Comparison of Letrozole and Clomiphene citrate on ovulation in achievement of successful Pregnancy

Objective: to compare the efficacy of letrozole and clomiphene citrate in terms of pregnancy achievement and in anovulatory infertile women. Study Design: A randomized controlled trial. Place and Duration: study conducted at the department of obstetrics and gynaecology DG Khan Teaching Hospital. DG Khan from March 2017 to March 2018. Methodology: Two hundred and ten patients were included in this study. The patients were equally divided into two Groups as Group A and Group B by random number method. Study was started after permission from hospital ethical committee. Study variables were age and duration of infertility. SPSS version 24 was used to analyze data. T test and chi square test were applied and p≤0.05 was taken as significant.  Results: the mean age and duration of infertility of Group B was 25.66±3.39 years and 3.72±2.01 years, respectively. There were 73.3% patients between 18-30 years and 26.7% in 31-40 years of age. There were 79% patients had <5 years of duration of infertility and 21% had >5 years of duration of infertility. The difference was statistically significant (p=0.000) for age. The efficacy of Group A and B was observed as 16.2% and 45.7%, respectively. The difference was statistically significant, (p=0.000). Conclusion: use of Letrzole is safe and more effective for achieving pregnancy in anovulatory infertile women as compared to clomiphene citrate. Keywords: Letrozole, Clomiphene Citrate, Ovulation, pregnancy rate, Infertility

Relation of Striae Gravidarum with Cesarean Scar and Peritoneal Adhesions

Objective: to find out the relation between striae gravidarum and, cesarean scar and peritoneal adhesions. Study Design: Cross sectional Study. Place and Study Duration: Department of Gynecology and Obstetrics, DG Khan Teaching Hospital Multan, from January 2018 to June 2018. Material and methods: A total number of 150 patients presenting to the department of gynecology and obstetrics for cesarean section were included in the study. Severity of striae gravidarum was assessed using Davey scoring system. Modified Blauer classification was used to define the intraperitoneal adhesions in five categories. Three groups were designed group 1, 2 and 3. In group 1 those women were involved that had no striae gravidarum, in group 2 were those women who had mild to moderate number of striae gravidarum and in group 3 women with severe amount of striae gravidarum were included. Students T test and Mann-Whitney test was applied to compare the two groups. Frequency and percentages were calculated for categorical variables and mean and standard deviation was calculated for continuous variables. P value of less than or equal to 0.05 was considered as statistically significant. Results: Grade 2-4 intraperitoneal adhesions, keloids and pigmentations were more in Group 2 and Group 3 but no statistically significant difference was present (p-value 0.517, 0.427 and 0.372, respectively). The appearance of scar was also not different among the three groups (p=0.541). Scar length was more in Group-3 (p=0.289) but the width was more in Group-1 (p=0.248) with no statistically significant difference. Conclusion: The results of this study show that striae gravidarum was associated with scar characteristics but no correlation between striae gravidarum and intraperitoneal adhesions could be observed as such. Keywords: Striae Gravidarum, Cesarean Section, Abdominal Adhesion

Oral Parafunctional Habits in Individuals with The Extravert Personality Type

OBJECTIVES:  To find the association of extraversion personality traits with oral parafunctional habits. METHODOLOGY: A Cross-sectional descriptive study was conducted on 200 individuals in the College of Dentistry, Sharif Medical and Dental College, Lahore, over 5 months from July to November 2021. Data was collected using a pre-validated medical questionnaire and a ten-item personality inventory scale (TIPI). The sampling technique used was Convenience sampling. A sample size of 200 was calculated with the help of WHO sample size determination software. RESULTS: There was a statistically significant difference in the scores of extraversion personality traits across the oral parafunctional habit group of nail-biting (p= 0.007). In contrast, that for tooth grinding (0.114), tooth clenching (0.076), biting hard objects (0.74) and chewing gum (p= 0.659) was non-significant. The highest mean rank score for the personality trait of extraversion was found in individuals who strongly agreed to have a habit of nail-biting (129.23), tooth grinding (153.63), and tooth clenching (142.61) and biting hard objects (12.07). The highest mean rank score for the parafunctional habit of chewing gum (107.28) was found in individuals who strongly disagreed with having the habit. CONCLUSION: The highest mean rank score for the personality trait of extraversion was found in individuals who strongly agreed to have a habit of nail-biting, tooth grinding, tooth clenching and biting hard objects. The highest mean rank score for the parafunctional habit of chewing gum was found in individuals who strongly disagreed with having the habit

An Evaluation Factors of Customer Satisfaction in Telecommunication Sector of Pakistan

The aim of this paper is to analyze the impact of customer satisfaction in the telecommunication sector. For this purpose previous research literature were critically reviewed and data were collected through questionnaire survey.180 questionnaires were distributed among the customers of telecommunication service providers in Pakistan. 150 complete questionnaires were received at a response rate of 83.33%. Non- probability sampling techniques was used for the selection of sample. To study the impact of customer satisfaction in telecommunication sector Pearson product moment correlation and regression analysis was used. Findings indicated that perceived expectation, quality, customer retention, price tolerance have positive whereas customer complaint has significant and negative effect on customer satisfaction. This study helps the managers that how they can develop the competitive edge by enhances their customer satisfaction level in the telecommunication sector. Future guidelines and limitations are also discussed

Breaking Down Barriers: The Moderating Role of Organizational Support in Facilitating Knowledge Sharing Among Software Developers

Effective knowledge sharing among software developers is crucial for maximizing software development output throughout the software development lifecycle. Building upon Triandis’ Facilitating condition, this study explores the moderating impact of two factors, namely Organizational support and Technological support, on the relationship between knowledge sharing intentions (KSI) and knowledge sharing behavior (KSB). Specifically, the study investigates the impact of KSB on individuals’ job performance in global software development organizations. A self-administered questionnaire was used to collect data from 302 Malaysian participants working on global software development projects. The collected data was analyzed using Structure Equation Modeling (SEM) through SmartPLS. The results reveal that only organizational support, among Triandis’ Facilitating conditions, moderates the relationship between KSI and KSB. Moreover, the study finds that KSB mediates the relationship between knowledge sharing intentions and job performance. The findings of this study provide practical and theoretical implications for software developers

Identification and characterization of rhizospheric microbial diversity by 16S ribosomal RNA gene sequencing

In the present study, samples of rhizosphere and root nodules were collected from different areas of Pakistan to isolate plant growth promoting rhizobacteria. Identification of bacterial isolates was made by 16S rRNA gene sequence analysis and taxonomical confirmation on EzTaxon Server. The identified bacterial strains were belonged to 5 genera i.e. Ensifer, Bacillus, Pseudomona, Leclercia and Rhizobium. Phylogenetic analysis inferred from 16S rRNA gene sequences showed the evolutionary relationship of bacterial strains with the respective genera. Based on phylogenetic analysis, some candidate novel species were also identified. The bacterial strains were also characterized for morphological, physiological, biochemical tests and glucose dehydrogenase (gdh) gene that involved in the phosphate solublization using cofactor pyrroloquinolone quinone (PQQ). Seven rhizoshperic and 3 root nodulating stains are positive for gdh gene. Furthermore, this study confirms a novel association between microbes and their hosts like field grown crops, leguminous and non-leguminous plants. It was concluded that a diverse group of bacterial population exist in the rhizosphere and root nodules that might be useful in evaluating the mechanisms behind plant microbial interactions and strains QAU-63 and QAU-68 have sequence similarity of 97 and 95% which might be declared as novel after further taxonomic characterization

In-vitro Susceptibility of FMD Virus Serotype A Endemic in KPK, Pakistan

Foot and Mouth Disease virus (FMDV) serotype A is considered to be antigenic ally diverse among various geographical locations leading to diverse patterns of resistance and sensitivity. This phenomenon is posing high risks to global trade. This is the first study to quantify the effects of different physical factors (temperature, pH, UV and gamma irradiation) affecting the infectivity of FMDV serotype A.The infectivity of virus was calculated in term of tissue culture infectivity dose-50 (TCID-50) and plaque forming units (PFU). Virus in suspension (6×106 particles/ml) was treated using Cobalt-60 source in BHK-21 cell line grown in 96 well plates. The virus showed complete inactivation on 3, 5, 9 and 11 pH and 10kGy dose of gamma irradiations.The results revealed that increase in temperature (both moist and dry heat) and UV light as well as increase in time of exposure with same dose of UV irradiations significantly decreased the infectivity of virus (p<0.05). These physical factors are a better alternate for virus inactivation than chemicals, which are toxic for the health and accumulate in the animal products. It is recommended that viral strains should be analyzed for their susceptibility to these physical methods. They could also be combined with thermal inactivation to further improve virus inactivity to obtain virus free products.

Evaluation of internet access and utilization by medical students in Lahore, Pakistan

<p>Abstract</p> <p>Background</p> <p>The internet is increasingly being used worldwide in imparting medical education and improving its delivery. It has become an important tool for healthcare professionals training but the data on its use by medical students in developing countries is lacking with no study on the subject from Pakistan. This study was, therefore, carried out with an aim to evaluate the pattern of internet access and utilization by medical students in Pakistan.</p> <p>Methods</p> <p>A structured pre-tested questionnaire was administered to a group of 750 medical students in clinical years studying at various public and private medical colleges in Lahore. The questions were related to patterns of internet access, purpose of use and self reported confidence in performing various internet related tasks, use of health related websites to supplement learning and the problems faced by students in using internet at the institution.</p> <p>Results</p> <p>A total of 532 medical students (70.9%) returned the questionnaire. The mean age of study participants was 21.04 years (SD 1.96 years). Majority of the respondents (84.0%) reported experience with internet use. About half of the students (42.1%) were using internet occasionally with 23.1%, 20.9% and 13.9% doing so frequently, regularly and rarely respectively. About two third of the students (61.0%) stated that they use internet for both academic and professional activities. Most of the participants preferred to use internet at home (70.5%). Self reported ability to search for required article from PubMed and PakMedinet was reported by only 34.0% of the entire sample. Students were moderately confident in performing various internet related tasks including downloading medical books from internet, searching internet for classification of diseases and downloading full text article. Health related websites were being accessed by 55.1% students to supplement their learning process. Lack of time, inadequate number of available computers and lack of support from staff were cited as the most common problems faced by students while accessing internet in the institution premises. There were significant differences among male and female students with respect to the place of internet use (p = 0.001) and the ability to search online databases for required articles (p = 0.014).</p> <p>Conclusions</p> <p>Majority of the medical students in this study had access to internet and were using it for both academic and personal reasons. Nevertheless, it was seen that there is under utilization of the potential of internet resources to augment learning. Increase in awareness, availability of requisite facilities and training in computing skills are required to enable better utilization of digital resources of digital resources by medical students.</p

Global injury morbidity and mortality from 1990 to 2017 : results from the Global Burden of Disease Study 2017

Correction:Background Past research in population health trends has shown that injuries form a substantial burden of population health loss. Regular updates to injury burden assessments are critical. We report Global Burden of Disease (GBD) 2017 Study estimates on morbidity and mortality for all injuries. Methods We reviewed results for injuries from the GBD 2017 study. GBD 2017 measured injury-specific mortality and years of life lost (YLLs) using the Cause of Death Ensemble model. To measure non-fatal injuries, GBD 2017 modelled injury-specific incidence and converted this to prevalence and years lived with disability (YLDs). YLLs and YLDs were summed to calculate disability-adjusted life years (DALYs). Findings In 1990, there were 4 260 493 (4 085 700 to 4 396 138) injury deaths, which increased to 4 484 722 (4 332 010 to 4 585 554) deaths in 2017, while age-standardised mortality decreased from 1079 (1073 to 1086) to 738 (730 to 745) per 100 000. In 1990, there were 354 064 302 (95% uncertainty interval: 338 174 876 to 371 610 802) new cases of injury globally, which increased to 520 710 288 (493 430 247 to 547 988 635) new cases in 2017. During this time, age-standardised incidence decreased non-significantly from 6824 (6534 to 7147) to 6763 (6412 to 7118) per 100 000. Between 1990 and 2017, age-standardised DALYs decreased from 4947 (4655 to 5233) per 100 000 to 3267 (3058 to 3505). Interpretation Injuries are an important cause of health loss globally, though mortality has declined between 1990 and 2017. Future research in injury burden should focus on prevention in high-burden populations, improving data collection and ensuring access to medical care.Peer reviewe