COMPARISON BETWEEN CAREER CHOICES OF MEDICAL STUDENTS IN FIRST YEAR MBBS AND CAREER CHOICES OF SAME STUDENTS IN SECOND YEAR MBBS

Background:Career choice is very important for every medical student even in firs year because if they don’t know their path and destination how they can walk through it. Purpose of our study is to find career choice in first and second year, factors responsible for making or changing a choice and their practice station. Methodology:It is an observational study in which 102 students of RAI medical college Sargodha were given questionnaire. Their career choice in 1st and 2nd year, factors influencing career choice and practice station was asked in that questionnaire. Result:Total 101(99%) students filled and returned performas. In our study 56(54.5%) participants were females and 46(45.5%) were males (6). Out of 101 students 66 (65.34%) students decided their career in 1sr year and did not change in second year. Among males cardiology is most preferred specialty in 1st year (26%) as well as 2nd year (23.91%) followed by general surgery and internal medicine. Among females cardiology is most preferred specialty in 1st year (23.63%) as well as 2nd year (18.18%). In 1st year cardiac surgery (12.72%) and obstetrics and gynaecology (10.9%) is next preferred specialty. In 2nd year obstetrics and gynaecology (16.36%) and dermatology (10.9%) is most preferred specialty. Most influencing factor is personal interest in both genders (83.16%). Most people preferred Pakistan as practice station (65.35%). Conclusion:This study showed mostly students chose clinical specialties. A few students have idea about new emerging fields. This study emphasizes the need of career counseling of medical student in early phase. Career guidance is also important for those students who remained undecided about their career even after house job

FREQUENCY AND SOURCE OF INFECTION IN PATIENTS WITH SEPSIS

Objective: To determine the frequency and source of infection in patients with sepsis. Patients and Methods: This one year cross sectional study was carried at tertiary care teaching hospital. The criteria for selection is any patient of ≥12 years of age, either gender admitted in ward who came under the criteria for sepsis accordingly as systemic inflammatory response syndrome due to infection as existent etiology or at least with clinical evidence of infection while the necessary specific and relevant investigations were also advised and sort accordingly whereas the blood and urine sample for bacterial culture / sensitivity was collected and sent soon to confirm the diagnosis. The frequency and percentages was calculated while the numerical statistics were used to compute mean ±SD. Results: During one year study period total fifty patients diagnosed with sepsis with the mean age ±SD for whole population was 40.84±6.85 years, of fifty individuals 28 (56%) were males and 22 (44%) were females and majority belonged to rural population (60%). The organ system dysfunction identified were coagulopathy (50%), central nervous system (40%), hepatic (38%) and renal (42%). The common source of infection detected were Respiratory tract infection (16%), urinary tract infections (16%), intravenous catheters (16%) and urethral catheterization (18%) respectively. Conclusion: The study detected higher incidence of infection with gram negative pathogen was common microorganism while the common source of infections identified urethral catheterization (18%), intravenous catheters (16%), urinary tract infections (16%) and respiratory tract infections (16%). Keywords: Sepsis, Blood culture, Source of infection & Systemic inflammatory response syndrome

Network analysis of global stock markets at the beginning of the coronavirus disease (Covid-19) outbreak

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Endonasal Endoscopic Repair of Cerebrospinal Fluid Leaks

Objective: To assess the outcome of Endonasal Endoscopic Repair of Cerebrospinal Fluid LeaksMethods and Materials: This study was conducted from July 2013 to October 2014 at the department of Neurosurgery, PGMI, Lahore General Hospital, Lahore. A total of 20 patients were included in this study of both gender (male and female) and in the age range of 15 – 65 years. All the patients undergone Endonasal Endoscopic with the use of a Karl Stortz rigid endoscope of 0º and 30º with a 4mm diameter. All of them were followed up for recurrence of CSF leak and any postoperative complication.Results: Out of 20 patients, there were 08 (40%) males and 12 (60%) female patients. Their age ranged from 15 – 65 years. The maximum numbers of patients were in their third and fourth decade of life. The cause of CSF leak was spontaneous in 11(55%), iatrogenic in 5 (25%) and traumatic in 4 (20%) of cases. In 13 (65%) patients, CSF rhinorrhea was from right nostril and in 7 (35%) patients left side was affected. Endonasal Endoscopic CSF repair was done in all patients and was successful in 18 (90%) of patients. Two patients (10%) presented with recurrence of CSF leak in which one was successfully re-operated endoscopically and other undergone transcranial approach. Overall the success rate was 95% in our study. Only one patient complicates with meningitis postoperatively which was resolved with antibiotics.Conclusion: The repair of the CSF rhinorrhea by Endonasal Endoscopic surgery is minimal invasive, safe, effective and is a valid alternative to the cranial approach. Abbreviations: CSF: Cerebrospinal Fluid. MRI: Magnetic Resonance Imaging

Outcome of Anterior Fixation in Lower Cervical Spine Injuries

Introduction: The fractures of cervical spine are divided into upper cervical spine (C1 – C2) and lower cervical spine (C3 – C7) fractures, also called sub-axial cervical spine. Sub-axial cervical injuries rangesfrom minor ligamentous strain or spinous process fracture to complete fracture dislocation with bone and ligament disruption, resulting in severe spinal cord injury. Objectives: The objective of this study was to determine the efficacy of anterior cervical spine fixation as regards the effective stabilization, immobilization and solid bony fusion in lower cervical spine injuries by the use of cervical spine locking plate (CSLP) attached with cancellous screws. Study Design: Descriptive case series study. Materials and Methods: This study was conducted from March 2013 to March 2014 in the department of Neurosurgery unit II, Lahore General Hospital Lahore. A total of 30 patients were included in this study of both gender and in the age range of 16 – 60 years. Results: In our study, there were 23 (76.7%) male patients and 7 (23.3%) female patients. The majority of the patients 25 (83.3%) were in the age range of 21 – 50 years with mean age was 38.2 ± 11.7 years. On one month follow up, the mean Frankel grade was 3.5 ± 1.6, 3.53 ± 1.6 on 3 months follow up and 3.6 ± 1.8 on 6 months follow-up. Similarly, 12 (40%) patients remained catheterized, 16 (53.3%) patients had normal control and 2 (6.7%) patients had partial recovery in 1 month time. After 3 months, 4 (13.3%) patients remained catheterized, 20 (66.7%) patients had normal control and 6 (20%) patients had partial recovery. After 6 months 3 (10%) patients remained catheterized, 25 (83.3%) patients had normal control and 2 (6.7%) had partial recovery. On follow up of one, three and six months, x-ray finding showed in 9 (30%) patients of good condition and 21 (70%) patients of satisfactory condition. Conclusion: The use of anterior approach in treatment of the injured lower spine is safe and effective. Abbreviations: CSLP = cervical spine locking plate

Search for new phenomena in final states with an energetic jet and large missing transverse momentum in pp collisions at √ s = 8 TeV with the ATLAS detector

Results of a search for new phenomena in final states with an energetic jet and large missing transverse momentum are reported. The search uses 20.3 fb−1 of √ s = 8 TeV data collected in 2012 with the ATLAS detector at the LHC. Events are required to have at least one jet with pT > 120 GeV and no leptons. Nine signal regions are considered with increasing missing transverse momentum requirements between Emiss T > 150 GeV and Emiss T > 700 GeV. Good agreement is observed between the number of events in data and Standard Model expectations. The results are translated into exclusion limits on models with either large extra spatial dimensions, pair production of weakly interacting dark matter candidates, or production of very light gravitinos in a gauge-mediated supersymmetric model. In addition, limits on the production of an invisibly decaying Higgs-like boson leading to similar topologies in the final state are presente

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Measurement of single top-quark production in association with a W boson in the single-lepton channel at \sqrt{s} = 8\,\text {TeV} with the ATLAS detector

The production cross-section of a top quark in association with a W boson is measured using proton–proton collisions at \sqrt{s} = 8\,\text {TeV}. The dataset corresponds to an integrated luminosity of 20.2\,\text {fb}^{-1}, and was collected in 2012 by the ATLAS detector at the Large Hadron Collider at CERN. The analysis is performed in the single-lepton channel. Events are selected by requiring one isolated lepton (electron or muon) and at least three jets. A neural network is trained to separate the tW signal from the dominant t{\bar{t}} background. The cross-section is extracted from a binned profile maximum-likelihood fit to a two-dimensional discriminant built from the neural-network output and the invariant mass of the hadronically decaying W boson. The measured cross-section is \sigma _{tW} = 26 \pm 7\,\text {pb}, in good agreement with the Standard Model expectation