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Objective: To determine the complications associated various types of tumors of advanced stage of thyroid disease at tertiary care hospital. Study Design: Descriptive study. Place and Duration: Two years study from April 2018 to March 2020 was conducted in Liaquat University of Medical and health sciences Jamshoro. Patients and Methods: All patients were admitted from Outpatient department (OPD) with advance stage of tumor of thyroid and either of gender were included. The patients were evaluated fully after history and clinical examinations berries sign and specific investigations of thyroid profile (T3,T4,TSH), ultrasound of thyroid, fine-needle aspiration cytology FNAC, image guided biopsy, frozen section biopsy for confirmation of diagnosis, indirect laryngoscopy, x - Ray neck and MRI. All the patients were assessed for pre-operative evaluation (complications) with advanced stage of thyroid tumors. All the data regarding developed complications was recorded via study proforma. Data was analyzed by using the SPSS version 20. Results: Most of the patients were found with age groups of 20 to 34 years and 35 to 55 years. Out of all, 25 patients were diagnosed papillary carcinoma, 12 patients were diagnosed as follicular carcinoma, 7 patients had Anaplastic carcinoma, 4 patients were diagnosed lymphoma and 2 patients were diagnosed as medullary carcinoma. As per complications of advanced disease 23 patients had thyroid swelling with cervical lymphadenopathy and pain, 13 patients had thyroid swelling with change of voice, 7 patients had thyroid swelling with dyspnea and dysphagia, 5 patients were presented with thyroid swelling with bony pain, weight loss and pathological fractures, 2 patients were presented with thyroid swelling with diarrhea. Conclusion: Various complications such as swelling, pain, hemorrhage, cervical lymphadenopathy, change in voice, weight loos, pathological fracture, dyspnea and dysphagia were frequently seen in patients presented with advanced stage of thyroid disease.

Objective: To determine the emergency treatment of Patients of Thoraco abdominal trauma in surgical ward according to Advance trauma and life support (ATLS). Methodology: Prospective observational study was conducted for two years from April 2018 to March 2020 at Liaquat university of Medical and Health Sciences Jamshoro/Hyderabad Hospital. The study comprises 50 patients. All were admitted from Emergency department. The patients were evaluated fully after history & clinical examinations. Results were analyzed by using statistical package for social sciences (SPSS) version 23. Results: In this study of 50 patients of Thoraco abdominal trauma, the maximum numbers of patients were in age group 15-70 years. Out of 50 patients 25 patients were presented with Trauma in Thorax, in which 5 patients were presented with penetrating injury & 20 patients were presented with Blunt trauma, 10 patients were presented with combine Thoraco abdominal trauma in which 2 patient were presented with penetrating injury & 8 patients were presented with Blunt trauma. Related to chest trauma 10 patients were treated needle thoracotomy with chest intubation, 5 patients were treated endotracheal intubation, 3 patients were treated thoracotomy and 2 patients were treated cardiosentesis, 5 patients were treated cricothyroidotomy. Better out were seen in 45 patients and mortality were seen in 5 patients. Conclusion: Advance trauma and life support (ATLS) has a vital role in thoraco abdominal trauma intervention. 90% of successful interventions were obtained using advance trauma and life support.

Objective: To determine the clinical presentation of carcinoma of thyroid and its treatment modalities at tertiary care Hospital. Study Design: Prospective observational study. Place and Duration: This study was conducted in Liaquat university of Medical and health sciences Jamshoro/Hyderabad, Pakistan, during two years from July 2017 to June 2020. Patients and Methods: All the patients with age range between 20 to 80 years having swelling in front of neck according to clinical examination with hard inconsistency along with change of voice lymphadenopathy, difficulty in swallowing and breathing, patients diagnosis with malignancy according to FNAC and CT, and either of gender were included. FNAC was done in each patient except toxic goiter, diffuse goiter and multinodular goiter with dominant nodules. Patients those were diagnosed with stage I and II, underwent surgical treatment and remaining were referred to oncology department for new adjuvant therapy and then surgeries were done if possible. All the data was recorded in study proforma and data analysis was done by using SPSS data analysis software version 20. Results: Out of all cases of suspicious of carcinoma thyroid, 70% were females. Neck swelling was in all of the cases, followed by pain, cervical lymphadenopathy, recurrent laryngeal nerve palsy with change of voice, swallowing difficulty, cyanosis and pathological fracture. According to tumor staging, most of the cases were found with benign tumor, followed by 5 cases with stage I, three cases with stage II, three patients presented with stage IV and one was seen with secondary’s from malignant melanoma. Most of the cases 70.0% underwent subtotal and near total thyroidectomies Eight patients were initially operated having stage I and II of malignancy and remaining 7 patients of stage III and IV were referring to oncology department for further management. Conclusion: In the conclusion of this study the neck swelling was the commonest clinical presentation. Surgical decision making and the operative planning is one of the new challenges. Mostly patients underwent subtotal and near total thyroidectomies having benign presentation and patients those had stage I and II of malignancy were initially operated, while patients of stage III and IV including secondary were referred to oncology.

Objectives: The main focus of this study is to find the role of social media marketing between the relationship of entrepreneurial marketing strategies and Performance of Small and medium enterprises (SMEs) in Pakistan. This research will answer the question that how social media marketing can be crucial for the entrepreneurial marketing to increase the performance of small and medium enterprises in Pakistan. Methodology: The SMEs operating in Pakistan have been considered and the respondents are the Marketing Managers of SMEs. The total number of SME’s in Pakistan is 3.3 million having one marketing manager. The total population of study is 3.3 million. Roscoe 1975 technique has used for selecting sample size. The 384 SME’s managers were selected through Roscoe sampling method and survey instrument has randomly been distributed among the marketing managers of SMEs in Pakistan through the primary data collection mode. Discussion: Hypotheses have been tested through “Structural Equation Modeling”. Since SEM is latest second generation tool of multivariate analysis and it has been used in this study to test the hypothesis. Findings: It is found from the results and discussion that entrepreneurial marketing strategies; proactive orientation, value creation,innovativeness and customer focus plays important role in enhancing the SMEs performance in Pakistan and Social media marketing can highly be effective to implement entrepreneurial marketing strategies to improve the performance of small and medium enterprises in Pakistan. Keywords: Entrepreneurial marketing strategies; SMEs Performance; role of social media marketing

Objectives: This study has investigated the role of internet marketing to build brand awareness which definitely leads a quick purchase decision. The main objective of the study was to investigate the components of brand awareness which directly cannot be cause of purchase decision for the mobile products but the use of internet marketing specifically social media advertising will be helpful in improving the brand awareness which increases the chances of purchase decision. Methodology: The study is quantitative and based on the philosophy of positivism because of the large population and its quantitative nature. Population includes all android mobile users of district Khairpur who uses the social media. Population was unknown so the Roscoe (1975) sampling techniques have used to select sample for the study and according to that, sample become three hundred and fifty. By using convenient sampling method, respondents are selected from the 3 universities of district Khairpur and primary mode of data collection has used to obtain responses on the five point\'s Likert-scale randomly. Analysis: Data was analyzed and interpreted through a robust technique SEM, performed in AMOS 22 version in which CFA and path analysis has done. Conclusion: According to study\'s interpretation results it is concluded that brand awareness has positive and significant impact on the online purchase decision of mobile products and internet marketing partially mediates the relation between Awareness and online purchase decision of mobile product. Keywords: Brand image; Social media advertising; Purchase decision

To run any organization flourishingly most treasures assets are human resources. Capable and well-educated employers are considered crucial part for organization’s success. Modern age has become globalized village where competencies between companies are scaled in terms of competent human resources. It is relatively difficult to handle people with different background, ethnicity, culture and religion. Leadership style comes handy in this regard. Leadership enables people to work in single platform. Organizations now days are more concerned about development, enhancing their leadership style. Now more and more organizations move towards modern approach of leadership called transformational leadership. Transformational leadership provides vision, cultivate hope, increase their communication horizon, and enable workers to think innovatively. All these factors lead towards organizational learning, job performance and job satisfaction. Job satisfaction helps to create positive image on employees, boost their morale and enhance innovate thinking. The employer who is satisfied with his job tends to remain loyal to their company. Job performance helps to create profitable organization in terms of monetary value as well as positive impact on organization. Transformational leadership style increases higher job performance which results in lower turnout ratio. Organizational learning increases when employees have trust, commitment and dedication towards work. Transformational leadership helps these goals to achieve effectively and efficiently. Employee motivation is the degree of vitality, duty, and imagination that an organization's laborers bring to their occupations. Regardless of whether the economy is developing or contracting, discovering approaches to spur workers is constantly an administration concern. The objective of research is to study effect of transformational leadership on organizational learning, job performance and job satisfaction with employee motivation. For this purpose we have taken multiple organizations across Karachi (Pakistan).