Can early orthotic support and physical Therapy improve the functional level and Decrease rate of surgical interventions In spastic cerebral palsy?

cerebral palsy is a disorder of movement and posture that results from a non progressive lesion of brain within 3 years of age. To determine the role of early orthotics and physical therapy in improving the functional status and in decreasing the rate of surgical interventions in management of spastic diplegic cerebral palsy child

COMPARISON OF EFFICACY OF N-ACETYLCYSTEINE WITH SALBUTAMOL NEBULIZATION IN ACUTE BRONCHIOLITIS

Background; A substantial proportion of children will experience at least one episode with bronchiolitis, and as much as 2-3% of all children will be hospitalized with bronchiolitis during their first year of life. Bronchiolitis is the most common reason for hospitalization of children in many countries, challenging both economy, area and staffing in paediatric departments. Objective; To compare efficacy of N-acetylcysteine nebulization versus salbutamol nebulization in children with acute bronchiolitis. Material and Methods; The study cases were randomly divided into 2 groups by draws methods. Group A, each child was nebulized with 20 mg NAC in 3 ml of 0.9% of saline while group B was nebulized with 2.5 mg salbutamol in 3 ml of 0.9% saline solution. Patients of each group were nebulized three times a day (8 hours apart) for 5 days. These patients were closely monitored for the severity of the disease daily and clinical severity score was employed to record any improvement in both cases.  All the data was entered and analyzed using SPSS-18. Results; Of these 390 study cases, 228 (58.5%) were boys while 162 (41.5%) were girls. Mean age of our study cases was 7.92 ± 5.18 months . Most of the study cases i.e. 264 (67.7%) were from poor social background and mothers of most of these children were less educated as 85.6% of the mothers of these children were having their educational status equal/less than matriculation. Mean hospital stay in our study was 4.73 ± 0.829 days. Mean baseline clinical severity score was 5.52 ± 813. Mean clinical severity score after therapy was 1.85 ± 0.812 (with minimum clinical severity score was 1 while maximum was score was 4). Clinical severity score in group A was 1.21 ± 0.405 while in group B was 2.49 ± 0.578 (p= 0.000). Conclusion; Our study results support the use N – acetylcysteine nebulization in children with acute bronchiolitis as compared with salbutamol nebulization. N – acetylcysteine nebulization was found to be more effective in improving clinical severity score and reducing duration of hospitalization. Its use was safe, reliable and no adverse side effects were noted. Keywords; Acute Bronchiolitis, Salbutamol, N – acetylcysteine. DOI: 10.7176/JMPB/55-12 Publication date:May 31st 201

ROLE OF ENDOMETRIOSIS AS A RISK FACTOR FOR THE FEMALES WITH PRIMARY SUB-FERTILITY.

Objectives; To determine the role of endometriosis among women in cases of primary sub-fertility. Material and methods; A total of 169 women having primary infertility were included in this cross-sectional study which was done from January 2018 to May 2019 at Department of Obstetrics and Gynecology, Nishtar Hospital, Multan. Complete history was taken for age, duration of infertility, duration of marriage, sexual history, history of intake of contraceptive drugs, past medical/surgical history and if patients had taken any previous treatment for fertility issues. General physical as well as systemic examination were performed by a trained doctor along with pelvic examination. Baseline investigations like ESR, FSH, LH, serum prolactin levels were done. These study cases will undergo pelvic ultrasound and laparoscopy was performed in proliferative stages of menstrual cycle. Data was analyzed by using SPSS Version 20. Results; Mean age of our study cases was noted to be 28.92 ± 4.55 years (with minimum age was 22 years while maximum age was 38 years). Family history of infertility was noted in 33 (19.5%) of our study cases. Mean duration of marriage in our study cases was noted to be 4.33 ± 1.03 years. Mean BMI of our study cases was 22.21 ± 3.01 kg/m2 (with minimum BMI was 18 kg/m2 while maximum BMI was 32 kg/m2). Our study results have shown that obesity was present in 36 (21.3%) of our study cases. In our study, endometriosis was seen in 27 (16 %) of our study cases. Stage 1 endometriosis was seen in 4 (2.4%), stage 2 endometriosis in 6 (3.6%), stage 3 endometriosis in 8 (4.7%) and stage 4 endometriosis in 9 (5.3%) of our study cases. Conclusion; Frequency of endometriosis was high in our study. Our study results indicate that it is a common gynecological problem which usually found in patients of young and reproductive age. Laparoscopy is a minimally invasive procedure which requires minimum time of hospitalization and minor post-operative discomfort in diagnosis of endometriosis. Laparoscopic procedures in women with infertility should be employed earlier as they are relatively less invasive, convenient and more accurate tool for diagnosis. There is a dire need to bring about awareness among infertile women to consult infertility clinics at proper time. It emphasizes the need to recognize the outcomes of laparoscopic procedures for management and diagnostic purposes. Keywords; Primary infertility, endometriosis, laparoscopy. DOI: 10.7176/JMPB/55-13 Publication date:May 31st 201

Non-compliance to social distancing during COVID-19 pandemic: A comparative cross-sectional study between the developed and developing countries

Background: Despite mass vaccination campaigns, the world has seen a steady rise in the number of SARS-CoV-2 cases, with 178,765,626 cases and 3,869,994 COVID-19 related deaths by June 19th, 2021. Therefore, it is important to enforce social distancing to control its spread. With the variation observed in the severity of the pandemic in different countries, it is also imperative to study the social distancing behaviors amongst the population in developed and developing countries. Design and Methods: In this cross-sectional study, a total of 384 participants from 14 different countries were surveyed via an online REDCap form. Results: In this study, it was highlighted that despite adequate knowledge, the overall compliance to COVID-19 related preventive measures remains poor, the lowest being in the senior age group (≥ 65 years), and the highest being in adults aged between 25-64 years (p-value =0.003). Population from the developing countries were more compliant to all preventative measures against COVID-19 spread, except for handwashing, where the difference between the two populations remained insignificant (p-value = 0.038, \u3c0.001, 0.016). Socioeconomic status, prior history of COVID-19 infection, or presence of comorbidities did not significantly affect compliance rates, however, participants with no prior history of this infection were found to be more compliant to donning a mask in public as compared to those with a positive history (p-value = 0.044). Conclusions: Since compliance remains subpar in both the developing and the developed countries, mass campaigns about COVID-19 related preventive measures remain essential in controlling the disease spread

Comparison of APACHE II, SAPS II and SOFA Scoring Systems as Predictors of Mortality in ICU Patients

Objective: The comparison of the APACHE II, SAPS II and SOFA scoring systems as predictors of mortality in ICU patients. Study Design: A prospective observational study. Place and Duration of Study: Intensive care unit of Ch. Pervaiz Ellahi Institute of Cardiology and  Nishtar Medical University and Hospital, Multan, from May 13, 2018 to September 24, 2018. Methodology: For 36 patients included in study, results for APACHE II, SAPS II and SOFA were calculated with the worst values recorded. At the end of ICU stay, patient outcome was labelled as survivors and non-survivors. Data was analyzed with SPSS v.23. Descriptive data was stated as median (minimum-maximum) or percentages. Pearson Chi square test and non-parametric statistics were applied accordingly. Linear regression analysis was also performed. Cut off value for statistical significance was taken as ≤0.05. Results: Of 36 patients, 22 survived and 14 died after being observed for 12 (2-17) days. On linear regression analysis, all the scoring systems were significantly associated with the mortality rates (p<0.05). However, after adjustment, only the APACHE II was a significant predictor of mortality (p<0.001). APACHE II scoring system calculated highest estimated mortality rates i.e.  19.3%, while SAPS II and SOFA scoring systems estimated 8.6% and 13.5% mortality, respectively. Conclusion: APACHE II scoring system was much superior to SAPS II and SOFA scoring systems as a significant predictor of the mortality among the ICU patients. Keywords: Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score (SAPS II), Sequential Organ Failure Assessment (SOFA), Intensive care units (ICU), Mortality. DOI: 10.7176/JMPB/53-03 Publication date:March 31st 201

Gaps Between Theory and Practice: Novice Teachers’ Perspectives

This study aimed to explore the novice teachers’ perception of gaps between theory andpractice. Novice teachers’ perceptions were further explored based on teachers’ gender. The surveymethod was used to collect the data. A questionnaire was developed by the researcher consisted of 39items with 5 points Likert rating scale to collect data from randomly selected 600 teachers includingmale and female. The data were analyzed by using the mean, standard deviation, and percentage ofeach five points of the Likert rating scale. The results revealed that most novice teachers were applyingtheir learned theory in their practice regarding lesson planning & delivery, classroom management,and students’ active involvement. They were not only willing to but also were applying learned theoriesin their practice. It also came into the knowledge that there were fewer gaps between novice teachers’theory and practice. It is recommended by the researchers suggested that these pre-service trainingcenters should develop a strong and viable link to make the theory more practical, operational and upto-dat

Information Seeking Behavior and Needs of Women Parliamentarians of Pakistan: A Case Study

This study probes into the information needs and seeking behavior of women parliamentarians in the 12th National Assembly of Pakistan during 2002 through 2007. It attempts to answer some of the questions raised on women’s political participation in the parliament and their information habits and needs by analyzing their preferred sources used in preparing for speeches, resolutions, bills, and laws. It also measures their information and communication technology skills. The study gauges their dependence and perception about the National Assembly Library and other sources of information available and suggests possible means by which information services to parliamentarians can be further enhanced. The findings of this study may present aspects which have never before been considered by researchers in trying to meet women parliamentarians’information needs

The Effect of Leverage on Financial Health of the Firms: A Study from Cement Industry of Pakistan

This research paper has tried to measure the relationship between leverage and profitability of firms in the cement industry of Pakistan. Debt to equity is used to measure the leverage of the companies in the cement industry in Pakistan. Short term debt to equity (STD/E) and long term debt to equity (LTD/E) are considered as leverage variables .Return on equity (ROE) and return on assets (ROA) are used to measure the financial performance of the companies. For this research paper 10 cement companies are considered, listed in the Karachi Stock Exchange during the time period 2008-2012. To measure the relationship between leverage and profitability of firms in the cement industry of Pakistan regression model and descriptive statistics have been used. Our results found negative and significant relationship between leverage and profitability of the firm. Keywords: Leverage, Profitability, Cement industry, Capital Structur

Impact of Motivation and Performance Expectancy on Women Entrepreneurial Intention

The purpose of this paper is to review the Motivation and performance expectancy to explore the commonalities of the present theories among the women entrepreneur intentions to boost up the business enterprises. In a fact-finding study information were gathered about the aptitude of motivation and performance expectancy to foresee the Intention of the women’s being examined by the sample of 150women in Pakistan March 2020. A mixed method evaluation design has been adopted in this study. Analysis of regression model uncovered the result that the connection between performance expectations and motivation was intruded positively by entrepreneurial intention of women toward business. The sample is restricted to women entrepreneurs, limiting the generalizability of the findings. The analyses of the influence of motivation variable towards women entrepreneurial intention furnishes us with inspiration to inquire about on the developing questions of how and why females are turning out to be more business people these days. This research supports the progression of study on motivation, performance expectancy variables and its relationship to women entrepreneurial intention in an assortment of settings

Self-Assessment of Students’ Anxiety during High Stake Laboratory Work Examinations

The present study intends to explore the level of practical examination anxietyamong secondary and higher secondary school students and its causes andremedies. A self-developed Perceived Science Practical Anxiety Scale (PSPAS)was used to collect quantitative data from 900 science students of two districts of central Punjab: Sargodha and Faisalabad. Moreover, 50 students were interviewed to explore their perceptions of the causes of science practical examination anxiety and the remedies to reduce it. All students had recently taken science practical examination and therefore had first-hand vivid experience of science practical examination anxiety. The analysis of responses in the questionnaire revealed that on an average more than half (61.50 %) of the students experienced anxiety during practical examination. Fourteen sources of anxiety during practical examination were ranked and synthesis of qualitative data from interviews recorded five categories of anxiety causes: shortage and unavailability of the materials, lack of practice, harsh behaviour of laboratory personnel, over loaded syllabus and lack of guidance. The students’ opinion regarding reducing anxiety was synthesized into four themes: relaxation during practical examination, individual level preparation, completion of practical syllabus well before time and training of laboratory personnel. The findings of the study may be beneficial for teachers, school mangers and policy makers and those who are responsible for the preparation and execution of examination policies, to reduce anxiety among students.Keywords: high stake examinations, higher secondary schools, laboratory work examinations, self-assessment, student anxiet