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Human bones are the hard organs that protect vital organs such as the heart, lungs, and other internal organs. Fractures of the bones are a prevalent issue among humans. Bone fractures may develop from an accident or another circumstance when there is great pressure on the bones. It may be difficult and time-consuming to determine the site of a fracture in a patient who is suffering discomfort. The manual examination of fractures during radiological interpretation is a time-consuming and error-prone process. This may result in erroneous detection, poor fracture healing, and an extensive procedure. So, this research proposed an effective approach to rectifying bone fractures with the inclusion of the latest technologies. The solution is proposed by employing a Deep learning model. Moreover, a novel concept of classification is also incorporated. Firstly; the MURA dataset was collected from Stanford. Secondly; The proposed model used techniques like DCNN (Deep Convolution Neural Network) and use Alex Net model. Bones are classified into fractured or non-fractured through a classification approach. The proposed model was created using Google Colab. The proposed model was trained by repeating several experiments. The performance was evaluated based on accuracy. The suggested model results were compared with baseline algorithms as well. Consequently, the findings of this work will be useful for the medical industry.

Introduction The study objective was to determine the effect of conventional physiotherapy treatment with and without mirror therapy on phantom limb pain and psychosocial adjustment to amputation among prosthesis wearers. Methods It was a randomized controlled trial. Data were collected in the Physiotherapy Department of the Pakistan Society for the Rehabilitation of the Disabled, Lahore, and University of Lahore teaching hospital, Lahore. Overall, 36 participants with unilateral lower extremity traumatic amputation and phantom limb pain were recruited. Results At baseline, the experimental and control groups were comparable for both Numeric Pain Rating Scale (6.17 ± 1.80 and 6.33 ± 1.74) and psychosocial adjustment of the Trinity Amputation and Prosthesis Experience Scales, i.e. general adjustment (19.22 ± 2.39 and 19.67 ± 2.76), adjustment to limitation (12.78 ± 4.36 and 11.72 ± 3.69), and social adjustment (20.22 ± 1.83 and 20.05 ± 2.87). At the end of the 4th week, a significant reduction in pain was observed (2.27 ± 1.17 and 4 ± 1.37). Changes were recorded in general adjustment (22.27 ± 2.63 and 21.89 ± 2.21) and adjustment to limitation (19.67 ± 2.54 and 16.00 ± 3.97) but no significant difference was seen in social adjustment (22.67 ± 1.90 and 21.89 ± 1.99). Conclusions Mirror therapy combined with routine physical therapy is a beneficial approach and shows better results in mitigating phantom limb pain and in psychosocial adjustment to the prosthesis than routine physical therapy alone.

Objective: To determine the frequency of various causes of gross Haematuria presenting in our hospital and recommend a working protocol to young doctors.Study Design: Prospective descriptive study.Place and Duration of Study: Urology Department, District Headquarter and Teaching Hospital, Sargodha Medical College, from Mar 2012 to Mar 2014.Material and Method: All fresh patients reporting to the hospital with complaints of 'blood in urine' were included in the study, while patients presenting with Microscopic haematuria were excluded. The patients, after being managed by the urology registrar, were given a questionnaire to fill, assisted by a resident, a reference number allotted for follow-up. A request for urine routine examination and urine microscopy/cytology was made to confirm haematuria and exclude malignant cells. Followed by ultrasound, X-Ray KUB, cystoscopy and IVU / CTU scan, as required. The results obtained were recorded and analyzed.Results: A total of 391 patients presented with complaints of 'blood in urine'. Trauma: was the most frequent cause seen in 21.7% (n=85), followed by Urinary tract infections (21.0%, n=82), Urolithasis (20.2%, n=79) and Urological tumors seen 19.4% (n=76) cases. About two thirds of the patients (56.6%, n=43) with urological tumors were not investigated, at primary health care level, to ascertain the cause and presented with advanced disease.Conclusion: General practitioners should be encouraged to request ultrasound scan for patients presenting with gross haematuria, as urothelial tumours, if detected early, can be managed effectively with better long term outcome.

The best way to communicate and disseminate knowledge in a profession is through publications and research activities. Maintaining and developing the body of knowledge specific to physiotherapy is crucial for enhancing the current knowledge and supporting the idea of evidence-based physiotherapy practice. This study aimed to investigate the research output of physiotherapy professionals in Pakistan during the last three decades (1992-2022). The bibliometric analysis technique was adopted to conduct this study. Data from the Web of Science (core collection) was extracted in November 2022 via electronic searching using the query: ALL= (Physical therapy AND Pakistan OR physiotherapy AND Pakistan OR manual therapy AND Pakistan OR physical rehabilitation AND Pakistan OR Exercise therapy AND Pakistan. The search yielded 2, 390 articles that were published between 1992 and 2022. 508 relevant publications were finally selected for further analysis based on the study's inclusion criteria. The bibliometric analysis results highlighted that there has been a consistent rise in the number of published articles over the past 30 years, with the peak publication trend seen in 2020. The analysis also revealed the most productive authors, journals, and their co-authors' networking in this domain. The most frequently used author keywords and the most collaborative country in research with Pakistan were also identified. However, it was observed that there were specific clusters of research work; certain institutions and authors were very active in research, highlighting a somewhat non-diversified research activity in the profession. Furthermore, the articles were primarily published in Pakistan-based journals, indicating a limited spread of knowledge.

The best way to communicate and disseminate knowledge in a profession is through publications and research activities. Maintaining and developing the body of knowledge specific to physiotherapy is crucial for enhancing the current knowledge and supporting the idea of evidence-based physiotherapy practice. This study aimed to investigate the research output of physiotherapy professionals in Pakistan during the last three decades (1992-2022). The bibliometric analysis technique was adopted to conduct this study. Data from the Web of Science (core collection) was extracted in November 2022 via electronic searching using the query: ALL= (Physical therapy AND Pakistan OR physiotherapy AND Pakistan OR manual therapy AND Pakistan OR physical rehabilitation AND Pakistan OR Exercise therapy AND Pakistan. The search yielded 2, 390 articles that were published between 1992 and 2022. 508 relevant publications were finally selected for further analysis based on the study's inclusion criteria. The bibliometric analysis results highlighted that there has been a consistent rise in the number of published articles over the past 30 years, with the peak publication trend seen in 2020. The analysis also revealed the most productive authors, journals, and their co-authors' networking in this domain. The most frequently used author keywords and the most collaborative country in research with Pakistan were also identified. However, it was observed that there were specific clusters of research work; certain institutions and authors were very active in research, highlighting a somewhat non-diversified research activity in the profession. Furthermore, the articles were primarily published in Pakistan-based journals, indicating a limited spread of knowledge.

The best way to communicate and disseminate knowledge in a profession is through publications and research activities. Maintaining and developing the body of knowledge specific to physiotherapy is crucial for enhancing the current knowledge and supporting the idea of evidence-based physiotherapy practice. This study aimed to investigate the research output of physiotherapy professionals in Pakistan during the last three decades (1992-2022). The bibliometric analysis technique was adopted to conduct this study. Data from the Web of Science (core collection) was extracted in November 2022 via electronic searching using the query: ALL= (Physical therapy AND Pakistan OR physiotherapy AND Pakistan OR manual therapy AND Pakistan OR physical rehabilitation AND Pakistan OR Exercise therapy AND Pakistan. The search yielded 2, 390 articles that were published between 1992 and 2022. 508 relevant publications were finally selected for further analysis based on the study's inclusion criteria. The bibliometric analysis results highlighted that there has been a consistent rise in the number of published articles over the past 30 years, with the peak publication trend seen in 2020. The analysis also revealed the most productive authors, journals, and their co-authors' networking in this domain. The most frequently used author keywords and the most collaborative country in research with Pakistan were also identified. However, it was observed that there were specific clusters of research work; certain institutions and authors were very active in research, highlighting a somewhat non-diversified research activity in the profession. Furthermore, the articles were primarily published in Pakistan-based journals, indicating a limited spread of knowledge.

Cysteine-rich receptor-like-kinases ( CRKs ), a transmembrane subfamily of receptor-like kinase, play crucial roles in plant adaptation. As such cotton is the major source of fiber for the textile industry, but environmental stresses are limiting its growth and production. Here, we have performed a deep computational analysis of CRKs in five Gossypium species, including G. arboreum (60 genes) , G. raimondii (74 genes) , G. herbaceum (65 genes) , G. hirsutum (118 genes), and G. barbadense (120 genes). All identified CRKs were classified into 11 major classes and 43 subclasses with the finding of several novel CRK-associated domains including ALMT, FUSC_2, Cript, FYVE, and Pkinase . Of these, DUF26_DUF26_Pkinase_Tyr was common and had elevated expression under different biotic and abiotic stresses. Moreover, the 35 land plants comparison identified several new CRKs domain-architectures. Likewise, several SNPs and InDels were observed in CLCuD resistant G. hirsutum . The miRNA target side prediction and their expression profiling in different tissues predicted miR172 as a major CRK regulating miR. The expression profiling of CRKs identified multiple clusters with co-expression under certain stress conditions. The expression analysis under CLCuD highlighted the role of GhCRK057, GhCRK059, GhCRK058, and GhCRK081 in resistant accession. Overall, these results provided primary data for future potential functional analysis as well as a reference study for other agronomically important crops.

In this article, we present a detailed model of anisotropic quintessence stars in the hypothesis of f ( R , ϕ , X ) gravity, where R is the Ricci scalar, ϕ represents the potential scalar and a kinetic term of ϕ is X . The Karori–Barua technique was used to solve the dynamical calculations in the f ( R , ϕ , X ) hypothesis using an anisotropic fluid and quintessence field. We observed that all of the answers we found are independent of focal peculiarity and possibly steady. The masses and radii of compact stars like Her X-1, SAX J1808.4-3658, and 4U 1820-30 were utilized to compute the value of obscure constants in the Krori and Barua metric. Graphical plots have been created for the fluid parameters density, radial, transverse, and anisotropy factors. To talk about the model’s regularity, the first and second derivatives of density and radial pressure have been assessed. The stability of the developed model is determined utilizing radial sound speed velocity and tangential sound speed velocity. The true bounds of the stars such as anisotropy, intensity, and redshift have been thoroughly investigated.

Background Evidence suggests improvement in nursing staff satisfaction, competence, and retention after implementation of evidence-based mentorship programmes. When guided by a framework of compassion, mentoring as a caring action can not only build healthy, transformative relationships but a similar behavior is reciprocated to patients which subsequently can drive patient experience of care. However, examples of on-job mentorship programs for nurses in low- and middle-income countries (LMIC) are limited. Objective The objective of the study was to develop an on-job nursing mentorship programme using a compassionate framework aimed at improving nurses’ experience and thus enhancing patient experience in a tertiary care hospital in Pakistan. Methods Designed as an intervention development study, it was completed between January 2018–December 2019. The programme was developed by a team composed of service and nursing leadership, director patient experience of care and a compassion specialist using a theory of change model. The package followed a series of steps, a) identification of a framework, b) creation of working group c) needs assessment and d) multiple meetings to frame the model followed by implementing the preconditions for roll-out of the programme with the frontline staff. Results The eventual outcome was improving the patient’s experience of compassion while the intermediate outcome was to have nurses demonstrate compassionate care. The pre-conditions were identified as: recruitment of staff with appropriate skills for pediatric care, provision of compassionate experience to the frontline nurses by addressing their specific pain points, development of competent head nurses as supervisors and creation of a compassionate culture. To ensure the pre-conditions, various interventions were planned with some implemented through the course of the study while others are in the process of being rolled out. These involved, inclusion of pediatric compassion specific module during orientation of new hires, creation of space to talk about compassionate skills with staff, provision of trainings and mentorship to create competent head nurses, and creating a culture that promoted and recognized compassionate care values. Conclusion The approach helped to delineate feasible pathways for an on-job compassionate mentorship programme enhancing routine supervisors' role as facilitators of compassionate care.

Background Self-harm is an important predictor of a suicide death. Culturally appropriate strategies for the prevention of self-harm and suicide are needed but the evidence is very limited from low- and middle-income countries (LMICs). This study aims to investigate the effectiveness of a culturally adapted manual-assisted problem-solving intervention (CMAP) for patients presenting after self-harm. Methods This was a rater-blind, multicenter randomised controlled trial. The study sites were all participating emergency departments, medical wards of general hospitals and primary care centres in Karachi, Lahore, Rawalpindi, Peshawar, and Quetta, Pakistan. Patients presenting after a self-harm episode ( n  = 901) to participating recruitment sites were assessed and randomised (1:1) to one of the two arms; CMAP with enhanced treatment as usual (E-TAU) or E-TAU. The intervention (CMAP) is a manual-assisted, cognitive behaviour therapy (CBT)-informed problem-focused therapy, comprising six one-to-one sessions delivered over three months. Repetition of self-harm at 12-month post-randomisation was the primary outcome and secondary outcomes included suicidal ideation, hopelessness, depression, health-related quality of life (QoL), coping resources, and level of satisfaction with service received, assessed at baseline, 3-, 6-, 9-, and 12-month post-randomisation. The trial is registered on ClinicalTrials.gov. NCT02742922 (April 2016). Results We screened 3786 patients for eligibility and 901 eligible, consented patients were randomly assigned to the CMAP plus E-TAU arm ( n  = 440) and E-TAU arm ( N  = 461). The number of self-harm repetitions for CMAP plus E-TAU was lower ( n  = 17) compared to the E-TAU arm ( n  = 23) at 12-month post-randomisation, but the difference was not statistically significant ( p  = 0.407). There was a statistically and clinically significant reduction in other outcomes including suicidal ideation (− 3.6 (− 4.9, − 2.4)), depression (− 7.1 (− 8.7, − 5.4)), hopelessness (− 2.6 (− 3.4, − 1.8), and improvement in health-related QoL and coping resources after completion of the intervention in the CMAP plus E-TAU arm compared to the E-TAU arm. The effect was sustained at 12-month follow-up for all the outcomes except for suicidal ideation and hopelessness. On suicidal ideation and hopelessness, participants in the intervention arm scored lower compared to the E-TAU arm but the difference was not statistically significant, though the participants in both arms were in low-risk category at 12-month follow-up. The improvement in both arms is explained by the established role of enhanced care in suicide prevention. Conclusions Suicidal ideation is considered an important target for the prevention of suicide, therefore, CMAP intervention should be considered for inclusion in the self-harm and suicide prevention guidelines. Given the improvement in the E-TAU arm, the potential use of brief interventions such as regular contact requires further exploration.