Biosecurity and Biosafety concerns of Research and diagnostic Laboratory under International Guidelines

Currently, academic research labs and diagnostic laboratories are facing a serious issue of biosecurity and biosafety globally. The high rate of mutations and continuous new emerging infectious diseases with the risk of bioterrorism demands that each lab personnel share equal responsibility for biosecurity & biosafety at their work. The primary job of government authorities is to implement a well-organized detection system and limit the spread of hazardous biological agents by providing a biologically safe setting for lab scientists and for the common man in communities and institutes. The safety of lab personnel, lab environment, and pathogens depends on effective and safe laboratory working and pathogen handling which determines the reliable and accurate results of laboratory experiments. The aim of this article is to address the basic components of laboratory biosafety, laboratory biosecurity, and laboratory management. Further DURC (dual-use research of concern) deals with the commencement of lawful reasons to generate information, knowledge, technology, and products that are used for either harmful or beneficial purposes. The precautions are taken to ensure laboratory biosecurity and biosafety should be a part of the laboratory safety policy manual for guidance and implementation for a safe laboratory environment.Keywords: Antioxidants; tomato; lycopene; β-carotene; reactive oxygen species (ROS)

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

Tuberous sclerosis complex with sub-ependymal giant cell astrocytomas

Tuberous sclerosis complex (TSC) is a rare autosomal disorder that typically affects children. The manifestations of TSC include development of benign lesions in various organs, primarily in the brain, skin, kidneys, heart, and lungs. TSC management often involves multidisciplinary specialties. Herein, we present a case of a 5-year-old male patient who presented with a headache, vomiting and fever. Radiological assessment demonstrated a lobulated enhancing tumor in the right lateral ventricle near the foramen of Monro for which he underwent craniotomy (total tumor resection), which turned out to be subependymal giant cell astrocytomas upon histopathological examination. A follow-up MRI after 10 months showed cortical dysplasias, with tiny subependymal nodules. Dermatology examination revealed hypomelanotic macules, angiofibromas and shagreen patch. At his one-year follow-up, the patient exhibited normal mental and physical growth. Therefore, calling attention to TSC diagnosis and management depending upon the particular presentation may improve the quality of life of TSC patients

Comparison of the Outcome of Drain Vs Pressure Dressing in Ventral Hernia Repair

OBJECTIVES: The purpose of this study was to compare the outcome of drain vs. pressure in ventral hernia repair. METHODOLOGY: A cross sectional comparative study conducted at the Department of General Surgery, Hayat Abad Medical Complex Peshawar from January 2018 till December 2019. One twenty six patients both male and female were admitted as elective cases through OPD and were divided into “A” and “B” groups. Experienced surgeons of the unit performed all surgeries. Postoperative pain, seroma/hematoma formation, wound infection and hospital stay was noted in both groups. RESULTS: Out of 126 patients, 32 (25.3%) were males while 94 (74.6%) were females with male to female ratio of 1:3. All types of hernia were more common in the age range of 31-50 years. The common complications in both groups were seroma/hematoma formation (7.1%) and wound infection (6.3%). Mean hospital stay was 2-4 days. CONCLUSION: Mesh repair is the standard procedure for ventral hernia repair. Postoperative complications are comparatively lesser in pressure dressing than those with drain placement group. &nbsp

Assessment of medication adherence among type 2 diabetic patients in Quetta city, Pakistan

Aims: Type 2 diabetes (T2DM) is a growing burden among all countries including Pakistan, with medication adherence very important. However, little is known about medication adherence in Pakistan and potential predictors among T2DM patients to provide future guidance. This needs to be addressed. Consequently, the present study sought to assess medication adherence among type 2 diabetic patients in Quetta city, Pakistan. Methods: Questionnaire based, descriptive study among 300 Pakistani patients attending public and private hospitals aged 18 years and above, having a confirmed diagnosis of T2DM, without additional co-morbidities were targeted. Descriptive statistics were used to describe demographic and disease characteristics. The association between socio-demographic data and study variables was compared through Man Whitney / Kruskal Wallis test (where applicable). The factors that were significantly associated with medication adherence were further assessed by logistic regression analysis. Results: 55.6% of patients had high adherence although overall patients reported moderate adherence. Age, gender, education, diabetes-related knowledge and treatment satisfaction were significantly associated with medication adherence. Older males with only primary education and with poor diabetes-related knowledge had the lowest adherence. Conclusions: This study presents a model that is associated with medication adherence among T2DM patients, with disease-related knowledge as a significant predictor of likely adherence. Results of the current study revealed that improved diabetes related knowledge plays a significant role in improving medication adherence. Healthcare practitioners and the system should formalize and acknowledge patient education as a key component to treat patients with T2DM. This should include a greater role for pharmacists and other professionals

Perceptions of gender equality, work environment, support and social issues for women doctors at a university hospital in Riyadh, Kingdom of Saudi Arabia

<div><p>The Kingdom of Saudi Arabia (KSA) is an Islamic monarchy and was established in 1932. Saudi women first entered the medical field in 1975 and the country has since seen a steady increase in women pursuing medicine. However, there is limited data on gender related issues for women doctors practicing in Saudi Arabia. Therefore, our study objective was to assess the perception amongst peers regarding gender equality and social issues faced by women doctors in Saudi Arabia. An online anonymous cross-sectional survey was administered in English to doctors at King Khalid Hospital, affiliated to King Saud University, in Riyadh, between April and May of 2016. Of 1015 doctors, 304 (30%) participated, of which 129 (42.4%) were females and 231 (76%) were Saudi nationals. The average age was 32.4 years (±SD: 8.7). The majority opined that there was no gender discrimination in salaries (73.7% p-value = 0.4), hospital benefits (62.2% p-value = 0.06) or entry into any field of Medicine/Pediatrics (68.4% p-value = 0.207). However, only a minority believed that there was no gender discrimination for entry into surgery (37.3% p-value = .091). A higher proportion of male doctors agreed that promotion opportunities are equal (66.3% vs 45.7%, p-value = 0.002). However, of 54 consultants, only 18 (33.3%) were women. Over half of the women (52.3%) reported that they never wear the face veil. Only a minority of male and female doctors (12.2%) believed women doctors should wear the veil since they examine male patients. Fewer respondents believed that female doctors face harassment from male doctors (14.5%) whereas 30.7% believed female doctors face harassment from male patients. More females, than males, agreed with the statement that female doctors are as committed to their careers as are males (92.2% vs 67.4%, p-value<0.0001). Of 304 participants, 210 (69.1%) said that they would still choose to become a doctor with approximately equal proportions between males and females (68% vs 70.5%, p-value = 0.79). In conclusion, our survey of male and female doctors at a government university hospital in Saudi Arabia revealed that the majority believed there was gender equality amongst doctors in terms of salaries, benefits, opportunities for promotion and entry into any field of medicine or pediatrics, but not surgery. However, there were significantly fewer women at consultant positions, a deficiency that needs to be addressed.</p></div

Demographic characteristics of 304 doctors at King Khalid University Hospital, Riyadh.

<p>Demographic characteristics of 304 doctors at King Khalid University Hospital, Riyadh.</p

Hospital attire of women doctors at King Khalid University Hospital.

<p>Hospital attire of women doctors at King Khalid University Hospital.</p

Perception of doctors regarding gender equality between doctors who are of similar nationality, qualifications, professional level, competence, and years of experience at King Khalid University Hospital.

<p>Perception of doctors regarding gender equality between doctors who are of similar nationality, qualifications, professional level, competence, and years of experience at King Khalid University Hospital.</p

Perception amongst doctors regarding support provided to them by their department and supervisors at King Khalid University Hospital.

<p>Perception amongst doctors regarding support provided to them by their department and supervisors at King Khalid University Hospital.</p