کھوکھلی محبت
میں تیری محبت کی عفت کو کیسے مان لوں
جو کئی قسم کی محبتوں کا مرکب ہے
دغا کی عفونت
لالچ کی رنگینیاں
جھوٹ کی نمائش
فریفتگی کے جھانسے
وعدوں کا فریب
اس عارضی رنگین مرکب کو کیا سمجھوں
چند روزہ سکوں۔۔؟
یا غلاظت کے ڈھیر پہ پڑا ہوا گلاب
Background: For organizations, conducting work in a safe environment has become mandatory under the provisions and guidelines provided by international and local laws. Occupational health and safety (OHS) standards have become a requisite in almost every industry these days; however, many organizations in developing countries are negligent at adhering to the safety measures, and there is also an absence of proper monitoring. Objective: Our objective was to determine the occupational health and safety standards that are prevailing in the food manufacturing sector of Pakistan. For this, we approached several food manufacturing companies and conducted interviews with quality assurance managers and health and safety executives to evaluate and analyze the workplace conditions to understand their OHS practices. Methods: We conducted 7 interviews with quality assurance managers in the food manufacturing and services companies of Pakistan. The interview guide was used for eliciting responses and a coding method was used to arrive at the themes of the data gathered. Results: The interviews conducted with quality assurance managers and those working to ensure that safety measures are practiced in their company, showed that the export-oriented food manufacturing companies in Pakistan are following OHS standards, as it has become a necessity, with numerous benefits such as ensuring worker safety, maintaining company reputation. However, the extent to which these measures are implemented and strictly followed varies, as there are certain issues that arise when companies try to follow and implement OHS practices The problems vary from company to company however, most of them relate to worker adaptability, costs, and training needs. OHS situation in local firms is concerning. Most of them do not have HSE officers, not the concept of toolbox talk, no preventive and safety measures. These poor practices make the situation unsafe, which lead to fatalities Conclusion: By establishing a national framework for policies and legislations as per the conventions of ILO for a better workplace environment along with proper law enforcement improvement in occupational health and safety domain can be achieved.
Background: Epidural volume extension (EVE), is a technique whereby a small-dose intrathecal block is enhanced by an epidural injection of physiological saline. This epidural injection exerts a compression effect on the dura, which then leads to a cranial increase in sensory spread of the intrathecal local anaesthetic. The lower dose of local anaesthetic required in the EVE technique has made it possible to avoid the side effects of the conventional dose of local anaesthetic while still having the benefit of adequate anaesthesia. Several studies have been conducted in this area; these studies have either used or omitted fentanyl. The successful results demonstrated in these trials have been solely attributed to the EVE effect without taking into consideration the pharmacological effect of fentanyl on the total outcome. No study has been done to demonstrate the effect of fentanyl on the epidural volume extension block and whether adding or omitting it would make a difference on spinal block level and other characteristics. Objective: The study aims at determining the effect of fentanyl plus low dose bupivacaine on the spinal block level of combined spinal epidural (CSE) anaesthesia utilizing the Epidural Volume Extension technique. Study design: A randomised controlled trial Methods - Intervention: Forty four women scheduled for elective caesarean section were randomized to 2 groups. One group got intrathecal bupivacaine with fentanyl followed by Epidural Volume Extension with physiological saline (Fentanyl group). The second group got intrathecal bupivacaine without fentanyl followed by epidural volume extension with physiological saline (No-fentanyl group). - Outcome measures: The outcome measures for this study were, the maximum sensory level which was measured by loss of sensation to temperature using a cold spirit swab, the motor block which was assessed using the Bromage score and the time to first request to analgesia taken as the time the patient first needed to use their PCA device or epidural supplementation intraoperatively. Results: The sensory block level after epidural volume extension increased in both arms. The increase was more in the intervention arm (Fentanyl group) than in the control arm (Nofentanyl group). This increase was however not statistically significant P=0.19. The sensory block level after epidural volume extension in the fentanyl group was 4 levels higher than the initial intrathecal block, while in the control arm the change was 3 levels higher than the than the initial intrathecal block. The time to first request of analgesia was shorter in the no-fentanyl