Study of the Postoperative Nausea and Vomiting Incidence for Pediatric Surgery in Baghdad Educational Hospital

يعتبر حدوث الغثيان والقيء في مرحلة مابعد التداخل الجراحي من اهم العقبات التي يواجهها الكادر الطبي والتي قد تتسبب باضطراب الوضع الصحي للمريض والنزف الدموي والاستنشاق الرئوي لمحتويات المعدة واختلال تراكيز الاملاح والسوائل الامرالذي قد يطيل من مدة بقاء المريض داخل المستشفى والذي احيانا قد يؤدي لتدهور حالته الصحيه بشكل عام.لقد اجريت العديد من البحوث العلمية والدراسات  للحد من حدوث ذلك للوصول لطرق علاجيه كاستخدام تقنيات التخدير الحديثة واعطاء المسكنات والسوائل الوريدية والعلاج الدوائي المتوازن وغير ذلك. ان الهدف من الدراسة هوتقييم نسبة حدوث الغثيان والقيءفي مرحلة مابعد التداخل الجراحي للاطفال(140)(74ذكور,66اناث) والذين تراوحت اعمارهم من6الى 12سنة ولقد كانت فترة التداخل الجراحي مساوية ولاتتجاوز 30دقيقةولعدة انواع من العمليات الجراحية وبمقياس كتلة الجسم اقل من30,لقد خضعت كل حالات الدراسةللتخدير العام غير الطارئ ولاسئلة استبيان الدراسة.لقد تم متابعة المرضى في غرفة الافاقة وبمايتلاءم وحالة المريض الصحيةوتم التوصل الى ان30بالمئة من حالات الدراسة عانوا من الغثيان والتقيء والذي قد يعزى لاسباب عديدة كالقلق ونوع العملية الجراحية وادوية التخدير المستخدمة واختلاف الجنس,واما الذين لم يعانوا من حدوث الغثيان والقيء فلقد كانت نسبتهم 70بالمئةوالذي قد يكون نتيجة لعدة اسباب كالسمنة ومواد التخدير الاستنشاقية.Generally speaking postoperative nausea and vomiting (PONV) as the most conventional complaint afterward anesthesia that can attend the desolation like bleeding, electrolyte disorders, gastric content aspiration as well as delay hospital remittance. Postoperative emesis where as has a high incidence even though the extensive whole of research done in this field and the variety of antiemetic drugs accessible. In order to manage this crisis, they need a multi approach which can include the certified analgesia, emetogenic anesthetic techniques as well as appropriate intravenous hydration. The current study aims to assess the postoperative nausea and vomiting incidence for pediatric undergoing surgical operations. A total number of 140 patients (74 male and 66 female) with age ranges (6-12) years old, duration of surgery equals or less than 30 min and body mass index less than 30 . General anesthesia is achieved for admitted elective patients. All patients are confirming according the questions of questionnaire; we monitor the incidence of nausea and vomiting in the recovery room. We conclude that the patients with (30%) have an incidence of nausea and vomiting postoperatively that may be related by causes  (age, history of PONV,  anxiety , type of operation and anesthetic drug).and  patients with (70%) have no nausea and vomiting incidence postoperatively that may be related by causes (sex, obesity and inhalation agents).   &nbsp

Family needs of patients admitted to intensive care units at a tertiary care hospital, Karachi, Pakistan an analytical cross-sectional study

Background: The admission of patients to the ICU is a distressing emergency. Family members of ICU patients suffer from anxiety and depression compounded by disrupted routines and role conflicts. Nurses often prioritise patient care over family support, while the family goes ignored. The family members staying in hospital have different physical and psychological needs. Family members frequently bear the responsibility of making critical decisions for the patients. The unmet important family needs add to their stress and anxiety.Purpose: This study aimed to assess the self-perceived importance of family needs in the ICU using the CCFNI Scale and identifying socio-demographic factors influencing CCFNI scores.Method: An analytical cross-sectional design was used to assess the important family needs. A sample of 150 participants was conveniently recruited from three ICUs in a tertiary care hospital. The data was collected using a reliable and validated tool CCFNI. The results were analysed using SPSS V.26, incorporating both descriptive and inferential statistics, with a linear regression model employed to determine the association between dependent and independent variables.Findings: The major findings revealed that ‘To be assured that the best care possible is being given to the patient’ (3.83 +0.445) was the most important need of the family members. The most important domain of needs of the family members identified was the domain of assurance (3.70 +0.391), followed by information (3.37 +0.541), and comfort (3.37 +0.582). The socio-demographic characteristics of Age, Gender, Marital Status, Education, Relationship with the Patient, Number of Hours Participants Stay in the Hospital and Distance from home to hospital were the significant predictors of the CCFNI score.Conclusion: This study underscores the importance of a patient and family-centred care approach in healthcare, highlighting the role of cultural and demographic factors. Policy changes, like flexible visiting hours, can better address family needs, impacting patient recovery and well-being

THE JOINT-DETERMINANTS OF LEVERAGE AND DIVIDEND POLICY: A BALANCED PANEL STUDY OF NON FINANCIAL FIRMS OF INDIA AND PAKISTAN.

This study aims to identify the joint determinants of leverage and dividend policy of non-financial firms in Pakistan and India. For analysis purpose, the data is gathered from the annual reports of companies from India and Pakistan during years 2010-2014. Multiple regression analysis is used on reduced form equations to see the impact of variables on dividend policy and leverage of the firms. Literature from finance indicates that liquidity, profitability, tangible assets, institutional ownership of firm and firm size, all affect the decisions regarding leverage and dividend payment. Regression results are used to see the effect of these variables and compare them with theories from finance. The results indicate that only size of the firm positively impacts the decision to take additional debt, while all other variables have negative effect on debt policy. From second regression, both profitability and liquidity negatively impact dividend policy while remaining variables impact it positively. Additionally, only liquidity of a firm jointly determines both leverage and dividend policy

Impact of Job Scope on the Outcomes with the Mediation of Intrinsic Motivation and Moderation of Servant Leadership

This research aims to find the impact of job scope on OCB and in role performance with mediation of intrinsic motivation. The relationship of job scope and intrinsic motivation was moderated by servant leadership. The research was conducted in education sector employees in Punjab (Pakistan). Purposive sampling was used for data collection and total respondents were 475. Results suggested that all hypotheses were accepted significantly and had great implication in selected sector. Keywords: Servant Leadership, OCB, Job scope, Intrinsic Motivatio

Neostigmine as an Adjunct to 0.5% Lignocaine Quality of Anaesthetia and Analgesia in Intravention Regional Anaesthesia

Objective:- To compare the duration of anaesthesia and the degree of post operative pain relief. Material and methods:- This Interventional type of study was carried out in the Anaesthesia department, Nishtar Hospital Multan from January 2017 to January 2018. A total of 100 patients (two groups of 50 patients in each group). Results:- The onset of anaesthesia and quality of anaesthesia were better in neostigmine group (P<0.05). Post operative pain relief was also better. No significant difference in hemodynamics and no adverse effects were observed. Conclusion:- With the addition of neostigmine in traditional lignocaine solution for IVRA the quality of anaesthesia and analgesia is improved. Key words:- Intravenous regional anaesthesia, IVRA, lignocaine, neostigmine

PATTERN OF DISEASES IN MEDICAL WARDS OF A TERTIARY CARE HOSPITAL OF SOUTH PUNJAB, PAKISTAN.

Objective:- To assess the frequency and pattern of diseases in a medical wards at tertiary care hospital of Southern Punjab. Study design:- Cross-sectional study. Setting:-Medical Units of Nishtar Hospital Multan. Patients and methods:- Patients admitted at different Medical Units of Nishtar Hospital, Multan were included in the study.  Specially designed proforma was filled, data were collected and analysed on SPSS-20. Results:- Total admitted patients in medical units of Nishtar Hospital, Multan from May, 2016 to May, 2017 were 660. Out of these 660, 390 (59.1%) were males and 270 (40.9%) were females. Age ranges from12-70 and above. Mean age was 43.88 years with standard deviation 18.87 years. Mostly (63.5%) patients were from home district. Chief complaints were uncontrolled diabetes mellitus (17.6%), fever (13.6%), weakness of one-half of body (10%), uncontrolled hypertension (9.7%), cough and fever (8.5%), yellowness of eyes (5.8%) and vomiting (4.2%). Most common disease was diabetes mellitus (19.1%) followed by hypertension (17.9%), cerebro-vascular accidents (10%), chronic liver diseases (9.7%), acute hepatitis (8.9%), pneumonia (7.4%), meningitis (5.9%), chronic renal failure (3.2%), acid peptic disease (2%) and acute myeloid leukemia (1.5%). Conclusion:- Study revealed diabetes mellitus, hypertension, ischemic heart disease  (IHD) and Cerebro-vascular accident  (CVA) are most common diseases. Important measure to control diabetes mellitus and hypertension must be adopted. More detailed and large scale study are needed on pattern of diseases at tertiary care hospital so that disease pattern are known and on these basis strategies for control of diseases and patients care can be derived. Keywords:- Chief complaints, Disease pattern, Disease burden

A Sectoral Analysis of Poverty in Pakistan

Since independence, the problem of mass poverty in Pakistan has been substantial. The number of the destitute has continued to soar. The problem of poverty now looks to be beyond control. The vast masses of the people, particularly in rural areas, are indeed, miserably below the poverty line. Moreover, the socioeconomic and demographic indicators are dismal. Official planning and the market economy system have failed to lessen poverty. The policies formulated to eradicate it have failed to achieve their objectives. The issue of poverty in Pakistan has its significance for sustainable development. Long run development is not possible without protecting the rights of the vulnerable groups and the participation of the entire population in the development process. Although Pakistan’s economic growth has been quite respectable for much of the last four decades but it has failed to trickle down to the masses. The country has experienced poverty and stagnation in 1950s, increasing poverty and growth in the 1960s, stagnation of growth but declining poverty in the 1970s, increasing growth and declining poverty in the 1980s and finally, increasing poverty and falling growth in the 1990s [MHCHD/UNDP (1999)]. The mainstream approach to identifying the poor specifies a cut-off point ‘poverty line’, defining the level of income/expenditure below which people are diagnosed as poor. The conventional measure of poverty, head-count index, has been widely used in Pakistan. However, in practice this absolute threshold usually cannot stand the pressures of changing circumstances and is not as absolute as the term would appear to imply [Zaidi and de Vos (1993)]. To show the true face of poverty this study uses Foster, Greer and Thorbecke (1984) class of additively decomposable measure to estimate the variation in the incidence, intensity and severity of poverty across sectors of employment. This study also determines the relative contribution of the various sectors to aggregate poverty. Location index is also used to measure the concentration of poor in each sector. To evaluate the sources of observed changes in sectoral poverty at the micro level ‘HIES’ data sets are used.