Background Melanoma, the most lethal form of skin cancer, contributes to a majority of skin cancer fatalities globally. It carries a grim prognosis with a high propensity for early metastasis. People are not aware of moles, their natural course of progression, and skin self-examination. Consistent skin examinations have demonstrated enhanced survival rates. The month of May is celebrated for melanoma awareness. Objective This study aims to evaluate the awareness of the general public on mole cancer and skin self-examination (SSE). Materials and methods This prospective, survey-based study was conducted through interviews in the outpatient department of Lahore General Hospital, Lahore, Pakistan, in May 2022. Questions based on knowledge, attitudes, and practices of melanoma and skin self-examination were asked during the survey in the native language. The collected data underwent analysis using Google Form (Google Inc., Mountain View, USA) and IBM SPSS Statistics for Windows, Version 24 (Released 2016; IBM Corp., Armonk, New York, United States). Descriptive analysis was performed by a statistician. Categorical data were analyzed to determine frequency and percentage, while continuous data were computed as mean and standard deviation. Results The findings reveal that a staggering 81% of the surveyed population were unaware of melanoma. A staggering 70% admitted to never having conducted self-body examinations. Interestingly, about 57% of the population had moles on their bodies, yet a significant 90% showed no concern about them. Alarmingly, 85% had never sought medical advice on this matter. On average, half of the participants believed in the protective benefits of sunscreen, umbrellas, and sunglasses. Among those interviewed, 52% recognized the severity of melanoma, while only 33% understood its potential for spreading to other organs. Additionally, 57% agreed that self-examination could facilitate early detection, and 62% believed in the efficacy of regular skin checks for improving survival rates. Impressively, 90% of the patients found the survey informative, with half expressing high satisfaction with its conduct. Conclusion Melanoma is a concerning diagnosis, and simple SSE can increase survival. This survey concluded that it is imperative to raise awareness regarding the risk of melanoma, the benefit of conducting self-examination, and when to seek medical help. Larger studies are needed to extract broader aspects of various factors creating barriers to awareness.

Objective:To assess the clinical presentation, causative agents, and treatment outcomes in patients diagnosed with Elsberg syndrome (ES). Methods:A thorough literature search was conducted on the mentioned topic using PRISMA guidelines via PubMed, Google Scholar, and SCOPUS. Articles published between 2000 and 2023 were included using advanced search and Boolean strategy. A total of 19 case reports were included in the systematic review according to set criteria and after quality assessment. Results:The average age at presentation was 48.9 ± 18.9 years, with a male majority of 57.9%. Lower limb sensory deficit followed by bladder dysfunction were the two most common presenting symptoms in 52.63% and 47.37% patients, respectively. Sensory loss and vesicular rash were the most frequently found signs at presentation in 36.84% and 26.32% patients, respectively. Varicella zoster virus (VZV) and herpes simplex virus (HSV) were the most common infectious agents found equivocally in 36.84% cases each. Complete resolution with definitive treatment was seen in 84.21% of patients. The average follow-up duration was 5.16 months. Conclusion:ES should be considered as a differential in patients with a prior or recent history of HSV or VZV infection who present with signs and symptoms of acute lumbosacral myeloradiculopathy. Combination therapy with antimicrobials and corticosteroids has shown promising results targeting both the infectious and inflammatory aspects of the disease.

Internet pornography provides explicit content in various forms and can progress from habit to addiction. The consumption of online porn has risen due to the general use of current technology. The main reasons people consume it are sexual arousal and sexual enhancement. We planned this review study to identify the reasons for online pornography utilization, the mechanisms involved in its addiction, and its physiological, emotional, behavioral, social, and substance abuse effects. After a detailed literature search using PubMed Central and Google Scholar, four case studies and nine original articles from 2000 to 2022 were included. The main findings of the literature demonstrated that watching porn was most frequently done out of boredom, for sexual gratification, and to pick up new fashion and behavior ideas from these movies. In all facets of the users' lives, negative consequences were seen. Due to the explosion of new technologies, online pornography has risen to an alarming level, which has very injurious effects on societies and individuals. Therefore, it is high time to get rid of this addiction to protect our lives from its harmful effects.

Background and objective Testicular cancer is the commonest of all types of cancer males are affected with. Testicular cancer, when diagnosed early, has one of the best prognoses. However, in Pakistan, early detection is hindered by religious and sociocultural norms, lack of education, and awareness deficit. Testicular self-examination (TSE) can significantly facilitate early detection of the condition and decrease associated mortality rate. This study aimed to acquire the frame of mind regarding testicular cancer (TC) and testicular self-examination (TSE) among the male outdoor patients of Lahore General Hospital, Lahore. Materials and methods After ethical considerations, elaborated literature review and consequent pilot study were done to develop a bilingual questionnaire. Following patient consent, answers to a set of questions were noted down by the authors. A 90-second bilingual, motivational video was displayed and an educational pamphlet on the same topic was also handed over. Afterward, another survey was conducted to grasp the comprehension, satisfaction, and willingness to spread the message. Results About 92% of the subjects had not heard of or performed TSE and 58.3% mentioned lack of education as the reason for not knowing the method. Eighty-two percent patients had never heard of TC. Post-education, 100% patients claimed that their knowledge of the subject improved and 97% were ready to teach other male relatives. Conclusion The results indicate that the population's lack of awareness regarding testicular self-examination and testicular cancer is alarming. Most subjects did not know the age group, risk factors, presentation, and early prevention of testicular cancer.

Background The purpose of obtaining informed consent is to ensure that patients undergoing any medical or surgical intervention are neither deceived nor coerced. Accurately estimating surgical risks is critical for shared decision-making and informed consent. Probable complications and alternative procedures should be presented to the patient so that they can freely choose an operative option. However, this factor is difficult to carry on in emergencies where an urgent decision is required. Objective This study aimed to assess the ongoing clinical practices of informed consent in emergency surgeries at a tertiary care facility. Materials and methods A cross-sectional survey was carried out from March 2022 to June 2022 at the Department of General Surgery, Lahore General Hospital, Lahore, Pakistan, with patients who had undergone surgical procedures under local, spinal, or general anesthesia within 24 hours of presentation. A Google Form (Google Inc., Mountainview, CA) was designed, containing a predefined set of 32 standard questions, and patients were interviewed in their native language to assess their satisfaction regarding the pattern and components of emergency informed consent. Categorical data were assessed using measures of central tendency, frequencies, and percentages. Results A total of 169 patients were selected for the study. Only 1.6% of them signed the consent form themselves, while 93.5% of the forms were signed by their first-degree relatives. Verbal consent was taken in 4.8% of cases. In 88% of cases, informed consent was obtained by the house surgeons. The majority of patients, i.e., 78.2%, were not able to read the written consent form; however, 83.1% understood the verbal information. About 66.3% of patients agreed that they were informed about the nature of their disease, while 67.5%, 14.8%, and 13.7% affirmed that they were explained the nature of surgical intervention, associated risks, and type of anesthesia, respectively. Overall, 59.5% of patients felt satisfied with the process of informed consent. About 91.1% of the patients believed that their decisions were unaffected by the procurement of informed consent. Conclusion The existing practices of informed consent and comprehension by the population were found to be substandard. Physicians seem to ignore bioethics, and patients appear to be unaware of their basic rights. Although practiced at our center, not all components of informed consent were communicated to the patients. The risks of the procedures and the mode of anesthesia used were not well addressed by doctors. There is a grave need to educate the medical community about the legal and ethical aspects of informed consent, as well as the public masses regarding their rights.

Alveolar soft part sarcoma is a very rare malignant neoplasm of peripheral muscular, adipose or neural tissue. Its occurrence, as a primary intracranial tumour, is even rarer. To the best of our knowledge, only nine cases of primary intracranial alveolar soft part sarcoma exist in English scientific literature. We attempt to write a comprehensive review on this poorly understood intracranial malignancy, with no evident systemic lesions, such as in the case of our 22 years old patient. In addition to absent definitive proof of benefit of radiologic or chemotherapeutic management, we highlight the role of surgery as the primary treatment. Younger patients with this tumour may have a worse prognosis than elderly patients.

Background Skin and soft tissue swellings (SSTS) frequently present in dermatology, plastic surgery, and general surgery departments. While a general surgeon can take care of excisable lesions, people typically seek plastic surgery for cosmetic reasons. According to the signs and symptoms, soft tissue and skin lesions must be removed, and it is crucial to maintain cosmesis following their removal. Objective The aim of this article is to describe the clinical and histopathological types, sites, laterality, and postoperative complications of SSTS. Material and methods This retrospective study was conducted at the Department of Plastic and Reconstructive Surgery, Lahore General Hospital, Lahore, Pakistan in November 2022. We studied admitted patients from July 1, 2020 to June 30, 2022 for SSTS excision. Data on patients’ demographics, associated features of SSTS, and their postoperative complications was gathered using Google Docs-generated proforma and sent to a statistician for the computation of results via a Microsoft Excel-generated spreadsheet. Results Out of the total 60 patients, 66.7% of the lesions were found in women. The mean age at presentation came out to be 34.16±17.42 years. Nevi with 16.7% were the most common SSTS in our study. The most common site of presentation of SSTS was the scalp and face in 63.3% of cases. Fever was the most frequently encountered post-excision complication in 40% of patients. Conclusion A comprehensive history, clinical examination, signs and symptoms, and the histology of the lesion, all play a crucial role in the management of such swellings. Surgery was the definitive treatment option for SSTS. There were very few major complications in a handful of patients.

It is a very common practice to label the episodes of headache, sleepless nights, nausea, vomiting and weight loss as “routine complaints”. Though highly prevalent, such signs and symptoms can be an indicator of a life-threatening brain tumor. The general population of the underdeveloped and the developing countries is habitual of taking over-the-counter drugs to manage these presentations while avoiding specialists' consultations till later stages of the brain tumours. Here, we try to discuss and identify few major barriers in the timely diagnosis of brain tumors and how to overcome them at the grass-roots level in Pakistan.

Hyperglycemia is a metabolic issue rising mortality and bleakness around the world. The point of efficacy study was to explore the impact of flaxseeds and chia seeds on type 2 diabetes mellitus in light of the fact that they are financially savvy and gives a great deal of medicinal advantages and are attainable to low and middle salary populace. Both comprise of many vital substances like omega-3 and omega-6, dissolvable dietary fiber, and phytochemicals. To produce the desired results of flaxseeds and chia seeds fortified yogurt to reduce hyperglycemia an efficacy study design was carried out. Fifteen healthy rodents weighing 150280g, 2-3 months old were utilized for the examination. Rats which tested were nourished high sucrose diet for diabetes induction for roughly 15 days. Following 15 days, with the assistance of glucometer blood glucose level was checked to ratify hyperglycemia. Fifteen healthy rodents were distributed into three groups having five rodents in each. The group 1 was controlled and nourished 15ml yogurt (controlled). Group 2 including diabetic rodents was treated with 15ml yogurt invigorated with 1.5g of flaxseeds and group 3 including diabetic rodents was treated with 15ml yogurt braced with 1.5g of chia seeds for a period of 45 days. Physiological and biological tests were carried out after the completion of trials and attained results were statistically analyzed. Conclusively even with the resemblance in nutritional conformation, chia seeds seems to take the capability to alter glucose into a slow release sugar and mark satiety to a better level than flaxseeds.

The objective of the study was to measure the effects of Big Five personality traits on employee’s job performance among the teaching staff in the higher educational institutes/universities in the city of Peshawar. The study employed quantitative methodology, and survey based method for data collection. Through sampling approach, data was collected from selected universities including Qurtba, Cecos, Sarhad and Iqra national university of Peshawar. Our results indicate that among the Big Five personality dimensions, openness to experience, conscientiousness, and agreeableness has positive and significant effects on employee job performance. The result for extraversion is positive but insignificant and for emotional stability, result is negative and insignificant. The Big Five personality traits explain 81% change in the employee job performance. Our result implies that candidate’s personality traits should be assessed during the recruitment and selection process of university teaching staff

In this study, a mechanism is developed to support the distribution system operators (DSOs) with a better grid management scheme regarding congestion management by incorporating a data-driven congestion scheme and thus reducing the congestion. The objective of the work is to avoid/reduce the thermal overloading of the transformer with an affordable approach. A data-driven model is developed, which...

In this paper we propose an simple digital learning platform for flexible energy detection using data with fine granularity. The platform is empowered with artificially intelligent methods aiming to quantify the uncertainty of building energy consumption at building level, as well as at the aggregated level. Two major learning tasks are perform in this context: prediction and classification. Firstly, the building energy prediction with various time steps resolution are perform using methods such as Fully Connected Neural Networks (FCNN), Long short-term memory (LSTM), and Decision Trees (DT). Secondly, a Support Vector Machine (SVM) method is used to unlock the building energy flexibility by performing classification assuming three different levels of flexibility. Further on, a collaborative task is integrate within the platform to improve the multi-class classification accuracy. Through the end, we argue that this approach can be considered a solid integrated and automated basic block able to incorporate future AI models in (near) real-time to explore the benefits at the synergy between built environment and emerging smart grid technologies and applications.

Now the design of energy system requires need-owners to play an active role by using advanced technical solutions to improve their responsiveness, process adaptability and empower end-users. Although need-owners via Demand Response (DR) has gain sufficient strategic improvement in energy management recently, there are still some fundamental impediments to achieve a trade-off between demand flexibility scheduling and dispatch. To find a solution to the challenge, the paper introduces the steps of an agile development process for energy systems, refers to a co-creation of solutions based on co-existing technologies and iterative development, where need-owners requirements and solutions evolve through collaboration between cross-functional intelligent agents. The proof-of-the-concept is investigated by agent-oriented simulation for a generic low-voltage network of the Netherlands, which encounters transformer congestion. Simulation results reveal a significant reduction in congestion over a year while confirming expected levels of performance.

Although congestion management via Demand Response (DR) has gain sufficient popularity recently, there are still some fundamental impediments to achieve a trade-off between demand flexibility scheduling and demand flexibility dispatch for congestion management. To find a solution to the challenge, the paper introduces the concept and design of an Agile Net, which is an agile control strategy for congestion management. The model of Agile Net has triple cores. First, it percepts the network environment by using the concept of demand elasticity. Second, it possesses an online model-free learning technique for the management of network externality, such as congestion. Third, it enables distributed system scalability. The efficiency of the proposed Agile Net is investigated by extending the simulation tool for DR paradigm for a generic low-voltage network of the Netherlands. Simulation results reveal a significant reduction in congestion over a year while confirming expected levels of performance.

This chapter provided an overview of DSM and especially, DR. In the past years, a wide range of DR programs have been developed in different power systems across the world. These programs aim at engaging all the types of consumers: from large industrial customers to residential end-users with relatively small electricity consumption, considering also special types of consumers such as the EV and data centers. The primary motive for developing DR programs is that by enabling the participation of the demand side in electricity markets significant benefits are anticipated: more efficient and sustainable system planning, enhancement of the operation of the distribution system, lower and more stable electricity prices in the long run, mitigation of the market power of several participants and promotion of competition, economic benefits for the consumers, and increased operational flexibility. Increased operational flexibility is directly linked to accommodating the handicaps of the trend that indicates that significant amount of variable RES generation will be introduced in power systems in the future.

Effective Energy Management with an active Demand Response (DR) is crucial for future smart energy system. Increasing number of Distributed Energy Resources (DER), local microgrids and prosumers have an essential and real influence on present power distribution system and generate new challenges in power, energy and demand management. A relatively new paradigm in this field is transactive energy (TE), with its value and market-based economic and technical mechanisms to control energy flows. Due to a distributed structure of present and future power system, the Internet of Things (IoT) environment is needed to fully explore flexibility potential from the end-users and prosumers, to offer a bid to involved actors of the smart energy system. In this paper, new approach to connect the market-driven (bottom-up) DR program with current demand-driven (top-down) energy management system (EMS) is presented. Authors consider multi-agent system (MAS) to realize the approach and introduce a concept and standardize the design of new Energy Flexometer. It is proposed as a fundamental agent in the method. Three different functional blocks have been designed and presented as an IoT platform logical interface according to the LonWorks technology. An evaluation study has been performed as well. Results presented in the paper prove the proposed concept and design.

Effective Energy Management with an active Demand Response (DR) is crucial for future smart energy system. Increasing number of Distributed Energy Resources (DER), local microgrids and prosumers have an essential and real influence on present power distribution system and generate new challenges in power, energy and demand management. A relatively new paradigm in this field is transactive energy (TE), with its value and market-based economic and technical mechanisms to control energy flows. Due to a distributed structure of present and future power system, the Internet of Things (IOT) environment is needed to fully explore flexibility potential from the end-users and prosumers, to offer a bid to involved actors of the smart energy system. In this paper, new approach to connect the market-driven (bottom-up) DR program with current demand-driven (top-down) energy management system (EMS) is presented. Authors consider multi-agent system (MAS) to realize the approach and introduce a concept and standardize the design of new Energy Flexometer. It is proposed as a fundamental agent in the method. Three different functional blocks have been designed and presented as an IOT platform logical interface according to the LonWorks technology. An evaluation study has been performed as well. Results presented in the paper prove the proposed concept and design.

This paper formulates an applied methodology for an agile demand response using mathematical micromodels. The optimal strategy chosen by an aggregator is the maximization of social welfare derived from demand flexibility. The notion of complex demand bidding is already given in the literature, however heretofore it is formulated as the relationship of price with both demand elasticity and marginal cost along with temporal and profit constraints. Although the planning of flexible demand is already handled by using advance learning techniques in literature, herein simple Q-learning technique in a decentralized fashion is proposed. Moreover, trade-offs between the proposed complex bidding rules are explored in a day-ahead market context. Due to the given complex bidding rules and principle of learning, the methodology can be easily applied in active distribution network. Several number of houses, equipped with the proposed complex bidding mechanism and decentralized learning capability, has been simulated, thus illustrating the application of methodology formulated herein.

The design of future electricity markets requires Distribution System Operators (DSOs) to emerge as an active player by implementing advanced technical solutions which improve their market responsiveness, process adaptability and meet their business needs. This paper presents a methodology that helps DSOs carry out such a complex task. The proposed methodology enhances the Smart Grid Architecture Model (SGAM) framework in the context of transactive energy and multi-agent system (MAS). The proposed method is referred to as agile methodology because it made the SGAM architectures Adaptive, Goal-oriented, Intelligent, Linked and Expandable (AGILE). It is implemented using an object-oriented application that facilitates the analysis of agility in the network management.

This paper formulates an applied methodology for an agile demand response using mathematical micromodels. The optimal strategy chosen by an aggregator is the maximization of social welfare derived from demand flexibility. The notion of complex demand bidding is already given in the literature, however heretofore it is formulated as the relationship of price with both demand elasticity and marginal cost along with temporal and profit constraints. Although the planning of flexible demand is already handled by using advance learning techniques in literature, herein simple Q-learning technique in a decentralized fashion is proposed. Moreover, trade-offs between the proposed complex bidding rules are explored in a day-ahead market context. Due to the given complex bidding rules and principle of learning, the methodology can be easily applied in active distribution network. Several number of houses, equipped with the proposed complex bidding mechanism and decentralized learning capability, has been simulated, thus illustrating the application of methodology formulated herein.