Background: Approximately 1% to 2% of hospitalized patients get discharged or leave from the hospital against medical advice and up to 26% in some centers. They have higher readmission rate and risk of complications than patients who receive complete care. In this study we aimed to determine the rate of leave against medical advice (LAMA) and reasons for the same across different in-patient departments of a tertiary care hospital. Methods: Retrospective cohort study on patients admitted in all departments at our institute over a 1-year period. All patients who were admitted to an in-patient ward at the hospital and who left against medical advice by submitting a duly filled LAMA form were included. Univariate and multivariate logistic regression models with forward selection methods were employed. Revisit to hospital within 30 days; to clinic or emergency department was outcome variable for regression. Results: From June 2015 to May 2016 there were 429 LAMA patients, accounting for 0.7% of total admissions. Females were 223 (52%) compared to males 206 (48%). Finances were quoted as the most common reason for LAMA by 174 (41%) patients followed by domestic problems 78 (18%). Internal medicine was the service with the highest number of LAMA patients ie, 153 (36%) followed by Pediatric medicine with 73 (17%). Of the 429 patients, 147 (34%) patients revisited the hospital within 30 days. Sixty-one percent of these ‘bounced-back’ LAMA patients had worsening or persistence of same problem, or new problem/s had developed. In unadjusted bivariate logistic model, patients who were advised for follow-up during discharge against medical advice were four times more likely to revisit the hospital. Patients who were married had an increased odd of revisiting the hospital. Conclusion: Financial reasons are the most common stated reasons to LAMA. Patients who LAMA are at a high risk of clinical worsening and ‘bouncing back.’ This is the first study from our region on in-patient LAMA rates, to our knowledge. The results can be used for planning measures to reduce LAMA rates and its consequences.
The experiment was conducted at Biochemistry Section, Ayub Agricultural Research Institute, Faisalabad Pakistan, during the year 2017-18 to assess the total phenols and antioxidants potential of mango, grapes, banana, guava, mulberry, strawberry, loquat, melon, apricot and phalsa. Fruits samples were obtained from the market of Faisalabad Pakistan, washed, dry at room temperature, extracted their juice/pulp. The juice was stored at 4 °C for further analysis. Juice samples were processed for Vitamin- C, pH, TSS, total phenolics and total antioxidant capacity. The results showed that among all the ten fruits vitamin C was higher in mango (24.33 mg/100 mL) followed by phalsa (19.74 mg/100 mL) and Grapes (11.25 mg/100 mL), whereas lower value was observed in melon (3.3 mg/100 mL) and loquat (3.4 mg/100 mL). Vitamin C for other fruits lies between these. Highly acidic pH of fresh juices of all the fruits was observed except in melon (5.82) and guava (5.38) which is less acidic. Percentage of TSS was higher in phalsa, mulberry and mangoes (13.8, 13.5 and 13.9% respectively) and lesser in melon (5.6%). Antioxidant capacity (% DPPH reduction) was found higher in grapes (91.9%) and mango (91.2%) which was statistically at par with melon (90.9%), while lesser value was observed in mulberry (51.6%). Total phenolics were significantly higher in grapes (1266.4 µg GAE/mL), whereas minimum phenolic contents were found in melon (4.1 µg GAE/mL). Therefore, it was concluded that grapes are more nutritious and healthy fruit than other.
The goal of this study is to determine and compare the degree of OER usage, the influences on OER use, and the opinions of OER use by business school and health science school teachers at leading universities in Pakistan. Two business schools and two schools of health sciences from various institutions were included in our study. Using the questionnaire approach, information is gathered from a sample of 80 respondents from two prestigious institutions. The findings of the data show that teachers at business schools utilize digital and OER resources more frequently than those in health science institutions and possess advanced technical abilities. The teachers of business school also show more positive perceptions about the use of different OER with the lectures as supporting material than the health science schools. Keywords: Questionnaire, OER (Open Educational Resources), adherence, perception.
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