Effect of physical parameters in enhancing prodigiosin production and anti-MRSA activity of marine bacterium, Serratia marcescens IBRL USM84

Aims@#Marine bacteria have been reported to produce potential natural pigment with pharmaceutical properties and their growth can be manipulated in the laboratory to increase pigment production and their antimicrobial activity. Hence, this study aimed to enhance the prodigiosin production in Serratia marcescens IBRL USM84 by improving physical conditions.@*Methodology and results@#The quantification of the pigment produced by S. marcescens IBRL USM84, bacterial cell growth, and its antibacterial activity in the broth medium were determined using a spectrophotometry method. Meanwhile, the antibacterial effect of red pigment on MRSA cells was observed under a scanning electron microscope (SEM). This marine isolate produced the highest yield of prodigiosin (6.95 μg/mL) when cultivated in marine broth with the addition of 0.2% of agar, 25 °C incubation temperature, initial medium pH of 7, 150 rpm of agitation speed for 48 h of cultivation time under light illumination. There was an increment of 151.81% in prodigiosin production after enhancement compared to before the enhancement of cultural conditions. SEM observations revealed that severe damage to the cell’s morphologies was exposed to red pigment as indicated by the formation of small dents, which led to completely collapse and eventually, cell death.@*Conclusion, significance and impact of study@#A positive correlation between pigment production and antibacterial activity was observed in the present study. The results supported the fact that marine bacteria are a reservoir of various pigments with antimicrobial properties. Also, the pigment production by S. marcescens and its antibacterial activity were significantly influenced by physical parameters.

Determinants of Willingness to Undergo Lung Cancer Screening among High- Risk Current and Ex-smokers in Sabah, Malaysia: A Cross-Sectional Pilot Study / 결핵및호흡기질환

Background@#Attitudes towards smoking, lung cancer screening, and perceived risk of lung cancer have not been widely studied in Malaysia. The primary objective of this study was to describe the factors affecting the willingness of high-risk current smokers and ex-smokers to undergo low-dose computed tomography (LDCT) screening for lung cancer. @*Methods@#A prospective, cross-sectional questionnaire study was conducted in current smokers or ex-smokers aged between 55 and 80 years at three hospitals in Kota Kinabalu, Sabah, Malaysia. The questionnaire recorded the following parameters: perceived lung cancer risk; Prostate Lung Colon Ovarian Cancer 2012 risk prediction model excluding race and ethnicity predictor (PLCOm2012norace); demographic characteristics; psychosocial characteristics; and attitudes towards lung cancer and lung cancer screening. @*Results@#A vast majority of the 95 respondents (94.7%) indicated their willingness to undergo screening. Stigma of lung cancer, low levels of knowledge about lung cancer symptoms, concerns about financial constraints, and a preference for traditional medication were still prevalent among the respondents, and they may represent potential barriers to lung cancer screening uptake. A desire to have an early diagnosis (odds ratio [OR], 11.33; 95% confidence interval [CI], 1.53 to 84.05; p=0.02), perceived time constraints (OR, 3.94; 95% CI, 1.32 to 11.73; p=0.01), and proximity of LDCT screening facilities (OR, 14.33; 95% CI, 1.84 to 111.4; p=0.01) had significantly higher odds of willingness to undergo screening. @*Conclusion@#Although high-risk current smokers and ex-smokers are likely to undergo screening for lung cancer, several psychosocial barriers persist. The results of this study may guide the policymakers and clinicians regarding the need to improve lung cancer awareness in our population.

SARS-Cov-2 infection and severe proximal myopathy secondary to dermatomyositis and overlap systemic sclerosis: A Case Report from Zambia

Background: Myositis has been reported to be associated or triggered by viruses. Genetic and environmental factors are documented risk for myopathies. Viruses have also been shown to modify the clinical course of auto-immune diseases. We therefore report a case of SARS-Cov-2 infection in a 26-year-old female black Zambian patient with proximal myopathy. Case Presentation: We present the case of a 26-yearold chemical factory worker with severe acute respiratory distress syndrome corona virus 2 (SARS-cov-2) infection and proximal myopathy. She presented to a local private hospital with fever, weakness and flu-like symptoms after being exposed to a colleague diagnosed with SARS-cov-2 infection at the time Zambia declared the July 2021 third wave of SARS-cov-2pandemic. She also reported difficulties in climbing stairs, had Raynaud's phenomenon, proximal myopathy, classic dermatomyositis features, symptoms of systemic sclerosis, raised creatine phosphokinase (CPK), and a positive nasopharyngeal PCR test for SARS-Cov-2 infection. Conclusions: We presented, for the first time in Zambia, the case of a patient with SARS-Cov-2 infection and severe proximal myopathy secondary to newly diagnosed dermatomyositis and overlap systemic sclerosis. The myopathy appeared to have been worsened by SARS-Cov-2 viral infection.

Antibacterial and Antibiofilm Activities of Crude Extract of Lasiodiplodia pseudotheobromae IBRL OS-64 against Foodborne Bacterium, Yersinia enterocolitica

The antibacterial and antibiofilm activities of crude extract of Lasiodiplodia pseudotheobromaeIBRL OS-64 was studied and tested against a foodborne pathogenic bacterium, Yersinia enterocolitica. The ethylacetate extract exhibited favorable antibacterial activity with the zone of inhibition was 20.3±0.6 mm compared to dichloromethane (15.0±0.3 mm) and butanol (9.0±0.3 mm) extracts. Minimum inhibition concentration (MIC) and minimum bactericidal concentration (MBC) values of the extract were 125 and 250 μg/mL, respectively. Structural degeneration studies through scanning electron microscopy (SEM) and transmission electron microscope (TEM) micrographs exhibited major abnormalities that occurred on thebacterial cells after exposureto the extract were complete alterations in their morphology and collapsed of the cells beyond repair. The findings showed that the extract possesses antibiofilm activity against the initial and preformed biofilm of Y. enterocoliticawith the highest inhibition value of 69.12% and 58.70%, respectively The results also revealed the initial biofilm was more susceptible to the extract as compared to pre-formed biofilm. The light microscopy (LM) and SEM photomicrographs proved that thefungal extract significantly eliminates extracellular polysaccharide (EPS) matrices and hinder the attachment of the bacterial cells for biofilm formation. Therefore, the current study suggested the ethyl acetate crude extract from an endophytic fungus, L. pseudotheobromae IBRL OS-64 may be an effective antibacterial and anti-biofilm agent to treat foodborne pathogens

Knowledge, Compliance And Complication Of Contact Lens Usage Among Medical Students In Universiti Kebangsaan Malaysia Medical Centre

@#Non-compliance to hygienic practices in contact lens wear is regarded as a significant risk factor for contact lens-related complications. Non-compliant behaviour continues to prevent efforts to improve contact lens safety despite advancements in lens materials and care solutions. The objective of this study was to identify the association between knowledge, compliance and complications of contact lens wear. A cross-sectional design was used and contact lens users among medical faculty students were identified and recruited via convenience sampling throughout October 2013 to March 2014. A total of 36 close-ended questions that focused on knowledge level, compliance to standard contact lens practice, and experience of complications were administered. A total of 188 respondents, majority of females (89.4%; n=168) participated in this study. Although majority had good knowledge level (68.1%; n=128) on care and usage of contact lens while only a small number having moderate knowledge (26.6%; n=50) and poor knowledge (5.3%; n=10), most of them were partially compliant (74.5%; n=140) to the recommended contact lens practices. However, a small group was found to be fully compliant (24.4%; n=46) and the rest being non-compliant (1.1%; n=2). There was a significant association between knowledge on contact lens usage and compliance level to standard practices (p=0.0003). In addition, a significant association also existed between compliance level to recommended practices and risk of complications from contact lens usage (p=0.023). Findings of this study showed the positive association between knowledge of contact lens usage and compliance to recommended practices and negative association between knowledge of contact lens usage and complications experienced by contact lens users. By providing basic knowledge on contact lens care and usage via education, improvement on compliance and enhancement of safety of contact lens wear could invariably be achieved.

Time-kill study and morphological changes of Proteus mirabilis cells exposed to ethyl acetate crude extract of Lasiodiplodia pseudotheobromae IBRL OS-64

@#Aims: To investigate time-kill curve and morphological changes of Proteus mirabilis cells exposed to ethyl acetate crude extract of endophytic fungus, Lasiodiplodia pseudotheobromae IBRL OS-64, isolated from Ocimum sanctum. Methodology and results: Inhibitory effect of the fungal extract against the test bacteria via disc diffusion assay showed a fair antibacterial activity with diameter of inhibition zone was 12.0 ± 0.4 mm. The Minimal Inhibition Concentration (MIC) and Minimal Bactericidal Concentration (MBC) values of the ethyl acetate extract against P. mirabilis was 250 and 500 µg/mL, respectively. The value of MBC which is two-fold higher than MIC value indicated that the fungal extract exerted bactericidal effect on bacterial cells of P. mirabilis. Time-kill curve study revealed that the bactericidal effect of the crude extract towards test bacteria was both dose and time dependent. Scanning electron microscope (SEM) observation revealed that the bacterial cells of P. mirabilis exposed to fungal crude extract resulted in formation of pits, irregular shape of the bacterial cell and ultimately cell death beyond repair. Conclusion, significance and impact of the study: The time-kill curve study, and cell morphological changes suggested the potential of ethyl acetate extract of L. pseudotheobromae IBRL OS-64 against P. mirabilis infection by formation of cavities, irregular bacterial cell that leads to ultimate cell death and the extract may have pharmaceutical potential to be develop as antibacterial agent.

Hamman’s Syndrome: A Rare Benign Syndrome

@#Hamman’s syndrome by definition is spontaneous pneumomediastinum with the exclusion of thoracic trauma or iatrogenic cause. It is rare and is more common in adolescence male. Amongst the risk factors are underlying lung condition such as asthma and interstitial lung disease, drug inhalation and parturient woman. Patient usually presents with sudden onset of shortness of breath and chest pain with subcutaneous emphysema on examination. The diagnosis is confirmed with chest radiograph. The prognosis of Hamman’s syndrome is excellent. Most cases are self-limiting and resolve spontaneously. However, Hamman’s syndrome is a poorly recognised disease due to its rarity. Therefore, the patient may be subjected to misdiagnosis and treatment. This is a case report of Hamman’s syndrome misdiagnosed and treated as pneumothorax. The objective of this case report is to highlight the importance of differentiating this benign syndrome with life threatening differentials which may have similar clinical presentation. Thus, avoiding unnecessary costly investigation, treatment and invasive procedures.

Effect of ethyl acetate crude extract of Lasiodiplodia pseudotheobromae IBRL OS-64 against oral cavity bacteria with emphasis on Streptococcus mutans

Streptococcus mutans and Streptococcus agalactiae have been reported in human oral diseases including cariesand periodontitis. Thus, the present study was performed to investigate the effect of ethyl acetate crude extract ofLasiodiplodia pseudotheobromae IBRL OS-64, an endophytic fungus isolated from Ocimum sanctum leaf againstS. mutans and S. agalactiae. Disk diffusion and broth microdilution assays were used to determine the antimicrobialactivities with minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) values.Meanwhile, the microscopic analysis was used to study the structural degeneration of bacterial cells. The fungal crudeextracts demonstrated favorable antibacterial activity toward both test bacteria and produced an inhibition zone rangingfrom 16.0 to 21.2 mm. The MIC and MBC values of the fungal crude extract toward S. mutans and S. agalactiae weredetermined and the results showed that the MIC and MBC values were in the range of 125–500 µg/ml and 125–1,000µg/ml, respectively. The time-kill study suggested that the ethyl acetate crude extract possessed bactericidal effectwith concentration and time-dependent. Structural degeneration studies revealed the major abnormalities occurredto S. mutans cells after treated with the fungal crude extract where completed alterations of their morphology withthe formation of cavities and collapsed cells beyond repair occurred. Therefore, the current study suggested the ethylacetate crude extract of L. pseudotheobromae IBRL OS-64 could be an effective antibacterial agent to treat oral cavitybacteria.

Antibacterial activity of an endophytic fungus Lasiodiplodia pseudotheobromae IBRL OS-64 residing in leaves of a medicinal herb, Ocimum sanctum Linn.

The study was carried out to investigate the antibacterial activity of an endophytic fungal isolate, Lasiodiplodiapseudotheobromae IBRL OS-64 residing in leaves of a medicinal herb, Ocimum sanctum Linn. Qualitative screeningof the antimicrobial activity was done using an agar plug assay, and the results showed that the fungal isolate wasable to inhibit all the 13 test bacteria. Three Gram-positive bacteria (methicillin-resistant Staphylococcus aureus[MRSA] ATCC 33591, Staphylococcus aureus, and Streptococcus mutans) were the most susceptible species withthe inhibition zones of ≥21 mm. The other three (Bacillus cereus ATCC 10876, Bacillus subtilis IBRL A3, andStreptococcus agalactiae) showed the inhibition zones of 11–≤20 mm of diameter. As for Gram-negative bacteria,Yersinia enterocolitica was the most susceptible to the fungal isolate with the size of inhibition zone of ≥21 mm,followed by Klebsiella pneumoniae ATCC 13883, Salmonella typhimurium, and Shigella boydii ATCC 9207 withthe inhibition zones of 11–≤20 mm, whereas Escherichia coli IBRL 0157, Proteus mirabilis, and Pseudomonasaeruginosa ATCC 27883 were the least susceptible with the inhibition zones of ≤10 mm. Quantitative screeningusing disc diffusion assay showed that the fungal ethyl acetate extract prepared from the fermentative broth(extracellular) exhibited better antibacterial activity compared to the methanolic extract prepared from the fungalbiomass (intracellular). The results showed that the ethyl acetate extract exhibited antibacterial activity against all the13 test bacteria with the inhibition zone sizes of 20.0 ± 0.3–31.3 ± 1.2 mm in diameter for Gram-positive bacteria and10.31 ± 0.6–20.1 ± 0.6 mm in diameter for Gram-negative bacteria. On the other hand, the methanolic extract onlyinhibited three Gram-positive bacteria (MRSA ATCC 33591, S. aureus, and S. mutans) with the inhibition zones of9.0 ± 0.6–11.0 ± 0.3 mm in diameter, whereas only one Gram-negative (S. typhimurium) with the inhibition zone sizeof 13.3 ± 1.5 mm diameter. The minimal inhibitory concentration (MIC) and minimum bactericidal concentration(MBC) values of the ethyl acetate extract on Gram-positive bacteria were in the range of 62.50–125.00 and 62.50–500.00 µg/mL, respectively, whereas for the Gram-negative bacteria, the MIC and MBC values were 125.00–250.00and 250.0–1000.00 µg/mL, respectively. On the other hand, the MIC and MBC values for methanolic extract againstGram-positive bacteria were 250.00–500.00 µg/mL and against Gram-negative bacteria were 1000.00 µg/mL,respectively. Both of the extracts exhibited bactericidal effects on test bacteria with the MBC/MIC ratio ≤4. Further,detail of the effects of the ethyl acetate extract on the bacterial cells was observed from the scanning electronmicroscopy photomicrographs which revealed the severity of the morphological deterioration experienced by theextract-treated cells were beyond repair, and the most possible mode of actions were by interrupting the cell wallbiosynthesis and cell membrane permeability

Relation between depressive disorder and iron deficiency anemia among adults reporting to a secondary healthcare facility: a hospital-based case control study

Objective: To determine the relationship between iron deficiency anemia and depressive disorder; and identify the correlation between severity of anemia and depressive disorder

Study Design: Descriptive, analytical study

Place and Duration of Study: Department of Psychiatry and Medical Reception Center, Sindh Rangers Hospital, Karachi [a secondary healthcare facility], from January to July 2017

Methodology: Depressive disorder was diagnosed by psychiatrist on ICD 10 criteria and severity of symptoms was assessed on HAM-D rating scale. Hundred cases and equal number of age and gender matched controls were enrolled in the study. A semi-structured proforma was used for documenting the socio-demographic factors and outcome variables. Blood samples were taken for Hemoglobin [Hb] level and peripheral film from both groups

Results: Median Hb levels were 11.9 [IQR=1.27]] for depressed patients versus 12.9 [IQR=1.3] for healthy participants. Significant difference between Hb levels of two groups was found [p<0.001], i.e. depressed participants were found to have higher frequency of anemia [73%] as compared to non depressed participants [16%, p=0.001]. Spearman rank correlation coefficient for Hb level and depression was -0.429 [p<0.01], showing significant negative correlation. The odds for Hb level were 0.487 [0.37-0.64], which showed that cases are less likely to be found with higher Hb levels as compared to controls [p<0.001]

Conclusion: This study concludes that there is relationship between iron deficiency anemia and depressive disorder; and severity of symptoms of DD increases with degree of IDA

Palatal rhinosporidiosis: an unusual case report and review of the literature

Rhinosporidiosis is a chronic, granulomatous, mucocutaneous infection caused by Rhinosporidium seeberi . The infection is non-contagious and sporadic in humans. The site most commonly affected is the mucous membrane of the nose and nasopharynx, followed by the oropharynx, trachea, bronchi, ear, eye, and genitourinary tract. It can also spread to other areas through blood and lymph. Here, we report a case of rhinosporidiosis affecting the palate in a 60-year-old female patient.

Comparative studies on rabbit plasma lipid profile fed with Silybum marianum oil, sunflower oil and vegetable ghee

Present work is aimed to compare the physicochemical characterization and biochemical effects of oil extracted from Silybum Marianum and Sunflower oil, collected from Peshawar [Pakistan]. To investigate the comparative effects on the body weight, organ weight and lipid profile, the crude oil of Silybum marianum, edible sunflower oil and vegetable ghee were given to three groups of rabbits under study. Percent proximate composition and food consumption of all rabbits were determined which showed no significant statistical variation. There is no data available about Silybum marianum oil on animal model in literature. This study clearly revealed that oil from Silybum marianum significantly reduces plasma cholesterol level in rabbits. A threefold higher Triglyceride levels was observed in vegetable ghee feeding groups compared with the sunflower and Silybum marianum oil feeding groups. The crude oil of Silybum marianum was found to be safe in rabbits compared with sunflower oil and vegetable ghee. The results of these studies revealed most valuable information and also support the refining and purification to convert this non-edible oil to edible oil

Diagnostic accuracy of diffusion weighted magnetic resonance imaging in the detection of myometrial invasion in endometrial carcinoma

Objective: To determine the diagnostic accuracy of Diffusion-Weighted Magnetic Resonance Imaging [DWMRI] in the detection of myometrial invasion in endometrial cancer taking histopathology as gold standard

Study Design: Cross-sectional validation study

Place and Duration of Study: Department of Radiology, The Aga Khan University Hospital, Karachi, from January to December 2012

Methodology: DWMRI [b-value = 50,400 and 800 s/mm[2]] was performed in 85 patients of biopsy-proven endometrial carcinoma before hysterectomy using body and spine coil at 1.5 Tesla. DWI was evaluated for presence of myometrial invasion by tumor with histopathology as gold standard. Sensitivity, specificity, the negative predictive value and positive predictive value and accuracy of DWI were assessed against the gold standard

Results: On DWI, superficial myometrial invasion was found in 42 patients and deep myometrial invasion in 43. On histopathology, superficial myometrial invasion was found in 53 patients and deep myometrial invasion in 32. Hence sensitivity, specificity, positive predictive value, negative predictive value and accuracy for the assessment of myometrial invasion by endometrial tumor on DW images was 90%, 73%, 67%, 92% and 80%, respectively. Diagnostic accuracy of diffusion-weighted magnetic resonance imaging in detection of myometrial invasion in endometrial cancer was 80%

Conclusion: DWI is highly accurate in assessing myometrial invasion and can be used as an adjunct to routine MRI for pre-operative evaluation of myometrial invasion of endometrial cancer

Physical Co-morbidity according to ICD-10 criteria among patients with depressive disorder

Objective: To detect the prevalence of physical co-morbidities according to International Classification of Diseases[ICD-10] among patients with Depressive disorder

Design: Descriptive cross sectional study

Setting: Psychiatric consultation clinic of JPMC Karachi

Methods: Patients of either gender and age >18 years were consecutively selected after informed consent, Ethical issues were addressed according to Institutional Review Board [IRB], JPMC, Karachi. Patients with psychotic symptoms, personality disorders, dementia, and history of substance use were excluded. ICD-10 criteria, beside complete history, physical examination and lab investigations were used to confirm the diagnosis of depression and physical co-morbid. Prescribed questionnaire was used to collect the data and analyzed in SPSS version-17. Descriptive statistics were calculated for age, gender, marital status, education, socioeconomic status and co-morbidity

Results: Total 100 cases fulfilled the inclusion criteria. Their Mean +/-SD age was 32.7 +/-16.7 years. Both genders were equally vulnerable, [50% each]. Fifty three percent had moderate, 31% mild and 16% had severe depressive disorder. Hypertension was the most common [18%] in male patients and sinusitis was the most common [28%] in female patients with depression. Other co-morbidities included Diabetes Mellitus, Epilepsy, Migraine, HCV, Anemia, Chronic Kidney Disease [CKD], Urinary Tract Infection [UTI] and Menopausal syndrome [in women], Obesity, Asthma and Facial pain

Conclusion: Physical co-morbidities are prevalent among patients with depressive disorder. Presence of physical co-morbid may decreases the chances of treatment compliance, increases risk of treatment failure, relapse of depression, worse prognosis and elevated the treatment cost. Early detection and simultaneous management of these co-morbid with depression are suggested

Phytochemical and dermatological investigations of tribulus terrestris l.

Tribulus terrestris extracts were prepared using solvents of different polarities and their irritant inducing effects were assessed in vivo on rabbit's ears

The result indicates that the polar components were in higher yield than the others and amounts of the extracted material were directly proportional to the polarities of solvents. Preliminary phytochemical screening shows diversity of compounds and comparative TLC analytical behaviour further indicated the resolution of mostly five compounds from the non-polar, intermediate polar and highly polar materials by different solvent systems. Irritant potency of water extract was assessed on rabbit's ears using a known method that was proved to be the most potent irritant [with +++ response, propagated in an area of 2.70 cm[2] diameter]

Fucntional and Radiological Outcome of Surgical Management of Acetabular Fractures in Tertiary Care Hospital / 대한고관절학회지

PURPOSE: Acetabular fractures are mainly caused by trauma and the incidence is rising in developing countries. Initially these fractures were managed conservatively, due to lack of specialized and dedicated acetabulum surgery centres. Our aim is to study the radiological and functional outcomes of surgical management of acetabular fractures in tertiary care hospital. MATERIALS AND METHODS: Total 50 patients were enrolled. The patients with acetabular fractures were enrolled between the years 2012 to 2014. Patients were evaluated clinically with Harris hip score (HHS) and radiologically with Matta outcome grading. The factors examined include age, gender, fracture pattern, time between injury and surgery, initial displacement and quality of reduction on the final outcome. RESULTS: There were 34 males and 16 females. Mean age was 44.20±11.65 years while mean duration of stay was 9.28±2.36 days. Duration of follow-up was 24 months. Most common mechanism of injury was motor vehicle accident (n=37, 74.0%). Open reduction and internal fixation of fractures were performed using reconstruction plates. Mean HHS at 24 months was 82.36±8.55. The clinical outcome was acceptable (excellent or good) in 35 (70.0%) cases and not acceptable (fair or poor) in 15 (30.0%) cases. The radiological outcome was anatomical in 39 (78.0%) cases, congruent in 5 (10.0%) cases, incongruent in 6 (12.0%) cases. CONCLUSION: Study results indicated that mechanism of injury, time between injury and surgery, initial degree of displacement and quality of reduction had significant effect on functional as well as radiological outcome.

Child sexual abuse: a burning issue

Child Sexual Abuse [CSA] is one of the major public health problems that exist globally. Abuse, is the term which has been using for long period of time since the human societies existed in the world. But, we would like to be more specific to the CSA in Pakistani context. For the purpose, Logical Framework Analysis [LFA] was developed to design project in the community health settings for a health prevention, promotion, and health maintenance of the people living in the community. Child Sexual Abuse, issue was identified after thorough assessment of the community which was prevalent but unreported. LFA approach was used to explore the problems through root cause analysis and discover some of the relevant strategies to solve the identified problems. In conclusion, there is an intense need of awareness regarding child sexual abuse to prevent this problem not only in the community but also at country level

Health care ethics - am I dying

One of the most complex ethical dilemmas faced by health care professionals working with terminally ill patients is whether, when, how and how much to tell terminal ill patients about their diagnosis and prognosis of disease. Deception is still sometimes used by health care professionals while treating terminally ill patients [Tuckett, 1998]. Truth telling to terminally ill patients is a common ethical dilemma that nurses have to deal with on a daily basis when families are reluctant to disclose the poor diagnosis with patients. However, by abiding by certain principles and ethics, the nurses can make the best decision. The purpose of this paper is to review, analyze and evaluate the case scenario in light of four principles of Beauchamp and Childress [2001] namely autonomy, beneficence, non-maleficence, and justice

Suicidal behavior among teenagers: a review

After every 16 minutes one individual die not merely from a disease or an accident but intentionally through suicide. Literature reveals that it is a long process usually stretches over years from suicidal ideation to planning and finally an attempt. The causes of suicidal behavior are immense which captivate these poor and innocent creatures in great troubles. In teenagers the suicidal ideations are related to multiple internal and external factors. They consume different lethal liquids and adopt different methods for performing this violent act. Further on its impact is not only on her individual and family life but has a great impact on the society as well. It is not an essay task to eradicate this violent act but as we a responsible member of the society we can assess their suffering and agony and help them identifying different social groups. Along with it we can also prevent the suicide at three different levels that's primary secondary and tertiary. We can also do the counseling. In conclusion, I would say that it is a rising issue of today's world and we all must give our efforts to show a reduction in its prevalence

Comparison and analysis of health care delivery system: Pakistan versus China

Healthcare delivery system is an arrangement that serves best to any country's population with effective, efficient and fair distributions of resources, and funds through organized infrastructure to thrive well. Better health improves country's labor force and ultimately raises human welfare and economic stability. This healthy labor force and productive human capital resources can be attained through structured healthcare facilities by the government for its people. Globally, health sectors varies from country to country and it depends on how much expenditures on health is been effectively utilized. In majority of the developing countries, private healthcare sectors, donor, and out of pocket expenditures are the primary contributors in health care services that may raise human capital and economic growth of the country. Whereas, public health sectors remains underprivileged due to structural fragmentation, lack of resources, and functional inabilities. This paper is mainly going to discuss about health care delivery system of Pakistan in comparison to China followed by organizational structure, analysis of both the healthcare systems, and some recommendations to improve healthcare reform and its utilization