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Objective: To evaluate the efficacy of combining Nitazoxanide with lactulose compared to lactulose alone in the treatment of overt hepatic encephalopathy. Methods: This Comparative Cross-sectional Study was conducted at the department of Gastroenterology and Hepatology, Pakistan Institute of Medical Sciences, Islamabad from July 2019 to December 2019. In this study, 150 cirrhotic patients with overt hepatic encephalopathy were randomized into two groups: one receiving Nitazoxanide plus Lactulose (Group A) and the other receiving Lactulose alone (Group B). Patient demographics, aetiology of cirrhosis, MELD score, and efficacy of treatment were assessed. Statistical analysis was conducted to compare outcomes between the two groups. Results: A total of 150 patients, with a mean age of 44.08 ± 11.31 years were enrolled. Hepatitis C was the predominant aetiology in 81 patients (54%). The mean MELD score was 23.24 in Group A and 22.36 in Group B. Upon admission, 20 patients (13.3%) presented with grade 2 hepatic encephalopathy (HE), while 70 patients (46.6%) had grade 4 HE. The duration of hospital stay showed statistical significance in both groups (p < 0.001). Furthermore, a significant difference in drug efficacy was observed between the two groups (p < 0.005). Conclusion: In conclusion, our study suggests that combining Nitazoxanide with Lactulose yields superior efficacy compared to Lactulose alone in managing overt hepatic encephalopathy among cirrhotic patients. [ABSTRACT FROM AUTHOR]

A field study (three years) was carried out to evaluate the outcome of various organic nutrient management technologies including farmyard manure (FYM) and poultry manure (PM) integrated with chemical fertilizers for microbial dynamics and growth and yield of rice at Experimental Farm of Nuclear Institute of Agriculture (NIA), Tandojam, Sindh, Pakistan. The most broadly grown rice variety, NIA-Shandar was selected for this study. The experiment involved integrating organic technologies, specifically Farm Yard Manure (FYM) and Poultry Manure (PM), each applied at 10 tons per hectare. These organic technologies were combined with varying levels of inorganic fertilizers: half (60 kg N ha-1 and 45 kg P2O5 ha-1) and full (120 kg N ha-1 and 90 kg P2O5 ha-1) recommended doses. Additionally, zinc was applied at 10 kg ha-1 . The study employed a randomized complete block design (RCBD) with three replications to assess treatment effects. Both organic technologies perform better for microbial dynamics and rice growth and yield enhancement either alone technology or combined with chemical fertilizers during three rice seasons. The maximum general microbial abundance (9.70 log10 CFU g soil-1), N2 fixing (7.37 log10 CFU g soil-1), P solubilizing (7.97 log10 CFU g soil-1) and Zn solubilizing (6.75 log10 CFU g soil-1) population was recorded in FYM alone or with half N and P2O5 fertilizer application. The highest plant height (106 cm), tiller numbers (17.10), panicle numbers (26.53), panicle length (26.32 cm), one thousand grain weight (26.53 g) and rice grain yield (7.92 t ha-1 ) were perceived in FYM with full rate N and P2O5 fertilizer application. Both technologies along with chemical fertilizer induced soil properties and soil nutrients which reflected to increase soil microbial abundance and growth and yield of rice however, FYM showed higher potential than poultry manure during the three years rice cultivation seasons. Hence, it was indicated that a significant contribution to the development of sustainable agricultural technologies that prioritize soil health, environmental stewardship, and food security. [ABSTRACT FROM AUTHOR]

Sustainable project management (SPM) is pivotal for enhancing sustainable project success (SPS) and transforming organizations into sustainable practices. Many prior studies empirically found that SPM is positively associated with SPS. This association can be further enhanced through sustainable leadership. However, the role of sustainable leadership as a moderator on the association between SPM and SPS has not been fully grabbed in the prior studies, especially the public sector development program (PSDP) in Pakistan remained unexplored. The study aimed to investigate the moderating role of sustainable leadership on the association between SPM and SPS in the PSDP projects in Pakistan. Using a quantitative survey-based design and the data from 285 completed PSDP projects collected through a single informant strategy, the hypothesized relationships were tested with the PLS-SEM-based hierarchical component modeling approach. The results revealed that SPM is positively associated with SPS and sustainable leadership moderates the association between SPM and SPS in this context. The study provides important insights into the emerging trend of SPM and SPS and evocatively contributes to the existing literature. The study also contributes to the practice and assists project managers, decision-makers, and policy-makers in planning and developing PSDP projects more effectively to achieve sustainable development goals (SDGs). The findings are also beneficial for other countries operating in similar circumstances. [ABSTRACT FROM AUTHOR]

Background: Hearing loss (HL) is an impairment of auditory function with identified genetic forms that can be syndromic (30%) or non-syndromic (70%). HL is genetically heterogeneous, with more than 1,000 variants across 150 causative genes identified to date. The genetic diagnostic rate varies significantly depending on the population being tested. Countries with a considerably high rate of consanguinity provide a unique resource for studying rare forms of recessive HL. In this study, we identified genetic variants associated with bilateral sensorineural HL (SNHL) using whole-exome sequencing (WES) in 11 families residing in the United Arab Emirates (UAE). Results:We established the molecular diagnosis in six probands, with six different pathogenic or likely pathogenic variants in the genes MYO15A, SLC26A4, and GJB2. One novel nonsense variant, MYO15A:p.Tyr1962Ter*, was identified in a homozygous state in one family, which has not been reported in any public database. SLC26A4 and GJB2 were found to be the most frequently associated genes in this study. In addition, six variants of uncertain significance (VUS) were detected in five probands in the genes CDH23, COL11A1, ADGRV1, NLRP3, and GDF6. In total, 12 variants were observed in eight genes. Among these variants, eight missense variants (66.7%), three nonsense variants (25.0%), and one frameshift (8.3%) were identified. The overall diagnostic rate of this study was 54.5%. Approximately 45.5% of the patients in this study came from consanguineous families. Conclusion: Understanding the genetic basis of HL provides insight for the clinical diagnosis of hearing impairment cases through the utilization of nextgeneration sequencing (NGS). Our findings contribute to the knowledge of the heterogeneous genetic profile of HL, especially in a population with a high rate of consanguineous marriage in the Arab population. [ABSTRACT FROM AUTHOR]

The study was conducted to assess phosphate-solubilizing bacteria (PSB) inoculated various carrier materials and their effect on growth of chilli plants. The P-solubilizing ability was checked in broth media using by inorganic P-sources (tri-calcium P and phosphate rock). The identified PSB strain “Enterobacter cloacae” was selected by inoculating in different carrier materials Farm yard manure (FYM) based, compost and sugarcane press mud (SPM) to test their shelf life. The FYM based carrier material proved better material for PSB survival and selected for further studies. The application of PSB inoculated carrier material to chilli plants was assessed in pot study organized by Completely Randomized Design (CRD) under net-house conditions. The highest P-solubilizing ability (42.7%) was observed in tri-calcium P (NBRIP) media during incubation. The maximum viability of cell count was observed in FYM carrier during the incubation period. The maximum plant height (22.14 cm), root length (5.80 cm), plant fresh (1.33 g plant-1) and dry biomass (0.57 g plant-1) was observed with PSB inoculated carriers with 100% recommended P fertilizer (RPF) application. In experimental soil, the maximum viable cell count (9.01 log CFUg-1 soil) was observed in PSB inoculated carrier treatments. Nevertheless, higher organic matter (OM) (0.45 %) and P-content (25 ppm) were shown in PSB inoculated carrier material (100% RPF). Likewise, the higher plant P uptake (24.7 kg ha-1) was also observed in PSB inoculated carrier with 100 % RPF. Significantly there were no differences in agronomic parameters observed among 75 % and 100 % RPF with PSB inoculated carrier. Hence, it can be concluded that, inoculated PSB in carrier could be a potential material for PSB based bio-fertilizer/bio-inoculant integrated with 75 % of RPF for enhancing growth of chillies. [ABSTRACT FROM AUTHOR]

This study contributes to the existing literature by empirically investigating the impact of environment, terrorist attacks and socio-economic deprivations on changes in vote shares of the major contesting political parties between two consecutive elections in Pakistan. It is assumed that performance of the incumbent political parties affects individuals' preferences, which are reflected in changes in the vote shares. For estimations, the study uses district level data and fixed effect technique on pooled data for the election years 2008 and 2013. Results of the study show that environmental degradation reflected in the rise of temperature and terrorist attacks that represent a deterioration of security of life and property have significant and adverse effects on the voters' preferences for the incumbent regimes. Similarly, economic deprivation, lack of educational opportunities, and health facilities has also played a significant role in reducing the vote shares of the incumbent parties. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to identify the barriers and challenges in the adoption of the Electronic Health Record system in hospitals of Islamabad and to compare the barriers and challenges faced in adopting and running the electronic health record system in government and private hospitals of Islamabad. Method: This multicentric cross-sectional study was carried out among 210 respondents in four government and four private hospitals in Islamabad from June 2022 to November 2022. Out of 210, 160 respondents filled the questionnaire A structured questionnaire was distributed to the management, health professionals, and staff using the EHR system by simple random sampling. The data were analysed using SPSS version 26. An independent sample t-test was applied for a comparative analysis of challenges and barriers in government and private hospitals. Results: The response rate for the electronic health record system survey was 160 (76%). Of those responding, 85.75% and 72% reported using the EHR system regarding patient care in government and private hospitals, respectively. Around 42.5% and 83.75% of government and private hospitals have fully functional EHR systems, and 72% of government and 90% of private responses reported the use of computers as a major mode of patients’ data entry. A significant difference was found between government and private hospitals regarding social and legal barriers and lack of knowledge of the EHR system (p-value <0.05). Implementation of single modules and multi modules was a big challenge for the government and private hospitals, respectively (p-value <0.05). Conclusion: Government and private hospitals equally face the challenges and barriers to the implementation of the EHR system, with social and legal barriers being more prevalent in government hospitals and barriers and implementation of single modules and multimodule were a big challenge for the government and private hospitals. [ABSTRACT FROM AUTHOR]