A sociological study about the factors affecting Immunization status of children at POF hospital Wah Cantt, Pakistan

Immunization assumes a noteworthy part in the aversion of illnesses and grimness and mortality in kids can be highly lessened just by usage and use of EPI (Expanded Program on inoculation). Targets: The goals of the examination were to decide the inoculation status of kids admitted to pediatric ward of tertiary care in POF doctor's facility, Wah Cantt. The purposes behind halfway Immunization and non-Immunization. The sociodemographic factors that influence the inoculation status. Plan, length of the investigation: The examination was Descriptive and span was around a half year Setting: Pediatric and Gynecology wards of POF Hospital Wah Cantt. Examining system: Convenient testing Subjects and Methods: Our investigation included moms of 18 two years matured kids who exhibited to POF Hospital Wah. A pre tried organized survey was filled by the understudies themselves. Results: 87.5% of youngsters were totally inoculated, 9.5% were incompletely vaccinated while 3% were not in the slightest degree. 33.5% of the guardians trusted that there were reactions of immunizations. 44.5% of the guardians suspected that lone oral polio immunization was required and 17% thought about it as annoying. Wellbeing office was distant for19.5% people and 23% face non accessibility of immunizations. Chi square test demonstrated a critical relationship between instructive status of father, mother and place of conveyance with Immunization status. Conclusion: The Immunization status of the kids was satisfactory and there was noteworthy relationship between education status of father, mother and place of conveyance with the inoculation status. The reasons of none and fractional Immunization were unavailability, non-accessibility of immunization, considering polio was the main required antibody and burden for the guardians. Key Words: Immunization, Children, Non Immunizatio

Potential Development of N-Doped Carbon Dots and Metal-Oxide Carbon Dot Composites for Chemical and Biosensing

Funding Information: The authors are would like to thank the Department of Chemistry, Government VYT PG Autonomous College Durg, Chhattisgarh, sponsored by DST-FIST (New Delhi), India and the Fundação para a Ciência e a Tecnologia (FCT), Portugal, for the Scientific Employment Stimulus-Institutional Call (CEEC-INST/00102/2018) and the Associate Laboratory for Green Chemistry-LAQV, financed by national funds from FCT/MCTES (UIDB/50006/2020 and UIDP/5006/2020). Publisher Copyright: © 2022 by the authors.Among carbon-based nanomaterials, carbon dots (CDs) have received a surge of interest in recent years due to their attractive features such as tunable photoluminescence, cost effectiveness, nontoxic renewable resources, quick and direct reactions, chemical and superior water solubility, good cell-membrane permeability, and simple operation. CDs and their composites have a large potential for sensing contaminants present in physical systems such as water resources as well as biological systems. Tuning the properties of CDs is a very important subject. This review discusses in detail heteroatom doping (N-doped CDs, N-CDs) and the formation of metal-based CD nanocomposites using a combination of matrices, such as metals and metal oxides. The properties of N-CDs and metal-based CDs nanocomposites, their syntheses, and applications in both chemical sensing and biosensing are reviewed.publishersversionpublishe

Community based lifestyle intervention for blood pressure reduction in children and young adults in developing country: cluster randomised controlled trial

Objective To assess the effectiveness of a community based lifestyle intervention on blood pressure in children and young adults in a developing country setting

A qualitative study exploring perceptions and attitudes of community pharmacists about extended pharmacy services in Lahore, Pakistan

Background In recent decades, community pharmacies reported a change of business model, whereby a shift from traditional services to the provision of extended roles was observed. However, such delivery of extended pharmacy services (EPS) is reported from the developed world, and there is scarcity of information from the developing nations. Within this context, the present study was aimed to explore knowledge, perception and attitude of community pharmacists (CPs) about EPS and their readiness and acceptance for practice change in the city of Lahore, Pakistan. Methods A qualitative approach was used to gain an in-depth knowledge of the issues. By using a semi-structured interview guide, 12 CPs practicing in the city of Lahore, Pakistan were conveniently selected. All interviews were audio-taped, transcribed verbatim, and were then analyzed for thematic contents by the standard content analysis framework. Results Thematic content analysis yielded five major themes. (1) Familiarity with EPS, (2) current practice of EPS, (3) training needed to provide EPS, (4) acceptance of EPS and (5) barriers toward EPS. Majority of the CPs were unaware of EPS and only a handful had the concept of extended services. Although majority of our study respondents were unaware of pharmaceutical care, they were ready to accept practice change if provided with the required skills and training. Lack of personal knowledge, poor public awareness, inadequate physician-pharmacist collaboration and deprived salary structures were reported as barriers towards the provision of EPS at the practice settings. Conclusion Although the study reported poor awareness towards EPS, the findings indicated a number of key themes that can be used in establishing the concept of EPS in Pakistan. Over all, CPs reported a positive attitude toward practice change provided to the support and facilitation of health and community based agencies in Pakistan

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

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Surface Ligand Engineering of Mn²⁺-Doped CsPbCl₃ Perovskite Nanocrystals with Ascorbic Acid

Halide perovskite quantum dots (QDs) have earned an excellent reputation as superior optoelectronic components. However, lead makes them poisonous, which seriously limits their ability to be used. They are attractive for light-emitting applications since the emission color can be adjusted across the visible spectral band. Doping transition metal ions like Mn2+ into the perovskite QDs can reduce lead toxicity, further influencing the optical and magnetic properties. The presence of the defect states and the Mn–Mn dimer formation do not allow the enhancement of the photoluminescence (PL) quantum yield and stability of the Mn-doped CsPbCl3 perovskite nanocrystal. Therefore, this study investigated the effects of post-treatment of Mn-doped CsPbCl3 nanocrystals treated with ascorbic acid to increase their PL and long-term durability. We have recorded PL data for untreated and ascorbic acid-treated Mn-doped CsPbCl3 perovskite nanocrystals up to 30 days after every 5 days. The ascorbic acid-treated Mn-doped CsPbCl3 perovskite nanocrystals exhibit outstanding ambient stability and photostability