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A retail business is basically the business opportunity for retailers in Pakistan, it is said that when analysis is done on buyer's requirements, that what changed the attitude and purchasing power of market in Pakistan. The competitive market has involved all segments of market in it for increasing interest of retailer to do more. Our local market activities on the basis of retail requires more effort to competitive market and variation in the market. If anybody survives its existence in the competition of businesses for acceleration in the traditional views business and business factors are based on the decision making of individuals that improved value of research. The local market opted the judgement on questionnaire but a question order to identify analysis of business and performance of market in Pakistan but the capital services, labor services and marketing services towards successful efforts for improvement of local market business. The outcome of the current analysis proved that the pattern of ethics having direct relationship with decision-making of management for local activities when data for 2017 to 2022 is analyzed, depending on marketing perspective which is more dominant and influential in Pakistan by taking facts from Lahore and Faisalabad. To understand the human nature of Business ethics and management decision, it is very important to note that the important elements of achieving retail business is showing different results for this study. [ABSTRACT FROM AUTHOR]

The pandemics in modern history has posedseveral problems for human beings. The new COVID-19 pandemic has also indulged in generating damaging impact on the world's aggregate economy, health and education. The extended lockdowns contributed to changes in working conditions among the institutions. Institutions of education have also moved their classes to online system. Considering aggregate population of countries affected by this whole episode, bring drastically psychological issues among people. In various parts of society, problems which already have unrevealing prevalence due to unfairness are illustrated at higher levels.In this context, the current study explores the role of the socio-economic classes in the prevalence of COVID-19 anxiety among students from various Pakistani universities. The findings show that students with lower socio-economic backgrounds have greater concern about COVID-19 than students with lower, lower-middle, and upper-middle socio-economic backgrounds. The study suggests the setting up of university institutions to help students deal with the issue of anxiety. [ABSTRACT FROM AUTHOR]

Introduction: In this study, 140 patients were taken under observation for the period of six months which were receiving treatment from the Revised National TB Control Program (RNTCP) center of Maharishi Markandeshwar Institute of Medical Science and Research. Methodology: The present study is the counseling aimed at, assessing outcomes of Directly Observed Treatment Short course (DOTS) therapy by asking close ended questions with yes/no and the procedure assessment in DOTS centers. Results: The most common age group to be effected with tuberculosis was found to be between 21-30 years with the percentage of 35.71%. Patients affected with tuberculosis were frequent in the weight group of 40-54kg (57.96%). Tuberculosis was found to be prevalent in male patients those are chronic smokers (57.15%) than in female patients (42.85%). On categorizing tuberculosis on the basis of tubercular type, study revealed that patients were prevalent to pulmonary tuberculosis in our area with percentage of 75.7% and extra pulmonary tuberculosis patients were found to be 24.3%. Study showed that tuberculosis exists predominantly with morbidities. Conclusion: The concomitant illness to be occurring with tuberculosis in the highest prevalence was concluded to be hypertension (32%). Our study showed that the RNTCP center under observation was having 95% of patient compliance to treatment and patients were receiving direct observation and assistance in pill administration with adequate guidance and counseling. From the study, we concluded that prevalence of tuberculosis is higher in males (53.6%) than in females (46.4%). [ABSTRACT FROM AUTHOR]

A descriptive study was conducted in the Department of Respiratory Medicine in a tertiary care center of Ambala. Aim of the study was to determine the prevalence of fungal infection among patient presents with sputum negative old treated pulmonary tuberculosis. The study was carried out among 39 post treated cases of Pulmonary Tuberculosis, whose sputum or bronchial wash showed isolation of Aspergillus. Demographic details and clinical findings were noted. Data collected were entered into Excel spreadsheet and quantitative data were expressed as number and percentage. The presentation of pulmonary aspergillosis in treated cases of pulmonary TB varies from aspergilloma (51.3%) to chronic necrotizing pulmonary aspergillosis (38.4%) to allergic bronchopulmonary aspergillosis (10.3%). Hemoptysis (79.5%) of varying severity was the most common symptom. Most of the patients were farmers by occupation. The most common species were Aspergillus fumigatus; others were Aspergillus flavus, Aspergillus niger and Aspergillus terrus in 23.2%, 20.5%, and 12.8%, respectively. Here we conclude that Aspergillus fumigatus was the most frequently isolated species in our region and aspergilloma was the commonest pulmonary manifestation as post-TB sequel. [ABSTRACT FROM AUTHOR]

Aim: study the prevalence of various risk factors and co-morbidities in patients with acute exacerbation of chronic obstructive pulmonary disease. Material and Method: 73 patients admitted with AE-COPD data on body mass index (BMI), smoking, symptoms, co-morbidities course of the disease, spirometry management were obtained. Results: Eighty-eight percent of the admitted patients had current or past smoking habit of ‘Bidi’ and 9% were cigarette smokers. of admitted patients, 46% had at least one co-morbid condition. Mean FEV1 was 42.5%. Conclusion: Study concluded that the hospitalized patient with AE-COPD suggests spirometric impairments because majority of the patients had current or past smoking habits. Diabetes and cardiovascular diseases were found to be the major co-morbidities. [ABSTRACT FROM AUTHOR]

Cough as symptom to diagnose achalasia cardia. Achalasia typically presents with dysphagia and regurgitation of undigested food. Diagnosis is usually performed with esophageal manometry, barium swallow before macroscopic anatomical changes appear. But sometime cough as a symptom can diagnose. We present a 45-year old women whose diagnosis was suspected with chest-x-ray showing enlargement of right mediastinum. Diagnosis was then confirmed with upper endoscopy and barium swallow. [ABSTRACT FROM AUTHOR]

Sputum examination is the most widely used test for diagnosis of TB. Under RNTCP two samples of sputum are required for examinations which are preferably 1st spot and early morning sample or two spot samples collected on the same day. Patients usually come from far off places at the tertiary care centre and frequent visits are usually not possible. Giving an early morning sample is usually defaulted by the patient due to various reasons. The present study was aimed at studying the delay in giving the early morning sample and barriers in accessing the sputum smear microscopy services at a tertiary care hospital. In this study 300 presumptive TB patients were studied. Patients were asked to give a 1st spot sample for sputum smear examination and asked to bring early morning sputum sample. Patients who refused to give early morning sample were asked to give 2nd spot sample and the reason for not coming early morning were noted. The patients who did not come despite agreeing to come were noted. If they came after a delay of few days, then also the reason of delay were noted. It was found that nearly one third (31%) of the patients agreed and came on the next day to give early morning sample. A large number of patients (16%) did not come at all to give the early morning sample. [ABSTRACT FROM AUTHOR]

To study the prevalence of obstructive airway disease in patient of OSA diagnosed by polysomnography. Method: This study is a descriptive cross-sectional and was carried out in patients admitted in the department of Respiratory Medicine who were diagnosed with OSA after polysomnography. Total 41 patients who were diagnosed as cases of obstructive sleep apnea were clinically evaluated and investigated by history taking and final diagnosis were made as either COPD, Asthma on basis of GOLD and GINA guidelines respectively. Results: Mean age of the study participants was 50.95 years. Prevalence of Asthma and COPD among cases with OSA was 58.5% and 14.6%.Mean AHI and ESS score was 42.45 and 16.80 respectively. The most common co-morbid condition was GERD (19.5%). Conclusion: Present study concluded that asthma is more prevalent than COPD in patients of obstructive sleep apnea. The main factors associated with Obstructive lung diseases and its pathogenesis is the obesity, hypertension, smoking habits, adenoids, tonsillitis, musculoskeletal changes, weakness and atrophy of muscles of upper respiratory tract. [ABSTRACT FROM AUTHOR]

ntroduction: CBNAAT is a very useful rapid diagnostic test for the early diagnosis of DS and DR TB. Report of sample can be available in just 2 hours. But the results of these tests are not available for many days to weeks which results in delay in diagnosis and treatment initiation. Material and Method: This study was conducted for a period of 4 months from mid-April to mid-august 2018 in MMIMSR, Mullana. A total of 535 samples were sent for CBNAAT to TB Hospital, Ambala and the time taken from sending of samples to the receiving of report was analysed and time lag was calculated. Results: Out of 535 samples, 429 samples were negative, 104 were positive for MTB and 2 samples resulted as invalid/error. Out of 104 positive samples, 95 were rifampicin sensitive and 9 were rifampicin resistant MTB. The average time lag in reporting of CBNAAT samples was 11.1 days with shortest time being 2 days and longest being 33 days. Conclusion: CBNAAT is a very useful modality in TB diagnosis and should be made available to all eligible patients especially so in high DR-TB prevalence areas. But delay in reporting undermines the purpose of the test i.e. rapid diagnosis and treatment. There is an urgent need to establish more centres with CBNAAT facility throughout India so that there is no delay in reporting and early treatment can be started. [ABSTRACT FROM AUTHOR]

Tuberculosis is an infectious disease. It is caused by bacteria Mycobacterium Tuberculosis. It can be diagnosed by demonstrating AFB by either phenotypic method like sputum smear microscopy, culture or by genotypic method like NAAT or LPA. For better results there should be a good quality sputum sample. Induction of sputum is a method for improving the quality of sample. The most commonly used method is induction using 3% saline. It has been seen that during taking throat swab specimen patients usually produce cough. This induced cough can produce better quality of sputum. The following study was done to know about the role of throat swab as a method of sputum induction. [ABSTRACT FROM AUTHOR]

Background: Pulse oximetry is widely used in patients of respiratory diseases for monitoring the oxygen saturation in blood. First commercial pulse oximetry was used in 1975. Although there have been many improvements in its design since then, still there are a few limitations. The limitations of pulse oximetry include mechanical artefacts accuracy, electromagnetic interference, calibration, delay, pulse dependence volume and rhythm, abnormal haemoglobins, other absorbents, pulsatile veins, pigmentation. Objective: Despite so many studies on the pulse oximetry, there still isn’t any study on pulse oximetry which focused changes in the readings of pulse oximeter with respect to position of finger in relation to the sensor. So in this study we tried to analyse the effect of anatomical plane of finger on O2 saturation as measured by pulse oximetry. Material and Method: This study was done on 400 patients and included both healthy and unhealthy patients. Portable pulse oximeter was used in the study. Pulse oximetry was done on the subjects with finger in supine, prone and lateral position in respect to the probe, while the patient was in sitting position with a waiting period of 1 min between each reading. Results: The study shows no significant difference (p value > 0.05) between Spo2 value obtained from any position of finger in relation to the sensor while applying the pulse oximeter. Conclusion: Pulse oximetry is a very safe, non-invasive and inexpensive way of continuous O2 saturation monitoring in critical patients. Mal-positioning of sensors can be potentially dangerous as it may give erroneous high or low readings. The ways to prevent mal-positioning of the sensor are good design of pulse oximeter and ensuring that it is properly visible to the clinician. [ABSTRACT FROM AUTHOR]

The aim was to evaluate the inhalation technique among COPD patients using pressurized metered dose inhaler and determinants of incorrect inhalation technique. In this hospital based cross-sectional study, total 92 COPD patients were enrolled. Basic socio-demographic information was collected. The inhalation technique was visually observed and scored on checklist. Statistical Analysis Used: Chi-square test and Fisher exact test. Among the 92 patients observed, 69 (75.0%) were males. The mean age of the patients was 45.8 ± 1.4 years. Correct technique was observed in only 22 (23.9%) patients step at which maximum number of patients committed mistake was exhalation 65.2% followed by breath holding 45.7% and multiple actuations were seen in 44.5%. It was found that substantial errors were made in the inhalation technique hence proper training and follow-up of the patients is required to achieve the desired effects of the inhaled medications. [ABSTRACT FROM AUTHOR]

Objective: Identification of allergens by intradermal test in patients with asthma, allergic rhinitis, and eczema. Materials and Methods: Intradermal test was performed in 100 patients of Ambala over an 8-year period to identify the common allergens. A total of 197 allergens including 50 types of pollen, 19 fungi, 17 insects, 14 types of dust, 6 animal dander, 7 types of fabric and feather and 82 types of foods, dust mite, and parthenium were tested. Results: In this study, the major allergens were pollen (51%) followed by foods (28.9%), insects (26.9%), fungus (12.6%), dusts (6.7%). Among pollen allergens, Brassica campestris (8%) was a major allergen followed by Ageratum conyzoides (7%) and Artemisia scoparia (6%) Cannabis sativa, Cynodon dactylon and Maerua arenaria (5%). Among the fungal group, Alternaria tenuis, Aspergillus flavus, Aspergillus fumigates, Candida albicans, Penicillium sp., Rhizopus nigricans (3%), Fusarium solani (2%) were found. In the insect group, mosquito (7%), ant (6%), grasshopper (5%), locust (male), moth, and house fly (4%) were the major allergens. Among the dust allergens, grain dust rice (3%), straw dust, house dust, and grain dust bajra (2%) were found. Among the food allergens, prawn (5%), almonds, Baker's yeast, Bengal gram (3%) and mushroom, mango ripe, rajma, cinnamon, chocolate, beans fresh, and areca nut (2%) were found. Conclusion: It can be said that the knowledge may help to create a mapping of allergens in this area and help to treat patients by immunotherapy or avoidance strategy. [ABSTRACT FROM AUTHOR]

Introduction: the association of Tuberculosis and Diabetes Mellitus is a cause of concern for the health sector. The coexistence of these two highly prevalent diseases has made the already existing treatments very complex. This issue is of particular significance to developing countries like India that bear a significant burden of these two diseases. Methods: retrospective analysis of 1000 consecutively admitted patients in a tertiary care hospital were analyzed for the coexistence of Tuberculosis and Diabetes Mellitus. Results: the study found that a significant proportion of diabetic patients had coexistent tuberculosis (65.5%). Rural population was predominantly affected in both the genders. The study observed that the coexistence of these two conditions increased with advanced age. Conclusion: the coexistence of Diabetes Mellitus with Tuberculosis needs to identified early and adequately addressed. The rural population needs to be educated about these two conditions and seek timely medical care. [ABSTRACT FROM AUTHOR]

The interaction of genetic and environmental factors can determine individual susceptibility to various cancers. We studied the influence of NAT2 and codon 72 p53 polymorphisms on 151 patients with lung cancer and an equal number of matched population controls. Polymorphisms of NAT2 and p53 were determined by PCR-RFLP techniques. The results were analyzed using logistic regression analysis. A statistically significant relationship between NAT2*5 and NAT2*6 alleles and lung cancer risk was observed. In addition, the population with slow acetylator alleles for NAT2*5 and NAT2*6 had a significantly higher risk of lung cancer compared with rapid acetylator alleles both in smokers and nonsmokers. The combined genotype of heterozygous arginine ( Arg)/proline ( Pro), Pro/Pro, and slow acetylator alleles of NAT2*5 and NAT2*6 showed higher, although not significant, risk of lung cancer compared with Arg/Arg and rapid acetylator alleles of NAT2*5 and NAT2*6. In conclusion, these findings suggest that the influence of NAT2 genotype, alone or in combination with p53 genotype, may confer increased susceptibility to lung cancer. [ABSTRACT FROM AUTHOR]

DNA ligases play an essential role in repair, replication, and recombination of DNA, and catalyzes the formation of a phosphodiester bond at a nick junction on single- and double-strand breaks. We have conducted a hospital-based case–control study to examine the role of polymorphism of DNA repair gene ligase I ( LIGI) in the context of lung cancer risk for north Indian population. One hundred, fifty-one primary lung cancer cases and an equal number of matching hospital controls were collected. The LIGI polymorphism was determined by using the PCR-RFLP method. The association between polymorphisms in the LIGI gene with the risk of lung cancer was estimated by computing odds ratios (ORs) and a 95% confidence interval (CI) using a Multivariate Logistic Regression Analysis. The risk for lung cancer was not associated for individuals featuring LIGI (AC) (OR –0.8, 95% CI = 0.44–1.40) and (AA) (OR –0.8, 95% CI = 0.41–1.80) genotypes. The DNA repair gene ( LIGI) may not be playing an important role in modulating the risk of lung cancer in the north Indian population. [ABSTRACT FROM AUTHOR]

Two cases of cyclopic malformations are described among 450 infants of diabetic mothers during a period of four years. Both died within 30 min. of birth. Both belonged to unrelated Libyan families with absent consanguinity and family history. No chromosomal defect was found in either. A possible etiological association with uncontrolled maternal diabetes is discussed. [ABSTRACT FROM AUTHOR]