Spectrum of Diseases in Patients with Non-Traumatic Acute Abdomen.

Introduction: Acute Abdomen is the most common presenting complaints about 20% of all emergency department, due to its varied etiology it poses significant diagnostic challenges for emergency surgeons. The proper management of patients with acute abdominal pain requires a timely decision about the need for surgical operation. Objective: To identify the spectrum of diseases in patients of non-traumatic leading to Acute abdomen, presenting in a surgical unit. Methodology: During Jan 2012 to Dec 2014, this retrospective study conducted at Surgical Department of Muhammad Medical College, all patients presenting with non-traumatic acute abdominal pain were included in this study. Gynecological and urological causes were excluded. The patient diagnosis and management were recorded from the case files and OT registers. Results: During the period, a total of 216 patients presented with non-traumatic acute abdomen; of which there were 145 (67.12%) males and 71 (32.87%) females, with a male to female ratio of 2:1. The highest incidence of acute abdomen 72 (33.33%) was found in patients of 22-32 years age group followed by under 21 years age group i.e. 51 (23.61%) and 33-42 years age group 43 (19.90%). There were 31 (14.35%) cases in 43-52 years and 19 (8.79%) cases in 53-70 years. The most common cause of acute abdomen was acute appendicitis 105 (48.61%) admissions. These patients were mostly young males in twenties. Intestinal obstruction was second cause 45 (20.83%) cases and this affected more commonly the middle-aged persons. Two hundred and seven (95.83 %) patients were treated successfully and discharged home while 5 (2.31 %) left against medical advice, while 4 expired giving a mortality of (1.85) % in patients with gut perforation Conclusion: The most common cause of acute abdomen is acute appendicitis affecting young population mostly. Another common cause is intestinal obstruction and gut perforation. Acute cholecystitis commonly affects the middle aged, post-menopausal women. Hepatic abscess and Pancreatitis are rare cause of acute abdomen in this area. Key Words:  Acute abdomen. Non-traumatic Acute appendicitis, Intestinal obstruction

POWER FLOW CONTROL IN A GRID CONNECTED PV SYSTEM BY USING MODULAR MULTILEVEL CONVERTERS WITH PI AND FUZZY CONTROLLERS

Large-scale grid-connected photovoltaic (PV) systems significantly contribute to worldwide renewable energy growth and penetration, which has inspired the application of cascaded modular multilevel converters due to their unique features such as modular structures, enhanced energy harvesting capability, scalability and so on. However, power distribution and control in the cascaded PV system faces tough challenge on output volt- age over modulation when considering the varied and non-uniform solar energy on segmented PV arrays. This paper addresses this issue and proposes a decoupled active and reactive power control strategy to enhance system operation performance. The relation- ship between output voltage components of each module and power generation is analyzed with the help of a newly derived vector diagram along with PI and fuzzy control which illustrates the proposed power distribution principle. On top of this, an effective control system including active and reactive components extraction, voltage distribution and synthesization by using PI and fuzzy control is developed to achieve independent active and reactive power distribution and mitigate the aforementioned issue. Simulation results are provided to demonstrate the effectiveness of the proposed control strategy for large-scale grid-connected cascaded PV systems

To Determine the Frequency of the Common Causes of Lower Gastrointestinal Bleeding after Colonoscopy

Introduction: Lower Gastrointestinal Bleeding (LGIB) is defined as bleeding from distal to the ligament of Treitz at the duodeno-jejunal flexure and it accounts for 30-40% of all gastrointestinal bleeding. Although it is less common than the upper gastrointestinal bleeding yet considered as medical and surgical emergency particularly when massive. The leading causes of LGIB are hemorrhoids, rectal ulcers, rectal polyps and colitis; while less frequent causes include ulcerative colitis, Crohn's disease and diverticulitis.   This is apparently in contrast to the western literature where inflammatory bowel diseases and diverticulitis are the common cause of LGIB. Presently Colonoscopy is the diagnostic and therapeutic procedure of choice in LGIB. Objective: To determine the frequency of the common causes of lower gastrointestinal bleeding (LGIB) after Colonoscopic examination in a tertiary care hospital of Lahore. Methodology: This cross-sectional descriptive study was conducted at Department of Gastroenterology, Services institute of Medical Sciences Lahore (SIMS) from April 2016 to March 2017. Results: A total of 277 patients were included in this study, 181(65.34%) were males and 96(34.65%) were females. The average age oi the patients was 45.5 years. Colonoscopy showed abnormal findings in 219 (79.06%) patients. The internal hemorrhoids were the most common cause of LGIB while least common cause of LGIB after Colonoscopic examination was malignant lesions of colon and rectum. Conclusion: In our study bleeding from internal hemorrhoids was the leading cause of lower gastrointestinal bleeding followed by rectal ulcers and polyps.   Keywords: Lower GI Bleeding, Hemorrhoids, Rectal Ulcer, Rectal polyps, Colonoscopy

An Audit of 138 Patients Admitted with Lump in the Neck in Surgical Department of Services Hospital Lahore, (SIMS)

Introduction: Neck swellings are very common problem in head and neck region. Causes are highly variable, ranging from simple treatable disease to a metastatic incurable carcinoma. The common causes may differ depending upon the different geographical location, gender and age of the patients. Therefore, the knowledge of local causative factors is important to avoid diagnostic delay. Commonly presenting head and neck masses are due to lymph node, thyroid and salivary gland enlargement. In third world countries, infective causes are most common. Malignant neoplasms were the second most common group. Therefore, frequent audit is necessary for prompt diagnosis and further work up. Objective: An audit of 138 patients admitted with neck swelling in surgical department of a tertiary care Hospital of Lahore. Methodology: This cross-sectional study was carried out at Department of Surgery, (unit-1) Services Institute of Medical Sciences Lahore, (SIMS) during January 2014 to July 2015. All patients who presented with neck swelling during study period were included. Diagnosis made after taking clinical history, examination and relevant laboratory work up. Results: Out of 138 patients with lump in the neck, 93 (67.39%) were female and 45 (32.60%) were male. The commonest swelling is tuberculous lymphadenitis that is 34 (24.63%) and 9 (6.52%) were lymphoma and 4 (3%) with reactive hyperplasia. 49 (35.5%) arose from thyroid (40 benign and 9 malignant). Among the benign swellings, 15 were solitary nodular goiter, 12 were Multinodular goiter and 13 were diffuse thyroid goiter, 11 were Thyroglossal cyst. Other causes included sebaceous cyst 12 (8.69%), lipoma 19 (13.67%), thyroglossal cyst 11 (8%) and carcinoma of thyroid 9 (6.52%) Conclusion: The most common cause of neck lump is thyroid disease and tuberculous lymphadenitis. Early diagnosis of tuberculosis and goiter is crucial for appropriate management.   Keywords: Head and Neck Swellings, Lymph Nodes, Tuberculous lymphadenitis, Goite

Prevalence of anxiety and depression among Medical Students in MMCH, Sindh, Pakistan

Introduction: Medical education is stressful. High levels of stress have been seen in medical students in various studies. The academic stressors include the volume of material to be learned, academic performance and evaluation, examination and continuous assessment, mental tension and too much work load. All this can result in decreased life satisfaction among students.  Stress during medical school can lead to problems later in professional life compromising patient care. Objectives: To know the prevalence of anxiety and depression among medical students of Muhammad Medical College, Mirpurkhas, Sindh, Pakistan  Methodology: A Cross-sectional study was done on the students of Muhammad Medical College, Mirpurkhas, Sindh, who had spent more than six months in the medical college. Self-administered questionnaire was given to the students, present in the class and willing to participate in the study. The instrument used to assess the anxiety and depression levels was the, Aga Khan University Anxiety and Depression Scale (AKUADS). Additional quotations regarding socioeconomic variables were also included in them survey instrument, such as student’s age order, family monthly income, and gender, marital status. Results: Using anxiety and depression scale it was found out that 318 (96.36%) students had anxiety and depression. Among them 215 (67.61%) were females and 103 (32.38%) males. Prevalence of anxiety and depression in students of Final, 4th year and 3rd year 2nd and 1st years was 13%, 15%, 20% and 21%, 28% respectively. It was significantly higher in 1st year and 2nd year students, as compared to final and 4th year and students. Conclusions: Most of medical students have anxiety and depression due to study burden and a busy schedule. It is also seen that anxiety and depression is more among female medical students, and more among in 1st year and 2nd year MBBS students, as compared to the final and forth year students.   Keywords: Anxiety, depression, Medical students, prevalenc

Developing Human Capital for Rural Community Tourism: Using Experiential Learning Approach

AbstractCommunity awareness, lack of tourism knowledge and skills are the basic constraints that limit the ability of the local people to actively participate in the tourism planning and development. In Malaysia, Miso Walai Homestay at Kinabatangan, Sabah was recognized as one of the best Community Based Tourism Model not only at national level but at the international level. Thus, this study was to explore the process of community capacity building particularly on the aspect of awareness, knowledge, skills as well as attitude of the rural community that enable them to involve themselves in tourism planning. This study applies a qualitative approach by conducting in-depth interview with key informants. All the data were analyzed using thematic analysis. The results of the study showed that about 3 years has been used by the NGO together with the pioneer MESCOT members for the capacity building particularly on the human capital development. The knowledge, skills as well as awareness of the local people have been developed through experiential learning approach

Machine Vision Approach for Identification of Four Variant Pakistani Rice Using Multi-Features Dataset

Crops are the most important and beneficial food source in Pakistan. The demand for food has been an increase in Pakistan due to population growth. Pakistan produced 7,410 million tons of rice according to the financial year survey 2020 (FYS-2020). Pakistani rice has been cultivated in 3,304 hectares of the agricultural land zone, and it is also export around the world. Rice is also increased by 0.6% Gross Domestic Product (GDP) of Pakistan (FYS-2020). The old and manual process of rice classification is more expensive and time-consuming. In this study, we describe a machine vision approach for rice identification. We use four different varieties of rice for the experimental process such as Pakei_Kaynat, Kaynat_Kauchei, and Kauchei_Super_Banaspati and Tootaa_Kauchei (P1, P2, P3, and P4). The 100 images dataset have been used for practical work and total calculated of 400 (4 x 100) image of rice. The different process has been deploying on available datasets such as introduction, preprocessing methodology, and result discussion. A quality enhancement technique has been implementing for clarifying between rice color and shape sampling, and it is also converted color image in gray scale level. Every image has been employing six different non-overlapping regions of interest (ROI’s) and calculated a total of 2400 (6 x 400) ROI’s. Binary (B), Histogram (H) and Texture (T) features have been implemented and extract 43 features on each ROI’s and total calculated 103,200 (2400 x 43) machine learning (ML) features. Best First Search (BFS) Algorithm was used for feature optimization. Different ML classifiers are implementing for experimental process namely; Function Multi-Layer-Perception, Function SMO, Random Tree, J48 Tree, Meta Classifier via Regression and Meta Bagging. The Function Multi-Layer-Perception overall accuracy (OA) has describe better accuracy result is 99.8333%

Adsorption potential of macroporous Amberlyst-15 for Cd(II) removal from aqueous solutions

The macroporous ion exchange resins are unique and most suitable for the adsorption of heavy metal ions due to their porous three-dimensional structures and large specific surface areas. In the current investigation, a macroporous sulphonic acid cation exchange resin Amberlyst-15 was implemented for the adsorption of Cd (II) using batch adsorption technique to evaluate its removal efficiency. The characterization of resin surface was performed by several techniques: Scanning Electron Microscopy/Energy dispersive X-Ray Spectroscopy (SEM/EDS), Thermogravimetric analysis (TGA), Fourier-transform infrared spectroscopy (FT-IR), Brunauer-Emmett-Teller (BET) surface area and Point of zero charge (PZC). The effects of various experimental parameters such as time, temperature, concentration, pH and dosage amount were examined in detail. The optimum pH for maximum uptake of Cd(II) onto the Amberlyst.15 was observed at pH 3 showing the efficient working of resin under highly acidic conditions. The results also proved that Amberlyst-15 showed tremendous adsorption potential toward Cd(II) removal; 99.95% removal within 30 minutes reaction time and 2.01mmol/g maximum adsorption capacity at 323K. The adsorption data was well described by Langmuir adsorption isotherm and pseudo second order models. The thermodynamic parameters revealed that the adsorption was endothermic, spontaneous and feasible process with increased randomness at resin surface. The free energy of adsorption (E) (13-15kJ/mol) determined from Dubinin-Radushkevitch (D-R) model proved the ion exchange reaction mechanism for Cd(II) adsorption. The experimental results reported herein validate that Amberlyst.15 resin is a promising adsorbent for the enhanced removal of Cd(II) and other toxic metals from contaminated water and waste effluents

Cyclodextrins: An Overview of Fundamentals, Types, and Applications

Cyclodextrins are one of the most interesting pharmaceutical excipients with substantial theoretical and applied impacts in pharmaceutical industry. Even though the chemical foundation of these macrocyclic molecules was laid more than 100 years ago by Villiers and Schardinger, it was not until recently that cyclodextrins have been regarded as a subject of numerous potential pharmaceutical applications including inclusion complexation. This particular chapter discusses the fundamental concepts of cyclodextrin chemistry, structure, properties, and host-guest interaction with a special focus on molecular dynamics. Further in this regard, applications of cyclodextrins and numerous drug delivery approaches including novel lipid-based nanosystems are also highlighted