12 research outputs found
Childhood Tuberculosis: Evaluation Of Clinical Outcomes And Treatment Compliance In Multicenter Hospitals Of Sindh, Pakistan
No full textPakistan is ranked 11 among the high tuberculosis (TB) burden countries where
TB is rated 6th of top 10 causes of mortality. Although, the national guidelines for the
diagnosis and management of TB in children were established in 2007, but little is
known about the management and treatment outcomes of childhood TB in Pakistan.
For this purpose, children treated under Directly Observed Treatment Short course
(DOTS) at (5) multicentre hospitals of Sindh were recruited as cohort in this
observational study. Total 2,167 children were registered during retrospective phase
from 2011 to 2015 and for prospective phase from 1st June 2016 to 30th November
2016, 508 children were enrolled with TB at the study site. During the study period,
childhood TB accounted 12.2% of all TB cases in Hyderabad, Jamshoro and Matiari
districts. In the present study, 12.1% were bacteriologically confirmed sputum smear
positive cases. At the end of intensive phase, 79.3% of patients achieved sputum smear
conversion. Patients who had household contacts with TB and experienced adverse
effects were significantly less likely to achieve sputum conversion and were more
likely to become sputum positive during the treatment. Around 13.2% of patients came
across with adverse effects. In multivariate analysis females and children with previous
treatment were at greater risk to develop adverse effects due to anti-TB drugs. The
overall treatment success rate was recorded as 93%. Rural residents, sputum smear
positive, children with previous treatment, those who had ADRs and household
contacts with TB emerged as predictors for unsuccessful treatment outcomes
Assessment of WHO/INRUD core drug use indicators at public and private healthcare centres in Lahore, Pakistan: a multicentre cross-sectional study
No full textBackground: A key element of the pharmaceutical care plan is the appropriate use of medications. Objectives: Using the WHO/INRUD core drug use indicators, this study sought to evaluate medication usage trends at both public and private healthcare centres in the Lahore district of the Punjab province of Pakistan. Methodology: A cross-sectional and descriptive study design was adopted. For data collection, 399 prescriptions (199prescriptionsfrom public and 200 prescriptions from private healthcare facilities) were systematically sampled written from February to July 2022. To evaluate the prescription indicator, patient-care and facility-specific indicators, patients randomly selected from both public and private hospitals were examined and interviewed. For each of the WHO/INRUD indicators, we considered ideal criteria that have been published. Results: The average number of medicines prescribed each encounter was reported to be 6.26% in public hospitals and 4.14% in private hospitals among the prescribing indicators, generic medication, antibiotics, and the number of times patients received injections were prescribed, respectively, in 54%, 84%, and 89% of public hospitals and 19%, 61.7%, and 78% of private hospitals. In the public and private sectors, respectively, 71% and 97% of prescription drugs were from the list of essential drugs. The average consultation time was found to be 2.1 minutes in public hospitals and 3.2 minutes in private hospitals, while the average dispensing time was reported to be 37 seconds in public hospitals and 39 seconds in private hospitals. Of the total prescribed medicines, 84% and 97%were dispensed in public and private hospitals respectively and the percent medicine adequately labelled was 100% in both healthcare facilities. Regarding patient awareness, 69% of patients in private hospitals and 42.5% of patients in public hospitals were aware of the proper dosage, frequency, and duration of the medications that were prescribed. In terms of facility-specific data, both public and private hospitals had 100% availability of the EDL copy and 82% stock of the important medications, respectively. Conclusion: Irrational use of drugs was observed in both public and private healthcare facilities. WHO/INRUD proposed 12 key initiatives to encourage rational use of medications must be put into practice as a result of present study
Epidemiology of tuberculosis and treatment outcomes among children in Pakistan: a 5 year retrospective study
No full textBackground Regardless of the advancement in medical technologies, the diagnosis of tuberculosis (TB) in children has remained a challenge. Childhood TB is rampant and an important cause of morbidity and mortality. The objective of this study was to determine the trend of TB and treatment outcomes in children aged ≤14 years registered for TB treatment under DOTS course in three districts of Sindh, Pakistan. Methods For this retrospective study, records of TB children (≤14 years) registered for the treatment of TB from January 2011 to December 2015 in three districts of Pakistan, were collected. Demographic data, baseline weight, clinical manifestations, radiography, histopathology results and treatment outcomes were collected from TB unit registers. Results A total of 2,167 children were treated for TB during the study period. Of these, 1,199 (55.3%) were females and 1,242 (57.3%) were from urban areas. Over three-quarter of patients (76.9%) had pulmonary TB with 13.3% of sputum smear positive cases. The overall treatment success rate was 92.4%. In multivariate analysis, rural residents (OR: 2.146, p < 0.001), sputum smear positive cases (OR: 3.409, p < 0.001) and re-treated patients (OR: 5.919, p < 0.001), were significantly associated with unsuccessful treatment outcomes. However, age group ≤2 years, male and those who were underweight were found to have the highest risk of pulmonary tuberculosis (OR: 1.953, p < 0.001; OR: 1.262, p = 0.028; OR: 1.342, p = 0.008), respectively. Conclusion Patients at risk of treatment failure must be given particular attention. Moreover, strategies are needed to further improve the diagnosis and treatment of TB among children and improve the recording system
A prospective study of socio-demographic, clinical characteristics and treatment outcomes of children with tuberculosis in Sindh, Pakistan
No full textAbstract Background Understanding the explanations behind unsuccessful treatment outcomes in tuberculosis (TB) patients is important to improve treatment success. Treatment completion for TB is the mainstay of TB prevention and control. The study was aimed to assess the treatment outcomes and predictors for unsuccessful outcomes among children with TB. Methods This was a prospective multicenter study conducted in Sindh. Children aged ≤14 years enrolled from June to November 2016 were included. A structured data collection tool was used to gather information with respect to patients’ socio-demographic, clinical and microbiological data. Additionally, to collect the information related to socio-economic and education level of caregivers, validated questionnaire was administered to the caregivers. Treatment outcomes were assessed according to the World Health Organization (WHO) guidelines. The relationship of unsuccessful treatment outcome with socio-demographic and clinical attributes of TB patients was analyzed using logistic regression model. Results Childhood TB represented 19.3% (508/2634) of all TB cases in selected hospitals. Of these, 268/508 (52.8%) were females and one third of the children were aged ≤2 years (34.3%). In multivariate analysis, pulmonary smear positive TB (PTB+) (AOR = 5.910, 95%CI = 1.64–21.29), those with adverse drug reactions (AOR = 11.601, 95%CI = 4.06–33.12) and those who had known TB contacts (AOR = 3.128, 95%CI = 1.21–8.06) showed statistically significant association with unsuccessful treatment outcomes. Conclusions The high proportion of childhood TB cases (19.3%) demonstrates the continuation of TB transmission in the study setting. Furthermore, an increased focus on PTB+ patients, those with adverse drug reactions and household contact with TB is warranted
Patriarchal Practices and Exploitation of Women: Walby\u27s Feminist Reading of Durrani’s Blasphemy
No full textThis study is a comprehensive critical account of Patriarchal Practices and Exploitation of Womanhood by the patriarchal society in the novel “Blasphemy”. Blasphemy, a 1998 novel by Pakistani renowned feminist author Tehmina Durrani, draws inspiration from a real-life incident. This study aims to analyse the patriarchal society in the novel Blasphemy. The study employs qualitative methods and draws on Salvia Walby\u27s theoretical framework in "Theorizing Patriarchy" to analyse the culture of patriarchy and the subjugation of women. Within this framework, the research explores the appalling atrocities committed in the name of religion to oppress women, as depicted in the novel "Blasphemy." Durrani conducts a thorough examination of the misrepresentation of Islam by exploitative religious leaders, highlighting how pseudo-clerics like Pir Sain manipulate Islamic principles to exploit his wife, Heer. Trapped in her husband\u27s brutal and corrupted world, she faces extreme exploitation. Despite Pir Sain proclaiming himself a man of God, his cruel actions towards his wife, other women, his daughter, and his son contradict this facade. This narrative sheds light on how contemporary religious leaders exploit their power and believers\u27 faith for personal gain
Nanoformulations and Clinical Trial Candidates as Probably Effective and Safe Therapy for Tuberculosis
No full textTuberculosis (TB) is the main infectious disease causing 1.8 million deaths worldwide every year and represents a principal cause of mortality resulting from a bacterial infection. The emergence of multidrug-resistant strains and lack of effective anti-TB drugs are threatening the future control of TB. The present multidrug regimen against TB needs daily administration for at least 6 months, and patients often fail to follow this complex regimen for such a long interval, thus leading to patient non-compliance and treatment related side effects. To avoid daily dosing, application of nanotechnology is a promising solution by virtue of sustained drug release. Nanotechnology-based rational targeting may improve therapeutic success by limiting adverse drug effects and requiring less frequent administration regimens, ultimately resulting in higher patient compliance, and thus attain higher adherence levels. Today, the pipeline of potential new treatments consists of several compounds in clinical trials or preclinical development with promising activities against sensitive and resistant Mycobacterium tuberculosis strains. Encapsulation of existing anti-TB drugs into nano-delivery systems and introduction of new drugs in combination treatment for all forms of tuberculosis have resulted in novel treatments with more effectiveness and reduced side effects.Keywords: Tuberculosis, Nanotechnology, Anti-tuberculosis drugs, Nano carriers, Rifampici
Isolation, Characterization, Crystal Structure Elucidation of Two Flavanones and Simultaneous RP-HPLC Determination of Five Major Compounds from Syzygium campanulatum Korth
No full textTwo flavanones named (2S)-7-Hydroxy-5-methoxy-6,8-dimethyl flavanone (1), (S)-5,7-dihydroxy-6,8-dimethyl-flavanone (2), along with known chalcone, namely, (E)-2ʹ,4ʹ- dihydroxy-6ʹ-methoxy-3ʹ,5ʹ-dimethylchalcone (3) and two triterpenoids, namely, betulinic and ursolic acids (4 and 5), were isolated from the leaves of Syzygium campanulatum Korth (Myrtaceae). The structures of compounds (1 and 2) were determined on the basis of UV-visible, FTIR, NMR spectroscopies and LC-EIMS analytical techniques. Furthermore, new, simple, precise, selective, accurate, highly sensitive, efficient and reproducible RP-HPLC method was developed and validated for the quantitative analysis of the compounds (1–5) from S. campanulatum plants of five different age. RP-HPLC method was validated in terms of specificity, linearity (r2 ≤ 0.999), precision (2.0% RSD), and recoveries (94.4%–105%). The LOD and LOQ of these compounds ranged from 0.13–0.38 and 0.10–2.23 μg·mL−1, OPEN ACCESS respectively. Anti-proliferative activity of isolated flavanones (1 and 2) and standardized extract of S. campanulatum was evaluated on human colon cancer (HCT 116) cell line. Compounds (1 and 2) and extract revealed potent and dose-dependent activity with IC50 67.6, 132.9 and 93.4 μg·mL−1, respectively. To the best of our knowledge, this is the first study on isolation, characterization, X-ray crystallographic analysis of compounds (1 and 2) and simultaneous RP-HPLC determination of five major compounds (1–5) from different age of S. campanulatum plants
Machine learning-based electricity theft detection using support vector machines
No full textElectricity theft is a serious issue that many nations face, especially in developing areas where non-technical losses can make up a significant percentage of the overall losses sustained by utilities. Electricity theft detection (ETD) is a very challenging task because it frequently introduces irregularities in customer electricity consumption patterns. In recent times, machine learning (ML) techniques have been investigated as a potential solution for ETD. In this research, author propose electricity theft detection based on four kernel functions of support vector machines (SVM). The proposed method analyzes the electricity consumption patterns and then predicts the category of the user. The kernel functions utilized includes polynomial, sigmoid, radial basis function (RBF) and linear kernel function. For experimentation and model training, a dataset of Pakistani utility company is used, which contains the electricity consumption information. The results highlight SVM method works well for accurate ETD. The detection accuracy of the various kernel functions of SVM is 83%, 79%, 80%, and 76% for RBF, polynomial, sigmoid, and linear kernel functions, respectively, demonstrating the effectiveness of the proposed SVM-based method for theft detection. By leveraging these ML-based methods, utility companies can strengthen their ability to detect and prevent electricity theft, leading to improved revenue management and dependability of services
Corporate social responsibility: A key driver of sustainable development in China's post-COVID economy.
No full textThe first goal of this research was to measure the impact of corporate social responsibility (CSR) on the sustainable development of an organization. However, the second objective examines the moderating influence of government policies, cultural norms, and stakeholder expectations on the relationship between CSR and an organization's sustainable development. This research primarily focused on the enterprises operating in the energy industry in Beijing. A sample of 498 individuals holding management positions within these enterprises was collected. The study's results established that CSR significantly influences the sustainable development of firms. Moreover, the results revealed that governmental regulations, cultural norms, and stakeholder expectations play a significant and positive role in moderating the impact of corporate social responsibility on the sustainable development of companies. The results of this study make a valuable contribution to the existing body of literature on CSR and its impact on the sustainable performance of enterprises in China
Isolation, Characterization, Crystal Structure Elucidation of Two Flavanones and Simultaneous RP-HPLC Determination of Five Major Compounds from Syzygium campanulatum Korth
No full textTwo flavanones named (2S)-7-Hydroxy-5-methoxy-6,8-dimethyl flavanone (1), (S)-5,7-dihydroxy-6,8-dimethyl-flavanone (2), along with known chalcone, namely, (E)-2ʹ,4ʹ- dihydroxy-6ʹ-methoxy-3ʹ,5ʹ-dimethylchalcone (3) and two triterpenoids, namely, betulinic and ursolic acids (4 and 5), were isolated from the leaves of Syzygium campanulatum Korth (Myrtaceae). The structures of compounds (1 and 2) were determined on the basis of UV-visible, FTIR, NMR spectroscopies and LC-EIMS analytical techniques. Furthermore, new, simple, precise, selective, accurate, highly sensitive, efficient and reproducible RP-HPLC method was developed and validated for the quantitative analysis of the compounds (1–5) from S. campanulatum plants of five different age. RP-HPLC method was validated in terms of specificity, linearity (r2 ≤ 0.999), precision (2.0% RSD), and recoveries (94.4%–105%). The LOD and LOQ of these compounds ranged from 0.13–0.38 and 0.10–2.23 μg·mL−1, OPEN ACCESS respectively. Anti-proliferative activity of isolated flavanones (1 and 2) and standardized extract of S. campanulatum was evaluated on human colon cancer (HCT 116) cell line. Compounds (1 and 2) and extract revealed potent and dose-dependent activity with IC50 67.6, 132.9 and 93.4 μg·mL−1, respectively. To the best of our knowledge, this is the first study on isolation, characterization, X-ray crystallographic analysis of compounds (1 and 2) and simultaneous RP-HPLC determination of five major compounds (1–5) from different age of S. campanulatum plants
