Effectiveness of Mckenzie Traction and Exercises on Neck Pain Secondary to Upper Crossed Syndrome.

OBJECTIVES:  To examine the effects of McKenzie traction and exercises on neck pain, cervical ranges, functional activities and posture secondary to upper crossed syndrome. METHODS: Randomized control trial was conducted on patient of neck pain secondary to upper crossed syndrome from physical therapy setups of Lahore and Sargodha in total six months. 120 patients of 20-60 years’ age group were allocated in two groups (experimental and control), both contained 60 respondents, both groups received neck pain exercises with TENS for eight weeks, weekly three times and McKenzie traction and exercises were additionally received by experimental group. Partakers were assessed after eight weeks of treatment. Oswestry questionnaire was used for assessment, reed co scale and goniometer parameters, was used. RESULTS: Collected data was analyzed in SPSS 20. Independent sample t-test was applied to compare mean of quantitative data at the end of treatment in both groups. Mean pre-treatment Oswestry disability score in general exercise group and McKenzie group was 60.37 and 56.82 respectively (with p-value > .05). Mean post treatment Oswestry disability score in general exercise group was 30.63 and in McKenzie group was 26.70 (with p-value.02). Mean pre-treatment flexion, extension, side flexion and rotation means in general group were 36.38, 47.10, 36.32, and 66.37 respectively whereas in McKenzie these values were 38.30, 45.47, 37.47 and 67.38 respectively (with p-value > .05). CONCLUSION: Both general exercises and McKenzie treatment improved neck pain secondary to upper crossed syndrome, however the McKenzie treatment stood significantly better than general exercise. Keywords: Mckenzie Traction, Exercise, Neck Pain, Mckenzie Treatment, Syndrome DOI: 10.7176/JHMN/74-07 Publication date:May 31st 202

Value-Based Fuzzy Approach for Non-functional Requirements Prioritization

Non-functional requirements (NFRs) are often addressed late in a project and, in turn, can get less attention in the requirements prioritization (RP) process. For various reasons, RP may happen based on functional requirements (FRs) only. While many approaches for prioritizing NFRs have been published, these are known also for some limitations, e.g. not being scalable, being domain-specific and not able to cope with changing requirements. In this paper, we proposes a value-based fuzzy approach for prioritizing NFRs together with FRs. Our proposed approach takes into account (1) the relationships of NFRs with FRs using experts’ evaluations and fuzzy logic, and (2) the dependencies among both types of requirements and also the interdependencies that particularly exist among the NFRs themselves. We evaluated our proposal by conducting a real-world case study of an ATM system. We also compared the list of prioritized NFRs with the list of NFRs prioritized by different stakeholders on the basis of classification factors. The results of applying the proposed approach on NFRs of ATM system show that the approach produces a conflict-free and consistent list of prioritized NFRs.</p

Efficacy of Azadirachta indica (Neem) leaf extract and hypertonic saline solution as intratesticular chemical sterilizing agents in dogs

A castração consiste na indução da esterilidade por meio físico, químico ou hormonal. A castração química é uma técnica eficiente e confiável, em contraste com outros procedimentos de esterilização, pois é menos dolorosa para os métodos físicos e econômicos para os métodos hormonais. Azadirachta indica (neem), é uma planta carismática, pois possui folhas anti-inflamatórias, antimicrobianas e antiandrogênicas. Para diminuir a crescente população humana no sul da Ásia, o óleo de nim e o extrato de folhas de nim têm sido efetivamente usados como agente contraceptivo. O principal determinante deste estudo atual foi avaliar o Neem como um agente esterilizante químico (necrótico ou apoptótico) em cães injetados intratesticularmente em comparação com uma solução salina hipertônica. O tamanho da largura testicular pré e pós-injeção e as amostras de sangue para os níveis séricos de testosterona foram colhidas em dias alternados. Os resultados obtidos revelaram alterações substanciais no tamanho da largura testicular, perfil histopatológico e nível sérico de testosterona. Observou-se uma leitura não significativa (P&gt; 0,05) da largura testicular da pré-injeção, em contraste com um aumento significativo (P &lt;0,05) três dias após a injeção em todos os grupos competitivos. Os valores médios registrados para o tamanho da largura testicular no final do estudo via extrato de folhas de nim, HSS a 30% e grupos controle foram 27,7362 ± 2,3315 mm, 30,9594 ± 4,6861 mm e 24,5023 ± 2,5387 mm, respectivamente. Uma tendência decrescente, com relação ao nível sérico de testosterona sendo estatisticamente significante (P &lt;0,05), foi registrada nos grupos tratados (A, B), em contraste com o grupo controle (C), pois os valores eram 1,5357 ± 0,7819ng, 1,2669 ± 0,9095ng e 2,4517 ± 0,1827ng nos grupos A, B e C, respectivamente. Os achados histopatológicos advogaram a presença de corpos apoptóticos no grupo tratado com nim, enquanto a presença de células intersticiais degeneradas, túbulos seminíferos necrosados, epitélio germinativo danificado e espermatogênese interrompida também foi estudada nos dois grupos competitivos. Assim, o efeito apoptótico e a propriedade anti-inflamatória do extrato de folhas de nim resultaram em uma castração menos dolorosa e confirmaram que a Azadirachta indica foi um melhor substituto para a castração química do que a solução salina hipertônica.Castration refers to induced sterility via physical, chemical, or hormonal methods. Chemical castration is an efficient and reliable technique in contrast to other sterilization procedures as it is less painful to physical methods and cost‑effective to hormonal methods. Azadirachta indica (neem), is a charismatic plant as its leaves possess anti-inflammatory, anti‑microbial, and anti-androgenic chattels. To abate the escalating human population in South Asia, neem oil and neem leaf extract have been effectively used as a contraceptive agent. The key determinant of the current study was to evaluate Neem as a chemical sterilizing agent, (either necrotic or apoptotic), in dogs injected intratesticular in comparison to a hypertonic saline solution. Pre- and post-injection testicular width size and blood samples for serum testosterone levels were collected on alternative days. Results disclosed substantial changes in testicular width size, histopathological profile, and serum testosterone level. A non-significant (P &gt; 0.05) pre-injection testicular width readings in contrast to a significant increase (P &lt; 0.05) three days post-injection was noted in all the competitive groups. The mean values recorded for testicular width size at the end of the trial study via neem leaf extract, 30% HSS and, control groups were 27.7362 ± 2.3315mm, 30.9594 ± 4.6861mm, and 24.5023 ± 2.5387mm, respectively. A declining trend, regarding serum testosterone level being statistically significant (P &lt; 0.05) was recorded in treated groups (A, B) in contrast to the control group (C) as the values were 1.5357 ± 0.7819ng, 1.2669 ± 0.9095ng, and 2.4517 ± 0.1827ng in groups A, B, and C, respectively. Histopathological findings advocated the presence of apoptotic bodies in the neem treated group whereas the presence of degenerated interstitial cells, necrosed seminiferous tubules, damaged germinal epithelium, and ceased spermatogenesis was also studied in both competitive groups. Thus, the apoptotic effect and anti-inflammatory property of neem leaf extract resulted in less painful castration and verified Azadirachta indica as a better substitute for chemical castration in contrast to hypertonic saline solution

Seroepidemiological Analysis of Contagious Caprine Pleuropneumonia through cELISA in Selected Districts of Khyber Pakhtunkhwa-Pakistan

Contagious caprine pleuropneumonia (CCPP) is a fatal disease of goats caused by Mycoplasma capricolum subsp. capripneumoniae (Mccp).This disease has been causing huge economic losses to goat rearing farmers in Khyber Pakhtunkhwa.  Seroepidemiological study of this disease was conducted for the first time in selected districts of Khyber Pakhtunkhwa namely Swat, Peshawar, Kohat and Dera Ismail Khan. Total 384 serum samples were collected randomly from goats having different ages and both sexes showing respiratory signs belonging to flocks with no vaccination history against CCPP. The serum samples were examined for Mccp directed antibodies using monoclonal antibody based cELISA. Out of total 384 samples 15 samples were detected positive on cELISA with 3.91% overall seroprevalence in the selected districts. The highest CCPP seroprevalence was recorded in district Swat (8.33%) followed by district Kohat and D.I Khan (3.13% in each district) and the lowest seroprevalence was observed in district Peshawar (1.04%). Age based CCPP seroprevalence was found highest (6.73%) in the goat kids of age 1 to 180 days followed by the (3.85%) young goat of 181 to 365 days while the lowest was found in the adult goats (2%) with age more than one year.Sex based seroprevalence was found more in female goats (4.01%) as compare to male goats (3.33%). This study determined the load of CCPP using highly specific monoclonal antibody based cELISA kit in the selected districts of Khyber Pakhtunkhwa for the first time. Further study on CCPP is needed with increased sample size, that cover wider region of Khyber Pakhtunkhwa as necessary for limiting this disease through effective control measures.

Evaluation of the Occlusal Contact between the Opposing Teeth and the Cusp of Carabelli in Maxillary Permanent First Molars in Patients Visiting Peshawar Dental College

Background: The Cusp of Carabelli is a small additional cusp which is situated on the mesiopalatal surface of first maxillary molars. This nonfunctional cusp comes in many forms including furrows, ridges or pits and is collectively known as the Carabelli trait Objective: To evaluate the frequency of the occlusal contacts between the accessory cusp of Carabelli and the opposing arch tooth among both genders in patients attending the out-patients department of Peshawar Dental Hospital, Peshawar Methodology: This descriptive cross-sectional study was conducted on 300 subjects visiting the OPD of Peshawar Dental Hospital from October 2022 to December 2022. The sample size was calculated using WHO formula N=p(100-p)z2/d2 (Http://www.fao.orgThe age group selected for the participants was from 13-30 years. Consecutive sampling technique was used.). Articulating paper was used to assess the occlusal contacts caused by the cusp of Carabelli. The data were analyzed using SPSS version 20. Pearson’s chi square test was applied to analyze the data. P value of ≤ 0.05 was considered statistically significant. Results: The results of the current study showed that 10.7% of the participants experienced occlusal contacts caused by the presence of their accessory cusp with the opposing arch tooth with no statistically significant difference between genders. Conclusion: The cusp of Carabelli is the most prevailing variation found on the palatal aspect of mesiopalatal cusp of permanent maxillary first molars in a hospital-based inhabitants of Peshawar with rare occlusal contacts experienced by the patients. Key words: Cusp of Carabelli, Maxillary permanent first molars, Occlusal contact

Non-functional Requirements Prioritization: A Systematic Literature Review

Continuous delivery and rapidly changing requirements in agile environments force the developers to put non-functional requirements (NFRs) on halt till maintenance phase. However, neglecting NFRs during prioritization phase may lead to inaccurate estimations for software projects resulting in high maintenance cost and failures. The subjective and uncertain nature of non-functional requirements makes them unfit to be prioritized using conventional prioritization methods. Although the existing literature reports on inadequate consideration given to NFRs prioritization, still no comprehensive systematic effort has been done to report the limitations and evaluation mechanisms of existing NFRs prioritization approaches. Requirements engineering society lacks a broad understanding of NFRs prioritization approaches and the challenges which need to be overcome. Therefore, we aim to investigate (i) the existing NFR prioritization techniques and their validation mechanisms, (ii) the role of Artificial Intelligence (AI) in NFRs prioritization, and (iii) the limitations of existing NFRs prioritization techniques. For this, we reviewed the literature published from 2008 till present and extracted 30 studies. The results reveal twenty-five NFRs prioritization techniques out of which only three are AI based. The major limitations we have come across are that most of the NFRs prioritization techniques are not scalable to large datasets, inter-dependencies between functional requirements (FRs) and NFRs are ignored, and the uncertainties associated with NFRs are not considered at all. However, the literature suggests that AI-based techniques and Fuzzy logic may be used to solve issues such as uncertainties i.e. ambiguities, vagueness, and subjective opinions of stakeholders. This review adds to the existing body of knowledge on NFRs and motivates the practitioners to focus on the NFR prioritization by highlighting the limitations of the existing methods

HPLC Method Validation for the Estimation of Lignocaine HCl, Ketoprofen and Hydrocortisone: Greenness Analysis Using AGREE Score

In the current study, the reversed-phased high-pressure liquid chromatography (RP-HPLC) method was proposed for the estimation of lignocaine hydrochloride (LIG), hydrocortisone (HYD) and Ketoprofen (KET) according to International Conference for Harmonization (ICH) Q2 R1 guidelines, in a gel formulation. The chromatographic evaluation was executed using Shimadzu RP-HPLC, equipped with a C8 column and detected using UV at 254 nm wavelength, using acetonitrile and buffer (50:50) as a mobile phase and diluent, at flow rate 1 mL/min and n injection volume of 20 μL. The retention time for LIG, HYD, and KET were 1.54, 2.57, and 5.78 min, correspondingly. The resultant values of analytical recovery demonstrate accuracy and precision of the method and was found specific in identification of the drugs from dosage form and marketed products. The limit of detection (LOD) for LIG, HYD, and KET were calculated to be 0.563, 0.611, and 0.669 ppm, while the limit of quantification (LOQ) was estimated almost at 1.690, 1.833, and 0.223 ppm, respectively. The AGREE software was utilized to evaluate the greenness score of the proposed method, and it was found greener in score (0.76). This study concluded that the proposed method was simple, accurate, precise, robust, economical, reproducible, and suitable for the estimation of drugs in transdermal gels

Integrating 1D/2D nanostructure based on Ni-Co-oxalate for energy storage applications

The performance of an electrochemical energy storage device highly depends on the electrode material. Currently, metal oxalates are evolving as low-cost and stable electrode materials for batteries and supercapacitors. Herein, mixed metal oxalate (NixCo1-xC2O4/NF) based binder-free electrode was fabricated. The nickel foam contributed not only as a substrate but also as a nickel source. The NixCo1-xC2O4/NF confirmed the crystalline phase through X-ray diffraction spectroscopy (XRD). Scanning electron microscopy (SEM) and transmission electron spectroscopy (TEM) confirmed the integrated 1D/2D-like morphology of NixCo1-xC2O4/NF. The electrochemical results reveled the NixCo1-xC2O4/NF electrode exhibit battery behavior with capacity retention of 86.58 % and possessed the highest specific capacity of 470.012 C g−1 at 1 A g-1. Hence, the nickel inclusion during the synthesis has further enhanced the overall properties and performance of the NixCo1-xC2O4/NF electrode

Special considerations for the treatment of multiple myeloma according to advanced age, comorbidities, frailty and organ dysfunction.

Multiple Myeloma (MM) is primarily a disease of old age with a median age of sixty-nine years at diagnosis. The development of novel therapies for induction and use of autologous stem cell transplantation has resulted in improved clinical outcomes and better quality of life for MM patients. Elderly patients, comprising the majority of MM population, have a higher incidence of age-related comorbidities, frailty and organ dysfunction which complicates the coordination of treatment and limits the selection of therapies. Even in the era of multiple chemotherapeutic options, the clinical heterogeneity of the myeloma patients\u27 demands personalized treatments which often require dose-adjustments or dose delays. The use of reduced-dose regimens and various comorbidity indices has improved clinical outcome and regimen tolerability in MM patients with renal, neurological and bone abnormalities. We focus on advancements in the treatment of multiple myeloma with the goal to guide clinicians towards patient-specific management