Knowledge, attitudes, and practices among nurses in Pakistan towards diabetic foot

Introduction: Diabetic foot ulcers are a pressing complication of diabetes mellitus. Wound care requires a significant proportion of healthcare resources. It is imperative, therefore, for healthcare professionals to possess sound knowledge of the disease along with a positive attitude to ensure better clinical practice. Our literature search revealed a scarcity of data pertaining to diabetic foot ulcers. Therefore, this study aims to evaluate the knowledge and attitudes of nurses regarding diabetic foot care. Methods: A cross-sectional study design was employed, a pre-validated and pre-tested questionnaire was used to collect data from a sample size of 250 nurses working at two tertiary care hospitals in Karachi, Pakistan. The study was conducted over a period of three months (January to March 2018) and included all nurses who possessed at least one year of clinical experience in diabetic ulcer care. The statistical software employed was SPSS version 19 (IBM Corp., Armonk, NY, US). Non-parametric tests and descriptive statistics were used for data analysis and statistical significance was assumed at a p-value of less than 0.5. Results: Only 54% of the nurses in our study possessed adequate knowledge of diabetic foot ulcers. The mean score of knowledge was 74.9 (±9.5). Macdonald’s standard criteria for learning outcomes was used to gauge the knowledge levels of our study population. Nurses performed best in the domain of ulcer care with 65.3% of the participants possessing good knowledge of the topic. The overall attitude of nurses towards patients with diabetic ulcers was positive. Conclusion: This study highlights important gaps in nurses’ knowledge and sheds light on the lack of evidence-based practice. Poor knowledge can compromise healthcare standards, even with the presence of positive attitudes. Hence, a comprehensive revision of nursing curricula across local tertiary hospitals for allowing nurses to update their knowledge is warrante

An Overview of Functional Food

Functional foods are responsible for the improvement of human health and can significantly reduce the probability of disease in the host body. Functional foods are directly or indirectly part of different food ingredients and can induce functional activities in the host biological system. Functional foods are present in fruits, vegetables, dairy, bakery, cereals and meat products. Functional foods are not additional food supplements, drugs or antibiotics, they are the main component of a normal human and animal diet. Functional foods are cost-effective and easily available in the market. Daily consumption of functional foods can prevent the gastrointestinal diseases and also provide ease against different acute and chronic diseases. Adequate administration of probiotics in a human food can convert a normal food into functional food. This chapter will highlight the effective role of functional food in an individual’s daily life

The development and validation of a scoring tool to predict the operative duration of elective laparoscopic cholecystectomy

Background: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. Methods: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration. A multivariable binary logistic regression model was produced in order to identify significant independent predictors of long (> 90 min) operations. The resulting model was converted to a risk score, which was subsequently validated on second cohort of patients using ROC curves. Results: After exclusions, data were available for 7227 patients in the derivation (CholeS) cohort. The median operative duration was 60 min (interquartile range 45–85), with 17.7% of operations lasting longer than 90 min. Ten factors were found to be significant independent predictors of operative durations > 90 min, including ASA, age, previous surgical admissions, BMI, gallbladder wall thickness and CBD diameter. A risk score was then produced from these factors, and applied to a cohort of 2405 patients from a tertiary centre for external validation. This returned an area under the ROC curve of 0.708 (SE = 0.013, p  90 min increasing more than eightfold from 5.1 to 41.8% in the extremes of the score. Conclusion: The scoring tool produced in this study was found to be significantly predictive of long operative durations on validation in an external cohort. As such, the tool may have the potential to enable organisations to better organise theatre lists and deliver greater efficiencies in care

QPV interval as a measure of arterial stiffness in women with systemic lupus erythematosus.

BACKGROUND: Systemic lupus erythematosus (SLE) is associated with premature atherosclerosis and increased arterial stiffness. The QPV interval has been proposed as a measure of arterial stiffness. The QPV interval is based on the premise that transit time from cardiac ejection to brachial artery flow is shortened in patients with increased arterial stiffness. HYPOTHESIS: The objective of this study was to determine the significance of the QPV interval as a measure of arterial stiffness in patients with SLE. METHODS: We prospectively studied 46 female SLE patients. The QPV interval was calculated as the time from onset of the QRS complex to peak flow velocity of the brachial artery during ultrasound examination. Measurements of arterial stiffness: augmentation index (AI) and pulse wave velocity (PWV) were obtained by applanation tonometry while patients were on a stable medical regimen. RESULTS: Mean age was 44+/-14 y and mean QPV interval was 198+/-18 msec QPV interval correlated inversely with age (r=-0.39, p=0.008), AI (r=-0.41, p=0.004), PWV (r=-0.39, p=0.007), and aortic pulse pressure (PP) (r=-0.45, p=0.002). On multivariate regression analysis, QPV interval was found to be an independent predictor of PWV after adjusting for age (R2=0.26, p\u3c0.001). CONCLUSION: In women with SLE, QPV decreases with age and is inversely related with measures of arterial stiffness. QPV may be useful in identifying SLE patients with higher arterial stiffness in the clinical or research setting. Further larger studies are needed to confirm these preliminary results

Islamic economics: a survey of the literature

A central thesis of this paper is that social science is the study of human experience, and hence is strongly conditioned by history. Modern Western political, economic and social structures have emerged as a consequence of the repudiation of religion associated with the Enlightenment and are based on secular principles. Many of these are inimical to Islamic principles, and cannot be adapted to an Islamic society. Muslim societies achieved freedom from colonial rule in the first half of the twentieth century and have sought to construct institutions in conformity with Islam. The development of Islamic economics is part of this process of transition away from Western colonial institutions. This paper is a survey of the literature on Islamic economics, which focuses on the contrasts between Western economic theories and Islamic approaches to the organization of economic affairs