Abstract-The transmission and reflection of electromagnetic waves at dielectric-fractal interface is studied, the fractal exhibits quasi fractional space properties. The closed form expressions for transmission and reflection coefficients are formulated for such an interface. The classical results are obtained when integer dimensions, instead of fractional dimension are inserted in the said expressions. This work can be used to study behavior of electromagnetic waves in slabs and waveguides filled with fractal media.

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Objective: To compare the effectiveness of betamethasone gel and lidocaine gel application in reduction of post-operative sore throat. Study Design: Randomized controlled trial Place and Duration: Study was conducted at anesthesia department of Dow University of Health Sciences, Karachi with duration from May 2022 to October 2022. Methodology: A total of 54 patients were enrolled and divided into two groups Betamethasone and Lidocaine (Lignocaine) by lottery method. In one group betamethasone gel 0.05% was applied over endotracheal tube (ETT) and in other group lignocaine gel 4% was applied over the ETTT. SPSS version 23 was used for data analysis. Mean ± SD and frequency (percentage) were calculated for numerical and categorical data respectively. Results: Majority of the patients in betamethasone group, 15 (55.6%) patients, had not developed sore throat whereas mild and moderate sore throat was most common in lidocaine group. Further, 5 (18.5%) patients in lidocaine group and only 2 (7.4%) patients in betamethasone group was severe sore throat. (p=0.015). Practical implication: Sore throat is a common post-operative complication having potential to lead poor surgical results. This study will help the clinicians/anesthesiologists to overcome the problem and reduce the incidence of sore throat in routine practice. Conclusion: Application of betamethasone gel over endotracheal tube just before insertion is associated with reduced risk of sore throat as compare to lignocaine gel. Keywords: Lidocaine gel, Betamethasone gel, Post-operative sore throat, Laryngoscopy, Endotracheal tube.

Objective: To evaluate the diagnostic accuracy of auscultation in the detection of inappropriate positioning of endotracheal tube, in patients undergoing elective surgeries, by taking fiberoptic bronchoscopy as gold standard. Study design: cross sectional study Place and duration: Department of anesthesia, Nishtar Hospital, Multan Methodology: A total of 205 patients admitted in general surgery ward were included in the study. The pre-operative assessment was done one day before surgery. The level of difficulty of intubation was assessed during pre-operative assessment. SPSS version 23 was used for data analysis. Tests of significance chi square and t-test were applied. P-value < 0.05 was taken as statistically significant. Results: Therefore, the estimated sensitivity was 72.03%. The estimated specificity was 65.6%. Positive predictive value was 73.9% and negative predictive value was 63.3%. Two hundred and five patients were included in this study of both genders. Gender distribution revealed as n=144 (70.2%) males and n=61 (29.8%) females. The mean age of the patients was 38.92±10.61years. ASA status I and II observed as n=121 (59.0%) and n=84 (41.0%), respectively. Mallampati grading I and II observed as n=127 (62.0%) and n=78 (38.0%), respectively. Laryngoscopy grading I and II observed as n=135 (65.9%) and n=70 (34.1%), respectively. Practical Implication: The main objective of this study was to evaluate the relative diagnostic accuracy of auscultation during GA. Therefore, we evaluated each technique's sensitivity, specificity, (PPV), (NPV) and overall accuracy in detecting incorrect endotracheal tube positioning. Conclusion: The five point auscultation technique is a reliable method of confirmation of endotracheal intubation, as verified by flexible fiberoptic bronchoscope. Keywords: Auscultation, Fiberoptic bronchoscopy, General analgesia, Diagnostic accuracy, sensitivity.

Objective: To compare the hypotension in lateral verses sitting positions during induction of spinal anaesthesia for caesarean section. Study Design: This is a Randomized control trial (RCT) study. Setting: Study carried out at Department of Anaesthesiology, Surgical Intensive Care Unit and Pain Management, Civil Hospital, Dow University of health sciences Karachi, from December 2018 to June 2019. Materials and Methods:  All women age 18 to 45 underwent elective caesarian section having ASA I and II, singleton pregnancy on ultrasound with parity ≤3 were enrolled. Patients were randomized to receive spinal anaesthesia in the lateral position (Group L) or the sitting position (Group S) through lottery methods. Using the L3-4 interspace, patients received intrathecal plain bupivacaine, 10mg or 12 mg according to their height, after which they was placed immediately in the supine position with left uterine displacement. Maternal blood pressure was measured with the help of Non-invasive BP apparatus. BP was recorded at baseline then every 5 min till 30 minutes by anesthetist who was unaware of parturient group. Any single or more reading of SBP of <90 mmHg was considered as Hypotension. Results: Mean age of the patients in lateral group was 31.49 ±10.87 years and mean age of the patients in sitting group was 31.80 ±10.77 years (p-value 0.869). Majority of the patients 35 (62.5%) with hypotension were presented with sitting position. Chi square test was applied and statistically significant difference was observed between groups (p-value 0.012).  Conclusion: We concluded that less frequency of hypotension was observed when spinal anaesthesia for caesarean section using plain bupivacaine in the lateral position.