Performance of Self Compacting Concrete Using Bentonite

Supplementary Cementitious Materials (SCMs) have the potential to enhance the properties of self-compacting concrete (SCC) while reducing the pressure on natural reserves and CO2 emissions. However, certain SCMs are not able to meet the needs in the construction industry. This research investigates the role of unheated bentonite (BN) clay and its synergistic effect with Ground Granulated Blast Furnace Slag (GGBS) as a partial substitute for cement on performance of SCC. Three different mixtures were prepared, each consisting of 0%, 15%, and 30% (by weight) BC as a replacement for cement, while GGBS remained constant to get the designed strength. Each mix was designed with two strength grades of 30 and 60 MPa by adjusting the compositional parameters and validating their 28 days compressive strength. Fresh Properties tests were conducted as per EFNARC standards. The ultrasonic pulse velocity of all tested specimens is greater than 4.5 km/s, indicating "good" and "excellent" quality concrete. The experimental results revealed that combining BC with GGBS concrete improved durability. The BC and GGBS made concrete more resistant to sulphate attack and chloride ingress. The concrete mixtures were found to be suitable and more durable for use in the construction industry

FUNCTIONAL OUTCOME AFTER DECOMPRESSION FOR DORSAL SPINE TUBERCULOSIS SURGREIS

OBJECTIVE: functional outcome of improvement after decompression for dorsal spine tuberculosis in terms of frankle grading. METHODOLOGY: This prospective study was conducted after ethical approval at neurosurgical ward mmc/mti through non-probability sampling. Clinical and radiological examined patients with carriers of dorsal spine tuberculosis were enrolled in study. After surgery they were followed for three months and improvement were measured comparing pre and post op Frankle grading. RESULTS:  Total of 38 patients underwent surgical procedure decompression ± fusion through postero-lat approach (costotransversectomy) in which 42% were male and 58% were female. Mean age was 34±5. Distribution for age group was 18-30(08), 31-40(13), and 51-60 (06). Level of disease D4-D8 were 17(44.8%), D9-D12 were 21(55.2%). CONCLUSION: decompression and stabilization in spine tuberculosis is safe, effective and results in good outcome clinically. The advantages of surgery include through debridement, decompression and achievement of spinal stabilization. KEY WORDS: Dorsal spine tuberculosis, corpectomy with fusion, laminectomy, outcome measure

A Squeeze-and-Excitation and Transformer based Cross-task System for Environmental Sound Recognition

Environmental sound recognition (ESR) is an emerging research topic in audio pattern recognition. Many tasks are presented to resort to computational systems for ESR in real-life applications. However, current systems are usually designed for individual tasks, and are not robust and applicable to other tasks. Cross-task systems, which promote unified knowledge modeling across various tasks, have not been thoroughly investigated. In this paper, we propose a cross-task system for three different tasks of ESR: acoustic scene classification, urban sound tagging, and anomalous sound detection. An architecture named SE-Trans is presented that uses attention mechanism-based Squeeze-and-Excitation and Transformer encoder modules to learn channel-wise relationship and temporal dependencies of the acoustic features. FMix is employed as the data augmentation method that improves the performance of ESR. Evaluations for the three tasks are conducted on the recent databases of DCASE challenges. The experimental results show that the proposed cross-task system achieves state-of-the-art performance on all tasks. Further analysis demonstrates that the proposed cross-task system can effectively utilize acoustic knowledge across different ESR tasks

Presentation And Diagnosis: Pregnancy Induce Diabetes And Hypertension In Medical Doctors At Hospital And Clinics

OBJECTIVES The aim of this study was to assess pregnancy induce diabetes and hypertension in medical doctors. METHODOLOGY This case-control study was conducted after approval by the ethics committee. A total of 72 physicians who were pregnant and diagnosed with pregnancies causing hypertension or diabetes participated in the study. Daily details of hourly blood glucose levels were recorded at the beginning and end of the day. Use SPSS version 24.0 to analyze the results. RESULTS Out of the 33 patients, 23 remained hypertensive at the end of the day, while 10 had normal hypertension at the beginning of the day. Hypotension appeared from the 39th day of which 24 of her ended high, 15 were normal and 10 were diet controlled. The maximum number of pregnancies was 40 in high-care controls and 32 in low-care controls. Out of 30(16) had high FBS at the beginning of the day and 17 of the 42 who had the highest at the end of the day had low FBS. The highest score of 17(42) was presented at the beginning of the day with low FBS and 17 at end of the day with a high ratio and high count of 42.   CONCLUSION   Health care is important for all patients, whether they are health workers or not. Daily Record helps patients and providers understand patient disease management and take appropriate action.

Frequency of Complications Following Cataract Surgery in Diabetic Patients at Tertiary Care Hospital

OBJECTIVES: To determine the frequency of complications following cataract surgery in diabetic patients admitted in the ophthalmology unit. METHODOLOGY: A prospective descriptive interventional case series study was conducted after approval of the ethical committee, from June 2017-June 2020 at the Ophthalmology department MTI-MMC. A total of 129 patients from either gender were enrolled in study. All the study patients went through detailed history and complete ocular examination. After necessary investigations, surgical procedure was carried out. Results were analyzed through the SPSS-24 version. RESULTS: Out of the total 129 eyes of the diabetic patients, fifty-nine (45.7%) were males and seventy (54.3%) were females with a ratio of 1:1.2. Uveitis leads the chart in complications found in twenty (15.50%) eyes while PODR being the least common found in only ten (7.75%) eyes. Worse visual acuity was observed in fourteen (10.85%) eyes. Striate keratopathy and posterior capsule opacification were found in sixteen (12.40%) and fifteen (11.62%) eyes respectively. Among the patients, 15.7% were having more than one complication during follow-up visits and eighty-eight (68.2%) eyes were found to have none complication. The age group 51-60 years observed frequent complications as compared to other groups. Similarly female gender (38.57%) has frequent complications as compared to males (2.7%). CONCLUSION: The study concludes Uveitis as the most common complication observed in 15.50% 0f the eyes while worse visual acuity (10.85%) and progression of diabetic retinopathy (7.75%) being the least common. Striate keratopathy was found in 12.40% while posterior capsule opacification in 11.62% of the eyes

SSDPT: Self-Supervised Dual-Path Transformer for Anomalous Sound Detection in Machine Condition Monitoring

Anomalous sound detection for machine condition monitoring has great potential in the development of Industry 4.0. However, these anomalous sounds of machines are usually unavailable in normal conditions. Therefore, the models employed have to learn acoustic representations with normal sounds for training, and detect anomalous sounds while testing. In this article, we propose a self-supervised dual-path Transformer (SSDPT) network to detect anomalous sounds in machine monitoring. The SSDPT network splits the acoustic features into segments and employs several DPT blocks for time and frequency modeling. DPT blocks use attention modules to alternately model the interactive information about the frequency and temporal components of the segmented acoustic features. To address the problem of lack of anomalous sound, we adopt a self-supervised learning approach to train the network with normal sound. Specifically, this approach randomly masks and reconstructs the acoustic features, and jointly classifies machine identity information to improve the performance of anomalous sound detection. We evaluated our method on the DCASE2021 task2 dataset. The experimental results show that the SSDPT network achieves a significant increase in the harmonic mean AUC score, in comparison to present state-of-the-art methods of anomalous sound detection

Outcome of Fistula in Ano after Incision Drainage of Acute Peri Anal Abscess

OBJECTIVES:  To determine outcome of fistula in ano after incision drainage of acute peri anal abscess. METHODOLOGY: This descriptive case series study was conducted after approval of the Ethical committee. A total of 154 patients were observed for a six-month duration. Pre-design proforma was used to collect data. An inclusive criterion was age between 18-50 years of both genders with acute perianal abscess with low-level fistula (submucosal and mucocutaneous) and high-level fistula (ischiorectal and pelvirectal). Exclusive criterion was observed in all admitted patients who include secondary abscess formation for example diabetes mellitus, tuberculosis, and carcinoma with any previous history of fistula in ano. The result was analyzed through the SPSS-24 version. RESULTS: Ratio 35 (22.72%) was obtained for age group 18-30, 49 (31.81%) for age group 31-40 and 70 (45.44%) were in age group 41-50. The mean age was 38.25 years with SD ±9.70. The ratio of Males 143 (92.85%) leads high to females 11 (7.15%).  The fistula was found in 64 (41.55%) patients postoperative after incision drainage for perianal abscess. Among 64 patients, 54 (37.01%) were male and 7 (4.54%) females. 90 (58.44%) patients had no fistula postoperatively. Low-level 45 (29.22%) and 19 (12.33%) high-level fistula was found in patients. Among the low-level ratio, 40 were male and 5 were female. Similarly, in high-level fistula 17 were male and 2 were female. CONCLUSION: Fistula is more common in males than females. Low lying fistula leads the chart more than a high lying fistula. The incidence of anal fistula in our observed patient’s abscess was 41.55%

Sehat Sahulat Program Effect on Patients Presenting to Secondary Level Hospital in Mardan

OBJECTIVES The aim was to find the difference between government and private hospitals at the Mardan secondary level for sehat sahulat card effect on patients for their selection of hospital, dates, and time issues for elective and emergency cases with department facilities. METHODOLOGY This quantitative cross-sectional study was conducted to see the difference between the government and private hospitals for sehat the sahulat program effect on patients. Patients care is important on both sides but to find out the difference where more work should be done to achieve universal global health under the Khyber Pakhtunkhwa government for the benefit of their people’s health. RESULTS Total patients 10112 visited District Head Quarter (DHQ) hospital from February 2021 to February 2022 while 5672 were in a private hospital in which the ratio for gynaecology was 19 % (854 pts. DHQ) and 31% (1652) private hospital. Medical admissions were 2224 (50%) for a government hospital and none for private while surgical admissions were 1379 (31%) for government and 2665 (50%) for private hospitals. The significant ratio for chi-sq was P<0.5 CONCLUSION Government hospital flow of patients is more than the private sector in admission ratio for medical cases then surgical while private has more flow for surgical admission than medical with all facilities provided on the desk and timely managed at the time of admission. Seniorm consultant’s ratio of surgeries in private is more than in government hospitals

Knowledge, attitudes and practices of parents regarding antibiotic use in children

Background: Emerging resistance to antimicrobial chemotherapy is becoming a challenge for medicine in recent times. Un-prescribed use of antibiotics is a major contributor to development of this problem. In Pakistan access to antibiotics remains unchecked and hence results in it are over use. The aim of this study was to assess knowledge of parents regarding use of antibiotics, its associated problems, their source of information and their expectations from Paediatricians for prescription of anti-biotics.Methods: This is a questionnaire based cross sectional study conducted in Hayatabad town, District Peshawar. Parents who were consenting, had children aged between 0-16 years, and were not related to medical profession were included in study. Total number of participants interviewed was 400. Analysis was done using prevalence ratios.Results: Most of the participants were mothers. Majority of respondents were literate with education up till level of Graduation. 64% mentioned that they enjoyed a good access to healthcare. Most common source for use of antibiotics was Physician. 35% mentioned that antibiotics must be administered in any case of fever, 47% thought antibiotics to increase recovery time and 51% knew that antibiotics have their own side effect. The most common reason to administer un-prescribed antibiotics was same antibiotic being prescribed by a physician earlier followed by family member or pharmacist recommending use of antibiotic. Lack of resources was denied as a reason for self-administration of antibiotics by majority of parents.CONCLUSION: There is a need of intervention to increase awareness regarding judicious use of antibiotics and to check un-prescribed dispensing of antibiotics

Current challenges of digital health interventions in Pakistan: Mixed methods analysis

Background: Digital health is well-positioned in low and middle-income countries (LMICs) to revolutionize health care due, in part, to increasing mobile phone access and internet connectivity. This paper evaluates the underlying factors that can potentially facilitate or hinder the progress of digital health in Pakistan.Objective: The objective of this study is to identify the current digital health projects and studies being carried out in Pakistan, as well as the key stakeholders involved in these initiatives. We aim to follow a mixed-methods strategy and to evaluate these projects and studies through a strengths, weaknesses, opportunities, and threats (SWOT) analysis to identify the internal and external factors that can potentially facilitate or hinder the progress of digital health in Pakistan.Methods: This study aims to evaluate digital health projects carried out in the last 5 years in Pakistan with mixed methods. The qualitative and quantitative data obtained from field surveys were categorized according to the World Health Organization\u27s (WHO) recommended building blocks for health systems research, and the data were analyzed using a SWOT analysis strategy.Results: Of the digital health projects carried out in the last 5 years in Pakistan, 51 are studied. Of these projects, 46% (23/51) used technology for conducting research, 30% (15/51) used technology for implementation, and 12% (6/51) used technology for app development. The health domains targeted were general health (23/51, 46%), immunization (13/51, 26%), and diagnostics (5/51, 10%). Smartphones and devices were used in 55% (28/51) of the interventions, and 59% (30/51) of projects included plans for scaling up. Artificial intelligence (AI) or machine learning (ML) was used in 31% (16/51) of projects, and 74% (38/51) of interventions were being evaluated. The barriers faced by developers during the implementation phase included the populations\u27 inability to use the technology or mobile phones in 21% (11/51) of projects, costs in 16% (8/51) of projects, and privacy concerns in 12% (6/51) of projects.Conclusions: We conclude that while digital health has a promising future in Pakistan, it is still in its infancy at the time of this study. However, due to the coronavirus disease 2019 (COVID-19) pandemic, there is an increase in demand for digital health and implementation of health outcomes following global social distancing protocols, especially in LMICs. Hence, there is a need for active involvement by public and private organizations to regulate, mobilize, and expand the digital health sector for the improvement of health care systems in countries