Unhappy on the Job: An Unpleasent Experience Faced by Cashiers in the Banking Sector of Pakistan: Evidence from District Faisalabad

The study is aimed to depict the factors that affect the job satisfaction of cashiers in the banking sector of Pakistan and make them to feel unhappy on the job. For in-depth understanding of the concept under study, qualitative research strategy is applied. To achieve the objectives, MCB Bank Limited and Habib Bank Limited were selected as population of the study from city district Faisalabad, Pakistan. A semi structured interview technique is employed to collect the data from cashiers of study who provide the necessary information about their feelings at their jobs and its different facets. Nvivo-10 software is used to analyze the data. Different queries are run to explore the factors contributing towards unhappiness of employees. We find that cashiers feel unhappy on the job at banks due to low salary, limited benefits & opportunities for promotion, job insecurity, long working hours, imbalance in work & family life, lack of participation in decision making and nature of work itself. The findings are helpful to the HR departments of the banking sector as the findings reveal cashiers are unhappy on their jobs which may lead towards increased absenteeism/turnover. HR department of banks can make effective policies to change the feelings of cashiers to increase their performance and avoid turnover costs. A wide range of factors contributing to unhappy feelings of cashiers, but in the current study we explore not many factors. Furthermore the study is limited to only two banks of district Faisalabad with only 30 interviews

The effects of different types of diets on obese individuals diagnosed with type 2 diabetics

The United Nation set out a goal to reduce poverty rates by 50% as part of its millennial goals, which was reached in 2010. Despite this reduction, attention is still given by organisations to decrease poverty further. Obesity was also mentioned in the UN report, however despite and the global effort, its rate is increasing exponentially with projections of a billion adults being obese by 2025. Historically this has been explained by Maslow’s hierarchy of needs which state that the most basic need of all people is food, which led to the belief that affordable food choices usually not as healthy as others and usually contains food groups which are known to contribute to obesity. Obesity can lead to diabetes which is likely preventable. This systematic review aim was to investigate the effect of food groups such as carbohydrate, protein and fat in different type of diets compared to the Mediterranean diet, to determine which diet provided the best benefit to decreasing fasting glucose, body mass index, waist circumference, low density cholesterol, systolic blood pressure levels as well as increasing high density cholesterol levels. This review concluded that low carbohydrate diet provided the best benefits compared to high protein, high fat and Mediterranean diet. A ketogenic diet was not as effective as standard low carbohydrate diet due to a risk of dehydration. Based on these findings, this review recommends that the e best diet is that contains a combination of low carbohydrate, high protein and high fat

Post-Operative Complications of Surgery for Chronic Subdural Hematoma (SDH) and Prevention

Objective:  The study aimed to determine the rate and type of complications during surgery for treatment of chronic subdural hematoma and assess ways for their prevention. Material and Methods:  A total of 50 patients of chronic SDH were selected from the Neurosurgery Department of Bahawal Victoria Hospital. Patients were treated surgically with a single burr hole evacuation under local anesthesia, introduced a subdural drain, nursed in a head-down position for 24 hours, and given plenty of fluids orally and intravenous route. The surgical technique involved a formation of a single burr hole at the point of maximum density. Results:  Out of 50, 43 patients recovered smoothly postoperatively and discharged on the 7th postoperative day. Two patients were re-operated due to inadequate evacuation or reaccumulation. One patient developed subdural empyema post-operatively and expired in spite of good antibiotic cover. In one patient subdural drain penetrated the brain parenchyma resulting in dysphasia. Another patient formed an intracerebral hematoma due to irrigation of the cavity with pressure. One patient with GCS 4/15 developed seizures postoperatively and expired after one hour. One patient developed gross subdural tension pneumocephalus after removing the subdural drain was re-operated and recovered. Conclusion:  Single burr hole evacuation of chronic SDH under local anesthesia is the most accepted surgical treatment. Using proper aseptic surgical techniques, the introduction of the minimum necessary length of the subdural catheter to avoid penetration into the brain parenchyma, followed by careful irrigation of the subdural cavity can help prevent complications

SHORT TERM OUTCOME OF PATIENTS WITH HEPATOPANCREATOBILIARY MALIGNANCIES TREATED IN A MULTIDISCIPLINARY HEPATOBILIARY UNIT IN A TERTIARY REFERRAL CENTER

Purpose: Specialisation in hepatopancreatobiliary (HPB) surgery has evolved over the past few decades based on better understanding of the biology and the behaviour of the diseases. In this review from a specialised HPB service, we aim to provide an overview of the HPB oncological cases managed in a tertiary care cancer hospital. Methods: All cases of HPB malignancies treated in our hospital between October 2014 and September 2015 were included in the study. Clinical findings, operative details and short-term post-operative outcomes were assessed from a prospectively managed database. Results: A total of 65 oncological procedures were performed over 1 year. These included 23 hepatic resections, 27 pancreaticoduodenectomies, 5 radical surgeries for gallbladder cancer, 2 distal pancreatectomy and 8 nephrectomies with exploration of the inferior vena cava. One patient successfully underwent Associated Liver Partition with Portal vein ligation and staged hepatectomy (ALPPS Procedure), which to our knowledge was the rst ALPPS procedure carried out in Pakistan. Conclusion: The short-term experience of patients managed in specialised HPB unit has shown good outcomes.There is a need for establishing HPB units in most tertiary care hospitals in the country. Key words: Associated liver partition with portal vein ligation and staged hepatectomy procedure, hepatic resections, hepatopancreatobiliary surgery, pancreaticoduodenectomy

An empirical examination of brand hate influence on negative consumer behaviors through NeWOM intensity. Does consumer personality matter?

Limited research has investigated the consequences of brand hate, particularly the pathways and contingent factors. This study addresses a critical gap by investigating the mediation of negative electronic word-of-mouth (NeWOM) intensity between brand hate and the two different forms of consumers’ coping behaviors: boycott (instrumental aggression) and brand sabotage (hostile aggression). It also demonstrates the moderating role of the Big Five personality traits in these pathways. An empirical survey with 391 participants recruited through Prolific reveals that brand hate directly affects NeWOM intensity, consumer boycott, and brand sabotage. These effects are more substantial for those who score high in neuroticism, extraversion, and conscientiousness. On the other hand, the effects of brand hate on NeWOM intensity and boycott are more profound when agreeableness is low. In contrast, only brand hate-to-boycott relationship strengthens when openness is low. Interestingly, NeWOM intensity mediates the relationships between brand hate and the two consumer behaviors, i.e., consumer boycott and brand sabotage. These findings enrich the literature on negative consumer-brand relationships and provide managers assistance in developing effective strategies for de-escalating consumers’ use of aggressive behaviors in response to brand hate

Comparison of clinical presentation and out-comes of chikungunya and dengue virus infections in patients with acute undifferentiated febrile illness from the Sindh region of Pakistan

Background: Arboviruses are a cause of acute febrile illness and outbreaks worldwide. Recent outbreaks of Chikungunya virus (CHIKV) in dengue endemic areas have alarmed clinicians as unique clinical features differentiating CHIKV from Dengue virus (DENV) are limited. This has complicated diagnostic efforts especially in resource limited countries where lab testing is not easily available. Therefore, it is essential to analyse and compare clinical features of laboratory confirmed cases to assist clinicians in suspecting possible CHIKV infection at time of clinical presentation.Methodology: A prospective point prevalence study was conducted, with the hypothesis that not all patients presenting with clinical suspicion of dengue infections at local hospitals are suffering from dengue and that other arboviruses such as Chikungunya, West Nile viruses, Japanese Encephalitis virus and Zika virus are co-circulating in the Sindh region of Pakistan. Out-patients and hospitalized (in-patients) of selected district hospitals in different parts of Sindh province of Pakistan were recruited. Patients with presumptive dengue like illness (Syndromic diagnosis) by the treating physicians were enrolled between 2015 and 2017. Current study is a subset of larger study mentioned above. Here-in we compared laboratory confirmed cases of CHIKV and DENV to assess clinical features and laboratory findings that may help differentiate CHIKV from DENV infection at the time of clinical presentation.Results: Ninety-eight (n = 98) cases tested positive for CHIKV, by IgM and PCR and these were selected for comparative analysis with DENV confirmed cases (n = 171). On multivariable analysis, presence of musculoskeletal [OR = 2.5 (95% CI:1.6-4.0)] and neurological symptoms [OR = 4.4 (95% CI:1.9-10.2)], and thrombocytosis [OR = 2.2 (95% CI:1.1-4.0)] were associated with CHIKV infection, while atypical lymphocytes [OR = 8.3 (95% CI:4.2-16.7)] and thrombocytopenia [OR = 8.1 (95% CI:1.7-38.8)] were associated with DENV cases at time of presentation. These findings may help clinicians in differentiating CHIKV from DENV infection.Conclusion: CHIKV is an important cause of illness amongst patients presenting with acute febrile illness in Sindh region of Pakistan. Arthralgia and encephalitis at time of presentation among patients with dengue-like illness should prompt suspicion of CHIKV infection, and laboratory confirmation must be sought