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Abstract Background Despite their importance in reducing maternal mortality, information on access to Mifepristone, Misoprostol, and contraceptive medicines in the Eastern Mediterranean Region is limited. Methods A standardized assessment tool measuring access to Mifepristone, Misoprostol, and contraceptive medicines included in the WHO essential medicines list (EML) was implemented in eight countries in the Eastern Mediterranean Region (Afghanistan, Iraq, Lebanon, Libya, Morocco, Palestine, Pakistan, and Somalia) between 2020–2021. The assessment focused on five access measures: 1) the inclusion of medicines in national family planning guidelines; 2) inclusion of medicines in comprehensive abortion care guidelines; 3) inclusion of medicines on national essential medicines lists; 4) medicines registration; and 5) procurement and forecasting of Mifepristone, Misoprostol, and contraceptive medicines. A descriptive analysis of findings from these eight national assessments was conducted. Results Only Lebanon and Pakistan included all 12 contraceptives that are enlisted in the WHO-EML within their national family planning guidelines. Only Afghanistan and Lebanon included mifepristone and mifepristone-misoprostol combination in post-abortion care guidelines, but these medicines were not included in their national EMLs. Libya and Somalia lacked a national regulatory authority for medicines registration. Most contraceptives included on the national EMLs for Lebanon, Morocco and Pakistan were registered. Misoprostol was included on the EMLs—and registered—in six countries (Afghanistan, Iraq, Lebanon, Morocco, Palestine, and Pakistan). However, only three countries procured misoprostol (Iraq, Morocco, and Somalia). Conclusion These findings can guide efforts aimed at improving the availability of Mifepristone, Misoprostol, and contraceptive medicines in the Eastern Mediterranean Region. Opportunities include expanding national EMLs to include more options for Mifepristone, Misoprostol, and contraceptive medicines and strengthening the registration and procurement systems to ensure these medicines’ availability were permitted under national law and where culturally acceptable.

Background: Pediatric palliative care (PPC) helps maintain the quality of life for both children and their families. It has been identified as an important goal within the global health agenda. In Saudi Arabia, the discipline remains in its infancy, as illustrated by the absence of PPC programs in academic and health care institutions. Aim: The aim was to conduct a pilot study assessing physicians' knowledge, attitudes, and perceptions toward PPC. Method: Data were gathered through a self-administered questionnaire sent to physicians working in Saudi Arabia. Results: One hundred twelve completed the survey (male 54.2%, n?=?50). A total of 40.8% (n?=?42) had 20 years or more of experience, 42.9% (n?=?48) were from the hematology-oncology specialty, and 68.5% (n?=?74) received no training in PPC. Half suggested that children should be informed of their condition but mostly when reaching 12 or 15 years of age. Various physicians reported that the most appropriate time to discuss a transition to palliative care goals is when diagnosing an incurable condition or when despite all efforts, a condition continues to progress and death is expected. Conclusion: Multiple gaps were identified. PPC basic concepts should be included in the formal medical curriculum (e.g., pain management, communication, and ethical considerations at the end of life). There is also a significant need to develop further both primary and specialized palliative care.

Background: Epilepsy is a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures that imposes heavy burden on individuals, families, and also on healthcare systems. As the better understanding of economic aspects of epilepsy will lead to better development of epilepsy care this study was conducted to estimate the cost of illness in epilepsy per patient per year in a tertiary care hospital in New Delhi. Aims and Objectives: The aim of study was to study the direct, indirect and total cost of illness in epilepsy per patient per year in a tertiary care hospital. Materials and Methods: Patients with epilepsy attending the Department of Neurology at Batra Hospital and Medical Research Centre in New Delhi were included in this study. All epilepsy patients fulfilling the inclusion and exclusion criteria were included in the study. The cost of illness was estimated as total, direct and indirect costs of illness per year for each patient. The information was collected on a properly formed format which consists of the demographic details of the patient, general biodata of patient, information about the direct medical costs and direct non-medical costs and information about indirect costs. The results are presented in Mean ± SD frequencies and percentages. The Kruskal-Wallis test was used to compare the costs of illness among different strata. The Mann-Whitney U test was used to compare the costs of illness between strata. The p-value

Objective: To identify the incidence of cardiac surgery associated acute kidney injury and its association with different risk factors. Study Design: Descriptive cross sectional study. Place and Duration of Study: Adult cardiac surgery department, AFIC/NIHD, from Jan to Jun 2019. Methodology: Three hundred forty patients undergoing cardiac surgery were evaluated for Cardiac Surgery associated acute kidney injury according to acute kidney injury network criteria over a period of 6 months. The chi-square test was used find the relationship of different factor for cardiac surgery associated acute kidney injury. Results: Total of 430 patients were included. 345 (80.2%) were male and mean age of 55 ± 11.6 years and mean pre operative creatinine clearance was 80.7 ml/hr. Coronary artery bypass grafting was the most common procedure performed. Intra aortic balloon pump, Cardio-pulmonary bypass time, AXc time, ionotropes, transfusion of RCC and FFPs were found to be highly significant risk factors of acute kidney injury. Conclusion: Cardiac surgery associated acute kidney injury is very common complication; some of the modifiablefactors should be identified and controlled to reduce acute kidney injury.

The sputa of 303 cases who were admitted at Ojha Sanitaurium Karachi were studied for comparing the efficacy and reliability of the three pretreatment methods including the standard method, and those recommended by Nassau (1958) and Becker (1916). Out of the total 223 cases were found to be positive after cultivation on LJ medium out of which 142 were found positive with ZNCF staining while in 81 cases no AFB could be detected. The number of cases found to be positive with standard method, Becker's method and Nassau's method were 117,131, and 147 respectively. As to the contamination, 58 were encountered with standard method, 25 with Becker's method and 84 with Nassau's method. 128 negatives were observed with the standard method, and 147 and 72 with Becker's method and Nassau's method respectively. The merits and demerits of the three methods are discussed.