Areca nut chewing and the risk of re-hospitalization and mortality among patients with acute coronary syndrome in Pakistan

Objectives: Areca nut is widely consumed in many parts of the world, especially in South and Southeast Asia, where cardiovascular disease (CVD) is also a huge burden. Among the forms of CVD, acute coronary syndrome (ACS) is a major cause of mortality and morbidity. Research has shown areca nut chewing to be associated with diabetes, hypertension, oropharyngeal and esophageal cancers, and CVD, but little is known about mortality and re-hospitalization secondary to ACS among areca nut users and non-users. Methods: A prospective cohort was studied to quantify the effect of areca nut chewing on patients with newly diagnosed ACS by categorizing the study population into exposed and non-exposed groups according to baseline chewing status. Cox proportional hazards models were used to examine the associations of areca nut chewing with the risk of re-hospitalization and 30-day mortality secondary to ACS. Results: Of the 384 ACS patients, 49.5% (n=190) were areca users. During 1-month of follow-up, 20.3% (n=78) deaths and 25.1% (n=96) re-hospitalizations occurred. A higher risk of re-hospitalization was found (adjusted hazard ratio [aHR], 2.05; 95% confidence interval [CI], 1.29 to 3.27; p=0.002) in areca users than in non-users. Moreover, patients with severe disease were at a significantly higher risk of 30-day mortality (aHR, 2.77; 95% CI, 1.67 to 4.59; p<0.001) and re-hospitalization (aHR, 2.72; 95% CI, 1.73 to 4.26; p<0.001). Conclusions: The 30-day re-hospitalization rate among ACS patients was found to be significantly higher in areca users and individuals with severe disease. These findings suggest that screening for a history of areca nut chewing may help to identify patients at a high risk for re-hospitalization due to secondary events

Diagnosing Carpal Tunnel Syndrome by Ultrasound

Background Carpal tunnel syndrome (CTS) istraditionally diagnosed by clinical evaluation and nerveconduction studies (NCS). Ultrasound is now widely usedin the diagnosis of musculoskeletal disorders. Theobjective of this study was to compare the sonographicmeasurements of median nerve in patients of CTS withNCS results, taking NCS as gold standard and to evaluatethe diagnostic role of ultrasound so that it could be used inthe diagnosis of CTS.Methods: This cross sectional Analytical study wascarried out at Department of Radiology, CombinedMilitary Hospital Lahore over a period of one year from21st August 2006 to 20th August 2007. One hundred andtwenty wrists in sixty CTS patients were imaged by highresolution ultrasound. The cross sectional area of themedian nerve was measured at the level of pisiform bone.All patients had nerve conduction studies. The ultrasoundmeasurements of the median nerve cross sectional area andthe results of nerve conduction studies were compared andanalyzed.Results: The mean cross sectional area of the mediannerve at the level of pisifom was 13mm2 in CTS patients.When NCS results were taken as gold standard, theultrasound yielded a sensitivity of 94.7%, specificity of63.6% and diagnostic accuracy of 87.8%.Conclusion: High resolution ultrasound is quiteaccurate and it can be used reliably and cost effectively inthe diagnosis of CTS especially for screening of largepopulation of CTS patients

Tris-diamine-derived transition metal complexes of flurbiprofen as cholinesterase inhibitors

Purpose: To synthesize novel tris-diamine-derived transition metal  complexes of flurbiprofen M(C2H8N2)3 (fp)2 and M(C3H10N2)3 (fp)2, and to evaluate their acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) inhibitory activities.Method: Tris-diamine-derived transition metal complexes of Co(II),  Ni(II), and Mn(II) were synthesized and characterized using ultraviolet-visible (UV-Vis) spectroscopy, Fourier transform-infrared (FT-IR) spectroscopy, elemental analysis, magnetic susceptibility, conductivity  measurement and single crystal x-ray analysis. The synthesized  complexes were also evaluated for their AChE and BChE inhibitory activities.Results: Based on magnetic susceptibility and electronic studies, the synthesized complexes possessed distorted octahedral geometry.  Conductance measurements indicated that diamine-derived metal complexes of flurbiprofen were electrolytes, whereas, simple metal complexes of flurbiprofen were non-electrolytes. The structure of Ni (C2H8N2)3 (fp)2 was also confirmed by single crystal x-ray analysis. The synthesized metal complexes exhibited moderate-to-very good inhibition of AChE and BChE. In vitro assays revealed that Ni complexes were most active, with the least half-maximal inhibitory concentration (IC50) values against AChE and BChE, compared to Co and Mn  complexes. Furthermore, 1, 2-diaminoethane-derived complexes were more potent, with lower IC50 values against both AChE and BChE, compared to 1,3-diaminopropane-derived complexes. Among the complexes, 4a and 5a revealed significant cholinesterase inhibitory activities relative to the standard drug, galantamine.Conclusion: All the synthesized metal complexes are active against  AChE and BChE, but only 4a and 5a are more active than the standard drug, galantamine, indicating their potential for drug development.Keywords: Flurbiprofen, Cholinesterase, Diamines, Galantamine, Metal complexes, Cholinesterase inhibitio

Increasing Employee Organizational Commitment by Correlating Goal Setting, Employee Engagement and Optimism at Workplace

The aim of this study is to explore the link among important factors with effect organizational commitment. Secondly this study focuses to make a positive significant relation in setting of goals, engagement of employee and optimistic approach of behavior at work place environment in order to enhance organizational commitment level of employee. The data for that hypothesized model will be collected form individual belongs to from different organizations and research institutions. The results of this study will contribute new improved ways to achieve maximum level of organizational commitment from employees. This study will provide new insight for the field of performance management. Key words: Organizational commitment, Employee engagement, Work place optimism, Enhancing performance, Goal Settin

Statistical Analysis of Dispositional and Psychological Factors and their Association with Cardiovascular Diseases

This study aims to explore the effects of dispositional and psychological factors on cardiovascular diseases (CVD) such as personality type ‘A’ and type ‘B’, pessimism, optimism, anxiety, depression and stress in the cardiac patients. Overall 292 adult patients (132 males, and 160 females, 133 from private sector and 159 from public sector job holders) were approached in Chaudhry Pervaiz Elahi Institute of Cardiology Multan, Pakistan for survey and Pearson correlation also independent sample t-test was performed to test the objectives of the present study. The results indicate that all the variables are significantly correlated with each other as well as clearly signify the effect of gender and job sector on above-said variables.  The findings also reveal that the level of personality type “A”, pessimism, depression, anxiety and stress are higher in females and private job holders therefore more indispose to suffering with cardiovascular diseases, where as the level of personality type “B” and optimism are higher in male patients and public job sectors holders. Type ‘A’ personality is more prone to cardiovascular diseases (CVD), due to its patron of behavior. Moreover, type and nature of job and level of satisfaction also considered as vital as a type of personality in regarding cardiovascular diseases (CVD). Certainly, workplace and environment exert and impact either positive or negative upon the health of an individual

Statistical Analysis of Dispositional and Psychological Factors and their Association with Cardiovascular Diseases

This study aims to explore the effects of dispositional and psychological factors on cardiovascular diseases (CVD) such as personality type ‘A’ and type ‘B’, pessimism, optimism, anxiety, depression and stress in the cardiac patients. Overall 292 adult patients (132 males, and 160 females, 133 from private sector and 159 from public sector job holders) were approached in Chaudhry Pervaiz Elahi Institute of Cardiology Multan, Pakistan for survey and Pearson correlation also independent sample t-test was performed to test the objectives of the present study. The results indicate that all the variables are significantly correlated with each other as well as clearly signify the effect of gender and job sector on above-said variables.  The findings also reveal that the level of personality type “A”, pessimism, depression, anxiety and stress are higher in females and private job holders therefore more indispose to suffering with cardiovascular diseases, where as the level of personality type “B” and optimism are higher in male patients and public job sectors holders. Type ‘A’ personality is more prone to cardiovascular diseases (CVD), due to its patron of behavior. Moreover, type and nature of job and level of satisfaction also considered as vital as a type of personality in regarding cardiovascular diseases (CVD). Certainly, workplace and environment exert and impact either positive or negative upon the health of an individual

Corporate Governance and Corporate Financing Decisions Impact on Firm Performance a Cement Industry Perspective of Pakistan

This paper empirically examines the impact of corporate governance and corporate financing decisions on the performance of cement industry of Pakistan. Multiple regression analysis is used in estimating the impact of corporate governance and corporate financing decisions on firm performance measures such as return on assets (ROA), return on equity (ROE), earning per share (EPS) and net profit margin (NPM) by using sample of 19 cement industry listed in Karachi Stock Exchange (KSE) for the  period 2006-2016 and E-views technique used to apply the correlation and regression analysis. The data are collected from annual reports of cement industry of Pakistan. The results of this study indicate that firm with larger board size (BS) and managerial ownership (MO) leads higher return on assets (ROA). CEO duality (CD), firm size (FS), short term debt ratio (STDR) and debt equity ratio (DER) negatively influence the return on equity (ROE). Larger firm size, long term debt (LTD), dividend policy (DP) positively influence the earning per share (EPS) and net profit margin (NPM). In short these results indicate that corporate governance and corporate financing decision impact the performance of cement industry of Pakistan.The result of this study may be helpful for investors, financial management consultants, financial managers and overall management of the company to understand the effect of board size, CEO duality, managerial ownership, board meeting, firm size, capital structure, debt maturity structure and dividend policy on the performance of firms. This study add value to the literature by exploring the impact of corporate governance and corporate financing decisions and on the factors that have impact on firm performance

Future Time Perspective and Frustration Intolerance in Medical students

Background: The future perception of students is affected by a series of events happening throughout their course of studies. The objective of this study is to measure the Future time perspective (FTP) and Future intolerance (FI) among medical students during the COVID-19 lockdown.Materials and Methods: It was a descriptive cross-sectional study done from January 15, 2020 to July 20, 2020 among MBBS students of Rawalpindi Medical University. The questionnaire consisted of 1) Socio-demographic details, 2) Future Time Perspective scale, and 3) Frustration Discomfort scale. An online survey was done using Google Forms. An ANOVA was run to check for differences in FTP and FI between the classes. Bivariate analysis for continuous variables was applied. The data were analysed using the Statistical Package for Social Sciences (SPSS) v.23.0 (IBM, Armonk, US). Results: Mean age of participants was 21.8 (SD=1.66) with majority females 331(58.4%). The mean FTP score and mean FI scores were 50.8(SD=19.43) and 91.46(SD=17.65) respectively. Final-year students had the highest mean score (Mean=57.94(SD=7.72)) for FI. On the other hand, mean scores for FDS were highest in first-year students (Mean=102.89 (SD=13.52)) while lowest in fourth-year students (Mean=81.73(SD=17.49)) with P=.005. There was a significant difference in the dimensions of Emotional Intolerance and achievement among females and males. Bivariate analysis showed a significant negative correlation was found between FTP and the dimension of discomfort intolerance (r = -0.158, p < 0.001), while a significant positive correlation was found between FTP and the dimension of achievement (r = 0.225, p < 0.001). Conclusion: Our study concludes that final-year students have a much higher tolerance level for adversities. Furthermore, they also have a much more positive perspective and a clearer vision regarding their future

MicroRNA and cDNA-Microarray as Potential Targets against Abiotic Stress Response in Plants: Advances and Prospects

Abiotic stresses, such as temperature (heat and cold), salinity, and drought negatively affect plant productivity; hence, the molecular responses of abiotic stresses need to be investigated. Numerous molecular and genetic engineering studies have made substantial contributions and revealed that abiotic stresses are the key factors associated with production losses in plants. In response to abiotic stresses, altered expression patterns of miRNAs have been reported, and, as a result, cDNA-microarray and microRNA (miRNA) have been used to identify genes and their expression patterns against environmental adversities in plants. MicroRNA plays a significant role in environmental stresses, plant growth and development, and regulation of various biological and metabolic activities. MicroRNAs have been studied for over a decade to identify those susceptible to environmental stimuli, characterize expression patterns, and recognize their involvement in stress responses and tolerance. Recent findings have been reported that plants assign miRNAs as critical post-transcriptional regulators of gene expression in a sequence-specific manner to adapt to multiple abiotic stresses during their growth and developmental cycle. In this study, we reviewed the current status and described the application of cDNA-microarray and miRNA to understand the abiotic stress responses and different approaches used in plants to survive against different stresses. Despite the accessibility to suitable miRNAs, there is a lack of simple ways to identify miRNA and the application of cDNA-microarray. The elucidation of miRNA responses to abiotic stresses may lead to developing technologies for the early detection of plant environmental stressors. The miRNAs and cDNA-microarrays are powerful tools to enhance abiotic stress tolerance in plants through multiple advanced sequencing and bioinformatics techniques, including miRNA-regulated network, miRNA target prediction, miRNA identification, expression profile, features (disease or stress, biomarkers) association, tools based on machine learning algorithms, NGS, and tools specific for plants. Such technologies were established to identify miRNA and their target gene network prediction, emphasizing current achievements, impediments, and future perspectives. Furthermore, there is also a need to identify and classify new functional genes that may play a role in stress resistance, since many plant genes constitute an unexplained fraction

Solar Technology in Agriculture

Promotion of sustainable agriculture is one of the most priority development goal set by United Nations for achieving the food security to meet the ever-increasing global population food demand. Because of extreme importance of agriculture sector, significant technological developments have been made that played pivotal role for sustainable agriculture by value addition in agricultural products and meeting energy demands for machinery and irrigation. These developments include improved cultivation practices, processing units for agricultural products and operation of machinery and irrigation systems based on solar energy. Moreover, the emergence of new technologies and climate smart solutions with reduced carbon footprints have significantly addressed the ever-increasing fuel costs and changing climate needs. PV based solar irrigation pumps and agricultural machinery is typical example of this. Because, awareness of these technological development is essential to overcome energy issues, availability of energy to perform agricultural activities for sustainable agriculture at farm level and socioeconomic uplift of farming community to meet food requirements needs in the future. Therefore, this chapter attempts at providing the introduction of technologies for direct and indirect use of solar energy in the agriculture sector. The typical examples of direct use of solar energy like greenhouses or tunnel farming for cultivation of crops and vegetables and use of solar dryers for drying agricultural products have been comprehensively discussed. Similarly, the solar powered tubewells, tractors, and lights, etc. are few important examples of indirect use of solar energy and have also been discussed in this chapter. The indirect use is made possible by converting solar energy into electrical energy with the help of photovoltaic devices, called “solar cells”. Also radio frequency (RF)-controlled seed sowing and spreading machines are discussed, which provide an eco-friendly method. Moreover, comprehensive discussion is made on solar based technologies in general as well regional context in view of their potential to scale-up and to address anticipated issues. The use of photovoltaics in agriculture is expected to be significant contribution in the near future that require urgent planning for the potential benefits and efficient use at the farm level. Therefore, the co-existence of “agrovoltaics” will be essential for the developments of agriculture and agroindustry