Purpose This study aims to develop a valid and reliable scale for measuring an integrated total quality and socially responsible management (TQSR-M) model, which affects business excellence. Design/methodology/approach Data were collected through a questionnaire in two phases (first for scale development and second for scale validation purpose) from managers employed in Pakistan Stock Exchange (PSX) listed companies. The structural equation modeling technique (SEM) was used to develop and validate the measurement and structural model. Findings This study confirmed the empirical validation of the eight distinct dimensions (top management, strategic planning management, human resource management, supplier management, customer management, social/community management and environmental management) of TQSR-M. Moreover, the validation of the TQSR-M model is further confirmed by testing the relationship between TQSR-M and the hypothetically associated business performance variables through SEM. Research limitations/implications The measurement scale helps companies assess the TQSR-M model related to business excellence. It assists managers in identifying the factors for implementing total quality management (TQM) and corporate social responsibility (CSR) practices in their organization for developing TQM and CSR plans, policies and strategies. Social implications This study confirmed that combined TQM-CSR approaches are potential sources of achieving business excellence, sustainable competitive advantages and improving the quality of life of the workforce, local communities and the environment in particular and even of society in general. Originality/value Despite such studies exploring the association between TQM and CSR, it remains unclear how the integration of both the concepts develops. Academics and managers lack a tool to measure TQM-CSR together. Therefore, this study integrates both distinct areas of TQM and CSR into a single comprehensive model by developing a measurement scale.

Premalignant conditions of larynx encompass a variety of lesions that have the potential to evolve into malignant changes. The dysplastic premalignant epithelial changes of larynx have significantly increased Risk of developing in cancer than the hyperplastic stage of epithelial changes and this transformation significantly depends on the grade of dysplasia. Therefore, early diagnosis & prompt treatment should thus prevent the development of invasive carcinoma requiring more debilitating surgical resection. The histopathological examination is diagnostic & the evolution of advanced laryngoscopic surgical procedures including CO2 laser and newer treatment methods such as photodynamic therapy has shown promising results in their management.

Background: Caregiving to substance-use disorder patients had a significant impact on mental and physical health which needs some modalities to be developed to support the caregiver’s self-care. Objectives: To determine the frequency of depression among caregivers of patients with Substance use disorder Setting: Department of psychiatry, Ganga Ram Hospital, Lahore Material and Methods: Total 100 caregivers of either gender of age 20 to 50 years old, of patients with substance use disorder. All those with significant physical, surgical, or psychiatric illness and/or mental retardation, dependence of more than one drug simultaneously, intravenous drug users, history of any past psychiatric illness in caregivers, care givers with medical problems (Diabetes, Hypertension, Asthma and COPD) that may mask depressive symptoms were excluded. For Substance use disorder DSM5 criterion was applied to the patient. Conclusion: We concluded that frequency of depression is higher among caregivers of patients with Substance use disorder which needs early intervention to reduce their mental health.

Objective:To evaluatethe frequency of QTC Prolongation among the patients of haemorrhagic stroke Methodology: A total of 120 cases of hemorrhagic stroke between 20-70 years of age of either gender presenting first time were enrolled from Rehmat-u-lil Alameen Institute of Cardiology, Lahore during the year May,2021 to April 2022. QT interval is a good non-invasive diagnostic indicator of ventricular repolarization and myocardial homogeneity. Low Glasgow coma scale (GCS), brain stem involvement, and a prolonged QTc interval are all poor prognostic indicators of hemorrhagic stroke. Results:In our study, 20-50 years aged patients were recorded in 31.67%(n=38) and 68.33%(n=82) were between 51-70 years of age. Male gender were 61.67%(n=74) and 38.3%(n=46) were females.QTC prolongation was recorded in 34.17%(n=41) whereas 65.83%(n=79) had no QTC prolongation. Conclusion: It is concluded by the results that frequency of QTc prolongation was higher in hemorrhagic strokecases, however, it is required that every stroke patient should be evaluated for cardiac examination so that early detection may reduce cardiac morbidities Keywords: Hemorrhagic stroke, ECG, QTC Interval

Objective: To compare clinical efficacy of Saccharomyces Boulardii vs. Yogurt Fluid for acute diarrhoea. Methodology: We enrolled 100 cases of acute non-bloody diarrhoea (regardless of gender) between 6 months and 2 years of age in which the duration of diarrhoea was less than 14 days from Madinah teaching hospital, Faisalabad during March till September, 2022. Cases were randomly classified into (A) and (B). Group A received Saccharomyces boulardii (250mg BD for five days) whereas Group B received yoghurt fluid (15 mL twice a day for toddlers 2 years and 30 mL twice a day for children 2 years). Both groups were rehydrated and fed. Clinical effectiveness was 3 stools or fewer each day till day 5. Results: In our study, mean age in Group A was 12.36+4.35 months and in Group B 12.96+5.12 months, p-value=0.529, mean No. of stools before treatment was 7.36+1.21 in Group A and 7.50+1.22 in Group B, p-value=0.565, which reduced to 4.38+1.37 in Group A and 5.24+1.00 in Group B, p-value=0.001. Gender distribution shows that male were 57(57%) and 43(43%) were females. Comparison of clinical efficacy shows that 32(64%) in Group A and 21(42%) in Group-B, p-value=0.022 showing a significant difference. Conclusion: We found that Saccharomyces Boulardi had a much better clinical effectiveness than yoghurt fluid in treating acute diarrhoea in children without blood. Keywords: Children, acute diarrhoea, Saccharomyces Boulardii, Yogurt Fluid, clinical efficacy