The use of socially complex education on organ donation: the impact on attitudes and readiness to donate organs.

In regards to transplantation, urban people are disproportionately affected by the donor shortage. The high morbidity rates and decreased willingness to donate commonplace among these demographics has created a devastating imbalance. Increasing urban donor presence will make the allocation process more favorable for urban candidates. The current study entailed the provision of a culturally sensitive educational intervention to sixty-five (n=65) students at The University of Southern Punjab Surveys were administered pre/post intervention to assess knowledge and attitudes towards donation. Pre-intervention data reflected findings from prior research. Post- intervention data showed that the intervention was able to mitigate these findings and that it was more effective in urban people, lamenting the need for more culturally specific approaches in the efforts to increase donor presence

The Mediating Role of Emotional Exhaustion in the Relationship between Abusive Supervision and Employee Cyberloafing Behaviour.

Cyberloafing is becoming a common problem in every organization that directly affects organizational productivity. In this study we are going to study the influence of abusive supervision on cyberloafing, further, we are studying the mediating effect of emotional exhaustion generated due to abusive supervision behaviour, motivating employees towards cyberloafing. The data were collected from 150 employees working in Saif Textile Mills Ltd & Kohat Textile Mills Ltd, Pakistan through questionnaires. The study sample was drawn using a convenience sampling technique. This study used SPSS 25 and process Hayes (2013) model 4 for data analysis and for model fitness we used CFA (AMOS 22). The data findings demonstrate that abusive supervision significantly and positively affects cyberloafing and also emotional exhaustion mediates this relation significantly. Therefore we conclude that abusive supervision is the main factor for employees to be exhausted and ultimately move towards cyberloafing. Based on these finding managers plays a vital role to maintain organization environment friendly

Extent of liver inflammation in predicting response to interferon alpha & Ribavirin in chronic hepatitis C patients: a cohort study

Background: Liver inflammation due to HCV infection leads to fibrosis, which is an independent predictor of treatment response to interferon therapy in Chronic Hepatitis C (CHC) patients. This relationship has not been studied for liver inflammation on pretreatment liver biopsy and End of Treatment Response (ETR). ALT is a less invasive test than liver biopsy for measuring liver inflammation. Aim of this study was to compare ETR to Interferon alpha (recombinant Interferon) & Ribavirin in CHC patients having higher and lower grades of liver inflammation and to determine the diagnostic accuracy of pretreatment ALT for grades of liver inflammation.Methods: A retrospective cohort of 876 naive CHC patients, who completed Interferon alpha & Ribavirin for 24weeks, was studied for ETR. Pretreatment grade of inflammation on liver biopsy was taken as the exposure variable. It was classified as high if there was moderate or severe and low if there was minimal or mild. Multivariable logistic regression modeling was performed. Diagnostic accuracy of pretreatment ALT for liver inflammation grades was determined by computing Area Under the Receiver Operator Curve (AUROC).Results: Of all patients, 672 having diagnostic liver biopsy and ETR available were analyzed. Among them, 103 had high and 569 had low grades of liver inflammation. Mean age was 36.9 (SD 9.1) years, with patients with high grades being older than those with low grades inflammation (p=0.03). High grades of liver inflammation was associated with ETR (RR 1.17, 95% CI 1.12-1.18) adjusting for age, Total Leukocyte count (TLC) and pretreatment levels of ALT, irrespective of liver fibrosis. This relation remained significant for \u27bridging fibrosis and cirrhosis\u27 and not for \u27no\u27 or \u27portal fibrosis\u27. AUROC of pretreatment ALT for males and females was moderately accurate for severe inflammation compared to minimal inflammation and less accurate for high grades compared to low grades.CONCLUSIONS: ETR in patients with higher grades of liver inflammation was 17% higher than those with lower grades irrespective of fibrosis and 9% higher for bridging fibrosis and cirrhosis. Pretreatment ALT was moderately accurate for severe inflammation only on liver biopsy in both males and females

Irritable Bowel Syndrome and Psychiatric Disorders in Pakistan: A Case Control Study

Background. The psychiatric disorders like anxiety and depression could have a profound influence on onset, expression, and course of Irritable bowel syndrome (IBS). Aim. To estimate the frequency and strength of association of common mental disorders (CMDs) in patients with IBS and patients with other chronic diseases, that is, migraine and hypertension. Method. This was a case control study. Individuals aged 18–70 years diagnosed as IBS were enrolled as cases. The control groups consisted of patients without IBS but diagnosed to have a chronic disease, that is, migraine or HTN. Self-Reporting Questonnaire-20(SRQ-20) was used as a screening tool for the detection of CMD. Results. 82 patients were enrolled in each group. Mean SRQ score was significantly higher in IBS group than controls (9.9 ± 4.5 versus 4.9 ± 3.6, P < 0.001). CMDs were more frequent (67.1% versus 22%) and the odds of CMD were 7.24 times higher among IBS patients than controls (95% CI 3.6–14.5, P < 0.001). No difference was found in frequency of CMDs among various subtypes of IBS. Conclusion. We found that CMDs are more common and strongly associated with IBS as compared to other chronic diseases. Early screening for CMDs might be useful for an effective management of IBS

Appraisal of Foreign Direct Investment Terrain of Brazil

Globalization has made worldwide mobility of money easy. Investors prefer to invest in places that offer attractive returns and are relatively less risky. The inflow of FDI gives developing countries access to capital that would otherwise be not available. FDI also provides much needed foreign exchange and thus helps to adjust some of the macroeconomic imbalances in developing countries.  Brazil is in the development mode, trying to boost up the growth rates from all corners, but the resources available are limited and very often insufficient, hence the country is competing against others to make the investment climate more investor-friendly and project itself as an investor-friendly destination for the FDI.  The main objectives of this study are to find out the status of Brazil as a destination for FDI, the factors that attract FDI into Brazil and the factors that hinder the flow of FDI into Brazil. This study is based on secondary data and covers five years.  The study analysis various determinants of FDI like market size, economic growth, infrastructure, political risk, corruption, labor market, raw materials, technological readiness, innovation, financial system, taxation, cost of capital, ease of doing business, and government policies. The study reveals that Brazil’s position in the global FDI map is on the decline as most of its rankings by global agencies are declining. Keywords: Foreign direct investment, Investment environment, Transnational Corporations DOI: 10.7176/EJBM/12-23-05 Publication date:August 31st 202

Prevalence of Sleep Paralysis in the Medical Students of a Local Medical College

Abstract Objective: To find out the prevalence of sleep paralysis among the medical students of a local Pakistani medical college. Methodology: This cross-sectional study was conducted on 107 medical students from, Karachi Institute of Medical Sciences (KIMS), Karachi, Pakistan. Non-probability Convenient Sampling Technique was utilized for this study. Students suffering from any psychiatric illness were excluded from this study. The study was performed after taking permission from the Institutional Ethical Review Committee. Written informed consent was taken from all the students. The data were collected using a pretested predesigned Questionnaire which was consisted of 10 questions related to the common10 happening and symptoms of sleep paralysis. Data were recorded in the form of frequency and percentages and analyzed using SPSS 24. Results: 52% (56 out of 107) participants have had an experience of sleep paralysis. Most of the participants (76.6%) described their experience as an Inability to move. Frequency of experience ranged from 0 to 20 times in the last year. Age at first experience ranged between 10-20 years. Conclusion: We found a high prevalence of sleep paralysis (47.2%) among the medical students at a local Pakistani medical college. Majority of the students experienced the phenomenon multiple times in their life. The students associated the symptoms the factors such as academic stress, anxiety, workload, emotional experiences, sleep deprivation, work routine, sleep pattern, sleep deprivation, fatigue, mental disturbance, studies and routine stress. 37.3% of the students also related the phenomenon to their position of sleep (lying on back). The participants described the experience as a source of great distress. Sleep paralysis needs to be studied, investigated and addressed in context of mental health of the students

Oral Parafunctional Habits in Individuals with The Extravert Personality Type

OBJECTIVES:  To find the association of extraversion personality traits with oral parafunctional habits. METHODOLOGY: A Cross-sectional descriptive study was conducted on 200 individuals in the College of Dentistry, Sharif Medical and Dental College, Lahore, over 5 months from July to November 2021. Data was collected using a pre-validated medical questionnaire and a ten-item personality inventory scale (TIPI). The sampling technique used was Convenience sampling. A sample size of 200 was calculated with the help of WHO sample size determination software. RESULTS: There was a statistically significant difference in the scores of extraversion personality traits across the oral parafunctional habit group of nail-biting (p= 0.007). In contrast, that for tooth grinding (0.114), tooth clenching (0.076), biting hard objects (0.74) and chewing gum (p= 0.659) was non-significant. The highest mean rank score for the personality trait of extraversion was found in individuals who strongly agreed to have a habit of nail-biting (129.23), tooth grinding (153.63), and tooth clenching (142.61) and biting hard objects (12.07). The highest mean rank score for the parafunctional habit of chewing gum (107.28) was found in individuals who strongly disagreed with having the habit. CONCLUSION: The highest mean rank score for the personality trait of extraversion was found in individuals who strongly agreed to have a habit of nail-biting, tooth grinding, tooth clenching and biting hard objects. The highest mean rank score for the parafunctional habit of chewing gum was found in individuals who strongly disagreed with having the habit

Consensus interferon plus ribavirin for Hepatitis C genotype 3 patients previously treated with pegylated interferon plus ribavirin

Background Not enough data are available about the effectiveness of consensus interferon (CIFN) among HCV genotype 3 patients who failed to respond to pegylated interferon and ribavirin. Objectives We aimed to assess the efficacy and safety of CIFN and ribavirin in non-responders and relapsers to pegylated interferon with ribavirin therapy. Patients and Methods This open-label investigator-initiated study included 44 patients who received CIFN 15 µg /day plus ribavirin 800-1200 mg daily. In patients with an early virological response (EVR), the dose of CIFN was reduced to 15 µg thrice a week for further 36 weeks. Patients with delayed virological response continued to receive daily CIFN plus ribavirin to complete 48 weeks. The patients were considered “non-responders” if there were less than 2 log reduction in HCV RNA at 12 weeks and detectable HCV RNA at 24 weeks. Results Twenty-four patients (55%) were non-responders and 20 patients were relapsers to the previous treatment with pegylated interferon plus ribavirin (mean age 43.6 ± 9.4 years, males 25 (57%)). Nine patients were clinically cirrhotic (Child A). End of treatment virological response was achieved in 19 (43.1%) patients and sustained virological response (SVR) occurred in 12 (27.3%). Out of these 12 patients, eight were non-responders and four were relapsers to the previous treatment. Advanced fibrosis or clinical cirrhosis was associated with low SVR. Adverse events were fever, myalgia, anorexia, depression, and weight loss. Two patients received granulocyte colony stimulating factor for transient neutropenia. Seven patients were given erythropoietin to improve hemoglobin, and six were treated for mild depression. Two patients developed portosystemic encephalopathy. Conclusions More than one-quarter of treatment-experienced patients with HCV genotype 3 achieved SVR after re-treatment with consensus interferon plus ribavirin

Genetic variability and evolutionary dynamics of atypical Papaya ringspot virus infecting Papaya

Papaya ringspot virus biotype-P is a detrimental pathogen of economically important papaya and cucurbits worldwide. The mutation prone feature of this virus perhaps accounts for its geographical dissemination. In this study, investigations of the atypical PRSV-P strain was conducted based on phylogenetic, recombination and genetic differentiation analyses considering of it’s likely spread across India and Bangladesh. Full length genomic sequences of 38 PRSV isolates and 35 CP gene sequences were subjected to recombination analysis. A total of 61 recombination events were detected in aligned complete PRSV genome sequences. 3 events were detected in complete genome of PRSV strain PK whereas one was in its CP gene sequence. The PRSV-PK appeared to be recombinant of a major parent from Bangladesh. However, the genetic differentiation based on full length genomic sequences revealed less frequent gene flow between virus PRSV-PK and the population from America, India, Colombia, other Asian Countries and Australia. Whereas, frequent gene flow exists between Pakistan and Bangladesh virus populations. These results provided evidence correlating geographical position and genetic distances. We speculate that the genetic variations and evolutionary dynamics of this virus may challenge the resistance developed in papaya against PRSV and give rise to virus lineage because of its atypical emergence where geographic spread is already occurring