Socio-Economic Determinants of Household access to Health Services in Selected District of Punjab

Background: Sound health is basic right of every individual and access to health care is necessary. The right to use health services (HS) is a multifarious idea. In Pakistan provision of basic health facilities of health are inadequate. Current study was aimed at highlighting the primary reasons behind it. Methods: This study used cross sectional data from Pakistan Social and Living Standard Measurement (PSLM) to determine the social and economic determinants of health care services in selected districts of province Punjab. Logistic regression technique is used to measure the impact of selected variables on health access. Results:  Results of the study showed that the health access services in the district of Faisalabad are greater as compared to the Rawalpindi and Layyah districts. Moreover, people were using private health facilities as compared to government health facilities. Conclusion: The study indicated that the education level, household (HH) head gender, work status, region and place of residence, and economic situation, affect the health access services in selected regions. Measures should be taken to reduce the monopoly of private health sector by providing better government health facilities

Optimization and validation of high performance liquid chromatography-ultra violet method for quantitation of metoprolol in rabbit plasma: application to pharmacokinetic studies

Purpose: To develop a sensitive, simple and validated high performance liquid chromatography (HPLC) analytical method for the determination of metoprolol tartrate in rabbit plasma.Methods: Mobile phase of methanol and 50 mM ammonium dihydrogen phosphate solution (50:50) at pH 3.05 was used for separation of metoprolol on BDS hypersil C18 column at a wavelength of 223 nm. Flow rate and retention time were 0.6 mL/min and 7.4 min, respectively. For pharmacokinetic study, rabbits were given an oral dose of 8 mg/kg of metoprolol in solution form. Blood samples were taken from jugular vein of the rabbits after drug administration and analysed by HPLC.Results: Separation of metoprolol was not interfered with other components in plasma. The calibration curve was linear in the range of 25 - 1000 ng/mL (r2 = 0.997). Lower limits of detection (LLOD) and quantitation (LLOQ) were 8.87 and 25 ng/mL, respectively. Relative standard deviation (RSD) of intraday and inter-day precision was < 14.27 and 7.61 %, respectively. Relative error of accuracy was between 4.85 and 14.37 %. Maximum plasma concentration (Cmax), time to maximum plasma concentration (Tmax) and half-life (t½) after metoprolol oral administration in rabbits were 186.29 ng/mL, 0.50 h and 2.27 h, respectively.Conclusion: A simple, accurate and precise HPLC-UV method for metoprolol determination in rabbit plasma has been successfully developed and applied to a pharmacokinetic study.Keywords: HPLC-UV, Metoprolol, Pharmacokinetics, Rabbit plasma, Liquid-liquid extraction, Validatio

Frequency of Predisposing Factor of Nausea and Vomiting After Chest Surgery Under General Anaesthesia

Background: Postoperative nausea and vomiting are common and distressing postsurgical symptoms. These symptoms are of particular concern in outpatient surgery because they may require additional direct resources, such as supplies and antiemetic drugs, and may delay discharge. The objective of this study was to measure the frequency of factors which can cause nausea and vomiting under general anaesthesia after chest surgery. Methodology: This descriptive case series evaluated frequency of predisposing factor of nausea and vomiting in patients of anaesthesia department of Gulab Devi Hospital Lahore. Questionnaire is made and patients were asked about their age, fever, previous surgery, NPO status, smoking history and hospital stay. This study included 140 patients with post-operative nausea and vomiting. Results: In this study, 140 patients were taken in which  65 (46.43%) were female and 75 (53.57%) were male. In 140 patient 134 (95.7%) were NPO and 6 (4.3%) were not  NPO, 25 (17.9%) were obese and 115 (82.1%) were not obese, 88 (62.9%) patients were suffering fever and 52 (37.1%) were not suffering fever, 80 (57.1%) were infected and 59 (42.1%) were not infected, 53 (37.9%) patients had previous surgery and 87 (62.1%) had no previous surgery, 94 (67.1%) patients had received nitrous oxide and 46 (32.9%) didn\u27t, 97 (69.3%) received volatile gases and 43 (30.7%) not received, 29 (20.7%) received ketamine and 111 (79.3%) not received, 87 (62.1%) received suxamethonium and 53 (37.9%) not received, 119 (85.0%) received propofol and 21 (15.0%) not received, 110 (78.6%) received naluphine and 28 (20.0%) not received. Out of 140 patients, there were 122 (87.1%) who were suffering from pain and 18 (12.9%) were not. 91 (65.0%) patients had gastric distention and 49 (35.0%) patients didn\u27t. Opioids were given to 34 (24.3%) patients and not given to 106 (75.7%) patient. Conclusion: It is concluded that the nausea and vomiting after surgey under genral anesthesia is due to patient related factors in which most frequent is NPO. Drug related factors include propofol and nalbupin administration. Post operative factors include pain. In whole study of 140 patients, the  most frequent is patient related factor (NPO) other than drug related factors and post-operative factors

Directly printable compact chipless RFID tag for humidity sensing

In this letter, 8-bit paper based printable chipless tag is presented. The tag not only justifies the green electronic concept but also it is examined for sensing functionality. The compact tag structure comprises of seven L-shaped and one I-shaped dipole structure. These conducting tracks/dipole structures are of silver nano-particle based ink having a conductivity of 1.1 × 107 S/m. Each conducting track yields one bit corresponding to one peak. The tag design is optimized and analyzed for three different flexible substrates i.e. paper, Kapton® HN, and PET. The tag has ability to identify 28 = 256 objects, by using different binary combinations. The variation in length of particular conducting strip results in a shift of peak for that specific conducting track. This shift corresponds to logic state-1. The response of the tag for paper, Kapton® HN, and PET substrates is observed in the frequency band of 2.2–6.1 GHz, 2.4–6.3 GHz, and 2.5–6.5 GHz, respectively. The tag has an attractive nature because of its easy printability and usage of low-cost, flexible substrates. The tag can be deployed in various low-cost sensing applications

Anomalous origin of the left coronary artery from the pulmonary artery: A surgical certainty

This study aims to assess the clinical presentation and the outcomes of a surgical correction of an anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA). A retrospective review was carried out on the charts of six patients admitted for ALCAPA surgery at Aga Khan University Hospital, Karachi from March 2017 to May 2018.Dyspnoea, palpitation, poor feeding, fatiguability, pallor and a murmur of mitral regurgitation were the main presenting features. The pre-operative median left ventricular ejection fraction (LVEF) was 64%. Coronary reimplantation was performed in all the patients with a mitral valve repair being done in only one patient. The mea n LV EF was 66 .3%,p ost- ope rativel y. Mitra l regurgitation (MR) improved in patients post-operatively with trace in 2 patients and mild MR in one. Surgical correction by coronary re-implantation yields favourable outcomes in ALCAPA and significantly reduces the morbidity and mortality rates associated with the disease

Fabrication and Evaluation of Rosuvastatin Calcium Fast- Disintegrating Tablets Using β-Cyclodextrin and Superdisintegrants

Purpose: To formulate fast-disintegrating tablets (FDT) of rosuvastatin calcium (RST) using β- cyclodextrin (CD) and different superdisintegrants to enhance their solubility.Methods: A total of 15 FDT formulations of RST were prepared using three different techniques. The FDTs were evaluated for micromeritic properties, as well as by Fourier transform infrared spectroscopy (FTIR), thermal analysis, disintegration time (DT), dissolution rate, powder x-ray diffraction (XRDP), scanning electron microscopy (SEM) and stability studies.Results: XRDP showed that RST was changed from crystalline to amorphous form. SEM images revealed the presence of small microscopic pores that enhanced water penetration and provided rapid dissolution rate compared with the pure drug. There was maximum release of drug (99 %) from F4 formulation containing solid dispersion of RST, CD and superdisintegrants. DT and wetting time were 25 s (p = 0.032) and 33 s (p = 0.023), respectively, for F4 formulation. In vitro dispersion time was also lowest for F4 at 23 s (p = 0.023). FTIR and DSC studies also confirmed complex formation of drug with CD and superdisintegrants.Conclusion: FDT is a suitable strategy to enhance the dissolution rate of RST and thus is an effective tool to improve bioavailability of poorly water soluble drugs.Keywords: Solubility, β-cyclodextrin, Kyron, Polymer, Rosuvastatin, Fast-disintegrating tablet

Level of Stress Among Health Care Workers in COVID-19 Dedicated Setup

Objective: To determine the co-relation between perceived social support and stress among nursing staff working in a COVID-19 dedicated hospital setup. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Mental Health (AFIMH), Rawalpindi from 30 Aug 2020 to 02 March 2021. Materials and Methods: We consecutively sampled 128 subjects. All participants were requested to complete a brief demographic sheet, Urdu version of the Depression, Anxiety and Stress Scale 21 (DASS-21) to assess the level of severity of stress among nursing staff and the Urdu version of the Multidimensional Scale of Perceived Social Support (MSPSS). Data analysis was done using SPSS version 23.0. Results: The mean duration of stay of nursing staff in ward was 4.86 ± 2.28 weeks. Sixty-two (48.44%) nurses had duration of 2 to 4 weeks while 66 (51.56%) nurses had duration of more than 4 weeks of stay in the ward. The mean total stress score was 6.86 ± 5.80. The mean multidimensional scale of perceived social support (MSPSS) score was 47.29 ± 22.53. There was significant negative correlation between MSPSS score and stress score (r= -0.396, p-value < 0.05). Conclusion: Results of this study highlighted that a significant negative co-relation is present between perceived social support and stress among nursing staff working in a COVID-19 dedicated hospital setup

Knowledge of Safe Swaddling Practices among Mothers of Neonates Visiting a Tertiary-Care Hospital in a Developing Country

OBJECTIVES Swaddling of new-borne and infants remains common in the developing world, but little is known about maternal knowledge of swaddling. Therefore, this study aimed to determine the level of knowledge of safe swaddling practices among mothers of neonates visiting a Tertiary-Care Hospital.METHODOLOGY This cross-sectional study was conducted in the paediatric unit of tertiary care hospital in Peshawar city, Pakistan, between July and December 2018. A total number of 370 mothers of neonates who volunteered their participation were selected using a non-probability consecutive sampling technique. The study was based on a questionnaire comprised of socio-demographic and other questions related to the knowledge of safe swaddling practices.RESULTSA total number of 370 mothers of neonates knowledge were assessed. The study participants ranged between 17 - 49 years, with a mean age of 27.14 (SD ± 5.46). Of the total, 365 (98.6%) mothers were swaddling their babies, while only 5 (1.3%) reported not practising swaddling. Most mothers (51.1%) had good knowledge, while 44.3% had adequate knowledge, and only 4.6% had insufficient knowledge regarding safe swaddling. Knowledge of safe swaddling increased with age and parity. Most mothers (90%) correctly identified that "cotton cloth or light blanket should be used to swaddle baby".CONCLUSIONIt is concluded from this study that most mothers have adequate knowledge about safe swaddling, and the level of knowledge increases with age and parity. Safe swaddling techniques and information should be given to mothers at the beginning of antenatal care to benefit from its positive outcomes and, at the same time to avoid its drawbacks

Reconnoitering Mycobacterium tuberculosis lipoproteins to design subunit vaccine by immunoinformatics approach

Background: Tuberculosis is an aerosol transmitted disease of human beings caused by Mycobacterium tuberculosis (Mtb). The only available vaccine for Mtb is Bacillus Calmette-Guérin (BCG). Currently no alternative or booster is available for BCG. The objective of this predictive approach was based on binding of MHC-I and MHC-II and B cell epitopes of Mtb for mouse host.Methods: Immunoinformatics approach was used to design subunit vaccine (SV) by joining 8 MHC-I bindings, 6 MHC-II bindings, and 8 B-Cell epitopes with AAV, GPGPG, and KK amino acid linkers, respectively. The efficacy of the SV was enhanced through Mtb protein Rv3763 (LpqH, PDB ID= 4ZJM) as an adjuvant at the N-terminal of SV. The in silico analyses evaluated the SV to predict allergenicity, antigenicity, and physico-chemical properties.Results: Predictions revealed that SV is non-allergic and highly antigenic. The physico-chemical analysis showed that the SV was stable and basic in nature. The three-dimensional structure of SV was stable with a high binding affinity against the mouse TLR2 receptor. In silico cloning suggested the effective transformation of SV into the eukaryotic expression vector.Conclusion: This study permits preclinical validation of the designed SV in mouse host to confirm its immunogenic potential and efficacy, which will help in controlling tuberculosis.Keywords: Immunoinformatics; Docking; Subunit vaccine; Lipoprotein; Tuberculosis