Creatinium hydrogen oxalate

The crystal structure of the title compound, C4H10N3O2 +·C2HO4 −, is stabilized by N—H⋯O and O—H⋯O hydrogen bonds. The anions are connected by an O—H⋯O hydrogen bond, leading to C(5) chain extending along c axis. The cations are dimerized around the corners of the unit cell, leading to an R 2 2(14) ring motif. This leads to a cationic mol­ecular aggregation at x = 0 or 1 and an anionic mol­ecular aggregation at x = 1/2

Creatininium 2-chloro­acetate

In the title compound (systematic name: 2-amino-1-methyl-4-oxo-4,5-dihydro-1H-imidazol-3-ium 2-chloro­acetate), C4H8N3O+·C2H2ClO2 −, the mol­ecular aggregations are stabil­ized through classical (N—H⋯O) and non-classical (C—H⋯O and C—H⋯N) hydrogen-bonding inter­actions. The cations are linked to the anions, forming ion pairs through two N—H⋯O bonds that produce characteristic R 2 2(8) ring motifs. These cation–anion pairs are connected through another N—H⋯O hydrogen bond, leading to an R 4 2(8) ring motif. Further weak C—H⋯N inter­actions link the mol­ecules along the a axis, while other C—H⋯O inter­actions generate zigzag chains extending along b

Role of Monitoring and Supervision to Improve Health Service Delivery in Basic Health Units of Punjab, Pakistan

Effective and efficient monitoring and evaluation system with a strong accountability mechanism have shown good results over the past few years in many countries of the world. Punjab has also successfully developed and implemented e-monitoring system by providing android phones to all district level health managers including Executive District Officer of Health (EDO), District Officer Health (DOH) and Deputy District Officer Health (DDOH). This e-monitoring system called as Health watch is being implemented successfully in all 36 districts of Punjab and real time data about availability of health facility staff, medicines and functional equipment and important service delivery indicators are being captured and reflected on a dashboard managed by Punjab Information Technology Board (PITB). In order to validate and verify the data collected by district level health managers, a second tier of monitoring and evaluation was introduced by hiring of 172 Monitoring Evaluation Assistants (MEAs) to monitor the primary health care facilities on the same dataset. The paper shows that field monitoring and validation of field monitoring through MEAs is bringing an improvement in service delivery indicators of Basic Health Units (BHUs). It also describes the process of e-monitoring for the improvement in health service delivery at BHUs. A real time data of all BHUs of 36 districts of Punjab has been taken into account. A quantitative comparison of Healthwatch data and MEAs data has been made to assess the situation of stock position of medicine, availability of functional equipments, staff absenteeism, and service delivery indicators. Subsequently evidence generated through the Healthwatch and MEAs data are used to develop appropriate strategies to address the bottlenecks. It has been shown that there is positive relationship between the results achieved and the resources used. This paper aims to provide a future course of action to strengthen the MEAs and Healthwatch data to be used for planning and policy making. Keywords: Healthwatch, Basic Health Units, Monitoring Evaluation Assistants, Policy and Strategic Planning Unit

Granuloma whorls

What is the significance of bone marrow examination in presence of peripheral cytopenias? It is still regarded as a mandatory investigation to diagnose hematological disorders. In this case, bone marrow trephine was initially done as a diagnosis of exclusion for ITP, whereas it revealed multiple granulomas suggesting mycobacterium tuberculosis infection

The curious case of HLA-DR-positive APL

The triad of weak/absent CD34, negative HLA-DR expression, and positivity to CD117 is pathognomonic for the diagnosis of acute promyelocytic leukemia. However, in rare cases, strong positivity to HLD-DR and CD34 may be noted

Creatininium cinnamate

The crystal structure of the title compound (systematic name: 2-amino-1-methyl-4-oxo-4,5-dihydro-1H-imidazol-3-ium 3-phenyl­prop-2-enoate), C4H8N3O+·C9H7O2 −, is stabilized by N—H⋯O hydrogen bonding. Cations are linked to anions to form ion pairs with an R 2 2(8) ring motif. These ion pairs are connected through a C 2 2(6) chain motif extending along the c axis of the unit cell. This crystal packing is characterized by hydro­phobic layers at x ∼ 1/2 packed between hydro­philic layers at x ∼ 0

RObustness of the Theory of Planned Behavior (TPB): A Comparative study between Pakistan and Thailand

© 2018, Allied Business Academies. As in the present era, an intention level for entrepreneurship among the people is continuously increasing on account of the important factors such as accomplishment of career and self-employment options. The present study attempts to explore out the entrepreneurial intention of Pakistani and Thai university students on the comparative basis. The development of theoretical framework is grounded on the Theory of Planned Behavior (TPB) which is applied among bachelor and master level students at the different public sector universities of Pakistan and Thailand. In total 385, from Pakistan and 392 valid samples Thailand being used for the final analysis. Overall results suggest a significant difference in personal attitude, subjective norms and perceived behavioral control towards entrepreneurial intention existing between the students from Pakistan and Thailand. The findings may contribute for the further validation of TPB in other Asian developing countries, particularly for comparison of students\u27 entrepreneurial intention

Harlequin colour change

Harlequin colour change (HCC) is a rare, benign and transient colour change presenting in normal healthy neonates in initial days of life and resolves spontaneously. It is thought to be due to hypothalamic immaturity, leading to capillary bed dysregulation. Gravity might also play a role, as this is apparent on the dependent side. It is important for physicians to recognize this phenomenon so that they do not order any irrelevant investigations. Here, we present a case of a healthy neonate who had HCC, which was unilateral, well demarcated erythema, with patchy pallor. Baby was vitally stable at that time. This colour change was observed twice and each time resolved within 20 minutes of its appearance and was not observed again to date (after 20 days). Baby was discharged in a stable condition after 48 hours of life