The Nature of Difficulties in Learning English by the students at Secondary School level in Pakistan

This study was a comparative investigation into the nature of difficulties in learning English by the secondary school students of Provincial and Federal government schools in N.W.F.P (Khyber Pukhtunkhwa). The objectives of the study were (1)To find out the level of difficulties of secondary school students of Provincial and Federal government schools of N.W.F.P (Khyber Pukhtunkhwa) in tenses, active and passives voices, direct and indirect narrations, conjunctions, prepositions, articles, construction of sentences and reading with comprehension and (2)To compare the level of difficulties in learning English as a second language at secondary level of Provincial and Federal government schools in N.W.F.P (Khyber Pukhtunkhwa). The sample of the study was comprised of 654 randomly selected students from twenty four Provincial government schools and twenty two Federal government schools located in twenty four districts of N.W.F.P. (Khyber Pukhtunkhwa). An English language achievement test for secondary classes was administered to the sample students of the study. The data obtained were tabulated and analyzed through SPSS 17.0 software to compute mean, standard deviation, t-value and p-value (significance) level. The main findings of the study were; the students of Provincial government schools faced more difficulties in learning of verb forms, narration, conjunctions, prepositions, articles, sentence arrangements and reading comprehension. The students of both types of schools systems faced same difficulties in learning voices. Key words: Nature of Difficulties, Tenses, Voices, Narrations, Conjunctions, Prepositions, Articles

Vascular cognitive impairment in first ever ischemic stroke survivors

Stroke and transient ischemic attacks (TIA) are highly prevalent in Pakistan. Post stroke dementia (PSD) is one of the main causes of dependency in survivors and includes any dementia after a stroke, irrespective of its cause, which includes vascular, degenerative, or mixed. Many Independent survivors have residual physical or cognitive deficits, or behavioral changes which can affect family life and have professional consequences. Study design: Cross sectional study at Department of Neurology CMC Hospital Larkana from Aug-2014 to Jan-2015 to find out frequency of dementia in first ever ischemic stroke patients, its severity and outcome. Methods: Study approved from ethical review committee of the institute. Patients 30-60 years of age, of either gender, previously non-demented with first episode of ischemic stroke were included in this study after informed consent. Patients of Hemorrhagic stroke, Parkinson’s disease, Terminal cancers and those on steroids were excluded. Stroke confirmed by CT scan brain/ MRI showing new infarcts. Dementia was defined as per MMSE dementia interview at baseline and 3 months of follow up. Score of \u3c23 indicated cognitive impairment. Activity of daily living was assessed by AD8 screening interview. Score \u3e2 indicated impairment in activity of daily living. Results: 120 patients were included in the study during 6 month period with mean age of 54(±3.4) years. Among them 74 were males and 46 were females. 52 (43.33%) patients had a lacunar stroke, 43(35.8%) a MCA infarct, 13(10.83%) with ACA infarct, 12 (10%) a posterior circulation stroke. Among vascular risk factors hypertension present in 32 (26%), diabetes in 22(18.3%), atrial fibrillation in 11(9.16%), previous myocardial infarction 10( 8.33%) and history of transient ischemic attack 34(28.33%). Their medical history, neurological deficit, activity of daily living, a blood screen and extent of vascular territory of the stroke were recorded. MMSE at 3 month of stroke follow up performed which revealed \u3c23 score among 33(26%) patients. The activity of daily living was impaired among the demented patients. Recall, language and attention was impaired more than registration and orientation. Discussion: Patients with PSD have high mortality rates and are likely to be functionally impaired. The progressive decline of recall and forgetfulness observed in our study severely affect the activity of daily living. The best way to prevent dementia is preventing vascular risk factors and the stroke by medications and follow up. Conclusion: Stroke patients should be assessed with dementia and monitored regularly with structured MMSE and activity of daily living as part of routine check up to prevent mortality and morbidity in stroke survivors

Therapeutic adherence in outpatients with heart failure registered with a community pharmacy

Realizou-se estudo descritivo transversal, de acordo com a classificação de adesão à terapêutica, para avaliar a adesão em 250 pacientes com diagnóstico de disfunção cardíaca, registrada no departamento de saúde do município de Santiago de Cuba, em 2009. A caracterização da amostra foi estudada, com a avaliação do nível de adesão e possíveis fatores associado a sexo, idade e hábitos tóxicos. Como instrumento para o trabalho, esquematizou-se aa extração de dados e realizou-se a entrevista nas moradias dos pacientes. Os resultados foram expressos em porcentagem e em nível de influência dos fatores associados, determinados por meio do teste do Q quadrado. Na população sob investigação, a adesão foi maior para as mulheres da faixa etária de 67 a 82 anos, e os hábitos tóxicos foram prevalentes. Na amostra em estudo, as farmacoterapias predominantes foram digoxina, clortalidona, captopril e dinitrato de isossorbida e se observou alto nível de adesão tanto para os tratamentos farmacológicos quanto para os não-farmacológicos. Observou-se alto nível de adesão para 63,6% dos pacientes, nível regular para 32% 3 somente 4,4% dos pacientes apresentaram baixa adesão. Os fatores que influenciaram foram conhecimento a respeito do tratamento, número de medicamentos, frequência de administração e satisfação com o serviço de atenção farmacêutica.A transverse descriptive study was carried out, according to the classification of therapeutic compliance, to evaluate adherence in 250 patients with a diagnosis of Heart Failure, registered with the health department of the municipality of Santiago de Cuba in 2009. The sample characterization was studied, with an assessment of adherence level and possible associated factors for sex, age and toxic habits. As an instrument for the work, data extraction was scheduled and the interview was carried out at patients' homes; the results were expressed in percentage and level of influence for associated factors. This was determined using the chi-square test. In the investigated population, adherence was greater for females, for age group 67-82 years, and toxic habits were found to have prevalence. Prevailing pharmacoterapies were digoxin, chlortalidone, captopril and isosorbide dinitrate, and a high level of adherence was found, both for the pharmacological and non-pharmacological treatments, in the studied sample. A good level of therapeutic adherence was found for 63.6% of the patients, regular level of adherence was found for 32% and only 4.4% or patients presented with poor adherence. Influencing factors were: knowledge of the treatment, number of medications, frequency of administration, and satisfaction with the service of pharmaceutical care

Variants and variations among gullian barre syndrome presenting as acute flaccid paralysis

Acute flaccid paralysis (AFP) is a clinical syndrome characterized by rapid onset of weakness that frequently includes respiratory and bulbar weakness. An accurate and early diagnosis of the cause has important bearing on the management and prognosis. Guillian Barre Syndrome (GBS) is a post infectious polyradiculoneuropathy involving mainly motor but sometimes sensory and autonomic nerves

Therapeutic Implications of Caffeic Acid in Cancer and Neurological Diseases

Caffeic acid (CA) is found abundantly in fruits, vegetables, tea, coffee, oils, and more. CA and its derivatives have been used for many centuries due to their natural healing and medicinal properties. CA possesses various biological and pharmacological activities, including antioxidant, anti-inflammatory, anticancer, and neuroprotective effects. The potential therapeutic effects of CA are mediated via repression and inhibition of transcription and growth factors. CA possesses potential anticancer and neuroprotective effects in human cell cultures and animal models. However, the biomolecular interactions and pathways of CA have been described highlighting the target binding proteins and signaling molecules. The current review focuses on CA’s chemical, physical, and pharmacological properties, including antioxidant, anti-inflammatory, anticancer, and neuroprotective effects. We further described CA’s characteristics and therapeutic potential and its future directions

Determination of Shear Bond Strength of Nanocomposite to Porcelain and Metal Alloy

Objective: To compare porcelain and metal repair done with both nanocomposite and conventional composite. Material and Methods: A total of 30 cylinders were fabricated from Porcelain (I), Porcelain fused to metal (II), and metal (III) substrate each. Control group (A) was bonded with conventional micro-hybrid composite and experimental group (B) was bonded with nanocomposite in a 2 mm thickness. All specimens were thermocycled and stored in distilled water at 37 °C for 7 days. A universal testing machine was used to measure the Shear bond strength (SBS). The difference between bond strengths of the groups was compared using an independent t-test. Results: In all three groups, the SBS was higher in the experimental group as compared to the control group. The use of nanocomposite of metal alloy presented maximum shear bond strength, followed by samples of porcelain fused to metal and finally porcelain, showing the lowest values of SBS. Conclusion: Porcelain and alloys bonded with nanocomposite exhibit enhanced adhesiveness as well as aesthetic and mechanical properties. This subsequently would translate into providing higher clinical serviceability and durability and hence a cost-effective and accessible repair option for human welfare

Capacity Optimization of Next-Generation UAV Communication Involving Non-Orthogonal Multiple Access †

Unmanned air vehicle communication (UAV) systems have recently emerged as a quick, low-cost, and adaptable solution to numerous challenges in the next-generation wireless network. In particular, UAV systems have shown to be very useful in wireless communication applications with sudden traffic demands, network recovery, aerial relays, and edge computing. Meanwhile, non-orthogonal multiple access (NOMA) has been able to maximize the number of served users with the highest traffic capacity for future aerial systems in the literature. However, the study of joint optimization of UAV altitude, user pairing, and power allocation for the problem of capacity maximization requires further investigation. Thus, a capacity optimization problem for the NOMA aerial system is evaluated in this paper, considering the combination of convex and heuristic optimization techniques. The proposed algorithm is evaluated by using multiple heuristic techniques and deployment scenarios. The results prove the efficiency of the proposed NOMA scheme in comparison to the benchmark technique of orthogonal multiple access (OMA). Moreover, a comparative analysis of heuristic techniques for capacity optimization is also presented

Determination of Shear Bond Strength of Nanocomposite to Porcelain and Metal Alloy

Objective: To compare porcelain and metal repair done with both nanocomposite and conventional composite. Material and Methods: A total of 30 cylinders were fabricated from Porcelain (I), Porcelain fused to metal (II), and metal (III) substrate each. Control group (A) was bonded with conventional micro-hybrid composite and experimental group (B) was bonded with nanocomposite in a 2 mm thickness. All specimens were thermocycled and stored in distilled water at 37 °C for 7 days. A universal testing machine was used to measure the Shear bond strength (SBS). The difference between bond strengths of the groups was compared using an independent t-test. Results: In all three groups, the SBS was higher in the experimental group as compared to the control group. The use of nanocomposite of metal alloy presented maximum shear bond strength, followed by samples of porcelain fused to metal and finally porcelain, showing the lowest values of SBS. Conclusion: Porcelain and alloys bonded with nanocomposite exhibit enhanced adhesiveness as well as aesthetic and mechanical properties. This subsequently would translate into providing higher clinical serviceability and durability and hence a cost-effective and accessible repair option for human welfare