This paper attempts to explore satisfying and dissatisfying determinants of online education in Pakistan. Participants were well abreast with the online mode of education due to the closure of physical classroom activities during the COVID-19 pandemic. Purposive sampling was research design.Students enrolled in communication skills course were drawn as study respondents. An open-ended questionnaire was a research instrument. Eighty (80) engineering students participated in this survey and provided feedback about satisfying and dissatisfying factors of online education in Pakistan. Data were analyzed using the content analysis approach. Results exhibited students were satisfied with ‘class feasibility, low financial cost and communication opportunities. On the other front, they were dissatisfied with ‘internet issue, load shedding of electricity, technical issue, home disturbance, expensive internet packages, and lack of communication. This research concluded that online education is never free from issues and challenges in Pakistan.
Many users of recreational drugs use cocaine and opioids together, often called “speedballing.” Hearing loss is a rarely reported adverse effect following recreational drug abuse. Only one case has been reported in history with hearing loss caused by speedballing. Here, we present the case of a 38-year-old female who presented with speedball abuse and new-onset bilateral hearing loss to the emergency department. A computed tomography scan of the head was unremarkable. She was treated with thiamine, folate, multivitamins, and intravenous fluids. The hearing loss improved without any acute intervention. The significance of sudden hearing loss due to recreational drug use is highlighted by this case. Apart from a few animal studies, there is no detailed research explaining the pathophysiology of speedball-induced hearing loss. Further studies and trials are needed to better understand the effects of combined and separate cocaine and opioid use on audiologic physiology.
Nephrologists are involved in the treatment of poisoning, as extracorporeal removal may be essential in some intoxications. After addressing the epidemiology and management considerations regarding extracorporeal therapy, the chapter outlines the clinical presentation and management of common poisonings such as toxic alcohols (methanol and ethylene glycol), salicylates, toluene, and lithium are outlined. Specific treatment within the purview of the nephrologist includes recognition and treatment of acid-base derangements, enhanced elimination, and diffusive and convective clearance. Evidence-based recommendations for the role of dialysis in these poisonings is provided. Finally, the clinical presentation and unique renal pathophysiologic effects of toluene and Cleistanthus collinus poisoning are reviewed.
Human beings scream for effective communication skills in this modern age of space technology. The 21st-century demands the engineering universities to address the speaking skill deficiencies of engineering students. This research discovers factors responsible for English speaking anxiety of engineering students. A qualitative research design was implemented and semi-structured interviews were piloted. A purposive sampling approach was employed.Outcomes revealed engineering students faced hesitation, poor confidence, poor mental approach,poor English, unknown fears, poor vocabulary, dearth of speaking opportunities, fear of criticism,nervousness, stress, lack of motivation, poor communication skill, poor language, and low self-esteem as English-speaking anxiety factors of engineering students. Additionally, they used deep breathing, giving space for thinking and code switch in gas strategies to overcome English-speaking anxiety.
Background: The Connection between smoking and lung cancer is now generally accepted. The objective of this studywas to observe smoking habits among different histological types of bronchogenic carcinoma. Setting: Bahawal Victoria Hospital,Bahawalpur. P e r i o d : April 2000 to March 2003. M e t h o d s : This was a simple descriptive study comprising of 30 consectivehistopathologically / cytologically confirmed cases of bronchogenic carcinoma that were admitted in different medical units of BahawalVictoria Hospital, Bahawalpur. History regarding smoking was taken in detail including type of smoking, quantity of tobacco smoked andduration of smoking in years. Smoking patterns were observed with their age, gender, living conditions and type of bronchogenic carcinoma.Results: Among eighteen cases of squmous cell carcinoma, history of smoking was present in all males. Only one female who belongedto a village was non- smoker. Cases with small cell carcinoma were six in total and all were males with five smokers, three urban areas andtwo rural areas. Only one was a non- smoker with a rural background. Three females and one male had adenocarcinoma. One male fromcity and one female from a village were smokers, while remaining two females were non-smoker and lived in urban areas. Two men sufferingfrom large carcinoma were smokers residing in urban areas. C o n c l u s i o n : Cigarette smoking is present in 87% of all bronchogenic carcinomaespecially with squamous cell, and large cell varieties. The involvement of smoking cases of adenocarcinoma has been found to be the leastcommon.
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