Numberdar Ka Neela: A Study of Postcolonial Context & Anti-Colonialism

Syed Ashraf's novel, "Numberdar Ka Neela," serves as a potent critique of the post-colonial condition. It illustrates how oppression and exploitation persist even after country gains independence. The author delves into issues like power concentration, power abuse, and resistance to oppression, set in the early 1950s post-colonial context. The central character, Thakur Odal Singh, embodies power, exploitation, and tyranny. He symbolizes the forces struggling to retain their dominance in a changing society. Thakur's authority is epitomized by his blue bull, ‘Neela’, representing the violent and destructive consequences of concentrated power. Despite Neela's sacred status in Hindu religion, the villagers gradually realize it is merely a tool of oppression wielded by Thakur to maintain control. The novel culminates with the villagers finally rebelling against this cruelty, resulting in Neela's defeat and disappearance, as well as the demise of Thakur and his two sons. This article critically analyzes the symbolism and postcolonial context of "Neela" in "Numberdar Ka Neela.

The Outcome of Minimally Invasive Percutaneous Transpedicular Screw Fixation (TPSF) in Thoracolumbar Spine Fractures

Background & Objective:  This study aimed to determine the outcome of percutaneous transpedicular screw fixation (TPSF) in patients with thoracolumbar fractures. Material & Methods:  A total of 157 patients with thoracolumbar fractures were included from the Department of Neurosurgery, LGH, PINS, Lahore. Patients were evaluated with plain X-rays, CT, and MRI scans. Neurological status was documented preoperatively and postoperatively. All patients were treated with Minimally Invasive Percutaneous Transpedicular screw fixation. Data for operative time and per-operative blood loss was obtained through the operative notes. The severity of postoperative pain and length of hospital stay were also documented. Results:  Out of 157 patients, 69.4% were male and 30.6% were female. The 141 (89.8%) were traumatic from road traffic accidents/falls, and 16 (10.2%) were pathologic. The 128 (81%) patients were discharged on the first day, 23(15%) were discharged on the second day, and 6(3.8%) on the third day. 79% of patients had a single level of spine fracture whereas, 20% had 2 spinal fracture levels. The average operative time for MIS percutaneous TPSF was 55 minutes. Postoperative pain was markedly reduced as compared to traditional open surgery and no patient had any new neurological deficit. The mean blood loss was 25 ml and none of the patients needed a postoperative blood transfusion. Conclusion:  Percutaneous transpedicular instrumentation is an ideal surgical approach for thoracolumbar spinal stabilization. Keywords:  Thoracolumbar Fractures, Percutaneous Transpedicular Screw Fixation, Minimally Invasive Spine Surgery, Road Traffic Accidents (RTA)

Comparative Study Regarding Efficacy of Radiofrequency Rhizotomy and the Microvascular Decompression in the Treatment of Trigeminal Neuralgia

Objective: Trigeminal neuralgia is the lancinating electric shock like pain because of neurovascular compression in trigeminal nerve distribution. We compared the efficacy of radiofrequency rhizotomy with microvascular decompression in terms of complete pain relief.Material and Methods: The randomized controlled trial study was conducted in the neurosurgery department, LGH Lahore for a period of one year June 2017 to June 2018. A total of 110 patients were included and distributed into two groups, i.e. group-I who underwent radiofrequency rhizotomy (RFR) and group-II who underwent microvascular decompression (MVD). Follow-up of all the patients was assured up to six months. All the data were analyzed using S.P.S.S Ver. 23.0.Results: There were 38 (34.6%) male and 72(65.4%) female. Mean age was 51.25 ± 8.80 years. At the end of six months, in Group-I (RFR), Nineteen (34.5%) patients were completely pain free, 25 (45.5%) patients had significant pain relief, 7 (12.7%) had mild improvement in the pain and 4 (7.3%) patients had no improvement in the pain. In group-II (MVD), 30 (54.5%) patients were completely pain free, 14 (25.5%) had significant pain relief, 9 (16.4%) had mild improvement and 2 (3.6%) had no improvement in their pain (Chi-square = 6.49, p = 0.090).Conclusion: Microvascular decompression had better results than a radiofrequency rhizotomy in patients presenting with trigeminal neuralgia regarding excellent pain relief and fewer complications

Role of Early Tracheostomy in the Management of Severe Head Injury

Objective: The objective of this study was to compare the role of early and late tracheostomy in patients presenting with severe head injuries.Material and Methods: This randomized controlled trial study was conducted in the department of neurosurgery, Lahore General Hospital Lahore from March 2018 to August 2018, after taking approval from the ethical committee. A total of one hundred and thirty patients was divided randomly into early (within three days) and late(after three days) tracheostomy groups. After tracheostomy, data regarding acute physiology, age and chronic health evaluation II (APACHE II), the total number of days since ventilation, tracheostomy, weaning, discharge from ICU and hospital, complications and mortality were noted. All the data was entered and analyzed with SPSS23.0. Quantitative variables were presented as mean and standard deviation, qualitative variables were presented as numbers and percentage. The Chi-square test was applied. A p-value of ≤0.05 was considered significant.Results: The mean age of the patients was 33.13 ± 2.53 years. There were 84 males (64.61%) and 46 females (35.38%) in the study. The duration of mechanical ventilation, ICU stay and stay in hospital for early and late tracheostomy groups were 25.68 ± 2.94 vs. 33.37 ± 3.32 days, 29.42 ± 2.97 vs. 38.54 ± 3.80 days and 37.20 ± 2.98 vs. 47.15 ± 3.84 days respectively. Four patients (3.08%) and seven patients (5.38%) suffered from mortality.Conclusion: Early tracheostomy among the patients presenting with severe head injuries was associated with a better outcome than late tracheostomy

Co-existence of Anaerobic Ammonium Oxidation Bacteria and Denitrifying Anaerobic Methane Oxidation Bacteria in Sewage Sludge: Community Diversity and Seasonal Dynamics

Anaerobic ammonium oxidation (ANAMMOX) and denitrifying anaerobic methane oxidation (DAMO) have been recently discovered as relevant processes in the carbon and nitrogen cycles of wastewater treatment plants. In this study, the seasonal dynamics of ANAMMOX and DAMO bacterial community structures and their abundance in sewage sludge collected from wastewater treatment plants were analysed. Results indicated that ANAMMOX and DAMO bacteria co-existed in sewage sludge in different seasons and their abundance was positively correlated (P < 0.05). The high abundance of ANAMMOX and DAMO bacteria in autumn and winter indicated that these seasons were the preferred time to favour the growth of ANAMMOX and DAMO bacteria. The community structure of ANNAMOX and DAMO bacteria could also shift with seasonal changes. The "Candidatus Brocadia" genus of ANAMMOX bacteria was mainly recovered in spring and summer, and an unknown cluster was primarily detected in autumn and winter. Similar patterns of seasonal variation in the community structure of DAMO bacteria were also observed. Group B was the dominant in spring and summer, whereas in autumn and winter, group A and group B presented almost the same proportion. The redundancy analysis revealed that pH and nitrate were the most significant factors affecting community structures of these two groups (P < 0.01). This study reported the diversity of ANAMMOX and DAMO in wastewater treatment plants that may be the basis for new nitrogen removal technologies

Comparing effectiveness of two client follow-up approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) among the underserved in rural Punjab, Pakistan : a study protocol and participants' profile

Background: Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants' profiling of a prospective cohort follow-up to compare the effectiveness of household based and telephonic approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) whilst to facilitate lowering method related discontinuation and increasing switching amongst the contraceptive users. Methods: A 12-month multi-centre, non-inferiority prospective user follow-up is employed using three different study categories: a) household based follow-up; b) telephonic follow-up; and c) passive or need-based follow-up along with the hypothetical assumption that the telephonic client follow-up is not inferior to the household based follow-up by continuation rate of LARC and the telephonic follow-up is less-costly than the household based client follow-up. This follow-up will be conducted in 22 health facilities -(16 rural and 6 urban based facilities) in district Chakwal. The first two study categories will receive scheduled but different follow-up from the field workers at 1, 3, 6, 9, and 12 month while the third one i.e. the 'passive or need-based follow-up' will serve as a control group. Using sampling software PASS 11, it was estimated to have 414 clients in each study category and around 1366 clients will be recruited to account for 10% attrition rate. Discussion: The study will help us to examine a more convenient method of effective follow-up for managing side effects, decreasing method discontinuation and increasing switching amongst users. The study information will also facilitate to develop a robust, effective and efficient mechanism for client follow-up to promote the continuation rates of LARC methods. The follow-up results and lessons learnt will be widely shared with stakeholders for their implementation and streamlining in health system

Comparing effectiveness of two client follow-up approaches in sustaining the use of long acting reversible contraceptives (LARC) among the underserved in rural Punjab, Pakistan: A study protocol and participants\u27 profile

Background: Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants\u27 profiling of a prospective cohort follow-up to compare the effectiveness of household based and telephonic approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) whilst to facilitate lowering method related discontinuation and increasing switching amongst the contraceptive users.Methods: A 12-month multi-centre, non-inferiority prospective user follow-up is employed using three different study categories: a) household based follow-up; b) telephonic follow-up; and c) passive or need-based follow-up along with the hypothetical assumption that the telephonic client follow-up is not inferior to the household based follow-up by continuation rate of LARC and the telephonic follow-up is less-costly than the household based client follow-up. This follow-up will be conducted in 22 health facilities - (16 rural and 6 urban based facilities) in district Chakwal. The first two study categories will receive scheduled but different follow-up from the field workers at 1, 3, 6, 9, and 12 month while the third one i.e. the \u27passive or need-based follow-up\u27 will serve as a control group. Using sampling software PASS 11, it was estimated to have 414 clients in each study category and around 1366 clients will be recruited to account for 10% attrition rate.Discussion: The study will help us to examine a more convenient method of effective follow-up for managing side effects, decreasing method discontinuation and increasing switching amongst users. The study information will also facilitate to develop a robust, effective and efficient mechanism for client follow-up to promote the continuation rates of LARC methods. The follow-up results and lessons learnt will be widely shared with stakeholders for their implementation and streamlining in health system

Assessing predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan: results of a cross-sectional baseline survey

Background: Although Pakistan was one of the first countries in Asia to launch national family planning programs, current modern contraceptive use stands at only 26% with a method mix skewed toward short-acting and permanent methods. As part of a multiyear operational research study, a baseline survey was conducted to understand the predictors of contraceptive use and demand for family planning services in underserved areas of Punjab province in Pakistan. This paper presents the baseline survey results; the outcomes of the intervention will be presented in a separate paper after the study has been completed. Method: A cross-sectional baseline household survey was conducted with randomly selected 3,998 married women of reproductive age (MWRA) in the Chakwal, Mianwali, and Bhakkar districts of Punjab. The data were analyzed on SPSS 17.0 using simple descriptive and logistic regression. Results: Most of the women had low socio-economic status and were younger than 30 years of age. Four-fifths of the women consulted private sector health facilities for reproductive health services; proximity, availability of services, and good reputation of the provider were the main predicators for choosing the facilities. Husbands were reported as the key decision maker regarding health-seeking and family planning uptake. Overall, the current contraceptive use ranged from 17% to 21% across the districts: condoms and female sterilization were widely used methods. Woman’s age, husband’s education, wealth quintiles, spousal communication, location of last delivery, and favorable attitude toward contraception have an association with current contraceptive use. Unmet need for contraception was 40.6%, 36.6%, and 31.9% in Chakwal, Mianwali, and Bhakkar, respectively. Notably, more than one fifth of the women across the districts expressed willingness to use quality, affordable long-term family planning services in the future. Conclusion: The baseline results highlight the need for quality, affordable long-term family planning services close to women’s homes. Furthermore, targeted community mobilization and behavior change efforts can lead to increased awareness, acceptability, and use of family planning and birth spacing services