 85% and 70 % of patients had closed fractures. Reamed intra medullary nailing was done in 80 patients and 25 patients with open fracture were treated with external fixator. In the remaining 5 patients we applied the POP cast. Nonunion was labeled at 9 months and was seen in 10.0% of patients while the delayed union was seen in 33.0% (40) of the patients. Among the patients who had nonunion 5 patients were treated with intramedullary nailing and 7 patients were treated with external fixator. Infection was seen in 10.0% (12) of patients and this happened in the patient with open fracture. No patient was lost in follow-up during the study. Overall mortality rate was 30% in the 1st year.

Objectives: To determine outcome in displaced tibial shaft fracture in children treated with elastic stable intra-medullary nailing. Study Design: Descriptive, Case Series study. Setting: Department of Orthopedic, Bahawal Victoria Hospital, Bahawalpur, HBS Medical & Dental College, Islamabad and HITEC-IMS Taxila Cantt, Pakistan. Period: 2012 to 2019. Material & Methods: A total of 62 cases of displaced tibial shaft fracture presenting within 7 days of the injury, 6 to 11 years of age of either gender were included. Patients with segmental tibial shaft fractures and open tibial shaft fractures, Gustilo Grade II & III were excluded. The titanium elastic nails system (TENS) was used in all patients according to the departmental protocols. The sampling technique was consecutive with non-probability. All the patients were followed up in OPD at 2 weeks interval up to 24 weeks after surgery and union of fracture was recorded at 24th week. Results: Mean age was8.55 ± 1.77 years. Out of these 62 patients, 45 (72.58%) were male and 17 (27.42%) were females with ratio of 2.65:1. Mean duration of fracture was 3.10 ± 1.95 days. Mean duration of union in displaced tibial shaft fracture in children treated with elastic stable intra-medullary nailing was 19.40 ± 3.35 weeks. Conclusion: This study concluded that use of elastic stable intra-medullary nailing for displaced tibial shaft fracture in children leads to shorter duration of union reliably with minimal complications.

The perturbation-based nonlinearity compensation (NLC) method is considered in conjunction with a forward error correction (FEC) code that is capable of detecting block errors. The FEC decoding is performed prior to the NLC, and NLC is then performed only for blocks, that could not be decoded correctly. The total NLC complexity is thus dramatically reduced to down to 1% in some cases w.r.t. the standard, hard decision-directed NLC performed prior to the FEC decoding. Negligible FEC decoding complexity increase is required for the subsequent decoding of the nonlinearity-compensated blocks. The proposed method achieves and sometimes outperforms the standard perturbation based NLC at a fraction of the overall complexity. Polar codes are used to exemplify the method.

We experimentally demonstrate a rate-adaptive concatenated forward error correction (FEC) scheme to minimize the information rate loss due to varying channel conditions. The concatenated coding scheme is based on inner soft-decision polar code and outer hard-decision staircase code. An experiment in a wavelength-division multiplexed (WDM) system with different SNR per WDM channel is performed by employing concatenated codes with various coded modulation schemes over a target distance of 140km which is relevant for extending the reach of data center interconnects. Experimental results show that the achieved data rate of the WDM system can be improved up to 37.6% with the proposed coding scheme w.r.t. the fixed code rate ZR FEC.

A rate-adaptive concatenated code, consisting of an outer staircase code and an inner polar code is proposed. Short blocklength inner polar codes offers rate-adaptivity and more than 0.35 dB gain compared to the 400ZR data-center-interconnect error-correcting code.

Background Pneumonia and diarrhea remain the leading infectious causes of mortality and morbidity in children under 5 years of age. 1According to the study carried out by WHO in 2017 the coverage of rotavirus is 23% while that of pneumococcal vaccine is 43% which accounts for serious health issues in children.2 An estimated 1 in 40 infants experience a severe episode of rotavirus gastroenteritis annually in Pakistan.3 Objective The objective of this study was to determine the frequency of diarrhea and pneumonia in vaccinated and unvaccinated children less than 5 years of age: A single center study Methods A descriptive cross sectional study was conducted in Department of Pediatrics at Darul Sehat Hospital and SESSI, Karachi from 1st November to 3rd February 2019.The 196 respondents were selected by convenience sampling and interview based questionnaire was administered. Variables such as age, gender, duration of illness, history of previous episodes, breastfeeding, number of vaccines, type of vaccines, reason for vaccination and not vaccinated were asked from participants. Results A total of 196 questionnaires were interviewed from mothers of children aged 1–60 months. ­­­­98 (52.7%) of the total was male and 88(47.3%) were females. Participants that received vaccination for rotavirus and pneumococcal vaccine were 172(88.7%) while 22(11.3%) remain unvaccinated. Incidence of watery diarrhea accounts for 66(63.5%). Frequency of diarrhoea was mild in 29(33.7%), moderate in27 (31.4%) and severe in 30(34.9)% in vaccinated children where as it was mild in 02(11.1%) moderate in 04 (22.2%) and severe in 12 (66.7%) in unvaccinated children with p value being 0.035. Frequency of severe pneumonia was far less then frequency of cough and cold in vaccinated participant as compared to unvaccinated participant with p value being Conclusion Human rotavirus and pneumococcal vaccines significantly reduced the occurrence of severe rotavirus gastroenteritis and acute respiratory tract infection. The research concludes that vaccination might not have significantly reduced the disease burden but has definitely reduced the severity of both diseases.

We propose a duplex dual-ring Radio Over Fiber (ROF) architecture considering the limitations imposed by the cost of the optical/electronic components and of deployed fiber. The proposed architecture uses two light sources and a low-frequency local oscillator (LO) at central unit (CU) for simultaneously transmitting and receiving 25 GHz RF signals to (from) eight simplified Radio Access Units (RAUs) arranged in dual-ring topology. A sophisticated combination of Polarization Multiplexing (PM), Optical Frequency Comb (OFC) generation, wavelength division multiplexing (WDM), wavelength reuse, remote heterodyne detection (RHD) and distributed antenna system (DAS) is conceived. It has been shown through simulations that the proposed architecture covers a large geographical area while maintaining the transmission integrity which is evaluated using bit-error rate (BER) matrics.

Next generation optical communication networks demand the use of the lower channel spacing and high input power in Wavelength Division Multiplexing (WDM) systems to achieve higher data rates. However, decreasing channel spacing and increasing input power create nonlinear effects including Four Wave Mixing (FWM). In this paper a method has been introduced in which alternative circular polarizers are used to change the polarization of input pulses into right and left handed polarized pulses before multiplexer which results in reduction of FWM. With the help of this technique we can completely eliminate FWM by optimizing optical network's parameters. Exhaustive set of simulations has been performed in Optisys and system's performance has been calculated.

International audience; A decentralized link adaptation algorithm designed for multi-link MIMO interference systems to jointly optimize the power and the number of links is presented in this contribution. Game theory is adapted and used for both allocating resources and admitting users (i.e. with embedded congestion control). The MIMO interference system is mapped into a multi-player game. The solution of the proposed game is provided by a new gradient based decentralized link adaptation algorithm. The new algorithm allocates adaptively the power and the modulation scheme of the transmitter and maintains the optimum number of links using soft decision criteria based on the link metric. Each link decision depends on the type of traffic and the QoS requirements. An analytical framework is provided along with simulations and an analysis of the algorithm behavior under different system conditions. This type of algorithm is applicable to spectrum sharing and power management to reduce interference and energy consumption