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Cultivation of high-yield varieties and unbalanced fertilization have induced micronutrient deficiency in soils worldwide. Zinc (Zn) is an essential nutrient for plant growth and its deficiency is most common in alkaline and calcareous soils. Therefore, this study aimed to evaluate the effect of Zn applied either alone or in combination with foliar application on the quality and production of wheat grown in alkaline soils. Zn was applied in the form of zinc sulfate (ZnSo4) to the soil and as a foliar spray during the sowing and tillering stages, respectively. Results showed that Zn fertilization of wheat, irrespective of modes of application, significantly increased grain and biological yield, grain per spike, and 1,000 grains weight over control; however, its effect was more noticeable when applied as 7.5 kg ha−1 of soil Zn combined with foliar Zn at 2.5 kg ha−1. Zn application significantly increased the grain protein content from 9.40% in the control to a maximum of 11.83% at soil Zn of 10 kg ha−1. Similarly, Zn application improved Zn, phosphorus (P), and potassium (K) concentrations in wheat grains. Moreover, correlation analysis showed that the grain Zn concentration was positively correlated with the grain P concentration. The correlation between P concentration in wheat grains and 1,000 grain weight was not significant. A total of 1,000 grains weight was positively correlated with tillers per plant, grain yield, and biological yield. There were positive correlations between protein content, biological yield, grain yield, and tillers per plant. Therefore, soil-applied Zn + foliar application in alkaline soils with limited Zn availability is crucial for improving wheat yield and grain quality.

Objective: To determine diagnostic accuracy of fractional flow reserve in diagnosing stentable intermediate stenosis in patients of coronary artery disease keeping angiography as gold standard. Study Design: Cross sectional validation study. Place and Duration of Study: Cardiology ward and Coronary Care Unit of PIMS Islamabad, from Jun 2015 to Nov 2015. Methodology: This study included 130 patients with coronary artery disease. General physical examination and systemic examination was done for all subjects as per protocol of inclusion and exclusion criteria. All the patients underwent Conventional angiography followed by fractional flow reserve in intermediate coronary artery disease. Diagnostic accuracy of fractional flow reserve was detected by determining sensitivity, specificity and accuracy. Results: The mean age of the patients was 56 ± 8.790 years, ranging from 31 to 72 years. There were 88 (67.7%) male patients and 42 (32.3%) female patients in the study. There were 31 true positive, 3 false negative and 92 were found true negative. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of fractional flow reserve for diagnosis of stentable intermediate stenosis was 91.2%, 95.8%, 88.6%, 96.8% and 94.6%, respectively. Conclusions: Fractional flow reserve is a reliable test for detection of stentable intermediate stenosis among patients with coronary artery disease and should be done in every case of coronary artery disease.

Objective: To review the outcome of percutaneous coronary intervention (PCI) in chronic total occlusion (CTO) of coronary arteries. Study Design: Cross sectional descriptive study. Place and Duration of Study: This study was carried out in the cardiology department of Pakistan Institute of Medical Sciences (PIMS) Islamabad, from Jan to Jul 2014. Material and Methods: In this study a total of 50 patients with chronic totally occluded coronary arteries having percutaneous coronary intervention (PCI) were included. The main outcome variable was frequency of procedural success. PCI and stent implantation were performed in a standard manner by expert interventionists having more than fifteen years’ experience of doing PCI. Thrombolysis in Myocardial Infarction (TIMI) flow was noted at the end of CTO PCI by observer. Results: The mean age of the patients was 60.44 ± 9.214 years. There were 32 (64%) male patients with male to female ratio of 1.78:1. The CTO of left anterior descending (LAD) was seen in 23 (46%) patients, CTO of left circumflex (LCX) was seen in 14 (28%) patients and CTO of right coronary artery (RCA) was seen in 13 (26%) patients. In the study sample majority 40 (80%) of the patients had coronary artery disease (CAD) from 3-6 months and only 10 (20%) patients had a duration of CAD more than 6 months. The procedural success (TIMI flow ≥2) was achieved in 41 (82%) patients. Here was no significant association (p-value>0.05) of age and gender with procedural success. There was a highly significant (p-value

Breast cancer is a problem for women's health globally. Early detection techniques come in a variety of forms ranging from local to systemic and from non-invasive to invasive. The treatment of cancer has always been challenging despite the availability of a wide range of therapeutics. This is either due to the variable behaviour and heterogeneity of the proliferating cells and/or the individual's response towards the treatment applied. However, advancements in cancer biology and scientific technology have changed the course of the cancer treatment approach. This current review briefly encompasses the diagnostics, the latest and most recent breakthrough strategies and challenges, and the limitations in fighting breast cancer, emphasising the development of breast cancer vaccines. It also includes the filed/granted patents referring to the same aspects. [ABSTRACT FROM AUTHOR]

Objective: To ascertain the vaginal birth rate following the trial of uterine scar and its outcomes. Study Design: Cross-sectional Observational study. Setting: Department of Gynecology Bakhtawar Amin Trust Teaching Hospital Multan. Period: 6th August 2020 to 6th August 2021. Material & Methods: After passing through selection criteria, all enrolled women underwent serial ultrasound including pelvis ultrasound to access scar thickness up to thirty-six gestation weeks. All women were evaluated for baseline investigations, clinical history, and underwent cardiotocography (CTG) which was then followed by a trial of labor (TOL). Women who experienced spontaneous labor after TOL were observed through partogram and intrapartum CTG. All maternal and fetal outcomes were observed. Results: Out of these 80 women, 51 (63.7%) had successfully given birth through the vaginal route while 29 (36.2%) underwent emergency CS following TOL. The majority of enrolled women, 62 (77.5%) had age less than 35 years, 45 (56.2%) had parity 1-4, and 74 (92.5%) had gestation age >36 weeks. 3 (5.8%) women had a history of VBAC and all had parity >4. Among the women with successful VBAC, the majority were younger than 35 years (88.2%), parity less than 4 (62.7%), and all were positive for previous successful VBAC. Postpartum hemorrhage was the most reported maternal complication (3.9%). Three (4.4%) experienced intra-uterine deaths which were the major fetal complications. Conclusion: Trial of vaginal birth following cesarean section could be a preferable option given its association with low fetal and maternal complications and considerable success rate. [ABSTRACT FROM AUTHOR]

The current study was conducted to quantify zinc in nail samples of iron welders from different areas of Lahore, Pakistan. This study intended to assess nutritional deficiencies of zinc in welders. As nails serve a beneficial biomarker of concentrations of trace elements, hence in the present study the nails of welders were used for monitoring. The total number of nail samples collected from workers of iron welding shops, were 40. In a standardized washing procedure the nail samples were scrapped and cleaned of dust particles with nonionic detergent (Triton X-100) and then nail samples were digested afterwards in acid mixture. The concentration of zinc was evaluated by atomic absorption spectrophotometer. The results revealed that concentration of zinc in nail samples ranged 0.297 - 1.718 mg/kg and averaged at 0.88±0.39 mg/kg which is below the ideal zinc levels in nail samples. Correlation of zinc (mg/kg) was significant with age (0.214< 0.5), weight (0.320< 0.5) and Body Mass Index (0.268< 0.5) of the welders, while a weak correlation of zinc (mg/kg) was found with height (0.042< 0.5) of the welders. [ABSTRACT FROM AUTHOR]

The blood-brain barrier (BBB) regulates blood and chemical exchange in the central nervous system. It is made up of brain parenchyma capillary endothelial cells. It separates the interstitial cerebrospinal fluid from the circulation and limits brain drug entry. Peptides, antibodies, and even tiny hydrophilic biomolecules cannot flow across the BBB due to their semi-permeability. It protects the brain from poisons, chemicals, and pathogens, and blood cells penetrate brain tissue. BBB-facilitated carrier molecules allow selective permeability of nutrients such as D-glucose, L-lactic acid, L-phenylalanine, L-arginine, and hormones, especially steroid hormones. Brain barriers prevent drug molecules from entering, making medication delivery difficult. Drugs can reach specific brain regions through the nasal cavity, making it a preferred route. The in-situ gels are mucoadhesive, which extends their stay in the nasal cavity, allows them to penetrate deep and makes them a dependable way of transporting numerous medications, including peptides and proteins, straight into the central nervous system. This approach holds great potential for neurological therapy as they deliver drugs directly to the central nervous system, with less interference and better drug release control. The brain affects daily life by processing sensory stimuli, controlling movement and behaviour, and sustaining mental, emotional, and cognitive functioning. Unlike systemic routes, the nasal mucosa is extensively vascularized and directly contacts olfactory sensory neurons. Compared to the systemic circulation, this improves brain bioavailability of medications. Drugs can be delivered to the brain using in-situ gel formulations safely and efficiently, with a greater therapeutic impact than with traditional techniques., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background: We compared the new outpatient clinic referrals during the first 10 months of the COVID-19 pandemic with the year before., Methods: We compared baseline characteristics of the 2208 new referrals in 2020 (n=922) and 2019 (n=1286) with Χ 2 and Mann-Whitney U tests and calculated ORs with binary logistic regression. To evaluate the expected changes in the cancer survival secondary to stage migration, we used the 5-year survival data of Survival, Epidemiology and End Results (SEER) Program 2010-2016., Results: The percentage of patients with inoperable or metastatic disease was significantly increased during the pandemic (49.8% vs 39%, OR: 1.553, 95% CI: 1.309 to 1.843, p<0.001). We observed a significant decrease in the percentage of patients diagnosed via the screening methods (18.8% vs 28.7%, OR: 1.698, 95% CI: 1.240 to 2.325, p=0.001). The 90-day mortality after the cancer diagnosis was significantly higher during the pandemic (10.5% vs 6.6%, OR: 1.661, 95% CI: 1.225 to 2.252, p=0.001). Due to the increased advanced-stage disease rate at first referral, significant decreases in 5-year survival rates were expected for breast cancer (-8.9%), colorectal cancer (-11.1%), cervix cancer (-10.3%) and melanoma (-7%)., Conclusion: We think that collaborative efforts are paramount to prevent the pandemic of late cancer diagnoses and ensure patient safety during the pandemic., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)