Extraocular Muscle Imbalance and Outcomes of Scleral Buckling Surgery for Primary Rhegmatogenous Retinal Detachment

Objective: The objective was to study the muscle imbalance, restrictive motility in unlike gazes and the outcomes of the scleral buckling surgery for rhegmatogenous retinal detachment. Study design: Prospective follow-up study Settings and duration: The study was conducted at Al-Shifa Trust Eye Hospital Rawalpindi from Aug 2015 to Jan 2016. Methodology: The patients were checked prior to surgery and two follow up visits were done afterwards. Thorough history was taken along with full orthoptic assessment and ocular motility in all four main gazes including elevation, depression, adduction and abduction. Vision, type and position of explants, site of detachment, and risk factors of detachment were also observed. Results: A total of 48 eyes of 46 patients were taken. Mean age of the study participants was 37.16±20.37 years. Horizontal, vertical and combined deviations were observed in study population. Exo deviation was most common deviation among patients. Most reported risk factors of retinal detachment included trauma, pseudophakia, aphakia and myopia. Motility limitations of all four gazes was observed and it was found out that after buckling the squint and restriction is been increased up till two months. Conclusion: Ocular restriction among the patients was observed over a period of 2 months and it depicted that encircling with sclera buckling elicited an increase in restrictive ocular motility from pre-operative to 1 week and 2 months after surgery

Role of Flipped Class in Developing Self-Regulated Learning of ESL Students at Undergraduate Level in Pakistan

Flipped learning is the inverted classroom method, which introduces the lesson at home and encourages practise as well as other already-introduced lesson-based activities inside the classroom for practical purposes. Students can use their self-regulated learning strategies to continue with their respective content learning. In the current research, undergraduate learners of a public sector university in Pakistan are enrolled in a "short reading comprehension course" and are classified into the control and experimental groups following the research questions. Data were accumulated quantitatively with the help of two questionnaires evaluating learners’ satisfaction with the flipped experiment as well as the effect of the flipped method on developing self-regulated learning strategies. Flipped group learners, on the whole, exhibited satisfactory attitudes towards implementing the flipped method. The current study will aid future researchers using the flipped method in navigating the additional dimensions and models featuring self-regulated learning (SRL) strategies, along with incorporating the SRL-based model into the flipped method to analyse the results

Performance Comparison of DSR and AODV Routing Protocols for Soft Delay Deadlines in Wireless Multimedia Sensor Network

Wireless Multimedia Sensor Network (WMSN) is a collection of the vast amount of different types of sensors like camera sensor, video and scalar sensors which are involved in retrieving multimedia data from the large environment. The real-time sending of video and audio content to the destination before a strict playout deadline has been necessary for multimedia environment. Otherwise, it will be dropped at the destination. In WMSN sending real time multimedia data with soft play deadlines is a challenging task to solve this challenge, routing protocols play an important role in WMSN. Routing demands of multimedia content of WMSNs need to be perfect routing protocols to optimize path selection and guarantee communication. This paper presents a performance comparison between two reactive routing protocols; namely AODV and DSR, with soft delay deadlines and efficient utilization of resources in WMSN. The objective is to assess the real-time behavior of these two protocols upon sending multimedia content. Here, we evaluate the performance with respect to the use of these matrices like latency, Average jitter, Average delay and throughput and factors includes are CBR and multimedia traffic with varying packet size and bandwidth. DSR perform better as compared to AODV routing protocol since it discovers the routes more efficiently. AODV is better in term of Jitter than DSR. NS-2 simulator tool used for the purpose of this comparison

A prospective comparative study of Proximal Femoral Nailing Anti-rotation (PFNA) and Sliding Hip Screw (SHS) for Per-trochanteric Femur Fracture

Objectives: To determine the functional outcome, operative risks, rate of union, and complication in Per-trochanteric  Fracture fixed with PFNA and SHS. Material and Methods: The present study has been conducted at Shalamar Medical and Dental College Lahore from January 2018 to December 2018.40 patients with per-trochanteric femur fracture treated with proximal femoral nailing anti-rotation (PFNA)  and Sliding hip screw (SHS) were enrolled in our study.20 patients were treated by PFNA and 20 patients by SHS. Timing of surgery, mobilization status, hospital stay, infection, weight-bearing status, radiological union, complications both technical and implant-related, amount of blood loss(ml), C ARM Exposures, and Harris hip score at the end of 6 months were recorded. Results: Union was better in the PFNA group (95%) as compared to the SHS group (85%). Complication rate, hospital stay, surgery timing, and requirement of revision surgery were more in the SHS group. The functional outcome was better in the PFNA group as compared to the SHS group. Conclusion: From our study, we concluded that PFNA is a better alternative than SHS in terms of higher union rates, low complication rates, and better functional outcomes. &nbsp

COMPARE THE INTENDED RESULT OF SINGLE BOLUS INTRAVENOUS LIGNOCAINE WITH MAGNESIUM SULPHATE TO REDUCE THE PRESSURE OF AVAILABILITY OF OXYGEN TO TISSUES DURING LARYNGOSCOPY AND INTUBATION

Background: Placement of flexible plastic tube into trachea to maintain an open airway is done during general anesthesia and its effect availability of oxygen to tissue in patients. Objectives: The aim of this study was to compare the intended result of single bolus intravenous lignocaine with magnesium sulphate to reduce the pressure of availability of oxygen to tissues during laryngoscopy and intubation. Material and Methods: There were 178 patients included in this study. Two groups were made with 89 patients each. Group A receive intravenous 1% lignocaine 1mg/kg. Group B receive intravenous magnesium sulphate 10mg/kg. the data about mean arterial pressure, heart rate was compared between 2 groups. Data was analyzed wing SPSS version 22. Place of study. 1st March, 2018 to 31ST August, 2018 in Jinnah Hospital. Lahore. Duration of study: Time period for this study was 6 months. Result: In 54% patients of group A, 20% reduction of mean Arterial pressure was observed and 36.69% reduction in group B. there was 25% reduction in heart rate from basilines values in 11% patients of group A and 6.23% in that of group B. Conclusion: Comparative study showed that lignocaine was more effective than magnesium sulphate by preventing increase in HR and MAP after intubation and laryngoscopy. Keywords: Hemodynamic changes, MAP, HR, Stress response

TO KNOW THE EFFICACY OF THYROIDECTOMY FOR THE MANAGEMENT OF MULTINODULAR GOITER

Objective: To evaluate the thyroid surgery results of multinodular goiter and compare total and subtotal thyroidectomy operations. Study Design: A Prospective Study. Place and duration: In the Surgical Unit I in collaboration with Head and Neck Surgery department of Services Hospital Lahore for six months duration from August 2018 to January 2019. Methods: Sixty multinodular goiter patients were included in the study. Into 2 groups, patients were divided. In 1st group subtotal thyroidectomy was done and total thyroidectomy done in other group. Data was analyzed and recorded in terms of demographic data, hospital stay, type of surgery and postoperative complications. Results: There was no vast variation between these two groups in terms of age, gender, hormonal status or goiter duration (P = 0.73, P = 0.64, P = 0.73 and P = 0.59, respectively). In both groups, the important manifestation for surgery was sudden increase in compression symptoms and size of goiter. The mean hospital stay and duration of surgery in cases of subtotal thyroidectomy was short, but there was no statistically significant variation (P> 0.06). The frequency of postoperative transient hypocalcemia was higher significantly in total thyroidectomy (P = 0.004). Although, postoperative hypocalcemia was not significantly permanent between 2 groups. Conclusion: In total thyroidectomy, permanent complications incidence is not more than subtotal thyroidectomy. Therefore, if for the first time total thyroidectomy is done for multinodular goiter, the possibility of disease recurrence can be decreased and the operation can be avoided for the second time. Key words: Subtotal thyroidectomy, total thyroidectomy goiter

Correlation of Foot Wears with MSK Disorders in Ankle Joints Among Females

AIM: This paper is a report of study conducted to explain the factors that causes ankle sprain by wearing high heels among students of Sargodha medical college and university of Sargodha.BACKGROUND: High heeled shoes have been worn for several centuries and despite numerous cautions against their use, they remain extremely popular. Wearing high heeled shoes is thought to increase the individual’s likelihood of experiencing a lateral ankle sprain. The 19th century saw the first warnings that wearing high heels footwear could lead to trips and falls. Previous investigations have shown that high heeled shoes align the foot in planter flexion, modifying the relative orientation of the skeletal structures of ankle, midtarsal, and metatarsophalangeal joints, and alter the insertion angles of the foot and gliding joint muscles, therefore increasing the risk factor for ankle sprain.METHODS: observational non-experimental study was conducted via a questionnaire which was distributed among 500 female students of SMC (Sargodha medical college) and university of Sargodha. These female students fall in age group between18-26.RESULT: The result of our study concluded that the types of heel and height of heel are the most significant factors that cause ankle sprain. The ankle sprain caused by wearing pencil heels and by use of <3 inch heels are greatest. Keywords: Pencil heel, height of heel, Ankle sprain, SMC, Female student. DOI: 10.7176/JHMN/80-09 Publication date:September 30th 202

Knowledge, attitude and practices towards eye care, among primary health care workers in District Ckakwal.

Introduction: Despite the fact, that an estimated 80% of worldwide blindness is preventable or treatable, the number of individuals living with blindness or impaired vision is on a rise. According to epidemiological data, worldwide over 2.2 billion people are blind or have impaired vision and 90% of them live in underdeveloped countries. A large number of people consult primary health care workers for their health issues, whether it is general illness or eye problems. Objectives: To assess the Knowledge, Attitude, and Practices (KAP) of Primary Health Care workers with regard to Primary Eye Care (PEC) in District Chakwal, Pakistan. Methodology: A Quantitative Cross-sectional study design, using a Random Sampling technique was employed. Participants in the study were given a standardized semi-structured questionnaire to fill out. The questionnaire included questions on primary health care providers’ knowledge, attitudes, and practices about PEC. The data were analyzed by using the statistical package for social sciences (SPSS) version 26. Results: Among the total of 232 Primary Health Care workers 73.7% were below 40 years of age. The majority of primary health care workers were female (60.8%). About 40.9% were having diplomas. The majority of workers (58.6%) had less than 5 years of experience as a Primary Health Care worker. Most of them (60%) had sufficient knowledge about the causes of eye diseases or injuries and (40.8%) had knowledge about conditions that may result in eye illnesses or injuries. The attitude toward referral of patients to medical doctors was 51.2%. The practices regarding method and approach for the treatment of eye diseases, of the majority of workers (58.9%) were not satisfactory. Conclusion: Knowledge regarding causes of eye diseases, diagnosis, and methods of treatment were not satisfactory amongst the primary health care workers. A positive attitude was noted for the will to improve the knowledge of eye care. The research revealed, the requirement for a training program for primary health care workers regarding modern primary eye care

From pressure to breaking point : exploring sport motivation, big five personality traits, and sport anxiety as antecedents of burnout in university athletes

The present study examined the relationship between motivation, sport anxiety, big five personality traits and athlete burnout, making use of a cross section research design. A total of 200 university athletes between the ages of 18-26 years participated in the study, completing a battery of scales measuring motivation, sport anxiety, and personality traits. Pearson product moment correlation, multiple hierarchical regression analyses and mediations analyses were conducted to evaluate the results. The findings show that sport motivation (intrinsic regulation, introjected regulation and amotivation), personality traits (neuroticism, conscientiousness), and sport anxiety are correlated with and predicted various dimensions of athlete burnout. Sport anxiety mediated the relationship between introjected regulation, intrinsic regulation and amotivation. The study identified several antecedents of burnout in university athletes than can help address symptoms of burnout and prevent the negative consequences that arise as a result of burnout.peer-reviewe