Maternal risk factors associated with low birth weight in Karachi: A case-control study

To evaluate maternal risk factors associated with low birth weight (LBW) among women aged 15-35 years, we carried out a hospital-based, case-control study on 262 cases (mothers of neonates weighing \u3c or = 2.5 kg) and 262 controls (mothers of neonates weighing \u3e 2.5 kg). Odds of delivering a low-birth-weight baby decreased with increase in maternal haemoglobin [odds ratio (OR): 0.701; 95% confidence interval (CI): 0.62-0.79]. Odds were greater among mothers not using iron supplements during pregnancy (OR: 2.88; 95% CI: 1.83-4.54). Mothers of LBW babies had lower haemoglobin levels before delivery

Development of an indigenous screening instrument in Pakistan: the Aga Khan University Anxiety and Depression Scale

The use of translations of instruments for detecting anxiety and depression continues to be debated. An indigenous screening instrument has been developed in Urdu for anxiety-depression syndromes at the Aga Khan University. It has been developed from the complaints of 150 anxious and depressed patients presenting to a non-speciality clinic and has been validated in 53 patients in a psychiatry clinic. The questionnaire has 25 items, 13 psychlogical and 12 somatic. At a score of 20 it has a sensitivity of 66%, a specificity of 79%, a positive predictive value of 83 and a negative predictive value of 60. In comparison with available instruments in Urdu, comprising of either psychological or somatic items, this scale includes both, which increases its reliability for use as a screening instrument by Community Health Workers in a primary health care setting, in epidemiologic work in Pakistan and in transcultural psychiatric research

Prognostic indicators of childhood acute viral encephalitis

Objective: To devise a set of clinical signs and laboratory parameters that would help clinicians assess prognosis in patients and plan appropriate management.Methods: Medical records of 147 paediatric cases (with a discharge diagnosis of acute viral encephalitis) admitted over a ten year period from 1987 to 1997 were reviewed and relevant information collected on a data extraction form.Results: Of 147 patients, 24 (16.3%) died and 48 (32.7%) were left with severe neurological deficits. A GCS (Glasgow Coma Scale) score between 6-10 had an association with poor outcome (OR = 2.62, Chi-square = 5.57, p-value = 0.018) and that a GCS score of \u3e or = 5 was even more strongly suggestive of poor outcome (OR = 5.49, Chi-square = 12.08, p-value = 0.0005). A history of having seizures, for more than 3 days, also showed a strong association with poor outcome (OR = 3.66, Chi-square = 5.46, p-value = 0.019).CONCLUSION: Patients with an increased risk of death and severe disability can be identified using a few guidelines. Of these, a history of seizures of \u3e 3 days and/or impaired consciousness (GCS \u3c or = 10), at the time of presentation to the hospital, constitute high risk. These cases must be identified promptly and aggressive therapy initiated in order to improve long term outcome

Preconcentration and Detection of Gefitinib Anti-Cancer Drug Traces from Water and Human Plasma Samples by Means of Magnetic Nanoparticles

Along of widespread application of anti-cancer drug Gefitinib (GEF), it appears in human body fluids as well as clinical wastewater. Consequently, a reliable and easy-to-adapt detection technique is of essential importance to quantify the drug in different media. The extraction and quantitative detection of anti-cancer drug Gefinitib (GEF) is demonstrated based on a straightforward and efficient magnetic nanoparticle-assisted preconcentration route from water and human plasma samples. Iron oxide magnetic nanoparticles (Fe3O4) have been prepared with an average particle size of 15 nm and utilized as extractible adsorbents for the magnetic solid-phase extraction (MSPE) of GEF in aqueous media. The method is based on MSPE and preconcentration of GEF followed by High-Performance Liquid Chromatography-Ultraviolet Detection (HPLC-UV). The yield of GEF extraction under the optimum MSPE conditions were 94% and 87% for water and plasma samples, respectively. The chromatographic separation was carried out isocratically at 25 °C on a Phenomenex C8 reversed phase column (150 mm × 4.6 mm, with 5 µm particle size). The proposed method was linear over concentration ranges of 15.0–300.0 and 80.0–600.0 ng/mL for water and plasma samples with limits of detection of 4.6 and 25.0 ng/mL in a respective order. Relative standard deviations (%RSD) for intra-day and inter-day were 0.75 and 0.94 for water samples and 1.26 and 1.70 for plasma samples, respectively. Using the magnetic nanoparticles (MNPs) as loaded drug-extractors made the detection of the anti-cancer drug environmentally friendly and simple and has great potential to be used for different drug-containing systems

Combination effect of argan oil and low frequency electromagnetic field on open wound in mice

This study was conducted to evaluate the effect of argan oil with the exposure of low frequency electromagnetic field (EMF) on open wound healing in mice. Eighteen male mice (20-40 g) were divided into three groups: phosphate buffer saline (PBS) as negative control, solcoseryl gel as positive control, and argan oil with the exposure of low frequency EMF, 1.2 mT (treatment group). Full thickness wounds (4 mm diameter) were induced on the shaved dorsal of the mouse. All mice were sacrificed on day 12 after the final treatment. Macroscopic observation, wound contraction rate, histopathology analysis and total protein content were examined in this study. Results showed that wounds treated with argan oil and exposed to low frequency EMF has a significant increase in wound contraction rate (p < 0.05) and total protein content (p < 0.05). Moreover, histopathological analysis on the wound tissues displayed complete re-epithelization with thick and dense collagen fibers in the argan oil with low frequency EMF exposure treated group. In conclusion, topical treatment of argan oil with low frequency EMF exposure yield a better healing progress and showed the ability to accelerate wound healing

The Impact of Restrictive Versus Conservative Intraoperative Fluid Strategies upon the Renal Outcome in Colorectal Surgeries. A Randomized Controlled Trial

Background: intraoperative fluid handling has a lot of concerns upon the postoperative organ function. One of the most sensitive organs which could be affected is the kidney. Objectives: We conducted this trial to address the impact of restrictive vs. conservative fluid approaches on postoperative renal complications, hemodynamics and hospital stay. Patients and methods: Prospective, randomized, double-blind placebo-controlled trial at Assiut University Hospitals. The study included 60 adult patients with American Society of Anesthesiologists (ASA) grade II-III undergoing elective colorectal surgery with an expected operative duration of at least two hours. Grouping was based upon the intraoperative fluid management Group (R): 6 mL/kg/h. of lactated ringer (LR), Group (C): 12 mL/kg/h. of LR. The preoperative serum Neutrophil gelatinase-associated lipocalin (NGAL) level (basal value) then by the 2nd and 24th postoperative hours, KDIGO (Kidney Disease: Improving Global Outcomes), serum urea and creatinine were documented by the end of 1st and 2nd postoperative days. Intraoperative hypovolemia events were noted as well. Results: serum NGAL has increased >149 ng/mlin three patients within group C, and two patients within group R; however, the difference was statistically insignificant p= 0.5. KDIGO showed significant difference between the two groups, with higher number of patients in the group R with p= 0.043. Serum urea and creatinine, intraoperative hypovolemic episodes showed insignificant differences between groups. Conclusion: no evident difference between restrictive and conservative intraoperative fluid strategies was noticed upon the early postoperative serum NGAL and other systems complications in patients undergoing major colorectal surgeries

Clean birth kits to improve birth practices: development and testing of a country level decision support tool

Background: Clean birth practices can prevent sepsis, one of the leading causes of both maternal and newborn mortality. Evidence suggests that clean birth kits (CBKs), as part of package that includes education, are associated with a reduction in newborn mortality, omphalitis, and puerperal sepsis. However, questions remain about how best to approach the introduction of CBKs in country. We set out to develop a practical decision support tool for programme managers of public health systems who are considering the potential role of CBKs in their strategy for care at birth. Methods: Development and testing of the decision support tool was a three-stage process involving an international expert group and country level testing. Stage 1, the development of the tool was undertaken by the Birth Kit Working Group and involved a review of the evidence, a consensus meeting, drafting of the proposed tool and expert review. In Stage 2 the tool was tested with users through interviews (9) and a focus group, with federal and provincial level decision makers in Pakistan. In Stage 3 the findings from the country level testing were reviewed by the expert group. Results: The decision support tool comprised three separate algorithms to guide the policy maker or programme manager through the specific steps required in making the country level decision about whether to use CBKs. The algorithms were supported by a series of questions (that could be administered by interview, focus group or questionnaire) to help the decision maker identify the information needed. The country level testing revealed that the decision support tool was easy to follow and helpful in making decisions about the potential role of CBKs. Minor modifications were made and the final algorithms are presented. Conclusion: Testing of the tool with users in Pakistan suggests that the tool facilitates discussion and aids decision making. However, testing in other countries is needed to determine whether these results can be replicated and to identify how the tool can be adapted to meet country specific needs