Attitude Towards Civil Service of Pakistan: A Perception Survey

Amid growing concerns on the popularity of the civil service among the students, the study reports the findings of a perception survey of enrolled university students. Contrary to common perceptions, the results suggest that the civil service still retains its allure among the potential entrants. Those who prefer the civil service as a career are more concerned with job security than those who prefer a job in the private sector. The Foreign Service of Pakistan appears to be the most favourite group whereas the Accounts Group is the least preferred. The District Management Group (DMG) seems to no longer enjoy a coveted position due perhaps to the implementation of the devolution plan which has stripped the group of its power and privileges.Students, Civil Service, Public Choice, Job Search, Employment Decision

Attitudes Towards Civil Service of Pakistan: A Perception Survey

The Civil Service of Pakistan (CSP) is generally regarded as a prestigious occupation offering numerous perks and benefits along with administrative power and high social status. Each year, thousands of applicants compete for a prized job in the civil service and only a fraction eventually makes it.1 Yet in recent years there has been a growing perception that the civil service might be losing its allure for at least three reasons. First, the salary structure of the civil service has not kept pace with the cost of living making it difficult for civil servants to maintain a decent living standard. Second, there has been a growing competition from the private sector which has created a variety of professional jobs in manufacturing and services sectors offering handsome salaries and other fringe benefits. Third, the civil service has faced mounting criticism in recent years for its inefficiency, and for its failure to modernise; and this may have spread a negative image among the potential entrants.2 It is important to note that the Federal Public Service Commission (FPSC) also laments the waning interest of highly qualified students in the civil service. 3 Against this backdrop, a survey was conducted to explore the students’ attitudes towards the civil service of Pakistan.4 This study reports some key findings of that survey. Section 2 provides some stylised facts about participants in the CSS examination based on secondary data. Section 3 spells out the survey methodology and highlights the key characteristics of the respondents. Section 4 examines students’ occupation choice in terms of a comparison between public and private sectors. Section 5 highlights student’s level of awareness about various aspects of the competitive examination while Section 6 explores students’ attitudes towards the civil service.5 Some key findings of the survey are summarised in the concluding section

Contemporary Management of Stent Failure: Part One

The occurrence of in-stent restenosis (ISR) still remains a daunting challenge in the current era, despite advancements in coronary intervention technology. The authors explore the underlying pathophysiology and mechanisms behind ISR, and describe how the use of different diagnostic tools helps to best elucidate these. They propose a simplistic algorithm to manage ISR, including a focus on how treatment strategies should be selected and a description of the contemporary technologies available. This article aims to provide a comprehensive outline of ISR that can be translated into evidence-based routine clinical practice, with the aim of providing the best outcomes for patients

Risk Factors of Intracerebral Hemorrhage – A Cross Sectional Study

ABSTRACT Background and Objective: Stroke is the major cause of disability and one of the top causes of death in the globe. Though the rate is decreasing in the West, it is most likely growing in Asia. In Pakistan, the burden of stroke risk factors is substantial. Although data on the incidence and prevalence of stroke in Pakistan is limited, there are several published case studies demonstrating major disparities in stroke epidemiology, risk factors, kinds, and patterns. This study aims to identify risk factors of intracerebral hemorrhage among patients presenting to a teaching hospital. Methods: From August 2019 to February 2020, 103 patients from DHQ Teaching Hospital Abbottabad\u27s medical units participated in this prospective cross-sectional research. A CT scan of the brain was performed in all patients to identify intra cerebral hemorrhage and was used to diagnose cerebrovascular events. In patients with intracerebral hemorrhage, detailed histories and medical records were thoroughly examined in order to identify risk factors such as uncontrolled hypertension. To detect poorly managed diabetes and hyperlipidemia, fasting blood glucose, fasting serum cholesterol, and fasting triglycerides were measured. SPSS 20 was used to evaluate the data obtained on a standardized proforma. Results: The majority of the patients (n=41) were over 70 years old, with 71 (68.93%) males and 32 (31.07%) females. Intracerebral hemorrhage was reported in 8.74 percent (n=9) of patients with acute cerebrovascular accidents, with 66.67 percent (n=6) having uncontrolled hypertension, 44.44 percent (n=4) having diabetes, and 33.33 percent (n=3) having hyperlipidemia. Conclusion: Intracerebral hemorrhage is prevalent in individuals who have had a cerebrovascular accident, and hypertension is the most common risk factor for this consequenc

Perception Survey of Civil Servants: A Preliminary Report

Despite various attempts at reforming the civil services the common perception seems to be that the system essentially remains similar to that inherited from the colonial past. Worse still, little is known about the perceptions of civil servants on various issues in civil service reforms. Against this backdrop, the Pakistan Institute of Development Economics conducted a perception survey of civil servants seeking their views on recruitment, training, performance evaluation, job satisfaction, and relationship with the private sector. This preliminary report highlights the key findings of the survey. Section 2 sets out the survey methodology. Sections 3 to 7 respectively highlight the survey findings with respect to recruitment, postings and training, performance evaluation, job satisfaction, bureaucracy, private sector, and institutions and reforms

Effect of ω-3 fatty acid supplementation on endothelial function, endogenous fibrinolysis and platelet activation in patients with a previous myocardial infarction:a randomised controlled trial

OBJECTIVE: The mechanisms through which ω-3 fatty acids reduce adverse cardiac events remain uncertain. We aimed to investigate the effect of ω-3 fatty acid supplementation on endothelial vasomotor function, endogenous fibrinolysis, and platelet and monocyte activation in patients with coronary heart disease. DESIGN: Randomised, double-blind, placebo-controlled, cross-over trial. SETTING: Academic cardiac centre. PARTICIPANTS: 20 male patients with a previous myocardial infarction. INTERVENTION: ω-3 Fatty acid supplementation (2 g/day for 6 weeks) versus olive oil placebo. OUTCOME MEASURES: Peripheral blood was taken for analysis of platelet and monocyte activation, and forearm blood flow (FBF) was assessed in a subset of 12 patients during intrabrachial infusions of acetylcholine, substance P and sodium nitroprusside. Stimulated plasma tissue plasminogen activator (t-PA) concentrations were measured during substance P infusion. RESULTS: All vasodilators caused dose-dependent increases in FBF (p<0.0001). ω-3 Fatty acid supplementation did not affect endothelium-dependent vasodilation with acetylcholine and substance P compared with placebo (p=0.5 and 0.9). Substance P caused a dose-dependent increase in plasma t-PA concentrations (p<0.0001), which was not affected by ω-3 fatty acid supplementation (p=0.9). ω-3 Fatty acids did not affect platelet–monocyte aggregation, platelet P-selectin or CD40L, or monocyte CD40. CONCLUSIONS: We have demonstrated that dietary supplementation with ω-3 fatty acids does not affect endothelial vasomotor function, endothelial t-PA release, or platelet and monocyte activation in patients with coronary heart disease. Cardiac benefits conferred by ω-3 fatty acids in coronary heart disease are unlikely to be mediated through effects on these systems

Salinity management alternatives for the Rechna Doab, Punjab, Pakistan. Volume 4 - Field data collection and processing

Irrigation management / Soil salinity / Agricultural development / Water quality / Data processing / Groundwater / Crop production / Intensive cropping / Models / Farm surveys / Pakistan / Punjab / Rechna Doab

Clinical correlates and prognostic impact of neurologic disorders in Takotsubo syndrome

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.Cardiac alterations are frequently observed after acute neurological disorders. Takotsubo syndrome (TTS) represents an acute heart failure syndrome and is increasingly recognized as part of the spectrum of cardiac complications observed after neurological disorders. A systematic investigation of TTS patients with neurological disorders has not been conducted yet. The aim of the study was to expand insights regarding neurological disease entities triggering TTS and to investigate the clinical profile and outcomes of TTS patients after primary neurological disorders. The International Takotsubo Registry is an observational multicenter collaborative effort of 45 centers in 14 countries (ClinicalTrials.gov, identifier NCT01947621). All patients in the registry fulfilled International Takotsubo Diagnostic Criteria. For the present study, patients were included if complete information on acute neurological disorders were available. 2402 patients in whom complete information on acute neurological status were available were analyzed. In 161 patients (6.7%) an acute neurological disorder was identified as the preceding triggering factor. The most common neurological disorders were seizures, intracranial hemorrhage, and ischemic stroke. Time from neurological symptoms to TTS diagnosis was ≤ 2 days in 87.3% of cases. TTS patients with neurological disorders were younger, had a lower female predominance, fewer cardiac symptoms, lower left ventricular ejection fraction, and higher levels of cardiac biomarkers. TTS patients with neurological disorders had a 3.2-fold increased odds of in-hospital mortality compared to TTS patients without neurological disorders. In this large-scale study, 1 out of 15 TTS patients had an acute neurological condition as the underlying triggering factor. Our data emphasize that a wide spectrum of neurological diseases ranging from benign to life-threatening encompass TTS. The high rates of adverse events highlight the need for clinical awareness.The International Takotsubo Registry was supported by the Biss Davies Charitable Trust. Dr. Scheitz has been supported by the Corona Foundation. Dr. Templin has been supported by the H.H. Sheikh Khalifa bin Hamad Al-Thani Research Programme and the Swiss Heart Foundation.info:eu-repo/semantics/publishedVersio

A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina.

Percutaneous coronary intervention (PCI) is frequently performed to reduce the symptoms of stable angina. Whether PCI relieves angina more than a placebo procedure in patients who are not receiving antianginal medication remains unknown. We conducted a double-blind, randomized, placebo-controlled trial of PCI in patients with stable angina. Patients stopped all antianginal medications and underwent a 2-week symptom assessment phase before randomization. Patients were then randomly assigned in a 1:1 ratio to undergo PCI or a placebo procedure and were followed for 12 weeks. The primary end point was the angina symptom score, which was calculated daily on the basis of the number of angina episodes that occurred on a given day, the number of antianginal medications prescribed on that day, and clinical events, including the occurrence of unblinding owing to unacceptable angina or acute coronary syndrome or death. Scores range from 0 to 79, with higher scores indicating worse health status with respect to angina. A total of 301 patients underwent randomization: 151 to the PCI group and 150 to the placebo group. The mean (±SD) age was 64±9 years, and 79% were men. Ischemia was present in one cardiac territory in 242 patients (80%), in two territories in 52 patients (17%), and in three territories in 7 patients (2%). In the target vessels, the median fractional flow reserve was 0.63 (interquartile range, 0.49 to 0.75), and the median instantaneous wave-free ratio was 0.78 (interquartile range, 0.55 to 0.87). At the 12-week follow-up, the mean angina symptom score was 2.9 in the PCI group and 5.6 in the placebo group (odds ratio, 2.21; 95% confidence interval, 1.41 to 3.47; P<0.001). One patient in the placebo group had unacceptable angina leading to unblinding. Acute coronary syndromes occurred in 4 patients in the PCI group and in 6 patients in the placebo group. Among patients with stable angina who were receiving little or no antianginal medication and had objective evidence of ischemia, PCI resulted in a lower angina symptom score than a placebo procedure, indicating a better health status with respect to angina. (Funded by the National Institute for Health and Care Research Imperial Biomedical Research Centre and others; ORBITA-2 ClinicalTrials.gov number, NCT03742050.). [Abstract copyright: Copyright © 2023 Massachusetts Medical Society.