Comparison between bipolar diathermy and silk ligation technique during tonsillectomy

Objective: to compare the use of bipolar diathermy and silk ligation in tonsillectomy with respect to operative time and post op hemorrhage, in our setting. Study design: randomized controlled trail. Place and duration of study: nishtar hospital, multan from May 2016 to May 2018.  Methodology: After consent, 234 patients of chronic tonsillitis of 5 to 35 year of age were selected as per inclusion and exclusion criteria. They were randomly divided in to two groups by using lottery method. In group A, tonsillectomy was done and suture ligation was applied for hemostasis. In group B, tonsillectomy was done and bipolar diathermy was used for hemostasis. Data was entered and analyzed by using SPSS software. Results: In our study, mean age was 13.84 + 5.83 years. Majority of patients 55.13% were between 5-15 years of age. Out of 234 patients, 71.37% were male and 28.63% were females. The mean operative time in group A was 29.45 + 9.71 minutes and in group B was 16.37 + 4.38 minutes with p-value <0.0001. Secondary hemorrhage was seen in 2.56% patients in group A (suture ligation group) and 10.56% patients in group B (Bipolar diathermy group) with p-value of 0.016. Conclusion: bipolar diathermy method of hemostasis in tonsillectomy is fast but associated with statistically increase risk of secondary hemorrhage compared to silk ligation. Keywords: tonsillectomy, silk ligation, bipolar diathermy, operative interval, secondary hemorrhage

Microbiological and clinical profile of infective endocarditis patients: an observational study experience from tertiary care center Karachi Pakistan

Background: The study analyzed microbiological and antimicrobial susceptibility profile of organisms isolated from patients with infective endocarditis (2015–17) and compared disease outcomes in cohorts of endocarditis patient with history of prior invasive vascular intervention (high risk group) vs those without (native valve group). We hypothesized that high risk group would be more likely to have severe disease outcomes. Methods: This was a prospective cohort study (2015–17). All blood and cardiac tissue samples of enrolled patients suspected of endocarditis according to modified Duke’s criteria were followed for microbiological and antimicrobial susceptibility profile. The high risk group was compared with the native valve group with 90 day follow up to determine difference in clinical course and outcome in terms of disease severity (defined as any patient with endocarditis undergoing surgical management, readmission or dying). The data was analyzed using SPSS 21.0 software and chi-square test. 90 day mortality was calculated using Kaplan Meier survival curves. Results: Total 104 patients with endocarditis were enrolled. Overall culture positivity rate was 71.2%. Streptococcus species were the most common isolate (36.7%), followed by S. aureus (17.3%) cases. In Streptococcus species, 14.2% showed intermediate susceptibility to penicillin. Thirty six patients were included in the cohort analysis. A poor outcome was seen in 85.7% high risk group as compared to 50% of native valve group. The overall mortality rate was 19.4%. Conclusions: We found Streptococcus species to be the predominant pathogen for endocarditis overall. However Staphylococcus aureus predominated native valve group. High risk group showed more complicated clinical cours

A Tale of the Ticker; Stock Market Capacity Building Hegemony and Temporal Performance in the Emerging Economies

This paper aims to examine stock market with a capacity building perspective for economic growth, focusing on the factors that enhance stock market capitalization in the long term. This study evaluates cross country series data of 26 emerging countries listed at MSCI index, through a period of 2006 to 2019. The data were collected through World Bank, Pakistan Stock Exchange and SECP database. Vector Error correction model and Multiple Regression analysis were applied on data to analyze the impact of assorted factors on stock market capitalization to GDP as a measure of long term capacity. The findings suggest that political stability and corporate tax rate are two important factors that may have significant impact on stock market capitalization to GDP. This research is different from all past researches with respect to methodological, aeon and acclimatization perspective. Capacity building is a relatively new phenomenon adopted from complex adaptive ecosystems and most studies in this area are of theoretical nature. Moreover, the fact that this research has considered not only the long term but also short-term market capitalization perspective, adds to its overall value and originality

Does Organizational Support Enhance the Organizational Citizenship Behavior in Service Industry with Moderating Role of Service Climate?

This study shows that the organizational support and altruism play vital role in increasing the organizational citizenship behavior. In the service industry, service climate play moderator role where the individuals of the organization feel the high intensity of obligation to perform their duties. Employees contact directly with their customers and it is necessary for employees to perform the supportive and helping behavior to achieve the effectiveness of organization while delivering services. Results of this study are based on the conceptual theory. It indicates that the organizational support and altruism have positive impact on the citizenship behavior. In other words perceived organizational support and altruism increases the OCB in the moderating effect of service climate. This study also indicates that the intensity of the OCB depends on the service climate if it will be weak the OCB will be low and if it is high the OCB will be high. Its importance has increased in the service industries. Managerial implications are also discussed in this study. Keywords: Organizational support, altruism, organizational citizenship behavior, service climate

Knowledge management maturity and growth: A strategic perspective of Pakistani universities

Purpose of the study was to provide a road map for practitioners to access the knowledge management maturity and align the knowledge management with business strategies achieving the objectives. This study is conducted in Pakistani universities. Knowledge management maturity assessment questionnaire is use in this study for accessing the level of knowledge management maturity and growth. Data is analyzed through SPSS and AMOS. Descriptive statistics, correlation, confirmatory factor analysis and structure equation modeling techniques are use in this study to interpret the data. Result of the study show that information management is enabler of knowledge the management but not a knowledge management. Results show that knowledge management is strategic resource, which is not transferable. Mean of variable show that organization considered the knowledge management as strategic resource and trying to build infrastructure for successful institutionalization of knowledge management. But there is still gap in formulation of knowledge management strategies and implementation of knowledge management strategies. This study suggests that knowledge management is not at maturity level in Pakistani universities. There is still need to focus more and more on knowledge management for achieving the knowledge management growth. Keywords: Knowledge management, Knowledge as asset, Formulation of knowledge management strategies, Implementation of knowledge management strategies, Knowledge management performance, Knowledge management maturity, Knowledge management growt

Comparison of Recurrence of Intranasal Polyps Treated with Intranasal Polypectomy versus Steroid Use

Objective: To compare recurrence of intranasal polyps treated with intranasal polypectomy versus steroid use. Study Settings and Duration: ENT department Nishtar hospital Multan from 24th December 2017 to 23 June 2018. Study design: randomized controlled trial Material and methods: All 50 cases were divided in two groups M and S. Group M were given oral prednisone (30-60 mg) for 15-20 days in tapering regimen while patients in S group, intranasal polypectomy done. Information was collected through pre-designed Performa. Mean and standard deviation was calculated for quantitative variables such as age. Frequencies and percentages were calculated for qualitative variables such as gender and outcome variable i.e. recurrence. Chi-square test was applied to compare recurrence in both groups and P ≤ 0.05 was considered as significant. Results: The mean age of patients in group A was 34.49 ± 6.51years and in group B was 34.15 ± 6.97years. Male were 64.44% and 35.56% were females with ratio of 1.81:1. The mean duration of disease in group A was 5.81 ± 4.33 days and in group B was 5.75 ± 4.56 days. Recurrence rate in Group A (steroid group) was 57.78% while in Group B (intranasal polypectomy group) was 22.22% (p =0.001) Conclusion: Intranasal polypectomy is more effective in terms of non-recurrence of nasal polyps as compared to steroid use in the management of nasal polyps. Keywords: Nasal polyps, non-recurrence, medical treatment, polypectomy. DOI: 10.7176/JMPB/60-06 Publication date:October 31st 2019

Comprehensive Evaluation of High-Speed and Medium-Speed Implementations of Five SHA-3 Finalists Using Xilinx and Altera FPGAs

In this paper we present a comprehensive comparison of all Round 3 SHA-3 candidates and the current standard SHA-2 from the point of view of hardware performance in modern FPGAs. Each algorithm is implemented using multiple architectures based on the concepts of iteration, folding, unrolling, pipelining, and circuit replication. Trade-offs between speed and area are investigated, and the best architecture from the point of view of the throughput to area ratio is identified. Finally, all algorithms are ranked based on their overall performance in FPGAs. The characteristic features of each algorithm important from the point of view of its implementation in hardware are identified