Incidence of Primary Brain Tumors: A Hospital Based Study of 200 Cases

Object:  The main objective of this study was to determine the incidence of primary brain tumors. It’s a hospital based study, which was conducted in the department of Neurosurgery Nishtar Hospital, Multan between 1996 and 1999. Patients of either sex were included in the study on the basis of history, clinical evaluation, laboratory and imaging investigations. The patients were admitted from outpatient department and by referrals from other medical units. After admission in the unit a uniform protocol of history taking, clinical and neurological examination, investigations and histopathological diagnosis was adopted for each patient. The information thus gathered was entered in a pro forma. The data analysed were age, sex, histological type, frequency and intracranial location of tumors. Results:  Among the 200 patients with primary brain tumors, there were 133 (66.5%) male and 67 (33.5%) female patients; the ratio being 1.98. The mean patient age was 33 years. The 31-40-year-old age bracket was found to be most highly represented, corresponding to 22.5% of total patients. In the younger age group, there were 34 (17%) male and 10 (5%) female patients, the ratio being 3.4 and the age mean of the patients was 7.6 years, with the range of 12 months to 15 years.  Conclusion:  The overall results conclude that primary brain tumors are more prevalent in males, with the age range of 31 and 50 years. Astrocytic tumors are the most frequent type of brain tumors with overall predilection for supratentorial compartment. Meningiomas and acoustic neuromas are rare in children

Multidimensional Inequality and Well-being in Pakistan: Evidence from Household Level Data

The present study investigated changes in multidimensional inequality in Pakistan. The study used Pakistan Social and Living Standard Measurement (PSLM) Survey datasets for three years 2001-02, 2007-08 and 2013-14. Three welfare distributions such as household per capita expenditures, access to education and health status are used in the study. The study employed Gini index, generalized entropy and stochastic dominance when inequality is measured for each dimension separately. The inequality is the highest in terms of education access. The stochastic dominance criteria demonstrate different orders for three attributes. The composite index is useful but social evolution function is not easy to construct as different formulations are considered. The pair wise technique has very useful policy implication when different attributes of welfare are distributed. The recommendations are made as specific regions or states should be focused where inequality is high. Moreover, efforts should also be made to narrow the skewed distribution of education

Spatial and Gender Based Comparison of Multidimensional Poverty: Household Level Analysis from Pakistan

The present study examines the multidimensional poverty in Pakistan by using three waves of (PSLM) survey data 2001-02, 2007-08 and 2013-14. Ten indicators such as enrolment, school attendance, immunization, prenatal care, electricity connection, gas, water, sanitation, crowding and assets are used for the measurement of multidimensional poverty. Alkire Foster and binary logistic techniques are employed for the measurement of multidimensional of poverty. Multidimensional poverty is measured at national and provincial, gender and regional level. The incidence of multidimensional poverty in Pakistan is high in rural areas as compared to the urban areas. Punjab province has the lowest while Balochistan province has the highest incidence of multidimensional poverty

Pakistan Randomized and Observational Trial to Evaluate Coronavirus Treatment (PROTECT) of Hydroxychloroquine, Oseltamivir and Azithromycin to treat newly diagnosed patients with COVID-19 infection who have no comorbidities like diabetes mellitus: A structured summary of a study protocol for a randomized controlled trial

Objectives: To evaluate the effectiveness of Hydroxychloroquine Phosphate/Sulfate (200 mg orally 8 hourly thrice a day for 5 days), versus oseltamivir (75 mg orally twice a day for 5 days), and versus Azithromycin (500 mg orally daily on day 1, followed by 250 mg orally twice a day on days 2-5) alone and in combination (in all seven groups), in clearing the coronavirus (COVID-19) nucleic acid from throat and nasal swab and in bringing about clinical improvement on day 7 of follow-up (primary outcomes).University of Health Sciences (UHS) Lahore, Punjab, Pakista

Spatial and Gender Based Comparison of Multidimensional Poverty: Household Level Analysis from Pakistan

The present study examines the multidimensional poverty in Pakistan by using three waves of (PSLM) survey data 2001-02, 2007-08 and 2013-14. Ten indicators such as enrolment, school attendance, immunization, prenatal care, electricity connection, gas, water, sanitation, crowding and assets are used for the measurement of multidimensional poverty. Alkire Foster and binary logistic techniques are employed for the measurement of multidimensional of poverty. Multidimensional poverty is measured at national and provincial, gender and regional level. The incidence of multidimensional poverty in Pakistan is high in rural areas as compared to the urban areas. Punjab province has the lowest while Balochistan province has the highest incidence of multidimensional poverty

Behavior of Sensitive Clay Subjected to Static and Cyclic Loading

Sensitive clay is the type of clay, which loses its shear strength when it is subjected to cyclic loading. High-rise buildings, towers, bridges etc., founded on sensitive clays and subjected to overturning moment are usually suffer from a steady reduction of the bearing capacity of their foundations and accordingly the safety factor. Cyclic loading of foundation on sensitive clay during the undrained period may lead to quick clay condition and catastrophic failure of the structure. In the literature, governing parameters are listed as: cyclic deviator stress, pore water pressure, axial strain, pre-consolidation pressure, confining stress, initial degree of saturation, water content, liquidity index and the number of cycles. The present study has introduced the governing parameters in two categories; namely physical and mechanical as a function of sensitivity number of the clay material. A well planned experimental investigation was conducted to examine the effect of these governing parameters during the undrained and the drained periods of sensitive clay subjected to static or cyclic loadings. The soil samples, known as “Champlain clay” were obtained from the city of Rigaud, Quebec (Canada). Consolidation tests, static and cyclic undrained and drained triaxial tests were performed on representative samples of this clay. Tests were conducted to identify the role of the key parameters governing this complex behavior during the drained and the undrained periods. The study examined individually the effect of cyclic loading, deviator stress, frequency, pre-consolidation pressure/OCR, and the confining pressure during the drained and undrained conditions. Absence or presence of the matric suction in fully saturated or partially saturated clay, effect of sensitivity number and liquidity index were also examined. Based on the results of the present experimental investigation, a hypothetical model was introduced to explain the process of shear strength reduction for the case of static and cyclic loading of sensitive clay subjected to cycling loading. The model was capable to define the term remolding agent or degree of remolding, the reduction in shear strength due to remolding. The increase in the water content is identified as the most critical or intrinsic shear strength for sensitive clay. The present study used the “Modified Cam Clay Model” to predict the factor of safety for a foundation on sensitive clay subjected to cyclic loading as function of the physical and mechanical parameters. A design procedure is developed to determine the safe zone for the undrained and drained responses, within which a combination of the cyclic deviator stress and the number of cycles for a given soil/loading/site conditions can achieve a quasi-elastic resilient state without reaching failure. The proposed design procedure is applicable to all regions around the world, where sensitive clays can be found. Furthermore, this procedure can be adopted to examine the conditions of existing foundations built on sensitive clay at any time during its lifespan

Strength of sensitive clay under cyclic loading

Sensitive clay is a kind of clay, which loses its shear strength when it is subjected to cyclic loading. High-rise buildings, towers, bridges etc., founded on sensitive clays usually suffer from reduction of the safety factor during its life span. Cyclic loading on foundation of sensitive clay during the undrained period may lead to quick clay condition and a catastrophic failure of the structure. In the literature, governing parameters such as cyclic deviator stress, pore water pressure, axial strain, pre-consolidation pressure, confining stress, initial degree of saturation, water content, liquidity index and the number of cycles are divided into two categories and then presented as a function of sensitivity. Nevertheless the limited data available has restricted the use of empirical formulae. It is of interest to note that sensitive clay's shear strength increases due to consolidation and decreases due to cyclic load. In this case, the pre-consolidation pressure plays the role of governing parameter. In this investigation, the experimental results available at Concordia University as well as the data available in literature will be used to evaluate the empirical formulae and models. The governing parameters will be evaluated on this basis. Based on this analysis, a procedure to assist practicing engineers in designing foundation on sensitive clay is proposed

Feed-forward control method for digital power factor correction in parallel connected buck-boost converter (CCM mode)

Amongst power converters, rectifiers are needed by many devices that are connected at the distribution end of AC electrical power networks. When large capacitors are used to reduce the voltage ripple at the dc output, the line current becomes non-sinusoidal. Such non-sinusoidal line currents increase the total harmonic distortion, resulting in significant power losses within the power network. The power factor correction converter or PFC converter is a well-known alternative to generate a flat dc voltage while shaping the input current to the input ac grid voltage, emulating a resistive behavior. As the parallel connection of PFC converters is a promising way to achieve a higher power rating, questions arise on balancing the current and power over these connected converters. In this paper, based on the differential equations of a buck-boost converter, a method is obtained to compute the duty cycles of the semiconductor devices aimed at obtaining the unity power factor while balancing the current. Feed-forward algorithms are used to tune the model parameters in order to strongly reduce the input current harmonics. The proposed scheme is simulated in MATLAB and results are given showing that the proposed algorithms result in a good power factor correction

Patient safety attitudes of frontline healthcare workers in Lahore: A multicenter study

All funding has been arranged by University of Health Sciences (UHS) Lahore, Punjab, Pakistan.Objectives: To evaluate patient safety attitudes of the frontline health workers in hospitals of Lahore, Pakistan. Methods: A self-administered Safety Attitudes Questionnaire (SAQ) survey was deployed in five hospitals across Lahore, Pakistan (July 2019 to June 2020). A total of 1250 consecutive consenting nurses and postgraduate trainee physicians of under five years working experience were recruited. Assessment for each of the six subdomains (teamwork climate, safety climate, job satisfaction, stress recognition, perception of management, working conditions) was done on a 0-100 scale. Multivariate analyses examined their relationship with job cadre (nurses and physicians), duration of respondents’ work experience (< 2 years, 3 - 4 years, > 4 years), and hospital sector (private and public). Results: The response rate was 97% (1212 individuals; 765 nurses, 447 physicians). Nurses scored less than physicians in teamwork climate (-2.4, 95% CI -4.5 – -0.2, p=0.02) and stress recognition (-10.6, 95% CI -13.5 – -7.7, p<0.001), but more in perception of management (4.2, 95% CI 1.5 – 6.8, p=0.002) and working conditions (3.4, 95% CI 0.66 – 6.2, p=0.01). Increasing work experience was related to greater scores in all subdomains. Private hospitals scored generally higher than public ones. Conclusion: Duration of job experience was positively correlated with patient safety attitudes of hospital staff. These finding could serve as the baseline to shape staff perceptions by cadre in both public and private sector hospitals.University of Health Sciences (UHS) Lahore, Punjab, Pakista

Predictors of Tuberculosis Treatment Default in Pulmonary

To detect the predictors of treatment defaults in Pulmonary Tuberculosis (PTB) and Extra Pulmonary Tuberculosis (EPTB). Methods: In this cross sectional study 140 adults, with diagnosis of pulmonary tuberculosis (PTB) and extra pulmonary tuberculosis ( EPTB), with treatment defaults, were included . The study protocol incorporated demographic, clinical characteristics of patients, structured questionnaire, physical examinations, radiological, laboratory investigations and relevant predictors for TB treatment defaults. The statistical analysis was performed using SPSS 20. Results: Mean age of study group was 42.3±20.3. Majority (67.1%) were male. Ninety four (67.1%) had PTB and 46 (32.9%) had EPTB. Factors identified to be associated with TB treatment default were male gender ,distance from the health post, displacement, financial constraints, no body at home to bring medicine or take patients to hospital, routes closed in winters, subjective improvement of symptoms and travelling /shifting to other place. Conclusions: Treatment default is seen in pulmonary and extra pulmonary tuberculosis. Due to lack of uniform diagnostic and therapeutic strategy in EPTB treatment, most physicians treat on clinical symptoms for a prolonged duration of 12 to 24 months