Internet Addiction and Its Relationship with Depression and Academic Performance: A Cross-Sectional Study at a Medical School in Pakistan

Background: Excessive Internet use may induce depression, influence relationships, and decrease academic performance. There is scarce information about Internet addiction in Pakistan. This study aimed to determine prevalence of Internet addiction and its relationship with depression and academic performance. Methods: A study based on a self-administered survey was carried out at a medical school in Peshawar, Pakistan. Participants were medical students (MBBS) and a non-randomized convenience sampling technique was utilized for data collection. We collected demographic information, last professional exam score, Internet addiction, and depression scores using the Young’s Internet Addiction Test (YIAT) and the Beck’s Depression Inventory (BDI), respectively. The analysis included binomial 95% confidence intervals (95% CI) estimations and linear and logistic regressions to assess variables relations. Results: We analyzed responses from 231 participants (380 students approached and 250 responded: response rate=65.79%, 19 excluded), 64.07% were male and the age average was 21±2 years. Profound and slight addiction to the Internet was found in 9.09% (95%CI=5.71-13.56) and 41.99% (95%CI=35.55-48.64) of students, respectively. Frequency of depression (mild-severe) was 59.74% (95%CI=53.11-66.12). Levels of Internet addiction and depression were found associated after adjusting by sex and age (?=0.27, R2=0.03, p-value=0.009). Internet addiction (OR=0.54, 95%CI=0.2-1.49, p-value=0.23) and depression (OR=0.62, 95%CI=0.36-1.09, p-value=0.10) were not significantly associated with low grades after adjusting by sex and age. Conclusion: More than half of the students are having excessive Internet usage which could result in despondency and academic performance deterioration. Internet addiction should be considered an emerging challenge and appropriate mitigation measures should be taken opportunely

Effect of phase angle on the efficiency of beta type Stirling engine

A Stirling Engine is a mechanical device, which operates on a closed regenerative cycle, based on cyclic compression and expansion through a piston and a displacer respectively. It can be widely used for many thermodynamic purposes such as stationary power generation, heat pumps or co-generation systems. Due to the external supply of heat and increasing scope of solar energy utility in Pakistan, this engine can be operated successfully with this useful source of energy. Phase angle is an important parameter of the Stirling engine and is one of the key factors on which performance of the engine depends. It is the angle by which expansion space volume leads the compression space with respect to the volume variations in the engine cycle. This paper describes the optimization and modelling of the phase angle of a single cylinder beta Stirling Engine with Helium as the working fluid. Schmidt analysis is considered to be the standard during this research for analysing the output efficiency of the engine. The volume and pressure variations are computed at different values of phase angle for a complete cycle and ultimately values chart and pressure-volume diagrams are prepared. The work done for each case is calculated for finding the optimum phase angle. It is calculated that the best suitable phase angle for the maximum efficiency of the engine is around 90°. Along with maximum and minimum pressure inside the engine, the overlap volume in beta type Stirling engine plays a vital role and efficiency increases with increase in overlap region.&nbsp

Predictors of Outcome of Bronchiolitis in Children Using Children Hospital of Wisconsin Respiratory Score: An Experience of a Tertiary Care Hospital

Objective: To study the correlation of CHWR score and its various clinical markers with the length of stay in hospital bronchiolitis. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Pediatrics Combined Military Hospital, Lahore Pakistan, from Nov 2018 to Apr 2019. Methodology: This study included children aged 2 to 24 months, clinically diagnosed with bronchiolitis. The Receiver Operator Characteristic (ROC) was used to determine the discriminative validity of the CHWR score in predicting the length of stay. Results: One hundred thirty-eight children of either gender were enrolled in the study. The median age of the study population was 10.8 (9) months. ROC curve showed significant discriminate validity of CHWR score and its component criterion on admission. CHWR score of >10.5 predicted a longer stay (>24 hours) in ICU. Pearson correlation showed a statistically significant positive correlation between CHWR score at admission and length of stay (r=0.831, p=<0.001). Conclusion: CHWR scoring system on admission is an easy, safe and effective way to classify bronchiolitis severity and thus help predict the length of stay

GENITOFEMORAL NERVE BLOCK AND INTRAOPERATIVE ANALGESIA IN CHILDREN DURING INGUINAL HERNIA REPAIR

ABSTRACT Ilioinguinal and iliohypogastric nerve blocks has been widely used in children undergoing inguinal herniorraphy. This technique may provide insufficient intraoperative analgesia as the inguinal region may receive innervation from genitofemoral nerve. We proposed that the addition of genitofemoral nerve block might improve the quality of analgesia. The objective was to find the efficacy of genitofemoral nerve block in addition to ilioinguinal and iliohypogastric nerve block for better intraoperative pain management in children under going inguinal hernia repair under general anaesthesia. After informed consent, 100 children of 1-10 yrs of age and ASA I or II status undergoing inguinal hernia repair were selected and divided in group I and II of 50 patients each. After induction of general anaesthesia, Group I patients received ilioinguinal and iliohypogastric block using bupivacaine 0.375% at a dose of 0.75 mg/kg, where as patients in group II were given genitofemoral in addition to ilioinguinal and iliohypogastric nerve blocks using bupivacaine 0.375% at a dose of 0.375 mg/kg at each site. Changes in heart rate, systolic, diastolic and mean arterial pressures were recorded before the start of surgery, at skin incision, at sac traction and at the end of surgery as a measure of efficacy of the block. Haemodynamic data was analysed using repeated measures ANOVA. The two groups showed increase in (Heart Rate) but the increase was lesser in group II at sac traction (p&lt;0.05). In group I all patients had an increase in systolic, diastolic and mean arterial pressure at sac traction while the patients in group II showed no change during the study period (p&lt;0.05). We conclude that the addition of a genitofemoral nerve block to ilioinguinal and iliohypogastric nerve blocks may contribute to haemodynamic stability during sac traction indicating better pain relief

Psychiatric morbidity among informal caregivers of children suffering from intellectual developmental disorders

Published in August 202

Effect of High Performance Work Practices on Job Embeddedness and Employee Innovative Behavior

Purpose – This study ascertained the high performance work practices effects on employee innovative behavior through key mediating role of the job embeddedness of front line service employees in Pakistan hospitality sector.Method – Data gathered from four and five-star hotel FLSEs in two waves with a time lag of two weeks, the relationships in the conceptual model were gauged through Partial Least Squares (PLS).Findings – The results suggest that job embeddedness mediate the relationship between high performance work practices and employee innovative behavior. In particular, front line service employees in presence of high performance work practices have high job embeddedness, and are more likely to exhibit innovative behaviors at work.Research implications – This study will send a strong message to service firms that provision of performance enhancing human resource practices is of prime importance to enhance. With this in mind management needs to take benefit of the strength of high performance work practices to enhance frontline employees attachment with organization to produce innovation related behaviors at wor

An Analysis of breakthrough seizures and related factors in pediatric epilepsy patients

Objective: To determine the frequency of breakthrough seizures among paediatric patients suffering from epilepsy, and factors related to theprecipitation of these seizures. Method: The cross-sectional study was conducted from July 1, 2018, to July 1, 2020, at the Combined Military Hospital Lahore and the Military Hospital, Rawalpindi, Pakistan, and comprised children of either gender aged 2-12 years diagnosed with any type of epilepsy presenting at the children outpatient department. Diagnosis of epilepsy was established by either a consultant adult neurophysician or a consultant paediatrician. The presence of breakthrough seizures was assessed by obtaining detailed history from the patient and the primary caregiver. Socio-demographic profile, duration of epilepsy and poly-pharmacy were noted. Data was analysed using SPSS 23. Results: Of the 450 subjects, 259(57.6%) were boys and 191(42.4%) were girls. The overall mean age was 6.353±4.732 years. The presence of breakthrough seizures was noted in 227(50.4%) subjects. Children with young age, with low family income, and those in need of poly-pharmacy showed significantly higher odds for breakthrough seizures (p<0.05). Conclusion: The incidence of breakthrough seizures in epileptic children was high despite the anticonvulsant agents that were previously effective in controlling seizures. Key Words: Breakthrough seizures, Childhood epilepsy, Anticonvulsants, Risk factors. Continuous..

Aceclofenac fast dispersible tablet formulations: Effect of different concentration levels of Avicel PH102 on the compactional, mechanical and drug release characteristics.

The objective of this study was based on the formulation development of fast dispersible Aceclofenac tablets (100 mg) and to evaluate the influence of pharmaceutical mixtures of directly compressible Avicel PH102 with Mannitol and Ac-di-sol on the compressional, mechanical characteristics and drug release properties. Fast dispersible Aceclofenac formulations were developed by central composite design (CCD). Among them the best possible formulation was selected on the basis of micromeritic properties, appropriate tablet weight and disintegration time for further study. Tablets were directly compressed using manual hydraulic press with a compressional force ranging from 7.2 to 77.2 MN/m2. Pre and post compression studies were performed and the compressed formulations (FA-FF) were assessed for different quality tests. The Heckel and Kawakita equations were applied for determination of compressional behavior of formulations. The quality attributes suggested that formulation (FB) containing avicel PH 102 (20%), mannitol (25%) and ac-di-sol (3%) as best optimized formulation showing better mechanical strength i.e. hardness 35.40 ± 6.93N, tensile strength 0.963 MN/m2, and friability 0.68%. Furthermore, compressional analysis of FB showed lowest PY value 59.520 MN/m2 and Pk value 1.040 MN/m2 indicating plasticity of the material. Formulation FB disintegrated rapidly within 21 seconds and released 99.92% drug after 45 min in phosphate buffer pH 6.8. Results of drug release kinetics showed that all formulations followed Weibull and First-order models in three different dissolution media. Avicel PH102 based formulation mixture exhibit excellent compactional strength with rapid disintegration and quick drug release

Effect of PRF on extraction socket healing

Extraction socket healing is a critical process in dental care that determines the success of subsequent dental treatments, such as implant placement. Platelet-rich fibrin (PRF) has emerged as a promising biomaterial for enhancing wound healing in various medical and dental applications. This abstract aims to provide a comprehensive overview of the effect of PRF on extraction socket healing, with a particular focus on the sample size of studies conducted in this area. PRF is an autologous blood-derived product rich in growth factors, cytokines, and platelets, which play key roles in tissue repair and regeneration. When applied to extraction sockets, PRF promotes accelerated wound healing by stimulating angiogenesis, enhancing cell proliferation, and modulating the inflammatory response. These biological effects contribute to improved soft tissue healing and osseous regeneration. A thorough review of the literature reveals that several studies have investigated the effect of PRF on extraction socket healing, with varying sample sizes. Sample sizes ranged from small-scale studies with fewer than 20 participants to larger-scale investigations involving over 100 subjects. The inclusion of sufficient sample size is crucial for obtaining statistically significant results and ensuring the generalizability of&nbsp; findings