Does NICU Intervention Improve Survivability in Consanguineous Trisomy 13?

Patau Syndrome is a fatal autosomal trisomy ,usually seen because of Meiotic nondisjunction due to maternal advanced age. It is observed at a higher frequency in non-consanguineous union.Trisomy has a prevalence of : 2,000– : 29,000 in newborns. ,Also known as Patau Syndrome, it is a rare and lethal autosomal trisomy 3 with a survivability of only 7- 0 days.Only an estimated 9% to 4% of live births survive beyond year of life and are associated with mosaicism. Severity of associated malformations also plays a key role in prognosis and survival.It presents with a wide array of dysmorphic features including microphthalmia, cutis aplasia, polydactyly, cleft lip, cleft palate, various congenital heart disease, omphalocele, holoprosencephaly and urogenital abnormalities. There is an intense discussion as to whether timely NICU interventions do play a role in improving mortality in the neonate and long term better prognosis and survivability as a result , especially in VLBW(Very Low Birth Weight) infants. There is a higher reporting frequency of Trisomy’s in non-consanguineous marriages one example of which is Down Syndrome. Currently diagnosis is based on increasing maternal age, sonographic findings, serum markers and amniocentesis followed in many cases by pregnancy termination as in the West. Risk increases with increasing maternal age with an average of age of 3 years

The Effect of Customer Education in relation to Banking Transactions on Traditional Retail Business: The Mediating Role of Emotional Design and Experience Design

The study focuses on how consumer education in relation to banking transactions affects traditional retailing, how emotional design and experience design operate as mediators, and how relevant psychological theory applies to Chinese labour. The project intends to create its own psychological theory and explore the impact on traditional retail and emotional design. The data was analyzed using a survey of 340 employees in China firms that was done both online and in-person. The results of structural equation modelling (SEM) show that traditional retail operations have a favourable influence on customer education. The study's findings also revealed a link between conventional retail business, emotional design, and experience design. Additional research can be carried out to keep the understanding of our model accurate. In China traditional retail, it is customary for the shareholder also serve as the store manager to run the company alongside their family. According to the study site's analysis of the data gathered, the bulk of traditional retail business owners conduct their operations and deal directly with customers. Despite our best efforts, we were only able to use a tiny sample for this inquiry. The major findings of this study could be verified in follow-up investigations using a bigger sample. A number of important policy recommendations, questions for further research, and recommended theoretical and practical repercussions are made

Spillover Effect of Financial Insecurity during the Covid-19 Pandemic in the Banking Industry: The Relationship Between HRM Practices, Workplace Social Support, Work Engagement and Turnover Intention

Financial remuneration, career flexibility, performance assessment, supervisor and coworker assistance, and workplace social support were the primary foci of this investigation into the connection between human resource practises and employee turnover intentions. The results demonstrated a moderated association between work engagement and financial uncertainty. In order to decrease employee turnover, businesses must acknowledge the role that work satisfaction plays

Generalized Neutrosophic TOPSIS to Solve Multi-Criteria Decision-Making Problems

Multi-criteria decision making (MCDM) is the technique of selecting the best alternative from multiple alternatives and multiple conditions. The technique for order preference by similarity to an ideal solution (TOPSIS) is a crucial practical technique for ranking and selecting different options by using a distance measure. In this article, we protract the fuzzy TOPSIS technique to neutrosophic fuzzy TOPSIS, and prove the accuracy of the method by explaining the MCDM problem with single-value neutrosophic information, and use the method for supplier selection in the production industry. We hope that this article will promote future scientific research on numerous existence issues based on multi-criteria decision making

O papel da justiça organizacional para desenvolver o comportamento de cidadania organizacional: efeito moderador da ética do trabalho islâmico

This paper aims to examine and test the role of organizational justice (distributive, procedural & interactional) to develop and promote organizational citizenship in Pakistani financial institutions under moderation effect of Islamic work ethics on the concepts of social exchange, equity and meta/normative ethics theories. In order to pledge the riven opinion on the relationship of organizational justice and organizational citizenship behavior in the existing literature, Islamic work ethics has been inducted as a moderator. The population of the study is the 19 Financial Institutions of Pakistan and data were collected through a survey based 230 questionnaires. PLS was employed to analyze the data and post analysis; it has been established that all three forms of organizational justice are playing a role in the development of organizational citizenship behavior with varying level of impact and interestingly interactional justice is more dominating. Islamic work ethics has no moderation part in the relationship of organizational justice and organizational citizenship behavior. Islamic work ethics is autonomous character for organizational citizenship behavior development. The study has significant contribution to the existing literature available on all the constructs. The imminent studies may expand its scope.Este documento tiene como objetivo examinar y probar el papel de la justicia organizacional (distributiva, procesal e interactiva) para desarrollar y promover la ciudadanía organizacional en las instituciones financieras pakistaníes bajo el efecto moderador de la ética laboral islámica sobre los conceptos de intercambio social, equidad y teorías de ética meta / normativa. Para garantizar la opinión dividida sobre la relación entre la justicia organizacional y el comportamiento de la ciudadanía organizacional en la literatura existente, la ética laboral islámica ha sido incorporada como moderadora. La población de estudio son las 19 instituciones financieras de Pakistán y los datos se recopilaron a través de una encuesta basada en 230 cuestionarios. PLS se empleó para analizar los datos y el análisis posterior; se ha establecido que las tres formas de justicia organizacional desempeñan un papel en el desarrollo del comportamiento de ciudadanía organizacional con diferentes niveles de impacto y, curiosamente, la justicia interactiva es más dominante. La ética laboral islámica no tiene una parte moderada en la relación entre la justicia organizacional y el comportamiento de la ciudadanía organizacional. La ética laboral islámica es de carácter autónomo para el desarrollo del comportamiento de la ciudadanía organizacional. El estudio tiene una contribución significativa a la literatura existente disponible en todos los constructos. Los estudios inminentes pueden ampliar su alcance.Este artigo tem como objetivo examinar e testar o papel da justiça organizacional (distributiva, processual e interacional) para desenvolver e promover a cidadania organizacional nas instituições financeiras paquistanesas sob efeito moderador da ética do trabalho islâmico nos conceitos de teorias de troca social, eqüidade e ética meta / normativa. . A fim de prometer a opinião distorcida sobre a relação entre a justiça organizacional e o comportamento de cidadania organizacional na literatura existente, a ética do trabalho islâmico foi introduzida como moderadora. A população do estudo é a 19 Instituições Financeiras do Paquistão e os dados foram coletados através de uma pesquisa baseada em 230 questionários. PLS foi empregado para analisar os dados e pós análise, foi estabelecido que todas as três formas de justiça organizacional estão desempenhando um papel no desenvolvimento do comportamento de cidadania organizacional com nível variável de impacto e a justiça interessantemente interacional é mais dominante. A ética do trabalho islâmico não tem parte moderadora na relação entre a justiça organizacional e o comportamento de cidadania organizacional. A ética islâmica do trabalho é um caráter autônomo para o desenvolvimento do comportamento de cidadania organizacional. O estudo tem contribuição significativa para a literatura existente disponível sobre todos os construtos. Os estudos iminentes podem ampliar seu escopo

Plithogenic Fuzzy Whole Hypersoft Set, Construction of Operators and their Application in Frequency Matrix Multi Attribute Decision Making Technique

In this paper, initially a matrix representation of Plithogenic Hypersoft Set (PHSS) is introduced and then with the help of this matrix some local operators for Plithogenic Fuzzy Hypersoft set (PFHSS) are developed. These local operators are used to generalize PFHSS to Plithogenic Fuzzy Whole Hypersoft set (PFWHSS). The generalized PFWHSS set is hybridization of Fuzzy Hypersoft set (which represent multiattributes and their subattributes as a combined whole membership i.e. case of having an exterior view of the event) and the Plithogenic Fuzzy Hypersoft set (in which multi attributes and their subattributes are represented with individual memberships case of having interior view). Thus, the speciality of PFWHSS is its presentation of an exterior and interior view of a situation simultaneously. Later, the PFWHSS is employed in development of multi attributes decision making scheme named as Frequency Matrix Multi Attributes Decision making scheme (FMMADMS). This innovative technique is not only simpler than any of the former MADM techniques, but also has a unique capability of dealing mathematically a variety of human mind psychologies at every level that are working in different environments (fuzzy, intuitionistic, neutrosophic, plithogenic). Besides, FMMADMS also provides the percentage authenticity of the final ranking which in itself is a new idea providing a transparent and unbiased ranking. Moreover, the new introduced idea of frequency matrix handles the ranking ties in the best possible way and has an ability to provide the authenticity comparative analysis of previously developed schemes. Lastly, application of this FMMADMS is described as a numerical example for a case of ranking and selecting the best alternative

Evaluation of Ischemic and Hemorrhagic Stroke on Computed Tomography

The stroke is the 3rd leading cause of death in Pakistan, wherein back in 2009, stroke used to be the 4th leading cause of death in Pakistan, a 19.2% increase is alarming (IHME, 2019). Ischemic stroke occurs 75-80 percent of the time, while hemorrhagic stroke occurs 8-20 percent of the time. The objective of our study is to evaluate the frequency and ratio of ischemic and hemorrhagic stroke on computed tomography. A Descriptive study was performed using non-probability convenient sampling technique. The study was conducted in Lahore General Hospital, Lahore, Pakistan. The data was collected from November 15, 2020 to February 15, 2021. Informed consent was taken from all the participants. In our study patients with provisional diagnose of clot or thrombosis, History of Ischemic Stroke, History of Hemorrhagic Stroke, patients who came with clinical manifestation of stroke, traumatic or Road Traffic Accidents (RTA) patients, patients with cerebral Transient Ischemic Stroke. Arterial Puncture in Last 7 days, patients with Active bleeding, peroneal nerve injuryand patients who have been injected Botulinum Toxic Injection in last 3 months were included in our study. Patients who had a previous history of Parkinson disease, patients not having any apparent cause or chronic or acute symptoms of stroke, no history of internal bleeding, patients with chronic cerebral disease and patients with other neurological defects were excluded.A total of 85 patients with Stroke were included in our study. Most of the patients were 40 to 65 years of age. The average age of the patients was 59.5 ± 11.1 years. Out of 85 there were 38.8% (P=33) positive with H/O Infarction females (P=11) and males (P=22 ) 55 (62.5%) were males and 33 (37.5%) were females with 1.62: 1 male to female ratio as shown in Fig 5.2. Ischemic stroke was observed in 33 (36.2%) patients and 40 (47.3%) were suffered hemorrhagic stroke and 12 (14.4%) patients were affected with TIA.The conclusion to this study is that to assess early stroke with extreme clarity, computed tomography is the safest modality for evaluating stroke patients and allows radiologists to more accurately assess these patients on CT in terms of prognosis, frequency, morbidity, and legitimacy. Keywords: Stroke, Hemorrhagic Stroke, Ischemic Stroke, Cerebral Infarction, Computed Tomography DOI: 10.7176/JHMN/90-06 Publication date:June 30th 202

Sonographic Evaluation of Causes of Right Hypochondriac Pain

Background: Right hypochondriac pain or right upper abdominal quadrant (RUQ) pain is the most common type of pain, reason of 7.9% patients presenting at the OPD and ET departments of hospitals. RUQ main has multiple recorded causes with different frequencies of presentation. Ultrasound is the essential imaging methodology of decision for introductory evaluation and fills in as a practical and dynamic methodology to give a conclusive finding. Various systems of organs are incorporated at standard RUQ US, and an assortment of ultrasonographically diagnosable infection cycles can be recognized, including states of hepatic, pancreatic, adrenal, renal, gastrointestinal, vascular, and thoracic, all of which may bring about RUQ torment and pain. Most common causes, however, incorporate acute hepatitis and issues with gall bladder such as cholelithiasis as reported in existing literature The present study was thus conducted to evaluate the causes of right hypochondriac pain adopting ultrasound as the modality of choice. All the patients were scanned using SIMENS Grey scale/doppler ultrasound machine. Scanning was done in both transverse, longitudinal and any other plane deemed necessary to adequately visualize the right upper quadrant. Patients of either sex suffering from right hypochondrium pain were included in the study. They were referred from surgical OPD/ward of Chaudhary Muhammad Akram Teaching and Research Hospital. Duration of study was 4 months, during this period 154 patients were selected on the basis of  age, gender and  radiological findings,  informed, verbal consent was taken and ultrasonographic reports were collected  from radiologist office. It was found that out of 154 recorded cases, 93 were females and 61 males. Patients presented with a mixed frequencies of pain, highest being generalized abdominal pain. For the causes of RUQ pain, hepatic cyst was found to be the major cause present in 38.3% study participants followed by cholelithiasis (13.6%), hepatic hemangioma (10.4%), and right renal cyst (6.5%). Other findings included conditions like fatty liver (5.8%), gallbladder polyp (5.8%), right renal stones and hepatocellular carcinoma (3.9%). It was concluded that hepatic cysts and gall bladder stones are the major cause of RUQ pain in the present study sample. Although in some cases  non-significant causes included hepatic calcification, focal nodular hyperplasia and lipomas are causes pain. As in our cases, US seems to be an important diagnostic modelity in both the diagnosis and follow-up of Right hypochondriac pain and it may provide a faster, easier method of diagnosis. Keywords: Right Hypochondriac Region, Cholelithiasis, Acute Hepatitis, Ultrasound, Inflammation. DOI: 10.7176/JHMN/91-06 Publication date:July 31st 202