For patients who receive a liver transplant (LTX) for alcoholic liver disease (ALD), investigators are focusing beyond survival to determine specific alcohol use outcomes. Studies suggest the use of alcohol ranges from 8 to 22% for the first posttransplant year with cumulative rates reaching 30 to 40% by 5 years following transplantation. Yet while investigators are interested in determining specific rates of alcohol use and predictors of use, only three studies since 1990 have been prospective. In 1998, we began a prospective study of post-LTX alcohol consumption in ALD recipients using multiple repeated measures of alcohol use. After 5 years of follow-up, we found that 22% had used any alcohol by the first year and 42% had a drink by 5 years. By 5 years, 26% drank at a heavier use (binge) pattern and 20% drank in a frequent pattern. In a univariate model, predictors of alcohol use included pre-transplant length of sobriety, a diagnosis of alcohol dependence, a history of other substance use, and prior alcohol rehabilitation. Liver Transpl 12: 813-820, 2006.

Alcohol and tobacco use commonly co-occur, with at least 90% of those with an alcohol problem also using tobacco. Thus, 3 years ago when we discovered higher rate of late deaths due to lung and oropharyngeal cancer in patients who had received a transplant for alcoholic liver disease (ALD), we hypothesized that these patients were continuing to expose themselves to tobacco after liver transplantation (post-LTX) and that this behavior was increasing their risk for cancer. We subsequently began a prospective investigation of post-LTX tobacco use in patients having undergone LTX for ALD (n ‫؍‬ 172). For 33 recipients we had data starting from our first assessment at 3 months post-LTX and for this subgroup we report on the details of the timing of tobacco use resumption and the redevelopment of nicotine addiction. We found that on average more than 40% are smoking across all time periods. ALD recipients resume smoking early post-LTX, increase their consumption over time, and quickly become tobacco dependent. These data highlight an underrecognized serious health risk for these patients and demonstrate our need for more stringent clinical monitoring and intervention for tobacco use in the pre-and post-LTX periods. (Liver Transpl 2005;11:679-683.)F our years ago we published data on an increased rate of late deaths (5 years and beyond) in patients who had undergone liver transplantation (LTX) for alcoholic liver disease (ALD) compared to othersdeaths that were primarily caused by lung and oropharyngeal cancers. 1 We also found that their rates of lung cancer and oropharyngeal cancers were 4 and 25 times higher, respectively, than the general non-LTX population. 1 Although we did not have data on tobacco consumption in these recipients, our presumption that smoking contributed to these deaths was not ungrounded. Nearly 90% of alcoholics smoke, 2 compared with only 30% of the general U.S. population. 3 However, from that study we recognized the lack of any data on post-LTX tobacco use by ALD LTX recipients or even any data on post-LTX tobacco use. To address this deficit, we began collecting tobacco use data on a cohort of ALD LTX recipients prospectively followed after LTX, and we present our findings herein.Indeed, there is a general lack of such data, surprisingly even in more pertinent transplant populations such as heart and lung transplant, in which smoking may have directly contributed to the original organ failure. One study of heart transplant recipients found that 50% of smokers resumed smoking after transplantation. 4 In our study of heart transplant recipients, through repeated surveys on smoking habits we found 11% to 23% smoking across time points from 2 to 12 months after transplantation. 7 Nagele et al. 16 found 26% (22 of 84 heart transplant recipients) smoked after transplantation, with a mean cigarette consumption of 11 cigarettes per day. A recent cross-sectional telephone survey of all LTX recipients at the University of Florida (42% of potential subjects) found 15% smoking after LTX, with the major...

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A major cause of maternal mortality and morbidity in developing world is post-partum hemorrhage (PPH). Different management options have been in use including use of oxytocins, prostaglandins, surgical exploration of genital tract, ligation or angiographic embolization of uterine/internal iliac arteries and hysterectomy. A simple and effective measure is to control bleeding with utero-vaginal packing which is easy and quick to perform and saves the patient need of major surgical procedures. did not respond to medical management were included in the study. Patients who had PPH due to genital tract trauma were excluded from this study. Frequencies and proportions of complications were calculated along with rate of successful cessation of bleeding. Data was analyzed by SPSS version 11. Results: 99 patients who presented with PPH were included in study.49.5% were between age of 31 -40 years, 38.4% were between 21-30 years. 8.1% of patients were P1-2, 52.5% were P3-5 and 39.4% were P6 and above. 76.7% had hemorrhage after vaginal delivery and 23.3% after lower segment caesarean section. Uterineatony was the most common cause of postpartum hemorrhage, seen in 78.78% of cases, 9.09% had placenta previa, 8.08% presented with abruption placenta and 4.04% had coagulopathy. Regarding complications 7 women had to undergo hysterectomy, fever occurred in 14.14%, 8.08% had wound infection and 2 patients died of Disseminated Intravascular Coagulation (DIC). Procedure was successful in 90.9% of cases. Conclusion: Utero-vaginal packing effectively controls postpartum hemorrhage with fewer complications and its role in emergency obstetric scan not be denied.

Market irregularities and irrational behavior triggered investor’s changes in the stock market, and this has led to an investigation into the impact of various behavioral biases and factors affecting decision-making for individual investors. The quality of individual investor behavior in making stock investment decisions is very important to be understood as a reference of the movement of the capital market. This study investigated the role of behavioral finance and investor psychology in investment decision-making at the Pakistan Stock Exchange (PSE). Using a sample of 147 individual investors, the study established that behavioral factors such as Herding, Heuristic, Market and Prospect that affected the decisions of the investors operating at the Pakistan Stock Exchange (PSE). As there are a few studies in Pakistan related to behavioral finance, so this study mainly contributes to the field of behavioral finance in Pakistan. This study focusses on existing theories of behavioral finance which led to develop the hypothesis. The result of the analysis is that the four variables have greatly influenced the investment decision and return on investment. All behavioral variables have a significant impact on the decision-making process of investors, which led to the acceptance of all assumptions regarding the level of influence of behavioral factors in decision making for individual investors