Comparison of sampling adequacy between OPD based pipelle biopsy and in- patient conventional D&C, presented with abnormal uterine bleeding

Objective: To determine agreement on adequacy of sample by pipelle biopsy and conventional dilatation and curettage in patients with abnormal uterine bleeding. Study design: Cross sectional studySetting and Duration of Study: Department of Obstetrics and Gyneacology, Islamic International Medical College Trust, Railway Hospital Rawalpindi. Study was carried out over a period of six months (11-07-2012 to 14-01-2013). Patients and Methods: 84 patients presented with abnormal uterine bleeding age 45 years and older, attended Gynecology department of Railway Hospital Rawalpindi. Who qualified the inclusion criteria were enrolled in this study by non-probability consecutive sampling technique. The diagnostic intervention for endometrial sampling was by pipelle device and by conventional D&C. Both procedures were performed in the OT at the same time.First the pipelle sample was taken and was labeled as “A” then conventional D&C was performed and was labeled as “B”. Both samples were sent to the pathologist, who was blinded as to the method of sample collection for histopathology assessment. Adequacy of the sample was assessed as per operational definition. A data base was made in SPSS version 17. Kappa statistics was applied to assess the agreement. Results: Out of 84 patients, 80 (98.8%) of the patients had adequate sample with Pipelle Biopsy as compared to conventional curettage and dilatation (D & C). We therefore recommend the use of pipelle biopsy as a first line tool for endometrial assessment for our setups instead of D&C. Conclusion: Our study concluded that the Pipelle biopsy is a useful and convenient method to the patients and physicians as ompared to D&C performed in the operating theatre. It is useful in obese and high-risk patients with minimum chances of perforation of uterus due to its soft flexible tip

An Empirical Evidence of Human Capital Constraint towards Economic Growth

Human capital plays a crucial role in enhancing sustainable economic growth. The aim of this study is to investigate the long run linkage between economic growth and human capital and explore the problems facing by education and health sectors in Pakistan, how to remove these problems in order to increase Human Capital, eminence of Human Capital and Economic Growth also. For this purpose, this study has been taken annual time series data from 1977 to 2014 and employed co-integration technique to find out the results. This study has been used the data from WDI, SBP, and Economic Survey of Pakistan (various issues). The results of this study revealed strong positive and significant long run association between human capital and economic growth in Pakistan. It is also found by the study that current status of health and education sectors in Pakistan is very poor. This study may be useful for health and educational policy making and human capital formation to boost up economic growth in Pakistan. Keywords: Human capital, Economic Growth, Johansen Co-integration, Skilled Worker

Object-Oriented Software Testing: A Review

Object-oriented (OO) software systems present specific challenges to the testing teams. As the object-oriented software contains the OO methodology and its different components, it is hard for the testing teams to test the software with arbitrary software components and the chance of errors could be increased. So different techniques, models, and methods researchers identified to tackle these challenges. In this paper, we are going to analyze and study the OO software testing. For handling challenges in OO software testing, different techniques and methods are proposed like UML diagrams, evolutionary testing, genetic algorithms, black-box testing, and white-box testing. The methodology used for research is literature review (LR) of the recent decay

Blind User

In this era of information and communication, technology has become indispensible for everyone including people with blindness. It is noticed that for visually challenged users, the progress has been a much slower as compared to normal people. There are number of visually impaired users who demands special application that could assist them in their routine tasks. User participation is a significant matter of the time that researched and discussed in software development industry. Software development knowledge reflects that participation of different users in the process of software development lifecycle (SDLC), can participate to usability of software. Necessary inclusion for having better usability and accessibility are generally lacking in software engineering procedures. The study outline that is established to inquire the importance of blind people participation in the software development. The main aim of the research is to explore the level of visually impaired participation in SDLC process. In the study the model; Blind User System Development Life Cycle (BUSDLC) is proposed. In the study a survey with 32 software experts is included. This paper attempts to bring attention towards visually challenged people and establish Blind user centered SDLC for visually challenged people. This will help to improve software development process. Moreover the proposed BUSDLC can be implemented in any software development industry to prove its effectiveness

Managerial Conflict Among the Software Development Team

Requirement engineering is one of the most essential and first steps of software development. This phase plays a vital role in the success of software. In this paper, we focus on managerial conflict, one of the types of software conflicts in a particular stage of software development that is a development phase. As there are many stakeholders and massive requirements, conflict comes across. This research proposed a framework to identify the cause of managerial conflicts and respond to these conflicts among the development team to solve them. The proposed framework helps to enlighten conflict management skills in the development team to increase productivity. When the development team knows how to work effectively in the face of managerial conflicts that will undoubtedly come their way, they can more easily make decisions quickly. Those decisions will help to prevent software from delayed deployment and failure of software

5 Years Mortality of Severe Traumatic Brain Injury during the Establishment of Closed System Neurocritical Care Unit in a Resource Constrained Developing Country

Background & Objectives: Severe traumatic brain injury is one of the leading causes of mortality and morbidity.Efficient management of severe traumatic brain injury demands a specialty driven focused intensive care. We developed our model of closed ICU driven by Neurosurgical Neurointensivist and the corollary to thiscommitment is a TBI patient centered Neurocritical care with the capacity and capability to deal with most of the neurological illnesses.Materials & Methods: A prospective study was conducted to find out the impact of the establishment of closed system of neurocritical care on 5 year mortality of severe TBI. Total 1288 patients met the inclusion criteria, which were enrolled. Tabulation was done for gender, age range, Glasgow outcome scale and mortality.Results: It was observed that mortality reduced from 47% to 35% over a span of five years. The most common age range was 30-40 years, which is the most productive group of any population. Bed sore incidence is always on rise in any ICU. After the implementation of SOPs based management and increase in nursing staff theincidence of bedsore also showed a detrimental pattern from 35 % to 19%.Conclusion: Neurocritical care unit is proven to be an integral part of any neurosurgical unit and this closed system of NCC unit provide best SOP based care with significant reduction in mortality of patients with STBI

Management of simultaneous bilateral femur fractures in a tertiary care hospital: a retrospective review

Abstract: Introduction: Bilateral long bone fractures are rare and usually are associated with increased risk of complications. These fractures are usually associated with poly traumatic injuries or high impact trauma resulting in shock. Commonest etiology is road traffic accident. Closed diaphyseal fractures are best managed by intramedullary nailing; management becomes difficult if there are open fractures and late arrival. In this study we intend to present our experience of managing these patients. Materials and Methods: Medical records of all adult patients (age more than 16 years of age) admitted at Aga Khan University and Hospital with bilateral femur fractures +/- other systemic injuries 2006-2014 were reviewed retrospectively. Adult patients with complete medical records were included and patients with missing data were excluded from the study. SPSS version 19 was used for data entering and Statistical analysis. Results: We retrieved 11 cases of bilateral femur fractures. Mean age of patients was 34.5 +/- 20.9, with male predominance constituting 72.7%. Common mode of injury was fall from height and road traffic accident (RTA) 45.5% each, with the exception of one gunshot. Mean Injury Severity Score was 26.9+/-7.79. Mean Revised Trauma Score was 7.39 +/-0.62; mean Trauma Injury and Severity Score was 92.4 +/- 6.6%. 2 patients had surgical site infections and 1 had non-union. We encountered no mortality. Increase ISS is associated with increased risk of morbidity and length of hospital stay (p= 0.02

Underwater Resurrection Routing Synergy using Astucious Energy Pods

The accomplishment of sustainable communication among source and destination sink node is a rigors challenge and even establishing bodacious communication link between these nodes is nothing short of a miracle because data routes are governed by the underwater environment. Energy consumption has a significant influence as all active devices rely on the battery. As cost-effective data packet transmission is established as a norm, no charging or replacement can be achieved. Hop link evaluation and shrewd connection discovery by way of a resurrecting linking element were just a genuinely grim task, and only feasible to create the extra powered energy pods (URR-SAEP) that had never been carried out before after detailed study. After packet transfer, the sensor node performs the link inspection process, and when a link is deemed shaky at less than or equivalent to 50 percent of capacity, the target node incorporates its residual capacity status and returns it to the source node that attaches other unoptimizable energy pods to improve only the targeted node link from 50 percent to 90 percent. Performance evaluation using NS2 with Aqua-Sim 2.0 simulator has been obtained comparing with DBR and EEDBR protocols in terms of point-to-point delay, Packet dissemination ratio, Network lifespan and Energy Diminution