Maternal health expenditures and health seeking behavior among lowest wealth quintile of the rural population in an under developed district of the Punjab, Pakistan

Background: Expenditures on maternal health is important factor to determine the health seeking behavior in pregnant women among the lowest economical section of Pakistan. This study was carried out determine the maternal health expenditures and health seeking behavior among lowest wealth quintile of rural Rahim Yar Khan.Methods: Sample Size: For this cross- sectional study, a total of 230 subjects were involved in the study from rural areas of Rahim Yar Khan including Basti Bahishti, Bah-o-Bahar and Chak 83/P. This study was comprised of duration of 06 months from 02/03/2016 to 04/09/2016. The head of Family (Husband) with monthly income less than 15000 Pakistani rupees (PKR) were included and marriage with in last 5 years with at alive delivery. While subjects having income more than 15000 PKR and not willing to participate in study were excluded from the study.Results: People with mean monthly income of PKR. 1176±4109 spent mean amount of PKR. 146442 ± 7747 on their marriages. While the mean expenses on treatment of complication in the last pregnancy were PKR. 35808±6771 and the amount saved for the treatment of complication was PKR. 2750±1157 only. Mean antenatal expenses were PKR. 1807±3335, Mean expenses on delivery were PKR. 7351±855 as compared to the money saved for delivery was PKR. 6115±1460. Mean expenses on complications during delivery were PKR. 1692±523. Mean expenses on postnatal care were PKR.8596±3597 while the mean amount used for treatment of postnatal complications were of PKR. 2451±560. Mean expenses on birth celebrations were of PKR. 7697±832.Conclusions: Present study reveals that there is a high financial cost of maternal health expenditures paid by the lowest wealth quintile in rural areas of Rahim Yar Khan when compared with the income of this quintile. Access of the people to the health sector is still limited due to low income of people, low health education and unavailability of health services in rural areas and even in 2017

The frequency of gestational diabetes mellitus among pregnant mothers admitted in gynaecology/obstetrics ward of Sheikh Zayed Hospital Rahim Yar Khan, Pakistan

Background: The gestational diabetes mellitus (GDM), defined as my degree of glucose intolerance with onset of first recognition during pregnancy, is poorly understood due to low socioeconomic dynamics among the pregnant mothers of Rahim Yar Khan. It results in many maternal and fetal complications. This study was carried out to determine the frequency and socio- demographic profile of pregnant mothers with gestational diabetes mellitus admitted in Gynecological Obstetrics wards of Sheikh Zayed Medical College Hospital Rahim Yar Khan.Methods: The data for this cross-sectional study was collected during the period from 30-01-2017 to 30-06-2017. The data was collected from labor room and wards of gynecology Sheikh Zayed Hospital Rahim Yar Khan. This study was conducted among the 160 pregnant mothers in Labor room and gynecological wards of Sheikh Zayed Hospital Rahim Yar Khan, admitted during the study period. A predesigned questionnaire was filled by interviewing these mother shaving variables of age, education, residence, working status, BMI, family monthly income, total numbers of children, knowledge of Gestational diabetes mellitus and family history of GDM.Results: The frequency of GDM in this study was significantly associated with reproductive age group 25-34 years (64%), Illiteracy in mothers (53.8 %) from rural area (>50%) housewives (83%), BMI (Mean = 22), Family Monthly income (> 10,000 Rs.), Average no. of Children (2-3), Diagnosed with Gestational Diabetes Mellitus (15.6%), Family history of D.M (>50%).Conclusions: It is concluded that the frequency of Gestational Diabetes Mellitus was high. Early detection, constant sup0ervision, delivery with intensive intra-partum monitoring, facilities of expert neonatologists, proper health care education to pregnant mothers can result in good maternal and fetal outcomes without much morbidity

A Study of the Different Factors That Affecting the Supply Chain Responsiveness

Supply chain management is a source of getting competitive advantage and sustainable growth for the firms on their rivals. Small and medium size industries in Pakistan and in other less developed countries are facing obstacles in responsive coordinated supply chain due to limited resources and improper guideline. The aim of this research is to test develop a theoretical framework to test it empirically to enhance the coordination in supply chain. SPSS software is use to evaluate the findings of this research. The results are found through regression analysis that helps to find weak factors of supply chain factors that are in interest of this study. There are total 32 enablers that have developed on the base of literature review. These are further divided into six categories that are: top level commitment, mutual understanding, organizational factors, flow of information, relationship and decision making and supply chain responsiveness. This study has observed that all variable have significant relationship with supply chain coordination but top level commitment and flow of information have need to improve . This study is conduct only three manufacturing firms in one city of Faisalabad, Pakistan. That further use for the whole firms in Pakistan for the betterment of supply chain coordination. The research paper evaluates the factors that help to build a responsive and coordinated supply chain in Pakistan’s environment. Further these factors with improvement can enhance the supply chain coordination of the firms

A Study of the Different Factors That Affecting the Supply Chain Responsiveness

Supply chain management is a source of getting competitive advantage and sustainable growth for the firms on their rivals. Small and medium size industries in Pakistan and in other less developed countries are facing obstacles in responsive coordinated supply chain due to limited resources and improper guideline. The aim of this research is to test develop a theoretical framework to test it empirically to enhance the coordination in supply chain. SPSS software is use to evaluate the findings of this research. The results are found through regression analysis that helps to find weak factors of supply chain factors that are in interest of this study. There are total 32 enablers that have developed on the base of literature review. These are further divided into six categories that are: top level commitment, mutual understanding, organizational factors, flow of information, relationship and decision making and supply chain responsiveness. This study has observed that all variable have significant relationship with supply chain coordination but top level commitment and flow of information have need to improve . This study is conduct only three manufacturing firms in one city of Faisalabad, Pakistan. That further use for the whole firms in Pakistan for the betterment of supply chain coordination. The research paper evaluates the factors that help to build a responsive and coordinated supply chain in Pakistan’s environment. Further these factors with improvement can enhance the supply chain coordination of the firms

Investigating the impact of knowledge management on HRM performance with moderating role of cultural dynamics : A Multi-group analysis of Family firms in Pakistan and Sweden

Abstract Introduction: Knowledge is the most crucial aspect to gain a competitive advantage in today's world. However, to gain H.R., the effective knowledge is the most challenging part of modern society. The creation, management and usage of information is straightforwardly influenced by a few practices and methodologies of Human Resource Management (HRM). Knowledge management and Human resource management, both disciplines, has a great effect on information financial aspects. Research Problem and Questions: This study is done with the intention to gauge the impact of Knowledge management practices on H.R. performances and to check that how cultural dynamics affect the performance of the family businesses. Theoretic Area of the Study The theoretic area of the study deals with knowledge management and human resource management output/performance along with cultural dynamic moderating impacts. Research Methodology: It is a cross-sectional comparative study, and data is collected usingquestionnaires. The cultural dynamics were compared from Sweden and Pakistan. The tool was adapted from already existing studies, and the reliability and validity were checked beforehand. Conclusion: From the study, it is seen that Cultural dynamics act as a moderator amongst the HRM performance and Knowledge Management, and there is a strong relationship between knowledge management practices and HRM performance. The results also show that the correlation between K.M. and H.R. performance is relatively stronger in Sweden while it is moderate in Pakistan

Investigating the impact of knowledge management on HRM performance with moderating role of cultural dynamics : A Multi-group analysis of Family firms in Pakistan and Sweden

Abstract Introduction: Knowledge is the most crucial aspect to gain a competitive advantage in today's world. However, to gain H.R., the effective knowledge is the most challenging part of modern society. The creation, management and usage of information is straightforwardly influenced by a few practices and methodologies of Human Resource Management (HRM). Knowledge management and Human resource management, both disciplines, has a great effect on information financial aspects. Research Problem and Questions: This study is done with the intention to gauge the impact of Knowledge management practices on H.R. performances and to check that how cultural dynamics affect the performance of the family businesses. Theoretic Area of the Study The theoretic area of the study deals with knowledge management and human resource management output/performance along with cultural dynamic moderating impacts. Research Methodology: It is a cross-sectional comparative study, and data is collected usingquestionnaires. The cultural dynamics were compared from Sweden and Pakistan. The tool was adapted from already existing studies, and the reliability and validity were checked beforehand. Conclusion: From the study, it is seen that Cultural dynamics act as a moderator amongst the HRM performance and Knowledge Management, and there is a strong relationship between knowledge management practices and HRM performance. The results also show that the correlation between K.M. and H.R. performance is relatively stronger in Sweden while it is moderate in Pakistan

Maternal health expenditures and health seeking behavior among lowest wealth quintile of the rural population in an under developed district of the Punjab, Pakistan

Background: Expenditures on maternal health is important factor to determine the health seeking behavior in pregnant women among the lowest economical section of Pakistan. This study was carried out determine the maternal health expenditures and health seeking behavior among lowest wealth quintile of rural Rahim Yar Khan.Methods: Sample Size: For this cross- sectional study, a total of 230 subjects were involved in the study from rural areas of Rahim Yar Khan including Basti Bahishti, Bah-o-Bahar and Chak 83/P. This study was comprised of duration of 06 months from 02/03/2016 to 04/09/2016. The head of Family (Husband) with monthly income less than 15000 Pakistani rupees (PKR) were included and marriage with in last 5 years with at alive delivery. While subjects having income more than 15000 PKR and not willing to participate in study were excluded from the study.Results: People with mean monthly income of PKR. 1176±4109 spent mean amount of PKR. 146442 ± 7747 on their marriages. While the mean expenses on treatment of complication in the last pregnancy were PKR. 35808±6771 and the amount saved for the treatment of complication was PKR. 2750±1157 only. Mean antenatal expenses were PKR. 1807±3335, Mean expenses on delivery were PKR. 7351±855 as compared to the money saved for delivery was PKR. 6115±1460. Mean expenses on complications during delivery were PKR. 1692±523. Mean expenses on postnatal care were PKR.8596±3597 while the mean amount used for treatment of postnatal complications were of PKR. 2451±560. Mean expenses on birth celebrations were of PKR. 7697±832.Conclusions: Present study reveals that there is a high financial cost of maternal health expenditures paid by the lowest wealth quintile in rural areas of Rahim Yar Khan when compared with the income of this quintile. Access of the people to the health sector is still limited due to low income of people, low health education and unavailability of health services in rural areas and even in 2017

The frequency of gestational diabetes mellitus among pregnant mothers admitted in gynaecology/obstetrics ward of Sheikh Zayed Hospital Rahim Yar Khan, Pakistan

Background: The gestational diabetes mellitus (GDM), defined as my degree of glucose intolerance with onset of first recognition during pregnancy, is poorly understood due to low socioeconomic dynamics among the pregnant mothers of Rahim Yar Khan. It results in many maternal and fetal complications. This study was carried out to determine the frequency and socio- demographic profile of pregnant mothers with gestational diabetes mellitus admitted in Gynecological Obstetrics wards of Sheikh Zayed Medical College Hospital Rahim Yar Khan.Methods: The data for this cross-sectional study was collected during the period from 30-01-2017 to 30-06-2017. The data was collected from labor room and wards of gynecology Sheikh Zayed Hospital Rahim Yar Khan. This study was conducted among the 160 pregnant mothers in Labor room and gynecological wards of Sheikh Zayed Hospital Rahim Yar Khan, admitted during the study period. A predesigned questionnaire was filled by interviewing these mother shaving variables of age, education, residence, working status, BMI, family monthly income, total numbers of children, knowledge of Gestational diabetes mellitus and family history of GDM.Results: The frequency of GDM in this study was significantly associated with reproductive age group 25-34 years (64%), Illiteracy in mothers (53.8 %) from rural area (>50%) housewives (83%), BMI (Mean = 22), Family Monthly income (> 10,000 Rs.), Average no. of Children (2-3), Diagnosed with Gestational Diabetes Mellitus (15.6%), Family history of D.M (>50%).Conclusions: It is concluded that the frequency of Gestational Diabetes Mellitus was high. Early detection, constant sup0ervision, delivery with intensive intra-partum monitoring, facilities of expert neonatologists, proper health care education to pregnant mothers can result in good maternal and fetal outcomes without much morbidity

Treatment of pilonidal sinus with rhomboid excision and Limberg flap operation

Pilonidal sinus is a widespread condition. There have been several surgical methods described for treating the sacrococcygeal pilonidal sinus. The Limberg flap after rhomboid excision is the method that is most frequently utilized. By flattening the natal cleft, a big, well-vascularized flap is used to create a tension-free repair. The best treatment options are said to have a recurrence rate of 0–5% and complication rate during surgery of 0–16%. Aim: This study was held to assess patient characteristics and treatment outcomes for pilonidal sinus patients who had rhomboid excision and reconstruction with Limberg flap in our setting. Methods: Information was collected retrospectively by analyzing the records of patients who were done with rhomboid excision and reconstruction with Limberg flap for sacrococcygeal pilonidal sinus in General Surgery department, Lady Reading Hospital, Peshawar during the period from January 2020 to December 2022. Results: The study included 40 patients in total, 34 (85%) men and 6 (15%) women. The mean age was 25.10. (range 18–45 years). The mean stay in hospital was 4.2 days, with 3 to 7-day of range. The primary disease affected 38 out of the 40 individuals, and a recurring disease affected 2 patients.&nbsp

Serum hepcidin levels in patients with end-stage renal disease on hemodialysis

Patients on hemodialysis (HD) are usually anemic because of defective erythropoeisis. Hepcidin is a polypeptide that regulates iron homeostasis and could serve as an indicator of functional iron deficiency in patients with end-stage renal disease (ESRD); this may also aid in the assessment of patient′s response to erythropoietin (EPO). The present study was directed to investigate serum levels of hepcidin, iron status and inflammation markers such as C-reactive protein (CRP) in patients with ESRD on maintenance HD and to observe the correlation of serum hepcidin with conventional iron and inflammatory markers. A total of 42 patients of both sexes on maintenance HD and EPO therapy were enrolled; 42 ageand sex-matched healthy subjects were included as controls. Laboratory tests including complete blood count, serum hepcidin, total iron binding capacity (TIBC), serum ferritin, serum iron and CRP were performed. Serum hepcidin levels were significantly higher in patients with ESRD than in the control group (18.2 ± 2.8 ng/mL and 8.5 ± 2.3 ng/mL, respectively P = 0.000). The hemoglobin, hematocrit, serum iron, TIBC and transferrin saturation levels in the patient group were significantly lower than in the control group. Higher hepcidin levels were found in EPO non-responders (19.6 ± 2.4 ng/mL) while lower levels (16.9 ± 2.5 ng/mL) were seen in responders (P = 0.001). A positive and significant correlation was observed between the values of serum hepcidin and CRP. Our study indicates that higher hepcidin levels are found in ESRD patients on HD and in those not responding to EPO. Our findings suggest that hepcidin might play a role in the pathophysiology of anemia associated with chronic diseases as well as EPO resistance