Antibiotics in acute calculous cholecystitis : do Tokyo guidelines influence the surgeons’ practices?

Abstract OBJECTIVE: To observe changes in surgeons\u27 practice of antibiotic usage in patients with acute cholecystitis before and after the implementation of Tokyo Guidelines. METHODS: This retrospective, descriptive study was conducted at the Aga Khan University Hospital, Karachi, and comprised the medical records of all patients with the diagnosis of acute calculus cholecystitis who presented in 2009 and those who presented in 2014 after the implementation of Tokyo Guidelines. The major variables included patients\u27 demographics, antibiotics used and surgical outcomes. SPSS 19 was used for data analysis. RESULTS: Of the 356 patients, 96(27%) were treated in 2009 and 260(73%) in 2014. The overall mean age was 48.9±14 years. There were 185(52%) females and 171(48%) males. Comparison of the data from 2 years showed no difference in gender, American Society of Anaesthesiologists level, grade of acute cholecystitis and frequency of use of empiric antibiotics (p\u3e0.05 each). However, there was significantly less use of combination therapy (p=0.00) and metronidazole (p=0.00) in 2014than in 2009. Interval cholecystectomy was significantly less practised in 2014 (p=0.03) resulting in shorter hospital stay (p=0.00). Despite improvement in antibiotic usage practices, post-operative infection rates remained the same in both the groups (p=0.58). CONCLUSIONS: Implementation of Tokyo Guidelines not only greatly influenced but also standardised the choice of antibiotics in patients without compromising the infective and surgical outcomes

Evaluation of noise level in coach and train station at LRT Kelana Jaya line

This study focus on noise evaluation done at LRT Kelana Jaya Line during train operation. The aim of this study was to estimate the level of noise during train operation and evaluate the actual level of noise measurement at selected LRT stations. After that, a concept to reduce noise level during train operation was proposed. In addition, the actual level of noise measurement was compared with the theoretical permissible noise based on existing predetermined guidelines and standards. For train interior noise level, sound level meter was installed at front end and gangway by following noise measurement procedure provided by standards and guidelines. For noise at train stations, noise level recorded at different distance from trackside which is 2, 4, 6, 8 and 10 meters. The results show that for train interior noise level, most of the time of train operation was exceeded the limitation provided by Prasarana based on standard ISO 3381, 75dB. The noise level also exceeded noise limit in tunnel which is 80dB during train operation. For station noise level data, only at distance 2 meter and 4 meter from track can achieve noise level more than 5dB than limits provided by DOE, about 80dB. In conclusion, interior train noise level may need to be decrease and at Setiawangsa station has the highest noise level than other stations

Analysis of epoxy composite with diapers waste as fillers: relationship of density, porosity and sound absorption coefficient

In this study, epoxy composites consisting of diapers waste (DW) as filler to improve the strength of the materials were produced by hand lay-up fabrication process. The inclusion of the DW significantly improves the sound absorption properties of epoxy composites. This study analyzes the relationship between the density, porosity and sound absorption coefficient properties of different weight ratio of the DW in the epoxy composites. Density and porosity is the key factor for acoustic efficiency determination in the same composite form. It can be mainly attributed to great number of voids which more porous and less dense into the matrix, increasing the sound absorption efficiency of the epoxy composites materials. The properties of the diapers waste are lightweight which show that, the incorporation of the diapers waste as fillers in the epoxy composite shows lower value of the density while increase in terms of porosity. Ratio 0.5 DW/epoxy had the most excellent properties in terms of lower density, higher porosity and sound absorption coefficient with 0.93 SAC score

THE SPORT PARTICIPATIONS AND SOCIAL CLASS RELATIONSHIP AMONG FEMALE ATHLETE OF PAKISTAN

The drive of the existing research was to determine the relationship between social class (gender inequality and dress code) and sports participation among successful female athletes of secondary schools of rural areas of Pakistan. The nature of the study was purely quantitative. The adopted and modified survey questionnaire was employed for the purpose of collecting the data. Simple random sampling was used as a sampling technique. In the sense of statistical techniques, descriptive statistics and correlation (Pearson) analysis was utilized to analyze the survey data. The results revealed that gender inequality and dress code had strong and significant relationships with sports participation (health, personal drive and interest), therefore, the direction of all relationships was found negative. It was concluded that both gender inequality and dress code found big hurdles in the way to female sports participation

THE RELATIONSHIP STUDY BETWEEN COHESION AND PERFORMANCEOF PLAYERS OF HOCKEY, IN PAKISTAN

This paper represents the findings of a larger study which highlights the relationship between cohesion and the performance among hockey players of Pakistan in view of socio-interactional context. Pakistan won laurels in Field hockey with four World Cup and three Olympics titles to its credit but no effort has been made to find out the factors which have turned Pakistan (as a team) from the status of a giant into a pygmy during the last two decades. The foremost objective of this paper is to scrutinize the relationship between cohesion and players’ performance. A sample of 296 players from 14sport departments was chosen as respondents. Adopted questionnaire was used to collect the survey data. The findings highlighted the significant (p=.001) relationship between cohesion and players’ performance. It is concluded that the cohesiveness among players is to be developed and expanded regarding players’ performance to fulfil sport requirements. Recommendations have been made to raise the excellence, relevance, and legitimacy in team regarding cohesion with players’ performance

THE RELATIONSHIP STUDY BETWEEN COHESION AND PERFORMANCEOF PLAYERS OF HOCKEY, IN PAKISTAN

This paper represents the findings of a larger study which highlights the relationship between cohesion and the performance among hockey players of Pakistan in view of socio-interactional context. Pakistan won laurels in Field hockey with four World Cup and three Olympics titles to its credit but no effort has been made to find out the factors which have turned Pakistan (as a team) from the status of a giant into a pygmy during the last two decades. The foremost objective of this paper is to scrutinize the relationship between cohesion and players’ performance. A sample of 296 players from 14sport departments was chosen as respondents. Adopted questionnaire was used to collect the survey data. The findings highlighted the significant (p=.001) relationship between cohesion and players’ performance. It is concluded that the cohesiveness among players is to be developed and expanded regarding players’ performance to fulfil sport requirements. Recommendations have been made to raise the excellence, relevance, and legitimacy in team regarding cohesion with players’ performance

The Mediating Role of Business Simulations on the Relationship between University Role Entrepreneurship Curriculum and Assessment of Teaching Approaches and Entrepreneurial Inclination

The primary purpose of the paper is provide an insight into present landscape of the role that universities are playing through entrepreneurship curriculum and business simulations in enhancing entrepreneurial inclination of the students through business simulations. The underlying theories of Experiential learning theory, Constructivist learning Theory and Blooms Taxonomy are described in relation with the objectives of the research. This study is conducted in the context of Malaysian Universities. The results of PLS-SEM illustrate that there is a significant positive mediating effect of business simulations on the relationship between entrepreneurship curriculum and contents, assessment of teaching approaches and entrepreneurial inclinations of students at Universiti Utara Malaysia. The present study aimed at providing an overview of the role that is assumed by the institutions of higher education whereas recommendations have been proposed for practitioners and researchers to cope with the challenges that higher education is facing currently. The future agenda of the research on similar lines has also been proposed

Empirical Investigation on the Relationship Between Strategic Orientations and SMEs Performance in Nigeria

This study examines the relationship between strategic orientations and SMEs performance in Nigeria. The debate on entrepreneurial orientation and market orientation to firm performance will for a long time remain area of research. The population of this paper consists of 3,723 of all the SMEs operating in Kaduna and Sokoto state North West Nigeria. Out of which 351 sample questionnaires were administered to respondents concerning the entrepreneurial orientation and market orientation to SMEs performance. 218 questionnaires were returned. The number of valid questionnaires is 213. The data were analyzed using Partial Least Square Structural Equation Modelling (PLS-SEM) to determine the effect of the variables of the study. The findings of the paper indicated that entrepreneurial orientation promoting SMEs performance in Kaduna and Sokoto state North West Nigeria. Similarly, the result shows a statistically significant positive influence of entrepreneurial orientation to SMEs performance. While market orientation has no relationship with SMEs’ performance in Kaduna and Sokoto state North West Nigeria. The findings will provide the government, policy maker(s) and other SMEs’ stakeholders with the important variables of these entrepreneurial orientation and market orientation to SMEs performance in Nigeria. Implications and Suggestions for future research direction were discussed Keywords: Strategic orientation, entrepreneurial orientation and market orientation, Small and Medium Performance

Investigating the Effect of Entrepreneurship Development on the Relationship between Market Orientation, Total Quality Management and SMEs Performance in Kano

This paper investigates the effect of entrepreneurship development on the Small and Medium Enterprises (SMEs) performance in Kano. The issue of Market Orientation (MO), Total Quality Management (TQM) on the Small and Medium Enterprises (SMEs) performance in Kano state will be an interesting area of research as a centre of commerce in Nigeria. The paper sample consists of 8,286 of all the SMEs operating in Kano state. Out of which 367 questionnaires were administered to respondents concerning the MO and TQM to SMEs performance, 297 were returned. The numbers of the valid questionnaires are 291. The data were analyzed using Partial Least Square Structural Equation Modelling (PLS-SEM) to determining the effect of the variables of the study. The findings of the paper indicated that entrepreneurship development factors: MO and TQM promoting SMEs performance in Kano state. The results showed a statistically significant positive influence of both MO and TQM to SMEs performance. The finding provides the government, policy maker, SMEDAN and SMEs owners/ managers with the important variables of this MO and TQM to SMEs performance in Nigeria. This paper also made some recommendations for future research

Relationship between entrepreneurial orientation, firm resources, SME branding and firm’s performance: is innovation the missing link?

Innovation is regarded as an engine for driving economic growth.Innovation is considered equally important for the large enterprises as well as the Small and Medium Enterprises (SMEs).Role of innovation becomes of even greater importance in the context of the business environment of developing countries such as Pakistan, where most of the SMEs do not embrace rigorous innovation and at the same time there is lack of sufficient external support to encourage innovation.It has been discussed that despite of healthy economic contribution to Pakistan’s Economy, SMEs are facing a low growth trap.Innovation can come up as a potential solution specifically for Pakistani SMEs and generally for SMEs in developing countries in other parts of the world. This paper reviews the literature in a thorough manner in a bid to build a novel conceptual framework proposing that innovation has causal linkages with entrepreneurial orientation, firm resources, branding and firm performance. On the basis of literature review, four thoughtful research propositions have been presented in this paper. The proposed framework can lead to very useful insights as it proposes that branding may lead to innovation as opposed to generally believed concept of innovation leading to branding. This paper is built on the underpinning theories like Resource Based View, Dynamic Capabilities Perspective, and Theory of Economic Development. This paper also provides useful implications for the entrepreneurs as well as external institutions responsible for ensuring higher extent of innovation in SMEs in Pakistan