Efficiency of blood utilization and characteristics of patients receiving blood transfusion at an associated hospital in North India

Background: Blood is the liquid connective tissue composed of cells and plasma. It is the most precious and unique gift that one person gives to another. Blood banks are not the manufacturing factories. It can only be available on replacement basis. Periodic review of blood components usage is essential to assess the blood utilization pattern in hospitals. This study was conducted to analyse the efficiency of blood utilization and to minimize the inappropriate use of blood.Methods: A retrospective cross-sectional study was conducted in the department of blood transfusion and immunohematology, government medical college and associated hospital, Rajouri for a period of one year with effect from November 2019 to November 2020. Data was collected using blood bank record. Blood utilization was calculated using crossmatch to transfusion ratio (C/T), transfusion probability (T%) and transfusion index (TI) indices.Results: A total of 974 patients were requested to prepare 1270 crossmatched units. Of these 1141 blood units were transfused for 664 patients. The total donations during that period were 1197. 998 donors were replacement donors and 199 were voluntary non-remunerated blood donors donated at various blood donation camps. The overall values of C/T, T% and TI were 1.1:1, 68.1% and 1.1 respectively.Conclusions: Blood utilization indices show efficient usage of blood. However, a blood ordering policy (MSBOS) must be developed to guide the clinicians regarding blood usage which can decrease overordering of blood thereby reducing unnecessary usage of reagents, manpower and also wastage of blood due to outdating.

Foreign Direct Investment Lead to Exports of Pakistan: An Econometric Evidence

The objective of the study is to empirically analyze that whether foreign direct investment lead to exports of Pakistan for the period from 1972 to 2014. Econometric results are estimated using Partial Adjustment Model for long run as well short run and then some diagnostic statistics are also applied for reliability of results. Long run and short run results propose positive influence of foreign direct investment, exchange rate, trade openness, and real GDP of Pakistan while inflation is found to have inverse effect of exports of Pakistan. Further tests indicate regression model free from Autocorrelation, Heteroskedasticity, abnormality of residuals and dynamic instability problems. Keywords: Foreign Direct Investment, Real GDP, Exports, Exchange Rate, Inflation

Automating the processes involved in facial composite production

Bringing a criminal to justice is a labour intensive process. In the current paper, we explored ways of reducing police time when constructing and identifying facial composites. In the former, we designed and evaluated a standalone version of the EvoFIT composite system. This was found to perform similarly to the full system that normally requires several hours of a police officer’s time. In the latter, we built a small database of composites that could be used to search for matching identities. It was found that pixel intensity (texture) information was valuable for composites produced from a traditional feature-based system, but feature shape information for composites produced from the recognition-based EvoFIT. The results show promise for the automated construction and identification of facial composites

Histological development of human foetal shoulder joint

Background: Shoulder joint is a multiaxial, diarthrodial joint of ball and socket variety. The various components of shoulder joint i.e. capsule, various ligaments, joint cavity and synovial tissue start developing in early embryonic and foetal life roughly in between 6th to 12th week of foetal development. The present study aims to analyze the sequences of development of various structures of shoulder joint in human embryo and compare the findings with other observers to gain some insight regarding its development and an attempt is made to correlate these observations clinically to analyze cause and management of recurrent shoulder dislocations. Methods: Shoulder joints of 32 foetuses collected from areas in and around Jammu were dissected properly and decalcified in Gooding and Stewart’s solution. Sections were cut after obtaining blocks by paraffin wax embedding method. Slides were stained using Haematoxylin and Eosin, Masson’s trichrome and orcein staining and important findings were documented.Results: The bony structures - head of humerus and glenoid fossa and joint cavity appear by 10 weeks which prolongs into bicipital sulcus by 12-1/2 weeks. Synovial tissue appears by 10 weeks and synovial villi appear by 14 weeks. Glenoid labrum, capsular ligament, coracohumeral ligament and superior glenohumeral ligament are seen by 10 weeks. Middle glenohumeral ligament is seen at 12-1/2 weeks while inferior glenohumeral ligament is seen at 14 weeks. Tendon of biceps is seen at 10 weeks. Conclusions: By 10 weeks of gestational age various structures of shoulder joint develop in situ, resembling in form and arrangement as those of adults. From these early stages, development proceeds rapidly to achieve adult characteristics. There are no intermediate stages in between where structures similar to those of lower forms i.e. syn/amphi artroses appear temporarily.

Translation of "Matti ki Mona Liza" Into "Mona Liza Made of Clay"

Translation is a process of conveying a source text into a target text which should reflect the contents of the original text. Translation is a practice in which the translator tries to find out the closest equivalent meaning of a source text into the target text language. Translation aims at telling the same idea or information as in the original. In this article the translators have chosen the text, that is a short story "Matti ki Mona Liza" (in Urdu) called "Mona Liza Made of Mud" (in English). The source text was written by A.Hameed, a renowned and legendry Urdu writer. By translating an Urdu short story into English language the translators wanted to present an incredible and splendid piece of Urdu literature to the readers at world level. Another aim was to contribute to the field of Applied Linguistics. The translators have selected the discipline of Applied Linguistics with particular focus on the theory of equivalence in translation. The methods of literal, semantic and faithful translation have been used in order to establish the closest equivalence between the source text and the target text. English is selected as the language of the target text

Environmental, Social, and Governance Performance and Value Creation in Product Market: Evidence from Emerging Economies

Using a unique sample of 13,412 firm-year observations from 19 countries of the emerging economies for the period of 2011 to 2019, we investigate the association between the firms’ environmental, social, and governance (ESG) performance and their value creation in the product market. Specifically, we first used the pooled OLS regression model for panel data as our baseline model and found that ESG performance (as well as its pillars) has a strong positive effect on the future value creation of the firms in the product market. We also conducted some additional analyses using various regression models, as well as adopting multiple tests for endogeneity, and the additional analyses revealed that the results are robust under different scenarios. Overall, the findings of this study highlight the importance of firm-level ESG performance for the value creation of firms in the product market in emerging economies and have theoretical and practical implications for academic researchers, market participants, and government entities in studying, evaluating, and governing firms’ ESG performance and reporting

Effect of cyclophosphamide on the microanatomy of liver of albino rats

Background: Cyclophosphamide is widely used in the treatment of various neoplastic diseases and diseases associated with altered immunity. Higher doses used for longer duration effects many organs like urinary bladder, lungs, liver, heart and male reproductive organs.Methods: To study the effect of cyclophosphamide on the micro anatomy of liver, sixty eight Albino rats were taken and divided into three groups, group A (control group) of 20 animals, were fed with routine diet, group B (low dose group) of 24 animals, were given cyclophosphamide at the dose of 0.5 mg/100 gms in addition to the routine diet and group C (high dose group) of 24 animals, were given high dose of cyclophosphamide at the dose of 0.7 mg/100 gms of weight of animal in addition to the routine diet. The animals were sacrificed at intervals of 3, 6, 9 and 12 weeks, 5 microns sections of the tissue were prepared and stained with Haematoxylin and Eosin stain.Results: Microscopic changes in liver were apparent in the drug treated animals. In group B the changes appeared after 6 weeks while in group C they started appearing after 3 weeks of drug treatment. The changes were in the form of fatty changes, hemorrhages and central vein congestion.Conclusion: Cyclophosphamide induces histological changes like fatty infiltration and central vein congestion in the liver. These changes are with low doses given for longer durations and manifest earlier when larger doses are used. Thus it is advised that patients receiving cyclophosphamide should be periodically evaluated for liver dysfunction.

Ginger essential oils-loaded nanoemulsions: potential strategy to manage bacterial leaf blight disease and enhanced rice yield

The bacterial leaf blight (BLB) caused by Xanthomonas oryzae pv. oryzae (Xoo) is one of the most serious rice diseases, causing huge yield losses worldwide. Several technologies and approaches have been opted to reduce the damage; however, these have had limited success. Recently, scientists have been focusing their efforts on developing efficient and environmentally friendly nanobactericides for controlling bacterial diseases in rice fields. In the present study, a scanning electron microscope (SEM), transmission electron microscope (TEM), and a confocal laser scanning microscope (CLSM) were utilized to investigate the mode of actions of ginger EOs on the cell structure of Xoo. The ginger EOs caused the cells to grow abnormally, resulting in an irregular form with hollow layers, whereas the dimethylsulfoxide (DMSO) treatment showed a typical rod shape for the Xoo cell. Ginger EOs restricted the growth and production of biofilms by reducing the number of biofilms generated as indicated by CLSM. Due to the instability, poor solubility, and durability of ginger EOs, a nanoemulsions approach was used, and a glasshouse trial was performed to assess their efficacy on BLB disease control. The in vitro antibacterial activity of the developed nanobactericides was promising at different concentration (50–125 µL/mL) tested. The efficacy was concentration-dependent. There was significant antibacterial activity recorded at higher concentrations. A glasshouse trial revealed that developed nanobactericides managed to suppress BLB disease severity effectively. Treatment at a concentration of 125 μL/mL was the best based on the suppression of disease severity index, AUDPC value, disease reduction (DR), and protection index (PI). Furthermore, findings on plant growth, physiological features, and yield parameters were significantly enhanced compared to the positive control treatment. In conclusion, the results indicated that ginger essential oils loaded-nanoemulsions are a promising alternative to synthetic antibiotics in suppressing Xoo growth, regulating the BLB disease, and enhancing rice yield under a glasshouse trial

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030