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AimsTo evaluate the provision of services to patients with challenging behaviour in East Lothian Community Learning Disability population with and without specialist behaviour support team.BackgroundBehaviour that proves to be a challenge to manage (Challenging behaviour) is not uncommon in adults with intellectual disability and has a reported prevalence of 10–15%.1,2Positive behaviour support (PBS) is recommended as evidence-based intervention for adults with intellectual disability who have challenging behaviour. East Lothian community learning disability team (CLDT) underwent a change in service model for people with challenging behaviour. This change followed a Health and Social care partnership agreement that behaviour support and management could be provided by multidisciplinary CLDT rather than region-wide specialist team.MethodData collection was split into two cycles. First cycle looked retrospectively at six months prior to exit of Specialist Positive Behaviour Support Team (SPBST). Second cycle looked prospectively at 6 months after exit of SPBST.In first cycle, data were collected doing retrospective review of cases known and referred to SPBST. This included calculating time spent on each individual case by SPBST and by CLDT. SPBST provided information in the form of hours spent on each individual case for patients identified by them. For CLDT, electronic medical records system (TRAK) was used by looking at appointment entries on TRAK. For second cycle, newly developed Complex Behaviour pathway was used to identify the patients. Data were collected by using TRAK system as in the first cycle for CLDT.Data collected in both cycles was compared at the end of second cycle.ResultIn first cycle, 5 patients were managed jointly by SPBST and CLDT in 96.4 hours over six months and average clinical time spent on each patient was 19 hours. SPBST spent a total of 59 hours and CLDT spent 40 clinical hours. In second cycle, 12 patients were managed by CLDT alone in 130 hours over six months and average clinical time spent on each patient was nearly 11 hours.ConclusionResults of this evaluation suggest that SPBST had been providing significant contribution to East Lothian CLDT not only with their expertise but also with clinical time. More than 50 % of total clinical time spent on the patients with challenging behaviour in first cycle, was provided by SPBST. This is also evidenced in second cycle where there is an increase in clinical time of some professions when SPBST was withdrawn.

Background: Mouthwashes are antiseptic solutions and produce anti-inflammatory properties against periodontal infections in humans.  Several in-vitro studies have been performed against virulent strains, as evidenced by an appropriate knowledge about their quality, effectiveness and safety in this research. This study is designed to test the antimicrobial effects and evaluation of mouthwashes against pathogens involved in dental caries and oral infections. Methodology: Rinse solution (Mouthwash) has been developed by three different formulations.  Anti-caries solutions were applied and checked against virulent bacterial and fungal pathogens. The antimicrobial effectiveness was identified using the agar well diffusion method and minimum inhibitory concentration (MIC). Results: Chemisol showed potential killing activity and a zone of inhibition against pathogens ranging in 21-30 mm, which comparatively have higher zones than biosol and herbisol. Biosol also indicated efficacy within 11-13 mm zone of inhibition against Salmonella typhi ATCC-14028, Salmonella enterica ATCC-6017 resistant to herbisol and chemisol. Moreover, biosol exhibited greater MIC against most microorganisms at direct concentration and 1:10 dilution compared to herbisol and chemisol. Conclusion: The significant difference observed in the antimicrobial activities of herbal, herbal & allopathic combination and allopathic dental washes against pathogenic strains. This study concluded that proper gargling with mouth wash solutions reduces the risk of life-threatening strains from fecal water & food.

Background: Pre and post-harvest spoilage is becoming a severe concern not only in Pakistan but also worldwide. Foodborne illness remains prevalent throughout Pakistan because of the lack of informed risks and safe handling practices of the food preparers and handlers at each food chain point. It causes food spoilage that results in substantial economic losses to both producers (farmers) and consumers. Therefore, this article aimed to review the microbial load of meat, dairy, and seafood products and how the microbial load/population's shelf life and food quality can be affected. Methodology: During this experimental study, a total 127 samples were collected directly from different industries and included. Total bacterial count (TBC), total coliform count (TCC), fecal coliform count (FCC) and detection of Salmonella were done to check the quality of foods of animal origin collected from the different food industries from 2019 to 2020 and Pakistan standard (P.S.) of food quality was used to compare the results. Results: Among 127 analyzed samples, 27 (34.29%) samples were found contaminated with four bacterial parameters, TBC (6.35%), TCC (19%), and FCC (8.89%). At the same time, Salmonella spp were found absent in all of the samples analyzed. Among seven perishable food commodities, the higher percentage of unsatisfactory samples were observed in the chicken meat (1.62%) and beef meat samples (1.5%), while fresh milk was highly contaminated (0.9%) as compared to the powder milk (0.42%), followed by yogurt (0.26%). Shrimp (0.26%) and fish items (0.2%) showed the least percentage of unsatisfactory samples. Conclusion: The results suggest that a significant quality difference is observed in the food items sold in the central region of Karachi, further representing a vulnerability to human health in terms of bacteriological hazards. Our findings suggest that safety measures should be taken seriously to stay away from possible uncertainties.

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