Technical and Quality Standards and Practices in Healthcare Facilities

This paper presents the highlights of many technical standards, as established by International Organization for Standardization (ISO) through International Classification for Standards (ICS) and British Standards (BS), and quality standards and practices as governed by some international, regional or national institutes in promoting patients rights and safety control in medical sciences and healthcare facilities. The paper draws attention to adopt these standards in Pakistan

Perception and Facts Regarding Electroconvulsive Therapy at Benazir Bhutto Hospital, Rawalpindi

Electroconvulsive Therapy (ECT) is a treatment method based on the induction of a generalized convulsion in patients after stimulation of the brain tissue with an electric current. ECT is widely used in United States as endorsed by American Psychiatric Association (APA, 2009) and has been demonstrated to be an effective treatment for certain psychiatric disorders (APA, 2001). ECT is demonstrated to have a property of mood stabilization that is considered superior to pharmacotherapy in the management of several psychiatric disorders such as depressive episode, manic episode as well as mixed episode in bipolar affective disorder (Medda, Tony & Perugi, 2014). Administration of ECT provides a quick therapeutic response as compared to psychotropic medications. Neuroplastic changes are visible even after a single electroconvulsive stimulation (Sadock & Ruiz, 2009). About each neurotransmitter system is influenced by ECT comprising serotonergic, muscarinic, adrenergic, dopaminergic and cholinergic systems (Anttila et al., 2008).   Administration of ECT Appropriate equipment to monitor vital signs of the patient and to provide initial medical emergency cover are available at the areas of ECT treatment and recovery. Any optimal site of treatment has separate facilities of waiting area to have ECT done, treatment area where ECT is conducted and recovery area where post-treatment monitoring is done (APA, 2001). Some important equipment includes stethoscope, sphygmomanometer, pulse oximetry, electrocardiographic device and system of oxygen delivery in the vicinity of treatment area where ECT is delivered (McCall, Andrade & Sienaert, 2014). None of the patients is treated with ECT without his or her written informed consent that includes the understanding of patient about the process and effectiveness of ECT as well as his or her commitment on compliance (Mankad, 2015). Besides the informed consent, vital stability and fundoscopy of the patient are some of the prerequisites to be ensured before the administration of ECT.   Previous research indicates that a combination of ECT and the maintenance medication is highly effective as compared to medication alone (McCall, 2018). For the treatment of residual symptoms of the patient, to help him or her cope with stress effectively and to encourage the patient to return to his or her normal life, psychotherapy is quite helpful including individual therapy, family therapy or group therapy (Sackeim, 2001).     Mechanism of ECT The treatment of certain psychiatric disorders by using Electroconvulsive Therapy was introduced in 1938 for the first time (UKECTRG, 2003). Since then, it has been considered as an effective treatment for certain psychiatric disorders (Pagnin et al, 2004) as evidenced by extensive research (Kho et al, 2003). Ladislas Meduna is recognized as the inventor of ECT (Meduna, 1935). During the course of ECT, certain changes in chemical composition of the brain takes place that helps in treatment of certain psychiatric disorders (Meduna, 1936). Many theories regarding the mechanism of ECT has been devised over 75 years of research on ECT (Rasmussen, 2009). In a study of 1979, these theories about mechanism of action in ECT were categorized into structural, psychological, electrophysiological and biochemical domains (Fink, 1979). Recent concept about mechanism of ECT include advanced technologies to investigate morphological changes at cellular level termed as ‘neuroplasticity’ for animal studies and ‘neural connectivity’ for human studies (Bouckaert, 2014).   &nbsp

Luteolin Causes 5′CpG Demethylation of the Promoters of TSGs and Modulates the Aberrant Histone Modifications, Restoring the Expression of TSGs in Human Cancer Cells

Cancer progression is linked to abnormal epigenetic alterations such as DNA methylation and histone modifications. Since epigenetic alterations, unlike genetic changes, are heritable and reversible, they have been considered as interesting targets for cancer prevention and therapy by dietary compounds such as luteolin. In this study, epigenetic modulatory behaviour of luteolin was analysed on HeLa cells. Various assays including colony forming and migration assays, followed by biochemical assays of epigenetic enzymes including DNA methyltransferase, histone methyl transferase, histone acetyl transferase, and histone deacetylases assays were performed. Furthermore, global DNA methylation and methylation‐specific PCR for examining the methylation status of CpG promoters of various tumour suppressor genes (TSGs) and the expression of these TSGs at transcript and protein level were performed. It was observed that luteolin inhibited migration and colony formation in HeLa cells. It also modulated DNA methylation at promoters of TSGs and the enzymatic activity of DNMT, HDAC, HMT, and HAT and reduced the global DNA methylation. Decrease in methylation resulted in the reactivation of silenced tumour suppressor genes including FHIT, DAPK1, PTEN, CDH1, SOCS1, TIMPS, VHL, TP53, TP73, etc. Hence, luteolin‐targeted epigenetic alterations provide a promising approach for cancer prevention and intervention

Bacteriological investigation of ground water sources in selected urban areas of district Mardan, Khyber Pakhtunkhwa, Pakistan

Microbial contamination of ground water sources is a common problem in all the big cities, which endangers health and impairs quality of living . To assess this, 39 water samples were collected from highly populated 13 union councils from the urban area of district Mardan. Faecal coliform and Escherichia coli were investigated both qualitatively and quantitatively. Qualitative study showed that faecal coliform was found in 90% samples and E. coli in 56% samples. Quantitatively, faecal coliform most probable number (MPN) was ranging from 1601 to 2400 for about 28% samples, followed by 551 to 1600 and 201 to 550 for 20% samples each, 40 to 200 for 18% samples and less than 40 for about 13% samples. The major cause of the bacteriological contamination was found to be the extent of susceptibility of the water sources to intrusions from the nearest contamination source.Keywords: Mardan, urban area, microbial contamination, faecal coliform, ground water, Escherichia col

Association of eNOS (G894T, rs1799983) and KCNJ11 (E23K, rs5219) gene polymorphism with coronary artery disease in North Indian population

Background: Endothelial nitric oxide synthase (eNOS) and potassium voltage-gated channel subfamily J member 11 (KCNJ11) could be the candidate genes for coronary artery disease (CAD). This study investigated the relationship of the eNOS (rs1799983) and KCNJ11 (rs5219) polymorphisms with the presence and severity of CAD in the North Indian population. Methods: This study included 300 subjects, 150 CAD cases and 150 healthy controls. Single nucleotide polymorphism was evaluated by Polymerase chain reaction and Restriction fragment length polymorphism (PCR-RFLP). Analysis was performed by SPSS (version 21.0). Results: We observed that KK genotype of KCNJ11E23K (rs5219) polymorphism (P=0.0001) genotypes and K allele (P=0.0001) was found to be a positive risk factor and strongly associated with CAD. In the case of eNOSG894T (rs1799983) there was no association found with CAD. Conclusion: These results illustrate the probability of associations between SNPs and CAD although specific genetic polymorphisms affecting ion channel function and expression have still to be clarified by further investigations involving larger cohorts

Improved bio-oil yield from thermo-catalytic pyrolysis of Citrus limetta waste over pumice: determination of kinetic parameters using Kissinger method

The focus of this research is on thermo-catalytic conversion of Citrus limetta waste, with and without pumice, using thermo gravimetric analysis and a pyrolysis chamber. TG/DTG results demonstrated weight reduction occurring in four stages i.e., evaporation of water, degradation of hemicellulose, decomposition of cellulose and lignin. Activation energy (Ea) calculated using Kissinger method for non-catalytic decomposition of hemicellulose, cellulose, and lignin was found as 99.76, 157.96 and 174.59 kJ mol−1 and for catalyzed reactions as 83.14, 91.45 and 149.65 kJ mol−1respectively. Thermal degradation of Citrus limetta waste produced 30 oil in the range of C2–C24, while catalytic pyrolysis produced more than 45 pyrolysis oil with a wide range of components from C4 to C32 which shows, that pumice has not only decreased the activation energy of the pyrolysis reaction but improved the quality of bio-oil making it suitable for energy on upgradation

Production of Fuel Range Hydrocarbons from Pyrolysis of Lignin over Zeolite Y, Hydrogen

In the current study, plain and lignin loaded with Zeolite Y, hydrogen was decomposed in a pyrolysis chamber. The reaction parameters were optimized and 390 °C, 3% catalyst with a reaction time of 40 min were observed as the most suitable conditions for better oil yield. The bio-oil collected from the catalyzed and non-catalyzed pyrolytic reactions was analyzed by gas chromatography mass spectrometry (GCMS). Catalytic pyrolysis resulted in the production of bio-oil consisting of 15 components ranging from C3 to C18 with a high percentage of fuel range benzene derivatives. Non-catalytic pyrolysis produced bio-oil that consists of 58 components ranging from C3 to C24; however, the number and quantity of fuel range hydrocarbons were lower than in the catalyzed products. The pyrolysis reaction was studied kinetically for both samples using thermogravimetry at heating rates of 5, 10, 15 and 20 °C/min in the temperature range 20–600 °C. The activation energies and pre-exponential factors were calculated using the Kissinger equation for both non-catalytic and catalytic decomposition and found to be 157.96 kJ/mol, 141.33 kJ/mol, 2.66 × 1013 min−1 and 2.17 × 1010 min−1, respectively. It was concluded that Zeolite Y, hydrogen worked well as a catalyst to decrease activation energy and enhance the quality of the bio-oil generated

Exploring gender disparities in burn injuries: A retrospective study at a burns centre in Karachi, Pakistan

Introduction: Burn is defined as any injury due to heat or acute trauma, according to the International Society of Burns Injury (ISBI). A neglected aspect of our country is the gender-specific pattern of burn injuries. This study aims to highlight the gender-based disparities of burns injuries and overcome the drastic effects of burns on an individual's life. Method: The data from the burns centre of Dr Ruth.K.M.Pfau Civil Hospital Karachi from Jan 1, 2021, to Dec 31, 2021, were retrospectively analyzed to perform this study. Different variables such as aetiology, circumstances, residence, age, TBSA, degree and occupation were recorded from the patient's files. They were compared by gender to find out any existing correlation. Results: The estimated sample size was 375, 180(48%) females, and 195(52%) were burned males. A significant correlation was found for gender with a degree of burns, aetiology, age, occupation, and residence. Whereas circumstances of burns and TBSA were non-significantly correlated to gender. Conclusion: In conclusion, our study determined that men most commonly suffer from burn injuries. In contrast, thermal injury is the most dominant etiological factor in every age group in both genders. Several risk factors are associated with a specific gender, requiring adaptive prevention and management approaches to culminate this issue

Luteolin Causes 5′CpG Demethylation of the Promoters of TSGs and Modulates the Aberrant Histone Modifications, Restoring the Expression of TSGs in Human Cancer Cells

Cancer progression is linked to abnormal epigenetic alterations such as DNA methylation and histone modifications. Since epigenetic alterations, unlike genetic changes, are heritable and reversible, they have been considered as interesting targets for cancer prevention and therapy by dietary compounds such as luteolin. In this study, epigenetic modulatory behaviour of luteolin was analysed on HeLa cells. Various assays including colony forming and migration assays, followed by biochemical assays of epigenetic enzymes including DNA methyltransferase, histone methyl transferase, histone acetyl transferase, and histone deacetylases assays were performed. Furthermore, global DNA methylation and methylation-specific PCR for examining the methylation status of CpG promoters of various tumour suppressor genes (TSGs) and the expression of these TSGs at transcript and protein level were performed. It was observed that luteolin inhibited migration and colony formation in HeLa cells. It also modulated DNA methylation at promoters of TSGs and the enzymatic activity of DNMT, HDAC, HMT, and HAT and reduced the global DNA methylation. Decrease in methylation resulted in the reactivation of silenced tumour suppressor genes including FHIT, DAPK1, PTEN, CDH1, SOCS1, TIMPS, VHL, TP53, TP73, etc. Hence, luteolin-targeted epigenetic alterations provide a promising approach for cancer prevention and intervention