Outcome of Anterior Cervical Discectomy with PEEK Cage Fixation for Single Level Cervical Disc Disease

Objective:  To assess the outcome of anterior cervical discectomy and fusion (ACDF) with PEEK cage. Material and Methods:  This prospective study was conducted in the Departments of Neurosurgery Prime Teaching Hospital and Irfan General Hospital Peshawar. Patients undergoing one level ACDF with PEEK cage fixation were enrolled in the study. Patients who needed multiple level ACDF or corpectomy with plating and redo cases were excluded from the study. A proforma, which included age, gender, address, level of prolapsed disc, sign and symptoms, pain score, MRI findings were filled. All patients were assessed on day of discharge and on follow-up visit after one month. Data was analyzed with SPSS version 22. Results:  Total 95 patients were included out of which 58 (61%) were male and 37 (39%) were female. Range of patients` Age was from 27 years to 64 years with 50.4 years mean age. Most patients (65%) had C6 radiculopathy. 58 patients (61%) had right sided radicular pain. 5 patients (5.26%) had radiculomyelopathy. C5 – C6 was the most common level operated (68 patients). Excellent results were achieved in 75 patients (79%) while satisfactory results in the rest of patients using Odom’s criteria. Bony fusion occurred in 92% of patients at 6 months. Conclusion:  ACDF with PEEK cage fixation is a safe and beneficial procedure in one level cervical prolapse disc diseas

The Regional Comprehensive Economic Partnership (RCEP): an analysis of its potential benefits for China

Regional Comprehensive Economic Partnership (RCEP) is a mega-regional free trade agreement aimed to remove tariff and non-tariff trade barriers, increase trade facilitation, liberalise investment, and promote global value chains among the member countries. The study aims to know the importance of RCEP regarding trade, foreign direct investment and other economic affairs for China and its potential economic benefits for members. It has provided for a 90% tariff reduction on trade among its 15 members. It can potentially increase trade and FDI inflow to China through the trade and FDI creation effects. Establishing a business-friendly market in the Asia Pacific region and the tariff reduction provisions of this agreement have many advantages for the Chinese economy. Among its members, China is the leading economic power. Therefore, she will get maximum economic benefits as, according to statistical simulations, it will increase her international trade, exports, services, and FDI inflow. The current 2.2% tariff imposed on Chinese exports in the RCEP market will be decreased to 0.4%. The expected economic profit to China from this agreement is 214 billion dollars, equal to 2.2% of its GDP and a 13.4% increase in FDI inflow

Impact of Performance Appraisal Politics on Work Outcome: Multidimensional Role of Intrinsic Motivation and Job Satisfaction

The current study focus on performance politics regarding appraisal in order to analyze the performance of employees, to interpret job satisfaction, organizational commitment, and employee’s turnover in the banking sector of Pakistan. At the same time, employees’ intrinsic motivation and satisfaction will were investigated as possible mediators. For this purpose, data was collected from the selected sample of various bank employees across different districts in KPK and Islamabad. Data was analyzed through exploratory factor analysis and structural equation modeling using SPSS & AMOS software. Results indicate that the relationship between performance appraisal politics (PALP) and employee’s commitment level is negative and significant, while performance appraisal politics is positively and significantly associated with turnover intentions. Interestingly, the relationship between job performance politics and job satisfaction was insignificant. In order to validate the meditational affect (Baron & Kenny, 1986) meditational technique was applied. Since the relationship between PAPL (Performance Appraisal Politics) and job satisfaction is found to be insignificant; hence, it is concluded that job satisfaction could not mediate the relationship between PAPL and turnover intention. In the proceeding step, the relationship between PAPL and turnover intention was checked with intrinsic motivation as a mediator. It was concluded that intrinsic motivation strongly mediated the relationship between PAPL and TRI. Based on the findings of the current study, future direction, managerial implication and limitations are also provided in the last section.&nbsp

MRI Imaging, Comparison of MRI with other Modalities, Noise in MRI Images and Machine Learning Techniques for Noise Removal : A Review

Medical imaging is to assume greater and greater significance in efficient and precise diagnosis process. It is a set of various methodologies which are used to capture internal or external images of human body and organs for clinical and diagnosis needs to examine human form for various kind of ailments [1]. Computationally intelligent machine learning techniques and their application in medical imaging can play a significant role in expediting the diagnosis process and making it more precise. This review presents an up-to-date coverage about research topics which include recent literature in the areas of MRI imaging, comparison with other modalities, noise in MRI and machine learning techniques to remove the noise

Outcome of Endoscopic Third Ventriculostomy: An Experience of 80 Treated Patients

Objective: To examine the outcome of Endoscopic Third Ventriculostomy in 80 consecutive patients operated in Irfan General Hospital and Prime Teaching Hospital Peshawar.Materials and Methods: Prospective observational study was conducted in the neurosurgery department of Prime Teaching Hospital and Irfan General Hospital Peshawar. 80 patients (48 male and 32 female) were followed for 3 months. The inclusion criteria all patients with Third ventricular hydrocephalus were included in this study and the exclusion criteria unwilling patients and those who opted for VP shunting rather than ETV. Data was analyzed using SPSS version 22.Results: ETV was performed in 80 patients. With highest success rate inAqueductal stenosis and posterior fossa tumors 88% and 87% respectively. ETV had a lowest success score of 50% in patients with Hydrocephalus TBM. Common post-operative complications were seizures and CSF leakage.Conclusion: ETV is less invasive and effective treatment for non-communicating hydrocephalus.ETV is most effective in treating aqueductal stenosis and posterior fossa tumors. The overall success rate of ETV is 74%. Based on these findings, it is recommended that ETV should be attempted as first line treatment for patients with triventricular hydrocephalus due to various pathologies

Digital Images Enhancement using Tiny Character Adjustment and Referenced Image Approach

Digital image enhancement has been a hot topic during the past decades. In this paper, we have established a new approach for local gray contrast adjustment of tiny characters and global referenced base contrast enhancement approach to improve the contrast of degraded images. The proposed approach initially adjusts the contrast of tiny characters and then enhances the contrast of whole image by finding out some vital information from the histogram of the referenced image. The experimental results show that the proposed algorithm can adjust the tiny characters and increase the image contrast efficiently

In Vitro, Ex Vivo, and In Vivo Evaluation of Nanoparticle-Based Topical Formulation Against Candida albicans Infection

Ketoconazole is commonly used in the treatment of topical fungal infections. The therapy requires frequent application for several weeks. Systemic side effects, allergic reactions, and prolonged treatment are often associated with non-compliance and therapy failure. Hence, we developed an optimized topical antifungal gel that can prolong the release of drug, reduce systemic absorption, enhance its therapeutic effect, and improve patient compliance. Ketoconazole-loaded PLGA nanoparticles were prepared by the emulsion/ solvent evaporation method and were characterized with respect to colloidal properties, surface morphology, and drug entrapment efficiency. The optimized ketoconazole-loaded PLGA nanoparticles and commercially available silver nanoparticles were incorporated into a Carbopol 934P-NF gel base. This arrangement was characterized and compared with commercially available 2% ketoconazole cream to assess physical characteristics of the gel, in vitro drug release, ex vivo skin permeation and retention, and in vivo studies on Wister male albino rats. The results showed that polymeric PLGA nanoparticles were very effective in extending the release of ketoconazole in our optimized formulation. Nanoparticles were smooth, spherical in shape, and below 200 nm in size which is consistent with the data obtained from light scattering and SEM images. The ex vivo data showed that our gel formulation could strongly reduce drug permeation through the skin, and more than 60% of the drug was retained on the upper surface of the skin in contrast to 38.42% of the commercial cream. The in vivo studies showed that gel formulation could effectively treat the infection. This study demonstrates that our topical gel could be effective in sustaining the release of drug and suggests its potential use as a possible strategy to combat antifungal-resistant Candida albicans