Clinicopathological Characteristics of Breast Carcinoma in Premenopausal Women

Background: Breast cancer is one of the leading causes of mortality world-wide. The objective of this study was to see the pattern and characteristics of carcinoma breast in premenopausal women reporting at a tertiary care hospital.Material and Methods: This cross-sectional study was conducted at surgical unit of Pakistan Institute of Medical Sciences (PIMS), Islamabad from May 2012 to April 2015. A total of 144 female patients were admitted during this period as diagnosed cases of carcinoma breast. Of these patients, all cases of breast carcinoma diagnosed in premenopausal women were selected and assessed for tumor type, TNM classification and involved breast quadrants.Results: Out of 144 patients 70 (48.6%) cases of carcinoma breast were reported in premenopausal women. The ages ranged from 14 to 48 years with a mean age of 33 ± 7.95 years. According to TNM classification, 2.9% patients were in T1, 25.7% were in T2, 32.9% were in T3 and 38.6% were in T4. Similarly, 37.1% patients presented with a nodal status of N0, 38.1% with N1, 21.4% with N2 and 2.9% with N3. Out of 70 patients, 11 (15.7%) presented with distant metastasis (M1) at the time of diagnosis. The upper outer quadrant of breast (32.9%) was most commonly involved site, followed by upper inner, lower outer and lower inner quadrants, respectively. Most common tumor type was invasive ductal carcinoma (85.7%), followed by invasive lobular carcinoma (7.1%), papillary carcinoma (4.3%), medullary carcinoma (1.4%) and malignant phylloides (1.4%). Regarding exposure to risk factors of breast cancer in these patients, 35.7% women did not breast feed and 27.1% were nulliparous. There was no history of use of oral contraceptive pills in 82.8% and positive family history was reported in 27.1% patients.Conclusions: Late presentation with advanced disease in premenopausal women is more common in our part of the world as compared to international literature. More studies on larger sample sizes should be carried out to validate these findings

Antecedents and Outcomes of Intimate Co-creation: A Qualitative Inquiry

This qualitative research study aims at re-conceptualizing intimate co-creation on the basis of a qualitative data analysis. Hence, along with a latest conceptualization, theory of intimation co-creation has been empirically examined in this study. Based on the qualitative research approach of interpretive phenomenological analysis, qualitative data obtained from eight in-depth interviews was transcribed and coded in QDA Miner Lite software for analysis. Results found that five emerging themes represent the phenomenon of intimate co-creation. Furthermore, the contribution of this study was that a new research framework on intimate co-creation has been developed in which antecedents and potential outcomes of intimate co-creation have been identified. Propositions have been given as well to elaborate the relationship of antecedents and outcomes of intimate co-creation for future research direction

Where you end and I begin: A new scale development on intimate co-creation

Purpose: Built upon the theories of psychological ownership, personal intimacies, and interpersonal relationship; the concept of intimate co-creation was conceptually theorized in the recent management literature. Intimate co-creation typically occurs at the dyadic level often for the creative task engagements and has a spillover effect on groups and teams. However, there is no measurement scale on intimate co-creation available in the management literature. Methodology: The current study has addressed this literature gap by developing a new measurement scale on intimate co-creation. Best practices for new measurement scale development as available in the management literature were followed. A qualitative study was conducted first to determine the dimensional structure of intimate co-creation and an initial pool of 72 items. Scale development experts’ review of the measurement scale, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) abetted in finalizing a 14 items measurement scale with four dimensions of intimate co-creation. Findings: This new measurement scale development is a milestone for further empirical research on intimate co-creation as it is the first-ever measurement scale on intimate co-creation. Conclusion: This is the first-ever measurement scale on intimate co-creation that is available for future researchers to empirically validate the concept of intimate co-creatio

Evolving Migration Trends from Afghanistan: Management andHonourable Repatriation of Afghan Refugees in Pakistan

Since 1979, Pakistan has been a key player in the management of Afghan refugees despite challenging economic and security conditions. The repatriation efforts in the past could not bring conclusive results as a significant population still live in Pakistan. The outbreak of COVID 19 has increased their vulnerability due to inadequate quarantine and health facilities. The positive political developments by way of new elections and a political settlement with the Taliban provide an opportunity for honourable repatriation of Afghan refugees. This article investigates the dilemma in the management of Afghan refugees in Pakistan and suggests a viable course of action for their honourable repatriation to Afghanistan

Acute necrotizing encephalopathy of childhood secondary to dengue infection: A case report from Pakistan

Acute necrotizing encephalopathy of childhood (ANEC) is a rare condition mainly affecting children with a distinct clinico-radiologic pattern. Initially thought to be secondary to respiratory viral infections, there have been more insights to the pathogenesis of ANEC including genetics. We present a case of a girl who developed this condition with classical clinico-radiologic findings of ANEC secondary to severe dengue infection and could not survive. We report this case with the aim to raise awareness about this fatal complication of dengue infection as dengue has become a global health-care problem

Impact of Compulsory Citizenship Behavior on Employee Performance: A Mediating Role of Perceived Insider Status and Moderating Role of Psychological Hardiness

The current study investigates the relationship between compulsory citizenship behavior (CCB) and employee performance (EP) through the underlying mechanism of perceived insider status (PIS) and the moderating effect of psychological hardiness (PH). For this purpose, data were collected through a non-probability convenience sampling technique in three-time lags from 376 employees working in hotels located in Pakistan. The results support the effect of compulsory citizenship behavior on employee performance, directly and indirectly, through the perceived insider status of employees. Results also support the moderating role of psychological Hardiness weakening the negative relationship between CCB and perceived insider status

Post-abortion care family planning use in Pakistan

Introduction: The stagnated CPR and high unmet need for contraception lead to approximately 890,000 induced abortions every year in Pakistan. A fairly recent study from Pakistan also revealed that around 40% of abortions are performed by unskilled workers in backstreet clinics. Considering these grave statistics, it should not come as surprise that unwanted pregnancies are the leading cause of induced abortions in Pakistan. Despite country\u27s inferior situation, there is no data available in Pakistan that unveils the much needed information pertaining to post-abortion care family planning (PAC) use. Thus, this paper attempts to document socio-demographic profile seeking post-abortion care clients; estimate proportion of post-abortion contraception uptake and determine its associated factors.Methods: Medical records of 17,262 women seeking PAC as a result of incomplete abortion and treatment for complications arising from unsafe abortions were analyzed. The associations between risk factors and post-abortion family planning uptake were assessed by applying univariate and multivariable logistic regression.Results: High post abortion contraceptive use (72.9%) was observed amongst the women who had sought for PAC services. where, 66% of the women opted to use short-term methods. The rest (33.5) considered long-term reversible IUD and implant as their method of choice and only 0.4% had undergone voluntary sterilization. Multiple logistic model identified province, women education, women occupation status, monthly family income, first time visitors to the centre, previous contraceptive use, and type of PAC treatment provided, women\u27s health condition after post-abortion treatment had significant associations with the uptake of contraception.Conclusion: The present study highlights the importance of strengthening post-abortion family planning services in the country which will not only contribute in increasing the overall contraceptive use in the country but will also prevent high unintended pregnancies that may ultimately lead to induced abortions

Recompensa, um motorista para a criatividade; papel mediador das avaliações de recompensa entre auto eficácia e desempenho criativo

The purpose of this dyadic study was to explore the insight that trigger the creative performance. For such purpose self-efficacy and rewards in shape of challenge and threat appraisal were used. A Survey was conducted to collect the data from the public and private sector organizations related to technical education in Punjab. Sample was the faculty member working on positions of instructors, senior instructor and lectures. A total of 302 respondents were analyzed. The results of the analysis show that there is significant relationship among self-efficacy and creative performance. The mediation analysis also shows that challenge appraisal of rewards for creativity and threat appraisal of reward also worked as mediator. Consequently, we reached at the point that having high level of self-efficacy, individuals in technical education organizations appraises the reward as a challenge and perform creatively. And on the other side having low level of self-efficacy, but appraising the Reward as a threat, tends to impact negatively on creative performance.El propósito de este estudio diádico fue explorar la información que desencadena el rendimiento creativo. Para tal fin se utilizaron la autoeficacia y las recompensas en forma de desafío y evaluación de amenazas. Se realizó una encuesta para recopilar los datos de las organizaciones del sector público y privado relacionadas con la educación técnica en Punjab. La muestra fue el miembro de la facultad que trabaja en posiciones de instructores, instructor senior y conferencias. Se analizaron un total de 302 encuestados. Los resultados del análisis muestran que existe una relación significativa entre la autoeficacia y el rendimiento creativo. El análisis de la mediación también muestra que la evaluación desafiante de las recompensas por la creatividad y la evaluación de la amenaza de recompensa también funcionó como mediador. En consecuencia, llegamos al punto en que, al tener un alto nivel de autoeficacia, los individuos en las organizaciones de educación técnica valoran la recompensa como un desafío y se desempeñan de manera creativa. Por otro lado, tiene un bajo nivel de autoeficacia, pero evaluar la recompensa como una amenaza, tiende a tener un impacto negativo en el rendimiento creativo.O objetivo deste estudo diádico foi explorar a percepção que aciona o desempenho criativo. Para esse propósito, a auto-eficácia e as recompensas em forma de desafio e avaliação de ameaça foram usadas. Uma pesquisa foi realizada para coletar os dados das organizações do setor público e privado relacionadas à educação técnica em Punjab. Amostra foi o membro do corpo docente trabalhando em posições de instrutores, instrutor sênior e palestras. Um total de 302 respondentes foi analisado. Os resultados da análise mostram que existe uma relação significativa entre autoeficácia e desempenho criativo. A análise da mediação também mostra que a avaliação de recompensas de recompensas por criatividade e avaliação de ameaças de recompensa também funcionou como mediador. Consequentemente, chegamos ao ponto em que, tendo alto nível de autoeficácia, indivíduos em organizações de educação técnica avaliam a recompensa como um desafio e realizam de forma criativa. Por outro lado, ter baixo nível de autoeficácia, mas avaliar a recompensa como uma ameaça, tende a impactar negativamente no desempenho criativo

Evaluation of Mesh of Liberation of Zard Koh and Kulli Koh Iron Ores of Pakistan

Liberation size plays a significant role to select a correct and successful concentration method for natural iron ores. This paper aims to evaluate the liberation size of two newly discovered iron ores, namely Zard Koh and Kulli Koh, existing in Chagai region of Pakistan. Zard Koh iron ore is mainly composed of maghemite along with the pyrite, chlorite, grossular and admontite as gangue minerals, whereas, Kulli Koh iron ore is comprised of hematite mostly with quartz, dravite and kaolinite as the gangue minerals. The representative samples of ores were pulverized and sieved to different size fractions. The liberation size of iron bearing minerals and gangues was investigated by analyzing the different size fractions of each ore using XRF (X-Ray Fluorescence), SEM (Scanning Electron Microscope) attached with EDS (Energy Dispersive Spectroscope). The XRF results revealed that the most probable liberation size of Zard Koh and Kulli Koh ores is most likely existing at -75+45 and -150+106 m, respectively. In order to confirm this liberation size, further evidences were collected using SEM and EDS examinations. It is interesting to note that the results obtained from SEM and EDS were quite in agreement with XRF result

Sclerosing Mesenteritis as a Cause of Abdominal Mass and Discomfort in an Elderly Patient: A Case Report and Literature Review

Sclerosing mesenteritis is a rare benign process that involves inflammation, fat necrosis, and fibrosis of the mesentery. The disease poses great diagnostic challenge due to its nonspecific clinical and diagnostic findings. We report the case of a 75-year-old man who presented with vague abdominal discomfort associated with an intra-abdominal mass. With suspicion of a bowel carcinoid tumor on computed tomography scans, the patient underwent diagnostic laparoscopy. A diagnosis of sclerosing mesenteritis was made on histological examination. The patient's symptoms responded to a combination of immunosuppressive drugs, with no interval change in the size of the mass on radiological examination after fifteen months