Smart Phones and Personal Listening Devices - Tinnitus & Hearing Impairment in Adolescent and Young Adult Earphone Users

OBJECTIVES To determine the frequency of tinnitus & hearing impairment in adolescent and young adult earphone users with smartphones and other personal listening devices.METHODOLOGY This prospective & descriptive study involving children with glue ears was conducted in the ENT Department of Medical Teaching Institute, Hayatabad Medical Complex, Peshawar, from Jan 1, 2022, to Sep 30, 2022. Personal listening device (PLD) users aged 12-25 years with complaints of tinnitus and hearing impairment were examined. Conductive hearing loss was excluded by audiological testing. The frequency of resultant hearing loss and tinnitus was calculated. The information obtained was analyzed using SPSS v 26.0 for windows. A Chi square test was performed to determine the significance of tinnitus & hearing impairment in earphones and other PLD users.RESULTS A total of 163 patients were included in the study. The patient’s age range was 12-25 years, with a mean age of 18.03 years and a standard deviation of ± 3.575. There were 117 males and 46 females. The male: female ratio was of 2.54:1.Tinnitus was present in 73% and Hearing impairment in 54.4% of the patients. The chi-square test and p-values determined showed that both tinnitus and hearing loss occurred in many patients using personal listening devices.CONCLUSION Tinnitus and hearing impairment occurs in a significant number of those who use personal listening devices. Their inappropriate use can lead to auditory system damage. It is recommended that PLD users undergo periodic audiological testing to detect early hearing loss and tinnitus to minimize damage to the ear

The Accuracy of Pre-Operative Ultrasonography in Localizing Parathyroid Adenoma for Minimally Invasive Parathyroidectomy (MIP)

OBJECTIVES To determine the sensitivity of pre-op ultrasonography in localizing parathyroid adenoma for minimally invasive parathyroidectomy (MIP) technique. METHODOLOGY The study was conducted at the department of ENT and Head & Neck Surgery, MTI Hayatabad Medical Complex Peshawar. It included a retrospective analysis of records of patients who underwent MIP from Jan 1, 2019, to July 31, 2022.  All patients had pre-operative meta-iodobenzylguanidine (MIBG) scans, and serum PTH, Serum calcium levels were determined. A pre-op ultrasound scan was acquired to mark the site of the parathyroid adenoma. MIP was carried out using a 3.5 to 4 cm transverse skin incision over the marked site to expose the thyroid gland. If the marked parathyroid gland was identified without using any other aids, the result was labelled as "True positive". The sensitivity of pre-op ultrasonography was calculated using SPSS v 26.0. RESULTS A total of 53 cases were included in the study. The male: female ratio was 1:1.8. The ages of patients ranged from 23-70 years with a mean age of 48.49 years with a standard deviation of +_ 10.818. Pre-op ultrasonography accurately localizes the site of parathyroid adenoma in 49 patients. Statistical analysis showed this to be a significant finding. CONCLUSION Pre-op ultrasonography is significantly helpful in localizing the parathyroid adenoma. Therefore its routine use is recommended to help localize the adenoma in minimally invasive parathyroidectomy

The International Natural Product Sciences Taskforce (INPST) and the power of Twitter networking exemplified through #INPST hashtag analysis

Background: The development of digital technologies and the evolution of open innovation approaches have enabled the creation of diverse virtual organizations and enterprises coordinating their activities primarily online. The open innovation platform titled "International Natural Product Sciences Taskforce" (INPST) was established in 2018, to bring together in collaborative environment individuals and organizations interested in natural product scientific research, and to empower their interactions by using digital communication tools. Methods: In this work, we present a general overview of INPST activities and showcase the specific use of Twitter as a powerful networking tool that was used to host a one-week "2021 INPST Twitter Networking Event" (spanning from 31st May 2021 to 6th June 2021) based on the application of the Twitter hashtag #INPST. Results and Conclusion: The use of this hashtag during the networking event period was analyzed with Symplur Signals (https://www.symplur.com/), revealing a total of 6,036 tweets, shared by 686 users, which generated a total of 65,004,773 impressions (views of the respective tweets). This networking event's achieved high visibility and participation rate showcases a convincing example of how this social media platform can be used as a highly effective tool to host virtual Twitter-based international biomedical research events

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Gamma-gamma directional correlations in the decay of ir

Ph.D.L. D. Wyly, Jr., C. H. Braden, and E. T. Patronis, Jr

Study the Effect of Animal Manure, Nitrogen and Phosphorus on Growth, Yield and Yield Components Traits of Mungbean

The field experiment was conducted to assess the effect of different fertilizers sources such as animal manure (AM), Nitrogen (N) and Phosphorus (P) fertilizers on growth, yield and yield components of Mungbean (Vigna radiate L.) during 2019 The applied levels of mentioned sources were (0, 30 ton ha­1), (0, 25 &amp; 50 N kg ha-1) and 0, 50 &amp; 70 P kg­ ha­-1) respectively. The experiment was laid out at the research farm of, Badghis University in factorial split-plot design (SPD) with 3 replications. Each replication consisted of (18) plots with (2m x 2m) size. Animal manure was applied to the main plots while, N and P fertilizers were applied to the subplots of the experiment. The results revealed that, animal manure significantly affected all characteristics of Mungbean except total dry matter, yield, and harvest index.&nbsp;The Interactive effect of nitrogen and phosphorus fertilizers was found significant for all characteristics of Mungbean, while the interactive effect of AM x N and AM x P was found non-significant for recorded parameters

Isolation of Antidiabetic Principle from Bougainvillea spectabilis Willd (Nyctaginaceae) Stem Bark

Purpose: To isolate and identify the constituents of Bougainvillea spectabilis Willd (Nyctaginaceae) stem bark. Methods: The methanol extract of Bougainvillea spectabilis stem bark powder was suspended in water and extracted with dichloromethane (CH2Cl2), ethyl acetate (EtOAc), and butanol (BuOH) successively. The ethyl acetate fraction was loaded in a column packed with silica gel and eluted with a gradient of chloroform (CHCl3): methanol (MeOH), and water yielded five fractions (A - E). Chemical constituents were isolated by repeated column chromatography of these fractions. Results: Column chromatography of fractions B and C afforded four compounds identified as pinitol, β-sitosterol, quercetin and quercetin-3-O-α-L-rhamnopyranoside. For the first time, pinitol, β-sitosterol, quercetin and quercetin-3-O-α-L-rhamnopyranoside were isolated from the stem bark of B. spectabilis Willd. Conclusion: An antidiabetic principle, pinitol, was successfully isolated from the stem bark of B. spectabilis Willd

Impact of Size and Risk Management on Economic Performance of Multinational Corporations

Abstract Keywords: Multinationals, economic performance, risk management ability, returns on assets, return on equity, return on investment, and size of an organization

Exploring Influencing Factors in the Utilization and Integration of Evidence-Based Practice in Nursing

Abstract Background: Evidence-based practice (EBP) is the foundation for providing high-quality, patient-centered care. Objective: This study aims to explore influencing factors in the utilization and integration of evidence-based practice in nursing. Methodology: This research adopted a cross-sectional, descriptive study design to investigate utilizing and integrating EBP in nursing at a tertiary care hospital in Karachi from June to August 2023. A total of 100 participants were recruited through the convenient sampling technique. Result: The study reveals essential barriers nurses face when using research in their practice. Some struggle to access research materials (21%), find research lacks clear practical use (19%), and have difficulty understanding statistical analyses (24%). For others, research doesn't seem relevant (24%), and they may not even be aware of available research (25%). Limited facilities (23%) and time (26%) further hinder research use. Generalizability concerns (29%) and a perceived lack of authority (36%) to implement changes based on research are common. Uncertainty about the benefits (21%) and credibility issues also affect research adoption, along with variable support from colleagues, physicians, and administrators (26% to 30%). These findings highlight diverse challenges in integrating research into nursing practice, necessitating strategies to overcome these obstacles and promote evidence-based care. Conclusion: The study identifies vital obstacles nurses encounter when incorporating research into their practice, including limited access to materials, uncertainty about practical implications, challenges grasping statistical analyses, and doubts about credibility. Time constraints, organizational factors, and perceived personal benefits contribute to the hurdles. Improving access, offering training, nurturing an evidence-based culture, and creating supportive environments are vital to address these issues. Promoting mentorship and emphasizing research's value can channel the breach among research and nursing training, ultimately benefiting patient care and outcomes