Popularity of Tracking Device as an Anti-theft Measure and Impact of its sales on Sales of Auto Insurance Policies: Evidence from Karachi, Pakistan

In this paper attempt has been made to examine the popularity of tracking devices and its impact on the sales of automobiles insurance policies. Literature review revealed that people insure their vehicles to protect them from theft as well as from other perils such as fire, SRCC, accidental losses and third party liability. The coverage is mainly obtained to prevent theft, which has the major significance. Insurance companies have been trying since a long time to curtail the cost of theft, which is the major cause for higher premium rates. To achieve the objectives of this study Non Probability Technique known as Purposive Sampling is applied, based upon questionnaire survey from a representative sample of tracker and insurance service users. This research revealed that blending the motor insurance policies, with tracker devices, have successfully attracted the major chunk of market and have gained access to a larger segment of the market, offering packaged policies with discounted premium rates and hence the loss ratio has declined with the use of these devices, which ultimately affects the premium rates. The researchers tested the relationship between tracker sales and insurance policy sales. The research revealed significant insights into the relationship.Tracker Devices, Auto Insurance, Sales, Theft, Third Party Liability.

Size dependent magnetic and electrical properties of Ba-doped nanocrystalline BiFeO3_3

Improvement in magnetic and electrical properties of multiferroic BiFeO$_3$ in conjunction with their dependence on particle size is crucial due to its potential applications in multifunctional miniaturized devices. In this investigation, we report a study on particle size dependent structural, magnetic and electrical properties of sol-gel derived Bi$_{0.9}$Ba$_{0.1}$FeO$_3$ nanoparticles of different sizes ranging from $\sim$ 12 to 49 nm. The substitution of Bi by Ba significantly suppresses oxygen vacancies, reduces leakage current density and Fe$^{2+}$ state. An improvement in both magnetic and electrical properties is observed for 10 % Ba-doped BiFeO$_3$ nanoparticles compared to its undoped counterpart. The saturation magnetization of Bi$_{0.9}$Ba$_{0.1}$FeO$_3$ nanoparticles increase with reducing particle size in contrast with a decreasing trend of ferroelectric polarization. Moreover, a first order metamagnetic transition is noticed for $\sim$ 49 nm Bi$_{0.9}$Ba$_{0.1}$FeO$_3$ nanoparticles which disappeared with decreasing particle size. The observed strong size dependent multiferroic properties are attributed to the complex interaction between vacancy induced crystallographic defects, multiple valence states of Fe, uncompensated surface spins, crystallographic distortion and suppression of spiral spin cycloid of BiFeO$_3$.Comment:

In vitro characterization and in vivo performance of mefenamic acid-sodium diethyldithiocarbamate based liposomes

Mefenamic acid (MFA) is a hydrophobic drug with low dissolution rate. This study aimed to develop stable and reproducible aqueous formulations of MFA using liposomes as drug carriers. The drug entrapment, particles size and drug release profiles, and stability and reproducibility of the liposomes were determined. In addition, the maximum tolerated dose (MTD) was determined in rats via the oral and intraperitoneal routes of administration. Also, the anti-inflammatory efficacy of these liposomes was evaluated using carrageenan-induced paw edema model in rats. MFA-DDC based liposomes demonstrated a drug entrapment efficacy of 93.6%, particles size of 170.9 nm, and polydispersity index of 0.24 which were not statistically affected when stored in room and refrigerated temperatures for at least 4 weeks. The MTD of the intraperitoneally administrated MFA-loaded liposomes was 20 mg MFA/kg, whereas for those of oral administrations, it was up to 80 mg MFA/kg. Intraperitoneal dose (80 mg MFA/kg) of MFA-DDC liposomes induced extrapyramidal symptoms associated with significant elevation in serum potassium and muscle enzymes. Moreover, significant inhibition of paw edema was demonstrated by the oral and intraperitoneal routes. These findings suggest that MFA-DDC based liposomes are an effective formulation of MFA and recommend the use of bioequivalence assessments with commercial formulations

Comparative ultrastructural hepatic alterations induced by free and liposome-encapsulated mefenamic acid

Mefenamic acid (MFA) is used as an anti-inflammatory, antinociceptive, and antipyretic agent for treatment of a wide range of pathological disorders. While the uncertainty of its safety and the poor oral bioavailability constitute the major limiting factors of its medical use, considerable efforts including liposomal encapsulation are needed to achieve maximum therapeutic advantages. The current work was conducted to investigate the ultrastructural alterations in the liver induced by free MFA and its liposomal preparation. Female Sprague-Dawley rats were treated with daily oral doses of either free MFA or MFA entrapped in Tween 80 inoculated liposomes at the concentration of 80 mg/kg for 28 days. Ultrathin sections were prepared from biopsies taken from the liver of each member of all animals under study and subjected to examination by transmission electron microscopy. The liver of rats that were exposed to liposomal MFA showed more ultrastructural alterations than the rats treated with the free drug. While both groups of rats demonstrated sinusoidal dilatation, Kupffer cell hyperplasia, mitochondrial damage, and nuclear alterations, rats treated with liposome-encapsulated MFA induced an increase in the multiple lysosomes formation, hepatocytic steatosis, and apoptotic activity than free MFA-treated rats. The ultrastructural findings of the present study indicate that the use of liposomal MFA induces more hepatic damage than the use of free MFA

Haemato-biochemical Response to Lignocaine alone or in Combination with Xylazine for Epidural Analgesia in Cow Calves

The present study was undertaken to evaluate the effect of local analgesic (lignocaine) alone or in combination withalpha-2 adrenergic agonist (xylazine) on haemato-biochemical parameters. The study was conducted on 12 healthy male cowcalves, which were divided into two equal groups (group A and group B), and induced into two equal quantity of lignocainealone (group A) or in combination with xylazine (group B). Haematological and biochemical parameters were measued beforeand at 15, 30, 60, 90, 120, 240 minutes and 24 hours intervals after administration of drugs. No significant changes were observedin animals of the group A, except the significant increase (P <0.01) in serum glucose concentration from 30 to 120minutes intervals. In group B, a significant decrease in haemoglobin concentration and packed cell volume was observed after 30 minutes, which persisted up to 120 minutes interval as compared to base value. There was a significant decrease in total leucocytes count at 60 minutes interval and a significant increase in neutrophils percent and simultaneous decrease in lymphocytes percent between 60 to 120 minutes intervals. In addition, a significant (P <0.01) increase in serum glucose concentration from 30 to 240 minutes intervals was observed. The decrease in serum total proteins (P <0.05), and the increase in blood urea nitrogen and creatinine (P <0.05) levels, and in ALT and AST (P <0.01) activities were significant between 60 to 120 minutes intervals. The values were returned to normalcy by 24 hours in both groups. Thus, epidural xylazine along with local anaesthetic can be safely used in cow calves as it caused transient haemato-biochemical alterations

Liposome encapsulation: a promising approach to enhanced and safe mefenamic acid therapy

Mefenamic acid (MEF) is a non-steroidal anti-inflammatory drug (NSAID) characterized by low bioavailability with relative high toxicity. Despite the efforts which have been paid to enhance its bioavailability, its inherent toxicity remains the limiting factor for its medical uses. Designing MFE as a prodrug of ester derivatives can attenuate gastrointestinal (GI) toxicity, but shows no advantages in term of therapeutic efficacy. Liposomes have a dual action and would be a promising tool to enhance MFE bioavailability and reduce its gastric and systemic adverse reactions. This review covers the pharmacological and toxicological aspects of MFE and provides substantial trend to enhance its clinical therapy

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial

Background: Tranexamic acid reduces surgical bleeding and reduces death due to bleeding in patients with trauma. Meta-analyses of small trials show that tranexamic acid might decrease deaths from gastrointestinal bleeding. We aimed to assess the effects of tranexamic acid in patients with gastrointestinal bleeding. Methods: We did an international, multicentre, randomised, placebo-controlled trial in 164 hospitals in 15 countries. Patients were enrolled if the responsible clinician was uncertain whether to use tranexamic acid, were aged above the minimum age considered an adult in their country (either aged 16 years and older or aged 18 years and older), and had significant (defined as at risk of bleeding to death) upper or lower gastrointestinal bleeding. Patients were randomly assigned by selection of a numbered treatment pack from a box containing eight packs that were identical apart from the pack number. Patients received either a loading dose of 1 g tranexamic acid, which was added to 100 mL infusion bag of 0·9% sodium chloride and infused by slow intravenous injection over 10 min, followed by a maintenance dose of 3 g tranexamic acid added to 1 L of any isotonic intravenous solution and infused at 125 mg/h for 24 h, or placebo (sodium chloride 0·9%). Patients, caregivers, and those assessing outcomes were masked to allocation. The primary outcome was death due to bleeding within 5 days of randomisation; analysis excluded patients who received neither dose of the allocated treatment and those for whom outcome data on death were unavailable. This trial was registered with Current Controlled Trials, ISRCTN11225767, and ClinicalTrials.gov, NCT01658124. Findings: Between July 4, 2013, and June 21, 2019, we randomly allocated 12 009 patients to receive tranexamic acid (5994, 49·9%) or matching placebo (6015, 50·1%), of whom 11 952 (99·5%) received the first dose of the allocated treatment. Death due to bleeding within 5 days of randomisation occurred in 222 (4%) of 5956 patients in the tranexamic acid group and in 226 (4%) of 5981 patients in the placebo group (risk ratio [RR] 0·99, 95% CI 0·82–1·18). Arterial thromboembolic events (myocardial infarction or stroke) were similar in the tranexamic acid group and placebo group (42 [0·7%] of 5952 vs 46 [0·8%] of 5977; 0·92; 0·60 to 1·39). Venous thromboembolic events (deep vein thrombosis or pulmonary embolism) were higher in tranexamic acid group than in the placebo group (48 [0·8%] of 5952 vs 26 [0·4%] of 5977; RR 1·85; 95% CI 1·15 to 2·98). Interpretation: We found that tranexamic acid did not reduce death from gastrointestinal bleeding. On the basis of our results, tranexamic acid should not be used for the treatment of gastrointestinal bleeding outside the context of a randomised trial

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