Soft tissue augmentation is required for contour deformities of the face. These contour irregularities of face frequently occur as a result of congenital disorders, acquired diseases, and traumatic and developmental deformities. Allogenic fillers such as Hyaluronic acid (HA) and autologous tissues such as dermal grafts, dermo-fat grafts and fascial grafts are suitable options to treat these deformities. Similarly, reconstructive surgery using pedicled or free flaps is the key reparative option for filling of large contour defects. All these autologous options, however, produce considerable donor site morbidity and there are certain limitations of using these options, including difficulty in fine contouring, graft resorption, and infection. Human fat tissue, being an autologous tissue source, has gained scientific attraction due to advantages such as abundant supply, availability in most patients, no immunogenicity and risk of infectious diseases. Although adipose tissue grafting is a well-known technique to correct contour irregularities, the lack of longevity and consistency of fat grafts remains a major problem in this field. In order to solve this problem of re-absorption of transplanted fat, other methods may help. The current study has used one such method to overcome the issues of re-absorption of transplanted fat. Human adipose tissue is a rich source of regenerative cells including adipose tissue derived stroma (stem cells) (ASCs). Recent animal studies have supported the role of ASCs as regenerative cells. ASCs have similar characteristics as mesenchymal stem cells (MSCs) isolated from other sources such as bone marrow, cord blood and cord tissue. The high number of ASCs in adipose tissue (as compared to bone marrow), significantly high proliferative potential and ability to differentiate into tissues of multiple lineages make these cells superlative candidates for tissue engineering and regenerative medicine applications. 2 Stromal vascular fraction (SVF) of adipose tissue that contains low number of ASCs can easily be expanded in vitro to increase ASC number and to get a pure population of ASCs. In the current study, patients with contour deformities of face requiring soft tissue augmentation were enrolled consecutively. Patients giving consent for traditional fat grafting underwent fat harvest, preparation and transfer on the same day (Conventional group). Patients giving consent for ASCs enriched fat transfer underwent fat harvest two times (Stem cell group). Adipose tissue was harvested with syringe aspiration in both groups and processed with gravity and filtration. In stem cell group, samples harvested on day one were used to isolate and expand ASCs. ASCs were isolated and culture-expanded using good manufacturing practice (GMP) grade reagents in a certified laboratory approved by the Institutional Review Board. After 2 weeks, the patients in Stem cell group again underwent fat harvest. This time prepared fat was enriched with ex vivo expanded ASCs and was transferred to recipient site. Prepared fat was injected throughout layers of tissue, till visual clinical symmetry with the opposite side was achieved. Number of fat grafting sessions and volume injected were noted. Both subjective and objective assessments were performed and complications were also noted. The mean (SD) age of patients was 25(9) years with 26(70%) females. Most common indication for fat grafting was Idiopathic Hemi-facial Atrophy in 19(51%) patients followed by congenital craniofacial microsomia in 9(24%), post traumatic deformity in 7(19%) and post infective deformity in 2(5%) patients respectively. Fat was harvested from the abdomen in 25(68%) and lateral thighs in 12(32%) patients. 3 Mean (SD) soft tissue thickness 72 hours and 6 months after first fat graft session in conventional group were 18.63(7.8) and 12.88(6.21) mm respectively whereas mean (SD) soft tissue thickness 72 hours and 6 months after the fat graft session in stem cell group were 23.62 (8.47) and 22.61(8.63) respectively. Mean (SD) percentage reduction in soft tissue thickness in conventional group and stem cell group, 6 months after the first graft session, was 30.77(13) and 5.03(3.39) respectively. Patient assessment scores were 2.52(0.521) in conventional group and 4.25(0.68) in stem cell group respectively. In patients undergoing ex-vivo expanded ASCs enriched fat graft, there was minimal decrease in soft tissue thickness of treated area six months post operatively and patients were highly satisfied with the outcome with the single session of the ex vivo expanded ASCs enriched fat graft. In conclusion fat grafting is safe and effective technique for correction of facial contour deformities. However the procedure needs to be repeated multiple times due to significant re-absorption. Beneficial effects of the use of ex-vivo expanded ASCs enriched fat grafting in terms of improving clinical outcome, has a potential to alter the current treatment paradigm of fat grafting for soft tissue reconstruction. In addition this technique will open new avenue for reducing the overall cost of procedure by reducing the number of sessions.
ایلافِ وفا کا تجزیاتی مطالعہ اخلاق حیدر آبادی (شعبہ اردو ، رفاہ انٹر نیشنل یونیورسٹی ،فیصل آباد) شاعری انسانی تخیل کا پُر جمال اور بلیغ اظہار ہے۔ شاعری میں نظم نے انسانی فکر اور ادراک کو مربوط اور پر اعتماد ہو کر آگے بڑھایا ہے۔ آرائش خیال کے لیے کبھی پابند نظم اور کبھی نظم ِ معرا کو خوب پذیرائی حاصل ہوئی۔ پھر آزاد نظم نے نسبتاً انسانی فکری جہتوں کو زیادہ بے باک انداز اور آزادی کے ساتھ پیش کیا ۔اردو شاعری کے منظر نامے میںنظم گو شعرا ابلاغ کی سطح پر پیش رفت کرتے نظر آتے ہیں۔ وقت کے ساتھ نظم کی روایت نے تخلیق کار کو ایک نئے آہنگ سے متعارف کرایا۔ شاعری کی بابت بہت کچھ کہا گیا ہے اور کہا جاسکتا ہے مگر مختصر اور جامع طور پر ہم کولرج اور شیلے کے ہم زبان ہو کر کہہ سکتے ہیں ’’شاعری تخیل کی زبان ہے‘‘ ۔کانٹ نے بہت دل نشین اندازمیں اپنی کتاب ’’انتقادِ محاکمہ(Aesthetic judgment of critique) ‘‘ میں اپنے کلیدی جملہ میں اپنے نظریہ تخیل کا خلاصہ یوں پیش کیا ہے ’’ تخیل اس مواد سے جو فطرت اس کے لیے مہیا کرتی ہے،ایک فطرتِ ثانی تخلیق کرنے والا ایک زبر دست عامل ہے‘‘(۱) شاعر یا تخلیق کار کے پاس اظہار کے لیے جو چیز اساس بنتی ہے۔ وہ اس کا احساسِ تخیل ہے۔ ابلاغ کے لیے علامت، استعارہ ،مشاہدہ اور تجربہ تو ہوتا ہے۔ بلکہ الفاظ کے انتخاب کا کڑا فیصلہ بھی شاعر کو ہی کرنا پڑتا ہے۔ اسی طرح نظم کا نام بلا شبہ علامت ہے۔ کسی چیز کی ماہیت نہیں ۔ شعریات کو صنف میں علامتی سطح پر وابستہ کیا جا سکتا ہے۔ حالی ؔ کا یہ قول’’ نفسِ شعر وزن کا محتاج نہیں‘‘ اب تک ایک بامعنی اور راہنما ہے۔ عبدالسمیع اپنی کتاب ’’اردو میں...
The woman was once considered a commodity and property of her male partner that was to be used for satisfying physical needs and procreation. There was no concept of woman rights in its ideal sense for many centuries in east and the west. Though socialists and historians claim that woman was once head of the family in the agricultural age due to certain factors of that age, the plight of women throughout various phases of history is pityful. It was when Islam came that the just rights for women were granted to them keeping in view their innate capabilities and requirement. The Islamic law of inheritance is one of such rights that accommodate and preserve economic needs of a woman in view of her rights and responsibilities as a mother, sister, daughter, and wife. Muslim states in the current age have also legislated and enforced certain laws in accordance with these Qur’anic principles. Contemporary Pashtun society, mainly a male-dominant society, indicates quite an opposite approach towards woman’s share in inheritance, however. An attempt has been made in this paper to study and explore the context, factors, and impacts of the Pashtun social traditions regarding women’s share in inheritance and explain the teachings of Islam based on rationality and divine wisdom and highlight the State Law in this respect as well.
A Phenomenological Study of Multilingual Memory and Lexical Access Bilingual memory has been a subject of psycholinguistic experimental studies for last 6 decades, whereas, the study of multilingual memory has so far largely been excluded. Moreover, tMhe psycholinguistic studies, though proven highly insightful, have always excessively relied on the experimental tasks used in them to the extent that subjects as language users were overshadowed. These were the two concerns that led the present study to examine two of the psycholinguistic phenomena, multilingual memory and lexical access, phenomenologically without disregarding the insight gained from psycholinguistic studies. Under the phenomenological framework, lived experiences of Punjabi-Urdu-English (P-U-E) trilinguals were explored in order to find out the processes these trilinguals employed for learning the three languages and making them work. Three of the phenomenological methods: semi-structured lifeworld interviews, focus group discussions and essay writing, were used for eliciting the experiences of 40 P-U-E trilingual participants, chosen from three different age groups (18-23 years, 30-40 years, and 50-60 years or above) to observe developmental changes in the learning and use of the three languages over a long period of time. Data explicitation was carried out using Hycner’s (1985) 15-step process, especially formulated for keeping the essence of the participants’ experiences of the phenomena intact. Major findings were: (1) the effect of the age of acquisition on the learning of new languages, L2 as well as L3, (2) Dependence on Urdu for using English and translation asymmetry at lower L3 proficiency levels, (3) Developmental aspect, (4) The need to exert conscious control for stopping interference from the other two languages in order to speak one language consistently, and (5) Proficiency as the most significant factor in lexical selection. The findings of this phenomenological study when compared with the results of psycholinguistic experimental studies, a phenomenological model emerged that attempts to capture the trilingual memory structure of a P-U-E trilingual, i.e., how the three lexicons are organized, how they interact with each other, and how lexical access is accomplished.