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The ground validation of satellite-based precipitation products (SPPs) is very important for their hydroclimatic application. This study evaluated the performance assessment of four soil moisture-based SPPs (SM2Rain, SM2Rain- ASCAT, SM2Rain-CCI, and GPM-SM2Rain). All data of SPPs were compared with 64 weather stations in Pakistan from January 2005 to December 2020. All SPPs estimations were evaluated on daily, monthly, seasonal, and yearly scales, over the whole spatial domain, and at point-to-pixel scale. Widely used evaluation indices (root mean square error (RMSE), correlation coefficient (CC), bias, and relative bias (rBias)) along with categorical indices (false alarm ratio (FAR), probability of detection (POD), success ratio (SR), and critical success index (CSI) were evaluated for performance analysis. The results of our study signposted that: (1) On a monthly scale, all SPPs estimations were in better agreement with gauge estimations as compared to daily scales. Moreover, SM2Rain and GPM-SM2Rain products accurately traced the spatio-temporal variability with CC >0.7 and rBIAS within the acceptable range (±10) of the whole country. (2) On a seasonal scale (spring, summer, winter, and autumn), GPM-SM2Rain performed more satisfactorily as compared to all other SPPs. (3) All SPPs performed better at capturing light precipitation events, as indicated by the Probability Density Function (PDF); however, in the summer season, all SPPs displayed considerable over/underestimates with respect to PDF (%). Moreover, GPM-SM2RAIN beat all other SPPs in terms of probability of detection. Consequently, we suggest the daily and monthly use of GPM-SM2Rain and SM2Rain for hydro climate applications in a semi-arid climate zone (Pakistan). [ABSTRACT FROM AUTHOR]

The study was conducted at Institute of Soil and Environmental Sciences, University of Agriculture, Faisalabad, Pakistan to monitor the impact assessment of tillage systems on soil health indicators by integrating organic and inorganic resources to sustain wheat production in arid and semi-arid conditions i.e. high temperature and low rainfall. The field experiment was conducted in 2019-20 and carried out in alkaline soil (pH 8.2) with low organic matter (0.45%) to grow wheat after rice and treatments were arranged in randomized complete block design. Farmyard manure (FYM 20.5 Mg/ha), rice crop residues application (CRA 100%) and chemical fertilizers (CF) N-P-K 100-80-60 kg/ha, respectively were used under conventional and conservation tillage systems. During this research different growth and yield parameters were noted and evaluated the level of N, P, K and organic matter contents from soil and plant at the harvest. The results indicated that the combined application of FYM and CRA with CF improved the chlorophyll contents (20% in conventional tillage and 39% in conservation tillage) which helped in nutrient translocation (N, P, K) and increased growth, biological and grain yield by improving soil organic carbon (SOC) and organic matter contents in soil. Growth parameter i.e. germination percentage upto 64%, plant height 27% and spike length upto 35% were increased by T7. The conservation tillage method was the best where we used T7 i.e. CF + 25% FYM + 50% CRA, and CF + 50% FYM + 25% CRA by conserving moisture and built OM (0.90%), soil organic carbon (0.49%) and mineral nutrition in soil as well as in wheat leaves. It is concluded that the integrated use of organic and inorganic resources are helpful for sustainable wheat production by enhancing fertilizer use efficiency (FUE) to improve soil health especially in arid to semi-arid climate conditions in alkaline soil. [ABSTRACT FROM AUTHOR]

The validity of two reanalysis (ERA5 and MEERA2) and seven satellite-based (CHIRPS, IMERG, PERSIANN-CCS, PERSIANN-CDR, PERSIANN-PDIR, PERSIANN, and TRMM) precipitation products was assessed in relation to the observations of in situ weather stations installed in different topographical and climatic regions of Pakistan. From 2010 to 2018, all precipitation products were evaluated on daily, monthly, seasonal, and annual bases at a point-to-pixel scale and over the entire spatial domain. The accuracy of the products was evaluated using commonly used evaluation and categorical indices, including Root Mean Square Error (RMSE), Correlation Coefficient (CC), Bias, Relative Bias (rBias), Critical Success Index (CSI), Success Ratio (SR) Probability of Detection (POD), and False Alarm Ratio (FAR). The results show that: (1) Over the entire country, the spatio-temporal distribution of observed precipitation could be represented by IMERG and TRMM products. (2) All products (reanalysis and SPPs) demonstrated good agreement with the reference data at the monthly scale compared to the daily data (CC > 0.7 at monthly scale). (3) All other products were outperformed by IMERG and TRMM in terms of their capacity to detect precipitation events throughout the year, regardless of the season (i.e., winter, spring, summer, and autumn). Furthermore, both products (IMERG and TRMM) consistently depicted the incidence of precipitation events across Pakistan's various topography and climatic regimes. (4) Generally, CHIRPS and ERA5 products showed moderate performances in the plan areas. PERSIANN, PERSIANN-CCS, PDIR, PERSIANN-CDR, and MEERA2 products were uncertain to detect the occurrence and precipitation over the higher intensities and altitudes. Considering the finding of this assessment, we recommend the use of daily and monthly estimates of the IMERG product for hydro climatic studies in Pakistan. [ABSTRACT FROM AUTHOR]

Background: Eastern Khyber Pakhtunkhwa is home to a vast range of medicinal and edible waterbird species due to its diverse geographical environment. Waterbird species have been used for various ailments and cultural practices since ancient times, while ethno-pharmacological applications and cultural uses of waterbird species in this area have seldom been documented. This study is the first ethnomedicinal and cultural assessment of waterbird species, and the first compilation and listing of all known data on these species in Eastern Khyber Pakhtunkhwa, Pakistan. Methods: Interviews and questionnaires were used to collect data from native respondents (N = 100). To analyze the data, principal component analysis (PCA), relative frequency of citation (RFC), fidelity level (FL%), relative popularity level (RPL), rank order priority, and similarity index were used. Results: In total, 64 waterbird species were utilized in cultural practices, of which 40 species are used to cure different infectious and chronic diseases such as cold, cough, flu, fever, respiratory disorders, asthma, TB, gastric ulcers, kidney stones, male impotency, obesity, paralysis, piles, cancer, arthritis, body pain, and weakness. PCA showed significant differences in the use of waterbird species among the local inhabitants of the study area, separated along the axis-2 (p < 0.05). The FL% of waterbird species varied from 12 to 100%. 100% FL was analyzed for four waterbird species, i.e., Charadrius mongolus (cold), Gallicrex cinerea (asthma), Anas platyrhynchos (cancer), and Esacus recurvirostris (body weakness). In this study, Mallard (Anas platyrhynchos) was the most popular species used in the healthcare system of Eastern Khyber Pakhtunkhwa, with high RFC (4.06), FL% (100), and RPL (1.0) values. Conclusion: We concluded that waterbird species are more used for medicine and food purposes in the study area. However, in vitro/in vivo assessment of biochemical activities of waterbird species with a maximum FL% might be significant to produce novel drugs. Recent research shows important ethno-ornithological information about native people and their links with waterbird species, which might be helpful for the sustainable use of waterbird diversity in the research area. [ABSTRACT FROM AUTHOR]

A study on antioxidant potential of cheddar cheese utilizing milk from cow and buffalo sources during ripening was conducted in 2019-20 at Institute of Food science and Nutrition, University of Sargodha, Pakistan. The cheese samples were placed at the controlled atmosphere (4°C) for ripening and were ripened for 3, 6 and 9 months. This research was conducted to evaluate antioxidant ability of cheddar cheese during ripening. Freeze dried water (WSE) and ethanol soluble fractions (ESE) of cheddar (cow and buffalo) were prepared and monitored for their antioxidant activities during ripening. Total antioxidant activity (TAA) of soluble fractions (WSE and ESE) was determined. Higher TAA was found in WSE (59.900 ± 1.59 μg/g trolox equivalent) and higher reducing power was observed in ESE (27.734 ± 5.76 μg/g) of buffalo milk cheddar cheese after 9 months of ripening. Increased values were found for total phenolic content (TPC) in freeze dried WSE (69.572 ± 5.88 μg/g gallic acid equivalent) and for DPPH in freeze-dried ESE (1436.1 ± 4.95 μmol/ml trolox equivalent) of cow milk cheddar cheese after 9 months of ripening. In short, it (cheddar cheese) can be utilized in manufacturing of functional foods due to its increased antioxidant potential. [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]

The population is increasing rapidly globally, and urban expansion of the cities has become an extensive trend in developing nations. Urban expansion patterns, such as transportation structure and road networks, affect transportation planning. This research was conducted on a mega project in Lahore city of Pakistan, i.e., the Lahore Ring Road (LRR) project. Limited research focused on the beneficiary assessment of the road project, and this research was carried out to fill this research gap. This research aims to evaluate the beneficiary assessment of DHA Phase 8 and Halloki Settlement along the Lahore Ring Road. The simple Random Sampling technique was used to conduct the household survey in the study area. This study concluded that most of the residents did not modify their houses nor increase the built-up area and height after the introduction of the project. This study inferred that the rental potential was high at some locations and low at old existing settlements. This research further concluded that community participation was ignored, and public facilities were not improved in the study area. But a project of LRR was very much beneficial and alive for the residents of Lahore city. Community participation should be enhanced in such types of megaprojects, and allied facilities in the nearby community should be upgraded. This research will be helpful for policymakers, urban planners, transportation planners, development authorities, and other stakeholders in planning future road projects in the country. [ABSTRACT FROM AUTHOR]

Safflower (Carthamus tinctorius L.) is a multipurpose crop of dry land yielding very high quality of edible oil. Present study was aimed to investigate the genetic diversity and population structure of 131 safflower accessions originating from 28 different countries using 13 iPBS-retrotransposon markers. A total of 295 iPBS bands were observed among which 275 (93.22%) were found polymorphic. Mean Polymorphism information content (0.48) and diversity parameters including mean effective number of alleles (1.33), mean Shannon’s information index (0.33), overall gene diversity (0.19), Fstatistic (0.21), and inbreeding coefficient (1.00) reflected the presence of sufficient amount of genetic diversity in the studied plant materials. Analysis of molecular variance (AMOVA) showed that more than 40% of genetic variation was derived from populations. Model-based structure, principal coordinate analysis (PCoA) and unweighted pair-group method with arithmetic means (UPGMA) algorithms clustered the 131 safflower accessions into four main populations A, B, C, D and an unclassified population, with no meaningful geographical origin. Most diverse accessions originated from Asian countries including Afghanistan, Pakistan, China, Turkey, and India. Four accessions, Turkey3, Afghanistan4, Afghanistan2, and Pakistan24 were found most genetically distant and might be recommended as a candidate parents for breeding purposes. The findings of this study are most probably supported by the seven similarity centers hypothesis of safflower. This is a first study to explore the genetic diversity and population structure in safflower accessions using the iPBS-retrotransposon markers. The information provided in this work will therefore be helpful for scientists interested in safflower breeding. [ABSTRACT FROM AUTHOR]

Background: Both Plasmodium vivax and Plasmodium falciparum are prevalent in Pakistan, yet up-to-date data on the epidemiology of malaria in Pakistan are not available. This study was undertaken to determine the current prevalence and distribution of Plasmodium species across the country. Methods: A malariometric population survey was conducted in 2011 using blood samples collected from 801 febrile patients of all ages in four provinces and the capital city of Islamabad. Microscopically confirmed Plasmodium-positive blood samples were reconfirmed by polymerase chain reaction (PCR). Confirmed parasite-positive samples were subjected to species-specific PCR capable of detecting four species of human malaria. Results: Of the 707 PCR-positive samples, 128 (18%) were P. falciparum, 536 (76%) were P. vivax, and 43 (6%) were mixed P. falciparum and P. vivax. Ninety-four microscopy-positive samples were PCR-negative, and Plasmodium malariae and Plasmodium ovale were not detected. Prevalence of P. vivax ranged from 2.4% in Punjab Province to 10.8% in Sindh Province and prevalence of P. falciparum ranged from 0.1% in Islamabad to 3.8% in Balochistan. Conclusions: Plasmodium infections in Pakistan are largely attributed to P. vivax but P. falciparum and mixed species infections are also prevalent. In addition, regional variation in the prevalence and species composition of malaria is high. [ABSTRACT FROM AUTHOR]

Increased edible oil demand due to increasing world population diverts the attention to explore the new agro-ecology zones for soybean cultivation where traditional oilseed crops have low yield potential. Present study was conducted to determine the optimal agronomic yield environment for soybean cultivars in semi-arid irrigated conditions. The randomized complete block design (RCBD) was used with split-plot arrangement with four replications. Three soybean varieties viz., NARC-2, RAWAL-1 and AJMERI were sown on 11th August, 26th August and 10th September 2018-19 at Agronomic Research Area, College of Agriculture, University of Sargodha, Pakistan by keeping varieties in sub-plots and sowing dates in main plots. Data was statistically analyzed by using Fisher's analysis of variance technique and treatment means were compared at 5% probability level. Maximum and statistically similar germination count was recorded in plots where crop was sown on 11th August and 10th September as compared to 26th August planting. Flower initiation, 50% flowering, complete flowering and pod formation took place earlier in cultivar AJMERI when it was sown on 10th September. Maximum number of branches per plant (10.66) and number of pods per plant (40.96) was produced in cultivar RAWAL-1 when it was sown on 10th September. The maximum number of seeds per pod (2.63) was recorded in all tested cultivars sown at 10th September. Cultivar RAWAL-1 produced maximum biological yield (3175.9 kg/ha) and final seed yield (785.03 kg/ha) that was sown on 10th September. It was concluded that before recommending a soybean cultivar in new agro-ecological region its compatibility must be verified for active and sustained adaptation by growers. [ABSTRACT FROM AUTHOR]

Introduction: Resistant strains of bacteria are rapidly emerging with increasing inappropriate use of antibiotics rendering them less efficacious. Self-purchasing of antibiotics particularly for viral infections is a key driver of inappropriate use, especially in lower- and middle-income countries. There is a particular issue in countries such as Pakistan. Consequently, there is a need to assess current rates of self-purchasing especially for reserve antibiotics to guide future policies. Aims: Assess the extent of current antibiotic sales without a prescription in urban areas of Pakistan. Methodology: A multicenter cross-sectional study was conducted in different areas of Punjab, Pakistan using Simulated Client technique. The investigators demanded different predefined antibiotics from WHO AWaRe groups without prescription. Three levels of demand were used to convince the pharmacy staff in order to dispense the antibiotic without a prescription. A data collection form was completed by simulated clients within 15 min of each visit. Results: Overall 353 pharmacies and medical stores were visited out of which 96.9% pharmacies and medical stores dispensed antibiotics without demanding a prescription (82.7% at demand level 1 and 14.2% at demand level 2), with only 3.1% of pharmacies refusing to dispense antibiotics. The most frequently dispensed antibiotic was ciprofloxacin (22.1%). Surprisingly, even the reserve group antibiotics were also dispensed without a prescription. In only 25.2% visits, pharmacy staff guided patients about the use of antibiotics, and in only 11.0% pharmacists enquired about other medication history. Conclusion: Currently, antibiotics are easily acquired without a legitimate prescription in Pakistan. There is a need for strict adherence to regulations combined with a multi-dimensional approach to enhance appropriate dispensing of antibiotics and limit any dispensing of WHO restricted antibiotics without a prescription. [ABSTRACT FROM AUTHOR]

Snow Leopard (Panthera uncia) is native to mountain ranges of Central and South Asia, where it occurs from 3,000–4500 m elevation. The species is enlisted as “Endangered” by IUCN and its populations are reportedly declining. In the current study, we compared the past and current distribution ranges of the species using spatial analysis. We used Quantum Geographical Information System (QGIS) software to reconstruct and quantify its past distribution range and compare with its current one. Snow leopard was found more widely distributed in the past having a distribution range of approximately 10.47 million km2 against the current 3.20 million km2. Range contraction of the species approximates 69%. A total of 719 terrestrial protected areas of Asia (out of total 7209) had this species in the past whereas at current, only 311 protected areas support this species. The results emphasize escalating conservation efforts to save its remaining distribution range. [ABSTRACT FROM AUTHOR]

Background: In Pakistan, artesunate (AS) in combination with sulfadoxine–pyrimethamine (SP) is the recommended treatment for uncomplicated Plasmodium falciparum malaria. Monitoring molecular markers of anti-malarial drug resistance is crucial for early detection and containment of parasite resistance to treatment. Currently, no data are available on molecular markers of artemisinin resistance (K13 mutations) in P. falciparum isolates from Pakistan. In this study, the prevalence of mutations associated with SP and artemisinin resistance was estimated in different regions of Pakistan. Methods: A total of 845 blood samples that were positive for malaria parasites by microscopy or rapid diagnostic test were collected from January 2016 to February 2017 from 16 different sites in Pakistan. Of these samples, 300 were positive for P. falciparum by PCR. Polymorphisms in the P. falciparum dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps) genes were identified by pyrosequencing while polymorphisms in the propeller domain of the pfk13 gene were identified by Sanger sequencing. Results: The prevalence of the PfDHFR 108N and 59R mutations was 100% and 98.8%, respectively, while the prevalence of PfDHFR 50R and 51I mutations was 8.6%. No mutation was observed at PfDHFR position 164. In PfDHPS, the prevalence of mutations at positions 436, 437, and 613 was 9.9%, 45.2%, and 0.4%, respectively. No mutations were found at PfDHPS positions 540 and 581. The prevalence of double PfDHFR mutants (59R + 108N) ranged from 93.8% to 100%, while the prevalence of parasites having the PfDHFR 59R + 108N mutations in addition to the PfDHPS 437G mutation ranged from 9.5% to 83.3% across different regions of Pakistan. Nine non-synonymous and four synonymous mutations were observed in the PfK13 propeller domain, none of which correspond to mutations validated to contribute to artemisinin resistance. Conclusion: The absence of the highly resistant PfDHFR/PfDHPS quintuple mutant parasites and the lack of PfK13 mutations associated with artemisinin resistance is consistent with AS + SP being effective in Pakistan. [ABSTRACT FROM AUTHOR]

Background: Plasmodium vivax is the most prevalent malaria species in Pakistan, with a distribution that coincides with Plasmodium falciparum in many parts of the country. Both species are likely exposed to drug pressure from a number of anti-malarials including chloroquine, sulphadoxine-pyrimethamine (SP), and artemisinin combination therapy, yet little is known regarding the effects of drug pressure on parasite genes associated with drug resistance. The aims of this study were to determine the prevalence of polymorphisms in the SP resistance-associated genes pvdhfr, pvdhps and chloroquine resistance-associated gene pvmdr1 in P. vivax isolates collected from across the country. Methods: In 2011, 801 microscopically confirmed malaria-parasite positive filter paper blood samples were collected at 14 sites representing four provinces and the capital city of Islamabad. Species-specific polymerase chain reaction (PCR) was used to identify human Plasmodium species infection. PCR-positive P. vivax isolates were subjected to sequencing of pvdhfr, pvdhps and pvmdr1 and to real-time PCR analysis to assess pvmdr1 copy number variation. Results: Of the 801 samples, 536 were determined to be P. vivax, 128 were P. falciparum, 43 were mixed vivax/ falciparum infections and 94 were PCR-negative for Plasmodium infection. Of PCR-positive P. vivax samples, 372 were selected for sequence analysis. Seventy-six of the isolates (23%) were double mutant at positions S58R and S117N in pvdhfr. Additionally, two mutations at positions N50I and S93H were observed in 55 (15%) and 24 (7%) of samples, respectively. Three 18 base pair insertion-deletions (indels) were observed in pvdhfr, with two insertions at different nucleotide positions in 36 isolates and deletions in 10. Ninety-two percent of samples contained the pvdhps (S382/A383G/K512/A553/V585) SAKAV wild type haplotype. For pvmdr1, all isolates were wild type at position Y976F and 335 (98%) carried the mutation at codon F1076L. All isolates harboured single copies of the pvmdr1 gene. Conclusions: The prevalence of mutations associated with SP resistance in P. vivax is low in Pakistan. The high prevalence of P. vivax mutant pvmdr1 codon F1076L indicates that efficacy of chloroquine plus primaquine could be in danger of being compromised, but further studies are required to assess the clinical relevance of this observation. These findings will serve as a baseline for further monitoring of drug-resistant P. vivax malaria in Pakistan. [ABSTRACT FROM AUTHOR]

Background: Few studies have been conducted in Pakistan to determine the efficacy of chloroquine and sulphadoxine-pyrimethamine (SP), which remain in use as treatment for Plasmodium vivax and in combination with artesunate to treat Plasmodium falciparum, respectively. In this study, samples from several sites across Pakistan were characterized to determine prevalence of molecular resistance markers in the P. falciparum chloroquine resistance transporter (pfcrt), multidrug resistance (pfmdr1), dihydrofolate reductase (pfdhfr) and dihydropteroate synthase (pfdhps) genes and the origin of chloroquine-resistant P. falciparum parasites. Methods: Microscopy-confirmed malaria parasite-positive blood samples from 801 patients across the country were collected in 2011. Of these, 171 infections were identified by polymerase chain reaction (PCR) as P. falciparum and analysed by pyrosequencing for mutations conferring chloroquine resistance (pfcrt codons 72-76), multidrug resistance (pfmdr1 N86Y, Y184F, S1034C, N1042D and D1246Y), pyrimethamine resistance (pfdhfr, C50R, N51I, C59R, S108N and I164L) and sulphadoxine resistance (pfdhps, S436A, A437G, K540E, A581G and A613T/S). pfmdr1 gene copy number variation was determined by real-time PCR, and microsatellites flanking the pfcrt locus were typed to determine the origin of the chloroquine-resistant haplotype. Results: The pfcrt K76T mutation was found in all samples as part of the S72/V73/M74/N75/T76 (SVMNT) haplotype. Microsatellites flanking pfcrt showed high similarity to the signature found in India and Papua New Guinea. pfmdr1 N86Y was found in 20% of samples and all samples harboured a single copy of the pfmdr1 gene. The pfdhfr double mutation C59R + S108N was present in 87% of samples while the pfdhfr triple mutant (N51I + C59R + S108N) was not detected. Pfdhps A437G was found in 60% of samples. Pure pfdhps K540E was rare, at 4%, but mixed genotype 540 K/E was found in 77% of samples. Similarly, pure pfdhps A581G was found in 4% of the isolates while mixed 581A/G was found in 39% of samples. Conclusions: These results suggest an emerging problem with multidrug resistant P. falciparum in Pakistan. The chloroquine resistance genotype has reached complete fixation in the population, with a microsatellite pattern indicative of a selective sweep. Moreover, the prevalence of mutations in both pfdhfr and pfdhps, albeit without the presence of the pfdhfr triple mutant, indicates that continued monitoring is warranted to assess whether SP remains efficacious as a partner drug for artesunate for the treatment of P. falciparum. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the study is to measure the efficacy of ionic-iodine polymer complex [1] for clinical and radiological improvement in coronavirus disease 2019 (COVID-19) patients.Trial Design: The trial will be closed label, randomized and placebo-controlled with a 1:1:1:1 allocation ratio and superiority framework.Participants: All PCR confirmed COVID-19 adult patients including non-pregnant females, with mild to moderate disease, will be enrolled from Shaikh Zayed Post-Graduate Medical Complex, Ali Clinic and Doctors Lounge in Lahore (Pakistan). Patients with any pre-existing chronic illness will be excluded from the study.Intervention and Comparator: In this multi-armed study ionic-iodine polymer complex with 200 mg of elemental iodine will be given using three formulations to evaluate efficacy. Patients will be receiving either encapsulated iodine complex of 200 mg (arm A), iodine complex syrup form 40 ml (arm B), iodine complex throat spray of 2 puffs (arm C) or empty capsule (arm D) as placebo; all three times a day. All the 4 arms will be receiving standard care as per version 3.0 of the clinical management guidelines for COVID-19 established by the Ministry of National Health Services of Pakistan.Main Outcomes: Primary outcomes will be viral clearance with radiological and clinical improvement. SARS-CoV-2 RT-PCR and HRCT chest scans will be done on the admission day and then after every fourth day for 12 days or till the symptoms are resolved. RT-PCR will only be shown as positive or negative while HRCT chest scoring will be done depending on the area and severity of lung involvement [2]. Time taken for the alleviation of symptoms will be calculated by the number of days the patient remained symptomatic. 30-day mortality will be considered as a secondary outcome.Randomisation: Stratification for initial COVID-19 status (or days from initial symptoms as a proxy), age groups, gender, baseline severity of symptoms and co-morbidities will be used to ensure that the study arms remain balanced in size for the 1:1:1:1 allocation ratio. Randomization will be done using the lottery method. As patients are being admitted at different times, they will be recruited after obtaining their voluntary written informed consent following all standard protocols of the infection, control and disinfection.Blinding (masking): This is a quadruple (participants, care providers, investigators and outcomes assessors) blinded study where only the study's Primary Investigator will have information about the arms and their interventions.Numbers To Be Randomised (sample Size): 200 patients will be randomized into four groups with three experimental and one placebo arm.Trial Status: Protocol Version Number is 2.3 and it is approved from IRB Shaikh Zayed Hospital with ID SZMC/IRB/Internal0056/2020 on July 14th, 2020. The recruitment is in progress. It was started on July 30, 2020, and the estimated end date for the trial is August 15, 2021.Trial Registration: Clinical Trial has been retrospectively registered on www.clinicaltrials.gov with registration ID NCT04473261 dated July 16, 2020.Full Protocol: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). With the intention of expediting dissemination of this trial, the conventional formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines. [ABSTRACT FROM AUTHOR]