To compare the efficacy of progesterone between oral versus vaginal routes of administration in the treatment of first trimester threatened miscarriage

Objective: To determine the efficacy of oral versus vaginal progesterone in the treatment of the first trimester threatened miscarriage. Methodology: This randomized controlled trial study was conducted at Gynaecology and Obstetrics Department of Mardan Medical Complex, Mardan from September 2019 to March 2020. A total of 126 women between ages 18-45 years presenting in their first trimester with threatened miscarriage were included. All patients were randomly allocated in two equal groups A and B by lottery method (63 in each group). Patients in group A were given oral progesterone 10 mg bid for one week and group B patients were given vaginal progesterone 400 mg for one week under the supervision of obstetrician. All patients were followed up till 20th week of pregnancy. The efficacy of the drug was evaluated based on the absence of bleeding per vagina and pregnancy proceeding beyond 20 weeks of gestation. Results: A total of 126 women were included. The majority of the patients 64 (50.79%) were between 18 to 30 years of age. The mean age of women in group A was 30.52 ± 4.52 years and in group, B was 30.73 ± 4.23 years. Efficacy of Oral progesterone (group A) was seen in 57 (90.48%) women and of vaginal progesterone (group B) was seen in 46 (73.02%) women. This showed a highly significant difference between the two routes of administration with p-value of 0.01. Conclusion: Oral progesterone is more effective than vaginal progesterone in treating first trimester threatened miscarriage in terms of prevention of blood loss and continuing the pregnancy beyond 20 weeks

Prevalence of Diabetic Retinopathy and Correlation with HbA1c in Patients Admitted in Khyber Teaching Hospital Peshawar

Objective: To determine the prevalence of diabetic retinopathy in patients admitted in Khyber Teaching Hospital Peshawar and to correlate different stages of diabetic retinopathy with HbA1C levels. Methodology: This cross sectional study was conducted at Department of Ophthalmology, Khyber Teaching Hospital, MTI, Peshawar from December 2019 to May 2020. All patients over the age of 15 years who were diagnosed with diabetes mellitus were included in the study while patients with cataract or retinopathy due to other pathologies were excluded. All diabetic patients were admitted through outpatient department. In the ward their blood pressures were recorded and HbA1c levels were also measured. Visual acuity (VA) was checked. Screening for diabetic retinopathy was done by a consultant ophthalmologist by Optos Ultrawide Field Imaging of retina and Optical Coherence Tomography (OCT) of macula to establish stages of diabetic retinopathy and presence of diabetic macular edema respectively. Results: A total of 103 diabetic patients were included. Their retina was photographed, viewed and analyzed. Diabetic retinopathy, irrespective of the type, was found in 69 patients with a prevalence of 66.9%. Patients with lower ranges of HbA1c (below 6%) showed no evidence of DR. The clustering of majority of patients with diabetic retinopathy with HbA1c levels of 8 to 12 %, showed a significant relationship between high blood sugar levels and severity. Conclusion: In our study the higher frequency of retinopathy is alarming by considering it one of the leading causes of blindness in working class. It is highly recommended that routine ophthalmologic examination may be carried out along with optimal diabetic control

Is Trade Openness the Reason of High Energy Demand in China?

The present study aims to examine the short-run and long-run impact of China's trade liberalization policies on its energy demand over the period from 1980 to 2018. The results of Autoregressive Distributed Lag approach of co-integration show that energy consumption significantly increases as a result of trade openness and increase in real Gross Domestic Product (GDP). The results of the granger causality test also confirm the unidirectional causality running from trade openness and real GDP to energy demand. The results of the study have an important implication because if China wants to continue its trade liberalization policies then it must increase its energy production. Keywords: Energy Consumption, Gross Domestic Product, Trade Openness, China, Time Series JEL Classifications: C22, F15, L98, Q43 DOI: https://doi.org/10.32479/ijeep.1116

Determinants of financial performance of financial sectors (An assessment through economic value added)

This study investigated determinants of financial performance of listed financial sectors in Karachi Stock Exchange from 2008 to 2012. The objective of this study was to investigate the factors of financial performance of financial sectors in Pakistan. Descriptive statistics, Correlation matrix, Chow test, Hausman Test for Fixed Effect Model and Random Effect Model and Breusch-Pagan Lagrange multiplier for Random Effect were used in this study. Estimated results revealed that determinants of financial sectors such as leverage, liquidity, size, risk and tangibility have significant effect on financial performance of financial sectors. It is recommended that financial sectors should consider EVA as an important factor for financial performance. It is suggested that increased number of independent variables will further enhanced the scope of the future studies

Illiteracy: A Threat to Peace in Federally Administrated Tribal Areas (FATA) of Pakistan

Pakistan’s decision of participating in the war on terror has put the entire country especially FATA on the mercy of extremist and terrorists. The current layer of terrorism and extremism has destroyed the peaceful traditional tribal society. The present study was conducted during 2013 to probe the effect of illiteracy on peace in the war-affected zone FATA. The major findings of the study reveal that illiteracy ratio was high at FATA, making FATA safe haven for militants and it was one of the main cases of terrorism, leading to violence, making the illiterate youth and madrasa students more vulnerable to militancy. Furthermore lacks of interest in education, dysfunctional education institution, and preference to madrasa education were also the variables, which were affecting peace in FATA. The study also reveals that in the presence of illiteracy sustainable peace is not possible in FATA

Changing Attitude Towards Women Education, An Outcome of Benefits of Women Education in Rural Area

Female constitute half of country population but still facing problem in almost all sectors of life in the male dominating Pakistani society. The major aim of the present study was to find out the benefits of female education as factor affecting their parent’s attitude towards education. Data for the study were collected from two hundred and fourteen (N=214) respondents belonging to two selected villages of district Bannu. A significant association was found among attitude about female education and by getting education females would become good housewives, good mothers, would be able to get better life partners, would bring up their children in a better way and could help their children in educational and social problems. Furthermore they would have job opportunities, would be socio- economically empowered, would make sensible decisions in important matters and they would be less likely to marry early. On the basis of encouraging findings of the study about expected benefits of female educations it is recommended that government and non-government organizations should keep people aware by highlighting these benefits which will ultimately motivate parents to provide education to their female children

Blending Old and New Teaching Methods and Tools in Medical Education

OBJECTIVES To identify a preference for current teaching methods and use new teaching aids through feedback by medical students and teachers of first and second-year MBBS. METHODOLOGY This cross-sectional study was conducted on 91 MBBS students and teachers of Nowshera Medical College (NMC), Nowshera. Both male and female students and teachers of NMC of class first and second-year MBBS participated in the study. A feedback proforma-based questionnaire was filled out by all the participants online using Google forms. Participants were given the option to select more than one option in the case of the mode of teaching and tool of teaching. The data was collected, analyzed and presented in tabular and graphical forms using SPSS version 23. RESULTS Out of the 91 participants who responded to our research, 45 (49.5%) were males, and 46(50.5%) were female. The majority, 74 (81.3%), were MBBS students, while 17(18.7%) were MBBS teachers. Most of the participants selected more than one option. Most 48(52.7%) of the participants preferred lectures as the mode of delivery while 35(38.4%) opted for SGD, for demonstrations 14(15.3%), PBL 33(36.2%), assignments 13(14.2%0 and notes opted by 4(4.39%). 60.4% (55) were selected to use whiteboards and markers. Only 15.3% (14) were in favour of Powerpoint use, dissection 25(27.4%), models 29(31.86%), and figures 11(12%). CONCLUSION Lectures remain the most preferred teaching method in basic medical sciences among teachers and students, along with other teaching methods. Multiple teaching tools must be used during the class instead of solely depending on Powerpoint presentations

Modifiable risk factors in patients with cerebrovascular accident

To determine the frequency of modifiable risk factors of stroke. Study Design: Descriptive Case series. Place and duration of study: Ayub Teaching Hospital, Abbottabad from March to December 2012. Methodology: 106 cases of cerebrovascular accident (CVA) above 20 years of age and of either sex admitted in medical units of Ayub Teaching Hospital, Abbottabad were included in this study. The patients below 20 years of age, those with recurrent history of CVA, patients not fulfilling the required criteria of risk factors set in operational definitions and patients having intracranial space occupying lesion such as tumors or brain abscess or neurological deficit secondary to head injury were not included in the study. The subjects were taken by non-probability sampling. Results: There were 106 patients in this study. Of these 62(58.5%) were male and 44(41.5%) were females. Mean age of the patients was 62.3 years. 66 (62.3%) patients had hypertension, 29 (27.3%) had Diabetes mellitus, 10 (9.4%) were smokers, 8 (7.5%) had dyslipidemia, 3 (2.83%) had atrial fibrillation, 4 (3.77%) were obese and 2 (1.88%) had carotid bruit. Conclusions: This study showed that hypertension was the commonest modifiable risk factor of CVA followed by diabetes mellitus, smoking, dyslipidemia, obesity, atrial fibrillation, and carotid bruit. CVA was more common in males as compared to female and mostly occurred in middle and old age patient

Parents Attitude Towards Enrollments in Public and Private Schools

Education not only enables us to become acceptable members of social sphere but also enable us to take right decision at right time. Parents’ decision play important role in the lives of their children. The major aim of the present study was to find out the major causes of enrolling students in public schools by parents. Data for the study were collected from 280 respondents belonging to three selected villages in Tehsil Oghi, District Mansehra. The study found significant association between perception about enrollment in public schools and children’s education was major priority of the educated parents, they understand their educational problems, teach them at home, give importance to sports, provides them latest technologies and facilities, provide tuition to children if needed, believed in hard work of parents and good grades of children in exams and ultimately educated parents’ children obtain good grades. The study recommends that government should initiate mobilization campaign for illiterate parents, which will enhance the enrollment of children in public school

Treatment outcomes of patients with tuberculosis in war affected region of Khyber Pakhtunkhwa, Pakistan

Background Globally, tuberculosis (TB) remains the leading cause of death from a single infectious disease. TB treatment outcome is an important indicator for the effectiveness of a national TB control program. This study aimed to assess treatment outcomes of TB patients and its determinants in Batkhela, Khyber Pakhtunkhwa, Pakistan. Methods A retrospective cohort study was designed using all TB patients who were enrolled at District Head Quarter (DHQ) Hospital Batkhela, Pakistan, from January 2011 to December 2014. A binary logistic regression models were used to identify factors associated with successful TB treatment outcomes defined as the sum of cure and completed treatment. Results A total of 515 TB patients were registered, of which 237 (46%) were males and 278 (53.98%) females. Of all patients, 234 (45.44%) were cured and 210 (40.77%) completed treatment. The overall treatment success rate was 444 (86.21%). Age 0-20 years (adjusted odds ratio, AOR = 3.47; 95% confidence interval, CI) = 1.54-7.81; P = 0.003), smear-positive pulmonary TB (AOR) = 3.58; 95% CI = 1.89-6.78; P = < 0.001), treatment category (AOR = 4.71; 95% CI = 1.17-18.97; P = 0.029), and year of enrollment 2012 (AOR = 6.26; 95% CI = 2.52-15.59; P = < 0.001) were significantly associated with successful treatment outcome. Conclusions The overall treatment success rate is satisfactory but still need to be improved to achieve the international targeted treatment outcome. Type of TB, age, treatment category, and year of enrollment were significantly associated with successful treatment outcomesThis study was supported by Chinese National Natural Fund (81573258), Jiangsu Provincial Six Talent Peak (WSN-002)