Determination of Shear Bond Strength of Nanocomposite to Porcelain and Metal Alloy

Abstract Objective: To compare porcelain and metal repair done with both nanocomposite and conventional composite. Material and Methods: A total of 30 cylinders were fabricated from Porcelain (I), Porcelain fused to metal (II), and metal (III) substrate each. Control group (A) was bonded with conventional micro-hybrid composite and experimental group (B) was bonded with nanocomposite in a 2 mm thickness. All specimens were thermocycled and stored in distilled water at 37 °C for 7 days. A universal testing machine was used to measure the Shear bond strength (SBS). The difference between bond strengths of the groups was compared using an independent t-test. Results: In all three groups, the SBS was higher in the experimental group as compared to the control group. The use of nanocomposite of metal alloy presented maximum shear bond strength, followed by samples of porcelain fused to metal and finally porcelain, showing the lowest values of SBS. Conclusion: Porcelain and alloys bonded with nanocomposite exhibit enhanced adhesiveness as well as aesthetic and mechanical properties. This subsequently would translate into providing higher clinical serviceability and durability and hence a cost-effective and accessible repair option for human welfare (AU).

Translation, adaptation and pilot testing of the Pictorial Fit-Frail Scale (PFFS) for use in Malaysia – The PFFS-Malay version (PFFS-M)

@#Background: Frailty is an important health issue in an aging population; it is a state of vulnerability that renders the elderly susceptible to adverse health outcomes, including disability, hospitalization, long-term care admission and death. Early frailty stages are recognizable through screening and are reversible with targeted interventions. To date, however, there is no screening tool for use in Malaysia. The English Pictorial Fit-Frail Scale (PFFS) is a visual tool that assesses a person’s fitness-frailty level in 14 health domains, with higher scores indicating higher frailty. Objective: The aim was to translate and adapt the English PFFS for use in Malaysian clinical settings. Methods: The original English PFFS underwent forward and backward-translation by two bilingual translators to and from the Malay language. A finalized version, the PFFS-Malay (PFFS-M), was formed after expert reviewers’ consensus and was pilot tested with 20 patients, 20 caregivers, 16 healthcare assistants, 17 nurses and 22 doctors. Score agreement between patients and their caregivers and among healthcare professionals were assessed. All participants rated their understanding of the scale using the feasibility survey forms. Results: A total of 95 participants were included. There were high percentages of scoring agreements among all participants on the scale (66.7% to 98.9%). Overall feedback from all respondents were positive and supported the face validity of the PFFS-M. Conclusion: The PFFS-M reflects an accurate translation for the Malaysian population. The scale is usable and feasible and has face validity. Reliability and predictive validity assessments of the PFFS-M are currently underway.

Consensus statement on the management of invasive candidiasis in Indian scenario

Invasive fungal infections in critically ill patients are associated with increased morbidity and mortality. Candida species are among the most common causes of nosocomial bloodstream infections and of invasive infections in intensive care units (ICUs). The high mortality mandates early identification of invasive candidiasis which is vital to initiate appropriate and timely treatment and improve outcomes. Delaying the initiation of treatment could result in an increase in mortality which can be avoided by usage of more rapid diagnostic techniques. There are multiple diagnostic tests including culture and non-culture tests like 1,3-β-D-glucan and newer techniques like MALDI-TOF which are available to diagnose candidemia but each with their drawbacks. Additionally, there are various guidelines like IDSA and ESCMID on treatment which aim to minimize death, late complications from deep-seated candidiasis and rise of drug- resistant Candida strains. Through this consensus statement prepared by a panel of experts, all of whom are senior intensivists, infectious disease specialists and microbiologists, we aim to address the major aspects of management of invasive candidiasis in the Indian population as per the authors opinions, backed by published evidence and supported by the latest clinical guidelines.

Phytocompounds of Anonna muricata leaves extract and cytotoxic effects on breast cancer cells

Objective: To identify the phytochemical compounds from Annona muricata (A. muricata) and to determine their in vitro anti-proliferative activities against breast cancer cells, MCF7 and MDA-MB-231. Methods: A. muricata leaves were successively extracted by soxhlet method using n-hexane, ethyl acetate and methanol, and decocted with water. Each extract was analysed by gas chromatography mass spectrometry (GCMS) and characterized with Wiley and NIST library searches. Anti-proliferative activity of each extract was evaluated on MCF7 and MDA-MB-231 breast cancer cells using MTT assay. Results: The GCMS analysis of different solvent extracts of A. muricata leaves showed presence of different chemical groups of compounds such as steroids, terpenoids, phenolic compounds, sugars, sugars alcohol and others including vitamin E. Ethyl acetate leaves extract exhibited the lowest IC

level of patient satisfaction in emergency departments of public sector tertiary care hospitals, faisalabad

Introduction: The patient satisfaction is a feeling which affects the patient's experience in the hospitals. The services which they are provided with in the emergency departments also known as ED, need to be assessed on certain parameters in order to recognize the standard of the provided health care services in the emergency, and the meticulous assessment of the areas which require improvement

Objective: To determine the outcome of patients who were satisfied by the emergency services provided at the public sector tertiary care hospitals of Faisalabad to evaluate the parameters from which the patients turned out to be unsatisfied, in order to improve the quality of care

Study Design: This is a descriptive cross-sectional study

Setting: It was carried out in the Emergency departments of tertiary care hospitals in Public sectors, Faisalabad

Duration of study: The study was carried out within time frame of three [03] months [March to May 2017]

Sample Size: A real time survey was conducted on approximately 4000 patients

Data collection procedure: The patients visiting the ED in tertiary care hospitals were interviewed regarding their experience, their time of arrival, the medical personnel who received them and their satisfaction level with the provided treatment and care

Results: The most consistently observed finding associated with higher levels of satisfaction, was the patient-oriented care provided by doctors, nurses and paramedic staff. Doctors and nurses who spent more time with the patient, had better communication skills, showed more empathy and treated the patients within 5 minutes of arrival in the emergency resulted in more patient satisfaction. On the basis of these characteristics, the calculated number of satisfied patients turned out to be 75%. However, 25% of the patients responded that they would not prefer emergency departments of public sector tertiary care hospitals of Faisalabad for future visits

Conclusion: The evaluation of patient satisfaction level provided a precise estimation of the health care services in the Emergency departments which were up to the mark and which required improvement in order to serve the patients well in future

Effect of video games on the aggressive behavior of children

Introduction: Video games are considered to be causing deleterious effect on children as they influence their minds regarding aggression. Aggressive behaviour includes fighting, arguing, yelling and bullying others. The promotion of these emotions by video games depends upon various factors like active parental surveillance and minimizing the number and duration of playing sessions, tactfully

Objective: To investigate the relation between over playing of video games and aggressiveness of children

Study design: Descriptive cross-sectional study

Setting: Community and Elementary schools of Faisalabad

Duration of study: Three months from January to March 2018

Sample size: 100 children. Both male and females were included

Data collection procedure: The children were given survey questionnaires and then assessed accordingly

Results: The children who played games with more violent content were found fighting and arguing in more number. This verified the significance of positive relation between video games and aggression

Conclusion: Video games play a prominent role in boosting the aggressive emotions in children

Intra-operative predictors of difficult cholecystectomy and conversion to open cholecystectomy - a new scoring system

Objective: To evaluate the intra-operative scoring system to predict difficult cholecystectomy and conversion to open surgery

Methods: This descriptive study was conducted from March 2016 to August, 2016 in the Department of Surgery, Shalimar Hospital. The study recruited 120 patients of either gender, age greater than 18 years and indicated for laparoscopic cholecystectomy [LC]. Intra-operatively all patients were evaluated using the new scoring system. The scoring system included five aspects; appearance and adhesion of Gall Bladder [GB], distension or contracture degree of GB, ease in access, local or septic complications, and time required for cystic artery and duct identification. The scoring system ranges from 0 to 10, classified as score of <2 being considered easy, 2 to 4 moderate, 5-7 very difficult, and 8 to 10, extreme. Patient demographic data [i.e. age, gender], co-morbidities, intra-operative scores using the scoring system and conversion to open were recorded. The data was analysed using statistical analysis software SPSS [IBM]

Results: Among one hundred and twenty participants, sixty seven percent were females and the mean age [years] was 43.05 +/- 14.16. Co-morbidities were present in twenty percent patients with eleven diagnosed with diabetes, six with hypertension and five with both hypertension and diabetes. The conversion rate to open surgery was 6.7%. The overall mean intra-operative scores were 3.52 +/- 2.23; however significant difference was seen in mean operative score of converted to open and those not converted to open [8.00 +/- 0.92 Vs. 3.20 V 1.92; p-value = 0.001]. Among eight cases converted to open, three [37.5%] were in very difficult category while five [62.5%] were in extreme category. Moreover, age greater than 40 years and being diabetic were also the risk factors for conversion to open surgery

Conclusion: The new intra-operative scoring system is a valuable assessment tool to predict difficult laparoscopic cholecystectomy and conversion parameters to open surgery and its utility could improve patient's clinical outcome indicated for laparoscopic cholecystectomy

Ethnobotanical, Phytochemical, and Pharmacological Aspects of Melastoma sp

@#Melastoma is a genus that belongs to the Melastomataceae family and consists of 50–70 species distributed around India, Southeast Asia, Australia and the Pacific Island. Numerous species of this plant show potential therapeutic purposes. This review summarizes the scientific findings on the ethnobotanical uses, phytochemistry and pharmacological activities of Melastoma sp. The leaves of Melastoma sp. was widely used by Asian as decoction for the remedy of gastrointestinal disorder apart from root, which was consumed as juice for skin diseases, fever and pain. Majority of the scientific studies focused on M. malabathricum showing high antimicrobial activity towards selected gram-negative and gram-positive bacteria from different parts of the plant. In vitro studies showed that Melastoma sp. possessed anti-coagulant, antioxidant, antiproliferative and immunomodulatory activities. Apart from in vitro, various in vivo studies have been conducted involving methanolic leaf extracts using Sprague Dawley rats for inhibition of anti-ulcer, anti-nociceptive, anti-inflammatory, anti-carcinogenic and anti-diabetic activities. Flavonoids, triterpenes, tannins, saponins and steroids are the main classes of secondary metabolites identified from Melastoma sp. Kaempferol derivatives exhibited significant main constituents from the flowers and leaves using various semi polar solvent extracts. Few phytosterols were also isolated from the leaves extract albeit the absence of alkaloids. This review shows that Melastoma sp. is an important genus of Melastomataceae family, however, the phytochemical and pharmacological findings of various species in this genus are still limited, indicating a great opportunity to explore new therapeutic activities with novel bioactive constituents.

Antimicrobial susceptibility patterns of clinical isolates of Pseudomonas aeruginosa isolated from patients of respiratory tract infections in a Tertiary Care Hospital, Peshawar

Objective: This study aims to determine the prevalence and susceptibility pattern of Pseudomonas aeruginosa and multidrug-resistant [MDR] isolates in patients suffering from respiratory tract infection

Methods: A cross sectional study was conducted from January to December 2014 in Northwest General Hospital and Research Centre, Peshawar. A total of 615 sputum samples were collected from both in and out-patients. Sputum samples were collected as per standard procedure and were inoculated on Blood, MacConkey and Chocolate agar. The isolates were identified by standard protocols using biochemical tests. The antibiotic susceptibility pattern of each isolate was checked as per Clinical and Laboratory Standards Institute [CLSI] guidelines using Kirby- Bauer's disc diffusion method

Results: Out of 615 sputum samples, 354 [57.56%] were culture positive. Out of these a total of 71 [20.05%] strains of Pseudomonas were isolated, where 54.93% was from males and 45.07% were from females [Mean age was 44.29 +/- 22.72]. Highest sensitivity was seen to Amikacin [92.86%] followed by Meropenem [91.55%] while lowest sensitivity was seen to Cefoperazone + Sulbactam [16.9%]. There were 39.44% MDR strains, out of which 25% were Extensively Drug Resistant [XDR] and 10.71% were Pan Drug Resistant [PDR]. In vitro susceptibility of MDR isolates showed highest sensitivity to Amikacin [82.14%] followed by Carbapenems [78.57%]. All MDR isolates were resistant to Cefoperazone + Sulbactam. Resistance to Piperacillin + Tazobactam was 96.43%

Conclusion: Pseudomonas aeruginosa is one of the commonly isolated organisms and it is becoming more resistant to commonly used antibiotics. Carbapenems and aminoglycosides were the two classes of drugs that showed highest activity against Pseudomonas aeruginosa

Exploring Durable Genetic Resistance against Leaf Rust through Phenotypic Characterization and Lr34Linked STS Marker in Wheat Germplasm / Explorando a resistência genética duradoura contra a ferrugem da folha através da caracterização fenotípica e do STS marker relacionado ao (GENE) LR34 do germoplasma do trigo

Present study was aimed to screening the population of 25 wheat genotypes from Baluchistan region of Pakistan along with five commercial cultivars for leaf rust adult plant resistance (APR) through gene postulation using natural inoculation of Puccinia triticina Erikss local pathotype. Infection severity was recorded on scale in comparison with susceptible control "Morroco" cultivar. On the basis of phenotypic score, seven accessions and four varieties (Zardana-89, Sariab-92, Zarlashta-99 and Raskoh-05) with AUDPC values up to 20% were characterized as resistant genotypes. Coefficient of infection (CI) score ranged from 0-10 for some accessions and cultivars showing high level of adult plant resistance. Furthermore, bi-allelic STS marker csLV34 having close linkage with Lr34 (0.4cM). This marker amplified one gene specific allele of 150bp in 21 genotypes, including 19 accessions and two commercial varieties (Sariab-92 and Zarghoon-79) which confirmed presence of Lr34 gene conferring adult plant resistance against leaf rust. The rust pathogenicity scale varied for accessions from resistant to moderately susceptible. However, beside Lr34, phenotypic gene postulation, in combination with marker assisted selection for leaf rust resistance, has revealed presence of some other unknown resistance genes in local wheat germplasm which signified its use in wheat improvement programs both locally and abroad.

O presente estudo teve como objetivo a triagem da população de 25 genótipos de trigo do Baluchistão, região do Paquistão, juntamente com cinco cultivares comerciais para o estudo da resistência à ferrugem da folha em plantas adultas (leaf rust adult plant resistance, APR, em inglês) através da postulação gênica usando a inoculação natural do patótipo local da Puccinia triticina Erikks. A gravidade da infecção foi registrada na escala em comparação ao cultivar de controle suscetível "Morroco". Com base na pontuação fenotípica, sete acessões e quatro variedades (Zardana-89, Sariab-92, Zarlashta-99 and Raskoh-05) com valores de AUDPC (area under the disease progress curve, em inglês) até 20% foram caracterizados como genótipos resistentes. A pontuação do coeficiente de infecção (CI) variou no intervalo de 0-10 para algumas acessões e cultivares evidenciando uma elevada resistência nas plantas adultas. Além disso, o STS marker para o csLV34 bi-alélico demonstrou uma ligação estreita com o Lr34 (0.4cM). Este marcador amplificou um alelo específico do gene do 150bp em 21 genótipos, incluindo 19 acessões e duas variedades comerciais (Sariab-92 and Zarghoon-79) o que confirmou a presença do gene Lr34 conferindo resistência às plantas adultas contra a ferrugem da folha. A escala de patogenicidade da ferrugem para as acessões de resistente a moderadamente suscetível. Contudo, além do Lr34, a postulação gênica fenotípica, em combinação com a seleção auxiliada (ou assistida) por marcadores para a resistência da ferrugem da folha, revelou a presença de outros genes resistentes desconhecidos no germoplasma do trigo local o que justifica a sua utilização em programas de melhoramento do trigo tanto a nível local quanto a nível internacional.

prospective observational study assessing the outcome of Sepsis in intensive care unit of a tertiary care hospital, Peshawar

Objective: The current study aims to explore the factors associated with outcome among patients with severe sepsis and septic shock admitted to the intensive care unit, Northwest General Hospital and Research Centre, Peshawar, Pakistan

Methods: A prospective observational study was carried out at intensive care unit of our hospital from February 2014 to October 2015. Data was collected using a structured format and statistical analysis was done using SPSS version 20®. Regression model was applied to identify the factors contributing to the outcome of severe sepsis and septic shock. P-value less than 0.05 was considered statistically significant

Results: Majority of the patients meeting the criteria of this study were male 147 [54.9%] with a mean age of 54.8. The most common source of sepsis was lung infections [42.2%] followed by urinary tract infections [18.7%], soft tissue infections [6.3%] abdominal infections [6%] and in 6.3% patients the source remained unknown. Further analysis has revealed that increase in number of days of hospitalization was observed to be slightly associated with the outcome of the treatment [1.086 [1.002 - 1.178], 0.046]. Moreover, the risk of mortality was the higher among the patients with septic shock 22.161[10.055 - 48.840], and having respiratory, kidney and central nervous system complications. Overall it is seen that septic shock alone was found responsible to cause death among 32.0% of the patients [Model 1: R2 0.32, p=0.000], and upon involvement of the organ complications the risk of mortality was observed to 42.0%

Conclusion: Chances of recovery were poor among the patients with septic shock. Moreover, those patients having respiratory and urinary tract infection are least likely to survive

Association between 25-hydroxy vitamin D and volumetric breast density via a fully automated software Volpara[Trade Mark] in the reproductive age group

Objective: To determine the association between serum 25 hydroxyvitamin D levels and percent breast density among asymptomatic premenopausal women

Methods:Hundred asymptomatic, pre-menopausal women who visited the General Surgery Breast Clinic, Patel Hospital, Karachi, Pakistan between 3rd March and 10th November, 2015 were included in this study. The serum 25 [OH]D and calcium levels were measured and mammographic density [MD] was assessed using automated volumetric breast density software, Volpara Research [algorithm version 1.5.1, Volpara solutions Ltd, Wellington, NZ] on the same day. The volumetric breast density [VBD] was categorized as; VG1: 0% - 4.5 %; VG2: 4.6% - 7.5%; VG3: 7.6% - 15.5% and VG4 >15.5%. Mean serum 25[OH]D and calcium levels were compared across the four volumetric breast density categories. The percent volumetric density was also correlated with anthropometric measurements and other related variables

Results:No significant difference was found in mean serum 25 [OH]D level across the four groups [15.87 Vs. 12.40 Vs. 8.99 Vs. 9.68; p-value = 0.106]. The percent VBD were found significantly negatively correlated with age [r = - 0.365; p-value = 0.001], weight [r = - 0.575; p-value = 0.001], height [r = - 0.197; p-value = 0.049], and BMI [r = - 0.519; p-value = 0.001]. The serum Vitamin D, and calcium levels were not found significantly correlated with percent VBD [p-value > 0.05]

Conclusion:No significant association exists between serum 25[OH]D level and breast density

Weight Perception among Non-pregnant Urban Malaysian Women: Is It Reliable?

In maternal healthcare, pre-pregnancy weight is used to predict pregnancy outcomes. Since no recorded data on pre-pregnancy weight, perceived weight is used alternatively. This study examines the relationship between perceived and actual weight among non-pregnant urban Malaysian women of childbearing age and identifies differences in perceived and actual weight by selected socio-demographic characteristics. A cross-sectional study was conducted between April and June 2013 among urban Malaysian women attending public health clinics in the Klang Valley. Information on height, perceived current weight and time when their weight was last taken were obtained and actual weight was the average of two measurements (TANITA-HD-323-digital-scale). Socio-demographic data collected were age, ethnicity, education level, marital and employment status and total household income. Mean age of 371 women in this study was 28.81±5.65, 82.2% were Malays, 62.8% had tertiary education, over 75% were married and employed, with more than half from middle-income households. Overall, the mean perceived and actual weight was 59.29±11.59 and 59.20±11.90 respectively. Pearson’s Correlation test showed a very strong positive correlation between perceived and actual weight (r=0.957;p<0.0001), ranging between 0.852 to 0.994 among subgroups; 258 (69.5%) perceived their weight accurately (±2.0 kg of actual weight), 49 (13.2%) under and 64 (17.3%) overestimated their weight. Main outliers were among younger women, Malays, tertiary educated, employed, middle-income and had weight last measured a month or more ago. Strong correlation between perceived and actual weight among women in this study reassured weight perception can be used more confidently in patients’ history taking and future research among urban Malaysian women using public health services.​

Knowledge and awareness about needle stick injuries among dental students of Bolan Medical College, Quetta

One of the most serious threats to Dental students, which they face during their clinical training, is the possibility of exposure to blood borne pathogens by Needle Stick Injuries [NSIs]. Injuries from occupational accidents are associated with the agents of biological risk, as they are the gateway to serious and potentially lethal infectious diseases that can be spread by contact between people. A cross-sectional observational study was carried out among Dental students and House Officers in Dental Section Bolan Medical College, Sandeman Provincial Hospital, Quetta. A total of 100 Dental students and House Officers participated in the study. Out of one hundred 56% were female and 44% were male. The ages of Students and House Officers were between 21-29 years. Majority of the respondents [50%] aged between 21-23 years, and the mean age was 23.6 years. In this study 98% of respondents knew that the transmission of pathogens occurs through needle stick injuries [NSI]. About 83% believed that there is no effective vaccine available against HCV. A majority of participants [69%] knew that recapping of needle prevents the risk of NSI. Data shows that 67% of Students and House Officers had never been exposed to NSI. Results indicated that the students of Bolan Medical College, Quetta had good knowledge and adequate awareness about Needle Stick Injury

Phytochemical analysis of Hibiscus caesius using high performance liquid chromatography coupled with mass spectrometry

Various species in genus Hibiscus are traditionally known for their therapeutic attributes. The present study focused on the phytochemical analysis of a rather unexplored species Hibiscus caesius [H. caesius], using high-pressure liquid chromatography coupled with mass spectrometry [HPLC-MS]. The analysis revealed five major compounds in the aqueous extract, viz. vanillic acid, protocatechoic acid, quercetin, quercetin glucoside and apigenin, being reported for the first time in H. caesius. Literature suggests that these compounds have important pharmacological traits such as anti-cancer, anti-inflammatory, anti-bacterial and hepatoprotective etc. however, this requires further pharmacological investigations at in vitro and in vivo scale. The above study concluded the medicinal potential of H. caesius

Identification and characterization of rhizospheric microbial diversity by 16S ribosomal RNA gene sequencing

In the present study, samples of rhizosphere and root nodules were collected from different areas of Pakistan to isolate plant growth promoting rhizobacteria. Identification of bacterial isolates was made by 16S rRNA gene sequence analysis and taxonomical confirmation on EzTaxon Server. The identified bacterial strains were belonged to 5 genera i.e. Ensifer, Bacillus, Pseudomona, Leclercia and Rhizobium. Phylogenetic analysis inferred from 16S rRNA gene sequences showed the evolutionary relationship of bacterial strains with the respective genera. Based on phylogenetic analysis, some candidate novel species were also identified. The bacterial strains were also characterized for morphological, physiological, biochemical tests and glucose dehydrogenase (gdh) gene that involved in the phosphate solublization using cofactor pyrroloquinolone quinone (PQQ). Seven rhizoshperic and 3 root nodulating stains are positive for gdh gene. Furthermore, this study confirms a novel association between microbes and their hosts like field grown crops, leguminous and non-leguminous plants. It was concluded that a diverse group of bacterial population exist in the rhizosphere and root nodules that might be useful in evaluating the mechanisms behind plant microbial interactions and strains QAU-63 and QAU-68 have sequence similarity of 97 and 95% which might be declared as novel after further taxonomic characterization.

Bioinformatics based structural characterization of glucose dehydrogenase (gdh) gene and growth promoting activity of Leclercia sp. QAU-66

Glucose dehydrogenase (GDH; EC 1.1. 5.2) is the member of quinoproteins group that use the redox cofactor pyrroloquinoline quinoine, calcium ions and glucose as substrate for its activity. In present study, Leclercia sp. QAU-66, isolated from rhizosphere of Vigna mungo, was characterized for phosphate solubilization and the role of GDH in plant growth promotion of Phaseolus vulgaris. The strain QAU-66 had ability to solubilize phosphorus and significantly (p < 0.05) promoted the shoot and root lengths of Phaseolus vulgaris. The structural determination of GDH protein was carried out using bioinformatics tools like Pfam, InterProScan, I-TASSER and COFACTOR. These tools predicted the structural based functional homology of pyrroloquinoline quinone domains in GDH. GDH of Leclercia sp. QAU-66 is one of the main factor that involved in plant growth promotion and provides a solid background for further research in plant growth promoting activities.

Malaysian private general practitioners’ views and experiences on continuous professional development: A qualitative study

Introduction: Continuous professional development (CPD) is an important aspect of a medical practitioner’s career. Aiming to be at par with other developed countries for high quality of professional practice, Malaysia is planning to implement compulsory CPD for the doctors. Aim: The aim of the study was to explore the private general practitioners’ (GPs) views, experiences and needs regarding CPD programme in the primary care service. Methods: This study used a qualitative methodology. Seven semi-structured interviews and three focus group discussions were conducted with private general practitioners from an urban area of Malaysia between January and December 2012. An interview topic guide was developed based on literature review and researchers’ discussions and it was used to guide the interviews. All the interviews were audio-recorded, transcribed verbatim and the transcripts formed the data for analysis using the thematic approach. Results: GPs undertook a wide range of CPD programmes to keep up with medical advances, meet patients’ expectations and improve financial rewards. Conferences, lectures and online recourses were the most mentioned methods of keeping updated. Some of the GPs felt that peer motivation and networking seem to motivate and facilitate participation in CPD programmes. However, they were wary of the validity and relevance of some CPD programmes, particularly those related to pharmaceutical industry. Although the participants agreed to the new mandatory CPD regulation, they voiced concerns on how it would be implemented and wished for a more effective method of monitoring. Conclusions: Organised peer support and relevant CPD content may improve GP participation in CPD but adequate regulatory measure should be in place to monitor the CPD activities.

R. damascena [Rose] is an important drug in unani medicine uses in various ailments since centuries a review

The Rose has given rise to innumerable solar myths both in the east and in the West, one of the prettiest being the well-known story of Gul-i-Bakawli. Dioscorides mentions the astringent properties of rose petals, the use of their ash as a collyrium. The whole plant flower buds, petals, stamens are used for different ailments in Unani System of Medicine since centuries.The Rose water has been considered as mildly astringent, carminative, and refrigerant cardiac tonic and the flowers considered as tonic, laxative, expectorant cardiotonic, good for the eyes, headache, toothache, stomatitis; benefits the lungs, the kidneys, the liver; used in heat of body, chronic fevers inflammation, intestinal affections; excessive perspiration; astringent when dry, strengthening, astringent expectorant; slightly laxative, promotes wounds healing, and scar formation, hemostatic, antiseptic, and anti-inflammatory, anti viral and anti bacterial, sedative, strengthens nerves, aphrodisiac, brain and heart tonic, mufarreh for brain and heart tonic

Arthritis among patients attending GMC hospital, Ajman, UAE: a cross sectional survey

To assess the frequency and contributing factors of arthritis among patients in GMC hospital, Ajman, UAE. A cross sectional study using a self-administered questionnaire was conducted in 304 patients attending the Out-patient departments of GMC hospital. Variables included socio -demographic variables, type and location of arthritis, aggravating and relieving factors. The data was analyzed using IBM SPSS Statistics Version 20. Chi square test was done for associations, p value less than 0.05 is considered to be significant. The total number of patients surveyed 17.4% had arthritis, 18.8% of males and 13.4% of females had arthritis. Patients with the highest BMI had the highest frequency of arthritis [20.4%]. Arthritis was seen in 31.9% of smokers 11.0% of non-smokers highest frequency of arthritis was seen in UAE nationals. The frequency of arthritis increased with increasing age. The most common type of the disease was osteoarthritis at 47.1%. Knee was the most common site of arthritis. The workers in the skilled category had the highest percentage of arthritis. Pain was reported as the most common symptom amongst Arthritis patients. The most common exercise among arthritis patients was walking. The most common aggravating factor was changing position and the least common was temperature. The most common relieving factor was rest and the least common was medication. Among the different management therapies for our arthritis patients, the most commonly used therapy Analgesics. The frequency of arthritis was in about one fifth of our patients. Arthritis was more among smokers and obese individuals. These risk factors can be modified by increasing awareness among patients