Impact of Merging Cloud with Customary ERP in Small and Medium Scale Enterprises in Pakistan

Information management system changes as system enhances. Current ERP in firms is known as a customary ERP system. In recent an innovative technology, cloud emerges with enterprise resource planning and these systems shift to the cloud. These systems are labelled as Cloud enterprise resource planning systems. Cloud ERP an effective solution of a number of problems, come across by customary ERP in terms of cost, accessibility and reliability. Cloud ERP is cost effectual in term of hardware and software. The aim of this research was to persuade that merging of cloud with ERP is an appropriate alternative to customary ERP for local and heavy data storage accessibility and impact of cloud adoption in SMEs and technology, organization, environment factors that affect the adoption and transformation on cloud a survey base investigation in applying on these factors. TOE was given a broader view of IT upgrade, adoption and transformation. Keywords: Customary ERP, Cloud ERP,  Cloud Computing, Cloud merging, TOE Framework

Unsolved Tricky Issues on COTS Selection and Evaluation

Component Based Software Engineering (CBSE) approach is based on the idea to develop software systems by selecting appropriate components and then to assemble them with a well-defined software architecture. (CBSE) offers developers the twin benefits of reduced software life cycles, shorter development times , saving cost and less effort as compare to build own component. However the success of the component based paradigm depends on the quality of the commercial off-the-shelf (COTS) components purchased and integrated into the existing software systems. It is need of the time to present a quality model that can be used by software programmer to evaluate the quality of software components before integrating them into legacy systems. The evaluation and selection of the COTS components are the most critical process. These evaluation and selection method cannot be resolved by the IT professionals itself. In this study the author tried to compare the twenty three available systematic methods for best evaluation and selection of COTS components

Valproic Acid-Induced Hyperammonemia with Encephalopathy (VIHE): A Case Report

Valproic acid (VPA) is a wide spectrum antiepileptic medication indicated for seizure prophylaxis across the spectrum of epilepsy. Since coming into clinical use, VPA has also been recommended for the management of a variety of other pathologies, including, most notably, mood stabilization in the manic patient. VPA’s common adverse effects include gastrointestinal, influenza-like symptoms, headache, and difficulties with sleep; nonetheless, in rare instances, VPA has been noted to cause the severe and potentially lethal condition of hyperammonemia with encephalopathy (VIHE). VIHE is the result of a dose-independent increase in ammonia levels. Often the patient is asymptomatic; if symptoms reach clinical threshold, lethargy is most common, though seizures, focal neurologic deficits and even coma are possible. VIHE can occur in patients despite normal hepatic function, normal loading doses, chronic stable doses and normal free serum drug levels. Once the diagnosis is confirmed, the first approach for symptomatic patients is to discontinue VPA, start alternative mood stabilizer as indicated, and supplement hyperammonemia treatment with lactulose, carnitine or carglumic acid. Below is a case report of VIHE that developed in an adolescent girl with a history of Bipolar I Disorder who was hospitalized in our facility for stabilization of mania.  As demonstrated below, early diagnosis of VIHE is pivotal in reducing morbidity and ultimately can be life-saving

Association of Dietary Practices and Lifestyle Modifications in Gastroesophageal Reflux Disease in Pakistani Women

Background: Gastroesophageal Reflux Disease (GERD) incidence is increasing day by day due to lifestyle changes and living standards that resulted in esophagitis, esophageal adenocarcinoma, Barrett’s esophagus and many other illness worldwide. Patients with GERD live with poor quality life and have low work capacity.  Aims: Main aim of the study is to diagnose GERD in early stages for the reduction in mortality and morbidity at different age groups. Methods: The pre-tested questionnaire was used to collect data from Sir Ganga Ram Hospital Lahore. A total of 230 female patients screened for GERD symptoms were included in this study. The collection of demographic data, dietary intake, lifestyle habits, physiology, and physical analysis were gathered during the 4 months.   Results: Data analysis shows us that GERD is highly significant with age, occupation. Moreover, burping is highly significant in these patients. Fried fatty foods, spicy foods, fizzy drinks, garlic intake were also correlated to GERD symptoms. These subjects also suffer from more skin problems.  Conclusion: From our results, we infer that GERD has a very strong bond with dietary and lifestyle patterns. If these parameters are kept under control, GERD patients will be less agonize from complications and minimize our morbidity and mortality.&nbsp

Faculty Satisfication Regarding Modular Teaching

Introduction: Recently many medical institutes have been shifted to integrated curriculum; however, the implementation of integrated curriculum has faced problems due to both faculty and student’s satisfaction. Though faculty gives value to it, still certain believe that it’s not as effective as the traditional system. This study aims to evaluate the satisfactory level regarding modular teaching among faculty members at three different medical institutes in Pakistan. Material and Methods: This was a descriptive study where the senior faculty members from three different medical institutes were included. After written consent from participants the data was collected through semi-structured questionnaire. Total of 88 faculty members were included through convenient sampling technique. Data analyzed by SPSS version-22. Results: Overall 50% participants agreed that strength of modular teaching is the integration process & clinical application. 38% agreed that modular teaching provides better understanding & clarity of concepts. Regarding weaknesses 44% agreed that modular teaching requires more trained faculty, 27% said that more resources are required. On the other hand, 84% showed satisfaction that students get more benefits from modular teaching as compare to conventional teaching & 72% agreed that teacher biasness is less, 82% agreed that students become a lifelong learner, 85% agreed that more applied knowledge is delivered through this system.Conclusion: The majority of participating faculties were satisfied with modular teaching as it has a good clinical application, provides better understanding & a student-centered approach. &nbsp

Comparison of diagnostic indices of MRI and EMG in diagnosis of lumbar radiculopathy

BACKGROUND: lumbosacral radiculopathy is one of the most common disorders that can be examined by neurologists. Electromyography (EMG) and magnetic resonance imaging (MRI) are used to inspect this disease; however, the application of MRI and EMG in patients with back pain is still under study. This study was designed and implemented to compare the diagnostic values of MRI and EMG in the diagnosis of lumbar radiculopathy. METHODS: This was cross-sectional study which included 62 patients with suspected lumbosacral radiculopathy in a referral neurology clinic in Sanandaj, Iran, in 2009-2010. EMG was considered as the gold standard test. Inclusion criteria were being older than 20 years of age, and suffering from back pain or radicular pain in the lower limbs for more than four weeks. Data were entered into SPSS software and the diagnostic indices and agreement were calculated. RESULTS: The percentage of agreement between MRI and EMG results were calculated as 80.6%. The sensitivity of MRI compared with EMG at different levels was calculated between 44.4% and 79.6% and its specificity was calculated between 46.1% and 94.3%. In total, sensitivity and specificity of MRI were 68.9% and 86.3%, respectively. The Lasègue's sign, used for detection of disc herniation, had the sensitivity, specificity, and positive and negative predictive value of 28.8%, 50%, 75%, and 11.9%, respectively. CONCLUSION: MRI and EMG tests have no superiority over one another for the evaluation of lumbar radiculopathy and it is necessary to do both. The Lasègue's sign is also not an appropriate test for detection of lumbar spine disc herniation, and it is not helpful in diagnosing or ruling out the disease

Knowledge attitude and practices of undergraduate students regarding first aid measures

OBJECTIVES: To assess knowledge, attitude and practices of first aid measures in undergraduate students of Karachi. METHODS: A cross-sectional study was carried out at six colleges of Karachi, three of which were medical colleges and three non-medical colleges. Knowledge was assessed regarding various emergency situations with the help of a questionnaire. The target population size was 460, based on 50% prevalence and 95% confidence interval. The eventual sample size achieved was 446. RESULTS: A total of 446 students were interviewed. Seventy eight students (17.5%) had formal First Aid (FA) training. The mean number of correct answers of students with FA training was 10.3 (+/- 3.5) as opposed to 8.58 (+/- 4.0) in those without FA training (p \u3c 0.001, 95% CI) with a mean difference of 7.84%. The mean number of correct answers by medical students with FA training was 11.2 (+/- 2.9) as opposed to 7.2 (+/- 3.43) by non-medical students (p \u3c 0.001, 95% CI) with a mean difference of 18.14%. Students having received formal first aid training scored better than those who had not (p \u3c 0.001). CONCLUSION: First aid training programmes should be introduced at school and college level in developing countries to decrease the early mortality and morbidity of accidents and emergencies