Surgical site infection; effect of contamination and duration of surgical procedure

Introduction: Surgical site infections are responsible for increased treatment cost, prolonged hospital stay and increased morbidity on surgical floor. Increased level of per operative contamination and prolonged surgery increases the incidence of surgical site infections.Objective: To know the effect of contamination and duration of surgery on the incidence of surgical site infections in emergency surgical patients so that specific strategies can be developed to decrease the morbidity and mortality caused by these infections.Materials and Methods: All the patients who underwent general surgical operations on an emergency basis at the surgical unit-1 of the Benazir Bhutto Hospital Rawalpindi from 01-01-2019 to 31-12-2020 were evaluated for surgical site infections. The level of contamination per operatively and duration of surgery were documented. Surgical site infections suspected clinically were confirmed by culture and sensitivity.Results: Among 2202 emergency-operated patients, two hundred and thirty-seven patients (10.76%) had surgical site infection confirmed on culture and sensitivity (C/S) report. About sixty-five percent of patients were male. Of two hundred and thirty-seven positive patients, seventy (29.09%) patients underwent laparotomy for penetrating and blunt abdominal trauma. About fifty-eight percent of SSI patients had contaminated wounds per operatively. Operative time was one to three hours in about sixty-seven percent of SSI-positive patients. Staph aureus was present in one hundred and forty-five (79.67%) patients. E.coli was the most commonest Gram-ve micro-organism (70.95%).Conclusion: Surgical site infection causes a significant rise in morbidity on the surgical floor. Increased levels of contamination per operatively and prolonged operative time increase the incidence of SSI in emergency surgical operations

Peripheral Vascular Disease “A Spectrum”

Background: To observe the spectrum of peripheralvascular disease presenting in a tertiary care hospital.Method: This observational, descriptive study wascarried out in Surgical Unit –I at Holy Family Hospital,Rawalpindi over a period of two years. All the patientspresenting with peripheral vascular disorders excludingacute vascular trauma patients, diabetics and varicoseveins patients were included in the study.Results: A total of 49 patients presented to the hospital.The male to female ratio was 2:1.The average age ofpresentation was 50.2 years. About 35% patients presentedwith occlusive disease, 18% with autoimmune disease and14% with embolism. The less common causes of peripheralvascular disorders included femoral pseudoaneurysms in8% patients and true aneurysms of iliac, popliteal andsubclavian arteries in 12% patients. Bilateral gangrene ofboth lower limbs was seen in 4% patients.Conclusion: Peripheral vascular disease is commonerin males and is mostly seen in the sixth decade of life.Atherosclerotic occlusive disease is the commonest causeof peripheral vascular disease followed by vasculitis,embolisms and aneurysms

Impact of Corporate Governance on Firm Performance: Evidence from Sugar Mills of Pakistan

This paper examines the impact of corporate governance mechanisms (Board Size, Board Composition, and CEO/Chairman Duality) on firm performance (Return on Asset) in sugar industry of Pakistan. The data of corporate governance mechanisms (Board Size, Board Composition, and CEO/Chairman Duality) collected from 12 listed sugar mills of Pakistan from 2005 to 2010. Using panel data methodology as a method of estimation Arithmetic mean, ANOVA and t-test applied on data by using SPSS. The results raveled that there is a significant impact of corporate governance on firm performance. Results further reveal that there is a significant impact of board size, CEO/Chairman Duality on ROA, and there is insignificant impact of Board Composition on ROA. Keywords: Corporate governance, Board of director, firm performanc

Teaching children road safety through storybooks: an approach to child health literacy in Pakistan

Background: Road traffic injuries (RTIs) commonly affect the younger population in low- and-middle-income countries. School children may be educated about road safety using storybooks with colorful pictures, which tends to increase the child’s interest in the text. Therefore, this study assessed the use of bilingual pictorial storybooks to improve RTI prevention knowledge among school children.Methods: This pretest-posttest study was conducted in eight public and nine private schools of Karachi, Pakistan, between February to May 2015. Children in grades four and five were enrolled at baseline (n = 410). The intervention was an interactive discussion about RTI prevention using a bilingual (Urdu and English) pictorial storybook. A baseline test was conducted to assess children’s pre-existing knowledge about RTI prevention followed by administration of the intervention. Two posttests were conducted: first immediately after the intervention, and second after 2 months. Test scores were analyzed using McNemar test and paired sample t-test. Results: There were 57% girls and 55% public school students; age range 8–16 years. Compared to the overall baseline score (5.1 ± 1.4), the number of correct answers increased in both subsequent tests (5.9 ± 1.2 and 6.1 ± 1.1 respectively, p-value \u3c 0.001). Statistically significant improvement in mean scores was observed based on gender, grades and school type over time (p-value \u3c 0.001).Conclusion: Discussions using bilingual pictorial storybooks helped primary school children in Pakistan grasp knowledge of RTI prevention. RTI education sessions may be incorporated into school curricula using storybooks as teaching tools. Potential exists to create similar models for other developing countries by translating the storybooks into local languages

Bomb blast injuries: an exploration of patient characteristics and outcome using Pakistan National Emergency Departments Surveillance (Pak-NEDS) data.

BACKGROUND: Bomb blast injuries result in premature deaths and burdening of healthcare systems. The objective of this study was to explore the characteristics and outcome of patients presenting to the emergency departments in Pakistan with bomb blast injuries. METHODS: Active surveillance was conducted in seven major emergency departments of Pakistan from November 2010-March 2011. All the sites are tertiary care urban centers. All the patients who presented to the hospital\u27s emergency department (ED) following a bomb blast injury as per self-report or the ambulance personnel were included in the study. Frequency of demographics, injury pattern, and outcomes were calculated. RESULTS: A total of 103 patients with bomb blast injuries presented to the selected emergency departments. The median age of patients was 30 years. Around three-fourth of the patients were males (n = 74, 74.7%). Most of the bomb blast patients were seen in Peshawar (n = 41, 39.8%) and Karachi city (n = 31, 30.1%) and the most common mode of arrival was non-ambulance transport (n = 71, 76.3%). Upper limb injuries (n = 12, 40%) were common in the under 18 age group and lower limb injuries (n = 31, 39.2%) in the 18 years and above group. There were a total of 8 (7.7%) deaths reported out of these 103 patients. CONCLUSION: Bomb blast injuries in Pakistan generally affect young males. Non-ambulance transport is the most common way to access emergency departments (ED). Overall ED mortality is high and capturing data during a disaster in an emergency department is challenging

Potential of siltstone and its composites with biochar and magnetite nanoparticles for the removal of cadmium from contaminated aqueous solutions: Batch and column scale studies

© 2020 Elsevier Ltd The present study is the first attempt to evaluate the pilot and batch scale adsorption potential of siltstone (SS) and its nanocomposites with biochar (EDB/SS), magnetite nanoparticles (MNPs/SS) and MNPs/EDB/SS for Cd removal from contaminated water. The SS, EDB/SS, MNPs/SS and MNPs/EDB/SS were characterized with FTIR, XRD, BET, SEM, TEM, TGA and point of zero charge (PZC). The effects of adsorbent dosage, contact time, initial Cd concentration, pH and presence of competing ions were evaluated on the Cd removal and its adsorption. The order for Cd removal was: MNPs/EDB/SS \u3e MNPs/SS \u3e EDB/SS \u3e SS (95.86–99.72% \u3e 93.10–98.5% \u3e 89.66.98–98.40% \u3e 74.90–90%). Column scale experiments yielded maximum retention (95%) of Cd even after 2 h of injection at 100 mg Cd/L. The exhausted SS, EDB/SS, MNPs/SS and MNPs/EDB/SS were reused without losing significant adsorption potential. Similarly, maximum Cd adsorption (117.38 mg/g) was obtained with MNPs/EDB/SS at dose 1.0 g/L. The results revealed that coexisting cations reduced the Cd removal due to competition with Cd ions. The experimental results were better explained with Freundlich isotherm model and pseudo 2nd order kinetic models. The results revealed that SS and its composites can be used efficiently for the removal of Cd from contaminated water

Insect Pest Complex of Wheat Crop

Wheat Triticum aestivum L. is grown on broad range of climatic conditions because of edible grains, cereal crop and stable food of about 2 Billion peoples worldwide. Additionally, it is the rich source of carbohydrates (55–60%), vegetable proteins and contributed 50–60% daily dietary requirement in Pakistan. Globally, wheat crops is grown over 90% area of total cultivated area; facing devastating biotic and abiotic factors. The estimated economic losses in wheat quantity and quality are about 4 thousands per tonne per year including physical crop losses and handling. Economic losses of about 80–90 million USD in Pakistan are recorded due to inadequate production and handling losses. Wheat agro-ecosystem of the world colonizes many herbivore insects which are abundant and causing significant losses. The feeding style of the insects made them dispersive from one habitat to another imposing significant crop loss. Areas of maximum wheat production are encountered with either insect which chew the vegetative as well as reproductive part or stem and root feeders. This chapter provides the pest’s taxonomic rank, distribution across the globe, biology and damage of chewing and sucking insect pest of wheat. It is very important to study biology of the pest in accordance with crop cycle to forecast which insect stage is economically important, what the proper time to manage pest is and what type of control is necessary to manage crop pest. The chapter will provide management strategies well suited to pest stage and environment