TIMES Journal of Health and Social Sciences
The TIMES Journal of Health and Social Sciences is a peer-reviewed academic journal dedicated to advancing research and scholarship in the interdisciplinary fields of health, social sciences, pharmaceuticals, and nursing. As an official publication of TIMES University Multan, the journal offers a platform for publishing original research, systematic reviews, clinical studies, theoretical contributions, and practical insights that address contemporary challenges in public health, social welfare, pharmaceutical sciences, and nursing practice. Our goal is to disseminate knowledge that promotes holistic development in healthcare and social services while bridging gaps between theory and practice.
VOICES FROM THE WARD: QUALITATIVE INSIGHTS INTO NURSING STUDENTS’ CHALLENGES TRANSLATING THEORY INTO PRACTICE” IN PAKISTAN
Background: Nursing theories underpin nursing practice, research, education, and professional growth. However, their application in clinical settings is frequently inadequate, revealing challenges in integrating theory into practice. The present study aimed to explore the barriers experienced by nursing students and clinical instructors in applying nursing theories within clinical environments. Methodology: A qualitative case study design was adopted to examine challenges related to theory-to-practice integration among 8th-semester Bachelor of Science in Nursing (BSN) students and clinical nursing instructors in Khyber Pakhtunkhwa (KP), Pakistan. Semi-structured interviews were conducted with ten participants, including five students and five instructors. Interviews were audio-recorded, transcribed verbatim, and analyzed using Braun and Clarke’s thematic analysis approach. Results: Analysis revealed four overarching themes: (1) discrepancies between classroom instruction and clinical realities, characterized by idealized theoretical content, limited hands-on practice, and conflicting guidance from educators and ward staff; (2) insufficient clinical supervision and support, reflected in limited instructor availability, weak academic–clinical collaboration, and inconsistent mentoring practices; (3) organizational and resource-related challenges, including heavy patient workloads, shortages of equipment, and routine-driven ward practices; and (4) student-related barriers, such as low self-confidence, communication difficulties, and inadequate recall of foundational theoretical knowledge. These findings illustrate the complex and multidimensional nature of the theory–practice gap in nursing education Conclusion: The theory–practice gap in nursing education in KP arises from intertwined educational, organizational, and learner-related factors. Addressing this gap requires strengthened academic–clinical partnerships, enhanced clinical mentor-ship, improved resource provision, and practice-oriented teaching strategies to foster students’ clinical competence and professional readiness.
Copyright (c) 2025 Maryam Qadeer (Author) https://creativecommons.org/licenses/by/4.0
RADIOGRAPH IMAGE-BASED CLASSIFICATION OF PERIODONTAL DISEASE USING DEEP LEARNING TECHNIQUES: Deep learning
Dental radiography is useful for clinical diagnosis, treatment, and quality assessment. Much effort has gone into developing digitalized dental X-ray image analysis systems to improve clinical quality. The preprocessing of dataset, procedures, and result evaluation of dental treatment performed using periapical X-ray images taken before and after the operation. I propose a tool pipeline for automated clinical quality evaluation to assist dentists in making clinical decisions. I use Deep Learning technique to detect the disease from the X-Ray images. The dataset contains 525 dental X-Ray images. X-Ray images are labelled as Normal and Diseased by designated dental experts. This research explores the application of deep learning models for dental disease detection, focusing on two advanced architectures: ResNet101 and ResNet152. The study involves training and evaluating these models on a curated dental dataset to assess their performance in classifying dental images. ResNet101, configured with a batch size of 256 and a learning rate of 0.001, achieved a training loss of 0.002 and a test loss of 0.015. The model demonstrated perfect training accuracy of 100% and a commendable test accuracy of 98.35%, indicating strong learning and generalization capabilities. In comparison, ResNet152, with a batch size of 64 and a higher learning rate of 0.01, exhibited a training loss of 0.02 and an exceptionally low-test loss of 0.001. The model achieved a training accuracy of 100% and a test accuracy of 99.15%, showcasing superior generalization to unseen data. The results highlight the effectiveness of both models in dental disease detection, with ResNet152 showing a marginally better performance on test data.
Dental Radiography, Oral Disease Detection, Deep Learning, Medical Image
Copyright (c) 2025 Hassan Ahmad (Author) https://creativecommons.org/licenses/by/4.0
DISEASE PREDICTION AND CLASSIFICATION OF LUNGS CANCER USING DEEP MACHINE LEARNING
Lungs cancer is the leading cause of death. However, with about 2.5 million occurrences worldwide in 2022, colon cancer ranks as the third most prevalent disease. Globally, there would be 9.95 million cancer-related deaths and around 19.2 million new cases in 2024. Cancer poses a significant threat due to its aggressive nature, potential for widespread metastasis, and inherent he erogeneity, which often leads to resistance to chemotherapy. Lungs cancer ranks among the most prevalent of cancer worldwide, affecting individuals of all genders. Timely and accurate lungs cancer detection is critical for improving cancer patients’ treatment outcomes and survival rates. Screening examinations for lungs cancer detection, however, frequently fall short of detecting small polyps and cancers. To address these limitations, computer-aided techniques for lungs cancer detection proved as an invaluable resource for both health care practitioners and patients. This study implements an enhanced EfficientNetB1 deep learning model for accurate detection and classification using histopathological images. The proposed technique accurately classifies the histopathological images into three distinct classes: No cancer (benign), Adenocarcinomas, and squamous cell carcinomas. The performance of proposed technique is being evaluated by histopathological (LC25000) lungs dataset. The image resizing and augmentation are followed by loading a pre-trained model and applying transfer learning. The dataset is then split into training and validation sets, with fine-tuning and retraining performed on the training dataset. The proposed model performance is evaluated on the validation dataset, and the results of lungs cancer detection and classification achieved 99.8% accuracy.
Convolutional Neural Network; Medical imaging; Disease prediction; Supervised learning; Deep Learning; Lungs cancer.
Copyright (c) 2025 Muhammad Atif (Author) https://creativecommons.org/licenses/by/4.0
PRESENT STATUS OF MICROBIOLOGICAL EVALUATION OF RAW MILK IN MULTAN CITY
Raw milk can oblige as energetic basis of nourishment nonetheless it can act as potential standard for conveying infective microorganisms and cause transferrable sicknesses. This study evaluates contagious superiority and antimicrobic confrontation of microorganisms secluded from raw milk advertised in Multan city, Pakistan. A whole of 300 raw milk tasters was together from several spaces. Standard microbiological method was employed for bacterial identification and antibiotic vulnerability testing was achieved by means of disc diffusion procedure. The outcomes exposed that mainstream of milk tasters were dirtied by pathogenic microbes, including Escherichia coli (66%), Staphylococcus aureus (45%), Shigella (14%), Proteus (19.6%), Listeria (16.3%) and Salmonella (8.6%). The pH of most samples was slightly acidic which suggest poor handling. On the other hand, antimicrobial defenselessness testing exhibited tall confrontation to ampicillin and doxycycline while ciprofloxacin and cefixime were the most effective antibiotics. Uncovering of Multidrug Resistant (MDR) isolates particularly amid E. coli besides S. aureus, shows the emerging treat of antimicrobial resistance in dairy sector. This study concludes that poor hygiene during milking, management then conveyance significantly contributes towards milk adulteration. To ensure microbial milk safety in Pakistan, government should strengthen food safety regulation and promote hygienic practices.
Raw milk, Microbial contamination, antimicrobial resistance, Multan, Pakistan, Food safety.
Copyright (c) 2025 Atif Nisar Ahmad (Author) https://creativecommons.org/licenses/by/4.0
NURSES’ PERSPECTIVES ON INTERDISCIPLINARY COLLABORATION AND ITS IMPACT ON PATIENT CARE IN HOSPITALS
Background: Interdisciplinary collaboration (IPC) is widely recognized as a cornerstone of high-quality healthcare delivery, contributing to improved patient outcomes, safety, and system efficiency. Nurses play a pivotal role in interdisciplinary teams due to their continuous patient contact and involvement in care coordination. This study aimed to assess nurses’ perspectives on interdisciplinary collaboration and its perceived impact on patient care outcomes in public and semi-autonomous hospitals in Khyber Pakhtunkhwa (KP), Pakistan. Methodology: A cross-sectional descriptive design was employed, involving 256 registered nurses working in inpatient settings. Data were collected using a structured, self-administered questionnaire, including a modified Nurse–Physician Collaboration Scale assessing communication, mutual respect, role clarity, shared decision-making, and coordination of care. Descriptive statistics and inferential analysis were performed using SPSS. Results: The findings revealed moderate to high levels of perceived interdisciplinary collaboration, with higher mean scores for communication and mutual respect, and comparatively lower scores for shared decision-making and role clarity, indicating the presence of hierarchical barriers. Most nurses perceived IPC as having a positive impact on patient care, including improvements in quality of care, patient safety, continuity of care, and reduction of medical errors. A statistically significant association was observed between overall collaboration scores and perceived quality of care and patient safety (p < 0.05). Despite positive perceptions, challenges such as limited involvement in decision-making and role ambiguity were evident. Conclusion: The study concludes that strengthening interdisciplinary collaboration through inter-professional education, role clarification, and inclusive decision-making processes may enhance patient outcomes and teamwork effectiveness in hospital settings. These findings provide valuable insights for healthcare policymakers and administrators seeking to improve collaborative practice in Pakistan’s healthcare system.
Copyright (c) 2025 Sheraz Khan (Author) https://creativecommons.org/licenses/by/4.0
CULTURAL NORMS, GENDER BIAS, AND THEIR IMPACT ON THE NURSING PROFESSION IN PAKISTAN: A CROSS-SECTIONAL STUDY
Background: The social and cultural obstacles experienced by nurses, a profession primarily occupied by women, will be highlighted in this research study conducted in nursing in Khyber Pukhtankhwa, Pakistan. It examines how patriarchal systems and prevalent gender stereotypes contribute to the marginalization and unfavorable opinions of nursing. Methodology: The study was a cross-sectional analysis conducted in Khyber Pakhtunkhwa with 184 nurses using purposive sampling from June to September 2025. Data were gathered through a structured questionnaire focusing on socio-demographic factors, cultural norms in nursing, gender bias experiences, and their effects on professional identity and career satisfaction. Analysis was performed using SPSS version 26, employing descriptive and inferential statistics, with ethical approval obtained to ensure confidentiality and voluntary participation. Results: A study of 186 registered nurses, mostly female (71.0%) and aged 25–35, highlighted significant perceptions of cultural norms and gender bias within the profession. High mean scores indicated nursing's perception as a feminine profession (4.12) and noted that gender bias negatively affected job satisfaction and professional advancement. Notably, higher perceived gender bias correlated with job dissatisfaction (p < 0.01), where those perceiving more bias were 2.86 times more likely to report dissatisfaction. Male nurses expressed greater dissatisfaction than females (OR = 1.90, p = 0.027). Conclusion The study highlights that cultural norms and gender bias negatively impact nurses' professional identity and job satisfaction, especially among male nurses. Perceived gender bias is the leading cause of dissatisfaction. The findings underscore the need for gender-sensitive workplace policies, institutional support, and educational reforms to enhance equity and retention in the nursing workforce.
Nursing, Social challenge, Cultural challenge, Gender-segregation, gender role, identity
Copyright (c) 2025 Khurshid Ali (Author) https://creativecommons.org/licenses/by/4.0
Comparison of postoperative pain in laparoscopic cholecystectomy with and without instillation of bupivacaine in the gall bladder bed
Laparoscopic surgery is a modern surgical technique in which operations in the abdomen is performed through small incisions. Cholecystectomy is the surgical removal of the gallbladder. Laparoscopic cholecystectomy is the most common laparoscopic procedure performed. The most common problem after laparoscopic cholecystectomy is the postoperative pain. One of the good procedures is to instil a local anaesthetic agent at the area from where gall bladder is removed. Inj. Bupivacaine 0.5 % is a long-acting local anaesthetic. It is effective in reducing postoperative pain after Laparoscopic Cholecystectomy. OBJECTIVE: To compare the mean postoperative pain in laparoscopic cholecystectomy with and without instillation of 0.5% bupivacaine in the gall bladder bed. OUTCOME MEASURE: The outcome was measured as pain post operatively at 0, 2, 4 and 6 hours by VAS. And the number of hours after which patients requested for analgesia. MATERIALAND METHODS: SETTING: Department of surgery, Benazir Bhutto Hospital Rawalpindi. DURATION: 6 months STUDYDESIGN: Randomized Controlled Trail. METHODS: 120 patients undergoing Laparoscopic Cholecystectomy were included in study. Patients were divided into two groups A& B. Group A(Experimental group) was given 10 ml 0.5% bupivacaine at gall bladder bed and under right hemidiaphragm at the end of surgery through laproscope port and Group B (Control group) was given 10 ml normal saline intraperitoneally at the same location. Patients were included through non probability sampling technique. RESULTS: 100 patients (83.3%) were female, and 20 patients (16.7%) were male. The demographic data including age, gender, and the average duration of surgery was not significantly different (p>0.05) in Bupivacaine and Saline group. A significant difference was observed between the pain scores of Bupivacaine and Saline groups after 0 hours, 2 hours and 4 hours of surgery (p<0.05). However no significant difference was observed between two groups after 6 hours of surgery (p>0.05). There was also a significant difference in the number of hours after which patients requested for analgesia (p<0.05). The patients of Bupivacaine group requested late for analgesia as compared to the patients of Saline group. CONCLUSION: Intraperitoneal instillation of Bupivacaine results in good pain relief after laparoscopic cholecystectomy.
Copyright (c) 2026 TIMES Journal of Health and Social Sciences https://creativecommons.org/licenses/by/4.0
Why do students get enroll in physiotherapy course? A Cross-sectional study
An individual with movement disorders, brought on by injury or disease, may get direct patient care from a physiotherapist (PT) in order to achieve their higher level of physical function and mobility. The most effective method of treating physical discomfort has been physical therapy. The number of universities and institutions offering the DPT degree program, and the number of students enrolled in the program both reflect the profession's rapid growth in different areas. A 5-year educational program leading to the doctor of physical therapy (DPT) degree includes courses in fundamental medical sciences in the first two years and in following 3 years it includes clinical sciences. The Higher Education Commission (HEC) of Pakistan oversees the DPT curricula, which is a 5-year degree/10-semester prospectus with 175 credit hours. Physical therapy has a long history in our country dating all the way back to 1955, but it wasn't a mainstream career until 2008. Objective: The aim of this study is to determine the reasons why students enrolled in doctor of physical therapy course and the factors affecting the students' choice in getting enrolled in DPT. Materials and methods: This is a cross-sectional study to find out the reasons why students enroll in physiotherapy course. The study was conducted in different universities of Gujranwala, Lahore and Sialkot. According to inclusion and exclusion criteria 370 subjects were selected. The data was collected from both male and female students. A questionnaire was filled by the subjects. Data was analyzed by SPSS version 20.0. Conclusion: It was concluded that parent's suggestions was most influencing factor to in choice of DPTand most of the student's received information about this physiotherapy course from friends and relatives.
Influence of Occupational Exposure to Hydrocarbons and Automobile Exhaust on the Health of Automobile Workshop Workers
The effect of hydrocarbons and automobile exhaust exposure on the hematological, cardiovascular, and hepatic parameters of the workers of automobile workshops was studied. The blood samples collected from five groups of workers with different duration of exposure (6-10, 11-15, 16-20, 21-25, and >25 years) and a control group including university students were analyzed for hematological and clinical parameters. An exposure-dependent statistically significant linear increase was observed in hemoglobin level (p=0.041, R2=0.8132) and serum levels of alanine aminotransferase (ALT) (p=0.000, R2=0.9604) and creatine kinase (CK) (p=0.000, R2=0.9759) of the workers. However, the parameters of blood count and serum levels of aspartate aminotransferase, alkaline phosphate, lactate dehydrogenase, and total bilirubin levels remained unaffected. The long-term exposure to hydrocarbons resulted in a significant time-dependent increase in the hemoglobin, ALT, and CK levels of the workers. The findings indicate a risk of developing hematological, cardiovascular, and hepatic disorders in the automobile workshop workers.
Promoting Religious Tolerance through National Spiritual Education in Pakistan: Building Bridges, Not Walls
This article examines the viability and obstacles associated with the implementation of national spiritual education in Pakistan, with an emphasis on the vital importance of religious tolerance. Pakistan, a country renowned for its diverse array of religious beliefs, confronts the formidable task of nurturing spiritual growth amidst an intricate religious terrain. This article has investigated the establishment and implementation of national spiritual education in Pakistan, emphasizing its capacity to foster interfaith understanding, social cohesion, and ethical values. The fundamental significance of religious tolerance in the provision of such education. This entails recognizing the multitude of religious convictions that exist within Islam and demonstrating reverence for the presence of other faiths in Pakistan. The difficulties associated with designing a curriculum that is sensitive to and inclusive of diverse religious perspectives. Prospective frameworks for nationwide spiritual education that place an emphasis on reverence and acceptance of diverse faiths. The Pakistani context offers a distinctive perspective through which to analyze the dynamic relationship between religious tolerance and spiritual education. The objective of this paper is to make a scholarly contribution to the ongoing discourse surrounding the promotion of a Pakistani society that is more spiritually conscious and inclusive.
The impact of policy expansion on policy execution: The influence of bureaucratic inundation and policy prioritization
Developing nations like Pakistan continue to face the problem of effectively implementing ambitious policy objectives. The effects of policy expansion on implementation are examined in this paper, with a particular emphasis on bureaucratic overburden and policy prioritization as they pertain to the Pakistani context. It looks at how bureaucratic institutions can become ineffective when faced with an increasing quantity of policies. The report goes on to discuss how important prioritization is for allocating resources and attention to the policies that will have the greatest impact. The research adds depth to the analysis by drawing parallels to England, a developed country with a robust system for putting policies into action. The research seeks to analyze the pros and cons of both systems in order to help Pakistan improve its bureaucratic capability and create better systems for prioritization. Pakistan and other emerging nations in a similar position will benefit greatly from this study's conclusions. For policymakers to effectively execute their mandates and provide real benefits to their constituents, they must have a firm grasp of the dynamics at play between policy expansion, bureaucratic constraints, and prioritization. This work addresses the lack of research on the impact of policy expansion on implementation in modern democracies. It introduces the concept of organizational "policy triage," which measures implementation effectiveness from the organization's perspective. The study also presents a theoretical framework considering the prevalence of policy triage and its impact on organizations' sensitivity to overload and compensation. The research is tested using comparative case studies on environmental policy implementation in England and Pakistan.
Sociology and Religion: Interaction, Conflict, and Social Change in Society Through the Lens of Hadith
Religion and sociology are in one essence are inseparable from human social existence. Religion is arguably the most significant factor in the lives of many people and communities across the world, being a source of power over values, actions, traditions, and social structures. Therefore, sociology is the study of social relationships, social institutions, and social change within society. The interconnectedness of these factors poses significant social dynamics. This work seeks to explore the link between religion and sociology particularly in relation to conflict and social change from the perspective of Hadith. The research strives to obtain a more detailed explanation of the way religion determines the social structure, norms and values of society. It also focuses how Sociology can be used as method to interpret religion as a social phenomenon. Another concern addressed by the research is the repercussions of religious conflicts on society as well as the impact of religion on the societal changes that exist. From the perspective of the sociology of religion, one may see that there exists an established scientific pattern of the idea that spiritual people build up the social structure that encourages loving-kindness and tolerance. Studying the sociology of religion helps the people to have personal influence on social actions and exercise self-control in religious contexts. Muhammad Saw (PBUH) the hadith of the Prophet teaches that people who adhere to science, tolerance and religion have a religious life, especially Muslims. In Islam, everything is arranged and may be put into practice, which makes religion the cornerstone of social forms.
Understanding Democratic Conflicts: The failures of Agonistic Theory
The Western societies possess a number of internal contradictions that generate uncertainties about the possibilities of consensual decision-making and social cohesion. Conversely, conflict has been a core element of democracy since time immemorial, but political theory has never focused on the diversity of political dispute, the way it functions or its dynamics. The objective of this research is to deepen our knowledge of democratic strife. This article critically reviews Mouffe's agonistic pluralism, it contrasts it with sociological conflict theory, and gives some initial ideas from which a theory of democratic conflicts should be developed. The work contributes to two areas of research: The paper shows that the agonistic pluralism just does not hold the water because it omits the mechanisms and consequences of conflict dynamics (group cohesion, intra-group conflicts, domination and escalation) and without analyzing all conflict interactions, it does not present a comprehensive theory of conflict. The adherents of agonistic pluralism should draw more attention in expounding the core idea of their theory. (2) This research would therefore consist of multidisciplinary investigation exploring how cognitive ideas interrelate with conflict interactions, employing conflict management techniques and implementing assessing procedural dynamics of conflicts to achieve a comprehensive grasp of democratic conflicts.
Exploring The Level of Awareness Among the Parents of Beta Thalasemia Patients in District Swat
Background: Thalassemia is an inherited condition that affects globin chain synthesis and affects hemoglobin production in various ways. The aim of the study was to determine the level of awareness of parents of patients diagnosed with beta-thalassemia (βT). Methodology:Across-sectional descriptive study design was used to collect data from parents of patient regularly visiting blood transfusion centers in Swat district from February to March 2024. The sample size of the study was 235 using purposive sampling technique, with data collected through a reliable and valid questionnaire. The study was approved by the Ethics Review Board, with informed consent obtained from each participant. Data were analyzed using SPSS 22 as descriptive and inferential statistics. Results: In the current study, most of the parents were female 146 (62.1%), age group 31-40 years 164 (69.8%), house wife 67 (28.5%), with a monthly income of 21,000 to 50,000 107 (45.5%), and parents without education with a civil registry 60 (25.5%). For most patients, the level of awareness was good (42%), followed by poor awareness (31%), while 27% of participants' responses were neutral. Most parents are aware of prohibited foods, thalassemia symptoms, preventive tests, complications, drug avoidance, regular laboratory tests, thalassemia genetic disorder, blood related marriages and HIVas a blood borne disease. Conclusion: The study concluded that majority of the participant level of awareness was good, but a national basis campaign is required that address the preventive strategies to prevent thalassemia.
Assessment of Diagnostic Accuracy of Early OGTT in Prediction of GDM taking 2nd Trimester OGTT as Gold Standard
Objectives: To determine the diagnostic accuracy of early OGTT in prediction of GDM taking 2nd trimester OGTTas gold standard. Methods: This study cross-sectional study enrolled 420 pregnant women with single pregnancy between 18 and 40 years of age, who had their first prenatal visit in PAF hospital at 1st or early 2nd trimester. All the women in their first trimester were subjected to 75g OGTT and the values of plasma glucose concentration were recorded at fasting level, after 1-hr and after 2-hrs respectively. All these results were compared with 2nd trimester OGTT of same patients taking 2nd trimester OGTTas gold standard. Results: The mean age±SD of women was 27.77±4.87 years. The mean±SD BSF, 1-hr and 2-hr plasma glucose of women in 1st OGTT were 4.74±0.36 mmol/L, 7.44±0.63 mmol/L and 6.58±0.63 mmol/L respectively. The mean±SD BSF, 1-hr and 2-hr plasma glucose of women in 2nd OGTT were 4.89±0.32 mmol/L, 7.15±0.92 mmol/L and 6.04±0.97 mmol/L respectively. The prevalence of GDM in 1st OGTT was found as 6.4% and in 2nd OGTT it was found as 20.5%. The sensitivity and specificity of 1st OGTT performed between 10 to 17 weeks of gestation was found as 26.7% and 98.8% respectively. The positive predictive value and negative predictive value of 1st OGTT performed between 10 to 17 weeks of gestation was found as 85.18% and 83.97% respectively. Conclusion: The early OGTT performed during 10-17 weeks of gestation has good specificity, positive predictive value and negative predictive value but poor sensitivity, taking the late 2nd trimester OGTTas a gold standard.
Investigating the level of awareness regarding informed consent among the post-operative patients in surgical ward
Background: The concept of informed consent is an important aspect of biomedical ethics, which is obtained in written form, but in some cases, it may be verbal, especially for non-invasive and relatively non-risky interventions. The study was conducted with the aim of evaluating the level of awareness among post-operative patients regarding informed consent. Methodology: The study design was cross-sectional descriptive and was conducted in the surgical ward of a tertiary care hospital in Swat, Pakistan from December 2023 to January 2024. The sample size of the study was 180 using the purposive sampling technique, while a valid and reliable questionnaire was used for data collection. Descriptive statistics were used through SPSS 22.0. The study was approved by an ethical review committee, and informed consent was obtained from every respondent. Results: The finding reveals that the majority of the participants were female 112 (55.7%), the age group 36–45 years was 75 (37.3%), and people belonged to village 189 (94%). The maximum number of patients level of awareness was good (58%), while the remaining 42% had a poor level of awareness. The majority of the patients know the type of surgery 181 (90%), alternative treatment to the surgery 123 (61.2%), number of hours to be nothing per oral (NPO) 190 (94.5%), time of surgery 197 (98%), and overall satisfaction regarding informed consent 201 (100%). Conclusion: The study found that patients lack awareness about the surgeon, procedure process, advantages and disadvantages, procedure importance, anesthesia type, and complications, highlighting the need for enough information regarding their procedure.
EU Competition Law and Sustainability: The Need for an Approach Focused on the Objectives of Sustainability Agreements
European Union (EU) competition legislation can potentially contribute to the achievement of sustainability objectives and the battle against climate change. This article highlights the importance of interpreting the rules of EU competition law in a way that aligns with the sustainability goals of the EU, such as the sustainable development goals (SDGs), the EU Green Deal, and related programs. Although Article 101 TFEU typically prohibits agreements between rivals, cooperative agreements among market participants with sustainability aims (known as sustainability agreements) may, under specific circumstances, be exempted from the cartel prohibition outlined in Article 101(3) TFEU. There has been a growing demand in recent years to establish clear guidelines for allowing sustainability agreements under EU competition law, particularly under Article 101(3) TFEU. This has sparked a contentious discussion among scholars, national competition authorities (NCAs), and the European Commission. This article will explore an alternative perspective on the evaluation of objectives and measures in agreements, specifically using the willingness-to-pay method. It will also propose a broader interpretation of Article 101(3) TFEU, which could facilitate the implementation of sustainability agreements. The feasibility of such a possibility will primarily rely on the specific goals outlined in the agreements. This approach may enable a thorough examination of the purposes of a sustainability agreement in certain scenarios, by concentrating on agreements that aim to achieve predetermined objectives based on international or national standards, or specific policy objectives that were not obligatory for the companies involved beforehand.
The Current HRM Practices in Banking Institutions of Pakistan with Reference to Technological Advancement
Organizations are being forced to adapt, and new trends are emerging in human resource management as a result of rapid technological development, rapid penetration, and accelerated globalization. Various technological advancements have not only saved the hustle of the management system but have also proved to be less expensive and time-saving. This study validates the impact and significance of the new technological gears, technology in HR practices, and the extent and effectiveness of HR technology on in the banking Institutes of Pakistan. The study is conducted by adapting a questionnaire survey filled out by the professionals serving the banking industry of Pakistan. Regression analysis, correlation analysis, and descriptive analysis are used to analyze the gathered data. The study concludes that technological tools used, technological HR practices, and the extent of HR technology is positively correlated through technology effectiveness. The result of this study is limited as it chooses only a few E-HR practices related to banks' performance. Electronic Human Resource strategies are important in improving bank performance therefore; there is a need to adopt E-HR practices that aim to improve banks' performance.
Prevalence of de Quervain's tenosynovitis among students attributed to smartphone texting habits.
Background: Earlier study has described a suggestion between texting messages referred and De Quervain's tenosynovitis (DQT) symptomatology. However, these investigations do not account phone dependence and De Quervain's symptomatology. Purpose: The aim of this study to assess the prevalence of De Quervain's tensosynovitis among smart phone users caused by excessive text messaging in undergraduate students of Gujranwala. Materials and Methodology: A Cross sectional study was conducted. Data was collected from different institutes of Gujranwala city. Institutes were selected by convenience sampling technique. 8 male and 12 female institutes were selected. The sample size at the time of study were 300. In this investigation, non- probability convenience sampling technique was used. Results: Results show that youngsters using smartphone frequently showed more positive result for Dequervain tenosynovitis (Finkelstein test p-value < 0.05). Conclusion: De Quervain's tenosynovitis is most prevalent among females. People with the age group of 20-21 are most effected as compared to the other age groups. There seems to be a direct link among heavy text communications on a smartphone and prevalence of Dequervain tenosynovitis.
Frequency of Major Types of Manifest Strabismus among Patients of Age Group 1 to 25 Years Presented toBenazir Bhutto Hospital Rawalpindi
Aim: To find out the occurrence of different types of manifest strabismus in patients among the age group of (1-25 years) attending ophthalmology out-patient department at Benazir Bhutto Hospital Rawalpindi. Study Design: This was a cross- sectional study conducted within the time period of four months (Sep 2015 to Dec 2015). Methods: By using Consecutive sampling technique, a total of 150 strabismus patients were examined. Detailed evaluation of strabismus was carried out which included Visual Acuity measurement with Snellen chart and Lea symbols or assessed qualitatively through light fixation and follow; and by performing Cover tests and Krimsky tests. All the tests were carried out with and without glasses, and at near and distance both. Cycloplegic refraction was done on children, by dilating them with 1% cyclopentolate eyedrops. Data was recorded on a Performa. Results: Overall occurrence of manifest strabismus was found to be 3.9%, with much greater frequency of Comitant type. 48.48% had ET out of which 51.56% was Accommodative ET, followed by 42.19% Constant ET & 6.25% Infantile ET. 51.51% had XT out of which 69.12% was Constant XT followed by 30.88% Intermittent XT. No pure vertical deviations were seen but 11.33% patients had co-existing vertical deviations with horizontal deviations. Conclusion: Comitant strabismus is more occurring than incomitant, with ET and XT having almost same proportion. Mostly occurring types are Accommodative ET, Constant ET, Constant XT and Intermittent XT. Amblyopia and refractive errors are often associated with it.
Incidence of Hepatitis C in Different Age Groups and Socio-Economic Status in Relation to Dietary Habits;A Hospital Based Study
Hepatitis C is an infectious disease which is caused by hepatitis C virus (HCV) infection. It causes the irritation or swelling of liver. The primary methods of its transmission include intravenous drugs use, blood transfusion and unsafe medical procedures. Hepatitis C disturbs the intake of food and its processing in the body which causes the deficiency of micro and macro nutrients. The purpose of this study was nutritional support of the patient, to determine the incidence of hepatitis C in different age and sexes, to assess the burden of disease in target population, and to determine the effect of dietary habits and life style on hepatitis C. Allied hospital Faisalabad was visited for one and a half month. 128 respondents were collected during this time period, and the data from them was collected by the help of already prepared questionnaire and it was processed by SPSS computer program. Chi-square test was applied to find the association. The salient findings of the study were: there were more males (53.9%) than females (46.1%) affected with hepatitis C. Most of the respondents (42.02%) were of the age between 31 to 40 years. Majority of them (80.5%) were married. Majority of the respondents (65.6%) belong to the low socio-economic status, (25.05) were illiterate and (53.1%) belongs to rural area. There was a significant association between egg and meat-eating habits and the respondent socioeconomic status. There was non-significant association between socioeconomic status of respondents and their wheat, rice, fruits, vegetables, yogurt, milk and salad eating habits.
Incidence of Hepatitis “B” in Patients Undergoing Operative Procedures at DHQ Hospital Faisalabad
Incidence of hepatitis B was determined in patients undergoing operative procedures in surgical wards of DHQ Hospital Faisalabad from 26 April to 28 July, 2010. All the patients undergoing operative procedures were screened for hepatitis B. In present study a total of 620 preoperative patients were screened for hepatitis B among them 13 (2.09%) were positive for hepatitis B. The incidence of hepatitis B was 38.5% in females and 61.5% in males respectively. The results were compared with previous study conducted in other areas of Pakistan. As comparisons, the result was somewhat similar with conducted study but also shown some variation on the other hand. Precautions were also suggested to protect the patients, patient family members and medical personnel or?who are at high risk. Present study suggested that all patients must be routinely screened for hepatitis B before going to surgery. Due to high incidence of hepatitis B in this study, it is suggested that all patients who are admitted for any surgery must be screened for hepatitis B. Those patients who found positive for hepatitis B by using simple assay like rapid chromatography immunoassay must be confirmed by ELISA technique. At the same time there must be ways to aware the people about hepatitis B. Such hepatitis patients must be operated in separate operation theaters in order to protect other patients who are at high risk.
Demographic Analysis of Fracture Profile of Patients at Accident & Emergency Department of Orthopedic Surgeriesand Traumatology (DOST)-Unit-1 Mayo Hospital Lahore
Background: Trauma is a type of body wound, collapse or breakdown due to unexpected physical injury like from collision or disaster. Trauma includes various injuries and accidents; the data was analyzed for the patient's demographic profiles, nature of severity of accidents, types of accidents, way of treatment of various injuries and accidents. This is a non-randomized, hospital based, single centered, retrospective study conducted at accident emergency (AE) department, Mayo hospital Lahore. Materials and Methods: Data was collected from department of orthopedic surgeries and traumatology king Edward medical university Mayo hospital Lahore. In this study I have analyzed that the data for the patients coming to A & E department with severe injuries occurring during accidents over a period of time one year. Historical study design was used in this project and I was provided with all the demographic data and required information. Data was analyzed by using spss 11.5. Objectives: To analyze the demography of fracture profiles of the patients at accident emergency department of orthopedic surgery and traumatology (dost)-unit-1 Mayo hospital Lahore. Descriptive Analysis: Descriptive statistical tools, frequency distribution, graphs, mean, standard deviation, chi square and proportion was used to analyze the data. Results: 1. the percentage of patients coming to accident and emergency department in month of August was greatest i.e. 10.65% by month of October and December having percentages 9.74% and 9.65% respectively. 2. Out of total 1970 patients 1511 (76.7%) were males and remaining 459 (23.3%) were females with different types of injuries and fractures have come to A & E department over a period of one year. 3. Out of 1970 patients 1608 (81.6%) patients were having close fracture while 337 (17.1%) were having open fracture 4. frequency of bone affected for hummers bone was 185 (9.4%). for femur was 427 (21.7%), for scapula was 26 (1.3%), for ankle was 64 (3.2%), for clavicle was 114 (5.8%), for ulna was 134 (6.8%), for radius was 164 (8.3%), for tibia was 330 (16.8%), for hand was 279 (14.2%), for foot was 126 (6.4%), for pelvic dislocation was 32 ( 1.6%), for patella was 44 (2.2%), for vertebral dislocation was14 (6.8%), for skull was 1 (0.1%), for metacarpals was 20 (1%), for elbow was 5 (0.3%), for metatarsals were 1 (0.1%) and for cervical was 2 (0.1%). Conclusions: From this research I concluded that the proportion of accidents in summer season in months of August and in winter season in months of October and December specially in males were greater than in females and injuries of lower limb involving femur and tibia was more common than fractures of upper limb in patients in year 2008.
Iatrogenic Bile Duct Injury: Hours of Joy, Moment of Terror
Abstract: Iatrogenic bile duct injuries following gallbladder surgery are one of the most challenging intricacies. These injuries are accompanied by considerable patient disability and increased healthcare cost. Two dimensional imaging, potential tenting of the common hepatic duct during retraction of the neck of the gallbladder, absence of tactile sensation, acute cholecystitis and a short cystic duct are some manifestations of laparoscopic cholecystectomy that pose considerable burden to patients. We present a case of a 48 years old lady, who underwent laparoscopic cholecystectomy following accidental bile duct injury. Immediate response to complication and prompt salvage surgery resulted in patient's survival.
Pharmacological effects of Rheum emodi: A multiple purpose plant in health and disease
Rheum emodi (Polygonaceae) is also known as Himalayan or Indian Rhubarb. It has been used in traditional system of medicine as a diuretic, tonic, laxative and also used to manage pyrexia, menstrual disorders, indigestion and cough since antiquity. This article comprises of pharmacological studies, chemical properties, folk- floric uses and ethnobotany of Rheum emodi. The material was obtained from books and journals via electronic and library search. The most important ingredients of Rheum emodi are resveratrol, picetannol, stilbene, physcion, emodin, aloe-emodin, chrysophanol, and rhein. Studies have indicated that Rheum emodi possesses nephroprotective, immune enhancing, hepatoprotective, anti-ulcer, spasmolytic, antiviral, cathartic, anti-hyperglycemic, antihyperlipidemic, antifungal, antimicrobial, anti-inflammatory, antioxidant, antiplatelet and anticancer activities. Further study to explore the medicinal potential of this plant may lead to the development of novel drugs for numerous disorders. This review concluded that Rheum emodi requires proper evaluation to establish its therapeutic role in modern medicine.
Yeast Cells Secondary Metabolites and their Industrial Applications; A Review
Yeasts are the members of the fungi kingdom, single cell eukaryotic microorganisms. About hundred million years ago first yeast was originated and till now at least 1500 species have been identified. Through fermentation process yeast like Saccharomyces cerevisiae produces Co2 and alcohol from carbohydrates which have vital importance in baking and beverages industries as well as used as biofuels. Yeasts are considered as the most thoroughly researched and experimentally used among eukaryotic microorganisms because this provided valuable information related to the biology of eukaryotic cells as well as humans. However, some species such as Candida albicans are harmful to humans. In recent years, yeasts have been used to generate electricity in microbial fuel cells and producing ethanol used in biofuel industry. There is a biological curiosity from decades that how the microbes can produce the electricity. Now the researchers have predicted that the microbes produced electricity from organic matter which can be used in watches and cameras as a power source as well as for bioreactors. The microbial fuel cells divert the electrons from ETC of the yeast and generates the electricity. The widely used yeast for biotechnology and food engineering are now used for fuel engineering that is the major step towards advancement.
Diagnostic Modalities Employed for the Diagnosis of Mycobacterium Tuberculosis
Tuberculosis (TB) is the second most deadly disease around the globe. Because of the higher mortality rate, this disease has been given worldwide attention, killing over 2 million individuals every year. Tuberculosis has the highest prevalence in sub-Saharan Africa, whereas China, Bangladesh, Pakistan, India, and Indonesia globally account for nearly half of the tuberculosis load. Mycobacterium tuberculosis, whose coating is impervious, makes gram-staining difficult, therefore, there are other processes to identify this pathogen. This pathogen causes intense cold-like symp- toms and thrives in the lungs, although it can also spread throughout the body. The main aspect of tuberculosis control is the quick diagnosis and efficient treatment of patients. In order to isolate and identify Mycobacteria, culture on slant media such as the Lowenstein-Jensen slant media is used. Biochemical testing is now surpassed by molecular or immune-chromatographic tests. The other common and accepted protocols for detection of active tuberculosis are nucleic acid amplification tests, anti- gen detection tests, Patho-TB kit, anti-tuberculosis antibodies and XPERT MTB/RIF molecular assays for quick recognition and simultaneous identification of rifampin resistance of M. tuberculosis right from patient samples. When screening for active tuberculosis, chest X-ray imaging is the most commonly used. There is also mo- lecular diagnostic tools that use the growth of the desired organism in culture to aid in the diagnosis of a patient suspected of having active tuberculosis, such as nucleic acid probes, line probe assays, and DNA sequencing. An insight of major in-practice diagnostic modalities for M. tuberculosis has being presented in present review.
Ethnobotanical, Pharmacological and Traditional Uses of Woodfordia fruticosa: A Review
Medicinal plants used all over the world since the dawn of Human civilization. They contain therapeutic phytochemical constituents used in different diseases. Many modern synthetic compounds are used for different ailments, but these compounds have many adverse effects on different organ of the body. About 80% of the world population now relies on natural medicine. They have fewer side effects compared to modern synthetic compounds. Woodford fruticosa of Lythraceae family is well known medicinal plant used all over the world for therapeutic purposes. This plant is a shrub and grows in many regions of the Asia. This plant is searched for many Pharmacological activities. It possesses immunostimulant, cytoxic, anticancer, antifertility activities. In the present review its ethnobotanical, traditional and pharmacological properties are discussed.
Complementary and Alternative Approach to Heal Cancer: A Review
Cancer is the dreadful and life-threatening disease characterized by irregular proliferation of cells and it is considering the main health issue of equally developed and developing states. After cardiovascular disease, cancer is one of the second foremost diseases of mortality. In view of high death rate related with malignant growth and on account of adverse and toxic reactions of its chemotherapy and radiation treatment, people have a preference to use natural plant products for treatment of cancer. Plants were being utilized for treating diseases since the beginning of human civilization. Herbs have played a key role in the prevention and treatment of cancer. The phytochemical investigation of the medicinal plants have contributed to some extent in the discovery of new anticancer drugs. This article has been made to evaluate some therapeutic plants utilized for the treatment of cancer and also gives the information about medicinal plants with anticancer property, which are utilized by people everywhere throughout the world. This review can help the researchers to investigate herbs to additional level and its use in different more diseases and toxicity studies along with clinical trials.
Comparison Between the Medical Versus Surgical Interventions for the Management of Nasal Polyp
Nasal polyps is an inflammatory condition affecting the nose and sinuses which is non-IgE-mediated and is often associated with the chronic non- allergic rhinitis, non- allergic asthma, and aspirin intolerance. Although the etiology of nasal polyps is not clear, the foremost symptoms include the nasal obstruction and a disturbed sense of smell. The nasal passage blockage could be treated by polypectomy to maintain the patient breathing through the nose in case a few large polyps are present. The use of surgical procedures can be performed which mainly depends on the severity of the disease to restore the physiology of the nose and to make the nose free from the polyps' drainage of the infected sinuses. The medical treatment of the polyps is essential because the surgical interventions are unable to deal with the inflammatory process of the nasal mucosa. The topical corticosteroids remained the drugs of choice for the reduction in the polyps' size and to prevent the recurrence following surgery and are frequently the main treatment choice in most patients. The use of fluticasone propionate and beclomethasone dipropionate was found to be effective as a medical tool in the management of polyposis. The short- term use of systemic corticosteroids is also an option which can be used for the control of nasal polyps. Still, most patients having nasal polyps are treated by using the combination of medical and surgical procedures.