Bilateral Hand-Assisted Laparoscopic Renal Surgery in the Supine Position: The Spleen at Risk

The spleen appears to be at increased risk for injury during hand-assisted, bilateral laparoscopic renal procedures when the patient is placed in the “airplanes” supine position

Analysis of CPEC Projects and Effect on Construction Sector of Pakistan

China Pakistan Economic Corridor a One Belt One Road initiative is considered as a game changer especially for the continent of Asia. The trade from one country to the other parts of the world will go through the control of Pakistan. China is investing US$ 62 Billion for fully operational of this corridor through short & long term planning projects envisaged to complete by 2030. The development of infrastructure in Baluchistan province can provide access to the reserves exploration worth trillion of dollars, development of infrastructure in Pakistan will create hundreds of thousand jobs, new business opportunities, overcome energy crisis, fast communication; resulting in socio – economic benefits to the country. Pakistan Cement and Steel industry are the major beneficiaries through the CPEC projects. In this paper we have made analysis on different infrastructure projects under the umbrella of CPEC and its impact specifically on the construction sector of Pakistan. The research methodology is qualitative based on analysis of projects combined with the interview of professionals on the infrastructure projects of CPEC. The contractors of Pakistan are less benefitted while special reliefs given to Chinese companies by the Government agencies of Pakistan. The utilization of funds with transparency by Government agency on projects will be the key to success of China Pakistan Economic Corridor. We identify in our research and foresee of short term benefits of jobs creation & business growth in construction sector of Pakistan.  China can benefit in long term with the development of this corridor by getting interest on its investment & reaching to the world in days instead of months. The development of infrastructure projects on GCL (Government Concessional Loans) & BOT (Built – Operate – Transfer) philosophy will keep the existence of Chinese companies in Pakistan for the next 25-30 years

Sleep deprivation and its associated factors among general ward patients at a tertiary care hospital in Pakistan

Objective: To estimate the occurrence rate of sleep deprivation and to identify the environmental, staff-related and patient-related factors associated with SD among general ward patients of a tertiary care hospital in Pakistan.Methods: In a cross-sectional study, a pre-tested questionnaire was administered to 108 patients admitted into the general medical and general surgical wards of Aga Khan University Hospital, Karachi.Results: In all, 50 (46.3%) respondents felt deprived of adequate sleep in the hospital. Worry about illness disturbed the night-time sleep of 47 (43.5%) patients; most of these had SD (70%) (p \u3c 0.001). Other patients\u27 noise disturbed 31.5% of study subjects and a significant majority (68%) of these had SD (p = 0.003). Over 17% of study subjects reported cell phone\u27s ringing as a disturbing factor; more by those with SD (68%) compared to those with no SD (32%); again the difference was significant (p = 0.003). Physical discomfort and presence of cannula were reported as disturbing factors by 41.7% and 28.7% of the study subjects respectively but these were not significantly associated with SD.CONCLUSION: Our study revealed that sleep deprivation occurs commonly among general ward patients in tertiary care setting. Factors found to be associated with SD were amenable to modification to a greater extent

Perceptions of Pakistani medical students about drugs and alcohol: a questionnaire-based survey

BACKGROUND: Drug abuse is hazardous and known to be prevalent among young adults, warranting efforts to increase awareness about harmful effects and to change attitudes. This study was conducted to assess the perceptions of a group of medical students from Pakistan, a predominantly Muslim country, regarding four drugs namely heroin, charas, benzodiazepines and alcohol. RESULTS: In total, 174 self-reported questionnaires were received (87% response rate). The most commonly cited reasons for why some students take these drugs were peer pressure (96%), academic stress (90%) and curiosity (88%). The most commonly cited justifiable reason was to go to sleep (34%). According to 77%, living in the college male hostel predisposed one to using these drugs. Sixty percent of students said that the drugs did not improve exam performance, while 54% said they alleviated stress. Seventy-eight percent said they did not intend to ever take drugs in the future. Females and day-scholars were more willing to discourage a friend who took drugs. Morality (78%), religion (76%) and harmful effects of drugs (57%) were the most common deterrents against drug intake. Five suggestions to decrease drug abuse included better counseling facilities (78%) and more recreational facilities (60%). CONCLUSION: Efforts need to be made to increase student awareness regarding effects and side effects of drugs. Our findings suggest that educating students about the adverse effects as well as the moral and religious implications of drug abuse is more likely to have a positive impact than increased policing. Proper student-counseling facilities and healthier avenues for recreation are also required

Role of rapid urease test and histopathology in the diagnosis of Helicobacter pylori infection in a developing country

BACKGROUND: The aim of this study was to determine the effect of commonly self-prescribed proton pump inhibitors (PPI) on the results of rapid urease test and histology for the diagnosis of H. pylori infection. METHODS: One hundred-nine consecutive patients with dyspeptic symptoms attending the endoscopy suite were enrolled in this study. Antrum biopsy specimens were collected at endoscopy for the rapid urease test (Pronto Dry, Medical Instrument Corp, France) and histopathology. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and like-hood ratio of a positive and negative of Pronto Dry test were compared against histology. The gold standard test for the diagnosis of H. pylori infection was histopathology. RESULTS: Sixty-one percent (66/109) patients were males with mean age of 43 ± 14.1 years and age range 17–80 years. Fifty-two percent (57/109) were not on any medications while 48% (52/109) used PPI before presentation to the outpatients. Pronto Dry was positive in 40% (44/109) and negative in 60% (65/109). Histopathology was positive for H. pylori in 57% (62/109) and negative in 43% (47/109). The sensitivity, specificity, PPV, NPV and like-hood ratio of a positive and negative Pronto Dry test with and without PPI were 43.3%, 86.4%, 81.3%, 3.18, 0.656 and 52.8% vs 71.9%, 80%, 82.1%, 69%, 3.59 and 0.35. CONCLUSION: This study shows that the sensitivity, specificity, NPV and PPV of rapid urease test was reduced in patients who are on PPI. The exclusive use of the rapid urease test for the diagnosis of Helicobacter pylori cannot be recommended in patients with prior PPI use

Chaikin’s perturbation subdivision scheme in non-stationary forms

AbstractIn this paper two non-stationary forms of Chaikin’s perturbation subdivision scheme, mentioned in Dyn et al. (2004), have been proposed with tension parameter ω. Comparison among the proposed subdivision schemes and the existing non-stationary subdivision scheme depicts that the trigonometric form is more efficient in the reproduction of circles and ellipses and the hyperbolic form is more suitable for the construction of many analytical curves