Incidental finding of a giant aortic root aneurysm and its repair

The prevalence of aortic aneurysms is 3-4% in individuals more than 65 years. Age and haemodynamic factors play an important role in the development of aortic aneurysms. Most patients with aortic aneurysms are asymptomatic at the time of discovery. Thoracic aneurysms are usually found incidentally after chest radiographs or other imaging studies. The most common complications of thoracic aortic aneurysms are acute rupture or dissection. Some patients present with tender or painful nonruptured aneurysms. Patients are thought to be at increased risk for rupture and should undergo surgical repair on an emergent basis We document a case of a 66-year-old man who presented with shortness of breath. On evaluation, he was found to have severe aortic regurgitation and large aortic root aneurysm. Patient underwent successful open heart surgery. Aortic root and aortic valve were replaced with valve conduit and coronary arteries were re-implanted. Patient had an uneventful recovery

A COMPARATIVE RESEARCH TO EVALUATE MVA (MANUAL VACUUM ASPIRATION) AND MEDICAL TREATMENT TO MANAGE MISSED MISCARRIAGE (FIRST TRIMESTER)

Objective: The objective of this research is to evaluate and contrast the medical treatment and MVA (Manual Vacuum Aspiration) for managing the miscarriage in the 1st trimester. Material and Methods: This comparative research was conducted at Sir Ganga Ram Hospital, Lahore (August 2017 to March 2018). This research consists of a total of 92 cases of patients having a gestation age of less than twelve (12) weeks of missed abortion in the first trimester. Two groups were made of the patients: group A was treated with MVA whereas group B was treated medically and their effectiveness was evaluated. Results: The patients’ mean age was (29.77 ± 6.786) years in which group A patients’ mean age was (30.61 ± 6.754) years while group B patients’ mean age was (28.93 ± 6.787) years. The gestational mean age was (5.87 ± 3.592) weeks in which group A gestational mean age was (6.09 ± 3.699) weeks while group B gestational mean age was (5.65 ± 3.510) weeks. In group A patients, the effectiveness of treatment was 91.30% (42 out of 46 patients) while in the group B patients, the effectiveness of the treatment was 69.57% (32 out of 46 patients). The rate of effectiveness of cure for group A was considerably greater than Group B i.e., 91.30% as compared to 69.57%, having (p=0.009). Conclusion: The outcome of this research proved that MVA is a far more useful modality of treatment than medical treatment i.e., misoprostol intravaginally, as the rate of effectiveness of cure was considerably greater for the group of MVA than the group which was treated medically and it was especially true in the group of patients with older ages. Keywords: Evacuation and Dilatation, Incomplete Abortion and Manual Vacuum Aspiration

Blockchain Adaptability in Internet of Thing (IoT) Environments

Blockchain is a considered to be a disruptive technology as like an Internet. The features of blockchain are giving more expectations in their applications. Internet of Things is emerging day by day with millions of connecting devices. Even though Internet of Things is evolving, the security of the internet of things is questionable with its architecture

Factors Responsible for the Prolonged Stay of Surgical Neonates in Intensive Care Units

Objectives: The length of hospital stay (HS) for patients is a major concern due to its social, economic and administrative implications; this is particularly important for neonates admitted to intensive care units (ICUs). This study aimed to determine the factors responsible for prolonged HS in surgical neonates. Methods: This retrospective study was conducted at Sultan Qaboos University Hospital, in Muscat, Oman. The medical records of 95 neonates admitted to the neonatal ICU who underwent general surgical procedures between July 2009 and June 2013 were reviewed. Mann-Whitney U and Pearson’s Chi-squared tests were used for non-parametric numerical and categorical variables, respectively. A multiple regression analysis was performed to find a relationship between the variables and to detect the most important factor responsible for prolonged HS. A P value of <0.05 was considered statistically significant. Results: Gestational age, birth weight, number of days on a ventilator and postoperative morbidity were associated with prolonged HS. Furthermore, the age of neonates at first full enteral feed was associated with increased HS using both independent and multiple regression analyses. Conclusion: Prolonged HS can occur as a result of many factors. In this study, a number of factors were identified, including low gestational age, low birth weight, increased number of days on a ventilator and postoperative morbidity. Additionally, neonate age at first full enteral feeds also correlated with increased HS. Further research on this topic is suggested to explore this correlation in more detail and to inform future practices

An experimental and DFT study on novel dyes incorporated with natural dyes on titanium dioxide (TiO2) towards solar cell application

Titanium dioxide (TiO2) thin flms were deposited on fuorine tin oxide (FTO) coated glass substrate using spin-coating techniques and as-deposited flms were sensitized with various dyes. A series of azo derivatives (2, 5a-b) having diferent structures were successfully prepared through the process of the azo coupling reaction. KAZO 6 was successfully synthesized by esterifcation of kojic acid obtained from sago waste with azo 5a. These azo dye were examined using density functional theory (DFT) and time-dependent density functional theory (TD-DFT) to obtain the vertical excitation, electron distribution, energy levels, band gap, and light-harvesting efciency in the ground and excited state. The obtained values exhibited a good correlation with the experimental values. Efciency enhancement was reported by the incorporation of KAZO 6 with curcumin extracted from turmeric. Spectroscopy and optical properties of synthesized dyes were characterized using CHNS elemental analysis, FTIR, 1 H NMR, 13C NMR, and UV–Vis spectroscopies. KAZO 6 displayed an efciency of 1.59% compared to azo derivatives 0.13–1.12%. The efciency of KAZO 6 enhanced from 1.59 to 1.74% with the incorporation of turmeric dye

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Quality Assurance of Security Requirement Engineering in Socio- Technical Systems

Quality assurance is a continuous process to check whether specified requirements are being fulfilled by a system or service. Quality assurance checks for the defects before they get into the final product. In this research a comprehensive survey of various literatures has been carried out to ensure quality standards. Different quality assurance techniques have been employed in this research that help in improving the quality of the socio technical systems from the perspective of security requirement engineering. The analysis of various type of literature reveals that after applying techniques presented in the literature review shows improvement in the performance of the socio technical systems. Tropos, SeeCo (Security via commitments), formative user centered evaluation technique, three-layer framework, Si*(Secure i*) ontology are the different techniques discussed throughout the research that ensures the quality standards. Some of the quality evaluation tools like STS-tool and STS-ml are also used in the research for quality assurance. This research also assesses the improvements of security requirement engineering in socio technical systems after applying Quality evaluation techniques

A Study of Project Management Processes for Sustainable and Successful Projects in Software Industry: Expectations vs Perceptions of Managers

Project Management Processes (PMPs) are essential to avoid project failures due to the complexity and nature of projects in the software industry, particularly in emerging economies. The software industry is growing rapidly in Pakistan with an increasing number of local, regional and international clients. The project managers who are familiar with PMPs are therefore needed for the proper implementation of these processes, which will lead to sustainable and successful software projects. However, very limited studies have analyzed the expectations and perceptions of the project managers of these PMPs. In order to fill this gap, therefore, this study examined the role of PMPs in the sustainable development and success of software projects by documenting the expectations and perceptions of managers. A structured questionnaire is designed to collect data from 143 participants working in software houses. SPSS is used for the processing and analysis of data using selected statistical tools. The results show a clear difference in expectations and perceptions for PMPs, which means that project managers are of a less rational, sentimental and emotional nature. The findings of this study also show that the male segment is dominant in the software industry which may be due to of Pakistan’s specific social and cultural environment. There is however no significant difference between expectations and perceptions of both male and female project managers for PMPs. The findings of this study will help researchers, practitioners, academics and other stakeholders in the software industry

Blockchain Adaptability in Internet of Thing (IoT) Environments

Blockchain is a considered to be a disruptive technology as like an Internet. The features of blockchain are giving more expectations in their applications. Internet of Things is emerging day by day with millions of connecting devices. Even though Internet of Things is evolving, the security of the internet of things is questionable with its architecture

Predicting stroke and mortality in mitral stenosis with atrial flutter: A machine learning approach

Abstract Background Our study hypothesized that an intelligent gradient boosting machine (GBM) model can predict cerebrovascular events and all‐cause mortality in mitral stenosis (MS) with atrial flutter (AFL) by recognizing comorbidities, electrocardiographic and echocardiographic parameters. Methods The machine learning model was used as a statistical analyzer in recognizing the key risk factors and high‐risk features with either outcome of cerebrovascular events or mortality. Results A total of 2184 patients with their chart data and imaging studies were included and the GBM analysis demonstrated mitral valve area (MVA), right ventricular systolic pressure, pulmonary artery pressure (PAP), left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) class, and surgery as the most significant predictors of transient ischemic attack (TIA/stroke). MVA, PAP, LVEF, creatinine, hemoglobin, and diastolic blood pressure were predictors for all‐cause mortality. Conclusion The GBM model assimilates clinical data from all diagnostic modalities and significantly improves risk prediction performance and identification of key variables for the outcome of MS with AFL