Comparison of open vs Plastibell techniques of circumcision for surgical outcomes and cosmetic satisfaction;A randomized control trial

Objective of the study: To compare the results of circumcision by open technique and the Plastibell technique in male babies. Methods: In this randomized controlled interventional study, 1440 babies whose circumcision was done as religious rite were divided into two groups. Group A underwent circumcision by open technique whereas group B underwent circumcision by Plastibell method. Results: Majority 720 (50%) were in age group 6-8 weeks. Compared with open method, significantly less number of patients in plastibel method experienced moderate pain (47.91% versus 35% p value .00001 and severe pain 31.94% versus 9.02% p value .00001.Rate of wound infection was significantly less in plastibell method 2.77% versus 4.86% p value .020. However more patients in plastibell technique needed re-do circumcision 4.02% versus 1.94% p value .0202. Overall greater parent’s satisfaction was attained with plastibel method. Conclusion: Plastibell technique has many advantages over open method in terms less post op pain, wound infection, and greater cosmetic  satisfaction however more patients will need re-do circumcision in this technique compared with conventional method. Keywords: Circumcision, open technique, Plastibell, post-op complication

ANALYSIS OF HEPATITIS AMONG PREGNANT WOMEN OF LAHORE

Introduction: Hepatitis B is one of the major global health infectious diseases affecting the liver. It is estimated that, globally, over 2 billion people have been infected with Hepatitis B virus and an estimated 240 million people are chronic carriers of the virus. Hepatitis C infection is one of the major health issue worldwide caused by hepatitis C virus. Objectives of the study: The main objective of the study is to analyze the hepatitis infection among pregnant women of Pakistan. Material and methods: This study was conducted at Government Lady Aitchison Hospital, Lahore during January 2018 to May 2018. A sample size of 100 individuals was targeted. A specific questionnaire was developed to determine viral hepatitis perception. This instrument was composed of two topics: demographic characteristics and viral hepatitis perception. Sociodemographic data included gender, age, education, and monthly family income. Results: Independent factors associated with insufficient reduced HBV knowledge include women outside the healthcare sector, lower education level, and no previous HBV testing. The majority of respondents could provide correct responses about the common aspects of HBV infection, including screening, blood-borne and perinatal transmissions, prevention by vaccination, and sequelae of HBV infection. Conclusion: It is concluded that knowledge and awareness of HBV among pregnant women in the Pakistan is low. Generalized across the country, this could have the potential to hamper effective HBV prevention and control in Pakistan

spectrum of acquired demyelinating disorders of the central nervous system in adults in a tertiary care hospital

Acquired demyelinating disorders of the central nervous system are diverse group of conditions characterized by destruction or disturbance of myelin sheath in the central nervous system i.e. brain and spinal cord. These vary in their causes, clinical presentations, and prognosis

PERFORMANCE ASSESSMENT AND JOB SATISFACTION OF SUPPORT STAFF IN ACADEMIC LIBRARIES

The purpose of current study was to investigate about the job performance and job satisfaction of support staff working in academic libraries of Lahore. Supporting staff is performing many imperative duties in academic libraries and their role in libraries is very important. The objective of current study was to investigate the job performance through job satisfaction, to test relationship between job performance and job satisfaction and to investigate the moderating effect of hurdles in work between job satisfaction and job performance. Quantitative approach was adopted and survey method was used to achieve the objective of the study. Questionnaire with Urdu translation was prepared to collect the data. Data was collected by visiting personally, through email and google form was also developed to collect the data. Higher Education Commission recognized academic universities of Lahore offering higher education programs was the population of current research. Participant of this study was supporting staff including “data entry operators, library assistants, library clerks, junior assistants, computer operators and shelvers etc.” those were performing their duties in government, semi-government and private sector universities main libraries of Lahore. Data was analyzed by using SPPS 22 version. The findings of this study revealed that supporting staff performing the duties in many major areas of library, like, Circulation, Technical, Cataloguing, Serial Management etc. The results showed positive impact of job satisfaction on job performance, but relationship between job satisfaction and performance found weak. The moderator like, low connectivity, down of computer, domestic issue, office environment effects the job performance of support staff

Barriers for the Adoption of Professional Development Courses (PDCs) in Public Sector University Libraries

Objective: The purpose of the study was to explore the major problems of Library Professionals working in the academic libraries of public sector universities regarding participation in Professional Development Courses (PDCs). Methodology: Public sector Universities affiliated with Higher Education Commission (HEC) Pakistan, located in Lahore, Pakistan were the target population. The Census sampling technique was adopted to accomplish the objectives of the conducted study. 67 respondents participated in the study. A quantitative research technique was used in the study. A self-created questionnaire was used to collect the data. Key Findings: The findings of the study revealed that a good number of respondents were willing to participate in development activities. But, due to numerous hurdles included shortage of library staff, poor allocation of budget for development activities and non-interesting attitude of organizational administration towards the professional development of Library professionals were the major barriers towards professional development activities. Rationale and Significance: Past literature indicated that no study was conducted covering the objective of barriers in professional development. No researcher made the proper investigation in the local scenario. It was highly desired to explore the barriers in participating in professional development activities in the local context. Implication: This study would contribute to the professional literature. It will also assist policy makers to take initiatives for the capacity building of library professionals

Prospects of Artificial Intelligence in the Improvement of Healthcare Professions: A Review

In 1956, the development of engineering science led to the birth of the first intelligent machines. This has led to the term Artificial Intelligence (AI) coined by a scientist named John McCarthy. The basic purpose of AI is to minimise human cognitive function. Advanced computer technology allows humans to do comparative critical thinking and simulate intelligent behaviour by producing intelligent modelling to solve boost and uplift cracking problems, imaging knowledge, and making a decision.  Consequently, rapid analytical technique progress, powered by the increasing data availability in healthcare, has directed a paradigm shift in the healthcare system, especially in the analysis of medical imaging in the disease of oncology by detection of brain tumours. It helps the diagnosis of cancer stages based on the abnormal cell growth in the brain. AI is also important in diagnosis and treatment in other medical departments like dermatology, nephrology, ophthalmology, pathology, pulmonary medicine, endocrinology, gastroenterology, and neurology.  In recent years, AI has played a key role in pharmacy, drug delivery, drug discovery, drug formulation development, hospital pharmacy, and poly-pharmacology. The term AI has a broad range of applications in medicine, medical statistics, medical diagnosis, human biology, pharmacy, clinical, and robotics. Automated selective medication uses the scientific task approach of pharmacists and is only possible by the use of AI. Algorithmic tasks reserved by using AI automation and such type of AI demonstration are better than pharmacists in comparison. In general terms of AI, the minimal intervention of humans implies intelligent behaviour through computer models. The invention of robots is deemed the starting point of the AI journey. It started with the introduction of robotic biosynthetic machines utilised to support medical personnel. In the meantime, an AI is capable of analysing complex clinical and medical data where a potentially significant data set relationship can be used for treatment and predicting outcomes in the case study and diagnosis

A COMPARATIVE STUDY ON JOB SATISFACTION AMONG PUBLIC AND PRIVATE BANKS EMPLOYEES

ABSTRAC

Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study

Background: Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. Methods: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older. Findings: Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change −0·2% [95% UI −1·5 to 1·0]; 2019 prevalence 9·58 cases per 1000 people [95% IU 8·51 to 10·8], 2010 prevalence 96·0 cases per 1000 people [86·0 to 107·0]). Age-standardised prevalence of avoidable blindness decreased by −15·4% [–16·8 to −14·3], while avoidable MSVI showed no change (0·5% [–0·8 to 1·6]). However, the number of cases increased for both avoidable blindness (10·8% [8·9 to 12·4]) and MSVI (31·5% [30·0 to 33·1]). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15·2 million cases [9% IU 12·7–18·0]), followed by glaucoma (3·6 million cases [2·8–4·4]), undercorrected refractive error (2·3 million cases [1·8–2·8]), age-related macular degeneration (1·8 million cases [1·3–2·4]), and diabetic retinopathy (0·86 million cases [0·59–1·23]). Leading causes of MSVI were undercorrected refractive error (86·1 million cases [74·2–101·0]) and cataract (78·8 million cases [67·2–91·4]). Interpretation: Results suggest eye care services contributed to the observed reduction of age-standardised rates of avoidable blindness but not of MSVI, and that the target in an ageing global population was not reached. Funding: Brien Holden Vision Institute, Fondation Théa, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

انور سجاد کا غیر مطبوعہ اردو اسٹیج ڈراما " ایک تھی ملکہ" : متنی و علامتی جائزہ

Enver Sajjad is well-known in the Urdu world as a short story writer, novelist and a playwright. He served as the first chairman of the Alhambra Arts Council (1973-1975) and recieved the Pride of Performance award in 1989. This article presents an analytical study of his first—yet unpublished—stage drama, Ēk thī Malikā. It reveals him as a unique stage drama writer whose symbolism ranges from social evils on one end to political oppression on the other. Through his unique style, he innovated the genre on many levels and presented a complete picture of his times despite limited resources.</p