Jaundice: a basic review

Jaundice is a complex disease. Jaundice is actually the high bilirubin level in the body. Yellowing of skin, mucous membranes and skin are common presentations of jaundice. Jaundice has various variants including pre-hepatic jaundice (due to hemolysis of red blood cells), hepatic jaundice (due to defect in capture, conjugation and excretion of bilirubin by liver) and post hepatic jaundice (due to the obstruction of extra hepatobiliary system). The causes of various variants of Jaundice is either acquired or congenital. High plasma bilirubin level can cause various manifestations involving satiety, gastrointestinal bleeding, diarrhea, anemia, edema, weight-loss and can be fatal because it can cause psychosis, lethargy, seizures, coma or even death. High bilirubin level can help in the diagnosis of Jaundice. Differential diagnosis of various variants of Jaundice can be carried out on the basis of bilirubin level (conjugated and unconjugated), ultrasonography and other radiological techniques. The proper management of Jaundice is high water intake and low fat diet. The primary effective treatment for pre-hepatic jaundice and neonatal physiological jaundice is phototherapy. Infusion of immunoglobulins is also used for treatment of pre-hepatic jaundice. Proper nutrition, steroids and immunosuppressant are used for treatment of hepatic jaundice. The treatment for post hepatic jaundice is decompression and surgery

TEM study of the oxidation resistance and diffusion processes in a multilayered TiSiN/TiN(Ag) coating designed for tribological applications

This work investigates the structure evolution of a multilayered TiSiN/TiN(Ag) coating with heating, oxide scale growth, diffusion processes occurring during oxidation, and changes in the structure and chemical composition of the non-oxidized zone. The coatings have a multilayered structure with a bilayer periodic thickness of ~40 nm. The TiN(Ag) layer consists of fcc TiN and Ag crystalline phases, where Ag nanocrystallites are homogenously distributed at the TiN grain boundaries. The TiSiN layer consists of fcc Ti–Si–N solid solution grains and an amorphous a-SiNx phase which segregates at the Ti–Si–N grain boundaries. In-situ hot-XRD analysis shows that the first signs of oxidation occur at 800 ◦C, when rutile-TiO2 starts to form. The oxidized part of the coating is Ag depleted, except the top layer terminating the structure, which contains some 1–3 nm Ag clusters. Ag diffuses towards the surface from oxidized zones. The cross-sectional analysis also shows no signs of recrystallization and structural changes, except for stress relaxation in the non-oxidized part after annealing at 800 ◦C. No Ag redistribution or diffusion is found in the non-oxidized part, even close to the interface with the oxide layer, which suggest effectiveness of the multilayered design to mitigate uncontrolled Ag migration towards the surface.info:eu-repo/semantics/publishedVersio

Technological Dramas and the Punjab Police: The Downfall of Front Desk

Electronic dependence and utilization have been emerging as one of the driving forces towards departmental growth and development in this new era of globalization and modernization in Punjab police. The Front Desk (FD) project has a sign of change in Punjab police. It was changing the face of the police from the very first day it was started, but with the passage of time, it has changed its motive and began to change in the color of police. Hence, this paper highlights the issues and their solutions regarding the implementation and utilization of the FD project in the Punjab police department. It also highlights the working of Punjab police with and without FD and the importance of FD in the police department to delivering the grievance and of analysis the true nature of crimes. It discusses various aspects of police department myths and mistakes undertaken by the Punjab police officials and suggests various solutions for changing the face of the department. Keywords: Front Desk Project, Information Technology, Police Culture, Policing, Police Myths, Working of FD, Training & Development. DOI: 10.7176/PPAR/11-1-07 Publication date: February 28th 202

Effect of Annealing Heat Treatment on the Composition, Morphology, Structure and Mechanical Properties of the W-S-N Coatings

Alloyed-transition metal dichalcogenide (TMD) coatings have been under investigation as multi-environment lubricants for the past few decades. These coatings display very low coefficient of friction properties at elevated temperatures. Studies on the annealing of these low-friction coatings are missing in the literature. For the first time, in this study, the annealing of the W-S-N dry lubricant coatings was carried out to study its effects on the composition, morphology, crystal structure and hardness of the coatings. The W-S-N coatings were deposited by direct current (DC) reactive magnetron sputtering. The analysis was carried out for as-deposited, 200 °C and 400 °C annealed coatings. The as-deposited coatings have N content in the range of 0–25.5 at. %. The coatings are compact and the densification increased with the increase in N-alloying. All the coatings are crystalline except the highest N-alloyed coating which is X-ray amorphous. A maximum hardness of 8.0 GPa was measured for the coating alloyed with 23 at. % N. Annealing did not affect the composition and morphology of the coatings, while some variations were observed in their crystal structure and hardness. The maximum hardness increased from 8 GPa to 9.2 GPa after 400 °C annealing of the 23 at. % N-alloyed coating.This study is sponsored by FEDER National funds FCT under the projects: SMARTLUB ref.“POCI-01-0145-FEDER-031807”, CEMMPRE ref. “UIDB/00285/2020”, On-SURF ref. “POCI-01-0247-FEDER-024521”, “LA/P/0112/2020” and Atrito-0 ref. “POCI-01-0145-FEDER-030446”.info:eu-repo/semantics/publishedVersio

Comparison of Frequency of Recurrence after Burr Hole Evacuation of Chronic Subdural Hematoma with or without Subdural Drain.

Chronic subdural hematoma (CSDH) is known to have a significant recurrence rate. The rate of recurrence of chronic subdural hematoma after surgery ranges from roughly 5% to 30%.  Burr hole evacuation without drainage is performed as a first line of treatment for CSDH. As there is controversy in literature regarding the use of drainage after burr hole evacuation, the results of my study may be helpful for selecting a proper treatment modality as a first line of treatment for CSDH in terms of recurrence. The objective of this study was to compare the frequency of recurrence after burr hole evacuation of CSDH with and without subdural drain. It was a randomized controlled trial conducted in Department of Neurosurgery, Allied hospital, Faisalabad form Aug 2016 to Aug 2018 RESULTS:In our study, out of 130 cases(65 in each group). 84.62%(n=55) in Group-A and 76.92%(n=50) in Group-B were between above 40 years of age whereas 15.38%(n=10) in Group-A and 23.08%(n=15) were between 18-40 years of age, mean+sd was calculated as  64.03+7.61 years in Group-A and 62.28+7.83 years in Group-B, 78.46%(n=51) in Group-A and 72.31%(n=47) in Group-B were male while 21.54%(n=14) in Group-A and 27.69%(n=18) in Group-B were females, comparison of frequency of recurrence after burr hole evacuation of CSDH with and without subdural drain shows 10.77%(n=7) in Group-A and 27.69%(n=18) in Group-B, p value was 0.01 showing a significant difference. CONCLUSION: We concluded that the frequency of recurrence after burrhole evacuation of CSDH is significantly lower with drain when compared without subdural drain

Spectrum of interstitial lung disease from a tertiary care hospital in Karachi

Objective: To determine the clinical features and patterns of interstitial lung disease.Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised record of patients diagnosed with interstitial lung disease from January 2005 to December 2015. All patients aged 16 years and above diagnosed with interstitial lung disease on the basis of clinical features, radiological features on high-resolution computed tomography of the chest, and lung biopsies were included. SPSS 19 was used for data analysis.Results: Of the 537 patients, 324(60.3%) of the participants were females. The overall mean age was 60.5±14.9 years. The most common co-morbid condition was diabetes mellitus in 72(13.4%) patients, followed by hypertension in 48(8.9%) and ischaemic heart disease in 21(3.9%). The most common interstitial lung disease was idiopathic pulmonary fibrosis in 217(40.4%) patients, followed by non-specific interstitial pneumonia in 106(19.7%), sarcoidosis in 82(15.3%) and connective tissue disease-related interstitial lung disease in 56(10.4%) patients.Conclusions: Idiopathic pulmonary fibrosis was found to be the most common interstitial lung disease subtype followed by non-specific interstitial pneumonia, sarcoidosis and connective tissue disease-related-interstitial lung disease

Results of Conservative Management of CSF Rhinorrhea in Post Traumatic Patients

Objectives:  We aimed to see the results of conservative management of CSF rhinorrhea in post-traumatic patients. Material and Methods:  An observational study was conducted on 50 patients for 3 months from 1st November 2021 to 31th Jan 2022. Patients presented to neurosurgery unit II, PINS. All patients had a history of road traffic accidents (RTA). Results:  The age range was 10 – 50 years. The mean age was 25 years. All patients were managed conservatively for one week. We advised complete bed rest to all patients for 2 weeks. Head ends of all patients were slightly inclined from 15 – 30 degrees to reduce pressure in basal cisterns. We gave acetazolamide, mannitol, antibiotics, and anti-epileptic medication to all patients. CSF rhinorrhea in our 43 (86%) patients was stopped completely. In our 5 (10%) patients, CSF rhinorrhea was cured completely after doing a lumbar puncture with drainage of CSF and with the placement of a lumbar drain at a rate of 10 ml per hour. In our 2 (4%) patients, CSF rhinorrhea was not cured. We have to do surgery either by trans cranial or endoscopic repair of CSF rhinorrhea. Conclusion:  CSF rhinorrhea is best cured by conservative management except in 4% of cases

Outcome of Endoscopic Repair of CSF Rhinorrhea with Endonasal Endoscopic Approach in terms of Success of Repair.

Objective: This descriptive case series conducted to evaluate the outcome of CSF rhinorrhea repair with the Endonasal Endoscopic approach in terms of success of the repair.Materials and Methods: The study was conducted at Neurosurgery department, Unit II, Punjab institute of neurosciences, Lahore. This study involved 40 patients aged between 3-80 years of both genders diagnosed of CSF rhinorrhea with presented with in 1 week after trauma and spontaneous and postoperative cases.Results: The age of the patients ranged from 5 years to 53 years with a mean of 22.75 ± 15.59 years. Total 30 (75%) male and 10 (25%) female patients are included in the study. The underlying etiology was found to be post-traumatic (67.5%) 27 cases, followed by post-operative in 7 (17.5%) and spontaneous in 6 (15.0%) cases. Successful repair was observed in 36 (90.0%). No significant difference was found in the frequency of successful repair among various age groups; 5-20, 21-36 and 37-53 years (95.7%, 83.3% and 81.8%; p = 0.381), gender groups; male verses female (86.2% and 100.0%; p = 0.194) and etiological groups; post-traumatic vs. post-operative vs. spontaneous (92.6% vs. 71.4% vs. 100.0%; p = 0.169).Conclusions: The frequency of successful repair was found to be 90% in patients of CSF rhinorrhea treated through Endonasal endoscopic approach. No statistically significant difference was found in successful repair frequency across patient’s gender, age and underlying cause of CSF rhinorrhea

Vacuum Tribological Properties of W-S-N Coatings Synthesized by Direct Current Magnetron Sputtering

This work deals with the investigation of the tribological performance of DC magnetron sputteredW-S-N coatings under vacuum atmosphere, as part of the exploration of multi-environment sliding properties of W-S-N solid lubricants. This study is part of the systematic testing of W-S-N solid lubricants in different environments, especially vacuum, which is often ignored. The trend is to test sliding properties in dry N2 by considering it as replacement of vacuum environment testing. This approach is not appropriate. In this work, a set of coatings was synthesized with N-alloying content in the range of 0–25.5 at.%. A maximum S/W ratio of 1.47 was observed for the pure WSx coating. A maximum hardness of 8.0 GPa was observed for 23 at.% of N-alloying. The coating with the lowest N content (14.6 at.%) displayed the lowest friction, specific wear rate and wear scar depth under vacuum conditions. Despite superior sliding performance at room temperature (35% humidity), 200 C and dry nitrogen conditions, the performance of the WSN12.5 coating deteriorated vacuum environment.This work is sponsored by FEDER National funds FCT under the projects: SMARTLUB ref. “POCI-01-0145-FEDER-031807”, CEMMPRE ref. “UIDB/00285/2020”, On-SURF ref. “POCI-01-0247- FEDER-024521”, “LA/P/0112/2020” and Atrito-0 ref. “POCI-01-0145-FEDER-030446”. Andrey Bondarev acknowledges the support of the project “International Mobility of the scientific workers MSCAIF IV at Czech Technical University in Prague, Grant No: CZ.02.2.69/0.0/0.0/20_079/0017983”.info:eu-repo/semantics/publishedVersio