محمد طاهر

The design of a stable slope in a rock mass environment is a quite complicated job due to the anisotropic behaviour of the rock mass. In this research work, the cut slopes at the Swat motorway in the weakest schist rock is numerically analyzed by the shear strength reduction (SSR) approach using the Finite Element-based 2D RS2 software. The slope is divided into two cases according to the nature of the rock. Each case of the cut slope is analyzed by two stabilization methods 1) changing the characteristics of the slope 2) support system installation based on the Mohr-Coulomb (MCC) and Generalized Hoek and Brown (GHB) failure criteria in order to propose the most appropriate method for slope stabilization. The results obtained reveal that the Critical Strength Reduction Factor (CSRF) before applying the stabilization methods is 1.34 (MCC) and 1.04 (GHB) for Case-I and 1.21 (MCC) and 0.53 (GHB) for Case-II. CSRF for Case-I after changing the characteristics of the slope is observed to be 2.43 (MCC) and 2.33 (GHB), while for Case-II is 1.82 (MCC) and 1.26 (GHB), respectively. CSRF for Case-I after the support installation criteria is 1.59 (MCC) and 1.07 (GHB), while for Case-II is 1.65 (MCC) and 0.5 (GHB), respectively. Based on the comparative analysis, it is revealed that changing the characteristics of the slope method shows prominent results in both cases; therefore, this method can be effectively used in order to stabilize the slope in the weakest rock mass environment.

Inflammatory bowel disease (IBD) is a chronic disorder that influences many aspects of a patient’s life. The medical treatment of the affected patient has been broadly investigated. Studies have shown that most physicians are familiar with treatment options, but they are not aware of proper preventive care for their patients. As most patients consider their gastroenterologists as their primary care provider, it is essential for gastroenterologists to inform the primary care providers of the unique needs of the patients with IBD, especially those receiving immunomodulators and biologics or are considered for such treatments. As most patients with are treated with long-term immune-suppressive drugs, and these drugs predispose the patients to many infectious diseases and cancers, it is important for primary care providers to document patients’ vaccination history comprehensively and screen for the cancers that these patients are encountered with, so that many of these disorders be prevented. Identification, safety, and proper timing of vaccinations, screening for cervical cancer, melanoma and non-melanoma skin cancers, osteoporosis, identification of depression and anxiety, smoking cessation, and care during traveling and flights are issues that will be discussed in this systemic review.

Hepatic cholestasis is characterized by elevated alkaline phosphatase and gama - glutamyl transpeptidase levels which is then followed by conjugated hyperbilirubinemia. It is classified into intrahepatic and extrahepatic cholestasis. Intrahepatic cholestasis indicates hepatocellular dysfunction or the presence of an obstructive lesion in intrahepatic bile ducts distal to biliary canalicular system. The first step in evaluating cholestasis is to distinguish intrahepatic from extrahepatic cholestasis. Abdominal sonography is a sensitive and specific modality to rule out intra- and extrahepatic biliary dilatation. If abnormal biliary tract is present, the next step is to perform Magnetic Resonance Cholangiopancreatography (MRCP) or Endoscopic Ultrasound (EUS). If there was not any evidence of biliary system obstruction in imaging, intrahepatic cholestasis is suggested and to evaluate this condition, initially Antimitochondrial antibody (AMA) should be checked and if the result was negative, liver biopsy should be considered.