Fixation of bilateral pelvic osteotomies with external fixator in exstrophy bladder complex

Abstract OBJECTIVE: To present the early results of pelvic osteotomies performed for repair of exstrophy bladder. METHODS: Five cases of exstrophy bladder were treated with closure following bilateral iliac osteotomies. Three patients underwent closure of pubic symphysis diastasis by use of external fixator, one by screws and cerclage wires, and one by use of K-wires and suture. The patients were followed up by the pediatric urologist and orthopedic surgeon. RESULTS: All patients achieved a closure of diastasis and a tension free repair after the index surgery. The average follow-up was 3.6 years with range of 4 months to 6 years. All osteotomies healed within two months and had closure of the diastasis, except one which had a partial failure with loss of 50% correction. No patient had any wound dehiscence or breakdown of the bladder repair. Preoperative mean diastasis of symphysis pubis was 6 cm (range; 4.5 cm to 7 cm) and post operative mean diastasis was 3.5 cm with the range of 2.5 cm to 4 cm at 12 months follow up. All patients achieved urinary continence post operatively and were passing urine per-urethra with satisfactory urinary control as followed-up with the pediatric urologists. CONCLUSION: Bilateral iliac osteotomies and use of external fixator in our series was found to be helpful in achieving a tension free closure and preventing dehiscence of the repair

Learning from Growth-Oriented Women Entrepreneurs: A Study of Women Entrepreneurs of Karachi

Purpose: Women contribute to economic growth. Changing global sociocultural conditions have increased interest in women's entrepreneurship research. Despite this trend, women entrepreneurs are still misunderstood, and the literature portrays them and their ventures as disadvantaged. This study presents a change in the methodology of studying women entrepreneurs by using a phenomenological research design and portraiture study on three growth-oriented women entrepreneurs. The paper describes how growth-oriented women entrepreneurs improved their knowledge, skills, and abilities and used growth enablers to start and grow their businesses. Methodology: This qualitative phenomenological study explains growth-oriented women entrepreneurs in Karachi. Karachi and women's offices were researched. In this study, women entrepreneurs met these criteria: (1) These Karachi businesswomen started their business from scratch; (2) They had been in business for at least three years to measure growth; and (4) They were willing to participate in interviews, observations, and artefacts gathering. Findings: The results of the study were summarized in five themes: (1) Women’s Entrepreneurial Experience; (2) Women’s Perception of Entrepreneurial Characteristics; (3) Women’s entrepreneurial learning; (4) Women’s entrepreneurial reflections on gender; (5) Women’s Entrepreneurial Self as Knower. Conclusion: The study's findings can be used to develop a model for aspiring or struggling women entrepreneurs. Future research and policy implications are also discussed

Old disease, new targets. Part-II, haematological malignancies

In last two decades newer therapies in cancer treatment have emerged and have opened new horizons. New term of targeted therapy has emerged and for certain malignancies the paradigm has really changed after the introduction of these agents. We have learnt and have seen the outcome of some diseases after the addition of these monoclonal antibodies (MoABs) and tyrosine kinase inhibitors (TKIs). Rituximab a MoAB against CD-20 has really paved its role in the treatment of B-cell lymphomas and become the sort of standard therapy. The TKIs are newer agents available in a pill form and have inhibited many pathways at cellular level which are necessary for cancer development. Imatinib has really changed the prognosis and outcome of chronic myeloid leukemia (CML) remarkably. For those patients who develope intolerance to imatinib or their disease became resistant to the imatinib the newer agents like dasatinib and nilotinib are second line options. The major edge of these newer agents is more potency with low side-effect profile. The major concern remains the cost

Frequency and outcome of graft versus host disease after stem cell transplantation: A Six-Year Experience from a Tertiary Care Center in Pakistan

Objective: The objective of this study was to evaluate the frequency and outcome of graft versus host disease after stem cell transplantation for various haematological disorders in Pakistan. Materials and Methods. Pretransplant workup of the patient and donor was performed. Mobilization was done with G-CSF 300 mu g twice daily for five day. Standard GvHD prophylaxis was done with methotrexate 15mg/m(2) on day +1 followed by 10mg/m(2) on days +3 and +6 and cyclosporine. Grading was done according to the Glucksberg classification. Results. A total of 153 transplants were done from April 2004 to December 2011. Out of these were allogeneic transplants. There were females and males. The overall frequency of any degree of graft versus host disease was 34%. Acute GvHD was present in patients while had chronic GvHD. Grade II GvHD was present in patients while grade III and IV GvHD was seen in patients each. Acute myeloid leukemia and chronic myeloid leukemia were most commonly associated with GvHD. The mortality in acute and chronic GvHD was 8.8% and 12% respectively. Conclusion. The frequency of graft versus host disease in this study was 34% which is lower compared to international literature. The decreased incidence can be attributed to reduced diversity of histocompatibility antigens in our population

Factors Promoting Foreign Aid Dependence in South Asian Countries

This study used panel data approach to investigate comprehensive set of determinant of foreign aid and extent to which these determinants, domestic saving, capital formation, human capital, government expenditure, military expenditure and trade deficit, can affect foreign aid dependence in south Asian countries like Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan, and SriLanka. This study used Error correction model to estimate the short run association between defined variables. The results indicate that capital formation, ,trade deficit, government budget deficit and military expenditure have positive and significant association with foreign aid in the long run while these determinant have positive but insignificant relationship with foreign aid in the short run except gross domestic capital formation (GDCF). However, domestic savings, human capital formation has negative and significant relationship with foreign aid in long run. The findings of the study help foreign aid policy makers, analysts, researchers and official donor agencie

Learning from Growth-Oriented Women Entrepreneurs: A Study of Women Entrepreneurs of Karachi

Purpose: Women contribute to economic growth. Changing global sociocultural conditions have increased interest in women's entrepreneurship research. Despite this trend, women entrepreneurs are still misunderstood, and the literature portrays them and their ventures as disadvantaged. This study presents a change in the methodology of studying women entrepreneurs by using a phenomenological research design and portraiture study on three growth-oriented women entrepreneurs. The paper describes how growth-oriented women entrepreneurs improved their knowledge, skills, and abilities and used growth enablers to start and grow their businesses. Methodology: This qualitative phenomenological study explains growth-oriented women entrepreneurs in Karachi. Karachi and women's offices were researched. In this study, women entrepreneurs met these criteria: (1) These Karachi businesswomen started their business from scratch; (2) They had been in business for at least three years to measure growth; and (4) They were willing to participate in interviews, observations, and artefacts gathering. Findings: The results of the study were summarized in five themes: (1) Women’s Entrepreneurial Experience; (2) Women’s Perception of Entrepreneurial Characteristics; (3) Women’s entrepreneurial learning; (4) Women’s entrepreneurial reflections on gender; (5) Women’s Entrepreneurial Self as Knower. Conclusion: The study's findings can be used to develop a model for aspiring or struggling women entrepreneurs. Future research and policy implications are also discussed

Changing Demographics and Economic Growth: A Case Study of Pakistan

The objective of this study is to determine the relationship between various demographic variables and economic growth of Pakistan for the period of 1980-2012. Time series econometric technique has been used for the analysis. Johansen’s co-integration test showed presence of long run relationship between different demographic variables. After establishing the presence of error correction term in the model, variance decomposition test has been used to identify the individual shocks between the variables. The study concludes that the demographic transition has very important role in the economic growth of Pakistan

Remote health monitoring systems for elderly people: a survey

This paper addresses the growing demand for healthcare systems, particularly among the elderly population. The need for these systems arises from the desire to enable patients and seniors to live independently in their homes without relying heavily on their families or caretakers. To achieve substantial improvements in healthcare, it is essential to ensure the continuous development and availability of information technologies tailored explicitly for patients and elderly individuals. The primary objective of this study is to comprehensively review the latest remote health monitoring systems, with a specific focus on those designed for older adults. To facilitate a comprehensive understanding, we categorize these remote monitoring systems and provide an overview of their general architectures. Additionally, we emphasize the standards utilized in their development and highlight the challenges encountered throughout the developmental processes. Moreover, this paper identifies several potential areas for future research, which promise further advancements in remote health monitoring systems. Addressing these research gaps can drive progress and innovation, ultimately enhancing the quality of healthcare services available to elderly individuals. This, in turn, empowers them to lead more independent and fulfilling lives while enjoying the comforts and familiarity of their own homes. By acknowledging the importance of healthcare systems for the elderly and recognizing the role of information technologies, we can address the evolving needs of this population. Through ongoing research and development, we can continue to enhance remote health monitoring systems, ensuring they remain effective, efficient, and responsive to the unique requirements of elderly individuals

Outcome of match related allogeneic stem cell transplantation procedures performed from 2004 till 2011

We present our initial experience of allogeneic stem cell transplant procedure performed between April 2004 and August 2011 for various haematological disorders. All patients with non-malignant and malignant haematological disorders with HLA matched donors were selected after pre-transplant workup. Ninety seven patients underwent the procedure. Most common indications for transplant were aplastic anaemia in n=34 (35%), followed by beta-Thalassemia major in n=21 (21.6%) and chronic myeloid leukemia in n=11 patients (11.3%). Primary graft failure present was present in 2.06%. Incidence of graft versus host disease (GvHD) in our patients was 34%. After median follow-up of five years the overall survival was 71.3% with a mean survival time of 51.2±3.3months

3-[Hy­droxy(3-meth­oxy­phen­yl)methyl­idene]-2-(2-oxo-2-phenyl­eth­yl)-3,4-dihydro-2H-1λ6,2-benzothia­zine-1,1,4-trione

In the title mol­ecule, C24H19NO6S, the heterocyclic thia­zine ring adopts a half-chair conformation with the S and N atoms displaced by 0.180 (5) and 0.497 (5) Å, respectively, on opposite sides of the mean plane formed by the remaining ring atoms. The benzene rings of the benzothia­zine unit and the meth­oxy­phenyl group are almost coplanar, with the dihedral angle between the mean planes of these rings being 5.9 (2)°, while the benzene ring of the 2-oxo-2-phenyl­ethyl group is inclined at 79.68 (11) and 81.01 (10)°, respectively, to these rings. The mol­ecular structure is consolidated by intra­molecular O—H⋯O and C—H⋯N inter­actions, and the crystal packing is stabilized by weak C—H⋯O hydrogen bonds