Internet banking in Pakistan: finding complexities

Technology is evolving every new day and has its impact on every thing. In this paper we will analyze the acceptance of technology in the Banking Industry of Pakisatn. This research investigates complexities (factors) that have resisted or obstructed the adoption of Internet Banking in Pakistan. Traditional innovation diffusion model (IDT) is used to develop the research model indicating the proposed complexities and acceptance of Internet Banking among Pakistani users. The model is tested with a survey sample (n=45). Out of the nine complexities identified, six are found significant. The findings of the research signify that 67 % of the proposed complexities, Familiarity with the technology, Concerns for Download Speed, Unfriendly Website Design, Fear of Government tracking transactions, Security and People Gaining Access/Misusing, hinder the users in accepting and adopting internet banking technology in Pakistan

HISTOPATHOLOGICAL EXAMINATION OF CONJUNCTIVAL SCRAPPING – AN OBJECTIVE METHOD TO KNOW THE EFFICACY OF DRUG IN VERNAL KERATO CONJUNCTIVITIS

Aim: The study aims to test the efficiency of FML and Azelastine in the treatment of  vernal kerato conjunctivitis  by objective method of doing HPE of conjunctival scrapping before and 4 weeks after treatment with these two drugs. Material and method: A double blind randomised study conducted at a tertiary eye care centre in Hyderabad with a study period from July 2004 and July 2005 was done. 100 patients of vernal kerato conjunctivitis were randomly divided in 2 groups of 50 each. Group 1 was given FML eye drops 4 times daily for 4 weeks. Group 2 was given azelastine eye drops 4 times daily for 4 weeks. All patients with VKC were included in the study. Patients with other eye disorders, corneal involvement, glaucoma and patients who received treatment within 1 month were excluded. HPE of conjunctival scrapping’s was done in both groups. Result: At the end of four weeks HPE was repeated 50 patients in group 1 showed absence of eosinophils and mast cells, whereas in group 2 only 15 cases showed absence of eosinophils and mast cells. Observation: Statistic chi square test show P value of 0 in group 1 and 0.3 in group 2 which is significant and proves that FML is superior to azelastine in the treatment of VKC

Family systems: perceptions of elderly patients and their attendents presenting at a university hospital in Karachi, Pakistan

Objective: To know the present status of family systems in Pakistan, changes they are undergoing and implications of such trends on health of the elderly population. Methods: A cross-sectional study was carried out at the out-patient clinics, AgaKhan University Hospital, using convenience sampling method. Verbal informed consent was taken from the participants. The questions included demographic profile, satisfaction with current family system, opinions about changing trends of family systems, and their implications on health. Analysis was done using SPSS 13.0. Results: Four hundred subjects aged 65 and above were interviewed, out of which 226 (56.5%) were living in the joint family system (JFS), whereas 174 (43.5%) were living in a nuclear family system (NFS). A total of 77.5% respondents were in the age class of 65-70 years (mean=69).Majority were men (78%), married (78%), retired (55.8%) and with education below intermediate (61.8%). A total of 366 (91.5%) respondents were satisfied with their family system. 326 (81.5%) respondents said that the trend in family systems in Pakistan was changing and 318 (97.5%) of these subjects thought that it was a JFS to NFS trend. A decline in the proportion of JFS was seen with subsequent generations. 340 (85%) subjects said that a family system has a significant impact on health care. Conclusion: We have identified changing trends in family systems in Pakistan. Satisfaction with family system and the opinion about the role of a family system on healthcare is documente

Surgical ligation of scrotal varicocele for male factor infertility is a valid option of treatment

Objective: To evaluate the role of surgical ligation of scrotal varicocele for treatment of male factor infertility. Methods: We studied 60 patients who presented with infertility and were also found to have scrotal varicocele. Patients with other probable causes contributing to infertility were excluded. Diagnosis was made by clinical examination and scrotal ultrasonography. All the patients underwent either laparoscopic varicocelectomy or open retroperitoneal high ligation of the testicular veins. Operative time and hospital stay was recorded. All patients were evaluated for postoperative improvement of semen parameters and development of any postoperative complication. The results were analyzed by commercially available software. Results: During the study period 5 patients were lost to follow up and were excluded. The rest of patients (n=55) were young, with age ranging from 20-35 years (Mean age 27.8 years, SD +/- 4.38). All patients had unilateral left sided varicocele; two patients (3.6%) had grade I varicocele, 21 patients (38.2%) had grade II varicocele and 32 patients (58.2%) had grade III varicocele. Statistically significant improvement in sperm density (p value \u3c 0.05), sperm activity (p value \u3c 0.05) and sperm morphology (p value \u3c 0.05) was observed after the surgical ligation. The mean operative time was 54.88 minutes (SD + 13). The mean hospital stay in laparoscopic procedure was 33.4 (SD + 15.3). Minor complications were noted in 13 patients and included superficial wound infection in 3 patients, 6 patients exhibited testicular pain and persistence of varicocele in 4 patients. Conclusion: Surgical ligation of scrotal varicocele is asafe and effective mode of treatment of male factor infertility in selected population

BOTOX! BETTER OPTION TO PROTECT CORNEA IN IDIOPATHIC BELL’S PALSY

Aim: Is to evaluate the efficacy of Chemo-denervation of LPS to induce temporary ptosis using Injection Botox in protecting Cornea and healing exposure keratopathy. Materials & Methods: Prospective interventional study conducted at Tertiary eye care centre of Hyderabad. Study period between June 2010 to May 2012. 24 cases of Bell’s palsy , 11 males & 14 females between age group of 20-80 years were included in the study. Facial palsy due to CP angle tumors, Hansen’s disease, Trauma, CSOM and post mastoidectomy were excluded as these are permanent causes. Patient with known allergy to Botox and patient who lost to follow up were also excluded. Cases included were examined by an ophthalmologist and radiologically evaluated to rule out other causes of facial palsy. Height of palpebral aperture, amount of Lagophthalmos, exposure keratopathy was documented. 0.25cc of injection Botox containing 6.25IU of Botox was injected at the insertion of LPS. Patient was examined at the end of 1st week, 2nd week, 4th week and 8th week to check all the 3 parameters. Results: At the end of 1st week in 16 cases mean palpebral height of 9mm (SD +/- 1.2mm) before injection was reduced to 2mm (SD+/- 1.0mm) after injection. At the end of 2nd week 8 cases achieved ptosis. Mean difference in Palpebral aperture height was 7mm (p value of 0.05) which is significant. All cases showed improvement in exposure keratopathy. 20 cases recovered from Bell’s palsy within 8 weeks . 4 cases required 2nd injection of Botox as ptosis started recovering but Bell’s palsy persists. Mean amount of Lagophthalmos of 4.3mm (SD+/- 0.7mm) before injection was reduced to 1.1mm (SD+/- 1.0mm) at the end of 2nd week. P value of <0.05 which is significant. Conclusion: Inj.Botox is safe and effective method to achieve ptosis by Chemo-denervation of LPS. Action of Botox remains for 8 weeks wherein 85% of cases recovered from Bell’s palsy

Does admission hyperglycemia predict intracranial and extracranial vasculopathy

OBJECTIVE: To study the association between admission hyperglycaemia and the presence and pattern of intracranial and extracranial vascular disease.METHODS: This retrospective study was conducted at a major tertiary care hospital in Karachi, Pakistan. Patients who had presented with acute stroke and had undergone a carotid ultrasound Doppler of the carotids and/or Magnetic Resonance Angiography (MRA) of the brain were included in the study. A multiple logistic regression analysis of variables was done for an abnormal finding on each investigation.RESULTS: Out of the total of 216 patients, the age of majority of the patients (83.3%) was \u3e 50 years and 134 (62%) were male. One hundred and fourteen patients (52.8%) had admission hyperglyaemia. Multiple logistic regression analysis revealed that increasing age and admission hyperglycaemia (P = 0.045, Odds ratio = 1.9 [95% CI: 1.0-3.6]) were independent predictors of an abnormal finding on a carotid Doppler investigation. Admission hyperglycaemia did not predict the presence of general intracranial vasculopathy but it was significantly associated with focal stenosis as visualized on a MRA.CONCLUSION: Admission hyperglycaemia is associated with large vessel disease manifesting itself in the carotids as plaques and in the intracranial circulation as focal stenosis. Acute stroke patients presenting with admission hyperglycemia would require a more careful investigation for large artery disease especially in the extracranial vessels

EXAMINATION OF EAR, NOSE & THROAT IS MANDATORY IN A CASE OF PROPTOSIS

Aim : To report an interesting case of Proptosis wherein clinical diagnosis can be made without even doing imaging of Orbit. Materials and Methods: A case of proptosis presented at Gandhi Hospital department of Ophthalmology after thoroughly examining we came to the clinical conclusion of Maxillary Antral Carcinoma or Fungal granuloma of Maxillary sinus involving orbit and oral cavity. Results & Discussion: Proptosis is not only caused by ocular or orbital conditions but also by diseases of para nasal air sinuses. Conclusion: Clinical diagnosis can be arrived at by examining a case of proptosis which should include examination of Ear, Nose and Throat of the patient. Key words: Proptosis, ENT exam, Maxillary antral carcinoma