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آج بھی دل میں درد اٹھا ہے

آج بھی دل میں دردُ اٹھا ہے
کیا پھر کسی نے یاد کیا ہے

اب کیوں اُس کو یاد کیا ہے
وہ تُو کب کا چھوڑ گیا ہے

مجھ کو کیوں برباد کیا ہے
کیا تجھ کو اچھا لگتا ہے!

تجھ بن دل اُجڑا اُجڑا ہے
اور تُو سب کچھ دیکھ رہا ہے

رات کے تین بجے ہیں اور تم
اب تک جاگ رہے ہو کیا ہے

گزری باتیں گزر چکی ہیں
تُو اب کس کو یاد رہا ہے

عشق ، محبت پاگل پن ہے
کیوں یہ روگ لگا رکھا ہے

کیا تُو اُس کو بھول سکے گا
اب جو تجھ کو بھول چکا ہے

اُس نے کہا تھا وہ تیرا ہے!
خود سے تُو نے سوچ لیا ہے

Arrhythmias after Implantation of the Left Ventricular Assisted Device Arrhythmias after Implantation of the Left Ventricular Assisted Device

Cardiac arrhythmias has been frequently reported after left ventricular assist devices implantation but currently literature shows no sufficient information on cardiac arrhythmias. Objective: The aim of this study was to assess the frequency and other features of ventricular and supra ventricular ectopic beats ((SVEB), atrial fibrillation (AF)/flutter (AFL) post device implantation. Methods: This is a retrospective study conducted in Department of Cardiac-Surgery, University of Verona Medical School, Verona, Italy from June 2014-September 2016. Rhythm monitoring and registration were collected from 16 patients (13 males; 45±13years) during the first five (05) days after implantation. To assess late post-operative rhythm, patient’s hospital electronic records were used as well asfunctional hemodynamic parameters including mean arterial pressure(MAP), right atrial pressure(RAP), heart rate(HR) and ST-deviation(d-ST). Results: Ventricular arrhythmia (n=9), atrial fibrillation (n=5) or atrial flutter (n=2) episodes were preoperatively present in 11 patients. Postoperatively, 5 patients developed either VT (n=2), AF (n=1) or both VT/AF (n=2) during a follow-up of 18±14 months. Prior to postoperative VT (POVT) episodes (n=123), MAP decreased, HR, d-ST increased and RAP remained unaltered. POVT were initiated either by single VEBS (28%), V-couplets (15%), V-run (46%) or occurred suddenly (11%). Conclusions: Ventricular and supraventricular arrhythmias are common after device implantation. The frequency of sustained VTA was less at early phase as compared to late postoperative phase.

An Analysis of Paradigm Shift from Public Extension to Public Private Partnership Extension System in Nwfp, Pakistan

A general weakness of agricultural extension is the low adoption of new agricultural technologies by poor and small farmers. As the present public extension systems in many countries have not been able to address the issues and concerns of small and poor farmers, a search for new extension models that are more effective, efficient, and responsive to different categories of farmers is essential. This essential model might be the public-private partnership. Govt. of NWFP has initiated a new public private partnership extension program in the province during the year 2000. This emerging system is locally called as Farm Services Centers (FSCs) where inputs delivery, market facilitation, exchange of experiences and knowledge are the main activities of the system. However, there is still information gap about whether this public-private partnership will be beneficial in developing and extending agricultural technologies. This study intends to fill up that information gap by analyzing this public-private partnership by measuring its strengths, weaknesses, opportunities and threats. For this purpose, out of 24 districts, two districts Swabi and Lakki Marwat were selected randomly as study area from where 217 and 274 farmer respondents were selected at random with the help of table given by Fitzggibbon et al. (1987), making a total of 491 respondents. All the Agricultural officers and district officers of the selected districts were also selected as respondents of the study. Quantitative data were colleted by survey method, while qualitative data by focus group discussion with the help of open-ended interview schedule. The results showed that the most important strength of FSC in the eyes of farmer respondents was ―managed by farmers‘ bodies‖ as ranked 1st with mean 4.05 and SD 1.29. The weaknesses of both extension systems as diagnosed by the farmer respondents were ―no sale arrangements for surplus produce‖. In case of opportunities, FSC was bottom up approach and ―based on partnership between farmers and the government‖ ranked 1st with mean 4.12 and SD 1.29. The threats for FSC as reported by farmers respondents were ―no trend to develop farmers‘ organizations among farming community‖, ―pressure exerted by political influential authorities‖ and ―low preference of agriculture by youth as full time occupation‖. According to EFS respondents the most important strength for FSC was ―managed by farmers‘ bodies‖ which ranked 1st with means 4.82 and SD 0.40. The major weaknesses of FSC as diagnosed by EFS respondents were ―no female staff‖, ―no sale arrangements for surplus produce‖, and ―lack of marketing facilities‖ ranked 1st, 2nd, and 3rd .The statements ―offers low cost of learning‖, ―based on partnership between farmers and the government‖, ―provides forum for farmers to get together‖, ―proved extension workers to be good change agents‖, and ―encourages farmers participation‖ were the top five opportunities of the system. Out of all threats, EFS ranked the statement ―no trend to develop farmers‘ organizations among farming community‖ as 1st threat with mean 3.82 and SD 1.40. On the basis of conclusions it was recommended that Government should provide the opportunities of availing projects of different funding agencies to increase the share of private sector on FSC basis. Government should formulate law to increase the participation of women in the present programs, as they are main component of agriculture. Department should provide more facilities like pay and other allowances to the staff indulged in FSC to increase their working efficiency. As recommended by respondents separate meeting places should be provided for female farmers, so as they effectively get trainings and efficiently utilized the acquired knowledge in relevant fields.
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