Resilience and quality of life (QoL) of head and neck cancer and brain tumour survivors in Pakistan: An analytical cross-sectional study protocol

Background: Cancer is a devastating disease and has detrimental effects on the quality of life (QoL) of cancer survivors and interferes with their treatment compliance. The aim of the study is to assess resilience and QoL among cancer survivors and to evaluate the important factors affecting their resilience and QoL, with respect to the Pakistani cultural context.Method and Analysis: A cross-sectional study will be conducted at a tertiary care hospital in Karachi, Pakistan. A minimum sample size of 250 head and neck cancers and 250 brain tumour survivors with 10% inflation for non-response rate will be required. The SD of QoL and resilience will range from 16.5 to 40.8 for head and neck cancer, and 12.7 to 34.1 for brain tumour, at 5% level of significance, with 2.5 precision. QoL will be assessed by European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30, EORTC QLQ-H&N35 and EORTC QLQ-BN20 and resilience will be evaluated by Wagnild and Young\u27s 14-item scale. Mean±SD will be reported for resilience and QoL scores. Unadjusted and adjusted β-coefficients, with 95% CI, will be reported by using multiple linear regression analysis. Correlation analysis will also be performed using Pearson or Spearman rank correlation coefficients. A p value of \u3c0.05 will be considered significant.Ethics and Dissemination: Ethical approval has been obtained from the Aga Khan University Pakistan\u27s Ethical Review Committee. Written informed consent will be taken from the participants by trained research assistants. A trained psychologist will provide on-spot counselling to the participants and those identified with severe depression will be referred to a psychiatrist. The study materials will be kept under lock and key and the electronic data base will be password protected and will only be accessed by the research team. The study findings will be disseminated through publications conferences and workshops and research briefs

Irrigation Scheduling under High Efficiency (Pressurized) Irrigation Systems

This is, indeed, highly gratifying to observe that high efficiency irrigation systems have established their worth with the farming community in Punjab and their acceptance is accelerating on day to day basis. The benefits of these HEISs have been experienced pragmatically by the beneficiaries and their interviews reveal that substantial savings in water, fertilizers, pesticides especially the weedicides, energy, and labor have been realized on most of the same. As a result extensive installation of drip and sprinkler irrigation systems under ( ) project in progress which, indeed, is helping in combating with the shortage of irrigation water in the country on one hand and is proving effective in bringing the yield levels of crops of the country at par with the world standards on the other. Their affectivity, however, largely depends upon accurate scheduling of irrigation through the same and a definite rise in their efficiency may be accrued through proper monitoring of the schedules both with respect to their preparation as well as their implementation. Since HEISs are relatively a new intervention in Pakistan, there exists a dearth of relevant printed material regarding various operational aspects of the systems especially in relation to preparation of fertigation, irrigation and chemigation schedules. Perhaps, the most critical and the most wanted facet of these newly introduced systems is the preparation of proper irrigation schedules for various crops being grown in their command. In addition, the training of project staff and the users of the systems regarding these schedules covering their understanding and implementation in the field appears to be a missing link. A fair analysis of the factors leading to such gaps reflects that lack of technical material on the subject is the primary reason The effort made by PSC in the form of this manual is expected to serve the purpose in question. Solved examples of preparation of schedules for a number of crops have been added to give an in depth orientation to the reader. Through requisite review of this manual, it will not only be possible to check and monitor the irrigation schedules supplied on some of the sites by the SSCs for their authenticity and accuracy but it will also enable the project staff especial ly the HEIS teams to prepare and provide the same at the farms/sites without these schedules on instant basis

Intra-pleural colistin methanesulfonate therapy for pleural infection caused by carbapenem-resistant Acinetobacter baumannii: a successful case report

Infections caused by carbapenem-resistant, Gram-negative bacteria are an increasing clinical challenge, since the antimicrobial treatment options are often limited to colistin methanesulfonate. No data are available regarding the pharmacokinetics of colistin in pleural fluid. We report the case of a 92-year old man with ventilator-associated pneumonia and pleurisy caused by Acinetobacter baumannii and Escherichia coli, which were both multidrug-resistant. After an unsuccessful treatment with intravenous colistin methanesulfonate and imipenem-cilastatin, the addition of intra-pleural colistin methanesulfonate to the intravenous treatment led to a prompt clinical, radiological and microbiological resolution. This is the first report of a successful use of intra-pleural colistin in the literature. The intra-pleural colistin therapy should be considered in selected cases of pleurisy caused by multi-resistant Gram-negative bacteria