Amplification of Environmental Appraisal Coordination at General Hospital Lahore and its Implications to Evaluate Management Review

Quality standards have been a significant achievement for organizations worldwide. Environmental standards should be established in hospitals by coding ISO14001. Hospital water pollution can cause health issues in nearby urban areas and settlements. The study was aimed to estimate, characterize, use, and response to water quality parameters on amplification of environmental coordination at General Hospital Lahore (GHL), and their implications for evaluation in management reviewing. For these purposes, the drinking water samples were collected from different locations in the study area. All these samples were analyzed for different water quality parameters namely, pH, TDS, turbidity, and chloride, and compared with national environmental quality standards (NEQS). All the results and management processeswere also compared with ISO 14001:2015, which indicated the weakness in the general administration framework and Environmental Management System (EMS). The results show that pH 8.6, TDS 1100 mg/l, turbidity 5.5 NTU, and chloride 260 mg/l were exceeding the maximum permissible limits. The present study recommended that GHL water should be treated before its use/ disposal. In the end, an EMS (a policy with protocol) manual was developed for continual improvement of water use. Drinking water quality assessment and EMS framework offer assistance to oversee the water quality and environment in health centers. Drinking water quality management under the guidelines of the environment management system manual developed in this study will greatly help to manage the environment, particularly water pollution in local hospitals of Pakistan

A review of groundwater fluoride contamination in Pakistan and an assessment of the risk of fluorosis

This study was conducted with the financial support of the Higher Education Commission of Pakistan, and the University of Peshawar, Pakistan. We greatly acknowledge with deep gratitude this financial supportPeer reviewedPublisher PD

Antimicrobial dispensing practices during COVID-19 and the implications for Pakistan

Antibiotics are one of the most frequently dispensed classes of medicines. However, excessive misuse and abuse enhances antimicrobial resistance (AMR). Previous studies in Pakistan have documented extensive dispensing of 'Watch' and 'Reserve' antibiotics, which is a concern. In view of this, there is a need to assess current dispensing patterns following COVID-19. A cross-sectional study was undertaken collecting dispensing data from 39 pharmacies and 53 drug stores from November 2022 to February 2023. Outlets were principally in urban areas (60.9%) with pharmacists/pharmacy technicians present in 32.6%. 11,092 prescriptions were analyzed. 67.1% of patients were supplied at least one antimicrobial, 74.3% were antibiotics, 10.2% antifungals and 7.9% anthelmintics. 33.2% of antimicrobials were supplied without a prescription. Common indications for dispensed antibiotics were respiratory (34.3%) and gastrointestinal (16.8%) infections, which can be self-limiting. 12% of antibiotics were dispensed for the prevention or treatment of COVID-19. The most frequent antibiotics dispensed were ceftriaxone (18.4%) and amoxicillin (15.4%). 59.2% antibiotics were 'Watch' antibiotics followed by 'Access' (40.3%) and 'Reserve' (0.5%) antibiotics. Of the total antibiotics dispensed for treating COVID-19, 68.3% were 'Watch' and 31.7% 'Access'. Overall, there appeared to be an appreciable number of antibiotics dispensed during the recent pandemic including for patients with COVID-19. Alongside this generally extensive dispensing of 'Watch' antibiotics. This needs urgent addressing with appropriate programs among pharmacists/pharmacy technicians to reduce AMR

Anti-neuropathic pain activity of a cationic palladium (II) dithiocarbamate by suppressing the inflammatory mediators in paclitaxel-induced neuropathic pain model

Neuropathic pain is a chronic pain state that negatively impacts the quality of life. Currently, available therapies for the treatment of neuropathic pain often lack efficacy and tolerability. Therefore, the search for novel drugs is crucial to obtain treatments that effectively suppress neuropathic pain.The present study was undertaken to investigate the antinociceptive properties of (1,4-bis-(diphenylphosphino) butane) palladium (II) chloride monohydrate (Compound 1) in a paclitaxel (PTX)-induced neuropathic pain model.Initially, behavioral tests such as mechanical and cold allodynia as well as thermal and tail immersion hyperalgesia were performed to investigate the antinociceptive potential of Compound 1 (5 and 10 mg/kg, b.w). RT-PCR was performed to determine the effect of Compound 1 on the mRNA expression level of inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), and proinflammatory cytokines such as tumor necrosis factor-alpha (TNF)-α, interleukin (IL)-1β, and IL-6. In addition, antioxidant protein, nitric oxide (NO), and malondialdehyde (MDA) levels were also determined.The results demonstrated that once-daily dosing of Compound 1 significantly suppressed the PTX-induced behavioral pain responses dose-dependently. The mRNA gene expressions of iNOS, COX-2, and inflammatory cytokines were markedly reduced by Compound 1. Furthermore, it enhanced the level of antioxidant enzymes and lowered the level of MDA and NO production.These findings suggest that the antinociceptive potential of Compound 1 in the PTX-induced neuropathic pain model is via suppression of oxidative stress and inflammation. Thus, Compound 1 might be a potential candidate for the therapeutic management of PTX induced neuropathic pain

Propofol Plus Midazolam Versus Propofol alone Sedation in Therapeutic Endoscopic Retrograde Cholangio Pancreatography (ERCP)

Background: To compare Endoscopic RetrogradeCholangio Pancreatography (ERCP) sedationreceiving propofol alone and with midazolam interms of mean propofol dosage and mean recoverytime.Methods: In this comparative study, patientsundergoing therapeutic ERCP were divided intoGroup A (Propofol alone) and Group B (Propofolplus Midazolam). Mean propofol dose adjusted toweight and duration of procedure and mean recoverytime was compared between the two groups.Results: There were 40 patients in each group;46.3% (n=37) males and 53.8% (n=43) females.According to ASA class stratification, 43% (n=34)patients were in ASA class I, 41% (n=33) patients inASA class II and 16% (n=13) patients in ASA classIII. The mean dose of propofol was not significantlydifferent between the two groups; 276 ± 124 mg(Group A) vs. 290 ± 115 mg (Group B), p=0.58). Themean adjusted dose when adjusted to weight andduration of procedure also did not significantlydiffer; 0.08 ± 0.04 (Group A) vs. 0.07 ± 0.03 (Group B),p= 0.38). The recovery time was significantly betterwith propofol monotherapy; 12 ± 7 min (Group A)vs. 44 ± 13 min (Group B), p=0.0001).Conclusion: In comparison to sedation withpropofol and midazolam in ERCP, recovery timefrom sedation is shorter with propofol monotherapywith no additional propofol dose requirement

Faecal and nitrate contamination in the groundwater of Mardan district, Pakistan

This study aimed to determine the status of groundwater contamination with faecal coliform and nitrate in the rural areas of Mardan district, Pakistan. Both analytes require regular monitoring according to the National Environmental Quality Standards (NEQS) of Pakistan. Groundwater samples (n = 100) were collected from 25 villages across four zones. Samples were analysed for physicochemical parameters including pH, electrical conductivity (EC), Escherichia coli (E. coli) contamination, nitrite, and nitrate (NO−2 and NO−3). Whilst the average concentrations of NO−3 in the water samples were within the permissible limits of 50 mg L−1 set by the World Health Organisation (WHO) and NEQS two villages exceeded the safety limits. Non-carcinogenic health risks of NO−3 were estimated in terms of average daily dose (ADD) and hazard quotient (HQ). The HQ values for NO−3 were > 1 for children signifying potential health risks; however, the adult population had HQ < 1 which indicates no risk. Groundwater samples tested positive for E. coli contamination in 13 villages, suggesting that residents may be living at risk of various microbial diseases due to drinking of contaminated water. The findings of this study provide valuable baseline data for groundwater researchers, policymakers, and the local public health department

RETRACTED ARTICLE: Suppression of NF-κB signaling by ECN in an arthritic model of inflammation

Abstract Background The 7β-(3-ethyl-cis-crotonoyloxy)-1α-(2-methylbutyryloxy)-3,14-dehydro-Z-notonipetranone (ECN), a sesquiterpenoid isolated from the Tussilago farfara Linneaus (Asteraceae), was evaluated against acute Carrageenan and chronic complete Freund’s adjuvant (CFA)-induced arthritis in mice. Methods Acute and chronic arthritis were induced by administering Carrageenan and CFA to the intraplantar surface of the mouse paw. Edema, mechanical allodynia, mechanical hyperalgesia, and thermal hyperalgesia were assessed in the paw. Similarly, histological and immunohistological parameters were assessed following arthritis induced by CFA. Antioxidants, inflammatory cytokines, and oxidative stress markers were also studied in all the treated groups. Results The ECN treatment significantly attenuated edema in the paw and elevated the nocifensive threshold following induction of this inflammatory model. Furthermore, ECN treatment markedly improved the arthritis index and distress symptoms, while attenuating the CFA-induced edema in the paw. ECN treatment also improved the histological parameters in the paw tissue compared to the control. At the same time, there was a significant reduction in edema and erosion in the ECN-treated group, as measured by radiographic analysis. Using the Comet’s assay, we showed that ECN treatment protected the DNA from chronic CFA-induced arthritis. Immunohistochemistry analysis showed a marked decrease in the expression level of p-JNK (phosphorylated C-Jun N-terminal kinase), NF-κB (Nuclear factor-kappa B), COX-2 (Cyclooxygenase-2), and TNF-α (Tumour necrosis factor-alpha) compared to the CFA-treated group. Biophysical analysis involving molecular docking, molecular dynamics simulations, and binding free energies of ECN were performed to explore the underlying mechanism. Conclusion ECN exhibited significant anti-inflammatory and anti-arthritic activity against Carrageenan and CFA-induced models

An application of ionic liquid for preparation of homogeneous collagen and alginate hydrogels for skin dressing

Ionic liquid due to its green nature as well as having the ability to dissolve biopolymer, was used in the preparation of collagen and alginate hydrogels. The collagen and alginate hydrogels were prepared in different ratios of collagen and alginate, labeled CA5040, CA6030 and CA7020. The prepared hydrogels were characterized with Fourier-transform infrared spectroscopy (FTIR), Scanning electron microscope (SEM), Thermogravimetric analysis (TGA) analysis. The samples were evaluated for water uptake behavior and mechanical properties using electrodynamic fatigue testing system. The biocompatibility was assessed through hemolysis and MTT assay on rat mesenchymal stem cells (rMSC) which showed satisfactory results. The drug loading and subsequent antibacterial properties were also performed. The prepared collagen and alginate hydrogels are suggested to be used for skin dressing

Molecular docking of Diospyrin as a LOX inhibitory compound

Diospyros lotus is traditionally used in various diseases including inflammation. In the current study an effort has been made to identify a bioactive constituent from D. lotus in order to scientifically validate its use in inflammatory disorders. Diospyrin was isolated from D. lotus and exhibited significant lipoxygenase (LOX) inhibitory activity (IC50 value: 31.89 ± 0.14 μmol). Molecular docking revealed significant molecular interactions between Diospyrin and LOX showing promising potential for further optimization as a potential anti-inflammatory lead compound

Ionic liquid as a potential solvent for preparation of collagen-alginate-hydroxyapatite beads as bone filler

© 2018 Informa UK Limited, trading as Taylor & Francis Group. In this study, collagen/alginate/hydroxyapatite beads having different proportions were prepared as bone fillers for the restoration of osteological defects. Ionic liquid was used to dissolve the collagen and subsequently the solution was mixed with sodium alginate solution. Hydroxyapatite was added in different proportions, with the rationale to enhance mechanical as well as biological properties. The prepared solutions were given characteristic bead shapes by dropwise addition into calcium chloride solution. The prepared beads were characterized using FTIR, XRD, TGA and SEM analysis. Microhardness testing was used to evaluate the mechanical properties. The prepared beads were investigated for water adsorption behavior to ascertain its ability for body fluid uptake and adjusted accordingly to the bone cavity. Drug loading and subsequently the antibacterial activity was investigated for the prepared beads. The biocompatibility was assessed using the hemolysis testing and cell proliferation assay. The prepared collagen-alginate-HA beads, having biocompatibility and good mechanical properties, have showed an option of promising biologically active bone fillers for bone regeneration