Role of Human Resources Management in the Effectiveness of Business Process Reengineering

The main idea of the paper to presents a model with the discussion of Human resources management role with line extent of Management competency, team working, effective communication, IT and Organizational structure and there impact on the effectiveness of Business Process Reengineering. The article suggest that the use of HRM with the implementation of the BPR find the better results and support the organizational better performance Keywords: human Resources Management, business process Reengineering, Organizational performanc

The role of TQM and BPR in executing quality improvement: a comparative study

In order to sustain a competitive edge in this global manufacturing era, enterprises need to adopt appropriate improvement schemes. This article examines a detailed study of quality improvement tools mostly used in the organizations. As this is the conceptual paper, the paper focuses on two important quality improvement techniques, BPR (Business Process Reengineering) and TQM (Total quality management). Both the approaches clinch the same thoughts and objectives for organizational enhancement but the difference lies in terms of means used by each technique, the risk, time frame and the magnitude of change expected from each of these programs. In order to attain this comparison, the article first defines and explains each of the approaches for the in depth understanding of the difference as well as similarities between these two. The articles (related to the comparison of these two improvement tools) of almost last 15 years are gathered and studied in detail and then conclusion is drawn based on the findings of different previous articles. The methodology used primarily is literature review as well as the case study method also helps in gathering the data. The study concludes that even though both the approaches intend to enhance organizational competence, they are relatively different both theoretically as well as practically and each of the approach is suitable for different situation depending upon the needs and requirements of the organization. Keywords: Competitive edge, TQM, BP

Frequency of dysnatremia in patients admitted with COVID-19 infection and its prognostic implication

Objective: We aimed to investigate the frequency of dysnatremia among patients admitted with COVID-19 infection and its association with inpatient mortality.Methods: This retrospective longitudinal study was conducted for 12 weeks. Serum sodium levels were recorded at admission, during the hospital stay, and within 48 hours of discharge or death. Logistic regression was used to determine the predictors of mortality.Results: This study included 574 patients (69.7% men, age 55.6 ± 14.4 years). On admission, mean sodium was 135.9 ± 6.4 mEq/L; 39% had hyponatremia and 4.7% had hypernatremia. During admission, hypernatremia increased to 18.8%; maximum sodium in patients who survived was 140.6 ± 5.0 mEq/L versus 151.0 ± 9.9 mEq/L in those who died. The final sodium was 145.4 ± 9.4 mEq/L in patients who died versus 137.7 ± 3.7 mEq/L in those who survived (odds ratio [OR]: 1.22, 95% confidence interval [CI]: 1.13-1.32). Other predictors of mortality included ischemic heart disease (OR: 3.65, 95% CI: 1.39-9.61), acute kidney injury (OR: 6.07, 95% CI: 2.39-15.42), invasive ventilation (OR: 28.4, 95% CI: 11.14-72.40), and length of stay (OR: 0.91, 95% CI: 0.86-0.97).Conclusion: Hypernatremia was frequently observed in patients who were critically ill and died and may be considered a predictor of mortality in COVID-19 infection

Diagnostic Accuracy Of Placental Thickness Measured By Ultrasonography In The Detection Of Intrauterine Growth Restricted (IUGR) Babies Keeping Actual Birth Weight As Gold Standard

Objective: To determine the diagnostic accuracy of the placental thickness measured by ultrasound in detecting IUGR babies keeping actual birth weight as the gold standard. Methods: This cross-sectional validation study was conducted in the Department of Radiology P.O.F Hospital Wah Cantt. The data was gathered over a period of six months, from 06-19-2017 to 12-18-2017. A total of 125 patients were included in this study. All pregnant women were examined by the greyscale and Doppler ultrasonography using a color Doppler scanner with a 5.0 MHz convex probe. Placental thickness was measured as the distance between the echogenic line of the chorionic plate and the hypoechoic myometrium. The pregnant females were followed till childbirth and the weight of the baby at birth was recorded. Results: Patients ranged between 20-35 years of age. The average age of the study participants was 27.6±3.3 years, the mean gestational age was 34.2±3.0 weeks, the mean BMI was 23.5±1.3 (kg/m2), and the mean parity was 1.1±1.0. We found a sensitivity of 65.5%, specificity of 83.3%, Positive Predictive Value( PPV) of 98.7%, Negative Predictive Value (NPV) of 10.8%, and diagnostic accuracy of 66.4% for antenatal prediction of IUGR based on placental thickness measurement. Stratification for age and gestational age was also carried out. Conclusion: Placental thickness on ultrasonography can be used as a reliable marker for detecting IUGR babies with an accuracy of 6.4%

Leaving against medical advice from In-patients departments rate, reasons and predicting risk factors for re-visiting hospital retrospective cohort from a tertiary care hospital

Background: Approximately 1% to 2% of hospitalized patients get discharged or leave from the hospital against medical advice and up to 26% in some centers. They have higher readmission rate and risk of complications than patients who receive complete care. In this study we aimed to determine the rate of leave against medical advice (LAMA) and reasons for the same across different in-patient departments of a tertiary care hospital. Methods: Retrospective cohort study on patients admitted in all departments at our institute over a 1-year period. All patients who were admitted to an in-patient ward at the hospital and who left against medical advice by submitting a duly filled LAMA form were included. Univariate and multivariate logistic regression models with forward selection methods were employed. Revisit to hospital within 30 days; to clinic or emergency department was outcome variable for regression. Results: From June 2015 to May 2016 there were 429 LAMA patients, accounting for 0.7% of total admissions. Females were 223 (52%) compared to males 206 (48%). Finances were quoted as the most common reason for LAMA by 174 (41%) patients followed by domestic problems 78 (18%). Internal medicine was the service with the highest number of LAMA patients ie, 153 (36%) followed by Pediatric medicine with 73 (17%). Of the 429 patients, 147 (34%) patients revisited the hospital within 30 days. Sixty-one percent of these \u27bounced-back\u27 LAMA patients had worsening or persistence of same problem, or new problem/s had developed. In unadjusted bivariate logistic model, patients who were advised for follow-up during discharge against medical advice were four times more likely to revisit the hospital. Patients who were married had an increased odd of revisiting the hospital. Conclusion: Financial reasons are the most common stated reasons to LAMA. Patients who LAMA are at a high risk of clinical worsening and \u27bouncing back.\u27 This is the first study from our region on in-patient LAMA rates, to our knowledge. The results can be used for planning measures to reduce LAMA rates and its consequences

Ecosystem Services in the Changing Climate: Calling Attention for the Conservation of Tropical and Subtropical Forests

Tropical and subtropical forests have diverse ecological functions but are most disturbed due to climatic changes. Peer-reviewed articles, books and reports were searched and downloaded to analyze the effect of climatic changes on tropical and subtropical forests and highlight the need for conservation efforts to ensure sustainable supply of ecosystem services. These forests store largest share (55%) of global terrestrial carbon pool. But the projected rise in temperature (4oC), CO2 levels (495 ppm) and changes in precipitation regime by 2100 are expected to cause significant changes in ecosystem productivity and nutrient turnover rate making forests more vulnerable to climate change. High temperature with low rainfall reduces tree growth, increases soil carbon fluxes by accelerating rate of nutrient cycling, restricts the range of pollinators and increases pest infestation (Phytophthora cinnamomi) affecting ecosystem health and future food security. Increase in heat waves increase the incidence of wild fires and degrade ecosystem quality. Climate change also reduces the scenic beauty, ecotourism and associated economic and mental health benefits. Proactive measures must be taken to mitigate the likely causes of climate change and efforts should be taken to conserve the existing forest reserves to ensure sustainable supply of the ecosystem services

Leaving Against Medical Advice From In-patients Departments Rate, Reasons and Predicting Risk Factors for Re-visiting Hospital Retrospective Cohort From a Tertiary Care Hospital

Background: Approximately 1% to 2% of hospitalized patients get discharged or leave from the hospital against medical advice and up to 26% in some centers. They have higher readmission rate and risk of complications than patients who receive complete care. In this study we aimed to determine the rate of leave against medical advice (LAMA) and reasons for the same across different in-patient departments of a tertiary care hospital.Methods: Retrospective cohort study on patients admitted in all departments at our institute over a 1-year period. All patients who were admitted to an in-patient ward at the hospital and who left against medical advice by submitting a duly filled LAMA form were included. Univariate and multivariate logistic regression models with forward selection methods were employed. Revisit to hospital within 30 days; to clinic or emergency department was outcome variable for regression.Results: From June 2015 to May 2016 there were 429 LAMA patients, accounting for 0.7% of total admissions. Females were 223 (52%) compared to males 206 (48%). Finances were quoted as the most common reason for LAMA by 174 (41%) patients followed by domestic problems 78 (18%). Internal medicine was the service with the highest number of LAMA patients ie, 153 (36%) followed by Pediatric medicine with 73 (17%). Of the 429 patients, 147 (34%) patients revisited the hospital within 30 days. Sixty-one percent of these ‘bounced-back’ LAMA patients had worsening or persistence of same problem, or new problem/s had developed. In unadjusted bivariate logistic model, patients who were advised for follow-up during discharge against medical advice were four times more likely to revisit the hospital. Patients who were married had an increased odd of revisiting the hospital.Conclusion: Financial reasons are the most common stated reasons to LAMA. Patients who LAMA are at a high risk of clinical worsening and ‘bouncing back.’ This is the first study from our region on in-patient LAMA rates, to our knowledge. The results can be used for planning measures to reduce LAMA rates and its consequences

Expression Characterization of Flavonoid Biosynthetic Pathway Genes and Transcription Factors in Peanut Under Water Deficit Conditions

Drought is one of the hostile environmental stresses that limit the yield production of crop plants by modulating their growth and development. Peanut (Arachis hypogaea) has a wide range of adaptations to arid and semi-arid climates, but its yield is prone to loss due to drought. Other than beneficial fatty acids and micronutrients, peanut harbors various bioactive compounds including flavonoids that hold a prominent position as antioxidants in plants and protect them from oxidative stress. In this study, understanding of the biosynthesis of flavonoids in peanut under water deficit conditions was developed through expression analysis and correlational analysis and determining the accumulation pattern of phenols, flavonols, and anthocyanins. Six peanut varieties (BARD479, BARI2011, BARI2000, GOLDEN, PG1102, and PG1265) having variable responses against drought stress have been selected. Higher water retention and flavonoid accumulation have been observed in BARI2011 but downregulation has been observed in the expression of genes and transcription factors (TFs) which indicated the maintenance of normal homeostasis. ANOVA revealed that the expression of flavonoid genes and TFs is highly dependent upon the genotype of peanut in a spatiotemporal manner. Correlation analysis between expression of flavonoid biosynthetic genes and TFs indicated the role of AhMYB111 and AhMYB7 as an inhibitor for AhF3H and AhFLS, respectively, and AhMYB7, AhTTG1, and AhCSU2 as a positive regulator for the expression of Ah4CL, AhCHS, and AhF3H, respectively. However, AhbHLH and AhGL3 revealed nil-to-little relation with the expression of flavonoid biosynthetic pathway genes. Correlational analysis between the expression of TFs related to the biosynthesis of flavonoids and the accumulation of phenolics, flavonols, and anthocyanins indicated coregulation of flavonoid synthesis by TFs under water deficit conditions in peanut. This study would provide insight into the role of flavonoid biosynthetic pathway in drought response in peanut and would aid to develop drought-tolerant varieties of peanut