Injection practices and sharp waste disposal by general practitioners of Murree, Pakistan

Objective: To describe the injection and sharp waste disposal practices of general practitioners of Murree, Pakistan.METHODOLOGY: In-depth interviews of all general practitioners available between 10th to 20th July 2000 were conducted. Practitioners were interviewed about injection administration and disposal of waste due to injections and other sharp material.Results: Twenty general practitioners out of 25 were interviewed. All claimed using disposable syringes only once. None of them was disposing off syringes in sharp containers in the clinic. Of 20, 12 (60%) were throwing syringes at open places and 5 (25%) in municipal waste bins. Most of the injections by general practitioners were administered for fever, body aches, diarrhea and respiratory tract infection.CONCLUSION: Sharp waste disposal is not safe in Murree. Improper disposal of sharp waste needs development of cost effective methods that are applicable at a small scale. Larger studies are required to quantify the gravity of the problem

Knowledge and practices of barbers about hepatitis B and C transmission in Rawalpindi and Islamabad

Objective: To assess the knowledge and practices of barbers regarding transmission risk of HBV and HCV viruses.Methods: A cross-sectional survey of barber\u27s shops in Rawalpindi and Islamabad was conducted during September- November1998. Barbers were queried about hepatitis, knowledge regarding hepatitis transmission through razor, vaccination, sterilization, and the form of media they use for information and entertainment. Use of instruments on at least 2 clients were observed in each shop. Proportion and their 95% confidence intervals were computed.Results: Of 96 barbers approached, 12 (13%) knew that hepatitis is a disease of the liver, causing jaundice, it is transmitted through parenteral route and could also be transmitted by razor. During the actual observation of 192 clients, razors were cleaned with antiseptic solution for 22 (11.4%) and reused for 88 (46%) shaves.CONCLUSION: Level of awareness among barbers about hepatitis and risks of transmission is very low, and their practice of razor reuse that may spread hepatitis is very common. Messages about hepatitis need to be incorporated in media campaigns, in addition to regulation of practices

Automatic seagrass detection: A survey

© 2017 IEEE. Seagrass is an important component of the marine ecosystem and plays a vital role in preserving the water quality. The traditional approaches for sea grass identification are either manual or semi-automated, resulting in costlier, time consuming and tedious solutions. There has been an increasing interest in the automatic identification of seagrasses and this article provides a survey of automatic classification techniques that are based on machine learning, fuzzy synthetic evaluation model and maximum likelihood classifier along with their performance. The article classifies the existing approaches on the basis of image types (i.e. aerial, satellite, and underwater digital), outlines the current challenges and provides future research directions

FEDSM2008-55248 Self-assembly of Particles into 2D Lattices with Adaptable Spacing

ABSTRACT It was recently shown i

IMECE2008-68048 Self-assembly of Rod-like Particles into 2D Lattices

ABSTRACT It was recently shown by us that spherical particles floating on a fluid-fluid interface can be self-assembled, and the lattice between them can be controlled, using an electric field. In this paper we show that the technique can also be used to self assemble rod-like particles on fluid-fluid interfaces. The method consists of sprinkling particles at a liquid interface and applying an electric field normal to the interface, thus resulting in a combination of hydrodynamic (capillary) and electrostatic forces acting on the particles. A rod floating on the fluid interface experiences both a lateral force and a torque normal to the interface due to capillarity, and in the presence of an electric field, it is also subjected to an electric force and torque. The electric force affects the rods' approach velocity and the torque aligns the rods parallel to each other. In the absence of an electric field, two rods that are initially more than one rod length away from each other come in contact so that they are either perpendicular or parallel to the line joining their centers, depending on their initial orientations. In the latter case, their ends are touching. Our experiments show that in an electric field of sufficiently large strength, only the latter arrangement is stable. Experiments also show that in this case the electric field causes the rods of the monolayer to align parallel to one another and that the lattice spacing of a self-assembled monolayer of rods increases

Workplace mistreatment and mental health in female surgeons in Pakistan

Background: Despite workplace mistreatment, which includes harassment, bullying and gender discrimination(GD)/bias, being serious problems for female surgeons, there are limited data from lower-middle-income countries like Pakistan. This study explored harassment and GD/bias experienced by female surgeons in Pakistan, and the effects of these experiences on mental health and well-being.Methods: A nationwide survey was conducted between July and September 2019 in collaboration with the Association of Women Surgeons of Pakistan, an organization consisting of female surgeons and trainees in Pakistan. An anonymous online survey was emailed directly, disseminated via social media platforms (such as Facebook, Twitter and Instagram), and sent to surgical programmes in Pakistan.Results: A total of 146 women surgeons responded to the survey; 67.1 per cent were trainees and the rest attending surgeons. Overall, 57.5 per cent of surgeons reported experiencing harassment, most common being verbal (64.0 per cent) and mental (45.9 per cent), but this mostly went unreported (91.5 per cent). On multivariable analysis adjusted for age and specialty, workplace harassment (odds ratio 2.02 (95 per cent c.i. 1.09 to 4.45)) and bullying (odds ratio 5.14 (95 per cent c.i. 2.00-13.17)) were significantly associated with severe self-perceived burnout, while having a support system was protective against feelings of depression (odds ratio 0.35 (95 per cent c.i. 0.16 to 0.74)). The overwhelming majority (91.3 per cent) believed that more institutional support groups were needed to help surgeons with stress reduction (78.8 per cent), receiving mentorship (74.7 per cent) and work-life balance (67.8 per cent).Conclusion: Workplace mistreatment, in particular harassment and bullying, has a damaging impact on the mental well-being of female surgeons, particularly trainees. The absence of support groups in Pakistan should be urgently addressed so that surgeons, especially trainees, may cope better with potentially harmful workplace stressors

Mixed ice accretion on aircraft wings

Ice accretion is a problematic natural phenomenon that an effects a wide range of engineering applications including power cables, radio masts and wind turbines. Accretion on aircraft wings occurs when supercooled water droplets freeze instantaneously on impact to form rime ice or runback as water along the wing to form glaze ice. Most models to date have ignored the accretion of mixed ice, which is a combination of rime and glaze. A parameter we term the `freezing fraction', is defined as the fraction of a supercooled droplet that freezes on impact with the top surface of the accretion ice to explore the concept of mixed ice accretion. Additionally we consider different `packing densities' of rime ice, mimicking the different bulk rime densities observed in nature. Ice accretion is considered in four stages: rime, primary mixed, secondary mixed and glaze ice. Predictions match with existing models and experimental data in the limiting rime and glaze cases. The mixed ice formulation consequently however provides additional insight into the composition of the overall ice structure, which ultimately influences adhesion and ice thickness; and shows that for similar atmospheric parameter ranges, this simple mixed ice description leads to very different accretion rates. A simple one-dimensional energy balance was solved to show how this freezing fraction parameter increases with decrease in atmospheric temperature, with lower freezing fraction promoting glaze ice accretion

An engineering perspective of water sharing issues in Pakistan

Water sharing within the states/provinces of a country and cross-border is unavoidable. Conflicts between the sharing entities might turn more severe due to additional dependency on water, growing population, and reduced availability as a result of climate change at many locations. Pakistan, being an agricultural country, is severely water stressed and heading toward a worsening situation in the near future. Pakistan is heading toward water scarcity as water availability in the Indus basin is becoming critical. Being a downstream riparian of India and Afghanistan in the Indus basin, water availability depends on the releases of water from both countries. The Indus Water Treaty is governing the water distribution rights between India and Pakistan. However, there exists no proper agreement between Pakistan and Afghanistan and the construction of new dams on the Kabul River is another threat to water availability to Pakistan. Correct implementation of the Indus Water Treaty with India is required, together with an effective agreement with Afghanistan about the water sharing. In addition to water shortage, poor management of water resources, inequitable sharing of water, lack of a systematic approach, old-fashioned irrigation practices, and growing agricultural products with large water footprints are all exacerbating the problem. The water shortage is now increasingly countered by the use of groundwater. This sudden high extraction of groundwater is causing depletion of the groundwater table and groundwater quality issues. This water shortage is exacerbating the provincial conflicts over water, such as those between Punjab and Sindh provinces. At one end, a uniform nationwide water allocation policy is required. At the same time, modern irrigation techniques and low-water-footprint agricultural products should be promoted. A fair water-pricing mechanism of surface water and groundwater could be an effective measure, whereas a strict policy on groundwater usage is equally important. Political will and determination to address the water issues are required. The solutions must be based on transparency and equity, by using engineering approaches, combined with comprehensive social support. To develop a comprehensive water strategy, a dedicated technopolitical institute to strengthen the capabilities of nationwide expertise and address the issues on a regular basis is required to overcome the complex and multidimensional water-related problems of the country

Koliko su studenti više medicinske škole u Bitoli upoznati s problemom infekcije HCV-om

Healthcare workers are at risk of occupationally-acquired viral infections such as human immunodefi ciency virus (HIV), hepatitis B (HBV), and hepatitis C (HCV). HCV is parenterally transmitted and has been found in every part of the world. This cross-sectional study was conducted to establish the awareness and attitude about HCV infections among 210 full-time and part-time nursing students of the Medical College in Bitola, Macedonia ‘from May to June 2009. For this purpose we used a self-administered questionnaire which consisted of three parts. The fi rst included demographic data, the second included questions about causes of infection, mode of transmission, symptoms, acute and chronic hepatitis, and prevention, and the third questions about students’ attitude toward patients with suspect or confi rmed HCV infection. Full-time students showed higher HCV awareness (84 %) than part-time students (69 %). 58 % of the full-time and 79 % of the part-time students said they would not avoid professional contact with suspect or HCV infected patients. Our study has shown that even though both groups of students have a suffi cient knowledge about HCV to face future challenges, they need further education on the subject. Practical recommendations would help to reduce stigmatising behaviour still further.Zdravstveni su radnici izloženi profesionalnomu riziku od infekcije virusom humane imunodefi cijencije (HIV-om), hepatitis B virusom (HBV-om) te hepatitis C virusom (HCV-om). HCV se prenosi parenteralno i ima ga posvuda u svijetu. Ovo smo presječno ispitivanje proveli da utvrdimo koliko su studenti za medicinske tehničare i sestre upoznati s infekcijom HCV-om i saznamo njihove stavove o tome. Ispitivanje je obuhvatilo 210 redovitih i izvanrednih studenata Visoke medicinske škole u Bitoli i trajalo je od svibnja do lipnja 2009. Za ispitivanje je rabljen opširan upitnik. Odgovori su pokazali da redoviti studenti imaju bolji uvid u predmet (s 84 % točnih odgovora) od izvanrednih studenata (69 %). U pogledu stava prema pacijentima 58 % redovitih i 79 % izvanrednih studenata ne izbjegava dodir s pacijentima koji su infi cirani HCV-om. Ispitivanje je pokazalo da su studenti iz obje skupine dovoljno upoznati s infekcijom HCV-om, rizičnim čimbenicima i načinom prijenosa, ali je potrebno to znanje nadograditi

Warfarin Anticoagulation Exacerbates the Risk of Hemorrhagic Transformation after rt-PA Treatment in Experimental Stroke: Therapeutic Potential of PCC

Background: Oral anticoagulant therapy (OAT) with warfarin is the standard of stroke prevention in patients with atrial fibrillation. Approximately 30% of patients with cardioembolic strokes are on OAT at the time of symptom onset. We investigated whether warfarin exacerbates the risk of thrombolysis-associated hemorrhagic transformation (HT) in a mouse model of ischemic stroke. Methods: 62 C57BL/6 mice were used for this study. To achieve effective anticoagulation, warfarin was administered orally. We performed right middle cerebral artery occlusion (MCAO) for 3 h and assessed functional deficit and HT blood volume after 24 h. Results: In non-anticoagulated mice, treatment with rt-PA (10 mg/kg i.v.) after 3 h MCAO led to a 5-fold higher degree of HT compared to vehicle-treated controls (4.0±0.5 µl vs. 0.8±0.1, p<0.001). Mice on warfarin revealed larger amounts of HT after rt-PA treatment in comparison to non-anticoagulated mice (9.2±3.2 µl vs. 2.8±1.0, p<0.05). The rapid reversal of anticoagulation by means of prothrombin complex concentrates (PCC, 100 IU/kg) at the end of the 3 h MCAO period, but prior to rt-PA administration, neutralized the exacerbated risk of HT as compared to sham-treated controls (3.8±0.7 µl vs. 15.0±3.8, p<0.001). Conclusion: In view of the vastly increased risk of HT, it seems to be justified to withhold tPA therapy in effectively anticoagulated patients with acute ischemic stroke. The rapid reversal of anticoagulation with PCC prior to tPA application reduces the risk attributed to warfarin pretreatment and may constitute an interesting therapeutic option