Purpose -The aim of this study is to test the hypothesis that Clozapine reduces rates of self injury and the use of restraint in a medium secure setting in female patients who have a diagnosis of borderline personality disorder (BPD) and mild learning disability.Design/methodology/approach -A retrospective method of data collection was used with a requirement of six months baseline data on rates of self injury and the use of restraint. Patients were required to remain on Clozapine for a minimum of six months.Findings -The mean number of incidents of self injury in the six months prior to Clozapine was 20.75 (SD 8.8) and 13.5 (SD 4.51) in the six months following Clozapine, a reduction of 35 per cent. The mean number of incidents of restraint in the six months prior to Clozapine was 17.75 (SD 6.86) compared with 9.25 (SD 4.96) in the six months following commencement of Clozapine therapy, a reduction of 48 per cent. The results were analysed using the paired t-test and the difference between the means (self injury and use of restraint) was not statistically significant. This study demonstrates a reduction in the rates of self injury and use of restraint in women with a diagnosis of BPD when treated with Clozapine which was clinically significant although not statistically significant.Originality/value -The authors are not aware of any published articles on the use of Clozapine in women with BPD and co-morbid learning disability.

Drug use evaluation is the method of performance improvement that focuses on evaluation and improvement of drug use processes to achieve optimal patient outcomes. Assessment of antimicrobials can be performed by evaluating their use. The quality of pharmaceuticals is a worldwide concern, poor quality and substandard medicines can cause harm in various ways. In developing countries including Pakistan there are the number of cases reported showing high incidence of empirical use of drugs. Empirical use of antibiotics leads to antimicrobial resistance, which forces the therapy to switch from 1st line drugs to 2nd line. Also increased use of antibiotics other than specified treatment results in increase patient stay at hospital and cost. The objective of this study was to evaluate the drug use practices of Ceftriaxone in private sector tertiary care hospital. In this concurrent cross-sectional study, medication orders of 50 patients who received Ceftriaxone were studied from August to October 2013. Data were collected randomly by using a structured format and evaluated against the standard criteria set from British National Formulary to evaluate drug use practices. It was observed that 42% of patients were prescribed with Ceftriaxone for UTI’s. Majority of the patients (54%) were of age ranging from 20-30 years and from male gender (90%). A dose of 2gm/day was prescribed in 52% of the patients. The dose and frequency that we observed were the same as that mentioned in standard (BNF). The prescribing practices were satisfactory according to our study but it can be enhanced further by adhering to national standard guidelines.

Background: Out of all the human beings present the 20% are infertile. The 10-15 couple experience difficulties in conceiving. Study design: It is a cross-sectional study with statistical approach, conducted at Department of Obstetrics and Gynaecology, Indus Hospital Jubliee Town, Lahore. Objective: The study aimed to study the psychological effects of subfertility on women. Material and Methods: The study was conducted on the 80 female patients under treatment as they are not conceiving after repeated unsuccessful attempts. The female attended the gynecology department of our institute teaching hospital. The review board of the hospital approved the study. The average duration of not getting pregnant was 2 years in these participants. The study was conducted for 6 month from January 2022 to June 2022. Results: The average duration of not getting pregnant was 2 years in these participants. Most of the women reported that they previously had no child. However, there were 14% of them that had one child already. The mean of the state anxiety in these female participants came out to be 44 with a SD of 9.5. And the trait anxiety was reported to be 41 with SD of 7.1. Both of these features were found to be higher in case of sub fertile female patients undergoing fertility treatment. The level of stress was shown to be high in case of marital issues as compare to the social stress and personal stress. The educational level was found to be statistically linked to the participant’s stress level. However, the financial condition and age was not found to be linked to stress in sub fertile female. Conclusion: The women undergoing fertility treatments as they are not being successful to conceive suffers from stress, anxiety and depression like psychological issues. The societal pressure and low educational level are some of the factors that elevates the psychological issues in sub fertile female. If proper professional guidance is given to the patients it can help them cope with the fertility issue stress free. Therefore, counseling is a much helpful thing to accept and face the challenges of sub fertility. Keywords: Subfertility, psychological status, stress, anxiety and education level

The present study assessed the accumulation of selected heavy metals (Cd, Cr, Pb and Cu) in different organs including brain, heart, lungs, liver, stomach, kidney and flesh (muscles) of several animals commercially available in the market of Lahore, Pakistan. The concentrations found in different organs of chicken, goat and cow ranged between 0.132-2.165 mg/g for Cd, 0.768-2.335 mg/g for Cr, 0.260-1.411 mg/g for Pb and 0.092-1.195 mg/g for Cu. In the absence of national safety standards in respect to the content of heavy metals in foodstuffs, the results obtained were compared with international guidelines and found concentrations considerably higher than the prescribed safe limits. Therefore, immediate attention must be paid to prevent public health risks associated with the presence of toxic heavy metals in the commercially available meat products.