Background & Objective: Neonatal jaundice is common reason for admission in neonatal units requiring further evaluation to prevent adverse neurodevelopmental outcome. Lactate dehydrogenase levels are high in hemolysis. This study was aimed to explore the diagnostic properties of Lactate Dehydrogenase (LDH)in hemolytic causes of neonatal hyperbilirubinemia. Methods: In this observational cross sectional study, prospective data was collected at Neonatology department of The Children’s Hospital and University of Child Health, Lahore fromFebruary 2020 to March 2022. A total of 364 neonates with the diagnosis of indirect hyperbilirubinemia were enrolled through convenient sampling method after excluding the comorbidities and sick neonates.The neonates were categorized into hemolytic and non-hemolytic group and lactate dehydrogenase levels were compared in both the group. Data was analyzed using SPSS version 24 Results: Out of 364 babies, 123 (33.79%) were diagnosed as having hemolytic jaundice while 241 (66.21%) fell in non-hemolytic group. Out of 123 newborns in hemolytic jaundice group, LDH levels of 101 (82.1%) newborns were raised while only 124 (51.5%) newborns in non-hemolytic group (241) had raised LDH (p-value <0.001). Sensitivity and Specificity of LDH levels as marker of hemolysis was 82.11% and 48.55% and positive predictive value and negative predictive value were 44.89% and 84.17% respectively. The practical implication that there are insufficient test s in common clinical usage that cal reliability make the the diagnosis of hemolysis Conclusion: LDH is an effective diagnostic tool for the diagnosis of hemolytic hyperbilirubinemia in neonates with a higher sensitivity and negative predictive value. Keywords: neonatal hyperbilirubinemia, hemolytic jaundice,lactate dehydrogenase
Attainment of goals and objectives of every institute lies in the performance of human resources. Public sector institutions and the judiciary as well face the problem of lower-level performance. In today's dynamic and competitive atmosphere, every organization needs to satisfy their employees to attain the optimum level of their skills and competencies to accomplish the organizational goals and objectives. The present study aims to examine the influence of HRM Practices on job satisfaction with the mediating mechanism of HR outcomes and employee affective commitment. Data collected for this study in two-time spans with a stratified random sample of 203 (186 males and 17 females) ministerial employees (Admin Office Coordinator, Senior Office Coordinator, and Office Coordinator) of Lahore High Court (Principal-seat and allied-Benches) to test the hypothesis. Findings of the study unveiled that HRM practices positively influenced the employees' satisfaction level. Moreover, mediation of HR outcomes and employee affective commitment found between the relationship of HRMPs and employee job satisfaction.
This note discusses the significance of the information content of dividends, which is reflected through the market price reactions to a firm’s dividend decisions. Informational asymmetries are the main reason for signaling whereby firm managers are likely to have better information than external participants, implying that their financial decisions will tend to convey the firm’s future prospects to the market. An efficient signaling equilibrium is that optimal combination of signaling costs and agency costs that minimizes any dissipative costs. An important consideration is the preference of the investor for dividend income versus capital gains due to the higher tax differential in the case of dividends.
Objective: To find diagnostic accuracy of increased total leucocyte count (TLC) and decreased absolute neutrophil count (ANC) for diagnosis of neonatal sepsis taking culture and sensitivity as gold standard.Methodology: Samples was collected from all the neonates with suspicion of sepsis admitted to neonatal due to severe bad health condition in the Children Hospital, Lahore. Parents were informed for consent. Total 3.5 cc sample was drawn by venipuncture.2.0 cc in CBC voil containing trisodium citrate, this sample was sent to CBC lab for automated CBC on sysmex KX-21 analyzer and peripheral smear. 1.5 cc was taken in specialized containers for blood culture and was sent to microbiology lab. Neonatal sepsis on TLC, ANC and blood count were be recorded. Patients of sepsis was managed as per hospital protocol. Data was analyzed using SPSS.Results: Neonates in this study was at mean age of 3.86±1.81 days. There was almost equal number of males and females neonates. Male were 155(51.7%) and female babies 145(48.3%). It was noted that 182(60.7%) babies were on term while 118(39.3%) were preterm neonates in this study. Neonatal sepsis was positive on TLC in 101(33.7%) cases. in 115(38.3%) on ANC.It was noted that sensitivity of the TLC was 71% while specificity was 66% with a diagnostic accuracy of 68%. On the other and, ANC sowed a sensitivity as 65%, specificity as 56% and diagnostic accuracy of 65%.Conclusion: Conclusively, TLC and ANC is not a good marker for the taking a neonate for the consideration of neonatal sepsis.
This paper describes the level of compliance with quality standards in relation to Pakistan’s top export product categories. With greater competition, innovations in technology, and stricter measures of quality being enforced, Pakistan needs to adopt a holistic, systematic approach to not just meeting, but also exceeding, international quality standards and certifications for its exports. Focusing on rice and textiles, we identify which compliance-related gaps need to be filled to ensure the sustainable growth of high-quality exports to major global markets. The study outlines the key dimensions of international quality standards as well as specific standards and requirements for textiles and rice, examines the quality assurance infrastructure in Pakistan, and presents policy recommendations.
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