Effects of Locations of Spur Dyke on Bed and Scour around Bridge Piers in Meandering Channel

Spur dykes are the structures which are used to protect the eroding bank of rivers. They are sometimes also used to safeguard the life of many structures such as bridge piers, abutments etc. The efficiency of spur dykes has been checked in straight channels by conducting model tests in laboratories by many investigators. Very few studies were done in curved channels. In present work an attempt has been made to study the effect of location of spur dyke on bed and scour around bridge pier in curved open channel (bend angle = 80o ) with time. Experiment has been carried out in 80o channel bend at constant discharge (3.5×10–3 m3 /s) and bridge pier is located at angular displacement ϴ = 60o . Here ϴ is the angle the line drawn at the inlet of any bend to the line joining the centre of curvature and any point on the outer portion of the bend. It is found that maximum scouring occurs at ϴ = 0o and 20o along inner wall and at ϴ = 60o and 80o along outer wall. It is also found that scouring around bridge pier is more in the vicinity of pier and decreases with increase in distance from pier. The most suitable location for spur dyke to protect bridge pier is at angular displacement ϴ = 20o . Scour developed rapidly during initial time and then rate of scouring decreases with elapse of time

Daily Living Functioning, Social Engagement and Wellness of Older Adults

Aim: The present study aim to investigate the contributing role of daily living functioning and social engagement in enhancing wellness and various dimensions of wellness in older adults. Method: A correlational research was designed. Socio-demographic data was collected. Lawton Instrumental Activities of Daily Living, Lubben Social Network Scale, and Perceived Wellness Survey were administered on a sample of 112 participants, including 56 men and 56 women. Results: A correlation analysis found positive correlations between daily living functioning, social engagement and wellness of older adults. The results of regression analysis concluded that both the daily living functioning and social engagement predicted wellness and domains of wellness as well. Conclusion: The obtained results indicate that older adults who are self-reliant lead a more satisfied life in old age and demonstrate to be more adjusted to the effects of aging

DEVELOPMENT OF NAMING, READING AND IMITATION SKILLS MANAGEMENT PROGRAMME FOR PATIENTS WITH BROCA’S APHASIA

OBJECTIVE: To develop the naming, reading and imitation skills management programme through mobile application of patients with severe Broca’s Aphasia. METHODS: A pilot study with eight patients was carried out. Purposive non-probability sampling technique was used to recruit the patients with severe Broca’s aphasia who received therapy through mobile application. It contains three domains: naming, reading and imitation. The programme was developed in Urdu language. Study was conducted in Yusra General Hospital, Islamabad and Railway Hospital, Rawalpindi, Pakistan. The inclusion criteria were patients above age of 40 and three months of stroke with diagnosis of chronic Broca’s Aphasias, while patients with severe cognitive impairment were excluded. The pre and post score of patients was recorded. Treatment protocol included 30-45 mints sessions, 4 days per week for total of 8 weeks. Data for each patient was analyzed based on their pre and post intervention scores. RESULTS: According to demographic variations 50.0% people lie in the age range 40-50 while 50.0% of people were 51-60 years. The mean age of sample was 49 years and 87% of participants were right handed. The pretest score on repetition was 16.25± 6.96 and post-test was 60.5±9.11 (p-value=0.000). The pretest score on naming was 49.75± 26.28 and post-test was 111.25±31.38 (p-value=0.000). The pretest reading score was 31.75±10.87 and post-test scores was 67.50±17.13 (p-value=0.000). CONCLUSION: It is concluded from the results that the naming, reading and imitation skills improved in patients with severe Broca’s aphasia through management applications

Psychological complications of polycystic ovarian syndrome and women’s health

Background: Polycystic Ovarian Syndrome (PCOS) affects approximately 5-10% females of reproductive age worldwide. Recent research shows that this syndrome is associated with psychological upset and devastating effects on women′s mental health and wellbeing.  Lack of clinicians′ awareness of adverse psychological effects is a major concern in developing countries to provide standard care and to improve overall health outcomes.Purpose of study was to determine the frequency of anxiety and depression among women with PCOS in order to promote awareness among clinicians about psychological complications of disease.Methods: Present study was conducted in the department of Obstetrics and Gynaecology/ University Medical and Dental College, from October 2018 to March 2019. Sixty patients with diagnosis of PCOD and sixty participants without this disease were included in the study. Participants having other endocrine or metabolic disorders were excluded from study. Hospital anxiety and depression scale was used to detect anxiety and depression among both groups. SPSS version 16 was used for data analysis. Chi- square test was applied to compare prevalence of anxiety and depression in both groups, p-value ˂0.05 was taken as statistically significant.Results: Women having PCOD exhibited statistically significant prevalence of anxiety (78.3% vs 35%) and depression (60% vs 30%) with p value of 0.0001 and 0.001 respectively.Conclusions: It is highly recommended that initial evaluation of these patients should include assessment of psychological domain of disease to provide more comprehensive treatment to improve overall health related quality of life

An Assessment of Groundwater Quality for Drinking Purpose in Tando Adam City of Sindh, Pakistan

The present study is aimed to assess the groundwater quality of Tando Adam city of district Sanghar, Sindh. Total twenty groundwater samples were randomly collected from handpump wells installed on different locations at various depths (50-90ft). The groundwater samples were analyzed for physicochemical and microbiological parameters to determine suitability for drinking purposes. Analytical results showed that most of water samples have elevated contents of Total Dissolved Solids (TDS) exceeding the permissible limit (<1000mg/l) for drinking water. The concentration of cations (Ca+2, Mg+2, Na+ , K+ ) and anions (Cl- , HCO3 - , SO4 -2 ) were so high that World Health Organization (WHO) standards seem overcrossing in >80% water samples. Local geology, poor irrigation practices, and anthropogenic activities are responsible for higher ion concentrations in the area. Furthermore, Microbiological contamination was found positive in half of the groundwater samples due to sewage contamination, poor sanitation and dumping of waste near well sites. The groundwater quality of the study area is highly contaminated and not suitable for human consumption but despite being commonly used for drinking purpose

Natural and Anthropogenic Sources of Groundwater Salinization in Parts of Karachi, Pakistan

This study is aimed to evaluate the groundwater quality of Gulshan-e-Iqbal and Liaquatabad towns inKarachi. Thirty (n=30) groundwater samples were randomly collected from different locations by electrically pumpedwells at various depths (14-91m). All the water samples were analyzed to determine their suitability for drinkingpurpose based on various physicochemical parameters. Data reveal that high concentration of TDS and hardness havedeteriorated the groundwater quality of study area. The main phenomenon responsible for groundwater pollution is theseawater intrusion due to the proximity of study area to the Arabian sea. Large scale unplanned urbanization, poorwaste management and other anthropogenic activities have also triggered the deterioration of groundwater quality.Study showed that local geology plays vital role in the distribution of major cations and anions. Data suggested thatground water of this study area is highly contaminated by seawater intrusion and considered not fit for drinkingpurpose

Multi-drug resistant gram negative infections and use of intravenous polymyxin B in critically ill children of developing country: Retrospective cohort study

Background: Patients in pediatric intensive care Units (PICU) are susceptible to infections with antibiotic resistant organisms which increase the morbidity, mortality and cost of care. To describe the clinical characteristics and mortality in patients with Multi-Drug Resistant (MDR) gram negative organisms. We also report safety of Polymyxin B use in these patients.Methods: Files of patients admitted in PICU of Aga Khan University Hospital, from January 2010 to December 2011, one month to 15 years of age were reviewed. Demographic and clinical features of patients with MDR gram negative infections, antibiotic susceptibility pattern of isolates, discharge disposition and adverse effects of Polymyxin B were recorded.Results: A total of 44.8/1000(36/803) admitted patients developed MDR gram negative infections, of which 47.2%(17/36) were male, with mean age of 3.4 yrs(+/-4.16). Acinetobacter Species (25.5%) was the most frequently isolated MDR organisms followed by Klebsiella Pneumoniae (17%). Sensitivity of isolates was 100% to Polymyxin B, followed by Imipenem (50%), and piperacillin/tazobactem (45%). The crude mortality rate of patients with MDR gram negative infections was 44.4% (16/36). Fourteen of 36 patients received Polymyxin B and 57.1%; (8/14) of them were cured. Nephrotoxicity was observed in 21.4% (3/14) cases, none of the patients showed signs of neuropathy.Conclusion: Our study highlights high rates of Carbapenem resistant gram negative isolates, leading to increasing use of Polymyxin B as the only drug to combat against these critically ill children. Therefore, we emphasizeon Stewardship of Antibiotics and continuous surveillance system as strategies in overall management of these critically ill children

Clinical outcome of post placental IUD CuT380 insertion in terms of expulsion

Background: Insertion of an intrauterine contraceptive device (IUD) immediately after delivery has been recommended by the World Health Organization (WHO), as one of the safe and effective methods of temporary contraception. In the immediate post delivery period the women are highly motivated and need an effective method for contraception so that the child can be brought up with a relaxed mind without the worry of unintended pregnancy. This approach is more applicable to our country where delivery may be the only time when a healthy woman comes in contact with health care personnel. However, immediate post-partum IUD insertion may have disadvantages as well. The risk of spontaneous expulsion may be unacceptably high.Methods: After taking approval from hospital ethical committee, all women planning vaginal delivery desiring IUD, admitted through OPD and emergency were evaluated in detailed on design Performa Performa include patient’s identity, age, parity, gestational age, no of alive children, outcome and timings of insertion. Informed consent was obtained. With aseptic precautions IUD was inserted with kellys forceps in the uterine cavity up to the fundus, then cervix was examined for thread (that should not be visible at cervix if proper insertion done). The procedure was performed by myself. Patients were followed at 6week by examining the threat of IUD. All the information was recorded by myself. Follow up was done by taking patients contact number.Results: In our study, out of 300 cases, 63.67% (n=191) were between 18-30 years of age while 36.33% (n=109) were between 31-40 years of age, mean+sd was calculated as 29.49+4.62 years, mean gestational age was calculated as 38.53+0.94 weeks, mean parity was calculated as 3.49+1.06 paras. Frequency of expulsion in post placental intra uterine device cuT 380 insertions reveals in 8.67% (n=26).Conclusions: We concluded that the frequency of expulsion in post placental intra uterine device cuT 380 insertions is not significantly higher and appears to be safe and effective method of contraception.

Oral versus intravenous maternal hydration in isolated third trimester oligohydramnios

Background: To study the effect of oral and intravenous maternal hydration in patients with isolated oligohydramnios in terms of mean change in amniotic fluid.Methods: A total number of 38 patients included in the study which fulfill the selection criteria.  Patients were randomly divided in two groups. Amniotic fluid index (AFI) of all patients was measured before the hydration therapy according to the method of Phelan et al.  In maternal oral hydration (Group A), every patient was instructed to drink two liters of water over two hours daily for 1 week. In intravenous hydration (Group B), every woman infused two liters of 0.9% normal saline in two hour daily for 1 week. After 48 hours and 1 week of oral and intravenous hydration, the AFI was reassessed by the same observer. Patients were monitored closely for sign and symptoms of fluid overload. Data was stratified for mean difference in improvement in amniotic fluid index.Results: After oral hydration therapy AFI was 5.926±0.4593 after 48 hours and 8.286±0.6000 after 7 days in Group A. In Group B AFI was 5.784±0.4622 after 48 hours and 7.868±0.2810 after 7 days of intravenous hydration. P value after 48 hours is 0.348 and p=0.014 after 7 days means oral hydration therapy significantly increase amniotic fluid index.Conclusions: Oral maternal hydration significantly increase the amniotic fluid index in patients with isolated oligohydramnios. It is simple, safe and non-invasive method