Client Satisfaction Towards Quality of Health Services: an Assessment at Primary Healthcare of District Gujranwala

This survey designed to evaluate the satisfaction level and the factors that affect the patient satisfaction regarding health care delivery services with the aim to improve the services in the primary health care settings of Gujranwala. A Cross Sectional Study done on randomly selected patients attending the basic health units of Gujranwala, with more than18 years of age. Pretested structured "Liker scale questionnaire" was used for data collection. Out of total respondents, 62 (41.3%) clients were satisfied with the services provided by the basic health units of Gujranwala. The factors identified to determine patient satisfaction were accessibility of services, behavior of staff, health education, level of cleanliness, drug availability and miscellaneous services. Not a single ranked area of satisfaction noticed. Client\u27s occupation and income had significant relationship with the patient satisfaction level. Gender, age, and education of clients were not contributing factors; they not affect the client satisfaction level.Less than half clients were satisfied with the services provided by the basic health units. Management of health facilities needs to improve the services

A rare case report on primary sjogren’s syndrome complicating as osteomalacia with renal tubular acidosis in a tertiary care teaching hospital tirupathi

Renal involvement in Sjogren’s syndrome (SS) is not uncommon and may precede other complaints. Tubulointerstitial nephritis is the most common renal disease in SS and may lead to, renal tubular acidosis (RTA), which in turn may cause osteomalacia. Nevertheless, osteomalacia rarely occurs as the first manifestation of a renal tubule connective tissue disorder due to SS. Here we are presenting a female patient of age 41 yrs was admitted in our hospital with chief complaints of bilateral thigh pain which restrict her walking with weakness. x-ray of long bone shows that extensive demineralization of the bone. Laboratory investigations revealed hypokalemia (3.2 mmol/L), hypophosphatemia (0.4 mmol/L), hypocalcemia (2.14 mmol/L) and hyperchloremic metabolic acidosis (chlorine: 214 mmol/L; alkaline reserve: 14 mmol/L). The serum alkaline phosphatase levels were elevated. The serum levels of 25-hydroxyvitamin D and 1,25-dihydroxy vitamin D were low and borderline low, respectively, and the parathyroid hormone level was 90 pg/L. Urinalysis showed inappropriate alkaline urine (urinary PH: 7), glycosuria. These values indicated the presence of both distal and proximal RTA. Our patient reported dryness of the mouth and eyes and Schirmer’s test showed xerophthalmia

A study of bone mineral density among people living with HIV in India and its correlation with CD4 count

Background: Data on the prevalence of osteoporosis in HIV patients in Asian population is scarce this study was done to find out the prevalence of osteoporosis in HIV infected patients and its correlation with CD4 counts.Methods: This cross- sectional study was conducted in NACO- ART center of tertiary care hospital. Total 115 HIV patients were included in this study which were divided into ART naive (n= 69) and patients taking ART (n= 46). We analysed BMD by DEXA in 115 HIV positive patients and 78 HIV negative age and sex matched controls. Correlation of BMD with a CD4 count and ART regimen was studied.Results: BMD was found to be low in HIV positive patients. T score in HIV positive patients was significantly lower (p<0.05) as compared to the HIV negative control group. The prevalence of osteopenia and osteoporosis in HIV positive patients was 50.4% and 29.6% respectively, as compared to 23.1% and 2.6% in HIV negative controls. BMD showed relation with CD4 count. We did not find any statistical difference between any ART regimen and BMD.Conclusions: The prevalence of osteopenia and osteoporosis in HIV infected cases was higher as compared to HIV negative controls and higher in ART group as compared to ART naïve group. Low BMD levels show correlation with low CD4 count. We recommend that HIV positive patients especially with advanced stage of disease, low CD4 count should be screened for low BMD by DEXA scan for osteoporosis and managed accordingl

Influence of Supplements on the Quality Parameters of Pleurotus sajor-caju (Fr.) Singer

Various supplements viz., Artemisia, soybean, ‘baisen’(Cicer arietinum) rice bran, apple pomace, wheat bran, ‘moong dal’ (Vigna radiate), maize flour at different concentrations (0.5, 1.0 and 1.5%) to a single base material i.e, paddy straw were evaluated for their influence on total number of flushes, average number and weight of fruit bodies and diameter of stipe and pileus. Artemisia recorded lowest average number (51.4) and highest weight (16.33g) of a fruit body. Whereas the highest average number (68.8) and lowest average weight (12.88) was registered in apple pomace. The average maximum diameter of pileus (12.33cm) was observed in Artemisia and lowest in apple pomace (10.89cm). Similarly, average maximum diameter of stipe (0.98cm) was recorded on soybean and lowest in maize flour (0.71cm).Key words: Pleurotus sajor-caju, Quality parameters, Supplements P.A. Sheikh et al. Influence of Supplements on the Quality Parameters of Pleurotus sajor-caju (Fr.) Singer. J Phytol 2/10 (2010) 60-6

Effects of hydrostatic and uniaxial stress on the Schottky barrier heights of Ga-polarity and N-polarity n-GaN

We report measurements of the Schottky barrier heights of Ni/Au contacts on Ga-polarity and N-polarity n-GaN under hydrostatic pressure and applied in-plane uniaxial stress. Under hydrostatic pressure the two different polarities of GaN yield significantly different rates of Schottky barrier height increase with increasing pressure. Uniaxial stress parallel to the surface affects the Schottky barrier height only minimally. The observed changes in barrier height under stress are attributed to a combination of band structure and piezoelectric effects

Genome wide association study of uric acid in Indian population and interaction of identified variants with type 2 diabetes

Abnormal level of Serum Uric Acid (SUA) is an important marker and risk factor for complex diseases including Type 2 diabetes. Since genetic determinant of uric acid in Indians is totally unexplored, we tried to identify common variants associated with SUA in Indians using Genome Wide Association Study (GWAS). Association of five known variants in SLC2A9 and SLC22A11 genes with SUA level in 4,834 normoglycemics (1,109 in discovery and 3,725 in validation phase) was revealed with different effect size in Indians compared to other major ethnic population of the world. Combined analysis of 1,077 T2DM subjects (772 in discovery and 305 in validation phase) and normoglycemics revealed additional GWAS signal in ABCG2 gene. Differences in effect sizes of ABCG2 and SLC2A9 gene variants were observed between normoglycemics and T2DM patients. We identified two novel variants near long non-coding RNA genes AL356739.1 and AC064865.1 with nearly genome wide significance level. Meta-analysis and in silico replication in 11,745 individuals from AUSTWIN consortium improved association for rs12206002 in AL356739.1 gene to sub-genome wide association level. Our results extends association of SLC2A9, SLC22A11 and ABCG2 genes with SUA level in Indians and enrich the assemblages of evidence for SUA level and T2DM interrelationship

Comparative genomics of <i>Helicobacter pylori</i> isolates recovered from ulcer disease patients in England

Background. Genomic diversity of H. pylori from many different human populations is largely unknown. We compared genomes of 65 H. pylori strains from Nottingham, England. Molecular analysis was carried out to identify rearrangements within and outside the cag-pathogenicity-island (cag PAI) and DNA sequence divergence in candidate genes. Phylogenetic analysis was carried out based on various high-resolution genotyping techniques. Results. Analyses of virulence genes (cagT, cagE, cagA, vacA, iceA, oipA and babB) revealed that H. pylori strains from England are genetically distinct from strains obtained from other countries. The toxigenic vacA s1m1 genotype was found to be less common and the plasticity region cluster was found to be disrupted in all the isolates. English isolates showed a predominance of iceA1 alleles and a functional proinflammatory oipA gene. The English H. pylori gene pool revealed several Asian/oriental features. This included the predominance of cagA – glr (cagA right junction) motif types III and II (up to 42%), presence of vacA m1c alleles and phylogenetic affinity towards East Asian / Amerindian gene pools based on fluorescent amplified fragment length polymorphism (FAFLP) analysis and glmM sequence analysis. Conclusion. Overall, our results demonstrated genetic affinities of H. pylori in England with both European and the Asian gene pools and some distinctive genetic features of virulence genes that may have evolved in this important European population

Effect of hydrostatic pressure on the current-voltage characteristics of GaN∕AlGaN∕GaN heterostructure devices

The current-voltage characteristics of n-GaN∕u-AlGaN∕n-GaN heterostructure devices are investigated for potential pressure sensor applications. Model calculations suggest that the current decreases with pressure as a result of the piezoelectric effect, and this effect becomes more significant with thicker AlGaN layers and increasing AlN composition. The change in current with pressure is shown to be highly sensitive to the change in interfacial polarization charge densities. The concept is verified by measuring the current versus voltage characteristics of an n-GaN∕u-Al0.2Ga0.8N∕n-GaN device under hydrostatic pressure over the range of 0–5 kbars. The measured current is found to decrease approximately linearly with applied pressure in agreement with the model results. A gauge factor, which is defined as the relative change in current divided by the in-plane strain, approaching 500 is extracted from the data, demonstrating the considerable potential of these devices for pressure sensing applications

AmpliBASE MT: a Mycobacterium tuberculosis diversity knowledgebase

AmpliBASE MT is an online databank of high-resolution DNA fingerprints representing fluorescent amplified fragment length polymorphism (FAFLP) profiles or amplitypes developed for the Mycobacterium tuberculosis complex strains from 48 different countries. AmpliBASE MT is based on a relational database management system that is hyperlinked to visualize genotyping results in the form of DNA fingerprint images for individual strains. A flexible search system based on systematic comparisons of fragment sizes in base pairs allows inter-laboratory comparison of FAFLP profiles. Besides this, the database also displays previously published data on IS6110 profiles, spoligotypes, MIRU-VNTRs and large sequence polymorphisms along with the FAFLP records that will give the overall comparisons. Being the first of its kind, AmpliBASE MT is expected to be a very helpful tool in strengthening the concept of 'geographic genomics' and will be very helpful to molecular epidemiologists and those interested in diagnostic development for tuberculosis