Identifying constraints for hospital infection control management via mckinsey 7s framework in Pakistan

Background: In Pakistan, structured guidelines for hospital infection control and prevention are deficient in most public sector facilities. There is dearth of literature available on management of hospital-care acquired infections and related issues. This study aims to understand infection control management as a proxy measure for quality of health care provided at a public sector tertiary care hospital in Karachi, Pakistan. In this study, we identify barriers to implementation of infection control measures and highlight key areas for quality improvement. Methods: A cross sectional study was carried out in 2008 using qualitative research methods. In-depth interviews were conducted with hospital staff belonging to three different management tiers. Results: There was lack of a centralized documented infection control policy, structure or management hierarchy in the hospital. The infection control mechanisms were managed at the individual ward level depending upon the interest of the individual Head of the Department. Lack of well-defined systems for human resource and financial management, resource allocation, documentation, communication, monitoring and evaluation for infection control further augmented the problem. Conclusion: Based on the results of this study, it is evident that quality infection control mechanisms must be organized and controlled at the hospital level not at the individual ward level. Human resource recruitment and training, budgetary allocation and designing of communication channels specific to infection control are needed at this tertiary care hospital. This is the first study to understand the management perspective for hospital infection control using 7S McKinsey framework of management in the largest tertiary care public sector hospital in Sindh

Is pre-sowing seed treatment with triacontanol effective in improving some physiological and biochemical attributes of wheat (Triticum aestivum L.) under salt stress?

In this study, seed-priming of two wheat cultivars S-24 and MH-97 was carried out with three triacontanol (TRIA) levels (0, 10 and 20 μM) for 12 h. Seeds pre-treated with TRIA were allowed to grow for 24 days in full strength Hoagland’s nutrient solution in a greenhouse, thereafter two salt treatments (0 and 150 mM NaCl) were applied and after 21 days of salt application, changes in growth attributes such as shoot and root dry weights, shoot and root lengths and total leaf area, leaf water relations such as water potential (Ψw), osmotic potential (Ψs), turgor potential (Ψp) and relative water contents (%), membrane permeability (%), total free amino acids, free proline, glycinebetaine and total phenolic contents were determined. Yield attributes such as 100-seed weight, total grain yield, number of grains and number of fertile tillers per plant were recorded at crop maturity. Salinity stress of 150 mM NaCl significantly caused reduction in all growth and yield attributes, leaf water relations except leaf turgor potential, while increased membrane permeability (%), leaf free proline, glycinebetaine and total free amino acids in both cultivars. Total phenolics and relative water contents (%) remained unaffected under salt stress. Pre-sowing seed treatment with TRIA did not mitigated the adverse effects of salt stress on wheat and thus could not prove to be effective to promote signifi cantly its growth, yield and other physiological and biochemical attributes (except leaf water potential of cultivar MH-97) under stress and non-stress conditions. Overall, performance of cultivar S-24 was better in growth, leaf water relations and free proline contents as compared to MH-97 under both non-saline and saline conditions

Phenolic Compounds from the Natural Sources and Their Cytotoxicity

Natural phenolic compounds are considered as one of the important secondary metabolites for their chemopreventive and chemotherapeutic effects in cancer. These compounds show potent activities for cancer prevention and its treatment. There are many phenolic compounds present in medicinal and edible plants such as, flavonoids, bioflavonoids, stilbenes, chalconoids, chromones, phenylpropanoids, curcuminoids, coumarins, tannins, lignans, neolignans, anthraquinones, quinones, xanthones, phenolic acids and their glycosides and many more. The antioxidant potential of phenolic compounds is almost bolded in the treatment and prevention of cancer. Mono phenolic, polyphenolic and phenolic acids compounds from a large variety of plants, foods, spices, insects, fungus, beverages, lichens, algae and mammals have been shown to inhibit or attenuate the initiation, progression and spread of cancers in cells in vitro and in animals in vivo. In this chapter, we try to cover general view and the recent literature to summarize structural information and cytotoxic effects of phenolic compounds on different cancer cell lines from medicinal herbs and plants

Green Chemistry and Synthesis of Anticancer Molecule

Green chemistry is a modern area of chemistry merged with chemical engineering methods. It highlighted the synthesis of molecules in a manner of using environment-friendly chemical reagents with low waste material for enhancing environmental performance which reduce the formation of hazard substances. Modern researches are trying to reduce the risk of human kind health and the environment of our world by doing magnificent work in the field of green chemistry. In the pharmaceutical field, green chemistry works very well with the formation of many drugs and it utilizes non-hazards, reproducible and environment-friendly solvents with low time and money costs by using catalyst, microwave, ultrasonic, solid phase and solvent-free synthesis. Until now, scientist has synthesized many anticancer molecules by using these modern green chemistry techniques. These compounds showed significant anticancer activities against many human cancer cell lines. In this chapter, we will cover different views and the recently published literature to summarize the role of green chemistry in the synthesis of anticancer compounds

Role of mHealth applications for improving antenatal and postnatal care in low and middle income countries: a systematic review

Background: From 1990 to 2015, the number of maternal deaths globally has dropped by 43%. Despite this, progress in attaining MDG 5 is not remarkable in LMICs. Only 52% of pregnant women in LMICs obtain WHO recommended minimum of four antenatal consultations and the coverage of postnatal care is relatively poor. In recent years, the increased cellphone penetration has brought the potential for mHealth to improve preventive maternal healthcare services. The objective of this review is to assess the effectiveness of mHealth solutions on a range of maternal health outcomes by categorizing the interventions according to the types of mHealth applications.Methods: Three international online electronic databases were searched between January 1, 2000 and January 25, 2016 to identify studies exploring the role of mHealth solutions in improving preventive maternal healthcare services. Of 1262 titles screened after duplication, 69 potentially relevant abstracts were obtained. Out of 69 abstracts, 42 abstracts were shortlisted. Full text of 42 articles was reviewed using data extraction sheet. A total of 14 full text studies were included in the final analysis.Results: The 14 final studies were categorized in to five mHealth applications defined in the conceptual framework. Based on our analysis, the most reported use of mHealth was for client education and behavior change communication, such as SMS and voice reminders [n = 9, 65%]. The categorization provided the understanding that much work have been done on client education and behavior change communication. Most of the studies showed that mHealth interventions have proven to be effective to improve antenatal care and postnatal care services, especially those that are aimed at changing behavior of pregnant women and women in postnatal period. However, little evidence exists on other type of mHealth applications.Conclusion: This review suggests that mHealth solutions targeted at pregnant women and women in postnatal period can improve preventive maternal healthcare services. However, there is a need to conduct more controlled-trials and quasi-experimental studies to strengthen the literature in this research area. The review recommends that mHealth researchers, sponsors, and publishers should prioritize the transparent reporting of interventions to allow effective interpretation of extracted data

Oleanolic acid (pentacyclic triterpenes) as a potential candidate for α-glycosidase inhibition activity

Background: Diabetes mellitus is a common health dilemma worldwide and is characterized by hyperglycemia. Inhibition in the activity of one of the digestive tract enzymes α-glucosidase is one of the therapeutic approaches to hydrolyze carbohydrates into glucose using natural agents. Many natural compounds with α-glucosidase inhibitory activity have transpired to be secondary metabolites. Monotheca buxifolia, native to Pakistan is a major medicinal tree, which has been known for its extensive pharmacological activities.Methods: α-glucosidase activity of ten isolated compounds (lupeol, lupeol acetate, betulin, β-sitosterol, β-amyrin, oleanolic acid, vanillic acid, protocatechuic acid, kaempferol and quercetin) from lipophilic hexane fraction of M. buxifolia (stem and leaves) was assessed against α-glucosidase enzyme using acarbose as a control.Results: All ten compounds hold α-glucosidase inhibition potential (91-99%). However, IC50 (half-maximal inhibitory concentration) values of oleanolic acid (5 µM) were 8-fold lower than that of acarbose. Moreover, inhibition potencies of lupeol (15.87 µM), β-amyrin (18.14 µM) betulin (21.49 µM), quercetin (23.47 µM), and lupeol acetate (29.45 µM) were much stronger than the inhibitory effect obtained from acarbose (38.25 µM).Conclusion: Oleanolic acid of M. buxifolia exhibited a potent inhibitory effect against α-glucosidase, therefore, oleanolic acid may be utilized in medicinal formulations against diabetic disorders.Keywords: Diabetes mellitus; Enzyme inhibition; Medicinal plants; Pentacyclic triterpenes

School-based study to assess the nutritional status (BMI based) of adolescents of Gojra city of district Toba Tek Singh, Punjab, Pakistan

Adolescence is the make-or-break stage of life. Major physical, mental, and psychological growth takes place at this age. Adequate and balanced nutrition is a vital requirement to support this phase. Adolescents living in developing and low-income countries are more likely to face nutritional challenges. Poor nutritional status during adolescence is an important determinant of health outcomes.Objective: To analyze the nutritional status (BMI based) of school-going adolescents in Gojra city, Punjab, Pakistan. Methods: A school-based cross-sectional survey was carried out covering 635 (6-8 grade) school-going adolescents (boys and girls) from public schools in Gojra city. Data were collected through anthropometric measures taken. Symptoms of malnutrition were also assessed. Mean and frequencies were reported for demographic variables and symptoms of malnutrition while two sample Independent T-test was used to compare the means of groups under study using SPSS version-23.Results: The overall prevalence of underweight in boys was found (33.9%) as compared to adolescent girls (32.3%). It was also found that malnutrition and related health complications were higher in adolescents with lower BMI values.Conclusions: Adolescent boys and girls were found with a high prevalence of malnutrition along with other symptoms