Search

Objective: The objective of this study was to determine the hemodynamic changes in the umbilical artery (UA) and middle cerebral artery (MCA) with oligohydramnios, during third trimester of pregnancy. Materials and Methods: A cross-sectional descriptive study was done in a perinatal ultrasound center, over a 9-month period. The participant sample size was 64, and all of the women were conveniently consented and selected for the study. All individuals were referred for obstetrical sonography in the third trimester, with oligohydramnios. All fetal anomalies, such as a neural tube defect, dwarfism, an abdominal wall defect, were excluded from the study. Results: The mean systolic to diastolic (S/D) ratio for the UA was 3.01, within a range of 1.49 to 5.60 (± 0.79 SD). The mean pulsatility index (PI), of the UA, was 1.11, within a range of 0.41 to 5.51 cm (± 0.64 SD). The mean resistive index (RI) of the UA was 0.66, within a range of 0.33 to 1.25 cm (± 0.13 SD). The mean S/D ratio of the MCA was 5.68, within a range of 2.05 to 26.10 (± 3.10 SD). The mean PI of the MCA was 1.67 within a range of 0.75 to 2.55 cm (± 0.45 SD). The mean resistive index (RI), of the UA, was 0.82 within a range of 0.51 to 1.77 cm (± 0.82 SD). Conclusion: The Doppler indices may rise as pregnancy advances, especially in fetuses with oligohydramnios. In these types of patients, the flow within the MCA may decrease, with an increase in the gestational age. Consequently, it appears that oligohydramnios may lead to vascular remodeling of the UA and MCA.

With the high competition in market, the increase in quality and reliability of gas sensors is highly desirable. Compatible gas sensors having high precision, high sensitivity, economical have attracted a lot of attention. For good gas sensing, research on sensing material have been broadly focused. An improvement in Nano technology and use of different materials has led to the development of efficient and effective gas sensors. The Nano- materials manifest properties that are incomparable with the granular polycrystalline counterpart. With the advancement in Micro and Nano technology, micro-sized gas sensors have been developed with great sensing performance. For detection of toxic gases various techniques are available but solid state gas sensors offer a wide spectrum of materials and their sensitivities towards various types of gases. Of all the solid state gas sensing materials, semiconductor metal oxide nanostructures are more preferable due to the stability of their oxides, high response, low cost for fabrication, response to wide range of chemicals etc. They are cost effective, reliable, and robust and have quick response time. In this paper we have studied about the semiconductor metal oxide gas sensors. The effects due to morphological structure on sensing properties are also discussed. The existing detailed literature survey on techniques and mechanisms for the nanostructures and their gas sensing ability are also involved.

Objective To explore the current evidences on effects of trigger point dry needling as a treatment strategy on pain and range of motion among subjects with lower extremity myofascial trigger areas. Methods The systematic review was conducted at the University Institute of Physical Therapy, Lahore, Pakistan, from February to August 2019, and comprised search of studies on Cochrane Library, PubMed, SPORTDiscus and PEDro databases published in the English language from 2000 to July 2019. The search terms used were 'Dry needling', 'Trigger points', 'Myofascial trigger points', 'Trigger area', 'Acupuncture therapy', 'Lower extremity' and 'Acupuncture'. Cochrane Risk of Bias tool was used to assess the randomised and non-randomised controlled trials. Methodological assessment was performed using Physiotherapy Evidence Database 10-point scale. Data synthesis was performed through vote counting method. Results Of the 564 articles initially found, 30(5.3%) were shortlisted for full-text assessment. Of them, 10(33.3%) were selected for final assessment; with 7(70%) scoring high and 3(30%) fair on the PEDro scale. All the 10(100%) studies documented improvement in the pain over time with dry needling strategy. None of the studies targeted any other outcome, like anxiety and sleep disturbances, related with myofascial trigger points. Conclusions On basis of the best evidences available, dry needling seemed to be effective in pain reduction related to lower extremity myofascial trigger points. Evidence also suggested that there was not much positive effect of myofascial trigger point dry needling on depression, anxiety, muscular strength and quality of life.

Incidence of colorectal cancer has surged in the past few decades, currently it accounts for approximately 10% cancer related mortality. Upfront curative surgery is the main stay of treatment for localized disease followed by adjuvant chemotherapy for high-risk disease; however, neo adjuvant chemoradiation followed by surgery and chemotherapy is a standard treatment for rectal cancer. Here, we present a case of a young male aged 33 years with eight months’ history of per rectal bleeding, associated with fever and weight loss who was later diagnosed as sigmoid colon adenocarcinoma. The patient managed to have only one cycle of neoadjuvant capecitabine, as his definitive surgery was delayed due to the rife in pandemic situation of Covid-19. Notably, follow up laparoscopic LAR specimen showed no residual disease, nevertheless, there was an eosinophilic abscess with a giant cell reaction and Ova of Ascaris lumbricoides, which seemingly contributed in achieving pathological complete response with minimal therapy.

It is widely believed that the tourism industry, particularly ecotourism, contributes significantly for sustainable development. However, planning for ecotourism development is a multi-criteria pro...

The ongoing COVID-19 pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in significant death and morbidity rates around the globe. SARS-CoV-2 infection has been linked to 43.3 million confirmed cases worldwide, killing 1.15 million people. Physical separation, quarantine, and isolation were successful in minimizing the number of individuals who became sick during the epidemic, but the lack of immunity in the community makes them vulnerable to further waves of SARS-CoV-2 infection. Elderly persons (those 60 and older) and those with pre-existing medical problems are particularly vulnerable. Material and Methods: In this observation study, people who were vaccinated with sinopharm vaccine and sinovac vaccine were included to see the response of vaccine in the body. The aim of the study was to compare the rise in the antibody level after 2 doses of two different COVID-19 vaccines i.e sinopharm and sinovac. Initially, in this pilot study, 40 people were included randomly from our health care team, after proper informed consent regarding the study. Results: Among total 40 people were involved, male were 21 of 40 (52.5%) and female were 19 of 40 (47.5%). Most of the individuals were doctors (26 of 40, 65%). Mean age, weight, height and body mass index (BMI) are also shown below. Conclusion: This study was to report the response of people of Pakistan toward sinopharm and sinoVac vaccines in terms of COVID antibody level. Response of the body was around 40 to 50% for sinopharm and 50 to 70 percent towards CoronaVac vaccine. Further data collection is being done to improve sample size and better outcome.

This research strives to explain the impact of personality type on the work-life balance of women academicians. With the positivist paradigm and quantitative approach, this study has been conducted with a survey methodology. Data was collected from 362 women academicians on adopted instruments and analyzed with multiple regression and ANOVA tests. Results revealed a positive effect of agreeableness, extraversion, and openness personality types on work-life balance. Those women academicians who are with agreeableness personalities are more in a capacity to manage their work-life balance. The results also show a difference in managing the work-life balance between those who are single and married, those who belong to a nuclear family, and those who belong to joint or extended families. This study will facilitate them to develop the personality type which has more capacity to manage work-life balance. It will help policymakers to facilitate women academicians to ensure better work-life balance.JEL Classification: M12How to Cite:Shahin, S., Baloch, M. N., Shaikh, N., Ibrahim, I., & Abbassi, A. A. (2021). Women in the Whirlpool: Traversing the Tie-up of Personality and Work-Life Balance of Pakistani Academicians. Etikonomi, 20(2), xx – xx. https://doi.org/10.15408/etk.v20i2.17272.

Work productivity is one of the most important economic measures in the manufacturing industry. However, the physical, psychosocial and individual risk factors of an industrial work environment affect workers' physical or mental health, resulting in work productivity loss, absenteeism and presenteeism. Therefore, this study aims to identify the most critical risk factors and develop statistical models for predicting work productivity loss, absenteeism and presenteeism of garment industry workers. A sample of 224 sewing machine operators was taken for data collection through observation and self-reported studies. The results indicated that the average work productivity loss, absenteeism and presenteeism was 38.21, 2.35 and 37.23%, respectively. Finally, the statistical models of work productivity loss, absenteeism and presenteeism was developed using multiple linear regression with precision of 69.9, 53.7 and 84.0%, respectively. Hence, this study will help garment industries to improve their work productivity by taking initiatives based on the developed models.

Objective: The objective of the study is to determine the occurrence, frequency, and severity of significant drug-drug interactions in stroke patients, with an emphasis on post complications and their symptomatic management. Methods: A prospective observational study was carried out for 6 mo at Osmania General Hospital, a Tertiary Care Teaching Hospital. The prescriptions taken by stroke patients throughout their hospital stay were analyzed for possible interactions using-Micromedex-2 (Thomson Reuters) × 2.0. Results: A total of 130 prescriptions was analyzed in the study in which 141 drug-drug interactions were found with a male predominance of 85.4%. The majority of interactions were of moderate severity (74.46%) and pharmacokinetics (67.37%) in nature. Among the clinical consequences, decreased atorvastatin efficacy (49.10%) was found to be the highest. The class of drugs most commonly involved in drug-drug interactions was found to be anti-epileptics and statins. 60.15% of the study population were identified with one complication, among which seizures account for 15% of patients. All the complications allied with the condition were treated with drug classes in the study population. Conclusion: This study highlighted the exigency for screening prescriptions of cerebrovascular accident patients for potential drug-drug interactions (pDDIs). Brain edema and seizure were the most accountable complications identified in the study population. The early detection of these problems can improve stroke outcomes and can reduce the mortality or disability rate.

Objective: Female infertility may be a commonly encountered problem that presently accounts for a great percentage of women seeking gynecologic services. A systematic review was preformed to evaluate the most common cause of infertility, using sonography. Materials and Methods: A search was executed with Google Scholar, PubMed, NCBI, and Medscape databases, from 2001 to 2020. Two investigators independently reviewed and assessed those studies for eligibility. The data were tabulated in a Microsoft Excel sheet. The Statistical Package for the Social Sciences (SPSS), version 24 software was used to evaluate the data. Results: Out of 70 studies, the contributing factors, detected with sonography, for infertility were as follows: polycystic ovarian syndrome (PCOS), 44.9%; fibroids, 43.6%; endometriosis, 33.3%; polyps, 29.5%; adhesions, 29.5%; pelvic inflammatory disease, 23.1%; ovarian cysts, 23.1%; congenital anomalies, 20.5%; and adenomyosis, 11.5%. Conclusion: The most common cause of infertility, detected with sonography, was PCOS, and the least contributor to infertility was adenomyosis.

Objective: To assess the diagnostic accuracy of sonomammography in diagnosis of BIRADS ≥4 suspicious breast lesions taking histopathology as gold standard. Design of the Study: It was a descriptive cross-sectional study. Study Settings: This study was carried out at Department Of Diagnostic Radiology And Diagnostic Imaging Combined Military Hospital, Lahore from January 2017 to June 2017. Material and Methods: A total of 190 patients of age 30-70 years, presenting with palpable breast lesions with BIRAD ≥4 undergoing biopsy under local anesthesia were included. Patients with already diagnosed with breast cancer and recurrent breast lesion were excluded. Then all patients were undergone USG by using a high-resolution unit (PLM703AT) with a linear array probe centered at 7, 5 MHz, along with mammography using mamomet 3000 NOVA SIEMENS, General Electric Medical Systems, Milwaukee. Patients were labeled as positive or negative. Sonomammography findings were correlated with histopathological findings. Results of the Study: In 117 sonomammography positive patients, 107 (True Positive) had malignant breast lesions and 08 (False Positive) had benign on histopathology findings. Among, 75 sonomammography negative patients, 06 (False Negative) had malignant breast lesions on histopathology whereas 69 (True Negative) had benign lesions on histopathology. Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of sonomammography in diagnosis of BIRADS ≥4 suspicious breast lesions taking histopathology as gold standard was 94.69%, 89.61%, 93.04%, 92.0% and 92.63% respectively. Conclusion: This study concluded that diagnostic accuracy of sonomammography in diagnosis of BIRADS ≥4 suspicious breast lesions is quite high. Keywords: Breast lesions, malignant, sonomammography, sensitivity.

Background: Optical coherence tomography (OCT) derived pachymetry mapping has potential in diagnosis of early and advancing keratoconus. The OCT corneal pachymetry map–based logistic regression formula and the keratoconus risk scoring system has been proven to provide very accurate results in keratoconus identification. In keratoconus screening these techniques might be helpful. Objectives: To ascertain the diagnostic accuracy of anterior segment optical coherence tomographic corneal pachymetry to diagnose the cases the cases of early keratoconus by using corneal topography as a high standard with which other techniques of these kinds are compared. Study Design: Cross-sectional (validation) study. Duration: One year from July 01, 2019 to June 30, 2020. Settings: Department of Ophthalmology, Allied Hospital/DHQ Hospital, Faisalabad Pakistan. Methodology: A total of 195 patients having asymmetrical astigmatism (>1 diopter), 12-40 years of age of both genders were included. Patients with corneal ulcer and corneal opacity were excluded. After complete examination corneal topography and anterior segment optical coherence tomography was performed. Tomographic minimum central corneal thickness was recorded and assessed for cutoff value, if exceeding cutoff value patient was diagnosed with the early keratoconus. Results: In OCT pachymetry positive patients, 103 (True Positive) had early keratoconus and 05 (False Positive) had no early keratoconus on corneal topography. Among 87, OCT pachymetry negative patients, 04 (False Negative) had early keratoconus on corneal topography whereas 83 (True Negative) had no early keratoconus on corneal topography (p=0.0001). Overall sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of anterior segment optical coherence tomographic corneal pachymetry to diagnose the cases of early keratoconus in the suspected individuals by using corneal topography as gold standard was 96.26%, 94.32%, 95.37%, 95.40% and 95.38% respectively. Conclusion: This study concluded that diagnostic accuracy of anterior segment optical coherence tomographic corneal pachymetry to find out the cases of early keratoconus is very high. Keywords: Optical coherence tomographic corneal pachymetry, Keratoconus, Sensitivity

Introduction: Liver Cancer is aggressive cancer and patients are mostly screened and diagnosed when they become symptomatic at advanced. Disease severity, depression, fatigue, joint pain, and poor appetite have been reported as strong determinants of quality of life (QoL) among liver cancer patients. Aims: The objective of the study was to assess the quality of life and depression among liver cancer patients in Pakistan. Study Design: A descriptive cross-sectional study design was used. Place and Duration of Study: The study was conducted in healthcare facilities of Islamabad and Rawalpindi, Pakistan between June 2020-December 2020. Methodology: Two pre-validated questionnaires i.e. EORTC QLQ-C30 and HADS were self-administered to a sample of 100 liver cancer patients selected using a convenience sampling technique for measuring QoL and depression, respectively. After data collection, data was cleaned, coded, and entered in SPSS. Results: The results highlighted that the lowest scores observed in the domain of symptom scale were: Nausea and Vomiting (23.72, ± 28.238), Dyspnea (25.27, ± 26.90), Constipation (26.03, ± 34.75) followed by Diarrhea (22.63, ± 28.42), whereas highest scores in the symptom scale were observed in the domain of fatigue (37.69, ± 20.06), pain (40.37, ± 18.44), insomnia (41.65, ± 32.37) and financial difficulties (60.33, ± 33.830). On the other hand, highest score on the functional scale was observed for physical functioning (64, ± 21.76) and the lowest score was observed in social functioning (53.19, ± 20.66). Conclusion: The present study concluded that liver cancer had a negative impact on risk factors/past medical history, co-morbidities, and poor socio-economic of life across all domains along with moderate depression in liver cancer patients. Illiteracy, advanced liver cancer stage, risk factors/past medical history, co-morbidities and poor socio-economic status negatively affected functional and symptom scale. Appropriate health educational and psychological interventional programs targeting patients should be initiated to improve awareness and reduce depression among liver cancer patients.

Future climate scenarios are predicting considerable threats to sustainable maize production in arid and semi-arid regions. These adverse impacts can be minimized by adopting modern agricultural tools to assess and develop successful adaptation practices. A multi-model approach (climate and crop) was used to assess the impacts and uncertainties of climate change on maize crop. An extensive field study was conducted to explore the temporal thermal variations on maize hybrids grown at farmer’s fields for ten sowing dates during two consecutive growing years. Data about phenology, morphology, biomass development, and yield were recorded by adopting standard procedures and protocols. The CSM-CERES, APSIM, and CSM-IXIM-Maize models were calibrated and evaluated. Five GCMs among 29 were selected based on classification into different groups and uncertainty to predict climatic changes in the future. The results predicted that there would be a rise in temperature (1.57–3.29 °C) during the maize growing season in five General Circulation Models (GCMs) by using RCP 8.5 scenarios for the mid-century (2040–2069) as compared with the baseline (1980–2015). The CERES-Maize and APSIM-Maize model showed lower root mean square error values (2.78 and 5.41), higher d-index (0.85 and 0.87) along reliable R2 (0.89 and 0.89), respectively for days to anthesis and maturity, while the CSM-IXIM-Maize model performed well for growth parameters (leaf area index, total dry matter) and yield with reasonably good statistical indices. The CSM-IXIM-Maize model performed well for all hybrids during both years whereas climate models, NorESM1-M and IPSL-CM5A-MR, showed less uncertain results for climate change impacts. Maize models along GCMs predicted a reduction in yield (8–55%) than baseline. Maize crop may face a high yield decline that could be overcome by modifying the sowing dates and fertilizer (fertigation) and heat and drought-tolerant hybrids.

Background: Since the prevalence and awareness AutismSpectrum Disorders (ASD) is growing day by day, it is crucial to correctly allocate diagnosis of ASD. According to the guidelines, there should be a multi-agency strategy group for diagnosis of ASD. Aim: To find out the diagnostic practices of ASD among different Health Professionals. Place and Duration of Study: Riphah International University, Lahore campus. The study was conducted from October 2017 till March 2018. Methodology: Data was collected from 116 professionals which included Speech-Language Pathologists, Pediatricians, Psychiatrists, Psychologists and Occupational Therapists by using questionnaire. A cross-sectional survey was carried out by using the technique of convenient sampling. Researcher collected the data from Riphah International University in person and some professionals were sent questionnaires online. Results: Majority of professionals provide diagnostic service i.e. 84.4% as a part of multidisciplinary team whereas 15.6% are sole practitioners for giving diagnosis; 51.1% collaborate with other professionals to make a consensus diagnosis and the most frequently used tool by professionals for diagnosing ASD is Childhood Autism Rating Scale CARS (76.7%) and Diagnostic and Statistical Manual of Mental Disorders V/IV (DSM V OR IV) criteria (67.8%). Conclusion: The professionals in the current study are using multidisciplinary approach for diagnosing ASD and a small number are sole practitioners. The most frequently used tool for diagnosing ASD are CARS and DSM V OR IV criteria. However, very few practitioners use the diagnostic tool Autism Diagnostic Observation Schedule ADOS and Autism Diagnostic Interview-Revised ADI-R. The professionals who provide diagnosis of ASD are Speech and language Pathologists, Psychologists, pediatricians, psychiatrists and Occupational therapists.

Objective:To find causes of maternal deaths and to calculate maternal mortality ratio at tertiary care hospital Karachi. Study Design and setting:An observational study was conducted from1st January 2019 to 31stDecember 2020 at theDepartment of Obstetrics & Gynecology Unit 1, JPMC Karachi. Methodology:Patients were selected according to inclusion criteria after ethical approval through non probability consecutivesampling technique. Details of patients were obtained from filesand record registers. Their demographic feature like age,parity, gestational age, booking status and presence or absence of medical disorders, their status of delivery and direct andindirect reasons of maternal deaths were noted and their frequency and percentages were calculated. Brought dead patientsand those who died accidently were excluded from the study. Results:During the period of two years the total numbers of deaths certified in the department were 90. Total number ofchild birth and live births were 19084 and 17892 respectively. The maternal mortality ratio was estimated as 503.01 per100,000 live births. Most of the patients 74(82.3%) were un booked. Direct Causes were about 67(74.5%). Haemorrhagewas found to be most common reason of maternal deaths in about21(23.3%). Eclampsia among18(20%) deaths. Anemia, cardiac disease, hepatic failure were the indirect causes of maternal deaths responsible for 23 (25.5%) of maternal deaths. Conclusion:Maternal Death rate is persistently elevated in JPMC, being tertiary care hospital mostly due to serious and referred complicated cases. Haemorrhage and eclampsia are still major killers of mothers as before.

Objective: To find out correlation of body measurements and exercise with blood pressure among medical students in Lahore, Pakistan. Study Design: Correlational study. Place and Duration of Study: Akhtar Saeed Medical and Dental College, Lahore, from May to Jul 2018. Methodology: A sample of 332 students was recruited through simple random sampling technique. Resting blood pressure in sitting position along with body mass index of respondents were taken after informed consent. Results: Mean age of respondents was 21.06 ± 1.53 years. Mean sitting systolic blood pressure was 117.5 ± 8.24mm Hg, Mean sitting diastolic blood pressure was 77.9 ± 7.05mm Hg. Significant association was found between weight and both Systolic (r=1, p≤0.00) and Diastolic (r=0.01, p=0.05) blood pressure. Height was negatively correlated with systolic blood pressure (r=-0.004) and diastolic blood pressure (r=-0.07). Body mass index was also significantly associated with systolic blood pressure (r=1, p≤0.00) and diastolic blood pressures (r=0.14, p=0.00). Significant association is found between systolic blood pressure and exercise with number of days (r=-0.15, p=0.05) and diastolic blood pressure (r=-0.11, p=0.00) and duration of exercise with systolic blood pressure (r=-0.13, p=0.01) and diastolic blood pressure (r=-0.16, p=0.04). Conclusion: Weight and Body mass index are positively correlated with systolic and diastolic blood pressure.Keywords: , , , .

Objective: To compare the corneal epithelium healing time and post-operative pain after pterygium surgery with and without he use of autologous serum drops. Study Design: Comparative cross-sectional study. Place and Duration of Study: Eye Department, Combined Military Hospital Quetta, from Jan to Aug 2019. Methodology: Twenty patients were included in this study and divided into two groups. All patients underwent pterygium excision with conjunctival autograft. Fourteen of them were instilled with autologous serum drops while 14 were given lubricants postoperatively until corneal epithelium healed completely. Corneal epithelium healing time, visual analog scale for postoperative pain assessment, conjunctival inflammation and recurrences were evaluated. Patients were followed up for 6 months. Results: For corneal epithelial healing, 1 (7.14%) patient showed complete healing on day 2 while 7 (50%) showed healing on day 3 and 6 (42.86%) on day 4. While in non-autologous serum drops group 7 (50%) showed complete healing on day 4 while 4 (28.57%) showed healing on day 5 and 3 (21.43%) on day 6. The mean corneal healing time of autologous serum drops group was 3.36 ± 0.63 days and that of non-autologous serum drops group was 4.71 ± 0.83 days. Patients of autologous serum drops group also experienced significantly less pain as compared to the non-autologous serum drops group. While the recurrence rate and conjunctival inflammation in the two groups was found to be of equal degree. Conclusion: Patients who used autologous serum eye drops post operatively experienced less pain and their corneal epithelium healed earlier than the.......

The primary objective of study is to know the influence of behavioral factors on investor’s investment decision and investment performance. Four behavioral factors as herding, prospect factors and market factors are used in this study and financial literacy as a moderating variable among the behavioral factors and investment decision. We use the questionnaire to collect primary data from individual investors actually trading in Pakistan Stock Exchange. For data analysis, we utilize AMOS software and Hayes Process tool in two stages. The findings reveal that behavioral factors positively influence investment decision and investment performance. But there is no moderating role of financial literacy. In addition to these, individual investors and security organizations can ultimately take advantage from the results of this research as a guide for their analysis and forecasting of security market trends in order to maximize the outcome and to improve their investment efficiency. Further, study recommended investigation of all investor types and in all financial markets including the behaviors of institutional investors along with behavioral financial factors; we should consider some economic factors that could have an impact on investors' decisions.

Background:. The MNS16A variable number tandem repeat (VNTR) polymorphism of the human telomerase reverse transcriptase (hTERT) gene acts as a regulator of hTERT promoter activity and has been shown to have a role in the predisposition toward various cancers. The current study aimed to investigate the association between MNS16A VNTR alleles and genetic predisposition to bladder cancer in the Kashmir region of northern India. Materials and methods:. A total of 130 patients with bladder cancer and 170 age- and gender-matched healthy controls were included in this study. Primer-specific polymerase chain reaction was used to genotype the different variants of VNTR alleles of the MNS16A VNTR polymorphism. Results:. Short allele VNTR-243 (SS) genotype frequency significantly differed between cases (9.23%) and controls (3.52%) (OR = 3.08 [95% CI = 1.10–8.61], p = 0.042). The VNTR-243 short allele (S) was found significantly more frequent in bladder cancer cases (28.46%) than controls (20.88%) (OR = 1.50 [95% CI = 1.03–2.19], p = 0.034). Likewise, the long allele (LL) hTERT MNS16A genotype was distributed more frequently in low stage disease versus high stage disease (60.29% vs. 39.70%) (OR = 0.79 [95% CI = 0.39–1.60], p = 0.595). Conclusion:. The MNS16A VNTR short allele (S) was associated with a higher risk for bladder cancer in our population as compared to long alleles.

Considering that antimicrobial resistance (AMR) is a global challenge, there is a dire need to gauge the knowledge, attitude, and practice (KAP) of clinicians in endemic countries. The aim of the current multicenter, cross-sectional study was to highlight the knowledge, aptitude and practice gaps in antimicrobial (AM) stewardship and AMR among practicing doctors working in public tertiary care teaching hospitals of Lahore, Pakistan. A KAP survey, based on a self-administered questionnaire containing 45 questions, was conducted among 336 clinicians practicing in 6 randomly selected hospitals of Lahore, Pakistan. Overall, 92% of the clinicians considered AMR as a worldwide problem but only 66% disagreed that cold and flu symptoms require antibiotics. Moreover, around 68% doctors felt confident about their practice in AM but still 96% felt need to get more knowledge about AM. Need to establish courses on rational antibiotic use was demanded by 84% of participants. The main contributing factors considered for AMR by the doctors included excessive AM usage in medical profession (87.1%) and multiple antibiotics per prescription (76.4%). Pharmacologically, AM spectrum was accurately chosen by 1.4% (ampicillin), 0.003% (erythromycin) and 0% (levofloxacin). Clinically, a more than 50% of clinicians used miscellaneous AM for empirical therapy of respiratory tract infection and cholecystitis. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 25. The knowledge of clinicians is relatively poor in AM spectrum and drugs of choice for certain infections. However, they know about their short comings with positive approach towards improvement.

Evans syndrome (ES) is characterized by autoimmune hemolytic anemia (AIHA) and immune-mediated thrombocytopenia. It is more common in the pediatric population than in adults. ES has been reported to be associated with thrombotic events and rarely can lead to acute coronary syndrome (ACS). There have been only a few reported cases of ACS secondary to ES. We present an interesting case of ES with unstable angina (UA) which had a limited response to oral and intravenous (IV) steroids requiring rituximab. A 64-year-old male with past medical history significant for hypertension, hyperlipidemia, diabetes mellitus and coronary artery disease, presented to the emergency room complaining of a 2-week history of chest pain, shortness of breath and hematuria. Physical examination indicated splenomegaly but was otherwise unremarkable with no petechiae or rash. Labs showed hemoglobin of 9.6 g/dL, platelet count 58 × 10 3 /µL, troponin < 0.03 ng/mL, lactic acid 2.5 mmol/L and with parameters indicative of hemolysis, evidenced by elevated lactate dehydrogenase, low haptoglobin and elevated bilirubin levels. Electrocardiography (EKG) demonstrated ST depression in leads I, aVL, V5 - V6 and T wave inversions in lead III and aVL, which were new compared to previous EKG. Peripheral blood smear indicated spherocytes. Direct antiglobulin test was positive for immunoglobulin G (IgG). Patient was admitted for ES and initially treated with oral prednisone 80 mg daily. He was also diagnosed with UA thought to be possibly secondary to ES. He then underwent cardiac stress test which showed mild reversible inferior apical ischemia. Cardiac catheterization revealed 95% stenosis of proximal left circumflex artery requiring single drug eluding stent placement and dual antiplatelet therapy. Patient continued to have anemia despite blood transfusions, although platelet count improved. Prednisone was transitioned to high-dose IV dexamethasone, and patient was also started on rituximab which resulted in stabilization of anemia. The presentation of ES with ACS is a rare occurrence. ACS can be challenging to manage as stent placement may be required followed by dual antiplatelet therapy. Treatment of ES involves steroids followed by rituximab, IV immunoglobulin (IVIG) or splenectomy for non-responsive cases. Early intervention and management can prevent mortality and morbidity. J Med Cases. 2021;12(10):415-418 doi: https://doi.org/10.14740/jmc3777

In the current era of social media, different platforms such as Twitter and Facebook have frequently been used by leaders and the followers of political parties to participate in political events, campaigns, and elections. The acquisition, analysis, and presentation of such content have received considerable attention from opinion‐mining researchers. For this purpose, different supervised and unsupervised techniques have been used. However, they have produced less efficient results, which need to be improved by incorporating additional classifiers with the extended data sets. The authors investigate different supervised machine learning classifiers for classifying the political affiliations of users. For this purpose, a data set of political reviews is acquired from Twitter and annotated with different polarity classes. After pre‐processing, different machine learning classifiers like K‐nearest neighbor, naïve Bayes, support vector machine, extreme gradient boosting, and others, are applied. Experimental results illustrate that support vector machine and extreme gradient boosting have shown promising results for predicting political affiliations.

Stress shifts plant growth in nearly all species evident by developmental problems, such as decreased yield of dry matter and leaf area. However, few plants remain least affected or may nearly be remain unaffected. Primarily stress includes metal toxicity, a key source of abiotic stress influencing the health of plants. In general, metal toxification has been one of the major challenges in developmental processes. To combat this, remarkable number of plants have been recognized that have produced noteworthy effects in detoxification. In the current scenario, remediation focused on plants shows a growing potential against organic/inorganic polluted soils which is technically termed as “Phytoremediation.” Phytoremediation requires multiple methods for eliminating toxins from soil, in general through altered expression of genes and enzymes in plants. Few studies have also reported the application of plant-associated microbiota for decontamination polluted soils, sediments, and underground water and thus are currently being expanded as an ecologically sound and budget-friendly technology. Various latest advancements in recognizing plant cell/molecular processes of uptake/tolerance have also been well studied. New innovative molecular technologies have improved the perspective further into metabolic pathways involved in stress tolerance/prevention mechanisms in frequent cultivated crops and hyperaccumulator plants. The purpose of this chapter is to concentrate on the underlying molecular basis associated in detoxification and tolerance to contaminants by plants. In addition, the focus in this chapter is on the ability of “omics” and genetic modification strategies to effectively remediate a contaminated environment has also been described

XYZ e-commerce is a company that sells an agricultural product that draws benefits from the COVID-19 pandemic. The purpose of this research was to analyze CRM factors, satisfaction, and consumer loyalty. This study using quantitative research selected with convenience sampling. The online survey applied toward 232 respondents who were unsatisfied with the service in Jabodetabek and processed using Structural Equation Model (SEM). Based on the SEM results, it was found that CRM has a significant effect on consumer satisfaction and consumer satisfaction with consumer loyalty. In contrast, CRM has no significant effect on consumer loyalty. This research concluded that XYZ needs to become a company that makes it easy for consumers, is professional, reliable and trustworthy. However, efforts need to be made to improve the relationship between criticism and suggestions, communication and providing information, regulating product availability, delivery time, and saving consumer costs—the results of this research results are expected to increase satisfaction and loyalty through the CRM approach.

Objective: To determine the frequency of organisms causing onychomycosis in a tertiary care hospital. Study Design: Cross-sectional study Setting and Duration: The Department of Dermatology, PNS Shifa Hospital, Karachi for duration of six months from 1st September 2019 to 28th February 2020 Material and Methods: Total 395 patients were included. Affected nail was cleaned with 70% alcohol and nail clipping was done. Scrapings were collected from distal portion of nail plate, the nail bed and undersurface of the nail. In case of multiple nail involvement, the nail that was most severely affected was selected. The culture plates were put to incubation and observed for 4 weeks period for the presence of growth. Descriptive statistics were calculated. Stratification was done. Poststratification chi-square test was applied. P-value ≤0.05 was considered as significant. Results: There were 63.8% male and 36.2% female patients. Color change of nail was observed in 94.9% cases, subungual hyperkeratosis in 28.6% cases, distal onycholysis in 24.6% cases, total nail plate dystrophy in 22% cases, partial nail plate dystrophy in 11.6% cases, and transverse ridges in 21.8% cases. Total 82.8% cases were classified as dermatophyte, 5.3% as yeast and 11.9% as non-dermatophytic mould. Conclusion: In conclusion, our study results showed that most prevalent mycological type of isolate was dermatophyte, followed by non-dermatophytic mould, and yeast. Keywords: Frequency, Organisms, Onychomycosis

Aims: To find out health related quality of life among patients being treated for tuberculosis in the hospital of Lahore, Pakistan. Study Design: Cross sectional survey is used as research design in this study. Place and Duration of Study: Farooq Hospital west wood branch Lahore, Gulab Davi Hospital Lahore, Social Security Hospital Lahore between June 2020 and July 2021. Methodology: Sample (N=150) was drawn through purposive sampling technique from various hospitals of Lahore with age range of 18 – 65 years of 56.7% male and 43.3% female patients of Tuberculosis.Standardized questionnaire (SF-36) was used to determine the health related quality of Life. This questionnaire determines the effect of TB on physical activities, social activities, emotional activities and limitation in routinely work. Data was analyzed through SPSS with descriptive statistic of frequency and percentages. Results: On the basis of total scores of general health category 53.3% patients considers their health as good when taking antituberculosis medicine. Total scores of Limitations of activities 70.7% patients considers their social activities limited a lot. On the basis of total score of physical health problem category 81.3% considered their physical health were not affected. On the basis of total score of social activities 70.0% patients considered their emotional health problems interfered with normal social activities affected. Conclusion: It was concluded that limitations of physical activity and compromised psychological status impacted the HRQOL in patient with pulmonary TB. Tuberculosis effect on patient’s physical, psychological and social activities of daily routine. Patient become bed bound due dyspnea and unable complete their task to fulfill the needs of life.

PurposeThe purpose of this study is to determine the effect of conscientiousness and extraversion personality traits on project success. The relationship is mediated by affective professional commitment, whilst the relationship between personality traits and project success is moderated by organizational project management maturity.Design/methodology/approachThe deductive approach is used to achieve the objectives of this study. Data were collected through a purposive sampling technique from 250 respondents with the help of questionnaires from information technology sectors. The structural equation modelling (SEM) in partial least squares-SEM and SPSS is used to analyse the data and to examine the hypothesis.FindingsThe outcomes demonstrate the partial mediating impact of affective professional commitment between the relationship of conscientiousness and extraversion personalities with project success. Additionally, it proves the moderating effects of project management maturity between the relationship of conscientiousness and extraversion personalities with project success.Practical implicationsThis study reflects that employee personality appears to be a reliable indicator of how an employee is faithful to his profession. This faithfulness or duty decides the employee’s execution in terms of offering a successful project. Thus, achieving employee commitment needs to be done by completing the project successfully by the organizations in the presence of project management maturity systems.Originality/valueIt is the first study of its kind to provide experimental proof of the impact of a manager’s personality traits on project success in the presence of affective professional commitment (mediator) and organizational project management maturity (moderator).

Background: This study investigated the effect of planter fascia stretch and heel pad with moist heat in the patients of planterfascitis among subjects aged 20-40. Planter fascia is a thickened fibrous sheet of connective tissue which begins from medial tubercle on undersurface of calcaneus and fans out joining to the metatarsophalangeal joints plates to form longitudinal foot arch. Manual active stretching or passive stretching of planter fascia and Achilles tendon are effective treatment option for patient with planter fasciitis. Aims and objectives: objectives of this study were to see the effect of planter fascia stretch and heel pad with moist heat in the patients of planterfascitis. Material and methodology: This study was quasi experimental study. It took samples by convenient method from 80 subjects among Faisalabad private hospitals community. The study was completed in the duration of 3 months. Data was conducted through convenient sampling from Faisalabad private hospitals. This study explored the effect of planter fascia stretch and heel pad with moist heat on subjects aging 20-40 years old. Subjects were allocated to group A (n=40) and group B (n=40). Group A received treatment as planter fascia stretch and group B received treatment as heel pad with moist heat. Follow up were taken after 4 weeks in 3 month duration study. Results: Statistical Analysis Data were analyzed using SPSS version 23.0. Intragroup comparison of differences between pre and post intervention scores of FFI and FADI was analyzed using independent T Test. The results were considered statistically significant if p values were less than 0.05). No statistically significant difference was observed in pre intervention score between the groups on FADI (p = 0.211) and FFI (p = 0.365), but, statistically significant difference was observed between all the groups on post intervention score with respect to FADI (p=0.000) and FFI (p=.001) as analyzed by independent t test. Conclusion: After applying the entire treatments and measuring pre and post value it conducted that planter fascia stretch has more significant effect on planterfascitis than heel pad with moist heat.

The progression of Internet of Things (IoT) has resulted in generation of huge amount of data. Effective handling and analysis of such big volumes of data proposes a crucial challenge. Existing cloud-based frameworks of Big Data visualization are rising costs for servers, equipment, and energy consumption. There is a need for a green solution targeting lesser cost and energy consumption with tamper-proof record-keeping, storage, and interactive visualization with only demanded data. We have proposed a Blockchain-based Green big data Visualization (BGbV) solution using Hyperledger Sawtooth for optimum utilization of organization resources. BGbV will support current distributed data visualization platforms and guarantee benefits like security and data availability with lesser storage costs. It helps reduce costs by utilizing small resources that are already available and consume less energy, making it an environmentally friendly solution.

Hydrogen generation through solar-water splitting is expected to address the global energy crisis by providing a source for a safer and sustainable alternative fuel. Herein, we report a facile synthesis of Cu2O nanowires and show that the magnetic field could influence the nanowires’ distribution and alignment. Orientation of nanowires was observed to become more inclined towards the magnetic field lines as the values of full-width at half maximum decreased from 140° to 46.2° with the increase in the field strength. Crystallographic, morphological, optoelectronic, and photoelectrochemical properties of the constructed p-n homojunction were analyzed by using different characterization techniques. A high built-in potential of +0.93 V vs. RHE was observed for a 50 nm layer of n-Cu2O over p-Cu2O nanowires that resulted in a significantly high photocurrent density of −7.42 mA/cm2. The stability in the photoelectrochemical medium was maintained for 14 h, generating 20 mmol/cm2 of H2.

Objective: Focused assessment with sonography for trauma (FAST) is a widely used imaging technique for the diagnosis of blunt abdominal trauma and has its limitations and advantages. A meta-analysis was completed to evaluate the reliability of FAST, in the diagnosis of blunt torso trauma. Materials and Methods: A search was completed with Google Scholar, PubMed, National Center for Biotechnology Information (NCBI), MEDLINE, and Medscape databases, from 1993 up to 2020. Eligible studies were included for information about FAST examination of abdominal trauma. The animal research was excluded from this review process. The eligible studies were first categorized and then data analysis was performed, according to specific pathologic conditions. This literature review retrieved studies’ sample size, application, sensitivity, and a specificity of diagnosis using FAST for abdominal trauma. Results: In total, 100 articles were identified through the database search. Besides, five articles were identified through other sources. Then, screening was performed, and as such, 46 published studies were included that had a qualitative synthesis. Conclusion: FAST has a high sensitivity and specificity in the diagnosis of blunt abdominal trauma. However, a large range of sensitivity and specificity of FAST in the evaluation of torso trauma reveal that sonography is operator, technique, and equipment dependent.

Purpose of the study: This research examines the emerging tendency of brands utilization and its impacts on the life satisfaction of university students. Methodology: It is a quantitative study where a survey research method has been used, and for data collection, the questionnaire has been prepared. Demographic variables like area, age, gender, qualification, and location are also included. A sample of 385 students was selected by using the proportional allocation method. Statistical analysis for data was done through SPSS software. Researchers used a linear regression analysis test to find out the impacts of brand utilization on the life satisfaction of university students. Principal Findings: The findings of the study show that life satisfaction has a significantly negative correlation with brand utilization. Research also indicates that most purchased items were branded clothing and cosmetic products. Application of the study: This paper will be helpful to understand brand utilization and its impacts on youth’s life satisfaction. Novelty/Originality of this study: To analyze the growing tendency of luxury and brands products, researchers determined to check the impacts of branded products on life satisfaction levels. To examine the impacts of brand utilization, this research focused on four Pakistani universities and the life satisfaction level of students has bees examined.