Effect on post Tonsillectomy pain control with IV and infiltrated dexamethasone and infiltrated bupivacaine: A Randomized Controlled Trial.

Objectives: To evaluate the effect on post tonsillectomy pain control with IV and infiltrated dexamethasone and infiltrated bupivacaine. Methodology: This randomized controlled trial study was conducted in the department of ENT and neck surgery of Holy Family hospital, Rawalpindi, over a period of one year from May 2019 to May 2020. A total of 140 pediatric patients were selected and were divided into four equal groups randomly by lottery method. Patients in all four groups had endotracheal intubation with general anesthesia. As premedication, all the patients received intravenous midazolam (1mg). Intravenous fentanyl (1.5mg/kg) and propofol (2.5 mg/kg) followed by endotracheal intubation facilitated with atracurium (0.5 mg/kg) were used as general anesthesia in all patients. Results: There was no significant (p-value >0.05) difference in gender, age of children, postoperative heart rate, postoperative SPO2, and fentanyl consumption. The duration of surgery was significantly (p-value < 0.05) different in all four groups. According to the results, no significant (p-value >0.05) difference was found based on postoperative nausea and vomiting and the requirement of antiemetics. The requirement of analgesics was significantly (p-value <0.05) different among four groups. Minimum number (22.86%) of patients who required the analgesic were in IV dexamethasone group and highest requirement rate (60%) was found in local dexamethasone group followed by bupivacaine (48.57%) group. Conclusion: Intravenous dexamethasone was found to be more effective for early postoperative pain control and reduction in requirement of analgesics. The use of dexamethasone can be a preferred choice in patients undergoing tonsillectomy

Impact of Human Resources Management Practices on Turnover, Productivity and Corporate Financial Performance

In developing countries, the human resource availability is quite easy but the most unfortunate part is its effective and efficient management. It is a well established fact that it is human beings behind the machines which can drive or drown the organizations. Human behavior and psychology is driven and motivated by varying degree of factors. The researchers across the globe have evolved and successfully practiced certain HRM techniques in order to achieve best performance and productivity from human capital. Unfortunately this area remained neglected and human resource could not be exploited to its full potential in Pakistan despite the fact that the country possesses  one of the best human capital in the world. This paper is an Endeavour to identify the best Human Resource Management practices applicable to Pakistani environments and analyze their positive effects on labor turnover, productivity and corporate financial performance. In order to achieve this objective, a survey questionnaire was designed and disseminated among respondents. A total of 200 questionnaires were distributed, out of which 145 completed questionnaires were received. The authors analyzed the data by using statpro software. the major conclusions and findings were; Need for articulation of vision, mission and values for organization, lack of performance management system, lack of benefit and compensation program, issue of corporate loyalty, poor workforce alignment, absence of HR development and training programs, lack of Human Resource Information System(HRIS),and non adoption of TQM. Keywords: HRM, Productivity, Pakistan, Turnover

Diagnostic Reliability of Paediatric Appendicitis Score & Ultrasound Scan in Children with Suspected Acute Appendicitis

Objective:  To evaluate the efficacy of Paediatric Appendicitis Score and ultrasound scan in the paediatric population. This study evaluates the best predictive measure for diagnosing acute appendicitis.Methodology: We conducted a prospective observational study on 120 children (02-13 years) in the department of Neonatal and Paediatric Surgery at The Children’s Hospital PIMS, Islamabad, with suspected appendicitis. Each patient was evaluated based on their Paediatric Appendicitis Score and ultrasound findings. We performed open appendectomy under general anaesthesia in patients with Paediatric Appendicitis Score ≥06 or who presented with severe tenderness on cough, TLC more than 10,000/mm3, or positive ultrasound findings.Results: In our study, the sensitivity and specificity of the Paediatric Appendicitis Score were 92.6% and 72.0%, respectively. Its sensitivity and specificity were 84.09% and 85.71%, respectively, with cutoff ≥6 combined with ultrasound findings. The combined sensitivity and specificity of Paediatric Appendicitis Score <6 and ultrasound were 85.71% and 94.44%, respectively.Conclusion: Paediatric Appendicitis Score is a useful diagnostic tool for suspected appendicitis in pediatric population. Its efficacy is significantly increased when combined with ultrasound. Combined application of the Paediatric Appendicitis Score with ultrasonography helps to rule out negative appendectomies and reduces complications associated with delayed diagnosis

Comparison of Essential Oil Yield, Chemical Composition and Biological Activities of Eucalyptus camaldulensis Leaf: Conventional Distillation versus Emerging Superheated Steam Distillation

Eucalyptus essential oil (EO) has significance economically since it is used in the medicinal and fragrance industries. The main objective of this study was to investigate the differences in yield, composition, antioxidant capacity, and antibacterial effectiveness of the EO extracted from Eucalyptus camaldulensis leaves. To achieve this, three distinct extraction techniques, namely steam distillation (SD), hydro distillation (HD), and superheated steam distillation (SHSD), were utilized to isolate the EO. The study aimed to analyze and compare these parameters among the three extraction methods. Based on the findings from the experiments, it has been found that using SHSD resulted in a higher EO yield than conventional techniques, and this SHSD produced a greater amount of EO in a shorter time. The EOs extracted using all three techniques have 1,8 cineole as the main constituent, according to gas chromatography-mass spectrometry (GC-MS) analysis results. All of the EOs demonstrated significant antioxidant capacities when tested in vitro using a variety of antioxidant assays. The EOs extracted through HD showed greater antibacterial activity among the other extraction processes, as evaluated by agar well diffusion and resazurin microtitre-plate assays. In conclusion, SHSD is more efficient for extracting EOs and antioxidant activity than traditional HD and SD

Synthesis and DPPH scavenging assay of reserpine analogues, computational studies and in silico docking studies in AChE and BChE responsible for Alzheimer's disease

A doença de Alzheimer (DA) é uma doença neurodegenerativado sistema nervoso central, em rápido crescimento, e antioxidantes ajudam a suprimir o estresse oxidativo causado por radicais livres, responsávies pela DA. Avaliou-se, biologicamente, série de derivados sintéticos de indol selecionados para identificar novos antioxidantes. A maioria dos compostos avaliados apresentou de significativa a boa propriedade antioxidante (valor de IC50 399,07140.0 ± 50 µM). Eftuaram-se estudos de Teoria do Funcional de Densidade (DFT) com os compostos e os seus correspondentes radicais livres. As diferenças de energia entre os compostos protótipos e os radicais livres correspondentes proporcionaram boa justificativa para a tendência encontrada nos seus valores de IC50. O ancoramento in silico dos compostos com a acetilcolinesterase (AChE) e com a butirilcolinesterase (BChE), que contribuem para a DA, foi, também, realizado para prever o seu potencial anti-DA.Alzheimer's disease (AD) is a fast growing neurodegenerative disorder of the central nervous system and anti-oxidants can be used to help suppress the oxidative stress caused by the free radicals that are responsible for AD. A series of selected synthetic indole derivatives were biologically evaluated to identify potent new antioxidants. Most of the evaluated compounds showed significant to modest antioxidant properties (IC50 value 399.07 140.0±50 µM). Density Functional Theory (DFT) studies were carried out on the compounds and their corresponding free radicals. Differences in the energy of the parent compounds and their corresponding free radicals provided a good justification for the trend found in their IC50 values. In silico, docking of compounds into the proteins acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), which are well known for contributing in AD disease, was also performed to predict anti-AD potential

COMPARATIVE STUDY OF THE FLEXURAL STRENGTH OF MAXILLARY DENTURE BASES MADE IN CONVENTIONAL AND HIGH IMPACT HEAT CURE ACRYLIC RESIN

OBJECTIVE: To compare the flexural strength of maxillary denture bases made in high impact and conventional heat cure acrylic resin. METHODS: This experimental laboratory-based study was conducted in Peshawar Dental College, Materials Research and Centralized Resource Laboratories University of Peshawar, Pakistan. Total 120 edentulous maxillary casts, sixty each of conventional acrylic (30 in subgroup-IA for shallow palate and 30 in subgroup-IB for deep palate and high impact acrylic (30 in subgroup II-A for shallow palate and 30 in subgroup II-B for deep palate) were made. These were then tested for flexural strength using universal testing machine. The load was applied at the rate of 5.0 mm/min. Independent samples t-test was applied for statistical analysis. RESULTS: Mean values of deflection at fracture, fracture load and flexure strength were 0.309±0.059 cm, 87.729±22.497 Kg and 13.645± 4.453 kg/cm² respectively. Mean Flexure Strength (kg/cm2) was 8.30±1.27, 16.54±1.77, 10.88±1.01 and 18.85±1 in subgroups I-A, I-B, II-A and II-B respectively (<0.001). Mean deflection at fracture (cm) was 0.24±0.04, 0.29±0.03, 0.35±0.03 & 0.368±0.03 in subgroups I-A, I-B, II-A and II-B respectively (<0.001).Mean Fracture Load (Kg) was 69.97±3.12, 114.9±6.75, 63.28±7.05 & 102.8±5.5 in in subgroups I-A, I-B, II-A and II-B respectively (<0.001). CONCLUSION: High impact acrylic resin was found to have significantly higher flexure strength as compared to conventional acrylic resi

Blockchain adoption for sustainable supply chain management : economic, environmental, and social perspectives

Due to the rapid increase in environmental degradation and depletion of natural resources, the focus of researchers is shifted from economic to socio-environmental problems. Blockchain is a disruptive technology that has the potential to restructure the entire supply chain for sustainable practices. Blockchain is a distributed ledger that provides a digital database for recording all the transactions of the supply chain. The main purpose of this research is to explore the literature relevant to blockchain for sustainable supply chain management. The focus of this review is on the sustainability of the blockchain-based supply chain concerning environmental conservation, social equality, and governance effectiveness. Using a systematic literature review, a total of 136 articles were evaluated and categorized according to the triple bottom-line aspects of sustainability. Challenges and barriers during blockchain adoption in different industrial sectors such as aviation, shipping, agriculture and food, manufacturing, automotive, pharmaceutical, and textile industries were critically examined. This study has not only explored the economic, environmental, and social impacts of blockchain but also highlighted the emerging trends in a circular supply chain with current developments of advanced technologies along with their critical success factors. Furthermore, research areas and gaps in the existing research are discussed, and future research directions are suggested. The findings of this study show that blockchain has the potential to revolutionize the entire supply chain from a sustainability perspective. Blockchain will not only improve the economic sustainability of the supply chain through effective traceability, enhanced visibility through information sharing, transparency in processes, and decentralization of the entire structure but also will help in achieving environmental and social sustainability through resource efficiency, accountability, smart contracts, trust development, and fraud prevention. The study will be helpful for managers and practitioners to understand the procedure of blockchain adoption and to increase the probability of its successful implementation to develop a sustainable supply chain network

Synthesis and DPPH scavenging assay of reserpine analogues, computational studies and in silico docking studies in AChE and BChE responsible for Alzheimer's disease

Alzheimer's disease (AD) is a fast growing neurodegenerative disorder of the central nervous system and anti-oxidants can be used to help suppress the oxidative stress caused by the free radicals that are responsible for AD. A series of selected synthetic indole derivatives were biologically evaluated to identify potent new antioxidants. Most of the evaluated compounds showed significant to modest antioxidant properties (IC50 value 399.07 140.0±50 µM). Density Functional Theory (DFT) studies were carried out on the compounds and their corresponding free radicals. Differences in the energy of the parent compounds and their corresponding free radicals provided a good justification for the trend found in their IC50 values. In silico, docking of compounds into the proteins acetylcholinesterase (AChE) and butyrylcholinesterase (BChE), which are well known for contributing in AD disease, was also performed to predict anti-AD potential

Ethnopharmacological uses of fauna among the people of central Punjab, Pakistan

IntroductionThe utilization of fauna and fauna-based byproducts in ethnomedicinal usages has been a longstanding human activity, practiced across various cultures worldwide. This study focuses on investigating the utilization of animal-based traditional medicine by the people of Pakistan, specifically in the Gujranwala area.MethodsData collection took place from January to September 2019 through interviews with local communities. Ethnomedicinal applications of animal products were analyzed using several indices, including Relative Frequency of Citation (RFC), Relative Popularity Level (RPL), Folk Use Value (FL), and Relative Occurrence Percentage (ROP).ResultsThe study identified the use of different body parts of 54 species of animals in treating various diseases and health issues. These include but are not limited to skin infections, sexual problems, pain management (e.g., in the backbone and joints), eyesight issues, immunity enhancement, cold, weakness, burns, smallpox, wounds, poisoning, muscular pain, arthritis, diabetes, fever, epilepsy, allergies, asthma, herpes, ear pain, paralysis, cough, swelling, cancer, bronchitis, girls’ maturity, and stomach-related problems. Certain species of fauna were noted by informers with high “frequency of citation” (FC), ranging from 1 to 77. For instance, the black cobra was the most frequently cited animal for eyesight issues (FC = 77), followed by the domestic rabbit for burn treatment (FC = 67), and the Indus Valley spiny-tailed ground lizard for sexual problems (FC = 66). Passer domesticus and Gallus gallus were noted to have the highest ROP value of 99.DiscussionThe findings of this study provide valuable preliminary insights for the conservation of fauna in the Gujranwala region of Punjab, Pakistan. Additionally, screening these animals for medicinally active compounds could potentially lead to the development of novel animal-based medications, contributing to both traditional medicine preservation and modern pharmaceutical advancements

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p&lt;0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p&lt;0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised