Public Health Posting As a Motivating Factor for Medical Students to Work in Rural Areas upon Graduation

Background: There is a serious concern on the shortage of healthcare workforce in rural Malaysia. Aim: To describe the effect of a public health programme on the student’s motivation to work in rural areas. Methods: Students were asked to rate on how they perceived their motivation to work in rural areas after the public health posting. Results: The level of motivation for the majority of the students ranged from good (38.5%) followed by very good (27.5%), fair (24.8%), excellent (6.4%) to poor (2.8%). Overall, majority of the students had a positive perception on the three domains studied i.e. knowledge of public health and their skills in dealing with patients, their ability to work with colleagues and their perception about rural communities Conclusion: Exposing the medical students to rural communities by way of field work has helped to motivate them to work in rural areas. Keywords: Medical students, doctors, rural, motivation, Malaysi

Factors Affecting Secondary School Principals’ Time Management Practices in Khyber Pakhtunkhwa

This study sought to investigate whether principal’s age, gender, administrative experience, training in time management area, school’s nature, level, location and complexity has any effect on the time management practices. Six time management practices used by secondary school principals i.e. scheduling contacts, managing meetings, delegating tasks, setting priorities, managing paperwork, handling interruptions were incorporated in a questionnaire. A questionnaire was designed, validated and administered to respondents for collecting data having Cronbach Alpha value of 0.864. Data were collected from 344 secondary school principals selected through stratified random sample from seven divisional headquarter districts of Khyber Pakhtunkhwa. Results show that principal’s administrative experience and school’s level have significant effect on principals’ time management practices. Whereas principal’s age, gender, training in time management area, school’s nature, location and complexity have no significant effect on principals’ time management practices. It was recommended that introductory courses, refresher courses, workshops, and seminars on time management practices should be included in in-service training program for principals to equip them with skills, knowledge and attitude on adequate time management practices regardless of their personal characteristics and school’s level, location, nature and complexity

A Phonemic and Acoustic Analysis of Hindko Fricatives

The Hindko language is mainly spoken in the province of Khyber Pukhtunkhaw, Pakistan. It relates to the Indo-Aryan family of languages. This paper focusses on the phonemic and acoustic analysis of Hindko fricatives. The phonemic analysis identifies that Hindko has eight fricatives. The acoustic analysis aims to explore temporal and spectral characteristics of these fricatives. The acoustic analysis discloses that Hindko fricatives are distinguishable on the basis of the temporal properties such as friction duration and spectral cues like turbulence noise

Musical power and its effect on consumer decision making

The purpose of this article is to discuss a study which aimed to explore how musical power in advertising can affect decision making of young consumers toward advertised products and services. The method used for this study is an in-depth interview with three groups of experts which are advertisers, musicians and academicians.Participants for this approach is based on snowball sampling.This study applies Elaboration Likelihood Model (ELM) to view the process of decision making made by the young consumers.This study uses the thematic analysis to analyse the interview data.Findings show that musical power in advertising can influence the decision making mood in choosing a produc

Morbidity of colostomy reversal

Abstract OBJECTIVE: To determine morbidity after colostomy reversal at a tertiary care hospital. METHODS: The retrospective case series was conducted at the Aga Khan University Hospital, Karachi, and comprised records of patients aged 15 years or more who underwent colostomy reversal from January 2003 to December 2011. Data was collected regarding demographics, procedure dates, indication, as well as type and location of colostomy. Details of colostomy reversal, including pre-operative, intra-operative and post-operative variables were recorded. RESULTS: The mean age of the 96 patients was 40±16 years; 72(75%) of them being males. The most frequent indications for fashioning of colostomy were bowel perforation in 53 (55.2%) and malignancy in 9(9.3%) patients. Intra-operative complications occurred in 5(5.2%) with bowel perforation in 3(3.1%) and bleeding in 2(2%) patients. Overall, 40(41.6%) patients had post-operative local complications; the most common being wound infection in 19(19.8%) followed by incisional hernia 15(15.6%). Patients who experienced post-operative complications had significantly longer hospital stay compared to those without complications (9±2.8 vs. 7±2.4days; p=0.038). CONCLUSIONS: Colostomy reversal was associated with non-negligible morbidity. The most common complications were wound infection and incisional hernia

Milligan Morgan Haemorrhoidectomy vs LigaSure Haemorrhoidectomy : Comparative Postoperative Outcomes

Objective: To compare the traditional Milligan Morgan haemorrhoidectomy with haemorrhoidectomy using LigaSure in terms of postoperative complications, patient satisfaction and hospital stay. Methodology: This is a randomized controlled trial carried out at the Department of Surgery Liaquat university hospital Jamshoro from July 2017 to June 2019. A total of 88 patients were admitted with the diagnoses of 3rd and 4th degree haemorrhoid were included in the study. Patients were randomly divided into two groups by lottery method. Group A underwent Milligan Morgan Haemorrhoidectomy and group B underwent Haemorrhoidectomy by Ligasure after the informed consent. Outcomes of both procedures were also compared by complications, patient satisfaction and hospital stay. Results: Out of 88 patients 35 were male (39.78%) and 53 were female (60.22%). The most common group of age involved was between 35–55 years. Third degree Haemorrhoids were present in 40 (45.45%) of patients while the remaining 48 (54.55%) had fourth degree Haemorrhoids. Group A included 44(50%) cases while Group B included 44 (50%) cases. The mean operating time of Group A was 50.5 (minutes) with a standard deviation of 11.5 while it was 35.5 ± 9.4 in B group. The mean blood loss in group A was 65.30 ml with a standard deviation of 14.58 while it was 45.45 ml ± 20.49 in group B. Conclusion: The Haemorrhoidectomy done by Ligasure is comparatively better than the Milligan Morgan Heamorrhoidectomy, in terms of operative time, less bleeding, less pain, less hospital stays and early return to work

Analysis and Design of Secure Sampled-Data Control Subject to Denial-of-Service Attacks

This study addresses the issue of secure control design for cyber-physical systems (CPS) against denial of service (DoS) attacks. We take into account a continuous-time linear system with a convex quadratic performance measure and a sampled linear state feedback control. DoS attacks impose constraints on the CPS, where packets may be jammed between the sensor and controller by a malicious entity, potentially resulting in system instability and performance degradation. We assume that the attacker can perform DoS attacks with a limited time and frequency due to energy restrictions. We devise an efficient procedure using the linear matrix inequality approach to compute an upper bound on the performance degradation brought on by the DoS attack. We also propose a redesign of the controller to minimize this performance degradation. Finally, a simulation example illustrates the computation of the performance degradation under a bounded DoS attack and the design of a secure controller. Simulation results show that the designed controller effectively keeps the feedback loop’s performance and stability under attack

An investigation of the antimicrobial activity of the aqueous, dichloromethane, ethanol and methanol extract of the seeds and whole plant of Ipomoea nil

Ipomoea nil (Linn) Roth, (morning glory / kaladanah; Convolvulaceae), is frequently grown in gardens and lawns for its ornamental flowers and often runs wild in hedges and wastelands. Plant is documented to possess beneficial effect in erectile dysfunction, impotence and also have antispasmodic, bronchodilator, blood purifier, diuretics, astringent, anti-inflammatory and hepato-protective etc. In this study, disc diffusion method was adopted to evaluate and compare the antimicrobial activity of the aqueous and organic (DCM, ethanol, methanol) extracts of the seeds and whole plant (leaves, flower and bark) of Ipomoea nil, in order to know the best extract and plant part having the beneficial activity against pathogenic bacteria species of both G +ve strains, i.e., Staphylococcus aureus, Bacillus pumilus, Streptococcus pneumoniae, G -ve strains, i.e., Escherichia coli, Citrobacter freundii and Klebsiella pneumoniae and two species of fungi (Candida albicans, Aspergillus niger). Methanolic and ethanolic extract of the seeds of the Ipomoea nil showed significant antibacterial activity against Staphylococcus aureus (G +ve) having the relative percentage of inhibition of 89.88 % and 85.67 % respectively, while methanolic extract of the whole plant also have relative percentage of inhibition of 83.96%, whereas ethanolic extract of the whole plant have good antibacterial activity. Aqueous and DCM extract of seeds and whole plant showed weak inhibitory response. Modified agar well diffusion method was adopted to measure the minimum inhibitory concentration (MIC) and MIC values for G +ve, lies within the range of 30 to 60 ?g /ml (seeds), 60 to 90 ?g /ml (whole plant) and for the Gram –ve, it lies within the range of 90 to 250 ?g /ml (seeds), 180 to 500 ?g /ml (whole plant)  and for the fungi, it varies from 500  to 2000 ?g /ml. Present study clearly indicate that the antimicrobial activity varies from part to part and the plant material used and it also indicate that the methanolic extract of Ipomoea nil is a potentially good candidate for the therapy of antibacterial-resistant bacteria and would therefore require further study

Difficulty breathing or just a case of the nerves? Incidental finding of primary pleural schwannoma in a COVID-19 survivor

Schwannoma is a rare tumor that arises from the Schwann cells, which are specialized, myelin-producing cells of the peripheral nerve sheaths. As anatomic logic would dictate, these masses commonly occur in the skull base, cerebellopontine angle, and posterior spinal roots. Of this already rare entity, rarer still are the pleural schwannomas, representing approximately 1-2% of thoracic tumors. These tumors commonly affect adults with a propensity for the third and sixth decades of life and a comparative male predilection. Schwannomas are benign, indolent, and follow an asymptomatic course. As such, they often come to light incidentally.Here we report a case of primary pleural schwannomas in a 68-year-old female, found incidentally on a CT scan of the chest. To the best of our knowledge and literature review, no other similar case has been reported in our country, Pakistan. Around three weeks before her presentation, she was diagnosed with COVID-19. Her infection had run a mild course with quick recovery without the need for any hospitalization. Therefore, the manifestation of shortness of breath after resolution of all other symptoms prompted a further workup. Radiographic chest x-ray revealed an incidental finding of a large right upper lobe lung mass, slightly impinging on the trachea. This was followed by a chest CT scan at our radiological imaging facility, which showed a large, well-encapsulated, right upper lobe lung mass in the paraspinal apical location. She then underwent an image-guided biopsy of the aforementioned mass, pathological analysis of which was suggestive of a benign peripheral nerve sheath tumor (PNST) arising from the pleura (pleural schwannoma). She underwent right posterolateral thoracotomy with uneventful complete surgical removal of the pleural-based lung mass. Postoperative investigations included a chest x-ray that showed interval complete resection of the mass. Currently, she is asymptomatic and her clinical condition has improved with the successful resumption of her daily routine.Physicians thus need to keep pleural schwannomas in mind as a probable diagnosis of intrathoracic tumors. Indolent and asymptomatic, they are very amenable to surgical resection with little to no chances of recurrence in the long term. However, these patients should be closely followed with repeat imaging studies when symptomatic