Knowledge, Attitude & Behaviors Related to Oral Health among Students & Faculty of Ayub Medical College, Abbottabad, Pakistan

OBJECTIVES: The aim of this study was to analyze the knowledge, attitude and practices of medical students and faculty related to oral health. METHODOLOGY: A cross-sectional study was conducted at Ayub Medical College, Abbottabad Pakistan comprising of medical students and their teaching faculty. The participants out of total 400 distributed data forms responded 330 questionnaires positively. Data analysis was performed using SPSS software version 25.0 (using descriptive analysis and Chi Square test). P value of less than 0.05 was statistically significant. RESULTS: The survey revealed that the high proportion (96.6%) of teachers knew about dental caries, which was significantly higher than students (p-value 0.031).  High percentage of teachers had habit of brushing twice daily as compared to students (p=0.001). CONCLUSION: Within limitations of this survey, teaching faculty possessed better knowledge, attitude and behavior related to oral health as compared to medical students

Role of Pheromone Application Technology for the Management of Codling Moth in High Altitude and Cold Arid Region of Ladakh

The codling moth is a threat to the apple industries in India. Currently, no solutions are available for the management of codling moth in Ladakh. Therefore, all fresh fruits from Ladakh are still banned due to quarantine regulations. Jammu and Kashmir and Himachal Pradesh and Ladakh are the three main apple producing states of India, both in quality and quantity. The ban on all fresh fruits from Ladakh directly affects the economy of rural populations. These fruits are sold in all the local markets of Kargil and Leh. Apples damaged by the larvae of codling moth are less preferred by inhabitants, tourists, and security forces, a large area of Ladakh is bordered with China and Pakistan. Field demonstration trials revealed significantly less fruit damage in apple orchards in different hamlets of Ladakh using pheromone dispensers, pheromone baited traps, and two applications of insecticides for codling moth management. A demonstration of the use of pheromone and pheromone dispenser technology for area-wide management for high dense populations of the codling moth in Ladakh has revealed successful results in the orchards of the apple growers. Area-wide management of the codling moth in some villages, using dispenser technology has shown promising results. The ban of fresh fruits in Ladakh may not be, therefore, appropriate as management of the codling moth appears to be successful with the use of pheromone dispenser technology. This technology will, surely, boost the apple industry and have a great potential for establishing commercial orchards and quality apples in high altitudes in the second-highest cold arid region of the world

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

A nationwide study of adults admitted to hospital with diabetic ketoacidosis or hyperosmolar hyperglycaemic state and COVID‐19

AimsTo investigate characteristics of people hospitalized with coronavirus-disease-2019 (COVID-19) and diabetic ketoacidosis (DKA) or hyperosmolar hyperglycaemic state (HHS), and to identify risk factors for mortality and intensive care admission.Materials and methodsRetrospective cohort study with anonymized data from the Association of British Clinical Diabetologists nationwide audit of hospital admissions with COVID-19 and diabetes, from start of pandemic to November 2021. The primary outcome was inpatient mortality. DKA and HHS were adjudicated against national criteria. Age-adjusted odds ratios were calculated using logistic regression.ResultsIn total, 85 confirmed DKA cases, and 20 HHS, occurred among 4073 people (211 type 1 diabetes, 3748 type 2 diabetes, 114 unknown type) hospitalized with COVID-19. Mean (SD) age was 60 (18.2) years in DKA and 74 (11.8) years in HHS (p < .001). A higher proportion of patients with HHS than with DKA were of non-White ethnicity (71.4% vs 39.0% p = .038). Mortality in DKA was 36.8% (n = 57) and 3.8% (n = 26) in type 2 and type 1 diabetes respectively. Among people with type 2 diabetes and DKA, mortality was lower in insulin users compared with non-users [21.4% vs. 52.2%; age-adjusted odds ratio 0.13 (95% CI 0.03-0.60)]. Crude mortality was lower in DKA than HHS (25.9% vs. 65.0%, p = .001) and in statin users versus non-users (36.4% vs. 100%; p = .035) but these were not statistically significant after age adjustment.ConclusionsHospitalization with COVID-19 and adjudicated DKA is four times more common than HHS but both associate with substantial mortality. There is a strong association of previous insulin therapy with survival in type 2 diabetes-associated DKA

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Satellite based seasonal land use classification and change detection analysis of landsat-8 operational land imager

This study investigated the Landsat-8 Operational Land Imager (OLI) to determine its suitability for change detection analysis and mapping applications due to its enhanced signal-to-noise ratio (SNR), spectral band configuration, technical superiority, improved system design and high radiometric resolution. Earlier Landsat series had a lower SNR, comparatively smaller radiometric resolution and limitations in spectral band configurations. Pre-classification methods e.g., image differencing; image rationing, vegetation indices and principal components used for change detection analysis do not indicate type of the change due to its limitations. Therefore, better technique of post classification change detection was used on OLI data in the study area which provided information of the type of the change i.e., from-to change detection. This paper evaluated the OLI support vector machines (SVM) classification suitability using data covering four different seasons (i.e., spring, autumn, winter, and summer) after pre-processing and atmospheric correction. After classification, the major change detection results of OLI SVM-classified data for the four seasons were compared to change detection results of six cases: (1) winter to spring; (2) winter to summer; (3) winter to autumn; (4) spring to summer; (5) spring to autumn; and (6) summer to autumn. Seasonal change in the shoreline resulted with the corresponding change in categories. The OLI data classifications were made by applying SVM classifier and due to its improved features, OLI data is found suitable for seasonal land cover classification and post classification change detection analysis

Satellite based seasonal land use classification and change detection analysis of landsat-8 operational land imager

This study investigated the Landsat-8 Operational Land Imager (OLI) to determine its suitability for change detection analysis and mapping applications due to its enhanced signal-to-noise ratio (SNR), spectral band configuration, technical superiority, improved system design and high radiometric resolution. Earlier Landsat series had a lower SNR, comparatively smaller radiometric resolution and limitations in spectral band configurations. Pre-classification methods e.g., image differencing; image rationing, vegetation indices and principal components used for change detection analysis do not indicate type of the change due to its limitations. Therefore, better technique of post classification change detection was used on OLI data in the study area which provided information of the type of the change i.e., from-to change detection. This paper evaluated the OLI support vector machines (SVM) classification suitability using data covering four different seasons (i.e., spring, autumn, winter, and summer) after pre-processing and atmospheric correction. After classification, the major change detection results of OLI SVM-classified data for the four seasons were compared to change detection results of six cases: (1) winter to spring; (2) winter to summer; (3) winter to autumn; (4) spring to summer; (5) spring to autumn; and (6) summer to autumn. Seasonal change in the shoreline resulted with the corresponding change in categories. The OLI data classifications were made by applying SVM classifier and due to its improved features, OLI data is found suitable for seasonal land cover classification and post classification change detection analysis

γ-Aminobutyric acid is involved in overlapping pathways against chilling injury by modulating glutamate decarboxylase and defense responses in papaya fruit

The effect of γ-aminobutyric acid (GABA) treatment at two concentrations (1 mM or 5 mM) on papaya fruit stored at 4°C and 80%–90% relative humidity for 5 weeks was investigated. The application of GABA at 5 mM apparently inhibited chilling injury, internal browning, electrolyte leakage, malondialdehyde (MDA), hydrogen peroxide (H2O2), polyphenol oxidase (PPO), phospholipase D (PLD), and lipoxygenase (LOX) activities of papaya fruit. Fruit treated with 5 mM GABA enhanced the activities of ascorbate peroxidase (APX), catalase (CAT), glutathione reductase (GR), superoxide dismutase (SOD), glutamate decarboxylase (GAD), and phenylalanine ammonia-lyase (PAL). In addition, GABA treatment significantly displayed higher levels of proline, endogenous GABA accumulation, phenolic contents, and total antioxidant activity than the nontreated papaya. The results suggested that GABA treatment may be a useful approach to improving the chilling tolerance of papaya fruit by reducing oxidative stress and enhancing the defense system

Use of Ionic Liquid Pretreated and Fermented Sugarcane Bagasse as an Adsorbent for Congo Red Removal

A large amount of industrial wastewater containing pollutants including toxic dyes needs to be processed prior to its discharge into the environment. Biological materials such as sugarcane bagasse (SB) have been reported for their role as adsorbents to remove the dyes from water. In this study, the residue SB after fermentation was utilized for the dye removal. A combined pretreatment of NaOH and methyltrioctylammonium chloride was given to SB for lignin removal, and the pretreated SB was utilized for cellulase production from Bacillus aestuarii UE25. The strain produced 118 IU mL−1 of endoglucanse and 70 IU mL−1 of β-glucosidase. Scanning electron microscopy and FTIR spectra showed lignin and cellulose removal in fermented SB. This residue was utilized for the adsorption of an azo dye, congo red (CR). The thermodynamic, isotherm and kinetics studies for the adsorption of CR revealed distinct adsorption features of SB. Untreated SB followed Langmuir isotherm, whereas pretreated SB and fermented SB obeyed the Freundlich isotherm model. The pseudo-second-order model fitted well for the studied adsorbents. The results of thermodynamic studies revealed spontaneous adsorption with negative standard free energy values. Untreated SB showed a 90.36% removal tendency at 303.15 K temperature, whereas the adsorbents comprised of pretreated and fermented SB removed about 98.35% and 97.70%, respectively. The study provided a strategy to utilize SB for cellulase production and its use as an adsorbent for toxic dyes removal