Estimation of Export Supply Function for Citrus Fruit in Pakistan

There is strong evidence in the literature that export and economic growth have a positive relationship. In Pakistan, with an agrarian economy, earnings from primary agricultural exports are vital for the overall growth process. Fruits are the traditional export commodities, which contribute more than half of total export earnings from primary agricultural commodities. The persistent instability in world market prices for primary commodities has depressed the export earnings from these commodities over time. This poses great challenges to a country like Pakistan. The present study aims at examining changes in the volume of export of citrus fruit from Pakistan caused by such factors as changes in domestic and export prices, national product, foreign exchange rate, etc. The study uses time series data for the period 1975–2004 for citrus exports and related domestic price, export price, GDP, and foreign exchange rate, employing the co-integration and error correction techniques for analysis purposes.

Patient Satisfaction Undergoing Surgery for Lumbar Disc Herniation

Objective: To assess patient’s satisfaction, who are undergoing surgery for lumbar disc herniation.Materials and Methods: This observational study was conducted in Neurosurgery Department of Rehman Medical Institute, Peshawar from February 2014 to July 2014. A total of 58 patients who underwent surgery with lumbar disc herniation were studied. Clinical outcomes were measured using the visual analog scale (VAS) score for leg and/or back pain pre-operatively and 2 weeks post-operatively. Patient was considered satisfied from surgery (Lumbar Microdiscectomy), if there is improvement in VAS, 2 weeks post-operatively of ≥ 3 score. All the patients were followed up for a minimum period of four weeks.Results: The mean age of the patients was 40.21 ± 12.51 years with majority (62.1%) of the male patients. The main bulk of the patients (75.8%) having lumbar disc herniation were in between 20 – 50 yearsof age. Regarding level of the prolapsed intervertebral disc, most of the patients were harboring lumbar disc herniation at L4-L5 level (41.4%). About 5.2% (n = 3) of the patients were lost to follow-up. Major bulk of the patient (89.1%) was satisfied from the surgery. There was statistically significant difference between pre-op and post-op VAS (p value = <0.01).Conclusion: Majority of the patients of lumbar prolapsed intervertebral disc was male with L4 – L5 level most commonly involved.Almost 90% of the patients were satisfied from the surgery, Lumbar microdiscectomy, with statistically significant p value

Probabilistic Analysis of Strength of Structural Concrete for Post-Code Buildings in Developing Countries

Code compliance and quality construction remain a point of interest for developing countries. For structural vulnerability studies on reinforced concrete buildings, researchers usually adopt random strength parameters to represent the compressive strength of concrete for various structural members. This matter becomes a challenge if researchers are dealing to quantify the structural response of code-compliant buildings. Since the research on the response of code-compliant buildings is limited hence this paper aims at data collection and presenting the probabilistic trends in compressive strength variation of structural concrete being used or has been used in multiple projects of the federal capital city of Pakistan for code-compliant buildings. The data has been collected from well-reputed academic and commercial testing labs in the area for past 10 years (the timeline after implementation of BCP 2007). Compressive strength testing records of concrete cylinders for 28 days strength have been sorted for different structural members i.e., beams, columns, shear walls, slabs and footings separately. From the selected data, histograms have been plotted for each member category and mean values with standard deviations have been highlighted. Obtained results are further compared with anticipated design compressive strengths which were obtained from different tagged reports, design offices and resident engineers of the sites. The produced results would lead to true representation of structural strength of concrete for code-compliant buildings, to be further studied for structural vulnerability and risk assessments of the desired areas in developing countries

Estimation of Export Supply Function for Citrus Fruit in Pakistan

Nature has blessed Pakistan with an ideal climate for growing a wide range of delicious fruits. Thus a very wide range of tropical, sub-tropical and temperate fruits are grown in the country. Over the years, Pakistani experts have developed unique strains of exotic fruit varieties. Pakistan is producing a large variety of fruits on an area of 734.6 thousand hectares with a total production of 5712.4 thousand tons. Out of this 354.4 thousand tons fruit is exported from the country [Pakistan (2004)]. Horticulture is an important sub-sector of agriculture and plays a vital role not only in rejuvenation of rural economy but also in improving human nutrition which is often deficient in ingredients such as vitamins and minerals. Citrus and mango are the main fruit crops which contribute substantially to the national income

Association of Etiological and Pathological Features of Brain Abscess with Outcome

To study the etiological andpathological factors of brain abscess and to relatewith the final outcome.Methods: In this observational study patients withbrain abscess were observed in detail with theclinical profile, etiology, microbiology and theirfinal outcome after one year.Chi-square test wasapplied to associate etiological and pathologicalfactors with management outcome.Results: The majority of patients were in their 2ndand 3rd decade of life with two third proportioncomprising of males. The most frequent etiologicalfactor was chronic suppurative otitis media (CSOM)( 55%),followed by head injury (12% ) and congenitalheart disease (10%). Microbiological data revealed16% streptococci, 10% staph. aureus, 7% staph.epidermidis and 5% proteus as major pathogens inthe study patients. Head injury and CSOM werefound associated with death and morbidity in thisstudy.Conclusion: Brain abscess has multi dimensionalcauses. CSOM and head injury were foundassociated with death and severe morbidity ashemiparesis and fits. CT findings andmicrobiological data were not associated withoutcome

RADIOLOGICAL AND PATHOLOGICAL CORRELATION OF LUNG NODULES IN A BACKGROUND OF METASTATIC DISEASE

Background: Computed tomography (CT) imaging has improved the chances of detecting small indeterminate (<1 cm) lung nodules. The determination of the underlying malignant or benign nature of a lung nodule poses a great diagnostic challenge and depends on a number of factors, including the radiographic appearance of nodule, the presence of non-pulmonary metastases, characteristics of growth and histological criteria. Methods: The medical records of 89 patients admitted to our specialist cancer centre between 2008 and 2013 were reviewed. Patients of all age groups and tumour category were included in the study. Clinical data of these patients were collected and the following parameters were analysed: Radiographic diagnosis, location, size, laterality and number of nodules and histological impression. The radiological findings were then correlated with histopathological findings. The nodules were sub-classified into groups on the basis of size (A = 0–0.5 cm; B = 0.5–0.9 cm; C = 1.0–1.5 cm and D = >1.5 cm). Results: CT scan reports of 89 patients with lung nodules were reviewed. On radiology, 73/89 (82%) were reported to be malignant nodule. Histopathological review of the biopsies of these 89 nodules confirmed malignancy in 50/89 (56.2%) patients. CT scan was found to be highly sensitive (94%, 95% confidence interval [CI]: 83.43–98.68%) but with a very low specificity (33.3%, 95% CI: 19.10–50.22%). CT scan was found to have a higher negative predictive value (81.2%, 95% CI: 54.34–95.73%) and a lower positive predictive value 64.4% (95% CI: 52.31–75.25%) when correlated with histopathological findings. Pathology of these nodules included metastatic sarcoma (27/89; 30.3%) and carcinoma (18/89; 20.2%). The frequency of the biopsy-proven malignant nodules on the right side was 26/45 (57.8%) and on the left side was 24/44 (54.5%) (P = 0.832). Malignant nodules were more frequent in lower lobes (28/43, 65.1%) than in upper lobes (14/32, 43.8%). These two sites combined accounted for 84% of all malignant nodules. There was a significant correlation between nodule size and likelihood of underlying malignancy. The overall prevalence of malignancy in the larger nodules (C and D) was much higher (23/30 and 76.7%) compared to the smaller sized (A and B) nodules (27/58 and 46.8%), P < 0.05.Conclusion: CT scan is a useful tool in the initial clinical assessment of indeterminate lung nodules with high sensitivity (94%) and a high negative predictive value (81.2%).Key words: Computed tomography, fibrosis, indeterminate lung nodule, infection, lung nodule, malignancy, metastase

NEED OF 7S IN SERVICE OPERATION ENVIRONMENT AS COMPARED TO 5S AND 6S

Manufacturing companies distinguish themselves by their operational efficiency and the quality of their products. The 5S and 6S methodologies are commonly used in service operations to enhance efficiency and productivity. Although there are some similarities between these approaches and the 7S technique, there are also notable differences. The 7S technique can be applied in service operations to improve efficiency and productivity by focusing on the spirit element. This study analyzes the significance of the spirit element in the 7S technique and assesses the effectiveness of 5S, 6S, and 7S in service operations. Furthermore, it aims to identify the necessity of the 7S approach in organizations where 5S and 6S are already being used efficiently. The research employs a quantitative methodology and the results indicate that 60% to 79% of the respondents believe that spirit is a crucial aspect of the 7S technique and has positive outcomes. Encouraging a positive spirit can enhance teamwork, motivate and engage employees, and instill a sense of ownership among them. The 7S technique emphasizes an organization's shared values and culture, which can create a positive work environment, encourage employee engagement, improve communication, to lead to better performance

Synovial Lipomatosis; A Clinicopathological Study of a Rare Entity

Objective: This study was conducted to analyse the clinicopathological and radiological features associated with Synovial lipomatosis.Patients and Methods: Cases diagnosed as Synovial lipomatosis from 2008 to 2018 were retrieved and clinical information and histology were reviewed.Results: Thirteen cases of Synovial lipomatosis were diagnosed between 2008 and 2018. Most common site was knee joint and mean age of presentation was 28.6. About 62% of subjects were males and mostly presented with joint pain and swelling. Two of the subjects had significant history of trauma and disease was bilateral in one of the cases. Microscopically, villous proliferation of synovium with infiltration of mature adipocytes was noted. Focal synovial hyperplasia and inflammatory infiltrate were other findings in some of the cases.Conclusion: Synovial lipomatosis should be considered in the differential diagnosis of joint pain and swelling and should be distinguished from Pigmented villonodular synovitis, Synovial haemangioma and intra-articular synovial lipoma (IASL) using radiological and histological features

Implementering av oppdatert retningslinje for tromboseprofylakse. Ikke-ortopediske, ikke-onkologiske kirurgiske pasienter Sykehuset Innlandet, Hamar

Tema/problemstilling: Oppgaven omhandler implementering av oppdatert retningslinje for tromboseprofylakse til ikke-ortopediske, ikke-onkologiske kirurgiske pasienter ved Sykehuset Innlandet - Hamar. Problemstillingen dreier seg om å systematisere den antitrombotiske behandlingen slik at alle risikopasienter får korrekt profylakse. Hensikten er å redusere risiko for pasientskade i form av venøs tromboembolisme. Kunnskapsgrunnlag: Kvalitetsforbedringsprosjektet er basert på norske retningslinjer for antitrombotisk behandling utgitt av Norsk Selskap for Trombose og Hemostase i 2013. Disse er igjen bygget på en omfattende retningslinje utgitt av American College of Chest Physicians kalt Antithrombotic Therapy and the Prevention of Thrombosis, 9th Edition: American College of Chest Physicians Evidence-based Guidelines (AT9). Tiltak/kvalitetsindikator: I følge de nevnte retningslinjene er det anbefalt å risikostratifisere pasientene inn i hovedgrupper noe som er avgjørende for valg av type antitrombotisk behandling. I de amerikanse retningslinjene brukes en modifisert Caprini-skår som er relativt omfattende. Vårt forslag til tiltak, også basert på Caprini-skår, er å innføre en forenklet risikostratifisering av de aktuelle pasientene. Dette skal gjøres ved at et skåringsskjema plasseres i innkomstmappa til hver enkelt pasient og fylles ut ved sykepleiemottagelsen ved ankomst til sykehuset. Som kvalitetsindikator har vi valgt en resultatindikator. Denne måler andel pasienter som er kvalifisert for antitrombotisk profylakse (i følge retningslinjene) og som faktisk får den. Ledelse/organisering: Prosjektet skal gå over relativt kort tid med 12 måneders varighet. Siden prosjektet omhandler systematisering av en behandling som allerede er i bruk, ansees omfanget å være begrenset og det det vil kun være nødvendig med en mindre prosjektgruppe. Prosjektet bør inkludere en kirurg og en sykepleier. Vi anbefaler dessuten at en superbruker i sykehusets kliniske jounalsystem DIPS deltar i prosjektgruppen. Milepælene for prosjektet vil være ved 3, 6 og 12 måneder. Resultatindikatoren måles etter 6 og 12 måneder og nødvendige justeringer iverksettes. Konklusjon: Studier tyder på at profylakse generelt gis til for få risikopasienter og at lokale retningslinjer/rutiner kan øke andelen som får korrekt behandling. Lokale retningslinjer mangler ved Hamar sykehus. Kvalitetsforbedringsprosjektet vil ikke være omfattende hverken i tid eller ressursbruk, kvalitetsindikatoren er enkel å måle og det er trolig rom for forbedring på Hamar sykehus. Vi tror prosjektet med fordel kan gjennomføres

RRT*-SMART: a rapid convergence implementation of RRT*

Many sampling based algorithms have been introduced recently. Among them Rapidly Exploring Random Tree (RRT) is one of the quickest and the most efficient obstacle free path finding algorithm. Although it ensures probabilistic completeness, it cannot guarantee finding the most optimal path. Rapidly Exploring Random Tree Star (RRT*), a recently proposed extension of RRT, claims to achieve convergence towards the optimal solution thus ensuring asymptotic optimality along with probabilistic completeness. However, it has been proven to take an infinite time to do so and with a slow convergence rate. In this paper an extension of RRT*, called as RRT*-Smart, has been prposed to overcome the limitaions of RRT*. The goal of the proposecd method is to accelerate the rate of convergence, in order to reach an optimum or near optimum solution at a much faster rate, thus reducing the execution time. The novel approach of the proposed algorithm makes use of two new techniques in RRT*–Path Optimization and Intelligent Sampling. Simulation results presented in various obstacle cluttered environments along with statistical and mathematical analysis confirm the efficiency of the proposed RRT*-Smart algorithm