Impact of Training and Development on Employee’s Performance: A Case Study of Private Local Schools, District Nowshehra, KPK

Training and development has been the phenomena related to organizations in different programs and activities and its objective to improve the performance of individual employee. This research study was aimed to identify the impact of training and development on employee’s performance. The research methodology was based on primary data that was collected through self administered questionnaires from teaching staff in private local schools in district Nowshehra, KPK. 250 question- naires were distributed among the teaching staff. 217 questionnaires were returned, whereas 8 improperly filled questionnaires were discarded and 209 properly filled questionnaires were included in the analysis of the study. From the results, it has been concluded that training and development was found to have significant impact on employees’ performance, hence hypothesis H1 was accepted

Management of Intracranial Haemangiopericytomas

Haemangiopericytomas are rare tumours, commonly mistaken as meningiomas on radiology. These tumours are considered malignant and treatment involves aggressive surgery, followed by adjuvant radiation therapy, and close radiological and clinical follow ups. Herein the authors have reviewed the recent literature on the management of these tumours

Permanent pre-operative cerebrospinal fluid diversion in paediatric patients with posterior fossa tumours

Management options for obstructive hydrocephalus in children with posterior fossa tumours have been debated upon throughout the course of neurosurgical practice. Permanent pre-operative CSF diversion via ventricular shunts or endoscopic third ventriculostomy have been employed to prevent the possible persistence of hydrocephalus after tumour removal, but is considered unnecessary and even dangerous amongst a large group of neurosurgeons. In this paper, we have reviewed the literature for the merits and demerits of pre-operative permanent CSF diversion in paediatric patients presenting with posterior fossa tumours

Stereotactic radiosurgery for pituitary adenomas: A review of literature

Stereotactic radiosurgery (SRS) is a choice of treatment for pituitary adenomas (PA), particularly for residual or recurrent disease, apart from surgery. It has a progression free survival and endocrine remission rate comparable to surgery, with fewer side effects, making it an ideal tool for dealing with PA. In this review, we have discussed the role of SRS for primary as well as post-operative residual/ recurrent PA, and have assessed its safety and outcomes

Seizure control after surgical resection of insular glioma

Insular gliomas most commonly present with drug-resistant seizures, irrespective of the tumour grade. Even though surgery is the mainstay of treatment, complex anatomical location and close proximity to eloquent cortex makes surgical resection difficult. Herein the authors have reviewed the literature with regards to seizure control after surgical management of these tumours. The review does not address quality of life, or survival benefits of surgery. In summary, excision of these gliomas significantly improves seizure control, and extent of resection along-with trans-cortical approach are important predictors of seizure outcome

Use of ultrasonic aspirator for CNS tumour resection

Ultrasonic aspirator (UA), or the Cavitron Ultrasonic Aspirator (CUSA) as it is commonly referred to, utilizes ultrasonic waves of variable range of frequencies to disintegrate and excise tumours. It is developed as a substitute of bipolar diathermy; a tool commonly employed for coagulation that uses focussed electric current and may damage tissues by virtue of contact, or by the heat that it produces. Over the last 30 years, CUSA has become increasingly popular in several soft tissue surgeries, especially brain and spine tumour resection, as it allows reduction in the use of bipolar diathermy. It is assumed that CUSA improves both surgical safety and clinical outcomes, and also reduces surgical time. Herein the authors have reviewed the available literature on the advantages of CUSA

Enhanced recovery after elective craniotomy for brain tumours

Enhanced recovery after surgery (ERAS) is aimed at accelerated rehabilitation after surgery, and involves a multidisciplinary approach. Significant work has been published on this concept with regards to abdominal surgeries, however, the idea is relatively new for those undergoing neurosurgical procedures. We have reviewed literature on ERAS in patients undergoing craniotomy for brain tumours

Primary intracranial malignant melanoma

Primary intracranial malignant melanoma (PIMM) are rare brain tumours; more infrequent than melanomas metastasizing to the brain or those extending to the brain from adjacent structures such as the orbit. Complete surgical excision with adjuvant chemotherapy and radiation remains the mainstay of treatment. Herein, we have reviewed the literature to find the treatment modalities for PIMMs that can lead to longer overall survivals and better patient outcomes

Role of intra-operative ultrasound in brain tumour surgeries

The use of intra-operative ultrasound remains a largely underutilized option in brain tumour surgeries. The widespread availability of neuronavigation may be the reason why such a useful modality has become less popular even though recent advances in ultrasound technology have greatly improved its utility. The available literature also clearly shows that it offers additional advantages especially when used with neuronavigation. Herein the authors have briefly touched upon the available literature on the role of intraoperative ultrasound in brain tumour surgeries

Prospective validation of a blood ordering protocol for elective spine arthrodesis and its impact on cost reduction

Background: On the basis of an institutional audit, the authors published an individual patient-based protocol for preoperative arrangement of blood products in patients undergoing elective spine arthrodesis. The present study was conducted for the prospective validation of the proposed protocol in reducing cross match to transfusion ratio, and its implications on overall cost.Methods: This cross-sectional study was conducted over 1 year (2012). All adult patients who underwent elective spinal arthrodesis were included and prospectively observed. The actual transfusion index was calculated for individual patients with the formula C1/T, where C1 is the number of units of packed RBCs cross matched and T is the number of actual transfusions. C1/T was then compared with a theoretical transfusion index C2/T for the same group of patients, C2 being the number derived from calculating the number of units of packed RBCs that would have been ordered for individual patient according to the protocol. The cost difference between C1/T and C2/T was analyzed.Results: A total of 125 patients were included. A total of 435 units of packed RBCs were ordered (C1), out of which only 108 units were transfused (T), yielding a C1/T of 4.02. The C2 for the same group of patients was 188 units of packed RBCs and the C2/T was thus calculated to be 1.74. Implementation of the protocol would reduce per patient cost from Pakistani Rupees (PKR) 6676.8 ± 4125.8 to 4700.8 ± 1712.86, with a P \u3c 0.001 and an overall reduction of 30%.Conclusion: Cross match to transfusion ratio and blood ordering related cost are both significantly reduced with the application of institutional cross-match protocol