Frequency of Hypertension in Ischemic and Hemorrhagic Stroke Patients at a Tertiary Care Hospital

Background: Stroke is a global health problem. Stroke is responsible for major disabilities in adult population, and is 2nd leading cause of deaths all over the world. Estimated 15 million people all over the world become victim of stroke every year all over the world, of which 5 million die and other 5 million are left permanently disabled and thus major burden on the sufferer and families as well. Different studies have reported hypertension as major cause of stroke in different populations. Objective: To determine the frequency of hypertension among ischemic stroke and hemorrhagic stroke at a tertiary care hospital. Subjects and Methods: Our study included 246 stroke patients which were recruited from Department of Medicine Fatima Memorial Hospital Lahore. Specific history concerning hypertension was inquired from all patients. Blood pressure of all the patients was measured. Blood pressure levels were measured by researcher using random-zero sphygmomanometers with the subject seated quietly. Two readings of blood pressure were taken and average of the two readings was noted in the proforma. ECG of all the patients was done and checked for the fulfillness of criteria of left ventricular hypertrophy i.e. Sokolow-Lyon Index, Cornell Voltage Criteria. Results: Our study included 246 stroke patients, 160 (65%) were male patients and 86 (35%) were female patients. Mean age of our study cases was 59.63 + 11.24 years. Ischemic stroke was observed in 133 (54.1%) of our study cases, while hemorrhagic stroke was noted in 113 (45.9%) of our study cases and 13 (5.3%) had previous history of stroke as well. Smoking was observed in 110 (44.7%) of our study cases and all the smokers were male patients. Alcohol consumption and family history of stroke was zero in our study cases. Of these 246 stroke patients, 148 (60.2%) were known hypertensive and all of them were taking anti-hypertensive medication. Frequency of hypertension in our study was 168 (68.3%) at presentation. Conclusion: Higher frequencies of modifiable risk factors was seen with Hypertension was the leading risk factor of stroke in our study. These findings point towards well directed efforts regarding conventional interventions in our population. Hemorrhagic stroke was significantly associated with elevated blood pressure. Hypertension was significantly associated with increasing age, diabetes, previous history of stroke, hemorrhagic stroke and smoking in stroke patients.Keywords: Stroke, Hypertension, Ischemic, hemorrhagic

Activity Based Teaching and Learning through Mentoring in Punjab Province of Pakistan: An Analysis

This paper studies the effects of mentoring process on the professional development of teachers through Activity Based Teaching and learning. Major objectives of the study includes: i) To review the mentoring process initiated for the Professional Development of Primary School Teachers in Punjab Province of Pakistan, and ii) To analyze the effects of mentoring process to promote Activity Based Learning among the Elementary Level Teachers in Punjab Pakistan. The population of the study was comprised on 47988 Primary School Teachers (Mentees) and 1370 District Teachers Educators (Mentors). The data was collected through questionnaires and interviews from the 381 Primary School Teachers (PSTs) and 302 District Teachers Educators (DTEs) were taken from the selected 12 districts of the Punjab. The difference in the scores of PSTs and DTEs showed that PSTs &DTEs mean opinion scores were noted respectively. Major recommendations of this study were; i) The training duration of the District Teacher Educators may be enhanced to enable them to prepare the Primary School Teachers for developing supporting materials that matches with the mental abilities of their students, when they are involved in Activity Based Learning, Keeping in the view societal, cultural, religious barriers and gender sensitization of the Pakistani context, female District Teacher Educators be recruited to provide mentoring services to the female Primary School Teachers to make the Activity Based Learning more effective. DOI: 10.5901/mjss.2016.v7n1s1p43

Professional Reflection a Cradle of Student Teacher’s Professional Development

The emergence of connotation of reflective practices within the field of teacher education has resulted in a greater need for student teachers to consider the effectiveness of their teaching practices to meet the increased levels of accountability that is associated with their professional development. This paper provided an examination of the potential contribution of reflection for the development of effective teaching skills among student teachers during practicum course by utilizing both quantitative and qualitative research methods. This paper aimed to study the potential links between reflective practices and professional development of student teachers. Paper also examines the reflective practices of student teachers. The results revealed that reflections on professional practices supported student teachers to improve their relations with students and colleagues. Student teachers reported that they got self-awareness, they were able to understand the knowledge-in-action which enhanced student teachers skills for delivery of lesson during practicum. DOI: 10.5901/mjss.2015.v6n3s1p37

Analysis and soliton solutions of biofilm model by new extended direct algebraic method

In this paper, the examination of soliton solutions of the biofilm model with the help of a new extended direct algebraic method is expressed. Besides the exact solutions, the existence of these solutions is also discussed with the help of the Schauder fixed point theorem. The nonlinear dynamical biofilm model which we consider in this paper is basically the bistable Allen–Cahn equation with quartic potential. For more physical understanding, the 3D plots of the solutions are presented. The different types of hyperbolic, trigonometric, and rational soliton solutions are gained. In the biofilm model, different parameters belong to certain spaces and give the exact solutions by applying the technique of new extended direct algebraic method. Exact solutions of the biofilm model are highlighted along with their restriction

Detecting Covid-19 chaos driven phishing/malicious URL attacks by a fuzzy logic and data mining based intelligence system

Article analyses the impact of Covid-19 on various cyber-security related aspects

Mentoring Process a Stimulus for Professional Development of Primary School Teachers in Punjab, Pakistan

This paper explores the effects of mentoring on the professional development of Primary School Teachers (PSTs) in Punjab province, Pakistan. The key objectives of the study include: to study the mentoring process started in Punjab province Pakistan for PSTs, to study the effects of mentoring process on the professional development of PSTs. The population of the study was 47988 PSTs and 1370 District Teachers Educators (DTEs) from the twelve districts of Punjab province. The sample was comprised of 381 PSTs and 302 DTEs from the 12 districts of the province. Quantitative data was collected through specifically designed questionnaires. The data was analyzed by using Mean Score, Chi-Square was used to compare the group frequencies and t-test was used to see the significance difference between the means of both groups. Qualitative data was collected through interviews and analyzed by using NVIVO software version 10. Majority of the PSTs and DTEs agreed that mentoring process helped them out in decreasing the professional stress and helped out in covering the backlogs of unseen days in an educational year. Both groups of respondents were agreed that mentoring process was not helpful in achieving the pre-set targets. Mentoring process may be designed in such a way that it should help the PSTs in managing the activities of absent days. Mentoring process should be designed to help out the PSTs in managing the teaching activities in a realistic ways. Directorate of Staff Development (DSD) should evolve a inclusive mentoring model for implementation of Continuous Professional Development (CPD) activities in different areas of professional development of Primary School Teachers with reference to research, training, monitoring and evaluation. DOI: 10.5901/mjss.2015.v6n3s1p14

A Systematic Review on Insights to Community Medicine and Clinical Research: Competency Training in Medical and Dental Education

Background: Competency based training in medical and dental education has become important to train healthcare professionals to tackle clinical, cultural, and social aspects of healthcare. The innovations and developments in these training programs enabled a better understanding of healthcare and treatment planning. The purpose of this systematic review was to assess the implications of competency training in medical and dental curricula; more specifically, the incorporation of competency-based trainings with community medicine and research trials. Methods: Using PRISMA criteria, the literature search was done in Google Scholar, ScienceDirect, and PubMed in articles published between 2020 and 2024. This review focused on competency-based education in medical and dental education, especially the intersection of competency-based education and community medicine and clinical research trials. Articles that were published in English and within the last five years were considered. Cross-referencing was done against other databases that ensured high-quality and comprehensive data. Studies that were related to non-healthcare students, without empirical evidence, or that were out of the scope were eliminated. The studies were evaluated by two independent reviewers, and the inter-rater reliability was calculated using Cohen’s kappa coefficient. These reviewers screened the titles and abstracts of studies and then reviewed the full texts of studies for eligibility. Duplicate studies were removed using EndNote X9, and risk of bias was assessed using the Cochrane risk of bias tool. Results: Out of 94 articles, 15 were selected because they described training designs, outcomes, or difficulties in fulfilling the goals. The total number of participants was 4978 across medical and dental education. Competency training programs illustrated better results on healthcare competencies that included improved communication skills, enhanced cultural competence, and increased patient satisfaction. Hands-on training programs and the use of multimedia tools showed better outcomes as compared to the traditional methods. Challenges that were faced included differences in implementation, constraints in resources, and a lack of standardized assessments. The certainty of evidence showed moderate results for communication skills and patient satisfaction, and low to moderate results for the readiness in clinical trials and cultural competence due to variability in study design. Discussion: Effective competency training curricula substantially enhanced the functioning of healthcare systems and results for patients. Variations in the implementation of competency training programs and the assessment methods used were the main reasons for heterogeneity. Inaccuracy was seen due to limitations in sample sizes in some studies and a lack of long-term follow-up in others, hence constraining the generalizability of the results. There should be improved structure and specification so that such techniques would be applied in routine across a wide range of establishments to create more systematically planned and effectively delivered training in diverse and complex settings

Population‐based cohort study of outcomes following cholecystectomy for benign gallbladder diseases

Background The aim was to describe the management of benign gallbladder disease and identify characteristics associated with all‐cause 30‐day readmissions and complications in a prospective population‐based cohort. Methods Data were collected on consecutive patients undergoing cholecystectomy in acute UK and Irish hospitals between 1 March and 1 May 2014. Potential explanatory variables influencing all‐cause 30‐day readmissions and complications were analysed by means of multilevel, multivariable logistic regression modelling using a two‐level hierarchical structure with patients (level 1) nested within hospitals (level 2). Results Data were collected on 8909 patients undergoing cholecystectomy from 167 hospitals. Some 1451 cholecystectomies (16·3 per cent) were performed as an emergency, 4165 (46·8 per cent) as elective operations, and 3293 patients (37·0 per cent) had had at least one previous emergency admission, but had surgery on a delayed basis. The readmission and complication rates at 30 days were 7·1 per cent (633 of 8909) and 10·8 per cent (962 of 8909) respectively. Both readmissions and complications were independently associated with increasing ASA fitness grade, duration of surgery, and increasing numbers of emergency admissions with gallbladder disease before cholecystectomy. No identifiable hospital characteristics were linked to readmissions and complications. Conclusion Readmissions and complications following cholecystectomy are common and associated with patient and disease characteristics

Current Issues in Time-Series Analysis for the Energy-Growth Nexus; Asymmetries and Nonlinearities Case Study: Pakistan

This paper investigates the asymmetric impact of energy consumption on economic growth by including oil prices, capital and labour as additional determinants in production function. In doing so, the non-linear ARDL bounds testing approach is applied for the period of 1985QI-2016QIV. The empirical evidence confirms the presence of symmetric and asymmetric cointegration between energy consumption, oil prices, capital, labour and economic growth over the period of 1985QI-2016QIV. Furthermore, rise in energy consumption (positive shock) adds to economic growth via stimulating economic activity and energy consumption negative shock retards economic growth insignificantly. Rise (positive shock) and fall (negative shock) in oil prices decline and stimulate economic growth. Capital and labor affect economic growth positively and negative by positive and negative shocks in capital and labor. The empirical findings open new insights for policy makers for long-run and sustainable economic development

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy.

Peer reviewe