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Plastic pollution has become a challenging issue worldwide, causing adverse impacts on the environment and ecosystem. Single-use plastic shopping bags and bottles are the main reasons behind plastic litter. These non-degradable bags create market externalities that can be internalized through different techniques. This study estimates the users' willingness to pay for biodegradable bags using the contingent valuation method. Data from 360 respondents were collected in a market survey through a designed questionnaire. Three market areas of Peshawar city were selected, which many consumers visit daily. Willingness to pay depends on the demographic and socioeconomic characteristics of the consumers. The Tobit model with marginal analysis yields significant results. The results show that the marginal change in the willingness to pay of an individual decreases with the increase in income. The marginal Willingness to Pay remains the same for respondents of all education categories. There is a downward trend in marginal willingness to pay when the family size of the respondent increases. 38% of the respondents were not using degradable bags. 35 percent strongly agreed on an awareness campaign. The study recommends that there should be a subsidized price on each good quality biodegradable cotton bag in shopping zones. [ABSTRACT FROM AUTHOR]

Objective: To determine if a goal-directed ECG workshop improves ECG interpretation competency and confidence among the house officers in PNS Shifa Hospital. Study Design: Prospective comparative study. Place and Duration of Study: Pakistan Naval Ship Shifa Hospital, Karachi Pakistan, from Jan to Dec 2021. Methodology: ECG workshops were conducted for House Officers in batches. The participants were asked to complete a questionnaire testing their ECG interpretation competency before and after the workshop and self-report their confidence level in ECG interpretation. Results: Sixty-eight house officers participated in the workshops and completed the test. There were 41(60.29%) female and 27(39.7%) male participants. The statistics showed significant improvement in ECG competency (p<0.001). In addition, the pre and post-workshop confidence levels also showed significant improvement (p<0.001). Conclusion: A goal-directed ECG workshop improves house officers' competency and confidence in ECG interpretation. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of Amlodipine with Captopril in the management of patients presenting to the emergency department with uncontrolled blood pressure. Study Design: Comparative prospective study. Place and Duration of Study: Emergency Department, Combined Military Hospital, Malir Pakistan, from Jul to Dec 2021. Methodology: A total of 127 individuals presenting to the Emergency Department with two readings of uncontrolled blood pressure (Systolic blood pressure > 160mmHg and Diastolic blood pressure >90mmHg) were included. They were administered a tablet of Captopril 12.5mg per oral and a tablet of Amlodipine 10mg per oral on the turn by turn basis. Patients were observed for 3 hours and monitored for the reduction in blood. The efficacy of medication was judged based on the ability to achieve target blood pressure reduction, which was at least a 20-30% reduction in systolic blood pressure. Results: Out of 127 individuals, 65(51.2%) patients were given a tablet of Captopril 12.5mg orally, and 62(48.8%) were given a tablet of Amlodipine 10mg orally. The mean reduction in systolic blood pressure was 20.73±5.17 in all patients. In addition, target blood pressure reduction was achieved in 35(53.8%) individuals of the Captopril-Group and 33(53.2%) of the Amlodipine-Group, with a total of 68(53.5%) individuals achieving target blood pressure within 3 hours after medication. Conclusion: Both medications were efficient in achieving target blood pressure levels. However, no drug was superior to another in reducing blood pressure in an emergency. [ABSTRACT FROM AUTHOR]

Objective: Current study aimed compare variations of width, length, and width-length ratio of MCIs among patients presenting with replacement of posterior teeth. Materials and Methods: A total of 120 participants male and female subjects with age between 18 to 40 years, having angle class I occlusion and anterior permanent teeth present, presence of anatomically whole MCI, from which good diagnostic cast can be obtained, and no restorations in MCI. Measurements of all these parameters were performed with digital vernier caliper. The clinical crowns of MCI were calculated, the maximum length of the crown and mesio-distal (MD) breadth between the incisal point of the MCI crown and the apical point of the gingival margin. Sample t-test will be applied to compare the effect of gender on width, length, and width-length ratio in both genders. The level of significance was kept 0.05. Results: The males were 54(53.3%) and females were 56(46.7%). The mean age was 30.12 ± 7.25 years. The width of central incisors on right and left sides were 7.96 ± 0.53mm and 7.83 ± 0.61mm respectively. The length of right and left central incisors were 8.27 ± 1.15mm and 8.06 ± 1.57 mm. The ratio of width/length on right and left side was 0.98±0.11 and 1.02±0.29 respectively. There was not statistical difference mean width among genders (p = 0.201 right side, p=0.388 left side). Conclusion: There was no sexual dimorphism for width but width to length ratio was statistically different among gender, higher in females. [ABSTRACT FROM AUTHOR]

Objective: to know the connection between Sodium intake/urinary Sodium excretion and the tendency to develop hypertension during pregnancy. Study design: Prospective longitudinal study. Place and Duration of Study: Combined Military Hospital Kharian, District Gujrat Pakistan from Jul 2019 to Dec 2020. Methodology: The included population was divided into two equal Groups (Normotensive and hypertensive). Blood pressure was measured at a pre-determined interval starting from the initial prenatal visit before 18 weeks of pregnancy to the 36th week of gestation. Urinary Sodium secretion was determined in 24-hours urine accumulated at three stages between 18 and 36 weeks of gestation. The main outcome actions were the implication of the difference in mean between urinary Sodium and alterations in maternal BP. Results: The mean age of our study population was 32 years ± 6.96 years, and it ranged from 31 to 48 years. The mean urinary sodium was 141.00±24.879, 140.00±29.73 and 139.00±15.17 mEq/day in the normotensive group, which was 142.00±21.90, 143.00±32.03 and 139.00±14.27 mEq/dl in the hypertensive group. In the hypertensive group, systolic Blood pressure was also high with mean systolic BP of 143.00±12.10, 141.00±12.47 and 148.00±16.82 respectively during the three trimesters. As expected, it was normal in the second group. Conclusion: There was no significant association between sodium intake and pregnancy-induced hypertension. [ABSTRACT FROM AUTHOR]

Accurate and reliable long term meteorological data is very difficult to be obtained in developing countries especially in hard and mountainous regions. This paper focuses to select the most suitable and reliable gridded datasets for the two most important meteorological parameters i.e., precipitation and temperature in a sparsely gauged transboundary Kabul River Basin (KRB) between Pakistan and Afghanistan. Novelty of this study is that gridded datasets were evaluated for precipitation and temperature based on monthly, seasonal and annual timescales against the available observed stations data on both sides of the KRB. Based on the literature studies, the five most frequently used datasets namely; National Centers for Environmental Prediction, Climate Forecast System Reanalysis (NCEP-CFSR), Asian Precipitation Highly Resolved Observational Data Integration towards Evaluation (APHRODITE v1101), Global Precipitation Climatology Centre (GPCC), Precipitation Estimation from Remotely Sensed Information using Artificial Neural Networks-Climate Data Record (PERSIANN-CDR) and Climate Research Unit (CRU TS v4.02) with different spatial and temporal resolutions were selected and evaluated. Analyses were done using the four most widely used statistical indices i.e., Modified Index of Agreement (d), Pearson's Correlation m Coefficient (r), Root Mean Square Error (RMSE), and Relative Bias (RB%). Results revealed that based on the statistical indices scores; APHRODITE (v1101) showed the best results followed by GPCC for precipitation while for temperature, CRU (TS v4.02) was found better compared to other datasets in the study basin. These findings can be used with confidence by the researchers for the future studies whose outcomes could be utilized by the water resource managers, planners and agriculturists. [ABSTRACT FROM AUTHOR]

Assessing trends of hydrometeorological variables is necessary for climate change modeling, accurate water resources management and improved regional planning. This study investigated the seasonal, annual, maximum (max.) and mean rainfall trend using data from 1986 to 2013 collected from three selected gauge stations including Tarbela, Daggar and Saidu sharif. Similarly, the historic data (1986 to 2013) of flow of Brandu river and max. and minimum (min.) temperature of Tarbela and Saidu Sharif gauge station were analysed. To identify trends for the hydrometeorological parameters, both non-parametric and parametric (MK) tests were applied at 10% significant level. The study concludes, a mixture of increasing and decreasing trends. Annual max. rainfall exhibited an increasing trend in the study area. Similarly, total annual and mean annual rainfall for Daggar and Saidu Sharif gauge stations showed decreasing trend while Tarbela gauge station exhibited an increasing trend. Statistically significant trends were found for annual total rainfall. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of Pregnancy-related acute kidney injury in the Pakistani population and its effect on maternal health. Study Design: Cross-sectional study. Place and Duration of the Study: Department of Nephrology and Obstetrics and Gynecology, Combined Military Hospital Kharian, from Jan 2018 to Dec 2020. Methodology: All pregnant women with normal renal functions at the time of enrolment in the study and no previous history of any kidney disease or renal procedure in the recent past (at least 3 months) before conception were included in our study at Combined Military Hospital Kharian. All participants had serum creatinine tested at enrolment and were inquired specifically about any history of renal disease or any renal procedure in the recent past (at least 3 months old). Results: Mean maternal age in the study was 29 ± 7.67 years however it ranged from 16-41 years. Around a quarter of acute kidney injury cases occurred in the first and second trimesters combined, with 26 (12%) and 24 (11%) cases in the first and second trimesters, respectively. Thirty percent of acute kidney injury cases were diagnosed in the third trimester. A substantial number 58 (27%) of cases developed azotemia which persisted beyond three months and developed chronic kidney disease of various stages. Regarding maternal outcomes, 166 (77%) mothers recovered completely. However, 43 (20%) patients had some degree pf azotemia, a few cases required permanent renal replacement therapy. Conclusion: Acute kidney injury is a common problem in our community leading to suboptimal maternal outcomes. Overall prognosis is relatively better but there is a definitive association with the development of chronic kidney disease and even permanent dialysis dependency. [ABSTRACT FROM AUTHOR]

Objective: To assess sleep quality in patients of Chronic Kidney Disease using Pittsburgh Sleep Quality Index score and to compare the effects of Alprazolam and Pregabalin in patients having poor sleep quality. Study Design: Quasi-experimental study. Place and Duration of Study: Nephrology Department of Combined Military Hospital, Karachi Pakistan, from Oct 2021 to Mar 2022. Methodology: A total of 127 individuals coming to Nephrology Department diagnosed with chronic kidney disease were included. Sleep quality was assessed using Pittsburgh Sleep Quality Index score. Age, gender, duration of Chronic Kidney Disease and history of Diabetes, Hypertension and Cardiovascular disease were recorded. Those individuals having poor sleep quality were started randomly on either Alprazolam 0.5 mg and Pregabalin 75 mg daily. Effects of these drugs were assessed by determining Pittsburgh Sleep Quality Index two months after administration of these drugs. Results: Out of 127 individuals, 82(64.5%) had poor quality sleep characterized by Pittsburgh Sleep Quality Index ≥5 at the time of presentation. Among them, 40(48.7%) were male and 42(51.3%) were female, 46(56.1%) had history of Diabetes Mellitus, 48(58.5%) had history of Hypertension and 31(37.8%) had history of Cardiovascular disease. Forty-one were started on Alprazolam and 41 on Pregabalin. No statistically significant difference was found in the sleep quality between groups at the end of two months of regular treatment (p-value =0.088). Conclusion: Sleep disturbances are present in majority of the patients of Chronic Kidney Disease. Both Alprazolam and Pregabalin can be used to treat sleep related disorders in these patients. [ABSTRACT FROM AUTHOR]

In drip irrigation system, emitters are the key system components. The hydraulic performance of these drip emitters may affect the efficiency of irrigation schemes if not conforming to specified standards. The main objective of this study was to investigate the hydraulic characteristics including average flow rate, emitter exponent, distribution uniformity, emitter discharge coefficient of variation, and statistical uniformity of locally available drip emitters. These indices were compared with the manufacturer data and available technical standards. A test bench was developed to measures the flow of emitters at different operating pressures. Data was consequently used for evaluating the hydraulic flow characteristics. Nine types of emitters marked S1-S9 having sample size of 27 were tested on the hydraulic bench. When evaluated for compliance with manufacturer claim for being marked as PC and Non-PC, all the emitters passed the test except for S1. The statistical uniformity of S9 ranked highest (96.62%) compared to other emitter types, while S2 ranked lowest (87.99%). When appraised for discharge variation under variable head, S3 discharge variation was not significant (2%) whereas S8 had the highest discharge variation of 38%. Overall the distribution uniformity of tested emitters ranged from 83.84% to 96.67%. Based on the outcome of this study it is suggested that drip emitters should be tested before adoption to ensure uniformity of water application. [ABSTRACT FROM AUTHOR]

Objective: To investigate and document the clinical course of typhoid fever and the sensitivity pattern of Salmonella typhi to antibiotics among patients admitted to Pakistan Naval Ship Shifa Hospital. Study Design: Cross-sectional study. Place and Duration of Study: Pakistan Naval Ship Shifa Hospital, from Jul to Dec 2021. Methodology: The patients admitted with typhoid fever to the hospital during the study period were included using consecutive sampling. After getting informed consent, the patients' demographic characteristics, course of the disease, blood culture sensitivity, the treatment administered, the complications that emerged, and the length of their hospital stay were noted. Results: There were 77 patients with culture-proven typhoid fever admitted during the study period. The mean age was 18.6±11.84 years (range 1-55 years). The most frequent presenting complaints were fever, abdominal pain, and vomiting. Additional symptoms included a rash, bodily aches, and weariness. Out of the 77 patients, 76(99%) were extensively drugresistant (sensitive to Meropenem and Azithromycin only). The complications noted were hepatitis, myocarditis, ascites, pleural effusion, and shock. The mean length of stay in the hospital was 16.56+3.87 days. The typical time gap between commencing culture-specific antibiotics and fever defervescence was 4.03±2.84 days. Conclusion: Almost all (99%) patients admitted with typhoid fever in PNS Shifa are extensively drug-resistant and require a relatively longer hospital stay for management. [ABSTRACT FROM AUTHOR]

Objective: To determine various factors associated with poor dialysis compliance as evident by early signoff and no shows. Study Design: Descriptive study. Place and Duration of Study: Nephrology department at Pak Emirates Military Hospital Rawalpindi, from Feb 2012 to Jan 2013. Material and Methods: A standardized proforma was formulated which was to be filled by dialysis staff each time a patient refused dialysis, absented "No show" or had premature termination of dialysis session against the medical advice, "early sign off" due to any cause. This data was compiled centrally on monthly basis and patients were counseled by doctors to evaluate the cause and various factors for early sign off and no shows. Using Non probability convenience sampling 364 dialysis sessions were included in our study. Data was analysed using SPSS version 20 and frequencies were calculated for various factors associated with early termination or absence altogether from dialysis. Results: A total of 11232 dialysis sessions were followed during study period. Amongst total of 364, 320 (88%) dialysis were terminated prematurely (Early sign off) while 44 (12%) dialysis sessions were missed out completely (no shows). Febrile reaction was most frequent factor causing early sign off n=97 (27%). Cramps were second most common factor for early sign offs n=70 (19%). Other factors like Symptomatic arrhythmias, nonspecific body aches, AV access site pain and socio economic issues also had contributions but less than 10% each. Conclusion: Poor hemodialysis compliance indicated by early sign offs and no show is fairly common problem in our community. Febrile reactions, cramps, poor education and hemodynamic instability are major contributory factors. These issues need to be addressed urgently to save a large population from life threatening complications and poor dialysis compliance. Identifying these complications and addressing them can ensure better compliance and likely will contribute to long term survival benefit. [ABSTRACT FROM AUTHOR]

Drought is a natural event that can have significant impact on the economy. Pakistan is a semi-arid country where hydrological drought generally causes adverse impacts on agricultural production and hydropower generation. In this research, the characteristics of hydrological droughts in Indus River basin using stream flow data of major rivers of Pakistan were investigated. Stream flow drought indices (SDI) were used to determine the severity of droughts for the Indus, Jhelum, Chenab and Kabul River at Tarbela, Mangla, Marala and Warsak hydrological stations for the period 1962-2011. A drought spell starting from 1999 and ending in 2002 was observed for all stations and is considered to be the worst drought in the history of Pakistan. Analysis of historical streamflow data indicated an increased occurrence of droughts in the last 12 years, which may be attributed to climate change. Extreme drought events were observed at Tarbela during October-September and at Mangla during October-June with SDI value of -2.36 and -2.74, respectively. Moderate to severe wet conditions were also detected in the analysis period. Several strategies for the mitigation of adverse impacts of droughts in the study region are recommended. [ABSTRACT FROM AUTHOR]

Objective: To compare frequency of Hyperprolactinemia with Risperidone and Olanzapine in patients with first episode psychosis. Study Design: Randomized controlled trial. Place and Duration of Study: Combined Military Hospital (CMH) Lahore, over a period of six months from Sep 2015 to Feb 2016. Subjects and Methods: Total 60 patients who had psychosis as accompanying feature in any of the various psychiatric illnesses according to ICD-10 diagnostic criteria were enrolled in this Randomized controlled Trial. Fasting venous blood samples for serum prolactin were collected between 0800 hrs and 1000 hrs at baseline (first visit). The patients were then randomly assigned to receive risperidone or olanzapine by lottery method. Serum prolactin levels were then collected at 3 months follow-up visit. All samples were tested in labortary of Pathology department, CMH Lahore for measurement of serum prolactin levels and results were verified by a classified pathologist. Confounding variables were identified and excluded by exclusion criteria. Results: A total of 35 patients (58.33%) developed hyperprolactinemia. The olanzapine group showed 13 out of 30 patients (43.33%) and risperidone group showed 22 out of 30 patients (73.33%) with raised prolactin levels with p-value of 0.018 indicating that the difference was statistically significant. Conclusion: Frequency of hyperprolactinemia is high with risperidone than with olanzapine in first episode psychosis. [ABSTRACT FROM AUTHOR]

In this study, the spatio-temporal characteristics of seasonal and annual rainfall were analyzed during 1961-2015 over nine selected climatic stations of the Punjab province (Pakistan) to identify the dry/wet rainfall events tendencies (moderate/dry) using the Standardized Precipitation Index (SPI) at 10% significance level. The various values of SPI indicate different levels of dry/wet events. An increasing tendency in moderately dry events was observed at two stations in spring, winter and summer while autumn remained unaffected. Significant increase in percentage of extremely dry rainfall events was seen only at two stations. Moderately wet rainfall events during 1990-2015 (F2) increased significantly at seven stations in winter, one in spring, three stations in summer and autumn compared to the period 1961-1990 (F1). The number of significantly extreme wet rainfall events increased at two, two, three, and seven stations in winter, spring, summer, and autumn respectively. Overall winter is vulnerable to moderately wet rainfall events while summer and autumn are subjected to wet extremes at the majority of stations. Drying tendency has little spatial extent and affected only two stations. Seasonal wetting is mostly concentrated in extreme north, midsouth and middle plains of the Punjab province while most wet events occurred during three decades i.e., 1981-1990, 1991-2000 and 2001-2010, the last being the wettest decade. Extremely wet events together with higher daytime temperature have the potential to disturb normal human life and growth of crops especially in summer. The risk of short-term greatest runoff in summer and autumn is very likely due to rainfall extremes. [ABSTRACT FROM AUTHOR]

Groundwater is one of the valuable resources for life sustenance in arid and semi-arid regions of the world. In recent past, its contamination due to lack of balance between its exploitation and recharge has posed a serious menace on its utilization for various purposes. Current study was conducted in District Karak during June to November, 2009 with the objectives to assess the changes in groundwater table depths due to withdrawal and the water quality parameters and to find the effect of small dams on recharge of ground water aquifer. Water table depths data from the ground surface, discharge of the wells, water quality parameters such as Sodium Adsorption Ratio (SAR) and Electrical Conductivity (ECw) were determined. Suitability of groundwater for irrigation purposes was evaluated following various classification schemes. The results show that in most part of the study area, water table is showing slightly rising trend, except Sur Dag, Narre Khawar and Takht-e-Nasrati areas, where the water table is declining. On other hand, the numbers of tube wells extracting ground water are increasing rapidly. The wells discharges of the sampled tube wells varied from 2 to 14 l/s and the horse power of the pumping units ranged from 2 to 30 hp and the pumps efficiencies of the wells ranged from 22 to 73% with an overall average of 42%. The number of hours the farmers operates their well ranged from 2 to 10 hours per day. The water quality reveals that pH of the water varies from 8.2-8.9 while ECw ranges from 0.4-4.7 dS/m. Out of 36, only inseven villages groundwater has ECw higher than the useable limit recommended by WAPDA (1974) and Sodium Adsorption Ratio was within safe range, following various classification schemes. In Richard's salinity diagram, it is observed that 21 (60%) villages water fall in C2-S1 class indicating medium salinity having low Sodium concentration and may be suitable to salt tolerant crop. Regular assessment of water resource and constant monitoring of water quality is recommended. An appropriate measure may be adopted for recharge of the ground water aquifer through development of small dams in the catchments plain. [ABSTRACT FROM AUTHOR]

Selection of a suitable emitter type is one of the main design parameter which significantly affects the performance of drip irrigation system. Emitters can change wetting pattern under different soils, and may cause water stress if proper emitter spacing is not maintained. The major objective of this study was to investigate the wetting pattern of two generally used emitter types (inline and online) on different soils (loamy sand, sandy loam, silt and clay) of Peshawar valley and compare the observed values with model simulation using Drip Irrigation Water Distribution Pattern Calculator (DIPAC) and Drip-Irriwater models. Experimental trials were conducted of inline and online emitters (n=30) having 60 cm spacing and a discharge of 4 liters per hour. The trials were replicated twice for each soil type. The vertical and lateral infiltration of each emitter and water applied were recorded at 30 minutes and 60 minutes intervals. The wetted depth and width were measured manually by digging and through visual measurements. The results showed an increasing tendency in vertical and lateral infiltration with increasing wetting time for both emitter types, evidenced by 70-80% larger wetted area at one hour wetting time when compared with 30 minutes wetting time. However, the sandy soil showed greater (40-50%) vertical infiltration when compared to clayey soil. Conversely, the lateral infiltration was identified larger (5-10%) for clay soil than sandy soil. Dripper's wetting pattern comparison was independent of the emitters type. Drip-Irriwater simulations were in close agreement with the observed values when compared to the empirical model DIPAC. The finding in this study has the potential to improve the decision support system for selecting a suitable emitter type for different soil types. In addition, the results of this study may be effectively utilized to obtain increased application efficiency by using the appropriate emitter type under limited water conditions. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic accuracy of modified computed tomography severity index (CTSI) and Bedside index for severity in acute pancreatitis (BISAP) scoring system in predicting severity in acute pancreatitis, keeping the Revised Atlanta Classification (RAC) as the gold standard. Study Design: Prospective longitudinal study. Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi Pakistan, Pakistan from Jan to Jul 2022. Methodology: This study was conducted on 100 patients with acute pancreatitis, both genders and ages. Patients with chronic pancreatitis, pancreatic calcifications, dilated pancreatic duct, areas of atrophy and pseudocysts were excluded. Detailed history and physical examination, and laboratory investigations were performed. Modified CTSI, BISAP and RAC were calculated. RAC was used as the gold standard. Sensitivity, specificity and other diagnostic parameters were calculated using R programme. Results: The mean age was 42.42±18.07 years. The males were 53%, and the females were 47%. CTSI was sensitive at 100%, specific at 58.43%, and overall diagnostic accuracy at 63%. BISAP was sensitive at 100%, specific at 68.54%, and overall diagnostic accuracy at 72%. Conclusion: BISAP and modified CTSI can assess severe acute pancreatitis (SAP) at primary and secondary care levels, enabling early triage and referral to higher centers. [ABSTRACT FROM AUTHOR]

The present study was conducted to see the effect of seeding depth, nitrogen placement method and biochar on the growth, yield and its related parameters of sugar beet (Beta vulgaris L.) at Sugar Crops Research Institute Mardan during 2011-12 and 2012-13. The experiment was laid out in a randomized complete block design with split plot arrangement in four replications. Sugar beet was sown at the rate of 6 kg ha-1 at four seeding depths from 1 to 4 cm. Nitrogen was applied at band and broadcast methods at the rate of 140 kg ha-1 mixed with biochar at the rate of 25 and 50 t ha-1. The data collected on various parameters were statistically analyzed and planned mean comparisons were carried out to explain significant differences. Seeding depth significantly affected all the studied parameters except sugar sucrose. Sugar beet planted at 2 cm depth showed highest germination process and gave better yield production. Mean maximum leaf area plant-1 (170.49 cm2), leaf area index (6.77), root length (35.50 cm) and root weight plant-1 (0.98 kg-1) were recorded in sugar beet planted at 2 cm depth. Nitrogen band placement method significantly affected growth and yield related attributes of sugar beet. Mean maximum leaf area plant-1 (173.32 cm2), leaf area index (6.68), root length (36.50 cm), root weight plant-1 (1.03 kg-1) and sugar sucrose (15.91%) were recorded in band placement method of nitrogen. Application of biochar significantly improved soil fertility and maximum leaf area plant-1 (171.99 cm2), leaf area index (6.48), root length (36.17 cm), root weight plant-1 (1.02 kg-1) and sucrose contents (15.91%) were recorded in plots where 50 t ha-1 biochar was incorporated. The amalgamation of banded nitrogen and 50 t ha-1 biochar showed mean maximum leaf area plant-1 (176.38 cm2), leaf area index (6.88), root length (37.10 cm), root weight plant-1 (1.04 kg-1) and sugar sucrose (16.07%). In conclusion, banded nitrogen merged with 50 t ha-1 biochar at 2 cm depth enhanced growth and yield attributes of sugar beet and is recommended. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To assess the frequency of the various medical conditions in patients presenting with altered mental status (AMS) in the Emergency Department of Pakistan Naval Ship (PNS) Shifa Hospital. Study Design: Prospective longitudinal study. Place and Duration of Study: Emergency Department, Pak Naval Ship Shifa Hospital, Karachi Pakistan from FebJul 2021. Methodology: Adult patients who have presented with altered mental status (Glasgow coma scale score less than 15) or who have the diagnosis "AMS" written in their notes were included in the study. Patients were observed in the wards until a definitive diagnosis could be made. Results: Sixty patients presented with AMS at the Emergency Department of PNS Shifa, during the study period. The causes of AMS were sepsis (20, 33.33%), CVA (12, 20%), metabolic (hepatic/uremic) encephalopathy (8, 13.33%), diabetic complications (7, 11.66%), seizures (5, 8.33%), drug intoxication (4, 6.66%) and respiratory failure due to lung pathology (4, 6.66%). The overall mortality rate was 20%. Conclusion: Sepsis is the most frequently encountered cause of altered mental state in emergency department patients, followed by CVA, metabolic encephalopathy, and diabetic complications. [ABSTRACT FROM AUTHOR]

The efficiency of extension systems for sustainable agriculture and rural development to ensure food security is a major policy concern for the contemporary governments and international agricultural development organizations. This study was carried out in northwest Pakistan to analyse and compare agricultural extension services in the area over a period of two decades -- from 1986-87 to 2005-06. Drawing on information from six villages, the study depicted that tendency of extension workers to contact farmers has significantly been reduced in the course of time. Majority of farmers, particularly small and medium holders, noted no visits of extension workers to their farm. Thereby, famers often relied on their traditional skills or advices from the non-technical input dealers in the local market. The study concludes that major reforms in extension system such as decentralization, effective research-extension-farmers linkages, and shift from public to private extension domains are essential to improving efficiency of extension services in Pakistan. [ABSTRACT FROM AUTHOR]

The aim of the study is to determine the association of oral lichen planus with hepatitis C and diabetes mellitus. A retrospective cohort study was carried out at the Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar from January 2011 to July 2015. A total of 34 male and female patients having oral lichen planus were selected with age range 20-60 years and mean age 39.4±15.8 years. Only clinical features were included to diagnose oral lichen planus which was made through the clinical evaluation of patient's oral cavity by a specialist team at the Department as proposed by van der Meij et al in 2003 based on the WHO definition of oral lichen planus. The data were analyzed through SPSS 22 with significance level of p-value ⩽0.05 and chi-square statistics were applied for association. The results showed that the data was statistically not significant with p-value >0.05 for all diseases having lichen planus and chi-square statistics revealed that no association exist among lichen planus, diabetes mellitus and hepatitis C. This study fails tofind any association between oral lichen planus, hepatitis C and diabetes mellitus. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy and safety of intravenous Insulin infusion versus subcutaneous Insulin in the management of hyperglycaemia in intensive care. Study Design: Quasi-experimental study. Place and Duration of Study: Medical Intensive Care Unit of Combined Military Hospital Malir, from Jul to Sep 2021. Methodology: 68 individuals admitted to the Medical ICU with the blood sugar levels of more than 180 mg/dl were included. Patients on one side of Intensive Care Unit were administered intravenous Insulin infusion, and on the other side were administered subcutaneous Insulin to control blood sugars. Age, gender, previous history of diabetes and use of Insulin and glycosylated haemoglobin were recorded. Efficacy of regimen was judged based on ability to achieve target glucose levels, mean blood glucose levels and total days of ICU stay. Adverse events like hypoglycaemia and hypokalaemia were recorded. Results: Out of 68 individuals, 27 (39.70%) were administered intravenous Insulin infusion, and 41 (60.29%) were adminis - tered subcutaneous Insulin. In the intravenous Insulin group, 22 (81.5%) individuals achieved target blood glucose compared to 29 (70.7%) in the subcutaneous Insulin group. The mean blood sugars in the intravenous group were 157.11 ± 25.54 mg/dl, whereas 168.32 ± 30.49 mg/dl in the subcutaneous group (p-value=0.164). The frequency of hypoglycaemia and hypokalaemia was more in the intravenous group than in the subcutaneous group. Conclusion: Optimal blood sugar levels were better achieved with intravenous Insulin than with subcutaneous Insulin. However, the frequency of adverse effects was also more with intravenous Insulin, so better monitoring and management are required with intravenous Insulin. [ABSTRACT FROM AUTHOR]

The aim of the study was to evaluate the causes of common conditions leading to tooth extraction, male/female ratio in diabetic patients. This was a retrospective cohort study. Data were collected from previous records between January 2011 to July 2015 from the Department of Oral and Maxillofacial Surgery, Sardar Begum Dental College, Peshawar. Among 2,103 total diabetic patients presented to the department, 1,618 diabetic patients have their complete record for tooth extractions. The primary reasons for exodontia specified in the records were Caries, Periodontitis, others. Others include those patients who have extractions either due to preprosthetic purpose, trauma or fracture or any other reason other than caries and periodontitis. The data was analysed through SPSS 22. The mean age presentation was 47.50 ± 19.82 years and the age range 25-70 years. There were 1,618 extractions carried out in 2,103 subjects (76.94%). The female diabetic patients predominate n=983 (60.75%) the male patients n=635 (39.25%). Caries was the dominant cause of tooth extraction in both subjects n= 1042 (64.40%) followed by periodontitis n= 416 (25.71%) and others n=160 (9.90%). Caries is the dominant cause of extraction in diabetic patients and female diabetic patients predominate male diabetic patients in terms of tooth extraction. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate current epidemiology of several types of oral clefts among the patients receiving treatment at two tertiary care hospitals, namely University Malaya Medical Centre (UMMC) Kuala Lumpur, and Hospital Kota Bharu / Hospital Raja Perumpuan Zainab II (HKB/ HRPZII) Kelantan. This study evaluated the records of 526 cleft lip and palate (CLP) patients with or without additional malformations, who came for treatment during 2003 to 2007. Of the total 526 patients registered in the study hospital records during the study period, 338 were from HKB/HRPZ II and 188 from UMMC. Majority 86.7% of these patients were in the age group ≤=18years. The results of this study show that 57% females and 43 % males were affected by oral cleft. Out of the total patients, 77.8% were CLP, 13.5% were cleft palate (CP), and 8.7% were cleft lip (CL) patients. Moreover 57.2% patients were with unilateral cleft, 32.7% were left sided and 24.5% were right sided. Total 42.8% patients were with bilateral oral cleft. To best of our knowledge this is the first reported multi-center study on CLP in Malaysia with regard to the proportion of different types of oral clefts. [ABSTRACT FROM AUTHOR]

Water is an essential part of life. The exploitation of groundwater is as ancient as civilization itself. Majority of the inhabitants of Upper Kurram valley depend on groundwater for drinking and agriculture practices. Drastic declination in water table has occurred in the recent past due to high runoff and low recharge, overexploitation of available water resources, and urbanization. Through this research, an attempt has been made to identify the potential zones for groundwater extraction, demarcation and natural recharge and devising proper artificial recharge mechanism using GIS and RS tools. In order to observe pre- and post-monsoon water table level in the study area, primary and secondary data was used for the year of 2008. Yearly monitoring of water table reveals that of 0.5m to 2.8m variation occurred in groundwater table in Upper Kurram valley. The water levels are divided into five arbitrary depth zones, on the basis of water table depth. Water table is deepest in the central part of the study area and shallow along the Kurram, Zeran and Kirman rivers. To identify the potential natural recharge areas, different thematic layers were considered namely, surface slope, land cover, proximity to settlement and road, drainage network, soil and geology. These themes were assigned proper weights and ranks on the basis of their relative contribution to groundwater recharge in the area following the guidelines of ASCE and FAO. Thematic layer were integrated in GIS environment using Overlay analysis. Results reveal that the suitable areas for natural recharge make 14% of the study area, which corresponds to nearly 137 km². To augment the groundwater, artificial recharge techniques can be used to enhance the groundwater capacity. Three artificial recharge mechanisms namely, small dams, percolation pond and plantation were considered and their suitability analysis was performed using seven parameters namely surface slope, settlement, soil, geology, roads, drainage and land use. Results reveal that suitable percentage areas for small dams is 3%, for plantation is 9% and 20% is suitable for percolation pond. The study can be helpful for government as well as for private organization to understand the groundwater situation in Upper Kurram valley. This study is also supportive in the selection of potential sites for artificial recharge techniques to enhance the declined groundwater situation. Study can be helpful to increase the groundwater availability for domestic as well for agriculture uses. [ABSTRACT FROM AUTHOR]