David N. Heller

Particle induced desorption and the analysis of large molecules

Abstract This opening lecture in the Texas Symposium on Particle Induced Desorption is intended to reflect on the state of the art, and to pose questions to the instrumentalists, the theoreticians and the analytical/bioorganic chemists participating in the three respective subdivisions of the symposium. Recent studies from our laboratory are discussed which investigate the information which can be deduced from the molecular ion envelope of an unknown middle mass or large molecule, evaluate the need for unit resolution above 5000 amu, and illustrate the ability of particle induced desorption to provide stable isotope analyses, absolute and relative quantitation in mixtures, as well as molecular weights and structural information.

Emergency and trauma care in Pakistan: a cross-sectional study of healthcare levels

Background The importance of emergency medical care for the successful functioning of health systems has been increasingly recognised. This study aimed to evaluate emergency and trauma care facilities in four districts of the province of Sindh, Pakistan. Method We conducted a cross-sectional health facility survey in four districts of the province of Sindh in Pakistan using a modified version of WHO’s Guidelines for essential trauma care. 93 public health facilities (81 primary care facilities, nine secondary care hospitals, three tertiary hospitals) and 12 large private hospitals were surveyed. Interviews of healthcare providers and visual inspections of essential equipment and supplies as per guidelines were performed. A total of 141 physicians providing various levels of care were tested for their knowledge of basic emergency care using a validated instrument. Results Only 4 (44%) public secondary, 3 (25%) private secondary hospitals and all three tertiary care hospitals had designated emergency rooms. The majority of primary care health facilities had less than 60% of all essential equipments overall. Most of the secondary level public hospitals (78%) had less than 60% of essential equipments, and none had 80% or more. A fourth of private secondary care facilities and all tertiary care hospitals (n=3; 100%) had 80% or more essential equipments. The average percentage score on the physician knowledge test was 30%. None of the physicians scored above 60% correct responses. Conclusions The study findings demonstrated a gap in both essential equipment and provider knowledge necessary for effective emergency and trauma care.

Thermal, laser, and fast atom desorption

Abstract The desorption methods show similarities in their spectra and suggest common mechanisms. However, thermal desorption spectra indicate that preformed ions and cationized species can be generated by purely thermal means, while differences in fast atom bombardment and field desorption spectra indicate the importance of external or localized fields in the kinds of ions extracted from the condensed phase.

A Combination Field Desorpt/Fast Atom Bombardment Source for the Ms-50 Mass Spectrometer

ABSTRACT Conversion of the combination EI/FD source supplied by Kratos for the MS-50 mass spectrometer to a combination FD/FAB source is described. Sensitivities in the combination source are equivalent to those of the stand alone FAB source supplied by Kratos and the EI/FD source. Some compounds could be analyzed by FAB only, others by FD only and a third group were susceptible to both techniques. The advantage of the combination source is that both techniques may be used without having to change ion sources or perform extensive instrumental manipulations.

Emergency and trauma care quality in Sindh province, Pakistan: a comprehensive assessment

Background Trauma and other medical emergencies are a substantial component of the burden of preventable morbidity and mortality in developing countries. We evaluate the availability of emergency medical equipments/ medicines across four districts Methods: This is a cross sectional study. We selected 93 out of 121 known public health facilities by stratified random sampling, These included a total of 67 Basic Health Units (BHUs), 14 rural Health Centers (RHCs), 12 public referral-level hospitals We have selected 12 private tertiary care hospitals by convenience sampling. The instrument for assessment of trauma and emergency equipment was derived directly from the WHO Guidelines for Essential Trauma Care. Results Overall, 105 healthcare facilities were surveyed. Majority of respondents (93.4%) reported no one in their facility had received formal training in emergency or trauma care. Many inexpensive and vital supplies were widely lacking, such as epinephrine (found in 30% of basic health unit facilities) and slings and splints (found in 18% of these facilities). Only one of 67 BHU facilities surveyed had an oral or nasal airway, compared to 11 of 12 private hospitals. Acetylsalicylic acid (aspirin) was available in only 67% of public referral hospitals and private hospitals; and an even smaller proportion of RHCs and BHU facilities. Fluid solutions, by contrast, were almost universally available across all levels of care. Conclusion Wider distribution of a handful of low-cost supplies could substantially decrease morbidity and mortality from emergencies and trauma in the province.

Assessment of knowledge of physicians about trauma/emergency care in public and private sectors in four districts of Sindh, pakistan

Background In Pakistan, currently there is only one institution, which offers postgraduate residency training program. Doctors from other specialties manage emergencies. Pakistan is vulnerable to natural and manmade emergencies. Therefore, our objective was to evaluate the emergency care knowledge of physicians across four districts of Sind province, Pakistan. Methods This was a cross-sectional study conducted between January and February 2009. The study included a convenience sample of 141 physicians staffing public and private sector health system. We developed a 35-item physician knowledge test derived from the Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) curriculum. The instrument was validated through pilot testing on 23 senior students at the Aga Khan University Medical College. Results Scores were uniformly poor, across all levels of physician training (p 0.34), tiers of care provided (0.74), public versus private (p 0.6) and districts (p 0.055) surveyed. The overall mean score was 11 (SD 5) of 35, and not one of the 141 physicians surveyed achieved a score above 20. Scores were low on several fill-in questions, such as on basic treatments for acute myocardial infarction (9% of respondents answered correctly), interpretation of electrocardiograms (3%) and the steps in basic life support (8%). Conclusion The knowledge deficit was severe and this likely compromises the ability of health facilities to use their available supplies most effectively. Better physician training would likely be the single most cost-effective way to ensure the optimal use of existing resources for emergency care in Sindh.