The current study was planned to evaluate the phytochemical analysis and oral acute toxicity study of the leaves of Baccaurea ramiflora and Microcos paniculata. The soxhlated extraction and standard methods were used for extractions and phytochemical analysis. The drug was administration orally, animal’s observed from cage side observations and mean body weight was taken for 14 days. There phytochemical analysis of ethanolic extract of the leaves of Baccaurea ramiflora and Microcos paniculata revealed the presence of alkaloids, carbohydrates, glycosides, tannins, phytosterols, saponins and flavonoids. The oral acute toxicity study showed no noticeable clinical signs of toxicity and mortality during 14 days of the study period. No statistically significant alterations in body weights, compared to control group. We conclude that the outcome of the present study may add scientific information of ethanolic, chloroform extracts and acute toxicity study of the leaves of Baccaurea ramiflora and Microcos paniculata to the system of medical specialization. Ethanolic extract of leaves of Baccaurea ramiflora and Microcos paniculata was found to be nontoxic up to 5000 mg/kg body weight, so the LD50 is greater than 5000 mg/kg body weight

Micro-particles with polymers have got widespread application in formulation and development of various pharmaceutical and Life Sciences for taste masking, improving bioavailability, creating enteric coating, developing sustained released formulation, colon targeting therapy and developing pH dependent formulations. The development of various polymer helps to develop effective drug delivery system in pharmaceuticals and Life Sciences formulations. This polymer helps to create comprehensive drug delivery platform by improved protection, improved solubility and sustained release effect. These polymers are industry choice for the targeted drug delivery profiles. The objective of current manuscript to evaluate importance of Poly (ε-Caprolactone) and Eudragit® and its application in pharmaceutical and Life Sciences Industry for the development of various type of dosage forms

Endotracheal suctioning is a crucial element in the management of the airway in intensive care units. The effectiveness and complication of the endotracheal suctioning procedure is associated with the method of performing. The procedure requires clinical expertise, so the nurses should perform this procedure safely and effectively. The present study was carried out to assess the gap between knowledge and practice in standard endotracheal suctioning of intensive care unit nurses. In this cross sectional descriptive study knowledge and practice of 118 nurses in the 11 ICU’s of children hospital Lahore, Pakistan was analyzed. The sampling method is purposive. Data were collected using 35 item questionnaire and 31 item checklist. Descriptive and inferential statistics was used to analyze the data. The result of the study revealed that the participant have good level of knowledge (mean score 24 ±3.0) and fair level of practice as (mean practice score was 17.85± 5.67) showing that there is a gap between knowledge and practice. There is no relationship between knowledge and practice score. Significant relationship was found between practice score, total experience (p=0.007) and ICU type (p=0.004). The study describes that despite the presence of good knowledge their practice level is not up to the mark. The result shows that there is a need for training in this skill and continue feedback until desire level of skill achieved.

A disaster is an incident that can causes massive damage and destruption. Disasters are common worldwide event now a days. Nurses role are very important in disaster management and its recovery. The purpose of this study was to assess the nurses' knowledge and practices Regarding disaster management and emergency preparedness. The objectives of this study was To assess the knowledge and determined the current practices of nurses in the emergency department and to identify the hospital specific plans regarding the disasters management. The Quantitative cross sectional study design was used in this study. semi stracture Questionnaire was used to collect the data. The questionnaires were administered by using convenient sampling. Data were statistically analyzed by descriptive criteria such as number, percentage, mean, median and standard deviation on SPSS version 21 and inferential statistics. Chi square test was used to check the relationship between the variable. The results of this study showed that Participant nurses have a good knowledge on disaster and its management. Overall good knowledge was 65.4%. However the practices were poor and overall poor practices were 83.3% so therefore it should be still need to do work on it. The conclusion of this study include that nurses knowledge about the disasters were good but practices were poor in the hospital setting. There is need to work on the practice and knowledge as well in these two hospital. The study revealed that hospitals currently have deficiencies in practices and management. Further, follow up research are necessary for maximizing nursing education and nursing quality.

Clinical practice guideline having much importance to improve the patient care outcomes and safety from complications. Nurses depend on multi-disciplinary knowledge and skills to use of clinical practice guidelines to promote their nursing practices. Nursing staff adherence to clinical practices guidelines is help in improving patient safety in hospital. The purpose of study is exploring the factors that promotes and inhibit adherence to clinical practices. This study considers the public hospital due to poor health care services. The population is comprised of registered nurses who are working in Jinnah hospital Lahore is included except critical areas, head nurses and other health care professionals. Sample size consists of 175 registered nurses of Jinnah hospital. According to analysis by using SPSS 21, results show that the organizational factors like development of guidelines, resources to carry out the skills, and support from hospital administration are the major promoters to adhere the clinical practice guidelines. Moreover, the results of this study depict that the personal factors including nurses have not enough knowledge about clinical practice guidelines, leadership and peer support, skill development, lack of communication, lack of resources and other facilities are major barriers to adherence the clinical practice guidelines. Finally, as a result of the research, multifaceted recommendation to assist the policy makers of health care organization and nursing managers to updating the guidelines, conduct educational and training session for nurses in a manner to up gradation of knowledge and improve the overall care and safety of patients

The main purpose of current study was to assess the relationship between self-compassion and emotional intelligence among nurses. For the accomplishment of this purpose 153 registered nurses were selected as study participants from Punjab Institute of Mental Health, Lahore. Well-constructed questionnaires by Dr. Neff were distributed among staff nurses to collect data. Data analysis was done on SPSS version 21. Descriptive analysis, correlation and regression tests were applied for the analysis of results. The results of study show positive relationship in both variables among nurses. Self-compassion as constant variable effects on dependent variable that shows emotional intelligence or emotional wellbeing of nurses can vary due to independent variable

Hand hygiene is a primary measure to reduce the infection in neonates and reduces the rate of morbidity and mortality rate. Contrary to this, negation of the hand hygiene compliance among health care workers increases the morbidity and mortality rates in newborn babies. The purpose of this study is to determine hand hygiene compliances among the nurses about caring newborn babies among the government hospitals of Pakistan. The self-administered questionnaire was distributed to 110 nurses of public hospitals of Lahore, Pakistan through convenient sampling technique. The results of the study show that nurses of public hospitals have low to moderate perception regarding the benefits of the hand washing. Similarly, the nurses of public hospitals of Lahore, Pakistan perceived difficult to extremely difficult to follow the protocols of washing hands. Therefore, public hospital’s management should emphasize on the education, skills development and training of the nurses regarding the hand washing protocols and make them accountable for the ignorance

Patient satisfaction is an integral part of the quality care in health care setting and also a very important factor to measure the quality nursing care. Satisfaction is a fundamental concept that depends upon various factors such as patients' past experience with the nursing care, their future expectation from nurses and social, ethical and moral values of the individuals. Hospital organization directly depends upon their patients; more patients were come when they were treat with the best quality of care. Now a day’s nurses are responsible for providing quality of care to patients but unfortunately they are not satisfied with their jobs due to following factors like: stress, workload, and unsafe working environment. This increases mortality and co morbidity rate and serious adverse events in the world. Quantitative descriptive correlational design was use in this study. The main aim of descriptive correlational study is to check the association between nurse’s job satisfaction and quality of care and factors which affecting on quality of care. Data analyzed by SPSS version 21.Sample size was 222 by convenience sample technique, 5 point scale likert scale questionnaire was used. Data collected by Register Nurses of Jinnah hospital Lahore, Pakistan. This study found that nurses’ job satisfaction and quality of care are positively correlated. 68.5% of participants believed the quality of care they provided was affected by employee job satisfaction. The finding of this study concluded that there was a positive correlation relationship between nurses’ job satisfaction and quality of care they deliver. This study also proves that work load, stress and unsafe work environment were main factors which effect on quality of care

Pressure ulcer lead to pain and discomfort for patients and also cause prolong illness, delay restoration, increase patient’s hospital stay, and may lead to infirmity and even death. The purpose of this study was to assess the nurse’s knowledge and practices towards pressure ulcer prevention. To check the association between nurses job experience and their knowledge and practices towards pressure ulcer prevention at Lahore General Hospital. A cross sectional study among 253 nurses conducted in Lahore General Hospital. The study participants were selected by convenience sampling technique. An adopted questionnaire distribute among study participants. Data entered and analyzed in SPSS version 21 for descriptive statistics and results presented in Graphs and Tables. Chi-Square test used to check the association between nurses job experience and their knowledge and practices. Nurses have poor knowledge (35.2%) regarding risk factors of pressure ulcer development, patient’s position every two hourly (49%), knowledge about the use of the risk assessment scale fore pressure ulcers was (37.2%), in order to give pressure ulcer prevention education to patient’s and caregivers(36%). Nurses overall knowledge was only (8.3%) have good knowledge, (11.1%) have fair knowledge and (80.6%) have poor knowledge about pressure ulcer prevention (82.6%) have poor practices, (7.1%) have fair practices and (10.3%) have good practices of pressure ulcer prevention. Nurse’s job experience has a significant association with their practices and knowledge toward pressure ulcer prevention. Nurses overall knowledge and practices toward pressure ulcer are poor. Working experience had a significant association with nurses Practices and knowledge at Lahore general hospital. So nurses need to get continuing education and training about pressure ulcer prevention that will enhance their knowledge and practices can be improved

Job dissatisfaction can cause the nurse’s burnout. The job at the hospitals produces the severe mental exhaustion or burnout. The purpose of the study is to examine the relationship between job satisfaction and nurse’s burnout among the registered nurses at Jinnah hospital Lahore, Pakistan. The descriptive correlational study design was utilized. The questionnaire was distributed to 260 registered nurses at Jinnah hospital included in the study, and head nurses midwives, assistance nurses were excluded from the study. Data was collected through convenient sampling technique and data was analyzed by using SPSS version 21. The results of the study depict that job satisfaction has significant negative relationship with nurses’ burnout. Therefore, hospital’s administration should emphasize on the factors which keep the nurses satisfied and the burnout of the nurses can be avoided. The study provides the limitations and recommendation in the end

Standard isolation precaution is a way to stop the spread of hospital acquired infection which may be in the form of blood, secretions, body waste, body fluids and mucous membrane that may contain contagious infectious agents. Nurses are the persons who have the moral obligation to care for sick persons and improve their regaining health and attain excellent worth of treatment care. Therefore health care providers should have proper awareness and good practice to strictly adhere to standard isolation precaution to infection control. The aim of the study is to assess the knowledge, attitude and practice of nurses toward standard isolation precaution among registered nurses. Study design of this study descriptive cross sectional was used and 132 participants were participate in this study from Children Hospital, Lahore through convenient sample method and all of the participants were female nurses. Results of the study revealed that answers from the participant clearly predicted that most of the nurses have good knowledge and unsatisfactory attitude and practice toward standard isolation precaution. Conclusion of the current study concluded that using standard isolation precaution is very important for nurses to control hospital acquired infection. Study finding also show that most of the nurses contributing in the study have good knowledge about standard isolation precaution but there attitude were not satisfactory toward standard isolation precaution. Study finding also predict that most of the nurses also have unsatisfactory practice and they do not use standard isolation precaution to control infection

Body mechanic means the use of body as a machine and as a mean of movements efficiently. It should be practiced in every moment of life. People from all profession are almost affected with back pain and other musculoskeletal problems. Nurses experience low back pain more than other group, incidence varies among countries. Nurses need to use body mechanic technique during performing every procedure. They can use body mechanics more effectively if they have well knowledge about it. Purpose of this study was to assess the knowledge and practices of body mechanic techniques. A cross sectional descriptive design was used for this study. A sample of 216 nurses was taken by using convenient sample technique. Instrument used for this study was set of questioner compose of demographic data, nurse’s knowledge and practices of body mechanic technique. Scoring was based on likers scale. Data was analyzed on SPSS (version 21) and results were presented in tables, pie charts and table for the demographic data, bar charts and table was used for the knowledge and practices of the participants. The demographic data revealed that all of the nurses were female and 41.3% (n=93) belong to the age group of 26-30years. Majority were from the ICU/CCU and having job experience of 0-5 years. 173% (n=173) were having diploma of general nursing and midwife as a qualification. 65% of nurses had fair knowledge about the body mechanic technique and 35% with poor knowledge. In term of practices, 60% nurses were practicing body mechanic techniques while the rest of 40% were not practicing. However, back pain is prevalent problem among nurses. Majority of the nurses was having knowledge about body mechanic technique but less was practicing it. Nurses need to be more educated about body mechanic technique and they should be emphasized to practice it in performing nursing procedure as well as in routine life

Service quality is a broad term and can be define as, critical differences among the patient’s observation and belief of the facility and the actual act of the service received by the client providing by the organization at a certain period of time and it has effect on client or patients’ satisfaction and behavioural intention. To investigate the effect of service quality on patient satisfaction and behavioural intention of doctors and nurses. Study design used in this study was descriptive cross sectional study design and 171 patients were selected for the study from indoor department of Lady Willingdon Hospital, Lahore through simple random method and all of the participants were female Result of the study reveal that hospital service quality greatly influences behavioural intention and patients. Finding show that most of the respondents were strongly agrees that service quality increase patient satisfaction and behavioural intention. While Regression analysis shows that service quality significantly positive effect on patient satisfaction and have negative effect on behavioural intention. Better Service quality is important for any organization especially in healthcare organization. They play important roles in customer/patient satisfaction and behavioural intention. Better Service quality has positive affect on patient satisfaction and behavioural intention. The results of this show that any hospital providing good service to their patients then will be satisfied and recommend their friends and neighbours for treatment to this hospital

Sri Lanka is a south-Asian island of Indian Ocean and situated south-east of the Indian subcontinent. It is in the grip of a severe dengue epidemic. Currently, dengue fever [DF] and dengue hemorrhagic [DHF] fever cases are reported all part of the SriLanka, but we could observe two peaks in absolute number and incidence of DF and DHF occur annually along with monsoon rain and density of two mosquito vector species (Aedes aegypti and Aedes albopictus).In the eastern part of the SriLanka, there were dengue out break started in January 2017.This study was conducted in the Tertiary care hospital Batticaloa, SriLanka. Objectives of the study were to know the pattern of distribution of DF among male and female and to know the incidence of laboratory confirmed dengue cases among clinically suspected dengue patients. During this last four month period number of suspected dengue fever cases increased steadily, from 1st of January 2017 to 31st of April there were 2562 suspected dengue cases admitted in this hospital. Last four months 1811 dengue-IgM and IgG antibodies tests were carried out, only 760(41.96%) cases were positive for primary infection

Needle stick injuries are wounds caused by needles that accidently harm the skin. These wounds are harmful for individuals who work with needles and other sharp equipments. These wounds can happen whenever individuals utilize, or discard needles. Needle stick injury (NSIs) is genuine reason behind blood borne infection transmitted among wellbeing mind personals. Administering infusion, pulling back blood, recapping needles, arranging needles, treatment of junk and dirty materials and exchanging blood or body liquid from syringe to example compartments are typical activities related with sharp injuries. The objective of this study is to assess knowledge and practice of needle stick injury among nurses. The significance of the study is that this study is beneficial for all nurses, undergraduate students and other health organization. In conclusion, the awareness of the nurses regarding needle stick injury and its preventive measure on their practical training was poor. A survey was finished by 253 nurses. In this review, needle stick harm was characterized by percutaneous harm brought about by empty borne needles, suturing needles, surgical tool and blades. In this review 77.1% nurses have great learning 20.2% have poor information and 2.8% have no information about empty borne needles and the fundamental driver of percutaneous wounds with empty bore needles were recapping). The greater part of wounds happened after utilize what's more, before disposal of the objects. . All in all, the familiarity with the nurses to needle stick harm and preventive measure and application on their functional preparing was poor. It would be suggest that the wellbeing training program for needle stick damage and preventive measure should be introduced to all the nurses and encourage them to apply during their daily practice

A research study to ascertain the perception towards decline in child sex ratio (DCSR) was carried out in Rewari district of Haryana state. Data was collected by interviewing 120 ANC (Antenatal care) clients using semi-structured interview schedule. The major findings of study are: (1) ANC beneficiaries are well aware of DCSR (Declining child sex ratio), but emphasized the need for more of BCC (Behavior change communication) activities by the Health Department. The factors mainly responsible for DCSR are: son preference and dowry. Mushrooming of USG (Ultrasonography) clinics is also expressed as a major factor by large number of respondents. (2) The various reasons for son preference are; that he is a supporter and provider for the parents in their old age; keeps the family name alive and are needed to perform their last rites. Also, by investing on sons’ education or business, the wealth remains in the family. (3) The major reasons for not preferring female child are dowry and perception of girls being paraya dhan. Other perceptions are that investing on girls is a waste with no returns and security reasons especially against sexual offences. (4) Majority of them perceived non-availability of brides as major repercussion of DCSR followed by increased crime against women and polyandry.

Surgical Site Infection (SSI) is a one of the most common healthcare-associated infection which has a great impact on patient safety. Knowledge and practices of nurses play a key role for the prevention of spread of infection. To provide quality of care, it is very important for nurses to have good knowledge and practice towards prevention of SSI. A descriptive correlation study was conducted in two public hospitals Mayo Hospital and Lady Willingdon Hospital Lahore Pakistan to assess nurses’ knowledge and practice regarding prevention of Surgical Site Infection and to determine relationship between both variables. A validated questionnaire and convenient sampling technique was used on 131 nurses to collect data. Descriptive statistics and Pearson Product Moment Correlation test was used to analyze the data on SPSS version 21. Data revealed that majority of the participants were within age between 20-30 yrs with job experience 1-5 years, majority were holding General nursing and Midwifery Diploma. Majority nurses showed poor level of knowledge while good level of practices towards prevention of surgical site infection was found. A strong negative significant relationship was found between knowledge and practice of nurses. The Findings of current study demonstrated poor knowledge which suggests an urgent need of educational and awareness programs for improvement in nurses’ knowledge regarding prevention of surgical site infection.

In the health sector, there is an emergent attention in spiritual care, which has resulted in more research around the topic spirituality and spiritual care. But, here is little research showing how nurse’s provide spiritual care. Nursing care of quality recognized by patient supporting and enhance overall patients spiritual needs. In nursing profession used skills for patient care as a set of spiritual care. The therapeutic relationship between nurses and patients sign of spirituality. Nurses responsible to listen actively, show empathy and hope and provide all facilities for patients. Aim of this study, “to assess spirituality and spiritual care in nursing practice in public hospitals Pakistan”. Descriptive cross-sectional survey was conducted in 2017 from nurses at work in public hospital, Pakistan. Data were collected using the spirituality and spiritual care related questions. Total 251 female nurses’ participants completed the survey questionnaire. Questionnaire were completed by 100% (n=251) of the intended convenience sample. Data was analyzed using SSPS 0.21. Descriptive inferential statistics, chi-square, correlation and regression were used for the study. Significant association found among spirituality and spiritual care, the average score spirituality 50.6% and spiritual care was, 41.4% result indicating a fair score. Education is warranted to improve nurses ‘more consciousness related to patient spiritual needs. Spiritual education considerate these needs that provide to nurses with these opportunities to address spirituality and spiritual care that reflect the nurses- patient rapport.

The current study assesses the knowledge and practices towards maintenance and care of the peripheral intravenous cannulation among the nurses of public hospitals of Lahore, Pakistan. The data was collected from 240 nurses of Services hospital Lahore, Pakistan through convenient sampling. The results of the current study depict that nurses of Services hospital, Lahore, Pakistan have good knowledge regarding care and IV cannula but lack the practices. Therefore, healthcare provider should train the nurses to improve the practices in the public hospitals especially. SPSS 21 used to analyze the data. Limitations and recommendations are given in the end of this study

Evidence based nursing is the process in which nurse is able to make clinical decisions by using the best available research evidence, their clinical expertise and patient preferences. The goal of this study is to gain knowledge about the recent awareness, perception, skills, and barriers for the implementation of Evidence based practices among the nurses of government hospitals Lahore Pakistan. There is approximately, over a half billion dollars per year spent on treatment, and medical follow-ups that did not follow the guidelines of evidence based practices [1]. A quantitative descriptive cross-section research design was used to evaluate nurses’ awareness, perceptions and barriers for implementation of Evidence Based Practice in healthcare. A convenient sample of 500 clinical nurses was selected. Tool; a structured questionnaire to collect socio-demographic data such as age, education level, and experiences, nurses awareness, perception and barriers for implementation of evidence based practice. A five-point Likers scale used. The finding of this study shows that awareness of nurses related to evidence based practices were (36%, 64%) satisfactory. The perception of participant was 55.48%. The Barriers for research utilization was 68.49% and barriers to research resource information were 71.92%. The study concluded that overall results awareness of Nurses about Evidence Based Practices was satisfactory but still they need to be excellent level of awareness. The barriers related to research utilization and research resource information were a big hurdle in evidence based practices and perceptions of skills were negative

Occupational hazards associated with health are present in every occupation, and they are the leading cause of death and mortality. Occupational safety at the workplace improves the employees’ health and increases their productivity. In the medical profession, Nurses constitute the largest group of healthcare workers, and experience a higher rate of workplace hazards exposure than other health care workers. This study aims to assess the knowledge, attitude and practices among nurses concerning occupational hazards in a public hospital. The research method was descriptive cross-sectional. The data was collected from Nawaz Sharif Social Security Hospital Lahore Pakistan. The data was collected from nurses by using questionnaires. The result showed that 67.5% nurses were with high knowledge about occupational hazards. Overall positive attitude was 56.91 % and overall practice level was 57.72% which is insufficient. The practical implication of the study is to improve the practices and reduce the exposure of occupational hazards. There should be training and educational meetings for the nurses to enhance the occupational safety, develop policies on all aspects related to occupational hazards

Time out protocol for surgery is very important for the declination of mortality rate because two hundred and thirty four millions surgeries have been performed every day worldwide in which 7 million had adverse complications. To assess the attitude and practice of surgical team members regarding time out protocol before surgery in Operation Theater. A descriptive, quantitative cross-sectional study design was done. An adopted questionnaire have been distributed among 154 participants to collect data from Services Hospital Lahore. SPSS version 21 was used to analyze the data. Descriptive statistics and chi-square were applied. In this study out of (N= 154) respondents 50 %(n=77) of the participants were male and 50%(n=154) were females and 58..4%of the respondents were between the age of 26-30 years.45% of the surgeons and 27% of anesthetists and only 26%of the nurses were participate in the study.50% of the participants were 6- 10 year of job experience. Respondents towards the attitude of time out protocol were positive.87%of the respondents think that check the patient identity, procedure side is a joint responsibility.92% of respondent said that time out protocol can avoid incorrect surgery.76%of the respondent confirm the patient identity before every operation.81% of the respondents confirm that surgical procedure before each operation. The Time out protocol is one of the important strategies to minimize the hazardous situation in Operation Theater. It is important in Operation Theater and surgical ward as well as in overall hospital to identify the patient properly, his diagnosis, his treatment planning, his medication and the site or part of surgery to be carried out

Epidemiological information on tuberculosis (TB) has always been vital for planning control strategies. It has now gained further importance for monitoring the impact of interventions to control the disease. The present study was done to estimate the prevalence of pulmonary tuberculosis in industrial population in a tertiary care centre in north India. It is a cross sectional study conducted at ESIC Medical college and hospital which caters to the registered /insured industrial worker under ESI scheme. All patients from chest clinic in the study period who were presumptive pulmonary TB patients were subjected to two sputum examination for AFB microscopy by ZN staining method. Demographic data of study subjects was collected, processed and statistical analyzed using SPSS software. Total 1315 patients participated in the study. Total sputum samples collected were 2623 out of which 351 were positive giving slide positivity rate of 13.58%. Among all of the total positive slides, male female ratio was 1.4:1. Maximum number of slide positive cases was present in 21-30 yr of age group in both male and female. 15.2% cases observed one of the two sputum samples as positive, thus emphasizing the importance of at least two sputum samples for diagnosis. The findings of this study reveal that younger age group patients 21-30 year old were most susceptible to tuberculosis and also percentage positivity of sputum among females was found significantly higher than males in the reproductive age group (21-50 yr). This finding, if corroborated in further studies could have major implications on the reproductive health of women

Chronotherapeutics refers to a treatment method in which in vivo drug availability is timed to match rhythms of disease, in order to optimise therapeutic outcomes and minimise side effects. The term "chrono" basically refers to the observation that every metabolic event undergoes rhythmic changes in time. It refers to a treatment method in which in vivo drug availability is timed to match rhythms of disease in order to optimize therapeutic outcomes and minimize side effects. It is based on the observation that there is an interdependent relationship between the peak-to-trough rhythmic activity in disease symptoms and risk factors, pharmacologic sensitivity, and pharmacokinetics of many drugs. In this present study invivo evaluation of bilayered tablets of Losartan and Hydrochlorothiazide were studied on rabbits to prove that the prepared formulation shows a pulsatile drug release. The plasma levels were measured using LC-MS/MS method. Pharmacokinetic parameters of these tablets were determined by using WINNOLIN Scientific software. The pulsatile release tablet formulation prepared in the lab managed to show some lag phase initially before releasing the drug with a maximum time (Tmax) at the 12th hour. From this present work the results of invivo studies proved that chronotherapeutical release of drug in the form of bi layered tablet can be achieved for newer chronotherapeutical drug delivery system.

The government of Taiwan has promoted the hierarchy of medical care in Taiwan in order to facilitate large-scale hospitals returning to the nature of teaching research, emergency and critical care services. Since 2017, the clinical and service growth of mild cases at medical centers and regional hospitals has been limited. This study adopts a retrospective study and uses the clinic application number of the NHI-insured as research subjects. The subject hospital in 2016 applied about 838,088 cases, and after screening about 158,631 people times were included as the research subjects. With the Chi-square test, a significant difference has been identified in age (p<0.001), gender (p<0.001), diagnosis of diabetes, high blood pressure, and hypercholesterolemia (p<0.001), and divisions visited (p<0.001). 2016 Q1’s primary care services rate was 15.18% with the annual average of 18.93% lower than national rate at the same period, 21.76%. Patients of primary care can be transferred by hospitals to community clinics to reduce financial losses. Relevant adoptive measures also need to be introduced by the government (such as policy promotion and adjustment of co-payment) to smoothly promote and develop primary care services.