Antecedents and Consequences of Human Resource Outsourcing; A Perspective from Higher Educational Institutions

Human Resource Outsourcing has numerous advantages in all Educational Institutions to trim down their expenses, to support up profitability keeping in mind the end goal to create superb items and administrations that can fulfill the clients require, can remain in competitive market to center around focal point of competition (Belcourt, 2006). This study focused on the antecedents and consequences of human resource outsourcing. The data was taken from past literature and results revealed that lacking human resource, demand for access to knowledge and risk management has positive effect on human resource outsourcing. Human resource outsourcing has a positive effect on competitive advantage, service production, time management and private publications and negative effect on employee morale

Association of long-term consumption of repeatedly heated mix vegetable oils in different doses and hepatic toxicity through fat accumulation

Background: Hepatic diseases are one of the chief reasons for worldwide morbidity and mortality. The increased incidence in Asian countries is driving researchers to explore preventive ways from nature. It is more practical to go with healthy routine edibles like vegetable oils to avoid environmental and chemical hepatic injuries. With the use of thermally oxidized oils overproduction of reactive oxygen species (ROS) with overwhelmed cellular antioxidants defense system results in oxidative stress, the known cause of cardiovascular diseases (CVDs), cancers and neurodegenerative disorders. Little is investigated about the effect of daily used oxidized cooking oils on hepatic function changes with oxidative stress especially in the animal model that mimics the human situation.Methods: In this study, healthy adult male rabbits of local strain were divided into 4 groups (n = 12). First, two sets of rabbits were treated with 1 and 2 ml/kg/day of repeatedly heated mix vegetable oils (RHMVO) respectively. The third set of rabbits was given 1 ml/kg/day of single time heated mix vegetable oils (STHMVO) and the fourth set of rabbits served as controls and fed with normal rabbit diet to for 16 weeks. Serum liver function markers including total-protein, albumin, serum glutamic-oxaloacetic transaminase (SGOT), serum glutamic-pyruvic transaminase (SGPT) and alkaline phosphatase (ALP) along with the activity of hepatic antioxidant-enzymes including superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and malondialdehyde (MDA) for lipid peroxidation were compared among different groups of rabbits. Histopathological examination was performed for all four groups.Results: Significantly (p \u3c 0.05) elevated hepatic enzymes and MDA levels, with lower total protein, serum albumin, GPx, SOD and CAT levels were found in high and low doses RHMVO treated groups, in comparison to control. In the STHMVO group, all mentioned markers were insignificantly changed. Accumulation of liver fat in low and high dose oil-treated groups was further confirmed under the microscopic examination of liver tissues, presented significant fat accumulation in liver tissues, in addition, 40-60% increased oxidative stress compared to control, in a dose-dependent manner.Conclusions: These results conclude that consumption of thermally oxidized mix vegetable oils for longer duration can impair the liver function and destroy its histological structure significantly through fat accumulation and oxidative stress both in high as well as low doses

Adoption of E-Learning at Higher Education Institutions: A Systematic Literature Review

[EN] The concept of e-learning offers a number of benefits, however, the effective adoption of e-learning systems at HEIs is a relatively new concept and thus a challenging task. The comprehensive review of extant literature on the topic of adoption of e-learning systems at HEIs is provided. Using PRISMA search technique, relevant articles published from 2005 to 2020 owing to the widespread adoption of e-learning since 2005 were selected. The paper identifies and puts forward the level of compatibility and readiness of students and teachers in adopting e-learning, factors that motivate and hinder the adoption of e-learning respectively, benefits of adopting an e-learning system, and the strategies for the effective implementation of e-learning at the higher education institutions. In this realm of COVID-19 and e-learning, this paper also envisage different strategies, policies and recommendations for implementing e-learning in an effective way at HEIs.Awan, RK.; Afshan, G.; Memon, AB. (2021). Adoption of E-Learning at Higher Education Institutions: A Systematic Literature Review. Multidisciplinary Journal for Education, Social and Technological Sciences. 8(2):74-91. https://doi.org/10.4995/muse.2021.15813OJS749182Abou El-Seoud, M. S., Taj-Eddin, I. A., Seddiek, N., El-Khouly, M. M., & Nosseir, A. (2014). E-learning and students' motivation: A research study on the effect of e-learning on higher education. International Journal of Emerging Technologies in Learning, 9(4), 20-26. https://doi.org/10.3991/ijet.v9i4.3465Ahmed, S. S., Khan, E., Faisal, M., & Khan, S. (2017). The potential and challenges of MOOCs in Pakistan: a perspective of students and faculty. Asian Association of Open Universities Journal. https://doi.org/10.1108/AAOUJ-01-2017-0011Akçayır, M., Akçayır, G., Pektaş, H. M., & Ocak, M. A. (2016). Augmented reality in science laboratories: The effects of augmented reality on university students' laboratory skills and attitudes toward science laboratories. Computers in Human Behavior, 57, 334-342. https://doi.org/10.1016/j.chb.2015.12.054Al-Azawei, A., Parslow, P., & Lundqvist, K. (2017). Investigating the effect of learning styles in a blended e-learning system: An extension of the technology acceptance model (TAM). Australasian Journal of Educational Technology, 33(2). https://doi.org/10.14742/ajet.2741Al-Okaily, M., Alqudah, H., Matar, A., Lutfi, A., & Taamneh, A. (2020). Dataset on the Acceptance of e-learning System among Universities Students' under the COVID-19 Pandemic Conditions. Data in brief, 32, 106176. https://doi.org/10.1016/j.dib.2020.106176Al‐Taweel, F. B., Abdulkareem, A. A., Gul, S. S., & Alshami, M. L. (2021). Evaluation of technology‐based learning by dental students during the pandemic outbreak of coronavirus disease 2019. European Journal of Dental Education, 25(1), 183-190. https://doi.org/10.1111/eje.12589Al Shuaili, K., Al Musawi, A. S., & Hussain, R. M. (2020). The effectiveness of using augmented reality in teaching geography curriculum on the achievement and attitudes of Omani 10th Grade Students. Multidisciplinary Journal for Education, Social Technological Sciences, 7(2), 20-29. https://doi.org/10.4995/muse.2020.13014Alqahtani, A. Y., & Rajkhan, A. A. J. E. s. (2020). E-learning critical success factors during the covid-19 pandemic: A comprehensive analysis of e-learning managerial perspectives. 10(9), 216. https://doi.org/10.3390/educsci10090216Au, O. T.-S., Li, K., & Wong, T. (2019). Student persistence in open and distance learning: success factors and challenges. Asian Association of Open Universities Journal. https://doi.org/10.1108/AAOUJ-12-2018-0030Azlan, C. A., Wong, J. H. D., Tan, L. K., Huri, M. S. N. A., Ung, N. M., Pallath, V., Tan, C. P. L., Yeong, C. H., & Ng, K. H. (2020). Teaching and learning of postgraduate medical physics using Internet-based e-learning during the COVID-19 pandemic-A case study from Malaysia. Physica Medica, 80, 10-16. https://doi.org/10.1016/j.ejmp.2020.10.002Bates, A. T. (2005). Technology, e-learning and distance education: Routledge. https://doi.org/10.4324/9780203463772Birch, D., & Burnett, B. (2009). Bringing academics on board: Encouraging institution-wide diffusion of e-learning environments. Australasian Journal of Educational Technology, 25(1). https://doi.org/10.14742/ajet.1184Cha, H., Park, T., & Seo, J. J. S. (2020). What should be considered when developing ICT-integrated classroom models for a developing country? , 12(7), 2967. https://doi.org/10.3390/su12072967Costa, C., Alvelos, H., & Teixeira, L. (2012). The use of Moodle e-learning platform: a study in a Portuguese University. Procedia Technology, 5, 334-343. https://doi.org/10.1016/j.protcy.2012.09.037Erdmann, A., & Torres Marín, A. J. (2019). Can we improve academic performance and student satisfaction without additional time cost for teachers? Evidence from a blended methodology in Microeconomics. Multidisciplinary Journal for Education, Social Technological Sciences, 6(2), 54-91. https://doi.org/10.4995/muse.2019.11869Fereday, J., & Muir-Cochrane, E. (2006). Demonstrating rigor using thematic analysis: A hybrid approach of inductive and deductive coding and theme development. International journal of qualitative methods, 5(1), 80-92. https://doi.org/10.1177/160940690600500107Gerbic, P. (2011). Teaching using a blended approach-what does the literature tell us? Educational Media International, 48(3), 221-234. https://doi.org/10.1080/09523987.2011.615159Grimus, M. (2020). Emerging technologies: Impacting learning, pedagogy and curriculum development. In Emerging technologies and pedagogies in the curriculum (pp. 127-151): Springer. https://doi.org/10.1007/978-981-15-0618-5_8Hasan, R., Palaniappan, S., Mahmood, S., Abbas, A., Sarker, K. U., & Sattar, M. U. (2020). Predicting student performance in higher educational institutions using video learning analytics and data mining techniques. Applied Sciences, 10(11), 3894. https://doi.org/10.3390/app10113894Holt, D., Palmer, S., Munro, J., Solomonides, I., Gosper, M., Hicks, M., Sankey, M., Allan, G., & Hollenbeck, R. (2013). Leading the quality management of online learning environments in Australian higher education. Australasian Journal of Educational Technology, 29(3). https://doi.org/10.14742/ajet.84Huda, M., Maseleno, A., Atmotiyoso, P., Siregar, M., Ahmad, R., Jasmi, K., & Muhamad, N. (2018). Big data emerging technology: insights into innovative environment for online learning resources. International Journal of Emerging Technologies in Learning, 13(1), 23-36. https://doi.org/10.3991/ijet.v13i01.6990Ibrahim, M. M., & Nat, M. (2019). Blended learning motivation model for instructors in higher education institutions. International Journal of Educational Technology in Higher Education, 16(1), 1-21. https://doi.org/10.1186/s41239-019-0145-2Islam, A. N., & Azad, N. (2015). Satisfaction and continuance with a learning management system: Comparing perceptions of educators and students. The International Journal of Information Learning Technology. https://doi.org/10.1108/IJILT-09-2014-0020Jones, C., Ramanau, R., Cross, S., & Healing, G. (2010). Net generation or Digital Natives: Is there a distinct new generation entering university? Computers Education, 54(3), 722-732. https://doi.org/10.1016/j.compedu.2009.09.022Kamba, M. (2009). Problems, challenges and benefits of implementing e-learning in Nigerian universities: An empirical study. International Journal of Emerging Technologies in Learning, 4(1), 66-69. https://doi.org/10.3991/ijet.v4i1.653https://doi.org/10.3991/ijet.v4i1.653Kasim, N. N. M., & Khalid, F. (2016). Choosing the right learning management system (LMS) for the higher education institution context: A systematic review. International Journal of Emerging Technologies in Learning, 11(6). https://doi.org/10.3991/ijet.v11i06.5644Kennedy, G. E., Judd, T. S., Churchward, A., Gray, K., & Krause, K.-L. (2008). First year students' experiences with technology: Are they really digital natives? Australasian Journal of Educational Technology, 24(1). https://doi.org/10.14742/ajet.1233Khan, A. A., & Umair, S. (2017). Handbook of research on mobile devices and smart gadgets in K-12 education: IGI Global. https://doi.org/10.4018/978-1-5225-2706-0Kim, H. J., Hong, A. J., & Song, H.-D. (2019). The roles of academic engagement and digital readiness in students' achievements in university e-learning environments. International Journal of Educational Technology in Higher Education, 16(1), 1-18. https://doi.org/10.1186/s41239-019-0152-3Kjellsdotter, A. (2020). What matter (s)? A didactical analysis of primary school teachers' ICT integration. Journal of Curriculum Studies, 52(6), 823-839. https://doi.org/10.1080/00220272.2020.1759144Kobusińska, A., Leung, C., Hsu, C.-H., Raghavendra, S., & Chang, V. (2018). Emerging trends, issues and challenges in Internet of Things, Big Data and cloud computing. In: Elsevier. https://doi.org/10.1016/j.future.2018.05.021Lange, C., & Costley, J. (2020). Improving online video lectures: learning challenges created by media. International Journal of Educational Technology in Higher Education, 17(1), 1-18. https://doi.org/10.1186/s41239-020-00190-6Leo, S., Alsharari, N. M., Abbas, J., & Alshurideh, M. T. (2021). From Offline to Online Learning: A Qualitative Study of Challenges and Opportunities as a Response to the COVID-19 Pandemic in the UAE Higher Education Context. The Effect of Coronavirus Disease on Business Intelligence, 334, 203. https://doi.org/10.1007/978-3-030-67151-8_12Maldonado, U. P. T., Khan, G. F., Moon, J., & Rho, J. J. (2011). E‐learning motivation and educational portal acceptance in developing countries. Online Information Review. https://doi.org/10.1108/14684521111113597Mayer, R. E. (2014). Multimedia instruction. In Handbook of research on educational communications and technology (pp. 385-399): Springer. https://doi.org/10.1007/978-1-4614-3185-5_31Mehall, S. (2021). Purposeful interpersonal interaction and the point of diminishing returns for graduate learners. The Internet Higher Education, 48, 100774. https://doi.org/10.1016/j.iheduc.2020.100774Memon, A. B., & Meyer, K. (2017). Why we need dedicated web-based collaboration platforms for inter-organizational connectivity? A research synthesis. International Journal of Information Technology and Computer Science, 9(11), 1-11. https://doi.org/10.5815/ijitcs.2017.11.01Moore, J. L., Dickson-Deane, C., & Galyen, K. (2011). e-Learning, online learning, and distance learning environments: Are they the same? The Internet Higher Education, 14(2), 129-135. https://doi.org/10.1016/j.iheduc.2010.10.001Mtebe, J. S., & Raphael, C. J. A. J. o. E. T. (2018). Key factors in learners' satisfaction with the e-learning system at the University of Dar es Salaam, Tanzania. 34(4). https://doi.org/10.14742/ajet.2993Mumtaz, N., Saqulain, G., & Mumtaz, N. (2021). Online academics in Pakistan: COVID-19 and beyond. Pakistan Journal of Medical Sciences, 37(1), 283. https://doi.org/10.12669/pjms.37.1.2894Naveed, Q. N., Muhammed, A., Sanober, S., Qureshi, M. R. N., & Shah, A. (2017). Barriers Effecting Successful Implementation of E-Learning in Saudi Arabian Universities. International Journal of Emerging Technologies in Learning, 12(6). https://doi.org/10.3991/ijet.v12i06.7003Ngampornchai, A., & Adams, J. (2016). Students' acceptance and readiness for E-learning in Northeastern Thailand. International Journal of Educational Technology in Higher Education, 13(1), 1-13. https://doi.org/10.1186/s41239-016-0034-xOlum, R., Atulinda, L., Kigozi, E., Nassozi, D. R., Mulekwa, A., Bongomin, F., Kiguli, S. J. J. o. M. E., & Development, C. (2020). Medical education and E-learning during COVID-19 pandemic: awareness, attitudes, preferences, and barriers among undergraduate medicine and nursing students at Makerere University, Uganda. 7, 2382120520973212. https://doi.org/10.1177/2382120520973212Ouatik, F., & Ouatik, F. (2021). Learning Management System Comparison: New Approach Using Multi-Criteria Decision Making. Paper presented at the International Conference on Business Intelligence. https://doi.org/10.1007/978-3-030-76508-8_17Panda, S., & Mishra, S. (2007). E‐Learning in a Mega Open University: Faculty attitude, barriers and motivators. Educational Media International, 44(4), 323-338. https://doi.org/10.1080/09523980701680854Paul, J., & Criado, A. R. (2020). The art of writing literature review: What do we know and what do we need to know? International Business Review, 29(4), 101717. https://doi.org/10.1016/j.ibusrev.2020.101717Paul, J., Lim, W. M., O'Cass, A., Hao, A. W., & Bresciani, S. (2021). Scientific procedures and rationales for systematic literature reviews (SPAR‐4‐SLR). International Journal of Consumer Studies. https://doi.org/10.1111/ijcs.12695Pham, L., Limbu, Y. B., Bui, T. K., Nguyen, H. T., & Pham, H. T. (2019). Does e-learning service quality influence e-learning student satisfaction and loyalty? Evidence from Vietnam. International Journal of Educational Technology in Higher Education, 16(1), 1-26. https://doi.org/10.1186/s41239-019-0136-3Popoola, S. O., & Olajide, O. (2021). Influence of Library Anxiety and Computer Literacy Skills on Use of Library Information Resources by Undergraduates in Private Universities in Southwest Nigeria. International Information Library Review, 1-19. https://doi.org/10.1080/10572317.2021.1873051Rasheed, R. A., Kamsin, A., & Abdullah, N. A. (2020). Challenges in the online component of blended learning: A systematic review. Computers Education, 144, 103701. https://doi.org/10.1016/j.compedu.2019.103701Richardson, M., Abraham, C., & Bond, R. J. P. b. (2012). Psychological correlates of university students' academic performance: a systematic review and meta-analysis. 138(2), 353. http://doi.org/2012-04281-001Saeed Al-Maroof, R., Alhumaid, K., & Salloum, S. (2021). The continuous intention to use e-learning, from two different perspectives. Education Sciences, 11(1), 6. https://doi.org/10.3390/educsci11010006Sahibzada, U. F., Xu, Y., Afshan, G., & Khalid, R. (2021). Knowledge-oriented leadership towards organizational performance: symmetrical and asymmetrical approach. Business Process Management Journal. https://doi.org/10.1108/BPMJ-03-2021-0125Sánchez-Sordo, J. M. (2019). Data mining techniques for the study of online learning from an extended approach. Multidisciplinary Journal for Education, Social Technological Sciences, 6(1), 1-24. https://doi.org/10.4995/muse.2019.11482Sayaf, A. M., Alamri, M. M., Alqahtani, M. A., & Al-Rahmi, W. M. (2021). Information and Communications Technology Used in Higher Education: An Empirical Study on Digital Learning as Sustainability. Sustainability, 13(13), 7074. https://doi.org/10.3390/su13137074Singh, V., & Thurman, A. (2019). How many ways can we define online learning? A systematic literature review of definitions of online learning (1988-2018). American Journal of Distance Education, 33(4), 289-306. https://doi.org/10.1080/08923647.2019.1663082Tarhini, A., Hone, K., & Liu, X. (2014). Measuring the moderating effect of gender and age on e-learning acceptance in England: A structural equation modeling approach for an extended technology acceptance model. Journal of Educational Computing Research, 51(2), 163-184. https://doi.org/10.2190/EC.51.2.bWilliams, R. I., Clark, L. A., Clark, W. R., & Raffo, D. M. (2020). Re-examining systematic literature review in management research: Additional benefits and execution protocols. European Management Journal. https://doi.org/10.1016/j.emj.2020.09.007Wu, J.-H., Tennyson, R. D., & Hsia, T.-L. (2010). A study of student satisfaction in a blended e-learning system environment. Computers Education, 55(1), 155-164. https://doi.org/10.1016/j.compedu.2009.12.01

Impact of Education and Employment on Women Empowerment

This study is an endeavor to examine the status of women and most importantly the impact of education and employment on women empowerment in Quetta. Balochistan, Pakistan’s most rich and undeveloped Province in which most of the women in particular are still kept deprived of the facilities such as education and work/ employment, to be economically and educationally strong. Cross section, descriptive, and empirical study was done using survey technique method to gather information from the educated and employed women of Quetta district. The result indicates that education and employment have high significant positive relationship with women empowerment in decision making, control over the resources and voice. Education helps women get employment and employment makes them financially independent and economically strong which then leads to their empowerment. When women are empowered they reach out and empower other women. Research findings will definitely help the future researchers to understand influence of education and employment on women residing in Quetta, Pakistan to improve their ability to make strategic life choice to attain the capability desired for them and her family members, moreover the finding also provides a view on the status of women residing in Quetta

Repeatedly heated mix vegetable oils-induced atherosclerosis and effects of murraya koenigii

Background: Statins are considered as standard drugs to control cholesterol levels, but their use is also associated with renal hypertrophy, hemorrhagic stroke, hepatomegaly, and myopathy. Murraya koenigii is an herb that is used in traditional cuisine and as a medicine in South Asia. Here we assessed the antidyslipidemic and antiatherosclerotic effects of this spice in repeated heated mix vegetable oils (RHMVO)-induced atherosclerotic models.Methods: Aqueous extract of M. koenigii leaves (Mk LE) was prepared and its phytoconstituents were determined. Rabbits were divided into 5 groups (n = 10). Except for the control group, all the other four groups were treated with RHMVO for 16 weeks (dose = 2 ml/kg/day) to induce dyslipidemia and atherosclerosis. These groups were further treated for 10 weeks either with 300 and 500 mg/kg/day Mk LE, lovastatin, RHMVO, or left untreated. Body and organ weights were measured along with oxidative stress and tissue damage parameters. Lipid profile and hepatic function markers were studied. Atheroma measurement and histopathological examination were also performed in control and treated groups.Results: Mk LE significantly (p \u3c 0.05) attenuated RHMVO-induced dyslipidemia and atheroma formation. Furthermore, fat accumulation and lipid peroxidation in hepatic tissues were reduced by Mk LE in a dose-dependent manner. Our results indicated that the antidyslipidemic effects of Mk LE in 500 mg/kg/day dose were comparable to lovastatin. Additionally, oxidative stress markers were reduced much more significantly in Mk LE-500 than in the statin group (p \u3c 0.05).Conclusions: This study recommends Mk LE as a potent antioxidant and lipid-lowering natural medicine that can attenuate the RHMVO-induced atherosclerotic in optimal doses and duration. Therefore, Mk LE can be accessible, cheap, and free of adverse effects alternate to statins

Predictors and Consequences of Human Resource Outsourcing; A Quantitative study of Higher educational institution of Baluchistan, Pakistan

Human Resource Outsourcing has become one of the familiar thoughts to the media and business terms. This research is focused on the predictor and consequences of human resource outsourcing in educational institutions. Further, it helped us to establish a framework which would clearly highlight the factors and consequences of human resource outsourcing in educational institution of Baluchistan “Quetta”, Pakistan along with advantages and disadvantages of Human resource outsourcing policies. The Baluchistan was taken for research because this province has very less literacy rate. The research comprises very latest empirical and theoretical work which directly addresses the predictors and consequences of Human Resource outsourcing. Human resource outsourcing positively increases these effects in higher educational institutions. The study found that human resource outsourcing has negative effect on time management and communication issues in higher educational Institutions thus it can be said because of human resource outsourcing organizations may feel time management conflicts and communication issues among their employees. The results of 2 sample t test concluded that human resource outsourcing level does not differ in public and private institutes of Quetta, Baluchistan

Is GeneXpert MTB/RIF assay reliable for the diagnosis of pleural tuberculosis?

Background: Tuberculosis is the most common cause of infectious diseases related mortality globally. Tuberculous pleural effusion is a common presentation of extra pulmonary tuberculosis and a diagnostic challenge most of time. The rapid diagnosis of tuberculous pleural effusion is essential for early treatment. GeneXpert is a new tool for rapid diagnosis but the ability to correctly diagnose of GeneXpert is a vital concern in the diagnosis of extra pulmonary tuberculosis. Objective: To determine the accurate ability of diagnosing the pleural fluid GeneXpert MTB/RIF assessment in the suspected pleural tuberculosis patients considering as gold standard to the pleural biopsy. Methods: This study was a validational cross sectional survey and it was conducted in pulmonology department of –removed for blind review---from 1st July to 31st December 2018 after approval of IRB. Participants with suspected pathology ≥ 18 year with exudative pleural effusion were included in the study. By implementing the process of standard technique, closed needle pleural biopsy was executed by means of ABRAM’S needle. The collected samples of patients were sent to the pathology department of Pakistan Institute of Medical Sciences for histopathology. Pleural fluid was referred to National Institute of Health Islamabad for GeneXpert MTB/RIF assessment on the alike day and reports were assembled. All findings were entered in a structured Proforma. Data was entered in SPSS version 20 and analyzed. Results: Total 180 patients were included; 65.6% patients were male. When the sensitivity of pleural fluid GeneXpert MTB/RIF examination was calculated it was 10.4% whereas, the calculated specificity was 72.8%. While +ve predictive value of GeneXpert was 22.2% and -ve predictive value was 52.1%. Likelihood ratio was 8.25 and ROC curve also showed similar values.  Conclusion: The sensitivity of pleural fluid GeneXpert MTB/RIF assay is very low and specificity is moderate for diagnosis of pleural tuberculosis when compared with pleural biopsy. Key words: Extra pulmonary tuberculosis; GeneXpert; Pleural biopsy; Tuberculosis

Is GeneXpert MTB/RIF assay reliable for the diagnosis of pleural tuberculosis?

Background: Tuberculosis is the most common cause of infectious diseases related mortality globally. Tuberculous pleural effusion is a common presentation of extra pulmonary tuberculosis and a diagnostic challenge most of time. The rapid diagnosis of tuberculous pleural effusion is essential for early treatment. GeneXpert is a new tool for rapid diagnosis but the ability to correctly diagnose of GeneXpert is a vital concern in the diagnosis of extra pulmonary tuberculosis. Objective: To determine the accurate ability of diagnosing the pleural fluid GeneXpert MTB/RIF assessment in the suspected pleural tuberculosis patients considering as gold standard to the pleural biopsy. Methods: This study was a validational cross sectional survey and it was conducted in pulmonology department of –removed for blind review---from 1st July to 31st December 2018 after approval of IRB. Participants with suspected pathology ≥ 18 year with exudative pleural effusion were included in the study. By implementing the process of standard technique, closed needle pleural biopsy was executed by means of ABRAM’S needle. The collected samples of patients were sent to the pathology department of Pakistan Institute of Medical Sciences for histopathology. Pleural fluid was referred to National Institute of Health Islamabad for GeneXpert MTB/RIF assessment on the alike day and reports were assembled. All findings were entered in a structured Proforma. Data was entered in SPSS version 20 and analyzed. Results: Total 180 patients were included; 65.6% patients were male. When the sensitivity of pleural fluid GeneXpert MTB/RIF examination was calculated it was 10.4% whereas, the calculated specificity was 72.8%. While +ve predictive value of GeneXpert was 22.2% and -ve predictive value was 52.1%. Likelihood ratio was 8.25 and ROC curve also showed similar values.  Conclusion: The sensitivity of pleural fluid GeneXpert MTB/RIF assay is very low and specificity is moderate for diagnosis of pleural tuberculosis when compared with pleural biopsy. Key words: Extra pulmonary tuberculosis; GeneXpert; Pleural biopsy; Tuberculosis

Blindness in children at the Ida Rieu school for the blind and deaf

Objective: To identify the causes of blindness at the Ida Rieu school for the blind and deaf, Karachi, Pakistan.Methods: A cross sectional study was conducted at the Ida Rieu School for the blind and deaf. The data collected from medical record of students was entered into the WHO/PBL eye examination form for children with blindness and low vision.Results: Records of 144 pupils aged between 4-30 years were reviewed, including 67% males and 33% females. One third (31%) children had visual impairment (\u3c 6/18-6/60) and 69% were blind (\u3c 3/60-NPL). The commonest anatomical site was retina (41%) and whole globe (20%). The etiology was unknown in 49% cases. In 33% of cases, the data suggested hereditary cause as the etiology, 40% of cases were preventable and 13% treatable.CONCLUSION: Avoidable causes of blindness were seenin 53% of children, 58% of which were preventable and 19 were treatable