Post- Operative Recovery Profile after Laparoscopic Cholecystectomy: Comparing Inhalational Versus Intravenous Anaesthetic Regimen

Background: To compare inhalational anaesthetic regimen with intravenous regimen with regard to post operative recovery after laparoscopic cholecystectomy Methods: In this comparative study 166 patients were selected by lottery and assigned into two groups. Induction was done with sevoflurane 8% in 50% nitrous oxide in oxygen (group-A) and propofol 2mg/kg (group-B).All patients had volume controlled ventilation and standard monitoring.Before shifting Fast Track criteria was used inside operating room and Post Anaesthesia Discharge score employed in recovery area. Spearman’s Rank correlation was used to check interdependence between the two recovery scores i.e.Fast-Track criteria and Post Anaesthesia Discharge score in both groups. Results: Fast track criteria and post op anaesthesia scores were equal in both groups.Inhalation induction(group-A) was slightly slower as compared to intravenous induction with propofol (group-B) but a higher incidence of un-expected movement/cough was noted during propofol induction as compared to sevoflurane. ASA physical status classes of both groups are identical. Though different anaesthesia techniques were used in both groups while standardizing anaesthetic maintenance factors and per-operative medications, no clinical superiority in recovery times was noted in ambulatory laparoscopic cholecystectomy. The value of correlation co-efficient(r) was .372 and .556 respectively in both groups and significant at 0.01 level

Impact of Entrepreneurship Education on Intention and Desire for Venture Creation: An Empirical Study of Entrepreneurs and Non Entrepreneur Graduates

Study Objectives: The scope of entrepreneurship education is increasing round the globe but in Pakistan, entrepreneurship education is being neglected because of unawareness of its paybacks. Realizing the significance of entrepreneurship education, this research aims at investigating the scope of entrepreneurial education in developing and designing creative ideas and implementing them innovatively. This research focuses on the impact of entrepreneurship education on intention and desire for venture creation among university students of Pakistan. The study describes the main effects found in the literature by explaining that how this education can contribute to develop, design new ideas and finally to implement them.Research Design/Methodology: This study uses positivism paradigm. A survey was conducted from 160 respondents from private and public sector educational institutes by using close ended questionnaires. For explanation, this study used a five point Likert scale questionnaire. The students, who have taken entrepreneurship education and who have not, were the respondent’s category to explain the results. Statistical Package of Social Sciences (SPSS) software was used to analyze the results. Results and analyses were derived by independent sample t-tests with the help of SPSS software to measure the significance and difference of two groups. Research Limitations: This study is focused only on the students studying in Lahore and Faisalabad with the sample size of 160 participants. The sample size is narrow which can hinder the generalization of results of study. The financial implication of new venture creation is missing which may change the effect of the study. Further studies can accommodate these limitations for more effective results.  Practical Implications: The study proposes that education has strong impact on venture creation. The candidates, who hold an entrepreneurship degree, grow exponentially by exploiting opportunity, situation and ability (O-S-A). Knowledge of venture creation and confidence to venture has more impact on the establishment and growth of the venture.Originality/Value: Literature recognizes that entrepreneurship education and research on its importance is minute. So, this study will suggest avant-garde techniques for graduates to start new ventures. The results of this study will help graduates to make the economy stronger and independent by adopting new businesses. This study will open gate for new researchers to invent more creative techniques.   Keywords: Entrepreneurship Education, Venture Creation, Overseas, Team Building, Trust, Intention and Desire

Synthesis, Characterization and Properties of In-Situ Generated Polyimide/Silica/Polyoxometalate Hybrids via Sol-Gel Method

In this research attempt, polyimide (PI) was prepared using 4-bromobenzene-1,3-diamine dihydrochloride and trimellitic anhydride chloride. The organic-inorganic nanocomposites were developed by means of TEOS and various content of polyoxometalate (POM). The silica network was synthesized in the polyimide matrix through in-situ sol-gel technique. FTIR was used to study the formation of polyimide and sol-gel nanocomposites. The physical properties of the in-situ prepared polyimide/silica/polyoxometalate nanocomposites were compared with those of neat polymer and polyimide/silica composite. Morphology study confirmed the homogeneous dispersion of silica phase in PI bulk phase with the formation of porous network structure. The glass transition temperature of the nanocomposites was in the range of 240-275 °C, i.e. higher than the neat matrix (156 °C). The melting peaks were also increased compared with the neat polyimide. Water uptake studies exhibited significant improvement in property for hybrids with higher POM content. In summary, PI/TEOS/POM 50 nanocomposite depicted improved thermal and water absorption properties along with the well-dispersed morphology

Some algebraic invariants of the edge ideals of some qq-fold bristled graphs

In this paper, we compute the exact values of regularity of the quotient rings of the edge ideals associated to multi triangular snake and multi triangular ouroboros snake graphs. Also we compute the exact values of depth, Stanley depth, regularity and projective dimension of the quotient rings of the edge ideals associated to $q$-fold bristled graphs of multi triangular snake and multi triangular ouroboros snake graphs.Comment: Pages 18, figures

Simpson grading as predictor of meningioma recurrence

Meningimas are one of the commonest primary brain tumours and the commonest extra-axial primary brain tumour. Despite better understanding of the molecular pathogenesis of the tumours, surgical excision remains the treatment of choice, and in a large proportion of cases, complete excision is curative. Simpson grading for the extent of resection of meningiomas, was introduced more than six decades ago, and has stood the test of time. With modern technological advancements, however, the relevance of Simpson grading has been questioned. Herein we review the recent literature on the relevance of Simpson grading more than sixty years after its introduction

Serum biomarkers for glioblastoma multiforme

A number of different serum biomarkers are currently being evaluated for their potential use as diagnostic and prognostic biomarkers in Glioblastoma Multiforme. Amongst these, a vast number of different microRNAs have been studied, that are up-regulated or downregulated in relation to Glioblastoma Multiforme. Different studies have found numerous associations of these different microRNAs with recurrence, Karnofsky Performance Score, Progression Free Survival and Overall Survival. Other than microRNAs, serum Glial Fibrillary Acid Protein, cytokines and YLK-40, as well as a number of other candidate serum biomarkers are being studied.More studies, with larger sample sizes are required before these serum biomarkers can be routinely, and reliably used in clinical practice. Use of serum biomarkers can provide a non-invasive means for diagnosing and monitoring disease

The Nostalgic Detective: Identity formation in Detective Fiction of Pakistan

Through an analysis of Ibn-e-Safi’s writings, this article explores the existence of a reflective nostalgia in Post-Colonial Pakistan. We propose that this nostalgia operated at three levels; firstly, it represented an approach that saw the geographical separation of India not as a complete socio-cultural break where the entire heritage of India had to be disowned in order to become an “authentic†Pakistani. Secondly, it was a yearning for the inclusive religiosity where religion was a matter of personal choice and not a state enforced enterprise. Finally, it represented an attitude towards Colonialism  which accepted modernity and rationality while keeping indigenous traditional values intact

Neuroimaging of Tuberculosis- Modalities, Imaging Protocols and Radiomics: A Review

Background and objective: A large number of review and research articles exists in literature which describe the radiological appearance of various manifestations of nervous system tuberculosis, however there is paucity of text which describes the application of each and every imaging modality in the workup of the entire spectrum of this pathology. The intent of this article is to review the existing literature on the role of different radiological modalities in the stepwise work up of CNS TB. The article focuses on the role of plain radiograph, fluoroscopy, computed tomography, magnetic resonance imaging along with its advanced sequences and nuclear medicine in imaging of the many faces of tuberculosis in CNS. The article also aims to review the existing literature on the role of MR based textural analysis (Radiomics) as a problem-solving tool in various nervous system pathologies. Methods: We searched PubMed central databases for articles published in English from January 1 2000 to February 28 2021 along with references from the relevant articles. The search terms included “imaging in central nervous system tuberculosis” “Radiomics in tuberculosis “, “Radomics in central nervous system ”. In total 95 articles including case reports, case series, original articles and review articles were included in this review. Results: Conventional imaging modalities including radiograph and fluoroscopy are becoming extinct in work up of tuberculosis in the nervous system itself, however a plain radiograph still holds a key position in screening the chest for presence of subclinical respiratory tract infection in patients presenting with brain tuberculosis. In addition, it is a sensitive tool as baseline investigation in workup of spinal tuberculosis (T.B). Fluoroscopy is a useful tool in image guided procedures for collection of samples for histopathology and CSF analysis. Cross sectional imaging modalities including computed tomography and magnetic resonance imaging have revolutionized imaging of central nervous system pathologies in particular tuberculosis. Computed tomography acts as a screening tool to identify the presence of intracranial tuberculosis and recognize its complications. In addition it is an important tool to determine the extent of spinal T.B. Magnetic Resonance Imaging (MRI) along with its advanced sequences including spectroscopy, Magnetization transfer T1 sequence (MT T1), perfusion imaging, and magnetic resonance angiography (MRA) and magnetic resonance venography (MRV) is an ideal imaging method to work up CNS TB. It can identify numerous manifestations of tuberculosis in the brain, work up its associated complication, and explain the extent of neurological symptoms. Moreover, it has the capability to differentiate TB from other nervous system infections. Furthermore, it can differentiate neoplastic and inflammatory brain disorders from CNS TB. Radiomics, particularly the textural features based on MR imaging is the future of neuroimaging. Its role is getting established in the work up of several intracranial pathologies including brain tumors and neurodegenerative disorders. Certainly, it has significant potential in the imaging work up of CNS tuberculosis, which is underexplored and therefore requires the central attention of upcoming researchers focusing on this topic. Conclusion: Cross sectional imaging is the mainstay of imaging workup. Nuclear imaging is becoming an essential adjuvant to determine the burden of the disease. Role of radiomics is evolving in intracranial pathologies and certainly needs the central attention of future researches to establish its role in CNS TB imaging

DERANGED SERUM LIPID LEVELS IN WOMEN WITH PREECLAMPSIA.

Background; Preeclampsia (PE), as a risky pregnancy, is a systemic disease characterized by hypertension, proteinuria and edema, which are thought to be the result of diffuse endothelial activation and dysfunction. About 5% of all pregnant women have PE during the second half of gestation that can cause maternal death throughout the world and is accompanied by substantial perinatal morbidity and mortality. Objective; To determine the frequency of dyslipidemia in women with preeclampsia at a tertiary care hospital.   Material and Methods; A total of 135 women with preeclampsia (Both primigravida and multigravida) aged 20 – 40 years were included in our study.  Patients with twin pregnancy, taking lipid lowering therapy were excluded from our study. Detailed history and physical examination was conducted. Five ml venous blood sample was drawn and sent to central pathology laboratory of Nishtar Hospital, Multan for serum lipid profile estimation. Data was analyzed by using SPSS Version 20. Results; Mean gestational age of our study cases was 33.24 ± 2.77 weeks. Mean age of our study cases was 29.61 ± 3.54 years. Family history was positive in 41 (30.4%) of our study cases. Diabetes was present in 25 (18.5 %) of our study cases. Mean parity was 2.59 ± 1.72 and 77 (57.0%) had parity up to 3. Mean body mass index of our study cases was 25.85 ± 2.54 kg/m2 and obesity was present in 31 (23.0 %) of our study cases. Of these 135 study cases, 104 (77.0 %) were illiterate while 31 (23.0%) were literate. Of these 135 study cases, dyslipidemia was present in 73 (54.1%). Mean Serum Cholesterol level was 223.45 ± 47.21 mg/dl and it was deranged in 71 (52.59 %), mean serum LDL level was 147.15 ± 31.25 mg/dl and it was deranged in 72 (53.33%), mean serum triglyceride level was 154.21 ± 15.29 mg/dl and it was deranged in 70 (51.85%) of our study cases and mean HDL level was 52.42±8.53 mg/dl while it was deranged in 14 (10.37%).   Conclusion; Very high frequency of dyslipidemia was noted in our study in pre-eclamptic women. Dyslipidemia was significantly associated with gestational age, parity and diabetes.  All the preeclamptic women should be screened for serum lipid levels and be managed accordingly to avoid future fetomaternal adverse outcomes. Keywords; Preeclampsia, dyslipidemia, Frequency. DOI: 10.7176/JMPB/52-0