Asset or Problem: Decision Making and Strategic Ambiguity in Mega Projects

In mega projects, the project phases from the initial planning stage to implementation stage can be spread more than twenty year. In this long period numerous external changes occur which will effect on project directly or indirectly. Major factors are political conditions of the country, technology, financial conditions, labor and all working conditions, land and other market conditions will change in long run during the implementation of mega project. A lot of unforeseen events will occurs, these unforeseen conditions, realization and resources causes the different output as compared to expected outputs in the mega projects. That’s why the planning of mega project is most strategic decision making moment in the life of organizations. So, it’s the responsibility of the project managers to keep the mega and complex projects as simple and flexible which can be adjustable in unforeseen condition.  In this study the planning of mega projects is explored. The planning of mega projects is most important and organizations must have too kept in consideration the unforeseen conditions in their planning and decision making process. Mega and complex project have different uncertainty and ambiguity factors which can be minimized by taking rational decisions. Keywords: Mega Projects, Project Planning, Rational Decision Making, Strategic Ambiguity and Project Uncertainty

Modeling Dynamic Multifractal Efficiency of US Electricity Market

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Microbiology of Cerumen Bacterial Flora of Acute Otitis Externa Patients

Background:To compare the microbiology of Cerumen bacterial flora in acute otitis externa patients and healthy individuals.Methods: In this comparative study a total of 120 participants were included, consisting of 50 patients of acute otitis externa patients and 70 healthy participants. Healthy cases without any medical problems but with cerumen in the ear canal were enrolled ascontrol group. Clinical examination of the ear was performed and the patients' medical history was fully reviewed. Cerumen samples were obtained from both groups by suction, curettage or the use of a loop. Samples were then cultured on chocolate agar, blood agar and eosin methyl blue (EMB) media. The chocolate agar and EMB agar were incubated for 18-24 hrs at 37oC while the blood agar was incubated for 18-24 hrs at 37oC under Co2 condition. Colonies characteristics were then examined by direct microscopic examination (gram staining) and also special diagnostic tests. A p-value equal to or less than 0.05 was considered as significant.Results: Proportion of pathogenic bacteria was significantly (p-value = 0.000) higher in cases of otitis acute externa patients (44% vs. 8.57%) as compared to normal healthy patients. There were significantly (p-value < 0.05) higher gram negative bacteria in cases of otitis externa as compared to healthy control group. Most common microorganisms found in the patient group were Staphylococcus aureus (24.6%), Bacillus (21.2%) and Pseudomonas(9.0%). Staphylococcus epidermidis (41.5%), Diphtheroid (24.7%) and Streptococcus (19.5%) were the commonly found microorganisms in the control group. There was significant (p-value < 0.05) association between colony count and actue otitis externa status.Conclusion: Isolated bacteria from cerumen of healthy subjects were different in comparison to those of acute otitis externa patient

Frequency and Etiology of Secretory Otitis Media and its Morbidity in Children

Media with effusion(OME) among children in Rawalpindi region and to find out its aetiology and the associated hearing loss. Method: This descriptive study was conducted in Holy Family Hospital Rawalpindi over a period of one year (June, 7, 2007 to June, 7, 2008). Total of 563 children of 3-10 years of age presenting as out patients to ENT department during the research period were evaluated. Children with congenital anomalies of ears and impacted wax were excluded from the study. Thorough history was taken from parents of the child regarding hearing loss, tinnitus, discharge from ear, earache, itching in the ear, fever, rhinorhea, allergy, nasal obstruction, mouth breathing, recurrent sore throat, bottle feeding, language development and performance at school. Complete ENT examination was done. Hearing loss was assessed by pure tone audiometry (PTA) and OME was diagnosed with type B and C curve on tympanometry with hearing loss more than 25dB. Results: Out of 563 children, 306 were male and 257 were female. OME was common in 3-7 year age group with mean 5years. 65 children were still bottle-fed. Cleft lip and palate was found in 2, mouth breathing was seen in 29, simple rhinitis was present in 197, AURTI (acute upper respiratory tract infection) in 43 and hearing loss with delayed language development in 15 patients. On otoscopic examination, tympanic membrane was dull in 27 and retracted with decreased mobility in 20. OME was diagnosed in 39 children. 33 children showed type B curve with hearing loss of 30-40dB and 6 children showed type C curve with hearing loss of 25-30dB. Common symptoms in diagnosed cases were rhinitis in 21, mouth breathing (adenoids diagnosed on x-ray) in 13, cleft lip and palate in 2, hearing loss and delayed language development in 11 and AURTI in one child. All diagnosed cases had poor performance during their school activities. Conclusion: OME is a common disease in childhood and is closely related to various risk factors. It may result in serious morbidity in the form of delayed language development and poor performance at school due to hearing loss

Measurement of Food Insecurity in Selected Districts of Kabul City

Food Insecurity has significantly increased in both developed and developing countries, causing suffering for people due to lack of food. Food Insecurity has been mostly observed during major crises, such as the global economic crisis in 2008 and the Covid-19 outbreak in 2019. Despite fundamental efforts in fighting poverty, Afghanistan continues to struggle with food insecurity with a large proportion of its population living below the poverty line. Four districts of Kabul city were measured for Food Insecurity in which people were unable to obtain the necessary calories within 24 hours. At the present time, the social problem of Food Insecurity in Afghanistan is becoming more serious as people’s lives depend on humanitarian aid and donations. The Foster Greer Thorbecke method of measuring Food Insecurity was utilized in this paper to measure Food Insecurity in four selected districts of Kabul city. Household opinions have been collected via questionnaires and in-person interviewing. The results of this research show that District 13 has the highest level of Food Insecurity, with 70% of residents unable to have sufficient food. Subsequently, district 1 has 65% of people unable to have sufficient calories, district 16 has 62 %and district 8 has 61 %. This paper aims to highlight the efforts of Afghanistan in alleviating food insecurity with a focus on the impact of COVID-19, unfair government policies, bad security, weak infrastructure, low literacy level, medical services shortage, high unemployment rate and lack of modern technology that hinder Afghanistan from accessing enough food. We conclude that Afghanistan would need to develop update policies to mitigate food insecurity

Badiou’s Reading of Saint Paul

There has been a renewed interest in reading Saint Paul from different aspects by contemporary political theology and philosophy. However, being encountered with the sickness of contemporary philosophy and regarding it as sophistry, Badiou turns to Paul as an anti-philosopher, model, and someone who answers the question of ‘conditions of universal singularity’. In this article, the underlying reasons for the importance of Paul for Badiou will be discussed. By reflecting on the intricacies of Badiou’s reading( reactivation of Paul), his approach to problems and goals of event philosophy will be revealed. Therefore, paying attention to Paul’s interpretation as a part of Badiou’s event philosophy project will pave the way for the understanding of Badiou’s thought. On the other hand, by studying this exemplification of Christian history, a light will be shed on how Badiou relates politics to truth and recreates the political figure of the event. In the end, the criticism of his reading of Saint Paul mostly by theologians will be examined and responded

RELIGIOUS PROPAGANDA AS HEGEMONY STRATEGY DEPICTED IN AGORA (2009)

This paper entitled “Religious Propaganda as Hegemony Strategy Depicted in Agora (2009)” aims to find out the hegemony occurred in Agora movie that is reflected through religious propaganda. In conducting the research, the researcher uses the theory of hegemony by Antonio Gramsci. The data collection was based on the dialogue of the movie, which then supported by books, journals, and articles depicting the hegemony and the social setting of the movie. In conducting the research, the researchers found that the hegemony depicted in the Agora movie are reflected in the religious propaganda in the form of condemnation towards other religion and the preaching of the Christianity itself.    &nbsp

Frequency of angular malalignment after intramedullary nailing for femur shaft fractures - A cross-sectional study

Objective: To determine the frequency of angular malalignment of femur in patients undergoing Intra Medullary nailing for femur shaft fracture by measuring axis on immediate postoperative plain radiographs.Methods: A cross-sectional study was conducted at the Section of Orthopaedics, Department of Surgery, Aga Khan University Hospital, Karachi from 1st January 2019 till 30th June 2019. All patients between the ages of 15 to 80 years who underwent IM nailing for femur shaft fractures were included. Angulation was measured on immediate post-operative X-ray films and an angle of ≥5° on AP and/or lateral views was defined as malalignment.Results: A total of 65 patients were enrolled in the study with a mean age of 39.9 ± 16.5 years. Majority of the patients,49 (75.4) were males and road traffic accidents were found to be the most common mechanism of injury. Malalignment after surgery was encountered in 6(9.2%) patients. Proximal femur fractures were noted to be significantly associated with malalignment with a p-value of 0.014.Conclusions: This shows that frequency rate of malalignment after IM nail for femoral shaft fractures in a developing country like Pakistan is comparable to internationally reported literature and proximal femur fracture is a risk factor for malalignment

A Rare Case of Pneumoperitoneum due to Perforation at Tip of Appendix

Pneumoperitoneum caused by a perforated appendix is extremely rare. We encountered a case of a 24 years old male presented in the emergency department of EAST surgical ward of MAYO Hospital Lahore with a history of epigastric pain for 10 days, which later became generalized. Chest X-ray showed free air under the right hemidiaphragm. On the basis of clinical examination and radiological correlations diagnosis of duodenal ulcer perforation was made. On exploration of abdomen through midline incision it was found to be a perforated appendix at its tip. The body and base of the appendix was normal. No per operative and postoperative complications were encountered and the patient discharged on the second postoperative day. Biopsy of appendix showed acute inflammation of appendix