Impact of Terrorism on International tourism demand

Tourists seek safe and secure destinations and avoid that of overwhelmed with terrorism. This study quantifies the relationship between terrorism and international tourism demand in 200 destination countries and regions for the period of 1995 to 2020. To achieve the objective, the study implied two-dimensional analyses by using the gravity model through Pooled ordinary least square estimator to pay special attention towards demand distribution. Our empirical results depict that, terrorism and terrorism in a destination country has a statistically insignificant relationship on international tourism demand, more specifically, here radical decline in GDP was observed in the sub-period 2006 – 2020 due to the global financial crisis and its aftershocks which badly affects tourist’s attraction to destination countries. This study pinpoints new insights for national tourism policymakers and business purposes.          &nbsp

Beta Burr type X with application to rainfall data

We introduce a new extension distribution for Burr type X with one parameter named the Beta Burr type X. The new distribution is extended from the Burr type X with one parameter. Several important properties of the new extension distribution are derived like the moment, and moment generating function. The maximum likelihood estimation is used to estimate the parameters involved. A rainfall data set from 1975 to 2005 for 35 stations in peninsular Malaysia is used for the application of this new model. It gives a better fit compared to several other distributions

THE INFLUENCING FACTORS OF CO2 EMISSIONS AND THE ADOPTION OF ECO-INNOVATION ACROSS G-7 ECONOMIES: A NOVEL HYBRID MATHEMATICAL AND STATISTICAL APPROACH

The present study empirically analyzes the role of eco-innovation in plummeting carbon dioxide (CO2) emissions in conjunction with renewable energy usage, foreign direct investment, and trade openness for the states in G-7 from 1990 to 2019 in a mathematical and statistical context. Under the dynamical framework, the estimates of mathematical grey relational analyses indicate that eco-innovation holds a stronger degree of association with CO2 emissions. Further, the estimates demonstrate that, compared to the other G-7 states, Japan is the country where eco-innovation is a more striking variable. However, renewable energy utilization seems weaker in Japan, which necessitates adopting renewable energy to curb carbon emissions in the region. Statistically, the odds ratio illustrates a similar pattern, demonstrating that the odds of occurrence for eco-innovation are much stronger in reducing the rising levels of carbon emissions within the G-7 states. Moreover, trade openness and foreign direct investment were revealed to be the leading contributors to carbon emissions in Germany and Canada, respectively, whilst appearing to be significant variables in lowering emissions in the United States and the United Kingdom. The outcomes of this investigation offer significant perspectives for policymakers in formulating holistic and environmentally friendly policies by embracing eco-innovation as a potentially significant component for sustainable economic expansion and environmental health

Sturge Weber Syndrome (SWS): A case report in an infant

Introduction: Sturge Weber Syndrome (SWS), known as encephalotrigeminal angiomatosis, is a rare neurocutaneous disorder and is having a prevalence of 1/20-50,000, live births. The syndrome consists of leptomeningeal angiomas and the angiomas of the face, characteristically in the ophthalmic and maxillary divisions of the trigeminal nerve. The neurological presentations include fits, deficits in cognition, glaucoma, and visual field abnormalities. The overgrowth of the soft tissues and extracranial angiomas can also occur in SWS. Case presentation: We are presenting a rare case of Sturge Weber Syndrome in an infant who presented at an early stage of this disorder. The index case presented to us with a large port-wine stain and right-sided focal fits. The CT scan brain showed subtle gyriform tram-track calcification of the left cerebral cortex and the left-sided cerebral atrophy. Ophthalmological examination showed glaucoma of the left eye. The clinical and radiological criteria were used to make the final diagnosis of SWS. Conclusion: The case is being reported in order to increase awareness among medical professionals

The many guises of primary hyperparathyroidism… an unchanged scenario

Abstract OBJECTIVE: To study the causes, characteristics and outcome of treatment of patients with primary hyperparathyroidism. METHODS: This retrospective cohort analysis was conducted at the Jinnah Postgraduate Medical Centre, Karachi, and comprised data of patients with primary hyperparathyroidism between 2004 and 2014. .SPSS 17 was used for data analysis. RESULTS: Of the 25 patients,1(4%)was male and 24(96%) were female. The overall mean age was 41.72±15.9 years, with a mean duration of symptoms of 4.1±3.3 years. The mean pre-operative parathyroid hormone level was 879.48±793.51 pg/ml. Skeletal manifestations were reported in 17(68%) patients, whereas 4(16%) patients had renal stone disease. Besides, 2(8.0%) patients presented with severe abdominal pain, 1(4%) had asymptomatic hypercalcaemia and 1(4%) patient presented with headache and was diagnosed as parathyroid adenoma in the context of multiple endocrine neoplasia type 2A. All patients underwent parathyroidectomy. A solitary adenoma was reported in 23(92%) patients, carcinoma in 1(4%) and an adenoma with hyperplasia of other glands in 1(4%) patient. CONCLUSIONS: A high index of suspicion is required for early diagnosis of primary hyperparathyroidism

Covid-19 Induced Anxiety and Depression in Healthcare Workers: Experiences of a Developing Country

Background: Healthcare workers all over the world are suffering physically, mentally and emotionally due to the Covid-19 pandemic. While psychological effects may be more pronounced in a country like Pakistan where such disorders are still considered taboo and remain unattended. The study aimed to identify the prevalence and association of anxiety and depression in healthcare workers in a tertiary care hospital in Karachi during Covid-19 pandemic. Methods: A descriptive, cross sectional study was performed from 1st June-31stAugust 2020 on n=361 healthcare staff. General Anxiety Disorder-7 (GAD-7) and Patient Health Questionnaire-9 (PHQ-9) tools were used to assess for anxiety and depression respectively. Association between demographic variables age, gender, education, designation, work experience, Covid-19 exposure with anxiety and depression was assessed using the Chi-squared test with p ≤ 0.05 was considered statistically significant. Results: Anxiety 221(61.5%) and depression 276(76.9%) were more common in doctors compared to other health care workers. The prevalence of severe anxiety 248(69.2%) and severe depression 276(76.9%) was significantly higher in males. Both anxiety and depression were more common with less than 2 years of work experience (p=0.00). Association between years of work experience was similar, with people having less than 2 years of work experience feeling more anxiety (p=0.012) and depression (p=0.003). Conclusion: Doctors working with Covid-19 patients are more prone to severe anxiety and depression. Early identification and supportive care are essential to ensure that the clinical and para medical staff members assigned to patient care has access to both physical and mental health services. Keywords: Covid-19; SARS CoV-2; Anxiety; Depression; Generalized Anxiety Disorder; Patient Health Questionnaire

Variation of Peak Expiratory Flow Rate with Body Mass Index in Medical Students of Karachi, Pakistan

OBJECTIVE: The primary aim of our study was to assess the variation of PEFR with BMI in normal medical students of Karachi, PakistanDESIGN: Cross-sectional studySetting: Medical students of Karachi Medical and Dental CollegeParticipants: 138 non-smoker healthy medical students composed of 111 females and 27 males. VARIABLE PARAMETERS: They include mean age, body height and body weight and PEFR. They were marked separately for each genderRESULTS: The mean BMI in females was found out to be 18.54±2.10 corresponding with that of mean PEFR value 431.62±56.62 whereas in males the mean BMI was 25.07±2.96 corresponding with that of mean PEFR value 533.70±23.22. Also there is a statistically significant variation in PEFR with an increase in BMI.CONCLUSION: The study concludes that PEFR is affected positively by variation in BMI. Also young males have more BMI and PEFR values than their young female counterparts. A large sample size with accurate peak flow meter is required along with ethnic consideration of the study population for better and accurate result

Biosynthesis and characterization of silver nanoparticles from Cedrela toona leaf extracts: An exploration into their antibacterial, anticancer, and antioxidant potential

This research work aims to synthesize environmentally benign and cost-effective metal nanoparticles. In this current research scenario, the leaf extract of Cedrela toona was used as a reducing agent to biosynthesize silver nanoparticles (AgNPs). The synthesis of AgNPs was confirmed by the color shift of the reaction mixture, i.e., silver nitrate and plant extract, from yellow to dark brown colloidal suspension and was established by UV-visible analysis showing a surface plasmon resonance band at 434 nm. Different experimental factors were optimized for the formation and stability of AgNPs, and the optimum conditions were found to be 1 mM AgNO3 concentration, a 1:9 ratio of extract/precursor, and an incubation temperature of 70°C for 4 h. The Fourier transform infrared spectroscopy spectra indicated the presence of phytochemicals in the leaf extract that played the role of bioreducing agents in forming AgNPs. X-ray diffraction patterns confirmed the presence of AgNPs with a mean size of 25.9 nm. The size distribution and morphology of AgNPs were investigated by scanning electron microscopy, which clearly highlighted spherical nanoparticles with a size distribution of 22–30 nm with a mean average size of 25.5 nm. Moreover, prominent antibacterial activity was found against Enterococcus faecalis (21 ± 0.5 mm), Bacillus subtilis (20 ± 0.9 mm), Pseudomonas aeruginosa (18 ± 0.3 mm), Staphylococcus aureus (16 ± 0.7 mm), Klebsiella pneumoniae (16 ± 0.3 mm), and Escherichia coli (14 ± 0.7 mm). In addition, antioxidant activity was determined by DPPH and ABTS assays. Higher antioxidant activity was reported in AgNPs compared to the plant extract in both DPPH (IC50 = 69.62 µg·ml−1) and ABTS assays (IC50 = 47.90 µg·ml−1). Furthermore, cytotoxic activity was also investigated by the MTT assay against MCF-7 cells, and IC50 was found to be 32.55 ± 0.05 µg·ml−1. The crux of this research is that AgNPs synthesized from the Cedrela toona leaf extract could be employed as antibacterial, antioxidant, and anticancer agents for the treatment of bacterial, free radical-oriented, and cancerous diseases

Quality of Care for Patients with Acute Myocardial Infarction (AMI) in Pakistan: A Retrospective Study

A wide variation exists in the practice patterns of acute myocardial infarction (AMI) care worldwide, leading to differences in clinical outcomes. This study aims to evaluate the quality of process care and its impact on in-hospital outcomes among AMI patients in Pakistan, as no such study has been conducted in Pakistan thus far based upon recommended guidelines. We investigated a sample of 2663 AMI patients across 11 territory hospitals in Punjab province of Lahore, Faisalabad, Multan, Rawalpindi, and Islamabad from January 1, 2016 to December 31, 2017, with an in-hospital mortality rate of 8.6%. We calculated compliance rates of quality indicators (QIs) for all eligible patients. The association between process care and in-hospital outcome was assessed using hierarchical generalized linear model that adjusted for patient and hospital characteristics. In addition, we examined the effect of patient composite scores on clinical outcomes. Aspirin (73.08%) and clopidogrel (67.86%) indicated relatively better conformance than other QIs. The percutaneous coronary intervention also showed significantly low adherence. All QIs showed no significant association with in-hospital mortality. In contrast, 4 out of 8 QIs were observed positively correlated with in-hospital length of stay (LOS). The overall patient composite score was found to be statistically significant with in-hospital LOS. The assessment of quality of care showed low adherence to clinical care recommendations, and increased adherence was associated with longer in-hospital LOS among AMI patients. Evaluation of valid QIs for AMI treatment and their impact on in-hospital outcomes is an important tool for improving health care delivery in the overall AMI population in Pakistan. Low adherence to performance measures strongly compel to focus on guideline-based tools for AMI in Pakistan