Role of endovascular treatment in vascular injuries

OBJECTIVE: To evaluate retrospectively the results, complications and follow-up of patients after endovascular treatment of vascular injuries. METHODS: Fifty transcatheter embolisation procedures (TCE) were performed in 46 patients between 1999 and 2008 at the Aga Khan University Hospital, Karachi. Injuries in 14 (30.4%) patients were due to road traffic accident; iatrogenic in 13 (28%); accidental in 6 (13%). Firearms, bomb blasts and earthquake contributed to injuries in 8(17%), 4(8.8%) and 1(2.2%) patients respectively. All patients underwent angiography and had evidence of either active haemorrhage, pseudo-aneurysm, abnormal vascularity or arteriovenous fistula. Followup ranged from 1 day to 6 years with mean of 10.5 months. Medical record files, lab results and imaging reports were utilised for the study. Procedure was declared as technically successful when there was cessation of extravasation, occlusion of fistula or exclusion of pseudo-aneurysm in the post-embolisation angiograms. Treatment was deemed clinically successful if there was resolution of the indication for which the procedure was done. RESULTS: Transcatheter embolisation was technically successful in occluding vascular lesions in all 46 (100%) patients. Lesions recurred in 4 (9%) patients who underwent initially successful TCE. These patients were treated effectively with repeated TCE. Three patients died during the same hospital stay and 3 patients died after being discharged from the hospital. All these patients were treated successfully with TCE and had factors other then TCE contributing to their mortality. CONCLUSION: Transcatheter embolisation for vascular injuries was found to be a satisfactory procedure, with low morbidity and mortality rates

Investigating the Knowledge Sharing among students in Pakistan

This paper’s goal is to empirically examine the impact of trust, attitude, and ICT Use on knowledge sharing among degree students of universities in Vehari. Self-efficacy theory was used as an underpinning theory to test the suggested model. A sample size of 120 students was selected to collect the primary data through survey from respondents. Correlation and multiple regression analysis were performed to test the hypotheses drawn from this study. The findings show that trust, attitude and ICT Use are the key factors in order to boost knowledge sharing amongst students. The results show that ICT Use is highly significant and correlated predictor of knowledge sharing. The study also discussed implications, limitations and future research recommendation that can be helpful both universities and researchers for further study

Toxicity potential of heartwood extractives from two mulberry species against Heterotermes indicola

Choice and no-choice tests were run to evaluate natural resistance of the woods of two Morus species (Morus alba and Morus nigra) against the subterranean, by Heterotermes indicola under field conditions. Toxicity, antifeedant and repellency potential of the heartwood extractives was also investigated under laboratory conditions. Heartwood extractives were removed from wood shavings by using methanol or an ethanol: toluene (2:1) mixture. Results of choice and no-choice tests with sap and heartwood blocks exposed to termites, showed that both mulberry species were resistant to termites but in comparison. Morus alba wood was more resistant than Morus nigra to termite feeding as it showed <5 % weight loss after 90 days. Termites exhibited a concentration dependent mortality after exposure to either mulberry species’ heartwood extractives. The highest termite mortality occurred after termites were exposed to filter paper treated with Morus alba extractives at a concentration of 5%. . At this concentration, antifeedancy and repellency were calculated to be 91.67 and 84 %respectively. . Our results also showed that extractives from either mulberry species imparted resistance to vacuum-pressure treated non-durable Populus deltoides wood. Termite mortality was greater than 75 % after feeding on Populus deltoides wood treated with extractives from Morus alba. Solvent only (methanol) treated Populus deltoides controls, showed a minimum weight loss of 2.69 % after 28 days. These results suggest that Morus alba extractives have antitermitic properties and may be potentially useful in the development of environment friendly termiticides

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

Impact of emotional intelligence on teacher׳s performance in higher education institutions of Pakistan

This research paper aims at investigating the impact of emotional intelligence on teacher׳s job performance in the education sector of Pakistan. Sample size consists of 166 teachers from universities in the area of central Punjab, Pakistan. Theories of emotional intelligence proposed by Salovey and Mayer (1989â1990) were used as the conceptual framework and its relationship with the job performance of teachers was examined. Reliability and validity of variables was tested through measurement model of PLS-SEM. The result indicated that emotional intelligence has a significant impact on the teacher׳s job performance. Key research finding revealed that emotional self-awareness, self-confidence, achievement, developing others and conflict management have a positive and significant relationship with the teacher׳s job performance. Keywords: Emotional intelligence, Performance, Teachers, Pakista

Toxicity potential of heartwood extractives from two mulberry species against "Heterotermes indicola"

Choice and no-choice tests were run to evaluate natural resistance of the woods of two Morus species (Morus alba and Morus nigra) against the subterranean, by Heterotermes indicola under field conditions. Toxicity, antifeedant and repellency potential of the heartwood extractives was also investigated under laboratory conditions. Heartwood extractives were removed from wood shavings by using methanol or an ethanol: toluene (2:1) mixture. Results of choice and no-choice tests with sap and heartwood blocks exposed to termites, showed that both mulberry species were resistant to termites but in comparison. Morus alba wood was more resistant than Morus nigra to termite feeding as it showed <5 % weight loss after 90 days. Termites exhibited a concentration dependent mortality after exposure to either mulberry species’ heartwood extractives. The highest termite mortality occurred after termites were exposed to filter paper treated with Morus alba extractives at a concentration of 5%. . At this concentration, antifeedancy and repellency were calculated to be 91.67 and 84 %respectively. . Our results also showed that extractives from either mulberry species imparted resistance to vacuum-pressure treated non-durable Populus deltoides wood. Termite mortality was greater than 75 % after feeding on Populus deltoides wood treated with extractives from Morus alba. Solvent only (methanol) treated Populus deltoides controls, showed a minimum weight loss of 2.69 % after 28 days. These results suggest that Morus alba extractives have antitermitic properties and may be potentially useful in the development of environment friendly termiticides

The Effect of an Irradiation-Induced Recombination Suppressing Inversion on the Genetic Stability and Biological Quality of a White Eye-Based Aedes aegypti Genetic Sexing Strain

Aedes aegypti is the primary vector of diseases such as dengue, chikungunya, Zika fever, and yellow fever. The sterile insect technique (SIT) has been proposed as a species-specific and environment-friendly tool for the suppression of mosquito vector populations as a major component of integrated vector management strategies. As female mosquitoes are blood-feeders and may transmit pathogenic microorganisms, mosquito SIT depends on the release of sterile males. Genetic sexing strains (GSS) can be used for the efficient and robust separation of males from females. Two Ae. aegypti GSS were recently developed by exploiting eye colour mutations, resulting in the Red-eye GSS (RGSS) and the White-eye GSS (WGSS). In this study, we compared two WGSS, with and without the chromosomal inversion 35 (Inv35), and evaluated their biological quality, including genetic stability. Our results suggest that the WGSS/Inv35 presents a low recombination rate and long-term genetic stability when recombinants are removed from the colony (filtering) and a slow accumulation of recombinants when they are not removed from the colony (non-filtering). The two strains were similar with respect to fecundity, pupal and adult recovery rates, pupation curve, and pupal weight. However, differences were detected in fertility, survival rate of females, and flight ability of males. The WGSS/Inv35 presented lower fertility, higher survival rate of females, and better flight ability of males compared to the WGSS

IJCM_222A: Assessment of Implementation of Health and Wellness Centers in Kashmir Valley. A Descriptive Study

Background: Health and wellness canters component were launched under the ambit of Ayushman Bharat Yojana. In Kashmir, there was scarce data regarding health and wellness centers implementation therefore this study was undertaken to identify the gaps in implementation of the program at grassroot levels. Objective: to assess and compare the existing staff, services, lab services and infrastructure at health and wellness centers across ten districts of Kashmir valley. Methodology: a descriptive cross-sectional study was done to evaluate the implementation of health and wellness centers in ten districts of Kashmir valley. study population: staff at health and wellness centers study setting: selected health and wellness centers in 10 districts of Kashmir valley sampling: convenient sampling and random sampling 10 % of upgraded health and wellness center in each district at the beginning and 12 months of study. study timeline: 15months data collection 12 months interpretation 3 months study tools: preformed checklist, semi open questionnaires interviews Results: the results of the study indicated that there was still a gap in implementation of program as per guidelines. there were deficiencies in terms of yoga and wellness, proper space for health and wellness centers and staff was not trained properly about the program. Conclusion: this study was done in Kashmir valley to asess the implementation of health and wellness center component of Ayushman Bharat yojana. the study highlighted important deficiencies during the implementation of the program as per guidelines