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Energy is a crucial factor and a capital of a country's resources leading indicator. World's energy focus is shifting towards alternate renewable, cheap and environment-friendly resources that can provide long-term sustainability for survival. Due to the fossil fuels depletion and their ever-growing cost, the need to shift focus towards renewable energy resources has increased a lot. To overcome the above-said problems, there is a need to look for a feasible and robust solution for thermal applications in remote areas. Biomass gasification proved to be one of the most efficient and clean waste-to-energy conversion processes in contrast to direct combustion of agricultural waste. Other than controlled burning of biomass, it can be subjected for different purposes like a thermal, synthesis of ethanol, engine running, and for fuel cell applications. An excessive amount of impurities like char, ash, tar, and particulate matter are making these syngas non-feasible for thermal or engine applications. To overcome the above-stated problem, a downdraft gasifier with cyclone separator and hybrid biomass filter was fabricated using locally available materials in the workshop of the Dept. of Farm Machinery and Power at the University of Agriculture, Faisalabad. Uniform distribution of 2.54-5.08 cm2 sizes of feedstock was used for gasification. Air was used as a gasifying agent. The reactor capacity was 0.19 m3. The values of performance parameters for wood waste and corncobs were recorded as fuel consumption rate (0.002195, 0.002323) kg-s-1, the volume of gas produced (24.56, 26.33) m3, operating time (5480, 5164) s, cleaning unit efficiency (81.79, 79.9) % and gas yield (2.04, 2.19) m³-kg-1. [ABSTRACT FROM AUTHOR]

Energy is a crucial factor and a capital of a country’s resources leading indicator. World’s energy focus is shifting towards alternate renewable, cheap and environment-friendly resources that can provide long-term sustainability for survival. Due to the fossil fuels depletion and their ever-growing cost, the need to shift focus towards renewable energy resources has increased a lot. To overcome the above-said problems, there is a need to look for a feasible and robust solution for thermal applications in remote areas. Biomass gasification proved to be one of the most efficient and clean waste-to-energy conversion processes in contrast to direct combustion of agricultural waste. Other than controlled burning of biomass, it can be subjected for different purposes like a thermal, synthesis of ethanol, engine running, and for fuel cell applications. An excessive amount of impurities like char, ash, tar, and particulate matter are making these syngas non-feasible for thermal or engine applications. To overcome the above-stated problem, a downdraft gasifier with cyclone separator and hybrid biomass filter was fabricated using locally available materials in the workshop of the Dept. of Farm Machinery and Power at the University of Agriculture, Faisalabad. Uniform distribution of 2.54-5.08 cm² sizes of feedstock was used for gasification. Air was used as a gasifying agent. The reactor capacity was 0.19 m³ . The values of performance parameters for wood waste and corncobs were recorded as fuel consumption rate (0.002195, 0.002323) kg-s-1, the volume of gas produced (24.56, 26.33) m³, operating time (5480, 5164) s, cleaning unit efficiency (81.79, 79.9) % and gas yield (2.04, 2.19) m³ -kg-1. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of the information seminar on breast cancer awareness among the medical and nursing students of CMH institute of Medical Sciences (CIMS) Multan Pakistan. Study Design: Prospective Comparative Study. Place and Duration of Study: One-day seminar at CMH Institute of Medical Sciences (CIMS) Multan Pakistan. Methodology: A one-day seminar on breast cancer awareness was arranged at CMH Institute of Medical Sciences Multan Pakistan for 3rd and 4th-year MBBS and 3rd-year BSc Nursing students. A total of 137 participants were recruited. Participants were selected by non-probability consecutive sampling. A validated 13-question questionnaire was designed to assess participants' basic knowledge of breast cancer and breast self-examination (BSE). Results: The mean age of participants was 21.27±0.99 years. 30(21.9%) were males and 107(78.1%) were female students. Before the seminar, approximately half of the students were correct about the demographics and presentation of breast cancer which increased to more than 80% in all avenues post-seminar (p<0.001). The most significant improvement was the correct responses regarding the age at which BSE should begin. Its frequency and correct technique pre-seminar were 75(54.7%), 51(37.2%) and 23(16.8%), which in post-seminar were 98(71.5%), 106(77.4%) and 75(54.7%) respectively (p<0.001). Conclusion: This one-day educational seminar played a significant role in increasing awareness among medical and nursing students. [ABSTRACT FROM AUTHOR]

Objective: To detect the resistant pattern of uropathogens and find the association of different factors with the resistance in the Poonch District of Azad Kashmir. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Medicine, Shaikh Khalifa Bin Zayed Hospital, Rawalakot, from Mar to Aug 2019. Methodology: Patients having signs and symptoms of urinary tract infection and growth of bacteria on urine culture were included in the study. The antimicrobial susceptibility of the isolates was determined by using the standard, modified Kirby Buer disc diffusion method. Zone sizes were interpreted following Clinical Laboratory Standards Institute (CLSI) 2019 guidelines. Results: 68 culture-positive patients were included in the study, 45 (66%) patients were female. There was a previous history of urinary tract infection in 44 (64.7%) patients, and 52 (76.5%) gave a history of antibiotic use in the last three months. E. coli was the commonest organism isolated, followed by Klebsiella, Proteus and Pseudomonas. All patients were resistant to at least one antibiotic, 48 (72%) isolates were multi-drug resistant. Uropathogens showed the highest resistance to Ampicillin in 67 (98.5%) patients and the lowest resistance to Piperacillin/Tazobactam 2 (3%) patients only. Resistance was significantly higher in patients having a history of recurrent urinary tract infection (p=0.028) and the use of antibiotics in the last three months (p<0.001). Conclusion: Resistance to antimicrobial agents is increasing in community-acquired urinary tract infections. Resistance is significantly higher in patients having a history of recurrent urinary tract infection and the use of antibiotics in the last three months. [ABSTRACT FROM AUTHOR]

Over the years, a crop variety grown on the commercial scale and under different conditions becomes vulnerable to various kinds of issues involving both biotic and abiotic plant stresses, alone or in combinations. This demands their substitution with new and improved genotypes possessing higher productivity and inherent resistance/tolerance against yield-limiting stresses. In this context, this editorial reports the development of a new chickpea kabuli variety "Noor-2019". This cultivar has improved yield potential, dietary elements (proteins, fat, ash), and more importantly, resistance against fusarium wilt and ascochyta blight compared to the existing varieties. The evolution of this strain commenced in 2002-03 cropping season by crossing K-90399 as a female parent with K-52582 as a male parent. The female parent had high yield potential, whereas the male parent had wilt resistance and was developed through introgression breeding using ILWC-126, an accession of Cicer reticulatum. Henceforth, the genetic variability was created to select for high yield and wilt resistant recombinants in subsequent generations. Resultantly, a uniform and high yielding progeny line PCK-09012, later designated as "Noor-2019" was selected and evaluated for yield, agronomy, and insect pests. This cultivar revealed a potential yield of 2882 kg ha-1 in testing phase and outperformed standard checks by producing 78.2%, 13.1%, and 28.8% higher grain yield in station, adaptation and national uniform yield trials, respectively. The plants of Noor-2019 are 60-65cm tall, semi-erect, and medium in canopy spread. Its grains are light brown, ram-headed, medium in size with a 100-seed weight of 25 g. Adoption of this cultivar across different climatic regions of Punjab, and other provinces could contribute in attaining self-sufficiency in local chickpea production as well as plummeting import bill. [ABSTRACT FROM AUTHOR]

We present disseminated intravascular coagulation (DIC) with excessive fibrinolysis (XFL) as an unusual presenting manifestation of metastatic prostate cancer (PC), which was successfully treated with chemotherapy with Docetaxel which not only controlled the disease but also reversed the patient's coagulopathy within seven days effectively. Thus highlighting rare and life-threatening haemorrhagic complications of prostate cancer along with its satisfactory management option. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic accuracy of the Mentzer index as a screening tool for iron deficiency anaemia, using an iron profile as the gold standard in patients presenting with hypochromic microcytic anaemia. Study Design: Cross-sectional study. Place and Duration of Study: Department of Pediatrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2021 to May 2022. Methodology: Data was collected from 163 patients with hypochromic microcytic anaemia. Red cell indices were noted for each patient and recorded on a defined proforma. Results: The mean age of the patients was 8.23±3.57 years. 85(52.1%) patients were males and 78(47.9%) were females. Moreover, out of 163 patients, the specificity, sensitivity, negative predictive value, positive predictive value, and diagnostic accuracy of the Mentzer index for the diagnosis of iron deficiency anaemia were 90.1%, 90.1%, 84.6%, 93.8%, and 90.8%, respectively. Conclusion: The cell-count-based indices, especially the Mentzer index, are reliable and available methods for diagnosing iron deficiency anaemia. They have an accurate discrimination ability. [ABSTRACT FROM AUTHOR]

Current study was aimed to formulate a nutritious snack bar by incorporating date pit powder (by product) and soy protein isolate in date paste. Date bars were formulated after ingredients optimization and were analyzed for physico-chemical, in-vitro starch and protein digestibility, antioxidants and microbial count. Results showed that date bars are rich source of protein, fiber, carbohydrates and fat with good digestibility properties. Date pit powder and soy protein isolate incorporation enhanced the total antioxidants and DPPH activity in soy date bars however, decreasing trend was observed in total antioxidants and inhibition of DPPH radical activity during 90 days of storage. Based on the results, it has been suggested that date bars may be considered as a source to meet the energy requirements of health-conscious consumers. Moreover, date pit powder and soy protein isolate can be used as nutraceutical in different functional foods as a valuable nourishment source for target population. [ABSTRACT FROM AUTHOR]

Objective: To discern the relationship of height and weight with body composition in healthy attendants of cancer patients. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Oct to Dec 2022. Methodology: A total of 226 healthy adults aged 19-47 years having similar daily physical activity levels were included. The body composition of study participants was evaluated using a bioelectric impedance analysis (BIA) machine. The weight of all participants was recorded with the help of a weighing machine. The participants' height was measured using a Harp enden Stadiometer and recorded. Results: Our study showed that weight had a significant positive correlation with body fat mass (rs value=0.83), skeletal muscle mass (rs value=0.763), total body water (rs value=0.704), fat-free mass (rs value=0.75) and per cent body fat (rs value 0.716). On the other hand, height had a negative but non-significant association with fat mass (rs value= 0.025) and a negative significant association with per cent body fat (rs value=-0.16). Height had a positive and significant association with fat-free mass (rs value=0.553), total body water (rs value=0.501) and skeletal muscle mass (rs value=0.505). Conclusion: Weight, if used alone, is not a good indicator of obesity or emaciation, and height has a negative association with fat mass. [ABSTRACT FROM AUTHOR]

Objective: To validate a clinical scoring system for defining the severity of ailment that will assist in developing strategies for management prioritisation. Study Design: Cross-sectional analytical study. Place and Duration of Study: Paediatric Department, Combined Military Hospital Lahore, Pakistan, form Jan 2020 to Jul 2021. Methodology: The paediatric patients who reported to the Medical Reception Centre and were admitted to an Inpatient Facility were enrolled. Demographic profile, temperature, oxygen saturation, pulse, respiratory rate, seizures, and sensorium labelled as "TOPRS" score was recorded with "0 - Normal" and "1 - Abnormal" and scores calculated for each patient with the incorporation of systemic inflammatory response and advanced paediatric life support criteria. Results: A total of 300 paediatric patients with an age range of 1-18 years (mean: 3.86±5.43) were included. Of 300 patients, 237(79%) were discharged after improvement, and the mortality rate was 63(21%). A significant association with the mortality rate was deciphered with temperature, oxygen saturation, and respiratory rate variables. In contrast, pulse rate, sensorium, and seizures were concluded to have an insignificant association. Score "0" mortality was associated with the 4.4% mortality, whereas score "5" enumerated an 80% death rate. Conclusion: The TOPRS clinical scoring system has significant value in the diagnosis of mortality and morbidity of paediatric patients and, hence, can assist in early recognition and triage of patients, consequently aiding in the provision of prioriti sation protocols and management in a befitting manner. [ABSTRACT FROM AUTHOR]

Objective: To determine the efficacy of trimodality therapy in patients with muscle invasive carcinoma of the bladder with deranged renal profile. Study Design: Quasi-experimental study. Place and Duration of Study: Oncology Department, Combined Military Hospital Rawalpindi over 14 months, from Sep 2015 to Nov 2016. Patients and Methods: Forty patients (n=40) having histopathologically confirmed (urothelial) urinary bladder cancer, clinical stage II or III, aged 18 to 80 years, with Eastern Cooperative Oncology Group (ECOG) performance status ≤2 and having deranged renal functions were included in this study. After maximal transurethral resection of bladder tumour (TURBT), they received 4 courses of chemotherapy with mitomycin and 5 fluorouracil, followed by concurrent chemoradiation using same chemotherapy received 50 Grays in 20 fractions. Response was assessed using RECIST criteria. Results: Efficacy; defined in terms of complete and partial response, was observed in 85% (n=34) of patients. Treatment efficacy was better in males as compared to females (90.6% vs. 62.55: p<0.05). Patients with better ECOG-PS (0-1) and early stage (2) responded well to treatment while response was almost same in different age groups, (p>0.05 in all cases). Thirty-seven patients were able to complete the full study protocol, 2 had severe mucositis and hand-foot syndrome while one patient died after septicaemia. Conclusion: Trimodality treatment with TURBT, chemotherapy and chemo-radiation is a feasible option for bladder preservation in muscle invasive bladder cancer patients with compromised renal functions if we use 5-fluorouracil and mitomycin chemotherapy. [ABSTRACT FROM AUTHOR]

Objective: To determine the association of low maternal serum vitamin-D levels with serum vitamin-D levels of their term neonates and higher risk of early onset neonatal sepsis (EOS). Study Design: Prospective observational study. Place and Duration of Study: Neonatal intensive care unit (NICU) of Department of Pediatrics; Combined Military Hospital (CMH) Malir Cantt Karachi, from Apr 2016 to Apr 2017. Material and Methods: Ninety three term neonates with EOS formed the "sepsis group" and equal number (93) of healthy term neonates without sepsis were included in the control group selected as per inclusion criteria. Blood samples of mothers and their neonates were drawn during the first 72 hours after delivery for measurement of serum vitamin-D levels. Results: Mean serum vitamin-D levels were 18.16 ± 8.21 ng/ml and 13.93 ± 13.29 ng/ml in the mothers and their neonates respectively in the sepsis group and were significantly lower (p-value <0.001) than the mean serum vitamin-D levels of 33.35 ± 12.70 ng/ml and 27.92 ± 7.58ng/ml in the mothers and their neonates respectively in the control group. Vitamin-D deficiency was found in significantly higher number of cases in mothers (88.17%) and neonates (82.80%) in sepsis group as compared to 52.69% mothers and 39.78% neonates in control group (p-value<0.001). There were 14 (15.05%) cases of culture proven sepsis in the study group as compared to just 01 (1.08%) case of culture proven sepsis in control group which was statistically significant (p-value<0.001). Conclusion: Lower maternal serum vitamin-D levels are associated with lower serum vitamin-D levels and higher risk of EOS in their term neonates. [ABSTRACT FROM AUTHOR]

Objectives: To determine the diagnostic accuracy of the pSOFA score in predicting mortality in critically ill pediatric patients. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Paediatrics, Pak-Emirates Military Hospital, Rawalpindi Pakistan, Aug 2021 to Feb 2022. Methodology: We studied 76 critically ill paediatric patients. All patients underwent pSOFA scoring on admission and then at 72 hours post-admission and were followed up till discharge or till mortality occurred. A pSOFA score of >10 was considered a high mortality risk. The two-by-two table was constructed to calculate the sensitivity, specificity and diagnostic accuracy of the pSOFA score in predicting the occurrence of death. Results: The pSOFA score had a sensitivity of 88.9% at Day-0, which improved to 100% by Day-7 in predicting whether mortality occurred. The specificity was 80.6% on Day-0 and 97.0% on Day-7. The diagnostic accuracy of pSOFA in predicting mortality was 81.6% when performed on the day of admission, which increased to 90.8% when calculated on Day 3 and was the highest on Day-7 when it was 97.4%. Conclusion: The pSOFA score has good diagnostic accuracy in predicting the occurrence of mortality in paediatric patients admitted to intensive care, which increases as the length of stay increases. [ABSTRACT FROM AUTHOR]

Sinonasal glomangiopericytoma is a tumor showing similarities to a glomus tumor but is less aggressive with a low malignant potential. The treatment of choice is complete excision followed by a regular long-term surveillance. The role of adjuvant chemotherapy and radiation remains undetermined. Our patient was a 45-year-old man who presented with nasal obstruction. Endoscopic excision showed sinonasal glomangiopericytoma. No adjuvant treatment was offered and patient was advised active surveillance. Patient was on a regular three-monthly follow-up. There was no evidence of disease recurrence after one year. [ABSTRACT FROM AUTHOR]

Objective: To review the validity of the future of health and care of older people (TFHCOP), good death perception criteria in Muslim patients and health care providers in cultural background of Pakistan. Study Design: A mixed method design with qualitative and quantitative components. Place and Duration of Study: Oncology Department, Combined Military Hospital, Rawalpindi, from July 2015 to October 2015. Material and Methods: It is a sequential explanatory type of mixed method research. A total of 110 participants were included in the study by non probability convenient sampling technique. A modified questionnaire was used based on the principles of TFHCOP good death definition comprising of 8 questions. This was followed by interviews. For data collection and analysis grounded theory approach was used with constant comparisons and open coding. Descriptive statistics were used to analyze questionnaire responses. For bivariate analysis we used chi-square test. Results: There was a consensus on the principles presented in the modified questionnaire in the two groups studied. Total of three domains measured non-significant difference in patient’s and health care provider’s perspectives. Participants identified four more domains. The first domain was related to faith in Allah Almighty, second domain is about leaving the will for bereaved, third domain was about the concerns to finish unfinished agendas and the fourth domain was related to the importance of family security over treatment or death. Conclusion: Perception of good death by Muslim patients and health care providers in Pakistan is different from that of Western and Arab communities in certain domains like religious beliefs, leaving will for the bereaved, finishing unfinished work and the importance of family concerns. [ABSTRACT FROM AUTHOR]

Objective: To determine the impact of the information seminar on breast cancer awareness among the medical and nursing students of CMH institute of Medical Sciences (CIMS) Multan Pakistan. Study Design: Prospective Comparative Study. Place and Duration of Study: One-day seminar at CMH Institute of Medical Sciences (CIMS) Multan Pakistan. Methodology: A one-day seminar on breast cancer awareness was arranged at CMH Institute of Medical Sciences Multan Pakistan for 3rd and 4th-year MBBS and 3rd-year BSc Nursing students. A total of 137 participants were recruited. Participants were selected by non-probability consecutive sampling. A validated 13-question questionnaire was designed to assess participants' basic knowledge of breast cancer and breast self-examination (BSE). Results: The mean age of participants was 21.27±0.99 years. 30(21.9%) were males and 107(78.1%) were female students. Before the seminar, approximately half of the students were correct about the demographics and presentation of breast cancer which increased to more than 80% in all avenues post-seminar (p<0.001). The most significant improvement was the correct responses regarding the age at which BSE should begin. Its frequency and correct technique pre-seminar were 75(54.7%), 51(37.2%) and 23(16.8%), which in post-seminar were 98(71.5%), 106(77.4%) and 75(54.7%) respectively (p<0.001). Conclusion: This one-day educational seminar played a significant role in increasing awareness among medical and nursing students. [ABSTRACT FROM AUTHOR]

Analytical characterization of blends of butter oil and chia (Salvia hispanica L.) seed oil was performed. Chia oil was added in butter oil at four different levels i.e. 6.25%, 12.5%, 18.75% and 25% (T1, T2, T3 and T4), butter oil without any addition of chia oil served as control. Blends of butter oil and chia oil were packaged in tin containers, stored at ambient temperature (34±2°C) for 90-days. Iodine values of control, T1, T2, T3 and T4 were 36.85, 45.63, 57.22, 67.45 and 76.37 (cg/g).Concentration of omega-3 fatty acids in T1, T2, T3 and T4 were 4.17%, 7.39%, 12.55% and 16.74%. The extent of omega-6 fatty acids in T1, T2, T3 and T4 was 2.81%, 2.94%, 3.15% and 3.32%.Concentration of omega-3 and 6 fatty acids in butter oil can be increased by chia oil. [ABSTRACT FROM AUTHOR]

Analytical characterization of pure, blended watermelon (Citrulluslanatus) oil and impact of blending on oxidative stability was investigated. Watermelon oil was added with mango (Mangiferaindica L.) kernel oil at four different concentrations, 5, 10, 15 and 20% (B1, B2, B3 and B4) and referenced with a control (100% watermelon oil).All the blends were stored in transparent PET bottles at ambient temperature (25-28°C) for 3 months; storage stability was assessed at the interval of 1 month. Free fatty acid, unsaponifiable matter, saponification value, refractive index and iodine value of watermelon seed oil and mango kernel oil was, 1.38%, 0.34%; 0.71%, 1.68%; 198, 193; 1.468, 1.457; 107.51, 54.62; respectively. The α tocopherol content of watermelon oil, mango kernel oil, B1, B2, B3 and B4 was 127.49, 205.44, 135.24, 144.52, 156.81 and 169.34 mg/kg. δ tocopherol in watermelon oil, mango kernel oil, B1, B2, B3 and B4 was 55.26, 34.81, 53.64, 51.27, 50.14 and 48.23 mg/kg. Concentration of linoleic acid decreased from 50.78% to 30.17% when 40% mango kernel oil was added to watermelon oil. Oleic acid increased from 22.89% in watermelon oil to 25.19%, 28.84% and 30.64% in B1, B2, B3 and B4. The increase in peroxide value of watermelon oil, B1, B2, B3 and B4 was 10.07, 9.56, 7.62, 5.17 and 2.87 (meqO2/kg) in a time dependent manner. Induction period of pure watermelon oil was less than mango kernel oil and blends. These results suggest that chemical characteristics and oxidative stability of pure watermelon oil can be improved by blending with mango kernel oil. [ABSTRACT FROM AUTHOR]

The main purpose of the study was to determine the suitable selection method for genetic improvement in chickpea. The current investigation was conducted at the research area of the Arid Zone Research Institute, Bhakkar, Punjab, Pakistan. Twelve chickpea genotypes were sown in RCBD following three replicates. Data regarding primary & secondary per plant, days for maturity, plant height as well as potential yield were recorded. The measured data were analyzed to principal component analysis (PCA), correlation, and path coefficient analysis. Analysis of variants revealed good variation among the accessions for the data recorded traits. Principal coefficient analysis differentiates all the traits into six PCs. Two components expressed more than one Eigenvalue which collectively contributed 80.12% towards the genetic variation. High positive loadings were expressed by the secondary branches per plant and pods per plant in all components. Path analysis revealed that secondary branches/plants expressed the highest direct positive effect (0.872) grain yield followed by the pods per plant (0.623). Analysis of correlation coefficient also confirmed the highest significant contribution of secondary branches per plant (91.57%) followed by pods (78.12%) and each plant's primary branches (64%). It was proved from the current experiment that Plants with secondary branches as well as pods may be focused on while assessing meaningful selection criteria for genetic improvement in chickpea. [ABSTRACT FROM AUTHOR]

The main purpose of the study was to determine the suitable selection method for genetic improvement in chickpea. The current investigation was conducted at the research area of the Arid Zone Research Institute, Bhakkar, Punjab, Pakistan. Twelve chickpea genotypes were sown in RCBD following three replicates. Data regarding primary & secondary per plant, days for maturity, plant height as well as potential yield were recorded. The measured data were analyzed to principal component analysis (PCA), correlation, and path coefficient analysis. Analysis of variants revealed good variation among the accessions for the data recorded traits. Principal coefficient analysis differentiates all the traits into six PCs. Two components expressed more than one Eigenvalue which collectively contributed 80.12% towards the genetic variation. High positive loadings were expressed by the secondary branches per plant and pods per plant in all components. Path analysis revealed that secondary branches/plants expressed the highest direct positive effect (0.872) grain yield followed by the pods per plant (0.623). Analysis of correlation coefficient also confirmed the highest significant contribution of secondary branches per plant (91.57%) followed by pods (78.12%) and each plant's primary branches (64%). It was proved from the current experiment that Plants with secondary branches as well as pods may be focused on while assessing meaningful selection criteria for genetic improvement in chickpea. [ABSTRACT FROM AUTHOR]

Objective: To analyze the presence of osteoporosis and osteopenia in post-menopausal breast cancer patients receiving hormonal therapy. Study Design: Comparative Cross-sectional Study. Place and Duration of Study: Oncology Department, Combined Military Hospital Rawalpindi Pakistan, from Dec 2020 to May 2021. Methodology: This study was conducted on 200 post-menopausal female breast cancer patients who had been taking Aromatase inhibitors for more than six months. All the study participants underwent a dual-energy X-ray absorptiometry (DEXA) scan to measure bone mineral density. As a result, they were classified as having osteoporosis or osteopenia based on bone mineral density. In addition, age, duration of therapy, tumour stage and molecular subtypes of breast cancer were correlated with the presence of osteopenia/osteoporosis in the study participants. Results: A total of 200 post-menopausal patients with breast cancer using hormonal therapy for more than six months were included in the final analysis. The mean age of the patients was 56.331 ± 6.744 years. In addition, 55 (22.5%) patients had normal bone mineral density, 92 (46%) had osteopenia, while 53 (26.5%) had osteoporosis on a dual-energy X-ray absorptiometry (DEXA) scan. Molecular subtypes of the tumour, the advancing age of patients and the long duration of hormonal therapy were statistically significantly associated with the presence of osteopenia/osteoporosis (p-value <0.05) in our study participants. Conclusion: Considerable number of post-menopausal patients with advanced breast cancer taking hormonal therapy showed the presence of osteopenia and osteoporosis. Molecular subtyping, the advanced age of patients and the long duration of hormonal therapy significantly predicted osteopenia/osteoporosis in patients included in our study. [ABSTRACT FROM AUTHOR]

Objective: To look for QTc changes associated with Tyrosine Kinase inhibitors and factors related to these changes among patients suffering from cancer. Study Design: Comparative cross-sectional study. Place and Duration of Study: Oncology Department, CMH Rawalpindi Pakistan from Dec 2020 to Apr 2021. Methodology: The study included one hundred and eighty patients with solid or haematological malignancies taking Tyrosine Kinase inhibitors for more than three months. They underwent 12 lead ECGs inside the oncology department. QTc interval was calculated on the ECG of all the patients, and they were evaluated for the presence of prolonged QT interval. Age, gender, duration of Tyrosine Kinase inhibitor use and presence of comorbid illness were correlated with the presence of QTc changes in our study participants. Results: Out of 180 cancer patients using Tyrosine Kinase inhibitors for more than three months included in the study, 96 (53.3%) were male, while 84 (46.7%) were female. One hundred and eighteen (65.5%) had normal QTc intervals, while 62 (34.5%) had prolonged QTc intervals in our study participants. Chi square test revealed that the advanced age of the patient and prolonged use of Tyrosine Kinase inhibitors was statistically significantly associated with QTc prolongation in our study (p-value<0.001). Conclusion: Significant number of cancer patients using Tyrosine Kinase inhibitors had prolonged QTc intervals in our study. Special attention should be paid to cancer patients with advancing age and prolonged use of Tyrosine Kinase inhibitors. [ABSTRACT FROM AUTHOR]

Objective: To determine the association of serum cholesterol and body mass index with body composition in the healthy Pakistani adults. Study Design: Cross sectional study. Place and Duration of Study: Physiology Department, Army Medical College Rawalpindi/National University of Medical Sciences (NUMS), in collaboration with Armed Forces Institute of Rehabilitation Medicine (AFIRM) Rawalpindi and Clinical Pathology Laboratory (CPL), Pak-Emirates Military Hospital, Rawalpindi. (Duration to be asked form the authors). Methodology: The total study sample of 100 participants was taken, that comprised of two groups. Group-1 included male participants (n=50) while group-2 included female participants (n=50). The participants were healthy adults of ages 18-60 years having same physical activity background. Body composition of the participants was evaluated by bioelectric impedance analysis machine. Measurement of serum cholesterol was carried out by the Bosh Diagnostic Kit. Body Mass Index (BMI) was determined by the formula. Results: Serum cholesterol was found to be significantly correlated with body fat mass and percent body fat in males (r-value = 0.90 and 0.82, p-value <0.001 and 0.002 respectively) and in females there was significantly positive correlation with the body fat mass (r-value=0.51, p-value 0.007), skeletal muscle mass (r-value = 0.59, p-value 0.005), total body water (r-value=0.67, pvalue 0.006) and fat free mass (r-value=0.47, p-value 0.008). Conclusion: Serum cholesterol and BMI were associated with the body composition in females but with only fat parameters in the males. [ABSTRACT FROM AUTHOR]

Objective: To investigate the dependency on feeding gastrostomy tubes in patients with head and neck cancers treated with radiotherapy alone or concurrent chemo-radiotherapy. Study Design: Retrospective longitudinal study. Place and Duration of Study: Combined Military Hospital, Rawalpindi and Shaukat Khanum Hospital, Peshawar Pakistan, from Jan and Jul 2022. Methodology: A total of 115 patients with head and neck cancers having no baseline dysphagia and having gastrostomy tubes were included. All had received an equivalent of 60 greys in 30 fractions or more of radiotherapy. Their swallowing was evaluated weekly during radiotherapy and then every 4-6 weeks on post-treatment follow-up. The total time duration of patient dependency on feeding gastrostomy tube after treatment completion was noted for each head and neck cancer subsite. Results: Of a total of 115 patients, 49(43%) of the patients had nasopharyngeal cancers, 22(19%) had laryngeal, 29(24%) oral cavity, 7(6%) hypopharyngeal and 9(8%) had cervical esophageal cancers. Proportion retaining gastrostomy tube for more than six months of treatment was 8.7% (median duration of retention was five months) with hypopharyngeal, nasopharyngeal, oral cavity, and laryngeal cancer were 14%, 9%, 9% and 5%, respectively. Conclusion: The proportion of patients with head and neck cancers requiring more than six months of a gastrostomy tube is 5-14%. Baseline assessment of swallowing and nutrition and prophylactic feeding gastrostomy can avoid treatment interruptions. Longer duration of retention of a gastrostomy tube is associated with poor quality of life in head and neck cancer patients receiving radiation or concurrent chemo-radiation. [ABSTRACT FROM AUTHOR]

The authors stress the need for a cost effective treatment for cancer in the Pakistan Armed Forces. Topics covered include the rise in the cost of treatments as the medical technology advances, the task of the oncology formulary committee formulated at Combined Military Hospital Rawalpindi, and the increase in the number of cancer patients each year.

Objective: To compare oral Montelukast with oral Doxycycline in the treatment of moderate Acne Vulgaris in terms of mean change in acne severity index. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital Rawalpindi, from Mar 2016 to Aug 2016. Methodology: A total of 84 patients were included in the study. They were randomly assigned to group A and B by consecutive non probability sampling technique. Group A was given 100mg Doxycycline with topical 10% benzoyl peroxide and group B was given 5mg Montelukast with topical 10% benzoyl peroxide. Acne severity index (ASI) was calculated at base line and after one month. Mean change in acne severity index was observed for both the groups. Results: Independent sample t-test was used to compare the means. Mean post treatment change in acne severity index of group A was 5.45 ± 1.29 and group B was 1.80 ± .59 respectively (p-value <0.001). On post stratification analysis for age and gender results were consistent. Conclusion: Efficacy of Doxycycline is significantly better in terms of mean change in Acne Severity Index, as compared to Montelukast. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic value of red blood cell distribution width and red cell distribution width index in differentiating iron deficiency anaemia and beta-thalassemia trait. Study Design: Cross-sectional study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2021 to Feb 2022. Methodology: A study population of 110 children with an age limit of 1.5-7 years who reported low haemoglobin was subjected to serum iron and ferritin levels with further evaluation of red cell count, blood morphology, and comparison of mean corpuscular volume. Red cell distribution width was taken from the lab report, whereas Red blood cell distribution width index value was computed for the samples. Results: A total of 110 patients were enrolled in the study. Seventy-five (68.18%) participants were diagnosed with IDA, 26(23.63%) participants were the candidate of PTT. Nine participants were suffering from anaemia of variable etiologies such as chronic ailment and sideroblastic, etc. PTT patients presented with higher RBC counts with a mean of 5.71±1.2 x1012 /l (6.8-8.5 x1012 /l) when compared to IDA participants who deciphered values of 3.5±0.5 (2.6-4.3 x1012 /l). Mean MCV in PTT was 52.2±2.7(50.1-56.8) whereas for IDA were 72.5±1.2(61.2-78.3). In IDA low serum ferritin was recorded 4.02±1.1(2.2-9.2) as compared to mean values of PTT patients. Conclusion: Red cell distribution width index and Red blood cell distribution width are authentic variables and inexpensive modalities in differentiating between iron deficiency anaemia and beta-thalassemia trait with reliability. [ABSTRACT FROM AUTHOR]

Neuroendocrine breast carcinoma (NEBC) is histologically a rare type of invasive breast cancer. It constitutes only 0.2-0.5% of all invasive breast cancers. In this case series, we are presenting five cases having primary neuroendocrine breast cancers that had been reported at a high-volume cancer centre in Pakistan. In this study, neuroendocrine breast cancer patients at Shaukat Khanum Memorial Cancer Hospital and Research Centre Peshawar were evaluated. We had retrospectively collected information on demographic characteristics of our patients, physical examination, radiological findings, surgical procedures with their outcomes, histopathological and immuno-histochemical characteristics, systemic adjuvant/neoadjuvant therapy and follow-up. [ABSTRACT FROM AUTHOR]

A field trial was conducted to test the bio-efficacy of five commercial acaricidal formulationsviz., azocyclotine 25% WP (Gallop), fenpyroximate 5% SC (Unique-M), diafenthiuron 500 SC (Trophy), hexythiazon 10% WP (Nissorun) and abamectin 1.8% EC (Commando) against brinjal mites, Tetranychus urticae, on brinjal crop under field conditions. Brinjal vegetable was raised under standard agronomic practices. Field recommended dose of these acaricides were used knapsack sprayer. Results showed a significant mite reductionby allacaricides as compared to control. Among the tested acaricides, hexythiazon 10% WP (Nissorun) gave the highest reduction of mites (i.e., 41.42, 55.56 and 37.90%) after 3, 5, and 7 days of first spray, respectively. Similarly, after second spray, hexythiazon 10% WP (Nissorun) again gave maximum reduction (i.e., 41.65, 39.33 and 16.40%) of T. urticae at 3, 5 and 7 days, respectively. [ABSTRACT FROM AUTHOR]

To improve yield and shelf life of stock can enhance economic value to flowers growers globally. A study was conducted to evaluate the efficacy of various bio-stimulants on yield and quality of stock. Three cultivars of stock, viz. 'Cheerful White', 'Iron Rose' and 'Iron White' foliarly sprayed by bio-stimulants (Isabion and Tecamin Max) with three different concentrations (1 ppm, 3 ppm, and 5 ppm) with the different number of sprays (1, 2, or 3 sprays). The first spray was applied after one month of transplanting, while the other two were applied at fortnight intervals after the first spray. Fisher's Analysis of variance revealed that Isabion at 1 ppm as 1 spray, 3 ppm as 3 sprays, and 5 ppm as 3 sprays produced the highest plant height for three cultivars of stock. 'Cheerful White' had the highest stem length when plants were sprayed once at 1 ppm Isabion. Among cultivars, 'Iron Rose', produced highest leaf area (42.8 cm2) with 3 ppm Isabion application, when sprayed only one time. Among the number of sprays, plants sprayed three times with Isabion produced the thickest stem diameter followed by 2 and 1 sprays. 'Cheerful White' had maximum leaf total chlorophyll contents, followed by 'Iron White' and 'Iron Rose' (69.1 SPAD and 68.8 SPAD, respectively). Among the number of sprays, plants sprayed three times had the longest vase life. Cheerful White proved early cultivar of stock while Iron White were late cultivars when grown in agro-climatic conditions of Faisalabad. Tecamoin Mix is recommended biostimulant for quality production of Mathiola incoma L. rather than isabion. [ABSTRACT FROM AUTHOR]

Purple blotch disease is exerting a severe threat on onion production. The current study was conducted for screening of accessions against purple blotch disease and determining the source of resistance against Purple blotch disease of onion caused by Alternaria porri. Potential of 50 onion accessions was evaluated against A. porri during 2017 and 2018 under field conditions. After that effect of some fungicides and plant extracts was determined for disease suppression on a susceptible variety of onion. During both years of study, eight accessions (Phulkara, Texas Early, Cylon, Sunset, Red Gystal, Rubi F1, Red Flame, ON-14133) exhibited resistant response with minimum percent disease index (PDI) which ranged between 5-10%, followed by Mirpurkhas, Nasarpuri, HON-1069, Pania, Rubi F2, GSL-132, Red Moon, PK-1032, F-1122, Red Imposta, Early Red, Desi Large and Vrio-4 which showed moderately resistant response to A.porri with PDI of 11-20%, whereas, the four accession including Golden Arab, Desired, Sultan F1 and Red Nasik expressed Moderately resistant response with PDI of 21-40%. Moreover, six accessions (Yellow Gystal, Vrio-9, Vrio-5, Vrio-4, Vrio-1, and Vrio-3) expressed susceptible response with high value of PDI 41-60% whereas; nine accessions (CBS-130, ON-14121, Pink Panther, Vrio-7, Vrio-3, F1 Zeus, SE-16, Vrio-8 and Marvi) showed maximum value (Above 60%) of PDI and expressed highly susceptible response to A.porri. Among fungicides and botanical extracts, Chlorostrobin and Azadirachta indica extract expressed significant reduction in disease severity. It was concluded that out of 50, only eight accessions were resistant which might be grown successfully for higher crop production. Moreover, use of Chlostrobin and extract of Azadirachta indica may be used for disease management. [ABSTRACT FROM AUTHOR]

To improve yield and shelf life of stock can enhance economic value to flowers growers globally. A study was conducted to evaluate the efficacy of various bio-stimulants on yield and quality of stock. Three cultivars of stock, viz. ‘Cheerful White’, ‘Iron Rose’ and ‘Iron White’ foliarly sprayed by bio-stimulants (Isabion and Tecamin Max) with three different concentrations (1 ppm, 3 ppm, and 5 ppm) with the different number of sprays (1, 2, or 3 sprays). The first spray was applied after one month of transplanting, while the other two were applied at fortnight intervals after the first spray. Fisher’s Analysis of variance revealed that Isabion at 1 ppm as 1 spray, 3 ppm as 3 sprays, and 5 ppm as 3 sprays produced the highest plant height for three cultivars of stock. ‘Cheerful White’ had the highest stem length when plants were sprayed once at 1 ppm Isabion. Among cultivars, ‘Iron Rose’, produced highest leaf area (42.8 cm² ) with 3 ppm Isabion application, when sprayed only one time. Among the number of sprays, plants sprayed three times with Isabion produced the thickest stem diameter followed by 2 and 1 sprays. ‘Cheerful White’ had maximum leaf total chlorophyll contents, followed by ‘Iron White’ and ‘Iron Rose’ (69.1 SPAD and 68.8 SPAD, respectively). Among the number of sprays, plants sprayed three times had the longest vase life. Cheerful White proved early cultivar of stock while Iron White were late cultivars when grown in agro-climatic conditions of Faisalabad. Tecamoin Mix is recommended biostimulant for quality production of Mathiola incoma L. rather than isabion. [ABSTRACT FROM AUTHOR]

Purple blotch disease is exerting a severe threat on onion production. The current study was conducted for screening of accessions against purple blotch disease and determining the source of resistance against Purple blotch disease of onion caused by Alternaria porri. Potential of 50 onion accessions was evaluated against A. porri during 2017 and 2018 under field conditions. After that effect of some fungicides and plant extracts was determined for disease suppression on a susceptible variety of onion. During both years of study, eight accessions (Phulkara, Texas Early, Cylon, Sunset, Red Gystal, Rubi F1, Red Flame, ON-14133) exhibited resistant response with minimum percent disease index (PDI) which ranged between 5-10%, followed by Mirpurkhas, Nasarpuri, HON-1069, Pania, Rubi F2, GSL-132, Red Moon, PK-1032, F-1122, Red Imposta, Early Red, Desi Large and Vrio-4 which showed moderately resistant response to A.porri with PDI of 11-20%, whereas, the four accession including Golden Arab, Desired, Sultan F1 and Red Nasik expressed Moderately resistant response with PDI of 21-40%. Moreover, six accessions (Yellow Gystal, Vrio-9, Vrio-5, Vrio-4, Vrio-1, and Vrio-3) expressed susceptible response with high value of PDI 41-60% whereas; nine accessions (CBS-130, ON-14121, Pink Panther, Vrio-7, Vrio-3, F1 Zeus, SE-16, Vrio-8 and Marvi) showed maximum value (Above 60%) of PDI and expressed highly susceptible response to A.porri. Among fungicides and botanical extracts, Chlorostrobin and Azadirachta indica extract expressed significant reduction in disease severity. It was concluded that out of 50, only eight accessions were resistant which might be grown successfully for higher crop production. Moreover, use of Chlostrobin and extract of Azadirachta indica may be used for disease management. [ABSTRACT FROM AUTHOR]

Objective: To study the role of Hydroxyurea in patients suffering from P-thalassemia major. Study Design: Prospective longitudinal study. Place and Duration of Study: Department Paediatrics, Combined Military Hospital, Malir Cantt, Karachi Pakistan, from Nov 2019 to Oct 2020. Methodology: Data from 73 beta-thalassemia major patients was collected using a structured questionnaire containing inquiries about basic socio-demographic details, disease history, laboratory reports and particulars of former treatment regimens. Hydroxyurea was administered, and its effects were noted among the subjects regarding the frequency of transfusion, haemoglobin levels and severity of clinical symptoms. Results: The mean age of study subjects was 9.15±3.99 years, and most study subjects (56.14%) were boys. The preintervention (before administration of Hydroxyurea) levels of Hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular haemoglobin concentration (MCHC), and serum ferritin levels were unremarkable when compared to postintervention levels. However, a significant difference was observed in HbF levels. In addition, an encouraging decrease was reported in the self-rated severity (using VAS) of symptoms such as fatigue (p<0.05), weakness (p>0.05), and shortness of breath (p>0.05). In addition, the transfusion interval was significantly reduced (p<0.05). Conclusion: After carefully considering the results, it can be concluded that Hydroxyurea plays a positive role and brings about significant improvement among patients suffering from P-thalassemia major. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To analyze the factors associated with adverse effects in elderly women receiving chemotherapy for breast cancer. Study Design: Comparative Cross-sectional Study. Place and Duration of Study: Oncology Department, Combined Military Hospital (CMH), Rawalpindi Pakistan, from Dec 2020 to Nov 2021. Methodology: This study was conducted on 145 female patients (>65 years) with breast cancer who were taking chemotherapy of any type and had undergone one cycle. All the study participants underwent detailed clinical evaluation by a consultant oncologist to assess the presence of various adverse effects of chemotherapy. In addition, the association of Anthracycline use, >3 months of treatment, low haemoglobin at baseline and abnormal liver functions at baseline were studied with adverse effects in the study participants. Results: The final analysis included one hundred fortyfive elderly female patients with breast cancer receiving chemotherapy. The mean age of the patients was 69.731±8.794 years. 89(61.4%) patients had no adverse effects, while 56(38.6%) had one or more adverse effects during chemotherapy. Anaemia 26(17.9%) was the commonest adverse effect, followed by fatigue 18(12.4%) and abnormal liver function tests 18(12.4%). It was revealed that the use of Anthracyclinebased chemotherapy and long duration of chemotherapy were statistically significantly associated with adverse effects (p-value<0.05) in our study participants. Conclusion: Considerable number of elderly patients with breast cancer undergoing chemotherapy showed the presence of adverse effects. In addition, patients using Anthracyclinebased chemotherapy and taking chemotherapy for more than three months were more at risk of developing adverse effects. [ABSTRACT FROM AUTHOR]

Objective: To analyze the presence of osteoporosis and osteopenia in post-menopausal breast cancer patients receiving hormonal therapy. Study Design: Comparative Cross-sectional Study. Place and Duration of Study: Oncology Department, Combined Military Hospital Rawalpindi Pakistan, from Dec 2020 to May 2021. Methodology: This study was conducted on 200 post-menopausal female breast cancer patients who had been taking Aromatase inhibitors for more than six months. All the study participants underwent a dual-energy X-ray absorptiometry (DEXA) scan to measure bone mineral density. As a result, they were classified as having osteoporosis or osteopenia based on bone mineral density. In addition, age, duration of therapy, tumour stage and molecular subtypes of breast cancer were correlated with the presence of osteopenia/osteoporosis in the study participants. Results: A total of 200 post-menopausal patients with breast cancer using hormonal therapy for more than six months were included in the final analysis. The mean age of the patients was 56.331 ± 6.744 years. In addition, 55 (22.5%) patients had normal bone mineral density, 92 (46%) had osteopenia, while 53 (26.5%) had osteoporosis on a dual-energy X-ray absorptiometry (DEXA) scan. Molecular subtypes of the tumour, the advancing age of patients and the long duration of hormonal therapy were statistically significantly associated with the presence of osteopenia/osteoporosis (p-value <0.05) in our study participants. Conclusion: Considerable number of post-menopausal patients with advanced breast cancer taking hormonal therapy showed the presence of osteopenia and osteoporosis. Molecular subtyping, the advanced age of patients and the long duration of hormonal therapy significantly predicted osteopenia/osteoporosis in patients included in our study. [ABSTRACT FROM AUTHOR]

Objective: To look for QTc changes associated with Tyrosine Kinase inhibitors and factors related to these changes among patients suffering from cancer. Study Design: Comparative cross-sectional study. Place and Duration of Study: Oncology Department, CMH Rawalpindi Pakistan from Dec 2020 to Apr 2021. Methodology: The study included one hundred and eighty patients with solid or haematological malignancies taking Tyrosine Kinase inhibitors for more than three months. They underwent 12 lead ECGs inside the oncology department. QTc interval was calculated on the ECG of all the patients, and they were evaluated for the presence of prolonged QT interval. Age, gender, duration of Tyrosine Kinase inhibitor use and presence of comorbid illness were correlated with the presence of QTc changes in our study participants. Results: Out of 180 cancer patients using Tyrosine Kinase inhibitors for more than three months included in the study, 96 (53.3%) were male, while 84 (46.7%) were female. One hundred and eighteen (65.5%) had normal QTc intervals, while 62 (34.5%) had prolonged QTc intervals in our study participants. Chi square test revealed that the advanced age of the patient and prolonged use of Tyrosine Kinase inhibitors was statistically significantly associated with QTc prolongation in our study (p-value<0.001). Conclusion: Significant number of cancer patients using Tyrosine Kinase inhibitors had prolonged QTc intervals in our study. Special attention should be paid to cancer patients with advancing age and prolonged use of Tyrosine Kinase inhibitors. [ABSTRACT FROM AUTHOR]

Weeds are serious pests in rice sown under direct-seeded rice (DSR) technology. Herbicide-based weed management is becoming increasingly popular, but there is a dire need to choose appropriate herbicides and their effective dose for controlling weeds in DSR fields. A field trial was conducted to appraise the comparative efficacy of three post-emergent herbicides applied at different doses [Clover 20% EC (bispyribac sodium) at 39.54, 59.30, and 79.07 g a.i. ha-1, Pyranex Gold 30% WDG (bispyribac sodium + bensulfuron methyl) at 74.13, 111.20, and 148.26 g a.i. ha-1, and Puma Super 7.5% EW (fenoxaprop-p-ethyl) at 46.33 and 92.66 g a.i. ha-1] at 20 days after sowing (DAS) for weed control and paddy yield performance under DSR system. A weedy check was retained as control. Results revealed that Clover and Pyranex Gold applied at either dose significantly (p≤0.05) reduced the population and growth of Cyperus iria (90-97% weed density and 93-97% weed dry biomass) and Echinochloa colona (94-97% weed density and weed dry biomass) weeds over control, while Puma Super proved efficient in suppressing Leptochloa chinensis and Echinochloa colona weeds. Among all the tested treatments, application of Puma Super at 92.66 g a.i. ha-1 furnished the highest number of tillers (137.3 in 2014 and 141.3 in 2015), grains panicle-1 (77 in 2014 and 79 in 2015), final paddy yield (1983.8 and 1570 kg ha-1 in 2014 and 2015, respectively), and net economic returns (Rs. 95915 ha-1), followed by the use of Puma Super at 46.33 g a.i. ha-1 which offered the next best economic benefits (Rs. 81906 ha-1). Thus, applying Puma Super at 92.66 g a.i. ha-1 is appeared viable approach to control grassy weed flora and ensure higher paddy yield with higher economic returns when rice is sown under DSR technology. [ABSTRACT FROM AUTHOR]

1H and 13C-NMR spectra indicate that naphthalene portion of 1,4-bis-(chloromethyl)- naphthalene was slightly twisted due to C8 – H---Cl* bonding. The electrons distribution on magnetically equivalent carbons became uneven that is why ten carbon peaks instead of five pairs of magnetically equivalent carbons had appeared in 13C-NMR spectra. Due to C8 – H --- Cl* bonding, extension and contraction in bond lengths from their normal positions had occurred. Similar case was with 1H-NMR of the said compound. The molecule also showed antifungal and antibacterial properties. [ABSTRACT FROM AUTHOR]

Tunnel farming is getting popular in the farmer's community of Pakistan due to the possibility of growing off-season vegetable crops with high yield in a controlled environment. In the current study, the development and validation of IoT system consisting of monitoring and control units were carried out for controlling the environmental factors in tunnel farming. Three tunnels were set for monitoring the environmental factors using temperature, humidity and soil moisture sensors. Two of three tunnels were fit with control units of exhaust fans and air heaters and a water pump for controlling the temperature and soil moisture. During the testing and validation of the system, temperatures recorded through DHT-21 sensor and thermometer in tunnel 1, 2 and 3 had strong correlations of 0.9986, 0.998 and 0.9978 respectively. Similarly, strong correlations of 0.9987, 0.9994 and 0.998 were found for RH (%) measured through DHT-21 sensor and RH meter for tunnel 1, 2 and 3 respectively. For soil moisture measurement, similar correlations were observed for resistive soil moisture sensor and oven dry method. It was explored that an increase in temperature through an air heater decreases the RH in tunnel 1 and 2 compared to tunnel 3 which has higher RH because it was not installed with air heater and exhaust fan. System controlled the temperature and soil moisture within adjusted limits of 22-27 °C, 17-23 % for tunnel 1 and 19-22 °C, and 19-23 % for tunnel 2. [ABSTRACT FROM AUTHOR]

Tunnel farming is getting popular in the farmer's community of Pakistan due to the possibility of growing off-season vegetable crops with high yield in a controlled environment. In the current study, the development and validation of IoT system consisting of monitoring and control units were carried out for controlling the environmental factors in tunnel farming. Three tunnels were set for monitoring the environmental factors using temperature, humidity and soil moisture sensors. Two of three tunnels were fit with control units of exhaust fans and air heaters and a water pump for controlling the temperature and soil moisture. During the testing and validation of the system, temperatures recorded through DHT-21 sensor and thermometer in tunnel 1, 2 and 3 had strong correlations of 0.9986, 0.998 and 0.9978 respectively. Similarly, strong correlations of 0.9987, 0.9994 and 0.998 were found for RH (%) measured through DHT-21 sensor and RH meter for tunnel 1, 2 and 3 respectively. For soil moisture measurement, similar correlations were observed for resistive soil moisture sensor and oven dry method. It was explored that an increase in temperature through an air heater decreases the RH in tunnel 1 and 2 compared to tunnel 3 which has higher RH because it was not installed with air heater and exhaust fan. System controlled the temperature and soil moisture within adjusted limits of 22-27 °C, 17-23 % for tunnel 1 and 19-22 °C, and 19-23 % for tunnel 2. [ABSTRACT FROM AUTHOR]

Objective: To assess the predictors associated with mortality within 8 weeks in patients undergoing endoscopic N-butyl-2-cyanoacrylate treatment. Study Design: Prospective comparative study. Place and Duration of Study: Department of Gastroenterology, Services Institute of Medical Sciences, Lahore Pakistan, from Mar 2018 to Mar 2019. Methodology: A total of 106 patients of gastric variceal bleed were enrolled in the study. Tissue glue was injected into the varix endoscopically and mortality within 8 weeks after endoscopic intervention was noted. Results: Among the enrolled patients, 65 (61.3%) were male and 41(38.7%) were female. Mortality was noted in 19 (17.9%) patients within 8 weeks after endoscopic therapy. Chi-square analysis showed creatinine >1.5, Child Pugh score >9, MELD score >18, re-bleeding within 7 days, low blood pressure <90/60 at presentation and hepatic encephalopathy as significant predictors of mortality (p<0.005). Conclusion: Cirrhotic patients undergoing endoscopic injection of gastric varix with N-butyl 2-cyanoacrylate after gastric variceal bleed have high risk of death within 8 weeks. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the impact of adjuvant Granulocyte-Macrophage Colony-Stimulating Factor (GM-CSF) therapy in neonatal sepsis. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Lahore Pakistan, Mar 2019 to Mar 2020. Methodology: Thirty neonates (15 cases and 15 controls) were randomly selected for this study. The Interventional Group was given GM-CSF and standard-of-care treatment; the Control Group only received standard care. Both groups were followed for the primary outcome (i.e., discharge or death). Secondary outcomes included the effects of GM-CSF on haematological parameters of neonatal sepsis. Results: The mean gestational age of the children was 33.46±2.47 weeks. In the Interventional-Group, 56.7% of the neonates were discharged with the resolution of the sepsis. There was no significant difference concerning the secondary outcome, but the mortality was higher in the neonates among the Control-Group (p-value>0.05). Conclusion: Our study showed no difference in mortality between the Interventional and the Control Groups. The GM-CSF therapy could be used as an adjuvant therapy in neonates with neonatal sepsis to increase the total leukocyte and absolute neutrophil counts. Further studies are needed to holistically chart the clinical benefit of GM-CSF adjuvant therapy. [ABSTRACT FROM AUTHOR]

Objective: To determine the relationship of baseline quantitative BCR ABL1 gene percentage and therapeutic response i.e. Early Molecular Response (EMR) at 3 months with first generation Tyrosine kinase inhibitors (Imatinib) in patients with Chronic Myeloid Leukemia (CML) in chronic phase (CP) Study Design: Prospective observational study. Place and Duration of Study: Combined Military Hospital, Rawalpindi, Pakistan, and Armed Forces Institute of Pathology Rawalpindi, Pakistan from Oct 2017 to Oct 2019. Methodology: One hundred and seventy patients, 18 years of age or older with newly diagnosed Chronic Myeloid Leukemia (CML) in chronic phase (CP) with quantitative baseline BCR-ABL (IS) transcript were included in the study. All enrolled patients were placed on Imatinib therapy (400 mg/day) and Reverse transcription polymerase chain reaction (RT-PCR) for BCR ABL transcript was repeated at 3 months to document EMR (BCR-ABL (IS) <10%). Patients who were in accelerated/blast phase, or already taking any Tyrosine Kinase Inhibitors (TKI) or chemotherapy were excluded from the study Results: In our study 101 (59.4%) patients achieved early molecular response. Out of these 80 (70.8%) patients with BCR-ABL<50% at baseline value showed early molecular response. However, only 21 (36.8%) with BCRABL >50% at baseline achieved early molecular response (p-value <0.001). Conclusion: A significant number of patients achieved early molecular response with Imatinib therapy that had BCR ABL below 50%, however those with baseline BCR ABL >50%, the rate of EMR was comparatively lower. [ABSTRACT FROM AUTHOR]

Wastewater contains a surplus amount of trace metals that contaminate the soil and crops. A pot trial was performed to determine the impact of wastewater on the zinc accumulation in forages and their associated health risk. Forages both of summer (Zea mays, Echinochloa colona, Pennisetum typhoideum, Sorghum vulgare, Sorghum bicolor, Sesbania rostrata, and Cyamopsis tetragonoloba) and winter (Trifolium alexandrinum, Medicago sativa, Brassica campestris, Trifolium resupinatum, Brassica juncea, and Brassica napus) were grown with sewage water and tap water treatment. The experiment was laid down in a completely randomized design with five replicates. The concentration of zinc in water, root and forage samples were analysed by atomic absorption spectrophotometer. In tap water, the zinc value was 0.498 mg/L and in wastewater 0.509 mg/L, respectively. The maximum level of zinc in the forages leaves was 3.582 mg/kg found in Brassica napus grown in the winter season. The maximum observed value for zinc bioconcentration factor in Brassica juncea was (2.88) grown in winter. The values of pollution load index for zinc were found less than 1. The values of daily intake of metal and health risk index for zinc in all forages were less than 1 indicated that consumption of these forages was free of risk. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the safety profile of Hasson’s technique of laparoscopic port access in patients undergoing laparoscopic cholecystectomy. Study Design: Cross-sectional study. Place and Duration of Study: Department of general surgery, Combined Military Hospital Lahore, from Oct 2014 to Aug 2018. Methodology: A total of 1037 patients with acute or chronic cholecystitis who were scheduled for laparoscopic cholecystectomy were included. Hasson (open) technique was used to insert first laparoscopy port for creation of pneumoperitoneum. Following laparoscopic cholecystectomy, data of intra-operative and post-operative complications was noted. Patients were followed during hospital stay to evaluate any procedure related injury. Follow-up was done at up-to six months to determine wound infections and formation of umbilical hernia. Results: Mean age of the patients was 44.65 ± 8.98 years. Out of 1037 patients, procedure was simple in 655 (63.16%) patients and complex in 382 (36.83%) patients due to the presence of inflammatory adhesions and anatomic access. There was no intra-abdominal injury, omental injury, vascular injury or gut perforation. Port-site infections were diagnosed in 6 (0.57%) patients during 06 months’ follow-up. Umbilical hernia was diagnosed in only 1 (0.09%) patient. Conclusion: We found that Hasson technique of first laparoscopy port access for creation of pneumoperitoneum was a safe technique with minimum number access related complications. [ABSTRACT FROM AUTHOR]

Highlights from the article: The potassium metal ion is forming a bond with a nitrogen atom of azine nitrogens, Potassium metal ion is forming seven bonds through K(1)-S(3)#3 3.2481(14) N(1)#2-K(1)-S(3)#3 142.11(8) K(1)-S(1)#1 3.3129(14) O(1)-K(1)-S(1)#1 148.10(8) K(1)-S(1) 3.3475(14) C(1)-S(1)-K(1) 96.04(13).

Objective: The objective of this study was to investigate the effects of androgen deprivation therapy (ADT) on risk of subsequent cardiovascular morbidity in men with prostate cancer. Study Design: Quasi experimental study. Place and Duration of Study: Department of oncology Combined Military Hospital Rawalpindi, from Sep 2014 to May 2015. Patients and Methods: Thirty consecutive patients fulfilling inclusion criteria were enrolled. All patients were subjected to medical castration/ androgen deprivation therapy (ADT) with monthly 3.75 mg leuprorelin acetate intramuscular injection until castrate levels of testosterone (<50ng/dL) were achieved. We used Framingham’s score for assessment of 10 years cardiovascular risk of individual patient before initiation and after completion of 6 months ADT. Serum lipid profile (fasting), systolic blood pressure, history of smoking, diabetes and antihypertensive medication were recorded. Proforma was designed to get clinical information. A p-value of <0.05 was considered significant. A paired-samples t-test was conducted to compare Framingham cardiovascular risk scores before initiation and after completion of 6 months ADT. Results: We enrolled 30 men with high/intermediate risk localized prostate cancer. Mean age was 63.47 ± 7.32 years. All patients received 6 months ADT with monthly 3.75 mg leuprorelin acetate intramuscular injection. There was a significant difference in Framingham cardiovascular risk scores before (mean ± sd; 20.95 ± 7.98) and after (mean ± sd; 25.72 ± 6.15) 6 months ADT; t (29) =−4.54, p<0.01, two-tailed. Hence ADT resulted in a significant increase (mean ± sd; 25.7 ± 6.15) in 10 years cardiovascular morbidity risk t (29) =−4.54, p<0.01, two-tailed. Subset analyses revealed significant increase in fasting serum total cholesterol, triglycerides and Low-density lipoprotein (LDL) levels after 6 months ADT (p<0.01, <0.01 and <0.01 respectively) however high density lipoprotein (HDL) remained un-changed (p=0.043) in comparison to pre-ADT values. Conclusion: Androgen deprivation therapy results in significantly increased risk of cardiovascular morbidity in patients with prostate cancer however this relationship between ADT and risk of cardiovascular morbidity may be confounded by unmeasured variables like obesity, atherosclerosis and body mass index (BMI) variations. [ABSTRACT FROM AUTHOR]

Objective: To study the role of Hydroxyurea in patients suffering from β-thalassemia major. Study Design: Prospective longitudinal study. Place and Duration of Study: Department Paediatrics, Combined Military Hospital, Malir Cantt, Karachi Pakistan, from Nov 2019 to Oct 2020. Methodology: Data from 73 beta-thalassemia major patients was collected using a structured questionnaire containing inquiries about basic socio-demographic details, disease history, laboratory reports and particulars of former treatment regimens. Hydroxyurea was administered, and its effects were noted among the subjects regarding the frequency of transfusion, haemoglobin levels and severity of clinical symptoms. Results: The mean age of study subjects was 9.15±3.99 years, and most study subjects (56.14%) were boys. The pre-intervention (before administration of Hydroxyurea) levels of Hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular haemoglobin concentration (MCHC), and serum ferritin levels were unremarkable when compared to post - intervention levels. However, a significant difference was observed in HbF levels. In addition, an encouraging decrease was reported in the self-rated severity (using VAS) of symptoms such as fatigue (p<0.05), weakness (p>0.05), and shortness of breath (p>0.05). In addition, the transfusion interval was significantly reduced (p<0.05). Conclusion: After carefully considering the results, it can be concluded that Hydroxyurea plays a positive role and brings about significant improvement among patients suffering from β-thalassemia major. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To assess the clinical characteristics of COVID-19 Virus disease in the pediatric population in Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar 2020 to Jan 2021. Methodology: All children presenting to the department with symptoms consistent with COVID-19 disease were tested for the virus. Patients who tested positive on the PCR were included in the study. Patients with nonconsistent symptoms of COVID-19 and those who tested negative on the PCR were excluded from the study. All clinical data, including the age of the child, the onset of symptoms, the gap between the onset of symptoms and presentation as well as clinical symptoms, were documented on a predefined proforma. Results: A total of 106 patients were enrolled on the study. The mean age of patients was 5.6±2.5 years. The most frequent symptoms were fever (63, 59.6%) and cough (49, 46.2%). There were 3(2.9%) cases with severe or critical illness. The most frequent abnormal laboratory findings were leukopenia (29, 27.4%) and increased creatine kinase (38, 36.0%). Groundglass opacities were observed in the HRCT chest of 17(65.3%) cases, out of 26 children diagnosed with pneumonia. The majority (70, 66%), had a positive exposure history. 88(83%) cases did not abide by the precautionary measures against the COVID-19 disease. Conclusions: The current study indicates that children usually present with mild symptoms but can present as severe diseases, as observed in this study. [ABSTRACT FROM AUTHOR]