Neurocognitive Functions after Stereotactic Radiosurgery- An Analysis with Mini-Mental State Examination (MMSE)

Background: During the last decade, neuro-oncological research has increased awareness regarding the importance of cognitive functions as an outcome in different treatment modalities for primary brain tumor patients but only a few studies have addressed the issue of the possibility of cognitive dysfunction in patients who undergo stereotactic radiosurgery/stereotactic radiotherapy. Objectives: To determine the effect of stereotactic radiosurgery/stereotactic radiotherapy on neurocognitive functions (NCF) in various brain tumors. Methods: A prospective observational study was carried out at Neurospinal and Cancer Care Institute (NCCI), Karachi. A total of 100 patients who had undergone multisession stereotactic radiosurgery /stereotactic radiotherapy were selected after taking their written informed consent by employing convenient sampling technique. The type of tumor was classified and identified on radiological and histological basis. Neurocognitive function evaluation was carried out through Mini-Mental State Examination (MMSE) score questionnaire providing to the patient at pre-radiotherapy baseline, at 6 months, and annually thereafter until 5 years. Results: The mean age of the patients was 37.3±15.2 years and most of them (28%) belonged to 31-40 years age group. Majority of them were males whereas the most common pathology found was glioma (31%).Moreover, both overall and in patients who had undergone prior surgery, the comparison of different MMSE score levels showed that there was a significant increase in patients with normal score levels and a significant decrease in patients with mild and moderate score levels after treatment (P=0.006 and P=0.046 respectively) at 5 years time. Conclusion: Stereotactic radiosurgery results in improvement of neurocognitive functions. Previously known radiation related impairment of NCF should be re-explored in the light of modern radiosurgery / radiotherapy techniques with larger studies

Role of Optimal Production Plan at the Focal Firm in Optimization of the Supply Chain

Supply chain management and optimization is a critical aspect of modern enterprises and an expanding area of research. Modeling and optimization are the traditional tools of supply chain management. The techniques have been used by many companies for planning, manufacturing, and other decision areas in supply chains. Current study is motivated by the fact that optimization studies in supply chain management have mostly considered network optimization. Supply chain management however, requires alignment between the supply chain partners at the tactical level. As a first step towards achieving this goal, current study presents a model that incorporates the activity level planning at the focal firm in a supply chain. This paper presents a new mixed integer programming model that incorporates optimization of production planning at the focal firm while optimizing the strategic alignment of the supply chain entities. The model represents a four step, multi-echelon supply chain including supplier, warehouse, manufacturer, and retailer. The manufacturer in this network represents the focal firm. This model is an attempt to integrate the production planning decisions in the network optimization decisions

Measuring Training Effectiveness: A Case Study Of Public Sector Project Management In Pakistan

Many organizations do invest precious resources on training and development but without examining how training interventions could effectively contribute in the achievement of organizational objectives, eventually resources are wasted. To yield desired level of performance, it is an imperative that organizations effectively plan, implement and evaluate their training interventions. Several authors have studied the training and development practices but most the studies lack any operational framework for diagnosing the training and development system. This study used Kunder’s (1998) indicators of training ineffectiveness and developed a framework for measuring effectiveness of training and diagnosing problems at various stages of training and development. We developed a questionnaire based on framework and collected data from 115 project directors to measure training effectiveness in project organizations in Pakistan. The study had found that on overall basis training practices are ineffective. Results reveal that there is a poor mechanism of evaluation of training and use of evaluation results. The framework developed by this study can be used in other organizations to measure training effectiveness and diagnose problems at various stages of training cycle

Protective Effects of Salivary Factors in Dental Caries in Diabetic Patients of Pakistan

Salivary factors have been studied for their effects on the process of dental caries in patients of diabetes mellitus type 2. In this study, protective role of salivary pH, salivary flow rate, and salivary calcium is assessed in the patients of diabetes mellitus type 2 with dental caries. The samples of saliva were collected from 400 patients of diabetes mellitus type 2 and 300 age- and sex- matched controls after getting informed consent. All the subjects were classified into four groups according to age. The severity of dental caries was counted by decayed, missed, and filled teeth (DMFT) score. The salivary pH, flow rate, and calcium levels were found to be low in patients as compared to controls. The levels of fasting blood sugar, HbA1c, and DMFT score were found to be significantly high in patients than controls. The glycemic factors were significantly correlated with salivary factors indicating their influence on progression of caries in diabetes. On the basis of findings, it is concluded that the suitable salivary pH and flow rate may be regarded as main protective factors against dental caries in diabetes. Optimum level of salivary calcium may be responsible for continuous supply of calcium to arrest the demineralization and help reduce the occurrence of dental caries

Does bank size and operational efficiency matters? an impact of financial gearing and asset management on Islamic bank’s performance in Pakistan

Purpose: The persistent growth of Islamic banks has been the distinction of the Muslim world financial background in the 1980s and 1990s. Through a network that spans more than 62 countries and an asset base of more than $169 billion; Islamic banks are now performing a progressively more significant role in their particular economies. The core objective of this study is to find the impact of some of the key bank-specific factors (internal determinants) on the profitability of Islamic banks in Pakistan. Factors that opted in this study are bank size, operating efficiency, gearing ratio and asset management. Secondary data was obtained from 5 Islamic banks in Pakistan from year 2007 to 2015. The Ordinary Least Square (OLS) was used to analyze the empirical findings. The estimation results show that bank size significantly and positively influence the bank profitability while the asset management inversely affects the bank profitability. For future studies, it is recommended that more sample size and determinant factors can be included in determining the impact on bank's profitability

Challenges and Opportunities of Globalization for the Development of Human Rights in Pakistan 2010-2014

Globalization is a growing phenomenon in the contemporary times when man has become modern in its thinking, actions and evaluation. Growing awareness regarding human rights is not only bringing human into mainstream affairs being major stakeholders indirectly but also greater expectations. This reality of preservation of human rights has brought the issue into legislation to make it law as a written part of the constitution at national, regional and global level in almost all spheres. Consequently, assurance of human fundamental rights is ground reality and written part of all the constitutions of the world. Globalization has transformed the world into a global village where there are commonalities of the cultures, exchange of ideas and free economic approaches are struggling to bring consensus among the world society to protect and preserve the human rights against any violation. World has divided into two blocks global north and global south based on their economic and political capacities. Globalization phenomenon was started by global north so it augurs well for the advancement of their interests while South is less benefited because of having underdeveloped status and weaker rule of law, social, economic and political condition.&nbsp

Hydrophobicity properties of graphite and reduced graphene oxide of the polysulfone (PSf) mixed matrix membrane

Hydrophobicity properties of graphite and reduced graphene oxide (rGO) (from exfoliated graphite/rGO) towards PSf polymer membrane characteristic and properties at different additives weight concentrations (1, 2, 3, 4 and 5 wt. %) were investigated. Both PSF/graphite and PSf/rGO membranes were characterized in term of hydrophobicity, surface bonding, surface roughness and porosity. FTIR peaks revealed that membrane with graphite and reduced graphene oxide nearly diminished their O-H bonding which was opposite to the graphene oxide peak that shows a strong O-H bonding as increased exfoliated times. These results were in line with the contact angle results that showed strong hydrophobicity of graphite and reduced graphene oxide membranes as increased these additives concentration. The effect of strong hydrophobicity in these membranes also has resulted in smoother surface roughness compared to pristine PSf membrane. Further investigation of the performance of water flux also proved that both above membranes have strong hydrophobic effect, with the lowest pure water flux rate (L/m2h) was given by PSf/rGO 3% membrane at 19.2437 L/m2h

Prevalence, awareness, treatment and control of hypertension in Malaysia: A national study of 16,440 subjects.

Study design: A cross-sectional study was conducted in all states of Malaysia to determine the prevalence, awareness, treatment and control of hypertension. A stratified two-stage cluster sampling design with proportional allocation was used. Methods: Trained nurses obtained two blood pressure measurements from each subject. Hypertension was defined as mean systolic blood pressure 4140 mmHg, diastolic blood pressure490 mmHg, or a self-reported diagnosis of hypertension and taking antihypertensive medication. All data were analysed using Stata 9.2 software and took the complex survey design into account. A two-sided P-value of o0.05 was considered to be statistically significant. Results: The overall prevalence of hypertension for subjects aged X15 years was 27.8% (95% confidence interval (CI) 26.9–28.8). The prevalence of hypertension was significantly higher in males (29.6%, 95% CI 28.3–31.0) compared with females (26.0%, 95% CI 25.0–27.1). Multivariate logistic regression showed that the odds of having hypertension increased with increasing age, in males, in subjects with a family history of hypertension, with increasing body mass index, in non-smokers and with decreasing levels of education. Only 34.6% of the subjects with hypertension were aware of their hypertensive status, and 32.4 were taking antihypertensive medication. Amongst the latter group, only 26.8% had their blood pressure under control. The prevalence of hypertension amongst those aged X30 years has increased from 32.9% in 1996 to 40.5% in 2004. Conclusion: In Malaysia, the prevalence of hypertension is high, but levels of awareness, treatment and control are low. There is an urgent need for a comprehensive integrated population-based intervention programme to ameliorate the growing problem of hypertension in Malaysians