Minimally invasive posterior spinal fusion in unstable thoracolumbar

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfillment of the requirements for the degree of Master of Medicine in the branch of Orthopaedic Surgery Johannesburg, 2017Background Unstable Thoracolumbar spinal fractures are conventionally treated by open reduction and internal fixation. This involves extensive mobilization of paraspinal muscles, which in turn leads to long-term disability in the form of chronic backache. One of the reasons fractures are stabilized is to prevent kyphotic deformity. Posterior lumbar stabilization done through a minimally invasive technique can achieve the same result as the open technique at the expense of less mobilization of the paraspinal muscles. Aim of the study The aim of the study was to assess the effectiveness of minimally invasive posterior spinal fixation in unstable Thoraco-lumbar fractures in our setting at Charlotte Maxeke Academic Hospital. Objectives To assess the effectiveness of Minimally Invasive Spine Surgery over a short term of minimum of 12 months regarding: Maintaining the correction of fracture kyphosis, Re-operations and Any serious Adverse Events Methodology This was a prospective interventional pilot study. Fractures were classified according to the AO comprehensive system. AO Comprehensive classification fractures A3, B1, B2, C1 and C2 were considered suitable for this technique. Pre-operative, immediate post-operative and one year follow up Cobb’s angles of fracture kyphosis were measured on plain lateral x-rays. Any Serious Adverse Events (SAE) that may have required re-operations were recorded over the minimum of 12 months follow up. Results Twenty patients met the inclusion criteria for this study. Post-operative follow up ranged between 12 and 22 months. There were 14 males and 6 females. The age ranged between 16 years to 54 years with mean of 33.9 years. L1 was the most commonly fractured vertebra. Eleven out of 20 patients sustained fracture of L1, 6 patients had fracture of L2 whereas 3 patients sustained fracture of T12. The AO classification types included one B1, five B2, seven C1 and seven C2 fractures. The pre-operative Cobb’s angle ranged from 7 degrees to 38 degrees with mean of 21.2 degrees. The immediate post-operative Cobb’s angle ranged between zero degrees to 16 degrees with mean of 8.3 degrees. The last follow up Cobb’s angle ranged between zero degrees to 21 degrees with a mean of 10.7 degrees. The loss of correction of fracture kyphosis ranged between zero degrees to 6 degrees with a mean of 2.4 degrees. The post-operative Cobb’s angle was maintained. There was no deterioration of pre-operative neurological status. There was no serious adverse event requiring a re-operation. Conclusion Minimally Invasive Posterior Spinal stabilization for thoracolumbar fractures had an acceptable outcome in our hands in appropriately selected cases. The average loss of correction of 2.4 degrees was in keeping with that found in open technique as well as MIS at other centers. While the number is less, this procedure can be recommended for well selected patients where skills are available.MT201

Impact of Socialization on Organizational Commitment of Employees: A Case Study of Private Degree Colleges in Nowshehra, District, KPK

Implementations of HR practices carry a significant weightage towards organization’s success. The study was focused to find out the impact of socialization process on organizational commitment of employees working in private degree colleges. 200 hundred questionnaires were distributed among the teaching staff of degree colleges using convenient sampling technique. 126 properly filled questionnaires forming a response rate of 63% were analyzed to get meaningful results. The results of the study showed that socialization process was found to have significant impact on organizational commitment of employees

Impact of Awareness Campaign on the Knowledge of Risk Factors of HIV & AIDS among Students of University of Gujrat, Pakistan

Background: Individuals of age 15-25 years are at highest risk of HIV/AIDS due to presence of high risk behavior. Public health professionals are of the view that educational intervention are more successful in improving knowledge attitudes and preventive practices among the young rather than abstinence only intervention. The aim of this study was to access the knowledge regarding HIV/AIDS of students of University of Gujrat, Gujrat and to find the effect of imparting education on these parameters. Methodology: pre-post quasi experimental study design conducted at University of Gujrat, Pakistan in the year 2015-2016. A sample size of 370 students was taken. A pre-structured self-administered questionnaire was used as a study tool, privacy and anonymity of the respondents were maintained. A comprehensive lecture and educational session was carried out that delivered information regarding HIV/AIDS disease nature, modes of transmission, myths associated with HIV/AIDS, and other disease facts. After an interval of three weeks the same questionnaire again got filled from the same students. The pre-intervention knowledge was compared to the post educational intervention one. Obtained data were evaluated by using SPSS version 20. Results were considered significant at p value of less than 0.05. Results: The student of UOG had fairly moderate knowledge of HIV/AIDS that was significantly modified (p≤0.01) after educational conditioning. And there was clear presence of will to disseminate HIV information, so that not only themselves but also their family member can be protected from this deadly infection. Conclusion: Educational intervention statistically significantly conditioned students knowledge of HIV/AIDS

Cultural impact on trust-building process between Norwegian and Pakistani importers/exporters (traders)

Masteroppgave i bedriftsøkonomi - Universitetet i Nordland, 201

Uveitis in spondyloarthropathies

Background: Uveitis is associated with several systemic disorders. It may be the initial presentation or manifestation of a systemic disease. It is the most common ocular complication and is sometimes the earliest manifestation of spondyloarthropathies. This study aimed to review the current literature on spondyloarthropathies and associated uveitis. Methods: A narrative review was performed using various combinations of the keywords spondyloarthropathies, seronegative spondylarthritis-related uveitis, and human leukocyte antigen-associated uveitis using PubMed/MEDLINE and Google Scholar from January 1, 2000, to September 30, 2022. We describe the disease mechanisms, genetics, and classification of spondyloarthropathies, the clinical patterns of their related ocular diseases, and the current modalities for the management of their ocular or systemic manifestations. Results: Seronegative spondyloarthropathies are a group of rheumatic disorders including ankylosing spondylitis, reactive arthritis, psoriatic arthritis, inflammatory bowel disease-related spondyloarthropathy, juvenile-onset spondyloarthritis, and undifferentiated spondyloarthritis. These are characterized by enthesitis in the absence of serum rheumatoid factor and have a strong association with human leukocyte antigen B27. The clinical courses and features of spondyloarthropathies are remarkably diverse. Ocular inflammation is common in spondyloarthropathies, often precedes the onset or diagnosis of systemic disease, and responds well to topical therapy. Timely diagnosis of systemic diseases may improve quality of life and help avoid ocular and skeletal complications. Recurrence of ocular inflammation is frequent; on occasion, it may be associated with etanercept administration. Conclusions: Eye care professionals should be able to recognize spondyloarthropathies, manage ocular disease, and collaborate with related specialties for modification of systemic treatment if associated with ocular complications. Timely referral and early management could attenuate or prevent ocular or systemic morbidities associated with spondyloarthropathies

Fiscal Decentralization in Pakistan: 7th NFC Award as Case Study

The globalization and its associated challenges have transformed the concept of decentralization from mere business of local government to a broader concept of Governance. By transferring payments to lower tiers of government, the central government actually tries to involve all federating units in economic development of the country. After independence, the Government of Pakistan adopted the colonial fiscal structure for payments and grants between the Centre and provinces but this mechanism could not be put into practice due to undemocratic political culture. The resource distribution formulas were often condemned by the smaller provinces being unjust. After enactment of 18th amendment to the 1973 Constitution, provinces were given more financial and administrative autonomy through 7th NFC Award based on the criterion of population, backwardness and inverse population density (IPD). This study finds that the constitutional reforms and 7th NFC award has strengthen the perception about provincial autonomy but due to capacity issues, benefits of fiscal decentralization could not be achieved in Pakistan. Keywords: Fiscal Federalism and Decentralization, Provincial Autonomy, NFC Award, Pakistan

Current Foreign Chinese Politics and its Resilience in the Globalized World

The efficacy of a state’s political system, irrespective of its type (democratic or non-democratic, liberal or centralized, presidential or parliamentary and representing common citizens or demonstrating only elite aristocrats etc.), depends upon the basic principle how much responsiveness it shows in serving the interest of the common people. This paper is an attempt to evaluate the resilience of the Chinese Model. The framework for the analysis is the governance, legitimacy and public participation in policy making process. The assessment of the Chinese politics reveals that the Communist Party of China (CPC) is dominating the overall governance. It has been making efforts to endorse rule of law, human rights, free trade, transparency and establishment of lasting relations across the world. The ruling party has created a sense of harmony and uniformity in the functioning of various branches of the government such as the legislature, the executive and the judiciary. The success of Chinese model with such an extreme domination of single party over a period of time denote that the Chinese society has been legitimizing the traditional position of CPC through elections at national as well as provincial levels.  It can easily be concluded that the resilience of the Chinese Model is reliant on the performance of the dominant Communist Party. Keywords: Political System, Communist Party of China, Global Politics, Western Liberal Democracy, Asia-Pacific