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Growth and development of cereal crops are linked to weather, day length and growing degree-days (GDDs) which make them responsive to the specific environments in specific seasons. Global temperature is rising due to human activities such as burning of fossil fuels and clearance of woodlands for building construction. The rise in temperature disrupts crop growth and development. Disturbance mainly causes a shift in phenological development of crops and affects their economic yield. Scientists and farmers adapt to these phenological shifts, in part, by changing sowing time and cultivar shifts which may increase or decrease crop growth duration. Nonetheless, climate warming is a global phenomenon and cannot be avoided. In this scenario, food security can be ensured by improving cereal production through agronomic management, breeding of climate-adapted genotypes and increasing genetic biodiversity. In this review, climate warming, its impact and consequences are discussed with reference to their influences on phenological shifts. Furthermore, how different cereal crops adapt to climate warming by regulating their phenological development is elaborated. Based on the above mentioned discussion, different management strategies to cope with climate warming are suggested.

Objective: To compare the outcomes of tubeless percutaneous nephrolithotomy (PCNL) over standard PCNL in terms of postoperative pain and rescue analgesia needed. Study type, settings and duration: This comparative randomized controlled study was done at Department of Urology, Pakistan Institute of Medical Sciences, Islamabad from September 2022 to February 2023. Methodology: Total 112 adult patients of either gender between age 18-65 years were enrolled. The patients had radiographic findings of ≥ 1cm kidney stones. Enrolled patients were allocated randomly into two treatment groups. Patients of Group-A underwent tubeless PCNL procedure in which nephrostomy tube was not inserted and a double J (DJ) stent was placed. Patients of Group-B underwent PCNL with placement of nephrostomy tube for drainage and DJ stent was not inserted. Postoperative pain was assessed in both groups. The hospital stay mean was also estimated in the groups. Results: Patients mean age was 35.3±12.7 years. Stone size mean in group-A was 1.82±0.61 cm and in group-B was 2.15±0.64 cm. Mean VAS score was estimated at different time intervals. At 24 hours after the surgery, mean VAS was 2.09±1.24 in group-A and it was 3.69±1.41 in group-B (p =0.001). In group-A, mean number of rescue injections used in 24 hours after surgery was 2.18±1.18 and in group-B it was 3.51±0.66 (p =0.001). The hospital stay mean was also estimated in both groups. In group-A, mean was 1.44±0.51 days and in group-B it was 2.86±0.75 (p =0.001). Conclusion: The VAS mean was found to be significantly lower at 24 hours after the surgery, and mean hospital stay was significant shorter in patients underwent tubeless PCNL as compared to those underwent PCNL with tube.

The present study was conducted for efficient and quality production of the stingless wasp, Trichogramma chilonis Ishii with respect to rearing temperature and host egg age of the angoumois grain moth, Sitotroga cereallela (Olivier) and the rice meal moth, Corcyra cephalonica (Stainton) on its biology. Maximum parasitism was observed 95.7 and 84.3% at 28 C degree, while minimum parasitism was 61.3 and 39.6% at 32 C degree on S. cereallela and C. cephalonica eggs, respectively. The most favorable temperature was 28 oC on which maximum parasitism and adult emergence were obtained from S. cereallela eggs. Maximum parasitism was observed 97.4 and 79.4% in 2 h old, while minimum parasitism was 24.6 and 17.3% in 72 h old eggs of S. cereallela and C. cephalonica eggs, respectively. Parasitism by T. chilonis decreased with increasing host eggs age. Maximum adult T. chilonis emergence was 98.2% in 2 h old eggs, while minimum emergence was 21.5% on 72 h old eggs of S. cereallela. Adult T. chilonis longevity on the host eggs of different ages of female wasp was non-significantly different to each other except the 2 and 12 h old eggs which were significantly different from rest of the treatments in both hosts' eggs of different ages. Maximum female longevity was 4.0 d on 2 h fresh eggs C. cephalonica, while minimum was 3.0 d on 24-48 h old S. cereallela eggs. The female ratio for different host eggs age was almost non-significant to each other except 2 h old eggs with maximum number of female (64). The results showed that T. chilonis preferred young eggs when offered older eggs, simultaneously.

We presented a nonlinear time-fractional model of Hepatitis B in order to understand the ‎outbreaks of this epidemic disease. The fractional parameter is used to develop the system of ‎complex nonlinear differential equations by using Caputo sense with fractional order ‎derivative. We investigated the qualitative analysis of the fractional-order model and also the ‎stability of the model was checked through the analysis. Hepatitis B is a highly contagious ‎disease that can spread in a population depending on the number of susceptible people or patients ‎with chronic disease and also depending on their dynamics in the community. The solution of the ‎classical, as well as the time-fractional model, was procured by using LADM. Finally, ‎numerical simulations are also established to investigate the influence of the system parameter ‎on the spread of the disease‎‎.

Objective: To compare the outcomes of tubeless percutaneous nephrolithotomy (PCNL) over standard PCNL in terms of postoperative pain and rescue analgesia needed. Study type, settings & duration: This comparative randomized controlled study was done at Department of Urology, Pakistan Institute of Medical Sciences, Islamabad from September 2022 to February 2023. Methodology: Total 112 adult patients of either gender between age 18-65 years were enrolled. The patients had radiographic findings of ≥ 1cm kidney stones. Enrolled patients were allocated randomly into two treatment groups. Patients of Group-A underwent tubeless PCNL procedure in which nephrostomy tube was not inserted and a double J (DJ) stent was placed. Patients of Group-B underwent PCNL with placement of nephrostomy tube for drainage and DJ stent was not inserted. Postoperative pain was assessed in both groups. The hospital stay mean was also estimated in the groups. Results: Patients mean age was 35.3±12.7 years. Stone size mean in group-A was 1.82±0.61 cm and in group-B was 2.15±0.64 cm. Mean VAS score was estimated at different time intervals. At 24 hours after the surgery, mean VAS was 2.09±1.24 in group-A and it was 3.69±1.41 in group-B (p =0.001). In group-A, mean number of rescue injections used in 24 hours after surgery was 2.18±1.18 and in group-B it was 3.51±0.66 (p =0.001). The hospital stay mean was also estimated in both groups. In group-A, mean was 1.44±0.51 days and in group-B it was 2.86±0.75 (p =0.001).  

Background: Percutaneous access to the kidney with the patient in supine position was described in 1998. Although not frequently used in Pakistan there is a constant effort to adopt the supine position, primarily because it offers certain advantages over prone position. Objective: To present our experience in performing supine percutaneous nephrolithotomy and to compare our results with those reported in the international literature. Study type, settings & duration: A retrospective study was conducted at Federal Government Polyclinic hospital Islamabad from January 2015 to January 2020.   Methodology: The medical records of 63 patients that underwent supine percutaneous nephrolithotomy were reviewed. The evaluated variables were: age, gender, body mass index, stone location and size, surgery duration, success rate, and complications. Results: A total of 63 patients and 70 kidneys were treated. The mean age of the patients was 41.7 years (16-76) with predominance of males 37 (58%) while there were 26 (42%) females. Mean body mass index was 25 m2 (18-34), mean stone size was 31 mm (12-80).Topography of the calculi was pelvic, 17 (24.2%); caliceal system; inferior 16 (22.8%), middle 3 (4.2%), superior 5 (7.14%). and mean duration of surgery was 80 min (30-160). The first intervention success rate was 90%, the second intervention success rate was 95%, and the complication rate was 11% (Clavien: I and II). Conclusion: Supine percutaneous nephrolithotomy is safe and efficacious, with a high success rate, low complication rate, and undisputable advantages of anesthesia management.

Background: Percutaneous access to the kidney with the patient in supine position was described in 1998. Although not frequently used in Pakistan there is a constant effort to adopt the supine position, primarily because it offers certain advantages over prone position. Objective: To present our experience in performing supine percutaneous nephrolithotomy and to compare our results with those reported in the international literature. Study type, settings & duration: A retrospective study was conducted at Federal Government Polyclinic hospital Islamabad from January 2015 to January 2020.   Methodology: The medical records of 63 patients that underwent supine percutaneous nephrolithotomy were reviewed. The evaluated variables were: age, gender, body mass index, stone location and size, surgery duration, success rate, and complications. Results: A total of 63 patients and 70 kidneys were treated. The mean age of the patients was 41.7 years (16-76) with predominance of males 37 (58%) while there were 26 (42%) females. Mean body mass index was 25 m2 (18-34), mean stone size was 31 mm (12-80).Topography of the calculi was pelvic, 17 (24.2%); caliceal system; inferior 16 (22.8%), middle 3 (4.2%), superior 5 (7.14%). and mean duration of surgery was 80 min (30-160). The first intervention success rate was 90%, the second intervention success rate was 95%, and the complication rate was 11% (Clavien: I and II). Conclusion: Supine percutaneous nephrolithotomy is safe and efficacious, with a high success rate, low complication rate, and undisputable advantages of anesthesia management.

Background: Percutaneous access to the kidney with the patient in supine position was described in 1998. Although not frequently used in Pakistan there is a constant effort to adopt the supine position, primarily because it offers certain advantages over prone position. Objective: To present our experience in performing supine percutaneous nephrolithotomy and to compare our results with those reported in the international literature. Study type, settings & duration: A retrospective study was conducted at Federal Government Polyclinic hospital Islamabad from January 2015 to January 2020. Methodology: The medical records of 63 patients that underwent supine percutaneous nephrolithotomy were reviewed. The evaluated variables were: age, gender, body mass index, stone location and size, surgery duration, success rate, and complications. Results: A total of 63 patients and 70 kidneys were treated. The mean age of the patients was 41.7 years (16-76) with predominance of males 37 (58%) while there were 26 (42%) females. Mean body mass index was 25 m2 (18-34), mean stone size was 31 mm (12-80).Topography of the calculi was pelvic, 17 (24.2%); caliceal system; inferior 16 (22.8%), middle 3 (4.2%), superior 5 (7.14%). and mean duration of surgery was 80 min (30-160). The first intervention success rate was 90%, the second intervention success rate was 95%, and the complication rate was 11% (Clavien: I and II). Conclusion: Supine percutaneous nephrolithotomy is safe and efficacious, with a high success rate, low complication rate, and undisputable advantages of anesthesia management.

Objectives: To determine the frequency and immediate outcome of acute neurologic complications (ANCs) in children undergoing congenital heart surgery (CHS). Materials and Methods: Inthis retrospective study, all patients undergoing CHS at our hospital from January 2007 to June 2016 were included. Patients were followed up for the development of seizures, altered level of consciousness (ALOC), abnormal movements, and stroke. Results are presented as mean with standard deviation and frequency with percentages. Results: Of 2000 patients who underwent CHS at our center during the study, 35 patients (1.75%) developed ANC. Seizures occurred in 28 (80%), ALOC in 5 (14%), clinical stroke in 2, brain death in 6 patients. Antiepileptic drugs (AEDs) were started in 32 patients, of which 13 patients required more than one AED. Mean length of stay was 10 ± 7.36 days. Of 35 patients who developed ANC, 7 expired during the study. Conclusion: Neurological complications are scarce but significant morbidity after CHS at our center.