Medicinal plants contain numerous bioactive phytochemicals or bionutrients. Various studies carried out during the past 2– 3 decades on these phytochemicals reveal their important role in preventing chronic diseases like cancer, diabetes and coronary heart disease. The major classes of phytochemicals with disease-preventing functions are dietary fibre, antioxidants, anticancer, detoxifying agents, immunity-potentiating agents and neuropharmacological agents. Each class of these useful agents consists of a wide range of chemicals with immense potential. Some of these have more than one function. In the present work the sulphorhodamine B (SRB) assays of Shorea robusta oleoresin, the triterpenes amyrenol isolated from its defatted portion and Wrightia tinctoria bark ethanol extract were carried out. Amyrenol showed the best highest activity and lowest IC50 value (37.56, 11.61 and 61.14 µg/mL) with cervical cell lines while the other extracts also registered fairly good activity. Amyrenol merits further evaluation as an anticancer agent

Ventilator-associated pneumonia (VAP) is the most common nosocomial infection in critical care settings and affects between 9%-27% of mechanically ventilated patients for more than 48 or 72 hours. One of the strategies that reduce the VAP incidence is subglottic secretion drainage (SSD) through a lumen attached to a specialised endotracheal tube. This integrative review aims to investigate the efficacy of intermittent and continuous SSD in reducing VAP among critically ill ventilated patients. A systematic electronic search was conducted via CINAHL, PUBMED, MEDLINE and COCHRANE using the key terms. A manual search was also conducted through the references of retrieved studies, Scopus, and Google Scholar. Sixteen relevant primary articles were identified; twelve studies were conducted on general ICU populations examining intermittent subglottic drainage (ISD) and continuous aspiration of subglottic secretions (CASS) while four other studies were undertaken in cardiothoracic ICUs investigating CASS. No studies were found concerning the efficacy of ISD in this setting. Current evidence has revealed that ISD and CASS appear to be effective in general ICU settings while CASS did show significant reduction among the cardiothoracic ICU population. It was found that ISD appears to be safer in terms of tracheal damage despite the concerns of secretion pooling. This integrative review concluded that ISD and CASS appears to be effective methods in reducing VAP incidence among general ICU populations. Further research is needed to investigate both methods among cardiothoracic patients. A large randomised controlled trial is also required to compare the two settings and to determine the optimal frequency and suction pressure that could minimise complications.

Implementation of standardised oral hygiene protocols could potentially minimise the occurrence of ventilator-associated pneumonia (VAP) among critically ill patients. However, inclusion of the topical application of oral chlorhexidine as an effective oral antiseptic in such protocols and VAP guidelines remains controversial and questionable, due to inconstancy in the current evidential findings. The aim is to investigate the efficacy of oral chlorhexidine in reducing the incidence of VAP among mechanically ventilated patients in different critical care settings. A comprehensive electronic and manual literature search was conducted utilising different databases, including Cinahl, Medline, PubMed, Google Scholar and Scopus, and using related keywords to identify the relevant primary research sources published in English since 2005. Data were extracted and summarised in tables and then were critically appraised using validated tools. When the relevant studies were analysed, they were grouped based on two main themes and varied subthemes. One of these is the patient population, including those admitted to mixed or general ICU and those who had undergone cardiac surgery. The second theme is the chlorhexidine type, in which solution and gel were investigated at varied concentration using different frequencies. Topical application of chlorhexidine may have the potential benefit of reducing VAP incidence; however, no recommendation can be made regarding the best type or optimal concentration that can be used. Thus, a large-scale randomised control trial to investigate further the effectiveness of its routine use among mixed ICU patients and to demonstrate the optimal form, as well as concentration and frequency, is required

To assure the quality, safety and efficacy of a drug, a drug will be developed, tested, delivered, and used under strict regulatory legislations. Off-label prescribing refers to prescribing or use a registered medicine that not included in the product information. Off-label prescribing is legal, yet common around the world. Pharmacists in the hospitals, clinics, and community pharmacies are in the front line in protecting the general population from being hurt by such OLP. The current study investigated the pharmacist’s attitudes toward OLP. 109 pharmacists were included in the investigation by answering the structured questionnaire. The survey indicated that the pharmacists were well trained to perform a good practice toward the off line use. The current study suggested integrating the efforts of all healthcare professionals to improve the national’s knowledge on medication safety

Polysaccharides define as complex polymers composed of units interlinked with glycosidic bonds originated naturally. Polysaccharides are categorizing in several groups and among them, Gums are those with critical roles in food systems. Guar Gum is imparting softness, emulsification, stabilizing via its addition to formulas. This Gum is a fast soluble in cold water and can be active in a wide range of pH. The aim of this overview is giving an initial concept about guar gum and then convey to an introduction of its applications in food industries

Stress is a sad situation that leads to the desperation of the individual, a situation that occurs when the physical and mental limits of the organism are forced and threatened, affecting the lives of the individual. Individual stress sources include individual needs, capacity and character. Perceived differences, experiences, family problems, relationships among family members, child rearing, education, relatives' work problems, divorce and death are also individual stress factors. The working environment can also be a stress factor. If the competition among the employees in the working environment is not controlled by the managers and the employers, it causes the employees to feel incapacitated and weak in the individuals and thus the working person has difficulty in adjusting to the organization. In terms of the nursing profession, there are many stressful situations in the working environment. In order for the nurse to work more effectively and efficiently, it is necessary to minimize the internal and external factors that cause this stress and to develop effective ways of coping with the stressors as much as possible when the stress is encountered. It is very important to know how to cope with the stressors of the nursing profession from the work and social life and to develop the positive behaviors both in terms of the nursing profession as well as the qualified care the society being served.

Among the many scientists who enriched the scientific panorama in medieval Spain, one of the most important is without any doubt the Cordovan physician and surgeon Abulcasis Al-Zahrawi (circa 936-circa 1013). This paper is an approach to his figure and his main work entitled Kitab al-Tasrif (Book of medical arrangement) with special reference to its treatise XIX which deals to cosmetics and drugs for embellishment of body. The article contains an introduction about the author and the translation into English of some fragments of this part of the Tasrif, according to the Arabic manuscript no.5772 from the National Library of Paris. These translated texts include interesting medieval recipes for treatment of hair of great value for history of medicine and pharmacy

Cation exchange high performance liquid chromatography (CE-HPLC) is an important tool in rapid diagnosis of a varied spectrum of Hemoglobinopathies. The aim of the study was to detect hemoglobin variants and hematological parameters in a tertiary care hospital in Mumbai district of Western India. A total of 130 blood samples were examined on the Bio-Rad Variant CE-HPLC system by β-thalassaemia short program. The concentrations of the haemoglobin variants (%), retention times and the peak characteristics for all hemoglobin fractions were recorded. Blood indices were measured on an automated haematology counter. Out of 130 samples tested in different communities, 69 (53%) were found to have normal HPLC pattern and used as controls. Total 61 (47%) subjects were found to be hemoglobinopathies. Among those having hemoglobinopathies, 2 (3%) had β- thalassaemia major, 20 (33%) β- thalassaemia trait, 1(2%) HbE/β- thal, 2 (3%) Hb-SS, 14 (23%) Hb-S trait and HbS/β- thal respectively. The percentage of sickle-thalassemia double heterozygous subjects was 23% and their number was 22. Other variants were also found and their number was 8. Haemogram of all the study subjects with hemoglobinopathies were altered as compared to those of controls and anisopoikilocytosis, hypochromia, and abnormal red cell distribution width (RDW) were found in majority of cases. Mean corpuscular volume (MCV) was generally normal to very low. In conclusion, CE-HPLC was found to be a simple, rapid and reliable method for the quantification of HbF, HbA2, HbS and other hemoglobin variants for screening and confirmation of common hemoglobinopathies like sickle cell anemia, β- thalassemia. Abnormal hemoglobins as HbS HbA2 and HbF very common in our study. Scheduled caste had the highest prevalence of hemoglobinopathies

Curcumin and Artemisinin are a poorly water-soluble drugs and its poor oral bioavailability is very low. A new self-micro emulsifying drug delivery system (SMEDDS) has been magnificently developed to improve the solubility of curcumin and Artemisinin. Appropriate compositions of SMEDDS formulation were selected via solubility studies of curcumin and Artemisinin. The formulation of SMEDDS was optimized by D-Optimal Mixture design. The optimal formulation of SMEDDS was comprised of 3ml surfactant (Tween 80), 1 ml of co-surfactant (PEG 400) and 1 ml oil (Oleic acid). The solubility of curcumin (4.4 mg/3ml) and Artemisinin (73.4 mg/3ml) was increased considerably in SMEDDS. The average particle size of SMEDDS-containing curcumin and Artemisinin was 150.7 nm. The diffusion study (in vitro) showed that more than 63.81% of curcumin and 54.91% of Artemisinin in SMEDDS could be dissolved in medium with pH 1.2 in 1 hr 30 min. Our study illustrated that the developed SMEDDS formulation held great potential as a possible alternative to traditional oral formulations of curcumin and artemisinin

The oral care is essential component of nursing job and it have great impact on patient’s safety and comfort during hospitalization. It prevent from hospital acquired infections. Mortality and morbidity rates are increased due to poor oral hygiene .Nurses are accountable for oral care but oral care is neglected in hospitals due to poor knowledge, attitude and practices. The aim of study was to determine nurse’s knowledge, attitude and practices towards oral care. Quantitative, descriptive cross sectional study design was used to achieve the aim of the study. The study was conducted in services hospital Lahore, Pakistan. The study population was registered nurses working in services hospital Lahore, Pakistan. Sample size was be 222. Data was collected by convenience sampling. Tools: for data collection: I: Demographic characteristics, 2: Mouth hygiene knowledge sheet, 3: Attitudes regarding oral care, Part 4: Practice towards oral care. The data was analyzed using (SPSS) mainly descriptive statistics methods percentage distribution. Chi square to test the associations between variables. Results: the mean and St. D of the age of participants was 1.77+ 0.800 with maximum experience of 1 - 5years 38.7% (n= 86). Educational level of participants was diploma in Nursing 69.8% (n= 115). The nurses had knowledge had fair knowledge >50% and Attitude level was negative < 60% and Practice level was poor < 60%.Majority of nurses do not perform oral care and give it less priority Oral hygiene care is often missed and neglected care. There is need to improve the nurse’s knowledge and practice by training sessions, seminar and workshops. Nurses are in great need to improve the skill and competency to improve patient quality care

Snake bite is one of the important causes of morbidity and mortality in tropical countries like India. In India, the most important venomous snakes are cobra, krait, Russell’s viper and saw-scaled viper. This study was undertaken in a teaching hospital of West Bengal to find out the epidemiological profile and clinical presentations of snake bite cases in a defined geographical area of rural West Bengal. Data were collected from the snake bite cases came to emergency and internal medicine department of a tertiary level Medical College and Hospital since March 2013 to February 2014. In the study, 685 snake bite cases were reviewed over a one year period. Most common presenting symptoms were swelling at the site of bite (56.05%) and hematuria (27.59%).18.97% cases reached hospital within 4 hours and 22.48% cases within 4 to 8 hours. 8.02% cases presented with acute kidney injury, overall mortality rate was 5.48%. Snake bite is one of the common life threatening emergencies in the study area. Delay in hospitalization is associated with poor prognosis and increased mortality.

Obesity is a noticeable public health problem worldwide. It is well known that obesity affects physical health and cognitive function. It impairs all domains of cognitive function. Moreover, obesity affects both metabolic activity and cerebral structure of the brain. Bariatric surgery is surgical procedures that help patients with extreme obesity to lose weight. Multiple domains of cognitive function improve 24 to 36 months after bariatric surgery. Mechanism of such improvement is still questionable. It may be related to improvement of underlying medical condition, improved glucose regulation and insulin sensitivity, or correction of leptin and ghrelin systems. In this article, we review the effect of bariatric surgery on cognitive function and its possible mechanism.

It is common in the intensive care unit to have many syringe pumps connected to a stopcock manifold and then attached to the port of a central line. The treatment of such critical patients also involves the alteration of flow rates of these syringe pumps. There are varied practices with respect to how the syringe pumps are placed when connected to the central line. Three syringe pumps containing inert fluid with a prefixed amount of different measurable electrolytes were connected to a central line via stopcock manifold .These pumps were commenced at a predetermined flow rate .At the end of prefixed intervals the samples were analysed to assess the quantity of electrolytes in the fluid delivered at the end of a central line. Alteration in flow rates and their subsequent end effect was studied. Further an infusion pump was connected to the distal end of the manifold and the fluid mechanics with various permutations of flow rate were studied. As per the results of our study, when a carrier infusion pump was connected in series to multiple syringe pumps connected to the manifold , the initial 5 minutes showed a significant dilutional effect for the contents of the proximal infusion pump (closest to the central line port)when alteration were made to the other pumps. This laboratory experiment does seem to suggest that there seems to be a significant dilutional effect with the use of carrier infusion in series as compared to when the carrier infusion is not used when drug alterations are done . This study further lays an impetus to study the above experiment in vivo in order to ascertain whether this has biological relevance.

This study measured the blood pressure, lipid, lipoproteins and total antioxidant status in physically active premenopausal and postmenopausal school teachers in selected secondary schools in Osogbo, Osun State, Nigeria. Thirty six premenopausal (group I) and forty postmenopausal (group II) participated in the study. Body weight, height, waist- hip circumference, Systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the teachers were measured. Body mass index (BMI), waist-hip ratio (WHR), pulse pressure (PP) and mean arterial blood pressure (MAP) were calculated using standard formulae. Total Cholesterol (TC), Triglycerides (TG), high density lipoprotein cholesterol (HDL-C) were measured by enzymatic methods. Low Density Lipoprotein Cholesterol (LDL-C) and Very Low Density Lipoproteins Cholesterol (VLDLC) were calculated using Friedewald's equation. Total Antioxidant Status (TAS) was measured by spectrophotometric method. Results showed that the means of BMI (30.98 ± 4.86), WHR (0.87 ± 0.10), TG (1.74 ± 0.50) and VLDL (0.79 ± 0.23) in group II were increased (p<0.05) when compared with corresponding means of BMI (28.19± 4.81), WHR (0.85± 0.06), TG (0.89 ± 0.80) and VLDL (0.40 ± 0.36) in group I. A decrease in mean TAS (1.16 ± 0.07) in group II was observed when compared with corresponding mean TAS (1.24 ± 0.03) of group I. A negative association (r = -0.371, p<0.01) was observed between age and TAS. No difference was seen in mean SBP, DBP and levels of TC, HDL-C, and LDL-C in group II when compared with values of group I. Changes in TAS, lipids and lipoproteins observed in post menopausal women could be associated with oxidative stress, aging process and hormonal changes in menopause and could lead to an increased risk in developing CVD despite absence of a sedentary lifestyle.

Healthcare system faced with a critical shortage of nursing faculty. One of the challenges faced by deans and directors of schools of nursing is to identify strategies that will encourage faculty to stay in academic. Establishing a clear relationship between these variables is vital to resolving the problem of faculty shortage. The literature review provides limited accounts of the various dimensions. The current study investigates the influence of workload, job satisfaction and role conflict on nursing faculty turnover in private schools of nursing of Lahore, Pakistan. The study was conducted in private schools of nursing and online questioner was floated. A quantitative, descriptive and correlational cross sectional study design was used for this study. The self-administered questionnaire was distributed to 122 nursing faculty of private schools of nursing of Lahore, Pakistan through simple random sampling. The data were collected by using questionnaires and used multiple regression analysis. The results of the current study reveal that workload and role conflict has significant and positive relationship with nursing faculty turnover and a job satisfaction has significant and negative relationship with nursing faculty turnover. Academic sector authorities should adopt these strategies to reduce the nursing faculty turnover in current position. Furthermore, limitations and recommendations are given in the last chapter.

Wasp stings are not uncommon worldwide. In developed countries people are affected by one or few stings. Commonly cause self-limiting local reaction. Infrequently more serious systemic reactions such as anaphylaxis, rhabdomyolysis, and intravascular haemolysis may occur, especially with multiple stings. Wasps stung complicated with multiple organ damage is frequently reported, but complicated with pancreatitis is very rare complication as well as it is a life threatening phenomenon.