Radial forearm free flap: A dynamic flap for single-staged multiple subunit reconstruction

We report the case of a middle aged patient with biopsy proven squamous cell carcinoma of buccal mucosa who presented to us in Aga Khan University Hospital Karachi in April, 2017 and required reconstruction of buccal mucosa, upper lip and lower lip. As per protocol of our institute the lesion was excised by the head and neck surgeon and the defect was reconstructed by our team. The defect was large comprising of buccal mucosa including the left oral commissure, upper lip and the lower lip. It was reconstructed via a free flap and a radial forearm free flap. A specially designed radial forearm free flap was harvested and used for reconstruction which resulted in a good aesthetic and functional outcome

Versatility of the anterolateral thigh flap : an AKUH experience.

Anterolateral thigh flap is used for reconstruction of various soft tissue defects. We planned the study to evaluate the versatility of the anterolateral thigh flap as it may be used for reconstruction of head and neck, torso and extremities with minimal donor-site morbidity. The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised date from October 2012 to December 2015. Of the 75 patients in which anterolateral thigh flap was used for reconstruction, 6(8%) flaps did not survive. The overall flap survival was 69(92%). Anterolateral thigh flap was versatile enough to provide soft tissue coverage to defects of various soft tissue and bulk requirements. Adequate outcomes were achieved pertaining to the reconstruction of the soft tissue defects. Anterolateral thigh flap can be used to reconstruct soft tissue defects almost anywhere and almost of any complexity

School Heads’ Perceptions About Their Leadership Styles

This study explores school heads’ perceptions regarding their school leadership styles. The study adopted qualitative design. The sample of the study consisted of 10 male and 10 female head teachers from Peshawar, Khyber Pakhtunkhwa. Data were collected using semi-structured interviews. Findings revealed that school heads adopted a number of leadership styles. The main leadership styles found included instructional leadership, transformational leadership and moral leadership. These different leadership styles were adopted keeping in view the need of the different situations that heads found themselves working in. The study has important implications for school management, school teachers, researchers and policy makers.Keywords: instructional leadership, moral leadership, school leadership,transformation leadershi

A featureless approach for object detection and tracking in dynamic environments

One of the challenging problems in mobile robotics is mapping a dynamic environment for navigating robots. In order to disambiguate multiple moving obstacles, state-of-art techniques often solve some form of dynamic SLAM (Simultaneous Localization and Mapping) problem. Unfortunately, their higher computational complexity press the need for simpler and more efficient approaches suitable for real-time embedded systems. In this paper, we present a ROS-based efficient algorithm for constructing dynamic maps, which exploits the spatial-temporal locality for detecting and tracking moving objects without relying on prior knowledge of their geometrical features. A two-prong contribution of this work is as follows: first, an efficient scheme for decoding sensory data into an estimated time-varying object boundary that ultimately decides its orientation and trajectory based on the iteratively updated robot Field of View (FoV); second, lower time-complexity of updating the dynamic environment through manipulating spatial-temporal locality available in the object motion profile. Unlike existing approaches, the snapshots of the environment remain constant in the number of moving objects. We validate the efficacy of our algorithm on both V-Rep simulations and real-life experiments with a wide array of dynamic environments. We show that the algorithm accurately detects and tracks objects with a high probability as long as sensor noise is low and the speed of moving objects remains within acceptable limits

Comparison of Dexmedetomidine with Midazolam during Monitored Care Anesthesia (MAC) in Patients Undergoing Septoplasty

Objective: To compare the sedative and analgesic outcomes of dexmedetomidine with midazolam for monitored anesthesia care (MAC) in patients undergoing Septoplasty. Methodology:  This comparative study was conducted at Shalamar Medical and Dental College Lahore from March 2019 to August 2020. A total of 150 patients who were planned for Septoplasty under MAC having age 18-45 years, and ASA status I-II in Shalamar Medical and Dental College Lahore. Patients were randomly divided into two equal groups; In group D; IV dexmedetomidine 1 µg.Kg-1 was given over five mins after that IV infusion at the rate of 0.5 µg.Kg-1.hour-1 was started. In group M; midazolam 0.06 mg.Kg-1 was given as slow bolus after that continuous infusion at the rate of 0.01 mg.Kg-1.hour-1 was started. Sedation was monitored according to Ramsay sedation scale and VAS scale was used to measure the intensity of pain. Results: The Mean age was 34.3±5.7 years in group D versus 35.7±6.1 years in group M. There were 49 (65.3%) male patients in group D and 47 (62.7%) in group M. Mean sedation and pain score was significantly less in group D as compared to group M (p-value 0.001 & 0.002 respectively). There were 12 (16.0%) patients in group D who required rescue sedation and 32 (42.7%) in group M required rescue sedation (p-value 0.003). There were 14 (18.7%) patients in group D who required rescue analgesia versus 29 (38.7%) in group M (p-value 0.006). Conclusion: Use of dexmedetomidine for MAC is advantageous as compared to midazolam in-terms of better sedation and analgesia and reduced requirements of rescue doses of sedatives and analgesics

Appraisal of Geotechnical Characteristics of Ormara Soil, Baluchistan, Pakistan

Ormara is located 240 km west of Karachi which is a coastal and port city (25° 16' 29N, 64° 35' 10E) ofPakistan. Present study evaluates engineering properties of soils of Ormara for future construction plans and possibleexpansions in the area. Fifty bore holes were done in study area at depths of 20m, 40m and some (10 bore holes) were60m deep. The study area was divided into three major zones i.e. Foot hills, on-shore and off-shore. Groundwater wasencountered at depths of 2.75m on onshore and offshore zones and at 3.65m depth in foothill zone. Laboratory testingi.e. moisture content (12 to 38 %), liquid limit (from 26 to 34), plasticity index (10 to 18) of soil samples indicate thatsoils are low plastic to moderate plastic in nature. Soil samples of granular soils indicate angles of internal friction (ø)varying from 260- 36ºin upper sand layers while 260 to 30º in lower silt layers (encountered after the clay layer) andCohesion ranges 0 to 0.04kg/cm2 in all three zones. Further, unconsolidated undrained triaxial compression tests on aclayey soil sample indicated an undrained cohesion value of 28 kPa. Density values ranges from 1.6 to 2.05gm/cm3.Consolidation (Cv = 0.20 to 0.40 cm2/minute, Cc = 0.149 to 0.17) has been calculated for clay layer. Chemical testscarried out on soil samples indicated that soil and water both are reactive aggressively and may cause corrosion to steeland concrete disintegration