Outcomes of surgical management of liver trauma at LUMHS Jamshoro

Background: Mortality from liver trauma remains high despite surgical advancements. The objective of this study was to determine the outcomes of surgical management of liver trauma at LUMHS Jamshoro.Methods: A cross-sectional observational study using non-probability convenient sampling technique was done at department of surgery LUMHS Jamshoro for 18 months. Patients between 14 to 50 years with blunt hepatic trauma presenting to the E.R. within 04 hours of incident were included and hepatic trauma patients managed conservatively, having multiple trauma and hemo-dynamically stable were excluded. SPSS version 20 was used for data analysis with mean and SD reported for qualitative and frequency and percentages for quantitative variables. Chi-square test was applied keeping p-value of < 0.05 as statistically significant.Results: From 136 patients with mean age of 32.33±1.23 years, 120 (88%) were male. 122 (89.7%) were admitted due to blunt trauma and 14 (10.3%) due to penetrating trauma. Peri-hepatic packing was performed in 116 (85.2%) and suture hepatorrhaphy in 20 (14.8%). Intra-abdominal sepsis was seen in 41 (30%) of patients followed by recurrent hemorrhage in 33 (24%) while 30 (22%) of patients died. Substantial differences (p < 0.001) were observed in terms of surgical technique and each of the complication i.e. sepsis, bile leak and recurrent hemorrhage among alive patientsConclusions: The most common post-operative complication was intra-abdominal sepsis followed by recurrent haemorrhage and bile leak. Significant mortality was observed in between type of complication as well as surgical technique

Complication rates in managing hepatic trauma: a cross-sectional study stratifying their outcomes

Background: Liver trauma is the most commonly observed injured organ in abdominal trauma. The objectives of this study was to determine and evaluate the rates of complication in the management of liver traumaMethods: This cross-sectional observational study using non-probability convenient sampling technique was done at surgical unit of Liaquat University of Medical and Health Sciences, Jamshoro, for 06 months. After ethical approval from Institute’s Institutional Review Board (IRB), patients presenting to surgical emergency of the hospital between ages 16 to 60 years having blunt or penetrating liver trauma within 04 hours of incident, either road traffic accident, sustaining a fall, sporting injury, knife or stab wound were include while patients of liver trauma conservatively managed or had severe co-morbid, not fit for anesthesia, with multiple organs lesions (polytrauma) and all hepatic injury patients that were hemo-dynamically stable were excluded. SPSS version 23 was used for data analysis keeping p-value <0.05 as significant.Results: Among 136 patients with mean age 32.33±11.23 years, 120(88.2%) were males. 122(89.7%) of the patients were admitted due to liver trauma of blunt variety while 14(10%) with penetrating liver injury. Overall mean duration of hospital stay was 13.1±4.58 days. 41(30%) patients reported intra-abdominal sepsis, followed by recurrent hemorrhage in 33(24%) of patients while in 22(16%) of patients, biliary leakage was observed. An insignificant difference persisted in either surgical intervention in terms of the complication rates.Conclusions: Higher complication rates were observed in patients with peri-hepatic packing, however outcome of both surgical techniques in terms of complication rates were found to be insignificant. Further studies are needed to shed light upon the findings or this study

A Hydrological Response Analysis Considering Climatic Variability: Case Study of Hunza Catchment

The hydrological response of mountainous catchments particularly dependent on melting runoff is very vulnerable to climatic variability. This study is an attempt to assess hydrological response towards climatic variability of the Hunza catchment located in the mountainous chain of greater Hindu Kush-Himalaya (HKH) region. The hydrological response is analyzed through changes in snowmelt, ice melt and total runoff simulated through the application of the hydrological modeling system PREVAH under hypothetically developed climate change scenarios. The developed scenarios are based on changes in precipitation (Prp) and temperature (Tmp) and their combination. Under all the warmer scenarios, the increase in temperature systematically decreases the mean annual snow melt and increases significantly glacier melt volume. Temperature changes from 1°C to 4°C produce a large increase in spring and summer runoff, while no major variation was observed in the winter and autumn runoff. The maximum seasonal changes recorded under the Tmp+4°C, Prp+10% scenario

High temperature dielectric properties of Apical, Kapton, Peek, Teflon AF, and Upilex polymers

Reliable lightweight systems capable of providing electrical power at the magawatt level are a requirement for future manned space exploration missions. This can be achieved by the development of high temperature insulating materials which are not only capable of surviving the hostile space environment but can contribute to reducing the mass and weight of the heat rejection system. In this work, Apical, Upilex, Kapton, Teflon AF, and Peek polymers are characterized for AC and DC dielectric breakdown in air and in silicone oil at temperatures up to 250 C. The materials are also tested in terms of their dielectric constant and dissipation factor at high temperatures with an electrical stress of 60 Hz, 200 V/mil present. The effects of thermal aging on the properties of the films are determined after 15 hours of exposure to 200 and 250 C, each. The results obtained are discussed and conclusions are made concerning the suitability of these dielectrics for use in capacitors and cable insulations in high temperature environments

Growth responses of NaCl stressed rice (Oryza sativa L.) plants germinated from seed in aseptic nutrient cultures supplemented with proline

Negative impact of salinity on plant germination is significant because of abundance of Na+ in culture medium, which causes growth inhibition. Effect of salinity (NaCl) in the presence of proline was assessed in rice (Oryza sativa L.) variety Khushbo-95 at seedling stage. Seeds were cultured on MS0 (MS basal medium), MS1 (MS0 + 100 mM NaCl) and MS2 (MS1 + 5 mM proline) for 20 days. Seedlings and its biomass decreased in saline culture. Similarly, total protein and sugar contents also decreased, while reducing sugars and proline contents increased. These parameters were observed to be slightly adverse in cultures supplemented with proline (MS2) and NaCl (MS2). Among cultures, leaf demography (cell size) was affected significantly; this may be the reflection of accumulation of proline, Na+ and Cl- and exclusion of K+ in developed rice seedlings.Key words: Oryza sativa L., seedling biomass, epidermal cells, proline content

Quality of Experience Framework for Cloud Computing (QoC)

Cloud computing provides platform for pay per use services such as software (e.g., database, data processing, application servers, etc.), hardware (e.g., GPUs, CPUs, storage, etc.) and platforms (e.g., Linux, Microsoft Windows and Apple macOS). Previous cloud frameworks use fix policies that do not have the functionality to upgrade services on demand when the user do not receive services according to Service Level Agreement (SLA). Also, there was a lack of functionality to monitor external network and client device resources. This paper presents Quality of experience framework for Cloud computing (QoC) for monitoring the Quality of Experience (QoE) of the end user using video streaming services in the cloud computing environment. The management platform is used for administration purpose in QoC framework that provides facility to easily manage the cloud environment and provide services according to SLA via runtime policy change. The objective QoE/QoS section will automatically monitor the Quality of Service (QoS) data. It will also compare and analyze the subjective QoE submitted by the users and objective QoS data collected by agent based framework for accurate QoE prediction and proper management. The proposed QoC framework has new features of real time network monitoring, client device monitoring and allows changing policy in runtime environment which to our knowledge is currently not provided by existing frameworks

Growth Pattern and Morphological Variation of Labeo calbasu Found in Indus River, Sindh-Pakistan

The present work reports the length–weight relationships (LWR) and condition factor relationships for Labeo calbasu collected from Upstream (Matyari) Kotri barrage at, River Indus, Pakistan, because stock assessment helps the fisheries managers to conserve the commercially important fish. Morphological characters of fish as well as Length-weight relationship are an important tool for fishery management. The results of LWR (W= aLb), for L calbasu.  Representing negative allometric growth pattern. LWRs and condition factor relationships were found significantly correlated. A total of 200 and 190 specimens from upstream and downstream were collected, respectively. The assessed values of length-weight correlation and condition factor were calculated as Kn=39.663 (LeCren), and K=11.915 (Fulton) for upstream and Kn=44.066 and K=13.872 for downstream. Length-weight was found with a strong correlation of n= 2.892, a=0.0235 with r2=0.934 for upstream population then the downstream population.  The results of this work would be beneficial for sustainable management as well as fishery managers. 

Common Factors of Cost Escalation in Construction Industry of Pakistan

Cost escalation is a ubiquitous problem, especially in Government organizations. Though bigger projects encompass escalation cost, in smaller projects, it is generally ignored. Several internal and external factors are responsible for the undesirably increased cost of a project. Among them some are tangible, and some are intangible. The scope of this study is to highlight most common remittable and non-remittable factors responsible for cost escalations. Thirty most common factors responsible were listed. A survey was done in order to have the stakeholder’s opinion on identifying the most common factors. Out of 102 generally identified escalating factors, 30 factors were shortlisted based on literature and initial study. Participants responded on a 1 to 5 Likert’s scale. Out of 200 distributed questionnaires, 52 reliable set of questionnaires were selected for data analysis. Clients, consultants, and constructors were selected from different projects like roads, structure, public amenities etc. Minimum threshold to participate in the survey was that a respondent must had at least a Diploma or Bachelor’s degree in the field of civil engineering. Results highlighted that financial problems, slow payments, and inflation are the top-ranked identified factors responsible for cost escalation in the construction industry of Pakistan. The weighted average of all factors ranges between 0.355 and 0.688, having 0.668, 0.629 and 0.625 for the top three factors

Assessment of Climate Driven Changes in Flow Series of Alpine Basin: A Case Study of Danube River Basin

This study was carried out in order to analyze the climate change driven influence on mean monthly flow series of Danube River and its tributaries during the last century. The study confirms some signs of climate driven alterations in monthly river flow series along with change in flow seasonality during the last century. In spite of this, man-made interference in the basin like i.e. groundwater extraction, irrigation, river regulation, land use alteration and urbanization, has significantly changed Danube flow regime in most areas of the catchment. The analysis of Achleiten station demonstrates that average annual flow regime is a little bit increased. Major increase is observed in winter and autumn months and decrease in summer months. These seasonal alterations clearly signal a future glimpse of reduced water availability in alpine basins. This will mainly occur due to the change in the form of precipitation in winter, from snow to rain and the consequent less snow accumulation, and the early melt of snow storage, less precipitation and high evaporation rate in summer

Application of Quality of Experience in Networked Services: Review, Trend & Perspectives

Full text embargoed until 17.10.2019 (publisher's embargo period, 12 months