Unified multi-tupled fixed point theorems involving mixed monotone property in ordered metric spaces

In the present article, we introduce a unified notion of multi-tupled fixed points and utilize the same to prove some existence and uniqueness unified multi-tupled fixed point theorems for Boyd-Wong type nonlinear contractions satisfying generalized mixed monotone property in ordered metric spaces. Our results unify several classical and well-known n-tupled (including coupled, tripled and quadrupled ones) fixed point results existing in the literature.Comment: arXiv admin note: substantial text overlap with arXiv: 1601.0251

Surgery transformations and spectral estimates of δ\delta beam operators

We introduce $\delta$ type vertex conditions for beam operators, the fourth derivative operator, on metric graphs and study the effect of certain geometrical alterations (graph surgery) of the graph on the spectra of beam operators on compact metric graphs. Results are obtained for a class of vertex conditions which can be seen as an analogue of {\delta} vertex conditions for quantum graphs. There are a number of possible candidates of {\delta} type conditions for beam operators. We develop surgery principles and record the monotonicity properties of the spectrum, keeping in view the possibility that vertex conditions may change within the same class after certain graph alterations. We also demonstrate the applications of surgery principles by obtaining several lower and upper estimates on the eigenvalues

Malignant peripheral nerve sheath tumour of maxilla

Malignant peripheral nerve sheath tumour (MPNST) is a very rare entity in head and neck with high rate of recurrences and local invasiveness. This tumour is usually found in lower extremities and only 10-12% occur in head and neck region. The diagnosis is considered as the most elusive and difficult among soft tissue sarcomas because of its non specific presentation, both clinically as well as pathologically. This difficulty has now been overcome by immunohistochemistry. We report here a case of MPNST in a 50 years old male with a localized right maxillary growth

Risk Factors for Injury to Recurrent Laryngeal Nerve in Thyroid Surgeries - A Tertiary Care Centre Experience

Objective: To evaluate the risk factors of recurrent laryngeal nerve injury during thyroid surgery. Study Design: Descriptive study. Place And Duration Of Study: Department of Otorhinolaryngology-Head and Neck Surgery, Sindh Government Lyari General Hospital / Shaheed Mohatarma Benazir Bhutto Medical College and Dr Ruth K. M. Pfau Civil Hospital Karachi, Dow University of Health Sciences from   July 2014 to August 2018.  Methods: Every patient with goiter (multinodular / solitary nodule) admitted for primary or revision surgery with normal vocal cord movements were included in this study, while patients having hoarseness due to impaired vocal cords movements were excluded from this study. Results: Out of 120 Patients 28 (23.33%) were operated for Total Thyroidectomy, 4 (3.34%) had Near total thyroidectomy and 49(40.83%) for Right lobectomy with isthmusectomy, 35(29.17%) for Left lobectomy with isthmusectomy and 4(3.3%) cases operated for recurrent goiter. Transient unilateral vocal cord paralysis occurred in 5 cases, became permanent in 3 cases. Bilateral vocal cord paralysis was seen in revision thyroidectomy in 1 case. Conclusion: With this study we have tried to evaluate the relation of injury to RLN and type of surgery performed. It can be concluded that thyroid surgery, if performed by expert surgeons carries low risk of injury to RLN. Lobectomies have a slightly lower risk of nerve injury compared to total thyroidectomies. In revision surgeries RLN are at greater risk. Careful dissections of nerve make an important pillar in preservation of RLN during surgery. Keywords:  Thyroidectomy, Recurrent Laryngeal Nerve Palsy, Risk Factors

Frequency of various risk factors for Meconium aspiration syndrome

Objective: To study the frequency of various factor leading to meconium aspiration syndrome. Material & Method: This present descriptive cross sectional study was carried out at Department of Pediatrics Medicine Bahawal Victoria  Hospital Multan. for 6 months i.e. from October 8, 2018 to April 8, 2019. The non-probability, consecutive sampling technique was used. Newborns having staining of vocal cords and respiratory distress were included in this study. ABG and X ray Chest was done in all neonates. Factors like, Post-term pregnancy, IUGR, thick meconium, low APGAR score at 1 and 5 minutes were noted. All the collected data was entered and analyzed on SPSS version 23. Chi square and T test were used to check significant relation of risk factors with meconium aspiration syndrome. P value of 0,05 was consider significant. Results: Among total enrolled 150 babies, the mean age of babies was 37.37±18.96 hours, the male to female ratio of the babies was 1.03:1. The mean maternal age was 28.85±6.602 years. The thick meconium was observed in 89(59.33%) patients, 79(52.7%) patients went through vaginal delivery, postdate pregnancy was noted in 68(45.3%) patients, IUGR was observed in 52(34.7%) patients and poor APGAR score at 1 min was noted in 79(52.7%) patients. Conclusion: The observations of our study revealed that Meconium aspiration syndrome has significant relation with maternal age(P value 0.000), postdated pregnancy(P Value 0.001), IUGR (P value 0.021), poor APGAR score at 5 minutes( P value 0.034), and thick meconium(P value 0.000). Keywords: Postdate, Meconium  Aspiration , Syndrome, APGAR, Pregnancy DOI: 10.7176/JMPB/55-19 Publication date:May 31st 201

Screening of Diabetes and HIV Infection in Newly Diagnosed Pulmonary Tuberculosis Patients

Objective: Aim of the study was to investigate the prevalence of diabetes and HIV infection by screening in newly diagnosed pulmonary tuberculosis patients. Methods: This cross sectional study was conducted in Pulmonology department Bahawal Victoria Hospital Bahawalpur.  From  1 June 2018 to 1 June 2019 after taking approval from the institutional ethical committee. Total 159 newly diagnosed pulmonary tuberculosis patients were recruited by non-probability consecutive sampling. Mean and SD was calculated for numerical variables like age , BMI, FBG, Hemoglobin and monthly income. Ferquancy and percentages were calculated for categorical variables like gender, smooking status, educational status, alcohol consumption, prevelance of HIV and diabetes, Ch square test was use to check significant different in PTB and Non PTB patients. P value of < 0.05 was taken as significant. Results: Significant difference was found between age (p=0.000), BMI (p=0.000), FBG (p=0.000), hemoglobin (p=0.000), gender (p=0.002) and alcohol consumption (p=0.034), in groups, except education status (p=0.090) and monthly income (p=0.068). The main outcome variables of this study were HIV infection and diabetes. HIV infection was noted in 3.1% (n=5) and 1.9% (n=3) patients for PTB and non-PTB group respectively. While, 8.2% (n=13) and 4.4% (n=4) patients suffered from diabetes, for both the groups respectively. Conclusion: The results of our study revealed that on screening of newly diagnosed pulmonary tuberculosis patients with HIV infection and diabetes, their prevalence was high as compared to non-pulmonary tuberculosis group. But this difference was statistically non significant (P value 0.474 and 0.166). Key words:   Pulmonary tuberculosis, Diabetes, HIV infection DOI: 10.7176/JMPB/55-21 Publication date:May 31st 201