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Productivity can be enhanced by reducing wastages in a process while maintaining or increasing the amount of output. This is real work carried out in the automotive industry. In our work, we enhanced the productivity of the assembly line in an automotive plant by applying lean methodologies. There is an extensive range of tools available to remove all kinds of wastes, from which we selected the following two tools to remove waste that will enhance productivity, Value Stream Map (VSM) and Overall Equipment Effectiveness (OEE). The purpose of using VSM is that it easily highlights the bottlenecks in any existing process. For VSM we need to conduct a time and motion study to understand the structure of an organization. At the same time, OEE helps us measure the efficiency of our system being utilized. After applying these tools, we easily identified the parts which needed improvement in the process. It has reduced our cycle time of sub-assemblies by 50% and transportation time by 60%. This overall enhanced the productivity of the system by 20%. The index of OEE increased by 2%. Our work has improved the productivity of the assembly line in an automotive plant. In the future this work can be further improved by our successors for better productivity, fulfilling future customer needs.

Diabetes mellitus is a chronic progressive illness that causes considerable morbidity related to macro and micro vascular complications, resulting in an ever growing healthcare burden globally. Early Initiation of Insulin has significant impact on improving both long term health outcomes and quality of life among diabetics in comparison to oral medications alone. But both patients and physicians often resist early initiation of therapy, a phenomenon known as “Psychological Insulin Resistance” (PIR). Objective of study was to assess such barriers among diabetic patients in Pakistan. We selected 300 patients both type 1 and 2 through convenience sampling from diabetic clinics of 2 tertiary care hospitals. Data was collected through structured questionnaires and analyzed using SPSS version 17. A p-value 5 years) and advanced disease were more satisfied about their glycemic control with insulin and willing to recommend it to others but at the same time, feared about its lifelong commitment once started, with all these variables having statistical significance (p-value

Background and Objective: Initiation of Insulin therapy during earlier stages has proved to significantly improve health outcomes among diabetics in comparison to oral medications. Not only patients but physicians are also often resistant to early initiation of insulin therapy. The objective was to assess misconceptions and barriers to early initiation of insulin therapy among diabetic patients coming to a diabetic clinic. Methods: This cross sectional study was conducted on 300 patients selected by convenience sampling arriving in Diabetes Outdoor Clinics of Mayo and Services Hospitals, Lahore during August 2017 to May 2018. The data was entered and analyzed by using SPSS version 17. Results: Out of 300 patients included in study, 39% (n= 117) were males and 61% (n=183) were females. The mean age of the participants at presentation was 48.46±13.15 years with a range of 13 to 80 years. Study participants considered it embarrassing to inject insulin in public place (p-value 0.01). The fear associated with lifelong commitment to insulin therapy once it is started, was also found statistically significant (p-value 0.001)particularly in subjects who have long duration of DM (>5 years). Conclusion: Perceptions of diabetic patients about insulin therapy are still barriers to early initiation of therapy and tend to prevail in Pakistan and around the globe. How to cite this:Arshad I, Mohsin S, Iftikhar S, Kazmi T, Nagi LF. Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals. Pak J Med Sci. 2019;35(1):39-44. doi: https://doi.org/10.12669/pjms.35.1.237 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Software-defined networking (SDN) is the propitious step towards the future. Data Plane decoupling from control plane makes the networking environment more flexible and programmable. Cost effectiveness, flexibility, programmability makes SDN the favorite choice for todays industry. SDN architecture can also provide numerous benefits in wireless scenario. However, there are some open research issues related to security that need researcher’s and academia’s attention. Attack plane is introduced due to the fact that control logic is separated from tje data forwarding plane. This paper presents a simple authentication mechanism using hash table, cryptographic hash function and REST API for access points (APs) and applications to secure the communications. The unauthorized applications are not allowed to access network resources. Additionally, unauthorized access points are not allowed to communicate with other network elements. The wireless topology is emulated and tje proposed application is tested to validate the results. The application generates the report about total authorized and unauthorized access points in the topology. The application is allowed to run at all times in the network and alert the administrator about malicious device. This malicious device and application is not allowed to communicate with other network element or access network resources. Performance evaluation has been carried out by measruing the time required to run the application for varying number of Access Points (APs).