Comparison of Functional Outcomes in Terms Of Post-Operative Mobility for Unipolar Versus Bipolar Un-Cemented Hemiarthroplasty in Elderly Patients with Displaced Intracapsular Femoral Neck Fractures

Objective: To compare of functional outcomes in terms of post-operative mobility for unipolar versus bipolar un-cemented hemiarthroplasty in elderly patients with displaced intracapsular femoral neck fractures. Methodology: Our study design is Randomized Control Trialconducted inDepartment of Orthopedics Bahawal Victoria Hospital, Bahawalpur. April 2015 to October 2016.Sample size is (calculated by taking n6 =138, confidence interval 95, power of study 80, P1= 33%, P2=13%) 69 in each group. Sampling technique used was non probability consecutive sampling. All patients who meet the inclusion criteria presenting to orthopedic unit of Nishtar Hospital Multan with fracture neck of femur were selected for study. Patients were divided into two groups randomly by lottery method and enrolled for unipolar or bipolar hemiarthroplasty. Chi-square test was used to compare outcome variable in both groups. A p-value < 0.05 was considered statistically significant. Effect modifiers like age and sex was controlled by stratification. Chi square test was applied to see significant difference. Results: Overall, there were 100% (n=138) patients in this study, both genders. The mean age of the patients was 66.35±4.29 years. (Range: 60 to 80years) Mean age and SD of group A (no walking aid) was 54.52 ± 3.10 and in group B (walking aid) 54.99 ± 3.19. Time up go score was noted as successful 33.3% (n=46) and 66.7% (n=92) as unsuccessful. Walking aid was noted in 65.2% (n=90) patients. Functional outcome was noted as good in 26.8% (n=37) patients and noted as bad in 73.2% (n=101) patients. Out of 100% (n=38) patients, good outcome was 26.3% (n=10) unipolar and 73.7% (n=28) bipolar. Out of 100% (n=100) Bad outcome was 59% unipolar and bipolar 41%. Conclusion: Functional outcome in term of mobility is better in case of bipolar prosthesis as compared to unipolar. Thus in our conclusion bipolar prosthesis is preferred procedure as compared to unipolar hemiarthroplasty in treating patients with displaced intracapsular femoral neck fracture. Keywords:Bipolar Hemiarthroplasty, Unipolar Hemiarthroplasty, Displaced intracapsular femoral neck fractures

Comparison of Absorbable with non Absorbable sutures in closure of Laparotomy incisions

Objective: To compare the absorbable with non absorbable sutures in wound dehiscence after closure of Laparotomy incisions. Methodology: This randomized control trial was conducted in the department of general surgery, Bahawal Victoria Hospital, Bahawalpur in seven months duration from June 2016 to January 2017. Data was entered in statistical software SPSS version 23 and analyzed for desired variable analysis. Mean and SD was calculated for numerical data like age and Body Mass Index,  and frequency percentages were calculated categorical data like gender, Anemia etc. Chi square test was applied for effect modification or association of outcome variables with effect modifiers. P value < 0.05 was considered as significant. Results: In this study, a total number of 100% (n=130) patients were included, divided into two equal groups, 65 in each i.e. group Prolene and group Vicryl. In our study, wound dehiscence occurred in 6.2% (n=4) cases in whom Prolene was used whereas 21.5% (n=14) had wound dehiscence with the use of Vicryl suture. Vicryl was followed by significantly higher incidence of wound dehiscence than closure by Prolene (χ2= 6.448 DF = 1, P value=0.011). Conclusion: Observation of our study concluded that non absorbable Prolene has better outcome and less wound dehiscence and other complication as compared to absorbable Vicryl suture. Keywords: Absorbable suture, non absorbable suture, wound dehiscence, laparotomy

Applications of Love Construction in Modern Drawings

اهتم الباحثان بدراسة مفهوم العشق في الرسم الحديث، إذ قسم الباحثان موضوع بحثهما: إلى أربعة فصول؛ عني الفصل الأول بمقدمة البحث التي ضمت مشكلة البحث وتبلورت بالتساؤل الآتي: (ما مدى إمكانية تطبيقات بنية العشق في الرسم الحديث؟). أما حدود البحث فتمثلت بالحدود المكانية (أوربا)، في ما تمثلت حدوده الزمانية للمدة (1839-1897م)، أما الحدود الموضوعية تضمنت دراسة تطبيقات بنية العشق في الرسم الحديث والمتواجدة في بعض الوثائق والموسوعات العالمية وغيرها التي شملت (المعارض الفنية، والمقتنيات العامة، والمتاحف، وشبكة المعلومات الإلكترونية، المجلات الصحف)، أما الفصل الثاني فقسم إلى مبحثين: عني المبحث الأول بـ(بنية العشق في الأدب الأوربي)، أما المبحث الثاني فتناول (مفهوم العشق في الفن الأوربي)، وتضمن الفصل الثالث إجراءات البحث ومجتمعه وعينته وتحليلها. وتضمن الفصل الرابع نتائج البحث واستنتاجاتها وكان من أهم النتائج هي: 1- تطبيقات مضامين العشق الإنسانية والاجتماعية على بنية الرسم الحديث، فحكاياته وألوانه المشبعة بالشمس والعناق المشحون بالعشق والمعاناة والمحرمات واللذة فهو يأخذنا إلى عالم ينعم بالمحبة والإنسانية). اما استنتاجات البحث وكان اهمها 1- معظم الفنانين الأوربيين استخدموا الأشكال المتمثلة في العشق في العمل الفني، فقد اعتمدوا على الرسم بالألوان التي توحي بالعشق، بأشكال أو حركات أو أحداث. وتضمن الفصل الرابع التوصيات والمقترحات واختتم البحث بقائمة المصادر العربية والاجنبية والملخص باللغة الانكليزية.The two researchers were interested in studying the concept of love in modern painting, as the researchers divided the subject of their research into four chapters. As for the limits of the research, it was represented by the spatial limits (Europe), while its temporal limits were represented for the period (1839-1897 AD), while the objective limits included the study of the applications of the structure of love in modern drawing, which are found in some documents and international encyclopedias and others, which included (art galleries, public holdings, museums, The electronic information network, magazines, newspapers). As for the second chapter, it was divided into two sections about me. The first topic (the structure of love in European literature) As for the second topic (the concept of love in European art), while the third chapter included the research procedures, the research community, the research sample and its analysis.The fourth chapter included the results of the research and its conclusions, and the most important results were 1- Applications of the human and social contents of love in the structure of modern painting. As for the conclusions of the research, the most important of them were 1- Most European artists used the forms of love in their artwork. They relied on drawing with colors that suggest love, in forms, movements, or events. The fourth chapter included recommendations and proposals, and the research concluded with a list of Arab and foreign sources and a summary in English.                                                                                                                       &nbsp

SPORTS SENTIMENTS AND FINANCIAL MARKETS: SHADENFREUDE IN RIVALRY OF INDIA AND PAKISTAN

This paper examines the reaction of sports (International Cricket) outcomes on stock markets of Pakistan and India. Valuation of stock markets is taken in terms of abnormal stock returns around the dates of one day international (ODI) matches. Event study has been employed in this paper for 605 ODI matches played by Pakistan and 660 ODI matches played by India in period of 1990-2019. Findings suggest that on next trading day following the match stock returns are positive after win and negative after losing the game in both countries. In this paper one novel finding is existence of negative abnormal returns one day before matches due to anxiety of fan investors before game starts. Another important aspect of rivalry is examined as two rival countries are taken as sample. Results suggest that fan investors experience schadenfreude as they feel positive when their national team wins or rival team loses and feel bad when their team loses or rival wins. This optimism or pessimism results in abnormal stock returns mentioned in results of this paper

Terrorist bombings: Medical response in a developing country

Objective: To evaluate the process of transport and immediate Emergency Department (ER) management of mass casualties following the recent bomb blasts in Karachi and review in detail the medical response and management of victims undertaken in these two incidents. Methods: Eyewitness accounts of the victims, medical personnel and newspaper clippings were used to understand and identify difficulties faced during the rescue process. Data regarding presenting injuries and their outcomes was also collected from all victims presenting to the emergency department at Aga Khan University Hospital. Results: Seventy nine individuals died and over 250 victims were injured in the two incidents. All victims and dead bodies were shifted to the nearest public sector hospital overwhelming the health care facility. Subsequently all victims were evacuated to private sector hospitals creating similar difficulties. Over half of the victims presenting at the emergency department had minor injuries and did not require admission. Most patients requiring admission needed orthopaedic intervention. Conclusion: A comprehensive disaster plan with a centralized command and control system is required for the city of Karachi, involving all stake holders including charity ambulance services, security agencies, and trauma management facilities. Training courses and exercises for health care personnel should also be made mandatory to achieve professional excellence

Noise-Crypt: Image Encryption with Non-linear Noise, Hybrid Chaotic Maps, and Hashing

To secure the digital images over insecure transmission channels, a new image encryption algorithm Noise-Crypt is proposed in this paper. Noise-Crypt integrates non-linear random noise, hybrid chaotic maps, and SHA-256 hashing algorithm. The utilized hybrid chaotic maps are the logistic-tent and the logistic-sine-cosine map. The hybrid chaotic maps enhance the pseudorandom sequence generation and selection of substitution boxes, while the logistic-sine-cosine map induces non-linearity in the algorithm through random noise. This deliberate inclusion of noise contributes to increased resistance against cryptanalysis. The proposed scheme has been evaluated for several security parameters, such as differential attacks, entropy, correlation, etc. Extensive evaluation demonstrates the efficacy of the proposed scheme, with almost ideal values of entropy of 7.99 and correlation of -0.0040. Results of the security analysis validate the potency of the proposed scheme in achieving robust image encryption

Effects of IV Magnesium Sulphate on Hemodynamic Response To Pneumoperitoneum In Laparoscopic Cholecyctectomy; A Randomized Control Trial

Objective: To determine the effect of IV Magnesium sulphate (MgSO4) in attenuating the hemodynamic effects of pneumoperitoneum. Methodology: Our single blind randomized control trial (based on computer generated randomize allocation) was carried out at Holy Family Hospital and included 60 patients, not allergic to MgSO4 and belonging to the American Society of Anesthesiology (class 1 and 2. Patients were divided into two groups with Intervention group (M group) receiving 30 mg/kg of MgSO4 and the control group (C group) receiving a placebo. Hemodynamic parameters were then measured at different points of time during surgery. Data was collected and analyzed by using statistical package for the social sciences (SPSS) version 25.0. Results: Out of 60 patients selected 86.7% were females while 13.3% were males. Mean age was 35.78(SD=8.26). As compared to group, patients belonging to group had significantly lower heart rate, systolic and diastolic blood pressure at 15 minutes, after release of pneumoperitoneum and at extubation with p values less than 0.05. Conclusion: Our study concludes that 30 mg/kg of MgSO4 given as a bolus just before creation of pneumoperitoneum protect against its possible adverse hemodynamic effects

Expression analysis of cyclooxygenase-2 in patients suffering from esophageal squamous cell carcinoma

Esophageal squamous cell carcinoma (ESCC) is one of the aggressive malignancies and mechanisms underlying its pathogenesis remain unclear. Cyclooxygenase-2 (COX-2) enzyme system plays a crucial role in many gastrointestinal malignancies and is an important regulator of cell growth, proliferation, apoptosis, differentiation and transformation. More precise outcome of COX-2 in ESCC is less investigated. In this study we investigated the risk factors of ESCC and expression of COX-2 in Carcinoma in situ (CIS) and ESCC compared to normal esophageal mucosa. ESCC relationship to clinico-pathological parameters using immunohistochemistry was also part of this investigation. Current study was conducted in the Institute of Basic Medical Sciences, Khyber Medical University, Peshawar, Pakistan. A total of 69 diagnosed patients of ESCC, both Pakistanis and Afghans were enrolled. Various risk factors associated with ESCC were recorded. Mean age at the time of diagnosis was 55 years. Out of 69 patients of ESCC 46 (67%) were users of dipping tobacco (Naswar). Expression of COX-2 was determined in normal esophageal mucosa, CIS and invasive ESCC using Immunohistochemistry (IHC). Differences of mean were computed using ANOVA followed by applying Post Hoc test. Patients were categorized as positive with high expression or negative with low to nil expression. ANOVA showed large differences in expression of COX-2 in normal healthy mucosa compared with CIS and ESCC with the mean difference of -9.529 and -7.370 respectively, p-value being.05 at 95% CI. Our complete cohort (23-85 years) showed statistically significant difference in the expression of COX-2 gene in ESCC and CIS tissue samples compared with normal healthy mucosa. Results of this study indicate that over-expression of COX-2 is positively associated with ESCC

Effect of hydroxide, carbonate, and sulphate anions on the β-dicalcium silicate hydration rate

The effect of fixed (0.8 M) Na+ balanced by either OH−, SO42−, and CO32− anions on β-dicalcium silicate (C2S) reactivity is investigated. The exothermic reaction of varying water-to-solid ratios and chemical activation is monitored. Subsequently, the hydration products are characterized via FTIR, TG/DTG, QXRD, and SEM analysis. The findings showed that the carbonate ions expedited the reactivity up to 55% at 1–7 days due to the simultaneous precipitation of calcium silicate hydrate (C-S-H) and calcite. At 7–28 days, the lack of transportable cations between the solid surface and solution impeded further hydration, as confirmed by in-situ pH and conductivity measurements. The sulphate ions accelerated the reactivity only upon calcium sulphate dissolution at high pH. The hydroxide ions decelerated the hydration due to the earlier precipitation of portlandite than C-S-H. Overall, the β-C2S reaction with water exhibited the highest hydration degree (~67%) after 28 days of hydration