7 research outputs found

    Awareness to Handle Research and Healthcare Waste (RHCW) in teaching and research institutes; a comprehensive review

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    Environmental pollution has become the major challenge not only for developing countries but also for developed ones Worldwide. The major goal of this comprehensive review is to compile the reference data regarding the different types of waste generated in teaching, research, and healthcare institutes and specific strategy to manage such wastes. In addition to the pharmaceutical, leather, chemicals, food, and paper industries, teaching, research, and healthcare institutions are also significant sources of different types of Non-hazardous as well as hazardous wastes. Therefore, a simple and implementable guideline for cleaning and waste disposal services in such institutions requires strict adherence to applicable policies and procedures. Research and healthcare waste (RHCW) management is a joint effort among Research Laboratory Personnel, Healthcare facilitators, Building Services Personnel, and Local Environmental Health and Safety Personnel. As Pakistan is among the developing countries situated in South Asia, most of the institutes, including teaching, research, and healthcare, try to follow the WHO guidance or manage hazardous and non-hazardous wastes with self-planned strategies. Although most of the local Governing bodies and Institutional bodies are trying to handle the wastes at their levels by following different protocols, introducing a protocol at the National level is the need of the current era to fight against environmental pollutants.

    Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

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    IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non‚Äďcritically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n‚ÄČ=‚ÄČ257), ARB (n‚ÄČ=‚ÄČ248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n‚ÄČ=‚ÄČ10), or no RAS inhibitor (control; n‚ÄČ=‚ÄČ264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support‚Äďfree days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support‚Äďfree days among critically ill patients was 10 (‚Äď1 to 16) in the ACE inhibitor group (n‚ÄČ=‚ÄČ231), 8 (‚Äď1 to 17) in the ARB group (n‚ÄČ=‚ÄČ217), and 12 (0 to 17) in the control group (n‚ÄČ=‚ÄČ231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support‚Äďfree days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

    Impact of Food Literacy on Consumer's Food Purchasing Habits and Dietary Intake - A Systematic Review

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    Introduction: A well-nourished population represents the sustainable development of a nation. Poor alignment between food intake and dietary recommendations results in consumption of high calorie, low nutrient dense foods. Aims & Objectives: The main goal of this study is to find the relation between food literacy and dietary intake. Secondly, to assess the influence of food literacy on food purchasing habits. Place and duration of study: For this review, collection of studies from PubMed and Cochrane databases was started in May 2020 and was finalized by June 2020. Material & Methods: The eligibility criteria were based on two factors; that the study be written in English and published through a peer reviewed journal. Through the database search, total 673 studies were identified. After checking studies thoroughly at various steps, only 26 were included in this review. Results: 11 studies claimed the link between food label reading and intake of nutrients, while there were 10 studies that measured the consumer's purchase and food choices by their awareness level about food labels. Conclusion: This systematic review demonstrates nutrition education to be directly correlated with the food-related habits of people. Further research is required to get a clear vision about knowledge of nutritional labels and its effect on real life dietary choices

    Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease‚ąó

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    OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease

    Presentation, care and outcomes of patients with NSTEMI according to World Bank country income classification: the ACVC-EAPCI EORP NSTEMI Registry of the European Society of Cardiology.