Notes

Any put together physicochemical approach in the direction of human tenocyte phenotype servicing.
Pastoralism is practiced in remote parts of the Karakoram and Hindukush high mountains, which sprawl across Northern Pakistan, with women and children travelling to high pastures with their animals during summer. The pastures are not accessible by road, while glaciers and hazardous terrain accentuate their remoteness. A cross-sectional observational study was carried out along Pakistan's border with Afghanistan's Wakhan province to assess health indicators in children in pastoral communities. A questionnaire was used to collect basic health data; height / length, and weight were also measured. Thirty-five children were included in the study. This paper offers preliminary conclusions about health indicators and access to health care facilities. For children in the pastures, health care, and other amenities entail long and sometimes hazardous journeys. Living at high altitudes with their livestock, food consists almost exclusively of wheat (roti) and dairy products. The most significant finding was severe stunting in 34.2% of the children. This is higher as compared to the national data, and from Gilgit-Baltistan.A cross-sectional survey was conducted from February 2016 to September 2016 to assess the knowledge, attitude and practices regarding contraceptive implants among women of childbearing age visiting the Reproductive Health Services Centre, Civil Hospital, Karachi. A total of 396 adult, non-pregnant, married women of childbearing age, between 18 and 49 years, were interviewed using a structured questionnaire. Only 153 (38.6%) of the respondents had any knowledge about implants, out of whom 122 (79.7%) had acquired the information from family planning clinics. Almost two thirds of the respondents, 267(67.4%) were in favour of using implants as a contraceptive method. Moreover, 244 (61.6%) respondents were of the opinion that if given a choice, they will use implanon, though out of the 316 (79.8%) respondents who had ever used contraceptives, only 3 (0.9%) used implants. Despite a favourable attitude, limited knowledge and poor practices of the respondents were the highlights of the study findings.Core Bereavement Items Scale was translated into Urdu language and validated in Pakistani population through forward-backward procedure. It is a 17-item scale with three subscales, namely Images and Thoughts, Acute Separation, and Grief. A cross-sectional study was commenced on June 10, 2016, and completed by July 2017 as part of a pilot study of PhD research at National Institute of Psychology, Quaid-i-Azam University, Islamabad. Two hundred and sixty (260) participants were selected through a combination of convenience and snowball techniques. Results showed good alpha reliability and item-total correlation ranged from 0.62 to 0.77. Confirmatory factor analysis showed good fit of the model on the data. The findings supported the three-factor solution for the translated version of the CBI. The findings also indicated that females and participants living in nuclear family system report more severe bereavement. CBI Urdu version can be used as a valid and reliable measure for the assessment of bereavement intensity in Urdu speaking population anywhere in the world.Carefully developed guidelines for clinical practice serve as an important tool for desirable changes in health care of a country. They act as an important source of information for physicians as well as policy makers and educational institutions thereby improving the quality of care of patients. The outbreak of Novel Coronavirus Disease (COVID-19) in 2019 has placed a huge burden on health care system globally. The first line health care provider bears the brunt of this disease with limited and varying sources of information as most of the patients present to them. Varied presentation of disease along with limited hospital facilities for admission is a huge challenge for appropriate management and referral of these patients. These guidelines, prepared after reviewing the interim guidelines in literature, will serve as a source of guidance for GPs to manage mild cases at home and refer those with moderate and severe disease to tertiary care hospitals.Musculoskeletal disorders are common conditions involving joints, muscles, nerves, ligaments and tendons. These disorders affect normal activities and cause discomfort. These discomforts are managed by different types of interventions, including exercise, acupuncture, soft tissue release and manual therapy, as conservative modes of management. Soft tissue release, including active release technique, fascial abrasion, and myo-fascial release are considered effective for musculoskeletal function improvement. Advanced technology-improved and instrument-assisted techniques are being used nowadays. These instruments are sensitive in the localisation, specification and facilitation of the target area with the help of mechanical pressure applied on tissue with movement of specific muscle. Prognosis varies with good outcomes using fewer sessions than the others. But it needs proper localisation of the muscle involved and special training. The advantage considered is that musculoskeletal disorders can also be prevented in practitioners as well.
The accreditation standards developed by the World Federation of Medical Education (WFME) are acknowledged as regulatory mechanism for quality assurance of medical education programmes. The scoping review was planned to collect all the literature for identification of the barriers affecting the implementation of quality curriculum defined by WFME.

The literature was searched in electronic databases for relevant peer-reviewed studies over the last ten years. The search terms used were, `challenges of WFME accreditation', `barriers to accreditation', `challenges to accreditation in healthcare system', `hindrances to WFME accreditation standards', and `barriers to WFME standards', in PubMed, ERIC, PsycINFO databases, and in Google Scholar for grey literature. SIS3 After screening and assessing for eligibility, 922 publications were retrieved and only 19 articles were included in study. The QualSyst appraisal tool was used to appraise the quality of studies. Data was synthsized to present the findings.

The themes identified after data synthesis broadly described the barriers to implementation in various domains of WFME standards. The themes were social and political support, process of curriculum development, involvement of students in curricular planning, organizational setup, infrastructure, technical issues/ management of curriculum. The social and political support referred to leadership and governance, a prime barrier to address. Similarly, organizational setup, infrastructure and technical issues should also be looked for apart from students and curriculum.

The scoping review will inform and lay the foundation for more empirical studies on quality improvement in health professional education, particularly in low and middle-income countries.
The scoping review will inform and lay the foundation for more empirical studies on quality improvement in health professional education, particularly in low and middle-income countries.Medicine use review is a tool to improve medication adherence and safety. Current narrative review was planned to explore global policies and practices of medicine use review by community pharmacists in chronic diseases and its impact and way forward for low- and middle-income countries. Key words, such as ″medicine use review″, ″medication therapy management″ and ″community pharmacy″ were used for search on PubMed and CINAHL databases for articles published from 2004 to 2019. Medicine use review has opened an avenue of ongoing collaboration between community pharmacists and general practitioners. High-income countries have witnessed a gradual yet cautious adoption of these services through effective policy shift. In terms of practices and impact, the situation in high-income countries was promising where on an average ″type-II″ medicine use review was widely in practice and had improved clinical, humanistic and economic outcomes in chronic disease. However, in low- and middle-income countries, a paucity of effective policies was noted. Nevertheless, an emergent recognition of the potential of community pharmacists to contribute to the management of chronic diseases was evident.Self-medication is the use of medicines by people on the basis of their own experience without consulting a doctor. People use medicines for pain management or to cure a disease and sometime this may be unnecessary. There are a lot of public and professional health concerns about misuse of medicines and globally physicians agree upon this rising issue that leads to antibiotic resistance. In developing countries, medicines without prescription are easily available which results in many adverse outcomes, especially bacterial resistance. Insufficient healthcare services and socioeconomic factors result in increased proportion of self-medication compared to drugs prescribed by physicians. The current narrative review was planned to focus on indicating prevalence rate of self-medication in different developed and under-developed countries, major risk factors and control of self-medication due to which antibiotic resistance rate can be minimised. The issue needs urgent attention of representative authorities for taking serious actions. link2 Furthermore, arranging awareness seminars and implementing new policies/regulations to prevent the sale of any drug/antibiotic without prescription could play a vital role in bringing this alarming issue under control.Biomarkers are anatomical characteristics or naturally occurring measurable molecules indicating physiological or pathological state of an individual. These biomarkers have the potential to detect or predict diseases at an early stage, which is particularly beneficial in timely management of common complications of radiation therapy done in head and neck cancer treatment regime. Xerostomia is one of the most common oral complaints of radiation therapy. Saliva has an abundance of protein biomarkers; however, those related to post-radiation therapy xerostomia need to be explored further. Textural and imaging-based biomarkers are helpful in predicting xerostomia in such patients. This narrative review provides an account of salivary protein and imaging-based biomarkers of radiation therapy-induced xerostomia in head and neck cancer patients.In the last decade, there has been an emergent interest, supported by various experimental and epidemiological studies, for health benefits of camel milk, in preventing various pathologic conditions, ranging from cancer to diabetes. However, the precise mechanisms by which camel milk induce these health benefits remain to be investigated. Various reports have shown that consumption of camel milk by diabetes patients on a daily basis reduces blood sugar and glycosylated hemoglobin (HbA1C) levels and also reduces insulin requirements. link3 Despite that these findings provide scientific evidences of anti-diabetic activities of camel milk, research is yet to be initiated with assurance for patients of diabetes and other metabolic disorders. This review summarizes the medicinal values of bioactive constituents of camel milk and reviews camel milk findings from the most significant preclinical studies in diabetes.
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