This study evaluates three popular loose plastic packaging namely polyethylene (PE), polypropylene (PP) and polyvinylchloride (PVC) for damage in packaging and weight loss in packed wheat flour by Tribolium castaneum Herbst (Coleoptera: Tenebriondiae) for three different time periods. The study lasted for three months and data was recorded three times with 30 day interval between data recordings to see damages in packaging, i.e., holes and penetrations made by beetles in packaging; number of beetles inside packages were counted to see their population growth after a given time period inside packed wheat flour and weight loss in wheat flour. Maximum holes by beetles were in polyethylene packaging, penetrations and numbers of beetles were more in polyethylene packaging type. Similarly weight loss in wheat flour was also more in polyethylene bags in contrast with other packaging materials used (P < 0.05). Effect of time period showed significantly more weight loss in wheat flour after 90 days than after 60 or 30 days (P < 0.05) however time period had non-significant effect on holes made by beetles into packaging and penetrations as well as numbers of beetles counted or their population growth after given time period in different packaging materials (P > 0.05). These results revealed that out of three packaging materials tested polyethylene was a susceptible packaging material because it had maximum number of holes and penetrations by insects into them. Similarly maximum weight loss occurred in polyethylene. Effect of time period showed non-significant effect on holes and insect penetrations into packaging materials. However more weight loss occurred after more time period than after less time period. These results are important and can be employed for integrated management of T. castaneum regarding packed foodstuffs i.e., wheat flour.

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Background: Among the various complications of diabetes, lower-extremity amputation due to diabetic foot is a common problem. In Pakistan, 6-7% of patients with diabetes suffer from diabetic foot ulceration. Objectives: Our primary objective was to explore the frequency of diabetic foot amputations, and the secondary objective was to calculate the economic burden of these preventable surgeries on the health budget of the provincial government. Materials & Methods: It was a retrospective cross-sectional observational study conducted after obtaining approval from the Ethical Review Committee of Allied hospital, Faisalabad Medical University. The data of diabetic foot patients who underwent amputations between July 2017 and December 2017 were retrieved from three Surgical Units (I, II & III), using a purposive sampling technique. All amputations carried out for reasons other than diabetic foot were excluded. The direct medical cost of one diabetic foot amputation was calculated via a local survey of the various private hospitals of Faisalabad. The indirect costs in terms of loss of productivity and disability costs, transport costs, rehabilitation costs were not included in this study. The data were evaluated by using SPSS Version 23. Results: A total of 85 patients were included in our study. The male to female ratio was 2.7 to 1. The mean direct treatment cost for minor amputation was PKR 46926.00 ± 11730.90 ($382.35 ± 95.58), and the mean direct treatment cost for major amputation was PKR 53720.00 ± 12401.24 ($437.71 ± 101.40). Out of 85 amputations, 63 (74%) were major amputations, and the remaining 22 (26%) were minor amputations. The total cost for 63 major amputations was PKR 3,384,360 ($27568.91) and for 22 minor amputation was PKR 1,032,372 ($8409.67). The net cost came out to be PKR 4,416,732 ($35978.59) for all the 85 cases being reported in a tertiary care hospital of Faisalabad for six months. Conclusion: Diabetic foot, a preventable complication of long-term diabetes mellitus, has an economic burden on the hospital budget, which, if adequately addressed via primary prevention programme, can yield not just economical but medical benefits as well.

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