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Aim: To describe characteristics, etiological factors, maternal and perinatal outcome of perimortem Caesarean section. Design: Prospective study Setting: Emergency Room of Department of Obstetrics & Gynecology Unit IDr.Ruth KM Pfau Civil Hospital & Dow Medical College, Karachi. Methodology: This study was carried out in the Department of Obstetrics and Gynaecology, Civil Hospital Karachi from November 2020 to March 2021. All women who were presented in emergency in a collapsed state were included in the study and those women who were brought dead were excluded. Clinical details including age, gestational age, reason for perimortem Caesarean section, perinatal and maternal outcome were recorded on a predesigned proforma. Results: A total of 27 women underwent perimortem Cesarean section. The mean age of women who underwent PMCS was 266.5 years, and mean gestational age was 35±4weeks. Sixteen (59%) women were referred from either primary care or small clinics. Majority 15(55%), underwent PMCS within 5 minutes of maternal collapse and 12(44%) underwent PMCS, after 5 minutes of collapse. Septic shock 21(77%) was the main etiological factor for PMCS, followed by hypertension and cardiomyopathy 2(7%) each. Twenty three (85%) women survived, following PMCS, whereas 4(14%) died. Reasons for maternal death included hepatic encephalopathy(1), peripartum cardiomyopathy(2), eclampsia(1). The perinatal mortality was high, with only 14(51%) live birth and mean APGAR score at 1 and 5 minutes was 3. The mean stay in intensive care was 37 35 hours, whereas mean stay in ward was 5739 hours. Practical implications: This study suggests that if perimortem caesarean section accomplished in a timely manner, it can improve fetomaternal outcome. Conclusion: Perimortem Caesarean section can improve upon maternal survival. Greater awareness among doctors, multidisciplinary approach, proper documentation and information for family members are cornerstone of this emergency procedure. Keywords: Perimortem Cesarean section, septic shock,eclampsia,postpartumhaemorrhage, maternal mortality.

In this mini review, we highlight some key work from the last 2 years where ionic polymers have been used as a catalyst to convert CO2 into cyclic carbonates. Emerging ionic polymers reported for this catalytic application include materials such as poly(ionic liquid)s (PILs), ionic porous organic polymers (iPOPs) or ionic covalent organic frameworks (iCOFs) among others. All these organic materials share in common the ionic moiety cations such as imidazolium, pyridinium, viologen, ammonium, phosphonium, and guanidinium, and anions such as halides, [BF4]–, [PF6]–, and [Tf2N]–. The mechanistic aspects and efficiency of the CO2 conversion reaction and the polymer design including functional groups and porosity are discussed in detail. This review should provide valuable information for researchers to design new polymers for important catalysis applications.

Summary H2 as a storable fuel can be sustainably generated from direct cleavage of water with a catalytic approach. However, H2 generation is severely affected by poor catalytic activities and the instability of catalyst materials. Recently, transition-metal-based nitrides (TMNs) have been widely explored because of their intrinsic abilities to catalyze water splitting, wide pH stability, high corrosion resistance, and potential for structural modulations. Most investigations have focused on the design of advanced heterostructures for improving catalytic activity. However, identification of the active sites and decoding the inherent mechanisms are often neglected. Here, we investigate the fundamental aspects of H2 production to elucidate the cutting-edge progress of TMNs. First, we explore the engineering of the active sites of ordered and disordered structures and the relation with hydrogen evolution reaction activity. Second, we explain the development of advanced oxygen evolution reaction catalysts by focusing on minimizing autoxidation. Third and finally, we discuss complementary strategies for converting unifunctional TMNs to bifunctional catalysts for overall water splitting.

Aerosol-assisted chemical vapor deposition (AACVD) is successfully implemented for the fabrication of nanostructured palladium (Pd) thin films on FTO substrate. The Pd films are produced using a commercially available precursor palladium acetylacetonate (Pd(C5H7O2)2) under the flow of N2 gas without incorporating hydrogen gas or any other reducing agent. This synthetic strategy can effectively confront the previous problems related with conventional CVD approach while depositing palladium thin films such as reduced volatility and thermal instability of precursors. The palladium thin films were characterized by powder X-ray diffraction (pXRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and energy-dispersive X-ray (EDX) analysis. Hydrazine is a colorless and flammable chemical routinely used in rocket fuel, agro-chemicals, textile dyes, and as corrosion inhibitors in various industries. However, hydrazine is a toxic and highly carcinogenic chemical. The newly fabricated palladium nanostructured films were tested for electrochemical sensing of hydrazine in this study. A highly stable and reproducible amperometric response for hydrazine oxidation was obtained with a superior limit of detection (LOD) of 10 nM, and limit of quantification (LOQ) of 33 nM while the sensitivity value calculated was 2.94 μA μM−1 cm−2. A linear concentration range of 1–325 μM was achieved by chronoamperometry.

Building capacity for developing skills as leadership, teamwork, and continuous academic support has become essential for fulfilling a successful pharmacy career. This study aims to assess Jordanian pharmacists’ views on professional development, namely: the continuous education infrastructure, strategies and programs for personal development, leadership skills, incentive schemes, drug information resources and digital services. As well as exploring options for better academic support delivered to pharmacists. To capture participant’s views, an online validated and reliable survey was developed. Non-probability sampling design was used. Participants were qualified pharmacists working at Royal Medical Services (RMS) and Community Pharmacists (CP). Comparison and descriptive statistics were used to report the results. A total of 271 pharmacists participated, 144 from RMS (8% more than the needed sample) and 127 CP (7% more than the needed sample). There was a strong desire amongst both RMS and PC groups for continuous educational training particularly in the following areas, first: Advanced counselling and communication skills (means = 8.99±0.145, CI 95% = 3.70–4.28 and 9.37±0.096, CI 95% = 4.18–4.56). Second: Personal development skills (mean = 8.92±0.142, CI 95% = 3.64–4.20 and 9.02±0.145, CI 95% = 3.73–4.30). Third, Pharmaceutical health promotion (mean = 8.05±0.180, CI 95% = 2.70–3.41 and 8.57±0.159, CI 95% = 3.26–3.89). Only 19.4% and 18.1% of the RMS and CPs respectively reported the presence of a written policy for personal development and leadership in their workplace. There were few incentives for pharmacists to participate in research. Few pharmacists used the available drug information and toxicology centers. The professional and continuous personal development of pharmacists support an evolving healthcare system. This study emphasizes the need for a tailored and documented postgraduate educational strategy, personal development, and leadership skills training in Jordan. Implementing a well-defined scheme of incentives should be encouraged to engage pharmacists in continuous professional development programs and pharmaceutical research. Such strategy and training should enhance both professional and personal performance.

Coeliac disease or celiac disease is a long-term autoimmune disorder that primarily affects the small intestine. Classic symptoms include gastrointestinal problems such as chronic diarrhoea, abdominal distention, malabsorption, loss of appetite, and among children failure to grow normally. This cross-sectional study was conducted among the patients presenting in the outdoor department of different hospitals. Name, age, gender, symptoms of pale, loose stools, weight loss were noted on a predefined proforma. All the data was entered and analyzed with SPSS Ver. 23.0. A total of 100 patients presenting in the outdoor department were included in this study i.e., 50 males (50%) and 50 females (50%). The mean age of the patients was 3.23±2.23 years. Out of these patients, five patients were suspected as a case of coeliac disease. Further workup was suggested after that.

Indigestion, also known as dyspepsia or upset stomach, is a condition of impaired digestion. Symptoms may include upper abdominal fullness, heartburn, nausea, belching, or upper abdominal pain. This cross-sectional study was conducted among the patients presenting in the outdoor department of different hospitals. Name, age, gender, presence of oral ulcers and their severity were noted on a predefined proforma. All the data was entered and analyzed with SPSS Ver. 23.0. A total of 80 patients presenting in the outdoor department were included in this study i.e., 40 males (50%) and 40 females (50%). The mean age of the patients was 31.23±5.23 years. Out of these patients, eleven patients presented with oral ulcers, mild to moderate in nature. Further workup was advised accordingly.

Metal–organic frameworks (MOFs) are an emerging class of materials exhibiting high surface areas, controlled pore sizes, open metal sites and organic linkers. Utilizing MOFs as direct electrode materials for electrochemical sensing can offer inherent advantages such as containing a sensing element and a redox mediator in a single molecule; however, the direct use of MOFs as electrode materials is hindered because of their insulating nature and less stability in an aqueous medium. In this study, a new water stable Zn-MOF was synthesized and used directly as an electrode material. The Zn-MOF possesses good ability to electrocatalyze the hydrazine oxidation reaction. The Zn-MOF's inherent poor conductivity was overcome by including a hydrophobic electrolyte, tetrakis(4-chlorophenyl)borate tetradodecylammonium salt (ETH 500), during the fabrication of the Zn-MOF membrane. After coating a thin film of the nafion-ETH500 supported Zn-MOF over a glassy carbon electrode (GCE), the response for hydrazine oxidation was substantially improved. Linear sweep voltammetry (LSV) demonstrated a wide linear range from 20 to 350 μM (R2 = 0.9922) for hydrazine. A detection limit of 2 μM (n = 3) was observed. The electrochemical behavior of the ZnMOF/ETH500/nafion modified GCE revealed that MOFs have a promising future as electrode materials for direct electrochemical sensing.

In direct methanol fuel cell technology, highly stable electrochemical catalysts are critically important for their practical utilization at the commercial scale. In this study, sub ~10 nm hollow Pt-Ni (1:1 at. ratio) nanoboxes supported on functionalized Vulcan carbon (Pt-Ni/C-R2) were synthesized through a facile method for the efficient electrooxidation of methanol. Two reaction procedures, namely, a simultaneous reduction and a modified sequential reduction method using a reverse microemulsion (RME) method, were adopted to synthesize solid Pt-Ni NPs and hollow nanoboxes, respectively. To correlate the alloy composition and surface structure with the enhanced catalytic activity, the results were compared with the nanocatalyst synthesized using a conventional NaBH4 reduction method. The calculated electroactive surface area for the Pt-Ni/C-R2 nanoboxes was 190.8 m2.g−1, which is significantly higher compared to that of the Pt-Ni nanocatalyst (96.4 m2.g−1) synthesized by a conventional reduction method. Hollow nanoboxes showed 34% and 44% increases in mass activity and rate of methanol oxidation reaction, respectively, compared to solid NPs. These results support the nanoreactor confinement effect of the hollow nanoboxes. The experimental results were supported by Density Functional Theory (DFT) studies, which revealed that the lowest CO poisoning of the Pt1Ni1 catalyst among all Ptm-Nin mixing ratios may account for the enhanced methanol oxidation. The synthesized hollow Pt-Ni/C (R2) nanoboxes may prove to be a valuable and highly efficient catalysts for the electrochemical oxidation of methanol due to their low cost, numerous catalytically active sites, low carbon monoxide poisoning, large electroactive surface area and long-term stability.

Objectives: The research objective is the determination of the frequency of etiological agents like Neisseria meningitides, Haemophilus influenza, and Streptococcus pneumonia in Acute Bacterial Meningitis having CSF-culture as ‘positive’. To determine the survival frequency of Acute Bacterial Meningitis patients. Material and Methods: We conducted this case-series study at Medicine Department of Services Hospital, Lahore (January 2017 to September 2017). We selected 292 patients having Acute Bacterial Meningitis for our study. Results: We recorded (39.98 ± 17.57) years of mean age among patients. The number of patients with Streptococcus pneumonia, Neisseria meningitides, and Haemophilus influenza was 52% (153), 36% (105), and 12% (34) respectively. We recorded 82% (239) with survival and 18% (53) patients expired. Conclusion: The study concludes that SP is the most common EA that causes ABM. The number of male victims of ABM is higher than that of the females though survival has no association with gender. The age of the patient significantly associates with survival. Keywords: Acute Bacterial Meningitis (ABM), Streptococcus Pneumonia (SP), Haemophilus Influenza (HI), Cerebrospinal Fluid (CSF), Neisseria Meningitides (NM), Etiological Agents (EA), and Invasive Meningococcal Disease.

Penelitian ini bertujuan untuk mengetahui bentuk perilaku konsumeris pengunjung Mall Lippo Plaza Kota Kendari dan untuk mengetahui motivasi perilaku konsumeris pengunjung Mall Lippo Plaza Kota Kendari. Dalam penelitian ini digunakan pendekatan deskriptif kualitatif dimana data dikumpulkan melalui teknik observasi, dokumentasi dan wawancara. Wawancara dilakukan kepada 20 informan yang dipilih secara accidental sampling yakni para pengunjung Mall Lippo Plaza yang memiliki motivasi konsumeris. Hasil penelitian ini menunjukan bahwa bentuk perilaku konsumeris pengunjung Mall Lippo Plaza Kota Kendari, yaitu: 1) Hidup Mewah adalah pola hidup konsumtif dan boros untuk keperluan pribadi atau keluarga. 2) Mentalitas Instan artinya membawa manusia untuk tidak usah melalui proses berbelit belit dalam hal mendapatkan suatu kebahagiaan. 3) Pola Hidup Boros adalah gaya hidup yang gemar berlebih-lebihan dalam menggunakan uang. Para pengunjung merasa termotivasi berprilaku konsumtif dengan alasan antara lain: 1) Ingin refreshing karena banyak tugas kuliah, banyak beban kerja di Kantor dan di Rumah, mereka merasa refreshing bisa membuat pikiran jernih kembali. 2) Meningkatkan Status Sosial, pengunjung Mall menjadi percaya diri ketika masuk ke Mall. Orang kaya dan orang biasa semuanya berkunjung ke Mall hanya untuk nongkrong di cafe, berbelanja dan jalan-jalan. Kata Kunci: Perilaku, Konsumtif, Pengunjung Mall

We propose a system consisting of two coupled optical whispering-gallery-mode (WGM) microresonators to investigate the Fano resonances of the output probe field. The WGM microresonators are driven coherently by a strong pump field and a weak probe field via tapered fibers (Peng et al 2014 Nat. Phys. 10 394). By making one of the resonators optomechanical and properly adjusting the coupling strength between the microresonators, we tune the Fano line shapes by varying the optomechanical strength. It is found that Fano line shapes appear on introducing optomechanical effects into the system. Interestingly enough, the gain–loss ratio in the proposed system has a key role in tuning a single Fano line shape to double. For the -symmetric phase, we investigate a more prominent double Fano line shape. The adjustment from single Fano line shape to double via the gain–loss ratio is the major part of this work. Our results can be used for all-optical switching and high-sensitivity sensing.

Background: hypertension affects many people worldwide and it is highly prevalent in Jordan. Living at different areas with different attitudes may have impacts in hypertension. Study objectives: to identify the prevalence of hypertension in two areas in Jordan with different attitudes and to determine the impact of attitudes in hypertension and angiotensin II to be able to determine the appropriate antihypertensive drug for such population. Methodology: a cross-sectional study design was conducted to collect data from participants. The study included 1000 participants, 500 from each area. A constructed questionnaire was used in this study. Blood samples were taken from participants to assay for angiotensin II. Blood pressure was measured for all patients. Data was analyzed using SPSS version 20. Data was presented as means, frequencies, percentages. The relationship between variables was examined using independent T-test. Significance was considered at alpha level 0.05). Conclusions: living in high altitude is associated with increased potential to have increased levels of cardiac parameters independently of the level of angiotensin II and the therapeutic options for patients with hypertension should be taken into account.

Introduction Linear accelerator is a device that can able to generate high energy photon from 4 MV to 25 MV, and these beams are used for radiation therapy. There are different treatment techniques using now a days to deliver radiation externally but most common is 3DCRT (3D conformal radiotherapy) and Intensity modulated radiation therapy. The major issue arises using photon beam having energy ∼10 MV and above is the productions of secondary neutron which can maximize the patient absorb doses. Purpose The aim of the study is to evaluate 3D conformal radiation therapy and step and shoot intensity modulated radiation therapy (ssIMRT) techniques for less neutron contamination that lead to minimum patient exposure from neutrons. Material and methods For this purpose five treatment plan of breast were made on both 3DCRT and ssIMRT using 10MV photon. Linear accelerator Elekta Synergy is used to deliver these plans and for measuring neutrons dose in primary beam, a portable, Ludlum neutron detector is used which is placed on patient’s couch. Results Obtained data shows that the mean values with standard error for each technique was found to be 14.56 mSv ± 0.38 and 25.07 mSv ± 1.2 for 3D CRT and ssIMRT, respectively. Mean difference between two techniques for neutron contamination was found to be 10.5 mSv. Conclusion It can be concluded from the study that contamination of neutrons increases by a factor of 10.5 when we move from 3D CRT to ssIMRT. This is because of increase no. of MUs that are being used in ssIMRT. Although ssIMRT therapy provides better plan optimization for target than 3DCTR but contains greater neutron contamination.

Ternary metal catalysts were synthesized by impregnation method. The mixture of metal solutions was reduced slowly under inert atmosphere and the reduced metals were deposited on the Vulcan Carbon(VC). Tungsten, molybdenum, cerium, iron and copper were added to specified amounts of platinum and nickel. Addition of nickel generally improves catalytic activity of platinum. The XRD of the catalysts was done and the crystallite size and other parameters were calculated. Crystallite sizes were in the range of 5 to 16 nm. Electrochemical surface areas of the catalysts were determined by cyclic voltammetry (CV) in acidic media and are compared. Electro oxidation of methanol on the catalysts was done and peak potential, peak current, mass activity of the catalysts were calculated and are compared. These parameters were determined in acidic and basic media. It was found that mass activity increased significantly in basic media. Rate constants for the electro oxidation of methanol were also calculated in acidic and basic media and are compared and discussed. Rate constants were generally higher in basic media. Ternary catalysts showed improved catalytic activity than the binary catalyst. Nano alloying improved the catalytic activity and stability of the ternary catalysts.

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