Doing Pre-operative Investigations in Emergency Department; a Clinical Audit

Introduction: Pre-operative investigations for emergency surgical patients differ between centers. Following established guidelines can reduce unnecessary investigation, cost of treatment and hospital stay. The present audit was carried out to evaluate the condition of doing pre-operative investigations for three common surgical emergencies compared to National Institute for Health and Care Excellence (NICE) guidelines and local criteria.Methods: A retrospective clinical audit of acute-appendicitis, abscess and hernia patients admitted to the emergency department was carried out over a one-year period from July 2014 to July 2015. Data of laboratory investigations, their indication, cost and duration of hospital stay was collected and compared with NICE-guidelines.Results: A total of 201 patients were admitted to the emergency department during the audit period. These included 77(38.3%) cases of acute-appendicitis, 112 (55.7%) cases of abscesses, and 12 (6%) cases of hernia. Investigations not indicated by NICE-guidelines included 42 (20.9%) full blood counts, 29 (14.4%) random blood sugars, 26 (12.9%) urea tests, 4 (2%) chest x-rays, 13 (6.5%) electrocardiographs, and 58 (28.9%) urine analyses. These cost 25,675 Rupees (245.46 Dollars) in unnecessary investigation costs and 65.7 days of additional hospital stay.Conclusions: Unnecessary investigations for emergency surgical patients can be reduced by following NICE-guidelines. This will reduce workload on emergency services, treatment costs and the length of hospital stay

Misuse of Antibiotics in Poultry Threatens Pakistan Communitys Health

A survey was conducted from February 2022 to May 2022 on the usage of antibiotics at a poultry farm in different areas of Multan, Punjab Pakistan. A well-organized questionnaire was used for the collection of data. Sixty poultry farms were surveyed randomly in the Multan district. All of these Farms were using antibiotics. Antibiotics are commonly used for the treatment of diseases. Some are used as preventive medicine and a few are used as growth promotors. neomycin, erythromycin, oxytetracycline, streptomycin, and colistin are the broad-spectrum antibiotics that are being used commercially. Enrofloxacin and Furazolidone are the common antibiotics that are being used in Studies these days. The class of Fluoroquinolones is commonly used in poultry farms. Thirty-three patterns of antibiotic usage were observed at poultry farms. multi-drug practices were also observed on various farms. In this study, 25% of antibiotics are prescribed by the veterans while more than 90 % were acquired from the veterinary store. This study provides information about the antibiotics which are commonly being used in the study location district Multan. It is expected that the finding of this survey will be helpful in the development of new strategies against the misuse of antibiotics on farms

Standard of surgical venous thrombo-prophylaxis in admitted patients

Objective: To determine the standard of venous-thrombosis prophylaxis at the Surgical Department of Khyber Teaching Hospital, Peshawar. Methods: A retrospective clinical audit of patients admitted to the surgical department over a one-year period from July 2014 to July 2015 was carried out. Data on risk assessment for venous thrombosis and prophylaxis was collected, including indications for enoxaparin and graduated stockings, their prescription and use. The correct dose and timing for enoxaparin, review of prophylaxis and counselling was also noted. Results: 157 patients, including 37 (23.6%) males and 120 (76.4%) females requiring thromboembolism prophylaxis were admitted to the emergency department during the audit period. Mean age was 50.97±12.74 years. Enoxaparin was indicated in all 157 patients, prescribed to 126 (80.3%) and administered in 120 (76.4%), respectively. Only 80 (51%) patients received the correct dosage and 85 (54.1%) patients received it at the required time. Graduated stockings were indicated in 110 (70.1%) patients, prescribed in 35(22.3%) cases and applied in 28 (17.8%), respectively. Review of prophylaxis was not performed in any of the patients at 72 hours. Counselling and information was provided to 31 (19.7%) patients. Thrombotic events occurred in 17 (10.8%) cases, of which 12 (7.6%) were lower limb deep venous thromboses and 5 (3.2%) were cases of pulmonary embolism. Conclusions: The audit fell short of the guidelines. Enoxaparin was prescribed and administered only in certain cases, both with the wrong timing and dosage. Stockings administration was rare and its counselling was lacking. Review of management was not performed in any case. The proposed recommendations should be implemented and assessed afterwards with a second audit cycle. [Arch Clin Exp Surg 2017; 6(2.000): 74-80

Barrier access control using sensors platform and vehicle license plate characters recognition

The paper proposes a sensors platform to control a barrier that is installed for vehicles entrance. This platform is automatized by image-based license plate recognition of the vehicle. However, in situations where standardized license plates are not used, such image-based recognition becomes non-trivial and challenging due to the variations in license plate background, fonts and deformations. The proposed method first detects the approaching vehicle via ultrasonic sensors and, at the same time, captures its image via a camera installed along with the barrier. From this image, the license plate is automatically extracted and further processed to segment the license plate characters. Finally, these characters are recognized with the help of a standard optical character recognition (OCR) pipeline. The evaluation of the proposed system shows an accuracy of 98% for license plates extraction, 96% for character segmentation and 93% for character recognition

Inter Simple Sequence Repeat-Based Genetic Divergence and Varietal Identification of Banana in Pakistan

Banana is one of the major cash and fruit crops of Pakistan. The lack of information concerning genetic diversity and purity within locally cultivated banana varieties is a major bottleneck in improving its genetics. Due to the existence of a narrow genetic background, it’s quite important to find genomic variations in banana varieties. DNA marker-based techniques have been used to effectively characterize banana varieties. In the current study, Inter Simple Sequence Repeat (ISSR) markers were used to characterize banana cultivars and to assess the genetic diversity of 14 local banana varieties grown in Pakistan. Out of the 45 primers used, 40 primers revealed reproducible results and produced 121 polymorphic bands, which contributed a ratio of 47.87 polymorphism. The ISSR UBC-835 and UBC-834 possessed the highest PIC ranged between (86–88%) in banana varieties, while the lowest PIC (46%) was detected in the case of UBC−857 marker with (100–1500 bp) PCR product size. Pairwise Jaccard’s similarity coefficient values were also calculated, and these were ranged from 0.56–0.88. Multivariate analysis divided 14 banana varieties into two distinct groups—A and B respectively—and furthermore into subgroups, clusters, and sub−clusters. Our results indicated that at the molecular level, the banana varieties in group—A were found to be 66% similar whereas in group B were 88% similar. Nei’s genetic diversity, PCA analysis, and a minimum spanning tree depicted Fenjiao, Dajiao, and NIGAB-2 as the most diverse members as compared to all other varieties of the three populations. Out of 14 varieties used, 11 varieties were uniquely identified by 54 polymorphic ISSR bands of different sizes. Some varieties like NIGAB-2 and NIGAB-3 were uniquely identified only with one band while others were tagged by multiple unique bands. In future, this study will be utilized to establish a molecular-based protocol for the identification of banana varieties