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Background: Developing a reliable predictive tool of disease severity in COVID-19 infection is important to help triage patients and ensure the appropriate utilization of health-care resources. Objective: To develop, validate, and compare three CT scoring systems (CTSS) to predict severe disease on initial diagnosis of COVID-19 infection. Methods: One hundred and twenty and 80 symptomatic adults with confirmed COVID-19 infection who presented to emergency department were evaluated retrospectively in the primary and validation groups, respectively. All patients had non-contrast CT chest within 48 hours of admission. Three lobarbased CTSS were assessed and compared. The simple lobar system was based on the extent of pulmonary infiltration. Attenuation corrected lobar system (ACL) assigned further weighting factor based on attenuation of pulmonary infiltrates. Attenuation and volume-corrected lobar system incorporated further weighting factor based on proportional lobar volume. The total CT severity score (TSS) was calculated by adding individual lobar scores. The disease severity assessment was based on Chinese National Health Commission guidelines. Disease severity discrimination was assessed by the area under the receiver operating characteristic curve (AUC). Results: The ACL CTSS demonstrated the best predictive and consistent accuracy of disease severity with an AUC of 0.93(95%CI:0.88-0.97) in the primary cohort and 0.97 (95%CI:0.91.5-1) in the validation group. Applying a TSS cut-off value of 9.25, the sensitivities were 96.4% and 100% and the specificities were 75% and 91% in the primary and validation groups, respectively. Conclusion: The ACL CTSS showed the highest accuracy and consistency in predicting severe disease on initial diagnosis of COVID-19. This scoring system may provide frontline physicians with a triage tool to guide admission, discharge, and early detection of severe illness.

OBJECTIVE: This study was designed to assess the effects of a combination of Allium sativum and Olea europaea oil on disturbed lipid profiles in patients with type 2 diabetes mellitus (T2DM). METHODS: This randomized control trial (RCT) involved 160 patients of either sex (aged 40–60 years) with T2DM and dyslipidemia, and were equally divided into two groups. Group A patients received hypoglycemic and lipid lowering agents (Tab glimepiride 2 mg + metformin HCl 500 mg and Tab rosuvastatin 10 mg once a day orally). Patients in group B were given the same allopathic drugs as group A, in combination with A. sativum and O. europaea oil over a period of 6 months. Blood samples were taken at three stages of the study to allow the analysis of lipid profiles. RESULTS: Analysis showed that after 3 and 6 months of treatment, the mean levels of serum cholesterol, triglycerides (TGs) and low-density lipoprotein (LDL) were reduced in both groups and that there was a highly significant (P

The main focus of this research is to determine the molecular phylogeny and characterization of Mundri Sheep (Ovis aries) through sequencing of mitochondrial Cytochrome b and Cytochrome Oxidase Subunit I (COI). This sheep breed appears morphologically different from other local sheep breeds of Pakistan. The current research is carried out to appraise the status of Mundri sheep whether it is aa different breed from other breeds or not. Blood samples of Mundri sheep were collected from Livestock Experiment Station, (LES) Fazilpur in district Rajanpur (Punjab). DNA was isolated and subjected to Polymerase Chain Reaction (PCR) for amplification of Cytochrome b and COI genes using appropriate primers. PCR products were sequenced and analyzed by MEGA X software. The phylogeny analysis categorized Ovis aries including Mundri sheep into three and two groups for Cytochrome b and COI genes respectively. It showed Mundri sheep as a separate group and thus as a separate breed from all other local sheep breeds. Hence the study validates based on Cytochrome b and COI that Mundri sheep is a distinctive breed from the rest of the local sheep breed.

Today, the primary responsibility of a structural or civil engineer is structural design. As of right now, a variety of factors are taken into account while constructing a structure, and these factors have an impact on the longevity, quality, and functionality of the building. In the modern world, structures are designed using software. Staad pro and Etabs are two examples of modern software that is utilized on a daily basis. So, in this project, we'll plan, design, and use Etabs to analyze a residential G+8 building. The major consideration of this project is depending on the wind criteria on the sloping ground there were three structures we have considered, and all these three structures is resting on 4 slopes. The four slopes which we are considered are 0, 5, 10, 15 degrees respectively. And we are going to analyze the structure that which structure is going to give us the best possible result

Automatic paraphrase detection is the task of measuring the semantic overlap between two given texts. A major hurdle in the development and evaluation of paraphrase detection approaches, particularly for South Asian languages like Urdu, is the inadequacy of standard evaluation resources. The very few available paraphrased corpora for these languages are manually created. As a result, they are constrained to smaller sizes and are not very feasible to evaluate mainstream data-driven and deep neural networks (DNNs)-based approaches. Consequently, there is a need to develop semi- or fully automated corpus generation approaches for the resource-scarce languages. There is currently no semi- or fully automatically generated sentence-level Urdu paraphrase corpus. Moreover, no study is available to localize and compare approaches for Urdu paraphrase detection that focus on various mainstream deep neural architectures and pretrained language models. This research study addresses this problem by presenting a semi-automatic pipeline for generating paraphrased corpora for Urdu. It also presents a corpus that is generated using the proposed approach. This corpus contains 3147 semi-automatically extracted Urdu sentence pairs that are manually tagged as paraphrased (854) and non-paraphrased (2293). Finally, this paper proposes two novel approaches based on DNNs for the task of paraphrase detection in Urdu text. These are Word Embeddings n-gram Overlap (henceforth called WENGO), and a modified approach, Deep Text Reuse and Paraphrase Plagiarism Detection (henceforth called D-TRAPPD). Both of these approaches have been evaluated on two related tasks: (i) paraphrase detection, and (ii) text reuse and plagiarism detection. The results from these evaluations revealed that D-TRAPPD ( $F_1 = 96.80$ for paraphrase detection and $F_1 = 88.90$ for text reuse and plagiarism detection) outperformed WENGO ( $F_1 = 81.64$ for paraphrase detection and $F_1 = 61.19$ for text reuse and plagiarism detection) as well as other state-of-the-art approaches for these two tasks. The corpus, models, and our implementations have been made available as free to download for the research community.

Cost overrun is common problem in construction projects worldwide. Most Indian construction projects, particularly those involving high-rise buildings, have had severe cost overruns. For managers, architects, engineers, and contractors, completing building projects within the specified cost budget has become the most important and hard assignment. Since it is common for high-rise building projects to go over budget, the aim of this study is to find out the causes of cost overruns and provide effective measures. The study found 70 cost overrun factors based on a comprehensive literature review and expert opinions. A Google form questionnaire was distributed to 150 construction professionals across India. After following up, 101 of the 150 responses were received. A five-point Likert scale was used and the acquired data was analyzed and ranked using the Relative Importance Index (RII) technique. According to the findings of RII, the top ten critical factors influencing cost overruns were frequent change orders during construction by the owner, delay in construction, escalation of material prices, market inflation or deflation, rework, frequent changes in design, inaccurate evaluation of the project timeline, unforeseen ground condition, inaccurate quantity take-off, and delay in progressive payment by the owner. Spearman’s rank correlation test revealed that there is a very significant relationship between the rankings of factors provided by the owner, the consultant, and the contractor. In addition, a factor analysis tool in the SPSS software was also used to categorize the seventy factors into sixteen core components. The top ten critical factors were presented to subject matter experts, and their suggestions were being compiled. These results are expected to help construction professionals minimize cost overruns, improve cost control measures, and initiate future research.

This research project aims to design and develop a 3D interior designing application to provide a virtual experience to users in which they can visualize a standard home (sample space) and do interior designing. Users can interact with four main interior design modules i.e., Furniture, Tiles, Paints and Customization (Mix and Match). Users will be able to experience it on two different platforms, which are the desktop and the VR version. Its primary purpose is to display interior design products with complete context, unlike stores where small samples are displayed. This will help customers to make a better buying decision when it comes to design and decorate their homes.

Background: ST-elevation myocardial infarction (STEMI) is life-threatening condition requiring prompt medical attention. The diagonal branches are a group of blood vessels that supply blood to the front of the heart, and their involvement in anterior STEMI can result in worse outcomes. Early diagnosis and intervention are essential for enhancing patient outcomes. Objectives: This study's objective is to assess the efficacy of early angiography and intervention in the treatment of anterior STEMI involving diagonal branches. Methods: We conducted cross-sectional investigation of patients admitted to Medical Training Institute, Lady Reading Hospital, Peshawar, Pakistan during 2022-23, with anterior STEMI involving diagonal branches, including 250 patients whom underwent early angiography and intervention within 12 hours of symptom onset. Medical records were mined for clinical data, including demographics, medical history, electrocardiogram (ECG) findings, hematological laboratory results, and treatment modalities. The primary outcome measure was all-cause mortality at 30 days following hospitalization. Results: Mean age of STEMI patients was 61.91+8.71 years, and 68.8% were males. Median time between onset of symptoms and hospitalization was 3.50+0.78 hours. The 30-day mortality rate was 10.8% overall (27/250). Our results indicated that early intervention improved mortality outcomes, whereas late intervention increased the number of cases requiring revascularization.

Background: Acute myocardial infarction (AMI) can result in severe left ventricular dysfunction (LVD) and cardiac failure, increasing risk of complications like stroke, thrombo-embolism, and recurrent AMI. Appropriate anticoagulation strategies are crucial for mitigating adverse events. The risk stratification of these patients involves evaluating their propensity for thrombotic and hemorrhagic events. Objectives: The study determined risk stratification and anticoagulation strategies for AMI patients with severe LVD post-PCI. Methods: At a tertiary hospital in Peshawar Pakistan, an investigation was conducted on 300 patients who presented with anterior AMI and 40% LVEF upon admission. Group A received anticoagulant therapy as part of their post-PCI management, whereas Group B received standard post-PCI management without anticoagulant therapy. Various risk scores, including CHA2DS2-VASc and HAS-BLED score, and major adverse cardiovascular events, were used in assessing patient's risk of thrombosis events of bleeding through risk stratification. Results: Mean age of patients was 63.47+8.19 years, mean BMI was 28.76+3.0 and 193/300 (64.33%) were females. Hypertension, hyperlipidemia and diabetes were the prevailing comorbidities (p

With increasing globalization, communication among people of diverse cultural backgrounds is also taking place to a very large extent in the present era. Issues like language diversity in various parts of the world can lead to hindrance in communication. The usage of social media and user-generated material has grown at an exponential rate and existing supervised sentiment polarity classification techniques need labelling for the training dataset. In this study, two problems have been analyzed. First, sentiment analysis of the Twitter dataset and sense disambiguation of morphologically rich Hindi language. A rule-based fuzzy logics-based system for self-supervised sentiment classification was used to compute and analyze the self-supervised or completely unsupervised sentiment categorization of a social-media dataset using three types of lexicons. The combination of fuzzy with three different types of lexicons gives sentiment analysis a new path. The unsupervised fuzzy rules integrate the fuzziness of both negative as well as positive scores, and fuzzy logic-based systems can cope with ambiguity and vagueness. The fuzzy-system uses an unsupervised/self-supervised fuzzy rule-based technique to identify text using natural language processing (NLP) and sense of word. We compared the results of fuzzy rule based self-supervised sentiment classification by using three types of lexicons on five different datasets, with unsupervised as well as supervised sentiment classification techniques. Second, using cross-lingual sense embedding rather than cross-lingual word embedding resolves the ambiguity issue. The word sense embeddings are produced for the source languages to learn multiple or various senses of the words. Different evaluation metrics depict an improved performance for English-Hindi language.

Cardiovascular disease that causes heart failure is one of the diseases with the highest mortality rate in the world. Therefore, there is a need for an accurate model to classify heart failure based on clinical information and the lifestyle of patients with the disease, as an alternative solution in administering appropriate drugs. This study compared the classification model of living and deceased heart failure patients based on clinical information and patient lifestyle using the random forest method when using resampling techniques and not using resampling techniques. The results obtained from this study are that the Random Forest model with a combination of the SMOTE and Edited Nearest Neighbors methods is the best model for classifying someone with heart failure as alive or dead. The Random Forest model with a combination of the SMOTE and Edited Nearest Neighbors methods has a high level of classification accuracy in the evaluation model that focuses on recall, namely rf_model_smoteenn can classify 82.96% of patients with living status and 90% of patients with death status.

Among the greatest general challenges in bioengineering is to mimic human physiology. Advanced efforts in tissue engineering have led to sophisticated ‘brain-on-chip’ (BoC) microfluidic devices that can mimic structural and functional aspects of brain tissue. BoC may be used to understand the biochemical pathways of neurolgical pathologies and assess promising therapeutic agents for facilitating regenerative medicine. We evaluated the potential of microfluidic BoC devices in various neurological pathologies, such as Alzheimer's, glioblastoma, traumatic brain injury, stroke and epilepsy. We also discuss the principles, limitations and future considerations of BoC technology. Results suggest that BoC models can help understand complex neurological pathologies and augment drug testing efforts for regenerative applications. However, implementing organ-on-chip technology to clinical practice has some practical limitations that warrant greater attention to improve large-scale applicability. Nevertheless, they remain to be versatile and powerful tools that can broaden our understanding of pathophysiological and therapeutic uncertainties to neurological diseases.

Past bridge failures due to earthquakes have been found to be due to inadequate seismic design of the bridge piers. It is thus essential to investigate the effect of lateral confinement on the seismic behaviour of bridge piers. The aim of this study was to evaluate, experimentally and numerically, the seismic performance of reinforced concrete bridge piers with various types of transverse reinforcement. For this purpose, three scaled-down (1 : 4) circular bridge pier specimens were tested under constant axial and quasi-static cyclic loading (QSCL). A control specimen was made with spiral lateral reinforcement, while the other two specimens were made with stirrups with cross-ties and strips with cross-ties. The hysteresis loops, envelope curves, energy dissipation and stiffness degradation of all three specimens were determined in order to evaluate their seismic behaviour. Compared with the control specimen, the specimen with strips and cross-ties showed increased lateral load capacity, cumulative energy dissipation and higher initial stiffness due to the effect of increased confinement. The results of finite-element analysis showed good agreement with the experimental results. The findings of this study indicate that strips with cross-ties can be used in bridge piers when a high lateral load carrying capacity and energy dissipation are required.

OBJECTIVE Bone morphogenetic proteins (BMPs) are part of the transforming growth factor–beta superfamily and are involved in bone formation and repair. In spine surgery, recombinant human BMP (rhBMP) is used as an alternative to autografts for spinal fusions. This study aimed to evaluate bibliometric parameters and citations of the literature on BMPs to provide an overview of how the field has evolved. METHODS A comprehensive search of the literature was conducted using Elsevier’s Scopus database to capture all the published and indexed studies relevant to BMPs from 1955 to the present. A discrete set of validated bibliometric parameters was extracted and analyzed. All statistical analyses were performed using R 4.1.1. RESULTS The 100 most cited articles were published between 1994 and 2018 by 472 unique authors in 40 sources (e.g., journals and books). On average, there were 279 citations per publication and 17.69 citations per publication per year. The United States had the publications with the most citations (n = 23,761), followed by Hong Kong (n = 580) and the United Kingdom (n = 490). The three institutions in the United States with the greatest number of publications in the field were Emory University (n = 14), Hughston Clinic (n = 9), Hospital for Special Surgery (n = 6), and University of California (n = 6). CONCLUSIONS The authors evaluated and characterized the 100 most cited articles about BMP. Most of the publications were clinical in nature and focused on BMP’s application in spine surgery. While early scientific efforts focused on basic science research to advance the understanding of BMP’s mechanism of action in promoting bone formation, the majority of the more recent publications are clinically focused. It will be beneficial to conduct more controlled clinical trials to compare the outcomes of BMP use with other methods.

The current focus is on the overall pattern of seed storage present in the fragments of the soil of piedmont and alluvial landscapes of the environment. The present study predicted the seed banks of both soils of alluvial and piedmont zones in different ecological conditions and evaluate the potential of seeds in the restoration of both environments. The composition of the seed bank of soil is mainly affected by the alluvial environment and the structure of cleared area shows that more species of germinating annual grasses and growable seeds with the higher total number. Extant vegetation structures have an important role in the diversity of soil seed reservoirs, whose composition corresponded with the openness of the site. When in situ soil seed bank is recruited, it helps to restore only some components of the plant community in an alluvial environment. In our current research, it was confirmed that seed richness was higher in number at lower elevation (alluvial) than that at high elevation (piedmont). Seed richness showed a significant negative correlation with anions, cations, while significantly positive with altitude that suggests the richness pattern of the overall seed bank of the area is influenced by various environmental factors. Resumo O foco atual está no padrão geral de armazenamento de sementes presente nos fragmentos de solo do Piemonte e nas paisagens aluviais do meio ambiente. O presente estudo previu os bancos de sementes de ambos os solos das zonas aluvial e piemontesa em diferentes condições ecológicas e avaliou o potencial das sementes na restauração de ambos os ambientes. A composição do banco de sementes do solo é afetada principalmente pelo ambiente aluvial e a estrutura da área desmatada mostra que mais espécies de gramíneas anuais em germinação e sementes cultiváveis apresentam o maior número total. As estruturas da vegetação existente têm um papel importante na diversidade dos reservatórios de sementes do solo, cuja composição correspondeu à abertura do local. Quando o banco de sementes do solo in situ é recrutado, o mesmo ajuda a restaurar apenas alguns componentes da comunidade de plantas em um ambiente aluvial. Em nossa pesquisa atual, foi confirmado que a riqueza de sementes era maior em número em altitudes mais baixas (aluviais) do que em altitudes elevadas (Piemonte). A riqueza de sementes mostrou uma correlação negativa significativa com ânions, cátions, enquanto significativamente positiva com a altitude, o que sugere que o padrão de riqueza do banco geral de sementes da área é influenciado por vários fatores ambientais.

Abstract: PCOS is a complex multigenic condition influenced by significant epigenetic and environmental variables, including nutrition and lifestyle. IR is found in roughly 80% of obese women with PCOS and 30–40% of lean women. IR is an impairment of insulin to mediate metabolism in skeletal muscle, adipocytes and liver. Following weight gain, the severity of IR in women with PCOS increases. IR affects many PCOS women who are not overweight, and minor weight loss improves clinical results in those with near-normal body weight. The effect of exercise on IS is optimized through glucose transport and metabolism. Exercise is the first-line treatment for PCOS. Moderate intensity (60–70% VO2max; comparable to 75–80% HRmax) and high-intensity aerobic exercise (heart rate >80%) improves IR in women with PCOS. These exercises are performed for at least 30 minutes per session and 3–5 days per week. A single bout of exercise (2–72 hours postexercise) can improve IS immediately. Exercise improves IS and glycemic management as well as helps in lowering the abdominal fat. Therefore, exercise performed on a regular basis can help improve insulin resistance in women with PCOS.

Background: Diabetes and depression are major issues globally, with CBT identified as the most effective treatment for depression. Self-help CBT in Pakistan has shown positive results for depression treatment. A study has found that CBT leads to a higher remission rate for depression in Type 2 diabetes patients, highlighting the need for proper treatment of diabetes-related depression to improve health outcomes.Methods: In a randomized controlled trial a total of 32 patients with diabetes and depression were allocated to CBT therapy (n=16) and controls without CBT therapy (n=16). The study was conducted at the Department of Psychiatry, and diabetic’s clinic of Department of General Medicine, Pakistan Institute of Medical Sciences, Islamabad, in a period of 2 months. Known cases of Type 2 Diabetes fulfilling the diagnostic criteria of Depression and anxiety using DSM –V research criteria, and who lived within the catchment area were approached. Formal approval from hospital ethical committee and written informed consent from participants were obtained. Those persons, who agreed to enter the study, were assessed 2 weeks after the first screening, to fill in the baseline measures when they attended their first appointment. These persons were asked to attend further appointments and were assessed every two weeks till end of the study final assessment were made. Results: The mean age of patients was 50.9 + 7.5 years in group A (CBT) and 45.4 + 10.1 years in group B (without CBT). Male and female cases were equally selected in both groups respectively. The mean HADS was found similar at baseline in both study groups while post intervention phases in group A, greater improvement was observed (8.8 + 2.6) compared to (10.3 + 2.9) in group B. The WHO quality of life scale was almost similar in both groups at baseline, however, greater improvement in quality of life was observed in group A (90.7 + 9.0) compared to group B (82.1 + 13.9) and the difference in mean WHOQOL was found statistically significant (p-value = 0.04). Conclusions: The CBT intervention has a clear role in the management of depression in diabetic patients. In this study it has shown significant improvement in the health and depression scales and also in the overall quality of life according to WHO scale.

There is a growing body of work suggesting that social class stereotypes are amplified when people perceive higher levels of economic inequality—that is, the wealthy are perceived as more competent and assertive and the poor as more incompetent and unassertive. The present study tested this prediction in 32 societies and also examines the role of wealth-based categorization in explaining this relationship. We found that people who perceived higher economic inequality were indeed more likely to consider wealth as a meaningful basis for categorization. Unexpectedly, however, higher levels of perceived inequality were associated with perceiving the wealthy as less competent and assertive and the poor as more competent and assertive. Unpacking this further, exploratory analyses showed that the observed tendency to stereotype the wealthy negatively only emerged in societies with lower social mobility and democracy and higher corruption. This points to the importance of understanding how socio-structural features that co-occur with economic inequality may shape perceptions of the wealthy and the poor. © 2022 The Authors. European Journal of Social Psychology published by John Wiley & Sons Ltd. WOS:000880016700001 2-s2.0-85141616689 Social Sciences Citation Index Q2 Article Uluslararası işbirliği ile yapılan - EVET 2022 YÖK - 2022-23 Kasım

Objective: To study frequency of contributing factors of lumbar puncture refusal in children presented with suspected meningitis. Methodology: In this descriptive cross-sectional study during 2019 to 2020 at Pediatric Department Ghurki Trust Teaching Hospital, Lahore a total of 155 cases of 2 months to 12 years of age who presented with suspected meningitis and refused the procedure were included. They were asked about various contributing factors like fear of side effects, little knowledge of the disease, unsuccessful experience and lack of medical facility. Results: In this study there were total 155 cases. Out of these 84 (54.19%) were males and 71 (45.81%) females. The mean age of the participants was 3.81±2.03 years. Among contributing factors for refusal, most common factor was fear of side effect which was observed in 39 (25.16%), followed by unsuccessful experience seen in 18 (11.61%), lack of medical facility seen in 16 (10.3%) and little knowledge of the disease in 13 (8.39%) of the cases. There was no significant association with any of the contributing factor with variable of this study. CONCLUSION: There are number of factors for refusal of LP and fear of side effect was the most common. There was near significant association of high socioeconomic class with lack of medical facility. Keywords: Lumber puncture, CSF, Medical Facility, Fear

Application of English textbooks for Integrated Language Skills (ILS) development of bi-lingual students remains a challenge for English language teachers through integrated classroom activities in Pakistan. This research measured the opinion of the English teachers of private schools of District Central Karachi about the application of English textbook to develop ILS of bi-lingual students through integrated classroom activities. Literature reported that locally designed English textbooks in Pakistan proved insufficient related to interactive classroom activities for students and as a pedagogical resource for the teachers. A survey was designed bearing 45 items related to 6 variables from diversified dimensions of the research objectives. Five hundred questionnaires were received and fed in SPSS for data analysis and treatment. The findings proved that the current classroom activities based on prescribed English textbooks were not supportive to develop ILS of bi-lingual students. A significant difference in the opinion of male and female was found about application of English textbooks related to classroom activities, experiential learning, reflective thinking skills, teachers’ perception and affective factors in second language acquisition process. Regression model predicted that Second language acquisition was based on classroom activities, experiential learning and teachers’ perception about the application of English textbook. This study recommends that reading skill must be emphasized more in English textbooks with speaking, writing and listening skills for ILS development of bi-lingual students.

Post-Partum Hemorrhage (PPH) has many reported causes such as retained placenta, genital tract lacerations and uterine atony. Objective: To see effect of Nursing Care Practices based on Clinical Interventions on the Incidence of Primary Post-Partum Hemorrhage in females undergoing spontaneous vaginal delivery (SVD). Methods: In this study Pre & Post Study design was used. Sample size 196 was used respectively for Incidence of Primary PPH. In this study Sampling Technique Purposive was used. September 2021 to May 2022 was study duration in which study was conducted. Mothers who were advised to undergo Spontaneous Vaginal Delivery by an obstetrician. Females were including in this study whose maternal age was in years 20-50years. Females admitted to gynecology ward for lower segment caesarian section (LSCS) and Females diagnosed with Preeclampsia were excluded from the study. The Incidence Checklist for PPH was adopted with (Cronbach alpha = 0.89). Results: There was a significant improvement in the incidence of Primary PPH was 27.55% in females undergoing SVD before any change in nursing practices. However, the incidence decreased to 14.48% after clinical interventions in nursing care practices. Conclusions: Nursing Care Practices based on Clinical Interventions was effective. Clinical interventions in nursing care practices showed significant improvement. Furthermore, it also reduces the incidence of Primary PPH and ultimately decreases hospital stay

Proton pump inhibitors (PPIs) are widely used for the treatment of acid-related gastrointestinal disorders. However, their overuse or inappropriate prescription can lead to adverse effects, increased healthcare costs, and development of antibiotic-resistant infections. Objectives: To ascertain whether the Omeprazole (Risek®)-PPIs prescription patterns by practitioners in the inpatient and outpatient departments of various healthcare facilities in Pakistan are in compliance with the therapeutic indications and to evaluate the safety profile associated with each therapeutic indication. Methods: A cross-sectional multicenter study was conducted for 4 months at various healthcare facilities inpatient and outpatient departments. A total of 1384 patients ≥ 18 years prescribed Omeprazole (Risek®) were enrolled while pregnant or lactating women, patients with chronic diarrhea, those with a history of Omeprazole allergic reaction, and with diagnosed malignancy of the GI tract were excluded. The drug use was determined based on the prescribed frequency, dosage, and duration of therapy with respect to each indication. Results: Of the total, 29.8% were already taking oral PPI or Histamine H2-Receptor Antagonists. The common indication for Omeprazole (Risek®) was Gastroesophageal Reflux Disease (GERD), followed by peptic ulcer. Mostly the drug was infused/injected in 40 mg dosage, once daily and for five days among 76.6% and 41.8%, respectively. Around 13.3% of patients experienced mild adverse events like flatulence, fever, vomiting, abdominal pain, constipation, diarrhea, nausea, rash, etc. Most off-label uses were observed in GERD concerning the duration of therapy (55.9%), prescribed frequency (19.7%), and dosage (5.9%). The Omeprazole (Risek®) treatment was also prescribed for stress ulcer prophylaxis and upper GI bleeding against the treatment protocol for the particular therapeutic indication. The adverse events were most frequent among patients with GERD, followed by NSAID-induced ulcers. Conclusions: This study provides clinical evidence on the Omeprazole (Risek®) use in concordance with the product label, in both inpatient and outpatient departments of Pakistan for various therapeutic indications.

Bacterial spot of tomato is a major constraint to tomato production in tropical, subtropical, and temperate climates, leading to significant crop losses. The current study aimed to manage the highly devastating disease bacterial spot of tomato, caused by Xanthomonas perforans, using green silver nanoparticles based on Berberis vulgaris plant extract. Disease parameters, namely disease prevalence and disease incidence, were calculated from tomato growing areas of district Poonch, AJK, to document the current status of bacterial spot disease on local tomato cultivars. The associated pathogenic strains were purified, and virulence study was conducted on healthy tomato seedlings followed by characterization using morphological, biochemical, and molecular analysis. B. vulgaris plant extract was used for the preparation of green silver nanoparticles (AgNPs), and three different concentrations were prepared (0.2%, 0.4%, and 0.6%). For texture and molecular composition study, characterization of green AgNPs was done using Fourier-transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). Green silver nanoparticles were then evaluated using the inhibition zone technique in the lab, and it was found that the maximum inhibition zone of 24.32 mm was observed at a 0.6% concentration. Similarly, in the greenhouse experiment, the minimum disease incidence was recorded in the treatment with a 0.6% concentration of green AgNPs. The results of the current study showed a significant reduction in disease incidence while using green silver nanoparticles against bacterial spot of tomato

Plants have played a significant role in traditional medicine for treating a wide range of human ailments. Among the many medicinal herbs used in Unani medicine, Bombax ceiba Linn. has been employed for centuries. This herbaceous plant is renowned for its impressive height, reaching approximately 150 feet. It can be found in temperate and tropical regions of Australia, Africa, and, Asia with occurrences in India at altitudes of up to 1500 meters. The indigenous communities and forest dwellers extensively utilize various components of this plant, including the root, flower, gum, leaf, prickles, stem bark, fruit, seed, and heartwood, to address diverse diseases. Ethnobotanical research reveals that Bombax ceiba Linn. is effectively employed in the treatment of ailments such as diarrhea, boils, wounds, leprosy, acne, and various other skin conditions. Furthermore, it has been used as an anthelmintic since ancient times. Through scientific investigations, the presence of numerous beneficial properties has been confirmed in different parts of this plant, thus validating its traditional medicinal use. These properties include hypotensive, antioxidant, pain-relieving, anti-inflammatory, antipyretic, antiangiogenic, antioxidant, antibacterial, antidiabetic, hepatoprotective, anticancer, and anti-helicobacter pylori properties

DNA binding with one-finger (Dof) protein belongs to the plant-specific transcription factors (PSTFs) gene family. These transcription factors have a variety of roles in many biological processes in plants. However, there is limited research on their role in Cashew. A total of 67 Dof genes were found in the cashew genome and were classified into 11 subgroups (A, B1, B2, C1, C2, D, E1, E2, F1, F2, and F3) by comparing them with Dof genes from Arabidopsis and lettuce. Cashew Dof genes were present in 9 of these subgroups, except for A and F1. This article provides a detailed discussion of the gene structures, chromosome positions, phylogeny, subcellular localization, cis-regulatory analysis, protein motifs, and evolutionary patterns of Dof genes in cashew. The only type of duplication found in cashew was segmental duplication, which mainly contributes to the large Dof gene family. The analysis of cis-regulatory elements (CREs) revealed the presence of light, ethylene, seed, circadian, meristem, and auxin-sensitive elements, which are particularly sensitive to these factors. The article also includes a comparative analysis of the evolutionary or phylogenetic relationships between Dof genes from lettuce, cashew, and Arabidopsis. This study provides a comprehensive understanding of the Dof gene family in cashew and can serve as a guide for functional analysis and cloning of its gene family members.

Fishery management is an activity that must be carried out to achieve sustainable fisheries. Fisheries management using the Ecosystem Approach to Fisheries Management (EAFM) approach is the sustainable use of fishery resources and protection of fish stocks in nature. One of the objectives of fisheries management in social and economic aspects is how fisheries can ensure the socio-economic welfare of the fishing community. Using fishing gear that is not environmentally friendly is one of the triggers for social conflict between fishermen and the uncertain selling price when the peak season of fish impacted the fishermen's economy. Therefore, the purpose of this research is to examine the socio-economic domain indicators from the aspect of EAFM-based coastal and marine resource ecosystem management. This research was conducted from January to February 2021, located in Simeulue District, Sub-District East Simeulue. The data collection method used in the study was interviews and field surveys. The determination of respondents is done by using a gradual sampling technique or stratified random sampling. Data analysis uses an ordinal-based Likert score of 1,2,3 for each indicator, namely the economic domain, fishery household income (RTP), savings ratio, asset ownership, and the social domain, namely stakeholder participation fisheries conflict and the use of local knowledge in fish resource management. Management status in East Simeulue District assessed the aggregate value of the economic domain in the medium category with a score of 48.3. Fishermen still earn less than the minimum wage, while in the social domain, it is in the excellent category with a score of 100 because fishermen, institutions, and related agencies work with each other. Keywords:EAFMEcosystem approachFishery management

A type of wound healing known as hepatic fibrosis arises in response to chronic liver damage brought on by viruses, toxins, and medications that are detrimental to the liver. The syndrome is characterized by inflammation, which is followed by the deposition of extracellular matrix proteins and the development of scar tissue. Ephrin receptor A2 is a host cofactor that has been associated to Hepatitis C virus (HCV) entry (EphA2). The Abelmoschus moschatus seed belong to family Malvaceae. It contains sitosterol b. total phenol, flavonoids which are responsible for antioxidant, antimicrobial and free radical scavenging activity. The exact mechanism of action for the hepatoprotective action of Myricetin was still not revealed. With intent to propose the most probable mechanism of action of Myricetin the docking based computational analysis has been performed against the hepatoprotective drug targets like PPARα enzyme. Research Article

Background and Aim: The purpose of this research was to examine the influence of Z-Prime Plus and G-Bond on zirconia posts fracture resistance affixed to the walls of root canals. Place of Study: Avicenna Medical College Lahore Study Duration: March 2021 to April 2022 Materials and Methods: In this in-vitro experimental study, the diameter and length of each of the 20 mandibular premolars used were identical. This assured that the study's findings were comparable. Once a cut was made at the cementoenamel junction (CEJ) to prepare the teeth for root canal therapy, the teeth were randomly assigned to one of two groups (n=11) with the same number of teeth in each group. In the experiment, a single tooth from each group was chosen at random to serve as the control. A post space of approximately 10 millimeters in length was established in the remaining teeth. The following process involved etching the intracanal dentin, followed by rinsing and drying the material. The technique involved filling the canal with Panavia F2 resin cement. After applying G-Bond and Z-Prime Plus to the zirconia posts in respectively, groups 1 and 2, the placement of post was done in the canals and subsequently cemented. The photo core resin composite material was utilized in the fabrication of the cores. The longitudinal axis of the teeth was compressed by a force application to the core of central fossa o at a crosshead speed of 0.5 millimeters per minute. This was accomplished with a crosshead speed of 0.5 mm/min. The load that caused the fracture was measured and documented. To analyze the data, a t-test was conducted, and a normal distribution was also taken into account. Result: The results indicated that the average fracture resistance of G-Bond was 1088.1±330 while the average fracture resistance of Z-Prime Plus was 898.4±369 however, the difference was not statistically significant (P=0.3). Practical Implication: The influence of Z-Prime Plus and G-Bond on zirconia posts fracture resistance affixed to the walls of root canals Conclusion: There was no significant difference between the fracture resistance of zirconia posts bound with G-Bond and Z-Prime Plus to root canal walls. In contrast, G-Bond is highly advised for usage in this application due to its decreased coefficient of variation (CV) and significantly increased fracture resistance. This makes it a great option for the current endeavor. Keywords: Primer; resin composite; shear bond strength; zirconia ceramic, G-Bond, Post and Core Technique, Z-Prime Plus