Exploration of radial nerve in patients with humerus shaft fracture with radial nerve palsy, is it necessary?

Fractures in the distal third of the humerus shaft usually are associated with complete or incomplete radial nerve lesions which may be caused due to traction, entrapment or compression between bony fragments. We managed these patients by bridge plating using minimally invasive percutaneous plate osteosynthesis. A total of 5 patients were operated on and all showed full functional recovery of radial nerve. Fracture united in all cases and no patient developed any complication

A Comparison of Technical Efficiency of Performance of Different Banks Before and After Merger: A Study of Pakistan Banking Industry

Mergers and acquisitions are the part and parcel of every field, especially in banking industry. This research is focused on the performance of mergers in the last decade. As evident from recent past the banking industry in Pakistan has to cop with many mergers. Mergers are not opted only for the sake of synergy and economic benefits but there are certain other reasons. In Pakistan the other stimulant is the State Bank of Pakistan’s capital requirement, which is being raised with the passage of time. This study has analyzed the performance of 6 mergers (Prime and ABN AMRO, ABN AMRO and Royal Bank of Scotland, RBS and Faysal Bank, Saudi Pak Commercial Bank and Silk Bank, Union Bank and Standard Chartered Bank and Cres and Samba Bank), occurred in the last decade in Pakistan banking industry. Regression analysis is used to analyze the contribution level of different variables in the bank profitability. The results for net assets, net advances, branches and labor productivity were found to be extensive and quite significant. In the second phase the Data Envelopment Analysis of all the banks were done and it is found that all the banks involved in merger have got their performance improved by some extent. The two stage analysis was used for the analysis of the bank performance i.e. first for efficiency and the later for effectiveness of the bank. The first stage results were found to be impressive for most of the banks but in second stage (effectiveness) the results were quite different. A complete comparison of the individual variables has been done in order to pin point the deficiency of individual banks. Main four resulting banks have shown significant improvement in all the independent variables except the Faysal Bank whose labor productivity has shown rapid downward trend. Overall, the mergers and acquisitions, especially in Pakistani environment, are found to be a win-win situation. Key words: Data envelopment analysis (DEA), Mergers and Acquisition (M&A

Epidemiology of Obesity in Asia: Challenges and Prevention

Obesity is a complex, multifactorial and largely preventable disease affecting over a third of the world’s population today. In this review, prevalence of childhood and adult obesity, its causes, risk factors, interventions and management in different Asian countries was explored. It has been observed that obesity has grown up as an epidemic and it will intensify in the coming years if appropriate preventive measures are not adopted. Proper policies are needed to be implemented. Additionally, massive nation-wide public awareness programs with better structural infrastructure will be answer to this giant problematic challenge.Keywords: Asia, body mass index; Obesity; Physical Activity; Prevalence; World Health Organization

Association of Big Data with Sustainable Competitive Advantage in Online Retail Segment: A Serial Mediation Model for Relating Big Data with Strategic Management Tools

Purpose: Big-Data is one of the most studied and researched topics of recent times. The tool has been studied vastly in the western world. However, the domains were either related to science and technology, although there is a need to relate Big Data to strategic management and competitive advantage to remove the lack of research in that vein. Methodology: This study is systematically conducted to explore the effect of big data on the attainment of business improvement in the online retail segment. The model has been developed through an in-depth literature review to relate the resource-based view with the attainment of sustainable competitive advantage through serial mediation of big-data analytics knowledge and innovative capabilities. Data was collected through non-probability sampling from IT managers and specialists associated with the online retail segment and analysis was conducted through SMART-PLS. Findings: Results indicated that big data is for the improvement of business for the online retail segment. However, data availability is a must for applying big-data analytics toward sustainable competitive advantage. Conclusion: This study concludes that all the relations and indicates that Bug-Data is fruitful for booting advanced knowledge and innovative capabilities. However, the onlin IT sector needs to have some other elements like advanced IT skills to legitimize the relationshi

Jatropha curcas leaves mulch effect on seedling emergence and growth of maize (zea mays)

Allelopathy is a process in which one plant species may usefully or adversely affect the growth of other plant species through the production of allelochemicals. During the present investigation, mulch effect of Jatropha curcas leaves was evaluated on seed germination and seedling growth of maize varieties viz. Pioneer (V1), Azam (V2) and Jalal (V3). Mulch was applied at 1 and 2 tons/hectare. Phenolic compounds were detected in Jatropha curcas leaf (131.15 mg gallic acid eq./gm extract). Mulch applied at 2 tons/hectare significantly reduced seed germination (%), germination index, relative water content, root width and seedling dry weight. From the findings of the present investigation, it was inferred that Jatropha curcas leaves exhibited phytotoxic effects on maize at high concentrations

Bacterial ventriculoperitoneal shunt infections: changing trends in antimicrobial susceptibility, a 7-year retrospective study from Pakistan

BACKGROUND: Ventriculoperitoneal (VP) shunt infections in adults represent a severe complication and make treatment more challenging. Therefore, drug susceptibility patterns are crucial for therapeutic decisions and infection control in neurosurgical centers. This 7-year retrospective study aimed to identify the bacteria responsible for adult VP shunt infections and determine their drug susceptibility patterns. METHODS: This single-center study was performed from 2015 to 2021 in Lahore, Pakistan, and included CSF cultures from VP shunt infections. Demographic data, causative organisms, and antimicrobial susceptibility testing results were collected. Multivariate analysis of variance (MANOVA) and two-sample t-tests were used to analyze and compare the antibiotic sensitivity trends over the study period. RESULTS: 14,473 isolates recovered from 13,937 CSF samples of VP shunt infections were identified and analyzed for their susceptibility patterns to antimicrobials. The proportion of Gram-negative and Gram-positive bacteria were 11,030 (76%) and 3443 (24)%, respectively. The predominant bacteria were Acinetobacter species (n = 5898, 41%), followed by Pseudomonas species (n = 2368, 16%) and coagulase-negative Staphylococcus (CoNS) (n = 1880, 13%). 100% of Staphylococcus aureus (S.aureus) and CoNS were sensitive to vancomycin and linezolid (n = 2580). However, 52% of S. aureus (719/1,343) were methicillin-resistant Staphylococcus aureus (MRSA). Acinetobacter showed maximum sensitivity to meropenem at 69% (2759/4768). Pseudomonas was 80% (1385/1863 sensitive to piperacillin-tazobactam, Escherichia coli (E. coli) showed 72% to amikacin (748/1055), while Klebsiella spp. was 57% (574/1170) sensitive to piperacillin-tazobactam. The sensitivity of piperacillin-tazobactam and meropenem for Gram-negative bacteria decreased significantly (p < 0.05) over 7 years, with 92.2% and 88.91% sensitive in 2015 and 66.7% and 62.8% sensitive in 2021, respectively. CONCLUSION: The significant decrease in the effectiveness of carbapenem and beta-lactam/beta-lactamase inhibitor combination drugs for the common Gram-negative causative agents of VP shunt infections suggests that alternative antibiotics such as colistin, fosfomycin, ceftazidime/avibactam, ceftolozane/tazobactam, and tigecycline should be considered and in consequence included in testing panels. Additionally, it is recommended to adopt care bundles for the prevention of VP shunt infection

Harmonic scalpel versus electrocautery tonsillectomy: a comparative study in adult patients

OBJECTIVE: To compare harmonic scalpel (HS) tonsillectomy with electrocautery (EC) tonsillectomy in terms of operating time, intra-operative blood loss, post-operative pain and secondary haemorrhage.METHODS: Sixty adult patients subjected to tonsillectomy only, were evaluated in this prospective study. The patients were stratified into 2 groups (30 each) based on the dissecting instrument used (HS vs. EC) at Aga Khan University Hospital Karachi Pakistan from June, 2006 to August, 2008.RESULTS: The mean operative time was less in electrocautery group (EC 3.57 +/- 0.85 minutes Vs HS 4.20 +/- 1.37 minutes;

The reciprocal ledge closing wedge osteotomy for post traumatic coxa vara

To report a proximal femoral osteotomy with retention of bone ledges in a reciprocal position to increase bone contact and stability. The method was applied to 5 patients over a 3-year period. All patients had coxa vara. The average length gained was 1.5 cm, and the average neck shaft angle improvement was 30°. The Harris hip score improved from an average of 63 to 82. The reciprocal ledge osteotomy is technically less demanding and also allows conversion of normal shear forces around the upper femur to stabilizing forces. This method allows easier use of the DHS implant as potential rotation about the axis of the screw is negated by the ledges and the dynamic forces