A numerical investigation of three-dimensional unsteady turbulent channel flow subjected to temporal acceleration

Investigation of turbulence response during constant temporal acceleration and deceleration can assist in improving the understanding of turbulence evolution and flow physics. Such flows have potential importance in engineering applications for example the air flow through the main trachea during the breathing cycle experience temporal acceleration and deceleration. The previous experimental and theoretical investigations based on conventional computational fluid dynamics (CFD) modelling could not provide the detailed information about turbulence response in the near-wall region in such types of flows. In particular, the response of near-wall structures has not been studied for turbulent flow with temporal acceleration and deceleration. In the present study, turbulent flows involving temporal acceleration and deceleration has been investigated using DNS and LES. A fully implicit fractional step method is implemented in the present study. The Navier-Stokes equations are discretised using finite volume method. Second-order- implicit Crank-Nicolson method is used for temporal discretisation for the convective and viscous terms. Second-order accuracy of spatial discretisation is achieved using four neighbouring points to calculate velocity gradients. A uniform grid is used in the streamwise and spanwise directions while a non-uniform grid is employed in the wall-normal direction. The numerical implementation has been validated for three test cases. The dynamic subgrid-scale model has been implemented for LES calculations. The LES model implementation has been validated through comparison with benchmark data available in literature. As one of the first DNS of accelerating turbulent flow, this study has produced a comprehensive database of turbulent statistics which can be used for unsteady turbulence modelling and validation. The detailed investigation has substantially enhanced the understanding of turbulence response for such flows. The flow physics has been studied in detail using turbulent kinetic energy budget analysis, vorticity analysis, anisotropy invariant maps and energy spectra. The evolution of new turbulent structures during the acceleration has been investigated using low-speed streaks and λ2 plots and many interesting ow characteristics have been found. The effect of different acceleration rates has been studied using LES. The turbulence propaga- tion in the core region has been studied for different acceleration rates. Turbulent flow subjected to constant temporal deceleration has also been investigated using LES. The effect of different deceleration rates has been also studied. The turbulent flow response to temporal deceleration has been analysed using the rms velocity and vorticity, kinetic energy budget and Reynolds stress anisotropy tensor analysis

Extending Secure Execution Environments Beyond the TPM

This project discusses some of the shortcomings and limitations of secure execution with the current state of the Trusted Computing Group (TCG) specifications. Though we feel that the various industry initiatives taken by the TCG and CPU manufacturers for hardware based platform security are a step in the right direction, the problem of secure isolated code execution and TCB minimization still remains unsolved. This project proposes and implements an alternative architecture for secure code execution. Rather than proposing recommendations for hardware changes or building isolated execution environments inside a Trusted Platform Module (TPM), we use a platform that provides related, yet different services for secure / trusted code execution; couple its functionality and bind it to a TPM using cryptographic primitives. For the purpose of this study we used multi-application programmable SmartCards but similar work can also be implemented on other platforms as long as they meet some pre-requisites described in his report. Though newer hardware platforms such as IntelTXT (Trusted Execution Technology; formerly known as LaGrande) or AMD-V add support for native virtualization and secure interfacing with the TPM, the solution implemented in this project assumes a highly un-trusted environment and works on general purpose commodity hardware. Implementing a solution like this allows application developers to focus exclusively on the functionality and security of just their own code. Hence enabling them to execute their applications in isolation from numerous shortcomings and vulnerabilities that exist both in the form of hardware and software attacks. Furthermore we provide an interface to extend the existing functionality of the TPM by implementing special purpose code modules inside a smart card which can be used for all the functionalities missing in the TPM (for example replace-able cryptographic algorithms) yet required by high assurance and security sensitive applications. Furthermore by making small application closures running inside the secure execution environment of smart cards, we can minimize the TCB that a user needs to trust. We first discuss the challenges we face in the coupling process and the platform differences between the TPM and a Smart Card. We also discuss what solutions are possible and impossible in this scenario. Then we describe our implementation of a secure TPM / Smart Card cryptographic binding that gives us assurances of strong authentication with confidentiality and integrity services for the applications built with the coupled architecture. We move forward to describe our implementations of some of the enhanced TPM / Smart Card coupled services that were not possible with either a TPM or Smart Card alone and we discuss how these enhanced services add value to the current applications. With these enhanced TPM services we implement some applications that change the way conventional TPM or Smart Card applications are perceived. Finally we shed some light on potential future applications and future work

Kimura’s disease of head and neck: A rare case presentation

Kimura\u27s disease (KD) is a rare, unusual occurrence, predominantly seen in Asian men, and poses a diagnostic challenge, often manifesting with allergic, eosinophilic hyperplasia, and nonspecific lymphadenitis. A 39-year-old man presented with mobile, well circumscribed, facial and neck swelling. His earlier biopsy showed a reactive lymph node hyperplasia on ultrasound neck and was suggestive of lipomatosis. As definitive diagnosis could not be made, the patient was planned for excision and biopsy. Subsequent histopathology demonstrated eosinophilic infiltration of lymphoid follicles and expansion of interfollicular area with interfollicular eosinophilic abscess formation and capillary venule proliferation. This was quite interesting as the previously diagnosed case of nonspecific lymphadenitis based on biopsy later turned out to be a rare occurrence of KD. Furthermore, because of other systemic symptoms (pedal edema and eye irritation), which probably reflected generalized manifestations of KD, the patient was referred to a rheumatologist after diagnosis, where he was effectively managed with immunotherapy and steroids

Is Stylet Use During Intubation Associated with Post Intubation Complications

Objective: The basic objective is to evaluate the impacts of placing stylet during tracheal intubation on the post-operative pharyngeal pain in anesthetized patients. Methodology: This randomized control trail was conducted in the department of Anesthesia and ICU, Ch. Pervaiz Ellahi Institute of Cardiology and  Nishter Hospital Multan from   May 2017 to December 2018. All these patients were divided into two groups group S (stylet group) and group C (control group) by lottery method. All the data was entered and analyzed by the computer software SPSS version 23.2. Results: A total number of 100% (n=386) patients were included in this study, both genders. Gender distribution showed that there were more males than females i.e. 56.2% (n=217) and 43.8% (n=169) respectively. The main outcome variables of this study were pharyngeal pain, airway maintenance and sore throat. It was also noted that group (S) showed easy airway maintenance in 95.9% (n=185) patients. It was observed that, in group (S), 63.2% (n=122) patients were complained from sore throat and 67.4% (n=130) were complained about pharyngeal pain.  While on the other hand, in group (C), only 8.3% (n=16) patients were complained about sore throat and 11.4% (n=22) were complained about pharyngeal pain Conclusion: Use of stylet during endotracheal intubation decreases the incidences multiple attempts and make the airway maintenance easy for the anesthetist but on the other side it have complications like sore throat and post intubation pharyngeal pain than those patients in which stylet was not usede. Keywords: Pharyngeal pain, Tracheal Intubation, Stylet, Post-operative. DOI: 10.7176/JMPB/53-05 Publication date:March 31st 201

Comparison of APACHE II, SAPS II and SOFA Scoring Systems as Predictors of Mortality in ICU Patients

Objective: The comparison of the APACHE II, SAPS II and SOFA scoring systems as predictors of mortality in ICU patients. Study Design: A prospective observational study. Place and Duration of Study: Intensive care unit of Ch. Pervaiz Ellahi Institute of Cardiology and  Nishtar Medical University and Hospital, Multan, from May 13, 2018 to September 24, 2018. Methodology: For 36 patients included in study, results for APACHE II, SAPS II and SOFA were calculated with the worst values recorded. At the end of ICU stay, patient outcome was labelled as survivors and non-survivors. Data was analyzed with SPSS v.23. Descriptive data was stated as median (minimum-maximum) or percentages. Pearson Chi square test and non-parametric statistics were applied accordingly. Linear regression analysis was also performed. Cut off value for statistical significance was taken as ≤0.05. Results: Of 36 patients, 22 survived and 14 died after being observed for 12 (2-17) days. On linear regression analysis, all the scoring systems were significantly associated with the mortality rates (p<0.05). However, after adjustment, only the APACHE II was a significant predictor of mortality (p<0.001). APACHE II scoring system calculated highest estimated mortality rates i.e.  19.3%, while SAPS II and SOFA scoring systems estimated 8.6% and 13.5% mortality, respectively. Conclusion: APACHE II scoring system was much superior to SAPS II and SOFA scoring systems as a significant predictor of the mortality among the ICU patients. Keywords: Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score (SAPS II), Sequential Organ Failure Assessment (SOFA), Intensive care units (ICU), Mortality. DOI: 10.7176/JMPB/53-03 Publication date:March 31st 201

Technological Dramas and the Punjab Police: The Downfall of Front Desk

Electronic dependence and utilization have been emerging as one of the driving forces towards departmental growth and development in this new era of globalization and modernization in Punjab police. The Front Desk (FD) project has a sign of change in Punjab police. It was changing the face of the police from the very first day it was started, but with the passage of time, it has changed its motive and began to change in the color of police. Hence, this paper highlights the issues and their solutions regarding the implementation and utilization of the FD project in the Punjab police department. It also highlights the working of Punjab police with and without FD and the importance of FD in the police department to delivering the grievance and of analysis the true nature of crimes. It discusses various aspects of police department myths and mistakes undertaken by the Punjab police officials and suggests various solutions for changing the face of the department. Keywords: Front Desk Project, Information Technology, Police Culture, Policing, Police Myths, Working of FD, Training & Development. DOI: 10.7176/PPAR/11-1-07 Publication date: February 28th 202

Comparison of Frequency of Recurrence after Burr Hole Evacuation of Chronic Subdural Hematoma with or without Subdural Drain.

Chronic subdural hematoma (CSDH) is known to have a significant recurrence rate. The rate of recurrence of chronic subdural hematoma after surgery ranges from roughly 5% to 30%.  Burr hole evacuation without drainage is performed as a first line of treatment for CSDH. As there is controversy in literature regarding the use of drainage after burr hole evacuation, the results of my study may be helpful for selecting a proper treatment modality as a first line of treatment for CSDH in terms of recurrence. The objective of this study was to compare the frequency of recurrence after burr hole evacuation of CSDH with and without subdural drain. It was a randomized controlled trial conducted in Department of Neurosurgery, Allied hospital, Faisalabad form Aug 2016 to Aug 2018 RESULTS:In our study, out of 130 cases(65 in each group). 84.62%(n=55) in Group-A and 76.92%(n=50) in Group-B were between above 40 years of age whereas 15.38%(n=10) in Group-A and 23.08%(n=15) were between 18-40 years of age, mean+sd was calculated as  64.03+7.61 years in Group-A and 62.28+7.83 years in Group-B, 78.46%(n=51) in Group-A and 72.31%(n=47) in Group-B were male while 21.54%(n=14) in Group-A and 27.69%(n=18) in Group-B were females, comparison of frequency of recurrence after burr hole evacuation of CSDH with and without subdural drain shows 10.77%(n=7) in Group-A and 27.69%(n=18) in Group-B, p value was 0.01 showing a significant difference. CONCLUSION: We concluded that the frequency of recurrence after burrhole evacuation of CSDH is significantly lower with drain when compared without subdural drain

A rare case of three years disease free survival in a locally advanced parathyroid carcinoma successfully excised by complete surgical resection

Parathyroid carcinoma (PC) is one of the rarest malignancies making approximately 0.005% of all cancers. It may arise sporadically or less commonly, in conjunction with genetic endocrine syndromes. Due to the rarity of the disease, no general consensus or definitive guidelines exist for its pre-operative diagnosis, management, or follow up. Surgical tumor removal is the gold standard treatment to prevent its recurrence. Parathyroid carcinoma has a high recurrence rate ranging from 40 to 60% in recent literature. We report a case of a seventy-year-old elderly female with locally advanced parathyroid carcinoma successfully surgically excised completely with a 3 year disease free survival period without adjuvant chemotherapy or radiotherapy

Comparison of Surgical versus Conservative Management of Borderline Traumatic Extradural Hematomas Without Neurological Deficit

Objective:  To compare the outcome of surgical versus conservative treatment of traumatic extradural hematoma in the supratentorial regin. Material and Methods:  It was a prospective randomized controlled trial conducted in Departments of Neurosurgery, Allied Hospitals, Faisalabad between December 2019 to November, 2020. A total of 100 patients Supratentorial EDH; fulfilling the selection criteria were enrolled. All patients underwent clinical and radiological assessment of EDH volume by the same neurosurgical team. The patients were then divided randomly into two groups by using the lottery methods. Group A patients were conservatively managed. Group B underwent surgery. All surgeries were done by the same surgical team. Glasgow outcome scale was noted in 5 days after admission or surgery in both groups. Results:  The patients average age was 29.96 years, male to female ratio was 1.7:1. The mean volume of hematoma was 24.68 and 27.56 in group A (conservative group) and Group B (operated group) respectively. The favorable outcome was noted in all the patients and no mortality occurred in any patients. Conclusion:  Both surgical and conservative treatments are equally effective in terms of a favorable outcome and mortality occurrence in management of traumatic EDH <30ml without neurological deficit. The conservative treatment is safe and cost-effective in borderline patients