Disclosure of Medical error

With the advancement of medical sciences, lives are being prolonged and practice of medicine is considered an art and no longer as science. ‘To Err is Human Report’ has been released and gives data of medical errors in United States which opened people’s eyes but there is grieving need that health professional in Pakistan also report the medical errors. Medical errors are common, costly, and often preventable. This could only happen when health professional are trained and made aware to report the errors. Evidences shows that full and honest disclosure of error and restitution are factors that may lead to significant improvement in responsibility of medical cases

Cultural practices of rearing preterm infants: A qualitative study in a tertiary care hospital, Karachi, Pakistan

The research work explores the cultural practices of feeding and hygiene of preterm infants in the Pakistani context. A Qualitative descriptive-exploratory design has been used. Purposive sampling was utilized to recruit 17 mothers, who met inclusion criteria from a largest government tertiary care hospital in Karachi, Pakistan. The semi-structured interview was used to collect the data, which lasted for approximately 45-60 minutes. Thematic analysis was conducted to analyze the key findings of the study. Welcoming newborn with \u27honey\u27 and herbal remedies were reported as a common ritual among mothers. Findings revealed differences in the time period of initial bath given to the preterm, ranges from 3 days to 1 month. These custom variations of rearing preterm have its own meaning in the prescribed culture; however, these customs are the insights to explore more on its effects on infants\u27 health. This study provides useful insights into several practices of cultures, which serve as the determinants of infants\u27 nutrition and health status. It provides an insight to the health care professionals to provide quality care to preterm infants

The relationship between Prenatal Stress, Depression, Cortisol and Preterm Birth: A review

Preterm birth is one of the most common adverse pregnancy outcomes. Maternal risk factors such as stress and depression have been associated with preterm birth. Preterm infants are at a higher risk of poor growth and neuro developmental outcomes. The objective of this paper is to examine the relationship between maternal stress, depression, cortisol level, and preterm birth. Preterm birth is one of the most common adverse pregnancy outcomes with a global prevalence of 9.6% and one of the major contributors to infant mortality and morbidity. The association between psychosocial stress and preterm birth, although examined for more than 25 years, has not yet been fully established. A systemic review was conducted in which research studies and review articles from 1970 to 2012, published in English, focusing on human subjects, and addressing the relationship between stress, depression, cortisol and preterm birth were included in this review. The studies examining the relationship between stress, cortisol levels and preterm birth have shown inconsistent findings that may be explained by varied study designs, differences in defining and measuring stress, timing of stress measurement, sample characteristics, and study designs. The relationship between stress, cortisol levels and preterm birth may be multifactorial and complex with premature birth being the final common pathway. A longitudinal cohort study, with a large sample size and multiple measures of stress, depression, and cortisol level, as well as a measure of anxiety and other stress hormone biomarkers may add new knowledge and enhance our understanding about the contribution of psychosocial stress to preterm birth

AN OPEN-LABEL RANDOMIZED CLINICAL STUDY OF TOPICAL NANOPARTICULATE ANTIPSORIATIC POLYHERBAL CREAM

Objective: Objective of the study was to investigate the safety, efficacy, and antipsoriatic activity of topical cream enriched with Nanostructured Lipid Carriers (NLC) of Azadirachta indica, Lawsonia inermis, and Mallotus philippensis through the controlled clinical study. Methods: The randomized controlled trial was performed for 12 months on 65 adult patients between the age group 20 and 60 years of either sex of diagnosed, uncomplicated cases of psoriasis Vulgaris. The Test group received a local application of the herbal antipsoriatic NLC enriched cream, while the Control group was treated with Clobetasol propionate 0.05% cream twice daily for 3 months. Both groups were assessed for parameters of skin and nail examinations, lab investigation, and Psoriasis Area and Severity Index (PASI) score. The data were analyzed and interpreted statistically. Results: Significant improvement in itching and PASI score was seen during successive visits in both groups. However, recurrence of mild itching and erythema in a few patients of the control group was seen after 2 weeks, whereas no such recurrence is seen in the test group. Statistically significant reduction in eosinophilia in the control group was observed before and after treatment. The efficacy of clobetasol in the control group and the prepared formulation in the test group both show statistical efficacy at par. Conclusion: The data suggest that the NLC enriched cream exhibited significant relief in all the symptoms of psoriasis and therefore can be used as a potent antipsoriatic agent due to the easy availability of the drugs and cultural affinity for herbal formulations

IBX promoted one-pot condensation of β-naphthol, aldehydes, and 1,3-dicarbonyl compounds

Abstract An efficient and mild protocol has been developed for one-pot condensation of β-naphthol, aldehydes, and 1,3-dicarbolyl compounds in presence of o-iodoxybenzoic acid has been found to be an excellent catalyst for the synthesis of tetrahydrobenzo[a]xanthen-one, 1H-benzo[f]chromen-2-yl)-one via one-pot three-component condensation of β-naphthol, aldehydes, and 1,3-dicarbonyl compounds. Short reaction time, ambient conditions, simple workup, and high yield with selective manner are some of the striking features of the present protocol

Accuracy, Sensitivity and Specificity of Oral Brush Cytology in the Diagnosis of Oral Epithelial Lesions

Background: Oral Squamous cell carcinoma (SCC) is highly prevalent in Pakistan than the rest of the world. Five-year survival rate is 80% if SCC is diagnosed at an early stage. The survival rate declines to 20% if diagnosed at a later stage. The objective of the present study was to find out the usefulness of oral brush cytology in detecting oral lesions. Material and Methods: In the present prospective observational study, 88 samples were collected from Maxillofacial Surgery Out-Patient Department (OPD), Liaquat University Hospital and ISRA University Hospital from July 2015 to December 2015. After taking written informed consent, oral brush cytology was performed and stained with standard Papanicolaou (PAP) staining protocol. The biopsy of the patients was performed by standard protocols of oral biopsy and specimen preserved in 10% buffered formalin. Cross tabulation between diagnosis of brush cytology and biopsy of same patients was done and accuracy, sensitivity and specificity were calculated. Results: According to the distribution of patients on brush cytology, 59.1% patients were diagnosed with malignant tumors, whereas 17.1% had benign tumors. On biopsy of the same patients, squamous cell carcinoma was confirmed in 72.7% and benign tumors were found in 17% of the patients. Comparison of brush cytology with biopsy of same patients revealed no significant difference. Accuracy, sensitivity and specificity of brush cytology of the oral cavity for detection of malignant tumor were calculated as 86.36%, 81.25% and 100% respectively. Whereas accuracy, sensitivity and specificity of brush cytology of the oral cavity for detection of benign and inflammatory conditions were 100%. Conclusion: Oral brush cytology has good accuracy, sensitivity and specificity for detection of oral epithelial lesions and can be useful in early detection of oral cancer as well as other lesions. Moreover, as an easy-to-do, painless and non-invasive procedure, it can be a good screening method for detection of oral lesions

Altered Coagulation Pattern in Different Histological Grades of Squamous Cell Carcinoma

Background: The incidence of squamous cell carcinoma has doubled in the last three decades associated with a high rate of morbidity and mortality. The incidence of bleeding and/or thrombosis in advanced stage cancer necessitates a need for research in blood coagulation abnormalities in malignancy. The objective of the present study was to determine the alteration in coagulation pattern among patients diagnosed with squamous cell carcinoma (SCC). Material and Methods: This cross-sectional study was conducted in Pathology department of Isra University Hospital, Hyderabad over a period of 06 months. A total of 126 samples were selected through non-probability convenient sampling. Both male and female patients of all age groups having SCC of skin, gastrointestinal and genital tract were included. The coagulation profile was analyzed by Sysmax CA 50 and Nycocard reader II. Data was entered into SPSS version 22.0 and results were analyzed. Results: The mean age of the patients with SCC in the present study was 55.5 ± 12 years with more male patients (n=81; 64.3%) as compared to females (n=45; 35.7%). Oral SCC was found to be the most common site of squamous cell carcinoma (43.7%). Majority of the patients had well differentiated SCC (42.1%) followed by moderately differentiated (40.5%) and poorly differentiated SCC (17.4%). The comparison of severity of SCC with coagulation profile revealed that PT (P=0.01), APTT (P=0.001), D-dimers (P=0.01 and TT (P=0.01) were significantly increased, whereas fibrinogen was significantly decreased (P=0.001). Conclusions: The histological differentiation of SCC (from well differentiated to poorly differentiated tumors) showed a highly significant association with different coagulation profile parameters like PT, APTT, BT, CT, D-dimer, TT, and fibrinogen levels

Medico-Legal Cases (MLC) Presented at a Tertiary Care Center and Acute Symptoms of Post-Traumatic Stress Disorder among the Survivors

Objectives:  An observational, prospective study was conducted to determine the incidence and risk factors associated with victims of physical assault and symptoms of post-traumatic stress disorder (PTSD). Material & Methods:  All the registered medico-legal cases reported to the emergency department of Gambat hospital were included in the study. The data was collected on a predefined questionnaire including age, gender, mode of injury, weapon of the injury, type of assault (blunt or penetrating), firearm injuries, and road traffic accidents from medico-legal registers. Impact of Event Scale (IES) was used to assess Post-traumatic stress disorder. Results:  The mean age (SD) of victims was 29.3 (10.25) years. Blunt injuries were experienced by 47 (31.33%) victims. The majority of the victims suffered road traffic collision injuries, 59 (39.33%). Forty-eight (32%) victims had substantially higher IES scores (above 37) that confirmed severe PTSD that may contribute to the suppression of the immune system’s functioning among survivors. The majority of the victims were between 18 and 40 years. Conclusion:  The most common cases were related to road traffic collisions followed by blunt injuries. The incidence rate of PTSD was also prevalent in these individuals. Thus, strategies should be developed to prevent such incidents and those who suffer from such traumatic events must be offered psychiatric consultation

Model of LPG Refrigerator: A Literature Review

This work investigates the result of an experimental study carried out to determine the Coefficient of performance of domestic refrigerator when a propane-butane mixture is liquefied petroleum gas (LPG) which is available and comprises 56.4% butane, 24.4%propane, and 17.2% isobutene. This paper also presented an experimental investigation of COP by the effect of changing capillary tube length, capillary tube inner diameter and capillary coil diameter on the mass flow rate of refrigerant in an adiabatic helical capillary tube. Large amount of electricity supply is not available easily in large part of underdevelopment country like India. It will also prove to be an effective for remote area such as research sites, mines, & deserts where electricity is generally not available. The LPG is cheaper and possesses an environmental free in nature with no ozone depletion potential (ODP). Also LPG is available as a side product in local refineries. The results of the present work indicate the successful use of this propane-butane mixture as an alternative refrigerant to CFCs and HFCs in domestic refrigerator. It would include Experimental setup of working model and detailed observation of the LPG refrigerator and represents its application in refinery, hotel, chemical industries where requirement of LPG is more. Keywords: LPG refrigerator, domestic refrigerator, eco friendly refrigerants, Mixed Refrigerant

Efficiency Improvement of a Plant Layout

Abstract: Facilities layout is a systematic and functional arrangement of different departments, machines, equipments and services in a manufacturing industry. It is essential to have a well developed plant layout for all the available resources in an optimum manner and get the maximum out of the capacity of the facilities. The efficiency of production depends on how well the various machines, services production facilities and employee's amenities are located in a plant. This research paper aims to study and improve the current plant layout and are analysed & designed by using string diagram. An Attempt is made to simulate the current and proposed factory layout by using ARENA software. Efficiency of the current & proposed plant layout are calculated