Progressive resistance training improving gait performance and mobility in acute and chronic stroke patients.

Stroke, a neurological disorder, leads to long-term disability thereby greatly affecting gait and mobility. The purpose of the current study was to investigate the effects of progressive resistance training in both acute and chronic stroke patients. A quasi interventional study was designed and 46 stroke patients were recruited through convenience sampling technique. Sample size was calculated using epi-tool. Patients who had cognitive problems, balance impairments and contractures were excluded from the study. The study was conducted from January to June 2018, at Rafsan Rehab & Research Centre, Peshawar. Progressive resistance exercises starting at 50 % of one repetition maximum (RM) were performed three days/week and for a total duration of nine weeks. Blind assessor measured readings at baseline and after nine weeks. Gait dynamic index (GDI), Six-Meter Walk Test (SMWT) and Five Times Sit-to-Stand (FTSTS) tools were used to collect the required data. The data was analysed at baseline and after nine weeks on SPSS-20. After nine weeks of intervention significant improvement was recorded in patients on GDI (p<0.001), SMWT score (P<0.001) and FTSTS (p<0.001). Progressive resistance training improves mobility limitations and gait in both acute and chronic stroke patients.

Healthcare Expatriate Adjustment in Qatar: Analyzing Challenges and Opportunities.

BACKGROUND: The healthcare sector in the Middle East, particularly in Qatar, relies heavily on expatriate professionals. The successful adaptation of these expatriates to the local environment is crucial as it significantly affects their job satisfaction and the quality of care they deliver to patients. This study aimed to identify and analyze the key factors influencing the adjustment of healthcare expatriates in Qatar to their professional roles and the cultural context of the region. METHODOLOGY: This study involved the use of a cross-sectional survey approach targeting healthcare professionals in Qatar, with a targeted sample size of 385 participants selected to ensure a comprehensive representation of the expatriate workforce. The survey was disseminated through expatriate-specific WhatsApp groups from October 1, 2022, to December 31, 2022. It was structured to examine a variety of factors influencing expatriate adjustment, including age, gender, proficiency in the Arabic language, social support networks, job type, and length of stay in Qatar. The primary focus of this study is a thematic analysis of the respondents' free-text comments. These comments offer valuable insights into their experiences, both positive and negative, in adapting to life and work in Qatar. RESULTS: This study achieved a response rate of 51.69% (199 out of 385), with participants representing 10 nationalities, being predominantly aged between 35 and 44 years, and having spent four to seven years in Qatar. The majority of respondents were nurses and doctors, accounting for 83.9% of the sample. The following five main themes emerged from the analysis of 218 free-text comments: personal and family concerns, work-related matters, government and system-related challenges, social and cultural challenges, and Arabic language challenges. Although participants valued supportive employer practices in family relocation and professional environments, they encountered language barriers, bureaucratic complexities, and cultural adaptation challenges. CONCLUSION: The results of this study shed light on the multifaceted nature of expatriate adjustment in the healthcare sector of Qatar, highlighting the supportive elements and the obstacles encountered. They emphasize the need for comprehensive support mechanisms, including language training, streamlined bureaucratic processes, and cultural orientation programs, to facilitate successful and fulfilling expatriate experiences in the Middle Eastern healthcare context.

Knowledge, Attitude, and Practice of Cigarette Smoking Among Medical Students of Quaid-E-Azam Medical College, Bahawalpur: A Web-Based Cross-Sectional Study.

Cigarette smoking acknowledged as the foremost contributor to preventable illnesses and deaths, has steadily risen since its inception, evolving into a global health crisis of paramount significance, particularly within the context of medical students who represent the future healthcare workforce. This study, conducted at Quaid-e-Azam Medical College, Bahawalpur, aimed to comprehensively evaluate current students' knowledge, attitudes, and practices concerning cigarette smoking. Employing a web-based cross-sectional observational descriptive study design over the study period from June 15, 2020, to August 1, 2020, a sample of 200 medical students drawn from the first to fifth year was examined using stratified sampling. Data collection involved the distribution of a meticulously designed and pre-tested questionnaire through social media platforms, encompassing inquiries about participants' biodata and research-related topics. The subsequent data analysis utilized Google Spreadsheets, Microsoft Excel, Microsoft Word, and SPSS software to calculate percentages, create graphical representations, construct tables, and apply the chi-square test. The survey findings illuminated a remarkably high level of awareness, with 99% of respondents recognizing the harmful effects of smoking, including elevated cancer risk, and 94% acknowledging its addictive nature. A substantial 93% regarded passive smoking as equally detrimental as active smoking. In comparison, 98.5% were aware of the heightened risk of respiratory illnesses in children exposed to smoking. The majority exhibited a responsible stance towards discouraging smoking, with 90.5% feeling a duty to encourage cessation and 71.5% considering maintaining good health a sufficient incentive to quit. Additionally, 97% concurred that smoking in the presence of children should be avoided. Concerning smoking cessation, 64.5% believed high taxes were effective, and 97.5% deemed public smoking bans effective measures. Notably, 74% thought professional advice had limited influence on a smoker's attitude. Active smokers constituted a mere 20% of the sample, with a mere 2% commencing smoking before age 16 and 10% succumbing to peer pressure or media influence as instigating factors. Furthermore, 13.5% reported exam-related anxiety as a trigger for smoking, and 10% admitted to smoking in the company of non-smokers. Encouragingly, 19.5% expressed a desire to quit, with 5% seeking professional guidance in their cessation attempts. In conclusion, most participants exhibited commendable knowledge and a positive attitude towards cigarette smoking, contributing to a low prevalence of tobacco consumption among them. Nevertheless, the study underscores the need for ongoing improvements through targeted educational initiatives and governmental regulations to further mitigate tobacco use among future healthcare professionals and the broader population.

Scaling Solute-Solvent Distances to Improve Solubility and Ion Paring Predictions in Rigid Ion Models.

Force fields based on the rigid ion model (RIM) have been developed to accurately predict the various physical and chemical properties of salts and water. However, the combined use of these models often fails to accurately predict the solubility of salts in water. To address this issue, several approaches, such as charge scaling or reparameterization, have been proposed. Nevertheless, these methods require laborious reparameterization of nonbonded force field parameters. In this article, we propose a scaling solute-solvent distance (SSSD) method to improve force fields in predicting salt solubility without changing the solute-solute and solvent-solvent interactions in the original force fields. This method can also tune the ion pairing of salt in water. One main advantage of the SSSD method is that reparameterization of the crystal and water models is not needed. We use two RIMs for the NaCl-water system (JC-SPC/E and SD-SPC/E) and the CHARMM force field for the KCl-water system to demonstrate the improved accuracy in predicting solubility by the SSSD method. Furthermore, we use the RDG-SPC/Fw force field to show that the SSSD method can also be used to tune the ion pairing of CaCO3 in water. Limitations of this method are also discussed.

Development and characterisation of sustained release solid dispersion oral tablets containing the poorly water soluble drug disulfiram.

Administration of drugs via the oral route is the most common and preferred route due to its ease of administration, cost-effectiveness and flexibility in design. However, if the drug being administered has limited aqueous solubility it can result in poor bioavailability. Furthermore, the low pH of the stomach as well as enzymatic activity can result in drugs delivered via the oral route being rapidly metabolised and degraded. Here we demonstrate the development and characterisation of sustained release solid dispersion oral tablets, containing the poorly water-soluble drug disulfiram (DSF). The tablets, which are manufactured from two different polymers (Kolliphor(®) P 188 and P 237) specifically designed for the manufacture of solid dispersions and two different polymers (Kollidon(®) SR and HPMC) specifically designed to provide sustained release, can enhance the solubility of DSF, sustain its release, while protecting it from degradation in simulated gastric fluid (SGF). The paper demonstrates that when using the hot melt method at 80°C the DSF loading capacity of the Kolliphor(®) P 188 and P 237 polymers is approximately 43 and 46% respectively, with the DSF completely in an amorphous state. The addition of 80% Kollidon(®) SR to the formulation completely protected the DSF in SGF for up to 70 min with 16% degradation after 120 min, while 75% degradation occurred after 120 min with the addition of 80% HPMC. The release rate of DSF can be manipulated by both the loading and type of sustained release polymer used, with HPMC providing for a much faster release rate compared to Kollidon(®) SR.