Experiences of newly diagnosed oral cancer patients during the first wave of the COVID-19 pandemic: A qualitative study from Pakistan

The COVID-19 pandemic has resulted in the scaling back or postponement of non-emergency hospital services, including care of cancer patients. The present qualitative study explored the experiences of newly diagnosed oral cancer patients during the first wave of the COVID-19 pandemic in Pakistan. Patients who attended the Department of Maxillofacial Surgery, Khyber College of Dentistry in July 2020 were selected using a maximum variation purposive sampling method. Seventeen semi-structured interviews were conducted in Pashto, the local language of Khyber Pakhtunkhwa. All interviews were audiotaped, transcribed verbatim, and translated into English. Thematic content analysis yielded eight major themes: pain and generalised physical weakness, shock at diagnosis, psychological distress of the COVID-19 pandemic, faith and religion, double hit loss of employment, social isolation, social support from caregivers, and lack of support from health care professionals. In conclusion, the COVID-19 pandemic has a clear impact on the life experiences of newly diagnosed oral cancer patients. Distress due to delay in accessing health care and lack of support from health care providers are a matter of great concern. Appropriate interventions should be introduced to ensure psychological and social support strategies are in place for patients during interruptions of health care services

Experiences of newly diagnosed oral cancer patients during the first wave of the COVID-19 pandemic: A qualitative study from Pakistan

The COVID-19 pandemic has resulted in the scaling back or postponement of non-emergency hospital services, including care of cancer patients. The present qualitative study explored the experiences of newly diagnosed oral cancer patients during the first wave of the COVID-19 pandemic in Pakistan. Patients who attended the Department of Maxillofacial Surgery, Khyber College of Dentistry in July 2020 were selected using a maximum variation purposive sampling method. Seventeen semi-structured interviews were conducted in Pashto, the local language of Khyber Pakhtunkhwa. All interviews were audiotaped, transcribed verbatim, and translated into English. Thematic content analysis yielded eight major themes: pain and generalised physical weakness, shock at diagnosis, psychological distress of the COVID-19 pandemic, faith and religion, double hit loss of employment, social isolation, social support from caregivers, and lack of support from health care professionals. In conclusion, the COVID-19 pandemic has a clear impact on the life experiences of newly diagnosed oral cancer patients. Distress due to delay in accessing health care and lack of support from health care providers are a matter of great concern. Appropriate interventions should be introduced to ensure psychological and social support strategies are in place for patients during interruptions of health care services

Effect of alternative protein sources on growth performance, plasma mineral concentration, bone mineralisation and mineral digestibility in broiler chickens

An experiment was conducted to investigate the effect of rapeseed meal (RSM), sunflower meal (SFM), canola meal (CM) and guar meal (GM) respectively at 50, 60, 100 and 50g/kg in a maize soyabean based diet on growth performance, plasma mineral concentration, bone mineralisation and mineral digestibility in broiler chickens. The control diet had soya bean meal (SBM; 320g/kg). Day old Hubbard broilers were allocated to five treatments each with 4 replicates and 10 birds. Partial replacement of SBM with other protein sources resulted in heavier (P<0.05) birds compared to control. Bone mineralisation was not affected (P>0.05) by diets. Plasma Ca concentration was higher (P<0.05) in birds fed GM compared to all other treatments. Retention of P, Mg, Na, Cu was increased and Ca retention was decreased in birds fed control diet whereas, no differences (P>0.05) were observed between treatments in K, Fe and Mn retention values. In conclusion, alternative protein sources improved growth but had variable effects on mineral utilisation

Effect of alternative protein sources on growth performance, plasma mineral concentration, bone mineralisation and mineral digestibility in broiler chickens

An experiment was conducted to investigate the effect of rapeseed meal (RSM), sunflower meal (SFM), canola meal (CM) and guar meal (GM) respectively at 50, 60, 100 and 50g/kg in a maize soyabean based diet on growth performance, plasma mineral concentration, bone mineralisation and mineral digestibility in broiler chickens. The control diet had soya bean meal (SBM; 320g/kg). Day old Hubbard broilers were allocated to five treatments each with 4 replicates and 10 birds. Partial replacement of SBM with other protein sources resulted in heavier (P<0.05) birds compared to control. Bone mineralisation was not affected (P>0.05) by diets. Plasma Ca concentration was higher (P<0.05) in birds fed GM compared to all other treatments. Retention of P, Mg, Na, Cu was increased and Ca retention was decreased in birds fed control diet whereas, no differences (P>0.05) were observed between treatments in K, Fe and Mn retention values. In conclusion, alternative protein sources improved growth but had variable effects on mineral utilisation

Potential Drug-Drug Interactions in Psychiatric Ward of a Tertiary Care Hospital: Prevalence, Levels and Association with Risk Factors

Purpose: To identify the prevalence of potential drug-drug interactions (pDDIs) in a psychiatric ward, their levels and association with risk factors.Methods: This study was conducted in the psychiatric ward of Ayub Teaching Hospital, Abbottabad, Pakistan. Medical records of 415 patients were retrospectively reviewed for pDDIs using Micromedex Drug-Reax software. Logistic regression was applied to determine association of pDDIs with age, gender, hospital stay and number of drugs.Results: In our study, we identified total number of 825 pDDIs of 126 types, with median number of 1 pDDIs per patient. Overall 64.8 % of the patients had at least one pDDI; 27.2 % at least one major pDDI; and 58.5 % patients at least one moderate pDDI. Among 825 identified pDDIs, most were of moderate (75.6 %) or major (20.8 %) severity, good (66.4 %) or fair (29 %) type of scientific evidence; and delayed onset (71 %). The most frequent major and moderate pDDIs included haloperidol + procyclidine (127 cases), haloperidol + olanzapine (49), haloperidol + promethazine (47), haloperidol + fluphenazine (41), diazepam + divalproex sodium (40), haloperidol + trihexyphenidyl (37), lorazepam + divalproex sodium (34), fluphenazine + procyclidine (33) and olanzapine + divalproex sodium (32). There was significant association of occurrence of pDDIs with hospital stay of 7 days or longer (p = 0.005) and taking 7 or more drugs (p < 0.001).                                                       Conclusion: A high prevalence of pDDIs in the psychiatric ward was recorded, a majority of which were of moderate severity. Patients with long hospital stay and increased number of drugs were more exposed to pDDIs.Keywords: Drug-drug interactions, Potential drug-drug interaction, Prescriptions screening, Drug-related problems, Clinical pharmacy

Root cause analysis (RCA) of fractured ASTM A53 carbon steel pipe at oil & gas company

Incident involving failures of ASTM A53 carbon steel (CS) pipe, connected to pressure safety valve (PSV) and carrying raw gas has caused serious supply disruption. This study was performed to identify the most probable cause of the pipe failure. It was conducted by reviewing the existing design, construction data and pipe material analysis using non-destructive techniques such as VT, PT, MT and UT along with metallographic, hardness and microscopic analysis. The investigation revealed that excessive material loss has occurred in both failure and its adjacent regions due to abrasive grinding, resulting in the formation of a through thickness flaw. These grindings were performed to accommodate the pre-installed piping spool to avoid alteration in the pipe position. RCA demonstrated that this rapid thinning of the steel pipe body later led to its failure. Metallurgical study using photomicrograph shows that the morphology of the steel material was consistent and did not show any evidence of internal corrosion or micro fractures. Further damage to the surface of already excessively reduced thickness occurred due to nominal pipe vibration and atmospheric effect during service. The research work described in the paper has a significant meaning to recognize the root cause of such failures in CS pipes and through given recommendations to eliminate future such happenings

Oral health behind the bars: oral health seeking behavior among jail prisoners at central jail of Peshawar, Pakistan: a cross-sectional study

Background: The oral health care-seeking behavior among prison inmates is an overlooked area, often leading to deteriorating general health due to the prisoners’ limited awareness of oral hygiene practices. It is crucial to address this issue and understand the factors associated with oral healthcare-seeking behavior in prisons. Objective: To assess the oral healthcare-seeking behavior of prison inmates at Central Prisoner Jail, Peshawar Pakistan and to look the factors associated with their dental care utilization. Material and Methods: This cross-sectional study was conducted at Central Prisoner Jail, Peshawar Khyber Pakhtunkhwa, Pakistan from November 2021 to April 2022. A consecutive sampling technique was used to collect data from both convicted and under-trial prisoners by using a pre-tested WHO Basic Oral Health Survey 2013 tool. Our outcome variable was “Visit to a dentist in the last 12 months (Never/Once or more than one visit). Chi-square test was used to determine univariate association with other explanatory variables while multivariable logistic regression was performed to adjust for potential confounders. Result: A total of 225 participants were recruited to the study with a mean (SD) age of 32.9(11.4). More than two-thirds of 200(88.9%) of the participants were males. One-third of the sample never visited the dentist75(33.3). Participants who completed college/university education and never visited the dentist in the last 12 months constituted a smaller proportion (17.6%) compared to those who visited the dentist once or more than once n = 28(82.4%, p-value = 0.003). Individuals who were using toothbrushes were most frequently visiting the dentist n = 130(72.6%=p value = 0.001) as compared to never visitors. Multivariate logistic regression analysis revealed that Participants who experienced teeth pain or discomfort had 0.42 times lower odds of visiting the dentist compared to those who did not experience any pain or discomfort [AOR 0.42 (95% CI 0.17–0.80), p = 0.04]. Similarly, Participants who do not use any denture have 4.06 times higher odds[AOR 4.06(95% CI 1.76–9.36), p = 0.001] of visiting the dentist compared to those who use a denture. Conclusion: Our result demonstrates that those prisoners who were experiencing tooth pain or discomfort and not using dentures were the strong predictors with lower dental visit frequency to seek oral health care

Electrochemical properties of single-crystalline Mn3O4 nanostructures and their capacitive performance in basic electrolyte

Single-crystalline Mn3O4 square-shaped nanostructures have been successfully synthesized by hydrothermal method without using any surfactant. The as-prepared products were characterized by X-ray diffraction (XRD), field emission scanning electron microscopy (FESEM), Transmission electron microscopy (TEM) and High Resolution transmission electron microscopy (HRTEM). To assess the potential properties of nanostructures, galvanostatic charging-discharging and cyclic voltammetry measurements were performed for their use in supercapacitors. The Mn3O4 nanoarchitectures used as supercapacitor electrode in 1mol L-1 KOH electrolyte have a specific capacitance value of 355.5 F g-1 at a low current density of 0.35 A.g-1. The device still retain 85.08% of its initial capacitance afterwards 2000 cycles at a current density of 5 A.g-1. The as-synthesized Mn3O4 nanostructures exhibited a good rate capability and stability for electrochemical properties. These results indicate their potential application as electrode material for high performance supercapacitor in basic medium. � 2016 The Authors

Prevalence of Parental refusal rate and its associated factors in routine immunization by using WHO Vaccine Hesitancy tool: A Cross sectional study at district Bannu, KP, Pakistan

Objective To determine the parents refusal rate, associated factors and the perceptions of refusal parents in routine immunization by using “WHO SAGE Working Group on Vaccine Hesitancy survey tool”. Material and Methods A cross sectional survey was conducted by using multi stage cluster sampling at the remote district Bannu Khyber Pakhtunkhwa Province, Pakistan from March 2019 to July 2019.A WHO validated questionaire was used. Our outcome variable was “Ever refusal from routine immunization (yes/No)”.logistic regression was run for association and multi regression was applied to see counfounders. Result Out of total 610 parents, the refusal rate was 170(27.9%).Mostly the mother of the children has no education 145(85.3%,P 0.03).Mother has no mobile but the father has 152(89.4%, p=<.001) higher frequency to have mobile. The refusal rate was high in those having secure food 88(51.8%) as compare to minimal 62(36.5%) and highly insecure food 20(11.8%,P=<.05).On multivariate logistic regression, those father who were employee (adjusted OR = 0.59; 95% CI 0.37 to 0.94; p = 0.02) and having higher education (adjusted OR = 0.21; 95% CI 0.08 to 0.50; p=<.001) were less likely to refuse to vaccinate their children while in contrast those having highly insecure food were more likely to refuse (adjusted OR = 2.2; 95% CI 1.0 to 0.50; p = 0.04) as compare to minimal insecure food (adjusted OR = 1.6; 95% CI 1.0 to 2.5; p = 0.02). Conclusion Refusal rate among parents was very high while those parents who’s can’t read or write and with no education, having mobile phone, unemployment and secure food were more to be associated with refusal