Knowledge and Practices Regarding Informed Consent among Dental Practitioners

  To assess the knowledge and practices of dental practitioners regarding informed consent. METHODOLOGY: A descriptive cross-sectional study was conducted on 150 dentists at the College of Dentistry, Sharif Medical and Dental College, Lahore from June 2019 to June 2020. A pre-validated questionnaire was used. Mann Whitney U test was performed to find the statistical difference in the knowledge and practice scores across the gender and place of practice of dentists and the Kruskal Wallis test for scores across the years of clinical experience and qualification of dentists. RESULTS: The mean practice score was significantly different across levels of qualification (p=0.032) but not across years of practice (0.366). There was no significant difference in the mean knowledge score across years of practice (p=0.744) and levels of qualification (p=0.366). The highest mean score among knowledge questions was seen for the questions which inquired if informed consent should be taken before treatment. The highest mean score among practice questions was seen for the question which inquired if dentists obtained informed consent from parents before treating children.   CONCLUSION: The mean knowledge score for females was higher in comparison to males and was the highest in dentists with an experience of greater than 10 years. Most dentists were aware of the concepts, types and processes of informed consent and the importance of taking the patient`s consent before treatment. Taking informed consent from patients before treatment, keeping it as part of their record and taking parents’ consent before treating children were practiced

Dose-Response Effects of Water Supplementation on Cognitive Performance and Mood in Children and Adults

Water supplementation has been found to facilitate visual attention and short-term memory, but the dose required to improve performance is not yet known. We assessed the dose response effect of water on thirst, mood and cognitive performance in both adults and children. Participants were offered either no water, 25 ml or 300 ml water to drink. Study 1 assessed 96 adults and in Study 2, data are presented from 60 children aged 7-9 years. In both studies, performance was assessed at baseline and 20 minutes after drinking (or no drink); on thirst and mood scales, letter cancellation and a digit span test. For both children and adults, a large drink (300 ml) was necessary to reduce thirst, while a small drink (25 ml) was sufficient to improve visual attention (letter cancellation). In adults, a large drink improved digit span, but there was no such effect in children. In children, but not adults, a small drink resulted in increased thirst ratings. Both children and adults show dose-response effects of drinking on visual attention. Visual attention is enhanced by small amounts of fluid and appears not to be contingent on thirst reduction. Memory performance may be related to thirst, but differently for children and adults. These contrasting dose-response characteristics could imply cognitive enhancement by different mechanisms for these two domains

Therapeutic potential and bioactive phenolics of locally grown Pakistani and Chinese varieties of ginger in relation to extraction solvents

Current study compares the Therapeutic/nutra-pharmaceuticals potential and phenolics profile of Pakistani grown Pakistani and Chinese varieties of ginger. Crude yield of bioactive components from the varieties tested, using different extraction solvents including chloroform, ethyl acetate, ether, methanol, ethanol and distilled water. The crude bioactives varied from 14.1-82.5%. The highest extraction yield was noted for Pakistani species. The HPLC analysis revalued significant amounts of phenolics including vanillin, protocatechuic, vanillic, ferulic, sinapinic and cinnamic acids. The highest anti-inflammatory activity was shown by ethanolic extract of Pakistani variety (IC50: 26.5±1.8) whereas Chinese variety exhibited potent anticancer potential against MCF-7 cell line (Inhibition: 91.38 %). The Chinese variety in general showed higher phenolics and anticancer, while the Pakistani exhibited higher anti-inflammatory activity. Pakistani grown ginger and ethanolic extract of Chinese ginger showed highest antimicrobial activity against Pseudomonas aeruginosa 18.0±0.02 & 15.00±0.02 mm respectively. Minimum results obtained with water for both varieties of ginger with range of 7.2±0.22 and 6±0.07 respectively. Moreover, the phenolics composition, anti-inflammatory, antibacterial and anticancer activities of both tested varieties of ginger were notably affected as a function of extraction solvents. Our findings advocate selection of appropriate solvent for recovery of effective phenolic bioactive compounds from ginger verities to support the Nutra-pharmaceutical formulation

Infant and Young Child Feeding Practices among Mothers in Lahore, Pakistan: A Cross-Sectional Study

Background: Inadequate child feeding practices lead to malnutrition, higher under-five mortality rates and adverse effects on quality of life. This study aimed to assess the breastfeeding and complementary feeding practices of mothers as well as the influence of various sociodemographic factors on them in local families of Lahore. Methods: This is a cross-sectional, descriptive study. It was conducted in CMH (Combined Military Hospital), Lahore in 2018. It comprises a sample of 203 mothers with children of at least two years of age, from various urban areas of Lahore. The subjects were selected on the basis of the inclusion criteria. Mothers with psychiatric illnesses and children with congenital anomalies were excluded from the study. Mothers were approached in the paediatric outpatient departments of four tertiary care hospitals of Lahore. Responses were recorded using a modified version of the Action Contre La Faim (ACF) questionnaire. Independent sample t-test and chi-square test were applied for analysis of the data. Results: Early initiation of breastfeeding within one hour from birth was observed in 83.3% children. Most children were administered colostrum (69.5%). The rate of exclusive breastfeeding for the first six months was 45.3%.  A child was being breastfed 8.21 ± 6.67 (mean ± SD) times a day. Maternal educational status, total number of adults in a household, and access to free healthcare were identified as important factors influencing the practice of breastfeeding. Porridge, khichdi, eggs, fruit and yoghurt were the most frequently used complementary foods. Conclusions: A high rate of an early start of breastfeeding and a low rate of exclusive breastfeeding for at least six months were predominant in our population. Administration of colostrum was observed in approximately two-thirds of the study participants. Education of the mother, type of the family system (nuclear or combined), and access to free healthcare strongly influence the breastfeeding practices

Estimation of Salivary Candida Count Among Pregnant and Non-Pregnant Women

Objective: Comparison of Candida count in the saliva of pregnant and non-pregnant women to determine how much salivary Candida count increases in pregnancy as compared to non-pregnant women. Study Design: Cross-sectional study. Place and Duration of Study: Pathology Dental Department, HITEC-IMS Hospital Taxila Cantt from 2 December 2021-30 May 2022. Materials and Methods: The study included 60 pregnant and 60 non-pregnant women of age group ranging from 18 to 40 years. The unstimulated whole saliva of the subjects was collected in sterile plastic containers. The sample was inoculated on Sabouraud dextrose agar. The grown colonies were counted after 48 to 72 hours. Gram staining was performed to confirm the presence of Gram-positive oval budding Candida. Results: The Candida count from the saliva of pregnant women was two times greater in number than saliva of non-pregnant women. The mean value in pregnant women was 237.7 CFU/ml while in non-pregnant, it was 103 CFU/ml. Conclusion: The changes during pregnancy make the oral cavity of pregnant women more vulnerable leading to increased growth of Candida and that increase is twice more than that of non-pregnant wome

Current challenges of digital health interventions in Pakistan: Mixed methods analysis

Background: Digital health is well-positioned in low and middle-income countries (LMICs) to revolutionize health care due, in part, to increasing mobile phone access and internet connectivity. This paper evaluates the underlying factors that can potentially facilitate or hinder the progress of digital health in Pakistan.Objective: The objective of this study is to identify the current digital health projects and studies being carried out in Pakistan, as well as the key stakeholders involved in these initiatives. We aim to follow a mixed-methods strategy and to evaluate these projects and studies through a strengths, weaknesses, opportunities, and threats (SWOT) analysis to identify the internal and external factors that can potentially facilitate or hinder the progress of digital health in Pakistan.Methods: This study aims to evaluate digital health projects carried out in the last 5 years in Pakistan with mixed methods. The qualitative and quantitative data obtained from field surveys were categorized according to the World Health Organization\u27s (WHO) recommended building blocks for health systems research, and the data were analyzed using a SWOT analysis strategy.Results: Of the digital health projects carried out in the last 5 years in Pakistan, 51 are studied. Of these projects, 46% (23/51) used technology for conducting research, 30% (15/51) used technology for implementation, and 12% (6/51) used technology for app development. The health domains targeted were general health (23/51, 46%), immunization (13/51, 26%), and diagnostics (5/51, 10%). Smartphones and devices were used in 55% (28/51) of the interventions, and 59% (30/51) of projects included plans for scaling up. Artificial intelligence (AI) or machine learning (ML) was used in 31% (16/51) of projects, and 74% (38/51) of interventions were being evaluated. The barriers faced by developers during the implementation phase included the populations\u27 inability to use the technology or mobile phones in 21% (11/51) of projects, costs in 16% (8/51) of projects, and privacy concerns in 12% (6/51) of projects.Conclusions: We conclude that while digital health has a promising future in Pakistan, it is still in its infancy at the time of this study. However, due to the coronavirus disease 2019 (COVID-19) pandemic, there is an increase in demand for digital health and implementation of health outcomes following global social distancing protocols, especially in LMICs. Hence, there is a need for active involvement by public and private organizations to regulate, mobilize, and expand the digital health sector for the improvement of health care systems in countries

Impacts of Covid-19 on Global Inflation and Unemployment

Objective: The COVID-19 virus disrupted the international system and trade patterns, resulting in panic and public health crises throughout the globe. The COVID-19 epidemic sparked a financial catastrophe with far-reaching consequences that outstripped the global financial crisis. The goal of this research is to see how the changes brought on by the COVID-19 epidemic affect global inflation and the jobs of individuals causing unemployment. This article is divided into two sections, considering inflation and unemployment the COVID-19 globally. Methodology: The methodology adopted for this study is empirical documentary research selecting first-hand research produced by international governmental and non-governmental organizations, newspapers, research articles of all categories as well as research published in scholarly journals available at online databases such as Taylor and Francis and JSTOR. The analysis has been done by applying the technique of content analysis. Findings: According to estimates, the virus slowed global economic growth in 2020 to roughly -3.2 percent on an annualised basis, with a recovery of 5.9 percent expected in 2021. Implications: According to consensus projections, the economic slump in 2020 will be less severe than previously anticipated, thanks in part to the fiscal and monetary policies implemented by governments in 2020

Comparison of Auramine Phenol and ZN Staining in Diagnosis of Pulmonary Tuberculosis with GeneXpert MTB/RIF as Gold Standard

Background: Pakistan faces an immense burden of pulmonary tuberculosis (TB) due to large number of cases and limited resources. Despite the recent advancement in the diagnostic techniques for pulmonary TB, smear microscopy is still a useful technique for the diagnosis of this disease. This study was conducted in order to compare the diagnostic value of Auramine stain with the conventional Ziehl-Neelsen (ZN) stain on the sputum smear for the diagnosis of pulmonary TB, keeping GeneXpert MTB/RIF as the gold standard. Method: This cross-sectional study was conducted on 356 suspected patients of pulmonary TB referred to the Pathology laboratory from TB ward and OPD of District Head Quarter (DHQ) teaching hospital Rawalpindi, Pakistan. Sputum specimen were collected and two smears were prepared from each sputum sample on which Auramine phenol and Ziehl-Neelsen staining were carried out as per WHO recommendations. All these samples were further tested using Gene Xpert MTB/RIF technique. The sensitivity, specificity, Positive predictive value (PPV) and Negative predictive values (NPV) of ZN and Auramine stain were calculated and compared with GeneXpert MTB/RIF technique. Results: Out of the total 356 samples, 64(18%) were positive and 291(82%) were negative by GeneXpert which was taken as the gold standard. On comparison with GeneXpert, percentage of true positive was greater in case of Auramine than ZN stained samples (16.29% versus 12.92%), while the percentage of false positive was same for both staining techniques (0.28%). There were lesser false negative cases observed in samples stained by Auramine as compared to the ones stained by ZN (1.68% versus 5.05%). The sensitivity, specificity, positive predictive value and negative predictive values were 97.87%, 94.17%, 71.88 and 99.66%, respectively for the ZN staining and 98.31%, 97.98%, 90.63% and 99.66% respectively, for the Auramine phenol staining. Conclusion: Smear microscopy using Auramine phenol stain is a useful technique for the diagnosis of pulmonary TB. The Auramine phenol staining with fluorescent microscopy is found to be superior to ZN staining because of higher sensitivity and specificity. Keywords: Auramine phenol, Fluorescence microscopy, GeneXpert, Mycobacterium tuberculosis, Ziehl-Neelse