Slow Infusion of Information Technology in Master Bank of Pakistan – A Case Study

E-Banking is now a well know phenomenon in the industry and amongst the banking users in Pakistan. This paper addresses the issues encountered and lessons derived by largest Pakistani bank while developing its e-banking capabilities. The paper explores some burning issues hindering key decisions of shifting to e-banking, e-banking delivery channel choice, enticing customers, and managing e-channel conflict to be made by bank. The findings indicated that the obstacles related to e banking customer location, customer satisfaction and the Bank’s software’s and communication infrastructure capabilities are influential factors in motivating the decision for shifting to a high-tech bank. The bank's E-channel choice is influenced by competence of application and software technologies that the bank acquires and the nature of diffusion of information and communications among its stakeholders. Technological development in Banking practices and awareness in customers due to presence of foreign and domestic banks in Pakistani financial market influenced the Master Bank to switch over to complete automated banking system. The sophistication of ebanking services and the further rapid improvement appears to influence strategies to entice E-channel conflict issues. The paper concludes by suggesting the Bank to optimally utilize its resources by deploying efficient applications and software’s and third party alliances and partnerships required to offer customized technology enabled banking services and develop appropriate e-banking risk mitigation strategies that bring the bank into a win-win position

Outcome of N-Acetylcysteine Nebulization Versus Salbutamol Nebulization in Children with Acute Bronchiolitis

Background: A substantial proportion of children will experience at least one episode with bronchiolitis, and as much as 2-3% of all children will be hospitalized with bronchiolitis during their first year of life. Bronchiolitis is the most common reason for hospitalization of children in many countries, challenging both economy, area and staffing in paediatric departments. Objective: To determine outcome (in terms of clinical severity score and hospital stay) of N-acetylcysteine nebulization versus salbutamol nebulization in children with acute bronchiolitis. Material and Methods: The study cases were randomly divided into 2 groups by draws methods. Group A, each child was nebulized with 20 mg NAC in 3 ml of 0.9% of saline while group B was nebulized with 2.5 mg salbutamol in 3 ml of 0.9% saline solution. Patients of each group were nebulized three times a day (8 hours apart) for 5 days. These patients were closely monitored for the severity of the disease daily and clinical severity score was employed to record any improvement in both cases.  All the data was entered and analyzed using SPSS-18. Results: Of these 390 study cases, 228 (58.5%) were boys while 162 (41.5%) were girls. Mean age of our study cases was 7.92 ± 5.18 months . Most of the study cases i.e. 264 (67.7%) were from poor social background and mothers of most of these children were less educated as 85.6% of the mothers of these children were having their educational status equal/less than matriculation. Mean hospital stay in our study was 4.73 ± 0.829 days. Mean baseline clinical severity score was 5.52 ± 813. Mean clinical severity score after therapy was 1.85 ± 0.812 (with minimum clinical severity score was 1 while maximum was score was 4). Clinical severity score in group A was 1.21 ± 0.405 while in group B was 2.49 ± 0.578 (p= 0.000). Conclusion: Our study results support the use N – acetylcysteine nebulization in children with acute bronchiolitis as compared with salbutamol nebulization. N – acetylcysteine nebulization was found to be more effective in improving clinical severity score and reducing duration of hospitalization. Its use was safe, reliable and no adverse side effects were noted. Keywords: Acute Bronchiolitis, Salbutamol, N – acetylcysteine

Economic Determinants of Non-Performing Loans: Perception of Pakistani Bankers

This study provides the perception of Pakistani bankers regarding the economic factors causing non-performing loans in the Pakistani banking sector since 2006. This is the first time that any study is conducted in Pakistan to highlight the economic factors of NPLs via primary data collection from loan providing and approving authorities of Pakistani banking industry. This study was conducted via a well structured questionnaire and data was collected from 201 bankers who are involved in the lending decisions or analyze the credit risk or handling non-performing loans portfolio. Correlation and regression analysis was carried out to analyze the impact of selected independent variables (Interest Rate, Energy Crisis, Unemployment, Inflation, GDP Growth, and Exchange Rate) on the non-performing loans of Pakistani banking sector. Top 10 Pakistani banks were selected as a sample. According to the results Pakistani bankers perceive that Interest Rate, Energy Crisis, Unemployment, Inflation, and Exchange Rate has a significant positive relationship with the non-performing loans of Pakistani banking sector while GDP growth has significant negative relationship with the non-performing loans of Pakistani banking sector. This study also discusses how good loans are turning into bad loans due to disaster in energy sector of Pakistan and how these energy crisis are badly affecting the banking sector of Pakistan. In future social determinants of non-performing loans should be studied. This study is first of its kind opening door for further primary research on NPLS of Pakistani banking sector. Key words: Non-performing loan; perception of Pakistani bankers; energy crisis; Economic determinants of Non-performing loan

Frequency of Lingual Nerve Injury after the Removal of Impacted Mandibular Third Molar

Objective: to determine the frequency of lingual nerve injury after the removal of impacted mandibular 3rd molar. Study Design: Cross sectional study Place and duration: outdoor patient department of Oral and Maxillofacial Surgery Hitec Dental College, Foundation College of Dentistry Peace Gernal Hospital, Nishtar Institute of  Dentistry,Multan from January 2018 to January 2019 in one year duration. Results: Study included 335 patients with mean age of 20.86+ 1.95 yrs. Males were 190(56.7%) and females were 145(43.3%).lingual nerve injury was found in 28 patients(8.4%)while it was absent in 307 patients(91.6%).There was no significant effect was found on the frequency of lingual nerve injury for age or gender of the patient population. Conclusion: Lingual nerve injury is a commonly encountered complication among those undergoing extraction of impacted third molar. It should be carefully sought in all the patients undergoing the surgical procedure and improvement in surgical skills and techniques needs to be emphasized to further reduce the incidence and risk of this complication. Keywords: Impacted third molar, Lingual nerve, OPG (orthopantomogram), Dentistry, Mandible. DOI: 10.7176/JMPB/57-01 Publication date: July 31st 201

Mobile Deep Classification of UAE Banknotes for the Visually Challenged

This paper proposes an artificial intelligence-powered mobile application for currency recognition to assist sufferers of visual disabilities. The proposed application uses RCNN, a pre-trained MobileNet V2 convolutional neural network, transfer learning, hough transform, and text-to-speech reader service to detect and classify captured currency and generate an auditory signal. To train our AI model, we collect 700 ultra-high definition images from the United Arab Emirates banknotes. We include the front and back faces of each banknote from various distances, angles, and lighting conditions to avoid overfitting. When triggered, our mobile application initiates a capture of an image using the mobile camera. The image is then pre-processed and input to our on-device currency detector and classifier. We finally use text-to-speech to change the textual class into an audio signal played on the user’s Bluetooth earpiece. Our results show that our system can be an effective tool in helping the visually challenged identify and differentiate banknotes using increasingly available smartphones. Our banknote classification model was validated using test-set and 5-fold cross-validation methods and achieved an average accuracy of 70% and 88%, respectively

Techies Agronomics Corporation : Portative Cutter / Muhammad Ali Al Muntazar Mohd Suhaimi...[et al.]

Our company, Techies Agronomics Corporations will produce a product called Portative Cutter. This product will give high satisfaction to the customer who want to deal with agriculture and farming. Our product is not just use for farming only, but it can use also for home lawn cleaning process. It is because, our product can use as a grass cutter. So, with our product the customer can save their money from buy two products. It is because our product has two function in one system or body

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

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

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication