The Relationship between Product Nature and Supply Chain Strategy; An empirical evidence

Abstract The purpose of the paper is to explore the relationship between the nature of product and respective supply chain strategy of the firms operation in manufacturing sector. The relationship is investigated by using the fishers model as conceptual framework. Data was collected through questionnaire-based self-administered survey. The results of the survey were analysed by testing the fishers model related to Supply Chain Strategy and product characteristics. The results of the study indicated that there is a significant relationship between nature of the product and supply chain strategy in manufacturing sector of Pakistan. The practical implication can be derived by the policy makers and practitioners of the supply chain strategy domain that characteristics of the product can have an impact of the decision to device supply chain strategy. Furthermore, this study is conducted in special context of underdeveloped country like Pakistan. Therefore, results of this study enhanced the existing literature on underdeveloped economies

Comparison between Tramadol and Pethidine in Patient Controlled Intravenous Analgesia

Objective: To compare the efficacy and side effects related to Tramadol with Pethidine in patient controlled intravenous analgesia (PCIA) after total abdominal hysterectomies. Methods: A total of 60 patients were randomized to receive either Tramadol or Pethidine by PCIA (30 in each group) after total abdominal hysterectomy. Pain assessments were recorded one hour after starting the PCIA and then at 6, 12, and 24 hours by using visual analogue scale (VAS). Nausea vomiting score and sedation score were also recorded. Good attempts, total attempts and total drug consumption was noted from PCIA pump at the end of the study period. Results: The analgesia achieved in Tramadol group was comparable to Pethidine. The incidence of nausea and vomiting was similar in both groups. Tramadol causes significantly less sedation than Pethidine (p \u3c 0.05). Mean drug consumption, total attempts and good attempts were also significantly less in Tramadol group than Pethidine group (p \u3c 0.05). Conclusion: Tramadol produces equivalent analgesia and less sedation and can be used as an alternative to Pethidine in Patient Controlled Intravenous Analgesia for postoperative pain relief after Total Abdominal Hysterectomy (TAH

Assessment of Hearing Loss by Audiometry - Our Experience at Tertiary Care Hospital

Objective: To analyze the results of pure tone audiometry in the terms of age, sex, and type of hearing loss attending the hospital with the complaint of hearing loss. Materials and Methods: In this descriptive study, patients attending Benazir Bhutto hospital with complaints of hearing loss were included. The data analysis was done under the terms of age, sex and unilateral/bilateral, and type of loss after pure tone audiometry of every case. The type of hearing loss was determined as conductive, SNHL, and mixed hearing loss. Results: There were 47 patients. Males were 34 (72.34%) outnumbering13females 13(27.66). Adults were44 (93.61%) and children were 3(6.34%). Mixed hearing loss was28 (59.57%)% compared to conductive hearing loss 15 (31.91) and SNHL4 (8.51%). Conclusion: Hearing loss is more common in adults and more prevalent in males. It is mostly bilateral. Mixed hearing loss is more common as compared to conductive and SNHL respectively. Sociacusis is to be taken seriously. &nbsp

Análise de desenhos experimentais com outliers

Primary purpose of the article is to develop outlier robust designs. As a matter of fact, negative effect of outliers in any experimental settings is established where the outliers at any specific design point can destroy the features of the design for which it is being developed. It is attempted here in this article to develop a version of robustness for central composite designs which may protect it for outliers by introducing the idea of minimax outlying effect. This involves the calculation of the degree of outlying effect(s) outlier(s) may produce and then minimize the maximum of these outlying effects in an attempt to equalize the influence of all design points. On comparison, these outlier robust designs are proved to be more optimal, on the scales of A, D, and E optimalities, against existing conventional rotatable, orthogonal, and other such designs. The outlier robust designs, developed here, are suitable for settings prone to outliers where conventional designs fail to represent and analyze the processes and systems.El objetivo principal del artículo es desarrollar diseños robustos atípicos. De hecho, el efecto negativo de los valores atípicos en cualquier configuración experimental se establece donde los valores atípicos en cualquier punto de diseño específico pueden destruir las características del diseño para el que se está desarrollando. En este artículo se intenta desarrollar una versión de robustez para los diseños compuestos centrales que pueden protegerlo de los valores atípicos mediante la introducción de la idea del efecto periférico minimax. Esto implica el cálculo del grado de efecto (s) externo (s) que puede producir un valor atípico y luego minimizar el máximo de estos efectos externos en un intento de igualar la influencia de todos los puntos de diseño. En comparación, se demuestra que estos diseños robustos atípicos son más óptimos, en las escalas de las optimidades A, D y E, frente a los diseños convencionales existentes, ortogonales, rotativos y otros similares. Los diseños robustos atípicos, desarrollados aquí, son adecuados para configuraciones propensas a los valores atípicos en los que los diseños convencionales no representan ni analizan los procesos y sistemas.Objetivo principal do artigo é desenvolver projetos robustos outlier. De fato, o efeito negativo de outliers em qualquer ambiente experimental é estabelecido onde os outliers em qualquer ponto de design específico podem destruir os recursos do design para o qual ele está sendo desenvolvido. Neste artigo, tenta-se desenvolver uma versão de robustez para projetos compostos centrais que possam protegê-lo de outliers, introduzindo a ideia de efeito periférico minimax. Isso envolve o cálculo do grau de efeito (s) outlier (s) outlier (s) pode produzir e, em seguida, minimizar o máximo desses efeitos periféricos em uma tentativa de equalizar a influência de todos os pontos do projeto. Em comparação, esses designs robustos discrepantes são comprovadamente mais otimizados, nas escalas de otimalidades A, D e E, contra os designs convencionais rotacionais, ortogonais e outros existentes. Os designs robustos outlier, desenvolvidos aqui, são adequados para configurações propensas a outliers em que projetos convencionais não representam e analisam os processos e sistemas

Impact of Delayed Pain to Needle and Variable Door to Needle Time On In-Hospital Complications in Patients With ST-Elevation Myocardial Infarction Who Underwent Thrombolysis: A Single-Center Experience.

Background Myocardial infarction is a life-threatening event, and timely intervention is essential to improve patient outcomes and mortality. Previous studies have shown that the time to thrombolysis should be less than 30 minutes of the patient\u27s arrival at the emergency room. Pain-to-needle time is a time from onset of chest pain to the initiation of thrombolysis, and door-to-needle time is a time between arrival to the emergency room to initiation of thrombolytic treatment. Ideally, the target for door-to-needle time should be less than 30 minutes; however, it is unclear if the door-to-needle time has a significant impact on patients presenting later than three hours from the onset of pain. As many of the previous studies were conducted in first-world countries, with established emergency medical services (EMS) systems and pre-hospital ST-elevation myocardial infarction (STEMI) triages and protocols, the data is not completely generalizable to developing countries. We, therefore, looked for the impact of the shorter and longer door-to-needle times on patient outcomes who presented to the emergency room (ER) with delayed pain-to-needle times (more than three hours of pain onset). Objective To determine the impact of delayed pain-to-needle time (PNT) with variable door-to-needle time (DNT) on in-hospital complications (post-infarct angina, heart failure, left ventricular dysfunction, and death) in patients with ST-elevation myocardial infarction (STEMI) who underwent thrombolysis. Methods and results A total of 300 STEMI patients who underwent thrombolysis within 12 hours of symptoms onset were included, which were divided into two groups based on PNT. These groups were further divided into subgroups based on DNT. The primary outcome was in-hospital complications between the two groups and between subgroups within each group. The pain-to-needle time was ≤3 hours in 73 (24.3%) patients and \u3e3 hours in 227 (75.7%) patients. In-hospital complications were higher in group II with PNT \u3e3 hours (p3 hours), has a significant impact on in-hospital complications with no difference in mortality

Dengue Outbreaks in Khyber Pakhtunkhwa (KPK), Pakistan in 2017: An Integrated Disease Surveillance and Response System (IDSRS)-Based Report

Snažni bočni vjetrovi koji pušu na mostovima i vijaduktima mogu dovesti do gubitka dinamičke stabilnosti vozila koja prelaze most. Da bi se omogućio nesmetan i siguran promet čak i u slučajevima nepovoljnih vremenskih uvjeta uzrokovanih snažnim bočnim vjetrom, na mostove se postavljaju zaštitni vjetrobrani. Karakteristike strujanja zraka preko mosta su značajno promijenjene u slučaju postavljanja vjetrobrana različitih visina i poroznosti. U okviru ovog rada ispitan je utjecaj visine vjetrobrana te utjecaj poroznosti vjetrobrana na karakteristike strujanja zraka oko vozila koje se nalazi na mostu. Vjetrobran je postavljen samo na uzvodni rub mosta, a za vozilo je korišten model Ahmedovog tijela koji je u svim simulacijama postavljen na udaljenost 2 m nizvodno od vjetrobrana. Pri računalnim simulacijama korišten je model stacionarnog trodimenzijskog turbulentnog strujanja nestlačivog fluida te k-ω SST model turbulencije sa standardnim zidnim funkcijama. Dobiveni rezultati ukazuju na značajan utjecaj vjetrobrana na koeficijente tlaka na površini vozila. Manja poroznost vjetrobrana i veća visina vjetrobrana uzrokuju smanjenje koeficijenta tlaka na nastrujavanoj površini vozila. Iako su vrijednosti koeficijenta tlaka na površini vozila za male poroznosti vjetrobrana relativno male, raspodjela vrtložnosti struje zraka sugerira da može doći do povećanih vrijednosti standardnih devijacija aerodinamičkih sila koje djeluju na vozilo. Karakteristike vjetrobrana imaju bitan utjecaj na raspodjelu brzine strujanja zraka uzvodno od vozila, odnosno u prostoru između vjetrobrana i vozila. Smanjenjem poroznosti vjetrobrana se brzine strujanja zraka u tom području značajno smanjuju. Utjecaj poroznosti vjetrobrana na raspodjelu brzine strujanja zraka u ovom području je značajniji u odnosu na utjecaj visine vjetrobrana. Aerodinamičke sile i momenti zabilježeni na vozilu su značajno smanjeni kada je vjetrobran postavljen na most. Rezultati dobiveni u okviru ovog rada sugeriraju da je, s obzirom na aerodinamičke sile koje djeluju na vozilo, optimalna visina vjetrobrana 5 m uz njihovu poroznost u iznosu od 30%.Strong cross winds that commonly blow on bridges and viaducts may cause dynamic instabilities of vehicles crossing the bridge. To allow for safe traffic even in the periods of bad weather conditions such as strong cross winds, bridges are equipped with wind barriers. Flow characteristics around the bridge are significantly modified with respect to the wind barrier height and porosity. In the present work, the influence of wind barrier height and porosity on flow characteristics around the vehicle passing the bridge was studied. The wind barrier was placed on the windward bridge-deck edge only, while the Ahmed body was used as a vehicle. It was placed 2 m downwind of the wind barrier. In the computational simulations, the stationary 3D turbulent incompressible flow was modeled together with the k-ω SST turbulence model and standard wall functions. The obtained results generally show a significant influence of the wind barrier on the pressure coefficients observed on the vehicle surface. Smaller porosity and larger height of the wind barrier causes smaller pressure coefficients on the windward side of the vehicle. Even though the pressure coefficients on the vehicle for the low-porous wind barrier are relatively small, the distribution of the flow vorticity suggests larger values of the standard deviation of the aerodynamic forces acting on the vehicle. Wind-barrier characteristics proved to have a large influence on the distribution of flow velocity in the area upstream of the vehicle and downstream of the wind barrier. For smaller porosities of the wind barrier, flow velocities in this area are significantly smaller. The influence of the porosity on the distribution of flow velocities in this area is relatively larger compared to the height of the wind barrier. The aerodynamic forces and moment are generally smaller when the wind barrier is in place. The obtained results suggest that the 5 m high and 30% porous wind barrier is optimal with respect to the aerodynamic forces and moment acting on the vehicle on the bridge

Cyber entrepreneurship: a note on indigenous perspective from a developing country

This research study is aimed at providing some insight into an emerging concept of cyber entrepreneurship with special reference to a development country like Pakistan. A detailed literature review is done in order to understand the concept and grasp the recent development in the emerging area. The main focus of this study was connecting and synchronizing available literature through practice with a special focus on Pakistani context. The present study will provide a useful implications in the area of entrepreneurship to the academic researchers and practitioners