Factors influencing medical student participation in an obstetrics and gynaecology clinic

Objective: To identify factors influencing medical student participation in an obstetrics and gynaecology (OBGYN) setting.Methods:This was a cross sectional study carried out on patients admitted in OBGYN wards of Aga Khan University Hospital, Karachi, Pakistan. A total of 250 patients consented to participate in this study.Results: Eighty three percent of the people responded \u27yes\u27 to the question of being initially seen by a medical student. People who consented were 3.5 times more likely to know that their primary consultant was a teacher at a medical school i.e. they were initially aware that they were in a teaching hospital (p-value \u3c 0.01). Additionally, people who did consent were 3.5 times more likely to have been admitted because of labour/delivery (p-value \u3c 0.001) and 2.7 times more likely to have a monthly income of more than Rs. 20,000 (p-value \u3c 0.05).Conclusions: A number of factors have been identified in our study along with proposed solutions. Identification of these potentially modifiable factors in the medical student-patient interaction is important to improve the involvement of medical students in the care of the patients

Frequency of bloodstream infection in febrile neutropenic patients, experience from a developing country

Introduction: About 20% of febrile neutropenic patients are presented with bloodstream infection which is a leading cause of mortality among these patients. Awareness of the locally prevalent pathogens and their susceptibility pattern is important for proper treatment of infection which improves survival in these patients. The objective of this study was to determine the frequency of bloodstream infection in patients with febrile neutropenia admitted in Abbasi Shaheed Hospital.Methods; This cross-sectional study was conducted in the Medical wards in Abbasi Shaheed Hospital, Karachi from 21-2-2016 to 20-8-2017. Patients of over 15 years of age of either gender with severe neutropenia were included in this study. Patients with noninfectious cause of fever, or fever prior to neutropenia were excluded. Patients meeting inclusion criteria were enrolled after taking informed consent. About 2-5 ml blood was collected under aseptic measures in Bactac culture bottles. Blood samples were sent to lab within 30 min of collection. Antimicrobial sensitivity testing of all isolates was performed on diagnostic Sensitivity test plates by Kerby - Bauer Method. Patients were referred back to treating physician if blood culture is positive. The data was analyzed using SPSS version 20.Results; Of 200 patients, the mean age was 25.8 ± 5.7 years, 120 (60%) were male with male to female ratio of 1.5:1, 89 (44.5%) had low grade fever (Temp. ≤102 °C) and 111 (55.5%) had high grade fever(Temp. \u3e102 °C). The frequency of staphylococcus aureus was 16%, E. coli was 14.5%, Pseudomonas 8.5% and Klebsiella 15.5.Conclusion: It is concluded that the frequency of staphylococcus aureus was 16%, E. coli was 14.5%, Pseudomonas 8.5% and Klebsiella 15.5

Recent Developments in Nano-Emulsions’ Preparatory Methods and their Applications: A Concise Review

Nano-emulsion is one of the most effective and size-controlled mediums for effective drug delivery systems, the formation of cosmetics products, food preservatives, and insecticidal and antimicrobial products. Therefore, a durable and sophisticated approach is primely important in preparing effective nano-emulsions. Some of the established fabrication approaches towards nano-emulsion are the high and low-energy methods. Depending upon the required results of formulations, these two methods are further divided into sub-categories such as ultra-sonicators, micro-fluidizers, high-pressure homogenizers, phase inversion temperature, phase inversion composition, etc. This review highlights all the available methods to form nano-emulsion by adopting high-energy and low-energy techniques. In addition, this review also elaborates on the importance of nano-emulsions in various end products, as nano-carriers and patents have also been awarded in this field. Besides, the required improvements in this field have been discussed briefly to establish the most authentic approach toward nano-emulsion formation

Awareness and Use of Benzodiazepines in Healthy Volunteers and Ambulatory Patients Visiting a Tertiary Care Hospital: A Cross Sectional Survey

Background: Indiscriminate prescription of Benzodiazepines in Pakistan and subsequent availability over-the-counter without prescription is a major public health problem, requiring systematic inquiry through research. Additionally, there is limited data on the awareness and use of Benzodiazepines from developing countries making it impossible to devise meaningful health policies. Methodology/Principal Findings: This was an Observational, Cross-Sectional study. conducted at Aga Khan University. A total of 475 (58.5 % males, 41.5 % females) people visiting a tertiary care hospital were interviewed by means of a structured questionnaire. The results showed that majority of population was aware of one or more Benzodiazepines (80.4%) and 30.4 % had used them at some point in life. 42.4 % of the users had been using it for more than a year. Commonest reason for use was sleep disturbance. Frequency of usage was higher for females, married individuals, educated (.Grade12), high socioeconomic status and housewives. More (59%) were prescribed than not and of them most by GP (58.5%). Only 36.5% of them were particularly told about the long-term addiction potential by the use of these drugs. Conclusion: Easy availability, access to re-fills without prescription and self prescription compounded with the lack of understanding of abuse potential of benzodiazepines constitutes a significant problem demanding serious consideratio

A Review of Novel Coronavirus: Cross-Disciplinal Perspective

The whole world is under the influence of coronavirus after its first report from Wuhan, China in December 2019. The virus is from coronaviridae family which has zoonotic viruses that can spread from animals to humans. The coronavirus like other viruses of this family produces mild flu-like symptoms within 2-14 days in the human host which progresses to death in severe cases. Unlikely coronavirus spread fast among humans-infectious diseases. Up till now (27/04/2020) around 2.97M cases and 207K deaths have been reported. The presence of a virus in respiratory secretions is diagnosed through molecular methods and chest scans. For this method, published articles on COVID-19 up to April 19, 2020, were screened. Keywords used were “Covid-19,” “novel coronavirus,” “SARS-CoV-2,” “2019-nCoV,” “Wuhan coronavirus,” and “Wuhan seafood market pneumonia virus.” After the cautious screening, published articles with confirmed cases were acknowledged and included. It has not only affecting physical health but has negatively affecting mental health. Vaccination has been introduced but global impact of this pandemic is still uncertain

Pain experienced by patient during epidural insertion using 16-gauge versus 18-gauge epidural needles

Objective: To compare the intensity of insertion-site pain between epidural catheterisation with 16-gauge needle and with 18-gauge needle at various time points, and the number of attempts taken to locate the epidural space while using either of the needles. Method: The single-blind prospective study was conducted from August 2019 to January 2020 at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised adult patients of either gender with American Society of Anaesthesiologist grade I-III status requiring thoracic epidural for elective abdominal procedures. The patients were divided into two groups using simple randomised sampling into group A receiving 16-gauge and group B receiving 18-gauge epidural. The intensity of insertion-site pain was noted at the time of insertion, at 24 hours and one week after the insertion. The number of attempts taken to locate the epidural space was also noted for the 2 groups. Data was analysed using SPSS 23. Results: Of the 135 patients enrolled, 126(93.3%) completed the study. There were 63(50%) subjects in group A; 30(47.6%) males, 33(52.3%) females, overall mean age 46.81±10.94. The remaining 63(50%) subjects were in group B; 22(34.9%) males, 41(65%) females, overall mean age 44.89±11.10 (p>0.05). Pain scores did not differ significantly on comparative analysis between groups (p>0.05). Similarly, number of patients requiring 2 or more attempts for successful epidural catheter insertion was not significantly different between the groups (p>0.05). Conclusion: The difference in pain scores or number of attempts for 16-guage or 18-guage groups were not significant

Sandfly—The vector of cutaneous leishmaniasis.

<p>Sandfly—The vector of cutaneous leishmaniasis.</p

Dual-Stage Deeply Supervised Attention-Based Convolutional Neural Networks for Mandibular Canal Segmentation in CBCT Scans

Accurate segmentation of mandibular canals in lower jaws is important in dental implantology. Medical experts manually determine the implant position and dimensions from 3D CT images to avoid damaging the mandibular nerve inside the canal. In this paper, we propose a novel dual-stage deep learning-based scheme for the automatic segmentation of the mandibular canal. In particular, we first enhance the CBCT scans by employing the novel histogram-based dynamic windowing scheme, which improves the visibility of mandibular canals. After enhancement, we designed 3D deeply supervised attention UNet architecture for localizing the Volumes Of Interest (VOIs), which contain the mandibular canals (i.e., left and right canals). Finally, we employed the Multi-Scale input Residual UNet (MSiR-UNet) architecture to segment the mandibular canals using VOIs accurately. The proposed method has been rigorously evaluated on 500 and 15 CBCT scans from our dataset and from the public dataset, respectively. The results demonstrate that our technique improves the existing performance of mandibular canal segmentation to a clinically acceptable range. Moreover, it is robust against the types of CBCT scans in terms of field of view