Self-Medication Practice and Their Risk Factors among BScN 4 Years Students

Self-medication is the use of medicines to treat self-diagnosed disorders or symptoms, or the periodical or continued use of prescribed drugs for acute or chronic disease or symptoms. It’s going to include the use of herbs, the retention and Re-use of Medication without prescribed by doctors. Self-medication is widely practiced in both developed and developing countries. . Practice of getting self-medication was relatively high, because of easy access of drugs from public pharmacy and they also have knowledge about medicines. The study's overall objective was to identify the level of knowledge, attitude, and self-medication practices among undergraduate BScN 4 year student. This would be a descriptive cross sectional quantitative study .Quantitative cross sectional design used data to make statistical inference about nursing students of knowledge, attitude and practice regarding self-medication. Total, 250 BScN students were involved in this study. The data was collected using a validated questionnaire. Overall 53.6% BScN students often practice self-medications,while 46.4% students were not practice self-medications. In a study conducted in a private college of Nursing Lahore, it was found that self-medication is significantly higher in among BScN 4 year’s student nurses. We found that our respondent’s education has also impact on practice and attitude of self-medication. The awareness regarding self-medication among student is good about 60% populations have knowledge regarding medication benefits. As per the findings, 75.8% BScN students visited to a qualified medical practitioner. While 24.2% students were not visited to a qualified medical practitioner. 71.2% BScN students respond that the indications of self-medication Headache/ fever. Inappropriate self-medication can cause harm to the students and also whom they recommend as healthcare providers in the future. Therefore, there is a need to educate nursing students and make them more aware about adverse effects of self-medication. Keywords: Self-care, medical practitioner, nursing Students, Drugs, Self-medication, Knowledge DOI: 10.7176/JHMN/104-03 Publication date: November 30th 202

Self-Medication Practice and Their Risk Factors Among BScN 4 Years Students

Self-medication is the use of medicines to treat self-diagnosed disorders or symptoms, or the periodical or continued use of prescribed drugs for acute or chronic disease or symptoms. It’s going to include the use of herbs, the retention and Re-use of Medication without prescribed by doctors. Self-medication is widely practiced in both developed and developing countries. . Practice of getting self-medication was relatively high, because of easy access of drugs from public pharmacy and they also have knowledge about medicines. The study's overall objective was to identify the level of knowledge, attitude, and self-medication practices among undergraduate BScN 4 year student. This would be a descriptive cross sectional quantitative study .Quantitative cross sectional design used data to make statistical inference about nursing students of knowledge, attitude and practice regarding self-medication. Total, 250 BScN students were involved in this study. The data was collected using a validated questionnaire. Overall 53.6% BScN students often practice self-medications,while 46.4% students were not practice self-medications. In a study conducted in a private college of Nursing Lahore, it was found that self-medication is significantly higher in among BScN 4 year’s student nurses. We found that our respondent’s education has also impact on practice and attitude of self-medication. The awareness regarding self-medication among student is good about 60% populations have knowledge regarding medication benefits. As per the findings, 75.8% BScN students visited to a qualified medical practitioner. While 24.2% students were not visited to a qualified medical practitioner. 71.2% BScN students respond that the indications of self-medication Headache/ fever. Inappropriate self-medication can cause harm to the students and also whom they recommend as healthcare providers in the future. Therefore, there is a need to educate nursing students and make them more aware about adverse effects of self-medication. Keywords: Self-care, medical practitioner, nursing Students, Drugs, Self-medication, Knowledge DOI: 10.7176/JNSR/13-18-02 Publication date:October 31st 202

Enseñanza del lenguaje a través de la literatura: un estudio basado en ELT

The present study aims to: firstly, highlight the effectiveness of using literature in ELT classes in an interesting and innovative manner in Pakistan; secondly, to help language teachers develop a thoughtful and principled approach to using literature in the language classroom; thirdly, to provide teachers with the tools for developing their own classroom materials and for using these materials in a way that is relevant to their learners’ needs. This paper explores the text of ‘Good Bye Mr. Chips’, a famous novel by James Hilton (1934) for teaching at the Intermediate level. For the analysis of data, insights are taken from the works of Dubin & Olshtain (1977), Collie & Slater (1987) and Robinette. B. W (1978). It was found that activities like role plays and a lot of pair work and group work not only caused reduction in anxiety level of students but also increased their level of interest and enthusiasm. It also concluded that for facilitating language teaching and learning, the formation of a variety of activities based on learners’ needs from carefully and properly selected texts is unavoidable. Future researchers can exploit similar literary texts following the same frameworks for language teaching purposes.El presente estudio tiene como objetivo: en primer lugar, destacar la eficacia del uso de la literatura en las clases de ELT de una manera interesante e innovadora en Pakistán; en segundo lugar, ayudar a los profesores de idiomas a desarrollar un enfoque reflexivo y basado en principios para utilizar la literatura en el aula de idiomas; tercero, proporcionar a los maestros las herramientas para desarrollar sus propios materiales de clase y para usar estos materiales de una manera que sea relevante para las necesidades de sus alumnos. Este artículo explora el texto de “Good Bye Mr. Chips”, una famosa novela de James Hilton (1934) para la enseñanza a nivel intermedio. Para el análisis de los datos, se toman ideas de los trabajos de Dubin y Olshtain (1977), Collie y Slater (1987) y Robinette. B. W (1978). Se descubrió que actividades como juegos de roles y mucho trabajo en pareja y en grupo no solo redujeron el nivel de ansiedad de los estudiantes sino que también aumentaron su nivel de interés y entusiasmo. También concluyó que para facilitar la enseñanza y el aprendizaje de idiomas, es inevitable la formación de una variedad de actividades basadas en las necesidades de los alumnos a partir de textos cuidadosamente seleccionados. Los futuros investigadores pueden explotar textos literarios similares siguiendo los mismos marcos para la enseñanza de idiomas

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Temperature and pH Stability of Anthraquinones from Native Aloe vera Gel, Spray-Dried and Freeze-Dried Aloe vera Powders during Storage

The present study explored the stability of extracted anthraquinones (aloin, aloe-emodin and rhein) from whole-leaf Aloe vera gel (WLAG), its freeze-dried powder (FDP) and spray-dried powder (SDP) under varying pH and temperature conditions during storage. Each anthraquinone behaved differently under different processing parameters. The amount of anthraquinones present in the gel was higher than in FDP and SDP. The aloin contents decreased by more than 50% at 50 °C and 70 °C, while at 25 °C and 4 °C, the decrease was moderate. A substantial reduction in aloin concentration was noticed at pH 6.7, whereas it remained unaffected at pH 3.5. The temperature and pH had no significant effect on the stability of aloe-emodin. Interestingly, a small quantity of rhein was detected during storage due to the oxidative degradation of aloin into aloe-emodin and rhein. These findings can provide significant insight into retaining anthraquinones during processing while developing functional foods and nutraceuticals to obtain maximum health benefits

Ultrasound-Assisted Encapsulation of Anthraquinones Extracted from Aloe-Vera Plant into Casein Micelles

Aloe-vera extracted anthraquinones (aloin, aloe-emodin, rhein) possess a wide range of biological activities, have poor solubility and are sensitive to processing conditions. This work investigated the ultrasound-assisted encapsulation of these extracted anthraquinones (AQ) into casein micelles (CM). The particle size and zeta potential of casein micelles loaded with aloin (CMA), aloe-emodin (CMAE), rhein (CMR) and anthraquinone powder (CMAQ) ranged between 171–179 nm and −23 to −17 mV. The AQ powder had the maximum encapsulation efficiency (EE%) (aloin 99%, aloe-emodin 98% and rhein 100%) and encapsulation yield, while the whole leaf Aloe vera gel (WLAG) had the least encapsulation efficiency. Spray-dried powder (SDP) and freeze-dried powder (FDP) of Aloe vera showed a significant increase in size and zeta potential related to superficial coating instead of encapsulation. The significant variability in size, zeta potential and EE% were related to anthraquinone type, its binding affinity, and its ratio to CM. FTIR spectra confirmed that the structure of the casein micelle remained unchanged with the binding of anthraquinones except in casein micelles loaded with whole-leaf aloe vera gel (CMWLAG), where the structure was deformed. Based on our findings, Aloe vera extracted anthraquinones powder (AQ) possessed the best encapsulation efficiency within casein micelles without affecting its structure. Overall, this study provides new insights into developing new product formulations through better utilization of exceptional properties of casein micelles

Thyroid carcinoma in Pakistan

BACKGROUND AND OBJECTIVES: To address the need for epidemiologic data on thyroid carcinoma in Pakistan, we evaluated the frequency and types of thyroid carcinoma with respect to age and sex. METHODS: In a a retrospective study conducted at the Jinnah Postgraduate Medical Centre in Karachi, we reviewed thyroid lesions reported over a period of 5 years, from July 2000 to June 2005. Pathology slides were studied to determine the types and frequencies of malignant lesions of the thyroid. RESULTS: Of 998 thyroid lesions reviewed, 153 cases were malignant. Papillary carcinoma was the commonest malignant lesion with a frequency of 90.2%, followed by 4.5% for medullary carcinoma, 2% for follicular carcinoma, 2% for undifferentiated carcinoma and 0.7% each for mixed medullary and papillary carcinoma and poorly differentiated carcinoma. Females were predominant (82.4%) as compared with males (17.6%) for a female-to-male ratio 4.7:1. The maximum number of the patients were in the fourth decade of life followed by the third and second decades. CONCLUSION: The commonest malignant thyroid lesion was papillary carcinoma. Thyroid cancer was more common in females. Papillary, medullary and follicular carcinomas were found in patients in the third and fourth decades of life, while poorly and undifferentiated carcinomas were diagnosed from the fifth to seventh decades of life

Influence of Spray Drying on Encapsulation Efficiencies and Structure of Casein Micelles Loaded with Anthraquinones Extracted from <i>Aloe vera</i> Plant

The encapsulation efficiency (EE%) and structural changes within the Anthraquinones-encapsulated casein micelles (CM) powders were evaluated in this study. For this purpose, the anthraquinone powder extracted from Aloevera, its freeze-dried powder (FDP) and whole leaf Aloe vera gel (WLAG) has been encapsulated in CM through ultrasonication prior to spray dying to produce nanocapsules: CM encapsulated anthraquinone powder (CMAQP), CM encapsulated freeze-dried powder (CMFDP) and CM encapsulated Whole leaf aloe vera gel (CMWLAG). Based on the pH of the solution before drying, CMAQP had the highest EE% following spray drying. However, due to air-interface-related dehydration stresses, SD resulted in a slight decrease in the EE% of anthraquinones (aloin, aloe-emodin, and rhein) in CMAQP. Meanwhile, a significant increase in EE% of CMFDP was observed compared to the aqueous state. According to SEM findings, the particle size of CMAQP was 2.39 µm and ξ-potential of ~−17mV. The CMFDP had a rough fractal surface with large particle sizes and potential of 3.49 µm and ~−11mV respectively. CM deformed, having the least EE% and lowest ξ-potential (−4.5 mV). Spray drying enhances melanoidin formation in CMWLAG, as evidenced by the highest chroma values. The results suggested that EE%, stability, and degree of Maillard reaction are closely linked to the type of anthraquinone encapsulated, the pH of the solution, and the nanostructure of casein micelles during spray drying

Functional Literacy: Analysis of Literacy Practices of Female Attendants in Pakistani Context

William S.Gray (1956) initially defined the term functional literacy for UNESCO. He associated it with the approaches which also covers the successful acquisition of verb, cognitive and computational skills to fulfill not only the practical ends but also the culturally specific ways. So, A person is functionally literate who can engage in all those activities in which literacy is required for effective functioning of his group and community, and also for enabling him to continue reading, writing and calculating for his own and the community development. (A.M.Thomas, 1983).Functional literacy includes the possession of skills perceived as necessary by a particular individual or group to fulfill their self-determined objective as a family or community member, citizen, consumer, job-holder, or member of religious, social or other associations of their choosing (Haramn, 1984).Self-perceived need and self-determined objectives forms the basis of learning.The reason to review functional literacy through literacy practices of female attendants is that usually attendants are assumed to be devoid of formal education hence apparently lacking in skills (functional literacy) but the ground reality is they perform tasks which involves linguistic competence. So, the current study is an attempt to review the concept of functional literacy and functional literacy competence by analyzing specific literacy practices of female attendants at Fatima Jinnah Women University, Rawalpindi (FJWU). A qualitative approach was used to evaluate and analyses the literacy practices of female attendants. Population of the study comprised of five female attendants at FJWU chosen through random sampling method. Data was collected through semi structured interviews to probe deep in the literacy practices of female attendants. Findings of the study revealed that the literacy practices (dispatching documents, presenting refreshment, receiving keys etc.) of female attendants at FJWU are culture specific and performed through functional skills (verbal, cognitive and computational) by practitioner's self-determined objects (support family, perform the task accurately, get HODs approval, job benefits) formulated under practitioner's perception (precision and accuracy will result in reward). The study would pave the way for adult education policy makers to comprehend the literary practices of working adults and accordingly to design courses and policies to enhance their capabilities which would ultimately increase their productivity