Background: Guaranteeing the wellbeing and strength of medical care suppliers is essential, particularly during a pandemic. In this investigation, we intended to decide the determinants of nervousness for doctors on the job in Covid wards or isolate focuses.\nMethods: We led a cross-sectional quantitative study and added other subjective things. Utilizing things from two approved apparatuses, five segments of responsibility, weariness, family stress, insurance and nervousness were estimated. Changed for territorial importance. A factor examination was performed to show acceptable Cronbach alpha outcomes. Altogether, 103 specialists finished the poll.\nResults: The T-test results showed a huge relationship among sex and uneasiness. The primary condition model confirmed that high responsibility brought about more prominent weakness (β = 0.41, R2 = 0.17, p <0.001) and more noteworthy family strain (β = 0.47, R2 = 0.22, p <0.001). Fatigue (β=0.17, p<0.005), family stress (β=0.34, p<0.001) and security (β=-0.30, p<0.001) can well clarify tension (R2=0.28). The subjective examination results additionally recognized the extraordinary requirements of specialists regarding defensive hardware, remuneration, isolate the executives, asset assignment, security and public help, administration improvement, and wellbeing area advancement.\nConclusions: During the imperial pandemic, government and social help to specialists and other clinical recipients ought to be improved. Quick thought is relied upon to decrease the strain, duty and family desperation of top experts treating Covid patients, and improve their (protective) care. This is fundamental for patient security.

This paper presents soft computing based optimization techniques for the cogging torque reduction and thermal characterization by finite element analysis in a permanent magnet brushless DC motor (BLDC). Stator and rotor structure of BLDC motor are optimized to reduce the cogging torque, noise, and vibration by using the design parameters namely: length of magnet, length of air gap and opening in the stator slot which are selected by performing variance based sensitivity analysis. The proposed method is suitable in the preliminary design phase of the motor to determine the optimal structure to improve the efficiency. The comparison of results obtained using Firefly Algorithm (FA), Ant Colony Optimization (ACO) algorithm and Bat algorithm (BA) indicate that Firefly based optimization algorithm is capable of giving improved design parameter output. Cogging torque is created due to the interaction of magnets in the rotor and the stator slot of the motor. Thorough thermal analysis is also conceded out to investigate the thermal characteristics at dissimilar portions of the motor namely: stator core, stator slot, rotor core and permanent magnet at different operating environments in the continuous operation mode. Thermal investigation is required for the various high speed e-vehicle application The outcomes attained from simulation studies are validated through experimental hardware setup.

Introduction: Acute scrotal pain is most commonly caused by testicular torsion, torsion of the appendix testis, epididymitis and orchitis. Its complications can be diagnosed on Ultrasound and Histopathology for Surgical procedures. \nPurpose: To find out the diagnostic accuracy of color Doppler ultrasound for the diagnosis of painful scrotal by taking histopathology as the gold standard.\nMaterial Methods: It was a cross-sectional observational study conducted on 141 patients of scrotal masses that fulfilling inclusion criteria selected from Gondal Medical Complex Munir Chowk Gujranwala. Informed consent was obtained from all the patients. All patients were scanned on Toshiba Nemio 20 series with 11MHz biconvex and linear transducers. Diagnostic accuracy was determined by comparing it with the findings of histopathology by taking histopathology as the gold standard.\nResults: In this study, the mean age of patients was 37.0 ± 11.58 years. All the patients were subjected to histopathology. Amongst them 61 (43.3%) patients had positive results and 80(56.74%) patients were diagnosed negative. On Color Doppler ultrasonography, 64 (45.4%) patients had positive, while 77(54.6%) negative findings. The sensitivity, specificity, positive and Negative Predictive Values of Doppler sonography were 70.49%, 73.75%, 67.19% and 76.62% respectively. This study showed that the overall diagnostic accuracy of Doppler ULTRASONOGRAPHY was 72.34% \nConclusion: Doppler ultrasonography can be reliably being used to detect painful scrotal. Doppler ultrasound is an effective and non-invasive technique as a primary diagnostic tool to get rid of excessive surgery burden.

The present study was conducted to investigate the antidiabetic activity of ferula asafoetida resin and also its effects on Type 2 diabetes mellitus. Type 2 diabetes (adult onset diabetes) is the most common type of diabetes, accounting for around 90% of all diabetes cases with insulin resistance and insulin secretion defect. The key goal of anti diabetic therapy is to increase the development of insulin, immunity and or decrease the amount of blood glucose. While many synthetic compounds have been produced as antidiabetic agents, due to their side effects and limited effectiveness, their usefulness has been hindered. Terpenoids are a large and diverse class of naturally occurring organic chemicals, which can act as promising agents to inhibit enzymes responsible for the development of insulin resistance, normalization of plasma glucose, insulin levels, glucose metabolism and inhibiting several pathways involved in the treatment of type 2 diabetic mellitus and its complications. Appropriate properties tend to be demonstrated by terpenoids. This systematic review was undertaken to study the recent advances in terpenoids chemistry, its mechanisms, pathway interventions and its antidiabtic applications with special emphasis on Type 2 diabetes mellitus and its associated disorders. Very few clinical trials have so far been concerned with the use of terpenoids in the treatment of Type 2 diabetes mellitus. However, these compounds merit special attention due to their great therapeutic potential.

This note attempts to re-estimate the top income inequality in China with the data provided in Li et al. (2020) published in China Economic Review. The estimates of the income distribution with “the mixed data” presented in Li et al. (2020) seems to underestimate the top income inequality in China, although they try to gather the data for the top income groups in China as much as possible and construct “the mixed data” that combine the data for the top incomes of super-rich with the survey data in the CHIP. We show that the distribution of income inequality in China is significantly different with Li et al. (2020) and in particular the shares of the top incomes are heavily concentrated in the people such as the top 1% and top 0.1%. In addition, we show that the estimates of the top income inequality with “the mixed data” appears rather similar with the estimates of the top wealth inequality in the existing literature.

Introduction: Depression can have unfavorable complications for the mother and the baby. Given the probable relationship of social support with the amount of depression, the present study aimed to determine the relationship between perceived social support and depression, before and after cesarean in the pregnant women referring to Besat Hospital in Sanandaj in 2018.\nMaterials and methods: The present study is descriptive co-relational and cross-sectional, and was conducted on 180 pregnant women enrolled for the cesarean section referring to Besat hospital in 2018 who were selected according to available sampling method. The demographic information questionnaire, the perceived social support of MOS-SSS, and the depression, questionnaires Dass 21 were used to collect data. Using the SPSS 16 software, the data was analyzed through descriptive statistics, Pearson co-relation.\nResults : Results indicated that the degree of the overall rate of depression, before cesarean was 35.5% and in the post operation stage 21.7% respectively. In addition, there was a negative significant difference between social support and depression, before the operation (p<0.05, r= -0.816), and depression, after cesarean (P<0.05, r= -0.788).\nConclusion: The results of the study showed that there is a negative and significant relationship between perceived social support and depression, before and after cesarean section. Hence it is advised that interventions be designed to identify and promote the level of social support in the pregnant women enrolled for Cesarean.

Objective: Aim of the study is to correlate CT findings of pulmonary involvement in COVID-19 positive patients with clinical findings and to investigate the role of CT Score in predicting result of patients.\nStudy Design: Single-centered retrospective analysis\nPlace and Duration of Study: The study has been conducted from June to November, 2020. Research has been carried out in District Headquarter Teaching Hospital, Sargodha.\nMethodology: From June to November 2020, 138 COVID-19 patients who appeared positive for reverse transcriptase polymerase chain reaction were registered for chest CT analysis and clinical examination. Based on the range of lobular involvement quantitative CT scores were considered. Data was correlated with clinical findings.\nResults: Among the patients 106(76.8%) were males and 32(23.18%) were females. Among 138 positive patients, 51(36.9%) cases were categorized as severe while 87(63.04%) were placed in mild group. Normal chest CT is shown by 89 (64.4%) patients while 49 (35.5%) patients show parenchymal abnormalities. Among the patients with abnormal CT findings bilateral 39/51 (76.5 %), multilobar (88.2 %) lung involvement with a predominant peripheral and posterior distribution is commonly observed. Ground glass opacity is the dominant abnormality which we observe in all 48 (97.9 %) cases. Pure Ground glass opacity is detected in 13 (27.08 %) and Ground glass opacity with mixed consolidation is noted in 17(35.4 %).\nConclusion: Chest CT findings have potential role in predicting consequence of COVID-19 positive patients. It can be beneficial for speeding up diagnostic workflow as CT findings are correlated with disease severity and clinical findings.

Background: Surgery can now be performed very safely however, the post operative wound infection still remains the most difficult and important problem of current surgical practices. Drugs to be evaluated for prophylaxis should be safe, potent, non toxic, with complete antimicrobial spectrum and less chances of resistance. Ceftriaxone, a third generation cephalosporin, is considered an ideal antibiotic with minimal side effects.Gatifloxacin, a fourth generation flouroquinolone, is another antibiotic which claims to have similar efficacy as the current “gold standard ceftriaxone”.The aim of this study is to evaluate and compare the effectiveness of gatifloxacin and ceftriaxone as prophylactic antibiotic in elective clean surgical procedures.Methods:60 patients, undergoing laproscopic cholecystectomy were recruited consecutively and divided into 2 groups i.e Group A and Group B of 30 patients each.In Group A, a preoperative dose of injection ceftriaxone 1gm was administered intravenously half an hour before induction of anaesthesia and second dose was given 12 hour postoperatively.In Group B preoperative dose of tablet Gatifloxacin 400mg was administered night before operation and another tablet postoperatively when patient started orally in the evening. If not accepting orally then single intravenous infusion of Gatifloxacin was given in the evening. Results: In group A, one patient (3.33%) had grade 1 and two patients (6.66%) had grade 2 infection. Similarly in group B, one patient (3.33%) had grade 1 and two patients (6.66%) had grade 2 infection. None of the patients in both the groups had severe post operative wound infection (grade 3 and grade 4).Conclusion: Prophylactic gatifloxacin is non-inferior to the “current gold standard ceftriaxone” as far as effectiveness of the drug is concerned. In addition, it had a similar side effect profile and was equally safe as a prophylactic antibiotic in preventing wound infection following routine elective laparoscopic cholecystectomy.

Reactive arthritis, formerly called Reiter’s syndrome is extra-articular oligoarthropathy, which can be due to bacterial infection or genetic predisposition. The infections are either urogenital (chlamydia being most notorious) or gastrointestinal (e.g. salmonella, yersinia, etc.). The human leukocyte antigen (HLA-B27) antigen has been implicated as the most common predisposing factor. Reactive arthritis often involves the joints of the lower limb. Bacterial enteric infections are a potential threat in a Pediatric population that can be due to an acute illness or its sequelae. Reactive arthritis following outbreaks of enteric infections with Salmonella is uncommon in the pediatric population. We report a rare case of a 6 years old boy who came to ER with high-grade fever and severe pain in the right iliac fossa. Clinical diagnosis of appendicitis was made by the physicians on physical exam but after radio-pathological investigation like CBC, ESR, CRP, Blood culture, USG abdomen, CT abdomen, and MRI, diagnosis of reactive arthritis secondary to salmonella enteritis was made and the patient underwent right hip arthrotomy after which he was discharged. Thus, imaging played a pivotal role in the right diagnosis of a patient with proper management guidelines. This also showed that salmonella enteritis can present atypically mimicking septic arthritis or acute appendicitis. Reactive arthritis after salmonella infection is a very rare and one of its kind case reported in Pakistan.

Milk samples of 180 cows were divided into five groups according to the somatic cell count level. Milk composition and some chemical properties were measured in milk samples. The ratio of solid-non-fat, protein, lactose, and mineral matter decreased as the somatic cell count of the milk increased (p˂0.05). No statistically significant difference was observed between the fat content of the milk and the somatic cell count level (p˃0.05). Although specific gravity decreases (p˂0.01), the electrical conductivity increases (p˂0.01) in milk with high levels of somatic cell count. Milk quality of dairy cattle deteriorates due to high somatic cell count.

Fusarium wilt disease of tomato (Lycopersicon esculentum L.) is one of the highly serious and widely destructive vascular disease of tomato in Pakistan and worldwide. its management with synthetic chemicals is very costly and harmful for human beings as well for animals. The use of bioagents has been recognized as one of the most encouraging and safe options for the eco-friendly management of diseases. Therefore, this study was carried at Sindh Agriculture University, Tando Jam, Pakistan. The experiments were designed as randomized complete block design (RCBD) with four replications. Different bioagents were tested in lab and fields against Fusarium oxysporum f.sp. lycopersici. The highest inhibition 89.63% of the test fungus was noted by Trichoderma harzianum followed by Neurospora sp. 87.40% in the food poison method. In pot experiments the T. harzianum was found as highly effectual then Neurospora sp., Chaetomium subaffine and Arthrinium sp. providing minimum disease incidence and lowest mortality percent at higher and medium concentrations. The highest plant biomass and lowest root infection percent were noted in T. harzianum followed by Neurospora sp., C. subaffine and Arthrinium sp. at higher, medium and lower doses, whereas the lowest response was recorded by Nigrospora sphaerica and Dermateaceae sp. In in-vivo trials, the highest response was observed by T. harzianum followed by Neurospora sp., Arthrinium sp., N. sphaerica, respectively. The highest fruit yield was recorded by T. harzianum 6.66 (kg) followed by Neurospora sp. 5.66 (kg). Interestingly, Neurospora sp., Arthrinium sp., N. sphaerica, and Dermateaceae sp. have been first time recognized in the current study as potential bioagents against fusarium wilt of tomato. Based on the findings, it is suggested that T. harzianum and Neurospora sp., may be used as potential bioagents for ecofriendly management of tomato wilt disease.

Jejunal diverticula, small bowel pathology exist with prevalence of 0.5%-1.0% 1 \nJejunal diverticula mainly occurs as pulsion diverticula secondary to intestinal dyskinesia2 . Most of the time these diverticula are asymptomatic but when symptomatic these present with chronic symptoms such as pain, nausea, obstruction and peritonitis 3. \nIn this article we report a rare case of jejunal diverticula with presentation of severe epigastric pain, nausea, vomiting, abdominal fullness & absolute constipation.

BACKGROUND: Fusarium wilt of lentil caused by the Fusarium oxysporum f.sp. lentis (Fol) is one of the long-lasting destructive diseases in the world, causing substantial yield losses. In this study ten genotypes of lentil were screened for resistance under control and field conditions. In order to describe different level of incomplete resistance, a detailed method to evaluate the resistance of the pathogen under controlled conditions was established.\nRESULTS: Among studied genotypes, IB-7 appeared moderately resistant (10%), while IB-8 (%) and IB-2 (%) exhibited moderately susceptible (MS) reaction and remaining genotypes were found to be susceptible (S). However, no genotype was completely resistant. Pathogenicity tests were done to check disease response using four different methods: soil and seed infested (M1), soil infested (M2), seed infested (M3), and inoculation after germination (M4). Disease incidence percent and AUDPC were computed. According to statistical results, M1 appeared highly effective in producing the maximum disease, followed by M3 and M2. The maximum AUDPC value was obtained in plants inoculated by M1, M3 and M2, respectively. All fungicides slowed the rate of disease development as compared to control (no fungicide). Although the rate of disease development was greatly varied with the fungicides. Topsin- M appeared highly effective fungicides with the lowest AUDPC value.\nCONCLUSION: Based on the current study, it is suggested that more comprehensive varietal screening program should be conducted to find out more appropriate resistant sources. Disease can cause more losses when Fol is present in soil and seed.

Arthrogryposis multiplex congenita (AMC) refers to the development of multiple joint contractures affecting two or more areas of the body prior to birth. This is known with different names like congenital multiple arthrogryposis, fibrous ankylosis of multiple joints , myodystrophia fetalis deformans , otto syndrome and rossi syndrome. This disease affects joint prenatally. A permanent position either fixed in a bent or straight leads to a contracture . This contracture eventually results in muscular atrophy. The severity of this disease depends upon the number of joints involved.