Chronic obstructive pulmonary disease patients and steroids: benefit or harm

Background: Corticosteroids are being widely used in conditions related to allergy and inflammation. There are great species differences in the responses to glucocorticoids that mean a “steroid resistant” species. Steroids have profound effect on inflammatory response by way of vasoconstriction, decreased chemotaxis and interference with macrophages. There still are enormous gaps in our knowledge of the action of glucocorticosteroids in patients of chronic obstructive lung disease (COPD).Methods: This study was done in the department of general medicine at SKIMS, Srinagar from December 2017 to December 2018 on patients of chronic obstructive pulmonary disease. A total number of 100 patients were enrolled for the study but 20 patients, 10 from each group lost their follow up. To see the effect of steroids on pulmonary function tests, patients were divided into case and control group. Patients in case group were given prednisolone 30 mg orally for two week (tapering dose). Patients in control group were given placebo for the same duration of two weeks. Steroid response was defined as 15% improvement in baseline forced expiratory volume (FEV).Results: Steroid response was defined as 15% increase in forced expiratory volume in one second/forced vital capacity (FEV1/FVC) after receiving tapering dose of prednisone 30 mg for 2 weeks, no patients in case group showed increase in FEV1/FVC of 15%. The change in pulmonary function tests was comparable in each group (p>0.5).Conclusions: The change in pulmonary function tests were comparable in each group (p>0.5). So, steroids in stable patients of COPD are best to be avoided

Effect of Mergers and Acquisitions on Market Concentration and Interest Spread

This study investigates the relationship of mergers & acquisitions with the interest spread of the banking industry in Pakistan. To assess whether the merger of Pakistani banks were a success or otherwise, profitability, liquidity ratios, and net interest spread are computed which are considered essential to judge the financial performance of any bank. Data is taken for the period of 1997-2010 and this data have been used to calculate the interest spread and market concentration. Market Concentration is calculated by using Herfindahl-Hirschman Index or HHI. Findings show that the profitability and net interest spread of two merged banks declines as a result of mergers. It is also revealed that Concentration of the banking industry shows a rising trend during 2008 and 2009 after mergers occurred during 2007 as a result of merger. However, it shows the level that almost approaches the threshold i.e. 1000. One or two more mergers can push up threshold level of HH index. It means that it is the right time for banking industry of Pakistan to be reviewed by any antitrust authority to maintain the optimum level of competition

The Impact of Psychological Empowerment of Project-Oriented Employees on Project Success: A Moderated Mediation Model

In the current era of accelerated economic growth, project success – successful completion of the final product for which the project was initiated – is the ultimate goal of every organisation. It is essential for organisations to keep project-based employees motivated and focused on successfully accomplishing the project objectives. This research examined the association between psychological empowerment of project-based employees and project success. We explored the mediating role of knowledge sharing to explain the intervening mechanism between psychological empowerment and project success. We also tested the moderating role of employee creativity along with conditional indirect effects by performing a moderated mediation analysis. Using a time-lagged research design, multiple-source field data (N¼327) were collected from employees of project-based organisations in Pakistan. The findings of the study showed a positive association between psychological empowerment and project success and significant mediation of knowledge sharing. Project employees with high creativity are likely to achieve project success when they possess higher psychological empowerment too. Results concluded that psychological empowerment is positively associated with project success directly as well as indirectly through its impact on knowledge sharing. The study has its importance and implications for management specialists and project employees at all levels

Impact of virtual reality on learning perception

This thesis studies the perception of learners towards virtual reality as a learning tool to understand whether the learners hold any positive or negative perception towards VR and to build further knowledge on how VR should be adopted as an aid for teaching in academic and vocational institutes. Mixed research was conducted, which included an experiment where participants (n=31) were asked to wear a VR HMD and experience a pedagogical simulation, and then respond to a questionnaire. Subsequently, an online questionnaire (n=144) was dispersed amongst VR and non-VR users, to measure similar attributes based on their experience with VR technology. The questionnaire consisted of Likert, semantic differential scale, and open-ended questions. The results show that the perception of VR as a learning tool, although mostly positive, differs according to the experience of the participants with VR technology. The participants from the experiment and with prior academic VR experience have a dominant positive perception towards VR, whereas those with entertainment and no experience show marginally lower positive perception

Coincidence of dental midline with facial midline in a sample of Pakistani population

OBJECTIVE: To determine the frequency of coincidence of facial and dental midlines in a sample of Pakistani subjects. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Department of Prosthodontics, Fatima Jinnah Dental College and Hospital, Karachi, from October to December 2017. METHODOLOGY: Subjects of either gender (n=117) were selected from pool of otherwise healthy dental students. Facial portrait photographs using a DSLR camera were obtained while keeping the teeth in maximum inter-cuspation position. Auto-CAD software was used to analyse the coincidence of facial, maxillary and mandibular midlines. SPSS Version 23.0 was used for data analysis. The coincidence of the midlines were determined using Pearson correlation test. Level of significance was set at 0.05. RESULTS: The coincidence of maxilla-mandible midlines was 64.1% (75/117); whereas, coincidence of facial midline with maxillary and mandibular midlines were 47.9% (56/117) and 46.1% (54/117), respectively. Left sided deviations of dental midlines were more frequent than the right side. CONCLUSION: The coincidence of inter-maxillary midlines was seen in two-thirds of the participants only. The dental midlines were coincident with the facial midline in less than half of the sample

Violence Against Healthcare Professionals in Nishtar Medical University Hospital Multan, Pakistan: A Descriptive Cross-Sectional Study

Objective This study aims to identify the risk factors of physical violence against healthcare professionals in Nishtar Hospital Multan Pakistan. Study design Descriptive cross-sectional study Place and duration of study Department of Psychiatry and Behavioral Sciences, Nishtar Medical University Multan, Pakistan. The time span of study was from January 2016 to December 2017. Method A non-probabilistic strategy was used to select 200 healthcare professionalswho were serving at Nishtar hospital Multan Pakistan. We first obtained lists of all healthcare workers employed at our university hospital from hospital management and human resource department. We combined these lists, assigned a number to the name of each worker, and selected an average of 200 personnel from our university hospital. The study samples included doctors, nurses, and paramedical staff (e.g., medical technicians and administrative staff). All the members of study population were well informed of the purposes and methods of the study. Then we distributed the questionnaire. All the healthcare professionals responded as per their opinion and experiences and submitted it to a specified box. The dara were retrieved and analyzed by using computer program SPSS 20 version. Results Out of total study population a total of eighty six (43%) healthcare professionals reported that they were physically attacked in their hospital in the previous 12 months. Most of the time this illegal action was performed by the relatives of the patients (88 %), followed by the patient (12%); 73.6% of perpetrators young aged between 20 to 40 years of age. Pertaining to physical violence incidents, approximately 91% (n = 182) resulted in a physical injury, and 55.4% of respondents took two or three days of sick leave after sustaining that physical injury. Surprisingly, the reporting of workplace violence in hospitals to law enforcing agencies and higher authorities of hospital administration was considerably low (12.4%). Most of the healthcare professionals (87%) did not receive training on how to avoid workplace violence (n=174). The study showed that general nurses, aged 35 years or younger, were more likely to experience physical violence. Healthcare professionals with direct physical contact (washing, turning, lifting) with patients had a higher risk of physical violence compared to other health care workers. The lengthy and cumbersome legal and administrative delays in the procedures for reporting workplace violence were a major cause for physical violence. At work place, the reporting of incidence after psychological violence was protective than to waiting until an instance of physical violence takes palce. Conclusions Physical violence in hospitals is an occupational hazard for public health concern. Policy makers and higher authorities should introduce legal procedures and intervention to cope with this serious issue

Spontaneous intracranial hypotension

Spontaneous intracranial hypotension (SIH) is uncommon and usually undiagnosed entity which present most commonly with postural headache. The diagnosis is difficult because of the nonspecific symptoms and lack of awareness about the disease .It is important to recognize SIH as if the disease goes undiagnosed it can cause a significant delay in initiation of the treatment and exposing patient to the risks associated with the treatment for the disorders mimicking intracranial hypotension . We describe a patient with SIH and outline the important clinical and radiological features of this syndrome. The aim of presenting this case report is to emphasize the need for being vigilant for this rare disorder which should be considered in the differential diagnosis of recurrent posture related headache

Study of drug mediated effects in mice: Histology based findings

Aackground: Drugs induce numerous kinds of pharmacological effects in different body organs. For protecting organs from damage and destruction from drugs, the study of such effects is extremely important. Rapidly accumulating experimental data has opened new horizons for a comprehensive re-conceptualization of chemical modulated changes in histological features of body tissues.Methods: In this study we studied dextromethorphan, ethanol, methanol and midazolam induced changes in histological specimen from different organs in post-treated mice.Results: No pathological changes were observed in heart, liver and kidney by administering dextromethorphan at a dose of 61 mg/kg. While, ethanol causes pathological changes in heart, liver and kidney tissue at high dose i.e. 2000 mg/kg. Gross Pathological changes were observed in heart, liver and kidney by giving midazolam at a dose of 200 mg/kg.Conclusion: Dextromethorphan showed lesser side effects and is less toxic as compared with other drugs, such as, ethanol, methanol and midazolam. Lesser toxic effects were observed when drugs were administered alone, but in combination, these drugs produced higher toxic effects

Relationship of natural occlusal plane with different anatomical landmarks

Objective: To evaluate the parallelism of natural maxillary occlusal plane with inter-pupillary line and ala-tragus line, and to evaluate the anatomic relationship of natural mandibular occlusal plane with retromolar pad among dentate subjects.Methods: The cross-sectional study was conducted from September 2017 to February 2018 at Fatima Jinnah Dental College, Karachi, and comprised front and profile photographs of subjects aged 20-28 years while holding the camper\u27s plane against the maxillary occlusal plane. The photographs were imported in a software and an interpupillary line was drawn and the angle with Camper\u27s plane was measured. On both profile pictures, lines were drawn from base of the ala to the superior, middle and inferior points on the tragus. The angle between ala-tragus line and Camper\u27s plane were measured. Intra-orally, height of the mandibular occlusal plane in relation to the retromolar pad was evaluated using a stainless steel scale. Data was analysed using SPSS 23.Results: Of the 109 subjects with a mean age of 23.03±1.36 years, 76(69.72%) were females. Horizontal parallelism of occlusal plane with inter-pupillary line was observed with a mean angle of 1.17±1.27 degrees. The angle between the occlusal plane and the inferior ala-tragus line was 4.25 degrees on the right side, and 4.50 degrees on the left. Intraorally, mandibular occlusal plane coincided with the inferior 48(44%) and the middle third 48(44%) of the retromolar pad.Conclusions: Inter-pupillary line and retromolar pad area should be used as a guide in the determination of plane of occlusion. The ala-tragus line was not found to be a reliable guide