Seeing With Bifocals: The Evolution of a Muslim Chaplain

Muslims have problems, and yet there is no one educated to guide the community through grief, anger, death, dying, sickness toward wellness. Such guidance can be found throughout our sacred sources, which clearly articulate a pastoral theology of care based on compassion. That is why I believe that chaplaincy is very much as Islamic necessity that someone in every Muslim community must fulfill. We are in serious need of a missing lens

Comparative Study on The Socioeconomic Determinants of Crime in Pakistan and India: An Econometric Analysis

Purpose: This current study aims to identify the socioeconomic determinants of crime in Pakistan and India and compare the results of both the countries, which are unemployment, education, poverty, and economic growth. Methodology: The study is quantitative. Time series data for the period 1996 to 2020 has been taken and Autoregressive Distributed Lag (ARDL) bound testing approach to cointegration is applied for empirical verifications Findings: The results show that in Pakistan education and poverty are the important determinants of crime in the long run whereas in the short-run education is found to be the key cause of crime. On the other hand, in India poverty is an important determinant of crime. Conclusion: All over the world, the rate of crime has been increasing over time. The study is unique in the sense that causes of crime is studied in the two major south Asian countries India & Pakistan with a total population of over 1,500 million peoples. The outcome of the study will be helpful for the policymakers to overcome the shortfall in battling the crimes in the countries

Language and communication patterns in Universities in Pakistan: creating some sort of differentiation and division among people

This research paper looks at the language and communication patterns followed in different universities of Pakistan. What the paper aimed to explore and found answers to. Every country happens to have a distinct language culture which is represented by the majority of its population. Although, it is not possible to claim that University students form the largest chunk of Pakistan's population. Nonetheless, it would not be incorrect that these are the members of society who have been fully initiated in to the secondary level of language socialisation. They therefore, rightly depict the present-day association with language. The linguistic dilemma as faced by a country whose constitution declares that Urdu is the National language but, has several regional languages. On top of those indigenous tongues is English which, is propagated by the global need for its acceptance and to great extent by Elite of Pakistan. Hence, in this brewing hotpot of culture and linguistic heritage deciphering which language truly prevails becomes, an eminent question. The researchers have tried to provide insights and solution concerning the observation they have made regarding, the linguistic loophole in a multilingual society

Outcome of febrile neutropenic patients on granulocyte colony stimulating factor in a tertiary care hospital

Introduction: Febrile neutropenia is a relatively frequent event in cancer patients treated with chemotherapy and improvement in absolute neutrophil count (ANC) has been linked directly to improved outcome. Evaluation of granulocyte colony stimulating factors (GCSFs) for treatment has shown reduced incidences of episodes of prolonged neutropenia and protracted hospitalization. To determine absolute neutrophil counts with GCSF in febrile neutropenic cancer patients admitted to a tertiary care centre and to co-relate the improvement in ANC with mortality and hospital discharge.Methods: A prospective cross sectional study was carried at an oncology ward at Aga Khan University hospital from January 2010 to June 2011. All adult patients who were admitted and treated with GCSF for chemotherapy induced febrile neutropenia were included. Multivariable regression was conducted to identify the factors related with poor outcomes.Results: A total of 131 patients with febrile neutropenia were identified with mean age of 43.2 (18-85) years, 79 (60%) being ≤ 50. Seventy-five (57%) had solid tumors and 56 (43%) hematological malignancies, including lymphoma. Fifty seven (43.5%) had an ANC less 100 cells/mm(3), 34 (26%) one between 100-300 cells/mm(3) and 40 (31%) an ANC greater than 300 cells/mm(3). Thirty (23%) patients showed ANC recovery in 1-3 days, and 74(56%) within 4-7 days. Thirteen (10%) patients showed no recovery. The overall mortality was 18 (13.7%) patients. The mean time for ANC recovery seen in hematological malignancies was 6.34 days whereas for solid tumors it was 4.88 days. Patients with ANC /mm(3) were more likely to die than patients with ANC \u3e300 cells/mm(3) by a factor of 4.3. Similarly patients \u3e50 years of age were 2.7 times more likely to die than younger patients.CONCLUSION: Our study demonstrated that use of GCSF, in addition to intravenous antibiotics, in treatment of patients with chemotherapy induced febrile neutropenia accelerates neutrophil recovery, and shortens antibiotic therapy and hospitalization. We propose to risk classify the patients at the time of admission to evaluate the cost effectiveness of this approach in a resource constrained setup

Working Capital Management and Corporate Internal Growth Performance: Evidence of Listed Non-Financial Companies in Pakistan

Purpose: The main objective of this research is to determine the impact of working capital management (WCM) on the growth of manufacturing firms in Pakistan. Methodology: The dependent variable of Internal Growth Rate (IGR), is affected by independent variables of Days Sales Outstanding (DSO), Inventory Turnover (ITO), and Payables Deferral Period (PDP). Based on 5 years of (2016-2020) data of 174 non-financial listed companies taken from the Pakistan Stock Exchange (PSX), regression, descriptive and analytical analysis ascertained that the Working Capital Management (WCM) of a firm is comprehensively measured by the tool of Cash Conversion Cycle (CCC). Findings: The results showed that WCM played an important role in the value creation of the overall business as long as DSO and ITO have a negative impact on the IGR performance of the firm, and for the better performance of IGR, firms needed to keep DSO and ITO at a minimum level. Research limitations/implications: Due to the type of research that has been conducted, other sectors of the industry, such as service, finance, and food, have been left out, and focus has only been made on the manufacturing side. The findings of this study may not be completely applicable to all listed manufacturing firms due to the difference in size and environment that could also affect firms’ growth. Originality/value: This research provides a clear understanding and comprehension of the contribution of working capital management to profitability, and internal, and sustainable growth

Comparative Study on The Socioeconomic Determinants of Crime in Pakistan and India: An Econometric Analysis

Purpose: This current study aims to identify the socioeconomic determinants of crime in Pakistan and India and compare the results of both the countries, which are unemployment, education, poverty, and economic growth. Methodology: The study is quantitative. Time series data for the period 1996 to 2020 has been taken and Autoregressive Distributed Lag (ARDL) bound testing approach to cointegration is applied for empirical verifications Findings: The results show that in Pakistan education and poverty are the important determinants of crime in the long run whereas in the short-run education is found to be the key cause of crime. On the other hand, in India poverty is an important determinant of crime. Conclusion: All over the world, the rate of crime has been increasing over time. The study is unique in the sense that causes of crime is studied in the two major south Asian countries India & Pakistan with a total population of over 1,500 million peoples. The outcome of the study will be helpful for the policymakers to overcome the shortfall in battling the crimes in the countries

Epirubicin With Cyclophosphamide Followed by Docetaxel With Trastuzumab and Bevacizumab as Neoadjuvant Therapy for HER2-Positive Locally Advanced Breast Cancer or as Adjuvant Therapy for HER2-Positive Pathologic Stage III Breast Cancer: A Phase II Trial of the NSABP Foundation Research Group, FB-5

Background The purpose of this study was to determine the cardiac safety and clinical activity of trastuzumab and bevacizumab with docetaxel after epirubicin with cyclophosphamide (EC) in patients with HER2-positive locally advanced breast cancer (LABC) or pathologic stage 3 breast cancer (PS3BC). Patients and Methods Patients received every 3 week treatment with 4 cycles of EC (90/600 mg/m2) followed by 4 cycles of docetaxel (100 mg/m2). Targeted therapy with standard-dose trastuzumab with bevacizumab 15 mg/kg was given for a total of 1 year. Coprimary end points were (1) rate of cardiac events (CEs) in all patients defined as clinical congestive heart failure with a significant decrease in left ventricular ejection fraction or cardiac deaths; and (2) pathologic complete response (pCR) in breast and nodes in the neoadjuvant cohort. An independent cardiac review panel determined whether criteria for a CE were met. Results A total of 105 patients were accrued, 76 with LABC treated with neoadjuvant therapy and 29 with PS3BC treated with adjuvant therapy. Median follow-up was 59.2 months. Among 99 evaluable patients for cardiac safety, 4 (4%; 95% confidence interval [CI], 1.1%-10.0%) met CE criteria. The pCR percentage in LABC patients was 46% (95% CI, 34%-59%). Five-year recurrence-free survival (RFS) and overall survival (OS) for all patients was 79.9% and 90.8%, respectively. Conclusion The regimen met predefined criteria for activity of interest with an acceptable rate of CEs. Although the pCR percentage was comparable with chemotherapy regimens with trastuzumab alone the high RFS and OS are of interest in these high-risk populations

Transthoracic ultrasound guided fine needle aspiration cytology of peripheral lung lesions: an experience of a pulmonologist

Background: Ultrasound (USG) guided fine needle aspiration cytology (FNAC) is a simple and cost-effective method for the diagnosis of various peripheral lung lesions. Being radiation free and easily available in most of centres, it has become an important diagnostic modality for early diagnosis of peripheral lung lesions. Besides procedure is simple and complications if occur, can be managed by a pulmonologist effectively. This study was aimed to evaluate the role of Transthoracic ultrasound guided FNAC in diagnosis of peripheral lung lesion.Methods: This prospective observational study was conducted at Government Chest Diseases Hospital Srinagar over a period of one year from January 2018-December 2018. 61 patients who fulfilled inclusion criteria were included in this study. After properly explaining the procedure and taking informed consent, USG guided FNAC was done in patients with peripheral lung lesions under local anaesthesia. Radiological and cytological data of enrolled patients was collected prospectively and analysed.Result: About 61 patients were included in this study comprising of 39 males and 22 females in age range of 17- 90 years. Malignancy was the most common cytological diagnosis (78.57%). while as benign diagnosis was reached in 21.43%. In 8.19% of patients, FNAC was inconclusive. Among the malignant group, adenocarcinoma (47.72%) was most common cytological diagnosis. The overall diagnostic yield of USG guided FNAC in this study was 91.8%.Conclusion: USG guided FNAC of peripheral lung lesions is a simple procedure with high accuracy and less complication rate which can be performed by a pulmonologist for diagnosis

Arterial properties as determinants of left ventricular mass and fibrosis in severe aortic Stenosis : findings from ACRIN PA 4008

Background-The role of arterial load in severe aortic stenosis is increasingly recognized. However, patterns of pulsatile load and their implications in this population are unknown. We aimed to assess the relationship between the arterial properties and both (1) left ventricular remodeling and fibrosis and (2) the clinical course of patients with severe aortic stenosis undergoing aortic valve replacement (AVR). Methods and Results-We enrolled 38 participants with symptomatic severe aortic stenosis scheduled to undergo surgical AVR. Aortic root characteristic impedance, wave reflections parameters (reflection magnitude, reflected wave transit time), and myocardial extracellular mass were measured with cardiac magnetic resonance imaging and arterial tonometry Cardiac magnetic resonance imaging was repeated at 6 months in 30 participants. A reduction in cellular mass (133.6 versus 113.9 g; P=0.002) but not extracellular mass (42.3 versus 40.6 g; P=0.67) was seen after AVR. Participants with higher extracellular mass exhibited greater reflection magnitude (0.68 versus 0.54; P=0.006) and lower aortic root characteristic impedance (56.3 versus 96.9 dynes/s per cm(5); P=0.006). Reflection magnitude was a significant predictor of smaller improvement in the quality of life (Kansas City Cardiomyopathy Questionnaire score) after AVR (R=-0.51; P=0.0026). The 6-minute walk distance at 6 months after AVR was positively correlated with the reflected wave transit time (R=0.52; P=0.01). Conclusions-Consistent with animal studies, arterial wave reflections are associated with interstitial volume expansion in severe aortic stenosis and predict a smaller improvement in quality of life following AVR. Future trials should assess whether wave reflections represent a potential therapeutic target to mitigate myocardial interstitial remodeling and to improve the clinical status of this patient population