Neglected puerperal inversion of the uterus: ignorance makes acute a chronic form

Inversion of uterus is a rare complication of vaginal delivery. The reported incidence of puerperal inversion varies from approximately 1 in 550 to 1in several thousand normal deliveries. Maternal mortality has been reported to be as high as 15%, mainly because of associated life threateningblood loss and shock. Early diagnosis, prompt and aggressive management decrease the morbidity and mortality to minimal. We report a case of21 year old primi, who presented to us with uterine inversion after delivery at a rural set up by untrained birth attendant (“Dai”). She was managed surgically with Haultain’s operation and discharged after 5 days. She didn’t turn up for follow up and was readmitted after 4 weeks with uterine reinversion associated with endometritis. A recent case is described, followed by a short review of literature.Key words: Inversion of uterus, acute puerperal inversion, shock, post partum bleeding, neglec

Sanctuary in the Midst of Crisis? a Look Into Shariah Indices Using Multivariate GARCH DCC

Islamic Finance has evolved over the past few decades, and stands at over a trilliondollars today. At the foundations of Islamic finance lay the concept of risk sharing, and the purest forms of it in the modern day finance is equity investments. The evidence of Islamic investors pursing equity investments in reality is thin. Multitude of reasons are attributed to this low participation, mainly revolving around lack of empirical proof of Islamic investments being a reliable and steady return alternative. This study is an attempt to study the volatilities and correlations with the conventional global equity indices utilizing Multivariate GARCH Dynamic Conditional Correlations (MGARCH DCC) method. The findings provide an interesting angleto our study, where there is a significant downwards trend in the correlations during the crisis era. This provides substance to the argument that Islamic investors would experience lesser downside in economic crisis. This study further dwells into the linkage of Islamic indices with global financial indices to study if financial sector exclusion from Islamic indices benefits theinvestors. The findings are positive, with lower correlations and that to reducing in the recent global crisis. Islamic finances core philosophy is equity based investments and this study is a humble attempt to empirically substantiate its benefits

Supply response of potato in Bangladesh: a vector correction approach

An attempt has been made in this study to examine the supply response of potato in Bangladesh by using the vector error correction approach. The short-run price elasticity was 0.45 while the long run elasticity was 0.62. Price policies are effective in obtaining the desired level of output for potato. If intervention in the market is of necessity, then it must be implemented during the harvest season for altering price expectations. Also emphases should be given to increase potato export and establishing export oriented potato processing industries

Connections between the stability of a Poincare map and boundedness of certain associate sequences

Let $m\ge 1$ and $N\ge 2$ be two natural numbers and let ${\mathcal{U}}=\{U(p, q)\}_{p\ge q\ge 0}$ be the $N$-periodic discrete evolution family of $m\times m$ matrices, having complex scalars as entries, generated by ${\mathcal{L}}(\mathbb{C}^m)$-valued, $N$-periodic sequence of $m\times m$ matrices $(A_n).$ We prove that the solution of the following discrete problem $$y_{n+1}=A_ny_n+e^{i\mu n}b,\quad n\in\mathbb{Z}_+,\quad y_0=0$$ is bounded for each $\mu\in\mathbb{R}$ and each $m$-vector $b$ if the Poincare map $U(N, 0)$ is stable. The converse statement is also true if we add a new assumption to the boundedness condition. This new assumption refers to the invertibility for each $\mu\in\mathbb{R}$ of the matrix $V_{\mu}:=\sum\nolimits_{\nu=1}^NU(N, \nu)e^{i\mu \nu}.$ By an example it is shown that the assumption on invertibility cannot be removed. Finally, a strong variant of Barbashin's type theorem is proved

Relationship of Computer Usage and Work Self-Efficacy of Employees in the Organizations

An individual’s perceived ability to adopt computer or information technology successfully has been shown to be major factor affecting his or her willingness to accept new technology. Hence, the relationship of self-efficacy with information system usage (computer, Internet, new information technology, etc.) is noteworthy. This research aims at studying exactly that. Four major constructs of self-efficacy presented by Albert Bandura are discussed in the paper. The literature review and the relevant researches, mentioned previously, all suggest that a relationship exists between Computer/Information System Usage and Self-efficacy, both in learning institutions and workplace environments. This study, however aims at interrogating this relationship at workplace environments of Rawalpindi/Islamabad regions of Pakistan, in particular. To conclude the results 150 questionnaires were distributed out of which we received 127 back. The participants have matriculation to doctorate qualification; however, majority had master’s degree which is sixteen years of education in Pakistan. This study and its findings are significant on another level as well. Throughout the literature review, the researches that have been quoted have all been carried out abroad. Although, there is an advent of Information Technology in Pakistan and individuals are getting to be computer savvy, little to no research can be found that has been conducted here. This may be an initial step and that too in the small cities of Rawalpindi/Islamabad; the results nonetheless are promising and can pave a way for more thorough and large scale future investigations on the matter. In conclusion, the findings can also assist in creating awareness regarding the association between computer self-efficacy and work self-efficacy amongst the population. This in turn, can help bring about a change in the opinions and attitudes of individuals thus, creating a constructive and optimistic approach toward Information System and Computer usage whereby, increasing employee productivity and performance. Keywords: Self-Efficacy, Technological Self-Efficacy, Work Self-Efficacy, Information System’s Usage, Organizations and Computer Usage

Paraperesis: A rare complication after depressed skull fracture

Depressed skull fracture is an inward buckling of the skull bones, often because of direct blow to a small surface area of the skull with a bluntobject. Monoparesis is often among its clinical presentations, but midline depressed skull fracture presenting as motor weakness of both lowerlimbs (Paraperesis) has not yet been reported. We report the case of 55 year old male admitted to emergency department with alleged history ofhit on head by a wooden rod. He had pain, mild swelling and a small cut over scalp without any symptoms & signs of neurological deficit. On daytwo of admission patient developed weakness of both lower limbs. On CT scan patient had bilateral depressed skull fracture of high parietal boneon either side of midline. Patient was managed conservatively, made remarkable recovery and was discharged after 2 weeks.Key words: Fracture, paraperesis, edema, depressed fracture, skul

An audit of head trauma care and mortality

Objective: To analyze the factors contributing to deaths from head trauma by using standardized assessment parameters and to provide a peer-review of head injury deaths with focus on identifying deficiencies and analyzing contributory factors.Design: Descriptive study.Place and duration of study: The study was carried out at the Emergency, Aga Khan University Hospital during January 1998 to December 1999.Subjects and method: One hundred and three patients above the age of 15 years presenting alive to the Aga Khan University Hospital (AKUH) emergency with head injury were included in this study. Identified deaths data was reviewed by the Hospital Trauma Peer Review Committee and consensus arrived at for categorization of deaths. The potential deficiencies in care were identified and final recommendations made. The data was computed on CDC Trauma Registry (V 3.0) and SPSS (V 8.0).Results: Mean age was 31.9 years (n=103) with predominant male population (4:1). Severe head injury (GCS\u3c8) accounted for 21.3 % (n=22) of all cases with a total number of deaths being 12.6 % (n=13). Deaths were categorized preventable in 3 cases with non-preventable and potentially preventable in 4 and 6 cases respectively. Road traffic accidents were the predominant mechanism (n=8) in all deaths (n=13). The time interval in relation to mortality was biphasic, most deaths occurring either within 24 hours or between 3-7 days of injury. Inappropriate pre-hospital treatment, pre-hospital delays and inappropriate mode of transportation without inter-hospital communication were the process-related defects in pre-hospital care with major determinant of deaths outside AKUH (n=5). Prolonged emergency stay, delayed intensive care availability were the process-related deficiencies whereas inappropriate initial resuscitation, inappropriate initial head injury management were provider-related deficiencies in in-hospital care.Conclusion: Transfer of inappropriately managed patients, lapses in inter-hospital communications, delayed transfers were identified as the major pre-hospital factors whereas lack of ICU beds, portable ventilators in emergency room, delays in CT scan facilities were the deficiencies in the hospital services. Opportunities for improvement in head trauma care are needed to focus on initial resuscitation and appropriate surgical management