Severe Hyponatremia due to Hypopituitarism Secondary to Empty Sella Syndrome

This case is about a 68 years old patient presented with worsening generalized weakness, dizziness, low mood and reduced appetite with the background history of gout and vitamin D deficiency. On general examination, the patient appeared very lethargic. However, the systemic examination was unremarkable. The vitals check showed a low blood pressure of 104/72 mm Hg. The investigations showed low levels of serum Sodium, Thyroid stimulating hormone, Cortisol. The short Synacthen test was abnormal. The anterior pituitary hormones level showed low levels of Follicle stimulating hormone, Luteinizing hormone and prolactin. CT head with contrast showed enlarged fluid filled pituitary fossa with fat. An MRI Pituitary gland showed an empty sella syndrome. The patient was hydrated initially and electrolytes were monitored regularly. Treated with hydrocortisone and thyroxine to which the patient responded and improved significantly. A follow-up appointment was arranged at endocrine clini

In Vitro Supplementation of Glycine Improves Quality of Cryopreserved Bull Semen

The extender supplementation of glycine on quality of cryopreserved bull sperm was reported in current study. Three adult Sahiwal bulls was used for semen collection by artificial vagina having 42°C (three weeks) (replicates; n=18)). Collected semen was quickly shifted to laboratory for initial evaluation. Qualified semen ejaculates (>60% motility, >1mL volume, >0.5billion/mL cons.) was diluted in tris extender having 0 (control), 5, 10 and 15 and 20mM of glycine. Cooling of extended semen to (4℃) was done in 2 hours and kept for 4 hours for equilibration. French straws were used for filling at (4℃), liquid nitrogen used for freezing. Highest percentages of post thaw sperm progressive motility and acrosome integrity were observed in extender containing 5mM of glycine compared to other treatments and control (P<0.05). However, glycine supplementation in extender didn’t affect viability, chromatin integrity and plasma membrane integrity of bull sperm. In conclusion, glycine addition at 5 mM in extender improves quality of cryopreserved bull semen

Caregivers’ burden among parents of children with Cerebral Palsy

Introduction: Caregivers help a person in those actions which cannot be performed by an individual independently; a person’s personal needs, environmental barriers that hinders an individual’s abilities etc. This ultimately puts an increased burden on the caregiver. This study was conducted to determine the levels of caregivers’ burden among the parents of children with cerebral palsy. Material & Methods: A cross-sectional survey was conducted on 298 parents of children with cerebral palsy. Non-probability convenience sampling technique was used to collect data from the parents coming to the National Institute of Rehabilitation Medicine, Islamabad. The parents of children with cerebral palsy who were having auditory, cognitive or visual impairment were excluded from this study. Demographic information form and Caregiver Burden Inventory were used for the data collection. The data was analysed through IBM SPSS version 21 and results were presented in the form of frequency, percentages and mean ± sd with p-value wherever needed. Results: the result of this study showed a greater need for respite and other services for caregivers of children with cerebral palsy. The overall Caregiver Burden Inventory score was 45.19 ± 11.9. Out of the total included participants, 163 (54.33%) participants sometimes needed relief, 116 (36.67%) needed frequent need for relief and other services while 19 (6.33%) of the included parents rarely needed relief and other services. Conclusion: Majority of the caregivers of children with cerebral palsy needed relief and other services (compromise the growth, physical and emotional health and social relationship) to manage caregivers’ burden

Exploring tourism-generated social media communication, brand equity, satisfaction, and loyalty: A PLS-SEM-based multi-sequential approach

Although social media-based brand equity has become a vital area of interest for brand managers, insights into its destination-based dynamics and applications remain scarce, specifically in the destination brand context. To address this gap, we develop and test a theoretical model to investigate the role of destination marketing organization-generated and tourist-generated social media communication to determine the brand awareness and brand image of the Gilgit-Baltistan region, which in turn influence customer-based brand equity (CBBE) (i.e. perceived quality), satisfaction, and loyalty. Data come from well-known tourist sites in Gilgit-Baltistan. Using the multi-sequential approach in WarpPLS 7.0, findings shows that the social media communication dimensions show differential impacts on brand awareness as a metric of CBBE. Second, destination awareness demonstrates a differential impact on perceived destination image dimensions. Third, the destination image dimensions exert different effects on the perceived quality of the destination. Fourth, perceived quality positively influences satisfaction, which in turn enhances loyalty. We offer important implications that emerged from the analyzes and also suggest directions for future research

Structural, electronic properties and reflectivity of ScTGe (Ag, Cu) Compounds

We have investigated structural, electronic and optical properties of half-Heusler materials Scandium Silver Germanium (ScAgGe) and Scandium Copper Germanium (ScCuGe) compounds by using state of the art FPLAPW based on the DFT. Optimization procedure is used to obtain the structural properties of the compounds. The bands of these compounds ScTGe(T= Ag, Cu) cross the Fermi level so these compounds show semi-metallic nature. The density of states shows mixed s and d states in the bands. From the optical spectrum of compounds, it is observed that reflectivity of these compounds is very high.</jats:p