The International Public Policy of Pakistan is profoundly entangled between contractual laws, domestic arbitration, and loose & broad definition by Courts; hence hampering the execution of foreign arbitral award. The article seeks to better comprehend and investigate the doctrine of public policy as a basis for refusing enforcement of foreign arbitral awards. What complicates matters is the absence of a universally accepted definition of public policy or practise in its implementation, which differs from state to state. The vagueness, subjectivity, and unpredictability connected with the notion of public policy have hindered the efficacy of international commercial arbitration on many occasions. Pakistan, which is in dire need of international investment and access to international markets for its products, needs to come out with strong and predictable public policy mechanism. Case study is particularly done to understand the complex influence of domestic and international public policy. New phenomenon arising in the name of Transnational Public Policy is also explored. This study further argues that Pakistani courts need to redefine the categories of public policy keeping in consideration the growing demands of international trade and commerce. Keywords: Arbitral Award, Foreign Award, Public Policy, Arbitration, Domestic Public Policy.
Aim: To determine the outcome of different surgical conditions in neonates at a tertiary care hospital Study design: A cross-sectional study Place and Duration: Department of Pediatric Surgery Chandka Medical College Children’s hospital Larkana from Nov 2020 to Nov 2021 Methodology: All the neonates with surgical conditions were admitted through emergency and OPD. The variables were age, gender, diagnosis, surgery performed, postoperative course and complications if any. Patients soon after birth to 28 days of age with neonatal surgical conditions were enrolled in the study. The diagnosis was established either with pre-operative, intra-operative or post-operatively with relevant clinical, radiological, biochemical and histopathological findings described in standard textbooks of paediatric and neonatal surgery Results: A total of 208 patients were managed. The age range was 1 hour to 28 days. Male was 159 (76.4%) and 49 (23.6%) were female. The commonest conditions presented were anorectal malformations followed by necrotizing enterocolitis. Other conditions include Hirschsprung’s Disease, Omphalocele, Gastroschisis, Duodenal and Jejuno ileal Atresia, Myelomeningocele, Infantile Hypertrophic Pyloric Stenosis, Obstructed Inguinal Hernias, sacrococcygeal teratoma and skin and soft tissue infections. Frequently performed operation was the creation of stoma (Colostomy/Ileostomy). 180 (86.53%) neonates were discharged and 24 (11.53%) neonates expired while only 4 (1.92%) neonates were referred to other centers. Conclusion: Neonatal surgical conditions carry high mortality and morbidity even at centers with all facilities available. Our results at the resource-limited centre are comparable to the centres having state of art facilities. Keywords: Neonatal surgery, Anorectal Malformations, Abdominal wall defects, Necrotizing Enterocolitis (NEC)
Background: A stroke occurs when the central nervous system is disrupted by brain injury caused by a cerebrovascular hemorrhage, resulting in hemiparesis, nerve dysfunction, and muscular weakness but the use of innovative modalities for stroke is still unknown. The objective of this study is to investigate the comparative effects of whole-body vibration (WBV) training and squatting performance in chronic stroke patients. Methods: we reviewed 86 chronic stroke patients with the commencement of more than 6 months in physical therapy department of central park medical college, Lahore (2021-2022). An independent examiner randomized the patients individually after doing the baseline assessment. 86 ambulatory patients (51 men and 35 women) who are recruited in hospital. Results: During 2020-2021, 86 chronic stroke patients were investigated in hospital of whom all patients had a pre-existing medical condition like uncontrolled hypertension and diabetes. Total number of participants is N=86. Number of male participants N=25 and females N=18 in group A. Number of male participants in group B is 23 while number of females is 20. The participants in both groups demonstrated a significant increase in balance and mobility scores after 6 weeks of WBV training. Experimental group having 6th week BBS mean, standard deviation, 52.37, 1.92 and Control group having 6th week BBS mean, standard deviation 45.25, 4.18 respectively. The participants in both groups demonstrated a significant increase in balance and mobility scores after 6 weeks of WBV training but more pronounce results in experimental group. Conclusions:The results of this study concluded that whole-body vibration exercise with routine physical therapy treatment is very effective in improving balance, mobility, postural control, muscle strength, tone, power output, coordination reduced muscle spasticity and functional disability in patients with chronic stroke.
Aim: To determine the outcome of trans-fistula anorectoplasty (TFARP) in female children having anorectal malformation with recto-vestibular fistula. Study Design: A retrospective study. Place and Duration: Department of pediatric surgery during the period of February 2018 to February 2020. Methodology: A total of 87 female children who have imperforate anus with recto-vestibular fistula from the age of 3 months to 6 years were included in this study. Initially, we have started this technique with the covering sigmoid colostomy, then TFARP after 12 weeks interval & once new anus healed and hegar dilatation achieved then sigmoid colostomy closed after 24 weeks of the first procedure. When we were experienced then we start TFARP as a single-stage procedure. Post-operative data regarding early complications of local wound infections, prolapse of the rectal mucosa, and late complications for anal stenosis, rectal prolapse, and scarring in the perineal body were collected up to 2-3 months respectively. Results: A total of 87 patients were included in this study. The average operative time was 40 minutes. The total days of hospital stay were 3 to 5 days. Regarding early complications, skin excoriation was present in 21 (24%) followed by vaginal tear in 17 (19%) cases. Mucosal prolapse was a late complication observed in 17 (20%) cases. Continence was good (Score 0) in 33 (38%) cases, while it was fair (score 1) in 36 (41%) cases. Conclusion: Primary repair of recto-vestibular fistula by Trans-fistula anorectoplasty in children is a feasible procedure that has a good cosmetic appearance and anal continence. Single-stage reconstruction is possible in children with satisfactory results. It produces less morbidity and is a more efficient procedure.
Background: Chronic pain accompanies emotional element in the form of psychiatric disorders. Chronic medical conditions such as backache may make a person at higher risk for depression. Depressed patients also have somatic symptoms as headache, fatigue, and backache. To understand the relationship, we conducted this study at neurosurgery Outpatient department of Mardan medical complex, Mardan.Objective: The aim of this study was to clarify the causal relationship of backache and depression. The study also aimed to explore the frequency of depression among patients with backache.Material and Methods: This cross-sectional study was conducted at outpatient department of Mardan Medical Complex. Patients presenting with chief complaints of backache were invited for participation in the study. initial medical and neurological screening was conducted by consultant neurosurgeon and afterwards HAM-D was administered for assessment of depression. Results: We included 114 male and female patients ranging in age from 22 to 58 years, who presented to neurosurgery OPD with chief complaints of backache. More than half 58% of the patients were female. Minimal depression was found among 22 (19.3%) of the patients, 19 (16.7%) patients had mild depression, 47 (41.2%) had moderate depression, and 26 (22.8%) had severe depression. Highest frequency of depression was observed among patients with infection/ tumor (84.5 %) and those with degenerative backache (79 %). The correlation of type of backache and severity of depression was significant (p= .049). Conclusion: Depression is common among patients with backache, therefore screening patients with complaints of backache for psychiatric co morbidity in primary care is important because psychopathology may have significant consequences for prognosis, outcome and health care utilization.
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