Search

Background and Aims: Surgery in the pediatric age group entails a significant amount of anxiety for parents. Due to anxiety, parents are unable to take care of their children, which could affect the child's well‐being and contributes to poor outcomes. The primary objective of this study is to determine the frequency of preoperative anxiety in parents before the surgery of their children. Methods: It is a cross‐sectional descriptive study that included either parent of 147 children of American Society of Anaesthesiology (ASA) I & II, aged 1–12 years undergoing tonsillectomy over the period of 1 year. Each parent's demographic data were recorded and requested to answer a proforma containing the Amsterdam Preoperative Anxiety Information Scale (APAIS) for assessing anxiety on a 5‐point Likert scale. Median interquartile range (IQR), and frequency (%) were used to report the normal, skewed, and categorical variables. APAIS anxiety and information scores were compared by using either the Mann–Whitney U‐test or the Kruskal–Wallis test. Furthermore, anxiety scores were grouped (present/absent) with a cut‐off score of 11 for the presence of anxiety, and multivariate logistic regression was performed to explore the relationship between potential risk factors and the parent's anxiety. Results: Overall, anxiety was present in 59 (40.1%) respondents with 20 (33.9%) being fathers and 39 (66.1%) mothers. The median (IQR) for APAIS anxiety and information score were 9 ± 5 and 5 ± 2, respectively. Higher median anxiety scores were observed statistically significant in children under 5 years old, mother respondents, mothers aged 35 or younger, fathers under 40, and mothers with graduate or higher education (p < 0.05). Father respondents (AOR = 0.3, 95% CI = 0.1–0.8, p = 0.01), and mother's education less than graduation (AOR = 0.2, 95% CI = 0.1–0.6, p = 0.006) were also found to be statistically significant predictors. Conclusion: There is a significant prevalence of anxiety in parents of children who underwent surgery under general anaesthesia, and mothers have showed significantly higher anxiety levels than fathers. [ABSTRACT FROM AUTHOR]

This study utilizes Stimulus Organism Response (SOR) theory to examine how customer, employee, and physical servicescape affect consumer behavior in full-service restaurants, as well as how customer affection mediates, and gender moderates these effects. We managed to collect 308 valid responses, which we further analyzed through structural equation modeling. The data supported the idea that customers, employees, and physical servicescape favorably affect customer affection, which in turn influences revisit intentions and WoM. Customer affection also mediates the effects of the three servicescape dimensions on WoM and revisit intentions. Males were more affected by employee servicescape and customer affection. Whereas females had a larger effect of customer servicescape on customer affection; other differences were insignificant. Within the SOR theory, we added customer affection as a mediator and gender as a moderator between servicescapes’ dimensions and behavioral outcomes (e.g. WoM and revisit intentions). [ABSTRACT FROM AUTHOR]

The present research was intended to investigate the ChatGPT role as a private tutor in the context of its significance and effect on students' satisfaction and academic performance. The advent of technological innovations like ChatGPT and AI tools has changed the panorama of globally expanding private tutoring through the integration of AI tools. A quantitative research approach along with a descriptive research method was designed to accomplish the present research. A total of 151 university students were sample of research, selected through a simple random sampling technique. Results displayed that students were agreed about ChatGPT as a private tutor in the context of effectiveness, active engagement, personalized guidance, positive interaction, constructive feedback, integration, recommendations, and user interface. ChatGPT as a private tutor has significant effect on students' satisfaction with positive relationship. Students may be provided training in the use of AI tools like ChatGPT for private tutoring. Program developers of AI may address potential biases, challenges and misuse of AI applications in education. [ABSTRACT FROM AUTHOR]

Write your abstract here

Objective: To compare the probiotics with placebo in preventing the necrotizing enterocolitis (NEC) in preterm newborns. Study Design: Randomized Controlled Trial. Setting: Department of Pediatrics Unit-1, Bahawal Victoria Hospital, Bahawalpur, Pakistan. Period: May 2022 to April 2023. Material & Methods: A total of 92 pre-term neonates with gestational age between 28-32 weeks gestation were included. Patients were randomly assigned to either probiotics or placebo groups (46 in each group). In probiotics group, probiotics named Bifidobacteria (hiflora/gutcare one sachet daily) were given for 5 days while in placebo group, neonates were given placebo for 5 days. All neonates were observed for feeding intolerance, abdominal distension, grossly bloody stools (naked eye blood in stool) and change in colour of skin of abdomen (erythema). Patients having three or more of these features in first 7 days of life were labeled as having NEC. Results: In a total of 92 newborns, maternal age ranged between 18 to 40 years with mean age of 29.30±5.27 years. The mean gestational age was 30.88±2.08 weeks while the mean weight was 2.06±0.71 kg. The NEC was found in 3 (6.52%) neonates in probiotics groups versus 11 (23.9%) in placebo group (p=0.020). In the probiotics group, NEC was found to have significant association with gestational age between 31-32 weeks (p=0.012), spontaneous vaginal delivery (p=0.028) and maternal educational status as educated (p=0.006). In the placebo group, NEC had significant association with birth weight between 1-1.5 kg (p=0.007). Conclusion: This study concluded that probiotics are better in preventing NEC in preterm neonates than placebo. [ABSTRACT FROM AUTHOR]

Background & Objective: Self-extubation is reported as one of the most common adverse events in the adult intensive care units worldwide. We aimed to find out the incidence and determinants of self-extubation in surgical intensive care unit of our tertiary care hospital. Methodology: It was retrospective analysis of the data acquired from the hospital databases, about the patients who self-extubated during admission to surgical intensive care unit (SICU) of Aga Khan University Hospital, Karachi, Pakistan, during six calendar years, from January 01, 2010, through December 31, 2016. Data collection form was used to collect personal details, drugs used for sedation, sedation agitation score, pain score, nurse-patient ratio and the use of any restraint at the time of extubation. SPSS was used to analyze data applying the central limit theorem to calculate the mean and standard deviation for quantitative variables and the Chi-square test was conducted using a P < 0.05 for qualitative variables. Multivariate logistic regression analysis was performed to identify the independent risk factors for self-extubation Results: A total of 618 patients were admitted to the SICU who required mechanical ventilation during the study period. An overall 2.1% incidence of self-extubation was calculated with a documented thirteen self-extubation episodes. The mean age of patients was 38.46 ± 16.97 y with majority of them being males. Most, 9 (69.2%), of the patients were not restrained at the time of self-extubation. Nurse to patient ratio was 1:1. Majority of patients 7 (53.8%) were not on any sedative drug infusion and the mean sedation agitation score at that time was 4.46 ± 2.02 while mean pain score was 5.31 ± 2.72. Reintubation was performed in 10 (76.9%) of the patients, who had selfextubated. Conclusion: This study revealed that the incidence of self-extubation was 2.1% in SICU and there was strong correlation between absent physical restraint and self-extubation incidence during the weaning period. [ABSTRACT FROM AUTHOR]

Objective: To find out fetal and maternal factors linked with thrombocytopenia (TCP) among neonates admitted in neonatal intensive care unit (NICU) of a tertiary care hospital of South Punjab, Pakistan. Study Design: Cross-sectional study. Setting: The NICU of Sadiq Abbasi Hospital, Bahawalpur. Period: May 2022 to August 2022. Material & Methods: A total of 146 neonates of both genders admitted to NICU having TCP were analyzed. Neonatal TCP was categorized as mild (>100,000/ul to < 150,000/ul), moderate (>50,000/ul to 100,000/ul) and severe (<50,000/ul). Associations of baseline characteristics, fetal factors and maternal factors with categories of TCP were checked applying chi-square test considering p-value ≤0.05 as significant. Results: In a total of 147 neonates with TCP, 84 (57.5%) were male. Mean age was calculated to be 3.9±3.6 days while 109 (74.7%) neonates were aged between 1 to 3 days. Distribution of TCP categories showed that 78 (53.4%) neonates were having mild TCP, 43 (29.5%) moderate TCP whereas remaining 25 (17.1%) neonates were having severe TCP. Stratification of TCP with respect study variables showed that maternal anemia (p=0.0467), pre-term birth (0.0001) and sepsis (p<0.0001) among neonates were significantly linked with severity of TCP. Conclusion: Most neonates admitted to NICU were having mild to moderate degree of thrombocytopenia. Severe degree of thrombocytopenia was found among neonates with history of maternal anemia, pre-term birth and sepsis. [ABSTRACT FROM AUTHOR]

Objective: To find out fetal and maternal factors linked with thrombocytopenia (TCP) among neonates admitted in neonatal intensive care unit (NICU) of a tertiary care hospital of South Punjab, Pakistan. Study Design: Cross-sectional study. Setting: The NICU of Sadiq Abbasi Hospital, Bahawalpur. Period: May 2022 to August 2022. Material & Methods: A total of 146 neonates of both genders admitted to NICU having TCP were analyzed. Neonatal TCP was categorized as mild (>100,000/ul to < 150,000/ul), moderate (>50,000/ul to 100,000/ul) and severe (<50,000/ul). Associations of baseline characteristics, fetal factors and maternal factors with categories of TCP were checked applying chi-square test considering p-value =0.05 as significant. Results: In a total of 147 neonates with TCP, 84 (57.5%) were male. Mean age was calculated to be 3.9±3.6 days while 109 (74.7%) neonates were aged between 1 to 3 days. Distribution of TCP categories showed that 78 (53.4%) neonates were having mild TCP, 43 (29.5%) moderate TCP whereas remaining 25 (17.1%) neonates were having severe TCP. Stratification of TCP with respect study variables showed that maternal anemia (p=0.0467), pre-term birth (0.0001) and sepsis (p<0.0001) among neonates were significantly linked with severity of TCP. Conclusion: Most neonates admitted to NICU were having mild to moderate degree of thrombocytopenia. Severe degree of thrombocytopenia was found among neonates with history of maternal anemia, pre-term birth and sepsis. [ABSTRACT FROM AUTHOR]

The study was carried out to find out the effect of smart technology (Mobile Phone) on academic achievement of students at secondary level General Science in district Bagh AJ&K, Pakistan. To achieve objectives of the study the researchers conducted an experimental research. Two groups Experimental and Control were formed by generating random numbers from grade 9th students. Each group was consisted of 10 students. The experimental group was taught by the researcher using smart technology (Mobile Phone), while the students of control group were taught traditionally. The post tests were constructed on the basis first three levels (knowledge, comprehension and application) of Bloom taxonomy. At the end of every lesson a post test was given to the students of both the groups. Post tests were taken to assess the achievement of the students. Ten posttests were given to both groups of students and then tests were checked by researchers. Mean values of ten tests were calculated overall and three levels of cognitive domain. Data were recorded and then t-test independent sample was applied for the comparison of Mean values of the both groups. Findings of this research show variation relating two groups. Experimental group showed better performance as compared to the control group. It is concluded that smart technology is very effective technique for teaching-learning process of general science in schools. Smart Technology (use of Mobile Phone) is recommended for teaching-learning process at secondary school level. [ABSTRACT FROM AUTHOR]

[Introduction] Nowadays, many companies are shifting their businesses online due to the growing trend among customers to buy and shop online, as people prefer online purchasing products. [Problem] Users share a vast amount of information about products, making it difficult and challenging for the end-users to make certain decisions. [Motivation] Therefore, we need a mechanism to automatically analyze end-user opinions, thoughts, or feelings in the social media platform about the products that might be useful for the customers to make or change their decisions about buying or purchasing specific products. [Proposed Solution] For this purpose, we proposed an automated SentiDecpective approach, which classifies end-user reviews into negative, positive, and neutral sentiments and identifies deceptive crowd-users rating information in the social media platform to help the user in decisionmaking. [Methodology] For this purpose, we first collected 11781 end-users comments from the Amazon store and Flipkart web application covering distant products, such as watches, mobile, shoes, clothes, and perfumes. Next, we develop a coding guideline used as a base for the comments annotation process. We then applied the content analysis approach and existing VADER library to annotate the end-user comments in the data set with the identified codes, which results in a labelled data set used as an input to the machine learning classifiers. Finally, we applied the sentiment analysis approach to identify the end-users opinions and overcome the deceptive rating information in the social media platforms by first preprocessing the input data to remove the irrelevant (stop words, special characters, etc.) data from the dataset, employing two standard resampling approaches to balance the data set, i-e, oversampling, and under-sampling, extract different features (TF-IDF and BOW) from the textual data in the data set and then train & test the machine learning algorithms by applying a standard crossvalidation approach (KFold and Shuffle Split). [Results/Outcomes] Furthermore, to support our research study, we developed an automated tool that automatically analyzes each customer feedback and displays the collective sentiments of customers about a specific product with the help of a graph, which helps customers to make certain decisions. In a nutshell, our proposed sentiments approach produces good results when identifying the customer sentiments from the online user feedbacks, i-e, obtained an average 94.01% precision, 93.69% recall, and 93.81% F-measure value for classifying positive sentiments. [ABSTRACT FROM AUTHOR]

The current COVID-19 pandemic has posed a significant challenge not only to the developing countries but also to the rich and developed world. With a lack of well-developed healthcare system in the developing countries, the spread of COVID-19 can lead to catastrophic consequences. Patients suffering from this viral disease usually require well-equipped intensive care units. However, in most of the underdeveloped countries, there exists a substantial gap between demand and availability of specialized beds and facilities in the intensive care units, including monitors, ventilators, trained staff, and personal protective equipment. Coordinated efforts are required to overcome these problems. Here we mention few strategies in resource limiting critical care settings base upon our experience. [ABSTRACT FROM AUTHOR]

Background and Aims: It is a common practice to add intrathecal lipophilic opioids to local anesthetics to improve the quality of subarachnoid block. This study was designed to find a dose of intrathecal fentanyl, which can improve the quality of surgical anesthesia with minimal side effects in parturients undergoing cesarean section under spinal anesthesia with intrathecal bupivacaine. Material and Methods: In a prospective randomized double‑blind study, 243 parturients undergoing cesarean section under spinal anesthesia were randomly allocated to receive 10, 15, or 25 μg of intrathecal fentanyl with 10 mg of 0.5% hyperbaric bupivacaine. Patients were assessed for clinical efficacy by measuring pain score, need for rescue analgesia, conversion to general anesthesia, and complaints of inadequacy of surgical anesthesia by the surgeon. The side effects assessed were pruritus, nausea, vomiting, dizziness, and decrease in saturation and respiratory rate. In addition, neonatal APGAR score, patients' hemodynamics, need for vasopressors, onset and duration of sensory, and motor block were measured. Results: Patients receiving 25 μg of fentanyl had a significantly higher incidence of pruritus, nausea, and dizziness in addition to a significantly prolonged sensory and motor block (P < 0.001). All patients in three groups had adequate surgical anesthesia with no statistically significant difference in the onset of block, quality of surgical anesthesia, pain scores, neonatal APGAR score, hemodynamic variables, and need for vasopressor. Conclusion: For patients undergoing cesarean section, 10 or 15 μg of intrathecal fentanyl with 10 mg of bupivacaine provided adequate surgical anesthesia and analgesia with minimal side effects. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the adequacy of serum C-reactive protein (CRP) in diagnosing neonatal sepsis and role of CRP in determining the duration of antibiotic treatment in neonatal sepsis. Methods: In this validation study, we included 135 neonates with suspected diagnosis of sepsis within duration of nine months from September 2016 to May2017 in Children Hospital Multan. Blood samples were drawn from every neonate for culture sensitivity and measurement of serum C-reactive proteins. In all suspected neonates, empirical antibiotics e.g. Gentamycin or Ampicillin were started after taking blood samples. Serum CRP levels >5 mg/dl were marked as positive results. 2nd blood samples for measurement of serum CRP were taken after 72 hours of the first sample. There were two primary endpoints; one to determine the sensitivity and specificity of CRP against blood culture and second was to determine the negative predictive value of CRP in determining the duration of anti-biotic in neonates presenting with sepsis. Results: Out of these 135 babies, 102 (75.5%) were confirmed to have sepsis using blood culture reports. CRP results were Positive in 85 (62.9%) neonates on first baseline measurement and were positive in 103 (76.29%) neonates after 72 hours of admission. The sensitivity of CRP in diagnosing sepsis was 98.03%, specificity was 91.0%, positive predictive value (PPV) was 97% and negative predictive value (NPV) was 93.7%. The mean duration of antibiotic treatment in CRP guided group was 5.03 days versus 7.02 days in standard treatment duration group (p-value <0.001). The NPV of CRP in determining the duration of antibiotics was 100.0%. Conclusion: Serum CRP level is a reliable test in establishing the diagnosis of neonatal sepsis. It accurately monitors the duration of antibiotic therapy and results in significant reduction in the treatment duration of neonatal sepsis. [ABSTRACT FROM AUTHOR]