Influential factors in physician burnout in the United Arab Emirates

The purpose of this study was to explore the factors in physician burnout in the United Arab Emirates (UAE). The goal was to identify the influential factors and their manifestations. The interrelated objectives were: 1) to determine physicians\u27 perceptions of work-life balance, medical specialty and national culture on burnout; 2) to explore their general and personal perspectives on the influential factors in the incidence and prevalence of physician burnout. This exploratory qualitative study used in-depth interviews with physicians working in the UAE. The study contributes to the literature by identifying and explicating the influential factors, such as personality, work culture and work-life balance, in physician stress in a new national context, the UAE

Quality of life in patients with thalassemia major in a developing country.

Objective: To determine the problems faced by thalassemic patients in their personal, psychological and social life. Study Design: A cross-sectional multi-centre survey. Place and Duration of Study: Karachi, Lahore and Quetta Centres of Fatimid Foundation, from October 2009 to October 2010. Methodology: An indigenously developed Qualifty of Life (QoL) questionnaire modified from SF-36 questionnaire was administered to 101 transfusion dependent subjects suffering from thalassemia major. Variables were analyzed using SPSS version 15 for descriptive statistics. Results: The mean age of the subjects was 10.5 years ranging from 6 - 21 years. Less than one third of the patients felt that their health was slightly worse as compared to last year. Forty five (44%) of the patients felt loneliness due to their disease. Parents of 36 (35.6%) of the children at times did not allow their children to play because of their disease. Twenty eight (27.7%) stated difficulty in mingling with children of their age. Seventy one (70.3%) of the patients reported that at some or all times they were worried about their future life and career while 70 (69.3%) admitted being taken extra care of by their friends and 56 (55.4%) by their teachers. Conclusion: The quality of life of surveyed thalassemic patients was immensely affected. Having physical impairments,social stresses, financial burdens and problems with their education and career make them very much vulnerable to psychological trauma very early in their life. All of this creates a hindrance in their way of developing into autonomous functioning adults

Duplication cyst of the pylorus: A rare cause of gastric outlet obstruction

Alimentary tract duplications are a rare congenital malformation. They can present with varied symptoms owing to the locality of the duplication, along the gastrointestinal tract. Out of these duplications, the ones along the pylorus are the most rare. These are usually only diagnosed intraoperatively, as it is not a common differential on imaging due to its rarity. In lieu of the literature currently available, pyloric duplication cyst can present anytime from 1 week of age to 5 years, with some cases being detected antenatally due to the prevalence of regular antenatal scanning. Surgery remains the main stay of treatment with the goal of complete excision of the cyst and complete removal of the cyst mucosal lining. We report the case of a 5-year-old girl, which to our knowledge is the first ever reported case from Karachi, Pakistan

Ambivalence about Leadership in Women's Organizations: a Look at Bangladesh

Summary Women's organizations present special challenges for leadership. Feminist organizers are trying to create new organizational structures based on sharing power more equitably among members but they are still in transition and are capable of recreating hierarchical patterns of behaviour. The pressure of the male?dominated public sphere to conform to hierarchical modes of operation and attempts to undermine women's collective action also affects these change efforts. Women end up feeling ambivalent both as leaders and towards leadership and authority. Self?reflection and open communication on these issues can increase group effectiveness and solidarity. RESUME Les ambigus concernant la direction des organisations pour les femmes: une étude de cas au Bangladesh Les organisations pour les femmes présentent des problèmes particuliers au niveau de leur direction. Les organisatrices féministes tentent de créer de nouvelles structures organisationnelles fondées sur un partage plus équitable du pouvoir parmi les membres or ces nouvelles structures n'en sont qu'à un stade transitionnel et de ce fait, elles restent capables de recréer des modèles de comportement d'ordre hiérarchique. Les pressions dans un domaine public à dominance masculine pour se conformer à des normes d'opération hierarchisées, ainsi que les tentatives de saper l'action collective des femmes militent contre les efforts de changement. En fin de compte, les femmes ressentent une certaine ambivalence envers leur propre responsabilité et envers leurs responsables et l'autorité en général. L'introspection et la communication ouverte sont deux moyens qui permettent d'augmenter l'efficacité et la solidarité des groupes en ce qui concerne ces questions. RESUMEN Ambivalencia sobre liderazgo en organizaciones femeninas; el caso de Bangladesh Las organizaciones femeninas presentan desafíos especiales al liderazgo. Los organizadores feministas están tratando de crear nuevas estructuras basadas en una distribución más justa del poder entre sus miembros, pero todavía están en un período de transición y podrían llegar a recrear pautas jerárquicas de acción. La presión por parte de las esferas públicas para una aceptación de modos jerárquicos de acción y los intentos de socavar la acción colectiva de las mujeres también afectan estos esfuerzos dirigidos al cambio. Las mujeres terminan con un sentimiento de ambivalencia tanto con respecto a su posición de líderes como hacia el liderazgo y la autoridad en general. Para aumentar la efectividad del grupo y la solidaridad deben existir mas auto reflexión y mas comunicación

Synthesis, single crystal X-ray diffraction, Hirshfeld surface and biological activity of quinolone derivatives

Two new quinolone derivatives, 5-nitroquinolin-8-yl-3-bromobenzoate (1) and 5-nitroquinolin-8-yl-3-chlorobenzoate (2), were synthesized and their structures were elucidated using X-ray diffraction techniques. Both compounds crystallized in P21/n (monoclinic) space group having four independent molecules in asymmetric unit. The dihedral angle between benzene and planner quinoline rings in compounds 1 and 2 were found to be 117.7(2) and 117.4(2)ᵒ, respectively. No intermolecular hydrogen bonding was observed in compound 1. However, C-H···O intermolecular interaction was found to connect the molecules in crystal lattice of compound 2. Hirshfeld surfaces analysis was performed to evaluate the directions, and strength of interactions of molecules of compounds and 1 and 2 with neighbouring molecules, and the major contribution in the crystal packing was due to O-H (1, 24.6% and 2, 25.1%) interactions. The synthesized quinoline derivatives were found as potent anti-bacterial agents against E. coli reference (ATCC25922 and ATCC 35218) and multi-drug resistant strains (M2 and M3) with 91.42 to 94.72% inhibition. Both compounds 1 and 2 showed weak antileishmanial activity against L. Major promastigotes in vitro with IC50 values 73.2±3.1 and 72.2±2.3 mg/mL, respectively, and also found as cytotoxic in nature against 3T3 fibroblast cell line

Yield of Muscle Biopsy in Patients with Findings of Myopathy on Electrodiagnostic Testing

Background: The evaluation of neuromuscular diseases includes detailed clinical assessment, blood testing, electrodiagnostic studies (EDS), biopsy, and genetic tests. EDS alone cannot provide a specific diagnosis. Further testing in the form of genetic tests or muscle biopsy (MB) is required. Objective The objective of the study is to evaluate the yield of MB in patients with findings of myopathy on electrodiagnostic testing and assess the factors affecting an abnormal biopsy outcome. Methods: Electromyography (EMG)/nerve conduction studies (NCS) performed for suspected myopathy over 5 years from 2011 to 2016, at the neurophysiology department of a tertiary care center in Pakistan, were reviewed. Based on inclusion criteria, records of 58 patients were retrospectively reviewed. Results: After an EMG/NCS diagnosis of myopathy, the frequency of MB testing was only 10.1%. The median age of patients was 26.5 years. The clinically suspected diagnosis was categorized into hereditary myopathy (n = 15, 25.9%) and acquired myopathy (n = 18, 31%). The positive predictive value of EMG is 77.2%. Twenty-eight (48.2%) patients had abnormal MB whereas 20 (34.4%) revealed normal findings. Factors significantly influencing an abnormal outcome of biopsy included moderate-to-severe elevation of creatine kinase (\u3e2,000 U/L),presence of denervation changes, and severe myopathy on EMG. Conclusion: Even though the overall yield of MB testing may not be very high in our setting due to the unavailability of special techniques and expertise, certain factors can help to improve the diagnostic yield. Clinicians should encourage MB testing, especially in cases with strong clinical, laboratory and electrodiagnostic suspicion, and absence of genetic testing for suspected myopathy

Non-invasive measurement of a metabolic marker of infant brain function

While near-infrared spectroscopy (NIRS) haemodynamic measures have proven to be vastly useful in investigating human brain development, the haemodynamic response function (HRF) in infants is not yet fully understood. NIRS measurements of the oxidation state of mitochondrial enzyme cytochrome-c-oxidase (oxCCO) have the potential to yield key information about cellular oxygen utilisation and therefore energy metabolism. We used a broadband NIRS system to measure changes in oxCCO, in addition to haemodynamic changes, during functional activation in a group of 33 typically developing infants aged between 4 and 6 months. The responses were recorded over the right temporal lobe while the infants were presented with engaging videos containing social content. A significant increase in oxCCO was found in response to the social stimuli, with maximum increase of 0.238 ± 0.13 μM. These results are the first reported significant change in oxCCO in response to stimulus-evoked activation in human infants and open new vistas for investigating human infant brain function and its energy metabolism

Using multi-modal neuroimaging to characterise social brain specialisation in infants

The specialised regional functionality of the mature human cortex partly emerges through experience-dependent specialisation during early development. Our existing understanding of functional specialisation in the infant brain is based on evidence from unitary imaging modalities and has thus focused on isolated estimates of spatial or temporal selectivity of neural or haemodynamic activation, giving an incomplete picture. We speculate that functional specialisation will be underpinned by better coordinated haemodynamic and metabolic changes in a broadly orchestrated physiological response. To enable researchers to track this process through development, we develop new tools that allow the simultaneous measurement of coordinated neural activity (EEG), metabolic rate, and oxygenated blood supply (broadband near-infrared spectroscopy) in the awake infant. In 4- to 7-month-old infants, we use these new tools to show that social processing is accompanied by spatially and temporally specific increases in coupled activation in the temporal-parietal junction, a core hub region of the adult social brain. During non-social processing, coupled activation decreased in the same region, indicating specificity to social processing. Coupling was strongest with high-frequency brain activity (beta and gamma), consistent with the greater energetic requirements and more localised action of high-frequency brain activity. The development of simultaneous multimodal neural measures will enable future researchers to open new vistas in understanding functional specialisation of the brain