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Cancer is a leading cause of death, and its incidence is increasing, as reported in recent studies by GLOBOCAN. Cancer registry programs provide insights into currently trending tumors worldwide and aid in determining possible risk factors. This study was based on 7 years of cancer registry data recorded at NIMRA cancer hospital, Sindh, from 2015 to 2021. A total of 16,191 cancer patients were registered. In men, head and neck, lung, liver, colorectal and urinary tract cancers were most common. In women, breast cancer, head and neck cancer, gynecological tumors, esophageal cancer and colorectal cancer predominated. The overall data analysis indicated trending cancers in both sexes, including head and neck cancer (37.76%), breast cancer (13.83%), gynecological tumors (10.22%), esophageal cancer (5.18%), lung cancer (4.79%), colorectal cancer (4.27%), liver cancer (3.87%), lymphoma (3.16%), urinary tract cancer (3.11) and prostate cancer (1.53%). The mean age was 50.41 ± 11.78 years in men and 48.47 ± 11.88 years in women. Cancer prevalence has markedly increased worldwide, and is particularly alarming in developing countries. Various risk factors are involved in this increase, including the use of tobacco, areca nut, chewable tobacco, snuff or niswar. Current disease trends are substantially different from those in older studies at the institute. [ABSTRACT FROM AUTHOR]

The China-Pakistan Economic Corridor (CPEC) is an ongoing mega-construction project in Pakistan that necessitates further exploration of new natural resources of aggregate to facilitate the extensive construction. Therefore, the Late Permian strata of Chhidru and Wargal Limestone for aggregates resources were envisaged to evaluate their optimal way of construction usage through detailed geotechnical, geochemical, and petrographic analyses. Geotechnical analysis was performed under BS and ASTM standards with the help of employing different laboratory tests. A simple regression analysis was employed to ascertain mutual correlations between physical parameters. Based on the petrographic analysis, the Wargal Limestone is classified into mudstones and wackestone, and Chhidru Formation is categorized into wackestone and floatstone microfacies, both containing primary constituents of calcite and bioclasts. The geochemical analysis revealed that the Wargal Limestone and Chhidru Formation encompass calcium oxide (CaO) as the dominant mineral content. These analyses also depicted that the Wargal Limestone aggregates bear no vulnerability to alkali-aggregate reactions (AAR), whereas the Chhidru Formation tends to be susceptible to AAR and deleterious. Moreover, the coefficient of determination and strength characteristics, for instance, unconfined compressive strength and point load test were found inversely associated with bioclast concentrations and directly linked to calcite contents. Based on the geotechnical, petrographic, and geochemical analyses, the Wargal Limestone proved to be a significant potential source for both small and large-scale construction projects, such as CPEC, but the Chhidru Formation aggregates should be used with extra caution due to high silica content. [ABSTRACT FROM AUTHOR]

Drawing on the self-control perspective, this study investigated the buffering effect of emotional suppression in reducing the harmful influence of workplace ostracism on employee performance. The research also studied the mediating role of employee silence and voice behaviors based on social exchange theory. We performed moderated mediation analysis on responses received from 159 employees working in the financial industry of the Southern Punjab region of Pakistan. The results showed that workplace ostracism harms employee performance via employee silence and voice behaviors. Furthermore, emotional suppression moderated the mediated relationship between workplace ostracism and employee performance. The results indicated that if ostracized employees adopt voice behavior, emotional suppression cannot aid them in performing better as compared to those who remain silent and regain their self-esteem. Our findings highlight the importance of emotional suppression capability in reducing the damaging outcomes of ostracism in organizational settings. [ABSTRACT FROM AUTHOR]

Objective: To determine the association between serum vitamin D levels and febrile seizures in the paediatric patients. Study Design: Case-Control Study. Place and Duration of Study: Abbasi Shaheed Hospital, Karachi Pakistan, from Mar 2020 to Mar 2021. Methodology: The study included all pyrexia paediatric patients, both with and without febrile seizures, as cases and controls. Children aged below six months or older than 60 months, with a previous history of afebrile seizures, diagnosed with central nervous system infection, dehydration, or electrolyte disturbance, were excluded from the study. Serum vitamin D levels and other demographic data were documented. Results: The study included 86 cases and controls. The mean age of cases was 28.07±16.47, and the controls were 26.38±15.72 months. The rate of vitamin D insufficiency was three times more likely in cases compared to controls, i.e. [OR, 95% CI: 3.95 (2.084-7.489)] with p=0.0001. Conclusion: Vitamin D deficiency is substantially more likely in the case than in the control group. As a result, children with febrile seizures should have their serum vitamin D levels tested. [ABSTRACT FROM AUTHOR]

The idea of sustainable leadership is becoming more popular with organizations. Although sustainable leadership and its work‐associated outcomes have been examined in previous literature, only a small number of studies highlighted the role of sustainable leadership style in fostering employee innovation, mediated through their creative self‐efficacy (CSE) in the context of Pakistan. The purpose of this study is to explore the relationship between sustainable leadership and employee innovation in software houses. In addition, we intend to study the mediating role of CSE in the relationship between sustainable leadership and employee innovation. Data were collected via email from 250 staff working in Pakistan's software houses. They replied to questions about their leader's sustainable leadership style, employee CSE, and innovation. There was a response rate of 64.1%. PLS‐SEM has been used to analyze data. Study findings indicate that the effect of sustainable leadership on workplace creativity is essential. The results also revealed that CSE mediates the relationship between sustainable leadership and employee innovation. Although this study expands our knowledge about the mediating role of CSE between sustainable leadership and employee innovation, the prospects for future research are still present. The cross‐sectional design of the study might not have been able to extract the true essence of the cause‐and‐effect relationship between sustainable leadership and employee innovation. The study also offers several policy implications for policy‐makers to boost innovation among employees with the help of sustainable leadership and CSE. [ABSTRACT FROM AUTHOR]

This study represents the first‐ever attempt to explore the feasibility of region‐specific application of the theory of generations in the context of Pakistan. Building upon the Schuman and Scott's (1989) historical method of identification of the predominant events from the coming‐of‐age era of various age groups through the study of the collective memories of various age groups, in this study, primarily, a qualitative methodology was deployed across three (3) focus group discussions involving 50 academicians and industrial experts to ascertain the presence or otherwise of distinct workplace generations of Pakistan. The discussions were centred on participant's recollection of the socio‐economic, political and technologically significant events that happened during their coming‐of‐age era and the way it impacted the formation of unique characteristics of each generation. These events thus served as the generational pointers which led to the indication towards the presence of three distinct Pakistani generational cohorts as Pakistani Baby Boomer Generation, Pakistani Generation X, and Pakistani Millennials/Generation Y who are currently comprising the workforce of Punjab, which is the second‐largest and most developed province of the country. In the second paper of this series, it is anticipated that a larger quantitative investigation may well open the pathway to the generalization of these findings in support of the context‐specific application of the theory of generations. The generational profiling emanating from this study has strong implications for the HR practitioners concerning the design of generationally tailored HR policies such that the generational differences are mitigated through various diversity and inclusion initiatives. [ABSTRACT FROM AUTHOR]

The purpose of this research is to investigate different factors of employee's job motivation in the public sector commercial banks of Pakistan. Using a mixed method approach primary data were collected through survey questionnaires and interviews from 263 employees working in 4 large sized commercial banks of Pakistan. Findings reveal that perceived compensation fairness and job design are positively associated with the job motivation of bank employees. Moreover, the working environment plays a significant mediating role in the relationships between (i) compensation fairness and job motivation, and (ii) job design and job motivation. The statements derived from the interviews of employees working in the public sector commercial banks have further validated our results. The study also discusses the Policy guidelines, theoretical and practical implications, and limitations. As such, important implications have been accentuated for the top management and policy makers of the public sector commercial banks to ponder over the issues raised in the study. [ABSTRACT FROM AUTHOR]

This exploratory study investigated the benefits of social media and to enhance knowledge sharing in the healthcare settings along with identification of challenges and possible solutions. Furthermore, the study elaborated the orientation of doctors about social media applications and in-role and extra-role knowledge sharing in their work settings. Fifteen semi-structured and nondirective interviews with the doctors in healthcare institutions operating in Southern Punjab, Pakistan were carried out under constructionism perspective. The interviews resulted in five major themes. The social media applications were found to advance knowledge sharing by promoting job related information transfer and voluntary sharing of tacit knowledge and experiences among doctors. Furthermore, the challenges faced in using social media as a knowledge sharing mechanism, and suggestions for improvement of its use among doctors were also brought to surface. The results added to the existing literature on social media and knowledge sharing in light of 'dynamic theory of knowledge creation' and 'social network theory'. This study offered beneficial practical insights for practitioners and management of healthcare organizations for promotion of knowledge sharing through social media applications. [ABSTRACT FROM AUTHOR]

Background Hepatitis C virus (HCV) is estimated to infect 200 million individuals in the globe, including approximately 10 million in Pakistan causing both acute and chronic hepatitis. The standard treatment against HCV is pegylated interferon therapy in combination with a nucleoside analogue ribavirin. In addition, several herbal extracts and phytochemicals derivatives are used traditionally in the treatment of liver diseases as well as HCV infection. The present study determines the inhibitory effect of kaolin minerals compound against hepatitis C virus in Huh-7 cell lines. Methods Huh-7 cell lines were used for the in vitro HCV replication by using HCV positive sera from different patients with known HCV genotypes and viral titer/load. Total RNA was extracted from these infected cells and was quantified by real-time polymerase chain reaction (Realtime PCR). The viral titer was compared with the control samples to determine the anti-HCV activity of kaolin derived compounds. Kaolin is a group of clay minerals, with the chemical composition Al2 Si2O5 (OH) 4. Results The results showed promising effectiveness of local kaolin derived anti-HCV compounds by causing 28% to 77% decrease in the HCV titer, when applied to infected Huh-7 cell lines. This study provides the basis for future work on these compounds especially to determine the specific pathway and mechanism for inhibitory action in the replicon systems of viral hepatitis. Conclusions Kaolin mineral derivatives show promising inhibitory effects against HCV genotypes 3a and 1a infection, which suggests its possible use as complementary and alternative medicine for HCV viral infection. [ABSTRACT FROM AUTHOR]

Background. We evaluated the prevalence and clustering pattern of cardiovascular disease (CVD) related lifestyle factors and their association with CVD among patients with type 2 diabetes. We also examined the association of these factors with various sociodemographic characteristics. Methods. A total of 1000 patients with type 2 diabetes were interviewed in a cross-sectional, multicenter study in out-patient clinics in Karachi, Pakistan. Results. In this study 30.3% study participants had CVD. Majority of the patients were physically inactive and had adverse psychosocial factors. Forty percent of the study participants were exposed to passive smoking while 12.7% were current smokers. Only 8.8% of study subjects had none of the studied lifestyle factor, 27.5% had one, while 63.7% had two or three factors. CVDs were independently associated with physical inactivity, adverse psychosocial factors, passive smoking and clustering of two or three lifestyle factors. Physical inactivity was more prevalent among females and patients with no/less education. Proportion of adverse psychosocial factors were higher among females, elders and patients with no/less education. Clustering of these lifestyle factors was significantly higher among females, elderly and no/less educated patients. Conclusion. These results suggest the need of comprehensive and integrated interventions to reduce the prevalence of lifestyle factors. [ABSTRACT FROM AUTHOR]

Background Bronchiolitis is an acute inflammatory obstruction of small airways in children that occurs in first two years of life and is characterized by fever, rhinitis, cough, tachypnoea, expiratory wheeze and increased respiratory effort. Objective To study efficacy of nebulized adrenaline compared with placebo in acute bronchiolitis. Methodology Quasi-experimental study carried out at Department of Paediatrics, King Edward Medical University/ Mayo Hospital, Lahore from October 2006 through March 2007. After consent from parents, sixty children of age between 2 months to 2 years with the first episode consistent with clinical case definition of bronchiolitis were included by using convenient sampling. Clinical scoring system was used to grade the severity of disease as well as to monitor the efficacy of intervention. Those having score =8 were randomly allocated to the two study groups. The information was recorded at 0 minute and effect of each method of treatment was followed for 90 minutes. Results Our study population was 60 children. The mean age was 11±6 months. Male to female ratio was 1.2:1. Mean weight of the children was 9±3 kg. Improvement in clinical score, oxygen saturation, and length of hospital at 0 and 90 minutes was noted in both groups but when compared with placebo, there was no statistically significant difference. Conclusion There is no difference in the efficacy of nebulization with adrenaline compared with placebo in the management of acute bronchiolitis. [ABSTRACT FROM AUTHOR]

• An ANN based model has been suggested for f o F 2 values over EIA region stations during 1958–2008. • The developed model predicts f o F 2 with a root mean square error of less than 1 MHz for the unseen testing data. • The model may be used for practical purposes over Asian longitude sector, particularly for Pakistan. The critical frequency of F 2 -layer in the Equatorial Ionization Anomaly (EIA) region is one of the most challenging ionospheric characteristics to model. We illustrate the efforts to model monthly hourly medians of f o F 2 using Artificial Neural Network (ANN) over five EIA crest stations between 23.1° N – 30.5° N of Eastern longitudes during 1958–2008 (as per data availability per station). The ANN based model was designed to obtain f o F 2 values as output by inputting seven parameters defining diurnal (hour), seasonal (month), geographical (latitude & longitude) and solar cycle (year, F10.7 & F10.7P indices) dependency of f o F 2 . With this input space, the model uses a hidden layer of 96 neurons to generate output f o F 2 , producing a mean squared error of less than 1.0 MHz 2 . Additionally, the convergence of the model improved on introducing derived solar radio flux (F10.7P) by 6.0%. After training and validation, the model predicts f o F 2 values over the locations under study for unseen testing data of 1989, 1998 & 2008 as a representation of high, moderate and low solar activity, respectively. Our ANN based climatological model gave a Root Mean Square Error (RMSE) of 0.956 MHz and goodness of fit, r 2 =0.929 for the testing data. Data-model comparison with ANN model is better than the International Reference Ionosphere (IRI) estimations of f o F 2 with CCIR (IRIC) and URSI (IRIU) coefficients. IRIC and IRIU produced RMSE of 1.901 MHz ( r 2 = 0.732) and 1.926 MHz ( r 2 =0.716) for the same testing data set, respectively. The designed ANN based model successfully captures the climatological features of f o F 2 in the EIA region. After necessary modifications, the model may be applied for predicting daily hourly values, particularly in the Asian-longitudinal range over Pakistan, in future. [ABSTRACT FROM AUTHOR]

The author discusses the political administration of Nawaz Sharif as the 15th Prime Minister of India and tackles the international relation between Pakistan and India.

Objective: This study explores the relationship between sexual harassment and burnout among cardiology trainees, shedding light on the prevalence and impact of these experiences in medical practice., Methods: A cross-sectional online survey was conducted among 518 respondents, with 420 responding to the Sexual Experience Questionnaire (SEQ). The survey measured harassment experiences and their impact on burnout, especially among female physicians. Correlations were analyzed to understand the association between these variables., Results: Out of 1,375 invitees, we received 671 (48.8 %) responses. The study population was divided into two main groups: males (359) and females (312). The study identified a high prevalence of sexual harassment experiences among female physicians, with incidents occurring primarily during training. Moderate to large correlations were observed between SEQ subscales related to colleagues and patients and their families. While sexual harassment was not significantly related to burnout, this study suggests the need for interventions to create a safer medical workplace. Approximately 22 % of male participants (n = 359) reported career-related inappropriate sexual incidents, with 28 % of male physicians experiencing weekly burnout. Among female participants (n = 312), around 37 % reported inappropriate incidents, while 42 % of female physicians felt weekly burnout., Conclusion: Sexual harassment in medicine is a pervasive issue with potential implications for physician well-being. Initiatives aimed at changing the organizational response and fostering a more equitable environment are warranted to address this critical concern., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objective: To observe the difference in dimension of teeth among adult females with and without malocclusion., Methods: The cross-sectional study was conducted at Dr. Ishrat-ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, from April 2011 to April 2013, and used non-probability consecutive sampling. Mesiodistal and buccolingual crown dimensions were measured on study casts by using digital sliding caliper in 2 groups of females. Group 1 had 150 subjects with normal occlusion, while Group 2 had 234 with malocclusion. Independent t test was conducted to evaluate the difference between the dimensions of teeth of the two groups. Statistical analysis was done on SPSS version 16, and p value was considered significant at 0.05., Results: Overall, the difference between the groups showed a greater tooth dimension in the malocclusion group of population compared to the normal group, and the most significant difference was observed in the mesiodistal dimension of maxillary 2nd premolar, which was 0.9 +/- 0.6801mm greater in dimension in the malocclusion group compared to the normal group. The least difference was observed in the buccolingual dimension of the mandibular central incisor where the malocclusion group had only 0.08 +/- 0.5247mm larger mandibular central incisors in the buccolingual dimension compared to the normal group., Conclusion: Mesiodistal and buccolingual crown dimensions were characteristically larger in the malocclusion group.

Background: Honesty and integrity are key attributes of an ethically competent physician. However, academic misconduct, which includes but is not limited to plagiarism, cheating, and falsifying documentation, is common in medical colleges across the world. The purpose of this study is to describe differences in the self-reported attitudes and behaviours of medical students regarding academic misconduct depending on gender, year of study and type of medical institution in Pakistan., Methods: A cross sectional study was conducted with medical students from one private and one public sector medical college. A pre-coded questionnaire about attitudes and behaviours regarding plagiarism, lying, cheating and falsifying documentation was completed anonymously by the students., Results: A total of 465 medical students filled the questionnaire. 53% of private medical college students reported that they recognize copying an assignment verbatim and listing sources as references as wrong compared to 35% of public medical college students. 26% of private medical college students self-report this behaviour as compared to 42% of public medical college students. 22% of private versus 15% of public medical college students and 21% of students in clinical years compared to 17% in basic science years admit to submitting a fake medical certificate to justify an absence. 87% of students at a private medical college believe that cheating in an examination is wrong as compared to 66% of public medical college students and 24% self-report this behaviour in the former group as compared to 41% in the latter. 63% of clinical year students identify cheating as wrong compared to 89% of their junior colleagues. 71% of male versus 84% of female respondents believe that cheating is wrong and 42% of males compared to 23% of females admit to cheating., Conclusions: There are significant differences in medical students' attitudes and behaviours towards plagiarism, lying, cheating and stealing by gender, seniority status and type of institution. The ability to identify acts of academic misconduct does not deter students from engaging in the behaviour themselves, as evidenced by self-reporting.

Objective: To study the pattern of general surgery cases and their management in a rural teaching institution., Methods: This descriptive case-series was conducted prospectively in Surgical Unit II at Fatima Hospital and Baqai Medical University, from June 16, 2005 to June 15, 2010. There were 1125 patients in the series who were managed either conservatively or operated upon. All patients with symptoms suggesting a surgical disease and managed as a surgical case were included, while cases that were shifted to other departments and those that left against medical advice were excluded., Results: The majority of patients had alimentary tract diseases 327 (29.1%), followed by urinary tract diseases 241 (21.4%), hernia 176 (15.6%), superficial lumps 135 (12%), hepato-biliary-pancreatic diseases 102 (9.1%), breast diseases 47 (4.2%), scrotal diseases 37 (3.3%), thyroid diseases 19 (1.7), salivary gland diseases 10 (0.9%), vascular diseases 4 (0.4%), thoracic diseases 2 (0.2%), and miscellaneous 25 (2.2%). A total of 726 (64.5%) patients were managed as elective cases, while 399 (35.5%) were managed as emergency cases. As many as 834 (74.1%) patients were managed by operations and 244 (21.7%) patients by conservative treatment, while 47 (4.2%) patients were referred. Seven patients expired, giving a mortality rate of 0.62%., Conclusion: The commonest cause of seeking surgical care was alimentary tract diseases, followed by urinary tract diseases, hernias, superficial lumps, hepato-biliary-pancreatic diseases, breast diseases, scrotal diseases and thyroid diseases. Baqai Medical University is catering to the needs of rural population by providing essential surgical care to a broad spectrum of surgical diseases.

Background: Complications of diabetes can be prevented or delayed by providing high quality care. This study aimed to document the quality of care provided to people with type 2 diabetes in Pakistan and to identify the difference in care offered at various clinics., Design: Cross-sectional multi-centre study., Methods: Interviews were undertaken with 672 people with type 2 diabetes attending three different types of diabetes clinic (private clinic (A), non-governmental organisation (B) and public clinic (C)) in Karachi, Pakistan. A structured questionnaire was used to collect socio-demographic and clinical information from patients; quality of care indicators were also confirmed by reference to patients' medical records., Results: Overall, 68% (A: 92%, B: 58% and C: 52%, P<0.001) of study subjects were informed about diabetes complications. Blood pressure (BP) monitoring at every visit was completed for 80% of study respondents (A: 100%, B: 79% and C: 57%, P<0.001). Foot examination was infrequent (53%, A: 98%, B: 52% and C: 8% (P<0.001). Lipid profiles of 48% of patients had been done in the past 12 months (A: 77%, B: 16% and C: 50%, P<0.001). Microalbumin testing had been performed in 32% of patients in the previous year (A: 77%, B: 09% and C: 05%; P<0.001). Most participants had elevated glycaemic (58.2%) and BP levels (84.7%) with higher prevalence among people who attended clinics B and C (P<0.001). Overall, 82.6% of study subjects had an elevated body mass index; this was almost equally prevalent across clinics., Conclusion: Many patients with type 2 diabetes do not receive optimal diabetes care in Karachi. Among the different settings, care provided in private health sector clinics was of a better standard. However, our results reveal a need for overall improvement in the quality of diabetes care. Further research is also needed to evaluate the reasons for poor diabetes care, and to identify the most cost-effective means to address these.