Comparison of intra-articular lidocaine versus intravenous sedative and analgesic for reduction of anterior shoulder dislocation in terms of mean pain reduction using vas score

INTRODUCTION: The most common dislocation presenting to emergency department is anterior shoulder dislocation. Posterior dislocations and inferior dislocations are rare. Dislocations of the anterior shoulder mostly occur with the position of the arm is abducted and externally rotated. This results in injury of the humeral head, labrum, capsuloligamentous structures and glenoid. Such patients experience severe pain, therefore prompt reduction is necessary to ameliorate the pain. Intravenous analgesia combined with sedation or intra-articular lidocaine injection can be used for closed reduction of anterior shoulder dislocation. Due to its side effects, Intra-articular lidocaine (IAL) is recommended for use as a probable alternative to intravenous sedation-analgesia especially for patients with contraindication to intravenous sedation-analgesia. OBJECTIVE: To compare intra-articular lidocaine versus intravenous sedative and analgesic for management of anterior shoulder dislocation in terms of mean pain using VAS during reduction of shoulder joint. STUDT DESIGN:   Randomized controlled trial (RCT). SETTING: Removed for blind review DURATION: 6 months (November 22nd, 2017 to May 21st, 2018) SAMPLE SIZE: 60 patients (30 in each group) RESULTS: We included sixty patients in my study. 19 (31.7%) were females and 41 (68.3%) were male patients. Out of all the patients 38 (63.3%) had right sided shoulder dislocation, while the rest 22 (36.7%) patients had left sided shoulder dislocation. Patients mean age was 33.27±10.535 years and mean pain score of all the patients was 4.966±1.930. The mean pain score in Group A was 4.200±1.648, while the mean pain score in Group B was 5.733±1.910 (p value = 0.002. Stratification was done according to gender and age group of the patients, and post-stratification t-test was applied. CONCLUSION:   Intra-articular lidocaine is better option in pain control during reduction of anterior shoulder dislocation. KEY WORDS: Intra venous analgesia, Intra-articular lidocaine, shoulder dislocation

Comparison Of Prophylactic Injection Of Corticosteroid With Placebo, In Management Of Wrist Pain On Ulnar Aspect In Patients Of Fractures Of Distal Radius

INTRODUCTION: Distal radius fractures are one of the commonest fractures experienced by the Orthopaedic surgeons. Pain on the ulnar aspect of the wrist is the most usual complication of such fractures.  Corticosteroid injection is a simple and effective method for elevating pain of such nature.  OBJECTIVE: To compare the mean pain score with prophylactic corticosteroid injection versus placebo in management of wrist pain on ulnar aspect in patients presenting with fracture of distal radius. MATERIAL AND METHODS: Study Design: Randomized controlled trial Setting: Orthopedic Surgery Department, Benazir Bhutto Hospital, Rawalpindi Duration: Six months (March 5, 2018 to Sept 5, 2018) Data Collection Procedure: 80 patients were included by using non-probability consecutive sampling after fulfilling the selection criteria. Demographic profile (patient name, age, gender, anatomical side and contact details) was obtained. Patients were splitted in two random groups by simple lottery method. Patients of group A were given one shot of 80mg corticosteroid in the area of ulnar styloid process near TFCC and group B patients were given a shot of distilled water (2 cc). Both group of patients were followed in OPD for 3 months in their postoperative visits. Visual analogue scale (VAS) score was recorded. Data was analyzed using SPSS version 21. Results: The mean age of the patients was 41.05 ± 11.05 years and age range of 40 years. The mean age in the corticosteroid and placebo groups was 39.68±10.67 years and 42.42 ± 11.39 years respectively. There were 42 (52.50%) male and 38 (47.50%) female patients with a higher male ratio i.e., 1.10:1. In corticosteroid and placebo groups there were 21 (52.50%) male and 19 (47.50%) female cases. The mean pain at baseline was 7.72 ± 1.66 while in the corticosteroid and placebo group, the mean pain was 7.60 ± 1.67 and 7.85 ± 1.65 respectively with statistically equal mean pain p-value = 0.504. After 3 months of treatment, mean pain in the corticosteroid group was 1.30 ± 0.66 and was 2.60 ± 1.58 in the placebo group, p-value < 0.001. Conclusion: Our findings suggested that prophylactic corticosteroid injection is more effective in reducing pain in patients with distal radial fracture than placebo. By using prophylactic corticosteroid injections in the future, we can reduce pain to achieve more satisfaction of patients.

Protein Engineering of Endoglucanase CelR of Clostridium thermocellum for Enhanced Expression

Background: Enhanced production and improved properties of cellulases for a greater activity on plant biomass would rank amongst the top priorities for second-generation ethanol production. Based on the emergence of protein engineering as a cutting-edge technology for enhancing enzyme activity and expression level, the present study is aimed at the application of this technique to the major cellulosomal processing endoglucanase of C. thermocellum, CelR for refining enzyme characteristics. Methods: The full-length native enzyme gene (CelR) and a truncated version without the docking domains at C-terminus (CelR-CB) were PCR amplified using gene specific primers. The amplified PCR products were T/A cloned in the vector pTZ57 R/T and transformed in E. coli DH5α. The cellulase genes from the confirmed transformed plasmids were sub-cloned in T7 promoter-based expression vector pET-28a and expression analysis was done in E. coli (DE3) BL21 codon Plus. Results: An SDS PAGE analysis of both the CelR derivatives revealed that the truncated version i.e. CelR-CB showed a two-fold increase in expression level as compared to the full-length enzyme. Conclusion: The increased expression level of CelR in E. coli coupled with its increased production therefore makes it a promising method for augmenting the recombinant enzyme production for potential applications.

Sustainable banking regulations pre and during coronavirus outbreak: the moderating role of financial stability

With the worldwide dispersion of COVID-19, banking sector, among others, needs to adapt to unexpected challenges. For this purpose, this study examines the impact of sustainable banking regulations on bank-specific characteristics pre and during COVID19 period in Pakistan for the period spanning from 2006 to 2020. Moreover, financial stability is employed to test its moderating role on sustainable banking regulations. The dynamic estimator, named the system-Generalized Method of Moments, is used to analyze the endogenous nature of the data. Findings suggest that capital adequacy ratio, deposit ratio, and loan ratio are positive whereas leverage ratios are negatively related to profitability and market return. Overall, findings reveal that sustainable banking regulations influenced the bank-specific characteristics substantially. Importantly, the year-wise averages of variables reveal that Pakistani banks have made significant improvements in profitability, market return, capital adequacy, and deposit ratio pre and during pandemic era. Additionally, the financial stability significantly moderates the relationship highlighting lower default risk and the effectiveness of sustainable banking operations. Practically, despite global lockdowns, economic and trade restrictions during COVID-19, State Bank of Pakistan, sustained health of banking sector through its well-regulated monitoring mechanism

Influence of different formulation variables on the performance of transdermal drug delivery system containing tizanidine hydrochloride: in vitro and ex vivo evaluations

The present study was aimed at preparation of transdermal patches of tizanidine HCl, evaluation of the effect of polymers on in vitro release pattern of the drug, and the effect of permeation enhancers on the penetration of the drug through the rabbit skin. Various proportions of hydrophilic (HPMC) and hydrophobic (Eudragit L-100) polymers were used with PEG 400 as film-forming agent, and Span 20 or DMSO as permeation enhancer. The formulations were assessed for physicochemical characteristics and in vitro drug release studies using USP paddle over disc method in phosphate buffered saline (pH 7.4) at 32.0±1°C. On the basis of in vitro studies and physicochemical evaluations, S03-A and S04-A were selected at Eudragit : HPMC ratios of 8 : 2 and 7 : 3, respectively, for further ex vivo analysis. The effects of different concentrations of Span 20 and DMSO were evaluated on excised rabbit skin using Franz diffusion cell. Cumulative drug permeation, flux, permeability coefficient, target flux, and enhancement ratio were calculated and compared with the control formulations. Kinetic models and Tukey’s multiple comparison test were applied to evaluate the drug release patterns. Formulation SB03- PE containing Eudragit L-100:HPMC (7:3) with Span 20 (15% w/w) produced the highest enhancement in drug permeation, and followed zero order kinetic model with super case-II drug release mechanism

Green Human Resource Management Bibliometric Analysis of the Published Literature from 2008 to 2022

Purpose:  The rising amount of research being done in the realm of environmental protection has resulted in the establishment of a new research paradigm in the field of human resource administration (HRA) called green human resource management" (GHRM). The current study was conducted to highlight the work been done in the field of GHRM and provide a pictorial view to the readers to understand the effectiveness of GHRM in various organizations.   Theoretical framework:  This paper provides an explanation of the development of literature and makes it possible to comprehend the topics that have been investigated in previous works of literature regarding GHRM.   Design/methodology/approach:  The Scopus core-collection and VOS-viewer were utilized in the writing of this paper. For the purpose of the study, each and every GHRM related document that will already exist within the database between 2008 till 2022 will be analyzed. The display of the data via graphical visualization incorporates both bibliographic coupling and co-citation features into the presentation.   Findings:  It was discovered that 418 documents on the GHRM scholarship were evaluated in this bibliometric investigation. The purpose of this study was to examine the volume, rising tendency, worldwide distribution, major journals, pioneer authors, dominant countries, and dominant industries in the field of global human resource management. With the use of logical operators, six different word combinations were combined to create the final product, “TITLE-ABS-KEY ("green human resource management" OR "green hr" OR "green human resource" OR " green human resource practices" OR "GHRM" OR "GHRMP")”, thus, the range grows wider. In the review, it was found that the GHRM is still a new idea. This review is meant to help modern researchers by giving them an overview of the current state of things.   Research, Practical & Social implications:  A more thorough and objective knowledge structure evolution framework for the period 2008 to 2022 is provided by this research, which is useful to the evolution of the Human Resource Management field.   Originality/value:  We have added a global perspective to our understanding of the concept's evolution across time by weaving together bibliographic information and network diagrams in this paper

Investigating the environmental Kuznets curve (EKC) hypothesis by utilizing the ecological footprint as an indicator of environmental degradation

Entrepreneurial orientation (EO) is one of the widely researched areas in entrepreneurship studies. Yet researchers have to come to agreement to the dimensionality of this important construct. EO is a multi-dimensional construct with varying impact on the performance and success of an enterprise in a developing context. Likewise, family ownership of the entrepreneurial business is one of the oldest phenomena in business circles. In developing countries family owned businesses makeup sizeable majority. The present study is conducted to investigate the role EO plays in the success of an enterprise with the moderating influence of family involvement. The study results indicate that proactiveness and autonomy are the most significant dimensions in the success of an enterprise. The results indicate that when family is taken as a moderator, the overall influence of EO dimensions is considerably reduced. The study concludes that cultural setting of entrepreneurial businesses and entrepreneurs themselves are subject to cultural norms and values and this cultural setting inhibit certain aspects of entrepreneurial activity, limiting the growth of entrepreneurship in a country. The study also recommends and points out future directions for further researc

Satellite synergy: navigating resource allocation and energy efficiency in IoT networks

Satellite-assisted internet of things (IoT) networks have emerged as a beacon of promise, offering global coverage and uninterrupted connectivity. However, the challenges of resource allocation and task offloading in such networks are intricate due to the unique characteristics of satellite communication systems. This research’s findings enrich the landscape of energy-efficient and dependable satellite-assisted IoT networks. The paper navigates the delicate balance between energy efficiency, network throughput, and fairness in distributing resources among IoT devices. The proposed techniques, notably the Outer Approximation Algorithm (OAA), usher in seamless connectivity and resource optimization. The central challenge at hand, a concave fractional programming problem, transforms through the Charnes-Cooper transformation, presenting as a concave optimization enigma. Herein, the proposed outer approximation algorithm takes flight, navigating the intricate paths of concave optimization. The performance of the epsilon-optimal solution faces scrutiny under diverse system parameters—the constellation of IoT devices, their affiliations, fairness considerations, and the equitable distribution of resource blocks. This contribution not only enriches research but also opens doors to the boundless possibilities of satellite-assisted IoT networks

Optimization of single step multiplex PCR for detection of Eimeria tenella and Eimeria necatrix from commercial broilers

Multiplex polymerase chain reaction (PCR) was optimized for detection of 2 important species of Eimeria (Eimeria tenella and E. necatrix). This optimized protocol was used to screen 100 fecal samples collected from broiler birds in Lahore periphery. Out of 100 samples we found 6 tenella and only 1 E. necatrix positive by this method. The detection limit of oocysts by this method was as leastas 16 oocysts. This optimized multiplex PCR method can be used as routine diagnostic tool for detection of E. tenella and E. necatrix and can be extended up to the detection of 7 Eimeria species in future