Kautilya, the Indian Machiavelli; On War and diplomacy in Ancient India

In the contemporary times because of a little fluctuation in the global situation different variations have likewise occurred in act of diplomacy. Previously the emphasis was actually on hard power as a method of diplomatic preparation. However with establishment of the notion of soft power diplomatic practice became modernized in light of the fact that the idea of soft power gives a contrasting option to the discretionary emissaries to lead conciliatory practice without relating to candy and twig method. Despite India’s long history of reflection on interstate relations, Western assessments and theorizations continue to dominate the modern scholarship on India’s IR, with Indians mostly reacting to foreign assessments. This paper will elucidate various diplomatic views of Kautiya in the ancient India period that are still valuable for the Indian and world diplomacy. This paper will also try to shed light on Kautilya’s view on spies, agents and interstate relations

Open policy for wireless computers in classrooms: What makes it a good or a bad idea?

Increasingly, studies and media articles have been looking into possible adverse effects of open policies for using wireless ready computers in classrooms. Tablet PCs, as indicated by some of those authors, are under suspicion more than laptops because they make it harder for instructor to determine whether they are used productively or for off-the-task purposes. In this study students were invited to voluntarily bring their personal wireless computers to introductory physics classes in order to utilize them with DyKnow software. We compare performance of students who consistently used computers in classroom with those who did so less frequently or not at all. We also gauge how student attitudes and recommendations related to DyKnow software and Tablet PCs vary by the type of computer that was available to them in this course

Designing a Customer Retention Framework for Telecommunication Sector

Abstract: Telecommunication sector has grown over last decade while transforming behavioral intentions. New entrants are exploring these behavioral intentions to attract more customers. The aim of this study is to investigate the mediating effect of customer satisfaction in telecom industry on service quality, brand image and customer retention relationship. Furthermore, it identifies the key determinants of customer retention related to telecom service providers. A fully structured questionnaire survey was conducted to collect data from 310 mobile users. Non-probability sampling technique was adopted for data collection. Regression analysis and Sobel test technique were practiced to analyze the data. The result showed that customer satisfaction mediates the relationship between service quality, brand image and customer retention. Moreover, this study found that service quality, brand image and customer satisfaction are the strongest predictors of customer retention in telecom industry of Pakistan. Therefore, to gain customer loyalty, organizations should focus current-users and target-users by providing sterling service qualit

Thomas Hobbes’ views on Philosophy, State of Nature and International Relations

The state of nature of Hobbes is like a reflection of the depression of 1640s that prevailed in the United Kingdom. The basic concept that determines the state of nature is individuality. This phenomenon is the expression of individuality, the beginning of Renaissance but not of full competence, of expressing individuality, liberating oneself from doctrinal teachings and medieval conceptions. According to Hobbes, human beings are individuals who have the desire and choice to choose. The person's ability to use his will and preference determines his happiness or unhappiness. The emotions of feeling, fear, desire etc. which are the basic characteristics of human life, are not merely physical and factual phenomenon, but a moral phenomenon that becomes evident by loving, enjoying or disliking, desiring or avoiding oneself. For Hobbes, human life is competition and struggle. As a creature that thinks of the future, human beings are constantly struggling to secure their future ambitions. It is the basic survival condition of a person that wants to be sovereign. It is inevitable that people who are equal in terms of physical and mental force will fight everyone in natural condition. This paper tries to elucidate Thomas Hobbes’ understandings of the concepts of philosophy, state and state of nature. This article will further try to shed light on the Thomas Hobbes’s views on International Relations

SENTINEL LYMPH NODE SCINTIGRAPHY IN BREAST CARCINOMA- COMPARISON OF TWO VERSUS FOUR INJECTION SITE TECHNIQUE

Purpose: Sentinel lymph node (SLN) is the first regional node that drains lymph from the primary tumour and receives seeding of metastatic cells. Axillary node dissection remains the most reliable predictor of disease outcome. Controversies still exist about several aspects of lymphatic mapping and SLN biopsy for breast cancer, including number of radioisotope injection. The purpose of this study is to evaluate the success rate of different number of injection sites in the detection of SLN in breast cancer.Materials and Methods: A total of 120 consecutive breast cancer patients were divided into two groups. Group A (60 patients) received four intradermal periareolar (ID-PA) injections. Group B (60 patients) received two ID-PA injections.Imaging was carried out at 45 min post-injection. A gamma probe was used to explore the SLNs during surgery.Results: In Group A, 60 females with the mean age of 50.77 years were included in the study. 34 (56%) patients had single SLN. 25 (41.7%) had SLN with the second tier. 1 (1.7%) was negative. Group B included 60 patients (59 females and 1 male) with the mean age of 51.9 years. In 30 (50%) patients, single SLN was detected. 29 (48.3%) had SLN with the second tier. 1 (1.7%) was negative.Conclusion: SLN mapping with two periareolar ID injections carries less radiation dose and less pain as compared to the four injections with equal sensitivity for the visualization of SLNs.Key words: Breast cancer, intradermal injection, sentinel lymph node, Tc99 human serum albumi

Multiple mycotoxins in rice : occurrence and health risk assessment in children and adults of Punjab, Pakistan

Mycotoxin contamination in rice can create a health risk for the consumers. In this study, the measurement of 23 mycotoxins in rice samples (n = 180) was performed using a validated LC-MS/MS method. A food frequency questionnaire was used to get rice consumption data for the assessment of mycotoxin dietary exposure, before calculating the health risk in adults and children of north and south regions of the Pakistani Punjab province. The prevalence of aflatoxin B-1 (56%), aflatoxin B-2 (48%), nivalenol (28%), diacetoxyscirpenol (23%), fumonisin B-1 (42%), zearalenone (15%), HT-2 toxin (10%), deoxynivalenol (8%), and ochratoxin A (6%) was estimated in samples with a mean concentration range between 0.61 and 22.98 mu g/kg. Aflatoxin degradation by traditional Pakistani cooking recipes was evaluated and observed to be 41-63%. The dietary exposure to aflatoxins exceeded the tolerable daily intake at all levels, and ochratoxin A and zearalenone posed health risk at high contamination and high consumption levels. The margin of aflatoxin B-1 exposure ranged between 10 and 69 in adults and 10 and 62 in children. The mean cancer risk by aflatoxin B-1 exposure was 0.070 (adults) and 0.071 (children) cases/year/100,000 people in South Punjab population, and 0.122 (adults) and 0.127 (children) cases/year/100,000 people in North Punjab population. This study will provide new insights for the planning and management of mycotoxins in Pakistan

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

The global burden of adolescent and young adult cancer in 2019 : a systematic analysis for the Global Burden of Disease Study 2019

Background In estimating the global burden of cancer, adolescents and young adults with cancer are often overlooked, despite being a distinct subgroup with unique epidemiology, clinical care needs, and societal impact. Comprehensive estimates of the global cancer burden in adolescents and young adults (aged 15-39 years) are lacking. To address this gap, we analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, with a focus on the outcome of disability-adjusted life-years (DALYs), to inform global cancer control measures in adolescents and young adults. Methods Using the GBD 2019 methodology, international mortality data were collected from vital registration systems, verbal autopsies, and population-based cancer registry inputs modelled with mortality-to-incidence ratios (MIRs). Incidence was computed with mortality estimates and corresponding MIRs. Prevalence estimates were calculated using modelled survival and multiplied by disability weights to obtain years lived with disability (YLDs). Years of life lost (YLLs) were calculated as age-specific cancer deaths multiplied by the standard life expectancy at the age of death. The main outcome was DALYs (the sum of YLLs and YLDs). Estimates were presented globally and by Socio-demographic Index (SDI) quintiles (countries ranked and divided into five equal SDI groups), and all estimates were presented with corresponding 95% uncertainty intervals (UIs). For this analysis, we used the age range of 15-39 years to define adolescents and young adults. Findings There were 1.19 million (95% UI 1.11-1.28) incident cancer cases and 396 000 (370 000-425 000) deaths due to cancer among people aged 15-39 years worldwide in 2019. The highest age-standardised incidence rates occurred in high SDI (59.6 [54.5-65.7] per 100 000 person-years) and high-middle SDI countries (53.2 [48.8-57.9] per 100 000 person-years), while the highest age-standardised mortality rates were in low-middle SDI (14.2 [12.9-15.6] per 100 000 person-years) and middle SDI (13.6 [12.6-14.8] per 100 000 person-years) countries. In 2019, adolescent and young adult cancers contributed 23.5 million (21.9-25.2) DALYs to the global burden of disease, of which 2.7% (1.9-3.6) came from YLDs and 97.3% (96.4-98.1) from YLLs. Cancer was the fourth leading cause of death and tenth leading cause of DALYs in adolescents and young adults globally. Interpretation Adolescent and young adult cancers contributed substantially to the overall adolescent and young adult disease burden globally in 2019. These results provide new insights into the distribution and magnitude of the adolescent and young adult cancer burden around the world. With notable differences observed across SDI settings, these estimates can inform global and country-level cancer control efforts. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd.Peer reviewe