Causes of Chronic kidney disease

ABSTRACTChronic kidney disease is characterized by irreversible loss of kidney function. It is classified and staged according to Glomerular filtration rate. Chronic kidney disease presents with wide range of clinical symptoms and signs such anemia, pruritis, weight loss, anorexia, nausea, vomiting, kasmauls breathing, plusus paradoxus, pallor, bruising.There are various etiological causes of CKD including diabetes mellitus, hypertension, durg induced, autoimmune and polycystic kidney disease. This was an observational study conducted at DHQ hospital Nankana sahib in the dialysis unit. All the patients on dialysis were included in the study. By accessing their clinical notes and through history we determined cause of CKD in each.Results showed that Diabetes and hypertension were among the most common etiological factors of Chronic kidney disease. By adequate control and early detection of diabetes and hypertension we can gain a reduction in disease burden of CKD. Key words : CKD, Chronic renal failure, Hakeem medications, diabetic nephropathy ABSTRACTChronic kidney disease is characterized by irreversible loss of kidney function. It is classified and staged according to Glomerular filtration rate. Chronic kidney disease presents with wide range of clinical symptoms and signs such anemia, pruritis, weight loss, anorexia, nausea, vomiting, kasmauls breathing, plusus paradoxus, pallor, bruising.There are various etiological causes of CKD including diabetes mellitus, hypertension, durg induced, autoimmune and polycystic kidney disease. This was an observational study conducted at DHQ hospital Nankana sahib in the dialysis unit. All the patients on dialysis were included in the study. By accessing their clinical notes and through history we determined cause of CKD in each.Results showed that Diabetes and hypertension were among the most common etiological factors of Chronic kidney disease. By adequate control and early detection of diabetes and hypertension we can gain a reduction in disease burden of CKD. Key words : CKD, Chronic renal failure, Hakeem medications, diabetic nephropathy

Importance of Screening of Patients for HBV and HCV before Elective Surgery

Objective: Objective of this study was to emphasize on the importance of screening for hepatitis B and C before undergoing elective surgery.Patients & Methods: This study was done on 110 patients who were planned for surgery. These patients were admitted in surgical ward-4 of Bahawal Victoria Hospital Bahawalpur. The duration of study was fom January 2017 to August 2017. These cases were screened for HBV and HCV by ELISA technique. Tests were done in Government laboratory of the hospital which is well equipped with a trained faculty. Which patients had previous reports older than 3 months of ELISA for HBV –DNA and HCV-RNA their test was repeated by the laboratory of hospital. Results:  Out of 110 cases 60(54.5%) were males and 50(45.4%) were females. In ELISA technique 18(16.3%) were positive for anti HCV antibodies and 12(10.9%) were positive for HBsAg antigen. Out of 18 cases 10(55.5%) were males and 8(44.4%) were females. Similarly among 12 cases positive for HBV of which 5(41.6%) were males and 7(58.3%) were females. Their age was ranging from 24 to 55 years with mean age of 37.5 years.Conclusion: The screening of patients for hepatitis B and hepatitis C is very important before any sort of surgery so that necessary measures may be taken by the doctors and nurses for protection from HBV and HCV

Relationship between Financial Leverage and Financial Performance: Evidence from Fuel & Energy Sector of Pakistan

Fuel and energy sector serves as the backbone of the economy. The segment provides support, not only for the economic development of the country by showing positive trends towards the sectoral growth, but also serves as a steering wheel for the growth of manufacturing, trading and service sector. It provides significant inputs for production, trade and service. A general concept prevails that the financial leverage is helpful to enhance the financial performance of the companies. For measuring the impact of financial leverage on the financial health of the companies, it is essential to know whether a positive relationship exists between the financial leverage and financial performance or not? So, this study is intended to test the hypothesis and to measure a relationship between the financial leverage and the financial performance of the fuel and energy sector in Pakistan. The paper also examines the generalization that firms with higher profitability may choose high leverage by using various statistical tools. The findings of the study show a positive relationship between the financial leverage and the financial performance of the companies by accepting the alternate hypothesis H1 and Ho is rejected. The results of the study confirm that the firms having higher profitability may improve their financial performance by having high levels of financial leverage. The study provides evidence by evaluating different facts. It reveals that the players of the fuel and energy in Pakistan can improve at their financial performance by employing the financial leverage and can arrive at a sustainable future growth by making vital decisions about the choice of their optimal capital structure.   Key Words: Financial leverage, Firms’ Performance, Key Indicators- Financial Ratios, Fuel and Energy Sector in Pakistan

Analyzing an Appropriate Blend of Face-to-Face, Offline and Online Learning Approaches for the In-Service Vocational Teacher’s Training Program

Blended learning approaches are considered as the most viable for the delivery of training to remote areas and accessing learners at a mass level. Blended learning is a combination of different learning approaches to facilitate the learners’ needs. The National Vocational and Technical Training Commission (NAVTTC) conducted an in-service vocational teachers’ training program through blended learning approaches in Pakistan. This study aimed to find the appropriate blend of face-to-face, online, and offline learning approaches for the training of in-service teachers in Pakistan. A mixed methods research approach was adopted. A survey collected data from 781 in-service vocational teachers who participated in training programs through blended learning approaches. The ANOVA test was applied to find the difference of the training participants’ attitude toward different modes of learning. It was found that trainees had more positive attitude toward a face-to-face learning approach than online and the online learning approach than offline learning. Semi-structured interviews were also conducted with training participants, admission and placement officers, and principals. They also endorsed that face-to-face learning approaches must be given more weight than online, and the online approach should have more weight than the offline approach. This study has practical implications for technical education and vocational training (TVET) institutes in developing countries such as Pakistan to design blended learning approaches for the training of in-service vocational teachers. Future research may be conducted on the effectiveness of in-service vocational education teachers through blended learning

Analyzing an Appropriate Blend of Face-to-Face, Offline and Online Learning Approaches for the In-Service Vocational Teacher’s Training Program

Blended learning approaches are considered as the most viable for the delivery of training to remote areas and accessing learners at a mass level. Blended learning is a combination of different learning approaches to facilitate the learners’ needs. The National Vocational and Technical Training Commission (NAVTTC) conducted an in-service vocational teachers’ training program through blended learning approaches in Pakistan. This study aimed to find the appropriate blend of face-to-face, online, and offline learning approaches for the training of in-service teachers in Pakistan. A mixed methods research approach was adopted. A survey collected data from 781 in-service vocational teachers who participated in training programs through blended learning approaches. The ANOVA test was applied to find the difference of the training participants’ attitude toward different modes of learning. It was found that trainees had more positive attitude toward a face-to-face learning approach than online and the online learning approach than offline learning. Semi-structured interviews were also conducted with training participants, admission and placement officers, and principals. They also endorsed that face-to-face learning approaches must be given more weight than online, and the online approach should have more weight than the offline approach. This study has practical implications for technical education and vocational training (TVET) institutes in developing countries such as Pakistan to design blended learning approaches for the training of in-service vocational teachers. Future research may be conducted on the effectiveness of in-service vocational education teachers through blended learning

Indo-US Strategic Partnership: Implications for Pakistan

In the scheme of American grand strategy for the ‘new world order’, India has emerged as the most powerful regional ally. The emerging “strategic partnership” between the US and India is based on a shared view for democracy and concerns about the threat of global terrorism as well as mutual unease considering the long-term implications of the rise of China in Asia and beyond. US and India have complementary economic and strategic security interests as the former desires to maintain her economic and military supremacy in the world. India on her part wants to develop security ties with America to facilitate her becoming dominant regional and global power in the foreseeable future. Shared perception about ‘terrorism’ has further cemented their relations where India promptly endorses US stance on “War on Terrorism” with a hope to turn US interests to its advantage by labeling freedom struggle in Kashmir as Pakistan sponsored insurgency. Reflections of converging interests include: US-India Next Steps in Strategic Partnership (NSSP) initiative, signing of 123 Nuclear Agreement, missile defense, and ten-year defense framework agreement that calls for expanding bilateral security cooperation. Pakistan cannot afford to remain oblivious to these developments due to their security implications. Enhanced capacity building of Indian armed forces and nuclear collaborations may undermine the deterrent value of Pakistan's conventional and nuclear weapons. A combination of pragmatic foreign policy backed with credible conventional and nuclear deterrence could serve desired national security interests. While remaining strategically relevant to US, Islamabad will have to continue to cultivate good relationship with Beijing. On internal front, Pakistan must revive her economy and achieve more national cohesion so as to offset the negative effects of Indo-US strategic convergence

Biosynthesis of lovastatin using agro-industrial wastes as carrier substrates

Purpose: To compare fungal strains including Aspergillus flavipes GCBL-72, Aspergillus flavus GCBL-60, and Aspergillus niger GCBL-45 and determine whether solid- or liquid-state fermentation (SSF or LSF) is more appropriate for lovastatin production using various inexpensive raw materials.Methods: LSF and SSF techniques were used to produce the drug lovastatin.  High-performance liquid chromatography was performed out to quantify lovastatin production. A kinetic growth model was applied to estimate product formation at the expense of substrate utilization.Results: Aspergillus flavus GCBL-60 was a superior lovastatin-producing strain consuming wheat bran as the raw material in SSF. The optimum lovastatin production was 28.36 ± 0.76 mg/100mL at 35 °C, pH 5.5, inoculum size 2 mL, 96 h incubation time, and 60 % moisture content. Evaluation of the kinetic growth parameters for lovastatin production confirmed that product formation was improved after fermentation parameter optimization.Conclusion: Our results indicate that Aspergillus flavus GCBL-60 was best  lovastatin-producing strain and that SSF was superior to LSF for maximum  production. Careful optimization can enhance product formation.Keywords: Hypercholesterolemia, Kinetics, Optimization, Lovastatin, Solid-State Fermentation, Raw material

Bioavailability and Metabolic Pathway of Phenolic Compounds

As potential agents for preventing different oxidative stress-related diseases, phenolic compounds have attracted increasing attention with the passage of time. Intake of fruits, vegetables and cereals in higher quantities is linked with decreased chances of chronic diseases. In plant-based foods, phenolic compounds are very abundant. However, bio-accessibility and biotransformation of phenolic compound are not reviewed in these studies; therefore, a detailed action mechanism of phenolic compounds is not recognized. In this article, inclusive concept of different factors affecting the bioavailability of phenolic compounds and their metabolic processes is presented through which phenolic compounds go after ingestion