Effects of Assisted Autogenic Drainage and Chest Physical Therapy in Children Suffering from Pneumonia

The study started after RIRS's approval and Helsinki's declaration. The current study is based on the fact that newer techniques like Assisted Autogenic Drainage must be introduced as chest physical therapy is one of the oldest ways of clearing the chest. The objective is to determine the effectiveness of Assisted Autogenic Drainage in children with Pneumonia. A Quasi-experimental study, with a sample of n=60, was selected through Epi and calculated as Out of 70 approached patients, 56 met inclusion criteria. The patients were divided based on convenience into Group A. Group B. Group A patients were given standard medical and nursing care and chest physical therapy. Group B patients were given an additional treatment of AAD with a predetermined frequency, intensity, and duration. The data was collected after informed and signed. The data was analyzed using SPSS version 23. The study showed significant results while within group comparison for only one variable with p=-1.515. However, in between-group comparisons, some variables showed significant results with p>0.05, and others showed Non-significant results with p<0.05. Chest physical therapy is more effective than Assisted Autogenic Drainage in treating children with Pneumonia.

Determining the Influences of the Employee’s Loyalty in the Organizational Setting

The aim of the following research is to provide a brief insight into employee loyalty towards their organization and its effects on working conditions, working environment, and bonus and incentives. As employees are considered to be key strategic assets of every organization so it is essential for the organization to study the factors which produce a profound effect on loyalty. Loyalty is said to be a unique composition of employee attributes depicting a higher quality which is difficult to find significantly affecting the prevailing organization succession. For the progression of the research findings, the precedent research followed a T-test, F-test, ANOVA, multiple regressions, Factor analysis, Durbin Watson, correlation as the methodology. The following methodology aid inevaluating the crucial elements of the organization significantly affecting the employee loyalty. Moreover, in the research working condition, working environment and bonus and incentives served as the dependent variable, while employee loyalty as the independent variable. The researcher has employed the calculation of the observation from self-design 100 questionnaires which were filled by Muslim commercial bank employees in all over Karachi, all result have significant impact at 5% alpha.  On the basis of data, it can be concluded that the determinants of the independent variable of the current dissertation have a significant impact on employee loyalty. Moreover, all of the three independent variables have been accepted. Therefore, it is feasible to suggest that the organization should focus on the prevailing variables for enhancing the performance of the organization and driving the optimal outcome for securing the leading position in the industry

Outcomes of patients presenting with Cholecystitis in terms of Early vs Delayed Cholecystectomy

Introduction: Biliary tract diseases comprise the most frequently occurring pathology in the abdomen, among which cholelithiasis affects 10-15% of the population.  Early laparoscopic cholecystectomy, performed within 72 hours 2) Interval laparoscopic cholecystectomy, performed within 72 hours to 6 weeks 3) Delayed laparoscopic cholecystectomy in which patients are treated with antibiotics and given date of surgery within 6-8 weeks according to international criteria. Objective: To find out the variability between hot, urgent, and delayed laparoscopic cholecystectomy in terms of clinical complications and to find out the readmission rate, the persistence of symptoms, and the safety of the procedure. Materials and Methods: This is a retrospective study carried out in the Surgical Unit ll, Holy Family Hospital, Rawalpindi from January 2018 to March 2018. All adult male and female patients presenting with acute cholecystitis and pancreatitis were included in the study. Results: Total number of patients included in our study is 82. Most of the patients were female 80.5% with a mean age of 44 years. Most of the patients were categorized under delayed laparoscopic cholecystectomy 93.9%, 6.1% underwent interval/urgent cholecystectomy, and 1.2% early/hot cholecystectomy. Diagnosis in the study showed acute cholecystitis in 79.3% of patients, pancreatitis in 7.3%, empyema /gangrene of gallbladder in 6.1% mucocele in 6.1%, and choledocholithiasis in 1.2% of patients. Hence we figured out that performing early cholecystectomy leads to lesser complications. Conclusion: Early laparoscopic cholecystectomy was found out to be a safe and cost-effective procedure. There is an increased incidence of readmission and complications with delayed laparoscopic cholecystectomy. We suggest that measures must be taken in Pakistan to follow international guidelines in health practices to improve patient care

Early predictors in language-based learning disabilities: a bibliometric analysis

IntroductionLanguage-based learning disabilities (LBLD) refers to a spectrum of neurodevelopmental-associated disorders that are characterized by cognitive and behavioral differences in comprehending, processing and utilizing spoken and/or written language. The focus of this work was on identifying early predictors of three main specific LBLD including dyslexia, dyscalculia, and dysgraphia.MethodsThe Web of Science (WoS) was searched for literature related to (neurocognitive, neurophysiological, and neuroimaging) measurements used to identify early predictors of LBLD from 1991 to 25 October 2021. A retrospective bibliometric analysis was performed to analyze collaboration among countries, institutions, authors, publishing journals, reference co-citation patterns, keyword co-occurrence, keyword clustering, and burst keywords using Biblioanalytics software.ResultsIn total, 921 publications related to the identification of LBLD using (neurocognitive, neurophysiological, and neuroimaging) modalities were included. The data analysis shows a slow growth in research on the topic in the 90s and early 2000 and growing trend in recent years. The most prolific and cited journal is Neuroimage, followed by Neuropsychologia. The United States and Finland’s Universities Jyvaskyla and Helsinki are the leading country and institution in this field, respectively. “Neuroimaging,” “brain,” “fMRI,” “cognitive predictor,” “comorbidity,” “cortical thickness” were identified as hotspots and trends of (neurocognitive, neurophysiological, and neuroimaging) modalities in the identification of LBLD.DiscussionEarly predictors of LBLDs would be useful as targets for specific prevention and intervention programs to be implemented at very young ages, which could have a significant clinical impact. A novel finding of neuroimaging predictors combined with neurocognitive and neuropsychological batteries may have implications for future research

Analysis of Tp53 Codon 72 Polymorphisms, Tp53 Mutations, and HPV Infection in Cutaneous Squamous Cell Carcinomas

Non-melanoma skin cancers are one of the most common human malignancies accounting for 2-3% of tumors in the US and represent a significant health burden. Epidemiology studies have implicated Tp53 mutations triggered by UV exposure, and human papilloma virus (HPV) infection to be significant causes of non-melanoma skin cancer. However, the relationship between Tp53 and cutaneous HPV infection is not well understood in skin cancers. In this study we assessed the association of HPV infection and Tp53 polymorphisms and mutations in lesional specimens with squamous cell carcinomas.We studied 55 cases of histologically confirmed cutaneous squamous cell carcinoma and 41 controls for the presence of HPV infection and Tp53 genotype (mutations and polymorphism).We found an increased number of Tp53 mutations in the squamous cell carcinoma samples compared with perilesional or control samples. There was increased frequency of homozygous Tp53-72R polymorphism in cases with squamous cell carcinomas, while the Tp53-72P allele (Tp53-72R/P and Tp53-72P/P) was more frequent in normal control samples. Carcinoma samples positive for HPV showed a decreased frequency of Tp53 mutations compared to those without HPV infection. In addition, carcinoma samples with a Tp53-72P allele showed an increased incidence of Tp53 mutations in comparison carcinomas samples homozygous for Tp53-72R.These studies suggest there are two separate pathways (HPV infection and Tp53 mutation) leading to cutaneous squamous cell carcinomas stratified by the Tp53 codon-72 polymorphism. The presence of a Tp53-72P allele is protective against cutaneous squamous cell carcinoma, and carcinoma specimens with Tp53-72P are more likely to have Tp53 mutations. In contrast Tp53-72R is a significant risk factor for cutaneous squamous cell carcinoma and is frequently associated with HPV infection instead of Tp53 mutations. Heterozygosity for Tp53-72R/P is protective against squamous cell carcinomas, possibly reflecting a requirement for both HPV infection and Tp53 mutations

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Early-Stage Heart Disease Prediction using supervised Machine Learning Algorithms

Heart Disease is believed to be the number one killer globally, and its diagnosis has long been considered a very crucial problem. With the revolution of the modern world, it is very important to detect heart disease at its earlier stages so that patient treatment should be done effectively. Many previous researchers used Hybrid and Data Mining techniques to predict heart disease at its earlier stages, but they couldn’t get the required results. The evaluation of the Machine learning and artificial intelligence research community mainly focused on these techniques to get better results. This research paper used six supervised machine learning classifiers like Random Forest, Support Vector Machine, Logistic Regression, Decision Tree, K-Nearest Neighbor and Naïve Bayes. We used two different datasets for the sample data in terms of attributes and values. We also used three different feature selection techniques to improve our accuracy by selecting the most important features. We first applied these machine learning classifiers to our proposed dataset without using the feature selection technique and computing the results. After that, we applied LASSOM, MRMR and MIFS techniques and derived the results with improved accuracies. In the end, we make a comparison table between the results that are computed with and without the feature selection technique. According to our experimental results we can say that the results accuracies computed with the feature selection technique are higher than those computed without feature selection techniques. Evaluation techniques like Confusion matrix, Accuracy, precision, Recall, F1 Score, PR Curve and ROC curve are used to measure the performance of our classifiers.  So, we conclude that if we use any of these feature selection techniques, we can conclude better results and predict heart disease at its earlier stages with improved accuracy