Promoting Social Justice and Equity through University Education in Pakistan

Education is a social entity and takes input from the society and returns output to it as well. University education is considered as the hub that produces human capital into the market. Universities shall play their role to promote social justice and equity for people from all spheres of the society. This study was focused to explore the perceptions of teachers about the social injustice and inequity in universities of Pakistan. The aim was to promote social justice and equity in education by highlighting the factors that cause injustice and inequity, to find out the imbalance in the market value of our educational system, and to find the administrative measures that could promote social justice and equity. For that purpose the experienced teachers and administrators were purposely selected to participate in this research. Interviews were conducted with prior permission to record it. The data generated from 12 participants (10 males and 2 females) were analyzed by Thematic Description Approach under qualitative data analysis techniques. The themes for each question from the transcribed interviews were identified and coded. Major factors were identified and significant differences were revealed on behalf of the interviewees’ perceptions. Suggestions were given to take effective administrative measures. Results revealed practical implications for educationists and policy makers to promote social justice and equity

Bridging knowledge translation gap in health in developing countries: visibility, impact and publishing standards in journals from the Eastern Mediterranean

BACKGROUND: Local and regional scientific journals are important factors in bridging gaps in health knowledge translation in low-and middle-income countries. We assessed indexing, citations and publishing standards of journals from the Eastern Mediterranean region. METHODS: For journals from 22 countries in the collection of the Index Medicus for the Eastern Mediterranean Region (IMEMR), we analyzed indexing in bibliographical databases and citations during 2006–2009 to published items in 2006 in Web of Science (WoS) and SCOPUS. Adherence to editorial and publishing standards was assessed using a special checklist. RESULTS: Out of 419 journals in IMEMR, 19 were indexed in MEDLINE, 23 in WoS and 46 in SCOPUS. Their impact factors ranged from 0.016 to 1.417. For a subset of 175 journals with available tables of contents from 2006, articles published in 2006 from 93 journals received 2068 citations in SCOPUS (23.5% self-citations) and articles in 86 journals received 1579 citations in WoS (24.3% self-citations) during 2006–2009. Citations to articles came mostly from outside of the Eastern Mediterranean region (76.8% in WoS and 75.4% in SCOPUS). Articles receiving highest number of citations presented topics specific for the region. Many journals did not follow editorial and publishing standards, such addressing requirements about the patient’s privacy rights (68.0% out of 244 analyzed), policy on managing conflicts of interest (66.4%), and ethical conduct in clinical and animal research (66.4%). CONCLUSION: Journals from the Eastern Mediterranean are visible in and have impact on global scientific community. Coordinated effort of all stakeholders in journal publishing, including researchers, journal editors and owners, policy makers and citation databases, is needed to further promote local journals as windows to the research in the developing world and the doors for valuable regional research to the global scientific community

A case of an intraocular glass piece that has remained quiescent for four years

An intraocular foreign body (IOFB) is mainly acquired via a penetrating globe injury. Some foreign bodies like glass have an inert nature, and the timing of intervention can be delayed, but foreign bodies like metals have a toxic effect on the eye and require urgent removal. We present a case of a young male with a penetrating globe injury following a road traffic accident. He acquired a foreign body glass piece in his left eye, which was initially missed. Upon thorough examination, it was found at the inferotemporal quadrant of the retina. Considering the inert nature of IOFB and the risks of bleeding and damage to the surrounding intraocular structures, we decided not to remove it. The patient has been stable for four years with good vision in the same eye

Neural Signaling and Communication

To understand the complex nature of the human brain, network science approaches have played an important role. Neural signaling and communication form the basis for studying the dynamics of brain activity and functions. The neuroscientific community is interested in the network architecture of the human brain its simulation and for prediction of emergent network states. In this chapter we focus on how neurosignaling and communication is playing its part in medical psychology, furthermore, we have also reviewed how the interaction of network topology and dynamic models of a brain network

The Impact of Perceived Leadership Behavior and Organizational Commitment of Employees in the Education Sector of Pakistan

This paper aims to study the effect of perceived leadership behavior on organizational commitment of employees and the industry that this paper conducts the study in is the education sector of Pakistan. After a thorough review of the literature, research gap was identified and data was collected with the help of questionnaires. Out of 200 questionnaires that were handed out, 170 complete responses were received with a response rate of 85% as part of this self-administered questionnaire filling activity. These responses were obtained from the faculty members of different colleges and universities in Lahore, Pakistan. Random sampling was carried out for selection of the sample for this study. For analyzing the data Pearson’s product moment correlation and regression were used. This study found that there was a positive effect of participative and supportive leadership behavior and the organizational commitment of employees whereas there was a negative relationship between directive leadership and organizational commitment of employees. These findings are useful for managers to understand how they can increase organizational commitment amongst employees for greater organizational productivity. Limitations and future research possibilities have also been indicated

Percutaneous management of biliary enteric anastomotic strictures: an institutional review

Purpose Stricture formation at the biliary enteric anastomotic site is a common complication due to fibrotic healing. Few therapeutic options are available for biliary-enteric anastomotic site stricture (BES) including new surgical reconstruction or percutaneous transhepatic biliary drainage followed by balloon dilation of BES or stent placement. The purpose of this study is to assess the technical success, complications and reintervention rate of percutaneous transhepatic balloon dilatation (PTBD) of BES after iatrogenic bile duct injuries (BDI). Methods A retrospective review of patients who underwent PTBD for benign resistant BES, previously treated for iatrogenic BDI, from December 2004 to January 2016 was performed. Diagnostic transhepatic cholangiogram was performed to assess the level of obstruction. BES was dilated using 8-12 mm diameter balloons followed by placement of eight to ten Fr internal-external drainage catheters, which were removed after three to six weeks post-PTBD cholangiogram. Follow-up by clinical assessment, liver function tests, and ultrasound was done. Fischer exact test was used to determine if there was a significant association between PTBD sessions and recurrent strictures. Results In total, 37 patients underwent 66 sessions of PTBD, including 10 (27%) males and 27 (73%) females. The mean age was 41.3 years (range 23-70 years). Out of these, 29 (78%) were treated with choledochojejunostomy and eight (22%) with hepaticojejunostomy. 100% technical success was achieved in all the PTBD sessions. Nineteen (51.3%) patients were treated with a single PTBD session. Mean follow-up time was 36 months (range 1-75 months). Eighteen (48.7%) patients needed reintervention, out of these, 11 (29.7%) were symptom-free after second session on three-year follow-up, three (8%) were symptom-free after the third session of PTBD. No significant difference was observed in risk of recurrent strictures after first and second PTBD sessions [18 (48%) vs. 7 (39%); p-value 0.495]. In four (11%) patients, the symptoms persisted and BES recurred even after third session and those were treated by placing metallic stent. In total, three (8.1%) patients got complicated with the stone formation; in two (5%) patients stone was successfully removed percutaneously and in one (3%) patient percutaneous attempt failed so it was followed by surgical removal. Conclusion PTBD is a safe and useful treatment option for benign BES for long-term symptom-free time-period. However, there is no significant difference in developing recurrent BES after PTBD sessions. Few patients with resistant strictures might require stent placement

Craniovertebral Junctional Injuries and Management

Objective: Craniocervical junction injuries are less common. They are unique in their presentation and need specialized management. The objective was to determine diagnosis initial management and ultimate surgical procedures performed and efficacy of these procedures.Materials and Methods: A five year study from April 2003 to Oct. 2008 was conducted at department of neurosurgery unit II Lahore general hospital Lahore. A total of fifteen patients were included. All patients with upper cervical trauma with all modes of injuries were included irrespective of their age and sex. All patients were evaluated with routine X-rays cervical spine, anterioposterior, lateral and open mouth views. While dynamic views were advised only in those having osodontoideum. C.T with saggital reconstruction and MRI were performed in all patients to further augment and detect bony and soft tissue details. In all modes of injuries we maintain their airway breathing and circulation.Clinical Presentation: Out of total fifteen patients mostly were young in their twenties and thirtees, only two patients (13.33%) were below twenty and one patient (6.66%) was above fourty years. The main culprit was road traffic accident in most of patients (thirteen patients 80%) followed by fall in two patients (13.33%) and assault in one patient (6.66%). The odontoid fracture with reductable atlantoaxial instability was appeared to the most common problem in five patients (33.33%). In two patients (13.33%) transverse ligament found to be intact. In two other cases (13.33%) atlas fracture was simultaneously found. Osodontoideum detected in two patients (13.33%) while basilar invagination seen in one patient (6.66%). Irreducable atlantoaxial instability was seen in three patients (20%). Out of fifteen patients, three patients (20%) were neurologically intact, while one patient (6.66%) had complete injury. Eleven patients (73%) had partial injury.Surgical Procedures: In order to achieve stability, we performed posterior instrumentation and bony fusion in all nine reducible injury patients (60%). Atlanto axial fusion performed in seven patients (46.66%), while in two patients (13.33%) having concomitant C1 injury occipitocervical fusion was done. Initial transoral decompres-sion, prior to posterior fusion was done in all four (26.66%) non reducible injury patients. Transodontoid screw fixation was done in two patients (13.33%) having intact transverse ligament.Outcome: Overall 07 (46.66%) cases revealed excellent results all recovered without any complication. Four (26.66%) cases had some complication but recovered within 02 weeks and result was labeled as good. Two cases who had neurological deterioration, recovered slowly within 03 months. Recovery was labeled as fair. One patient who suffered neurological deterioration did not recovered and result was labeled as poor.Complications: One patient (6.66%) died after severe chest infection, although severe chest infection observed in three patients (20%). Mild wound infection and wound dehiscence seen in one patient (6.66%) each. These patients managed conservatively successfully. Neurological deterioration observed in three patients (20%), out of them two patients (13.66%) improved with 3 months

Vitamin D deficiency (VDD) and susceptibility towards severe Dengue fever:a prospective cross-sectional study of hospitalized Dengue fever patients from Lahore, Pakistan

Dengue is a mosquito-borne flaviviral serious febrile illness, most common in the tropical and subtropical regions including Pakistan. Vitamin D is a strong immunomodulator affecting both the innate and adaptive immune responses and plays a pivotal role in pathogen-defense mechanisms. There has been considerable interest in the possible role of vitamin D in dengue viral (DENV) infection. In the present prospective cross-sectional study, we assessed a possible association between serum vitamin D deficiency (VDD) and susceptibility towards severe dengue fever (DF) illness. Serum vitamin D levels were measured at the time of hospitalization in 97 patients diagnosed with dengue fever (DF), dengue hemorrhagic fever (DHF) or dengue shock syndrome (DSS) at Mayo Hospital, King Edward Medical University, Lahore, PK, from 16 November 2021 to 15 January 2022. In terms of disease severity, 37 (38.1%) patients were DF, 52 (53.6%) were DHF grade 1 and 2, and 8 (8.2%) were DSS. The results revealed that most patients (75 (77.3%)) were vitamin-D-deficient (i.e., serum level &lt; 20 ng/mL), including 27 (73.0%) in DF, 41 (78.8%) in DHF grade 1 and 2, and 7 (87.5%) in DSS. The degree of VDD was somewhat higher in DSS patients as compared to DF and DHF grade 1 and 2 patients. Overall, serum vitamin D levels ranged from 4.2 to 109.7 ng/mL, and the median (IQR) was in the VDD range, i.e., 12.2 (9.1, 17.8) ng/mL. Our results suggest that there may be a possible association between VDD and susceptibility towards severe dengue illness. Hence, maintaining sufficient vitamin D levels in the body either through diet or supplementation may help provide adequate immune protection against severe dengue fever illness. Further research is warranted.</p

Electrocardiographic changes in Emphysema

Chronic obstructive lung disease (COPD), predominantly emphysema, causes several thoracic anatomical and hemodynamic changes which may cause changes in various electrocardiographic parameters. A 12-lead electrocardiogram (ECG), which is often a part of routine evaluation in most clinical settings, may serve as a useful screening modality for diagnosis of COPD or emphysema. Our current article aims to provide a comprehensive review of the electrocardiographic changes encountered in COPD/emphysema utilizing published PubMed and Medline literature database. Several important ECG changes are present in COPD/emphysema and may serve as a good diagnostic tool. Verticalization of Pvector, changes in QRS duration, pattern recognition of precordial R-wave progression and axial shifts can be considered some of the most valuable markers among other changes. In conclusion, 12-lead surface electrocardiogram can serve as a valuable tool for the diagnosis of COPD and/or emphysema. An appropriate knowledge of these ECG changes can not only help in the diagnosis but can also immensely help in an appropriate clinical management of these patients