Professional Practices Promoting Health of Healthcare Workers: Comparison of Public and Private Hospitals in Pakistan

Background and Objectives: Health and safety of healthcare workers (HCWs) is a determinant of the quality of healthcare delivered to the population at large. This study aimed at comparing various dimension of HCWs’ health and safety between public and private hospitals (PHs) in the Pakistan context. Methods: A sample of 1146 HCWs from 2 public and 2 PHls in a metropolitan city were invited to response to a structured questionnaire, assessing various aspects of health and safety promotion practices in their hospital. Categorical data were compared using chi-square test or Fisher exact test or likelihood ratio tests. Findings: According to the responders, lack of written policies and guidelines for health promotion was 84% in public hospitals (GHs) vs. 22% in PH (P\u3c.001), communication of health policies, 64% vs. 42% (P\u3e\u3c.001), lack of access to health policies, 68% vs. 40% (P\u3e\u3c.001), lack of professional employees in safety 64% vs. 49%, lack of health promotion activities 91% vs. 51% (P\u3e\u3c.001), and absence of encouragements to participate in healthrelated activities 87% vs. 24% (P\u3e\u3c.001)…. vs. 24% (P\u3c.001). Conclusions: As revealed by our study, there is a large gap in HCWs’ health and safety promoting practices between public and PHs. The situation calls for increased budget and focused program to improve health and safety of HCWs in Pakistan’s GH

UNDERSTANDING HEALTH SEEKING BEHAVIOR OF HEALTH CARE PROFESSIONALS IN TERTIARY CARE HOSPITALS IN PAKISTAN

Background: Health seeking behaviour refers to the behaviour of people towards seeking their own health through provided health services. The medical professionals are at a higher risk of avoiding health seeking behaviour because they believe they are aware of the diseases and their symptoms as well as the pharmaceutical management of the disease. The aim of this study was to understand the healthcare seeking behaviour of nurses and doctors as well as the factors affecting it in hospitals of a major city in a developing country. Methods: A cross-sectional study was designed and a self-report questionnaire was distributed to healthcare workers at four tertiary care hospitals from July, 2012 to December, 2014. A total of 1015 participants responded. There were 234 (23%) doctors, 664 (65%) nurses, 60 (6%) ....BOTH GROUPS

A Review on Anticancer Potential of Nitric Oxide

Nitrous oxide (NO) is a free radical gas which performs various physiological and pathological processes in body. NO is produced by different enzymatic pathways and plays role in homeostasis. Over past years, NO has emerged as a molecule of interest in many ailments including cancer. But its role in cancer is still controversy. It can display dose-dependant anticancer therapy on one hand and induce procancer properties on the other hand. But as compared to conventional treatments, NO proved better tumor cell resistance. This review mentions dichotomous nature of NO that may encourage future research assessing the role of NO in cancer prevention and treatment either as a single agent or in combination with other antineoplastic compounds

A comparative analysis of sperm selection procedures prior to cryopreservation on Nili-Ravi buffalo bull (Bubalus bubalis) semen. Assessment of its impact on post-thaw sperm functional quality

Sperm selection techniques have been developed to get sperm suspensions enriched in motile and functional cells. Studies show that selection before cryopreservation improves post-thaw quality of cryopreserved sperm but information on buffalo bull sperm is scarce. The study was aimed to 1) perform a comparative analysis of sperm selection procedures; Swim-Up (SU), Sephadex?-G15 Filtration (S-G15) or Glass Wool Filtration (GWF) for total and motile cell recovery, 2) to assess the impact of sperm selection prior to cryopreservation on sperm quality (motility, morphology, cell membrane and normal apical ridge, viability and livability, chromatin integrity) and sperm functionality (Embryo Cleavage after IVF with selected sperm) in post-thawed suspensions of buffalo bull sperm. Semen was collected from 5 Nili Ravi buffalo bulls maintained at the Semen Production Unit Qadirabad, District Sahiwal, Pakistan. Ejaculates were divided into four aliquots for SU, S-G15 and GWF and control. After sperm selection, total and motile sperm recovery was highest in GWF samples (total sperm=84.08±8.39%; motile sperm=80.42±3.57%). An improvement (P<0.05) in all post-thaw parameters was observed in S-G15-selected sperm and, in some parameters in GWF-filtered sperm suspensions compared to control. The highest (P<0.05) embryo cleavage rate (%) was achieved with frozen-thawed sperm selected with S-G15 prior to cryopreservation (44.72±4.18) compared to control (21.98±3.00). In conclusion, post thaw sperm quality was improved after sperm selection from fresh buffalo bull semen through S-G15 and GWF procedures compared to SU and control while, the fertility rate (cleavage rate) was improved with sperm processed using the S-G15 procedure.Fil: Husna, Asma U. I.. Pir Mehr Ali Shah Arid Agriculture University; PakistánFil: Ejaz, Rabea. Pir Mehr Ali Shah Arid Agriculture University; PakistánFil: Qadeer, Saima. Pir Mehr Ali Shah Arid Agriculture University; PakistánFil: Azam, Asima. Pir Mehr Ali Shah Arid Agriculture University; PakistánFil: Rakha, Bushra. Pir Ali Shah Arid Agriculture University; PakistánFil: Ansari, Muhammad Sajjad. Pir Ali Shah Arid Agriculture University; PakistánFil: Shahzad, Quaisar. Buffalo Research Institute; PakistánFil: Javed, Moazzam. Semen Production Unit; PakistánFil: Vazquez, Monica Hebe. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Biología y Medicina Experimental. Fundación de Instituto de Biología y Medicina Experimental. Instituto de Biología y Medicina Experimental; ArgentinaFil: Akhter, Shamin. Pir Mehr Ali Shah Arid Agriculture University; Pakistá

Assessment, endoscopy, and treatment in patients with acute severe ulcerative colitis during the COVID-19 pandemic (PROTECT-ASUC): a multicentre, observational, case-control study

BackgroundThere is a paucity of evidence to support safe and effective management of patients with acute severe ulcerative colitis during the COVID-19 pandemic. We sought to identify alterations to established conventional evidence-based management of acute severe ulcerative colitis during the early COVID-19 pandemic, the effect on outcomes, and any associations with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe COVID-19 outcomes. MethodsThe PROTECT-ASUC study was a multicentre, observational, case-control study in 60 acute secondary care hospitals throughout the UK. We included adults (≥18 years) with either ulcerative colitis or inflammatory bowel disease unclassified, who presented with acute severe ulcerative colitis and fulfilled the Truelove and Witts criteria. Cases and controls were identified as either admitted or managed in emergency ambulatory care settings between March 1, 2020, and June 30, 2020 (COVID-19 pandemic period cohort), or between Jan 1, 2019, and June 30, 2019 (historical control cohort), respectively. The primary outcome was the proportion of patients with acute severe ulcerative colitis receiving rescue therapy (including primary induction) or colectomy. The study is registered with ClinicalTrials.gov, NCT04411784. FindingsWe included 782 patients (398 in the pandemic period cohort and 384 in the historical control cohort) who met the Truelove and Witts criteria for acute severe ulcerative colitis. The proportion of patients receiving rescue therapy (including primary induction) or surgery was higher during the pandemic period than in the historical period (217 [55%] of 393 patients vs 159 [42%] of 380 patients; p=0·00024) and the time to rescue therapy was shorter in the pandemic cohort than in the historical cohort (p=0·0026). This difference was driven by a greater use of rescue and primary induction therapies with biologicals, ciclosporin, or tofacitinib in the COVID-19 pandemic period cohort than in the historical control period cohort (177 [46%] of 387 patients in the COVID-19 cohort vs 134 [36%] of 373 patients in the historical cohort; p=0·0064). During the pandemic, more patients received ambulatory (outpatient) intravenous steroids (51 [13%] of 385 patients vs 19 [5%] of 360 patients; p=0·00023). Fewer patients received thiopurines (29 [7%] of 398 patients vs 46 [12%] of 384; p=0·029) and 5-aminosalicylic acids (67 [17%] of 398 patients vs 98 [26%] of 384; p=0·0037) during the pandemic than in the historical control period. Colectomy rates were similar between the pandemic and historical control groups (64 [16%] of 389 vs 50 [13%] of 375; p=0·26); however, laparoscopic surgery was less frequently performed during the pandemic period (34 [53%] of 64] vs 38 [76%] of 50; p=0·018). Five (2%) of 253 patients tested positive for SARS-CoV-2 during hospital treatment. Two (2%) of 103 patients re-tested for SARS-CoV-2 during the 3-month follow-up were positive 5 days and 12 days, respectively, after discharge from index admission. Both recovered without serious outcomes. InterpretationThe COVID-19 pandemic altered practice patterns of gastroenterologists and colorectal surgeons in the management of acute severe ulcerative colitis but was associated with similar outcomes to a historical cohort. Despite continued use of high-dose corticosteroids and biologicals, the incidence of COVID-19 within 3 months was low and not associated with adverse COVID-19 outcomes