OCCUPATIONAL INJURIES AND EMPLOYEES TURNOVER INTENTION: A MODERATING EFFECT OF SAFETY CULTURE

Occupational health and safety aims at promotion and maintenance of physical, mental and social health of employees.Unfortunately the conditions in a developing country like Pakistan are worse regarding safety at work. This study examines the effect of Occupational Injuries and Turnover Intention among workers in Pakistan with moderating role of Safety Culture. The study was done on a sample of111 workers belonging to safety sensitive areas. Three hypotheses were developed, two of them were accepted and one was rejected. Results showed that occupational injuries has an effect on turnover intention among employees and the safety culture does not lessen the extent of turnover due to non-prevalence of safety environment in Pakistan. It was concluded that due to differences in cultural context, concept of safety culture does not prevail in Pakistan, and evils like poverty and unemployment reduce chances of turnover intention

Spontaneous Lung Herniation Leading to Extensive Subcutaneous Emphysema, Pneumothorax, Pneumomediastinum, and Pneumopericardium.

Spontaneous lung herniation is a rare phenomenon in which the lung parenchyma along with the pleural membranes protrudes outside their usual boundaries and can lead to a wide variety of complications. We are reporting a case of a middle-aged male who presented with chronic obstructive pulmonary disease (COPD) exacerbation with severe bouts of cough. Initial computed tomography (CT) chest was unrevealing, but two days later, he developed spontaneous lung herniation, which was initially managed conservatively, but later it progressed to pneumothorax, pneumomediastinum, with striking CT scan images showing extensive subcutaneous emphysema. Blowhole incisions were done on the anterior chest wall which led to ultimate recovery

Another D in MUDPILES? A Review of Diet-Associated Nondiabetic Ketoacidosis.

Ketogenic diet or very-low-carbohydrate diet gained widespread popularity in the 1990s due to their favorable effects on weight loss and diabetes among others with good short-term safety data. People on ketogenic diets exist in a state of dietary ketosis in which the body production of ketone is equal to consumption and no harmful effects of ketonemia occur. However, in face of stress, the harmless dietary ketosis can lead to profound acid-base disturbances due to massive overproduction of ketone bodies that overwhelms the acid buffer system of the body. A handful of case reports have been published on this topic calling the safety of ketogenic diet into question. In this article, we chronicle a unique case of ketogenic (Atkins) diet-associated ketoacidosis, and we present a comprehensive literature review on the etiology of ketoacidosis

Low cost quality initiatives for management of neurosurgical patients in developing nations: Perspective from a tertiary care centre in Pakistan

Background: Targeting resources on cost-effective care strategies is pertinent for developing nations, specifically for already burdened specialties such as neurosurgery, where without state support and insurance companies, expenses are borne by the patient themselves.Methods: This was a descriptive review of literary work published by the section of neurosurgery at Aga Khan University Hospital, Pakistan. We searched PubMed and CiNAHL databases to identify articles, which were then critically analyzed and discussed from a perspective of low-cost quality care.Results: We demonstrate the cost effectiveness of three initiatives, namely, blood ordering protocol for elective spine arthrodesis, nonoperative management being superior to surgical stabilization in spine injury patients with complete neurological deficits, and early tracheostomy in patients with isolated severe traumatic brain injury.Conclusion: Initiation and implementation of such cost-effective strategies without compromising quality health standards must be emphasized by neurosurgical centers throughout the developing world for smart allocation and utilization of funds

Predicting financial distress: Applicability of O-score and logit model for Pakistani firms

Predicting financial distress have significant importance in corporate finance as it serves as an effective early warning system for the related stakeholders.The study applies the most admired financial distress prediction O-score model and compares its predictive accuracy with estimated logit model. The study estimates logit model by including the profitability ratios, liquidity ratios, leverage ratios, and cash flow ratios. This study filled the gap by using the cash flow ratios to predict financial distress for Pakistani listed firms. The sample for the estimation model consists of 290 firms with 45 distressed and 245 healthy firms for the period 2006-2016 and covers all sectors of Pakistan Stock Exchange. The study provides important insights on the role of different financial ratio in predicting financial distress and shows that estimated logit model produces higher accuracy rate in predicting financial distress

Psychometric Evaluation of Dietary Habits Questionnaire for Type 2 Diabetes Mellitus

This research evaluated the psychometric properties of English version of dietary habits questionnaires developed for type 2 diabetic patients. There is scarcity of literature about availability of standardized questionnaires for assessing dietary habits of type 2 diabetics in Saudi Arabia. As dietary habits vary from country to country, therefore, this was an attempt to develop questionnaires that can serve as a baseline. Through intensive literature review, four questionnaires were developed / modified and subsequently tested for psychometric properties. Prior to pilot study, a pre-test was conducted to evaluate the face validity and content validity. The pilot study was conducted from 23 October – 22 November, 2016 to evaluate the questionnaires’ reliability and validity. Systematic random sampling technique was used to collect the data from 132 patients by direct investigation method. Questionnaires assessing diabetes mellitus knowledge (0.891), dietary knowledge (0.869), dietary attitude (0.841) and dietary practices (0.874) had good internal consistency reliability. Factor analysis conducted on dietary attitude questionnaire showed a valid 5 factor solution. Directions of loadings were positive and free from factorial complexity. Relying on the data obtained from type 2 diabetics, these questionnaires can be considered as reliable and valid for the assessment of dietary habits in Saudi Arabia and neighbouring Gulf countries population

Effect of Diet on Type 2 Diabetes Mellitus: A Review

Globally, type 2 diabetes mellitus (T2DM) is considered as one of the most common diseases. The etiology of T2DM is complex and is associated with irreversible risk factors such as age, genetic, race, and ethnicity and reversible factors such as diet, physical activity and smoking. The objectives of this review are to examine various studies to explore relationship of T2DM with different dietary habits/patterns and practices and its complications. Dietary habits and sedentary lifestyle are the major factors for rapidly rising incidence of DM among developing countries. In type 2 diabetics, recently, elevated HbA1c level has also been considered as one of the leading risk factors for developing microvascular and macrovascular complications. Improvement in the elevated HbA1c level can be achieved through diet management; thus, the patients could be prevented from developing the diabetes complications. Awareness about diabetes complications and consequent improvement in dietary knowledge, attitude, and practices lead to better control of the disease. The stakeholders (health-care providers, health facilities, agencies involved in diabetes care, etc.) should encourage patients to understand the importance of diet which may help in disease management, appropriate self-care and better quality of life

Genome-Wide Identification of Natural Selection Footprints in Bos Indicus Using Principal Component Analysis

Background: To describe natural selection, numerous analytical methods for ascertaining candidate genomic region have been developed. There is a substantial drive in population genomics to identify loci intricate in local adaptation. A potent method to find genomic regions subject to local adaptation is to genotype numerous molecular markers and look for outlier loci. Methods: In this study, population structure and genome wide footprints scan of natural selection in cattle was performed using principal component analysis based on alternative individual method assumed in the PCAdapt R-package. This method was used on the hypothesis that extremely related population markers are also local population adaptation candidates. To test PCAdaptmethod in cattle, the data of sixty three animals were collected from four different origins or agro-ecological zones (Achai = 18, Cholistani = 13, Lohani = 19, and Tharparkar = 13) and genotyped using the high density SNPs BeadChip.Results: As expected from the sampling from different zones the principal component result indicated the clear division in these animals into three clusters. K=3 was the optimal number suggested by eigenvalues.Conclusion: The result of this study revealed that the genomic regions harboring signals of the candidate genes were associated with immunity system and muscle formation. Signature of selection detecting in this study targeted the historical adaptation in these breeds that will be useful in future to understand cattle origin under different environment

Overview of Disaster Preparedness and Response Strategies Regarding COVID-19 Crisis Control for Public Safety and Health Protection

The ongoing Coronavirus Disease 2019 (COVID-19) outbreak has incurred tremendous human, social, and economic costs, globally. Major economies across all continents are struggling to contain the COVID-19 pandemic and to flatten the infected curve.  This study focuses on critically reviewing the strategies opted globally to control COVID-19. The main objective of this paper is to overview the pandemic conditions, responses of the public, and actions of the governments with  the  aim to  highlight  the  importance  of  public health  preparedness  and  risk  management  strategies. The current study    uses    an    organized    method    of    locating,    assembling, summarizing, and evaluating the literature on COVID-19 control strategies adopted in different countries. It overviews the conditions of the COVID-19 pandemic in the countries hardest hit by it. The study uses the systemic literature review method to overview, summarize, and organize the literature regarding COVID-19 spread control strategies. A comprehensive Disaster Management and Response System (DMRS) strategy can be productive in limiting the pandemic spread and may also help to flatten the curve. The current study,  based  on  the  experiences of different  countries,  frames  a DMRS  strategy  to  contain  COVID-19  which  includes immediate government intervention, early recognition of the crisis, removal of cognitive  and confirmation biases,  political  and  religious biases, consensus development,  establishment  of a central  command  and control   center,   public   engagement,   integration   of   institutional functioning  using  ICT,  maintaining the medical  supply  chain, limiting  public  mobility  and  mass  gathering,  practicing  social distancing,    quarantining    and    isolation,    clear    and    effective communication for information dissemination, massive testing, and the use of ICT for information sharing, alerting, contact tracing and surveillance

MORBIDITY AND MORTALITY ASSESSMENT IN ACUTE HEPATITIS-E.

Background: Hepatitis-E is an enterically transmitted virus causing acute hepatitis. Mostly it is a self-limiting clinical course, but can be life threatening in certain high risk groups. Pakistan is endemic for Hepatitis-E with limited published literature. The aim of this study is to evaluate the predictors of mortality in patients with acute Hepatitis-E. Methods: We analyzed the medical records of 369 adult patients with Hepatitis-E infection admitted at Aga khan University Hospital, from January 1996 to December 2010. Details of their laboratory investigations, clinical course and complications such as FHF and mortality were noted. The outcome was compared, and determinants of mortality were evaluated in important patient subgroups. Results: Out of 369 patients with Hepatitis-E, 326 (88.3%) were discharged after full recovery. Out of these 22 (6%) patients had chronic liver disease CLD in this study, of whom 10 (2.7%) expired (p-value \u3c0.001). There were about 67 (18%) pregnant patients, with a mean gestational age of 29.19±7.68 weeks and 5 (1.4%) pregnant patients died (p-value=0.23). A total of 58 (15.7%) patients were co-infected with other hepatotropic virus, and a comparison did not find an increased risk of mortality in this group. Conclusion: This study showed that Hepatitis-E is significantly associated with mortality in patients suffering from pre-existing chronic liver disease. Pregnancy was not a determinant of mortality in Hepatitis-E patients in this study, and neither was co-infection with other Hepatotropic viruses