Foreign Capital, Political Instability and Financial Performance of Pakistan

Political Instability is one of the most important factor in the development of the country. To check the development of the country one must check the political instability of that country. I defined political instability is somehow the “the prosperity of government clash”. While going through different literature done on the political instability. Study showed that political instability and growth goes hand in hand. They both affect each other respectively. This study showed that investors are attracted only when there is stable environment for the business market. One variable is directed for future research that is corruption. In concluding the article it is concluded that political inability leads towards low growth of the country and similarly vice versa

Infección con Sarcoptes scabiei (Acari: Sarcoptidae) en conejos (Oryctolagus cuniculus): estudio de caso.

A partir de una sospecha de sarna sarcóptica en tres de cinco conejos albinos europeos (Oryctolagus cuniculus), mantenidos con fines experimentales, se hizo un examen general que reveló áreas multifocales de alopecia alrededor de los ojos, las fosas nasales y los labios. Se procesaron cortes de piel y un análisis de PCR con el objeto de identificar los ácaros. La histopatología de los cortes de piel mostró epidermis erupcionada y estrato córneo con una infiltración de células inflamatorias. El raspado o frotis de piel reveló la presencia de ácaros tanto en adultos como en huevos. Al examen microscópico, los ácaros adultos fueron identificados como Sarcoptes (S.) scabiei (Acari: Sarcoptidae). El análisis de muestras de los tres casos por PCR reveló una banda de 311 pb confirmando la infestación de S. scabiei en los conejos. La infección en conejos con S. scabiei puede representar un problema de salud pública de transmisión indirecta debida a la manipulación de conejos infestados. Hasta la presente, este es el primer reporte de infección por S. scabiei en conejos de Pakistán

Optimizing the Performance of Data Warehouse by Query Cache Mechanism

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PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Sarcoptes scabiei (Acari: Sarcoptidae) infestation in rabbits (Oryctolagus cuniculus): A case study

A partir de una sospecha de sarna sarcóptica en tres de cinco conejos albinos europeos (Oryctolagus cuniculus), mantenidos con fines experimentales, se hizo un examen general que reveló áreas multifocales de alopecia alrededor de los ojos, las fosas nasales y los labios. Se procesaron cortes de piel y un análisis de PCR con el objeto de identificar los ácaros. La histopatología de los cortes de piel mostró epidermis erupcionada y estrato córneo con una infiltración de células inflamatorias. El raspado o frotis de piel reveló la presencia de ácaros tanto en adultos como en huevos. Al examen microscópico, los ácaros adultos fueron identificados como Sarcoptes (S.) scabiei (Acari: Sarcoptidae). El análisis de muestras de los tres casos por PCR reveló una banda de 311 pb confirmando la infestación de S. scabiei en los conejos. La infección en conejos con S. scabiei puede representar un problema de salud pública de transmisión indirecta debida a la manipulación de conejos infestados. Hasta la presente, este es el primer reporte de infección por S. scabiei en conejos de Pakistán.Sarcoptic mange was suspected in three of five European albino rabbits (Oryctolagus cuniculus) kept for experimental purposes. Gross examination revealed multifocal areas of alopecia around the eyes, nostrils and lips. Skin snips were processed using PCR for the molecular identification of the suspected mites. Histopathology of the skin snips showed erupted epidermis and stratum corneum with an infiltration of inflammatory cells. Skin scraping examination revealed the presence of adult mites as well as eggs. Microscopic taxonomy identified the adult mites as Sarcoptes (S.) scabiei (Acari: Sarcoptidae). The results of PCR indicated a 311 bp band from all the three cases, which confirmed the S. scabiei infestation in rabbits. Sarcoptes scabiei may be a public health concernthrough direct transmission from rabbits infested with S. scabiei through handling. To the best of our knowledge, this is the first report of S. scabiei infection in rabbits from Pakistan

Dengue hemorrhagic fever: Comparison of patients with primary and secondary infections

Summary: Background: Dengue hemorrhagic fever (DHF) is considered to be associated with secondary dengue infection. This study was conducted to note frequency of primary and secondary dengue infection in DHF patients. Additionally these patients were compared in terms of age, gender, laboratory parameter, diseases severity and outcome. Materials and methods: In this cross sectional observational study DHF patients fulfilling DHF criteria of Dengue Expert Advisory Group (DEAG) were included and divided into groups based on dengue specific IgG positivity and ratio of IgM to IgG. Group I, patients with secondary dengue infection were IgG positive or their ratio of IgM to IgG was 1.2. The two Groups were compared for statistically significant association in terms of age, gender, laboratory parameter (at admission hematocrit [HCT], platelet, white blood cell [WBC] counts, alanine aminotransferase [ALT] value), severity (DHF or dengue shock syndrome), and outcome (recovered or expired). Results: Two hundred thirty-four DHF patients were included. 66.2% was male and 33.8% female. Mean patient age was 28.8 ± 12.4 years. Based on dengue markers results, 61.5% patients were categorized to Group I, and 38.5% to Group II. Statistically significant association between the two Groups was noted in terms of at admission platelet count, and ALT value, P value <0.05. Conclusion: Primary dengue infection is frequently associated with DHF. Patients with DHF caused by secondary dengue infection have lower at admission platelet counts and higher ALT value. Keywords: Dengue, Dengue hemorrhagic fever, Primary and secondary dengue infection, Platelet count, Alanine aminotransferas

An Adaptive M-Learning Usability Model for Facilitating M-Learning for Slow Learners

Mobile devices have evolved from communication tools to versatile platforms for various purposes, including learning. Usability is crucial for practical mobile learning applications, ensuring ease of use and expected performance. However, existing research on mobile educational apps has primarily focused on typical learners, neglecting the specific requirements of slow learners who face cognitive limitations. In this work, we fill this research gap by proposing an adaptable learning-oriented usability model (ALUM) for mobile learning apps specifically tailored to support slow learners. The research conducts a detailed usability analysis and systematic review to identify the problems users face and investigate how slow learners respond to learning apps in terms of efficiency, effectiveness, satisfaction, and learning outcomes. Twenty-four participants classified as slow learners evaluated the usability of 25 HTML-based learning apps. The evaluation revealed critical deficiencies in existing learning apps concerning the needs of slow learners, particularly in user-friendliness and learnability, leading to their dissatisfaction. We propose a model that leverages a hybrid recommendation system to address these challenges. The model incorporates a navigational graph, ontology, and item matrix to provide personalized topic recommendations, tailoring the content and delivery of educational materials based on individual needs and preferences. By enhancing the learning experience for slow learners, the proposed model aims to improve their learning outcomes. This research bridges the gap between academic research and practical applications in interactive mobile technologies. The adaptable learning-oriented usability model presented in this paper offers a framework for supporting slow learners, emphasizing its essential components and their interactions to enhance the learning outcomes for this user group