Solving Organisational Problems with Intranet Technology

Information serves as an essential intermediate input in decision-making for any business process. It is an essential requirement not only for effective and efficient management but also for medium and long term planning. In this era of technological advancement the rapid growth of information flow has contributed significantly in the expansion of business, commercial, industrial, financial, educational and research organisations. Electronic communication provides the ability to overcome many organisational problems. In recent years, an easy and inexpensive access to information through the Internet and e-mail has created an atmosphere of strong competition among organisations. In this competitive environment, the organisations need an efficient, productive and competent internal set-up based on a well-informed workforce. In the absence of effective co-ordination, the expansion of an organisation may result in inter-group conflicts, unhealthy bureaucratic activities, and various complexities in decision-making [Telleen (1996)]. This applies even more to organisations in developing countries such as Pakistan that are in need of efficient ways to improve governance and enhance institutional reforms.

Role of bone graft materials for cleft lip and palate patients: A systematic review

AbstractCleft lip and palate is a congenital anomaly. Its management requires a long term commitment, multidisciplinary and structured treatment. Treatment is initiated at infancy and continues till adolescence. Bone grafting is performed in order to provide bony stabilization for cleft maxillary alveolar arch and room for subsequent canine tooth eruption. The aim of this review was to discuss the success of various bone graft materials in managing unilateral and bilateral cleft lip and palate patients. For this purpose, a detailed literature search was performed using available electronic databases for peer reviewed papers published in English language. The review is based on published papers reporting the use of various bone graft materials for managing cleft lip and palate patients. The success of bone grafts was studied using the grading scales measuring the bone height at the grafted sites. Various types of bone graft materials including autogenous and allogenic were reviewed. Implant placement in cleft lip and palate patients required bone grafting after orthodontic expansion because of deficient bone in the anterior maxillary region. The grafted bone consequently provides stability and support to the maxillary alveolar arch. Success of bone graft as well as dental implants is multifactorial and therefore depends upon the type of bone graft, bone quality at cleft site and severity of cleft lip and palate

Solving Organisational Problems with Intranet Technology

Information serves as an essential intermediate input in decision-making for any business process. It is an essential requirement not only for effective and efficient management but also for medium and long term planning. In this era of technological advancement the rapid growth of information flow has contributed significantly in the expansion of business, commercial, industrial, financial, educational and research organisations. Electronic communication provides the ability to overcome many organisational problems. In recent years, an easy and inexpensive access to information through the Internet and e-mail has created an atmosphere of strong competition among organisations. In this competitive environment, the organisations need an efficient, productive and competent internal set-up based on a well-informed workforce. In the absence of effective co-ordination, the expansion of an organisation may result in inter-group conflicts, unhealthy bureaucratic activities, and various complexities in decision-making [Telleen (1996)]. This applies even more to organisations in developing countries such as Pakistan that are in need of efficient ways to improve governance and enhance institutional reforms

Effect of Ergonomical Factors on the Employees

To improve and enlightening production ergonomics is a search widespread to numerous organizations in diverse engineering and management zones. At the foundation is an ambition to eradicate hazards for job concerned musculoskeletal disorders, but recent observations on ergonomics have developed the discipline from a merely physiological, anthropometrical, and Psychosocial influential apprehension to an organizational, systems performance discipline. This research recommends that in an organization ergonomics infrastructure is made up of the structural, technical, executive and stakeholder comparative circumstances that allow or obstruct development of ergonomics. These circumstances spotlight on the positioning of diverse employees towards ergonomics concerns in an organization, the relationships between user, workers or employees, scenario, scheme and strategy they use for arguments, and the manipulate that occur from industry-particular culture, insolences and technical incorporation (or elimination) of ergonomics into engineering and production progressions. The information deduced from the research in this paper has been produced together with pertinent theoretical perceptions originated in the literature, into a Tentative Agenda which conducts empirical data assembly intended at planning the ergonomics infrastructure in an organization. Its step-by-step methodical appraisal of circumstances at diverse hierarchical levels in the organization should serve ergonomics experts and managers alike in classifying pathways and obstructions to improve production ergonomics

Phenological and Morpological Traits of Sesame as Affected by Irrigation, Tillage Systems and Phousphours Levels

Despite the importance of sesame (Sesamum indicum L.)  in the world, this crop has received only little research attention in Pakistan. Therefore, a field trail was conducted at New Developmental Farm of The University of Agriculture, Peshawar, Pakistan during summer 2012. The experiment was laid out in randomized complete block design with split plot arrangement having three replications. Irrigation interval (9 days, 18 days and 27 days) and tillage system (conventional tillage with cultivator, deep tillage with chisel plough and shallow tillage with MBP) were allotted to main plots, while phosphorus levels (0, 30, 60 and 90 kg ha-1) were allotted to sub plots. Irrigation interval significantly affected all the parameters. Water supply at 9 days interval had delayed days to first flowering (50), maximum plant height (180 cm), branches plant-1 (10), capsule length (2.71 cm), leaves plant-1 (23) and stover yield (5667 kg ha-1) as compared with other irrigation intervals but first capsule distance from ground is recorded greater in 27 days irrigation interval. Tillage system had significant effects on all the parameters, except days to first flowering, capsule length, first capsule distance from ground and leaves plant-1. Conventional tillage produced maximum plant height (168 cm), branches plant-1 (9) and stover yield (5105 kg ha-1) as compared with deep and shallow tillage system. Phosphorus application had also significantly affected all parameters except days to first flowering. Plots treated with 60 kg P ha-1 produced maximum plant height (178 cm), branches plant-1(9), capsule length (2.68 cm), leaves plant-1 (21) and stover yield (5538 kg ha-1) as compared with control plots but first capsule distance from ground is greater in control plot. Application of water at 9 days interval with conventional tillage method and treated with 60 kg P ha-1 had maximum plant height, leaves plant-1 and stover yield. Keywords: Sesame (Sesamum indicum L.), tillage systems, irrigation intervals, phousphours levels, phenology, morpholog

Neurodevelopment outcome of neonates treated with intraventricular colistin for ventriculitis caused by multiple drug-resistant pathogens-A case series

Background: Multiple-drug-resistant Gram-negative bacteria (MDR-GNB)-associated neonatal ventriculitis is a life-threatening complication that needs timely diagnosis and effective treatment with broad-spectrum antimicrobials in critical-care settings. Inadequate penetration of antibiotics through the blood-brain barrier also demands an intraventricular (IVT) route of administration. This study reports mortality and neurodevelopmental sequelae of neonates till 18 months of age, who received IVT-colistin for treating MDR-GNB associated ventriculitis. Methods: In a case series of seven neonates with ventriculitis due to MDR-GNB at NICU of Aga Khan University Hospital, Pakistan, between June 2015 and 2018, we reviewed IVT-colistin therapy in critically ill neonates. Treatment outcomes were assessed based on clinical sign\u27s resolution and MDR-GNB eradication in subsequent CSF cultures. Neurodevelopmental outcomes were evaluated at 18 months after discharge. Results: The average birth weight was 1.38 kg (range: 1.02-1.5 kg), and the average gestational age was 30.7 weeks (ranged: 26-34 weeks). All neonates reported colistin-sensitive MDR-GNB in CSF, five with Acinetobacter baumannii, and polymicrobial CNS infection was found in two patients (one due to Klebsiella pneumonia and A. baumannii and one due to K. pneumonia and Escherichia coli). All neonates received IVT colistin and concomitant intravenous meropenem, and five of them also received intravenous colistin. One neonate died. At the 18-month assessment, only one neonate had cerebral palsy and hydrocephaly and 50% had seizure disorders. Conclusion: Practicing intraventricular antibiotics in the neonatal population is challenging but may be used successfully, especially to overcome the limitation of poor penetration through the blood-brain barrier

Pharmacist-directed vancomycin therapeutic drug monitoring in pediatric patients: A collaborative-practice model

Background: Therapeutic drug monitoring (TDM) of Vancomycin (VCM) is required to prevent inappropriate dosage-associated bacterial resistance, therapeutic failure, and toxicities in pediatrics. Anecdotal experience and studies show that many healthcare institutions confront barriers while implementing TDM services, this study aimed to assess a pharmacist-directed VCM-TDM service for optimizing patient care in our institution.Materials and methods: Patients aged 1 month-18 years who received intravenous VCM were included in this quasi-experimental study. The pre-implementation phase (March-June 2018) consisted of retrospective assessment of pediatric patients, the interventional phase (July 2018 to February 2020) included educational programs and the post-implementation phase (March-June 2020) evaluated the participants based on pharmacist-directed VCM-TDM services as a collaborative-practice model including clinical and inpatient pharmacists to provide 24/7 TDM services. Outcomes of the study included the mean difference in the number of optimal (i) prescribed initial VCM doses (primary) (ii) dosage adjustments and (iii) VCM-sampling time (secondary). After ethical approval, data were collected retrospectively.Results: A hundred patients were there in each phase. The number of cases who were correctly prescribed initial VCM doses was significantly higher in the post-implementation phase, mean difference of 0.22, [95% CI (0.142-0.0.358), p \u3c 0.0001]. Patients who had correct dosage adjustments in the post-implementation phase also had higher statistical significance, mean difference of 0.29, [95% CI (0.152-0.423), p \u3c 0.05]. More correct practices of VCM-levels timing were observed in the post-implementation phase, mean difference of 0.15, [95% CI (- 0.053-0.264), p = 0.079].Conclusion: This study showed the significant role of pharmacist-directed TDM services to optimize the correct prescribing of initial VCM doses and dose adjustments

Assessment of Knowledge of Cardiopulmonary Resuscitation among Pharmacy Students of Mirpur, Azad Jammu & Kashmir

Introduction: Cardiopulmonary resuscitation (CPR) is the most important lifesaving technique in several emergency situations such as cardiac arrest. In future, being part of health care professionals, pharmacy students are deemed to possess basic skills and expertise which are required to perform CPR. Objective: To access the knowledge of cardiopulmonary among pharmacy students of Mirpur Azad Jammu & Kashmir. Methods: It was a questionnaire-based, descriptive cross-sectional study, conducted among 4th and 5th year students of two Pharmacy institutes of Mirpur AJ&K from November 2018 to January 2019. A pre-tested questionnaire from previous study was used to collect data. It comprised of 13 dichotomous questions with “Yes/No” options, regarding knowledge of CPR. Descriptive statistics was used to unfold the demographic characteristics. Inferential statistics (Kruskal Wallis and Man Whitney) tests were used for evaluating difference between dependent continuous variables and independent variables and Chi-square was applied to determine difference between grouped variables. P-value of less than 0.05 is considered significant. The data was analyzed using SPSS version 20. Result: Overall, 131 out of 150(response rate= 92%) students participated in current study. Gender distribution among the participants was almost equal with 66 males (50.4%) males and 65 (49.6%) females took part in current study. Participants of the age group 21-23 years (n=88, 67.2%) were dominant. Only few students (n=23, 17.6%) reported to have taken training in CPR previously. Eighty-eight (66.7%) had average knowledge of CPR. No significant differences among male and female, 4th and 5th year students of both the institutes were found. Conclusion: The study revealed that knowledge level of CPR is adequate in most of the students of pharmacy. However, further improvements are required to perform CPR in an efficient manner. Thus, training in CPR should be mandatory in the pharmacy curriculum

Ectopic Acromegaly Secondary to Bronchial Tumor; a Case Report of Rare Occurrence.

Introduction: Acromegaly is caused due to the unregulated and sustained overproduction of growth hormone (GH). The majority of the cases are caused by autonomous secretion of GH from anterior pituitary tumors. Nonetheless, in less than 1 % of the cases, the cause of autonomous secretion is secondary to ectopic growth hormone-releasing hormone (GHRH) production. Bronchial carcinoids are the most common cause of ectopic GHRH production. Case description:  A 32-year-old female presented to the clinic with a history of cough, hemoptysis, and undocumented weight loss for four years. Initial workup showed a large right main stem endobronchial mass. Transbronchial biopsy of the mass revealed a grade I neuroendocrine tumor (NET). During NET workup, a large sellar mass was incidentally found on cross-sectional imaging. The hormonal profile revealed markedly elevated insulin-like growth factor -1 (IGF-1) and mildly raised prolactin. The MRI Brain study revealed pituitary macroadenoma measuring 2 cm x 1.2 cm x 1.5 cm. The patient underwent bronchial carcinoid tumor resection, which led to normalization of serum IGF-1 and growth hormone response to an oral glucose tolerance test. Subsequent MRI brain revealed complete resolution of previously noted sellar mass. Practical implications:  This case highlights the importance of differentiating acromegaly secondary to pituitary adenoma and ectopic acromegaly. This case emphasizes the importance of keeping rare entities in the differential while assessing patients with pituitary macroadenoma