Spectrum of Complications in Children with Moderate to Severe DKA Admitted in Pediatric Intensive Care Unit of a Tertiary Care Hospital

Background: Diabetic Ketoacidosis (DKA) is the major source of mortality and morbidity in type 1 Diabetes Mellitus. Cautious fluid resuscitation, insulin and electrolyte replacement along with observation for complications is the mainstay of treatment. Early identification of complications lead to better management and outcome. Objective: To find out the complications of moderate to severe DKA in pediatric patients admitted in Pediatric Intensive Care Unit (PICU). Methods: Cross-sectional Study was conducted in PICU of University of Child Health Sciences & The Children’s Hospital, Lahore from Jan, 2015 to Dec, 2018.Data was collected from retrospective records of patients admitted in PICU. All patients with moderate/severe DKA were included. Patients with developmental delay were excluded. Data was analyzed using SPSS version 25. Chi-square test was used to find out p-value. Results: A total of 152 patients with moderate/severe DKA were included in the study, having mean age of 7.86 ± 4.06 years. Most patients 42% (n=64) were more than 10 years of age. Mean weight of the children was 19.89 ± 8.70 kg. Majority 59% (n= 89) were of new onset diabetes. Severe DKA was seen in 74% while moderate DKA in 26% patients. The complications seen were: hypokalemia 33% (n=50), cerebral edema 28% (n=42), hypernatremia 18% (n=27), hyponatremia 8% (n=12) and acute kidney injury (AKI) in 7% (n=11). Survival rate was 85% while mortality rate was 15%. Conclusion: Hypokalemia and cerebral edema were the most common complications observed. Complications were more common in those patients who presented with DKA in first presentation. Key words: complications, DKA severity, children, PICU

Spectrum of Complications in Children with Moderate to Severe DKA Admitted in Pediatric Intensive Care Unit of a Tertiary Care Hospital

Background: Diabetic Ketoacidosis (DKA) is the major source of mortality and morbidity in type 1 Diabetes Mellitus. Cautious fluid resuscitation, insulin and electrolyte replacement along with observation for complications is the mainstay of treatment. Early identification of complications lead to better management and outcome. Objective: To find out the complications of moderate to severe DKA in pediatric patients admitted in Pediatric Intensive Care Unit (PICU). Methods: Cross-sectional Study was conducted in PICU of University of Child Health Sciences & The Children’s Hospital, Lahore from Jan, 2015 to Dec, 2018.Data was collected from retrospective records of patients admitted in PICU. All patients with moderate/severe DKA were included. Patients with developmental delay were excluded. Data was analyzed using SPSS version 25. Chi-square test was used to find out p-value. Results: A total of 152 patients with moderate/severe DKA were included in the study, having mean age of 7.86 ± 4.06 years. Most patients 42% (n=64) were more than 10 years of age. Mean weight of the children was 19.89 ± 8.70 kg. Majority 59% (n= 89) were of new onset diabetes. Severe DKA was seen in 74% while moderate DKA in 26% patients. The complications seen were: hypokalemia 33% (n=50), cerebral edema 28% (n=42), hypernatremia 18% (n=27), hyponatremia 8% (n=12) and acute kidney injury (AKI) in 7% (n=11). Survival rate was 85% while mortality rate was 15%. Conclusion: Hypokalemia and cerebral edema were the most common complications observed. Complications were more common in those patients who presented with DKA in first presentation. Key words: complications, DKA severity, children, PICU

Effect of Job Design on Employee Satisfaction (A Study of Fertilizer Companies Listed in Lahore Stock Exchange)

Human is declared as “Better” in all living creation. That is the reason behind the importance of the Human Resource whether in Business Organizations or Non-Business Organization. It is the asset which can neither be copied nor be created. In the past two decades, the importance of Human Resource becomes shinier for the organizations especially for the business sectors. Human Resource Management, now a day, is the most important area for Business Organizations and Vital Topic for the Researchers as well. Achieving target and goals, capturing new markets and niches, acquiring and selling are one dimension of success for the organization, but now organizations are putting a valuable consideration to Human Resource Management and its issues. Job Design, Job Enrichment, Job Enlargement, Employee Satisfaction and Motivation, Brain Drain, Performance and Reward are some factors which captured the attention of the organizations. This Research exist in the orbit of the topic “Effect of job design on Employee Satisfaction” and declare 6 Variables of job design which is Independent Variable and find the relation of these variables with employee satisfaction through correlation and linear regression technique. Through Questionnaire, Primary data is collected and by the use of SPSS and Excel 2007, the results are concluded that there is a strong positive correlation between Job Design and Employee Satisfaction and both of these variables move in the same direction. Keyword: Job Design, Employee Satisfaction, Fertilizer Companies, Lahore Stock Exchang

How innovative climate leads to project success: the moderating role of gender and work culture

Purpose – In modern times, innovation is considered as a vital component of sustainable competitiveadvantage. The purpose of this paper is to identify how innovation at the individual level [innovative workbehavior (IWB)] and at the organizational level [innovative organizational climate (IOC)] affects the chances ofsuccess of a particular project. Additionally, the moderating effect of gender and work culture on the relationbetween innovative climate and behavior is tested in the study.Design/methodology/approach – Survey technique was used to collect data from 425 employeesworking in project departments at the executive, middle level and senior level management in the paintmanufacturing industry of Pakistan. Multiple regression, as well as Preacher and Hayes (2004) tests, wereapplied to test the hypotheses.Findings – The result of the data analysis showed that IWB acts as a mediator between IOC and projectsuccess (PS), thereby supporting the hypothesized model of innovation and PS. Work culture was supportedas a moderator; however, no moderating effect of gender was validated by the results.Research limitations/implications – The management must make sure that to maximize the rate ofsuccess of projects, innovative work climate within the organizations and departments be given dueimportance. In addition to this, personnel’s individual innovation capabilities must also be enhanced bytaking steps toward improvement through training and development. Originality/value – Though attention has been given to research in innovation in light of other relatedvariables, its relation to PS remains yet to be studied. The effect of gender and work culture on innovation inPakistani paint industry was long over-due which has been addressed by this stud

Clinical outcome of tetanus based on dakar tetanus severity score in paediatric intensive care unit of a tertiary care hospital

Objective: To evaluate the validity of  Dakar scoring system in predicting the outcome of tetanus in children of post neonatal age. Method: A prospective single center study conducted at ICU (Intensive Care Unit) of –removed for blind review-- 131 children with diagnosis of tetanus from January 2020 to June 2021 by analyzing demographic and clinical parameters. Results: Mean age of children was 8.11 ± 3.45 years with male predominance 91(69.5%). Major proportion of children were in range of 5-10 years comprising 65(50%). Period of onset of spasm was < 2 days in 92(70%) that correlate well with shorter incubation period (p-value <0.001). Mean duration of ICU stay was (18.81 ± 11.73) days. Only 14(10.7%) received three doses of vaccination but no one received booster dose. In majority of patients trauma due to road traffic accident 86(65.6%) was the predisposing factor followed by ear discharge 31(23.7%) and other causes 14(10.7%). Out of 131 patients 104(79.3%) received mechanical ventilation because of disease severity. Regarding outcome mild cases 2(1.5%), moderate 61(46.6%) and severe were 68(51.9%) according to Dakar scoring system and out of these severe cases 18(13.7%) expired (p-value < 0.001). However, 53(40.4%) discharged, 50(38.1%) shifted out to other wards after stabilization and 10(7.6%) left against medical advice. (p-value 0.001) Conclusion: Dakar scoring system correlates well with disease severity and should be adopted to aid clinical triage and management as with effective and appropriate treatment patients can have good prognosis. However, preventive aspects should be emphasized regarding booster dose of tetanus. Keywords: Tetanus, Outcome, Dakar scoring syste

Is Trade Openness the Reason of High Energy Demand in China?

The present study aims to examine the short-run and long-run impact of China's trade liberalization policies on its energy demand over the period from 1980 to 2018. The results of Autoregressive Distributed Lag approach of co-integration show that energy consumption significantly increases as a result of trade openness and increase in real Gross Domestic Product (GDP). The results of the granger causality test also confirm the unidirectional causality running from trade openness and real GDP to energy demand. The results of the study have an important implication because if China wants to continue its trade liberalization policies then it must increase its energy production. Keywords: Energy Consumption, Gross Domestic Product, Trade Openness, China, Time Series JEL Classifications: C22, F15, L98, Q43 DOI: https://doi.org/10.32479/ijeep.1116

Hyperglycemia-associated Alzheimer’s-like symptoms and other behavioral effects attenuated by Plumeria obtusa L. Extract in alloxan-induced diabetic rats

Diabetes mellitus is a chronic metabolic complaint with numerous short- and long-term complications that harm a person’s physical and psychological health. Plumeria obtusa L. is a traditional medicine used in the treatment of diabetes to reduce complications related to behavior. Plumeria is a genus with antipsychotic activities. The objective of this study was to examine the effects of a methanolic extract of Plumeria obtusa L. in the attenuation of diabetes, on symptoms of Alzheimer disease, and on other associated behavioral aspects. A single dose of alloxan was administered to an experimental group of rats to induce development of diabetes (150 mg/kg, intraperitoneal) and the rats were then administered selected doses of methanolic extract of Plumeria obtusa L. (Po.Cr) or glibenclamide (0.6 mg/kg) for 45 consecutive days. Behavioral effects were evaluated using three validated assays of anxiety-related behavior: the open field test, the light and dark test, and the elevated plus maze. Anti-depressant effects of Plumeria obtusa L. were evaluated using the forced swim test (FST) and memory and learning were assessed using the Morris water maze (MWM) task. Po.Cr was also evaluated for phytochemicals using total phenolic content (TPC), total flavonoid content (TFC), and high-performance liquid chromatography assays, and antioxidant capability was assessed through assays of DPPH radical scavenging, total oxidation capacity, and total reducing capacity. In the alloxan-induced model of diabetes, the administration of Po.Cr and glibenclamide for 45 days produced a marked decrease (p < 0.001) in hyperglycemia compared to control animals. Po.Cr treatment also resulted in improvement in indicators, such as body weight and lipid profile (p < 0.05), as well as restoration of normal levels of alanine transaminase (ALT) (p < 0.001), a biomarker of liver function. Diabetic rats presented more Alzheimer-like symptoms, with greater impairment of memory and learning, and increased anxiety and depression compared to non-diabetic normal rats, whereas treated diabetic rats showed significant improvements in memory and behavioral outcomes. These results demonstrate that Po.Cr reversed alloxan-induced hyperglycemia and ameliorated Alzheimer-related behavioral changes, which supports additional study and assessment of conventional use of the plant to treat diabetes and associated behavioral complications

Exploring the Impact of Socio-economic Indicators on Economic Growth of Pakistan

Since independence, Pakistan has faced many economic problems. Social and administrative issues have been an obstacle to its economic growth. Economic, social, and administrative problems have amalgamated and engulfed the whole nation like an epidemic. Being the most critical issue, bad governance is destroying the economy in many ways. Poor governance negatively contributes to the empirics of economic growth through increased poverty directly and through increased social evils, such as crimes, indirectly. The present study has used the Three Stages Least Square (3SLS) estimation technique to examine the role of governance in stimulating economic growth by considering important socio-economic variables like poverty and crime. The study results suggest that poor governance is contributing to increasing poverty in Pakistan, which is, in turn, raising crime rates drastically. Since high crime rates slow down the economic pace of the economy, improved governance, increased employment opportunities, mobilization of private investment, and diversion of public investment to rural areas are essential for promoting economic growth

Has Globalization Changed Lifestyles? A Case Study Of Punjab, Pakistan: Atif Khan Jadoon, Syeda Azra Batool, Ambreen Sarwar

In the past few decades, some remarkable developments in the fields of information technology, transportation and communication have led to the development of closer contacts between people all around the world. As a result of these developments and increased global integration, the world has started experiencing the effects of globalization more intensely than ever. The present study considers how, in response to globalization, respondents (from the three big cities, namely Lahore, Multan, and Rawalpindi, of province Punjab, Pakistan) with different socio-demographic profiles experience a varying degree of changes in their overall life patterns. The results show that individuals who are more educated and belong to the higher income group experience more prominent changes in their overall life patterns. The effect of globalization on the overall life of patterns of females and youngsters was, however, not found to be significant