Characterizing Social Determinants of Maternal and Child Health: A Qualitative Community Health Needs Assessment in Underserved Areas.

This study aimed to identify social determinants of maternal and child health (SDoH) in Pakistan. Using a qualitative study design, data were collected from community members in seven underserved areas of Lahore City, Pakistan. A total of 22 qualitative in-depth interviews and 10 focus group discussions (FGDs) were conducted. The participants included basic health unit healthcare staff, women of reproductive ages, male family members, mothers-in-law, and religious leaders. We found that maternal and child health is adversely affected by the following socioeconomic and environmental barriers: (i) poor housing quality and sanitation; (ii) inadequate food supply and safety; (iii) unsatisfactory public sector school services; (iv) a lack of safety and security; (v) scarce poverty alleviation efforts and loan schemes; (vi) unsatisfactory transport and internet services; and (vii) inadequate health services. The targets for maternal and child health in Pakistan cannot be met without close coordination between the primary health sector, local governance, and macro state structures, which collectively must monitor and improve housing adequacy, food security, public sector services (primary healthcare services, public schooling, public transport, and public internet access), overall safety, and poverty emergence.

The Therapeutic Potential of the Medicinal Plant Justicia Adhatoda and its Antibacterial and Antifungal Activities: A Comparative Study.

Context: Screening ethnobotanical plants is a pre-requisite to evaluating their therapeutic potential and can lead to the isolation of new bioactive compounds. Objective: To determine the antibacterial and antifungal therapeutic potential of Justicia adhatoda. Design: The research team conducted an antimicrobial activity. Setting: The study was conducted in a bioscience lab at International Islamic University, Islamabad, Pakistan. Intervention: Methanolic, ethanolic, and ethyl acetate crude extracts of Justicia adhatoda were prepared at concentrations of 1000, 500, and 100 µg/ml. Outcome measures: The crude extracts were evaluated for in vitro antibacterial activity against Bacillus subtilis, Staphylococcus aureus, Pseudomonas aeruginosa, and Escherichia coli and for in vitro antifungal activity against Aspergillus flavus, Aspergillus niger, Candida albicans, and Fusarium oxysporum, indicating different zones of inhibition. Results: The highest antibacterial activity was recorded in Justicia adhatoda-methanolic extract (16.33 ± 0.57 mm) and Justicia adhatoda-ethanolic extract (17 ± 1 mm) against Escherichia coli at 1000 µg/ml. Justicia adhatoda-ethyl acetate extract (13 ± 1 mm) showed a significant result as a zone of inhibition against Staphylococcus aureus at 1000 µg/ml. In the fungal strain culture, the highest antifungal activity was recorded in Justicia adhatoda-methanolic extract (15.66 ± 0.57 mm), Justicia adhatoda-ethanolic extract (14 ± 1 mm), and Justicia adhatoda-ethyl acetate extract (14.33 ± 1.15 mm) against the Aspergillus niger at 1000 µg/ml. Conclusion: The antimicrobial activities may be due to the strong occurrence of active compounds, i.e., saponins, tannins, alkaloids, steroids, phenols, and flavonoids. It has been concluded that Justicia adhatoda extracts are suitable candidates for the development of novel antibacterial compounds.

WhatsApp-Delivered Intervention for Continued Learning for Nurses in Pakistan During the COVID-19 Pandemic: Results of a Randomized-Controlled Trial.

The COVID-19 pandemic has necessitated support for continued learning in frontline practitioners through online digital mediums that are convenient and fast to maintain physical distancing. Nurses are already neglected professionals for support in training for infection control, leadership, and communication in Pakistan and other developing countries. For that reason, we aimed to deliver a WhatsApp-based intervention for continued learning in nurses who are currently working in both private and public sector. A 12-week intervention was delivered to 208 nurses (102 in the control group and 106 in the intervention group) who had been employed in the clinical setting during data collection. The analysis reveals that nurses in the intervention group show significantly better results for learning in "infection prevention and control" and "leadership and communication." Results of a content analysis based on participant's feedback also confirm that the WhatsApp-based intervention is a valuable tool for education. This study highlights the effectiveness of online-based digital interventions as a convenient training tool for awareness and management of infectious diseases, leadership, and communication during COVID-19 and beyond. Furthermore, this study emphasizes that group interventions with other healthcare practitioners and the role of on-going longer WhatsApp-based interventions can become integral tools to support continued learning and patient safety practices.

In Vivo Effects of Orally Administered Different Concentrations of Silver Oxide Nanoparticles in Hyperuricemic Mice.

Silver oxide nanoparticles (AgO-NPs) antioxidant, anti-cancer, anti-microbial, and tissue repair properties. Gouty arthritis is the inflammation of tissues and joints caused by the deposition of monosodium urate crystals. In this experiment, we investigated the anti-hyperuricemic effectiveness of different concentrations of AgO-NPs in mice. The present study aimed to investigate the effect of administration of AgO-NPs in monosodium urate (MSU)-induced gouty mice for the very first time. Monosodium urate (MSU) crystals were administered intraperitoneal for gout induction, followed by 5, 10, and 20 µg/mL doses of AgO-NPs for 2 weeks. The positive control was provided with the commercially available drug allopurinol to compare the effects of AgO-NPs and allopurinol. The main purpose of the study was to investigate the effectiveness of the nanoparticles in comparison with commercially available drugs. AgO-NPs have been shown to improve the condition of gouty arthritis by reducing significantly (P ˂ 0.001) increased levels of ALT, AST, and total bilirubin. The total protein estimation results showed significant improvement at concentration of 20 µg/mL of AgO-NPs. The lipid profile results showed that high concentration (20 µg/mL) of AgO-NPs decrease the lipid content significantly as compared to control. It was concluded from this study that the antioxidant, anti-inflammatory, and antilipidemic properties of AgO-NPs may improve the hyperuricemic condition in gouty arthritis mice.