Self-Medication Practice and Their Risk Factors Among BScN 4 Years Students

Self-medication is the use of medicines to treat self-diagnosed disorders or symptoms, or the periodical or continued use of prescribed drugs for acute or chronic disease or symptoms. It’s going to include the use of herbs, the retention and Re-use of Medication without prescribed by doctors. Self-medication is widely practiced in both developed and developing countries. . Practice of getting self-medication was relatively high, because of easy access of drugs from public pharmacy and they also have knowledge about medicines. The study's overall objective was to identify the level of knowledge, attitude, and self-medication practices among undergraduate BScN 4 year student. This would be a descriptive cross sectional quantitative study .Quantitative cross sectional design used data to make statistical inference about nursing students of knowledge, attitude and practice regarding self-medication. Total, 250 BScN students were involved in this study. The data was collected using a validated questionnaire. Overall 53.6% BScN students often practice self-medications,while 46.4% students were not practice self-medications. In a study conducted in a private college of Nursing Lahore, it was found that self-medication is significantly higher in among BScN 4 year’s student nurses. We found that our respondent’s education has also impact on practice and attitude of self-medication. The awareness regarding self-medication among student is good about 60% populations have knowledge regarding medication benefits. As per the findings, 75.8% BScN students visited to a qualified medical practitioner. While 24.2% students were not visited to a qualified medical practitioner. 71.2% BScN students respond that the indications of self-medication Headache/ fever. Inappropriate self-medication can cause harm to the students and also whom they recommend as healthcare providers in the future. Therefore, there is a need to educate nursing students and make them more aware about adverse effects of self-medication. Keywords: Self-care, medical practitioner, nursing Students, Drugs, Self-medication, Knowledge DOI: 10.7176/JNSR/13-18-02 Publication date:October 31st 202

Cross-sectional study identifying forms of tobacco used by Shisha smokers in Pakistan

OBJECTIVES: To estimate the frequency of different forms of tobacco intake such as smoker\u27s tobacco, chewable tobacco and snuff tobacco among shisha smoker\u27s and to study the patterns and predictors of shisha smoking affecting youth from different cities of Pakistan. METHODS: A cross-sectional study was conducted including youth from four cities. Participants were asked to fill out a data collection tool at shisha cafes, shopping malls and restaurants. Data was analyzed using SPSSv.18. RESULTS: A total of 406 participants, 296 (73%) males and 110 (27%) females were included in the study. There were 163 (40%) cigarette smokers; 65 (16%) chewed tobacco and 33 (8%) snuffed it. The median age at initiation of Shisha smoking was 20 years. 280 (69%) considered Shisha smoking to be less deleterious to health than cigarettes. Respiratory disease was the most commonly cited health effect reported. Most 248 (61%) of the participants were infrequent shisha smokers. CONCLUSION: There is high frequency of tobacco usage in the form of cigarettes, chewable tobacco and snuff tobacco among shisha smokers of Pakistan. The highest frequency is for cigarette smoking. The rise in Shisha smoking as a trendy social habit appears to be occurring despite emerging scientific evidence of its potential health risks

An unusual variant of choledochal cyst: a case report

<p>Abstract</p> <p>Introduction</p> <p>Choledochal cyst is an uncommon congenital disease of the biliary tract in the UK. There are five main types of choledochal cyst with several recognised sub-types. However, occasional variants do occur.</p> <p>Case presentation</p> <p>We report a case of a female infant with an antenatally diagnosed choledochal cyst. The operative cholangiogram revealed an unusual intrahepatic biliary tree. The cyst was successfully excised and the infant is well at 18-months follow up.</p> <p>Conclusion</p> <p>The anatomy should be clearly defined before surgical excision as abnormal variants can occur, which usually do not fit into the known classification types and subtypes.</p

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

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

APPRAISAL OF HEAVY METALS IN DRINKING WATER SOURCES ALONG THE RIVER INDUS DISTRICT DERA GHAZI KHAN

&nbsp; Safe drinking water is very important for the existence of life on earth. Access to safe drinking water is basic human right. Water quality is declining day by day due to anthropogenic activities, which are causing various health related issues all over the world. Certain health problems are associated with the occurrence of heavy metals and other contaminations in water. The main purpose of this research work to evaluate and investigate the underground drinking water Sources of various pollutants like physico-chemical parameters (pH, Turbidity, Electric Conductivity and Total Dissolved Solid) and Heavy metals (Iron, Zinc, Manganese, Arsenic and Copper) along the western bank of River Indus in Dera Ghazi Khan District (30.2748&deg; N, 70.2408&deg; E), Punjab, Pakistan. Water samples were collected from rural areas most common sources of drinking water of three regions Kot Chutta (K), Dera Ghazi Khan (D) and Taunsa (T) and analyzed physico-Chemical (pH, Turbidity, Electric Conductivity and Total Dissolved Solids), heavy metals (Iron, Zinc, Manganese, Arsenic and Copper) using standard methods. Results of water analysis of certain physicochemical parameters (pH, Turbidity, Electric Conductivity and Total Dissolved Solids). Turbidity values are exceeding at points Ranjha ala, Chah sobar wala, Chah inayat wala, Khoo mooli wala and Basti Bohar in three regions were higher than the world health organization (WHO) Standard value and Pakistan environmental quality standards for drinking water (PEQSDW). Total Dissolved solids (TDS) and Electrical conductivity (E.C) exceeded the standards value at Jakkar Imam Shah, Dauo Wala, Dawood kot, Chah kalar wala, Chah kabeer wala, and Mari gharbi than the WHO and PEQSDW. Furthermore, heavy metals analysis results shown higher concentration of arsenic (As) 37.1 % samples exceeded than WHO standard value and only 3.22 % samples exceeded from PEQSDW standards value, while 1.61% samples exceeded the WHO and PEQSDW standard value but Iron (Fe), Zinc (Zn) and Manganese (Mn) were within the standards limits. The heavy metals concentration in study area follows the order As&gt;Cu&gt;Fe&gt;Zn&gt;Mn. The groundwater drinking sources quality in these areas is poor and is not fit for drinking purposes, which is harsh condition for the human being of this area

Exact Solution for Some Rotational Motions of Fractional Oldroyd-B Fluids Between Circular Cylinders

In this analysis motion of an incompressible fractional OldroydB fluid [IFOBF] in an annulus is studied. The movement in fluid is created by the motion of the both cylinders. At (t = 0+), the inner cylinder exerts rotational shear which is time dependent and outer cylinder moves with time depended linear velocity. The analysis of velocity field and shear stress are made with the help of integral transform techniques. For simplicity and better perception, generalized R and G functions are used to represent the obtained results. These solutions are satisfied all the imposed conditions. By imposing favourable limits, general solution is reduced to ordinary Oldroyd-B, Maxwell, second grade and Newtonian fluids for the same motion. From the final expressions of velocity fields and shear stress, we recover the previously obtained results by choosing some limits. Finally, the effect of parameters and their comparison are explained graphically

Efficient data trading and storage in internet of vehicles using consortium blockchain

The radically increasing amount and enormous types of data generated by vehicles have brought in the innovated application of data trading in the Internet of Vehicles (IoV). However, the trustless environment in IoV enabled data trading faces conflicting interests and disputes of trading parties. To build trust, we exploit consortium blockchain for secure data trading with information transparency. In addition, a hash list of traded data is maintained by roadside units accompanied by bloom filters for fast lookup, to avoid data duplication. The reliability and integrity of trading data are ensured by using the digital signature scheme based on elliptic curve bilinear pairing. For long term availability of traded data, an external distributed storage, i.e., InterPlanetary File System (IPFS) can provide reliable, high capacity storage resources. The experimental results verified that our proposed solution is efficient for data trading in IoV and reliable for long term availability of data storage. © 2020 IEEE