Search results for: Anam Shahzad
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 80

Search results for: Anam Shahzad

20 Application of Water Soluble Polymers in Chemical Enhanced Oil Recovery

Authors: M. Shahzad Kamal, Abdullah S. Sultan, Usamah A. Al-Mubaiyedh, Ibnelwaleed A. Hussein

Abstract:

Oil recovery from reservoirs using conventional oil recovery techniques like water flooding is less than 20%. Enhanced oil recovery (EOR) techniques are applied to recover additional oil. Surfactant-polymer flooding is a promising EOR technique used to recover residual oil from reservoirs. Water soluble polymers are used to increase the viscosity of displacing fluids. Surfactants increase the capillary number by reducing the interfacial tension between oil and displacing fluid. Hydrolyzed polyacrylamide (HPAM) is widely used in polymer flooding applications due to its low cost and other desirable properties. HPAM works well in low-temperature and low salinity-environment. In the presence of salts HPAM viscosity decrease due to charge screening effect and it can precipitate at high temperatures in the presence of salts. Various strategies have been adopted to extend the application of water soluble polymers to high-temperature high-salinity (HTHS) reservoir. These include addition of monomers to acrylamide chain that can protect it against thermal hydrolysis. In this work, rheological properties of various water soluble polymers were investigated to find out suitable polymer and surfactant-polymer systems for HTHS reservoirs. Polymer concentration ranged from 0.1 to 1 % (w/v). Effect of temperature, salinity and polymer concentration was investigated using both steady shear and dynamic measurements. Acrylamido tertiary butyl sulfonate based copolymer showed better performance under HTHS conditions compared to HPAM. Moreover, thermoviscosifying polymer showed excellent rheological properties and increase in the viscosity was observed with increase temperature. This property is highly desirable for EOR application.

Keywords: rheology, polyacrylamide, salinity, enhanced oil recovery, polymer flooding

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19 Effects of Electric Field on Diffusion Coefficients and Share Viscosity in Dusty Plasmas

Authors: Muhammad Asif ShakoorI, Maogang He, Aamir Shahzad

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Dusty (complex) plasmas contained micro-sized charged dust particles in addition to ions, electrons, and neutrals. It is typically low-temperature plasma and exists in a wide variety of physical systems. In this work, the effects of an external electric field on the diffusion coefficient and share viscosity are investigated through equilibrium molecular dynamics (EMD) simulations in three-dimensional (3D) strongly coupled (SC) dusty plasmas (DPs). The effects of constant and varying normalized electric field strength (E*) have been computed along with different combinations of plasma states on the diffusion of dust particles using EMD simulations. Diffusion coefficient (D) and share viscosity (η) along with varied system sizes, in the limit of varying E* values, is accounted for an appropriate range of plasma coupling (Γ) and screening strength (κ) parameters. At varying E* values, it is revealed that the 3D diffusion coefficient increases with increasing E* and κ; however, it decreases with an increase of Γ but within statistical limits. The share viscosity increases with increasing E*and Γ and decreases with increasing κ. New simulation results are outstanding that the combined effects of electric field and screening strengths give well-matched values of Dandη at low-intermediate to large Γ with varying small-intermediate to large N. The current EMD simulation outcomes under varying electric field strengths are in satisfactory well-matched with previous known simulation data of EMD simulations of the SC-DPs. It has been shown that the present EMD simulation data enlarged the range of E* strength up to 0.1 ≤ E*≤ 1.0 in order to find the linear range of the DPs system and to demonstrate the fundamental nature of electric field linearity of 3D SC-DPs.

Keywords: strongly coupled dusty plasma, diffusion coefficient, share viscosity, molecular dynamics simulation, electric field strength

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18 The Impact of an Educational Program on Knowledge, Attitude and Practices of Healthcare Professionals towards Family Presence during Resuscitation in an Emergency Department at a Tertiary Care Setting, in Karachi, Pakistan

Authors: Shaista Meghani, Rozina Karmaliani, Khairulnissa Ajani, Shireen Shahzad, Nadeem Ullah Khan

Abstract:

Background: The concept of Family Presence During Resuscitation (FPDR) is gradually gaining recognition in western countries, however, it is rarely considered in South Asian countries including Pakistan. Over time, patients’ and families’ rights have gained recognition and healthcare has progressed to become more patient-family centered. Objectives: The objective of this study was to evaluate the impact of an educational program on the Knowledge, Attitude, and Practices (KAP) of healthcare professionals (HCPs) towards FPDR in Emergency Department (ED), at a tertiary care setting, in Karachi, Pakistan. Methods: This was a Pre-test and Post-test study design. A convenient universal sampling was done, and all ED nurses and physicians with more than one year of experience were eligible. The intervention included one-hour training sessions for physicians (three sessions) and nurses (eight sessions), The KAP of nurses and physicians were assessed immediately after (post-test I), and two weeks(post-test II) after the intervention using a pretested questionnaire. Results: The findings of the study revealed that the mean scores of knowledge and attitude of HCPs at both time points were statistically significant (p-value=<0.001), however, an insignificant difference was found on practice of FPDR (p-value=>0.05). Conclusion: The study findings recommend that the educational program on FPDR for HCPs needs to be offered on an ongoing basis. Moreover, training modules need to be developed for the staff, and formal guidelines need to be proposed for FPDR, through a multidisciplinary team approach.

Keywords: family presence, cardiopulmonary resuscitation, attitude, education, practices, health care professionals

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17 Antibiofilm Activities of Biogenic Silver Nanoparticles against Human Pathogenic Bacteria

Authors: Muhammad Shahzad Tufail, Iram Liaqat, Umer Sohail Meer, Muhammad Ishtaiq, Muhammad Sattar

Abstract:

Nanotechnology is a vibrant field with numerous applications in many different branches of science and technology. Several methods are used to synthesize nanoparticles (NPs), which have multiple range of applications. Comparatively, the biogenic synthesis of NPs is a more economical and environmentally favourable method than the traditional chemical method. The current study aims to synthesize biogenically silver nanoparticles (AgNPs) using bacterial isolates. Four bacterial strains Escherichia coli (MT448673), Pseudomonas aeruginosa (MN900691), Bacillus subtilis (MN900684) and Bacillus licheniformis (MN900686) were used for the synthesis of AgNPs from silver nitrate (AgNO3) solution. The biofilm time kinetics of four bacterial isolates (P. aeruginosa, E. coli, B. licheniformis and B. subtilis) was analysed by incubating bacterial cultures at 37◦C in test tubes over a period of different time intervals i.e., 2, 3, 5 and 7 days following crystal violet staining method. All the four strains had ability to form strong biofilms between 48 to 72 hours of incubation. Two strains (B. subtilis and B. licheniformis) formed significant (p < 0.05) biofilm after 3 days of incubation period. The other two strains (E. coli and P. aeruginosa) showed strong biofilm formation after 2 days of incubation. Next, the antibiofilm activity of biogenically synthesized AgNPs (10 - 100 µgmL-1) was analysed against biofilm forming human pathogenic bacteria. Findings of the work revealed that 60-90% inhibition was observed at 60 µgmL-1 of AgNPs, while maximum inhibition (i.e.,100%) was found at highest concentration (90 µgmL-1). It was evident that highly significant (p < 0.05) decrease in biofilm formation was observed with increasing concentration of AgNPs.

Keywords: antibiofilm, biofilm formation, nanotechnology, pathogenic bacteria, silver nanoparticles

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16 Metamorphic Approach in Architecture Studio to Re-Imagine Drawings in Acknowledgement of Architectural/Artistic Identity

Authors: Hassan Wajid, Syed T. Ahmed, Syed G. Haider Jr., Razia Latif, Ahsan Ali, Maira Anam

Abstract:

The phenomenon of Metamorphosis can be associated with any object, organism, or structure gradually and progressively going through the change of systemic or morphological form. This phenomenon can be integrated while teaching drawing to architecture students. In architectural drawings, metamorphosis’s main focus and purpose are not to completely imitate any object. In the process of drawing, the changes in systemic or morphological form happen until the complete process, and the visuals of the complete process change the drawing, opening up possibilities for the imagination of the perceivers. Metamorphosis in architectural drawings begins with an initial form and, through various noticeable stages, ends up final form or manifestation. How much of the initial form is manifested in the final form and progressively among various intermediate stages becomes an indication of the nature of metamorphosis as a phenomenon. It is important at this stage to clarify that the term metamorphosis is presently being coopted from its original domain, usually in life sciences. In this current exercise, the architectural drawings are to act as an operative analog process transforming one image of art and/or architecture in its broadest sense. That composition is claimed to have come from one source (individual work, a cultural artifact, civilizational remain). It dialectically meets, opposes, or confronts some carefully chosen alien opposites from a different domain. As an example, the layers of a detailed drawing of a Turkish prayer rug of 5 x 7 ratio over a detailed architectural plan of a religious, historical complex can be observed such that the two drawings, though at markedly different scales could dialectically converse with one another and through their mutual congruencies. In the final stage, the idea concludes contradictions across the scales to initiate the analogous roles of metamorphosed third reality, which suggests the previous un-acknowledged architectural or artistic identity. The proposed paper explores the trajectory of reproduction by analyzing drawings through detailed drawing stages and analyzes challenges as well as opportunities in the discovered realm of imagination. This description further aims at identifying factors influencing creativity and innovation in producing architectural drawings through the process of observing drawings from inception to the concluding stage.

Keywords: architectural drawings, metamorphosis, perceptions, discovery

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15 Salt Tolerance of Potato: Genetically Engineered with Atriplex canescens BADH Gene Driven by 3 Copies of CAMV35s Promoter

Authors: Arfan Ali, Muhammad Shahzad Iqbal, Idrees Ahmad Nasir

Abstract:

Potato (Solanum tuberosum L.) is ranked among the top leading staple foods in the world. Salinity adversely affects potato crop yield and quality. Therefore, increased level of salt tolerance is a key factor to ensure high yield. The present study focused on the Agrobacterium-mediated transformation of Atriplex canescens betaine aldehyde dehydrogenase (BADH) gene, using single, double and triple CAMV35s promoter to improve salt tolerance in potato. Detection of seven potato lines harboring BADH gene, followed by identification of T-DNA insertions, determination of transgenes copies no through Southern Hybridization and quantification of BADH protein through Enzyme Linked Immunosorbent Assay were considered in this study. The results clearly depict that the salt tolerance of potato was found to be promoter-dependent, as the potato transgenic lines with triple promoter showed 4.4 times more glycine betaine production which consequently leads towards high resistance to salt stress as compared to transgenic potato lines with single and double promoters having least production of glycine betaine. Moreover, triple promoter transgenic potato lines have also shown lower levels of H2O2, malondialdehyde (MDA), relative electrical conductivity, high proline and chlorophyll content as compared other two lines having a single and double promoter. Insilco analysis also confirmed that Atriplex canescens BADH has the tendency to interact with sodium ions and water molecules. Taken together these facts it can be concluded that over-expression of BADH under triple CAMV35s promoter with more glycine betaine, chlorophyll & MDA contents, high relative quantities of other metabolites results in an enhanced level of salt tolerance in potato.

Keywords: Atriplex canescens, BADH, CAMV35s promotor, potato, Solanum tubersum

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14 Reintroduction and in vitro Propagation of Declapeis arayalpathra: A Critically Endangered Plant of Western Ghats, India

Authors: Zishan Ahmad, Anwar Shahzad

Abstract:

The present studies describe a protocol for high frequency in vitro propagation through nodal segments and shoot tips in D. arayalpathra, a critically endangered medicinal liana of the Western Ghats, India. Nodal segments were more responsive than shoot tips in terms of shoot multiplication. Murashige and Skoog’s (MS) basal medium supplemented with 2.5 µM 6-benzyladenine (BA) was optimum for shoot induction through both the explants. Among different combinations of plant growth regulator (PGRs) and growth additive screened, MS medium supplemented with BA (2.5 µM) + indole-3-acetic acid (IAA) (0.25 µM) + adenine sulphate (ADS) (10.0 µM) induced a maximum of 9.0 shoots per nodal segment and 3.9 shoots per shoot tip with mean shoot length of 8.5 and 3.9 cm respectively. Half-strength MS medium supplemented with Naphthaleneacetic acid (NAA) (2.5 µM) was the best for in vitro root induction. After successful acclimatization in SoilriteTM, 92 % plantlets were survived in field conditions. Acclimatized plantlets were studied for chlorophyll and carotenoid content, net photosynthetic rate (PN) and related attributes such as stomatal conductance (Gs) and transpiration rate during subsequent days of acclimatization. The rise and fall of different biochemical enzymes (SOD, CAT, APX and GR) were also studies during successful days of acclimatization. Moreover, the effect of acclimatization on the synthesis of 2-hydroxy-4-methoxy benzaldehyde (2H4MB) was also studied in relation to the biomass production. Maximum fresh weight (2.8 gm/plant), dry weight (0.35 gm/plant) of roots and 2H4MB content (8.5 µg/ ml of root extract) were recorded after 8 weeks of acclimatization. The screening of in vitro raised plantlet root was also carried out by using GC-MS analysis which witnessed more than 25 compounds. The regenerated plantlets were also screened for homogeneity by using RAPD and ISSR. The proposed protocol surely can be used for the conservation and commercial production of the plant.

Keywords: 6-benzyladenine, PGRs, RAPD, 2H4MB

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13 Portrayal of Pak-US Relations in Perspective of Bin Laden Killing by the Leading American and British Newspapers: A Content Analysis of the Guardian, the Telegraph, Washington Post and the New York Times

Authors: Shahzad Ali

Abstract:

This article expounds the coverage of Pak-US relations in the context of Osama Bin Laden killing in four selected leading newspapers of UK and the US viz The Telegraph, The Guardian, The New York Times and The Washington Post during the specific time period of three months, i.e., April-June, 2011. The study is scrutinized on the basis of Operation Neptune Spear. The research study is theoretically linked with the propaganda model of Herman and Chomsky and the Shoemaker and Reeve‘s theory of content effect, specifically the impact of foreign policy as a driving instrument influencing the nature and treatment of the coverage of Pak-US relations. The relations between Pakistan and USA are of great importance in the context of Bin Laden. The Pak-US relations were less aggravated and hostile in pre OBL period but post OBL period worsened these relations. It is also interesting to mention that the policies of these newspapers were dependent on the foreign policy of their countries. It was explored that the news coverage was found favorable as and when the relations Pakistan and the US or UK were cordial and smooth. And it turned into negative and unfavorable when the relations were in strain and deteriorating and endorsed various studies that the Western mainstream media tried to be more nationalistic in projecting official stance while covering foreign coverage instead of adhering to universal cannon of journalism, i.e., objectivity, fairness, and neutrality, etc. Overall 219 news items of these four selected newspapers regarding Pak-US relations in the context of pre and post OBL’s killing operation were undertaken for analysis. The ratio of negative slants was found higher as compared to the positive and neutral slants. Besides, the ratio of news items with unfavorable frames was found higher in post OBL operation in comparison of pre-era of the coverage related to Pak-US relations in the leading British and American newspapers.

Keywords: Osama Bin Laden, Pakistan, USA, UK, relations, Guardian, Washington Post, Telegraph, New York Times, Operation Neptune Spear

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12 A Comparative, Epidemiological Study of Acute Renal Colic Presentations to Major Academic Emergency Departments in Doha, Qatar and Melbourne, Australia

Authors: Sameer A. Pathan, Biswadev Mitra, Zain A. Bhutta, Isma Qureshi, Elle Spencer, Asmaa A. Hameed, Sana Nadeem, Ramsha Tahir, Shahzad Anjum, Peter A. Cameron

Abstract:

Background: This study aimed to compare epidemiology, clinical presentations, management and outcomes of renal colic presentations in two major academic centers and discuss potential implications of these results for the applicability of current evidence in the management of renal colic. Methods: We undertook a retrospective cohort study of patients with renal colic who presented to the Hamad General Hospital Emergency Department (HGH-ED), Qatar, and The Alfred ED, Melbourne, Australia, during a period of one year from August 1, 2012, to July 3, 2013. Cases were identified using ICD-9-CM codes, and an electronic template was used to record the data on predefined clinical variables. Results: A total of 12,223 from the HGH-ED and 384 from The Alfred ED were identified as renal colic presentations during the study period. The rate of renal colic presentations at the HGH-ED was 27.9 per 1000 ED visits compared to 6.7 per 1000 ED visits at The Alfred ED. Patients presenting to the HGH-ED were significantly younger [34.9 years (29.0- 43.4) than The Alfred ED [48 years (37-60); P < 0.001]. The median stone size was larger in the HGH-ED group [6 (4-8) mm] versus The Alfred ED group [4 (3-6) mm, P < 0.001]. The intervention rate in the stone-positive population was significantly higher in the HGH-ED group as opposed to The Alfred ED group (38.7% versus 11.9%, p<0.001). At the time of discharge, The Alfred ED group received less analgesic prescriptions (55.8% versus 83.5%, P < 0.001) and more tamsulosin prescriptions (25.3% versus 11.7%, P < 0.001). Conclusions: Renal colic presentations to the HGH-ED, Qatar, were younger, with larger stone size, compared to The Alfred ED, whereas, medical expulsion therapy use was higher at the Alfred ED. Differences in epidemiology should be considered while tailoring strategies for effective management of patients with renal colic in the given setting.

Keywords: kidney stones, urolithiasis, nephrolithiasis, renal colic, epidemiology

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11 Bean in Turkey: Characterization, Inter Gene Pool Hybridization Events, Breeding, Utilizations

Authors: Faheem Shahzad Baloch, Muhammad Azhar Nadeem, Muhammad Amjad Nawaz, Ephrem Habyarimana, Gonul Comertpay, Tolga Karakoy, Rustu Hatipoglu, Mehmet Zahit Yeken, Vahdettin Ciftci

Abstract:

Turkey is considered a bridge between Europe, Asia, and Africa and possibly played an important role in the distribution of many crops including common bean. Hundreds of common bean landraces can be found in Turkey, particularly in farmers’ fields, and they consistently contribute to the overall production. To investigate the existing genetic diversity and hybridization events between the Andean and Mesoamerican gene pools in the Turkish common bean, 188 common bean accessions (182 landraces and 6 modern cultivars as controls) were collected from 19 different Turkish geographic regions. These accessions were characterized using phenotypic data (growth habit and seed weight), geographic provenance, 12557 high-quality whole-genome DArTseq markers, and 3767 novel DArTseq loci were also identified. The clustering algorithms resolved the Turkish common bean landrace germplasm into the two recognized gene pools, the Mesoamerican and Andean gene pools. Hybridization events were observed in both gene pools (14.36% of the accessions) but mostly in the Mesoamerican (7.97% of the accessions), and was low relative to previous European studies. The lower level of hybridization witnessed the existence of Turkish common bean germplasm in its original form as compared to Europe. Mesoamerican gene pool reflected a higher level of diversity, while the Andean gene pool was predominant (56.91% of the accessions), but genetically less diverse and phenotypically more pure, reflecting farmers greater preference for the Andean gene pool. We also found some genetically distinct landraces and overall, a meaningful level of genetic variability which can be used by the scientific community in breeding efforts to develop superior common bean strains.

Keywords: bean germplasm, DArTseq markers, genotyping by sequencing, Turkey, whole genome diversity

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10 Growth and Yield Potential of Quinoa genotypes on Salt Affected Soils

Authors: Shahzad M. A. Basra, Shahid Iqbal, Irfan Afzal, Hafeez-ur-Rehman

Abstract:

Quinoa a facultative halophyte crop plant is a new introduction in Pakistan due to its superior nutritional profile and its abiotic stress tolerance, especially against salinity. Present study was conducted to explore halophytic behavior of quinoa. Four quinoa genotypes (A1, A2, A7 and A9) were evaluated against high salinity (control, 100, 200, 300 and 400 mM). Evaluation was made on the basis of ionic analysis (Na+, K+ and K+: Na+ ratio in shoot) and root- shoot fresh and dry weight at four leaf stage. Seedling growth i.e. fresh and dry weight of shoot and root increased by 100 mM salinity and then growth decreased gradually with increasing salinity level in all geno types. Mineral analysis indicated that A2 and A7 have more tolerant behavior having low Na+ and high K+ ¬concentration as compared to A1 and A9. Same geno types as above were also evaluated against high salinity (control, 10, 20, 30, and 40 dS m-1) in pot culture during 2012-13. It was found that increase in salinity up to 10 dS m-1 the plant height, stem diameter and yield related traits increased but decreased with further increase in salinity. Same trend was observed in ionic contents. Maximum grain yield was achieved by A7 (100 g plant-1) followed by A2 (82 g plant-1) at salinity level 10 dS m-1. Next phase was carried out through field settings by using salt tolerant geno types (A2 and A7) at Crop Physiology Research Area Farm (non saline soil as control)/ Proka Farm (salt affected with EC up to 15 dS m-1), University of Agriculture, Faisalabad and Soil Salinity Research Institute, Pindi Bhtiaan (SSRI) Farm (one normal as control and two salt affected fields with EC values up to 15 and 30 dS m-1) during 2013-14. Genotype A7 showed maximum growth and gave maximum yield (3200 kg ha-1) at Proka Farm which was statistically at par to the values of yield obtained on normal soils of Faisalabad. Geno type A7 also gave maximum yield 2800 kg ha-1 on normal field of Pindi bhtiaan followed by as obtained (2340) on salt problem field (15 dS m-1) of same location.

Keywords: quinoa, salinity, halophyte, genotype

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9 Qualitative Modeling of Transforming Growth Factor Beta-Associated Biological Regulatory Network: Insight into Renal Fibrosis

Authors: Ayesha Waqar Khan, Mariam Altaf, Jamil Ahmad, Shaheen Shahzad

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Kidney fibrosis is an anticipated outcome of possibly all types of progressive chronic kidney disease (CKD). Epithelial-mesenchymal transition (EMT) signaling pathway is responsible for production of matrix-producing fibroblasts and myofibroblasts in diseased kidney. In this study, a discrete model of TGF-beta (transforming growth factor) and CTGF (connective tissue growth factor) was constructed using Rene Thomas formalism to investigate renal fibrosis turn over. The kinetic logic proposed by Rene Thomas is a renowned approach for modeling of Biological Regulatory Networks (BRNs). This modeling approach uses a set of constraints which represents the dynamics of the BRN thus analyzing the pathway and predicting critical trajectories that lead to a normal or diseased state. The molecular connection between TGF-beta, Smad 2/3 (transcription factor) phosphorylation and CTGF is modeled using GenoTech. The order of BRN is CTGF, TGF-B, and SMAD3 respectively. The predicted cycle depicts activation of TGF-B (TGF-β) via cleavage of its own pro-domain (0,1,0) and presentation to TGFR-II receptor phosphorylating SMAD3 (Smad2/3) in the state (0,1,1). Later TGF-B is turned off (0,0,1) thereby activating SMAD3 that further stimulates the expression of CTGF in the state (1,0,1) and itself turns off in (1,0,0). Elevated CTGF expression reactivates TGF-B (1,1,0) and the cycle continues. The predicted model has generated one cycle and two steady states. Cyclic behavior in this study represents the diseased state in which all three proteins contribute to renal fibrosis. The proposed model is in accordance with the experimental findings of the existing diseased state. Extended cycle results in enhanced CTGF expression through Smad2/3 and Smad4 translocation in the nucleus. The results suggest that the system converges towards organ fibrogenesis if CTGF remains constructively active along with Smad2/3 and Smad 4 that plays an important role in kidney fibrosis. Therefore, modeling regulatory pathways of kidney fibrosis will escort to the progress of therapeutic tools and real-world useful applications such as predictive and preventive medicine.

Keywords: CTGF, renal fibrosis signaling pathway, system biology, qualitative modeling

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8 Quality of Life after Damage Control Laparotomy for Trauma

Authors: Noman Shahzad, Amyn Pardhan, Hasnain Zafar

Abstract:

Introduction: Though short term survival advantage of damage control laparotomy in management of critically ill trauma patients is established, there is little known about the long-term quality of life of these patients. Facial closure rate after damage control laparotomy is reported to be 20-70 percent. Abdominal wall reconstruction in those who failed to achieve facial closure is challenging and can potentially affect quality of life of these patients. Methodology: We conducted retrospective matched cohort study. Adult patients who underwent damage control laparotomy from Jan 2007 till Jun 2013 were identified through medical record. Patients who had concomitant disabling brain injury or limb injuries requiring amputation were excluded. Age, gender and presentation time matched non exposure group of patients who underwent laparotomy for trauma but no damage control were identified for each damage control laparotomy patient. Quality of life assessment was done via telephonic interview at least one year after the operation, using Urdu version of EuroQol Group Quality of Life (QOL) questionnaire EQ5D after permission. Wilcoxon signed rank test was used to compare QOL scores and McNemar test was used to compare individual parameters of QOL questionnaire. Study was approved by institutional ethical review committee. Results: Out of 32 patients who underwent damage control laparotomy during study period, 20 fulfilled the selection criteria for which 20 matched controls were selected. Median age of patients (IQ Range) was 33 (26-40) years. Facial closure rate in damage control laparotomy group was 40% (8/20). One third of those who did not achieve facial closure (4/12) underwent abdominal wall reconstruction. Self-reported QOL score of damage control laparotomy patients was significantly worse than non-damage control group (p = 0.032). There was no statistically significant difference in two groups regarding individual QOL measures. Significantly, more patients in damage control group were requiring use of abdominal binder, and more patients in damage control group had to either change their job or had limitations in continuing previous job. Our study was not adequately powered to detect factors responsible for worse QOL in damage control group. Conclusion: Quality of life of damage control patients is worse than their age and gender matched patients who underwent trauma laparotomy but not damage control. Adequately powered studies need to be conducted to explore factors responsible for this finding for potential improvement.

Keywords: damage control laparotomy, laparostomy, quality of life

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7 Relationship between Job Satisfaction, Job Stressors and Long Term Physical Morbidities among University Employees in Pakistan

Authors: Shahzad A. Mughal, Ameer A. P. Ghaloo, Faisal Laghari, Mohsin A. Mirza

Abstract:

Job satisfaction and level of job stressors among employees of a university are considered as essential factors responsible for institutional success. Job satisfaction is usually believed as a single baseline variable for the evaluation of a university human resource area. The objectives of this study were to assess the level of job satisfaction and influence of job stressors among university teachers and their association with long term physical health of the employees in government sector universities in Pakistan. A cross-sectional study was conducted on university employees including faculty members and administrative staff of three government sector universities in Sindh province of Pakistan who have completed at least ten years of their job. The study period was six months. All the employees were randomly selected. The job satisfaction scale Questionnaire with yes and no options, together with questions regarding demographic factors, job stress or other working factors and physical health issues were administered in questionnaires. These questionnaires were handed out to 100 faculty members of both genders with permanent job and 50 non faculty staff of grade 17 and above with permanent employment status. Students’ T test and one way ANOVA was applied to categorical variables and Pearson’s correlation analysis was performed to evaluate the correlations between study variables. 121 successful responses were obtained (effective respondent rate 80.6%). The average score of overall job satisfaction was 65.6%. Statistical analysis revealed that the job satisfaction and work related stressors had negative impact on overall health status of the employees with resultant less efficacy and mental stress. The positive relation was perceived by employees for organizational support and high income with job satisfaction. Demographic features such as age and female gender were also linked to the level of job satisfaction and health related issues. The total variation among all responses regarding correlation between job satisfaction job stressors and health related issues was 55%. A study was conducted on University employees of government sector Universities in Pakistan, regarding association of job satisfaction and job stressors with long term physical health of the employees. Study revealed a moderate level of job satisfaction among the employees of all universities included in this study. Attitude and personal relations with heads of the departments and institution along with salary packages were considered as biggest job stressors related correlated directly with physical health. Demographic features and gender were associated factors for job satisfaction. Organizational support was the strongest factor for job satisfaction and results pointed out that by improving support level from University may improve the quality of job satisfaction and overall health of employees.

Keywords: job satisfaction, organizational support, physical health, university employees

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6 Efficacy of Mitomycin C in Reducing Recurrence of Anterior Urethral Stricture after Internal Optical Urethrotomy

Authors: Liaqat Ali, Ehsan, Muhammad Shahzad, Nasir Orakzai

Abstract:

Introduction: Internal optical urethrotomy is the main stay treatment modality in management of urethral stricture. Being minimal invasive with less morbidity, it is commonly performed and favored procedure by urologists across the globe. Although short-term success rate of optical urethrotomy is promising but long-term efficacy of IOU is questionable with high recurrence rate in different studies. Numerous techniques had been adopted to reduce the recurrence after IOU like prolong catheterization and self-clean intermittent catheterization with varying success. Mitomycin C has anti-fibroblast and anti-collagen properties and has been used in trabeculectomy, myringotomy and after keloid scar excision in contemporary surgical practice. Present study according to the best of our knowledge is a pioneer pilot study in Pakistan to determine the efficacy of Mitomycin C in preventing recurrence of urethral stricture after internal optical urethrotomy. Objective: To determine the efficacy of Mitomycin C in reducing the recurrence of anterior urethral stricture after internal optical urethrotomy. Methods: It is a randomized control trial conducted in department of urology, Institute of Kidney Diseases Hayatabad Medical Complex Peshawar from March 2011 till December 2013. After approval of hospital ethical committee, we included maximum of 2 cm anterior urethral stricture irrespective of etiology. Total of 140 patients were equally divided into two groups by lottery method. Group A (Case) comprising of 70 patients in whom Mitomycin C 0.1% was injected sub mucosal in stricture area at 1,11,6 and 12 O clock position using straight working channel paediatric cystoscope after conventional optical urethrotomy. Group B (Control) 70 patients in whom only optical urethrotomy was performed. SCIC was not offered in both the groups. All the patients were regularly followed on a monthly basis for 3 months then three monthly for remaining 9 months. Recurrence was diagnosed by using diagnostic tools of retrograde urethrogram and flexible urethroscopy in selected cased. Data was collected on structured Proforma and was analyzed on SPSS. Result: The mean age in Group A was 33 ±1.5 years and Group B was 35 years. External trauma was leading cause of urethral stricture in both groups 46 (65%) Group A and 50 (71.4%) Group B. In Group A. Iatrogenic urethral trauma was 2nd etiological factor in both groups. 18(25%) Group A while 15( 21.4%) in Group B. At the end of 1 year, At the end of one year, recurrence of urethral stricture was recorded in 11 (15.71%) patient in Mitomycin C Group A and it was recorded in 27 (38.5 %) patients in group B. Significant difference p=0.001 was found in favour of group A Mitomycin group. Conclusion: Recurrence of urethral stricture is high after optical urethrotomy. Mitomycin C is found highly effective in preventing recurrence of urethral stricture after IOU.

Keywords: urethral stricture, mitomycine, internal optical urethrotomy, medical and health sciences

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5 Improving the Quality of Discussion and Documentation of Advance Care Directives in a Community-Based Resident Primary Care Clinic

Authors: Jason Ceavers, Travis Thompson, Juan Torres, Ramanakumar Anam, Alan Wong, Andrei Carvalho, Shane Quo, Shawn Alonso, Moises Cintron, Ricardo C. Carrero, German Lopez, Vamsi Garimella, German Giese

Abstract:

Introduction: Advance directives (AD) are essential for patients to communicate their wishes when they are not able to. Ideally, these discussions should not occur for the first time when a patient is hospitalized with an acute life-threatening illness. There is a large number of patients who do not have clearly documented ADs, resulting in the misutilization of resources and additional patient harm. This is a nationwide issue, and the Joint Commission has it as one of its national quality metrics. Presented here is a proposed protocol to increase the number of documented AD discussions in a community-based, internal medicine residency primary care clinic in South Florida. Methods: The SMART Aim for this quality improvement project is to increase documentation of AD discussions in the outpatient setting by 25% within three months in medicare patients. A survey was sent to stakeholders (clinic attendings, residents, medical assistants, front desk staff, and clinic managers), asking them for three factors they believed contributed most to the low documentation rate of AD discussions. The two most important factors were time constraints and systems issues (such as lack of a standard method to document ADs and ADs not being uploaded to the chart) which were brought up by 25% and 21.2% of the 32 survey responders, respectively. Pre-intervention data from clinic patients in 2020-2021 revealed 17.05% of patients had clear, actionable ADs documented. To address these issues, an AD pocket card was created to give to patients. One side of the card has a brief explanation of what ADs are. The other side has a column of interventions (cardiopulmonary resuscitation, mechanical ventilation, dialysis, tracheostomy, feeding tube) with boxes patients check off if they want the intervention done, do not want the intervention, do not want to discuss the topic, or need more information. These cards are to be filled out and scanned into their electronic chart to be reviewed by the resident before their appointment. The interventions that patients want more information on will be discussed by the provider. If any changes are made, the card will be re-scanned into their chart. After three months, we will chart review the patients seen in the clinic to determine how many medicare patients have a pocket card uploaded and how many have advance directives discussions documented in a progress note or annual wellness note. If there is not enough time for an AD discussion, a follow-up appointment can be scheduled for that discussion. Discussion: ADs are a crucial part of patient care, and failure to understand a patient’s wishes leads to improper utilization of resources, avoidable litigation, and patient harm. Time constraints and systems issues were identified as two major factors contributing to the lack of advance directive discussion in our community-based resident primary care clinic. Our project aims at increasing the documentation rate for ADs through a simple pocket card intervention. These are self-explanatory, easy to read and allow the patients to clearly express what interventions they desire or what they want to discuss further with their physician.

Keywords: advance directives, community-based, pocket card, primary care clinic

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4 Italian Speech Vowels Landmark Detection through the Legacy Tool 'xkl' with Integration of Combined CNNs and RNNs

Authors: Kaleem Kashif, Tayyaba Anam, Yizhi Wu

Abstract:

This paper introduces a methodology for advancing Italian speech vowels landmark detection within the distinctive feature-based speech recognition domain. Leveraging the legacy tool 'xkl' by integrating combined convolutional neural networks (CNNs) and recurrent neural networks (RNNs), the study presents a comprehensive enhancement to the 'xkl' legacy software. This integration incorporates re-assigned spectrogram methodologies, enabling meticulous acoustic analysis. Simultaneously, our proposed model, integrating combined CNNs and RNNs, demonstrates unprecedented precision and robustness in landmark detection. The augmentation of re-assigned spectrogram fusion within the 'xkl' software signifies a meticulous advancement, particularly enhancing precision related to vowel formant estimation. This augmentation catalyzes unparalleled accuracy in landmark detection, resulting in a substantial performance leap compared to conventional methods. The proposed model emerges as a state-of-the-art solution in the distinctive feature-based speech recognition systems domain. In the realm of deep learning, a synergistic integration of combined CNNs and RNNs is introduced, endowed with specialized temporal embeddings, harnessing self-attention mechanisms, and positional embeddings. The proposed model allows it to excel in capturing intricate dependencies within Italian speech vowels, rendering it highly adaptable and sophisticated in the distinctive feature domain. Furthermore, our advanced temporal modeling approach employs Bayesian temporal encoding, refining the measurement of inter-landmark intervals. Comparative analysis against state-of-the-art models reveals a substantial improvement in accuracy, highlighting the robustness and efficacy of the proposed methodology. Upon rigorous testing on a database (LaMIT) speech recorded in a silent room by four Italian native speakers, the landmark detector demonstrates exceptional performance, achieving a 95% true detection rate and a 10% false detection rate. A majority of missed landmarks were observed in proximity to reduced vowels. These promising results underscore the robust identifiability of landmarks within the speech waveform, establishing the feasibility of employing a landmark detector as a front end in a speech recognition system. The synergistic integration of re-assigned spectrogram fusion, CNNs, RNNs, and Bayesian temporal encoding not only signifies a significant advancement in Italian speech vowels landmark detection but also positions the proposed model as a leader in the field. The model offers distinct advantages, including unparalleled accuracy, adaptability, and sophistication, marking a milestone in the intersection of deep learning and distinctive feature-based speech recognition. This work contributes to the broader scientific community by presenting a methodologically rigorous framework for enhancing landmark detection accuracy in Italian speech vowels. The integration of cutting-edge techniques establishes a foundation for future advancements in speech signal processing, emphasizing the potential of the proposed model in practical applications across various domains requiring robust speech recognition systems.

Keywords: landmark detection, acoustic analysis, convolutional neural network, recurrent neural network

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3 A Cross-Sectional Study Assessing Communication Practices among Doctors at a University Hospital in Pakistan

Authors: Muhammad Waqas Baqai, Noman Shahzad, Rehman Alvi

Abstract:

Communication among health care givers is the essence of quality patient care and any compromise results in errors and inefficiency leading to cumbersome outcomes. The use of smartphone among health professionals has increased tremendously. Almost every health professional carries it and majority of them uses a third party communication software called whatsApp for work related communications. It gives instant access to the person responsible for any particular query and therefore helps in efficient and timely decision making. It is also an easy way of sharing medical documents, multimedia and provides platform for consensual decision making through group discussions. However clinical communication through whatsApp has some demerits too including reduction in verbal communication, worsening professional relations, unprofessional behavior, risk of confidentiality breach and threats from cyber-attacks. On the other hand the traditional pager device being used in many health care systems is a unidirectional communication that lacks the ability to convey any information other than the number to which the receiver has to respond. Our study focused on these two widely used modalities of communication among doctors of the largest tertiary care center of Pakistan i.e. The Aga Khan University Hospital. Our aim was to note which modality is considered better and has fewer threats to medical data. Approval from ethical review committee of the institute was taken prior to conduction of this study. We submitted an online survey form to all the interns and residents working at our institute and collected their response in a month’s time. 162 submissions were recorded and analyzed using descriptive statistics. Only 20% of them were comfortable with using pagers exclusively, 52% with whatsApp and 28% with both. 65% think that whatsApp is time-saving and quicker than pager. 54% of them considered whatsApp to be causing nuisance from work related notifications in their off-work hours. 60% think that they are more likely to miss information through pager system because of the unidirectional nature. Almost all (96%) of residents and interns found whatsApp to be useful in terms of saving information for future reference. For urgent issues, majority (70%) preferred pager over whatsApp and also pager was considered more valid in terms of hospital policies and legal issues. Among major advantages of whatsApp as listed by them were; easy mass communication, sharing of clinical pictures, universal access and no need of carrying additional device. However the major drawback of using whatsApp for clinical communication that everyone shared was threat to patients’ confidentiality as clinicians usually share pictures of wounds, clinical documents etc. Lastly we asked them if they think there is a need of a separate application for instant communication dedicated to clinical communication only and 90% responded positively. Therefore, we concluded that both modalities have their merits and demerits but the greatest drawback with whatsApp is the risk of breach in patients’ confidentiality and off-work disturbance. Hence, we recommend a more secure, institute-run application for all intra hospital communications where they can share documents, pictures etc. easily under a controlled environment.

Keywords: WhatsApp, pager, clinical communication, confidentiality

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2 Novel Numerical Technique for Dusty Plasma Dynamics (Yukawa Liquids): Microfluidic and Role of Heat Transport

Authors: Aamir Shahzad, Mao-Gang He

Abstract:

Currently, dusty plasmas motivated the researchers' widespread interest. Since the last two decades, substantial efforts have been made by the scientific and technological community to investigate the transport properties and their nonlinear behavior of three-dimensional and two-dimensional nonideal complex (dusty plasma) liquids (NICDPLs). Different calculations have been made to sustain and utilize strongly coupled NICDPLs because of their remarkable scientific and industrial applications. Understanding of the thermophysical properties of complex liquids under various conditions is of practical interest in the field of science and technology. The determination of thermal conductivity is also a demanding question for thermophysical researchers, due to some reasons; very few results are offered for this significant property. Lack of information of the thermal conductivity of dense and complex liquids at different parameters related to the industrial developments is a major barrier to quantitative knowledge of the heat flux flow from one medium to another medium or surface. The exact numerical investigation of transport properties of complex liquids is a fundamental research task in the field of thermophysics, as various transport data are closely related with the setup and confirmation of equations of state. A reliable knowledge of transport data is also important for an optimized design of processes and apparatus in various engineering and science fields (thermoelectric devices), and, in particular, the provision of precise data for the parameters of heat, mass, and momentum transport is required. One of the promising computational techniques, the homogenous nonequilibrium molecular dynamics (HNEMD) simulation, is over viewed with a special importance on the application to transport problems of complex liquids. This proposed work is particularly motivated by the FIRST TIME to modify the problem of heat conduction equations leads to polynomial velocity and temperature profiles algorithm for the investigation of transport properties with their nonlinear behaviors in the NICDPLs. The aim of proposed work is to implement a NEMDS algorithm (Poiseuille flow) and to delve the understanding of thermal conductivity behaviors in Yukawa liquids. The Yukawa system is equilibrated through the Gaussian thermostat in order to maintain the constant system temperature (canonical ensemble ≡ NVT)). The output steps will be developed between 3.0×105/ωp and 1.5×105/ωp simulation time steps for the computation of λ data. The HNEMD algorithm shows that the thermal conductivity is dependent on plasma parameters and the minimum value of lmin shifts toward higher G with an increase in k, as expected. New investigations give more reliable simulated data for the plasma conductivity than earlier known simulation data and generally the plasma λ0 by 2%-20%, depending on Γ and κ. It has been shown that the obtained results at normalized force field are in satisfactory agreement with various earlier simulation results. This algorithm shows that the new technique provides more accurate results with fast convergence and small size effects over a wide range of plasma states.

Keywords: molecular dynamics simulation, thermal conductivity, nonideal complex plasma, Poiseuille flow

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1 Supplementation of Yeast Cell Wall on Growth Performance in Broiler Reared under High Ambient Temperature

Authors: Muhammad Shahzad Hussain

Abstract:

Two major problems are facing generally by conventional poultry farming that is disease outbreaks and poor performance, which results due to improper management. To enhance the growth performance and efficiency of feed and reduce disease outbreaks, antibiotic growth promoters (AGPs) which are antibiotics at sub-therapeutic levels, are extensively used in the poultry industry. European Union has banned the use of antibiotics due to their presence in poultry products, development of antibiotic-resistant pathogens, and disturbance of normal gut microbial ecology. These residues cause serious health concerns and produce antibiotic resistance in pathogenic microbes in human beings. These issues strengthen the need for the withdrawal of AGPs from poultry feed. Nowadays, global warming is a major issue, and it is more critical in tropical areas like Pakistan, where heat stress is already a major problem. Heat stress leads to poor production performance, high mortality, immuno-suppression, and concomitant diseases outbreak. The poultry feed industry in Pakistan, like other countries of the world, has been facing shortages and high prices of local as well as imported feed ingredients. Prebiotics are potential replacer for AGP as prebiotics has properties to enhance the production potential and reduce the growth of harmful bacteria as well as stimulate the growth/activity of beneficial bacteria. The most commonly used prebiotics in poultry includes mannan oligosaccharide (MOS). MOS is an essential component of the yeast cell wall (YCW) (Saccharomyces cerevisiae); therefore, the YCW wall possesses prebiotic properties. The use of distillery yeast wall (YCW) has the potential to replace conventional AGPs and to reduce mortality due to heat stress as well as to bind toxins in the feed. The dietary addition of YCW has not only positive effects on production performance in poultry during normal conditions but during stressful conditions. A total of 168-day-old broilers were divided into 6 groups, each of which has 28 birds with 4 replicates (n=7).Yeast cell wall (YCW) supplementation @ 0%, 1%, 1.5%, 2%, 2.5%, 3% from day 0 to 35. Heat stress was exposed from day 21 to 35 at 30±1.1ᵒC with relative humidity 65±5%. Zootechnical parameters like body weight, FCR, Organ development, and histomorphometric parameters were studied. A significant weight gain was observed at group C supplemented @ 1.5% YCW during the fifth week. Significant organ weight gain of Gizzard, spleen, small intestine, and cecum was observed at group C supplemented @ 1.5% YCW. According to morphometric indices Duodenum, Jejunum, and Ileum has significant villus height, while Jejunum and Ileum have also significant villus surface area in the group supplemented with 1.5% YCW. IEL count was only decreased in 1.5% YCW-fed group in jejunum and ileum, not in duodenum, that was less in 2% YCW-supplemented group. Dietary yeast cell wall of saccharomyces cerevisiae partially reduced the effects of high ambient temperature in terms of better growth and modified gut histology and components of mucosal immune response to better withstand heat stress in broilers.

Keywords: antibiotics, AGPs, broilers, MOS, prebiotics, YCW

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