Comparison of real-world roadway lighting, dynamic simulation and CBE and Glaremark predictive systems

Call number: LD2668 .T4 1985 H87Master of Scienc

Spectrum of Spinal Dysraphism in Pediatric Patients in a Tertiary Care Hospital

Objectives:  To report the spectrum of spinal dysraphism presenting in pediatric patients admitted to the Department of Neurosurgery Lady reading hospital Peshawar. Material & Methods:  A descriptive case series was conducted and total of 89 patients (age between 2 months to 12 years) were included who underwent the surgical treatment. All patients were examined for clinical and radiological diagnosis of spinal dysraphism. Results:  The average age at treatment was 23 ± 39.77 months. The most recurring (52.8%) presenting symptom was the swelling on the back followed by lower limb weakness. Meningocele was reported in 11.2%, myelomeningocele in 47.2%, myelomeningocele & hydrocephalus in 12.4%, tethered cord syndrome in 25.8%, and diastematomyelia 3.4% of patients. Excision combined with the repair was done in 58.4%, release & repair done in 29.2% and endoscopic third ventriculostomy/ventriculoperitoneal shunts with the repair were done in 12.4% patients. Cerebrospinal fluid leak was reported in 3.7%, wound infection in 4.5% and mortality was reported in 3.4% patients. Conclusion:  Overall, a good outcome was reported in the majority of our patients. Surgical procedures like myelomeningocele’s excision & repair, tethered cord’s release & repair, and ETV/VP shunt in patients with hydrocephalus can lead to satisfactory clinical outcomes

Prescribing pattern in outpatient department of neurosurgery in a tertiary care hospital of North India

Background: The neurosurgical disorders are amongst the leading cause of global mortality and morbidity. Though surgical intervention is thought to be the main management protocol in the neurosurgical setup but drugs are being equally used especially in the outpatient setting. The present study was carried out in view of the sparse data available on prescribing pattern in neurosurgery.Methods: The present study was conducted by the department of pharmacology in outpatient department of neurosurgery in a tertiary care centre to look into the prescription pattern among these patients.Results: In 268 patients analyzed, mean age was 43.02±15.93 years and 52.23% were females. Majority of our participants (44%) were found to be of young to middle age group (21-40 years). The diagnosis among the study population was spread over large number of diseases. Lumbar Disc Prolapse (LDP) was found to be the leading cause of neurosurgical morbidity, amounting to 32%. As far as the prescription of various drugs in the outpatient of neurosurgery is concerned, Analgesics were the most common drugs prescribed constituting about 48% of the total drugs prescribed followed by GABA analogues and multivitamins which equally formed 41% of the total prescribed drugs.Conclusions: Although the prescription pattern studies among the outpatient neurosurgery patients are very scant, the analysis of prescription studies will be helpful to encourage the rational drug prescribing pattern

Drug Storage and Self-medication Practices in Kashmir, India: A Cross-sectional Study

Introduction: Among the various potential health risks, self-medication and inappropriate storage of medicines at home are found to be very important. Inappropriate storage conditions and irrational use of medication without medical consultation may result in serious health problems. Worldwide there has been an increase in the self-medication rate, which can lead to waste of resources and serious adverse reactions. Aim: To assess the practice of self-medication and household storage of medicines amongst the study population. Materials and Methods: This was a cross-sectional and questionnaire based study conducted in the southern district of Kashmir, India from 1st September 2021 to 28th February 2022. A total of 471 households were included and interviewed to determine the practice of home storage of medicines and self-medication pattern. Quantitative data was presented as means and standard deviation (mean±SD) and qualitative data as frequency and 95% Confidence Interval (CI). Results: Almost three quarters of the households were having monthly income of less than 20,000 INR whereas 219 (46.50%) of them were illiterate. Proton pump inhibitors, minerals and vitamins, antibiotics and analgesics were the most common medicines stored at home. Drawer was the most common place used for storage of medicines whereas the refrigerator was used in less than 1% of cases for the same. Solid dosage forms were mostly used by the householders and the injectables were least used for household storage purposes. Conclusion: The study revealed that the studied householders stored large amount of medicines in homes, often under inappropriate storage conditions. There is a need for better public knowledge and information about the risks of reuse of prescribed medications

Key Performance Indicators for Sustainable Freight Transport and Scenario-based Impediments in Pakistan Freight Industry

Freight transport enables economic growth, market connectivity, and access to the global supply chain systems which contribute to the societal progress and inclusive development of a country. However, it may undermine the sustainable operations by incurring external costs, inefficiency, and economic losses due to non-reliability, poor services, and information systems. In this research study, the Key Performance Indicators (KPIs) for Sustainable Freight Transport Systems (SFTS) are discussed based on available literature review and standards of sustainability measurement in freight transport. Then, based on KPIs some of the scenario-based impediments are highlighted which hinder the performance of the freight transport in Pakistan for achieving sustainable development goals. The core impediments included are Strategic Determinants (SD), Information Systems (IS), Infrastructure Management Systems (IMS) and City Logistics (CL). The negative direct impacts of the key identified factors are also highlighted and linked with each scenario-based impediment. This research study would provide an opportunity for the stakeholders to get tangible idea for policy making and upgradation of the freight transport industry in the country. The highlighted implications will also be validated via expert surveys and Delphi-analysis in the future study.

The Relationship between Ethical Leadership and Whistle-Blowing: The Moderating Effects of Job Security and Affective Commitment

The present study examines the positive impact of ethical leadership on whistleblowing. The study further investigates the role of job security and affective commitment as moderators on the relationship between ethical leadership and whistleblowing. This study examined the fundamental moderating mechanism, which is unique because no such mechanism has been investigated in previous research. A cross-sectional representative sample of 285 Federal Government employees from various Ministries/Divisions and the Benazir Income Support Programme, a corporate body and a renowned social safety net under the Federal Government of Pakistan, was collected. Of the 285 questionnaires, only 241 were deemed useable and were analyzed. A statistical analysis was carried out through correlation, descriptive, and moderated regression analysis. The results supported the first three hypotheses that ethical leadership and whistleblowing had a positive relationship. Furthermore, job security moderated the positive relationship between ethical leadership and whistleblowing, such that the relationship is stronger for employees with high job security and weaker for employees with low job security. Affective commitment also moderated the relationship directly meaning that the relationship is stronger when the affective commitment is strong and weaker when it is weak. Discussion, implications, limitations, and future directions have been suggested in accordance with the results of the study

Geopolitical Risk and Tourism Stocks of Emerging Economies

A bulk of literature suggests that geopolitical events such as terrorist attacks dampen tourism demand. However, there is little research on whether this effect helps predict the return of the tourism equity sector. We provide country-level evidence on whether local and global geopolitical risk (GPR) predicts the first and second moments of tourism stocks in emerging economies. This objective was achieved by employing the non-parametric causality-in-quantiles (CiQ) model and a cross-quantilogram (CQ) test, which allowed us to uncover the predictive potential of GPR for the tourism sector equities. Our findings, obtained through the CiQ model, suggest that while both local and global GPRs carry significant potential for predicting the returns and volatility of tourism stocks of most emerging economies under normal market conditions, they seem to play no such role in certain countries. These countries include South Korea, for which only a limited number of tourism stocks trade on the domestic stock market compared to other sectors, and Colombia, for which both the domestic stock market and tourism sectors are at an emerging stage. Further, it turns out that, compared to its local counterpart, global GPR has a more pronounced predictive power for the tourism stocks of emerging economies. Finally, with some exceptions, the results are qualitatively similar, and hence reasonably robust, to those when a directional predictability model is applied. Given that geopolitical shocks are largely unanticipated, our findings underscore the importance of a robust tourism sector that can help the market recover to stability as well as an open economy that allows local investors to diversify country-specific risks in their portfolios. Implications and directions for future research are discussed