Operative management of patients with non-spinal metastatic bone disease. Does it actually improve quality of life?

Abstract OBJECTIVE: To determine the survival rate and functional outcome of skeletal stabilisation in patients with metastatic bone disease. METHODS: The retrospective study was conducted at Aga Khan University Hospital, Karachi, and comprised data of patients with non-spinalmetastatic bone disease managed surgically from January 2002 to December 2010. All patients had been managed by experienced orthopaedic, oncology and multidisciplinary teams. Patients managed by non-oncologic orthopaedic surgeons were excluded. The prognostic influence of clinical, pathological and treatment variables on Musculoskeletal Tumour Society score, range of motion, local complications and death rate were measured. SPSS 19 was used for statistical analysis. RESULTS: Of the 49 patients whose records were included in the study, 21(42.9%) males and 28(57.1%) females with an overall median age of 59 years. Most common primary tumour site was breast in 15(3.8%) followed by lungs in 11(22.4%), Open reduction and internal fixation was the mpst commonly used procedure in 18(36.7%) patients. Mean duration of follow-up was 30.20±29.2 SD months (range: 10-48 months). The median patient survival was 23 months. 23% patients have superficial surgical site infection. Mean Musculoskeletal Tumour Society score was 23.73±14.3 SD. CONCLUSIONS: The results confirm the principle that surgery for metastatic disease is done primarily to improve quality of life and ambulation status, and to alleviate pain

COMPARISON OF EFFICACY OF 40% TOPOICAL SALICYLIC ACID AND CRYOTHERAPY IN PATIENTS WITH PALMOPLANTAR WARTS.

Background; Palmoplantar warts (verrucae) are extremely common. Although many will spontaneously disappear without treatment, treatment may be sought for a variety of reasons such as discomfort. There are a number of different treatments for cutaneous warts, with salicylic acid and cryotherapy using liquid nitrogen being two of the most common forms of treatment. Objective: To evaluate the efficacy of 40% topical salicylic acid versus cryotherapy in the treatment of palmoplantar warts. Study Setting; Department of General Medicine, Nishtar Hospital, Multan, which is a tertiary care Hospital. Study Design; Randomized Controlled Trial (RCT). Results; Of these 102 study cases, 57 (55.9%) were males and 45 (44.1%) were females. Mean age of our study cases was 25.22 ± 6.03 years Mean weight of our study cases was 61.42 ± 10.39 kilograms. Mean weight in group A was 61.25 ± 10.44 kilograms while in Group B was 61.59 ± 10.46 kilograms (p= 0.872). Size of lesion was equally distributed as in 51 (50%) of our study cases it was less than 1 centimeters while in remaining 50 % was in the range of 1 to 1.5 centimeters. In 78 (76.5%) of our study cases, number of lesions was 1- 3 and mean no. of lesions was 2.48 ± 1.35. Mean duration of disease was 4.72 ± 2.90 weeks (with minimum duration was 1 week while maximum duration was 10 weeks). In group A treated with salicylic acid, efficacy was noted in 34 (66.7%) of our study cases, while in group B treated with cryotherapy, efficacy was seen in 29 (56.9%) of our study cases. Conclusion; Efficacy of 40 % topical salicylic acid is more than cryotherapy. It can be safely used for the treatment of plantar warts, as no serious side effects were observed in our study. Being cost effective, it provides cheaper treatment option compared with cryotherapy which is quite expensive. Early treatment can help patients to maintain routine daily lives and physical activities such as sports without any pain and side effects. Keywords; Salicylic acid, Cryotherapy, warts

DEPRESSIVE SYMPTOMS AMONG PATIENTS WITH ACUTE EXACERBATIONS OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Background; chronic obstructive pulmonary disease (COPD) leads to significant morbidity and poor quality of life among patients. This study was conducted to evaluate depression among patients with COPD as there is no such study done in our population. Objective: To determine the frequency of depression among the patients with COPD presenting at a tertiary care hospital. Material and methods; A total of 196 patients with COPD were enrolled from department of Medicine, Nishtar Hospital, Multan, Pakistan in this cross-sectional study. The purpose of the study was explained to each patient and informed consent was obtained. Patient’s basic data and demography was noted. All patients were interviewed for depression using HADS scale. Data were entered and analyzed using SPSS. Results; Of these 196 study cases, 124 (63.3 %) were male patients while 72 (36.7%) were female patients. Mean age of our study cases was 53.89 ± 10.01 years (with minimum age of our study cases was 32 years while maximum age was 70 years). Mean age of the male patients was noted to be 56.82 ± 9.74 years while that female patients was 48.83 ± 8.37 years (p=0.000). Our study results have indicated that majority of our study cases i.e. 116 (59.2 %) were aged more than 50 years. Of these 196 study cases, 94 (48 %) belonged to rural areas and 102 (52 %) belonged to urban areas. Monthly family income up to 35000 rupees was noted in 123 (62.8%) and 73 (37.2%) had monthly family income more than 35000 rupees. Diabetes was presented in 51 (26.0 %) of our study cases. Hypertension was present in 87 (44.4 %) of our study cases. History of smoking was noted in 66 (33.7%) of our study cases. Mean disease duration was 19.68 ± 8.36 months and 129 (65.8%) had duration of illness more than 1 year. Mean HADS score was 10.51 ± 2.41 and depression was present in 131 (66.8%) of our study cases. Conclusion; High frequency of depression was noted in our study among patients having chronic obstructive pulmonary disease (COPD). Depression was significantly associated with gender, hypertension, smoking and prolonged disease duration. All clinicians treating such patients should check such patients for depression. Early diagnosis of depression followed by early treatment can help to improve clinical outcome and decrease disease related morbidity. Keywords; Frequency, depression, Chronic obstructive pulmonary disease

The Relationship between Work Values, Affective Commitment, Emotional Intelligence, and Employee Engagement: A Moderated Mediation Model

Affective commitment is considered to be the most critical element of organizational commitment because of its impact in reducing employee turnover, absenteeism and in enhancing the effectiveness of the organization. Because of the nature of the job, emotional intelligence is also a significant trait for employees working in banks. Based on a sample of 354 employees selected from the banking sector of Pakistan, this study revealed that work values had a significant impact on affective commitment. The findings of this study also confirmed the mediation of emotional intelligence and moderation of employee engagement between the relationship of work values and affective commitment among banking professionals of Pakistan. This study also provides practical foresight for the HRM professionals to enhance retention of effective manpower

Cost of Justice and Exclusion

The main objective of an economic system is to help people in satisfying the basic necessities of life without compromising an individual’s freedom. However, almost every society in the world depicts a clear division among people. Some individuals have access to all facilities required for a decent life, while others are excluded from having such facilities. This paper focuses on testing whether this is the case with the judicial system of Pakistan. Based on the philosophical approach towards life, this paper assumes that the foundation on which the current judicial system has been evolved is exclusive in its nature. The paper attempts to show that the exclusive nature of the judiciary cannot become inclusive until we bring the philosophy of the current economic system in line with reality. The paper claims that the philosophy of the current economic system protects the interest of rich and wealthy people. Hence, all sub-systems such as political, judicial, and executive mainly facilitate and promote the welfare of rich people. The final outcome is in favor of those who are wealthy and have high intercept in the society in terms of money and social capital (links with influential people such as politicians/bureaucrats/army generals, etc.). On the other hand, the intuitional framework of the judiciary is less likely to help those who fall into the group of people who do not have money and social capital. The paper test the presumptions empirically based on the primary data collected from Lawyers in the district courts of Islamabad. Here we compare the cost of various types of cases across courts with the average income of an average family. The average cost of almost all types of cases is higher than the average income of an average family. This shows the excludability of the judicial structure of Pakistan. The average family income is calculated from Household Integrated Economics Survey (HIES). The study suggests that a judicial structure with the agents having primary objective of settling the disputes of people are required. The current structure has flaw as it link earnings with the disputes of people. We need a society where the ills of one such as diseases, disputes, weakness, etc., should not become the source of earning for others. The study also claims that until we develop such a society, the true spirit of justice will remain a mere dream for the excluded people

Impact of Servant Leadership on Project Success Through Mediating Role of Team Motivation and Effectiveness:A Case of Software Industry

Project management in today’s intensely competitive environment has compelled organizations to adopt project management approach for better business results. Therefore, current research study aims to investigate the impact of servant leadership on project success with the mediating role of team motivation and team effectiveness in the software industry. A field survey was conducted, using a questionnaire as a survey tool. Data were collected from 219 respondents who have been working as team members of software development projects. The statistical results were obtained using the SPSS Process macro. The results show project managers need to exhibit a servant leadership style due to its strong influence on project success, albeit through team motivation and effectiveness. The findings from this study contribute to the field of leadership and project management along with the field of information systems and software engineering.</p

The Relationship between Work Values, Affective Commitment, Emotional Intelligence, and Employee Engagement: A Moderated Mediation Model

Affective commitment is considered to be the most critical element of organizational commitment because of its impact in reducing employee turnover, absenteeism and in enhancing the effectiveness of the organization. Because of the nature of the job, emotional intelligence is also a significant trait for employees working in banks. Based on a sample of 354 employees selected from the banking sector of Pakistan, this study revealed that work values had a significant impact on affective commitment. The findings of this study also confirmed the mediation of emotional intelligence and moderation of employee engagement between the relationship of work values and affective commitment among banking professionals of Pakistan. This study also provides practical foresight for the HRM professionals to enhance retention of effective manpower

Evaluation of Bacteriological Quality of Ready-to-eat Chicken Products by Total Viable Count Method

The present investigation describes the total viable count of ready-to-eat chicken products (chicken patties and chicken rolls) in Srinagar city during two seasons viz. autumn and winter. A total of 120 ready-to-eat chicken products comprising of 60 chicken patties and 60 chicken rolls were tested. The mean bacterial count of 60 chicken patties and 60 chicken rolls was 5.1281 and 4.9395 log10 cfu/g. Bacillus cereus strains were isolated from 25 of chicken patties and 22 of the chicken rolls resulting in prevalence of 41.66% and 36.67%, respectively

Bedtime Smart Phone Usage and Its Effects on Work-Related Behaviour at Workplace

The over usage and over dependency on digital devices, like smartphones, has been considered as a growing international epidemic. The increased dependency on gadgets, especially smartphones for personal and official uses, has also brought many detrimental effects on individual users. Hence it is vital to understand the negative effects of smartphone usage on human. Therefore, this study aims to investigate the effects of bedtime smartphone usage on work performances, interpersonal conflicts, and work engagement, via the mediating role of sleep quality among employees. Using a cross-sectional study design, a questionnaire-based field survey was conducted on 315 employees who participated as respondents. The results confirmed the negative effects of bedtime smartphone usage on sleep quality. Along with it, the effects of sleep quality on work performances, work engagements and interpersonal conflicts were also proven to be statistically significant. Regarding the mediating role of sleep quality, it was empirically evident that sleep quality mediates the relationship between bedtime smartphone usage with work performances and interpersonal conflicts. The findings revealed that bedtime smartphone usage reduces sleep quality among the employees, resulting in lower work performances and engagements while contributing to higher interpersonal conflicts. The findings concluded that smartphone usage before sleep increases the prospects of employees to be less productive, less engaged, and have more workplace conflicts. The findings warrant the continued managerial as well as academic research attention, as the smartphones are now used by many organisations to run businesses as well

Face recognition using illumination-invariant local patches

Illumination variation that span globally and locally across the facial surface is one of the most important aspect in designing a robust face recognition system. The illumination variations due to changes in lighting conditions could produce different shape of shading on the face thus deforming the facial features. The effect of these variations is simply more severe in the presence of single-sample constraint since there would be many variables with very limited observations. Illumination variations have been modelled in literature as a series of undetermined multiplicative and additive noise, hence it is more convenient to eliminate or reduce the effect rather than computing them. In this paper, we present an illumination-invariant method where we use local features as basis for face classification which is obtained from partitioning histogram-equalized faces into smaller overlapping local patches (LPs). We can achieve illumination-invariance for these LPs by subtracting the vectors with local average illumination and then these vectors are logarithmically normalized to enhance the local contrast. The degree of invariance is controlled by a weight connected to the average intensity component. We have tested this method in single sample face recognition setting on AR Database and Extended YALE B Database. Recognition results show that the proposed method is suitable for robust face recognition since it achieve good performance in both even illumination and uneven illumination cases