In a remarkable transformation, the landscape of medical science, including Orthopaedic and Spine care, is rapidly evolving. Even in regions like Pakistan, characterized as third-world countries, ...healthcare is swiftly adopting the latest techniques, technologies, and research predominantly originating from the Western world. The origins of Orthopaedic Surgery in Pakistan trace back to the era when General Surgeons initially handled these responsibilities. However, the true development of Orthopaedic specialization began in the 1970s when the necessity for dedicated Orthopaedic treatment became evident. This marked the inception of the Orthopaedic era in the country. By the early 2000s, many medical professionals opted for this specialization, leading to a saturation point that paved the way for sub-specializations within Orthopaedics. These sub-specialities include Periotic, Trauma, Hand, Oncology, Arthroplasty, Sports, and Spine.1 Between 2000 and 2015, these sub-specialties also progressed to a saturation point, prompting a demand for even more specialized expertise. Over the past 5 to 8 years, each sub-speciality has further fragmented, with individuals or teams dedicated to refining systems that provide superior management of pathologies, thus enhancing prognoses and patient outcomes.2 This evolution has seen the emergence of both sub-specialties and super-specialties, reflecting the contemporary medical practice needs. The trajectory is clear: as exposure and practical experience accumulate, a cadre of experts will naturally emerge within these specialized domains.
The domain of Spine specialization, once regarded with apprehension due to its challenging nature and variable outcomes, has been revolutionized by integrating cutting-edge technology, advanced surgical techniques, and in-depth research. Distinct categories within the Spine speciality have emerged, spanning Trauma, Oncology, Deformity Correction, Degenerative Spine, and Infection.3 These intricate surgeries are now performed using minimally invasive techniques, informed by meticulous research prioritizing anatomical precision. These advancements involve smaller incisions, real-time X-ray guidance, and even endoscopic approaches for enhanced operative field visualization. This curtails inflammatory responses and expedites patient recovery, facilitating earlier discharge from medical facilities.
A noteworthy addition to Pakistan’s Spine surgery landscape is the introduction of Endoscopic Spine Surgery. Over the past half-decade, many Neuro and Orthopaedic Spine Surgeons have sought training in this cutting-edge super-specialty. The procedure offers substantial advantages such as same-day patient discharge and quicker return to normal routines. Presently, only a handful of centres in the country provide this innovative treatment modality, marking a significant stride in Spine care.
In Pakistan, child abuse has risen alarmingly, i.e., 30% of cases from 2020-2021 statistics.1 WHOcomprehensively drafts the definition as, "Child abuse or maltreatment constitutes all forms of ...physical and oremotional ill-treatment, sexual abuse, neglect or negligent treatment, or commercial or other exploitation,resulting in actual or potential harm to the child’s health, survival, development or dignity in the context of arelationship or responsibilities, trust or power." There is an urgent need to address these issues in the prevention,psychotherapeutic treatment and rehabilitation of such victims and suffering. On the contrary, there will be ascary consequence. According to WHO, about 1 billion old children (2-17 years) across the globe are subjectedto physical, sexual, or emotional harm by their caregivers or strangers Violence or abuse does not haveboundaries of country, religion, class, or gender.2 At the same time, the related stigma keeps it underreported.Every year, around 500 million children suffer from abuse. In the USA, more than 3 million cases are reported,causing 2000 deaths and 18000 permanent disabilities, the victim results every year. The count for sexuallymolested girls is 1 in 4, and for boys, it is 1 in 7.3 In New Delhi, Child abuse is 8 in 10 kids, whereas boys (7 in10 kids) are more vulnerable than girls (6.5 in 10 kids).4 The percentage of sexual abuse in India is 52% onlyadmitted patients annually, whereas statistics for unreported and other molestation are unknown.5 In Sri Lanka,more than 40000 children were involved in prostitution, where children are used by paedophile sex tourists.6In an unofficial report, every year , somewhat 15-20% of children are sexually abused in Pakistan. According toan NGO, there is a rise of 2 to 10 reported cases of Child Sexual Abuse (CSA) per day in the upcoming year,whereas the actual numbers would be much higher because CSA is culturally veiled. They documented that bothgenders were equally victimized, although 0-5 years of CSA victims were mostly boys. The perpetratorsincluded close family ties and acquaintances, marking an increase in per year cases reported. Out of a total 3852number of CSA cases, 2211 (51%) were from Punjab. A total number of 92 cases were reported murder after theassault.7According to the latest study, the amygdala in the brain shrinks with repeated trauma, resulting in delayedlearning abilities and deficient memory.8 Depression, isolation, and delinquency are a few more to enumerate.There are physical, behavioural and emotional indicators of abuse that a physician must be able to identify,address and refer to a psychologist for professional treatment. The prevention measures of awareness, trainingfor parenting, character building of parents and psychological treatment can prevent and decrease a victim’ssuffering. The only way to prevent CSA is to educate and spread awareness against this act on two levels. One iseducating parents and teachers, and the other is making the child aware of the good and bad touch. In this regard,the P AAC group has worked. They have prepared useful brochures to protect the child from encountering theissue. The whole structure of society needs renovation, and the best renovation is building attributes based on thepsychological training present in the seerah of the Prophet (SAW) and his companions.
Universal health coverage means every person has access to quality health care without suffering financial hardships. The basis of universal health coverage lies in the primary health care concept, ...which was envisioned way back in 1978, as mentioned in Alma Ata Declaration1. The "World Health Report" published by the World Health Organization (WHO) in 2008 structures primary health care reforms in four groups. One of the crucial reforms was universal coverage reform to improve health equity2. WHO and UNICEF in 2018 documented how primary health care will be in the 21st century? The approach was towards universal health coverage and sustainable development goals. Sustainable development goals were to be achieved by 2030, and they were a continuation of millennium development goals 2000–20153. The resolution on Transforming our world: the 2030 Agenda for Sustainable Development adopted the target of universal health coverage by 2030, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicines and vaccines for all4. Currently, many developing nations do not have access to health services. About 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health. To make health for all, we need individuals and communities to have high-quality health services to take care of their families health. Skilled health workers providing quality, people-centred care and policy-makers should be committed to investing in universal health coverage. Universal health coverage should be based on intense, people-centred primary health care. Good health systems are rooted in the communities they serve. They focus not only on preventing and treating disease and illness but also on helping to improve well-being and quality of life5. Pakistan, the developing country, is struggling to provide good quality health services, mostly availed from the out-of-pocket expenditure.
Both private and public sector hospitals were trying to deliver health services, but poor people failed to have access to many services due to poverty. To overcome this obstacle and address indicator 3.8 of SDGs, the current government developed a five-year program to improve the targeted population's health by increasing their access to quality health services. The initiative will also reduce poverty, as the government will cover most of their health budget through the "Sehat Sahulat Program". The program was part of the National vision to ensure Universal Health Coverage (UHC) for all Pakistani families. No one is denied quality healthcare services only because of financial constraints. Initially, it was piloted in selected four districts of Khyber Pakhtunkhwa, which was later extended to all over the province. Currently, 7.2 million families are getting free in-patient health care services, and the program's annual cost is 18 billion. It was a bold initiative of the current government, which helped improve access to UHC, thus addressing one of the sustainable development goals6,7.
To maintain the wellbeing of the human gut, the role of its microflora and their metabolites is fundamental. Probiotics is a Greek term, which is used to define non-living microbes that are ...beneficial in nature and exert numerous advantages on the host body. The intestinal microflora’s function and activity may also be improved by administering some of the prebiotics (indigestible dietary fibers) independently or in a c combination with probiotics. The term “Synbiotics” is used to denote the combination of both prebiotics and probiotics. It should always be noted that numerous disorders are being associated with the abnormal function of microbiota/microflora that can be regulated and stabilized with the help of ingestion of probiotics, prebiotics or their combination. Multiple benefits are associated with the use of these probiotics, synbiotics and prebiotics including healthier digestive system, proper immune response of the gut and treatment of numerous GI tract disorders. All these issues are encountered because of treatments with new synthetic drugs that affect the digestive system as well as numerous organs in the body. Ulcerative colitis is a term that refers to chronic inflammation of the colon emerging as a result of improper immune response to intestinal microflora of the host. Researchers have studied the effects of synbiotics to treat this chronic condition1. As for the action mechanism of the synbiotics is concerned, it is assumed that they modulate the inflammatory response through expression of the cytokines, probiotic bacteria assisted modulation of the immune cells and prebiotics assisted production of certain short chain fatty acids. Jayanama and Theou studied the consequences of improper ingestion of probiotics and prebiotics in elderly patients. They revealed that physical inactivity, sarcopenia, and polypharmacy could be treated with the help of probiotics, prebiotics or a combination of both2. All the aforementioned disorders can lead to gut dysbiosis.
The researchers have also revealed that the gut microbiota homeostasis can be improved with the help of probiotics and prebiotics and they can be a helping hand in the prevention of aging and frailty. It is evident that left and right prescriptions of antibiotics and their use caused antibiotic resistance in the pathogens. This issue can be best resolved with the ingestion of probiotics and prebiotics. The systematic evidence to treat infected chronic wounds has been provided by Brognara et al3. Similarly, chronic wounds and burns treatment is done widely with the use of Lactobacillus plantarum. Some other researchers have reviewed the available data associated with the use of numerous prebiotics in the treatment of idiopathic constipation, and highly prevalent GIT disorrderrs4-6. This is due to the capability of prebiotics to improve the consistency of the stool, bloating and number of bowel movements. A limited data is available regarding the efficacy of prebiotics in the treatment of ulcerative colitis and pouchitis. It is concluded that probiotics, prebiotics and synbiotics have been imparting a role in treating GIT disorders including indigestion, traveler’s diarrhea, IBD etc. Scientific reports have revealed their role in the treatment of cancerous disease, obesity, kidney and brain disorders. Many tools for the research of probiotics, prebiotics and synbiotics are now available; therefore, the future bio-therapeutics are going to be changed with the passage of time.
The imams (experts in Ahadith) and (critical) scholars of hadith sciences made great efforts in preserving the hadith. They collected the texts and chains (asnaad) and explained the conditions of the ...narrators in detail. They recorded for posterity not only the exact wording of the hadith but also took pains to elaborate on the differences of the narrators in the chains. They revealed the difference between narrators in the “Isnads” and the wording of the hadith. They collected the hadiths that were reasoned “Ahadees e Ma’alola” in private books and distinguished the correct from the defective, but they did not state the reasons for the Caused “Illat”. Most of the time, they did not show the presumptions of Weighting clues. Some of them accepted it (Siqa) sometimes for/as evidence, and returned/rejected on other occasions. This is the approach of the advanced scholars in the field; they neither accept nor reject it fully. However, a theoretical account of clues by which a scholar of hadith is to accept or reject the increase is not explicitly mentioned by forerunners in the tradition of hadith scholarship. Rather, these clues are implicit in their rulings on the hadiths and can be explained in detail by exploring the conditions o the narrators. Among these critics and imams of illal, Sheikh Al-Dari Qutni is well-known for his experience and understanding of the science (of illal). The researchers aim to highlight the reasons behind the acceptance or rejection, total or partial, of the increase. For this, the methodology of these rulings on the hadiths with increase confidence is analyzed in detail. This, in turn, will highlight the clues by which Al-Dari Qutni accepts siqa or rejects it.
According to United Nations Educational, Scientific and Cultural Organization (UNESCO)1, 850 million children and young adults are out of education or training because of the COVID-19 pandemic. In ...many countries, this has resulted in a shift from traditional in-person learning to online learning. However, online learning is not new in developed countries. Many universities had ventured since long into online education with some courses offered as a supplement to in-person teaching. Pakistan is one of the countries lacking both accessibility and infrastructure for this major transition2. Hence there is a need to examine the current challenges and the impact on our students.
There will be certainly an increase in educational inequalities and the setback will last for a long-time affecting employment and income especially for those coming from underdeveloped areas. As regards medical students, this pandemic presents the greatest practical and logistical challenge3. It has disrupted medical education, requiring intense and prompt attention from medical educators. These challenges have affected patient care due to focusing attention on COVID-19 patients, which has severely limited the availability of bedside teaching opportunities for medical students4. Resultantly they are unable to complete clerkships and lack direct patient care experience. To make online education more inclusive, institutions need to ensure that learners benefit from technologies and have access to the Internet. Smartphone use has increased manifold in our country, and it can be easily used for online learning, which is a good replacement for laptops. Surveys focusing on accessibility to the Internet, laptops/tablets/smartphones can provide a platform, involving stakeholders who can help students who have limited or no access5. The college IT department should be involved which should help students with issues that come up during e-learning. Although e-learning is not an alternative to hospital rotations, yet it can help continue medical education through access to clinical videos and other online resources focusing on clinical scenarios and examination techniques. We need to ensure teachers’ training for the unique demands that online teaching poses. Many strategies have been developed for improving the quality of online teaching and engaging students. These include interacting with students, encouraging student’s participation by giving more open-ended questions, sharing videos focusing on examination techniques and different clinical scenarios, providing clear directions at the start of the session, and providing students with emotional support in this time of crisis. We should not forget that students’ attitudes are influenced by the support they receive from families and teachers. As teachers, we play an important role in the development of positive attitudes and providing students with emotional support6. There is a need for specific guidelines for online medical education framed by Pakistan Medical Council for implementing e-learning. With this sudden shift, away from the classroom in many parts of the world, some are wondering whether the adoption of online learning will continue to persist post-pandemic. For teachers, it is an opportunity to implement this teaching and learning methodology in our medical schools and training institutions whereas for students it is an opportunity to make use of e-learning for deriving maximum benefit thus preparing us for an unforeseeable situation in the future.
The ultimate objectives of shariah have been indicated (stated) in numerous verses of the Holy Quran and in the sacred traditions of Holy profit (SAWS) and a set of reforms have been highlighted for ...enforcement as a purpose of divine commands. Brillscholars and stalwarts of Islamic sciences like Imam Ghazali, Allama Azzedine bin Abdus salam Allama ibn e Qayyum, Allama Shatbi, and imam Shah Wali Ullah R.A have rendered their valuable services in the above-mentioned domain. This article is an introductory study of that knowledge and in the article significance and essentiality of the purposes of shariah have been explained after detailed interpretations of these purposes. Opinions of ancient and modern experts of the concerned field of knowledge have also been incorporated. Finally, various types of objectives of shariah have been debated.
In this era of startling developments in the medical field there remains a serious worry about the hazardous potential of various by products which if not properly addressed can lead to ...consequences of immense public concern. Hospitals and other health care facilities generate waste products which are evidently hazardous to all those exposed to its potentially harmful effects. Need for effective legislation ensuring its safe disposal is supposed to be an integral part of any country's health related policy. This issue is of special importance in developing countries like Pakistan which in spite of framing various regulations for safeguarding public health, seem to overlook its actual implementation. The result unfortunately is the price wehave to pay not only in terms of rampant spread of crippling infections but a significant spending of health budget on combating epidemics which could easily have been avoided through effective waste disposal measures in the first place. Waste classified under the heading 'bio-hazardous' includes any infectious or potentially infectious material which can be injurious or harmful to humans and other living organisms. Amongst the many potential sources are the hospitals or other health delivery centres which are ironically supposed to be the centres of infection control and treatment. Whilst working in these setups, health care workers such as doctors, nurses, paramedical staff and sanitation workers are actually the ones most exposed and vulnerable to these challenges. Biomedical waste may broadly be classified into Infectious and toxic waste. Infectious waste includes sharps, blood, body fluids and tissues etcwhile substances such as radioactive material and by-products of certain drugs qualify as toxic waste. Furthermore health institutions also have to cater for general municipal waste such as carton boxes, paper and plastics. The World Health Organisation has its own general classification of hospital waste divided into almost eight categories of which almost 15% (10% infectious and 5% toxic) is estimated to be of a hazardous nature while the remaining 85% is general non hazardous content.1A recent study from Faisalabad, Pakistan has estimated hospital waste generation around 1 to 1.5 kg / bed /day for public sector hospitals in the region,2while figures quoted from neighbouring India are approximately 0.5 to 2 KG / hospital bed /day.3 Elsewhere in the world variable daily hospital waste production has been observed ranging from as low as 0.14 to 0.49 kg /day in Korea4 and 0.26 to 0.89 kg/day in Greece5to as high as 2.1 to 3.83 kg/day in Turkey6 and 0.84 to 5.8 kg/day in Tanzania.7Ill effects of improper management of hospital waste can manifest as nosocomial infections or occupational hazards such as needle stick injuries. Pathogens or spores can be borne either through the oro-faecal or respiratory routes in addition to direct inoculation through contact with infected needles or sharps. Environmental pollution can result from improper burning of toxic material leading to emission of dioxins, particulate matter or furans into the air. The habitat can also be affected by illegal dumping and landfills or washing up of medical waste released into the sea or river. Potential organisms implicated in diseases secondary to mismanagement of hospital waste disposal include salmonella, cholera, shigella, helminths, strep pneumonia, measles, tuberculosis, herpesvirus, anthrax, meningitis, HIV, hepatitis and candida etc. These infections can cause a considerable strain on the overall health and finances of the community or individuals affected. The basic principal of Public health management i.e 'prevention is better than cure' cannot be more stressed in this scenario as compared to any other health challenge. Health facilities must have a clear policy on hazardous waste management. To ensure a safe environment hospitals need to adopt and implement international and local systems of waste disposal. Hospital waste management plan entails policy and procedures addressing waste generation, accumulation, handling, transportation, storage, treatment and disposal. Waste needs to be collected in marked containers usually colour coded and leak proof. Segregation at source is of vital importance. The standard practice in many countries is the Basic Three Bin System ie to segregate the waste into RED bags/ boxes for sharps, YELLOW bags for biological waste and BLUE or BLACK ones for general/ municipal waste. All hospital staff needs to be trained in the concept of putting the right waste in relevant containers/ bags. They need to know that more than anything else this practice is vital for their own safety. The message can be reinforced through appropriate labelling on the bins and having posters with simple delineations to avoid mixing of different waste types. Sharps essentially should be kept in rigid, leak and puncture-resistant containers which are tightly lidded and labelled. Regular training sessions for nurses and cleaning staff can be organised as they are the personnel who are more likely to deal with waste disposition at the level of their respective departments. Next of course is transportation of waste products to the storage or disposal. Sanitary staff and janitors must be aware of the basic concepts of waste handling and should wear protective clothing, masks and gloves etc, besides ensuring regular practice of disinfection and sterilization techniques.8Special trolleys or vehicles exclusively designed and reserved for biomedical waste and operated by trained individuals should be used for transportation to the dumping or treatment site. Biomedical waste treatment whether on site or off site is a specialised entity involving use of chemicals and equipment intended for curtailing the hazardous potential of the material at hand. Thermal treatment via incinerators, not only results in combustion of organic substances but the final product in the form of non-toxicash is only 10 to 15% of the original solid mass of waste material fed to the machine. Dedicated autoclaves and microwaves can also be used for the purpose of disinfection. Chemicals such as bleach, sodium hydroxides, chlorine dioxide and sodiumhypochlorite are also effective disinfectants having specialised indications. Countries around the world have their own regulations for waste management. United Kingdom practices strict observance of Environmental protection act 1990, Waste managementlicensing regulations 1994 and Hazardous waste regulations 2005 making it one of thesafest countries in terms of hazardous waste disposal. Similar regulations specific for each state have been adopted in United States following passage of the Medical Waste tracking act 1988. In Pakistan, every hospital must comply with the Waste Management Rules 2005 (Environment Protection Act 1997), though actual compliance is far from satisfactory. It is high time that the government and responsible community organisations shape up to seriously tackle the issue of bio hazardous waste management through enforcement of effective policies and standard operating procedures for safeguarding the health and lives of the public in general and health workers in particular.
In this era of startling developments in the medical field there remains a serious worry about the hazardous potential of various by products which if not properly addressed can lead to ...consequences of immense public concern. Hospitals and other health care facilities generate waste products which are evidently hazardous to all those exposed to its potentially harmful effects. Need for effective legislation ensuring its safe disposal is supposed to be an integral part of any country's health related policy. This issue is of special importance in developing countries like Pakistan which in spite of framing various regulations for safeguarding public health, seem to overlook its actual implementation. The result unfortunately is the price wehave to pay not only in terms of rampant spread of crippling infections but a significant spending of health budget on combating epidemics which could easily have been avoided through effective waste disposal measures in the first place. Waste classified under the heading 'bio-hazardous' includes any infectious or potentially infectious material which can be injurious or harmful to humans and other living organisms. Amongst the many potential sources are the hospitals or other health delivery centres which are ironically supposed to be the centres of infection control and treatment. Whilst working in these setups, health care workers such as doctors, nurses, paramedical staff and sanitation workers are actually the ones most exposed and vulnerable to these challenges. Biomedical waste may broadly be classified into Infectious and toxic waste. Infectious waste includes sharps, blood, body fluids and tissues etcwhile substances such as radioactive material and by-products of certain drugs qualify as toxic waste. Furthermore health institutions also have to cater for general municipal waste such as carton boxes, paper and plastics. The World Health Organisation has its own general classification of hospital waste divided into almost eight categories of which almost 15% (10% infectious and 5% toxic) is estimated to be of a hazardous nature while the remaining 85% is general non hazardous content.1A recent study from Faisalabad, Pakistan has estimated hospital waste generation around 1 to 1.5 kg / bed /day for public sector hospitals in the region,2while figures quoted from neighbouring India are approximately 0.5 to 2 KG / hospital bed /day.3 Elsewhere in the world variable daily hospital waste production has been observed ranging from as low as 0.14 to 0.49 kg /day in Korea4 and 0.26 to 0.89 kg/day in Greece5to as high as 2.1 to 3.83 kg/day in Turkey6 and 0.84 to 5.8 kg/day in Tanzania.7Ill effects of improper management of hospital waste can manifest as nosocomial infections or occupational hazards such as needle stick injuries. Pathogens or spores can be borne either through the oro-faecal or respiratory routes in addition to direct inoculation through contact with infected needles or sharps. Environmental pollution can result from improper burning of toxic material leading to emission of dioxins, particulate matter or furans into the air. The habitat can also be affected by illegal dumping and landfills or washing up of medical waste released into the sea or river. Potential organisms implicated in diseases secondary to mismanagement of hospital waste disposal include salmonella, cholera, shigella, helminths, strep pneumonia, measles, tuberculosis, herpesvirus, anthrax, meningitis, HIV, hepatitis and candida etc. These infections can cause a considerable strain on the overall health and finances of the community or individuals affected. The basic principal of Public health management i.e 'prevention is better than cure' cannot be more stressed in this scenario as compared to any other health challenge. Health facilities must have a clear policy on hazardous waste management. To ensure a safe environment hospitals need to adopt and implement international and local systems of waste disposal. Hospital waste management plan entails policy and procedures addressing waste generation, accumulation, handling, transportation, storage, treatment and disposal. Waste needs to be collected in marked containers usually colour coded and leak proof. Segregation at source is of vital importance. The standard practice in many countries is the Basic Three Bin System ie to segregate the waste into RED bags/ boxes for sharps, YELLOW bags for biological waste and BLUE or BLACK ones for general/ municipal waste. All hospital staff needs to be trained in the concept of putting the right waste in relevant containers/ bags. They need to know that more than anything else this practice is vital for their own safety. The message can be reinforced through appropriate labelling on the bins and having posters with simple delineations to avoid mixing of different waste types. Sharps essentially should be kept in rigid, leak and puncture-resistant containers which are tightly lidded and labelled. Regular training sessions for nurses and cleaning staff can be organised as they are the personnel who are more likely to deal with waste disposition at the level of their respective departments. Next of course is transportation of waste products to the storage or disposal. Sanitary staff and janitors must be aware of the basic concepts of waste handling and should wear protective clothing, masks and gloves etc, besides ensuring regular practice of disinfection and sterilization techniques.8Special trolleys or vehicles exclusively designed and reserved for biomedical waste and operated by trained individuals should be used for transportation to the dumping or treatment site. Biomedical waste treatment whether on site or off site is a specialised entity involving use of chemicals and equipment intended for curtailing the hazardous potential of the material at hand. Thermal treatment via incinerators, not only results in combustion of organic substances but the final product in the form of non-toxicash is only 10 to 15% of the original solid mass of waste material fed to the machine. Dedicated autoclaves and microwaves can also be used for the purpose of disinfection. Chemicals such as bleach, sodium hydroxides, chlorine dioxide and sodiumhypochlorite are also effective disinfectants having specialised indications. Countries around the world have their own regulations for waste management. United Kingdom practices strict observance of Environmental protection act 1990, Waste managementlicensing regulations 1994 and Hazardous waste regulations 2005 making it one of thesafest countries in terms of hazardous waste disposal. Similar regulations specific for each state have been adopted in United States following passage of the Medical Waste tracking act 1988. In Pakistan, every hospital must comply with the Waste Management Rules 2005 (Environment Protection Act 1997), though actual compliance is far from satisfactory. It is high time that the government and responsible community organisations shape up to seriously tackle the issue of bio hazardous waste management through enforcement of effective policies and standard operating procedures for safeguarding the health and lives of the public in general and health workers in particular.
Outbreaks, defined as excess cases of a particular disease or illness which outweighs the response capabilities, have the capacity to overwhelm health care facilities and need timely response and attention to details in order to avoid potentially disastrous sequelae . In this day and age when improvement in public health practices have significantly curtailed outbreak of various diseases, certain viral illnesses continue to make headlines. One of the notable vector borne infectious disease affecting significant portions of south east Asia in the early part of twenty first century is 'Dengue fever'. Dreaded as it is by those suffering from the illness, a lot of the hysteria created is secondary to a lack of education and understanding of the nature of the disease and at times a result of disinformation campaign for vested interests by certain political and media sections.'Dengue' in fact is a Spanish word, assumed to have originated from the Swahili phrase -ka dinga peppo -which describes the disease as being caused by evil spirit. 1 Over the course of time it has been called 'breakbone fever', 'bilious vomiting fever', 'break heart fever', 'dandy fever', 'la dengue' and 'Phillipine, Thai and Singapore hemorrhagic fever' Whilst the first reported case referring to dengue fever as a water poison spread by flying insects, exists in the Chinese medical encyclopedia from Jin Dynasty (265-420 AD), the disease is believed to have disseminated from Africa with the spread of the primary vector, aedes egypti, in the 15th to 19th century as a result of globalisation of slave trade 45In 80% of the patients affected by this condition the presentation is rather insidious and at best characterized by mild fever. The classical 'Dengue fever' present in about 5% of the cases is characterized by high temperature, body aches, vomiting and at times a skin rash. The disease may regresses in two to seven days. However inrare instances (<5%) it may develop into more serious conditions such as Dengue hemorrhagic fever whereby the platelet count is significantly reduced leading to bleeding tendencies and may even culminate in a more life threatening presentation i.e Dengue shock syndrome.6To understand the actual dynamics of Dengue epidemic it is important to understand the mode of its spread in affected areas. Aedes mosquito (significantly Aedes Egypti) acts a vector for this disease. Early morning and evening times7 are favoured by these mosquitos to feed on their prey.
Nanoimprint Lithography (NIL) has been an interesting and growing field in recent years since its beginnings in the mid-1990s. During that time, nanoimprinting has undergone significant changes and ...developments and nowadays is a technology used in R&D labs and industrial production processes around the world. One of the exciting things about nanoimprinting process is its remarkable versatility and the broad range of applications. This reprint includes ten articles, which represent a small glimpse of the challenges and possibilities of this technology. Six contributions deal with nanoimprint processes aiming at specific applications, while the other four papers focus on more general aspects of nanoimprint processes or present novel materials. Several different types of nanoimprint processes are used: plate-to-plate, roll-to-plate, and roll-to-roll. Plate-to-plate NIL here also includes the use of soft and flexible stamps. The application fields in this reprint are broad and can be identified as plasmonics, superhydrophibicity, biomimetics, optics/datacom, and life sciences, showing the broad applicability of nanoimprinting. The sections on the nanoimprint process discuss filling and wetting aspects during nanoimprinting as well as materials for stamps and imprinting.
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