Evaluating Suitability of Glutaraldehyde Tanning in Conformity with Physical Properties of Conventional Chrome-Tanned Leather

Leather manufacturing involves a number of unit processes, out of which tanning is the most important in so far as it converts the putrescible hides/skins into non-putrescible leather. In this study, glutaraldehyde has been exploited as a means to reduce the use of basic chromium sulfate for the production of quality shoe upper crust leather. The paper consists in studying the physical properties of aldehyde-tanned leather and chrometanned leather. The aim is to find out the possibility of replacing the wet-blue leather, containing Cr(III) salts, with the glutaraldehyde-tanned wet-white leather. The physical properties of the aldehyde-tanned leather were evaluated, analyzed and compared with the conventional chrome-tanned shoe upper crust leather. Statistical analysis illustrated that the tensile strength, the percentage of elongation, stitch tear strength, Baumann tear strength and grain crack strength of the leather was 211±1 kg/cm2, 38±0.5 %, 89±0.11 kg/cm, 63±0.4 kg/cm and 23±0.4 kg respectively. It was observed that the property of the experimental leather was quite comparable with the conventional chrome-tanned leather and able to meet the requirements of the shoe upper crust leather after re-tanning. The shrinkage temperature of the experimental tanned leather was found to be 87 °C, lower than that of corresponding control, which indicates lesser tanning power of aldehyde. However, the morphology of the aldehyde-tanned leather was quite akin with the conventional leather. This study suggests that using glutaraldehyde in the tanning process in order to minimize the chromium load in the tanning and the re-tanning process during the production of shoe upper crust leather reduces the generation of toxic waste and its impact on the environment

REDUNDANT PUBLICATION – A dilemma of Publication Ethics

The term duplicate or redundant publication was defined by the ICMJE as: “publication of a paper that overlaps substantially with one already published, without clear, visible reference to the previous publication”.1 Redundant publication cannot be ignored by an editor. More in practice in recent times, due to the availability of the electronic gadgets, it is mainly due to the race for publishing a large number of articles for academic purposes. Lack of time, insufficient research integrity and the competition to achieve more in a short span, makes an author resort to this unethical act. Duplicate submission/publication is “the practice of submitting the same study to two journals or publishing similar contents from the same study in two journals. These submissions/publications can be nearly simultaneous or years later”.2 Both the practices are very much in use by authors because the disadvantages are either not anticipated or not known. There is also a need of a certain number of publications for their promotion or restrained due to shortage of time for conducting the research and then writing it. Authors indulging in these unethical acts do not anticipate the risks they are undertaking. Detection of such falsified acts, which is very easy, will spoil their reputation, as the matter will be reported to the head of the institution. If the article is published and later retracted due to being a redundant/duplicate publication, the fact will not remain hidden. It could become evident during an interview. In some institutions, unethical acts are given serious consideration and can lead to demotion or barrier to promotion. Continue.

A regional survey on the physician awareness & practices for the management of hypertension and prevention of stroke

Introduction: Approximately 54% of strokes are attributed to high blood pressure. A survey was conducted to assess the awareness and practices of physicians for hypertension & stroke. Methods: A questionnaire based survey was conducted during ICMF in Sri Lanka by Getz Pharma (Nov 2013). Of the total 100 forms, 68 were returned by physicians from S.Asia, S.E.Asia & Africa. The data was analyzed by SPSS v.20. Results: The ages of 46 (67.6%) delegates were ≥ 46 whereas remaining were \u3c 46 years. M:F were 4:1. The specialty included 31 (45.6%) internists/medicine, 24 (35.3%) cardiologists and 13 (19.1%) endocrinologists/diabetologists with 59 (79.7%) having \u3e10 years of practicing experience. In daily practice, 27 (39.7%) physicians dealt with50%. Those who agreed on hypertension as the single most important risk factor for stroke were 40 (59%), 42 (61.8%) suggested stroke as the most preventable hypertension related cardiovascular event, 25 (36.8%) IHD, 8 (11.8%) kidney disease and 3 (4.4%) multiple preventable events. Quality of life having a direct impact on CVD due to overweight was believed by 57 (83.8%). The most reported risk factors in hypertensive patients with CAD were diabetes 45 (66.2%), dyslipidemia 38 (55.8%), smoking 34 (50%), family history of CVD 12 (17.7%), age 8 (11.8%), gender 3 (4.4%) and 14 (20.6%) considered all of them as risk factors. The preferred antihypertensive agents were; 34 (50%) ACE inhibitors, 28 (41.2%) ARBs, 15 (22.1%) Ca++ Channel Blockers, 2 (2.9%) each of Thiazide diuretics & Beta Blockers and 3 (4.4%) preferred all of the drugs. Sixty two (91%) physicians believed antihypertensives lowered stroke risk by 22%. Conclusion: The survey projects a varying level of awareness in physicians from the aforementioned regions on risk factors and treatment for hypertension & stroke. Keywords: Hypertension, Stroke, ICMF, Surve

Publishing in the modern era

Printed words are used to convey and conserve knowledge. The history of printing dates back to 3000 BC when documents were written on clay tablets. Other materials used were pottery imprints, wood and cloth such as silk. Printing on paper started in China in the 7th century during the Tang Dynasty which lead to the printing of books. The first printing press was created by Johannes Gutenberg from Germany in the 15th century which lead to printing of the ‘Gutenberg Bible’, opening the gateway to fast dissemination of knowledge and start of ‘Gutenberg Revolution’ with spread of the printing press and mass production of books.1 The offset printing was introduced in the late 19th century and was considered the best printing method. At the start of the 21st century, the computers further  revolutionised the printing methods by replacing them with digital or electronic format. This new electronic method was a competitor for the offset printing. In developed countries, newspapers and magazines adopted the on-line digital versions for swift distribution of the material over the printed version. Comparing the two modes of publishing, the electronic form definitely offers many advantages; like ease in availability, being exceedingly visible to a large audience and user friendly links for citation.2 Journals in the e-form have more citations and particularly if open access,  have a worldwide readership. Readers can provide immediate feedbacks and corrections if needed, which are easier to incorporate. The printed journals have to be purchased and physically distributed, a cumbersome process. Moreover, in printed format, any correction of errors is included in a forth coming issue as an erratum. Last decade has seen rapid transition of printed format to digital format and many journals now exist in both the forms and are steadily converting old articles as electronic archives, while others have completely phased out printed format.3 Environmental concerns of the printed media products are grave. Printing less conserves forest and natural resources. Offset printing uses chemical laden inks which release large quantities of greenhouse gasses including carbon dioxide into the atmosphere.4 The rising inflation and its impact on cost of printing cannot be ignored, especially in the developing countries. In contrast the electronic journals are gaining acceptance and popularity for being environmentally friendly and economical. Medical journals are publications which help the medical community to keep abreast with the latest research. They deliver new knowledge, foster research and disseminate information. History shows that the medical journals were published on paper as early as the 17th century and were mailed to the subscribers. The digital era with advent of portable computers and smart phones in the late 20th century, transformed the way we read medical literature today. For instance, the Journal of American Medical Association has 1.8 million subscribers linked on line every week.4 The Journal of Pakistan Medical Association (JPMA) this year completes 73 years of its purposeful life. Since its first publication in 1950, it continues to provide results of research to its worldwide readers. It is the oldest medical journal in Pakistan, and being the organ of the Pakistan Medical Association, a matter of pride for all medical professionals. To shape the future and move forward we must look back at the past. During its 73 years journey, JPMA has provided cutting edge research and high-quality contents. Launched as a quarterly publication, the journal became a monthly publication within three years and now exists in print and electronic format. It is further enriched by periodic supplements on specialised topics; thus fulfilling the appetite of its ardent readers. To keep pace with the developments in publishing, JPMA made many improvements in the past. A user friendly website was introduced with links to the latest and previous issues. The forthcoming articles can be accessed on the website by the middle of the month. Comments and appreciative remarks are received from readers residing in all countries of the world, an evidence that JPMA reach out to the medical community internationally. With a successful digital version of JPMA leading to a wider readership, the decision to discontinue the print version is being considered. JPMA will be completely digitalised which will make it environment friendly and easy to access. The digital version will increase the capacity and space for inclusion of more educational and original research articles, reviews, opinion notes, case reports, commentaries and letters to editors. As rightly quoted by Albert Einstein : ‘The measure of intelligence is the ability to change’, this change in the mode of publication will further enhance the global visibility of the journal. We hope that our readers will embrace this change and continue our patronage in the future too

Challenges in Type 1 diabetes management in South East Asia: Descriptive situational assessment

Treatment of type 1 diabetes is a challenging issue in South East Asia. Unlike in the developed countries, patients have to procure insulin, glucometer strips and other treatment facilities from their own pockets. Coupled with poor resources are the difficulties with diagnosis, insulin initiation, insulin storage, marital and emotional challenges. Being a disease affecting only a minority of people, it is largely ignored by the governments and policy makers. Comprehensive diagnostic, treatment and team based educational facilities are available only in the speciality diabetes centers in the private sector whereas majority of the subjects with type 1 diabetes are from a poor socio-economic background. Unlike in the Western world, being known as a diabetes patient is a social sigma and poses huge emotional burden living with the disease and getting married. Even with best of the resources, long-term treatment of type 1 diabetes still remains a huge challenge across the globe. In this review, authors from India, Pakistan, Nepal, Sri Lanka, Myanmar and Bangladesh detail the country-specific challenges and discuss the possible solutions

South Asian women with diabetes: Psychosocial challenges and management: Consensus statement

Diabetes is the ninth leading cause of death in women globally. In South Asians mortality in women with diabetes stands second highest. There is a marked gender discrimination which is faced by women across South Asia esp in access to services and support for diabetes, resulting in high rates of morbidity and mortality in women with diabetes. The most important risk factor identified for the diabetes epidemic is obesity along with genetic susceptibility. Lack of health care, social and cultural disparity, discrimination at work, disparity in marriage, restricted medical facilities are prevalent. Diabetes and depression are common in women. Increasing age, low level of education, low socioeconomic conditions, difficulties posed in finding partners, frequent divorce and family history of psychiatric illness are significant risk factors for diabetes and depression. Such patients usually have poor metabolic control, higher complication rates, increased healthcare costs, lost productivity, lower quality of life as well as increased risk of death.Preconception counseling should be incorporated in the routine diabetes clinic visit for all women of childbearing potential. Women with diabetes should have information and access to contraception. Proper family planning counseling and psychological support can help stop practices such as female foeticide and multiple pregnancies. Psychological support to patients and their families are needed to break the barrier.There is emerging evidence that women with diabetes are more prone to untoward outcomes as compared to men. Central obesity, metabolic syndrome and the polycystic ovary syndrome show ethnic specific differences in South Asian women. Optimal sexuality is an integral part of holistic health. Shortage of trained female health care professionals, lack of privacy in over-crowded health care facilities, a social taboo attached to such matters, and lack of confidence in patients contribute to the neglect of sexual issues in women attending diabetes clinics across South Asia. Guidelines for counselling in female sexual dysfunction, written in culturally appropriate manner for South Asia, are needed. Diabetes affects women more severely because of their unique biological, cultural and socioeconomic circumstances. Women have limited access to health care facilities because of illiteracy, ignorance and negative social customs. Transcending the gender hierarchy and inequality is a formidable challenge. Sensitising men, empowering women on self care and providing peer support maybe the answer to this challenge. It is essential for health care providers to use appropriate coping mechanism such as building psychological contact with the patient, including family and friends as part of social support and empower patient with complete process of managing diabetes. Increasing awareness through the media, seminars, posters, group discussions and education, regular monitoring and consulting the doctor, support group for women and facilities for aerobic exercises are recommended. The health care systems should consider custom-designed prevention and control programs tailored for women based on local and regional attitudes on health care, cultural beliefs, and available social support systems. Policies that empower adolescent girls and young women to take control of their metabolic management must be encouraged. Provision of gender specific diabetes education with a holistic life-cycle approach is recommended