The Impact of Trade Liberalisation on Wage Inequality: Case of Pakistan.

This paper examines whether trade liberalisation played a role in shaping the wage structure of Pakistan in the late 1990s and early 2000. It uses manufacturing workers data from LFS supplemented by external information to analyse the impact of trade liberalisation. In general, the results show that trade liberalisation, measured through import penetration ratio, export penetration ratio and relative prices of each industry, not only impacted wages but also increased wage inequality across skill levels from 1996-97 to 2005-06. The econometrics analysis confirms that increase in import penetration raises skilled premium while simultaneously reducing unskilled premium; a result in contention with the findings of the Stolper-Sameulson Theorem

Poor Quality of Sleep and its Relationship with Depression in First Year Medical Students.

Introduction: High incidence of depression has been reported in undergraduate medical students. Sleep disturbance has been associated with depressive symptoms and higher body mass index (BMI). This study evaluated the relationship between sleep disturbance measured by Pittsburgh Sleep Quality Index ( PSQI) and Epworth sleepiness scale (ESS) with BMI and depression measured by Beck Depression Inventory (BDI)  in 1st year  medical students. Method: Following Institutional Ethics Committee approval, 1st year medical students who volunteered for study and gave written informed consent (n=73) were administered PSQI, ESS & BDI questionnaires after seven months of admission. Height and weight were measured by standard method. Scores of PSQI, BDI and BMI were calculated and their interrelationship was measured statically.  Results: Poor quality of sleep (PSQI score greater or equal to five) and depression (BDI score eleven or greater) was seen in majority of students (64 and 60 % respectively). BMI was not significantly correlated with PSQI, ESS or BDI scores .There was significant positive correlation between PSQI and BDI (Pearson correlation, r = 0.410, P < 0.001), higher the BDI scores higher the PSQI scores. Conclusions: Poor sleep quality and depressive symptoms were observed in majority of 1st year medical students. Sleep quality and depressive symptoms were interrelated. Prevention and treatment strategies should target sleep as a factor that can potentially influence the development and course of Depression leading to poor academic performance. There is an urgent need to address this issue. Keywords: PSQI, BDI, Medical students, college students, adolescent health, freshman, freshers

Splenic Artery Embolization for Idiopathic Warm Autoimmune Hemolytic Anemia Refractory to Medical Therapy

Purpose: While Partial Splenic Artery Embolization (PSAE) is a useful procedure that has been performed for a variety of indications including trauma and hypersplenism, it has been rarely described as a treatment for Idiopathic warm Autoimmune Hemolytic Anemia (AIHA). Previous reports in the literature are limited to case reports in situations that include the patient being a poor surgical candidate, the inability to transfuse blood during surgery because of autoantibodies, and a patient\u27s refusal of blood products on religious grounds. The purpose of this study is to demonstrate the utility of PSAE in the acute management of AIHA refractory to medical treatment. Materials: A case report describing the management of a 27-year-old male diagnosed with AIHA treated successfully with PSAE as a bridging therapy to definitive surgical splenectomy. Relevant laboratory results and imaging were extracted from the electronic medical record. Results: The patient was diagnosed with AIHA and treated with intravenous solumedrol and rituximab and received 12 units of RBCs at an outside institution. The patient was transferred to our institution after developing antibodies that precluded more transfusions. The decision was made to proceed with PSAE. The first hemoglobin post-procedure was 4.5 g/dl, an increase from 2.1 g/dl pre-procedure. After embolization, the patient remained in the inpatient setting for eight days. During the inpatient hospitalization the patient\u27s hemoglobin continued to trend upwards until it stabilized around 6 g/dl. Inpatient laboratory workup showed increasing haptoglobin, and decreasing LDH. After discharge, the patient developed persistent pain two months post-procedure. An elective splenectomy was scheduled three months after the embolization procedure to address the persistent pain. Six months post embolization procedure and three months postoperatively, the patient is doing well clinically with a hemoglobin of 14 g/dl. Conclusions: In conclusion, this case demonstrates the utility of PSAE as an acute life-saving intervention for poor surgical candidates with idiopathic warm AIHA refractory to medical management.https://scholarlycommons.henryford.com/merf2020caserpt/1047/thumbnail.jp

Cloud Forensics : Isolating Cloud Instance

Cloud computing has been the trending model for storing, accessing and modifying the data over the Internet in the recent years. Rising use of the cloud has generated a new concept related to the cloud which is cloud forensics. Cloud forensics can be defined as investigating for evidence over the cloud, so it can be viewed as a combination of both cloud computing and digital forensics. Many issues of applying forensics in the cloud have been addressed. Isolating the location of the incident has become an essential part of forensic process. This is done to ensure that evidence will not be modified or changed. Isolating an instant in the cloud computing has become even more challenging, due to the nature of the cloud environment. In the cloud, the same storage or virtual machine have been used by many users. Hence, the evidence is most likely will be overwritten and lost. The proposed solution in this paper is to isolate a cloud instance. This can be achieved by marking the instant that reside in the servers as "Under Investigation". To do so, cloud file system must be studied. One of the well-known file systems used in the cloud is Apache Hadoop Distributed File System (HDFS). Thus, in this paper the methodology used for isolating a cloud instance would be based on the HDFS architecture

Orthosiphon stamineus leaf extract protects against ethanol-induced gastropathy in rats

Orthosiphon stamineus Benth., which is used as a gastroprotective herbal remedy in Malaysia, was assessed for its anti-ulcerogenic activity against ethanol-induced ulcers in rats. Fifty percent methanol was used to extract the oven-dried O. stamineus leaves. The extract was then lyophilized with a rotary evaporator and freeze-dried. Oral administration of O. stamineus methanolic extract (OSME) (125, 250, 500, and 1,000mg/kg) was found to significantly decrease the ulcer index (P<.01, P<.001, P<.001, and P<.001, respectively). Histological study of a section of the rat stomach also showed a marked improvement in the gastric mucosal damage in groups receiving OSME. In order to further investigate the gastroprotective mechanism of OSME, mucus secretion and lipid peroxidation level were estimated in vitro and ex vivo. OSME exhibited dose-dependent stimulation of mucus secretion (r=0.718, P<.001) and inhibition of lipid peroxidation in rat gastric mucosal homogenates (both in vitro [r=0.819, P<.05] and ex vivo [r=0.981, P<.05]). It was concluded that the gastroprotective mechanism of OSME was partly due to its ability to inhibit lipid peroxidation and stimulate gastric mucus secretion

Emergency peripartum hysterectomy in a tertiary hospital in Upper Egypt: six years analysis

Background: Emergency peripartum hysterectomy (EPH) is often performed for life-threatening obstetric conditions especially when conservative treatment approach fails to stop postpartum hemorrhage. The aim of the study is to detect the incidence, indications, and complications of EPH over 6 years in Assiut Women Health Hospital in Upper Egypt.Methods: A historical cohort study conducted between January 2009 and December 2014. Detailed review of all files of cases of EPH including maternal age, parity, gestational age, type of delivery, indications for EPH and outcome of the hysterectomy.Results: The overall incidence of EPH was 1.30 per 1,000 deliveries. The main indications for hysterectomies were uterine atony 60 (48.78 %), abnormal placentation 27 (21.95 %) and rupture uterus 25 (20.32 %). There were 48 (39.02%) maternal deaths, while the perinatal mortality was 20.32% (25 cases). Using multivariate logistic regression analysis, we found that woman’s age ≥ 40 years and parity ≥ 5 were the most significant independent predictors for maternal mortality in cases of EPH (OR 5.49; 95% CI 2.16 - 13.96) and (OR 0.34; 95% CI 0.15 - 0.77) respectively.Conclusions: The incidence of EPH in Upper Egypt is high. Uterine atony is the major indication for EPH in our hospital. Late referral and delayed decisions to perform hysterectomy contributes in the high mortality rate

Sosialisasi Pengelolaan Limbah Dapur Serta Program 3R (Reuse, Reduce, Recycle) Bagi Pemilik Rumah Makan dan Jasa Boga di Wilayah Kota Tasikmalaya

Society services activity in kitchen waste management system has been implemented to the owner of restaurant and catering work in Tasikmalaya City area. This activity has colaborated with Indonesian Catering Associations (APJI). The rapid growth of restaurant and catering activities has created serious problems of energy requirement, water, and solid waste disposal. Less information and limited area become the problems in handling of kitchen waste. A simple technique is needed to overcome the environmental problem which is caused by kitchen waste. The components of kitchen waste include vegetables, peelings, fruit skins, spoilt fruit, cooked and uncooked meat, bones, fats, egg-shells, bread and pastries, cooked food waste, etc. Due to a high organic content, bioconversion technologies such as anaerobic digestion are more suitable to handle the waste convert to biogas. It would be reducing the LPG usage. For the kitchen wastewater, grease trap as pre-treatment followed by a physical and biological process is one of a simple process which can produce the effluent in accordance with government standard. The activities were continued by the socialization of 3R program (reuse, reduce, recycle) by doing demo utilization of kitchen solid waste such as packing material, mineral water bottle is made a handicraft. Knowledge transfer run well and the enthusiasm of the participants in following the activity were very good

Transcriptome analysis suggests a role for the differential expression of cerebral aquaporins and the MAPK signalling pathway in human temporal lobe epilepsy

Epilepsies are common disorders of the central nervous system (CNS), affecting up to 2% of the global population. Pharmaco-resistance is a major clinical challenge affecting about 30% of temporal lobe epilepsy (TLE) patients. Water homeostasis has been shown crucial for regulation of neuronal excitability. The control of water movement is achieved through a family of small integral membrane channel proteins called aquaporins (AQPs). Despite the fact that changes in water homeostasis occur in sclerotic hippocampi of people with TLE, the expression of AQPs in the epileptic brain is not fully characterised. This study uses microarray and ELISA methods to analyse the mRNA and protein expression of the human cerebral AQPs in sclerotic hippocampi (TLE-HS) and adjacent neocortex tissue (TLE-NC) of TLE patients. The expression of AQP1 and AQP4 transcripts was significantly increased, while that of the AQP9 transcript was significantly reduced in TLE-HS compared to TLE-NC. AQP4 protein expression was also increased while expression of AQP1 protein remained unchanged, and AQP9 was undetected. Microarray data analysis identified 3,333 differentially regulated genes and suggested the involvement of the MAPK signalling pathway in TLE pathogenesis. Proteome array data validated the translational profile for 26 genes and within the MAPK pathway (e.g. p38, JNK) that were identified as differentially expressed from microarray analysis. ELISA data showed that p38 and JNK inhibitors decrease AQP4 protein levels in cultured human primary cortical astrocytes. Elucidating the mechanism of selective regulation of different AQPs and associated regulatory proteins may provide a new therapeutic approach to epilepsy treatment. This article is protected by copyright. All rights reserved

Barriers, challenges and way forward for implementation of person centered care model of patient and physician consultation: a survey of patients’ perspective from Eastern Mediterranean countries

Background: Person-Centered Care (PCC) is now considered a mandatory approach in Patient-Physician consultation. The aim of the study was to identify patients’ perception regarding barriers and possible remedies for implementation of PCC in Eastern Mediterranean Region (EMR). Methods: A cross-sectional multi-country study was conducted in six countries of EMR during May 2014 to October 2014. Expert Family Physicians from each country were identified and asked to participate in the study. The Family Physicians then recruited Patients from their own clinics (\u3e18 years). Data analysis was performed on SPSS 19 and results are reported in the form of proportions, odds ratios and 95% confidence intervals. Results: A total of 234 patients were recruited, 60.6% were aged between 20 to 30 years and 36.3% of them were males. 56% of the patients preferred Person-Centered Care model for patient-physician consultation. The major barriers identified by patients in its implementing were; time constraints (73.9%, OR: 1.5; 95% CI: 0.86-2.78), doctors desire to control patient (OR: 2.6; 95% CI: 1.55-4.49), cultural and religious reasons (52.1%), increased cost (50.9%). Patients responded that increased cost related to Person-Centered Care practice would be acceptable (58.1%), if increase proved to be in the interest of better health and care outcomes (40.6%). Conclusion: Person-Centered Care (PCC) is associated with significant barriers in its implementation in Eastern Mediterranean Region. These barriers can be overcome in the interest of better health and care related outcomes