Frequency of Surgical Site Infection in Response to Single Dose Antibiotic Prophylaxis in Lumbar Intervertebral Disc Excision

Objective: To measure the frequency of infection with single dose antibiotic prophylaxis in surgery for intervertebral disc prolapse.Patients and Methods: This cross-sectional study was conducted at the Department of Neurosurgery, Pakistan Institute of Medical Sciences, Islamabad for ten months. In total 400 patients both male and female, undergoing surgery for lumbar disc herniation (single level lumbar intervertebral disc), meeting inclusion criteria, were selected for the study. Postoperative frequency of surgical site infection was measured using redness, pain, raised local temperature and wound discharge as diagnostic criteria. Postoperative surgical site infection was measured using the above criteria scale on 3rd postoperative day and 15th postoperative day. The frequency of infection in the studied patients on day 3 and day 15 was calculated. P-value of <0.05 5 was considered as statistically significant.Results: Out of total 400 patients, 290 were males and 110 were females, the age distribution was from 24 to 70 years. Mean age was 48.2± 10.8 SD. ESR for the patients ranged from 2 to 36 with a mean of 11±4.6. White cell count of the patients ranged from 2900 to 20100 with a mean of 7342±2100. Only 7 patients (1.7%) developed infection on third day of surgery and it persisted in only 4 patients (1%) till day 15 of surgery.Conclusion: Single dose preoperative antibiotic is effective in postoperative wound infection prophylaxis. This protocol if followed can prevent drug resistance and multiple doses related side effects and can cut hospital cost

Impact of Time Taken on the Surgical Outcome of Extradural Hematoma in Patients with Road Traffic Accidents

Background: To determine the impact of time taken on the surgical outcome of extradural hematoma in patients with road traffic accidents.Methods: Sixty adult patients with history of road traffic accident with extradural hematoma on axial images of CT scan brain were included. All patients were allocated into three groups with 20 patients in each group. Patients in Group I were those in whom time from the occurrence of trauma to the surgical evacuation of hematoma was < 1 hour, 1 to 6 hours in group II and > 6 hours in group III.Results: In group I, majority (90 %) showed favourable outcome. In group II, 70 % showed favourable outcome. In group III, 50 % showed favourable outcome. Significant association was found between outcome and time of surgery (p<0.05).Conclusions: Frequency of favourable outcome after surgical evacuation was significantly higher in patients in whom surgery was performed within one hour after the trauma (P<0.05)

Existence and data dependence of the fixed points of generalized contraction mappings with applications

The aim of this paper is to introduce a newtype of generalized multivalued contraction mappings and to present some results regarding fixed points of new class of multivalued contractions. As applications we obtain some basic results in fixed point theory like characterization of metric completeness, data dependence of fixed points and homotopy result. We prove the existence and uniqueness of bounded solution of functional equation arising in dynamic programming. Our results generalize, extend and unify various comparable results in the existing literature.http://link.springer.com/journal/133982016-09-30hb201

Human Capital Outflow and Economic Misery:Fresh Evidence for Pakistan

This paper visits the impact of economic misery on human capital outflow using time series data over the period of 1975-2012. We have applied the combined cointegration tests and innovative accounting approach to examine long run and causal relationship between the variables. Our results affirm the presence of cointegration between the variables. We find that economic misery increases human capital outflow. Foreign remittances add in human capital outflow from Pakistan. The migration from Pakistan to rest of world is boosted by depreciation in local currency. Income inequality is also a major contributor to human capital outflow. The present study is comprehensive effort and may provide new insights to policy makers for handling the issue of human capital outflow by controlling economic misery in Pakistan

Human Capital Outflow and Economic Misery:Fresh Evidence for Pakistan

This paper visits the impact of economic misery on human capital outflow using time series data over the period of 1975-2012. We have applied the combined cointegration tests and innovative accounting approach to examine long run and causal relationship between the variables. Our results affirm the presence of cointegration between the variables. We find that economic misery increases human capital outflow. Foreign remittances add in human capital outflow from Pakistan. The migration from Pakistan to rest of world is boosted by depreciation in local currency. Income inequality is also a major contributor to human capital outflow. The present study is comprehensive effort and may provide new insights to policy makers for handling the issue of human capital outflow by controlling economic misery in Pakistan

Klasifikasi al-Quran terhadap tingkah laku manusia dalam membina peradaban

Sebagai panduan dan pedoman bagi manusia, al-Quran tidak hanya merangkumi perkara yang berkaitan dengan aqidah, ibadah, muamalah dan akhlak, tetapi juga membincangkan hal-hal yang berhubung kait dengan manusia, seperti asal kejadian, proses penciptaan serta matlamat dan tujuan mereka dicipta oleh Allah SWT. Al-Quran juga tidak ketinggalan membincangkan perilaku, sikap dan tabiat manusia, baik yang dapat dikesan oleh pancainderia mahupun yang tersembunyi dalam hati sanubari. Hal ini dimaktubkan dalam banyak surah dan ayat. Namun adanya penjelasan tentang hakikat tingkah laku ini kurang disedari oleh kebanyakan sarjana, sedangkan ianya amat penting untuk menyelesaikan masalah manusia yang berkaitan khususnya tingkah laku yang negatif. Mereka lebih banyak merujuk kepada sumber bukan daripada al-Quran ataupun pandangan sarjana barat semata-mata apabila membicarakan tentang tingkah laku dan perkara yang berhubungan dengannya. Sehubungan dengan itu, penulisan ini bertujuan membincangkan kepelbagaian tingkah laku manusia menerusi ayat al-Quran serta huraiannya. Huraian al-Quran mengenainya adalah isyarat kepada tranformasi tingkah laku manusia yang dianjurkan bagi membina peradaban yang unggul. Perbincangan merujuk kepada ayat al-Quran dan huraian serta analisisnya menurut sarjana Islam, khususnya dalam kalangan ahli tafsir. Boleh dirumuskan bahawa al-Quran telah mengisyaratkan kepelbagaian tingkah laku manusia samada tingkah laku yang meliputi aspek luaran manusia (fizikal) dan juga aspek dalaman (rohani). Mengetahui dan memahami kepelbagaian ini dapat membantu usaha menyelesaikan masalah yang dihadapi oleh seseorang dengan mengenal pasti diri mereka dari sudut tindakan dan perbuatannya

Single nucleotide polymorphism and phylogenetic analysis of the exon 2 of leptin gene in Lohi sheep

Background: Leptin hormone, encoded by leptin (LEP) gene is involved in many biological and physiological processes in the body. Polymorphism in LEP gene has been observed and correlated with a variety of reproductive and productive traits in several sheep breeds worldwide, but its role has not been much studied in local sheep breeds of Pakistan. The present study was conducted to analyze polymorphism in LEP gene in Lohi breed of sheep.Methods: Subsequent to statistical analysis (generalized linear model), 18 animals were selected randomly from the flock for blood samples collection followed by DNA extraction, amplification using PCR prior to sequencing. The amplified product of exon 2 and partial intron 2 regions of LEP gene was 268bp.Results: Molecular analysis showed a heterozygous condition i.e. C>Y at position 15 and 18 in exon 2. The data on average daily weight gain (ADG) from birthday to 90 days were used for association study, while environmental effects were minimized by means of generalized linear model. Association of polymorphisms in LEP gene with ADG did not yield any significant results.Conclusion: In conclusion, analysis of LEP gene sequence verified the existence of genetic changes in Lohi sheep. Further investigations are needed to find variations that might be linked with traits of economic importance for upcoming breeding program sand marker-assisted selection.Keywords: DNA; Exon 2; LEP; PCR; Loh

Role of Surgical Feeding Gastrostomy in Patients Requiring Prolonged Nutrition in a Neurosurgical Department

Objective: To build up the nutritional status of the neurosurgical patients with an easy and practical way. Patients and Methods: This prospective study was conducted in Neurosurgery department of Pakistan Institute of Medical Sciences Islamabad in a six months’ time. In total thirty adult patients of either gender with H/O road traffic accident with severe head injury and GCS less than 8/15, persistent vegetative state, brain tumor patients who had developed lower cranial nerve palsies were included in the study. 28 for two way Foleys catheter was used in feeding gastrostomy. Results: Thirty patients, with the median age of 35 years (range, 18-55 years) underwent feeding gastrostomy. Before the gastrostomy tube insertion, 18 patients had enteral nutrition by a nasogastric tube and 10 had parenteral nutrition (PN), with a median duration of 14.5 (range, 4-60) and 12 (range, 7-25) days, respectively. Two patients accidentally pulled out the gastrostomy tubes 10 and 11 days after insertion. Buried bumper syndrome developed in 1 patient. Two patients died 8 and 34 days after the procedure in the neurosurgical ICU. Twenty-eight patients were discharged from the hospital while being fed via the gastrostomy tubes. In 11 patients who were able to resume oral feeding, the tube was removed, with a median interval of 62 (range, 25-150) days. There was no Procedure-related mortality. Conclusion: An improvised method of nutritional support according to our circumstances. This study can be extended to other surgical and medical patients who need nutritional support for longer period of time.&nbsp

Performance of self-compacting concrete incorporating waste glass as coarse aggregate

The purpose of this paper is to develop gather data on the rheological and mechanical properties of self-compacting concrete (SCC) containing varying percentages of waste glass aggregate (WGA). In this current experiment, the coarse aggregate was substituted by adding WGA, with replacement percentages of 0%, 10%, 20%, and 30% by weight being investigated. The rheological properties of SCC were performed to explore the consequence of WGA using various methods, including the J-ring, slump flow, L-box, and V-funnel. In contrast, the compressive, flexural, modulus of elasticity, and stress-strain responses of hardened concrete were assessed in this study. The results of the fresh concrete tests revealed that the substitution of an optimal level of waste glass in SCC provides adequate implementation in flowability, passing ability, and viscosity behaviors. Besides, hardened characteristics were shown to have a steady decrease in strength with increasing WGA content in the concrete mixtures