Restless legs syndrome (RLS) is a common neurological disorder in hemodialysis (HD) patients. It is associated with poor sleep and decreased quality of life. The precipitants for the disorder are still poorly understood. The condition has not been studied extensively in Pakistan, which has a vast majority of end-stage renal disease patients on maintenance HD. We aimed to determine the prevalence of this condition in patients attending HD units of the largest renal dialysis center in Northern Pakistan. We also strived to determine any associations with dialysis inadequacy and the total duration of HD. This was an observational study comprising 279 patients. RLS was diagnosed using the International Restless Leg Syndrome Study Group criteria. Dialysis adequacy was determined using the Urea Reduction Ratio and the Kt/V technique. The prevalence of RLS in this large HD population was 24%. Our results show that a longer duration and greater number of HD sessions were significantly associated with the development of RLS (p<0.05). Dialysis inadequacy was not associated with the development of the disorder. These results may indicate that the pro-inflammatory nature of hemodialysis may have a role in the pathophysiology of RLS in HD patients and prolonged exposure to it may make them more prone to developing the disorder.

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Selection of optimal route among available choices in the presence of various factors has been a prime focus in logistics. In this paper, Analytical Hierarchy Process (AHP) is used for selection of optimum route among available options for revere logistics of electronics scrap from Pakistan to the industry using End of Life (EOL) products as there raw material. The main objective of this study is to find out the optimal reverse logistic path for electronic scrap considering: cost of transportation, time of transportation, volume of goods to be transported, nature of goods (refurbished, recyclable or scrap), and financial value of the goods being transported. Recently developed China Pakistan Economic Corridor named as CPEC is also considered among available routes which are being analyzed. The results show that CPEC is the best possible route. In addition, the proposed mechanism also provides hierarchical list for the possible route preferences which helps in finding an alternate in case the best/better route isn't available due to some unavoidable factors.

Groundwater is an essential water resource in the current era, and studying its sustainability and management is highly necessary nowadays. In the current area of research interest, the reduced mean annual Sutlej River flow, the increase in the population/built-up areas, and enhanced groundwater abstractions have reduced groundwater recharge. To address this issue, groundwater recharge modeling through ponding of the Sutlej River was carried out using a modular three-dimensional finite-difference groundwater flow model (MODFLOW) in a 400 km2 area adjacent to Sutlej River. The mean historical water table decline rate in the study area is 139 mm/year. The population and urbanization rates have increased by 2.23 and 1.62% per year in the last 8 years. Domestic and agricultural groundwater abstraction are increasing by 1.15–1.30% per year. Abstraction from wells and recharge from the river, the Fordwah Canal, and rainfall were modeled in MODFLOW, which was calibrated and validated using observed data for 3 years. The model results show that the study area’s average water table depletion rate will be 201 mm/year for 20 years. The model was re-run for this scenario, providing river ponding levels of 148–151 m. The model results depict that the water table adjacent to the river will rise by 3–5 m, and average water table depletion is expected to be reduced to 151 to 95 mm/year. The model results reveal that for ponding levels of 148–151 m, storage capacity varies from 26.5–153 Mm3, contributing a recharge of 7.91–12.50 million gallons per day (MGD), and benefiting a 27,650–32,100-acre area; this means that for areas benefitted by dam recharge, the groundwater abstraction rate will remain sustainable for more than 50 years, and for the overall study area, it will remain sustainable for 7–12.3 years. Considering the current water balance, a recharging mechanism, i.e., ponding in the river through the dam, is recommended for sustainable groundwater abstraction.

The mycotic tuberculous aneurysm of the Abdominal Aorta is an extremely rare disease. An aortic mycotic aneurysm is a life-threatening condition caused by tuberculous infection. Tuberculous aneurysms of the aorta usually present as rapidly growing or ruptured pseudoaneurysms. Most of these aneurysms are of the pseudoaneurysm type. We presented a case of a 61-year-old man who was diagnosed with a tubercular abdominal aortic mycotic aneurysm associated with the posterior invasion of the vertebral body leading to discitis. The patient underwent a mycotic aneurysm repair with grafting. Even with a combination of surgical and medical treatment, a favorable outcome could not be achieved.