StakeMeter: value-based stakeholder identification and quantification framework for value-based software systems.

Value-based requirements engineering plays a vital role in the development of value-based software (VBS). Stakeholders are the key players in the requirements engineering process, and the selection of critical stakeholders for the VBS systems is highly desirable. Based on the stakeholder requirements, the innovative or value-based idea is realized. The quality of the VBS system is associated with the concrete set of valuable requirements, and the valuable requirements can only be obtained if all the relevant valuable stakeholders participate in the requirements elicitation phase. The existing value-based approaches focus on the design of the VBS systems. However, the focus on the valuable stakeholders and requirements is inadequate. The current stakeholder identification and quantification (SIQ) approaches are neither state-of-the-art nor systematic for the VBS systems. The existing approaches are time-consuming, complex and inconsistent which makes the initiation process difficult. Moreover, the main motivation of this research is that the existing SIQ approaches do not provide the low level implementation details for SIQ initiation and stakeholder metrics for quantification. Hence, keeping in view the existing SIQ problems, this research contributes in the form of a new SIQ framework called 'StakeMeter'. The StakeMeter framework is verified and validated through case studies. The proposed framework provides low-level implementation guidelines, attributes, metrics, quantification criteria and application procedure as compared to the other methods. The proposed framework solves the issues of stakeholder quantification or prioritization, higher time consumption, complexity, and process initiation. The framework helps in the selection of highly critical stakeholders for the VBS systems with less judgmental error.

Frequency of the metabolic syndrome in adult type 2 diabetics presenting to Pakistan Institute of Medical Sciences.

OBJECTIVE: To determine the frequency of metabolic syndrome in both genders, in a limited adult type 2 diabetic population presenting to Pakistan Institute of Medical Sciences, Islamabad. METHODS: This was a cross sectional study conducted in a tertiary care teaching hospital. During the six months of study period, 106 adult type 2 diabetics were examined and evaluated for the presence of metabolic syndrome according to the ATP-III criteria. Asian standards for the waist circumference were used. RESULTS: Out of 106 patients, 91 (85.8%) had metabolic syndrome of whom 95% were females. Abdominal obesity was present in 91% females and 86% males. Low HDL levels were present in all females and 83% males. Seventy eight percent females and 63% males had elevated levels of triglycerides. Hypertension was present in 68% and 73% females and males respectively. CONCLUSION: This study showed a very high prevalence of the metabolic syndrome in type2 diabetic population. Females were more affected than males in all respects.

Are live kidney donors at risk?

OBJECTIVE: To share experience of live donor nephrectomy (including intraoperative variables, morbidity and ethical aspects) and to give an overview of surgical technique being practiced. DESIGN: A department-based prospective study. PLACE AND DURATION OF STUDY: Department of Urology and Kidney Transplantation, Lahore General Hospital, Lahore, (September 1998 to March 2002). SUBJECTS AND METHODS During the study period, 58 patients had undergone live donor nephrectomy through 11th rib bed flank incision. Evaluation of donors comprised of counseling, history taking, physical examination and laboratory testing and radiological studies to document bilaterally functioning kidneys. Medical ailments, immunological incompatibility and inability to make a valid consent were contraindications for kidney donation. RESULTS: Majority of the donors (58.5%) were 31-50 years old and 70.6% were first degree relatives. Left sided kidney was taken in 96.5% cases. Mean operative time was 145 minutes. Mean renal warm ischemia time from cross clamping of renal vessels to cold perfusion on the bench was 1.5 minutes per operation. Operative complications encountered were injury to lumbar veins in 5.1 % cases, slipping of satinsky clamp on vena cava stump in 1.7 % and accidental pleural damage in 5.1 % cases. Postoperative morbid complications found were urinary retention in 6.4% cases, epididymo-orchitis in 1.7 %, prolonged lymph drain in 3.4%, stitch infection in 1.7 % and prolonged wound discomfort in 5.1 % patients. CONCLUSIONS: Open live donor nephrectomy appears to be safe procedure for harvesting kidney. Related or emotionally related donors must be the choice in all cases. Non-related donors may be entertained in selected cases despite the probability of organ vending in our society.

Pneumatic lithotripsy for the management of ureteric calculi.

OBJECTIVE: To determine the efficacy of Swiss lithoclast in the management of ureteric calculi and complications encountered in lithoclasty. DESIGN: A prospective observational study. PLACE AND DURATION OF STUDY: Department of Urology, Lahore General Hospital, Lahore (October 1999 - September 2001). SUBJECTS AND METHODS: Thirty ureteric stones (in 20 subjects) were treated over a 2-year period. Site, size and number of stones were noted in these patients. Swiss lithoclast, introduced through a ureteroscope, was used to break the stone. The Lithotripsy time was 30 min. Stone breakage was assessed by plain X-ray KUB or retrograde pyelography. RESULTS: Fragmentation was complete in 90 % cases. At one week follow up, 90% of patients were stone-free and at 3 months follow-up 95 % of patients had spontaneous passage of the fragments. Re-treatment was required in 5% cases. Mean hospital stay was 2.4 days. Complications (including both significant and minor) occurred in 25% of cases. CONCLUSION: Lithoclasty is safe, simple and effective procedure for ureteric calculi. However, complications of the procedure may prolong the usual 48 hours hospital stay seen in uncomplicated cases.

Applications and complications of subclavian vein catheterization for hemodialysis.

OBJECTIVE: To study the indications, complications and duration of 605 subclavian catheters inserted over a period of 4 years as venous access for the management of renal failure in local setup. DESIGN: Cross-sectional descriptive study. PLACE AND DURATION OF STUDY: Hemodialysis section, Department of Urology and Kidney Transplantation, Lahore General Hospital, Lahore. The study was conducted from October, 1998 to July, 2002. SUBJECTS AND METHODS: All patients coming for dialysis during the period of October 1998 to July 2002 were included information noted on specific form. RESULTS: Among the patients who underwent subclavian vein catheterization, 75.2% patients were suffering from chronic renal failure and 24.7% patients were admitted for acute renal failure. Among chronic renal failure patients, 21.9% catheters had to be replaced due to various complications e.g. thrombosis, infection or kinking of the catheter. The subclavian catheters remained in place for a mean duration of 4 weeks. Early complications encountered were arterial puncture, inability to cannulate the innominate vein, hemothorax, puncture of thoracic duct, hemomediastinum, arrhythmias and pulmonary hematoma in 10.7%, 16.5%, 0.5%, 0.2%, 0.6% and 0.2% of patients respectively. Mortality attributed to the procedure occurred in 0.1 % cases. Delayed complications included early infection in 15% catheterizations while delayed infection occurred in 39 % cases. CONCLUSION: Percutaneous subclavian catheterization is valuable, relatively easy to learn and safe method with acceptable rate of complications for patients necessitating hemodialysis and no established permanent vascular access.