Comparison of Outcome of two different Methods for the treatment of Intra-articular fracture of Distal Radius

Objective: It is to compare the radiological and functional outcome of two different fixation methods for displaced intra articular distal radius fracture (DRF): open reduction and internal fixation with anatomical plate and closed reduction with percutaneous K-wires. Methodology: A randomized controlled trial was conducted in Orthopaedics department, Shaikh Zayed Hospital, Lahore for one year; from April 2017 to March, 2018. Total 90 patients were selected in the study by ‘non-probability, consecutive sampling technique’ with 45 patients in each group of the study; Group-A (fixation method: Open reduction with internal fixation with volar plate) and Group-B (Fixation method: Kirschner-wire known as K-wire). Results: The mean age in the group A and group B was 53.7 ± 11.8 years and 55.2 ± 12.3 years respectively. There were 58 male and 32 females in the study. The differences in volar tilt, radial inclination, radial length and modified Mayo score were significantly better in group A than group B (p-value < 0.05). The differences were not significantly different for articular step off in the two study groups (p-value > 0.05). Conclusion: Open reduction with internal fixation using volar locking plates yielded significantly better radiological and functional outcomes than percutaneous fixation using K-wire in the 6 months’ postoperative period

Comparison of casting versus elastic nail for the treatment of pediatric tibial diaphyseal fractures

Objective: To assess outcomes of Titanium elastic nail (regarding radiologic union, a discrepancy of limb length, malalignment, pain and complications) in treating pediatric tibial fractures in comparison with the traditional Casting method.Methodology: This randomized controlled trial study was conducted in Department of Orthopaedics, Shaikh Zayed Hospital, Lahore through emergency /Outdoor patient department from May 2018 to Feb 2019. The total number of patients were categorized into two groups, 14 each group. In Group A, patients underwent treatment by elastic nails and patients in group B, underwent treatment with cast method. Post op X-Rays (serial) were done and Leg length inequality, Malalignment, pain and radiological union were assessed radiologically. Follow up of the patients was done in the outpatient department of Orthopaedic department after 1,3 and 6 months. The comparison for this among both groups was done by using Chi-square test. P value ≤ 0.05 was considered significant.Results: The mechanism of injury was statistically same in both groups, p-value > 0.05. In group-A, 7(50.0%) cases had Transverse, 4(28.6%) had Oblique and 3(21.4%) cases had comminuted fracture while in group-B there were 5(35.7%) cases who had Transverse, 2(14.3%) had Spiral, 4(28.6%) cases had Oblique and 3(21.4%) cases had Comminuted fracture, p-value > 0.05. In both groups, the leg length inequality, frequency of malalignment, pain severity and complications were statistically same, p-value was > 0.05.Conclusion: Similar outcomes of Titanium elastic intramedullary nailing as compared to cast application in terms of bone union, alignment and infection rates

Non-invasive diagnostic tests for Helicobacter pylori infection

BACKGROUND: Helicobacter pylori (H pylori) infection has been implicated in a number of malignancies and non-malignant conditions including peptic ulcers, non-ulcer dyspepsia, recurrent peptic ulcer bleeding, unexplained iron deficiency anaemia, idiopathic thrombocytopaenia purpura, and colorectal adenomas. The confirmatory diagnosis of H pylori is by endoscopic biopsy, followed by histopathological examination using haemotoxylin and eosin (H & E) stain or special stains such as Giemsa stain and Warthin-Starry stain. Special stains are more accurate than H & E stain. There is significant uncertainty about the diagnostic accuracy of non-invasive tests for diagnosis of H pylori. OBJECTIVES: To compare the diagnostic accuracy of urea breath test, serology, and stool antigen test, used alone or in combination, for diagnosis of H pylori infection in symptomatic and asymptomatic people, so that eradication therapy for H pylori can be started. SEARCH METHODS: We searched MEDLINE, Embase, the Science Citation Index and the National Institute for Health Research Health Technology Assessment Database on 4 March 2016. We screened references in the included studies to identify additional studies. We also conducted citation searches of relevant studies, most recently on 4 December 2016. We did not restrict studies by language or publication status, or whether data were collected prospectively or retrospectively. SELECTION CRITERIA: We included diagnostic accuracy studies that evaluated at least one of the index tests (urea breath test using isotopes such as13C or14C, serology and stool antigen test) against the reference standard (histopathological examination using H & E stain, special stains or immunohistochemical stain) in people suspected of having H pylori infection. DATA COLLECTION AND ANALYSIS: Two review authors independently screened the references to identify relevant studies and independently extracted data. We assessed the methodological quality of studies using the QUADAS-2 tool. We performed meta-analysis by using the hierarchical summary receiver operating characteristic (HSROC) model to estimate and compare SROC curves. Where appropriate, we used bivariate or univariate logistic regression models to estimate summary sensitivities and specificities. MAIN RESULTS: We included 101 studies involving 11,003 participants, of which 5839 participants (53.1%) had H pylori infection. The prevalence of H pylori infection in the studies ranged from 15.2% to 94.7%, with a median prevalence of 53.7% (interquartile range 42.0% to 66.5%). Most of the studies (57%) included participants with dyspepsia and 53 studies excluded participants who recently had proton pump inhibitors or antibiotics.There was at least an unclear risk of bias or unclear applicability concern for each study.Of the 101 studies, 15 compared the accuracy of two index tests and two studies compared the accuracy of three index tests. Thirty-four studies (4242 participants) evaluated serology; 29 studies (2988 participants) evaluated stool antigen test; 34 studies (3139 participants) evaluated urea breath test-13C; 21 studies (1810 participants) evaluated urea breath test-14C; and two studies (127 participants) evaluated urea breath test but did not report the isotope used. The thresholds used to define test positivity and the staining techniques used for histopathological examination (reference standard) varied between studies. Due to sparse data for each threshold reported, it was not possible to identify the best threshold for each test.Using data from 99 studies in an indirect test comparison, there was statistical evidence of a difference in diagnostic accuracy between urea breath test-13C, urea breath test-14C, serology and stool antigen test (P = 0.024). The diagnostic odds ratios for urea breath test-13C, urea breath test-14C, serology, and stool antigen test were 153 (95% confidence interval (CI) 73.7 to 316), 105 (95% CI 74.0 to 150), 47.4 (95% CI 25.5 to 88.1) and 45.1 (95% CI 24.2 to 84.1). The sensitivity (95% CI) estimated at a fixed specificity of 0.90 (median from studies across the four tests), was 0.94 (95% CI 0.89 to 0.97) for urea breath test-13C, 0.92 (95% CI 0.89 to 0.94) for urea breath test-14C, 0.84 (95% CI 0.74 to 0.91) for serology, and 0.83 (95% CI 0.73 to 0.90) for stool antigen test. This implies that on average, given a specificity of 0.90 and prevalence of 53.7% (median specificity and prevalence in the studies), out of 1000 people tested for H pylori infection, there will be 46 false positives (people without H pylori infection who will be diagnosed as having H pylori infection). In this hypothetical cohort, urea breath test-13C, urea breath test-14C, serology, and stool antigen test will give 30 (95% CI 15 to 58), 42 (95% CI 30 to 58), 86 (95% CI 50 to 140), and 89 (95% CI 52 to 146) false negatives respectively (people with H pylori infection for whom the diagnosis of H pylori will be missed).Direct comparisons were based on few head-to-head studies. The ratios of diagnostic odds ratios (DORs) were 0.68 (95% CI 0.12 to 3.70; P = 0.56) for urea breath test-13C versus serology (seven studies), and 0.88 (95% CI 0.14 to 5.56; P = 0.84) for urea breath test-13C versus stool antigen test (seven studies). The 95% CIs of these estimates overlap with those of the ratios of DORs from the indirect comparison. Data were limited or unavailable for meta-analysis of other direct comparisons. AUTHORS' CONCLUSIONS: In people without a history of gastrectomy and those who have not recently had antibiotics or proton ,pump inhibitors, urea breath tests had high diagnostic accuracy while serology and stool antigen tests were less accurate for diagnosis of Helicobacter pylori infection.This is based on an indirect test comparison (with potential for bias due to confounding), as evidence from direct comparisons was limited or unavailable. The thresholds used for these tests were highly variable and we were unable to identify specific thresholds that might be useful in clinical practice.We need further comparative studies of high methodological quality to obtain more reliable evidence of relative accuracy between the tests. Such studies should be conducted prospectively in a representative spectrum of participants and clearly reported to ensure low risk of bias. Most importantly, studies should prespecify and clearly report thresholds used, and should avoid inappropriate exclusions

فیض کی شاعرانہ امیجری

In poetry the process of creating images with the help of words owes essentially to the poetic imagination. Poetic imagination is innate, not earned. Faiz considers imagination the very soul and magical power of poetry, which gives life to poetic images. Faiz aesthetic and artistic sense has played a primary role in the creation of images in his poetry. This aesthetic and artistic sense has made its appearance in his poetry primarily in two ways: firstly in his particular fondness for beauty of women and secondly in his deep affinity with scenic beauty of nature. Faiz makes creative images combining both these phenomena of beauty. While drawing the word pictures of external scenes, Faiz harmonises the scenes with his own personality and thus he successfully produces breathing and lively images animated with his feeling and emotions. Faiz knows the art of forming a larger and bigger image by  combining and arranging several small and unique images, like a collage, in such a superlative and masterly way that they give the reader a deeper sense of the unity of impression. The spirit of his age pervades the imagery of Faiz. Consequently, his poetic images mirror the political, social and economic condition of his age. His experience of prison has also played a vital role in the shaping of his poetic images. Solitary confinement spurred his imaginative faculty and he himself invented most vivid images that linked his internal world with his external world. Visual images abound in Faiz's poetry. However, Faiz has very successfully created some auditory images through the effects produced by the sounds of words. On the whole the poetic images of Faiz exemplify his psychological conditions and they create a misty romantic atmosphere. However, the poetic images of Faiz emit gentlewarmth of life.</p

اخباری صحافت کے اردو زبان پر اثرات

Media, which are primarily used to communicate the informative material from one man or place to another man or place, are of two types: Print media Electronic media These media have played a far-reaching role in bringing drastic change in the ways of thinking and living of today’s man. These changes begin from the middle of the 15th century (1454 AD) with the invention of printing press. The happenings in one society start to effect the other societies. Especially the impact of these cultural changes is all too visible on the language and literature of the dominated culture. In this article an effort has been made to trace, through a careful study of Urdu newspapers, the impact of western and local culture on the Urdu language and literature

Adsorption of ruthenium ions on activated charcoal: influence of temperature on the kinetics of the adsorption process

Influence of temperature on ruthenium adsorption on activated charcoal from 3 mol/L HNO(3) solutions was investigated in the temperature range of 288 K to 308 K. It was observed that the rise in temperature increases the adsorption of ruthenium ions on activated charcoal and follows the kinetics of first order rate law with rate constant values 0.0564–0.0640 min(−1) in the temperature range of 288 K to 308 K respectively. The activation energy for the adsorption process was found to be 1.3806 kJ/mol. Various thermodynamics quantities namely ΔH, ΔS and ΔG were computed from the equilibrium constant K (C) values. The results indicated a positive heat of adsorption, a positive ΔS and a negative ΔG

Active Carbon as an Adsorbent for Lead Ions

A commercial active carbon has been tested as an adsorbent for the removal of lead ions from aqueous solutions. Optimum conditions for maximum adsorption in terms of shaking time, lead ion concentration, temperature and concentration of different acids were established. The results obtained reveal that the adsorption of lead ions on active carbon is athermic (ΔH = 0) in nature and follows first-order kinetics. The first-order rate constant was evaluated as 0.049 min −1 and the intraparticle diffusion rate as 3.07 × 10 −4 (g/g min 1/2 ). The data also obey the Freundlich, Langmuir and Dubinin-Radushkevich (D-R) isotherm equations over the concentration range studied. The magnitude of the adsorption energy, 7.61 kJ/mol, calculated from the β-constant of the D-R equation lies in the energy range for physical adsorption which is attributed to weak bonding between the lead ions and the active carbon

Adsorption of UO Ions on Activated Charcoal: pH Effect

The adsorption of UO 2 2+ ions on activated charcoal was studied as a function of pH. The adsorption mechanism of UO 2 2+ ions has been discussed in terms of hydrolyzed species formed in aqueous solution at different pH values

The Influence of Manto and Maupassant on Social Life

Literature is expression and interpretation of life. The Realism of life is exhibited in the literary masterpieces of the writers who understand life and possess enough courage to express it in their creative writings. This is quite befitting for French writer Guy DeMaupassant and Urdu writer Saadat Hassan Manto. They, through their world famous short stories, put a great impact on world literature. Their special field is Realism. They painted life as it appeared to them. They were blamed for vulgarity and resultantly suffered for that matter. The researchers and critics have acknowledged their love for humanity and their superiority as writers and as trend setters

The Isosteric Heat of Adsorption of Sr, Ce, Sm, Gd, Th and UO Ions on Activated Charcoal

The values of the isosteric heat of adsorption (q st ) of Sr 2+ , Ce 3+ , Sm 3+ , Gd 3+ , Th 4+ and UO 2 2+ ions on activated charcoal have been calculated at different surface coverages and temperatures by applying the Clausius–Clapeyron equation. The variation of q st with surface coverage indicates the heterogeneous nature with varying activities of the activated charcoal surface. The behaviour of q st values with temperature suggests that two types of adsorption processes occur simultaneously; one with a small activation energy and the other with a large activation energy. A large increase in the q st values indicates that increasing temperature changes the physical adsorption process to chemisorption