Hepatitis B vaccination status of health care workers and their antiHBs titres - A cross sectional study

Back ground: The risk from occupational exposure to HBV infection is 2-4 times higher in HCW’s. A protective vaccine with a reported efficacy of 95% is available. Yet many HCW’s in developing countries remain non vaccinated, incompletely vaccinated or if vaccinated unaware of their post vaccination anti HBs status. Estimation of protective immune response following vaccination is essential to clear the misconceptions regarding booster dose of vaccine and non responder state which prevails among the HCW’s. Objective: The present study is designed to assess the hepatitis B vaccination rates in HCW’s and their antiHBs titres. Material and methods: A cross sectional study on 87 subjects was carried out at a tertiary care hospital by testing their sera for HBsAg & anti HBs levels. Results: None of the HCW’s were found to be HBsAg positive. Vaccination rate observed was 79%. Most vaccinated were the doctors and least the paramedics. Among doctors variation within the occupational groups was noticed. More number of males and young subjects were vaccinated and protected. Only 49% of the vaccinated HCW’s were vaccine compliant and 35% of these were protected. Factors like age, sex and time since last dose of vaccine influenced the anti HBs titres. None were aware of their anti HBs titres post vaccination. Conclusion: The study group involves only a small number of HCW’s but the findings are significant. Keeping in mind the annual global hepatitis B infection rates in HCW’s in developing countries we recommend the health care authorities to strengthen the existing educational programmes on Hepattis B infection which improves the awareness levels and thereby increases the vaccine rates. Further to make essential post vaccination assessment of antiHBs titres and its documentation to clear misconceptions regarding booster dose of vaccine

Emerging Targeted Therapies for Treatment of Hepatocellular Carcinoma (HCC)

Hepatocellular carcinoma (HCC) has dismal diagnosis due to the presence of underlying cirrhosis, late diagnosis, and limited treatment options. Surgery or liver transplantation is restricted to those with small tumours or well-compensated liver diseases. Despite advances in early screening and diagnosis of HCC, survival of patients has not improved greatly. Furthermore, treatment options for advanced HCC are restricted to best supportive care. Currently, sorafenib is the only drug approved for the treatment of advanced HCC patients as well as for those not suitable for transarterial chemoembolization (TACE). Therefore, there is an urgent need to develop new agents for treatment. Hepatocarcinogenesis is a complex multistep process that involves deregulation of various signalling pathways. Thus, there is no dominant molecular mechanism in HCC and understanding of these pathways provides an opportunity for development of potential therapeutic agents in an effort to reverse, prevent or delay tumourigenesis. This review will summarise the significance of these pathways in HCC and discuss the therapeutic benefits or drawbacks of the potential target agents against these pathways especially those that have been part of clinical trials

Job Embeddedness: Factors and Barriers of Persons with Disabilities

Addressing the employment problems facing persons with disabilities (PWDs) is complicated as it depends on the presence of certain core values of others such as non-discrimination, in order to recognise their capabilities. PWDs can engage in many economic activities in Pakistan, however, in general, the employment rate for PWDs is relatively low. Qualitative research was used to ascertain insight into a central phenomenon. Data was collected through interviews and observation from five different workplaces through purposive sampling, and a thematic analysis technique was used to analyse the data. The participants were 50 years or less and were mainly men who had worked with people with disabilities for 2-5 years The study revealed that the major issue of employers was their perception that PWDs were less productive than those employees without a disability.  The study reported that the responsibility to create a positive image and to think inclusively about PWD’s working capabilities was the responsibility of the persons with disabilities

Expression variation of OGG1 and HPRT gene and DNA damage in arsenic exposed industrial workers

Arsenic exposure alters redox balance, induces DNA damage, and deregulates many genes. OGG1 gene involved in base repair mechanism, for excision of 8-oxoguanine (8-oxoG) from DNA formed as a result of accumulation of ROS in cell. HPRT gene encode transferase enzymes involved in purine recycling mechanism. The main focus of the study was to evaluate the expression variation in HPRT, OGG1 gene expression, and DNA damage of industrial workers. Blood samples of 300 occupational workers were collected from welding, brick kiln, furniture, pesticide, and paint industry (n = 60/industry) to evaluate the expression variation in HPRT, OGG1 gene expression, and DNA damage in blood cells by comet assay along with age and gender matched 300 control individuals. Blood arsenic content was higher (P\u3c0.001) in an industrial group compared to the control. OGG1 and HPRT expression were (P\u3c0.05) downregulated in exposed workers compared to controls. Spearman correlation analysis showed a significant positive correlation between HPRT vs OGG1 (P\u3c 0.0001) in exposed workers compared to controls. Altered expression of both genes was observed between workers with \u3c25years and \u3e25years of age as well as between workers with \u3c10years and \u3e10year exposure. Reduced expression (P\u3c0.05) of both genes and a high extent of DNA damage was evident in exposed smokers compared to respective non-smokers. DNA fragmentation was higher (P\u3c0.05) in the furniture, welding and brick kiln group compared to control, and other industries. The present study suggests that altered expression of OGG1 and HPRT gene induce oxidative stress, showed a negative impact on the recycling of purines leading to DNA damage which increase the vulnerability of workers to carcinogenicity

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

The role of dickkopfs (DKKs) in hepatocellular carcinoma: with a focus on DKK4

published_or_final_versionSurgeryDoctoralDoctor of Philosoph

Proactive Personality and Innovative Work Behaviors: The mediating role of Knowledge Creation Ability

The aim of this study was to understand the effect that proactive personality has on individuals’ knowledge creation ability and innovative work behaviors. This study proposed a model which assists in understanding the effects that proactive personality has on innovative work behaviors through individual knowledge creation. The results were based on data that was collected through a cross-sectional field survey. The data consisted of a diverse paired sample of employees and their supervisors (N=249) who belonged to various organizations in Pakistan. The results of the main effects regression revealed that proactive personality had a positive relationship with both knowledge creation ability and innovative work behaviors. To test the mediating hypothesis, mediating regression analysis was used which showed that individual knowledge creation ability mediated the link between proactive personality and innovative work behaviors. The results of the mediation were also confirmed through a Sobel test.  The study adds to the body of knowledge by investigating the antecedents and outcomes of knowledge creation ability. In addition, it uniquely contributes to the body of research by providing an underlying mechanism through which proactive personality predicts innovative work behavior. The topic of individual knowledge creation ability that has been overlooked previously by research has been elaborated in this study

Information Seeking Behaviour of Researchers in Central Drug Research Institute (CDRI), Lucknow

This study is based on Information-Seeking Behaviour of researchers of Central Drug Research Institute (CDRI), Lucknow. In this study, the method of collection of data, analysis, interpretation, findings are presented in a systematic manner. The primary data is collected through a questionnaire of 54 researchers of Central Drug Research Institute (CDRI), Lucknow. This study reveals the frequency of visit to the library, purpose of visiting the library, types of services, sources used to locate to the documents, behaviour of staff and user satisfaction, journal subscription, Internet facility etc. On the basis of data interpretation certain findings are given