The minds of mothers: maternal mental health in an urban squatter settlement of Karachi.

BACKGROUND: Community-based information on maternal mental health in developing countries is meager and nearly non-existent in Pakistan. OBJECTIVE: To determine the proportion of probable cases of women with mental disorders and examine the associated conditions and risk factors which contribute to maternal mental ill-health. METHODS: With convenient sampling 260 mothers in an urban squatter settlement of Karachi were interviewed. The tools consisted of a household questionnaire collecting information on basic demographic and other characteristics and the Aga Khan University Anxiety and Depression Scale (AKUADS), an instrument to assess psychiatric morbidity. RESULTS: The proportion of probable cases of mental disorder was 28.8% (n = 75). Reviewing the gradient of responses the most frequently expressed psychiatric symptoms were being worried and crying . Amongst somatic complaints the most frequently reported was headache. Study also suggests that women in the older age group (OR 2.30, CI 1.27-4.19, p = 0.0031) and those with longer duration of marriage (OR 1.80, CI 1.01-3.22, p = 0.032) are more likely to be mentally distressed. Arguments with husband (OR 5.0, CI 2.19-11.52, p = 0.00001) or in-laws (OR 2.43, CI 1.22-4.85, p = 0.0059), husband\u27s unemployment (OR 4.1, CI 1.27-13.6, p = 0.0058), not having permanent source of income and lack of autonomy in making decisions significantly contributed towards mental illness. CONCLUSION: Approximately 1 out of 4 women suffer from mental illness. This is alarmingly high. Besides counseling in cases of matrimonial disharmony, community-based interventions should aim to improve the socioeconomic status of households

Design and Evaluation of Modified Release Bilayer Tablets of Flurbiprofen Projekt i ocena dwuwarstwowych tabletek flurbiprofenu o zmodyfikowanym uwalnianiu

Abstract Objectives. To design and evaluate modified release bilayer tablets of flurbiprofen. Material and Methods. In this study, bilayer modified release (MR) tablets of flurbiprofen were formulated using ethyl cellulose (EC) and polyvinylpyrrolidone (PVP) in different ratios as release retardant materials using a wet granulation method. In vitro release studies were done in dissolution media of varying pH i.e. pH 1.2, 4.5, 7.0 and 7.5. Results. All tablets exhibited good physical quality with respect to appearance, content uniformity, hardness, weight variation and friability. In vitro dissolution data showed that increasing proportions of EC retarded whereas increasing PVP enhanced the drug release rate. The bilayer MR tablets showed an initial release of approximately 35% (i.e. 100 mg drug) in about 1 h, then sustaining the release for 12 h, ending up with 89.56% and 96.12% for formulation MR1 and MR2, respectively. The kinetic analysis of dissolution data showed that zero order release was observed in these tablets. When data was fitted to the Korsmeyer-Peppas model, a non-Fickian transport was observed with the MR tablets. A model independent approach showed that as the release rate increases, the MDT decreases, showing the retarding behavior of the non-biodegradable polymers employed in formulation development. Conclusions. Bilayer modified release tablets of flurbiprofen can be successfully formulated using ethylcellulose and polyvinylpyrrolidone in different ratios as release retardant materials employing a wet granulation method (Adv Clin Exp Med 2011, 20, 3, 343-349). Key words: ethylcellulose, polyvinylpyrrolidone, wet granulation method, non-Fickian release. Streszczenie Cel pracy. Zaprojektowanie i ocena dwuwarstwowych tabletek flurbiprofenu o zmodyfikowanym uwalnianiu. Materiał i metody. W badaniu tym dwuwarstwowe tabletki flurbiprofenu o zmodyfikowanym uwalnianiu (MR) zostały stworzone z użyciem etylocelulozy (EC) i poliwinylopirolidonu (PVP) w różnych proporcjach jako środki opóźniające uwolnienie metodą mokrej granulacji. W badaniach uwalniania in vitro użyto środków rozpuszczają-cych o różnym pH, tj. pH 1,2; 4,5; 7,0 i 7,5. Wyniki. Wszystkie tabletki miały dobre fizyczne właściwości w odniesieniu do wyglądu, jednolitości zawartości, twardości, wahań wagi i kruszenia. W badaniach in vitro wykazano, że zwiększenie zawartości EC spowalniało, a zwiększenie zawartości PVP przyspieszało tempo uwalniania leku. Dwuwarstwowe tabletki MR wykazały począt-kowo uwalnianie ok. 35% (tj. 100 mg leku) w ciągu około 1 godz., a następnie utrzymanie rozpuszczenia przez 12 godz., kończąc na 89,56 i 96,12% dla preparatów MR1 i MR2. Analiza kinetyczna danych na temat rozpuszczania pokazała, że w tych tabletkach wystąpiło uwalnianie rzędu zerowego. Gdy dane dopasowano do modelu Korsmeyera-Peppasa, obserwowano transport masy tabletek MR niezgodny z prawem Ficka. Niezależne podejście wykazało, że w miarę wzrostu szybkości uwalniania, MDT zmniejsza się, co pokazuje opóźniające działanie nieulegających biodegradacji polimerów stosowanych w produkcji preparatu. Wnioski. Dwuwarstwowe tabletki o zmodyfikowanym uwalnianiu flurbiprofenu z powodzeniem można produkować, stosując etylocelulozę i poliwinylopirolidon w różnych proporcjach jako środki opóźniające uwolnienie metodą mokrej granulacji Słowa kluczowe: etyloceluloza, poliwinylopirolidon, metoda mokrej granulacji, uwalnianie niezgodne z prawem Ficka

PROTOTIPE SISTEM PENGATUR PENGISIAN TANDON AIR DI PERUMAHAN GIRI PALMA BERBASIS ARDUINO

ABSTRAK Kebutuhan air bersih warga di Perumahan Giri Palma membutuhkan penampungan air sementara. Saat ini, sistem penampungan air yang digunakan masih beroprasi secara manual yang mengandalkan sumber daya manusia sebagai pengontrol dan pengamat dari tandon-tandon yang ada di perumahan Giri Palma. Sistem pengadaan air di Perumahan Giri Palma menggunakan dua buah sumur pompa dan tiga buah tandon. Dari tiga tandon tersebut, dua tandon masing-masing terletak berdekatan dengan sumur berfungsi sebagai penampung air sementara, dan satu tandon yang berfungsi sebagai tandon distribusi. Metode manual yang digunakan saat  ini dapat menimbulkan kerugian jika terjadi keteledoran pada petugas. Sistem otomatis yang dibuat menggunakan sensor air sebagai pendeteksi air pada sumur, dan sensor ultrasonic sebagai pendeteksi ketinggian air pada tandon, yang bekerja dengan menggunakan Arduino. Prototipe sistem pengadaan air otomatis yang ada pada penelitian ini diharapkan bisa diaplikasikan dan menjadi solusi dari permasalahan yang ada di perumahan Giri Palma. Kata Kunci: Sistem Pengadaan Air Tandon, Arduino.   ABSTRACT The need for clean water for residents of Giri Palma Housing Estate  requires temporary water storage. Currently, the water storage system is still operating manually, which relies on human resources as controllers and observers of the reservoirs in the Giri Palma Housing Estate. The water supply system in Giri Palma Housing uses two pump wells and three reservoirs. From those three reservoirs, two reservoirs are located adjacent to the well as a temporary water reservoir, and one reservoir as distribution reservoir. The manual method used today can cause harm of there is some negligence on the part of the officer. The automated system, is made using a water sensor as a water detector in the well, and an ultrasonic sensor as a water level detector in every reservoir, which works using Arduino. The prototype automatic water supply system in this study is expected to be applied as a solution to problems that exist in Giri Palma Estate. Keywords: Reservoir Water System, Arduino

PROTOTIPE SISTEM PENGATUR PENGISIAN TANDON AIR DI PERUMAHAN GIRI PALMA BERBASIS ARDUINO

ABSTRAK Kebutuhan air bersih warga di Perumahan Giri Palma membutuhkan penampungan air sementara. Saat ini, sistem penampungan air yang digunakan masih beroprasi secara manual yang mengandalkan sumber daya manusia sebagai pengontrol dan pengamat dari tandon-tandon yang ada di perumahan Giri Palma. Sistem pengadaan air di Perumahan Giri Palma menggunakan dua buah sumur pompa dan tiga buah tandon. Dari tiga tandon tersebut, dua tandon masing-masing terletak berdekatan dengan sumur berfungsi sebagai penampung air sementara, dan satu tandon yang berfungsi sebagai tandon distribusi. Metode manual yang digunakan saat  ini dapat menimbulkan kerugian jika terjadi keteledoran pada petugas. Sistem otomatis yang dibuat menggunakan sensor air sebagai pendeteksi air pada sumur, dan sensor ultrasonic sebagai pendeteksi ketinggian air pada tandon, yang bekerja dengan menggunakan Arduino. Prototipe sistem pengadaan air otomatis yang ada pada penelitian ini diharapkan bisa diaplikasikan dan menjadi solusi dari permasalahan yang ada di perumahan Giri Palma. Kata Kunci: Sistem Pengadaan Air Tandon, Arduino.   ABSTRACT The need for clean water for residents of Giri Palma Housing Estate  requires temporary water storage. Currently, the water storage system is still operating manually, which relies on human resources as controllers and observers of the reservoirs in the Giri Palma Housing Estate. The water supply system in Giri Palma Housing uses two pump wells and three reservoirs. From those three reservoirs, two reservoirs are located adjacent to the well as a temporary water reservoir, and one reservoir as distribution reservoir. The manual method used today can cause harm of there is some negligence on the part of the officer. The automated system, is made using a water sensor as a water detector in the well, and an ultrasonic sensor as a water level detector in every reservoir, which works using Arduino. The prototype automatic water supply system in this study is expected to be applied as a solution to problems that exist in Giri Palma Estate. Keywords: Reservoir Water System, Arduino

Predictors of Mortality in COVID-19-Positive Patients On and Off CPAP: A Review From a Tertiary Care Setting in the NHS.

Introduction Since the first description of a coronavirus-related pneumonia outbreak in December 2019, the virus SARS-CoV-2 that causes the infection/disease coronavirus disease 2019 (COVID-19) has evolved into a pandemic, and as of today, millions have been affected. Objectives Our aim was to identify the predictors of mortality in COVID-19-positive patients on or off continuous positive airway pressure (CPAP). Methodology This was an observational study. Data were collected from February 2020 to April 2020 with patients admitted to the COVID-19 ward at The James Cook University Hospital, Middlesbrough, England. The inclusion criteria were COVID-19-positive patients confirmed through PCR tests on or off CPAP. Patients who had negative RT-PCR for COVID-19 and those who were intubated were excluded. Results A total of 56 patients diagnosed with COVID-19 (through RT-PCR) were included in the final analysis, among which 27 were on CPAP, while 29 did not require CPAP (NCPAP). The overall mean age of the patients was 66 ± 14 (range: 26-94) years. The mean age of CPAP and NCPAP patients was 63 ± 15 (range: 26-85) years and 68 ± 13 (range: 40-94) years, respectively. The ethnicity of 54 (96.4%) patients was White-Caucasian, while 2 (3.6%) were British-Asian. In the study sample, 16 (28.6%) patients expired, of which 11 (40.7%) were on CPAP, while 5 (16.7%) did not require CPAP during the disease course. Correlation analysis showed that overall higher age, Medical Research Council Dyspnoea (MRCD) score, performance status (PS), and consolidation affecting more than one quadrant of the lungs were significantly correlated with increased mortality. Among patients receiving CPAP, higher age, MRCD score, and PS were significant predictors of mortality. Among the NCPAP group, advancing age, respiratory rate, MRCD score, PS, increased creatinine levels, and consolidation affecting more than one quadrant of the lungs were the predictors of mortality. Conclusion Even with a small sample size, we can see that there are definitive predictors that are directly proportional to increased mortality in COVID-19 patients on CPAP, such as higher age, performance status, MRCD score, and increased lung involvement of consolidation in more than one quadrant, which can help us rationalize management