We describe a rare case of hypertension and bilateral pleural effusion simultaneously in twenty-two years old otherwise healthy young female in March 2017. The patient presented with an allergic reaction to an insect sting. Hence, she developed a generalized rash and shortness of breathing where she received a methylprednisolone 80 mg intravenously every 8 hourly for five days where she was discharged home. However, the patient readmitted within 24 hours with non-resolving shortness of breathing, dry cough, hypertension and bilateral pleural effusions more significant on the right side are confirmed clinically and radiologically. Five days after methylprednisolone was discontinued, patient became normotensive and chest x-rays was normal. These manifestations that include symptoms, signs and radiological images and their resolutions are given a name of a syndrome called “Yahya Al –Fifi’s syndrome

Nurses provide care to patients and they feel hope to get comfort and recover. Nurses use the knowledge and skills to provide care to the patients. There are many health care professionals who involved in providing care for sick patients but nurses are the central part of this process. There are many tasks which nurses have to perform in routine and medication administration is one of them. To assess nurses’ perception about medication administration errors and the factors that are associated with the medication packaging, physician communication, pharmacy process, nursing staff and medication administration. Descriptive cross sectional study design and quantitative survey technique was used in this study. The sample size of this study was 264. The self-administered questionnaire was distributed to 300 nurses of Children Hospital, Lahore, Pakistan through convenient sampling and all the participants were females. The study found that nursing related factor is the highest reason of the medication error among the nurses of the Children hospital Lahore, Pakistan. However, pharmacy is the lowest reason of the medication error. Thus, management should focus on the training and development of the nurses regarding medication error so that the better health care services can be ensured

Nursing education is a program in which, through nursing training, nursing student becomes a competent nurse. Nursing training is a mixture of two learning, Theoretical learning and practical learning. Nursing Students in clinical setting learn from the behavior, knowledge, experience and skills of their clinical instructor, clinical Teaching Behavior and students learning have a significant relationship to each other. The Purpose of this study was “To assess the relationship of the teaching behaviors of nursing faculty in clinical site with students learning”. This study was carried out by using descriptive cross sectional study design an the data was collected through convenient sampling method from Sir Ganga Ram Hospital and Mayo Hospital in Lahore, Pakistan. Sample size was 180 and the consent were taken from the participants prior from data taken. Questionnaire was adopted from previous study and data is analyzed through SPSS version 21. Statistics of the study shows that All of 180 students were female students, 77% participants having education level of FSc and take admission in Nursing Diploma. 86% of the participants fall in age group of 18 to 22. The Overall result shows that 89% of teaching behavior have string and positive relationship with students learning and it affect the students learning significantly and this is concluded from this study that the behaviors of clinical teaching faculty have positive relationship and influence students learning.

It is important for any health system to provide Nursing care and treatment with great quality and respond the client’s necessities. About Hepatitis C disease discrimination and stigmatization is very common in health care sector. In India nursing college student stated that Patients with hepatitis C often encounter incrimination and prejudice in the hospitals, by the family and common people. Because of increasing prevalence of Hepatitis C, It is very important to take appropriate action regarding HCV in Government Hospital of Jhang. The aim was to assess the exact knowledge and attitude of Nurses about care and treatment of Hepatitis C. Quantitative descriptive cross sectional study design was used and questioners on five point Likert scale ranging from strongly disagree, disagree, neutral, agree, strongly agree were distributed . Simple convenient sampling technique was used and Sample size was 222 Nurses from selected hospital. Reliability was checked on Cronbach, s alpha, it was .886 for knowledge and .738 for attitude that is reliable. Data was analyzed SPSS software 21. Most of the participant shown negative attitude regarding HCV 65% (n=146) shown sorry for HCV contracted through blood transfusion. 72% (n=160) respondent not like treating patient with HCV. 69.8% (n=155) respondent were not willing to treat HCV patient. 72.4% (n=162) not believe that their profession plays an important role in HCV treatment. 83.7% (n=186) agree that that they do, not have skills needed to effectively and safely in treating HCV patient .There was association between knowledge and attitude score. Study result shows lack of readiness about HCV patient, that is due to bias and stigmatization .It is therefore very important to improve Nurses knowledge and attitude about hepatitis C disease.

Etoposide is an anticancer drug that belonging to topoisomerase II inhibitors, it used to treat various human malignancies. Ginger (Zingiber officinale) is a medicinal plant belonging to the family Zingiberaceae. The present study evaluated the possible protective potential of oral treatment of ginger oil (75&150 mg/kg body weight) three times weekly for 21 days against the genotoxic effects of etoposide oral administration (1mg/kg body weight) three times weekly for 21 days on bone marrow in male albino rat (Rattus norvegicus). Sixty adult male albino rats were used as the following, 30 rats (5 for each group) were prepared for DNA, evaluated the oxidative status in liver tissue (they were received the treatments for 21 days). The other 30 rats were used for chromosomal aberrations in bone marrow in addition to mitotic index in bone marrow (they were received the treatments for 72 hours only). Animals treated with etoposide showed DNA fragmentations on agarose gel electrophoresis and a significant increase in the percentage of bone marrow total chromosomal aberrations (TCA: 183.3±2.7) with significant decrease (P<0.01) in mitotic index in bone marrow (22.3± 2.25 ). Malondialdehyde and nitric oxide as indicators for oxidative stress showed an increase (2.42 ±0.05, 24.25 ±0.41) respectively, in contrast superoxide dismutase, catalase and glutathione showed decrease (P<0.01) with values (15.2 ±0.20, 5.42±0.31, 1.43±0.09) respectively, after etoposide treatment. While treatments with ginger oil (either 75 or 150 mg/kg b. wt.) normalize the oxidative status in liver tissues. In conclusion, the results of the present study indicated that ginger oil exerted a protective effect against genotoxicity and cytotoxicity induced by etoposide that may be due to its antioxidant effects. Consequently, we recommended that ginger oil can be suggested to be administrated as co-medicine in chemotherapeutic treatments of cancer

Dengue is a vector born viral infection that belongs to family Flaviviridae. It is a single stranded RNA virus and endangers 2.5 billion people world wild. Dengue viral (DENV) infections cause a broad spectrum of illnesses from self-limited fever to severe hemorrhagic manifestations and increased vascular permeability. Cardiac manifestations of dengue are rarely associated with severe dengue fever. There are ample of dengue with myocarditis reported all over the World. But dengue with acute myocardial infarction (AMI) is rare, we reported dengue with AMI during the last outbreak and also we reported our challenges faced during the management period.

Around the globe, occupational-related diseases are widespread and common. Posture during work and duty hours are the major risk factor in the development of musculoskeletal disorder. The rationale behind the study is to find out the prevalence of musculoskeletal disorder among dentist. Data was evaluated by using chi square test. The duration of the study was from Dec 2016 to Feb 2017 including pilot survey. 60 dentists were elected randomly and were questioned about personal characteristics, job history, work load, physical risk factors at work place and about low back pain (LBP) and neck pain. 5 point Likert Scale was used to measure responses and 10 item-scales was used to evaluate the prevalence of MSD. Informed consent was signed by the participants. Non-probability sampling technique was applied Confidentiality was assured. Data was analyzed by using SPSS 21.00 version. As evaluated from a study that back and neck pain is highly prevalent among dentist. According to results, 75% dentist exhibited back pain, 45% showed shoulder pain, 10% had elbow pain, 3% had wrist pain, 36% had upper back pain, 48.3% had lower back pain, 16% had hip, buttock and thigh pain, 8% showed bilateral knee pain, and 5% had bilateral ankle pain

Gastroretentive systems can remain in the gastric region for several hours and hence significantly prolong the gastric residence time of drugs. Prolonged gastric retention improves bioavailability, reduces drug waste, and improves solubility for drugs that are less soluble in a high pH environment. The present work describes the formulation and evaluation of gastroretentive system of an antiretroviral agent, Stavudine, based on the concept of altered density. Emulsion gelation technique was used to prepare the floating microcarriers using sodium alginate as the polymer. Microcarriers containing oil was prepared by gently mixing and homogenizing oil and water phase containing sodium alginate which was then extruded into calcium chloride solution. The prepared microcarriers were evaluated for drug entrapment efficiency, particle size and shape, micrometric properties, buoyancy and in-vitro drug release studies. The results of FTIR spectroscopy showed stable character of Stavudine. The mean particle size of microcarriers was in the range of 0.59-1.25mm. Microcarriers were spherical and free flowing. The drug entrapment efficiency was found to be 44.6-69.1%. The microcarriers remained buoyant for more than about 12h. The drug release study showed that Stavudine from the microcarriers was prolonged more than 10hrs. The results demonstrate that the amount of the oil entrapped in each microcarrier is play role in particle size entrapment efficiency and in vitro drug release

Finger Tip Unit (FTU) is being considered as a means of quantifying dosages but rough guides are provided in literature and it is without psychometric value. The primary aims of this study were to determine reference values for FTU metric length (FTUML) and compare values of 6 different age groups. 600 participants were purposively recruited. The weight, height and selected anatomic girths were measured using standard procedures. The FTUML was measured from the tip of index finger to the distal palmar crease using an inelastic tape measure. Body Somatotype and BMI were computed. Descriptive and Inferential statistics were used to analyse the data. The mean FTUML for participants between 11 and 20 years, 21 and 30 years and other age groups were 2.5cm, 2.7cm and 2.4cm (SD = 0.3cm each) respectively, There was significant difference between the FTUs of different age groups (F= 15.37, P= 0.001). The FTUML of age group of 21-30 years was significantly higher than that of others (p=0.001). There was significant correlation between FTUML and height, wrist, ankle girths and body Somatotype (r- values= 0.410, 0.234, 0.472 and -0.106 respectively, p<0.01). Age and other independent variables considered were significant predictors of FTUML (F=32.46, P=0.001). The variables contributed 39.9% to the prediction of FTUML. The predictive equation obtained for FTUML was valid (r = 0.63, p = 0.001). It was concluded that the Fingertip Unit Metric Length of the participants ranged between 2.4 and 2.7cm and it differed across different age groups. Age, height, weight, Body Mass Index, girths and somatotype were significant correlates and predictors of Fingertip Units Metric Length

Work environment and engagement has great importance regarding organizational commitment. Now a day’s nurses are stressed and burdened due to poor working environment and less engagement. Organizational commitment means loyalty or commitment of an employee to his or her organization. Thus, the current study aims to assess the effects of work environment and engagement on nurse’s organizational commitment in public hospitals Lahore, Pakistan. Cross-sectional study design was used in this study. Self-administered questionnaire distributed to 200 nurses through convenient random sampling. Descriptive analysis was used to analyze the data while regression analysis was used to test the hypothesis. Finding of the current study reveals the significant positive relationship between work environment and nurse’s organizational commitment or between engagement and nurse’s organizational commitment

The study was carried out to determine the prevalence of prostatic disorders in a large population of dogs in Jos, Plateau State. Medical records from 2 major veterinary hospitals were retrieved. A total of 38,201 cases in male dogs were presented to the small animal units of the hospitals from 1st January 2011 to 31st December 2016, out of which a total of 2 (0.01%) were found to be prostatic disorders. These prostatic disorders were benign prostatic hyperplasia 1(50%) and prostatic carcinoma 1(50%). The study revealed a prevalence of 0.01% of prostatic disorders observed in intact male dogs of ages 2years and 3years. Based on breeds of dog affected by these disorders, the German shepherd and Mongrel were the predisposing breeds. In conclusion, it is either those prostatic diseases are rare in dogs in Jos or the conditions are misdiagnosed

FIB-4 Score is a simple formula to predict liver fibrosis based on the standard biochemical / hematological values i.e. AST, ALT, Platelet count and age. The Score lower than 1.45 has a Negative Predictive Value (NPV) of 95% for significant fibrosis i.e. F3-F4 while, a Score of greater than 3.25 has a PPV of 80% for advance fibrosis i.e. F3-F4. So an improvement of FIB-4 Score is a possible indicator of change in liver fibrosis. The objective is to observe the disparity in paired FIB-04 Score in hepatitis C patients treated with pegylated interferon and ribavirin at the beginning of the treatment and at the end of treatment evaluation (ETR). An observational study was carried out in patients with mono-infected, compensated CHC patients ,treated with Pegylated Interferon & Ribavirin for 24weeks to 48 weeks (according to genotype)in a tertiary care hospital (i.e. Baqai Medical University Hospital Nazimabad) from Jan 2010 to March 2015 in a paired manner i.e. before (at beginning) and at the End of treatment evaluation (ETR). Responses were analyzed by using ‘Wilcoxon signed rank test. SPSS 23.00 version was used to analyze data. Fifty eight patients diagnosed with hepatitis C took part in the study out of which 24 were males (41.4%) with mean age 38.8 (22y-60y) and 34 were females (58.6%) with mean age 43.6 (31y-60y). Out of 58 participants, 8 patients were type 1 genotype, 48 patients were type 3 genotype and 1 was type 4. Genotype of 1 participant was not recorded. According to result evaluated, there is a statically significant decrease in FIB04 score from beginning of treatment (M=2.52, SD=1.35) to ETR (M=1.74, SD=1.37) justifying that there is a definite positive change in FIB-04 score (i.e. improvement in fibrosis). Distinct positive change in FIB-4 Score was observed in Chronic Hepatitis C patients treated with pegylated interferon/ribavirin at the end of treatment

The purpose of this study is to search for more affordable as well as effective natural excipients that can be used as viable alternative for the formulation of pharmaceutical suspension. The suspending properties of mucilage of Colocasia esculenta were evaluated comparatively with those of compound tragacanth and acacia in Paracetamol suspension. Characterization tests were carried out on Colocasia esculenta mucilage. Sedimentation volume, rheology, pH, degree of flocculation and redispersibility were the evaluation parameters. The values obtained were used as basis for comparison of the suspending agents studied. Colocasia esculenta mucilage showed comparable suspending ability as acacia and compound tragacanth although Colocasia esculenta mucilage was found to be less viscous than acacia and compound tragacanth. Also, the redispersibility of the materials was found to be in the order: Colocasia esculenta mucilage > Acacia > Compound Tragacanth. The Study indicates that Colocasia esculenta mucilage may be useful as a pharmaceutical adjuvant and as a suspending agent

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide with a high mortality, and still there are only few effective methods to treat it. To this end, alternative medicines from traditional Chinese medicine (TCM) are being investigated for their ability to eliminate the tumor or halt its progression. A large number of studies have shown that TCM can be an effective approach to treat the HCC in clinical trials when used alone or in combination with other therapies. Thus, TCM has made significant progress, and has begun to gain worldwide popularity for promoting healthcare and HCC treatment. Because of this progress, periodic summaries are needed to facilitate further research for the use of TCM to treat HCC. This paper provides a comprehensive summary of this work with regard to the following aspects: herbalist views on the etiology and therapeutic principles for treatment of HCC, treating HCC by TCM alone, treating HCC with TCM in combination with resection, chemotherapy, radiotherapy and interventional therapy, and other therapies. Additionally, the current main problems and future application prospects for treatment of HCC by TCM described, which could provide scientific guidance for clinician as well as references for the treatment of other cancers

Many ocular inflammatory and proliferative diseases require long-term pharmacological intervention/treatment. However, delivery of drugs in therapeutic levels to the back of the eye is challenging using conventional topical application, due to the poor efficacy. Systemic injections of drugs pose severe adverse effects. Direct injection into the eye may need surgical intervention. In the recent years, small size microneedles are fabricated to insert into various ocular tissues depending upon the complexity and state of disease to be treated. Microneedles are capable of delivering drugs through cornea or sclera in a minimally invasive way. There are few reports that large molecules, proteins, vaccines could be delivered into eye using microneedles. Drug delivery to the posterior segment of the eye is a significantly challenging task due to the various ocular barriers and precorneal factors. In this review, the targeted drug delivery to the ocular tissues via minimally invasive approach is discussed

Tuberculosis is a zoonotic and infectious granulomatous disease of virtually all vertebrates caused by the bacterial genus, Mycobacterium. Previous studies have shown that both humans and livestock like cattle, sheep and goat are susceptible to both Mycobacterium tuberculosis and Mycobacterium bovis. This retrospective study determined the prevalence of tuberculosis among these livestock slaughtered at Jos abattoir for human consumption between 2006 and 2012, which were potential sources of humans infections. It also determined the yearly and month-wise distribution of the prevalence of tuberculosis, and compared the prevalence among the study species. Seven-year abattoir entries were collated. All the prevalence were calculated using Microsoft Excel, and further subjected to Chi-square test for establishment of statistical significance using Graph-pad Prism. Lesions suggestive of tuberculosis were found in 5,726 (2.22%) animals (cattle: 5,504, sheep: 74, goat: 148) out of the 257,553 (cattle: 64,091, sheep: 72,004, goat: 121,458) slaughtered during the study period. Yearly prevalence was highest (4.21%) in 2011, and lowest (1.76%) in 2006. Month-wise prevalence for the study period was highest (3.24%) and lowest (1.37%) in November and April respectively. Prevalence in cattle, sheep and goat were 8.59%, 0.1% and 0.12% respectively. This study reported high prevalence of tuberculosis among livestock slaughtered for human consumption in the abattoir. We therefore recommend that the appropriate authorities should intensify efforts in public awareness on the dangers of consuming tuberculosis-infected meat, establish active surveillance network, and enforce active and thorough meat inspection

The occurrence of brain metastases in oncology has become an increasing frequency event. Their management is complex and aims to control the symptoms and avoid neurological degradation. Radiotherapy retains a prominent place in any therapeutic approach. However, their prognosis remains bleak. We report our experience in the management of these metastases. Retrospective study of 129 patients with cerebral metastases treated between January 2011 and December 2016 at the Oncology Department of the Mohammed VI University Hospital Center in Marrakech, Morocco. The mean age was 47.34 years (range 19 and 78 years). The sex ratio was 1.04. Clinical symptomatology was dominated by intracranial hypertension (95.65%), signs of focus (30%) and convulsive seizures (23.91%). Metastasis was indicative of the disease in 13% of cases. The primary focus was bronchial (37.3%), mammary (35.8%), digestive (10.2%), gynecological (6.6%), dermatological (4.3), urological (2.9%) and undetermined in 2.9% cases. The predominant histological types were infiltrating ductal carcinoma and bronchial adenocarcinoma. The lesions were multiple in 76.08% of the cases. Excision surgery was performed in 8.69% of cases. All patients were treated with brain radiotherapy according to two protocols; 30Gy in 10 sessions (78.26% of cases) and 20Gy in 5 sessions (21.73% of the cases). With an average follow-up of 7.3 months (between 1 month and 15 months), symptom improvement was observed in 63.04% of cases and neurocognitive disorders in 8.16% of cases. Radiotherapy retains a pivotal role in the treatment of brain metastases, although the optimal associations of systemic and local treatments remain to be defined

Cervical mass in neck region is very common. Mass may be inflammatory to neoplastic. Neoplastic mass may be benign as well as malignant form. It can be present as cervical lymph node, salivary gland lesion and thyroid lesion as well. Initially fine needle aspiration was introduced by hematooncologist Franzen in Sweden. Fine Needle Aspiration Cytology (FNAC) is simple, quick, inexpensive, minimal invasive and out-patient service technique used to diagnose different types of lesions located in the body. The present study was prospective cross-sectional study conducted in patients with FNAC of Cervical lesion at National Path Lab Collection Centre, Ghorahi, Dang, Nepal referred from General and Head and Neck Clinic from January 2016 to July 2016. A total of 96 study participants with palpable superficial cervical lesions between 17 months to 74 years of age were involved in this study. Most commonly lesions were occurred in male with 54.5%.Most common lesion in all sexes were reactive lymphadenitis with 51.5 % followed by tubercular and metastatic 12.1 %and 10.6% respectively. Predominant lesions in both sex were reactive lymphadenitis with slight male preponderance. Most of cases were below 20 year age group. Reactive lymphadenitis is the commonest cause of cervical swelling in all age group except in older age group. FNAC is quick diagnostic test for the all palpable cervical swelling. Non-neoplastic lesion was managed without surgery

Pediatric urolithiasis is an important medical problem, which has seen an increasing incidence in developing countries. A wide geographic variation in urolithiasis prevalence has been documented, which might be due to differences in diet, fluid intake, ethnicity and climate. The aim is to assess the biochemical and metabolic characteristics of the patients. The current study was conducted by the Department of Biochemistry of a tertiary care teaching hospital of western Uttar Pradesh. Pediatric patients presenting with urolithiasis formed the sampling frame. Medical records were studied for clinical and laboratory data. Study tools were records of the patients. Metabolic evaluation was done in all children. Sixty pediatric urolithiasis cases were included in this study. Gender wise, there were 23 females (38.3%) and 37 males (61.7%) with age ranged from 1 year to 11 years. Stone analysis revealed that big chunk (78.3%) of stones was renal stones. Vesicle calculus was least common (5%). On the other hand, Calcium oxalate stone was most common variety found in nearly half (46.20%) of the study participants. Least common variety (3.3%) was cystine type of stone. Hypocalcaemia was most common variety found in 86.67% of the study participants. Hyperuricaemia was observed in 3.33% of participants. Hyperoxaluria was the most common (78.3%) metabolic abnormality detected. 26.67% had Hypercalciuria. Only 5/29 (17.24%) patients managed conservatively had stone recurrence whereas 13/31 (41.9%) managed with a procedure had stone recurrence. Association of management modality with recurrence of Urinary Calculi was found statistically significant (p<0.05). Metabolic evaluation is advised in all pediatric patients as it helps in segregating patients needing medical therapy. Further studies are warranted to establish paediatric reference ranges for 24 hour urinary super saturation parameters in Indian population

Antibiotics are commonly prescribed in the Gynecology out-patient department for treatment of such infections which are not common in general out-patient departments. This cross-sectional, observational study was conducted to evaluate the recent antibiotic utilization pattern amongst the patients attending the Gynecology department of a tertiary care Teaching hospital in Eastern India. Six hundred and twelve prescriptions obtained from patients attending the out-patient department of Gynecology since June 2015 to November 2015 were included in the study. Data was collected in a pre-designed case record form. Baseline demographic features, provisional diagnosis/indication, type and number of antibiotics, formulation, duration, route of administration of antibiotics, average number of drugs per prescription and commonest antibiotic prescribed were noted. Single antibiotic was prescribed in 35.17% prescriptions while 66.83% received more than one antibiotic. The most common oral antibiotic used was doxycycline (67.08%) followed by cefixime (14.29%). In 97.2% prescriptions, drugs were written in their generic name. Doxycycline and cefixime were most commonly prescribed antibiotics; most of the antibiotics were prescribed in generic name from the essential medicine list of the country

Cryptococcal infection is characteristically associated with immunocompromised status. In most cases, the skin lesions represent a sentinel finding for disseminated cryptococcal infection. We describe a case of a 34 year old male, a solid organ transplant recipient (SOT), on immunosuppression, presenting with necrotising fasciitis of right lower limb. On microbiological and histopathological examination, a diagnosis of disseminated cryptococcal infection was made. In this report, we describe the spectrum of disease associated with Cryptococcus, its life cycle, pathogenesis and Immune Reconstitution Inflammatory Syndrome (IRIS). Cryptococcosis is a serious infection among SOT recipients, with diverse clinical features. This report underscores the need for a multidisciplinary clinical research and education from the Indian perspective.

Ocular drug delivery is challenging field to pharmaceutical scientists owing to the underlying anatomical, physiological and dynamic constraints put forth by the eye. Nonetheless, there is increasing need to overcome these barriers for the treatment of sight threatening ophthalmic ailments. Novel drug delivery strategies are being explored while intravitreal injections are still a standard treatment for the efficient treatment of ocular disorders. Topical ophthalmic in situ gels could be viable platform to increase mucoadhesivity, pre-corneal residence and thereby ocular bioavailability of drugs. In this review, various topical in situ gel formulations exploited for ocular delivery are summarized.

Topically applied drugs need to overcome physiological, anatomical and dynamic barriers in the ocular milieu for effective ocular penetration. There exists an urgency to develop novel approaches for the treatment of ophthalmic complications such as glaucoma, uveitis, retinitis, age related macular degeneration, diabetic retinopathy, retinitis pigmentosa. Efflux protein pumps present in the ocular tissues restrict the ocular absorption. Novel drug delivery strategies and approaches could improve ocular bioavailability of drugs which would be beneficial for the intervention of disorders. At present, the intravitreal route is widely used for posterior ophthalmic delivery. Over the past few years, liposomal systems were being exploited and targeted for posterior ocular delivery due to their unique structural framework to entrap lipophilic/hydrophilic drugs. The present review discusses about the recent advances the niche of liposomal ocular delivery.