Problem-based learning variant: Transition phase for a large institution

Objective: To compare students\u27 test scores and perceptions of problem-based learning (PBL) and lecture-based learning (LBL) by applying a PBL-variant.Method: For the transition from LBL to PBL, PBL was varied for one discipline only and for a large group of students. Two hundred forty nine second year medical students were taught a topic of Biochemistry by the LBL method and then 141 of these were taught another topic by the PBL-variant. At the conclusion of each topic an MCQ test was given. One week later a 9 item questionnaire was given to the 50 students now attending classes to assess their perceptions of the 2 teaching formats. The test scores of the two methods were compared. Students\u27 ratings were differentiated by the Wilcoxon Signed-Rank test.Results: There was no significant difference in the test scores by PBL or LBL, but PBL received significantly higher student ratings (p \u3c 0.05) than LBL in self-study time, library time, number of books and computer consulted, enthusiasm for the topic, group discussion, depth of knowledge and interest taken in the teaching format. But there was no significant difference in students\u27 ratings of the teacher\u27s importance in either PBL or LBL.Conclusion: PBL variant and LBL produced similar MCQ test scores but the former is more conducive to enthusiastic self-study. Thus in the transition phase, PBL may be applied to one discipline and a large group of students without undermining its merits

M-ATTEMPT: A New Energy-Efficient Routing Protocol for Wireless Body Area Sensor Networks

In this paper, we propose a new routing protocol for heterogeneous Wireless Body Area Sensor Networks (WBASNs); Mobility-supporting Adaptive Threshold-based Thermal-aware Energy-efficientMulti-hop ProTocol (M-ATTEMPT). A prototype is defined for employing heterogeneous sensors on human body. Direct communication is used for real-time traffic (critical data) or on-demand data while Multi-hop communication is used for normal data delivery. One of the prime challenges in WBASNs is sensing of the heat generated by the implanted sensor nodes. The proposed routing algorithm is thermal-aware which senses the link Hot-spot and routes the data away from these links. Continuous mobility of human body causes disconnection between previous established links. So, mobility support and energy-management is introduced to overcome the problem. Linear Programming (LP) model for maximum information extraction and minimum energy consumption is presented in this study. MATLAB simulations of proposed routing algorithm are performed for lifetime and successful packet delivery in comparison with Multi-hop communication. The results show that the proposed routing algorithm has less energy consumption and more reliable as compared to Multi-hop communication.Comment: arXiv admin note: substantial text overlap with arXiv:1208.609

Analyzing Energy-efficiency and Route-selection of Multi-level Hierarchal Routing Protocols in WSNs

The advent and development in the field of Wireless Sensor Networks (WSNs) in recent years has seen the growth of extremely small and low-cost sensors that possess sensing, signal processing and wireless communication capabilities. These sensors can be expended at a much lower cost and are capable of detecting conditions such as temperature, sound, security or any other system. A good protocol design should be able to scale well both in energy heterogeneous and homogeneous environment, meet the demands of different application scenarios and guarantee reliability. On this basis, we have compared six different protocols of different scenarios which are presenting their own schemes of energy minimizing, clustering and route selection in order to have more effective communication. This research is motivated to have an insight that which of the under consideration protocols suit well in which application and can be a guide-line for the design of a more robust and efficient protocol. MATLAB simulations are performed to analyze and compare the performance of LEACH, multi-level hierarchal LEACH and multihop LEACH.Comment: NGWMN with 7th IEEE Inter- national Conference on Broadband and Wireless Computing, Communication and Applications (BWCCA 2012), Victoria, Canada, 201

Type 1 diabetes mellitus presenting with diabetic ketoacidosis (DKA) in a neonate

Neonatal diabetes mellitus (NDM) is a rare manifestation with an incidence of one affected individual among 400000 live births. NDM can be divided into Transient (TNDM) and Permanent (PNDM) types. A significant overlap occurs between both groups, to an extent that TNDM cannot be distinguished from PNDM based solely on clinical features. Diabetic ketoacidosis (DKA) is the leading cause of morbidity and mortality in children with type 1 diabetes mellitus (TIDM). DKA at diagnosis is more common in young children near the age of five years. Neonatal DKA is a rare occurrence causing it to be missed in the differential diagnosis of neonatal illness and results delay in appropriate management and increase in morbidity and mortality rate

Presentation of Gynecomezia and Outcome after Operation

Objective: This study was done to know different presentations of gynecomezia and outcome after operation.Design and duration: This is a retrospective study. It was started in January 2017 and ended in December 2017. It comprises on the duration of one year.Place of study: It was conducted in a tertiary care hospital  Bahawal Victoria Hospital Bahawalpur Pakistan.Patients and Methods: In surgical OPD of the hospital daily 200-250 patients are seen. There were 38 cases presented with the complaint of gynecomazia. These cases belonged to different age groups and came from different areas of the city and few came from other cities as well. A proforma was designed containing all necessary related questions and data of each patient with gynecomazia was entered in the proforma. These cases were admitted in the surgical ward for operation. These patients were told about the procedure and outcomes already. They were given examples of previously operated cases and their photos before peration after operation and proper healing of wound were shown to them. They were undergone all necessary investigations in the laboratory of the hospital such as chest x ray, ultrasound breast, CBC, serum profile etc. These cases were also evaluated for any malignancy of breast. After doing all investigations they were undergone anesthesia fitness. A proper written consent was taken from these patients and also from the medical superintendant of the hospital for conducting this study. Data was calculated in the form of frequencies and expressed via tables and charts. Microsoft office version 2017 and SPSS were used for analyzing data.   Results:  This study was done on 38 cases which presented in OPD of surgery with gynecomazia. These all cases were admitted in the ward for operation. These cases were having age range of 20-65 years of age with mean age of 45.6 years. There were 21 cases with age range of 20-30 years, 3 cases with age 31-40 years, 5 cases with age 41-50 years, 4 cases having age 51-60 years and 5 cases with age above 60 years. Mostly cases were having age below 50 years. Presentation of this condition was varying in patients. In 9 cases only unilateral enlargement was found while in mostly cases 29 there was bilateral enlargement of breasts. In 12 cases breast tenderness was present.Conclusion: Gynecomazia is a disease of males which is not so common. Its incidence is low but wih the passage of time prevalence is increasing. Surgical treatment via excision is successful and recurrence rate is very low but possible is malignancy present. It is most common in adult age

Methanol poisoning: 27 years experience at a tertiary care hospital

Methanol toxicity can result in serious morbidity and mortality without timely diagnosis and treatment. Many cases of methanol poisoning outbreaks have been noted in our population but no study has been performed to estimate methanol exposure and its outcomes and complications. A retrospective study was conducted to review all the cases of methanol poisoning admitted from January 1988 to December 2015 at the Aga Khan University Hospital. A total of 35 methanol poisoning cases were reported. All the patients were male, and the mean age was 36.2±8.6 years. The mean Glasgow Coma Scale score on presentation in the emergency was 10.4 ± 4.4. Blurring of vision was present in 17 (48%) patients while 10 (28%) had complete blindness. Mean arterial pH was 6.8±0.5 on arrival. Ethanol was given to 30(88%) patients and 12(32%) patients received bicarbonate for immediate treatment. A total of 15 (42.8%) patients underwent dialysis, out of which only 5 (33.3%) patients survived. Overall, 19 (54.3%) patients expired secondary to methanol ingestion

Unanticipated hospital admission after ambulatory surgery

The unplanned admission rate is considered to be an important measure of the quality of ambulatory surgical units. The objective of our study was to evaluate the unanticipated hospital admission rate from the Surgical Day Care (SDC) unit of our university affiliated teaching hospital and to analyze the reasons for admission. A review of all unanticipated admissions over a one-year period was done. The admission rate was calculated and the reasons for admission were analysed. The overall admission rate was 4.93%. Most of the admissions were ordered by the surgeons (97%). The main reasons for admission were patient observation indicated for various reasons (72%) and patient request (18%). Eighty percent of the admitted patients had received general anaesthesia. Admissions were also related to the male gender (69%), age over 65 years (27%) and surgeries ending in the afternoon (69%). On analyzing the reasons for admission, a large number of admissions were found to be due to preventable causes. We conclude that proper selection of patients, careful scheduling of lists and education of patients and clinical professionals can help to avoid many unanticipated admissions after day care surgical procedures

Long-term Phytoremediating Abilities of Dalbergia sissoo Roxb. (Fabaceae)

The boom of tanneries in north India has converted the river Ganga into a waste dumping stream. The tanneries discharge their heavy metal-rich effluents into the river. Tissues of two-year-old tree saplings of Dalbergia sissoo, soil sediments and river water samples were collected from three sites along the river Ganga at Jajmau, Kanpur. Site-1 was located 1 km upstream from the point of discharge of the effluents of the tanneries, Site-2 was close to the source point, and Site-3 was about 1 km downstream from the source point. Accumulation of Cu, Cr and Ni in leaves, bark, wood growth rings, soil sediments and water samples was estimated using an atomic absorption spectrophotometer. The tissues of the two-year-old wood growth rings of D. sissoo accumulated large amounts of Cr, Cu and Ni. The Cr concentration in leaves, bark and wood rings had a strong, positive and linear correlation (r2) with the Cr concentration in soil sediments. The bioconcentration factors (BCFs) of Cr, Cu and Ni were higher than 1 in the wood, bark and leaves at all three selected sites, indicating the strong phytoremediating ability of the tree. The uptake of Cr and Ni was consistent in the bark and wood growth rings of two successive years. Owing to the strong uptake and accumulating abilities of Cr, Cu and Ni as evident from high BCF values and high biomass, we propose D. sissoo as a suitable species for phytoremediation throughout its range of distribution in Africa, Asia and the Americas

EFFECT OF SODIUM HYDROXIDE CONCENTRATION ON FRESH PROPERTIES AND COMPRESSIVE STRENGTH OF SELF-COMPACTING GEOPOLYMER CONCRETE

This paper reports the results of the laboratory tests conducted to investigate the effect of sodium hydroxide concentration on the fresh properties and compressive strength of self-compacting geopolymer concrete (SCGC). The experiments were conducted by varying the concentration of sodium hydroxide from 8 M to 14 M. Test methods such as Slump flow, V-Funnel, L-box and J-Ring were used to assess the workability characteristics of SCGC. The test specimens were cured at 70°C for a period of 48 hours and then kept in room temperature until the day of testing. Compressive strength test was carried out at the ages of 1, 3, 7 and 28 days. Test results indicate that concentration variation of sodium hydroxide had least effect on the fresh properties of SCGC. With the increase in sodium hydroxide concentration, the workability of fresh concrete was slightly reduced; however, the corresponding compressive strength was increased. Concrete samples with sodium hydroxide concentration of 12 M produced maximum compressive strength