MATERIALS AND METHODS: A cross-sectional online study using a validated questionnaire was distributed to doctors (MD), assistant medical officers (AMO), and staff nurses (SN) at an urban tertiary Emergency Department. It comprised of 40 knowledge and 10 confidence-level questions related to resuscitation and airway management steps.
RESULTS: A total of 135 from 167 eligible EHCW were enrolled. 68.9% (n = 93) had high knowledge while 53.3% (n = 72) possessed high confidence level. Overall knowledge mean score was 32.96/40 (SD = 3.63) between MD (33.88±3.09), AMO (32.28±4.03), and SN (32.00±3.60), P= 0.025. EHCWs with a length of service (LOS) between 4-10 years had the highest knowledge compared to those with LOS <4-year (33.71±3.39 versus 31.21±3.19 P = 0.002). Airway-related knowledge was significantly different between the designations and LOS (P = 0.002 and P = 0.003, respectively). Overall, EHCW confidence level against LOS showed significant difference [F (2, 132) = 5.46, P = 0.005] with longer LOS showing better confidence. MD showed the highest confidence compared to AMO and SN (3.67±0.69, 3.53±0.68, 3.26±0.64) P = 0.049. The majority EHCW were confident in performing high-quality chest-compression, and handling of Personal Protective Equipment but less than half were confident in resuscitating, leading the resuscitation, managing the airway or being successful in first intubation attempt.
CONCLUSIONS: EHCW possessed good knowledge in airway and resuscitation of COVID-19 patients, but differed between designations and LOS. A longer LOS was associated with better confidence, but there were some aspects in airway management and resuscitation that needed improvement.
OBJECTIVE: In this study, we report a rapid method for the residue analysis of IND and its metabolites, viz., IND-carboxylic acid, diaminotriazine, and triazine indanone in a wide range of palm oil matrices using liquid chromatography-tandem mass spectrometry (LC-MS/MS).
METHOD: The optimized sample preparation workflows included two options: (1) acetonitrile extraction (QuEChERS workflow), followed by freezing at -80°C and (2) acetonitrile extraction, followed by cleanup through a C18 solid phase extraction (SPE) cartridge. The optimized LC runtime was 7 min. All these analytes were estimated by LC-MS/MS multiple reaction monitoring.
RESULTS: Both sample preparation methods provided similar method performance and acceptable results. The limit of quantification (LOQ) of IND, IND-carboxylic acid, and triazine indanone was 0.001 mg/kg. For diaminotriazine, the LOQ was 0.005 mg/kg. The method accuracy and precision complied with the SANTE/12682/2019 guidelines of analytical quality control.
CONCLUSIONS: The potentiality of the method lies in a high throughput analysis of IND and its metabolites in a single chromatographic run with high selectivity and sensitivity. Considering its fit-for-purpose performance, the method can be implemented in regulatory testing of IND residues in a wide range of palm oil matrices that are consumed and traded worldwide.
HIGHLIGHTS: This work has provided a validated method for simultaneous residue analysis of indaziflam and its metabolites in crude palm oil and its derived matrices with high sensitivity, selectivity, and throughput.
OBJECTIVE: The objective of this study was the quantitative analysis of the alkaloid content of areca chewable products from different countries and regions using HPLC-UV, as well as the benefit of their safety evaluation products.
METHOD: An HPLC-UV method was established for qualitative and quantitative analyses of 65 batches of areca chewable products from different countries and regions. Additionally, similarity evaluation of chromatographic fingerprints was applied for data analysis.
RESULTS: These results reveal a significant variation in the levels of areca alkaloids among tested products, specifically guvacoline (0.060-1.216 mg/g), arecoline (0.376-3.592 mg/g), guvacine (0.028-1.184 mg/g), and arecaidine (0.184-1.291 mg/g). There were significant differences in the alkaloid content of areca chewable products from different producing areas.
CONCLUSIONS: The method will be useful in the safety evaluation of different areca chewable products.
HIGHLIGHTS: The established HPLC-UV method can be adopted for safety evaluation of areca chewable products from different countries and regions due to its general applicability.
METHODS: A cross-sectional study was conducted among 295 medical doctors and staff nurses from June to December 2015. Simple random sampling was applied. The data were collected using a self-administered questionnaire and analyzed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, NY, USA). Descriptive statistics and logistic regression analysis were performed.
RESULTS: The prevalence of unsuccessful exclusive breastfeeding among the study participants was 58.3%. Mothers who preferred formula milk (odds ratio [OR], 4.40; 95% confidence interval [CI], 1.45-13.31) delivered via lower segment cesarean section (OR, 2.31; 95% CI, 1.07-4.98) and produced inadequate breast milk (OR, 4.06; 95% CI, 2.40- 6.89) were significantly associated with unsuccessful exclusive breastfeeding.
CONCLUSION: The prevalence of unsuccessful exclusive breastfeeding among the study participants was high. Maternal characteristics such as preference towards formula milk, mode of delivery and adequacy of breast milk must be assessed to prevent unsuccessful exclusive breastfeeding among healthcare providers.
MATERIALS AND METHODS: This cross-sectional survey-based study comprised 1,000 adults residing in Pakistan. A questionnaire was formulated and circulated among adult population of Pakistan, the depression and anxiety symptoms using Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) scales were assessed.
STATISTICAL ANALYSIS: Independent t-test, cross tabulation, and regression analysis were used to identify variables having impact on PHQ-9 and GAD-7 scores. A p-value of ≤ 0.05 was considered statistically significant.
RESULTS: Among 1,000 participants, 573 were males and 427 were females who completed the survey. Majority were restricted to home for more than 40 days. Considerable number of participants reported depressive (540, 54%) and anxiety (480, 48%) symptoms. Gender, age, earnings, and occupation have significant relation with psychological distress, although similar was not found with education levels.
CONCLUSION: Psychological distress, a concerning yet addressable issue was found among adults arising amid COVID-19 outbreak. Currently, physical health effects of COVID-19 are being looked, while mental health effects being under-addressed. This issue should be addressed to avoid any psychological impact in future.
METHODS: A modified Delphi study was used. A total of 70 statements were presented, using an online platform, over three consensus-seeking rounds, to participants with experience in the hospital care of patients with acute vertebral fragility fractures from UK-based specialist societies. Participants rated the level of their agreement with each statement on a 5-point Likert scale. Consensus was defined at 70% of respondents choosing either agree/strongly agree or disagree/strong disagree. Over the first two rounds, statements not reaching consensus were modified in subsequent rounds, and new statements proposed by participants and agreed by the research team could be added.
RESULTS: There were 71 participants in the first round, 37 in the second round and 28 (most of whom were geriatricians) in the third round. Consensus was reached in 52 statements covering fracture diagnosis, second-line imaging, organisation of hospital care, pain management and falls and bone health assessment. Consensus was not achieved for whether vertebral fragility fractures should be managed in a specific clinical area.
DISCUSSION: These findings provide the basis for the development of clinical guidelines and quality improvement initiatives. They also help to justify research into the merits of managing acute vertebral fragility fracture patients in a specific clinical area.