Sinus of valsalva aneurysm rupturing into main pulmonary artery: A rare paediatric cardiac emergency

Congenital Sinus of Valsalva aneurysm is a rare congenital cardiac disease. Most common site of origin is the right sinus. It ruptures into right ventricle or right atrium most of the times. Only in less than 2% of the cases it ruptures into the pulmonary artery. We report a rare case of right sinus of valsalva aneurysm rupturing into pulmonary artery

Exploring the Relationship between Despotic Leadership and Job Satisfaction : The Role of Self Efficacy and Leader–Member Exchange

This study explores the effects of despotic leadership (DL) on employee job satisfaction (JS) using self-efficacy (SE) as a mediating variable and leader–member exchange (LMX) as a moderated variable. Building on the social learning and social exchange theory, our research proposes a research model. In this model, despotic leadership affects employee job satisfaction both directly and indirectly through self-efficacy and leader–member exchange. We used a questionnaire survey analysis approach to collect data. Data were collected from the employees of small- and medium-sized enterprises (SMEs) located in Guangdong Province, P.R. China. A pilot test of 20 participants with similar demographics as the final sample was performed to test the usability of the questionnaire. We distributed 500 questionnaires among the target population. In total, 230 usable questionnaires were returned, resulting in a response rate of 53%. To estimate the proposed relationships in the theoretical framework, we used SPSS and AMOS. The results of this study confirmed that despotic leadership has a negative impact on employee job satisfaction. Moreover, the outcomes of this study indicate that self-efficacy has a mediating effect between despotic leadership and employee job satisfaction. Similarly, the results also confirm that LMX has a moderating effect between despotic leadership and employee self-efficacy. Therefore, we conclude that the community is understanding of the mechanism of despotic leadership, identify the mechanism to effectively deal with its negative effects, broaden the relevant research on the antecedent variable of self-efficacy, and provide practical enlightenment enterprises to retain and employ people

Analysis of Motivation Level of L2 Learners in Enhancing Speaking Skill

The present study focuses on the second language (L2) learners’ motivation as a substantial factor for enhancing speaking skills at the graduate level. Motivation in L2 learning is a complex phenomenon that had gained the attention of researchers and theorists for many decades. Motivation to learn English as a second language have been described and categorized in several ways. However, the emerging trend of English language learning at a high rate calls forth to answer the question such as why learners are so ambitious to learn this language in the presence of a national language. Secondly, if they are learning the English language, what is the kind of motivation urging them to learn it. At the present scenario, the English language has become a compulsion in both academic and professional career of L2 learners; though, the L2 learners should be reinforced to speak in English inside and outside of the classroom. The hegemony of the English language cannot be refuted at any cost because it has been employed in the domains of power-administration, military, education, and commerce since the making of Pakistan. A random sample of hundred graduate students from University of Management and Technology and hundred from University of Education, Lahore were selected. The close-ended questionnaire was used and total numbers of items were 21. The data were analyzed quantitatively using the content analysis method which suggested that the majority of respondents agreed with the notion that learners motivate them to speak in the target language and they were well- known about the significance of English in Pakistan, despite the fact that English is used as a subject in the ESL context rather than as a language. At last, it can be ensured that the study might be utilized for both the L2 learners and in the same sociological conditions. The study ends with the suggestion that English language teaching curricula and teaching strategies should be designed keeping in view the type of motivation (instrumental motivation) which is driving the Pakistani learners

Situational Analysis of Public Sector Schools in Rural Areas of Southern Punjab, Pakistan

Training assumes an imperative part in the improvement of the nation and people. Pakistan is among the most thickly populated countries of the world. Pakistan has a standout amongst the most insignificant capability rates on the planet and as showed by the United Nations Educational, Scientific and Cultural Organization (UNESCO), it is 55 for each penny and stays at 160th in total countries of the world. The target of this examination is to distinguish the reason of low proficiency rate in rustic territories and to recognize physical structure we likewise checkout essential security courses of action in government schools and break down effect of missing offices on youngsters. We likewise discover the reason of dropout youngsters from school and recognize Staff nearness at school. A Situational logical examination was led in region Punjab and in multi arranges testing system was utilized in local Muzaffargarh. Two tehsils from locale were chosen purposively for information accumulation. Tehsil jatoi and Alipur were chosen from locale Muzaffargarh. 150 respondents were selected as a specimen size of the examination. Rate, chi square, gamma, examinations were utilized to investigate the connection between various factors. The outcomes with respect to sexual orientation, age, territory, instruction level, wage level, among various factors are tried by utilizing SPSS for discoveries of the examination. Government should actualize the instructive arrangements from the gross root level. Guys and females ought to incorporate equivalent level for instructive basic leadership process. Conventional esteems, financial obstructions and some other social imperatives ought to be debilitated at all levels in instruction segment particularly in provincial southern Punjab

Imaging Evaluation of Mesenteric Ischemia: Is There a Golden Period for This Entity?

Background.The study was aimed at assessing the role of ultrasonography and multidetector computed tomography angiography in evaluating patients with suspected mesenteric ischemia, as well as assessing the effect of the time from presentation to management on mortality and morbidity. Materials and Methods. Patients with clinically suspected mesenteric ischemia underwent Doppler ultrasound and contrast-enhanced computed tomography. On ultrasonography, we assessed any filling defect in the superior mesenteric artery/vein, narrowing or occlusion of the proximal superior mesenteric artery, ascites, bowel wall thickening, and pneumatosis/portal venous gas. Computed tomography angiography was performed looking for any filling defect in the superior mesenteric artery/vein, superior mesenteric artery/vein calibre, bowel wall thickening, calibre and enhancement and pneumatosis/portal vein gas. Most of our patients underwent emergency surgery and the findings correlated with imaging. All the patients were divided into Group A (n=30) and Group B (n=17) based on the time from presentation to management: within 48 hours of presentation and 48 hours after presentation, respectively. Results. On computed tomography scan, mesenteric vascular involvement was seen in 27 (55%) patients, mesenteric/intestinal twist was observed in 12 (25%) patients, and non-occlusive mesenteric ischemia was found in 6% of patients. The computed tomography findings were found to have a sensitivity of 86%, a specificity of 94% and an accuracy of 90% in cases of mesenteric ischemia. Among 35 patients operated on, those presenting within 48 hours, had a significantly less mortality (63%) in comparison to those presenting after 48 hours (90%). Conclusions. Clinical, laboratory and ultrasound features are non-specific in diagnosing mesenteric ischemia. Computed tomography angiography is a sine qua non in mesenteric ischemia diagnosis. Patients with venous ischemia respond well to conservative management. Early intervention within the first 48 hours is associated with better prognosis

Synthesis and consecutive reactions of a-azido ketones: a review

This review paper covers the major synthetic approaches attempted towards the synthesis of α-azido ketones, as well as the synthetic applications/consecutive reactions of α-azido ketones

Positioning Depression as a Critical Factor in Creating a Toxic Workplace Environment for Diminishing Worker Productivity

This study determined how a toxic workplace environment can influence worker productivity, directly and indirectly, using work depression as a mediating variable. A toxic workplace environment with multiple dimensions (harassment, bullying, ostracism, and incivility) was used in this study. We used a questionnaire survey approach to evaluate the data. A total of 53 items were used in the questionnaire with a five-point Likert scale. The data were collected from 23 branches of five Chinese banks in the vicinity of Shanghai. The authors distributed 250 questionnaires among targeted employees (senior managers, middle managers, and administrative staff) and received 186 filled questionnaires, among which six were incomplete. Thus, the completed sample size of the research was 180, and the overall response rate was 72%. To estimate the proposed relationships in the research model, we used partial least-squares structural equation modeling (PLS-SEM 3.2). The outcomes of this study indicate that for direct and indirect relationships, a toxic workplace environment negatively influences worker productivity. Moreover, the outcomes of this study also show that work depression negatively impacts worker productivity. The study concludes with a discussion, limitations, and future research directions

DOES OPTIMAL CASH HOLDING MATTER IN MAINTAINING AND IMPROVING PROFITABILITY?

ABSTRACT   Purpose: This study was aimed to identify optimal cash holding factors and how they impacted the profitability of Pakistani-listed enterprises