Mindfulness in the emergency department (MED): An asynchronous learning course to practise mindfulness and resilience in the emergency room of low resource setting

Owing to the fast-paced, stressful, and frequent crucial rapid decisions that trigger cognitive exhaustion, emergency physicians are especially vulnerable to burnout. Mindfulness practices have been defined in the literature and it focuses on the well-being and resilience. Mindfulness is characterised as the ability to use tools and expertise to mentally respond to environmental problems to fulfil psychological needs. To overcome burnout, a self-directed learning course was developed for emergency physicians that will include learning goals on mindfulness, peer group discussions and tasks, role playing and practising meditation exercises. It would concentrate on the foundations of mindfulness and resilience, learning and incorporating mindfulness, understanding the coping mechanisms and establishing a pathway to minimise anxiety and depression

Effectiveness of Health Education to Improve Oral Care of Primary School Children in A Rural Community of Pakistan

Oral health is an integral part of human general health. “Oral health is the beauty of the oral cavity, which includes teeth, tissue and its supporting structure, the overall health promotion is necessary but focuses on oral health is most important, it is primarily aiming to prevent from oral disease by health education. Methods: A quasi- experimental, quantitative, before and after study design was conducted  among the students total (n= 56) in the primary school of Ali Raza Abad Raiwind Road Lahore, Pakistan from September 2018 to December 2018. The educational intervention involve four meeting about oral hygiene in which the researcher educate the students about poor and good oral hygiene, prevention of disease which are caused by poor oral hygiene and appropriate way of tooth brushing lead to good oral health. Results: A total of 56 children participated in the study, the majority of the participants were boys 41(73.2%). The mean before the educational intervention is 5.83 (Standard deviation 3.80) and after the educational intervention is 7.86(Standard deviation 3.36). The mean difference between the two mean is 2.01. There is a statistically significant difference before and after the educational intervention. The educational intervention is highly effective because the significant value is 0.00 Conclusions: The result of the study shows that oral hygiene can be improved by educational intervention and by proper techniques of tooth brushing. Keywords- Improve oral care. Oral health education. DOI: 10.7176/JEP/11-7-03 Publication date:March 31st 202

Evaluation of efficacy and safety of doxofylline 800mg sustained release tablet in treatment of patients with COPD: an open label, prospective and RCT

Background: COPD is a major cause of health care burden worldwide and leading cause of death that is increasing in prevalence. Methylxanthines are used in the treatment of patients with asthma and COPD. Doxofylline (methylxanthine) shows improved disease control, reduced total daily dose of inhaled b2 agonists and improved patient compliance.Methods: This was a prospective, open labelled, randomized, two-arm, parallel group, controlled, clinical trial. 115 patients were randomized to two groups. Patients in group A received tablet doxofylline 400mg BD whereas patients in group B received tablet doxofylline 800mg SR for 4 weeks. Primary outcome measure of trial was change in FEV1 and secondary outcome measure were change in FVC/FEV1, change in symptoms score, effect on health-related quality of life (HRQOL) and safety of study medication.Results: At 4 week the FEV1increase by 13.028% and 17.647% in group A and B respectively. In group A FEV1/FVC increase by 5.79% and in group B it increases by 9.57% at 4 weeks. The symptom score of cough decrease by 77.35% and 97.43% in group A and group B respectively at 4 weeks. In group A shortness of breath decrease by 77.60% and in group B it decreases by 95.90% at 4 weeks. Tightness in chest decrease by 86.29% and 98.40% in group A and group B respectively at 4 weeks.Conclusions:Doxofylline 800mg sustained release tablet provided significantly greater improvement in FEV1, symptomatic control and health related quality of life compared to doxofylline 400mg.

Comparative study of safety and efficacy of pregabalin and gabapentin in management of neuropathic pain associated with chronic lumbar radiculopathy

Background: Chronic lumbar radiculopathy a clinical condition in which there is back and leg pain associated with sensory, reflex, or motor deficits in the area of nerve root distribution lasting for more than 12 weeks. The prevalence of lumbar radiculopathy has been reported to be 5.3% in men and 3.7% in women. Pregabalin and gabapentin, which fit in to a new category of drugs called as alpha-2-delta (α2δ) modulators, have been discovered to be effective in the treatment of neuropathic pain related with multiple conditions. So this study was done to compare safety and efficacy of pregabalin and gabapentin in management of pain associated with chronic lumbar radiculopathy.Methods: This was a randomized two arm comparative prospective study. Total 160 patients were enrolled and randomized equally into 2 groups. Group A patients were given capsule pregabalin 75 mg two times a day orally, Group B patients were given tablet gabapentin 300 mg two times a day. Pain intensity was assessed at the start of study i.e. at baseline (0 week), at 6 weeks and at 12 weeks of starting the treatment using numeric pain rating scale.Results: There was significant reduction in pain at the end of 12 weeks in both the groups (p<0.0001), but there was no significant difference between these two groups. The incidence of adverse effects was also more in group A.Conclusions: Both the drugs are having comparable efficacy but gabapentin is more tolerable in such cases

Knowledge and attitude towards identification and management of sepsis among resident physicians in a tertiary care teaching hospital in Pakistan

This study was conducted to determine the compliance and knowledge of sepsis guidelines among resident physicians in a tertiary care hospital of a developing country. A self-structured validated questionnaire was prepared to evaluate compliance and knowledge of the Surviving Sepsis Campaign (SSC) guidelines. A total of 76 resident physicians completed the questionnaire; out of these, 51 (67%) were from Internal Medicine department and 25 (33%) were from Emergency Medicine department of the Aga Khan University Hospital, Karachi. A total of 71 (93%) participants claimed to be aware of the SSC guidelines but only 20 (26%) considered themselves very knowledgeable on the subject. Thirty-five (46%) physicians claimed that they were using the guidelines regularly. We concluded that the overall knowledge and compliance of sepsis guidelines was suboptimal. This emphasises the need for increased awareness and teaching of sepsis and SSC guidelines to improve patient outcomes in developing countries

Drug utilization study in OPD of a tertiary care hospital in a rural area of Jalna, Maharashtra, India by using WHO prescribing indicators

Background: Drug utilization studies (DUS) are used as potential tool in the evaluation of healthcare system. DUS are conducted to facilitate the rational use of drugs in populations. The indicators of prescription in practice measure the performance of health care provider in several key dimensions related to appropriate use of drug. Therefore, the present study was undertaken to analyze the prescription written by doctors in a Tertiary Care Hospital in rural area.Methods: Present study is a cross sectional, prospective and observational study. The study was conducted in a rural tertiary, teaching hospital at JIIU’s Indian Institute of Medical Science and Research, Warudi, Taluka Badnapur from January 2017 to September 2017 for duration of 9 months. Data was obtained from 300 prescriptions. Data was analysed as per WHO prescribing indicators.Results: Average number of drugs in the present study was found to be 2.85. Percentage of drugs prescribed by generic name is 13.48%. Percentage of encounters with an antibiotic prescribed 60%. Percentage of encounters with an injection prescribed 4.33%. Percentage of drugs prescribed from essential drugs list 72.91%.Conclusions: These types of studies help to design policy for rational use of drugs and motivation of physician for rational use of drugs

A Comparative Analysis of Supportive Navigation on Movie Recommenders

This literature review covers the research and thought process that went into making a solution for the infinite scrolling problem faced in streaming services such as Netflix. Using the data collected, we have come to the conclusion that an alternate layout can somewhat alleviate the problems it takes in navigating a list of movies. We also found out by a comparative analysis that some layouts, the circular one in particular, is advantageous in certain settings making it an ideal candidate for a movie recommender system.Comment: This was an extensive survey and prototyping we did to purpose and alternative user interface for movie recommender systems like Netfli

Evaluation of efficacy and tolerability of eperisone and thiocolchicoside in treatment of low back pain associated with muscle spasm: An open label, prospective, randomized controlled trial

Background: Low back pain has a high prevalence in adult population. Because of reflex muscle spasm, muscle relaxants are frequently used either alone or in combination with analgesics. Eperisone inhibits voltage gated sodium channels in brain stem and Thiocolchicoside acts via GABA-mediated mechanism to relax muscle spasm and relieves pain.Methods: This was a prospective; open labeled, randomized, two-arm, parallel group, controlled, clinical trial. 113 patients were randomised to two groups. Patients in group A received Tablet Eperisone 100 mg whereas patients in group B received Tablet Thiocolchicoside 8 mg for seven days along with Tablet Paracetamol 500 mg. The outcome measures of trial were the improvement in finger to floor distance (FFD) and pain in lumbar region, relief of spasm and tenderness of paravertebral muscles on day 4 and 7.Results: At the end of the study FFD reduced by 18 cm in group A (p < 0.0001*) and 17.36 cm in group B (p<0.0001*) from baseline. Mean score of pain on day 7 reduced by 5.64 scale in group A as compared to 5.42 scale in group B (p<0.0001* in both groups). Paravertebral tenderness reduced by 92.6% in group A and 94.6% in group B at the end of the trial. On day 7, the spasm relief was 87% in group A and 88% in group B.Conclusions: Eperisone is an effective muscle relaxant with equivalent efficacy compared to Thiocolchicoside, and has a better tolerability in treatment of low back pain with muscle spasm

Design and Simulation of the Multi-RAT Load-balancing Algorithms for 5G-ALLSTAR Systems

This paper introduces algorithms for the multi-RAT load balancing function to maximize QoE in terrestrial and satellite combined system developed in the 5G-ALLSTAR project. The pros and cons of the considered algorithms are described and the simulator is also described in the paper with the on-going performance evaluation processes