ABSTRACT
Introduction: Clinical management outcome of emergency patients with delays are directly related to blocked access to the next level of care from emergency department. It predicts delay to the definitive procedure plan to manage the patient and is also a marker of hospital functional flaws
Objective: To study the frequency and associated factor of delays behind final disposition of patients presenting to the Emergency Department of a tertiary care hospital in Pakistan
Methods: This is comparative cross sectional study, conducted at Aga Khan University Hospital. Both adult and pediatric patients were included. Comparison was done between delayed and non-delayed emergency department patients. Six hour was taken as cut-off. SPSS version 19 and MS excel 2010 were used for analysis
Results: Out of 365 cases, 133 [36%] were pediatric and 232 [64%] were adults patients. There were 184 [50%] males. More than six hour delay was noted in 94 patients [27%]. Adult patients were delayed more than pediatric patients [p<0.001]. Laboratorial, radiological test and generated consults were all found highly significant difference for the delays [p<0.001]. 297 [81%] were discharged home, while 17 [5%] of them were admitted
Discussion: Overcrowding is common in Emergency Department [ED] and hence the chances of delay in disposition of patients from ED are very high which will ultimately compromise the patient care. Reducing the number of comparatively stable patients with effective triaging, ED clinics and diverting available resources towards more critical patients can reduce congestion, input and throughput. Reducing consults and unnecessary investigations with the provision of more experienced physicians and nurses is an important factor to reduce delays
Conclusion: Extended length of stay in ED may exceed the potential capability to deliver quality care within appropriate time frame; this may lead to drastic decrease in patient and family satisfaction, leading to compromised clinical care
ABSTRACT
56 species belonging to 20 genera of Order Chroococcales, Oscillatoriales and Nostocales as under are being recorded for the first time from Keenjhar Lake, Sindh, Pakistan.Chroococcales: Aphanothece, Chroococcus, Coelosphaerium, Gloeothece, Gloeocapsa, Gomphos-phaeria, Microcystis, Merismopedia. Oscillatoriales: Arthrospira, Lyngbya, Oscillatoria, Phormidium and Spirulina. Nostocales: Anabaena, Anabaenopsis, Calothrix, Nostoc, Rivularia
ABSTRACT
To find the frequency of hepatitis 'D' in patients of hepatitis 'B' seeking treatment and to compare clinical and biochemical features in patients harboring HDV with those who are not. Cross-sectional study. Medical Unit-IV, Civil Hospital Karachi, Medical Unit-VI and Surgical Unit-VII, Lyari General Hospital, Dow University of Health Sciences, Karachi; from July 2003 to June 2005. HBsAg positive patients seeking treatment were enrolled in the study. Anti-HDV was done in all. Patients were split into two groups according to their anti-HDV status into HDV positive and HDV negative groups. Liver biochemistries and viral profile for HCV, anti-HBc IgM and HBeAg were done and compared between the two groups. A total of 246 patients were selected. HDV was positive in 66 [26.8%] patients. No significant difference was observed in the frequency and stages of cirrhosis between the two groups while significant differences were observed in the mean SGPT [95% CI: -381.09 to -110.74; P = 0.001] and albumin levels [95% CI: 1.87 to 7.73; P = 0.007] and in the frequency of HBeAg [P = 0.001], anti- HBc IgM [P = 0.02] and HBV DNA [P < 0.001]. HDV infection was common in patients with HBV in this cohort of patients. All patients of HBV should be screened for HDV before treatment decision for the former is taken
Subject(s)
Humans , Male , Female , Hepatitis/epidemiology , Lamivudine , Interferons , Nucleosides , Nucleotides , Cross-Sectional StudiesABSTRACT
Lippia nodiflora L, an indigenous herb has many medicinal uses. Present work was carried out to study the antifungal activity of crude extracts of L. nodiflora L. against the human pathogenic fungi. Crude extracts from the leaves and shoots of plant were prepared in different solvents including ethanol, methanol, ethyl acetate, chloroform and water and tested for antifungal activity against Aspergillus niger, A.. flavus, Paecilomyces varioti, Microsporum gypseum, and Trichophyton rubrum. Concentration of various elements e.g. Al, Ca, Cu, Fe, Mg, Mn, P, S and Zn were determined by using atomic absorption spectrophotometer and UV spectrophotometer. All crude extracts including ethanol, methanol, ethyl acetate, chloroform and aqueous extracts showed high activity against test organisms. Ethanol and aqueous extracts appeared to be the most effective antifungal agents as compared to methanol, chloroform and ethyl acetate. Moreover, the plant L. nodiflora L has high concentration of various essential elements. The medicinal plant Lippia nodiflora L contains considerable amount of elements which are important component of many formulation, used in skin care
ABSTRACT
In this study five extracts such as ethanol, methanol, ethylacetate, chloroform and aqueous extract were obtained from the medicinal plant Datura alba Nees. These extracts were tested against the human pathogenic fungi, Aspergillus niger, Aspergillus flavus, Paecilomyces varioti, Microsporum gypseum, and Trichophyton rubrum. All crude extracts were found to be effective against test organism. Ethanol, methanol, and ethylacetate extracts appeared to be the most effective antifungal agents as compared to the chloroform and aqueous extract. Moreover in present study nine elements, Al, Ca, Cu, Fe, Mg, Mn, P, S and Zn have been determined from the medicinal plant Datura alba Nees, by using atomic absorption spectrophotometry and U.V. spectrophotometry. The medicinal plant Datura alba Nees contains considerable amount of elements which have therapeutic effects in skin diseases
ABSTRACT
To study the trends of cancer esophagus in Karachi South during 1995-2002 and identify risk factors. Incident esophageal cancer cases recorded at the Karachi Cancer Registry for Karachi South, during 1st January 1995 to 31st December 2003 were reviewed. For maximum completion of data, incident cases registered from 1st January 1995 to 31st December 2002 were included for final analyses. The Age Standardized Incidence Rates [ASIRs] of cancer esophagus in Karachi South for males were 6.5/100,000 [1995-1997] and 6.4/100,000 [1998-2002]. In females the observed rates were 7.0/100,000 [1995-1997] and 8.6/100,000 [1998-2002]. In the moderately high incidence, cancer esophagus zone of Karachi, the ASIRs in males remained stable during the last decade, but in females, an upward trend was observed suggesting a progressively higher exposure to risk factors in the latter. The potential risk factors in Karachi are use of all forms of tobacco, areca nut, infrequent consumption of raw fruits and vegetables and diet deficiencies. There is a necessity to actively control the proven risk factors and address the existence of other risk factors. The primary recommended strategy for the control of cancer esophagus would therefore be legislation against tobacco and areca nut in Pakistan and public health education. The risk factors of cancer esophagus identified in this article need to be further confirmed