Micro-level Study of Deforestation in Capital Territory of Pakistan

Wood products are better than artificial material, products when evaluating with environmental concerns, but our world's forests cannot be compromised for these products. As increasing demand for wood product leads to deforestation, more rapid tree cutting even without permits and cause threat to human health and wildlife. The current study estimates the percentage of wood cutting and gives a comparison of green cover for a period (2009-2016) in Margalla Hills National Park (MHNP), Islamabad. Scale and aftermath of wood harvesting is a major area of concern. The wood consumption by villagers of MHNP, the role of authorities and communities to safeguard MHNP and its effects are also studied by incorporating villagers and forest guards’ point of view through questionnaire and interviews respectively. Forest cover of MHNP is reduced at high percentage due to deforestation and different land use pattern. It needs to be monitored and taken as the responsibility of government and public to protect forests. Keywords: encapsulation of biodiversity, villagers’ particulars, forest guards’ particulars, response

BURDEN OF THROMBOCYTOPENIA IN CRITICALLY ILL PATIENTS AT A TERTIARY CARE HOSPITAL

Background; Neonatal thrombocytopenia is one of the commonest hematological abnormality encountered in neonatal intensive care unit. Though thrombocytopenia is prevalent it is often overlooked assuming it will resolve spontaneously. However, if it is not detected and managed properly can result in devastating complications. Objective; To determine the frequency of thrombocytopenia in sick neonates admitted in neonatal intensive care unit (NICU). Material and Methods; A total 282 newborns admitted to NICU of department of Pediatrics, Nishtar Hospital, Multan were included in this cross-sectional were enrolled, their blood samples were taken for estimation of platelet count to diagnose thrombocytopenia and all the data was analyzed by SPSS. Results; Of these 282 study cases, 198 (70.2 %) were male patients while 84 (29.8 %) were female patients. Mean age of our study cases was 5.18 ± 3.69 days. Of these 282 study cases, 85 (30.1 %) belonged to rural areas and 197 (69.9 %) belonged to urban areas. Of these 282 study cases, 187 (66.3%) mothers were illiterate while 95 (33.3%) were literate. Preterm birth was noted in 116 (41.1 %) of our study cases. Of these 282 study cases, 188 (66.7%) were born through vaginal deliveries while 94 (33.3%) by cesarean section. Mean duration of disease was 2.34 ± 1.10 days and 241 (85.5%) had disease duration up to 3 days. Mean platelet count of our study cases was 156575.24 ± 50250.53 mm3 and thrombocytopenia was present in 104 (36.9%).  Conclusion; High frequency of thrombocytopenia was observed in sick neonates in our study. Thrombocytopenia was significantly associated with age, residential status, maternal literacy, preterm births, mode of delivery and disease duration. All the clinicians treating such patients should regularly monitor platelet count of all the patients admitted to NICU for early diagnosis and timely management to save them further complications. This will not only decrease disease morbidity but will also reduce mortalities in these patients. Keywords; Thrombocytopenia, sick neonates, Frequency. DOI: 10.7176/JMPB/52-1

Pattern of Chest Surgery Related Diseases at a Tertiary Care Hospital of South-Punjab, Pakistan

Objective: To evaluate the pattern of thoracic surgical disease and surgical interventions performed in the Thoracic Surgery Department of a tertiary care hospital of Pakistan. Methodology: The following is a retrospective descriptive purposive study done in the year 2016 at the Thoracic Surgery Department of the Nishter Medical University Hospital, Multan, Pakistan. All the patients who were admitted through out-patient department or referred from other units, over the year 2016, were analyzed. Variables under consideration included mode of admission, patient’s diagnosis, surgical procedure performed, type of anesthesia induced and the mortality. Data was presented using descriptive statistics. Results: A total of 634 patients (370 females and 264 males) were admitted during the study period, out of which 566 came through the out-patient department while the remaining were referrals from other wards. In total, 697 surgeries were performed with esophagoscopy and dilation being the most frequent (38.7%), followed by tracheostomy (16.3%). Corrosive intake (49.8%) accounted as the cause for the highest number of admissions followed by empyema thoracis (11.4%). Conclusion: Local study on the topic of Thoracic Surgery audit, in terms of surgeries performed and variation of cases presented, has become an absolute necessity for better health care planning of Pakistan. The pattern of thoracic surgical diseases varies considerably in different regions and populations.  The evaluation of these disease patterns can help to adopt appropriate preventive measures to reduce the incidence of these diseases. Furthermore, it can significantly improve our health system. KEYWORDS: Thoracic surgery, Thoracic surgical diseases, Surgical Audit, Pakistan, Pattern of disease DOI: 10.7176/JMPB/66-07 Publication date:June 30th 202

ASSOCIATION OF FAST FOOD CONSUMPTION WITH OBESITY - A CROSS-SECTIONAL STUDY CONDUCTED AT NISHTAR HOSPITAL MULTAN, PAKISTAN

Background: The aim of the study was to determine obesity rate in Pakistani teenagers of Multan South-Punjab Pakistan, with high amount of fast food consumption. Methods: This cross-sectional study was conducted during the month of November 2019 in Multan, Pakistan. Information was collected from teenagers of different age groups ranging from 13-19 years old. A self- structured questionnaire was designed containing four sections to gathered information from participants. BMI and %age of different variables were calculated. Results: Total no of 1000 teenagers including male 536(53.6%) and females 464(46.4%) were approached out of which 334(34.4%) were overweight having BMI=25-29.9 and 544(54.4%) were obese having BMI>30.Mostly of them were 17-year-old 425(42.5%). Obesity rate is higher both in males and females but mostly females were more prone. Conclusion: It is concluded from our study that consumption of fast food on daily basis and increased caloric intake will leads towards obesity among teenagers now a days. Obesity rate is greater in females as compared to males however both males and females were prone towards obesity due to increased consumption (thrice a day) of fast food. Other variables like residential area of participants and type of fast food eaten were also accountable in this regard. Keywords: FOOD CONSUMPTION, OBESITY, PAKISTAN DOI: 10.7176/JMPB/66-06 Publication date:June 30th 202

IN-HOSPITAL MORTALITY ASSOCIATED WITH ACUTE KIDNEY INJURY AMONG NEWBORNS AT A TERTIARY CARE HOSPITAL

Objective; To determine association of in-hospital outcome of AKI with etiology in newborns at a tertiary care hospital. Methods; This descriptive cross-sectional study was conducted at Department of Pediatric Medicine, Nishtar Hospital, Multan by using non-probability purposive sampling technique from June 2016 to December 2017. A total of 101 newborns diagnosed with acute kidney injury were registered. Etiological factors were assessed and these patients were followed till discharge to monitor in-hospital outcomes. Results; Of these 101 newborns, 75 (74.3%) were boys while 26 (25.7%) were girls. Mean age of these newborns was 7.59 ± 6.13 days (range; 1 day to 28 days). Mean age of the boys was 5.73 ± 7.20 days while that of girls was 6.77 ± 6.16 days. (p=0.515). Mean weight of these neonates was 2545.05 ± 600.42 grams (range; 1000 grams to 4000 grams). Mean serum potassium level was 4.94 ± 0.92 mgEq/L ranging from 3.1 mgEq/L to 7.0 mgEq/L. Mean urea level was 73.35 ± 27.65 mg/dl ranging from 18 mg/dl to 206 mg/dl. Mean serum sodium level was 145.72 ± 12.64 mgEq/L ranging from 126 to 166 mEq/L. Eighty one (80.2%) were term babies while 20 (19.8%) were pre-term babies. Of these 101 study cases, 29 (28.7%) delivered vaginally while 72 (71.3%) through cesarean section. Delayed crying was noted in 48 (47.5%), dehydration 13 (12.9%), sepsis in 36 (35.6 %) and renal malformation in only 4 %. Neonatal mortality in these patients was 15 (14.9%) while 86 (85.1%) were discharged from hospital after recovery. Conclusion; Acute kidney disease in newborns is associated with significant disease morbidity and mortality with asphyxia and sepsis are the main etiological factors responsible. It is predominantly more common in boys compared with girls. Mortality rate was high in our study and it was significantly associated with female gender. Mortality was also associated with elevated serum sodium and urea level. Keywords; Acute Kidney Injury, Sepsis, Etiology

The Effect of Customer Education in relation to Banking Transactions on Traditional Retail Business: The Mediating Role of Emotional Design and Experience Design

The study focuses on how consumer education in relation to banking transactions affects traditional retailing, how emotional design and experience design operate as mediators, and how relevant psychological theory applies to Chinese labour. The project intends to create its own psychological theory and explore the impact on traditional retail and emotional design. The data was analyzed using a survey of 340 employees in China firms that was done both online and in-person. The results of structural equation modelling (SEM) show that traditional retail operations have a favourable influence on customer education. The study's findings also revealed a link between conventional retail business, emotional design, and experience design. Additional research can be carried out to keep the understanding of our model accurate. In China traditional retail, it is customary for the shareholder also serve as the store manager to run the company alongside their family. According to the study site's analysis of the data gathered, the bulk of traditional retail business owners conduct their operations and deal directly with customers. Despite our best efforts, we were only able to use a tiny sample for this inquiry. The major findings of this study could be verified in follow-up investigations using a bigger sample. A number of important policy recommendations, questions for further research, and recommended theoretical and practical repercussions are made

A case of gastric cancer associated to situs inversus totalis

The situs inversus is a rare congenital anomaly, which is a more or less complete inversion of the abdominal and thoracic organs. We report a case of 70 years old man, without pathological antecedents complaining about epigastric pains associated to haematemesis, and whose gastric endoscopy objectified a gastric tumor. The pulmonary x-ray and the abdominal computed tomography (CT) revealed the previously unrecognized situs inversus totalis. A subtotal gastrectomy was performed and patient had an uneventful postoperative course

Spillover Effect of Financial Insecurity during the Covid-19 Pandemic in the Banking Industry: The Relationship Between HRM Practices, Workplace Social Support, Work Engagement and Turnover Intention

Financial remuneration, career flexibility, performance assessment, supervisor and coworker assistance, and workplace social support were the primary foci of this investigation into the connection between human resource practises and employee turnover intentions. The results demonstrated a moderated association between work engagement and financial uncertainty. In order to decrease employee turnover, businesses must acknowledge the role that work satisfaction plays

Isolated cystic tuberculosis of medial cuneiform: a case report

Isolated tuberculosis of foot is a rare entity. Plenty of literature is available on osteoarticular tuberculosis but literature on tuberculosis of foot is limited. Additionally the condition mimics variety of other foot pathologies which can delay diagnosis and add to morbidity. We present a twelve year old boy who presented clinically with swelling, pain and discharging sinus of foot with a cystic lesion in medial cuneiform on radiography. Though histopathology and Ziehl Nielsen staining later on established the diagnosis, but initially it was mistaken as a case of mycotic osteomyelitis. Tuberculosis of foot, though rare, should always be one of the differential diagnoses in a patient presenting with bony lesion on radiography irrespective of absence of constitutional symptoms and negative tests for tuberculosis. If battery of tests fails to establish diagnosis, open biopsy with curettage and histopathology should be considered to work out the final diagnosis