Spatial distribution of physicochemical parameters and drinking and irrigation water quality indices in the Jhelum River, Pakistan.

Sustainable management of river systems is a serious concern, requiring vigilant monitoring of water contamination levels that could potentially threaten the ecological community. This study focused on the evaluation of water quality in the Jhelum River (JR), Azad Jammu and Kashmir, and northern Punjab, Pakistan. To achieve this, 60 water samples were collected from various points within the JR Basin (JRB) and subjected to a comprehensive analysis of their physicochemical parameters. The study findings indicated that the concentrations of physicochemical parameters in the JRB water remained within safety thresholds for both drinking and irrigation water, as established by the World Health Organization and Pakistan Environmental Protection Agency. These physicochemical parameters refer to various chemical and physical characteristics of the water that can have implications for both human health (drinking water) and agricultural practices (irrigation water). The spatial variations throughout the river course distinguished between the upstream, midstream, and downstream sections. Specifically, the downstream section exhibited significantly higher values for physicochemical parameters and a broader range, highlighting a substantial decline in its quality. Significant disparities in mean values and ranges were evident, particularly in the case of nitrates and total dissolved solids, when the downstream section was compared with its upstream and midstream counterparts. These variations indicated a deteriorating downstream water quality profile, which is likely attributable to a combination of geological and anthropogenic influences. Despite the observed deterioration in the downstream water quality, this study underscores that the JRB within the upper Indus Basin remains safe and suitable for domestic and agricultural purposes. The JRB was evaluated for various irrigation water quality indices. The principal component analysis conducted in this study revealed distinct covariance patterns among water quality variables, with the first five components explaining approximately 79% of the total variance. Recommending the continued utilization of the JRB for irrigation, we advocate for the preservation and enhancement of water quality in the downstream regions.

Digital technologies in management of chronic pain - a systematic review.

OBJECTIVE: To determine the effectiveness of digital health technologies in the management of chronic pain. METHODS: The systematic review comprised search for randomised controlled trials and controlled clinical trials involving patients with chronic pain published between 2010 and 2020. The search was conducted on PubMed, Google Scholar, MEDLINE, National Centre for Biotechnology Information, and National Library of Medicine databases. Risk bias tool was used to evaluate the biasness in the studies and Pedro scale was used to assess the quality of the included articles. RESULTS: Of the 33 articles fully assessed, 14(42.42%) were analysed. All the studies analysed were randomised controlled trials and scored 6-10 on the Pedro scale which showed high quality of methodology. The studies typically reported statistically significant benefits of digital health technologies in the management of chronic pain. One of the main benefits was enhanced pain coping skills of the patients. Additionally, majority of the studies included increased adherence to exercise as an essential advantage. CONCLUSIONS: All the studies analysed reported favourable conclusions regarding the use of digital intervention for chronic pain management.

Role of tele-rehabilitation in patients following total hip replacement: Systematic review of clinical trials.

OBJECTIVE: Tele-rehabilitation to explore current evidence on the effectiveness of tele-rehabilitation compared to face-to-face rehabilitation for patients after total hip replacement. METHODS: The systematic review of clinical trials comprised search of Cochrane, Medline, Embase and PEDro databases from 2000 to date for English-language, human studies dealing with postoperative rehabilitation of total hip replacement patients. A thorough search was performed to retrieve articles missed through databases as well as unpublished grey literature. Methodological quality assessment was done using the Cochrane risk of bias tool, and the studies were critically appraised using the PEDro scale. RESULTS: Of the 150 studies initially found on the databases, 11(7.3%) were subjected to detailed review; 4(36.4%) randomised trials, 3(27.3%) randomised controlled protocols, 3(27%) randomised pilot studies, and 1(9%) prospective cohort study. Overall, 8(72.7%) studies were of 'high' quality and 3(27.3%) fell under the category of 'fair'. CONCLUSIONS: Tele-rehabilitation group reported similar improvement in terms of activities of daily living and quality of life as did those exposed to traditional rehabilitation.

Role of virtual reality and active video games in motor and executive functions in cerebral palsy: A systematic review.

OBJECTIVE: To explore current evidence on the role of virtual reality and active video games in motor and executive functions compared to conventional physical therapies in cerebral palsy patients. METHODS: The systematic review was conducted at the University Institute of Physical Therapy, Lahore, Pakistan, and comprised search on MEDLINE via PubMed, Pedro and Cochrane Central related to randomised and clinical controlled trials published from 2005 to 2020. For critical appraisal of the studies, the Pedro tool was used, while methodological quality assessment was done using the Cochrane risk of bias tool. RESULTS: Of the 15 articles reviewed, 14(93.3%) reported significant effect of virtual reality and active video games on motor functions. Critical appraisal found the quality of the studies from fair to high. Low risk was found in 4(26.7%) articles in terms of selection, 3(20%) allocation, 6(40%) detection, and 8(53.3%) had attrition bias. Unclear risk was reported in the performance and reporting bias domain in all the 15(100%) articles. CONCLUSIONS: Virtual reality games cannot be used as a substitute for therapy, but along with the conventional physical therapy, they are very effective and produce significant changes in motor functions in cerebral palsy patients. As for executive functions, more research needs to be done to determine the impact of these games at a higher level of brain.

How frequent should the radiographic examination be to monitor magnetically controlled growing rods? A retrospective look two to seven years postoperatively.

PURPOSE: Magnetically controlled growing rods (MCGR) allow more frequent outpatient lengthenings to better mimic the physiological growth. The assessment of distractions with radiographs raised concerns regarding ionizing radiation exposure in growing children. The aim was to assess the necessity of radiographs after every lengthening of MCGR. METHODS: A retrospective analysis of 30 consecutive patients (19F, 11 M) treated in a single institution between 2011 and 2017. Planned radiographs were taken based on a protocol, updated over the years to involve less frequent acquisitions. Unplanned radiographs were obtained after a patient complaint or a significant clinical examination finding. Outcome measures were preoperative and postoperative radiographic measurements, and complications such as proximal and distal junctional kyphosis and failure, rod or actuator breakage, collapse of previously achieved height or failure to lengthen and worsening of deformity. RESULTS: Mean age at surgery was 7.5 (4-11) years. Mean follow-up was 45 (24-84) months. Mean number of lengthenings and radiographs per patient were 14.4 (8-23), and 13.2 (5-46), respectively. Nine patients (30%) experienced a total of 13 mechanical complications. Almost all complications were detected in unplanned radiographs. The probability of detecting a mechanical complication was significantly lower (p < 0.00001) in planned radiographs. CONCLUSIONS: Radiographs taken after routine lengthenings of MCGR are not likely to reveal any significant finding, since only 0.9% of planned radiographs displayed a mechanical complication. Exposing growing children to radiation with an intention of checking the MCGR device after every lengthening could not be justified. Obtaining post-lengthening radiographs with a decreased frequency and after a significant complaint or clinical finding may be considered.

A comprehensive numerical design of firefighting systems for onshore petroleum installations.

Petroleum facilities containing welded steel bulk flammable liquid product storage tanks possess sundry fire hazards inherent to the facility. These installations urgently require indigenous efficient firefighting systems. So, the efficient design of firewater and firefighting foam system is dynamic in controlling fire-related emergencies. The paper deals with the in-depth conceptualization of the design and analysis of firefighting systems for a typical petroleum handling, processing and storage facility in compliance with international standards. The study is aimed to formulate the elementary technique for designing an optimized firefighting system. The proposed objective was achieved by considering an ideal tank farm site that is most commonly located in a range of terminal stations, pumping stations, petroleum refineries, well sites, etc. Sufficient illumination was enumerated on the standardized classification of the liquid fuel product with respect their flammability range. Special guidelines regarding firefighting system design basis were defined and an optimized firefighting and foam system design was developed. Moreover, sufficient limitations that must be considered during the firefighting of huge tank fires are discussed. This comprehensive numerical design philosophy offers a simple and wide-ranging guide to industrial practitioners by formulating the principles for industrial firefighting system design.

Effects of dry needling in lower extremity myofascial trigger points.

OBJECTIVE: To explore the current evidences on effects of trigger point dry needling as a treatment strategy on pain and range of motion among subjects with lower extremity myofascial trigger areas. METHODS: The systematic review was conducted at the University Institute of Physical Therapy, Lahore, Pakistan, from February to August 2019, and comprised search of studies on Cochrane Library, PubMed, SPORTDiscus and PEDro databases published in the English language from 2000 to July 2019. The search terms used were 'Dry needling', 'Trigger points', 'Myofascial trigger points', 'Trigger area', 'Acupuncture therapy', 'Lower extremity' and 'Acupuncture'. Cochrane Risk of Bias tool was used to assess the randomised and non-randomised controlled trials. Methodological assessment was performed using Physiotherapy Evidence Database 10-point scale. Data synthesis was performed through vote counting method. RESULTS: Of the 564 articles initially found, 30(5.3%) were shortlisted for full-text assessment. Of them, 10(33.3%) were selected for final assessment; with 7(70%) scoring high and 3(30%) fair on the PEDro scale. All the 10(100%) studies documented improvement in the pain over time with dry needling strategy. None of the studies targeted any other outcome, like anxiety and sleep disturbances, related with myofascial trigger points. CONCLUSIONS: On basis of the best evidences available, dry needling seemed to be effective in pain reduction related to lower extremity myofascial trigger points. Evidence also suggested that there was not much positive effect of myofascial trigger point dry needling on depression, anxiety, muscular strength and quality of life.

Valorization of underutilized waste biomass from invasive species to produce biochar for energy and other value-added applications.

Biochar production from invasive species biomass discarded as waste was studied in a fixed bed reactor pyrolysis system under different temperature conditions for value-added applications. Prior to pyrolysis, the biomass feedstock was characterized by proximate, ultimate, and heating value analyses, while the biomass decomposition behavior was examined by thermogravimetric analysis. The heating values of the feedstock biomass ranged from 18.65 to 20.65 MJ/kg, whereas the volatile matter, fixed carbon, and ash content were 61.54-72.04 wt %, 19.27-26.61 wt % and 1.51-1.86 wt %, respectively. The elemental composition of carbon, hydrogen, and oxygen in the samples was reported to be in the range of 47.41-48.47 wt %, 5.50-5.88 wt % and 46.10-45.18 wt %, respectively, while the nitrogen and sulphur content in the biomass samples were at very low concentrations, making it more useful for valorization from environmental aspects. The biochar yields were reported in the range of 45.36-58.35 wt %, 28.63-44.38 wt % and 22.68-29.42 wt % at a pyrolysis temperature of 400 °C, 500 °C, and 600 °C, respectively. The biochars were characterized from ultimate analysis, heating value, energy densification ratio, energy yield, pH, Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy and energy dispersive X-ray spectrometry (SEM and EDX), to evaluate their potential for value-added applications. The carbon content, heating value, energy densification ratio, and the porosity of the biochars improved with the increase in pyrolysis temperature, while the energy yield, hydrogen, oxygen, and nitrogen content of the biochars decreased. This study revealed the potential of the valorization of underutilized discarded biomass of invasive species via a pyrolysis process to produce biochar for value-added applications.

Synthesis, thymidine phosphorylase, angiogenic inhibition and molecular docking study of isoquinoline derivatives.

Isoquinoline analogues (KA-1 to 16) have been synthesized and evaluated for their E. coli thymidine phosphorylase inhibitory activity. Except compound 11, all other analogs showed outstanding thymidine inhibitory potential ranging in between 4.40 ±â€¯0.20 to 69.30 ±â€¯1.80 µM when compared with standard drug 7-Deazaxanthine (IC50 = 38.68 ±â€¯4.42 µM). Structure Activity Relationships has been established for all compounds, mainly based on substitution pattern on phenyl ring. All analogs were characterized by various spectroscopic techniques such as 1H NMR, 13C NMR and EI-MS. The binding interactions of isoquinoline analogues with the active site of TP enzyme, the molecular docking studies were performed. Furthermore, the angiogenic inhibitory potentials of isoquinoline analogues (KA-1-9, 14, 12 and 16) were determined in the presence of standard drug Dexamethasone based on percentage inhibitions at various concentrations. Herein this work analogue KA-12, 14 and 16 emerged with most potent angiogenic inhibitory potentials among the synthesized analogues.

Joint Placement and Device Association of UAV Base Stations in IoT Networks.

Drone base stations (DBSs) have received significant research interest in recent years. They provide a flexible and cost-effective solution to improve the coverage, connectivity, quality of service (QoS), and energy efficiency of large-area Internet of Things (IoT) networks. However, as DBSs are costly and power-limited devices, they require an efficient scheme for their deployment in practical networks. This work proposes a realistic mathematical model for the joint optimization problem of DBS placement and IoT users' assignment in a massive IoT network scenario. The optimization goal is to maximize the connectivity of IoT users by utilizing the minimum number of DBS, while satisfying practical network constraints. Such an optimization problem is NP-hard, and the optimal solution has a complexity exponential to the number of DBSs and IoT users in the network. Furthermore, this work also proposes a linearization scheme and a low-complexity heuristic to solve the problem in polynomial time. The simulations are performed for a number of network scenarios, and demonstrate that the proposed heuristic is numerically accurate and performs close to the optimal solution.

Sparse representation-based demosaicing method for microgrid polarimeter imagery.

To address the key image interpolation issue in microgrid polarimeters, we propose a machine learning model based on sparse representation. The sparsity and non-local self-similarity priors are used as regularization terms to enhance the stability of an interpolation model. Moreover, to make the best of the correlation among different polarization orientations, patches of different polarization channels are joined to learn adaptive sub-dictionary. Synthetic and real images are used to evaluate the interpolated performance. The experimental results demonstrate that our proposed method achieves state-of-the-art results in terms of quantitative measures and visual quality.

Resource Management in Energy Harvesting Cooperative IoT Network under QoS Constraints.

Cooperative communication with RF energy harvesting relays has emerged as a promising technique to improve the reliability, coverage, longevity and capacity of future IoT networks. An efficient relay assignment with proper power allocation and splitting is required to satisfy the network's QoS requirements. This work considers the resource management problem in decode and forward relay based cooperative IoT network. A realistic mathematical model is proposed for joint user admission, relay assignment, power allocation and splitting ratio selection problem. The optimization problem is a mixed integer non-linear problem (MINLP) whose objective is to maximize the overall sum rate (bps) while satisfying the practical network constraints. Further, an outer approximation algorithm is adopted which provides epsilon-optimal solution to the problem with guaranteed convergence and reasonable complexity. Simulations of the proposed solution are carried out for various network scenarios. The simulation results demonstrate that cooperative communication with diversity achieves a better admission of IoT users and increases not only their individual data rates but also the overall sum rate of an IoT network.

Blood loss after intraarticular and intravenous tranexamic acid in total knee arthroplasty.

OBJECTIVE: To compare postoperative blood loss after intravenous and intraarticular tranexamic acid injection in patients of bilateral total knee arthroplasty. METHODS: This comparative randomised study was conducted at Ghurki Trust Teaching Hospital, Lahore, between July 2015 and January 2016, and comprised all patients admitted for bilateral total knee replacement. Patients were randomly divided into two equal groups. Group-A received intraarticular while Group-B received intravenous injection of 1.5 gmtranexamic acid. All data was analysed using SPSS 17. RESULTS: The total 140 patients were divided into two equal groups of 70(50%) each. In Group-A there were 32(45.7%) males and 38(54.3%) females, while in Group-B, there were 28(40%) males and 42(60%) females. The mean ages were 64.39±9.07 years in Group-A and 63.30±9.51 years in Group B. Blood loss in Group-A was significantly lower than Group-B (p=0.01).. CONCLUSIONS: Intraarticular administration of tranexamic acid was more effective than intravenous administration in terms of reducing blood loss.

Residual interpolation for division of focal plane polarization image sensors.

Division of focal plane (DoFP) polarization image sensors capture polarization properties of light at every imaging frame. However, these imaging sensors capture only partial polarization information, resulting in reduced spatial resolution output and a varying instantaneous field of overview (IFoV). Interpolation methods are used to reduce the drawbacks and recover the missing polarization information. In this paper, we propose residual interpolation as an alternative to normal interpolation for division of focal plane polarization image sensors, where the residual is the difference between an observed and a tentatively estimated pixel value. Our results validate that our proposed algorithm using residual interpolation can give state-of-the-art performance over several previously published interpolation methods, namely bilinear, bicubic, spline and gradient-based interpolation. Visual image evaluation as well as mean square error analysis is applied to test images. For an outdoor polarized image of a car, residual interpolation has less mean square error and better visual evaluation results.

Public Private Partnership And Utilization Of Maternal And Child Health Services In District Abbottabad, Pakistan.

BACKGROUND: Public Private Partnership has been experimented as an approach in Pakistan in 2005 and in eighteen districts of Khyber Pakhtunkhwa including Abbottabad in 2011, to improve delivery of maternal and child health services. This study was conducted to assess the utilization of maternal and child health services before and after implementation of Public Private Partnership in district Abbottabad. METHODS: A cross sectional study was conducted in district Abbottabad from July to December 2014. Study included all the 53 basic health units, outsourced to People's Primary Healthcare Initiative in 2011. Data related to selected maternal and child health services indicators (family planning services, antenatal and post-natal care, safe delivery, tetanus toxoid vaccination of pregnant women and child immunization), before and after the introduction of Public Private Partnership, was collected. Significance tests (t-test) was applied and p-value <0.05 was taken as significant. RESULTS: Marked improvement was observed in vaccination of target children (127%) and women (42%), respectively. Similarly, utilization of family planning services, antenatal and postnatal care increased by 60%, 9% and 38%, respectively. Public Private Partnership had significant effect on postnatal visits (p<0.001), family planning services (p<0.001), women vaccinated with tetanus toxoid (p<0.001) and children vaccinated in Expanded Program of Immunization (p=0.003). CONCLUSIONS: Public Private Partnership improved the utilization of maternal and child health services, particularly family planning services and maternal & child immunization. The partnership may be scaled up and extended, for an improved coverage of maternal and child health services.

Comparative Analysis Of Anterior Knee Pain In Transpatellar And Medial Parapatellar Tendon Approaches In Tibial Interlocking Nailing.

BACKGROUND: Anterior knee pain is the most common complaint after intramedullary nail of the tibia. The incidence of anterior knee pain ranges from 10-86% and the exact ethology is unclear. Transpatellar tendon approach is commonly used for tibial intramedullary interlocking nailing but it can also be done through medial parapatellar tendon approach. The objective of the study was to compare post-operative anterior knee pain after intramedullary nailing technique by transpatellar approach compared to medial parapatellar approach. METHODS: This randomized controlled trial was carried out in Department of Orthopaedic and Spine Surgery, Ghurki trust teaching hospital, Lahore from 20th February to 19th Nov 2015. Sixty patients who presented at emergency department for the treatment of simple tibial shaft fractures were included in the study. They were divided into two groups with 30 patients in each group, Group A containing patients operated through transpatellar tendon approach while group B containing patients operated through medial parapatellar tendon approach. RESULTS: In Group A, 27 patients were male and 3 patients were female with a mean age of 28.667±9.63 while in Group B, 28 were male and 2 were female with a mean age of 34.63±15.82. The main causes of tibial shaft fractures were RTA followed by fall. In Group A mean anterior knee pain was 4.4 while in Group B, it was was 2.5 with a p-value of .000. CONCLUSIONS: This study shows that medial parapatellar tendon approach causes less pain as compared to transpatellar approach.

One Stage Bilateral Knee And Hip Arthroplasties In 42 Years Old Female.

Knee and hip joint replacement surgeries are the mainstay of treatment in patients having grade 3 or grade 4 arthritis either due to degenerative process, rheumatoid disease or due to some other disease process. The main aims of these surgeries are to decrease the morbidity, early rehabilitation and decrease management costs of such patients. We report the first case in which bilateral total knee and total hip replacement surgery were done in single anaesthesia in 42 years old female patient suffering from Rheumatoid Arthritis.

Outcomes Of Distal Femur Fracture Treated With Dynamic Condylar Screw.

BACKROUND: Implants for open reduction and internal fixation of distal femoral fracture includes angle blade plate, rush nails, enders nail and interlocking nails. But all these devices are technically demanding and less effective in providing inter-fragmentary compression in osteoporotic bones. These problems can be solved with dynamic condylar screw (DCS).The objective of the study was to determine the frequency of different outcomes of distal femoral fracture treated with dynamic condylar screw. METHODS: This case series study was carried out in the Department of Trauma & Orthopaedics, Ayub Teaching Hospital Abbottabad from 1st October 2014 to August 2015, after approval of the ethical committee of the institution. Data of all patients with distal femoral fractures aged 20-70 years, recruited through emergency, OPD or consultant clinic collected on a pro forma. Standard treatment of trauma was given to the patients. Detailed history was taken including the past medical and surgical history. Detailed examination including air-way, breathing and circulation, general physical examination and abdomino-pelvic examination was done in each patient. Investigations including urinalysis, haemoglobin %, full blood count, X-ray (both AP and lateral view) of the involved femur (including hip and knee) was done. RESULTS: Mean age of the patients was 43.18±14.647 ranging from 20 to 70 years. Mean duration of hospital stay in days was 2.21±1.111 ranging from 1 to 6 days. Patients' follow-up assessment after 4 months of surgery for union of femoral fracture treated with dynamic condylar screw was found in 96 (94.1%), wound infection was found in 7 (6.9%), knee stiffness was found in 21 (20.6%) and limb shortening was found in 7 (6.9%). CONCLUSIONS: Dynamic condylar screw is an easy, scientifically less difficult and satisfying method of treatment for fra.ctures of femur.

Wireless Sensor Network Optimization: Multi-Objective Paradigm.

Optimization problems relating to wireless sensor network planning, design, deployment and operation often give rise to multi-objective optimization formulations where multiple desirable objectives compete with each other and the decision maker has to select one of the tradeoff solutions. These multiple objectives may or may not conflict with each other. Keeping in view the nature of the application, the sensing scenario and input/output of the problem, the type of optimization problem changes. To address different nature of optimization problems relating to wireless sensor network design, deployment, operation, planing and placement, there exist a plethora of optimization solution types. We review and analyze different desirable objectives to show whether they conflict with each other, support each other or they are design dependent. We also present a generic multi-objective optimization problem relating to wireless sensor network which consists of input variables, required output, objectives and constraints. A list of constraints is also presented to give an overview of different constraints which are considered while formulating the optimization problems in wireless sensor networks. Keeping in view the multi facet coverage of this article relating to multi-objective optimization, this will open up new avenues of research in the area of multi-objective optimization relating to wireless sensor networks.

OUTCOMES IN CLOSED REAMED INTERLOCKING NAIL IN FRACTURES OF SHAFT OF FEMUR.

BACKGROUND: Femoral shaft fracture is one of the common fractures seen in accident and emergency department of our hospital. Violent forces are required to break this and strongest of human bones. There are various treatment modalities for femoral shaft fractures in adults like traction, brace, platting, intramedullary nail (IMN), external fixators and inter locking nails. The study was done with an objective to evaluate the results of closed reamed interlocking nail in fractures of shaft of femur. METHODS: A prospective study of 114 cases of femoral shaft fractures was carried out at orthopaedic unit of Ayub Teaching Hospital Abbottabad during 1 year. All these cases were treated with statically locked nails under spinal or general anaesthesia. These cases were followed up for up to one year and Results of the interlocking nail were observed in terms of union and complications. RESULTS: Out of 114 patients, 95 underwent union in 90-150 days with a mean of 110.68 days. Ten patients had dynamization within six weeks because of obvious fracture gap in radiograph. There were 3 patients who had non-union, and 6 patients had delayed union which was treated with dynamization. CONCLUSION: Close reamed interlocking intramedullary nail in femoral shaft fractures is the treatment of choice. Patient rehabilitation is early, hospitalization is short, and fracture healing response is good.