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هدف البحث الى: بناء مقياس دور شخصية اللاعبة والعوامل الاجتماعية التي تحول دون تطبيق لائحة الاحتراف في كرة القدم النسوية بالأندية الرياضية في العراق، وأستعمل الباحثان المنهج الوصفي بالأسلوب المسحي لملائمته طبيعة البحث، ويتكون مجتمع البحث من الهيئات الإدارية في الأندية الرياضية العراقية المستوفية لكل محافظة حسب كتاب وزارة الشباب والرياضة البالغ عددهم (264) نادي وتم اختيار العينة بالطريقة العمدية وتكونت من (528) اداري واستنتج الباحثان ان عدم توفر أماكن ملائمة للتدريب ونظرة المجتمع للمرأة وأنها خلقت لإدارة شؤون العائلة والمنزل فقط وأن الدعم المقدم للأندية والاتحادات التي بادرت بفتح أنشطتها أمام النساء لا يزال محدود واوصى الباحثان ان الرياضة النسوية تتطلب الكثير من المقومات، بدءاً من الرغبة الداخلية لممارسة هذه اللعبة والنجاح فيها، لافتا إلى أن عدم تهيئة الظروف المناسبة لممارسة النساء لمثل هذه اللعبة يجعل أمر عدم وصوله عل المستوى المحلي والعربي متوقعاً.

Sustainability-related risk and vulnerability management have attained significant attention from academia and industry. Manufacturing industries in developing countries such as Pakistan are under severe economic pressure and striving to boost sustainable supply chain practices for achieving business excellence. In this context, the objectives of the present research are to examine the critical supply chain risks associated with sustainable development goals, namely social, economic, and environmental factors. The failure mode and effect analysis (FMEA) technique is employed for categorizing the risk factors and Pareto analysis for highlighting the more crucial and risky factors. For this purpose, a large-scale survey was carried out in the textile industries of Pakistan to develop a risk mitigation model for sustainability-related risks and vulnerability in a textile supply chain (TSC). It captures the input expressions of experts for risk factors, namely severity (s), occurrence (o), and detection (d) for calculating the risk priority numbers (RPNs) of identified alternatives. The results depict that endogenous environmental risks categorize as the most significant for the textile manufacturing industries, and the interfaces between the various risks associated with sustainability-related are also found very high. This study would be a toolkit for the industrial managers and policy-makers for creating sustainable manufacturing culture on organizational premises.

Drought stress is a most imperative environmental factor that often constrains crop production worldwide. The less availability of organic matter in soil and less available water are the major ecological issues to the world food security. In the current investigation, a pot experiment was conducted to the effect of animal manure and biochar on morpho-physiological and quality parameters of maize under well water and water deficit conditions. The maize hybrid 30-32-30 was grown in pots by using CRD factorial arrangement. The experiment was comprised of four treatments and five replications under both well water and water deficit. Treatments were consisting of sole and combined application of animal manure and biochar @ 10 t ha-1 while the combination have 1:1 ratio under both water regimes. Pots under well water were irrigated at 100% FC, while water deficit were irrigated on bases of 50% FC. After about 2 months of sowing, data related to its morpho-physiological and quality attributes were recorded. The observations revealed that deficit irrigation negatively affects the growth and quality of maize. The loss in shoot fresh and dry biomass was 38.5 and 42.5% under deficit irrigation as compared to well-watered control, however, combined applied animal manure and biochar improved it 48.5 and 71.3%, respectively. Similarly, root fresh and dry biomass were decreased to 44.8 and 86.4% by deficit irrigation, therefore, maximum improvement i.e. 68.8 and 96.4% was observed under the combination of organic matter and biochar. However, combined application of animal manure and biochar also best improved stem girth (67%), stem length (35%), no. of leaves plant-1 (67.7%), no. of nodes plant-1 (75%), chlorophyll contents (16.6%), Water use efficiency (93.3%) and photosynthetic rate (45%) as compare to control treatment, under water deficit conditions, showing that the combined application of amendments is more useful for maize growth than the sole application. However, the stomatal conductance and transpiration rate were reduced to 9.3 and 17.1% under combined use of animal manure and biochar in deficit irrigation treatments. Therefore, it is concluded that maize production can be improved by the combined use of biochar and animal manure under deficit irrigation, however detailed field research is required before wide applications in the field. [ABSTRACT FROM AUTHOR]

This study explores and documents the traditional medicinal uses of weed flora commonly found in field crops (rice, vegetables, wheat, and maize) in District Dir Upper, Khyber Pakhtunkhwa. Many medicinal plants grow wild or as weeds worldwide, including in Pakistan. The Dir Upper district boasts a diverse weed flora with significant medicinal value for daily use. Surveys using semi-structured open-ended questionnaires were carried out in distant villages of the Larjam subdivisions, specifically interviewing 120 local respondents (85 males, including herbalists and pansiris, and 35 women) regarding the naturally occurring medicinal weeds in the area. During the field survey, traditional knowledge and the ethnobotanical relevance of seasonal weeds were collected. A total of 65 species from 24 families were recorded across the four different seasons (spring, summer, autumn, and winter) in 2021--2023, including 54 angiosperms, 10 tracheophytes, and one pteridophyte. The dominant family was Poaceae (25%), followed by Asteraceae (15%) and Asclepiadaceae (2%). Given the essential roles that these weed species play in medicine, future research on the use and conservation of indigenous weed flora is highly recommended. [ABSTRACT FROM AUTHOR]

In this study, the spectral responses to drought stress of different parts in the leaf of oil palm seedlings named base, middle, and tip were investigated. The ability to detect stress even before symptoms emerge requires knowledge of which part of oil palm leaves responds more quickly to the stress. The analysis of the reflectance spectra in region 650–1050 nm was conducted on respective sections of the leaves of the oil palm seedlings. The analysis revealed that the stress affects the tip of the leaf, followed by the middle and then the base. It was noticed that the greatest loss of water and chlorophyll content was at the tip of the leaf. Principal component analysis (PCA) and hierarchical cluster analysis (HCA) were used for clustering, while support vector machine (SVM) and linear discriminant analysis (LDA) were applied for categorization purposes. The outcomes of the PCA and HCA showed that the separation between the samples was based on the day and stress levels at respective sections of the leaf. With this, the possession of distinct morphological and physiological features by each part of the leaf can be concluded. From the PCA loadings, it was found that the regions 699–756 nm, 833–877 nm, and 933–958 nm showed noticeable bands and can be used to distinguish between the oil palm seedlings under stress. In addition, LDA and SVM classifiers demonstrated that the prediction accuracy of the stress level in oil palm seedlings was not influenced by the location in the leaf where the spectra were acquired. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of coronary artery ectasia in patients with MI in our population. Study Design: Descriptive, Cross Sectional study. Setting: Cardiac Catheterization Department of Ch. Pervaiz Elahi Institute of Cardiology, Multan. Period: 1st October 2019 to 31st March 2020. Material & Methods: A total of 191 patients with myocardial infarction of age 18-60 years of either gender undergoing coronary angiography were included. Patients with vulvular heart disease, cardiomyopthies, heart failure and CKD were excluded. Full demographic informations including name, age, gender and risk factors like diabetes mellitus (DM), hypertension (HTN) and smoking were noted. The coronary angiographic films were reviewed and looked for presence or absence of coronary artery ectasia. Results: Mean age was 49.28 ± 9.64 years in our study. Out of the 191 patients, 85.86% were male and 14.14% were females with ratio of 6:1. The %age of vessel involvement in descending order was right coronary artery in 56.02%, left anterior descending artery in 25.13%, left circumflex artery in 13.10% and left main stem in 5.76% patients. Coronary artery ectasia was found in 62.83% patients. Conclusion: This study concluded that there is a high frequency of coronary artery ectasia (CAE) in myocardial infarction patients with positive association with older age, male gender, hypertension, diabetes mellitus and smoking. [ABSTRACT FROM AUTHOR]

Sustainability-related risk and vulnerability management have attained significant attention from academia and industry. Manufacturing industries in developing countries such as Pakistan are under severe economic pressure and striving to boost sustainable supply chain practices for achieving business excellence. In this context, the objectives of the present research are to examine the critical supply chain risks associated with sustainable development goals, namely social, economic, and environmental factors. The failure mode and effect analysis (FMEA) technique is employed for categorizing the risk factors and Pareto analysis for highlighting the more crucial and risky factors. For this purpose, a large-scale survey was carried out in the textile industries of Pakistan to develop a risk mitigation model for sustainability-related risks and vulnerability in a textile supply chain (TSC). It captures the input expressions of experts for risk factors, namely severity (s), occurrence (o), and detection (d) for calculating the risk priority numbers (RPNs) of identified alternatives. The results depict that endogenous environmental risks categorize as the most significant for the textile manufacturing industries, and the interfaces between the various risks associated with sustainability-related are also found very high. This study would be a toolkit for the industrial managers and policy-makers for creating sustainable manufacturing culture on organizational premises. [ABSTRACT FROM AUTHOR]

Drought is one of the most emerging threat that causes a severe reduction in cotton plant growth and development. Being cotton is a major cash crop has great threat to prevailing drought events in Pakistan. A field experiment was conducted in Kharif season 2018 at Research Area of MNS-University of Agriculture, Multan, Pakistan to assess the role of foliar applied kaolin and jasmonic acid on vegetative growth, gas exchange and reproductive traits of cotton under normal irrigated and artificial water deficit conditions. The experiment was laid -out in a factorial randomized complete block design with split – split plot arrangement. Main plots were allocated for irrigation levels, sub-plots for two -cotton genotypes viz. NIAB − 878 and SLH − 19 while sub – sub plots for treatments of kaolin and Jasmonic acid. Water deficit stress was created by skipping irrigation at flowering for 21 days. Foliar sprays of Kaolin (5%, w/v) and Jasmonic acid (100 μM) were applied alone or in combination at 60 days after planntinon both to normal irrigated and water-stresse skip irrigation while irrigation water alone was sprayed in control plots. Both cotton genotypes responded variably to normal irrigated and skip conditions. Skipping irrigation for up to 21 days at flowering caused a significant decrease in leaf relative water content, SPAD values, net photosynthetic rate and seed cotton yield in both the genotypes. Seed cotton yield showed an overall decline of 24.7% in skip over Normal irrigated crop. The genotype NIAB − 878 produced maximum seed cotton yield of 3.304 Mg ha−1 in normal that dropped to 2.579 Mg ha−1 in skip, thus showing an average decline of 21.9 %. Similarly, SLH − 19 produced 2.537 Mg ha−1 seed cotton under normal that dropped to 1.822 Mg ha−1 in skip, showing an average decline of 28.2%. The Application of Kaolin and JA Jasmonic acid, either applied individually or in combination, improved vegetative and reproductive development of both cotton varieties in normal and skip regimes. However, combined kaolin and Jasmonic Acid application proved to be more beneficial in terms of seed cotton production and other parameters studied. [ABSTRACT FROM AUTHOR]

Background: Continuous change is a vital factor for organization's sustainable growth and success. The implementation of modern information technology in business has become a core need of the hour. This study endeavours to answer how to cope with resistance to change when implementing new technology in the banking sector. A theoretical model has been developed with the blend of ADKAR change model, Technology Acceptance Model (TAM), and Hofstede dimensions of national culture to investigate the impact of the ADKAR change model on Technology Acceptance under the moderation of two national culture's dimensions. Materials and Methods: In order to collect data, 500 self-administered questionnaires were dropped personally in five major banks of five cities of Pakistan using the convenience-based employee intercept sampling technique. The validated response rate was 68% by having 340 fit questionnaires for analysis using covariance-based structure equation modelling with the help of SmartPLS. Results: The results uncover the significant existence of covariance between dimensions of the ADKAR change model and technology acceptance model. The findings are statistically significant, inferring the influential role of change management on technology adoption. Conclusion: The study results provide promising implications based on these conclusions and findings for both theoretical aspects of these different models and practitioners. [ABSTRACT FROM AUTHOR]

This research aims to identify, rank, and create an interplay among the psychological barriers to adopting Industry 4.0 technologies in the manufacturing sector. A comprehensive literature review tracked by a discussion with industry and academic experts recognized 20 barriers. Based on three widely acclaimed statistical techniques, hybrid AHP-TOPSIS (Analytical Hierarchy Process-Technique for Order Performance by Similarity to Ideal Solution) and ISM (Interpretative Structural Modeling), critical psychological barriers have been investigated. A group of 8 experts from industry and academia with at least 10 years of experience was consulted for AHP and ISM techniques. Whereas TOPSIS was conducted by 443 operational-level users, including managers and supervisors of different functional areas of the manufacturing industry located in Pakistan. The findings reveal that 'Fear of job losses', 'Fear of data loss/Risk of security breaches, 'Lack of advanced & continued education of employees' and 'Lack of standards and reference architecture', with highest importance weights, emerged as the most prominent psychological barriers in developing economies. Then the interrelations among these barriers resulted in a four-layered structural model. The driver barriers identified in the final model advocate that development in 'advanced & continued education of employees', 'standards & reference architecture' and 'minimization of fear of job & data loss' can expedite the adoption of industry 4.0 (i4.0) technologies. The study uniquely develops hierarchical relationships among the psychological barriers for adopting i4.0 in the manufacturing context using AHP-TOPSIS and ISM techniques. The study would be valuable for practitioners, decision-makers and companies that wish to focus their efforts and resources on removing the most critical barriers and challenges for the seamless implementation of Industry 4.0. [ABSTRACT FROM AUTHOR]

The Molten Salt Reactor (MSR) is the most important system suggested by Generation IV for the future direction in the nuclear reactor field. For more development of the MSR reactor, the core system inside the tube is proposed by naturally circulating molten fuel salt. The nonlinear kinetic equations form a linearized function and are obtained in state-space form. Reactivity feedback and delayed neutrons are extremely important for reactor control. In this paper, a thermal-hydraulic system for the commercial computation dynamic model is proposed. Currently, there is no commercial software to simulate the natural circulation flow. The proposed method can be easily employed to detect faults and can provide a feasible overall system performance. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study is to to determine the association of high BNP level with heart failure in patients presenting with STEMI. Study Design: Cohort Study. Setting: Department of Cardiology, Punjab Institute of Cardiology, Lahore. Period: 01 January 2017 to 30 June 2017. Material & Methods: After meeting the inclusion criteria 150 patients were enrolled. Informed consent and demographic information was taken. Then patients divided in two groups, high and normal BNP groups. Then patients were admitted in cardiology wards and were followed-up there for 5 days. Patients evaluated for symptoms of heart failure and underwent echocardiography for confirmation of presence or absence of heart failure. All the collected data was entered and analyzed on SPSS version 21. Results: In this study the mean age high BNP group was 48.87± 10.18 years while the mean age in normal BNP group was 48.99±12.15 years. Male to female ratio of the patients was 2:1. The heart failure occurred in 19(12.67%) patients. There is 1.58 times higher risk of heart failure in high BNP than normal BNP i.e. RR=1.58[1.14-2.19]. Conclusion: This present study concluded that high BNP level is strongly associated with heart failure in patients presenting with STEMI. [ABSTRACT FROM AUTHOR]

This study inculcate the discernment of despotic leadership through interpersonal deviance by the application of social exchange fit theory. Current research work also narrated the mediation moderation model of state self-esteem and core self-evaluation in the relationship of despotic leadership and interpersonal deviance. This study unfolded the fact that state self-esteem and core self-evaluation tend to curtail the effect of despotic leadership on interpersonal deviance.Through dispensing questionnaire to the educational department employees of Pakistan, data have been acquired from 500 employees to elucidate the hypothesis of the current study. Current research work employed SPSS and Model 7 to run the data analysis. The analysis explored that personal disposition and characteristics alleviate the positive relationship of despotic leadership and interpersonal deviance. More specifically, when the core self-evaluation level is higher in the relationship between despotic leadership and state self-esteem, the magnitude of mediation of state self-esteem became weaker. Moreover, following the social cognitive and conservation of resource theory, mediation moderation model buffers the positive relationship of despotic leadership and interpersonal deviance. Organizations can succor their employees by relating and pertaining to personality development and ameliorating their personal characteristics. [ABSTRACT FROM AUTHOR]

Introduction. Gallbladder agenesis (GA) is a rare congenital malformation, and majority are asymptomatic; however, symptomatic patients present with a clinical picture similar to biliary colic. Work up usually shows contracted gallbladder (GB) on ultrasound (US), and HIDA scan shows nonvisualization. Magnetic resonance cholangiopancreatography (MRCP) can be helpful in the diagnosis; however, the diagnosis without the latter can only be established intraoperatively. Management should be conservative treatment with antispasmodic drugs. Case Report. A 35-year-old female presented to the emergency department with nausea, vomiting, and worsening right upper quadrant (RUQ) abdominal pain. Vitals and laboratory values were unremarkable except for mild leukocytosis, and RUQ US reported "contracted GB, cholelithiasis, 4.2 mm wall thickness, and no ductal dilation." Surgical consultation was prompted by the diagnosis of acute cholecystitis. The patient was transferred to the operating room for laparoscopic cholecystectomy; however, no GB was found, which was confirmed by intraoperative indocyanine green cholangiography. The procedure was aborted. Postoperatively, CT scan showed absent GB. A HIDA scan showed nonvisualization of the GB after 4 hours. Gastroenterology consultation was suggested to assess for peptic ulcer disease, stricture, or other etiology for her presenting symptoms, and the upper endoscopy showed gastritis. Upper GI with small bowel follow-through study showed mild delayed gastric emptying and contrast in the colon in 45 minutes. Conclusion. When US imaging findings are equivocal for nonvisualization of GB in a patient with no known history of prior cholecystectomy, additional imaging is required considering the diagnosis of gallbladder agenesis. MRCP is the test of choice. Management is usually conservative with smooth muscle relaxants without the need for surgical operation. [ABSTRACT FROM AUTHOR]

Panama papers implicated celebrities round the globe for money laundering, tax evasion, and financing terrorist activities, on April 4th, 2016. Event study methodology is employed by using constant mean return model to gauge investors' behavior in forty-two stock exchanges before, on and after this event day. The study is believed to be first of its kind in the context of Panama papers. Results of 't - test' revealed statistically significant abnormal returns for three days, before and after the event day in two event windows (11, and 21 days), but on different dates, owing to accumulation effect. Thirty-three stock exchanges experienced statistically significant average abnormal returns (AAR), whereas, nine stock exchanges exhibited no response. Fifteen out of thirty-three exchanges witnessed cumulative average abnormal returns (CAAR) in positive direction, immediately after the event day for both event windows substantiating the underreaction hypothesis. Ten out of fifteen countries were found listed as 'more corrupt' on the Corruption Perception Index. The investors' apathy towards corruption in these countries, however, needs further research. [ABSTRACT FROM AUTHOR]

Background. Transient transaminitis is an expected outcome from liver retraction after foregut surgeries. However, severe thrombocytopenia is usually not a sequela of that. We present a case in which sevoflurane is suspected of inducing thrombocytopenia as it was the only newly introduced medication to the patient during the hospital course. Thrombocytopenia may present in a variety of settings in hospitalized patients. However, managing this occurrence requires deep exploration of pathophysiology that can cause decreased platelets, which may be a challenging task in certain circumstances. The liver plays an important role in thrombopoiesis by releasing megakaryocyte growth factors. Therefore, liver dysfunction can present as thrombocytopenia or other platelet dysfunctions. Objective. To describe a presentation of thrombocytopenia possibly associated with anesthesia-induced transaminitis after a robotic paraesophageal hernia repair with mesh and fundoplasty with intraoperative esophagogastroduodenoscopy (EGD). Methods. A 55-year-old presented to the ED with abdominal pain and was found to have a large type IV paraesophageal hernia that was surgically treated with a robotic paraesophageal hernia repair with mesh. However, on the first postoperative day (POD) (#1), the patient developed new onset thrombocytopenia with transaminitis. Workup for thrombocytopenia failed to determine an etiology. With platelet transfusion, platelet count showed an upward trend. The patient was then evaluated and cleared for discharge by POD#5. Results. The patient's POD#1 daily labs showed elevated values for liver function tests and a low platelet count of 10,000 platelets per microliter with an international normalized value (INR) of 1.3. She had received two doses of intravenous acetaminophen just prior to surgery. Her platelet count responded to two units of platelets but decreased again immediately after. She continued to have transaminitis with down-trending liver enzymes. Peripheral smear on review showed no evidence of schistocytes. A heparin-induced thrombocytopenia (HIT) screening was negative. The patient was regularly evaluated, and the platelets stabilized and slowly started to trend up. The patient recovered by the morning of her POD#5 and was cleared for discharge. Conclusion. We are reporting on a case of acute postoperative thrombocytopenia that was associated with transaminitis and elevated liver enzymes. We are linking the role of the liver dysfunction in noncirrhotic patients with surgical abdominal procedures. Although liver retraction transaminitis possibly played a role in the laboratory findings in the patient, the acute drop in her platelet count could be closely related to the use of sevoflurane anesthetic considering its potential hepatotoxic side effects. We also cannot rule out the sevoflurane directly affecting the platelet count. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the association between sedentary life style and Ischemic heart disease. Design: Analytical study. Settings: Faisalabad institute of cardiology Faisalabad. Duration of Study: 1st November 2017 to 30 April 2018. Sample Size: Sample size was 200 as calculated by WHO sample size calculator. Sampling Technique: Non probability convenient sampling. Subjects: All patients diagnosed with acute myocardial infarction Patients and methods; 200 patients presenting in outdoor for routine follow up checkup who were diagnosed cases of ischemic heart disease included in the study. Results: 200 patients with a history of acute myocardial infarction and capable of responding to a questionnaire were included in the study. 43% of the patients had history of sedentary lifestyle. Among five major risk factors, SLS stood second after diabetes according to my study. Conclusions: In patients with acute MI, there was significant number of patients who had history of sedentary lifestyle. Sedentary Lifestyle is going to be a major risk factor of ischemic heart disease. [ABSTRACT FROM AUTHOR]

Objectives: To assess the impact of myocardial infarction on quality of life in four year survivors and to determine factors associated with a poor quality of life. Design: Descriptive study. Settings: Faisalabad institute of cardiology Faisalabad. Duration of Study: 1st November 2017 to 30 April 2018. Sample Size: Sample size was 200 as calculated by WHO sample size calculator. Sampling Technique: Non probability consecutive sampling. Subjects: All patients diagnosed with acute myocardial infarction during 2013 and alive at a median of four years. Patients and Methods: 200 patients presenting in outdoor for routine follow up checkup who got MI approximately four years ago in year 2013 were included in the study. Results: 200 patients with an acute myocardial infarction in 2013 and alive and capable of responding to a questionnaire in 2018 were included in the study. Physical functioning was normal in 63%, fair in 25% and disturbed in 12% of patients. Social life functioning was normal in 66%, fair in 26% and disturbed in 8% of patients. No Angina episodes in 61.5%, 1 to 2 angina episodes per month in 25% and more than 3 episodes per month in 13.5% patients. 59% of patients were doing routine jobs, 21.5 % were doing off and on job and 19.5% were not doing any job after MI. Conclusions: this study provides valuable information for the practicing clinicians. Impaired quality of life was reported by patients, unfit for work, those with angina and dyspnea, patients with coexistent lung disease, those with anxiety and sleep disturbances and other co-morbid conditions. Improving quality of life after MI remains a challenge for practicing physicians. [ABSTRACT FROM AUTHOR]

Objectives: To observe the clinical characteristics of patients having normal coronary angiogram following an abnormal stress test or presented with chest pain indicating coronary angiogram. Study Design: A single center retrospective, descriptive study. Period: Coronary angiograms done from September 2015 to September 2016 were retrieved and reviewed for normal coronary arteries. Setting: Khatum-un-Nabyeen Heart Center. Methodology: Clinical profile of the patients having normal coronary angiogram was retrieved from hospital record. Results: Out of 900 angiograms reviewed, 81(9%) were having normal coronary arteries. Mean age was 43±10 years. Females were 64.1%. Clinical characteristic of study group was as follows: smokers 32.09%, family history of premature coronary artery disease 51.8%, hyperlipidemia 60.4% and hypertension 19.7%. Diabetes was present only in 20.9%. Among females: 19.2% were current users of oral contraceptives pills and 13.4% were post menopausal. Mean BMI was 25.4±4. Conclusion: Normal coronary angiogram is infrequent observation in cardiac catheterization laboratories and mostly found in younger to middle aged females. Family history of coronary artery disease and hyperlideimaare very common in such patients. [ABSTRACT FROM AUTHOR]

Introduction: The incidence of creatine kinase-myocardial band (CK-MB) isoenzyme elevation after percutaneous coronary intervention (PCI) ranges from 11% to 35%, including low-level elevations with no associated signs or symptoms as well as large non–Qwave and Q-wave myocardial infarction. Whereas the deleterious effect on survival of large periprocedural myocardial infarctions have been well documented. Large periprocedural myocardial infarctions, such as those caused by occlusion of a large side branch, flow-limiting dissection, or distal embolization of a large thrombus, would be undesirable and associated with worse subsequent cardiac outcomes. Objectives: To correlate the clinical outcome after PCI with cardiac biochemical markers. Study Design: Observational follow-up study. Setting: Faisalabad Institute of Cardiology, Faisalabad. Duration of Study with Dates: Six months (February, 2014 to August, 2014). Patients and Methods: Two hundred patients with symptoms of myocardial ischemia proceeding for percutaneous coronary intervention were enrolled in the study. After taking history and clinical examination, the patients divided into two groups: group I and group II. Group I comprised one hundred and fifty patients having normal cardiac enzymes and group II comprised fifty patients having raised cardiac enzymes. Results: Out of 50 patients with raised cardiac enzymes 42 (84%) were males and 8 (16%) were females, multi vessel coronary disease (58%), multi vessel PCI (54.3%). Periprocedural complications dissection (6%), side branch compromise (14%), slow flow (10%), no reflow (2%), sub-acute stent thrombosis (4%) occurred in group II as compared to slow flow (1.4%) and sub-acute stent thrombosis (0.7%) in group I. In hospital mortality (2%) in group II while no mortality in group I. On thirty day follow up 32% patients became symptomatic among which 6% developed non ST elevation MI in group II while only 1.4% patients had symptoms of angina in group I. 6% patients needed repeat target lesion revascularization in group II and only 0.7% in group I. Conclusion: Patients with raised cardiac enzymes had worse clinical outcome in terms of mortality, myocardial infarction and repeat target lesion revascularization than normal cardiac enzymes. [ABSTRACT FROM AUTHOR]

Background: Due to increased risk of CAD and cardiovascular events, prediction of severity and/or complexity of coronary artery disease (CAD) are valuable. Previously association between severity of CAD and total coronary artery calcium (CAC) score was not demonstrated but now there are lot of studies which have proven this association but still association between total CAC score and complexity of CAD is not well established. Objective: This study was conducted: (1) To investigate the association between coronary artery calcium (CAC) score and CAD assessed by CCTA. (2) To find which one of the two, CAD severity or complexity, is better associated with total CAC score in symptomatic patients having significant CAD. Study Design: Observational cross sectional study. Place and Duration: The study was conducted at Shifa International Hospital Faisalabad from March 2013 to June 2016. Materials and Methods: Total 195 consecutive patients of both gender age =20 years who was referred for CT angiography to our hospital and who fulfill the inclusion and exclusion criteria was included in the study. Before enrollment in the study all patients gave informed consent. Before CT angiography total CAC score was obtained by non- enhanced CT scans. Demographic characteristics of all patients were obtained. Regarding risk factors for CAD, history of hypertension, diabetes mellitus, family H/O ischemic heart disease and hyperlipidemia was noted. In all patients before CT angiography, Lab. investigations including complete blood count, fasting blood sugar, fasting lipid profile, blood urea and serum creatinine levels were obtained. Calcium scores were quantified by the scoring algorithm proposed by Agatston et al. All lesions were added to calculate the total CAC score by the Agatston method. Calcium scores were divided into the following categories: 0, 1-100, 101-400, and =400. The degree of stenosis was classified into four categories: (1) no stenosis, (2) minimal or mild stenosis (=50%), (3) moderate stenosis (50%-70%), and (4) severe stenosis (>70%). CAD was defined when lumen diameter reduction was greater than 50% (moderate or severe stenosis). Results: Total 195 patients were studied. 136 (69.7%) were male and 59 (30.3%) were female. Mean age of study population was 52.8±10.38 years. 81(41.54%) patients had H/O chest pain, 11(5.64%) had H/O shortness of breath and 96(49.23%) presented with chest tightness. 104(53.33%) patients were hypertensive, 71(36.41%) were diabetic, 67(34.35%) had increased cholesterol level. In 57 (29.2%) there was no coronary artery disease, 58(29.7%) had mild CAD, 32 (16.4%) had moderate and 48 (24.6%) had severe coronary artery disease on CT angiography. Single vessel was involved in 38(19.5%) patients, 20(10.3%) had two vessel disease and triple vessel disease was present in 22(11.3%) patients. 104(53.3%) patients had zero calcium score. 44(22.6%) had CAC score between 1-100, 37 (19%) had CAC score between 101-400 and more than 400 CAC score was documented in 10 (5.1%) patients. Conclusions: This study in addition to patient based analysis also confirms the significant relationship between vessels based CAD and CAC score. The prevalence of multivessel CAD increased in patients with CACS >100 and there is 100% incidence of CAD in patients with CACS >1000. Zero calcium cannot exclude the presence of significant CAD. Our data supports that in symptomatic patients calcium scoring is an additional filter before coronary angiography. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the study is to identify the precipitating factors among the patients presenting with AHF (Acute Heart Failure). Study Design: Cross sectional study. Setting: Punjab Institute of Cardiology, Lahore. Duration of Study: 6 months. From 01-01-2007 to 30-06-2007. Methodology: The calculated sample size was 170 cases with 5% margin of error, 95% confidence level taking expected percentage of uncontrolled hypertension i.e. 12% (least percentage among all precipitating factors). Results: In the study group, mostly patients of AHF were young with mean age of 55 + 6.99 years, male (61.8%), Diabetic (53.5%) and have history of chronic Heart Failure (63.5%). In male the most common precipitating factor of AHF was ACS (39.04%) while in female uncontrolled hypertension (38.46%). Conclusion: In diabetic patients the most common precipitating factor of AHF was ACS (30.7%). In patients with acute decompensation of chronic heart failure the most common precipitating factor was non-compliance of medication (30.55%) while in patients with de novo Acute Heart Failure it was ACS (41.93%). ACS was the common precipitating factor of Acute Heart Failure (28.2%) among the study group irrespective of gender, diabetes and history of Heart Failure. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy and safety of fornix based with limbus based conjunctival flaps in eyes undergoing primary trabeculectommy with MMC in P0AG& PXG. Design: Randomized control trial. Setting: Department of Khyber Institute of Ophthalmic Medical Sciences, Hayatabad Medical Complex, Peshawar, from 1st April 2011 to1stApril 2012. Methodology: Forty eight eyes of 42 patients were randomized into fornix based (FB) and limbus based (LB) groups. Primary trabeculectomy with MMC augmentation was performed by a single surgeon, on eyes in both the groups diagnosed as having POAG or PXG. MMC was used in a dose of 0.2 mg/dl for 2 minutes. Preoperative and postoperative IOP were noted to together with any adverse events during surgery and during study follow up. SPSS version 17 was used for data analysis. Follow up were done on 1st, 7th day, 30th day and 90th day. Results: Mean presenting IOP with medication was 24mmHg in FB and 27mmHg in LB group. Success rate (IOP <20mmHg without medication) was 100% in FB and 96% in LB and this difference was statistically insignificant (P value < 0.5). In our study the frequency of over-filtration was 58% (average for both groups i.e. 45% for LB and 33% for FB) at 7th post-operative day and then decreased to 20% for each group at 90th day. Difference between two groups regarding control of IOP and safety of the procedure was not statistically significant (P value < 0.5) at final follow up. The frequency of hypotony was higher in FB group as compared to LB group (37 vs. 25%) at 1st post-operative day. At final follow up, the number of eyes with hypotony decreased significantly but it was still 8% noted for FB group compared to 4% for LB (P value < 0.5%). Serious complications like blebitis and endophthalmitis were not noted in any case of our study. Conclusion: There is no statistically significant difference between the two types of MMC augmented primary trabeculectomies in terms of intraocular pressure control. Both surgical techniques are safe and effective to treat glaucoma (POAG and PXG). [ABSTRACT FROM AUTHOR]

The purpose of this research is to investigate various factors that play a role in determining Pakistani young consumers' purchase intentions to buy counterfeit brands. A sample of 310 students was taken from various universities of Pakistan by using non probability convenience sampling and data was collected by using a close-ended questionnaire. Multiple regression analysis and causal step approach for mediation were used in this research. It was found that novelty seeking and status consumption have positive influence on both attitude towards counterfeit brands and purchase intentions of counterfeits. On the other hand, personal gratification has negative impact on both attitude towards counterfeit brands and purchase intentions of counterfeits. Results supported that attitude towards counterfeit brands mediates the relationship of all independent variables with dependent variable purchase intentions of counterfeit brands. [ABSTRACT FROM AUTHOR]

Introduction Gunshot injuries are a result of a bullet or projectile fired from a weapon that penetrates the body. Homicide, suicide, and occasionally, accidental events are a significant cause of firearm-related injuries. In rare cases, the damage from the gunshot injury can be masked due to an atypical bullet trajectory. Presentation of case A 63-year-old male was found with a gunshot wound to the anterior left knee. Computed tomography (CT) scans revealed a bullet track extending from the anterior aspect of the left knee that traveled cephalad subcutaneously and entered into the peritoneal cavity, perforating the distal descending colon. The bullet was found to be at rest adjacent to the spleen and posterior chest wall, with no injury to the lungs, kidneys or the spleen. The patient required a sigmoid colectomy with descending colostomy and was subsequently discharged home without any complications. Discussion Intra-abdominal organ damage from a gunshot wound to the distal limb is a rare occurrence. Atypical gun shot wounds, such as this case, have the potential for multiple issues including: delayed diagnostic tests, inaccurate radiological readings, and inappropriate medical management. Conclusion If an abnormal trajectory is maintained, it is possible for a bullet to traverse half the length of the body without the patient realizing it. Accurate CT analysis and quick decisions in surgical and medical management are critical takeaways to provide quality care to patients with these injuries. [ABSTRACT FROM AUTHOR]

The cementation of copper ions from copper sulfate solution was studied using iron wire and iron powder. The influence of initial copper concentration has considerable effect on cumulative copper deposition. The copper deposition rate data could be interpreted by using shrinking core model. The effects of temperature and pH were substantial and have been studied and interpreted. The activation energy of the system within the temperature range of 23–54°C was found to be 14.23 (iron wire) and 30.20 kJ per mol (iron powder), respectively. The morphology of copper deposits studied showed that the reactions have the potential to produce particle sizes within nano range. [ABSTRACT FROM AUTHOR]