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مقصدِ حیات

مقصد حیات

                ہم جو بھی پڑھتے ہیں اس سے متاثر ضرور ہوتے ہیں۔اسی طرح ناول نگار بھی کسی زندگی کی عکاسی کرتاہے اور جس زندگی کی عکاسی کر رہا ہوتا ہے وہ مقصد سے خالی نہیں ہوتی۔ناول نگار قاری کیاحساسات کے بارے میں آگاہ ہوتا ہے۔اس لیے وہ انسانی نفسیات کو سمجھتے ہوئے ایک کہانی تخلیق کرتا ہے۔ایک استاد کی طرح اپنی بات کو قاری کے ذہن تک پہنچانے کا مقصد صرف اور صرف یہ ہوتا ہے کہ ایک خاص قسم کا فلسفہ اس کے ذہن میں زبردستی ڈالا جاتا ہے۔

                ناول نگار نے بھی ایک مقصدی کہانی لکھی ہے۔ وہ اپنی اس کہانی کے ذریعے ہمیں کرپشن اور ملک سے غداری کرنے والوں کو بینقاب کررہے ہیں۔وہ سیکس انڈسٹری کی ایک واضح تصویر اور اس کے نتائج کو ہمارے سامنے پیش کررہے ہیں جوکہ ایک عمدہ قدم ہے۔یقیناًنو لکھی کوٹھی کے بعد ناطق کا یہ دوسرا انتہائی شاندار ناول ہے جو یاد رکھے جانے کے قابل ہوگا۔ہر موڑ قاری کو ایک نئی راہ سے متعارف کروارہا ہے شوبز کی دنیا ایک جھانسہ ہے۔ہمارے معاشرے میں چلتے پھرتے لوگوں کے بارے میں خلاصہ کیاگیا ہے۔جائیداد کا لالچ تو ایک الگ بات ،اس پہ نسل در نسل بات پر اس طرح مٹی ڈال دی جاتی ہے کہ وہ ایک معمہ بن جائے اور حل نہ ہوپائے۔ناطق نے بہت ہی جانب داری کا مظاہرہ کیا ہے اور محسوسات کے مطابق ایک مقصدی کہانی لکھی ہے۔

 

 

Fasting Gastric Acidity Evidential Effect on Esophageal Mucosal Damage

Gastric substances that potentially increase the esophageal mucosal damage are: gastric acid, pepsin, bile salts, and pancreatic enzymes. From all of these substances, the highest potential for reflux damage is gastric acid. Although the main cause of clinical symptoms of GERD is acid reflux, it has been known that there are subgroups with typical reflux symptoms that do not provide sufficient response or not responsive to PPI treatment. Despite the improvement of esophagitis, there is no clinical improvements in reflux symptoms of 30% respondents. Therefore, this study was designed to determine fasting gastric acidity with endoscopic findings in patients with GERD. A comparative-analysis study, which determine the fasting gastric acidity from endoscopic findings in patients with GERD. Samples recruited using consecutives sampling technique and divided into groups of esophagitis and non-esophagitis reflux. A total of 40 samples involved in this study. The Mann-Whitney test, was used for analyzing the difference between fasting gastric acidity from endoscopic findings of esophagitis lesions in patient with GERD. The median value for fasting gastric acidity in the esophagitis reflux group was 1.88 (0.82-4.84), whereas the median value for fasting gastric acidity in the non-esophagitis reflux group was 2.49 (0.68-5.97). The Mann-Whitney test result was p=0.298 (p>0.05). This study shows that there is no significant difference of fasting gastric acidity from endoscopic findings between esophagitis and non esophagitis reflux groups in patients with gastroesophageal reflux disease (GERD). This study shows that esophagitis lesions are not affected by gastric acidity.

Comparison of Weight Adjusted Dose Versus Fixed Dose Ondansetron in Preventing Shivering Following Spinal Anesthesia for Cesarean Deliveries

Background: Spinal anesthesia is an effective regional anesthesia technique, which is preferred in almost 86% of cesarean sections in the United States and United Kingdom. Eighty percent of cesarean sections done at the Aga Khan University hospital are under spinal anesthesia. Shivering is a common complication of spinal anesthesia, it occurs in 40%-64% of patients after neuraxial anesthesia. Shivering may cause maternal and fetal hypoxemia, maternal discomfort and a problem to the anesthesiologists when it comes to monitoring the patient during cesarean sections. Ondansetron a 5-HT3 receptor antagonist is effective in treatment and prevention of post spinal anesthesia shivering. In published studies use of a fixed dose in patients with different weights, masked the dose effect ondansetron in preventing shivering. Such that not adjusting the dose according to the weight of patients’ resulted in a higher occurrence of shivering. No study compares different doses of ondansetron in preventing shivering in parturient women who have had spinal anesthesia for cesarean section. Objectives: To determine if a weight-adjusted dose is better than a fixed dose of ondansetron in preventing shivering following spinal anesthesia for cesarean delivery. Study design: Double blinded Randomized Controlled Trial. Method: This is a randomized, double-blinded controlled trial of 124 women scheduled for elective cesarean surgery. The Women were randomized into two equal groups. The intervention group received intravenous ondansetron weight adjusted dosing at 0.1mg/kg and the control group received a fixed dose of 4mg before spinal anesthesia. The occurrence and severity of shivering and other outcomes, such as headache, pruritus were assessed and recorded during the surgery and postoperative period. Results: A total of 124 patients were included in the study. Social demographic data and baseline vital signs did not differ significantly between the groups. Shivering was observed in 14 patients (22.6%) in the control group that received 4mg ondansetron and 7 patients (11.3%) in the intervention group that had 0.1mg/kg of ondansetron, but there was no statistical difference between the groups (p- value 0.090). The severity of shivering was greater in the control group compared to intervention group where patients who developed grade two shivering were 8.1% to 0% respectively. (P value 0.047). There was no difference in the occurrence of pruritus between the two groups. No patient developed a headache or required treatment for very severe shivering. Conclusion: This study, found that Ondansetron weight adjusted dose at 0.1mg/kg, reduced the severity of shivering when compared to
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