Factors Affecting Teachers Job Satisfaction

Teachers in Pakistan and across the world are generally not satisfied with their jobs. This leads towards high turnover and adverse performance. This study has measured the effects of work goals, self-efficacy, positive effect, working conditions, and goal support on teacher’s job satisfaction. The scope of the study was restricted to the school teachers of Karachi. A selfadministered questionnaire from the literature was adapted for the study. The developed model was tested through SEM. Prior to estimating the hypothesized model, the normality, reliability, and validity of the constructs on the present data set was checked. The results suggest that selfefficacy has a strong effect on job satisfaction followed by positive effect and working conditions.Keywords: Job satisfaction, work goals, self-efficacy, goal support, positive effect, working conditions

Role of Work Engagement and Job Performance in an LMX Environment

The banking environment in Pakistan is quite demanding. Employee motivation level is generally low and turnover intentions are high which has made it difficult for banks to retain talented employees. In view this problem, the study has developed a conceptual framework that has six direct and three indirect relationships. The scope of the study was restricted to the banking sector of Karachi, Pakistan. A self-administered questionnaire was used in the study and the sample size was 220. The results suggest that LMX has a significant effect on creative work involvement, work engagement, job performance and turnover intentions. The study also found that work engagement mediates leader member exchange (LMX) and job performance. Moreover, job performance mediates LMX and turnover intentions while job performance mediates work engagement and turnover intentions. The results suggest that organizations must focus on developing a sustainable LMX environment as it will improve work engagement, job commitment and organizational commitment. This study was restricted to the banking industry of Karachi. Future studies may examine the consequences of LMX in firms based in other cities of Pakistan.Keywords: Job performance, LMX, turnover intentions, work engagement, creative work involvement

JOB-RELATED CONSTRAINTS FACED BY WORKING WOMEN IN RURAL AREAS: A CASE STUDY OF AKBAR PURA DISTRICT NOWSHERA, KHYBER PAKHTUNKHWA, PAKISTAN

The study was conducted in Akbar Pura village, located in the Nowshera district of Khyber Pakhtunkhwa, Pakistan, with the objective of examining the job-related constraints faced by working women. The study aimed to identify the types and nature of jobs undertaken by these women and investigate the challenges they encountered both in the workplace and at home due to family responsibilities. A sample of households with working women was selected using simple random sampling, representing twenty-five percent of the total households. The findings of the study indicated that most of the respondents were literate, belonged to the young age group, and were unmarried; the majority of the working women were involved in teaching professions. The practice of pardah (veiling) was common among the respondents, and it was perceived as both a cultural and Islamic practice. The study identified several constraints and difficulties faced by working women, these included problems related to transportation, instances of men staring at women, time constraints, managing household responsibilities, lack of respect for female workers, and the expectation to return home early. The majority of the women shared these problems with their family members. Based on the findings, the study recommended the provision of a conducive and secure environment for working women so that they can perform their jobs effectively and support their families. It also emphasized the importance of prioritizing women's education to enable them to shoulder the economic burdens of their families. In summary, the study conducted in Akbar Pura village highlighted the job-related constraints faced by working women. The findings emphasized the need for a supportive environment and increased education for women to empower them economically and address the challenges they face in both the workplace and their homes.  Article visualizations

Imaging Guided Breast Interventions

Breast imaging is a developing field, with new and upcoming innovations, decreasing the morbidity and mortality related to breast pathologies with main emphasis on breast cancer. Breast imaging has an essential role in the detection and management of breast disease. It includes a multimodality approach, i.e. mammography, ultrasound, magnetic resonance imaging, nuclear medicine techniques and interventional procedures, done for the diagnosis and definitive management of breast abnormalities. The range of methods to perform biopsy of a suspicious breast lesion found on imaging has also increased markedly from the 1990s with hi-technological progress in surgical as well as percutaneous breast biopsy methods. The image guided percutaneous breast biopsy procedures cause minimal breast scarring, save time, and relieve the patient of the anxiety of going to the operation theatre. The aim of this review was to describe and discuss the different image guided breast biopsy techniques presently employed along with the indications, contraindication, merits and demerits of each method

Negative predictive value of ultrasound in predicting tumor-free margins in specimen sonography

OBJECTIVE: To evaluate the success of ultrasound in post-excision specimen visualization, and negative predictive value of ultrasound for estimation of tumor-free margins using histopathology as the gold standard. STUDY DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital, Karachi, Pakistan, from May 2010 till January 2013. METHODOLOGY: Sonography of all breast nodules was done before and after exicision by two female radiologists with at least five years clinical experience. All surgeries were performed by the same referring breast surgeons. All nodules were non-palpable and had histopathology as well as specimen sonography performed at AKUH. Subjects were excluded, if histopathology was not available, post-procedure sonogram not done or done in another hospital and nodules that were not seen on ultrasound. After needle localization in 47 patients using ultrasound and in 7 patients using mammogram was done, sonogram was conducted in all 54 lesions. These were then assessed by ultrasound for detection of lesion and tumor-free margins in malignant lesion. Post-excision ultrasound was performed for the evaluation of lesion whether visualized or absent with localizing needle in situ, lesion dimensions, depth measurement between the superior margin of the lesion and its edge. RESULTS: All 54 lesions were present on post-exicison scan, out of which 28 were documented as malignant and 26 as benign. Ultrasound declared all specimens as tumor-free. On histopathology, two lesions were documented as having tumor-positive margins and were proven to be invasive lobular carcinoma. Therefore, the negative predictive value of the specimen sonography for margin detection was 26/28 (92.8%). CONCLUSION: Ultrasound of the excised breast tumor specimen is a simple and reliable technique for confirmation of the tumor-free margins in non-palpable breast lesions

Transverse vaginal septum : Report of two patients with MRI findings.

The transverse vaginal septum is a rare form of Mullerian duct anomaly, and is a disorder of vertical fusion of Mullerian system with the sinovaginal bulb. Magnetic resonance imaging (MRI)is very useful in the detection, classification and management planning of this rare anomaly. We present two cases of transverse vaginal septum in two patients of different age groups and with different clinical presentations. The findings on MRI, related to presence of vaginal septum and the management work-up, are also discussed

Diagnostic accuracy of pelvic MRI for determination of the cervical involvement in endometrial cancer.

OBJECTIVE: To determine the diagnostic accuracy of pelvic MRI for assessment of the cervical involvement in endometrial cancer. STUDY DESIGN: Cross-sectional analytical study. PLACE AND DURATION OF STUDY: Radiology Department of the Aga Khan University Hospital, Karachi from January 2014 to December 2015. METHODOLOGY: Patients with biopsy-proven endometrial cancer were included, who had both their MRI and histopathological diagnosis performed at our institution. Those patients treated with chemo/radiotherapy or had incomplete medical records, were excluded. The extent of cervical involvement by endometrial carcinoma was seen on T2WI images, and findings were correlated after surgery taking histopathology as the gold standard. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated. RESULTS: The mean age of the 56 patients was 60.87 ±8.80 years (range 37-84 years). The most common clinical indication was post-menopausal bleeding (n=37, 66.1%). The most common histological subtype was endometrioid adenocarcinoma (n=50, 89.3%). The sensitivity, specificity, diagnostic accuracy, positive and negative predictive values of MRI in the detection of cervical invasion were 92.85%, 88.09%, 89.28%, 72.22% and 97.36%, respectively. CONCLUSION: MRI is a highly sensitive and specific imaging modality for detection of cervical invasion in endometrial carcinoma

Biomarkers of Metabolic Syndrome in Cardiomyopathy: A Leading Cause of Heart Failure

Cardiomyopathy is a disease of the heart muscle, which makes the muscles harder to pump blood to the rest of the body leading to heart failure. The main types of cardiomyopathies include dilated cardiomyopathy, hypertrophic cardiomyopathy, ischemic cardiomyopathy, arrhythmogenic right ventricular dysplasia, restrictive cardiomyopathy, and Takotsubo cardiomyopathy. On the other hand, Metabolic syndrome (MetS) is the clustering of different medical conditions, which requires at least three of the five following diseases. These diseases are high blood sugar, high blood pressure, high serum triglycerides, low serum high-density lipoprotein, and central obesity. The risk of developing type 2 diabetes and cardiovascular disease associated with metabolic syndrome. In MetS, many different biomarkers are used in the early detection and risk stratification of MetS patients. It includes adiponectin, leptin, interleukin 6, tumor necrosis factor-alpha, uric acid, interleukin 10, ghrelin, adiponectin, paraoxonase, oxidized low-density lipoprotein, and plasminogen activator inhibitor-1. This chapter provides an overview and focuses on the basic role of major biomarkers of metabolic syndrome in the pathogenesis of different types of cardiomyopathies, which mainly highlights recent pathophysiological aspects in the development and progress of cardiomyopathy which is the leading cause of heart failure. In conclusion, biomarkers of metabolic syndrome play a significant role in the development and progress of cardiomyopathy which is the leading cause of heart failure

Variability of breast density assessment and the need for additional imaging: A comparison between computed mammography and digital mammography

Objective: To determine the variability of breast density assessment and the need for additional imaging using computed radiography (CR) mammography versus digital radiography (DR) mammography.Study design: Cohort study.Place and duration of study: Department of Radiology, The Aga Khan University Hospital, Karachi from March to June 2018.Methodology: Patients who underwent screening CR mammography, followed by DR mammography a year later, were selected. Only disease-free individuals were included in the study. Evaluation of breast density was done subjectively, using the breast imaging reporting and data system (BI-RADS) by two independent experienced radiologists. Statistical analysis was performed using the Wilcox Signed Rank-sum test to compare both modalities. Fisher Exact method was used to compare the need for ultrasound imaging.Results: A total of 295 patients were included in the study. The mean age of the patients was 52.76 ± 0.64 years. There was a significant difference in the change of breast density when comparing both modalities (Z= -11.839, p \u3c0.001). A statistically significant reduction in the need for further breast ultrasound was observed after DR mammography than with CR mammography (p \u3c0.001).Conclusion: Use of DR mammography, especially in patients with dense breast parenchyma, is a better screening tool overall. It translates to better feasibility for the radiologist and is more economical for the patient. DR mammography decreases unnecessary imaging and leads to better visualisation, thus providing a more accurate categorisation of breast density. Key Word: Computed radiography mammography, Breast density, Screening, Breast cancer, Digital mammography, Ultrasound

Association patterns of Atrial Fibrillation with symptoms of metabolic syndrome

Background: Atrial fibrillation (AF) is the common cardiac arrhythmia in which heart beats irregularly usually greater than 100 beats per minutes. AF is well-documented public health problem causing substantial mortality and morbidity. Metabolic syndrome (MS) is a collection of metabolic risk factors like diabetes, hypertension, dyslipidemia, obesity and impaired glucose level that exists in one person. The aim of the present study is to find the relation between AF and MS.Methods: 100 patients of AF were sampled from Punjab Institute of Cardiology, Lahore from December, 2014 to June 2015. These patients were divided into two AF groups, 50 without MS and 50 with MS. 25 healthy subjects were also included for the comparison. Lipid profile was assessed by chemistry analyzer and serum insulin was measured by ELISA.Results: In our population, there was significantly high levels of insulin resistance (IR) and obesity in AF groups (without MS and with MS) as compared with healthy subjects (P<0.05). Highly significant differences was observed in relation with other parameters e.g. hypertension, hypertriglyceridemia, HDL-C among the studied groups (P<0.05). Significant positive correlation was observed between insulin and lipid profile (TC, TG, LDL) while inverse with HDL.Conclusion: The indictors of metabolic syndrome were significantly correlated with AF in the studied subjects, while IR was found significantly higher in MS group.