RESUMEN
Total knee arthroplasty (TKA) is a commonly performed surgery for individuals experiencing advanced knee osteoarthritis. Patients undergoing TKA can present with a variety of comorbidities, ranging from the absence of chronic illnesses to the presence of multiple health conditions. The complexity of these comorbidities can pose challenges in carrying out the desired procedure due to the elevated risk profile; this limits the anesthesia modalities that the physician can utilize. Careful consideration of patients' overall health status and personalized anesthesia approaches are crucial to ensure optimal outcomes in this diverse patient population. This case involves an eighty-year-old male with a history of multiple comorbidities who underwent a left TKA. The patient presented a high-risk profile during evaluation, classified as American Society of Anesthesiology (ASA) class IV, which made general and neuraxial anesthesia unfavorable due to high risks. Regional anesthesia was utilized as the sole modality of anesthesia and was successful. This demonstrates that regional anesthesia is a viable option when attending to patients with high risks associated with other anesthesia modalities.
RESUMEN
Land registration authorities are frequently held accountable for the alleged mismanagement and manipulation of land records in various countries. Pakistan's property records are especially vulnerable to falsification and corruption because of the country's poverty. Different parties therefore claim varying degrees of authority over a specific piece of land. Given the fact that this data has been consolidated, it has become significantly more vulnerable to security threats. The goal of decentralized system research has been to increase the reliability of these systems. In order to fix the flaws of centralized systems, blockchain-based decentralized systems are currently in development. By using significant land record registration models as the basis for this research, we hope to create a proof-of-concept system or framework for future use. Pakistan's land registration agency will benefit from our proposed conceptual framework. For the Pakistani government to implement a decentralized land record registry system, we propose a conceptual framework that outlines the essential components.