Pain, sensation and biological responses following human skin puncture with microneedles

Future work should optimise the design of microneedle devices for clinical delivery of active molecules

She may reach a facility but will still die! An analysis of quality of public sector maternal health services, District Multan, Pakistan

Objective: To assess the availability, utilization and functional capacity of the public health delivery system in terms of human resources, equipment, supplies and health provider knowledge regarding management of obstetric complications. Methods: A cross-sectional study was conducted in March 2003 for Multan\u27s public health delivery system. A complete inventory of equipment, supplies, drugs, staff availability and knowledge of obstetric complications management were assessed. Results: The number and distribution of public sector facilities serving a population of 3,2 million was well beyond the minimum requirement for basic obstetric care but fell short for comprehensive Emergency Obstetrical Care (EmOC). Utilization patterns were skewed to the tertiary facility for normal and complicated deliveries. Partograms were not available, magnesium sulphate was only available at the tertiary facility, while basic supplies like iron and folate tablets, broad spectrum antibiotics, oxytocics, gloves and sutures were not available at primary or secondary facilities. Knowledge scores regarding management of obstetric complications were less than average, especially among nurses at basic or comprehensive EmOC facilities, intensity of labour pains (nurses 59%) at basic EmOC facility and cervical dilatation by doctors at basic and comprehensive facilities were the most frequent responses for monitoring in labour. Conclusion: Strengthening the four interlinked health system elements - human resources, access to use and quality of services is essential though not sufficient

Management of Shoulder Dislocation by Prakash Method

OBJECTIVES: The objective of the study is to evaluate the effectiveness and safety of shoulder reduction developed by Prakash. METHODOLOGY: This descriptive study was carried out at Rehman Medical and Surgical Center District Buner and Naseer Teaching Hospital Peshawar from June 2017 to December 2019. All patients with a history of trauma to either shoulder were subjected to anterior-posterior shoulder radiograph. Those having shoulder dislocation were enrolled in the study. Data including age, gender, previous dislocation history, duration of dislocation and associated fracture, and fracture type were recorded in patient case sheet. Patients having recurrent dislocation, polytrauma, low GCS, fracture-dislocations, and more than a week history of dislocation were excluded from the study. RESULTS: This study was performed on 30 patients. The mean age of the patients was 36.46±11.58 years. Among them, 83.3% (n=25) were male and 16.7% (n=5) were female. While dislocation occurred on the right shoulder in 63.3% (n=19) and in 36.7% (n=11) on the left side. All the patients have dislocation for the first time. The reduction was performed using Prakash’s method. The success rate was 90% (n=27) and 10% (n=3) the reduction failed, which was then reduced under anesthesia using the Hippocratic method. CONCLUSION: The Prakash's method for reducing anterior shoulder dislocation requires minimum assistance with no anesthesia, it is safe, less time consuming, has a high success rate, less pain, and has minimal complications. &nbsp

Contracting-in management to strengthen publicly financed primary health services--The experience of Punjab, Pakistan

Objectives In response to low utilization of primary health services in rural areas, the Government of Punjab contracted with a local non-governmental organization (NGO) to manage the basic health units in one district.Methods To evaluate the performance of the contractor, health facility surveys, household surveys, and routinely collected information were used to compare the experimental district (Rahim Yar Khan, RYK) with a contiguous and equally poor district (Bahawalpur, BWP).Results The evaluation found that contracting led to more than a 50% increase in out-patient visits in RYK compared to BWP. There was also increased satisfaction of the community with health services. Technical quality of care was equally poor in both districts and contracting also had little effect on the coverage of preventive services. The latter was likely the result of the NGO not being given managerial responsibility over vaccinators and other community health workers.Conclusions Despite methodological limitations, this study found that contracting in management achieved important goals at the same cost to the Government, implying a large increase in efficiency. Contracting in management worked reasonably well in this context and has now been significantly expanded. The approach provides a plausible means for large-scale improvements of poorly performing primary health care systems.Contracting Primary health care Management of health services Pakistan

Analytical evaluation of RSA and AES using Windows Azure for cloud computing environment

Cryptography is a very useful tool to protect the properties of data like integrity, privacy, confidentiality in any environment. This paper explores some useful aspects of cryptography in cloud computing environment. There are different types of encryption algorithms used in order to ensure the data security. These algorithms are of different types like symmetric, a symmetric and hashing algorithms. The objective of this paper is performance analysis of selected set of algorithms on the basis of different parameters, so that the best out of all these options is chosen or combinations of some of them can be utilized to secure data in cloud computing environment. The algorithms included in this study are RSA, AES. The parameters which are used for performance analysis are CPU utilization, running time of the code, data encryption capacity. These are the performance parameters which are calculated for every algorithm in cloud based environment i.e. windows azure simulator by utilizing visual studio IDE and profiler services by integrating windows azure SDK. The interpretation of these results are done by using various graphs which shows trend of a particular algorithms on basis of time of encryption and decryption

Epidemiology of bronchial asthma in school children (10–16 years) in Srinagar

Objectives: To assess the epidemiological profile of asthma in school going children in Srinagar, Kashmir. Study design: Cross-sectional study. Setting: Thirty-one schools with proportionate representation from both government and private schools as well as from primary, middle, and high schools. Participants: School children aged 10–16 years with equal representation of sex and all ages. Main Outcome Measure: Prevalence of current and past asthma. Methods and Results: After administering a modified pretested questionnaire, peak expiratory flow measurement was carried. Children who had asthma-like symptoms or positive family history of asthma or physician-labeled asthma were subjected to spirometry and bronchodilator reversibility. Out of 806 children, bronchial asthma was seen in 60 (prevalence of 7.4%) which included 34 boys and 26 girls. Majority of asthmatic children (78.3% [n = 47]) had probable asthma; 6.7% (n = 4) had definite asthma; and 15% (n = 9) had physician-diagnosed asthma. Majority of children had intermittent asthma (78.3% [n = 47]). Mild persistent asthma was seen in 12.7% (n = 7) and 10% (n = 6) had moderate persistent asthma. None of the children had severe persistent asthma. The prevalence of current asthma was 3.2% (n = 26). On univariate analysis, the factors found to be statistically significant were family history of asthma (odds ratio [OR] =8.174; confidence interval [CI] =4.403–15.178), seasonal cough (OR = 4.266; CI = 2.336–7.791), allergic rhinitis (OR = 2.877; CI = 1.414–5.852), atopic dermatitis (OR = 6.597; CI = 2.72–16.004), and obesity (OR = 6.074; CI = 2.308–18.034). On multivariate analysis, family history, seasonal cough, allergic rhinitis, atopic dermatitis, and obesity were found to be significant independent risk factors. Conclusions: Srinagar qualifies as a low prevalence area for bronchial asthma in the age group of 10–16 years. Majority of children had mild intermittent asthma resulting in under diagnosis and wrong treatment