Oral Health Status Among Pregnant Women Attending Gynae OPD of Tertiary Care Hospital in Rawalpindi

Objective: The objectives of this study were to determine the oral health status and treatment needs using DMFT & CPITN indices in pregnant women attending Gynae OPD of tertiary care Hospital in Rawalpindi, to Determine Association of Oral health status using DMFT and CPITN with socioeconomic status and to determine oral health status of various trimesters of pregnancy Materials and methods: An analytical cross-sectional study was carried out to assess the oral health status and treatment needs among pregnant women at Tertiary Care Hospital, Rawalpindi from April’ 2020 to September’ 2020. Consecutive sampling was used to select the study participants. An adaptive version of WHO questionnaire was used. Results were presented in the form of frequency tables. Chi square test of statistics was applied to assess the association between categorical DMFT and CPITN with the sociodemographic characteristics of the participating females. Results: The mean DMFT score pregnant females was 2.41 + 2.30 and were belonged to a middle socioeconomic status 43.8% (n=173). About 61.8% (n=244) of participants had DMFT total score 1-7. Whereas, majority of the participants were reported bleeding gums on probing 30.6% (n=121) on assessment by CPITN. The participating pregnant females also depicted the worsening of periodontal tissues (P=0.00) and dentition status (P=0.02). Socioeconomic status was not significantly associated with dentition (P=0.39) and periodontal status (P=0.69). Conclusion: The study revealed that oral health status was deteriorated during pregnancy. Education and gestational period were strong indicator for oral health status among pregnant women. Bleeding gums were reported in majority of participants during second trimester of pregnancy. Socioeconomic status was not significantly associated with oral health status by CPITN and DMFT score

Highly Enhanced Concentration and Stability of Reactive Ce^3+ on Doped CeO_2 Surface Revealed In Operando

Trivalent cerium ions in CeO_2 are the key active species in a wide range of catalytic and electro-catalytic reactions. We employed ambient pressure X-ray photoelectron spectroscopy and electrochemical impedance spectroscopy to quantify simultaneously the concentration of the reactive Ce^3+ species on the surface and in the bulk of Sm-doped CeO_2(100) in hundreds of millitorr of H2–H2O gas mixtures. Under relatively oxidizing conditions, when the bulk cerium is almost entirely in the 4+ oxidation state, the surface concentration of the reduced Ce^3+ species can be over 180 times the bulk concentration. Furthermore, in stark contrast to the bulk, the surface’s 3+ oxidation state is also highly stable, with concentration almost independent of temperature and oxygen partial pressure. Our thermodynamic measurements reveal that the difference between the bulk and surface partial molar entropies plays a key role in this stabilization. The high concentration and stability of reactive surface Ce^3+ over wide ranges of temperature and oxygen partial pressure may be responsible for the high activity of doped ceria in many pollution-control and energy-conversion reactions, under conditions at which Ce^3+ is not abundant in the bulk

Evaluation of smooth muscle relaxant potential of Bismarckia nobilis (Hildebr. & Wendl.) in diarrhea, hypertension and asthma by ex-vivo and in-vivo method

To explore the mechanistic basis behind smooth muscle relaxant prospective of Bismarckia nobilis in gastrointestinal, respiratory and cardiovascular ailments. The methanolic extract of B. nobilis and sub-fractions have been evaluated in vitro rabbit isolated tissues, in vivo castor oil-induced diarrhea in rats and charcoal meal activity in mice. The B. nobilis extract relaxed spontaneous and K+ (80 mM)- induced contractions in rabbit isolated jejunum preparations, CCh (1 μM) and K+ (80 mM)-induced contractions in tracheal and bladder preparations, PE (1 μM) and K+ (80 mM)-induced concentrations in aorta preparations, likewise verapamil. Spasmolytic activity of dichloromethane fraction is stronger as compared to aqueous fraction. In vivo castor oil-induced diarrhea in rats and charcoal meal activity in mice further supported spasmolytic activity. B. nobilis extract possess anti-spasmodic, anti-diarrheal, airway relaxant and vasodilator activities possible mediated through calcium channel blocking mechanism, justifying therapeutic utility of B. nobilis in diarrhea, asthma and hypertension

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Estimating antibiotics consumption in a tertiary care hospital in Islamabad using a WHO’s defined daily dose methodology

Abstract Background Antibiotics have helped to reduce the incidence of common infectious diseases in all modern healthcare systems, but improper use of antibiotics including their overuse and misuse can change the bacteria so much that antibiotics don’t work against them. In case of developing imposable selective pressure with regard to the proportion of hospitalized patients who receive antibiotics, the quantity of antibiotics that are prescribed to them, and the proportion of patients who receive antibiotic treatment is one of the major contributors to the rising global health issue of antimicrobial resistance. Concerning the levels of antibiotic consumption in Pakistani hospitals, there is negligible research data available. Aim This study aimed to evaluate five-year inpatient antibiotic use in a tertiary care hospital in Islamabad using the World Health Organization (WHO) Recommended Anatomical Therapeutic Chemical (ATC) Classification / Defined Daily Dose (DDD) methodology. Method It was a descriptive study involving a retrospective record review of pharmacy records of antibiotics dispensed (amount in grams) to patients across different specialties of the hospital from January 2017 to December 2021 (i.e., 60 consecutive months). The antibiotic consumption was calculated by using the DDD/100-Bed Days (BDs) formula, and then relative percent change was estimated using Microsoft Excel 2021 edition. Result A total of 148,483 (77%) patients who received antibiotics were included in the study out of 193,436 patients admitted in the hospital. Antibiotic consumption trends showed considerable fluctuations over a five-year period. It kept on declining irregularly from 2017 to 2019, inclined vigorously in 2020, and then suddenly dropped to the lowest DDD/100 BDs value (96.02) in the last year of the study. The overall percentage of encounters in which antibiotics were prescribed at tertiary care hospital was 77% which is very high compared to the WHO standard reference value (< 30%). WATCH group antibiotics were prescribed (76%) and consumed more within inpatient settings than Access (12%) and Reserve (12%) antibiotics. Conclusion The hospital antibiotic consumption data is well maintained across different inpatient specialties but it is largely non-aligned with WHO AWaRe (Access-Watch-Reserve) antibiotics use and optimization during 2017–2021. Compared to the WHO standard reference figure, the overall percentage of antibiotics encountered was higher by about 47%. Antibiotic consumption trends vary with a slight increase in hospital occupancy rate, with positive relative changes being lower in number but higher in proportion than negative changes. Although the hospital antibiotics policy is in place but seems not to be followed with a high degree of adherence

Role Of Caffeine As A Bowel Stimulant After Major Gynecological Surgeries

Objective: To investigate the role of caffeine as a bowel stimulant after major gynecological surger- ies. Coffee is a low-cost strategy to accelerate postoperative recovery of intestinal function/motility af- ter colorectal and gynecological surgery. Postoperative ileus or bowel paralysis is quite common in the postoperative period after abdominal surgery, such as elective colectomy, colorectal resection, caesarean section, or gynecological surgery. The occurrence of postoperative ileus leads to pro- longed patient hospital stay. Methods: This randomized control study was single-centered, conducted in Obstetrics and Gynecol- ogy department of Liaquat National Hospital Karachi after approval from Research and Ethical review committee of hospital (Ref#:0416-2019-LNH-ERC ). The duration of study was one year from 20th February2019 to 20th February 2020. In this randomized controlled trial, 120 patients were randomly assigned before major gynecological surgery into control and intervention groups. Results: A total of 120 women who met the inclusion and exclusion criteria were included in the study. Descriptive statistics of the demographic data were similar between the two groups. Statistical significant difference (p= 0.001) was found between the mean time (23±6.9 vs. 30±9.4 hours) for the passage of first flatus between the intervention group and the control group. Mean time to first bowel movement (37±6.8 vs. 30±4.8 hours), mean time to first defecation (42±8.3 vs.32±6.6 hours) and mean length of hospital stay after surgery (101±7.8 vs.72±5.6 hours) showed statistical significant difference between the two groups with p-value<0.05. Conclusion: Coffee consumption (caffeine) after major gynecological surgery played an important role as a bowel stimulant. Drinking coffee reduced the mean time for first passage of flatus, First bowel sound, first defecation, and hours of hospital stay after surgery

Observation of Substrate Orientation-Dependent Oxygen Defect Filling in Thin WO3-delta/TiO2 Pulsed Laser-Deposited Films with in Situ XPS at High Oxygen Pressure and Temperature

WOS: 000308833400021Substoichiometric tungsten oxide films of approximately 10 nm thickness deposited with pulsed laser ablation on single-crystal TiO2 substrates with (001) and (110) orientation show defect states near the Fermi energy in the valence-band X-ray photoelectron spectroscopy (XPS) spectra. The spectral weight of the defect states is particularly strong for the film grown on the (001) surface. In situ XPS under an oxygen pressure of 100 mTorr shows that the spectral weight of the defect states decreases significantly at 500 K for the film on the (110) substrate, whereas that of the film grown on the (001) substrate remains the same at a temperature up to 673 K. Furthermore, diffusion of titanium from the substrate to the film surface is observed on the (110) substrate, as is evidenced by the sudden appearance of the Ti 2p core level signature above 623 K and below 673 K. The film grown on the (001) surface does not show such an interdiffusion effect, which suggests that the orientation of the substrate can have a significant influence on the high-temperature integrity of the tungsten oxide films. Quantitative analysis of the O Is core level XPS spectra shows that chemisorbed water from sample storage under ambient conditions is desorbed during heating under oxygen exposure.European Community [042095, 227179]; Swiss NSF [200021-116688, 200021-132126, IZK0Z2-133944, 20021-124812]; Swiss Federal Office of Energy [152316-101883, 153613-102809, 153476-102691]; Office of Science/BES, of the U.S. Department of Energy [DE-AC02-05CH11231]The research leading to these results received funding from the European Community's Sixth Framework Marie Curie International Reintegration Program (Grant 042095; HiTempEchem, X-ray and Electrochemical Studies on Solid Oxide Fuel Cells and Related Materials), Seventh Framework Program Novel Materials for Energy Applications (Grant 227179; NanoPEC, Nanostructured Photoelectrodes for Energy Conversion), Swiss NSF Grants 200021-116688 (to SE.), 200021-132126 and IZK0Z2-133944 (to A.B.), and 20021-124812 (to QC.), and Swiss Federal Office of Energy Contracts 152316-101883, 153613-102809, and 153476-102691. The ALS is supported by the Director, Office of Science/BES, of the U.S. Department of Energy (Contract DE-AC02-05CH11231)

Synthesis and Characterization of a Carbon‐Supported Cobalt Nitride Nano‐Catalyst

Transition metal nitrides have attracted great interest among the non‐noble catalysts employed in heterogeneous catalytic processes because of their exceptional stability and catalytic potential. However, the approach for their synthesis has remained a tremendous challenge. This study presents the synthesis of Co₄N/C catalyst fabricated at 400, 600, and 800 °, symbolized as Co₄N/C‐400, Co₄N/C‐600, Co₄N/C‐800, respectively. The characterization of fabricated catalysts is carried out through various advanced analytical techniques. As prepared nano‐catalyst Co₄N/C shows remarkable catalytic efficiency in terms of low activation energy (Ea=3.038×10⁻¹ KJ mol⁻¹), fast conversion rate (Kapp=0.2884 s⁻¹), and 97.57% conversion efficiency. Moreover, it also exhibits excellent stability and reusability because of its metallic characteristics. The outstanding catalytic activity of the catalyst is the combined effect in which the Co₄N nanoparticles acted as active sites, and the carbon support doped with nitrogen provided an expressway for the transport of electrons required for catalytic reduction. Moreover, the designed catalyst is immobilized on the cellulose membrane filter support, to demonstrate the catalytic reduction of 4‐nitrophenol to 4‐aminophenol. We envision that our work would facilitate the fabrication of cobalt nitrides‐based nano‐catalysts for a wide range of industrial applications

Synthesis and Characterization of a Carbon‐Supported Cobalt Nitride Nano‐Catalyst

Transition metal nitrides have attracted great interest among the non‐noble catalysts employed in heterogeneous catalytic processes because of their exceptional stability and catalytic potential. However, the approach for their synthesis has remained a tremendous challenge. This study presents the synthesis of Co₄N/C catalyst fabricated at 400, 600, and 800 °, symbolized as Co₄N/C‐400, Co₄N/C‐600, Co₄N/C‐800, respectively. The characterization of fabricated catalysts is carried out through various advanced analytical techniques. As prepared nano‐catalyst Co₄N/C shows remarkable catalytic efficiency in terms of low activation energy (Ea=3.038×10⁻¹ KJ mol⁻¹), fast conversion rate (Kapp=0.2884 s⁻¹), and 97.57% conversion efficiency. Moreover, it also exhibits excellent stability and reusability because of its metallic characteristics. The outstanding catalytic activity of the catalyst is the combined effect in which the Co₄N nanoparticles acted as active sites, and the carbon support doped with nitrogen provided an expressway for the transport of electrons required for catalytic reduction. Moreover, the designed catalyst is immobilized on the cellulose membrane filter support, to demonstrate the catalytic reduction of 4‐nitrophenol to 4‐aminophenol. We envision that our work would facilitate the fabrication of cobalt nitrides‐based nano‐catalysts for a wide range of industrial applications