Heart failure is a growing public health concern. Advanced heart failure is frequently associated with severe muscle wasting, termed cardiac cachexia This process is driven by systemic inflammation and tumor necrosis factor in a manner common to other forms of disease-related wasting seen with cancer or human immunodeficiency virus. A variable degree of malnutrition is often superimposed from poor nutrient intake. Cardiac cachexia significantly decreases quality of life and survival in patients with heart failure. This review outlines the evaluation of nutrition status in heart failure, explores the pathophysiology of cardiac cachexia, and discusses therapeutic interventions targeting wasting in these patients.

Background Antibiotics are regularly prescribed by dental professionals in their practice, for the purpose of dental treatment as well as for the prevention of infection. The inappropriate use of antibiotics is a significant factor in the rise of antibiotic resistance. There is an immediate need for the advancement of prescribing guidelines and instructive polices to encourage the rational and appropriate utilization of medications especially antibiotics in dentistry. Objective The aim of this study was to identify the frequency of antibiotic prescription for treating dental infections in children among dentists in teaching institutions of Karachi, Pakistan and whether they are adhering to the prescribed international guidelines. Methods A cross-sectional study was conducted in three private and two public colleges of Karachi. After taking written informed consent and checking the inclusion criteria, a total of 380 participants were interviewed using a pre-designed validated questionnaire which included demographic profile and clinical case scenarios. Data were entered and analyzed on SPSS version 20. Inferential analysis was performed using chi-square test. The significance level was set at 0.05. Results Of the 380 subjects, a majority (71.3%) treated 15 or less children per month (n = 271) while 28.7% of dentists (n = 109) treated more than 15 children per month. Overall adherence to American Academy of Pediatric Dentistry guidelines was low from 26.1% to 44.2%. The difference between adherence of dentists with low and high volume of pediatric patients was

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Background: Implementation of infection control standards in blood banks is important to prevent transmission of blood-borne infections such as HIV, hepatitis B and Hepatitis C. No study from Pakistan evaluated the infection control practices in the blood banks of Pakistan. Aims: This study aimed to evaluate infection control practices with reference to safe blood supply, staff safety and waste disposal practices in blood banks of Karachi, Pakistan. Methods: This was a cross-sectional study. Infection control practices of all blood banks working in Karachi were determined through a structured questionnaire followed by an educational intervention. Mean scores for overall infection control practices and specific practices regarding safe blood supply, staff safety and waste disposal were calculated and compared with different factors using statistical tools. Results: Patient safety scores of 49 (92.5%) blood banks were within the satisfactory range but staff safety and waste disposal scores of only 26 (49.1%) and 4 (7.5%) blood banks were satisfactory. Significantly lower infection control (IC) scores were observed for stand-alone blood banks and those working in the absence of a haematologist (P-value < 0.001). Availability of written standard operating procedures (SOPs) and IC guidelines correlated positively (P-value < 0.001) with mean IC scores. Conclusions: Blood banks in Karachi lack implementation of IC standards particularly with reference to staff safety and waste management and disposal. Sindh blood transfusion authority (SBTA) should take measures to increase IC compliance within blood banks.