What Is Limulus Amebocyte Lysate (LAL) and Its Applicability in Endotoxin Quantification of Pharma Products

Limulus amebocyte lysate (LAL) is an aqueous extract of blood cells (amoebocytes) from the horseshoe crab, Limulus polyphemus. LAL reagent reacts with bacterial endotoxin and lipopolysaccharide (LPS), which is a membrane constituent of Gram-negative bacteria. This reaction is the base on the LAL reagent, which is then used for the finding and quantification of bacterial endotoxins. The Gel Clot LAL test provides very simple positive or negative result and is most often mentioned in international pharmacopeia monographs as the official test. Gel Clot assay is a qualitative LAL test for detection of Gram-negative bacteria endotoxins. The Gel Clot assay is run in tubes that are placed in a water bath or in dry heated oven at 37°C. After a one-hour incubation period, the tubes are flipped 180°. A firm clot that stays in the bottom of the tube indicates a positive reaction. If the liquid flows down the side of the tube, the result is negative for endotoxins

A Descriptive Study on Patterns of Traumatic Spinal Injuries in a Tertiary Care Hospital Rawalpindi

Introduction: Spinal injuries are one of the most debilitating injuries if not fatal and affect every dimension of patients' lives i.e. early mortality and late complications. Lifelong disability due to spinal cord injury is very common even if the patient survives early death. The current study was aimed to investigate the frequency, management, mortality, the pattern of spinal injuries and to recommend plans for better patient management based on assessment.Material and Methods: The study was descriptive, cross-sectional, and was conducted at the Neurosurgery Department of Rawalpindi Medical University and Allied Hospitals for the duration of October 2018 to January 2019. All cases of traumatic spinal injuries were included and variables noted were gender, age, mode of Injury, presenting motor power in limbs, ASIA score, diagnosis, management, outcome, and deaths.Results: In the sample size of 84 patients, the mean age was 37.1 years, the mechanism of injury due to falls was most common at 73%, the lumbar region was found to be the most common area involved. Male patients outnumbered females in the study. 14% of the patients could not survive due to the injury, 15% received cervical traction, 4% received cervical traction and anterior cervical plating, and 43% of patients underwent Transpedicular Screw Fixation, the total number of patients who expired was 25%.Conclusion: Patterns of traumatic spinal injuries are changing, shifting from road traffic accidents to falls being the primary cause nowadays, with prolonged hospital stay periods, disability for life, and high-cost treatments putting a huge burden on our already exhausted health resources. Efforts should be made to make a national registry for traumatic spinal injuries presented to the emergency department and guidelines should be established regarding occupational hazards. Awareness should be given to the general population regarding hazards at home regarding falls

DEVELOPMENT OF A NEW HYBRID MULTI CRITERIA DECISION-MAKING METHOD FOR A CAR SELECTION SCENARIO

Increasing competition in the automobile industry has led to a vast variety of choices when buying a car thus making car selection a tedious task. The objective of this research is to develop a new hybrid multi-criteria decision-making technique, with accuracy greater than that of the already existing methods, in order to help the people in decision-making while buying a car. Hence, considering a broader spectrum, this study aims at easing the process of multi-criteria decision-making problems in different fields. To achieve the objective, seven different alternatives were evaluated with respect to the enlisted evaluation criteria, which were selected after analyzing the secondary data obtained from Pak wheels based on style, fuel economy, price, comfort and performance. These criteria were then analyzed using the proposed Full Consistency Fuzzy TOPSIS method. As the name tells, this method is a unique combination of two techniques. The Full Consistency method is used to calculate the weights of the criteria while the Fuzzy TOPSIS approach is applied to rank the alternatives according to their scores in the selected criteria. The outcomes demonstrate an increase in the consistency ratio of the weight coefficients due to which the ranking of the alternatives by the FCF-TOPSIS is more accurate than the TOPSIS and the Analytical Hierarchy Process. The novelty of the method lies in the fact that this combination has not been used for an alternative selection scenario before. In addition to this, it can be used in various industries where a choice between the available alternatives arises based on a set of evaluation criteria

Attitude of Medical Students Towards Psychiatry in a Tertiary Care Hospital

Background: Dearth of psychiatrist specialists is evident worldwide. Awareness of undergraduate students towards mental illness has an important role in affecting the quality of care the patient receives and in choosing  psychiatry as a career . Decision to specialize in psychiatry based on many factors, however attitude of undergraduates towards career choice play most important role in this aspect. Objective: This study aims to explore attitude and towards psychiatry among medical undergraduates in tertiary care hospital and factors influencing this decision. Methodology: It was Descriptive cross sectional study done at Nishtar medical University, tertiary care hospital of Multan Pakistan from July to December 2019. The total 384 students from first to final year were enrolled by non probability convenient sampling technique. Participation was voluntary and ensured that response would be kept anonymous. ATP-30 (Attitude towards Psychiatry)   a 30 item self- administered questionnaire was used to measure the attitude of medical students. Data collected on a pre defined questionnaire was analyzed using SPSS version 23. Results pertaining to rates were reported as frequencies and percentages. Result: 47.4% of study respondents were male and 52.6 % were female. 52.3% of our study respondents strongly agree that psychiatry was respected branch of medicine and 56.7% strongly agree that psychiatry should be an important part of medical curriculum. 19.4% of study respondents consider it in the list of the carrier choice while majority didn’t think that it should be in their career list options. Conclusion: Majority of students shows positive attitude. Mostly found it as respected and essential field of medicine. However insufficient knowledge and awareness can also be observed in responses pertaining to available treatment and advancement in the field. There is a need to revise the curriculum and clinical rotation schedule to raise interest of students  regarding  mental health issues of their community and ease their decision in choosing it as a career. Keywords: Attitude, Undergraduate medical students, Psychiatry, Multan, Pakistan DOI: 10.7176/JMPB/63-06 Publication date: January 31st 202

Out-of-Pocket Expenditure on Delivery Care in Public and Private Health Sectors – A Study in a Rural District of Pakistan

Pakistan witnessed a significant improvement in maternal health outcomes during the past two decades. However, persistent urban-rural and socio-economic inequalities exist in access to maternal healthcare services across the country. The objective of this study was to estimate out-of-pocket expenditure (OOPE) on delivery care by women in the public and private health sectors in RajanPur district. This was a cross-sectional study conducted, among 368 randomly selected mothers who had childbirths from 1st October to 31st December 2020. The study applied multi-stage random sampling technique to select the study participants. The results showed that about two-thirds of mothers preferred public hospitals for most recent delivery. The percentage of cesarean deliveries conducted in private hospitals (43.8%) was 4.7 times higher than in public hospitals (9.3%). About 99% of mothers incurred OOPE during delivery care, and the mean OOPE incurred during delivery care was PKR 2840 (US$17.75) in public hospitals and PKR 25596 (US$159.9) in private hospitals. OOPE on cesarean delivery in private hospitals (PKR 39654.7, US$247.8) was 2.5 times higher than the public hospitals (PKR16111.9, US$100.69), whereas OOPE incurred on normal delivery care in private hospitals (PKR14339, US$89.62) was 9.5 times higher than OOPE in public hospitals(PKR 1501.4, US$9.38).To conclude, the findings and recommendations drawn from the research would provide some insights to health policymakers and planners in developing an integrated and viable maternal healthcare program in Pakistan

Outcome of Lateral Mass Fixation and Fusion – A Comprehensive Analytical Study of 205 Lateral Mass Screws in 35 Patients at Punjab Institute of Neurosciences

Objective: To see outcome, accuracy and expected complications in passing lateral mass screws in patients with cervical spine injury, degenerative disease at the cervical spine level and neoplastic lesions.Materials and Methods: In this study, 35 patients were included and 205 screws passed in lateral mass patients’age ranged from 12-70 years (25 males and 10 females) with trauma to the cervical spine, degenerative disease at the cervical spine level and Intradural extramedullary benigntumors and extradural malignant neoplasm.Patients less than 12 years and more than 65 years of age,patients with traumatic ruptured disc causingspinal cord compression anteriorly and operated for cervical spine were excluded from our study.In all patients,we did lateral mass fixation with polyaxial screws and rods under fluoroscopic assistance.For assessment of screws trajectory and position, CT scan cervical spine with 3D reconstruction was performed on a first post op day to confirm screw orientation and direction and for fascet, foraminal, foramen transversarium violations.Results: All screws were passed by using Megrel’s trajectories. Not a single patient had nerve root, cord injury nor vertebral artery injury. One patient had screw pullouts requiring reoperation.12 to 14mm size screws were used under fluoro guidance. On postoperative CT cervical spine with 3D reconstruction shows no breach or violations of any foramen transversarium, nerve root injury or neural foramen penetration by screws. In all patients polyaxial screw/rod construct was used. Conclusion: Cervical spine lateral mass fixation with polyaxial screws is a safe and effective technique in expert hands under fluoroscopic assistance

A COMPARATIVE STUDY OF MECHANICAL PROPERTIES AND MICROSTRUCTURES OF DEFORMED BARS (GRADE-60) LOCALLY MANUFACTURED IN PAKISTAN

The MS deformed bars are widely used in construction, housing, bridges, flyovers, dams etc. And often the properties claimed by the industries may or may not be compatible with ASTM Standards. In order to check their compatibility with ASTM standards, MS deformed bar samples of Grade 60 of one inch (25 mm) diameter of five different companies were taken from open market. As One of Pakistan's popular examples of consistent business success has been the stainless steel and mild steel production. The hypothesis explored in this paper is that meeting such standards requires greater properties, both among producers as well as mechanical properties obtained by Tensometer and Universal Hydralic Tensile Machine. The study draws on qualitative data to examine either how much difference or similarity is drawn within samples of various industries. And these samples were coded as S-1, S-2, S-3, S-4 and S-5. First of all composition was determined by using Optical Spectrometer then Tensile performed at universal hydraulic Testing Machine and time load graphs were taken as this test is commercially used, and also Tensile was performed on Tensometer at laboratory level and Stress-Strain graph was obtained and calculated. It was concluded that the experimental results of most of the industries were in good agreement with ASTM but only a few did not show compatibility with ASTM standards