A comparison of two global optimization algorithms with sequential niche technique for structural model updating

Peer reviewedPostprin

Application of firefly algorithm to the dynamic model updating problem

Peer reviewedPostprin

Damage estimation using multi objective genetic algorithms

Peer reviewedPreprin

Quality assurance audit in adult cardiac anaesthesia

Objective: To assess different anaesthesia-related quality indicators during adult cardiac surgery.Methods: The prospective clinical audit was conducted at the Aga Khan University Hospital, Karachi, from October 2016 to March 2017, and comprised all adult patients scheduled for cardiac surgery. Different anaesthesia-related quality indicators were observed during the pre-induction phase, before the cardiopulmonary bypass, during the procedure, and post-surgery till the transfer from the operating room to the cardiac intensive care unit. Data was analysed using SPSS 19.Results: Of the 264 patients, 217(82.2%) had complete record; 160(73.7%) males and 57(26.3%) females. The overall mean age was 56.56±12.46 years. In the pre-induction phase, difficult intravenous and invasive line access was seen in 42(19.3%) patients. Inappropriate information in the preoperative form was found in 6(2.8%) patients, and preoperative drugs for anxiolysis were used in 145(66.8%) patients. Haemodynamic issues were significant during the surgery in 15(6.9%) patients. In the post-surgery period, abnormal activated clotting time was found in 17(7.8%) patients, while monitoring problems were faced in 7(3.2%) cases during transfer to cardiac intensive care unit.Conclusions: It will help to develop quality improvement policies to enhance patient safety, satisfaction and better outcome

Model Updating of a Full-Scale Building Structure Under Train Induced Vibration

Structure health monitoring (SHM) system is a method of monitoring and evaluation of structural health. Finite element method is extensively use to model the dynamics properties of a structure as it is believed to be an authentic tool for providing accurate results. To adopt a more precise dynamic properties of a structure, model updating technique involve updating a finite element model of a structure. However, due to many imaginary assumptions in the finite element (FE) model generation, the practical behaviour of full-scale structures contradicts the model results. It may be due to uncertain boundary conditions, poorly defined material properties of the structure or because of the simplified modeling of complicated structural systems. In this paper, six storey frame structure building has been investigated for dynamic model updating. The building was subjected to train induced excitation. Four accelerometers were employed to measure the response. Manual updating of building FEM model is carried out as per design parameters of the finite element model (elastic modulus and boundary constraints) to diminish the inconsistencies between the field measurement and the results of finite element model. For the subject building the supposition of semi-rigid joints (rotational area springs) can most precisely depict the dynamic properties of the subject building. The modified parameters obtained from the updated model are logical having meaningful interpretation

Misplaced central venous catheter in carotid artery during emergency surgery for the total correction of tetralogy of fallot of an adolescent boy

Ultrasound-guided central venous cannulation is now considered as the standard of care, and this has largely replaced blind central venous cannulation using anatomical landmarks. We are reporting a case of inadvertent placement of central venous catheter in the right common carotid artery with the use of ultrasound guidance during emergency surgery for the total correction of Tetralogy of Fallot (ToF). This patient luckily had a favourable outcome despite this inadvertent catheter placement which was not recognised even after completion of surgery .The patient also received drug infusions of inotropes and vasopressors through this malplaced central line into the aorta. The possible mechanism, consequences, prevention and management of this inadvertent cannulation are discussed in this report

The Relationship between Product Nature and Supply Chain Strategy; An empirical evidence

Abstract The purpose of the paper is to explore the relationship between the nature of product and respective supply chain strategy of the firms operation in manufacturing sector. The relationship is investigated by using the fishers model as conceptual framework. Data was collected through questionnaire-based self-administered survey. The results of the survey were analysed by testing the fishers model related to Supply Chain Strategy and product characteristics. The results of the study indicated that there is a significant relationship between nature of the product and supply chain strategy in manufacturing sector of Pakistan. The practical implication can be derived by the policy makers and practitioners of the supply chain strategy domain that characteristics of the product can have an impact of the decision to device supply chain strategy. Furthermore, this study is conducted in special context of underdeveloped country like Pakistan. Therefore, results of this study enhanced the existing literature on underdeveloped economies

Performance of Partially Bonded Engineered Cementitious Composites (ECC) In Concrete Block Masonry

The objective of this study is to examine the behavior and determine the potential implications of Engineered Cementitious Composites (ECC) to strengthen the concrete block masonry by using a unique method of partially bonding the tension face as tension strengthened beam under the out of plane loadings. The specimens under investigation were comprised of two categories i.e. un-strengthened concrete block masonry beams and tension strengthen beams with different thicknesses of ECC layers. All the specimens were experimented under the four point loadings to evaluate the flexural performance of fabricated beams. The current study reveals that the partially bonded ECC strengthening of concrete block masonry beams has significantly improved the strength and deformability

Clinical outcome of post placental IUD CuT380 insertion in terms of expulsion

Background: Insertion of an intrauterine contraceptive device (IUD) immediately after delivery has been recommended by the World Health Organization (WHO), as one of the safe and effective methods of temporary contraception. In the immediate post delivery period the women are highly motivated and need an effective method for contraception so that the child can be brought up with a relaxed mind without the worry of unintended pregnancy. This approach is more applicable to our country where delivery may be the only time when a healthy woman comes in contact with health care personnel. However, immediate post-partum IUD insertion may have disadvantages as well. The risk of spontaneous expulsion may be unacceptably high.Methods: After taking approval from hospital ethical committee, all women planning vaginal delivery desiring IUD, admitted through OPD and emergency were evaluated in detailed on design Performa Performa include patient’s identity, age, parity, gestational age, no of alive children, outcome and timings of insertion. Informed consent was obtained. With aseptic precautions IUD was inserted with kellys forceps in the uterine cavity up to the fundus, then cervix was examined for thread (that should not be visible at cervix if proper insertion done). The procedure was performed by myself. Patients were followed at 6week by examining the threat of IUD. All the information was recorded by myself. Follow up was done by taking patients contact number.Results: In our study, out of 300 cases, 63.67% (n=191) were between 18-30 years of age while 36.33% (n=109) were between 31-40 years of age, mean+sd was calculated as 29.49+4.62 years, mean gestational age was calculated as 38.53+0.94 weeks, mean parity was calculated as 3.49+1.06 paras. Frequency of expulsion in post placental intra uterine device cuT 380 insertions reveals in 8.67% (n=26).Conclusions: We concluded that the frequency of expulsion in post placental intra uterine device cuT 380 insertions is not significantly higher and appears to be safe and effective method of contraception.

Determine the frequency of peripartum hystrectomy in placenta previa

Background: Peripartum hysterectomy is one of the life saving procedure performed after vaginal delivery or caesarean birth or in the immediate postpartum period in cases of intractable haemorrhage due to uterine atony, rupture uterus and placental disorders and it is usually reserved for the situations where conservative measures fail to control the haemorrhage. The objective of the study was to determine the frequency of peripartum hysterectomy in placenta praevia.Methods: The study was cross-sectional. It was conducted at the Department of Obstetrics and Gynaecology, Punjab Medical College and affiliated Hospital, Faisalabad. Study was carried out over a period of six months from October 2010 to March 2011. Total 130 cases of placenta praevia undergone caesarean section were included in this study. In cases of primary postpartum haemorrhage conservative management was done first in the form of intramuscular syntometrine (Oxytocin 5 IU/ergometrine 0.5 mg). Intravenous infusion syntocinon (40 IU in 500ml 0.9% saline over 4-6 hours).Results: Mean age of the patients was found to be 30.9±6.7 years. Distribution of cases by gestational age shows, 52 (40.0%) patients had gestation of 28-36 weeks and 78 (60.0%) patients had gestation of 37-41. Mean gestational age was observed 37.5±3.4 weeks. Parity distribution was as follows: 76 (58.5%) patients had parity 0-3, 34 (26.1%) patients had parity 4-6 and 20 (15.4%) patients had parity > 6 with mean parity of 3.2±1.9. Conservative management was done in 129 patients (99.3%). Peripartum hysterectomy was found to be in 1 patient (0.7%).Conclusions: Placental pathology is the leading cause of postpartum hemorrhage and the main indications of peripartum hysterectomy. Timely operation minimizes the morbidity and mortality