The aim of this paper was to outline the factors that provoke the knowledge sharing intents of employees and contribute toward knowledge sharing processes that result in a better rate of innovation implementation by the organizations. This research follows a holistic approach to study ‘Knowledge Sharing’. Referring to the holistic approach, this study examined the relationship between knowledge sharing enablers, processes, and outcomes. Organizational level factors (Top Management Support, Organizational Rewards) and technology linked factors (Information and Communication Technology use) were studied to show their relationship to knowledge sharing processes (knowledge donating, knowledge collecting) and how knowledge sharing processes relate to innovation efficiency in organizations in Pakistan. Data were collected from employees of Lahore based organizations irrespective of their area of functioning and level of hierarchy in the organization. Structural equation modeling was employed to test the hypotheses using AMOS 20. The findings of the study indicate that top management support is very important in determining the knowledge sharing behavior of employees. However, organizational rewards and ICT use does not support employees in knowledge sharing activities. Finally, knowledge sharing processes are strongly related to organization innovation efficiency. This study provides guidelines to managers and organizations for establishing a knowledge sharing culture for innovative performance in the long run.

Objectives: Multiple organ dysfunction syndrome (MODS) is commonly encountered by pediatricians in Pediatric Intensive care Units (PICUs) among critically ill children. This study was done to find out the frequency of MODS in children admitted at PICU. Study Design: Case series. Setting: Department of Pediatrics Medicine, The Children’s hospital and the Institute of Child Health, Multan. Period: From May to November 2019. Material & Methods: Variables recorded for each case included age, gender, residential status, maternal education, height, weight and BMI. Venous blood sample was sent to the hospital pathology laboratory for baseline investigations to diagnose MODS. Results: Of these 101 study cases, majority, 61 (60.4 %) were male, 51 (50.5 %) belonged to rural areas, 74 (73.3%) from middle income families and 72 (71.3%) mothers of admitted children were illiterate. Overall mean age was 3.62 ± 1.95 years while mean body mass index was 24.85 ± 2.20 kg/m.2 Mean duration of PICU stay was 4.31 ± 3.39 day and 69 (68.3 %) had duration of PICU stay up to 5 days. Of these 101 study cases, multiple organ dysfunction was noted in 33 (32.7%). Conclusion: High Frequency of MOD was observed among children admitted to PICU. MODS was found to have association with male gender, residential status as rural, maternal education status as illiterate, obesity and duration of PICU of more than 5 days.

Objective: To determine different causes of portal hypertension in children. Study Design: Cross Sectional study. Setting: Department of Pediatric Medicine, Department of Pediatric Gastroenterology and Department of Medical Emergency, The Children’s Hospital and Institute of Child Health, Multan. Period: 3rd April 2019 to 2nd October 2019. Material & Methods: A total of 71 children presenting with portal hypertension aged 1 month to 15 years of either gender were included. Newborns or children with congenital heart diseases were excluded. Patient samples were collected for complete blood counts and liver function tests, Ultrasound Abdomen and color Doppler ultrasonography were done for portal vein pressure to determine various causes of portal hypertension. Results: Overall, mean age was 9.00 ± 3.64 years. Out of the 71 patients, 51 (71.83%) were male and 20 (28.17%) were females. Different causes of portal hypertension were portal vein thrombosis in 48 (67.61%), liver cirrhosis in 14 (19.72%) and biliary atresia in 9 (12.68%) children. Conclusion: Among children having portal hypertension, portal vein thrombosis was noted to be the commonest cause followed by liver cirrhosis and biliary atresia.

Objective: To determine the percentage of Hypothyroidism in children with severe acute malnutrition. Study Design: Cross Sectional study. Setting: Nutrition Rehabilitation Center, Children’s Hospital and Institute of Child Health Multan. Period: January 2019 to December 2019. Material & Methods: A total of 255 malnourished patients (as per inclusion criteria) were included in current study. A written Performa was designed to collect history, anthropometric measurements and systemic examination. Taking aseptic measures venous blood was sent for baseline tests as well as for T3, T4 and TSH, total serum protein albumin and total ferritin levels to hospital laboratory. Correlation between serum thyroid concentrations and total protein, albumin, hemoglobin and serum ferritin were estimated by using t-test and p-vlaue less than 0.05 was considered as significant. Total collected data was entered and analyzed in SPSS version 21.0. Results: A total of 255 malnourished children were included in this study. Majority of studied subjects were male (52.5%) with 83.92%, 3-5 years of age. Amongst the 255 children mean values of T3 in MAM and SAM patients were 105.4 ng/dl and 89.7 ng/dl respectively. There was a statistically significant (p <0.001) association between decreased T3 and type of malnutrition. Similarly, mean values of T4 in MAM and SAM patients were 6.3 ug/dl and 5.7 ug/dl respectively that was statistically significant (p <0.05). Lower values of T4 were higher among SAM children in 1 to 3 years age group compared to respective MAM children with p value .0.05 and high T4 value in 3-5 years age group of MAM children were both statistically insignificant. Higher mean Values of TSH was found in SAM compared to MAM children both age groups. Conclusion: Severe acute malnutrition (SAM) is associated with reduction in T3 and T4 levels and higher levels of TSH in SAM children as compared to MAM. The altered thyroid hormone status in children with PEM is perhaps a protective phenomenon to limit protein catabolism and lower energy requirements.

Introduction: Dengue can indicate a diverse clinical spectrum. The intensity ofhepatic involvement in patients, with dengue infection varies from soft injury to severe injury bymeans of jaundice and liver cell failure. Even if liver is not a most important objective limb, liverinvolvement is a renowned aspect. Objectives: The objective of this study was to assess liverinvolvement in dengue patients upto 12 years of age. Study Design: The study was Prospectiveobservational. Place and Duration of Study: Study was conducted in children ward, PaediatricDepartment, Holy Family Hospital Rawalpindi from August 2014 to October 2015. Methods:Upto 12 years of age, all suspected dengue children patients were screened and solitaryserologically established cases by dengue IgM capture ELISA were incorporated in the studyafter taking written permission from the parents of the patients. Patients were categorizedaccording to GCP dengue guidelines into dengue fever (DF), dengue hemorrhagic fever (DHF)and dengue shock syndrome (DSS). Results: Among 146 children, 78 were in the group of DF,35 were in the group of DHF and 33 were in the group of DSS. Most children (70 %) were above5 years. Fever was the leading illness followed by body aches, hepatomegly, rashes, edema,headache, petechiae, hepatic tenderness, pain in abdomen, vomiting, mucosal bleed andjaundice. Children with DSS have more liver involvement. Hepatomegaly and thickening of gallbladder was maximum in children with DSS and can be an indication of severe illness. Serumbilirubin, serum albumin, liver enzymes like ALT, AST and ALP were considerably elevated inchildren with DSS as compare to other two groups. 32 patients out of 33 with DSS had liverinvolvement. Conclusion: Dengue fever has become a main health issues at the moment inPakistan. Hepatic association in dengue in children has high fatality rate and spectrum variesfrom jaundice to rise of liver enzymes.