Multimedia Traffic Engineering in Next Generation Networks

Due to high speed Internet and Multimedia applications, future wireless communication are expected to support multimedia traffic such as voice, video and text with a variety of Quality of Service (QoS) requirements and make efficient use of radio resources. Such kind of traffic requires high level of QoS guarantees. Traffic management is a process of regulating the traffic over network. Since, multimedia traffic is more sensitive, therefore it requires special measures while transmission, especially in wireless networks. There are different queuing disciplines which are used to police the traffic, the Priority Queue and RIO (RED with In/Out) are queuing disciplines, PQ is used to prioritize the traffic, and the later is used to drop the lower priority packets at the time of congestion. Proposed solution is the integration of Priority Queue with RIO, which will serve as a classifier to prioritize the traffic and then it will also serve as a scheduler by dropping lower priority traffic when the congestion state occur. Simulation results show that by applying proposed Traffic Management Strategy (PriRIO), it assigns stable bandwidth to the Multimedia Traffic Flow and enhances its throughput. It also shows that Packet Losses for Multimedia Traffic are very minor, that is, equivalent to none. Further, delay values for Multimedia traffic also remain below the Best Effort traffic flows. Thus, on the basis of these simulation results and analysis, PriRIO outperforms significantly, as compare to other Traffic Management Strategies

Frequency of worsening liver function in severe dengue hepatitis patients receiving paracetamol: A retrospective analysis of hospital data.

Objective: To determine the frequency of worsening liver function among hospital in-patients with severe dengue hepatitis receiving paracetamol. Methods: This retrospective study was conducted at the Department of Medicine, Aga Khan University Hospital, Karachi, and comprised records of dengue patients with severe hepatitis who received paracetamol for control of fever between June 2007 and December 2014. Alanine aminotransferase at baseline and following paracetamol administration was noted, as well as dosage and duration of paracetamol, along with participants\u27 demographic details. Frequency of patients who developed worsening or improvement of alanine aminotransferase was also noted. SPSS 19 was used for data analysis. Results: Of the 113 subjects, 73(64.6%) were male and 40(35.4%) were female. Overall improvement was observed in subsequent alanine aminotransferase levels (491 units per litre, IQR 356.5 TO 775 vs 151 units per litre, IQR 49.5 to 299.5). Most commonly prescribed dose of paracetamol was 2g (IQR 1 to 5 grams), which was taken for a median duration of 1 day (IQR 1 to 3 days). Moreover, 100(88.5 %) patients showed improvement in alanine aminotransferase. Only 13(11.5 %) patients developed worsening of alanine aminotransferase. Of those with worsening liver function, 8(61.5 %) were discharged home with no clinical deterioration and 5(38.5 %) deaths were observed. However, causes of deaths were unrelated to liver dysfunction. Conclusion: The frequency of worsening liver function following paracetamol administration in patients with severe dengue hepatitis was relatively low

Anaesthetic management of patients undergoing deep brain simulation: A retrospective review of 8 cases from a tertiary care center of Pakistan

Objectives: To review anaesthesia related outcome, perioperative complications and overall length of stay (LOS) in hospital for patients who had deep brain stimulation (DBS).Methods: The study was retrospective review of patients medical records diagnosed with Parkinson disease (PD) and underwent DBS at The Aga Khan University Hospital, Karachi from 2017-2019. Data was reviewed from file notes and patient chart and recorded on predesigned Performa. Frequency and percentages were used to present the data.Results: All patients were anaesthetized using Sleep-Awake-Sleep technique (SAS). Dexmedetomidine was mainly used for conscious sedation. Bispectral index monitor (BIS) was used to monitor the depth of sedation, and kept between 70-85 during sedative phase. All patients had successful intraoperative neurological monitoring, stimulation, and placement of electrodes. Total duration of anesthesia varied significantly in between the patients. Maximum duration was 600 minutes. None of our patient had any intraoperative event related to anaesthetic management. Overall five patients had some adverse events during ward stay. Mean LOS in hospital was four days.Conclusion: Anaesthetic management of DBS is well-tolerated. It requires dedicated team. The SAS technique is excellent for intraoperative neurophysiological monitoring. Careful selection of sedative agents and monitoring depth of anaesthesia using BIS would be beneficial in terms of improving related outcomes

A Short Communication on Exploring the Rearing, Breeding, and Future Outlook of Damani Sheep in Pakistan

The intentional production of animals is predicated on their genetic proficiency, which is dependent on optimal resource utilization and manipulation of biotic and abiotic environmental components to increase production for societal sustenance. The annual global consumption of sheep meat is approximately 2.5 kilograms per individual, out of a total of 41.6 kilograms. Three management systems are used to rear sheep: extensive wool and meat production, intensive milk production, and traditional pastoralism. Possessing adequate resources for sheep husbandry contributes to positive welfare outcomes. This review examined the rearing, breeding, and future potential of Damani sheep in Pakistan. Damani sheep are a composite, meat-specialized breed with thin tails, tiny to medium bodies, white heads, and camel-colored legs. They are native to the Khyber Pakhtunkhwa districts of Dera Ismail Khan and Bannu and are predominantly raised for their meat and wool. Damani sheep have well-developed teats and udders, small ears, and a mature body height and weight of 53-61 cm and 27-28 kg, respectively. They are robust, well-adapted, and successful in their native environment. Damani ewes produce high-quality milk with an average fat content of 5.8 % and average lactation period of 120 days. Despite their potential, the breed\u27s per-unit meat and wool production has decreased due to cross-breeding, disease, malnutrition, improper management, and a lack of agricultural knowledge. Pakistan recognizes between 28 and 33 categories of sheep, but sheep continue to be an undervalued species with low productivity per animal unit

Global age-sex-specific mortality, life expectancy, and population estimates in 204 countries and territories and 811 subnational locations, 1950–2021, and the impact of the COVID-19 pandemic: a comprehensive demographic analysis for the Global Burden of Disease Study 2021

Background: Estimates of demographic metrics are crucial to assess levels and trends of population health outcomes. The profound impact of the COVID-19 pandemic on populations worldwide has underscored the need for timely estimates to understand this unprecedented event within the context of long-term population health trends. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 provides new demographic estimates for 204 countries and territories and 811 additional subnational locations from 1950 to 2021, with a particular emphasis on changes in mortality and life expectancy that occurred during the 2020–21 COVID-19 pandemic period. Methods: 22 223 data sources from vital registration, sample registration, surveys, censuses, and other sources were used to estimate mortality, with a subset of these sources used exclusively to estimate excess mortality due to the COVID-19 pandemic. 2026 data sources were used for population estimation. Additional sources were used to estimate migration; the effects of the HIV epidemic; and demographic discontinuities due to conflicts, famines, natural disasters, and pandemics, which are used as inputs for estimating mortality and population. Spatiotemporal Gaussian process regression (ST-GPR) was used to generate under-5 mortality rates, which synthesised 30 763 location-years of vital registration and sample registration data, 1365 surveys and censuses, and 80 other sources. ST-GPR was also used to estimate adult mortality (between ages 15 and 59 years) based on information from 31 642 location-years of vital registration and sample registration data, 355 surveys and censuses, and 24 other sources. Estimates of child and adult mortality rates were then used to generate life tables with a relational model life table system. For countries with large HIV epidemics, life tables were adjusted using independent estimates of HIV-specific mortality generated via an epidemiological analysis of HIV prevalence surveys, antenatal clinic serosurveillance, and other data sources. Excess mortality due to the COVID-19 pandemic in 2020 and 2021 was determined by subtracting observed all-cause mortality (adjusted for late registration and mortality anomalies) from the mortality expected in the absence of the pandemic. Expected mortality was calculated based on historical trends using an ensemble of models. In location-years where all-cause mortality data were unavailable, we estimated excess mortality rates using a regression model with covariates pertaining to the pandemic. Population size was computed using a Bayesian hierarchical cohort component model. Life expectancy was calculated using age-specific mortality rates and standard demographic methods. Uncertainty intervals (UIs) were calculated for every metric using the 25th and 975th ordered values from a 1000-draw posterior distribution. Findings: Global all-cause mortality followed two distinct patterns over the study period: age-standardised mortality rates declined between 1950 and 2019 (a 62·8% [95% UI 60·5–65·1] decline), and increased during the COVID-19 pandemic period (2020–21; 5·1% [0·9–9·6] increase). In contrast with the overall reverse in mortality trends during the pandemic period, child mortality continued to decline, with 4·66 million (3·98–5·50) global deaths in children younger than 5 years in 2021 compared with 5·21 million (4·50–6·01) in 2019. An estimated 131 million (126–137) people died globally from all causes in 2020 and 2021 combined, of which 15·9 million (14·7–17·2) were due to the COVID-19 pandemic (measured by excess mortality, which includes deaths directly due to SARS-CoV-2 infection and those indirectly due to other social, economic, or behavioural changes associated with the pandemic). Excess mortality rates exceeded 150 deaths per 100 000 population during at least one year of the pandemic in 80 countries and territories, whereas 20 nations had a negative excess mortality rate in 2020 or 2021, indicating that all-cause mortality in these countries was lower during the pandemic than expected based on historical trends. Between 1950 and 2021, global life expectancy at birth increased by 22·7 years (20·8–24·8), from 49·0 years (46·7–51·3) to 71·7 years (70·9–72·5). Global life expectancy at birth declined by 1·6 years (1·0–2·2) between 2019 and 2021, reversing historical trends. An increase in life expectancy was only observed in 32 (15·7%) of 204 countries and territories between 2019 and 2021. The global population reached 7·89 billion (7·67–8·13) people in 2021, by which time 56 of 204 countries and territories had peaked and subsequently populations have declined. The largest proportion of population growth between 2020 and 2021 was in sub-Saharan Africa (39·5% [28·4–52·7]) and south Asia (26·3% [9·0–44·7]). From 2000 to 2021, the ratio of the population aged 65 years and older to the population aged younger than 15 years increased in 188 (92·2%) of 204 nations. Interpretation: Global adult mortality rates markedly increased during the COVID-19 pandemic in 2020 and 2021, reversing past decreasing trends, while child mortality rates continued to decline, albeit more slowly than in earlier years. Although COVID-19 had a substantial impact on many demographic indicators during the first 2 years of the pandemic, overall global health progress over the 72 years evaluated has been profound, with considerable improvements in mortality and life expectancy. Additionally, we observed a deceleration of global population growth since 2017, despite steady or increasing growth in lower-income countries, combined with a continued global shift of population age structures towards older ages. These demographic changes will likely present future challenges to health systems, economies, and societies. The comprehensive demographic estimates reported here will enable researchers, policy makers, health practitioners, and other key stakeholders to better understand and address the profound changes that have occurred in the global health landscape following the first 2 years of the COVID-19 pandemic, and longer-term trends beyond the pandemic

Channel allocation in multi-radio multi-channel wireless mesh networks: a categorized survey

Wireless mesh networks are a special type of broadcast networks which cover the qualifications of both ad-hoc as well as infrastructure mode networks. These networks offer connectivity to the last mile through hop to hop communication and by comparatively reducing the cost of infrastructure in terms of wire and hardware. Channel assignment has always been the focused area for such networks specifically when using non-overlapping channels and sharing radio frequency spectrum while using multiple radios. It has always been a challenge for mesh network on impartial utilization of the resources (channels), with the increase in users. The rational utilization of multiple channels and multiple radios, not only increases the overall throughput, capacity and scalability, but also creates significant complexities for channel assignment methods. For a better understanding of research challenges, this paper discusses heuristic methods, measurements and channel utilization applications and also examines various researches that yield to overcome this problem. Finally, we highlight prospective directions of research

Anaesthetic management of cerebral arterio-venous malformation excision using awake craniotomy: Initial experience of two cases

This case series summarises the successful management of two cases with cerebral arterio-venous malformation (AVM). In first patient, it was located superficially in right frontal cortex, while the second one had this in left parieto-temporal region. Both were excised successfully using awake craniotomy. The patients had their assessment and psychological preparation by neuro-anesthetist and neurosurgeon. Along with the routine monitoring, invasive arterial line, and bispectral index monitoring was used to monitor the sedative effect of propofol. Intraoperative analgesia was provided using scalp block. The anaesthetic management was helpful in facilitating intraoperative neurological monitoring using verbal and motor responses. Patients remained pain-free and hemodynamically stable during resection phase. The postoperative period showed adequate pain control, decreased postoperative nausea/vomiting and shorter length of stay in the hospital. Both patients had 100% obliteration of AVM confirmed via cerebral angiography