Patients’ Satisfaction About Health Care Services in Outpatient Department of General Surgery at PIMS, Islamabad

Objective: To assess the Patients’ satisfaction about health care services in the outpatient department of General Surgery at PIMS, Islamabad. Methodology: This is a prospective cross sectional study done for six months at General Surgery OPD, PIMS, Islamabad. All patients who attended the outpatient department of GSU-III were included. After consent patients answered a specially designed 30-item cross-sectional questionnaire regarding general convenience and satisfaction aspects regarding the OPD. Questions depicting the interpersonal relationships and the role of Doctors and the paramedic staff at the hospital are also included. All data was collected, recorded and analyzed using SPSS 17 and excel 2013. Results: A total of 410 patients were included with the mean age of 41 years and male to female ratio was≈ 1:3. 57.4% patients had completed their secondary or higher secondary education. 12.1% were labourers, 19.5% were students, 19.5% were unemployed and 34.1% were housewives. Most of the population was already registered at the general surgery department PIMS. Response to various questions regarding general convenience and satisfaction aspects regarding the OPD were averagely rated ‘agree’ or ‘strongly agree’ by 96.3% patients, while 14.6% had their reservations. Answers depicting the interpersonal relationships and the role of Doctors and the paramedic staff at the hospital were appreciable in 71.95% and 64.6% of the cases respectively. 16.2% and 19.5% negated respectively. Interviews from all patients were taken into account in data analysis and conclusion. In sum, the patient’s satisfaction (58.5%) with the overall care (62.1%) were satisfactory. 59.7% patients wished to recommend this service to others. Conclusion: Most of the patients who visited the Outpatient department of General Surgery Unit III were satisfied regarding the overall care and the behavior of doctors and paramedical staff interacting with them

The Impact of Taxpayer Perception on Tax Compliance moderated by adoption of e-tax system

The underlying study focuses on investigating that if the impact of taxpayer perceptions have on tax compliance with moderating impact of adopting of e-tax system in Pakistan where Fairness perception, tax knowledge and tax complexity are taken as Independent variables, implementation of e-tax system as a moderating variable and tax compliance as dependent variable. Following a deductive approach, this research study has collected data through self-administered questionnaire from a sample of 163 subjects selected on the basis of convenience sampling technique. The data were analyzed through SPSS and multiple regression technique has been applied on the data. The outcomes suggest that fairness perceptions and tax compliance have direct relationship. The findings of the study suggest that the moderation relationship between the variable named adoption of e-tax system and tax perceptions and tax compliance is insignificant. Besides this, tax knowledge and tax complexity does not have a significant positive impact on tax compliance in Pakistan

The Impact of Taxpayer Perception on Tax Compliance moderated by adoption of e-tax system

The underlying study focuses on investigating that if the impact of taxpayer perceptions have on tax compliance with moderating impact of adopting of e-tax system in Pakistan where Fairness perception, tax knowledge and tax complexity are taken as Independent variables, implementation of e-tax system as a moderating variable and tax compliance as dependent variable. Following a deductive approach, this research study has collected data through self-administered questionnaire from a sample of 163 subjects selected on the basis of convenience sampling technique. The data were analyzed through SPSS and multiple regression technique has been applied on the data. The outcomes suggest that fairness perceptions and tax compliance have direct relationship. The findings of the study suggest that the moderation relationship between the variable named adoption of e-tax system and tax perceptions and tax compliance is insignificant. Besides this, tax knowledge and tax complexity does not have a significant positive impact on tax compliance in Pakistan

Hyperlipidemia Patterns in Newly Diagnosed Young Diabetic Patients

Objective: To analyze hyperlipidemia patterns among newly diagnosed young diabetic patients. Study Design: A descriptive cross-sectional study Place and Duration: Study was conducted in DHQ Teaching Hospital, DG Khan, Bahawal Victoria hospital, Bahawalpur, and Sheikh Zayd Hospital, Rahim Yar Khan from July 2017 to July 2018.Methodology: All the patients were young and newly diagnosed with Diabetes Mellitus. Data collection was done via non probability consecutive sampling included patients’ demographics, past medical history, co-morbidities, and lab findings were assessed. SPSS version 24 was used to analyze data. P value ≤ 0.05 was taken as significant.Results: Eighty patients were included in this study. Diabetic nephropathy, diabetic retinopathy, macrovascular complications, hyperglycemic hyperosmolar non-ketotic coma history, family history and hypertension were noted in n=12 (15%), n=6 (7.5%), n=9 (11.3%), n=1 (1.3%), n=34 (42.5%) and n=11 (13.8%) respectively. The mean hyperlipidemia, hypertriglyceridemia, of the patients was 4.54±0.52 mmol/L, 2.59±1.13 mmol/L, 1.39±0.80 mmol/L, 1.03±0.59 mmol/L respectively. Conclusion: the study has shown that the prevalence of increased levels of triglycerides is more than increased LDL cholesterol levels among these patients. As it has been established that hypertriglyceridemia is a known risk factor for causing cardiovascular disorders among diabetic patients, it should be addressed and managed accordingly at the onset of diabetes. Keywords: Hyperlipidemia, Diabetes Mellitus, low density lipoproteins, high density lipoproteins, insulin.

The Efficacy of Ivabradine Alone, Metoprolol Alone and Combination of Ivabradine and Metoprolol in Reducing Heart Rate Among Patients Undergoing Computed Tomography Coronary Angiography

Objectives: to determine the efficacy of Ivabradine alone, Metoprolol alone and Combination of Ivabradine and Metoprolol in reducing heart rate among patients undergoing Computed Tomography Coronary Angiography (CTCA). Methodology: it was a randomized controlled trial comprised of 200 patients. Patients undergoing CTCA having heart rates greater than 80 bpm were divided into three groups. Group A was given Ivabradine and a placebo, Group B received Metoprolol and placebo while Group C was administered with Ivabradine and Metoprolol an hour prior to the scan. The scan was carried under similar situations. Heart rate and variability was recorded before and during the scan. Results: The mean heart rate variability and mean reduction in heart rate of Group A was 3.13±1.01 and 19.02±2.05 respectively. The mean heart rate variability and mean reduction in heart rate of Group B was 4.27±1.08 and 12.11±2.45 respectively. While, the mean heart rate variability and mean reduction in heart rate of Group C was 1.88±0.42 and 25.03±2.74 respectively. Conclusion: Ivabradine is an effective and safe drug for reducing heart rate in patients having CTCA, especially among patients who are unable to tolerate calcium channel blockers and beta blockers owing to their side effects. Keywords: Ivabradine, Metoprolol, Computed tomography coronary angiography, heart rate reduction, heart rate variability

Patients’ Satisfaction About Health Care Services in Outpatient Department of General Surgery at PIMS, Islamabad

Objective: To assess the Patients’ satisfaction about health care services in the outpatient department of General Surgery at PIMS, Islamabad. Methodology: This is a prospective cross sectional study done for six months at General Surgery OPD, PIMS, Islamabad. All patients who attended the outpatient department of GSU-III were included. After consent patients answered a specially designed 30-item cross-sectional questionnaire regarding general convenience and satisfaction aspects regarding the OPD. Questions depicting the interpersonal relationships and the role of Doctors and the paramedic staff at the hospital are also included. All data was collected, recorded and analyzed using SPSS 17 and excel 2013. Results: A total of 410 patients were included with the mean age of 41 years and male to female ratio was≈ 1:3. 57.4% patients had completed their secondary or higher secondary education. 12.1% were labourers, 19.5% were students, 19.5% were unemployed and 34.1% were housewives. Most of the population was already registered at the general surgery department PIMS. Response to various questions regarding general convenience and satisfaction aspects regarding the OPD were averagely rated ‘agree’ or ‘strongly agree’ by 96.3% patients, while 14.6% had their reservations. Answers depicting the interpersonal relationships and the role of Doctors and the paramedic staff at the hospital were appreciable in 71.95% and 64.6% of the cases respectively. 16.2% and 19.5% negated respectively. Interviews from all patients were taken into account in data analysis and conclusion. In sum, the patient’s satisfaction (58.5%) with the overall care (62.1%) were satisfactory. 59.7% patients wished to recommend this service to others. Conclusion: Most of the patients who visited the Outpatient department of General Surgery Unit III were satisfied regarding the overall care and the behavior of doctors and paramedical staff interacting with them

Design, Fabrication, and Operation of a 10 L Biodiesel Production Unit Powered by Conventional and Solar Energy Systems

Biodiesel is regarded as a low-carbon substitute for petroleum-based fuels. This research study aimed to investigate a 10 L batch-scale biodiesel production system from waste cooking oil (WCO) powered energy by solar energy and conventional electricity. The unit’s design considers the mass balance of the system’s constituent parts. The methoxide mixing chamber volume was calculated as 2.5 L with an electric agitator power requirement of 25 W. In comparison, the volume occupied by reactants in the stirred reactor was determined to be 14.5 L with a 250 W electric motor agitator. The WCO biodiesel was produced by a two-step process, i.e., esterification followed by a transesterification reaction using conventional electricity and solar power, yielding 92% and 90% by volume, respectively. The characteristics of WCO biodiesel produced from both energy systems was comparable to ASTM D6751. The total amount of conventional electricity and solar power required was 2.006 kWh and 1.0 kWh per 10 L, respectively. The WCO biodiesel’s mass performance was 64.02% and 62.10%, whereas the energy productivity was 0.0242 kg/MJ and 0.0235 kg/MJ from conventional electricity and solar energy systems, respectively. Therefore, solar energy systems can be employed in biodiesel production with a massive reduction in traditional energy requirements, thus reducing the production’s carbon footprint

Grain refinement of ASTM A356 aluminum alloy using sloping plate process through gravity die casting

Sloping plate flow is used for enhancement of material properties through grain refinement in gravity die casting of Aluminum alloy ASTM A356. The castings are prepared with different slope angles of an 800 mm long, naturally cooled stainless steel plate. The specimens obtained are then tested for tensile strength and elongation. Microstructure of the cast specimens is observed and conclusions drawn on the grain size and precipitate morphology as a function of angle of sloping plate. Analysis is presented for the boundary layer created while the material flows over the plate. An indication of the boundary layer thickness is determined by measuring the thickness of the residual metal layer on the plate after casting. An analytical solution of the boundary layer thickness is also presented. It is shown that the calculated boundary layer thickness and the thickness of the layer of material left in the channel after casting are in good agreement. Moreover, microstructure examination and tensile tests show that best properties are achieved with a 60° sloping plate

Impact of Angoumois Grain Moth, Sitotroga cerealella Olivier (Lepidoptera: Gelechiidae) on the Viability of Maize Seed

The current study was conducted to determine the viability of maize seed infested with Angoumois Grain Moth Sitotroga cerealella (Olivier). The aim was to see how different cultivars of maize are resistant to this pest. Seeds of four cultivars of maize viz. Pop 2006, Soan, Margalla and Islamabad gold were examined in Stored Product Laboratory of Department of Entomology, Pir Mehr Ali Shah Arid Agriculture University Rawalpindi during the year 2009-2010. The Pop-2006 appeared susceptible for S. cerealella egg hatching with 91.66% hatchability and minimum percent hatchability in Margla with 89.33%. Maximum and minimum percent infestation 9.30 ± 0.35 and 6.30 ± 0.58 in Islamabad gold and Pop 2006 respectively. Results indicated that maximum percent grain losses in Islamabad gold and minimum in Pop 2006, i.e. 51.91 ± 1.91, and 30.06 ± 0.70 (mean ± SE) respectively. The cultivars Pop 2006 and Marglla are considered as important part in IPM tools to control the store grain losses in maize crop. Present study was conducted to evaluate the resistance of different maize cultivars against the S. Cerealella. The finding may improve the good quality store of the products with minimal use of synthetic chemicals