Determinants of Household Poverty: Empirical Evidence from Pakistan

The Millennium Development Goals (MDGs) aim at halving the percentage of world population in 1990 with income less than US $ 1 a day and halving the share of people who suffer from hunger by 2015. Being a developing nation, poverty reduction should be our foremost obligation. An appreciable decline has occurred recently, headcount decreased from 34.46 percent in 2000-01 to 23.94 in 2004-05 [Pakistan (2006-07)]. However, seeing only the statistics and the trends in poverty we can just observe that what happened to poverty in different periods and also the decomposition of poverty in different years gives us a more appropriate picture of the incidence of poverty. This knowledge is useful because it informs us whether poverty is increasing or decreasing overtime. However, this information does not provide us the details of the causes of poverty. For instance, is poverty high due to low education attainment or large family size or due to any other reason? Here is a need of research about the determinants of poverty that are positively or negatively linked with the poverty status. This is the area where research can be most useful because firstly we have to understand the main determinants of poverty before designing the most efficient policy to reduce poverty in the country

Carrier Status of Methicillin-Resistant Staphylococcus Aureus (MRSA)

To investigate nasal carriage of Methicillin-Resistant Staphylococcus aureus (MRSA) among dental healthcare workers (HCWs) , as the carriers could be the potential risk factor for the transmission of nosocomial infection when exposed to hospital setting during clinical posting. Methods: One hundred HCWs including postgraduate trainees, house physicians, staff nurses and technicians participated in the study. Nasal specimens were obtained by using cotton swabs moistened in sterile saline. The nasal specimens collected were processed as per (CLSI, 2008). Specimens were inoculated on blood agar to look for β-hemolysis of Staphylococcus aureus. Nutrient agar was used for the direct colony identification of Staphylococcus aureus. Mannitol salt agar (MSA) and DNAse were used as selective media for the isolation of Staphylococcus aureus and incubated at 35˚C for 48 hrs.Resistance to methicillin was detected with cefoxitin(30 μg) through Disk Diffusion Test and interpreted according to (CLSI, 2009). A diameter of ≥22 mm was considered as susceptible and ≤21 mm as resistant as per (CLSI, 2010).Results: Out of 100 nasal swabs collected, 71 nasal swabs were from the dental surgeons and 29 were from the nursing staff, 35 (35%) showed a growth of Staphylococcus aureus. Among those who were positive for Staphylococcus aureus 62.85%were positive for MRSA. Overall 22 (22%) out of a 100 individuals came out to be positive for MRSA.Conclusion: Health care workers (HCWs) were the potential colonizers of methicillin resistant Staphylococcus aureus and may serve as reservoirs or disseminators of MRSA

Toxic Epidermal Necrolysis

Toxic epidermal necrolysis (TEN) is the most severe form of drug-induced skin reaction and includes denudation of >30% of total body surface area. The mechanism of disease is not completely understood, but immunologic mechanisms, cytotoxic reactions, and delayed hypersensitivity seem to be involved. Drug-induced toxic epidermal necrolysis (TENS), also known as Lyell’s syndrome, remains one of the most dramatic dermatological emergencies characterized by extensive destruction of epidermis and mucosal epithelia that often can be caused by drugs. TEN affects between 0.4 and 1.5 cases per million people every year with a mortality rate between 15% to 40%, with a large portion of patients dying from infections or multi-organ failure.1-4 The pathogenesis of drug-induced TEN is unknown, although several theories have been developed. Recent discoveries have shown that keratinocytes in TEN undergo apoptosis, not simply necrosis.5,6 Further research has elucidated that this apoptosis can be induced by interactions between cell surface death receptor Fas and its ligand, FasL or CD95L. The management of these patients is primarily supportive, although the use of corticosteroids and intravenous immunoglobulin (IVIG) therapy has been widely used with controversy. We report a case of risperidone induced toxic epidermal necrolysis with excellent response to corticosteroid

Ewing\u27s sarcoma arising from the adrenal gland in a young male: a case report

Background: Ewing\u27s sarcoma uncommonly arises from extraosseous soft tissue or parenchymal organs. Primary adrenal Ewing\u27s Sarcoma, although very rare, is extremely aggressive and commonly fatal. CASE PRESENTATION: A 17 year old Pakistani male was referred to the outpatient oncology clinic at our center with a three month history of concomitant pain, swelling and dragging sensation in the right hypochondrium. Abdominal examination revealed a large, firm mass in the right hypochondrium extending into the right lumbar region and epigastrium. His genital exam was unremarkable and there were no stigmata of hepatic or adrenal disease.Computed tomography scans revealed a large peripherally enhancing mass in the hepatorenal area, biopsy of which showed a neoplastic lesion composed of small round blue cells which exhibited abundance of glycogen and stained diffusely positive for CD99 (MIC2 antigen). Fluorescence in situ hybridization demonstrated gene rearrangement at chromosome 22q12 which confirmed the diagnosis of Ewing\u27s sarcoma. Staging scans revealed pulmonary metastasis and hence he was commenced on systemic chemotherapy. CONCLUSION: This case report highlights the importance of keeping Ewing\u27s sarcoma in mind when a young patient presents with a large non-functional adrenal mass

IMPROVED AND ECONOMICAL SYNTHESIS OF CEFAZOLIN SODIUM

Cefazolin sodium was synthesized using 7-amino cephalosporanic acid (7-ACCA) and H-tertrazole acetic acid (TAA) by acylation reaction in methylene chloride as a solvent and pivaloyl chloride as a catalyst. Various parameters involving synthesis such as duration, temperature, pH, catalyst (acidic and basic), coupling and activating agents were optimized. The product yield was more than 100% with 98% purity as per BP/ USP specifications. The material kept at 70C and 75% of relative humidity for 72 h showed a slight change in general appearance from almost white to off white with 3-4% loss of weight due to removal of water, while pH of the material before and after the tests remained almost the same. The material complied well with pharmacopoeia specification. The described synthesis is found to be simple, efficient and economical and may be used by pharmaceutical raw material industr

FORMULATION DEVELOPMENT AND IN-VITRO EVALUATION OF BI-LAYER TABLET OF SUSTAINED RELEASE (S.R) FLURBIPROFEN AND IMMEDIATE RELEASE DOXYCYCLINE

The purpose of this study was to formulate and characterize bi-layer tablet of doxycycline immediate release and flurbiprofen sustained release. Bi-layer tablets were formulated by wet granulation method. Ethyl cellulose and HPMC K 100 were used as polymer for sustained release. Five immediate release formulations were developed with varying excipients. Bi-layer tablets were evaluated by pre formulation and post formulation parameters as stated by USP. Dissolution was conducted in 0.1N HCl and 6.8 phosphate buffer and resulting data were analyzed statistically by one way ANOVA and drug release kinetics was studied using various release kinetic models. Data from pre formulation confirmed the purity of doxycycline hyclate and flurbiprofen. FTIR spectroscopy confirmed the absence of incompatibility between drugs and excipients. Dissolution profile in 0.1N HCl and 6.8 phosphate buffer was according to USP guidelines. The regression coefficient (R ) values from kinetic analysis showed that release followed Higuchi model indicating release mechanism followed diffusion transport. Results of one way ANOVA confirmed that there is no statistically significant difference between drug dissolution of all formulations(p > 0.05). Bi-layer tablet was successfully formulated and it is a suitable approach to increase patient compliance and decrease cost of therapy