An analysis of pattern and burden of patients Referred for nerve conduction study in a Tertiary care hospital in Pakistan

Background: To analyze the trend and load of neurological diseases in a university medical center for reffered electrophysiology. Methodology: From January 2016 to December 2018, this retrospective study was carried out in department of Neurology, Pakistan Institute of Medical Sciences (PIMS) Islamabad. A total of 4527 patients were evaluated during this time period in neurophysiology lab through computerized data

Brand personality from an Islamic perspective: a conceptual analysis of Aaker’s model

Current challenges reflect intense competition in the market and low switching cost of customers. For any brand to be appealing and ultimately profitable, it necessitates differentiation in comparison with other brands. Marketers engage in various differentiation techniques such as Aaker’s brand personality model. Aaker’s model contains five dimensions (sincerity, excitement, competence, sophistication, and ruggedness) along with 42 underlying aspects. Brand personality helps in developing customer-brand relationship, brand image, and brand commitment. Extensive research has been done based on the above model yet several scholars have criticised it based on issues such as generalizability across countries and cultures. Religion being an important part of culture has also been ignored in the brand personality domain. This research proposes an Islamic brand personality model, which not only looks into the dimensions, but also examines the underlying aspects based on the Qur’an, hadith and the scholarly work of both traditional and modern Muslim scholars. This paper found that the Islamic brand personality model contains two new dimensions, namely trustworthiness and justice in addition to the existing dimensions. This model can benefit any Islamic brand (Islamic bank, Islamic Insurance company etc.) to differentiate itself from others, especially from conventional brands in order to develop a potentially larger Muslim consumer market

The Impacts of Microfinance on Women Entrepreneurs “A Case Study of District Quetta, Pakistan”

The main objective of this study is to find out whether the provision of microfinance services by BRAC, Pakistan at district Quetta Urban area has brought out any changes in women micro-entrepreneur. The cross sectional design using household as the unit of assessment was selected for the present study, the primary data was collected through structured questionnaires covered one group of 60 female from present beneficiaries or former beneficiaries who have already received loan from the BRAC, Pakistan at district Quetta for at least two years before 1st October, 2011 the date on which face to face interviews of clients were conducted and another group of 20 female consisting of new clients/ non-beneficiaries who have with the microfinance programs for maximum period of two to three months duration were used as control group using cluster random samples.From the analyzed data it was infer that microfinance was helpful in empowering female entrepreneurs socially as well as economically in urban area of Quetta district. Keywords: Microcredit, Microfinance, Microfinance Institutions, Microenterprise, Micro- entrepreneur

A Rare Case of X-Linked Bulbo-Spinal Muscular Atrophy with Sensory Neuropathy and Tremors

Kennedy disease (KD) is also known as spino bulbar muscular atrophy caused by a tandem C-A-G tri-nucleotide repeat. It is an adult-onset X-linked recessive inherited neurodegenerative disease involving lower motor neuron damage with predominance of facial muscles. It is often accompanied with androgen sensitivity, sensory nerve damage and endocrinal involvement. It has similar confusing symptoms and is often mis-diagnosed with most of the neuromuscular diseases like POEMS syndrome, myasthenia gravis, mitochondrial myopathy and amyotrophic lateral sclerosis. Hence clinical differentiation is important to prevent adverse outcomes and un-necessary treatment. Here we describe a rare case of a 46 year old Pakistani male who presented to us with progressive weakness and tingling of the limbs, bulbar symptoms, postural tremors and painful recurrent ulceration of the feet. Based on family history, clinical and electro diagnostic study he was diagnosed to have Kennedy disease. To the best of our knowledge, it is the first case report of Kennedy disease from Pakistan

To Find the Best Site for Urban Development in Prachuap Khiri khan, Thailand

Coastal areas in the western provinces of Thailand, a popular destination in Northern Thailand, are facing rapid tourism-related sustainable development issues and. This study aims to find the coastal areas which need to be conserved for tourism and find the areas which are safer and suitable for urban development in Prachuap Khirikhan province. Multiple criteria evaluation (MCE) and several available tools in GIS such as ‘Reclassify’, ‘Overlay’, ‘Proximity’, ‘Spatial analyst tools’ etc. are used during analysis. ‌Based on the available data and multi-criteria analysis, the area in the Prachuap Khirikhan has been classified into five categories from “Highly Suitable” to “Not Suitable. The results show that there are large number of Tambon which are highly suitable for urban development such as Phung Prasan, Kamnoet Nopphakhun, Thong chai, Thap sake, Huai Yang, Huai sai, Khlong Wan, Ko Lak, Ao Noi, Bo Nok. The Tambons which are found “Not suitable” or “Low suitable” for urban development are Nong Phap, Nong Ta Taem, Sila Loi and Chang Raek

Myotonic dystrophy in a Pakistani family: a case series and literature review

Myotonic dystrophy also known as (Steinert\u27s disease) is a clinically and genetically heterogeneous multisystem disorder with a prevalence of 1 in 8000 in the general population. It is inherited as an autosomal dominant trait. It is characterized by myotonia, myopathy of voluntary and involuntary muscles, frontal baldness in men, cardiac conduction abnormalities, cataracts, intellectual deterioration and endocrinopathies. Affected men may have gonadal atrophy and infertility. On the other hand women are generally fertile. We report a case series of three individuals belonging to the same family presenting with characteristic features of myotonic dystrophy. The presentation of these cases depicts that this disease can lead to disability, loss of independence and social isolation especially in the elderly. They warrant adequate work up for diagnosis which may sometimes be extensive. Proper genetic counseling of the family is required regarding nature of the disease and with risks and prognosis

Incentives in Adopting Cloud Computing for Shaikh Zayed University, Khost Afghanistan

Teaching in these days is almost regarded impossible without the Information Technology resources which needs a great amount of investments in this sector, there are a huge number of educational institutions which cannot afford these IT investments. Many institutions are in search of a cheap and economic way of delivering and managing these resources mainly in the Asian countries. Among such solutions, it is debated that Cloud computing is the right choice to reduce the expenses of the institutions. This paper describes the common benefits of cloud computing for Shaikh Zayed University. To provide imported and updated information and to deliver daily lectures on time, a physical structure such as (hardware and software) is needed. To attain this objective, the researcher conducted qualitative data to collect the data. Data from different experts were collected using the questionnaires in this field. The results of these survey showed that cloud computing had great role in reducing the Costs, achieved a Collaborating environment and all time Availability

Efficacy and Safety of Bempedoic Acid as a Treatment Option for Hyperlipidemia: A Systematic Review

Introduction: Bempedoic acid (BA) is an inhibitor of ATP-citrate lyase (ACL) and is used in the treatment of hyperlipidemia by inhibiting cholesterol synthesis. Randomized clinical trials (RCTs) have shown the efficacy of BA in lowering LDL-C levels and it is currently approved as a treatment option for patients with hyperlipidemia to achieve target LDL-C levels. We conducted a systematic review to further elucidate the efficacy and safety profile of BA in patients with hyperlipidemia. Methods: We searched the electronic database Medline, Embase, and Cochrane Library for RCTs between 2013 and 2023. We used keywords (“Bempedoic Acid”) AND (“Hypercholesterolemia”) AND (“Lipid Lowering”) AND (Randomized Controlled Trials”) AND (“Humans”). Pairs of reviewers also manually searched for RCTs to identify studies comparing the efficacy and safety profile of BA either alone or in combination with other lipid-lowering therapies. Results: We identified 11 RCTs in our systematic review, and it showed that the addition of BA either alone or in addition to other lipid-lowering therapies (statins and ezetimibe) resulted in the lowering of LDL-C levels. In addition, BA also led to a reduction in total cholesterol (TC), non-high-density lipoprotein cholesterol (non-HDL-C), apolipoprotein B (ApoB), and high sensitivity C reactive protein (hs-CRP) levels. For the safety profile of BA, results from the studies show that there is no difference in the incidence of adverse events between the two treatment arms. However, a few studies found that the use of BA was associated with a higher incidence of gout as compared to standard lipid-lowering therapies. Conclusion: The use of BA in patients with hyperlipidemia leads to a decrease in the level of LDL-C both alone and in addition to other lipid-lowering therapies like statins and ezetimibe. The addition of BA also led to a reduction in TC, non-HDL-C, ApoB, and hs-CRP levels which resulted in reduction in cardiovascular events. The safety data shows that BA is largely safe to use and the adverse events were similar in both groups, however, the rate of gout was higher in patients receiving BA. Larger clinical trials with longer follow-up duration are needed to adequately assess its effect on cardiovascular mortality and the safety profile of BA

Polyneuropathy associated with iga Paraproteinemia: a case report and literature Review.

Paraproteinemia is precipitated by an accumulation of monoclonal plasma cells or B lymphocytes. Idiopathic neuropathies that are associated with paraproteinemia account for only 10% of the neuropathies. Paraprotein acts like an antibody and is targeted against myelin and axons present in the peripheral nerves. Despite being of interest for quite a long time, the caudal relationship between paraproteinemias and peripheral neuropathies still remains a sorcery. We report a case of a middle aged male who presented with pain and parasthesias in both arms and legs. His workup revealed him to be having a paraproteinemic neuropathy consistent with IgA Lambda chains that account for being the most rare type of monoclonal gammopathy than IgM or IgG having the potential to progress to smouldering multiple myeloma

Initial Environmental Examination for Power Plant in Local Sugar Mill

This research presents the IEE (Initial Environmental Examination) and EIA (Environmental Impact Assessment) for sugar mills as power generation business. The study evaluates the proposed project according to the environmental assessment requirements of the Pakistan Environmental Protection Agency. The study has been conducted using standard environmental assessment methodology with the consultation of national and international environmental guidelines such as World Bank environmental and International Finance Corporation (IFC). The installation of 100 MW cogeneration thermal power plant adjacent to existing sugar mill located in district Muzaffargarh has been considered as a case study.  It has been concluded that the residual impacts of the proposed operation will be of minor significance and careful implementation of the Environmental Management Plan (EMP) will ensure that environmental impacts are managed