The Ground Was Always in Play

Without the people from Pakistan’s Tribal Areas to narrate the visual evidence, one wouldn’t necessarily know what one was looking at in the photos or videos of the aftermath of drone attacks. To tell their stories, they had moved through a territory pockmarked by bombs and checkpoints and drones and troops and fighters, but to those sitting in Islamabad or New York or London, these things signified that the territory was “wild” and its people therefore probably faithless. The doubt was unequally distributed, and the judgment was always made against the backdrop of a relentless distrust. A bitter pill: they endured the containment zone, but their experiences of it rendered the testimonies of their experiences unstable. As they were made mute, the forensic experts were called in to make objects speak

On FIDEs System by Modified Sumudu Decomposition Method

In this paper, the technique of modified Sumudu decomposition method has been employed to solve a system of Fredholm integro-differential equations with initial conditions. Two examples are discussed to show applicability, reliability and the performance of the modified sumudu decomposition method. This study showed the capability, simplicity and effectiveness of the modified approach. Keywords: Modified Sumudu decomposition method; System of Fredholm integro-differential equations

Credit Risk Management Techniques Used by the Banks of Southern Punjab for the Management of Highly Correlated and Localized Risks in Agricultural Finance

Purpose: Agricultural is an important sector in economy of Pakistan.  Agriculture plays significant role in economic development of Pakistan.  Its contribution to GDP is about 23% and approximately 60% of our total population lives in the rural areas and most of them earn their livelihood from agriculture.  Due to green revolution rapid changes have been occurred in production technologies and methods have been changed.  Too much capital is required to adopt these methods and technologies but small formers cannot afford them.  They need finance for production and investment purpose.  The small former has very limited ability to agricultural finance for both production and investment needs and they are facing shortfall of credit. Banks hesitate to award agriculture credit because of higher credit risk.  The main purpose of this research paper is to find out the credit risk that faced by the banks of Southern Punjab Pakistan and risk management techniques used by the banks of Southern Punjab Pakistan. Methodology: In this research paper quantitative study on credit risk faced and its management techniques used by the bank of Southern Punjab is being made.  Standard questionnaire is used for the collection of data on credit risk and its management techniques from the banks.  A sample of 45 banks branches from 17 banks that award agriculture credit was taken from two districts (Bahawalpur and Rahim Yar Khan).SPSS software is being used for the analysis purpose.  The Frequency distribution was used for analysis. Finding: The findings of this research article are that 82.2% of banks have faced the situation of credit risk in which farmers failed to pay back the credit to bank.  53.3% respondent considered the production, price and policy risk together affect all the farmers in a particular geographical area. 35% considered willfully rejection risk as important risk that arises due to individual farmer.  Sixty percent respondents use the crop insurance for the management of production risk. 48.9% bank used no technique for the management of price risk. 75.6% respondent’s views that improvement in laws and policies on land ownership will help in credit risk management.  Sixty percent respondent does not insure the life of farmer.  77.8% use collateral management for the management of willfully rejection risk.  According to 75.6% respondent fire/theft insurance of agricultural asset will help to manage this risk. Value: The value of this research paper is that it gives us idea about the credit risk faced and it management techniques used by the banks of Southern Punjab Pakistan.  It also gives us idea about the credit risk management techniques which are being used in the world but not in the Southern Punjab. Research Implications: The research implications of this paper are to increase the understanding of factors which are basis for credit risk in agriculture finance and its management techniques used by the banks of Southern Punjab. . Paper Type: Research Paper Keywords: agricultural Finance, credit risk, credit risk management techniques in agricultural finance, crop insurance, highly correlated risk, localized risk, price smoothing

Credit Risk Management Practices Used by Banks in Agricultural Finance: A Case Study of Pakistan

Purpose: Agricultural sector is an important sector of Pakistan’s economy. Agriculture plays a significant role in the economic development of Pakistan.  Its contribution to GDP is about 23% and approximately 60% of Pakistan’s total population live in the rural areas and most of them earn their livelihood from agriculture.  Due to the green revolution, rapid changes have been occurring  in production technologies, and methods have been changed.  As more capital is required to adopt these methods and technologies, so the small farmers cannot afford these methods. They need finances for production and investment purpose.  The small farmer has very limited ability to agricultural finance for both production and investment needs and they are facing a shortfall of credit. Banks hesitate to grant agriculture credit because of higher credit risk.  The main purpose of this research paper is to find out the credit risk faced by the banks of Pakistan and risk management techniques used by these banks. Research methodology: This research is basically quantitative in nature, and a Standard questionnaire is used for the collection of data on credit risk and its management techniques from the banks.  A sample of 45 bank branches of 17 banks that grant agriculture credit has been taken and questionnaire were being filled by credit officers of the agricultural sections of these banks. The Frequency distribution technique was applied through SPSS 17 to analyze and finalize the results. Findings: The major findings of this research are: 82.2% of banks had faced the situation of credit risk in which farmers failed to pay back the credit to the bank.  53.3% respondents considered the production, price and policy risk together affect all the farmers in a particular geographical area. 35% considered ‘’willful rejection risk” as an important risk that arises due to an individual farmer. 60% respondents use the crop insurance for the management of production risk. 48.9% bank used no technique for the management of price risk. 75.6% respondents suggest that the improvement in laws and policies on land ownership will help in credit risk management.  60% respondent does not insure the life of a farmer.  77.8% use collateral management for the management of “willful rejection risk”.  According to 75.6% respondent’s fire/theft insurance of agricultural asset will help to manage this risk. Originality /Value: The value of this research paper is that it gives us an idea about the credit risk faced and its management techniques used by the banks of Pakistan.  It also gives us an idea about the credit risk management techniques which are being used in the world but not in the Pakistan. Research Implications: The research implications of this paper are to increase the understanding of factors which are the basis for credit risk in agricultural financing and its management techniques used by the banks of Pakistan. Paper Type: Research Paper Keywords: agricultural finance, credit risk, Risk management practices, crop insurance, highly correlated risk, localized risk, price smoothing

TO KNOW THE EFFICACY OF THYROIDECTOMY FOR THE MANAGEMENT OF MULTINODULAR GOITER

Objective: To evaluate the thyroid surgery results of multinodular goiter and compare total and subtotal thyroidectomy operations. Study Design: A Prospective Study. Place and duration: In the Surgical Unit I in collaboration with Head and Neck Surgery department of Services Hospital Lahore for six months duration from August 2018 to January 2019. Methods: Sixty multinodular goiter patients were included in the study. Into 2 groups, patients were divided. In 1st group subtotal thyroidectomy was done and total thyroidectomy done in other group. Data was analyzed and recorded in terms of demographic data, hospital stay, type of surgery and postoperative complications. Results: There was no vast variation between these two groups in terms of age, gender, hormonal status or goiter duration (P = 0.73, P = 0.64, P = 0.73 and P = 0.59, respectively). In both groups, the important manifestation for surgery was sudden increase in compression symptoms and size of goiter. The mean hospital stay and duration of surgery in cases of subtotal thyroidectomy was short, but there was no statistically significant variation (P> 0.06). The frequency of postoperative transient hypocalcemia was higher significantly in total thyroidectomy (P = 0.004). Although, postoperative hypocalcemia was not significantly permanent between 2 groups. Conclusion: In total thyroidectomy, permanent complications incidence is not more than subtotal thyroidectomy. Therefore, if for the first time total thyroidectomy is done for multinodular goiter, the possibility of disease recurrence can be decreased and the operation can be avoided for the second time. Key words: Subtotal thyroidectomy, total thyroidectomy goiter

A Trainee’s Approach for Effective Operating Room Learning

Introduction: Surgical training has gone through a paradigm shift in recent years. The trends have shifted from an apprenticeship model to a new era of self-teaching and an attitude-driven learning. In this study, we aim to comprehensively investigate the knowledge and attitude pertaining to the perception of preparation required for the operating room and how the residents prepare themselves for it. Method: A quantitative study was conducted via predefined questionnaire. Surgical residents at a single tertiary care institution were asked to complete the survey via Google forms that was distributed by means of email to residents of the general surgery department. Inclusion and exclusion criteria were defined. Results: Forty surgical residents opted to participate in the survey. The majority of the residents had a similar perception of operating room preparation. The most prominent theme that emerged following the discussion was that the residents learned through trial and error, and advice solicited from co-residents, which in the majority of the cases, were senior level resident. The resources defined by the residents were similar among majority and factors that affected their preparation were variable. An important aspect highlighted through the discussion was that the level of postgraduate training affected the preparation done by residents in order to better perform in operation theatres. Conclusion: Knowledge and attitude regarding operating room preparation was quite similar among the surgical residents. They varied in their practice for preparation

A novel binary chaotic genetic algorithm for feature selection and its utility in affective computing and healthcare

© 2020, Springer-Verlag London Ltd., part of Springer Nature. Genetic algorithm (GA) is a nature-inspired algorithm to produce best possible solution by selecting the fittest individual from a pool of possible solutions. Like most of the optimization techniques, the GA can also stuck in the local optima, producing a suboptimal solution. This work presents a novel metaheuristic optimizer named as the binary chaotic genetic algorithm (BCGA) to improve the GA performance. The chaotic maps are applied to the initial population, and the reproduction operations follow. To demonstrate its utility, the proposed BCGA is applied to a feature selection task from an affective database, namely AMIGOS (A Dataset for Affect, Personality and Mood Research on Individuals and Groups) and two healthcare datasets having large feature space. Performance of the BCGA is compared with the traditional GA and two state-of-the-art feature selection methods. The comparison is made based on classification accuracy and the number of selected features. Experimental results suggest promising capability of BCGA to find the optimal subset of features that achieves better fitness values. The obtained results also suggest that the chaotic maps, especially sinusoidal chaotic map, perform better as compared to other maps in enhancing the performance of raw GA. The proposed approach obtains, on average, a fitness value twice as better than the one achieved through the raw GA in the identification of the seven classes of emotions

Prevalence of anxiety and depression among medical students of shifa college of medicine

To yield information regarding the prevalence of anxiety and depression among medical students in Islamabad and to emphasize on the need of psychological and mental well being of medical students.Methods: This is a cross-sectional study done at Shifa College of Medicine. A questionnaire was administered to 361 students who were present at the time of distribution and were consented. The instrument used to assess anxiety and depression level was the Aga khan University Anxiety and Depression Scale (AKUADS). The data collected was tabulated and analyzed using SPS v. 16.Results: Out of a total of 500 students in a five year MBBS program at Shifa College of Medicine, 402 students were present at the time of the survey out of which, 361 students agreed to participate. The response rate was 89.8%. According to the AKUADS, 39.6% of students were found to have anxiety and depression. Among them, 28.1 % were males and 49.5% were females. Hence, anxiety and depression was more prevalent among females. First year medical students were found to have more anxiety and depression (52.6%) as compared to the rest.Conclusion: Anxiety and Depression is widely seen among medical students. This study highlights the graveness of the situation, and the need for trained psychiatrists to deal with this enormous disease burden. There is a further need to explore the factors that influence anxiety and depression among medical students and its impact on students’ academic performance

Extended ICA and M-CSP with BiLSTM towards improved classification of EEG signals

Mental stress is an issue that creates functional limitations in the workplace. Chronic stress leads to a number of psychophysiological sicknesses. For instance, it raises the risk of depression, heart attack, and stroke. According to the most recent findings in neuroscience, the human brain is the primary focus of mental stress. Perception of biological motion in the human brain determines the risky and stressful situations. Neural signaling of the human brain is used as an objective measure for determining the stress level of a subject. The oscillations of electroencephalography (EEG) signals are utilized for classifying human stress. EEG signals have a higher temporal resolution and are rapidly distorted with unwanted noise, resulting in a variety of artifacts. This study utilizes Extended Independent Component Analysis based approach for artifacts removal. A Multiclass Common Spatial Pattern-based moving window technique is proposed here to obtain the most distinguishable time segment of EEG trials. BiLSTM is used to improve classification results. In order to validate the model performance, two publically available datasets (i.e., DEAP and SEED) are utilized. Employing these datasets, the proposed model achieves state-of-the-art results (93.1, 96.84%) for EEG signal classification to identify stress

Case Report: Candida dubliniensis as a Cause of Chronic Meningitis

Background: Candida dubliniensis is closely related to Candida albicans and rarely isolated in clinical specimens. C. dubliniensis is increasingly recognized as a pathogen in immunocompromised hosts. We present the third known case of Candida dubliniensis meningitis in a young immunocompetent host. Case Presentation: A 27-year-old female with a history of intravenous heroin use and chronic hepatitis C presented with a 10-month history of headaches and progressive bilateral vision loss. On physical examination, visual acuity was 20/20 in her right eye and grade II papilledema was noted. Examination of her left eye revealed complete loss of vision and grade IV papilledema. An MRI with and without contrast revealed increased leptomeningeal enhancement involving the posterior fossa and spinal cord. After multiple lumbar punctures, cerebrospinal fluid fungal cultures grew Candida dubliniensis. The patient was successfully treated with a combination of liposomal amphotericin and fluconazole for 6 weeks with complete resolution of her CNS symptoms, with the exception of irreversible vision loss. Conclusion: We report a case of chronic meningitis due to Candida dubliniensis in an immunocompetent woman with hepatitis C and a history of intravenous heroin use. Additional studies are needed to confirm risk factors for Candida dubliniensis colonization, which likely predisposes individuals to invasive candidiasis