Effects of Duties in Terminal Patients Wards on Nurses Well-Being

OBJECTIVES: This study was undertaken to explore the working conditions of nurses and well-being during performing their duties in terminally ill patients’ wards in B.V.H and find out the problems faced by them and to assess the impact of these problems on the social lives on nurses of Bahawal Victoria Hospital. METHODS: Survey method was used to collect data from respondents. A total of 214 nurses are working in terminally ill patients wards B.V.H from them sample size of 50% was selected randomly from all the wards of B.V.H with the response rate of 87%. Data was collected from 109 respondents using a self-administered questionnaire as a tool of data collection.RESULTS: The biggest problem faced by nurses in B.V.H is of excessive work load; nurses have to work a lot, B.V.H is facing grave scarcity of nursing staff. Due to intense nature of job, majority of nurses are victim of job stress. Job stressed has also proved to be cause of physical and psychological illnesses; like insomnia, dementia, hypertension and other disorders. What add to the injury is that apart from performing clinical duties, nurses also have to perform ward management as well. They have to maintain the records of medicine inventory in ward, maintain indent book and they are also responsible for the security of machinery or any equipment’s present in the ward. Most of the nurses are annoyed from patient’s attendants and consider them as the biggest hindrance in their job performance.CONCLUSION: Government must provide the accommodation facilities like staff colony for the nurses. The hospital administration should reduce the working hours of nurses to make some sort of relive Born their workload' There must be sufficient paid leaves in a year for the nurses. A proper service structure should be developed so the promotions and demotions should be done in accordance with some Preset rules and standards. The health department must also provide pick and drop services to the local nursing staff. Male nurses should be appointed especially for the night shift.  Quick and strict action should be taken against those who try to harass the nursing staff. Keywords: Nurses, Terminal Patients Wards, Hypertension, Insomnia, Dementia, Harassment. DOI: 10.7176/JHMN/80-07 Publication date:September 30th 2020

Development and validation of a chromatographic method for quantification of rasagiline in human plasma

Purpose: To develop a sensitive, reliable and cost-effective bioanalytical method for the pharmacokinetic analysis of rasagiline in human plasma.Method: Rasagiline was extracted by liquid-liquid extraction method and analyzed by reversed-phase high performance liquid chromatography (HPLC) using a mixture of ammonium acetate (pH 5.8) and acetonitrile (55:45, v/v) as mobile phase at a flow rate of 1 mL/min. The separation was performed on a Lichrosphere reverse-phase (RP) C18 column (250 x 4.6 mm, 5 μm particle size) at ambient temperature and rasagiline was detected at a wavelength of 265 nm by ultra-violet UV detection. The method was validated according to European Medicine Agency (EMA) guidelines. Results: The developed method was linear over a concentration range of 0.5 - 20 μg/ml with r2 ≥ 0.999 in human plasma. Run time was 10 min with rasagiline peak appearing at 7 min with no interference. Relative recovery and relative standard deviation (RSD) for accuracy and precision were within the acceptable limits prescribed in EMA guidelines. Rasagiline remained stable in human plasma for 24 h at room temperature, after three freeze and thaw cycles and also for 3 months at -20 °C.Conclusion: A simple and reliable method has been successfully developed and validated for the determination of rasagiline concentration in human plasma.Keywords: Rasagiline, Pharmacokinetics, Validation, Parkinson's diseas

An updated review on pharmacological activities and phytochemical constituents of evening primrose (genus Oenothera )

International audienceGenus Oenothera includes medicinal plants that are distributed throughout the world and are known since ancient times. Popular indications of different species of this genus include treatment of inflammations, diabetes, microbial infections, ulcers, tumors, kidney and liver problems. The plants of this genus are a botanical source for various pharmaceutically active components like sterols, alkaloids, phenolic acids, flavonoids, triterpe-noids, saponins, biflavonols and tocopherols. This review article is a compilation of chemical composition and biological activities of the various species of the genus Oenothera

Therapeutic Drug Monitoring of Isoniazid Among Newly Diagnosed Pulmonary Tuberculosis Patients

Introduction: Tuberculosis has a higher incidence in lower income countries. Positive treatment outcomes may be fewer due to comorbidities like diabetes mellitus and immunosuppressive illnesses. The Global Tuberculosis Network working under the umbrella of World Health Organization has composed different committees. The TB Pharmacology Committee has given the concept of precision medicine and treatment based on drug susceptibility testing. Achievement of optimum plasma levels of anti-tuberculous drugs by therapeutic drug monitoring (TDM) is imperative and being emphasized to achieve a TB cure. Aims and Objectives: To determine the levels of INH in low responders to ATT have lower plasma levels of Isoniazid. Place and Duration of study: University of Health Sciences and Gulab Devi Chest Hospital, Lahore, for 1 year from August 2017- July 2018. Material and Methods: A first dose therapeutic drug monitoring (TDM) of isoniazid (INH) was planned in 25 newly enrolled sputum positive tuberculous patients at Gulab-Devi Hospital. The work was approved by Ethical Review Committee. Fixed dose combination (FDC) of anti-tuberculous drugs was given under direct observation and blood samples were withdrawn at two hours (C2h) and six hours (C6h) on days one, 14 and 56th of drug therapy. Samples of sputum for acid fast bacilli (AFB) were also taken during blood sampling. Method development and validation of isoniazid estimation by high-performance liquid chromatography was carried out. Plasma INH concentration in test samples was measured with Shimadzu Chromatographic System, Japan. Data was entered and analyzed using SPSS version 20. A p value ? 0.05 was taken as statistically significant. Results: Among 25 patients enrolled to the current study, the mean plasma levels of isoniazid were 1.29±0.79 µg / ml and 0.56±0.43 µg / ml at two hours and six hours respectively throughout the research duration. Most of the patients had lesser plasma INH levels than the target ranges (< 3µg / ml). Sputum for acid fast bacilli was found 100% positive on day one and 14 however sputum conversion was 56% after four weeks drug therapy. Conclusion: An early TDM monitoring has revealed low plasma INH concentration. Correction of dose to achieve expected plasma INH level will have promising effect on sputum culture conversion. It will minimize the total statewide burden of slow responders and tuberculosis resistant cases

Phytochemical, Geographical, and Pharmacological Retrospect of Genus Torilis

International audienceBackground: Genus Torilis (Apiaceae) known as hedge parsley, encompasses 11-13 species distributed worldwide and shows potential pharmacological uses. Its phytochemical pattern is highly diversified including many phenolic and terpenic compounds. Objective: This research-review provides new highlighting of structural organizations, structure-activity trends, taxonomical, tissue and geographical distribution of phytocompounds of Torilis genus from extensive statistical analyses of available data. Method: In extenso, exploration of documented literature and statistical data analyses were applied to update the phytochemical pool of the genus under several aspects including structural diversity, geographical distribution, biological compartmentations and pharmacological activities. Results: Phytoconstituents were classified into homogeneous clusters that revealed to be associated with chemical constitutions (aglycone types, chemical groups) and distributions (through species, tissues, geographical). About bioactivities, terpenes were studied from a pharmacological point of view with relatively high frequencies for antifungal, antibacterial, cytotoxic and anti-inflammatory activities. Preliminary structure-activity relationships were highlighted implying opposite effects between hydroxylation and methylation in favor of different activities. Crude extracts and isolated compounds have shown several biological activities (antibacterial, anticancer, antiangiogenic, antiproliferative, etc.), thus providing authentic scientific proof for their diverse uses in folk medicines. Conclusion: The phytochemistry of the genus Torilis promises important perspectives in matters of pharmacological activities. These perspectives call for further investments in pharmacology because of (i) unbalance between phenolic and terpenic compounds according to the countries and (ii) more advanced current states of structural elucidations compared to biological evaluations

Anti-hyperuricemic Evaluation of Swertia-chirayita and Febuxostat on Potassium Oxonate Induced Hyperuricemic Animal Model

Introduction: Hyperuricemia is a metabolic disease characterized by an increase in serum uric acid levels. Hyperuricemia can be controlled by low purine diet or drugs like allopurinol and febuxostat; however, the incidence of adverse effects to these drugs, especially on chronic use, is a major clinical problem. Swertia chirayita; a herb from Gentianaceace family, was selected to observe it’s in vivo uric acid lowering effect in white Albino Wistar rats in whom hyperuricemia was induced through potassium oxonate. Febuxostat was used as a standard. Aims and Objectives: To observe the in vivo effect of different doses of Swertia chirayita extract (SCE) on uric acid levels and to compare its effect with the allopathic medicine febuxostat. Place and Duration of study: A randomized controlled study was held at University of Health Sciences Lahore between June- August 2017. Material and Methods: Forty-eight healthy adult Albino Wistar rats were randomly divided into six groups. Group I and II served as negative and positive controls respectively. Hyperuricemia was induced by injecting KO solution (01ml) intraperitoneally on 1st, 3rd and 7th day of study. Group III received febuxostat 5 mg/kg through oral gavage. Group IV, V and VI were experimental groups, treated with 100, 200 and 400 mg/kg doses of Swertia Chirayita extract respectively through oral route, 02 hours after induction by KO once daily for 07 days. Blood samples were collected to record serum uric acid levels on day zero, first, third and seventh days. (SPSS)version 20 was used for data entry and analysis, pvalue ? 0.05 was given statistical importance. Results: In all experimental groups (IV, V, VI), serum uric acid levels were significantly reduced by Swertia chirayita extract (SCE) (p ? 0.001) as compared to hyperuricemic rats (group II). SCE showed dose dependent SUA suppression. Results of both febuxostat and SCE showed that average SUA levels of these groups were markedly less than hyperuricemic rats (Group II) (p < 0.001) Conclusion: In the light of its hypouricemic activity; we conclude that in the future, Swertia chirayita has the potential for newer therapeutic applications in this regard

Anti-Ulcerogenic Evaluation of Torilis Leptophylla Plant Extract on Indomethacin Induced Mice Gastric Ulcer

Introduction: Despite conventional anti-ulcer therapies for peptic ulcer diseases, medicinal plants might provide effective new anti-ulcer compounds or, alternatively, as adjuncts to existing therapies. Aims & Objectives: To evaluate the effects of Torilis leptophylla on indomethacin-induced gastric ulcer in mice. Place and duration of study: It was an experimental study carried out in the Department of Pharmacology, University of Health Sciences, Lahore, from March to December 2016. Material & Methods: Thirty six (36) adult healthy male BALB/C mice were divided equally in 6 groups and assigned as group I (control), group II (positive control), group III–V (TLM low, medium and high dose) and group VI (omeprazole). Gastric ulcers were induced by oral ingestion of indomethacin in groups II -VI. Acute oral toxicity of the plant was also tested. Antiulcer effect was assessed by measuring body weight, amount and pH of gastric juice, ulcer count, severity of gastric lesion, ulcer index, percentage (%) inhibition of ulcer and histopathology of gastric tissue. Results were analyzed by SPSS 20.0, P-value<0.05 was considered significant. Results: Gastric ulcer reduced the body weight in indomethacin induced animals (28 ± 2.53, 29.66 ± 3.88, 29.66 ± 2.33, 31 ± 3.52,32 ± 3.099 g in group II, III, IV, V and VI respectively) at day 3. Omeprazole and TLM treated groups reduced the gastric volume and pH as compared to positive control. Ulcer index (18.83, 5.14, 3.42, 1.71, 1.76 of the group II, III, IV, V and VI respectively) depicted significant reduction by treatment groups. Ulcer's percentage inhibition (72.7, 81.8, 90.88, 90.65 of low, median and high dose of TLM and standard drug respectively) was increased. Histopathological observations were remarkably reversed by TLM treated groups. Conclusion: Torilis leptophylla could significantly protect gastric mucosa from damage by indomethacin

How frequent is routine use of probiotics in UK neonatal units?

Objective There is a lack of UK guidance regarding routine use of probiotics in preterm infants to prevent necrotising enterocolitis, late-onset sepsis and death. As practices can vary, we aimed to determine the current usage of probiotics within neonatal units in the UK.Design and setting Using NeoTRIPS, a trainee-led neonatal research network, an online survey was disseminated to neonatal units of all service levels within England, Scotland, Northern Ireland and Wales in 2022. Trainees were requested to complete one survey per unit regarding routine probiotic administration.Results 161 of 188 (86%) neonatal units responded to the survey. 70 of 161 (44%) respondents routinely give probiotics to preterm infants. 45 of 70 (64%) use the probiotic product Lactobacillus acidophilus NCFM/Bifidobacterium bifidum Bb-06/B. infantis Bi-26 (Labinic™). 57 of 70 (81%) start probiotics in infants ≤32 weeks’ gestation. 33 of 70 (47%) had microbiology departments that were aware of the use of probiotics and 64 of 70 (91%) had a guideline available. Commencing enteral feeds was a prerequisite to starting probiotics in 62 of 70 (89%) units. The majority would stop probiotics if enteral feeds were withheld (59 of 70; 84%) or if the infant was being treated for necrotising enterocolitis (69 of 70; 99%). 24 of 91 (26%) units that did not use probiotics at the time of the survey were planning to introduce them within the next 12 months.Conclusions More than 40% of all UK neonatal units that responded are now routinely administering probiotics, with variability in the product used. With increased probiotic usage in recent years, there is a need to establish whether this translates to improved clinical outcomes