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Abstract Very limited knowledge is available regarding the mental health of the immigrant population in the USA. We aim to assess the factors affecting the mental health of immigrants living in Houston from war-inflicted and stable countries of Middle Eastern and North African (MENA) origin during the pandemic. This cross-sectional study was conducted among the MENA immigrants using a validated survey of sociodemographic, general health, and COVID-19 questions. Multivariable logistic regression models assessed sociodemographic and clinical predictors of depression and anxiety. The outcome of interest was categorized as “moderate or severe” versus “minimal or mild” for depression and anxiety. Total of 94 participants completed the study, with the sample rate of "moderate or severe" symptoms of anxiety and depression being 29.78% and 64.89%, respectively. Multivariable regression analysis for depression showed that immigrants from war-inflicted countries of origin were less likely to report “moderate or severe” depression compared to immigrants from stable countries (OR = 0.082, 95% CI 0.012–0.551). Individuals with excellent overall health (OR = 0.074, 95% CI = 0.013–0.414) had a significantly lower likelihood of “moderate or severe” depression than those who reported fair/poor health. Non-smokers (OR = 0.068, 95% CI = 0.012–0.377) were less likely to report “moderate or severe” depression in comparison to those who engage in smoking behavior. Participants who responded to the question that they tried hard to avoid thoughts of COVID-19 were less likely to have symptoms of “moderate or severe” depression compared to participants who responded, “No” (OR = 0.110, 95% CI = 0.017–0.712). Those who have” excellent/good knowledge” (OR = 0.0146, 95% CI = 0.022–0.946) about the prevention of COVID-19 spread were less likely to have “moderate or severe” depression compared to those who had “average/poor/terrible”. Multivariable regression analysis revealed smoking as a significant predictor of anxiety, with non-smokers demonstrating a lower likelihood of experiencing "moderate or severe" anxiety than smokers (OR = 0.21, 95% CI = 0.06–0.84). MENA immigrant communities in the USA have diverse immigration experiences, cultural backgrounds, and instability issues in their home countries, possibly elevating the risk of depression and anxiety during the COVID-19 crisis. Predictors identified should be considered by policymakers when developing targeted interventions to ensure the mental and social well-being of immigrant communities in the USA.

Objective: To evaluate serum levels of 25-hydroxyvitamin D (25-OHD) in patients with viral warts. Study Design: Comparative cross-sectional study. Place and Duration of Study: Dermatology Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from Jul to Dec 2020. Methodology: One hundred patients were included in the study, 50 with viral warts (Group-1) and 50 without warts (Group2). Our study included both male and female patients of 10 to 60 years of age. Three categories were made according to their serum vitamin D levels. First, all participants were tested for serum vitamin D levels using ELISA. Results: In Group-1, 20(40%) had insufficient, and 25(50%) had deficient vitamin D levels. A statistically significant decrease in serum 25-OHD levels (p = 0.004) was found in patients with viral warts. In Group-2, 9(18%) had insufficient, and 2(4%) had deficient vitamin D levels. The mean serum vitamin D level was 22.61±10.11 in Group-1 and 45.12±24.60 in Group-2, resulting in a significant difference between patients with viral warts and those without viral warts regarding serum vitamin D levels (p=0.004). Conclusion: Patients with viral warts have deficient vitamin D levels.

Background: Metabolic syndrome (MetS) is a multifactorial disease, whose main stay of prevention and management is life-style modification which is difficult to attain. Combination of herbs have proven more efficacious in multi-targeted diseases, as compared to individual herbs owing to the “effect enhancing and side-effect neutralizing” properties of herbs, which forms the basis of polyherbal therapies This led us to review literature on the efficacy of herbal combinations in MetS.Methods: Electronic search of literature was conducted by using Cinnahl, Pubmed central, Cochrane and Web of Science, whereas, Google scholar was used as secondary search tool. The key words used were “metabolic syndrome, herbal/poly herbal,” metabolic syndrome, clinical trial” and the timings were limited between 2005–2020.Results: After filtering and removing duplications by using PRISMA guidelines, search results were limited to 41 studies, out of which 24 studies were evaluated for combinations used in animal models and 15 in clinical trials related to metabolic syndrome. SPICE and SPIDER models were used to assess the clinical trials, whereas, a checklist and a qualitative and a semi-quantitative questionnaire was formulated to report the findings for animal based studies. Taxonomic classification of Poly herbal combinations used in animal and clinical studies was designed.Conclusion: With this study we have identified the potential polyherbal combinations along with a proposed method to validate animal studies through systematic qualitative and quantitative review. This will help researchers to study various herbal combinations in MetS, in the drug development process and will give a future direction to research on prevention and management of MetS through polyherbal combinations.

Introduction: Tumors of the gastrointestinal (GI) tract, share a major burden for mortality and morbidity all over the world. The most common site of carcinoma of GIT is colon and rectum (70%). The etiological factors may be environmental (diet) and genetic. CDX-2 has been proposed as being present in most of the cases with colorectal carcinoma. Objective: To determine the frequency of positive expression of CDX2 in diagnosed cases of colorectal adenocarcinoma diagnosed on haematoxylin and eosin stain. Material and Methods: This was a cross-sectional study and was conducted at ---(deleted for blind review)--- over period of 2 years We included all paraffin embedded tissue sections of colorectal carcinoma of both genders with an age range of 25-75 years. Specimens were stained with Heamatoxylin and Eosin (H & E) and examined microscopically for presence or absence of invasive cancer. Another specimen was taken and stained with CDX2. The data were analyzed using SPSS version 24. Results: A total of 125 cases with colorectal carcinoma diagnosed on H & E stain were included in the study. The mean age of the patients was found to be 52.66 ± 14.62 years. In this study, 67 patients (53.6%) were male and 58 patients (46.4%) were having final diagnosis of Adenocarcinoma. Regarding the site, most common lesion involved rectum, followed by sigmoid colon and ascending colon. Among 125 specimens reviewed, 112 patients (89.6%) were CDX-2 positive while 13 patients (10.4%) were CDX-2 negative. Also we stratified the CDX-2 expression according to site and type of colorectal carcinoma and was found significant for both of these (P

Based on light and scanning electron microscopical observations, a new species of Cucullanus Müller, 1777 (Nematoda: Cucullanidae) is described from the intestine of marine edible fishes Otolithus ruber (Schneider, 1801), were collected ( February 2006 to July 2007) from fresh landing of Karachi coast, Pakistan. Detailed light and scanning electron microscopy revealed some important taxonomical features like, Broader anteriorly, posterior end pointed, provided with small bifurcated spike at the tip of the tail. Lateral alae absent. Oral opening dorsoventrally elongate, surrounded by narrow membranous flange or collarette supported by row of numerous teeth. Three submedian cephalic papillae and a pair of prominent lateral amphids are present. Pseudobuccal capsule or esophastome wider than posterior part of esophagus. Deirids simple, just anterior to esophagus and intestinal junction. Tail broadly conical, bifurcated at the tip.

A new species of Rhabdochona is described from the intestine of cyprinid fish collected from Khessar stream (Hamun River basin) at Nushki, Quetta Division, Balochistan. It is characterized mainly by having a spatulate right spicule with ventral barb at posterior end, the left spicule has notched anterior and razor-sharp distal tips, finely striated caudal region, fifteen pairs (10 preanal, 5 postanal) papillae in males, bifurcate deirids and conical tail tips in both the sexes. The subgeneric definition of R. (Rhabdochona) Railleit, 1916, R. (Filochona) Saidov, 1954, and R. (Globochona) Moravec, 1972a which were based primarily on egg morphology are considered of little value in determining specific relationships within the genus. The new species may be included in the subgenus Rhabdochona (Morphological group A, Moravec, 1975) in the presence of thick-shelled (slightly floated) eggs, which is, therefore, described here as Rhabdochona (Rhabdochona) spatulatum n. sp. This nematode is the first of the genus recovered from Cyprinion microphthalmum (Day) from this locality in Balochistan. [ABSTRACT FROM AUTHOR]

A new nematode Rhabdochona (Rhabdochona) haspani n. sp. is described on the basis of the specimens recovered from the intestine of a fish, Cyprinion watsoni (Day, 1872) from fresh waters in Harnai (Sibi Division) Balochistan. The new nematode specimens are clearly different from all the previously reported species of Rhabdochona Railliet, 1916 by the relevant length of esophagus, shape and sizes (0.24-0.34 and 0.071-0.076) of spicules, distance of nerve ring, deirids and excretory pore from the anterior extremity and, in the females by measurements of eggs (0.013-0.035), morphology of vagina, position of vulva and excretory pore. Additionally, the new specimens have 8 teeth in the prosotme and 13 pairs of caudal papillae including 8 preanal and 5 postanal. [ABSTRACT FROM AUTHOR]

The article describes a new trematode, Decemtestis johnii, from the fish Lutjanus johnii of Karachi coast, Pakistan. Characteristics of the new species include a small, flattened body, a narrow forebody, a sub-terminal oral sucker, a broader hind body, an acetabulum bigger than oral sucker, an absent pre-pharynx, and a pear-shaped pharynx. Ovary is made up of 7-8 lobes immediately anterior to testes, uterus coiled, small, between ovary and ventral sucker extending anteriorly to the level of genital atrium. Eggs are many, in oval shape, while excretory vesicle is extending to the level of anterior pair of testes.

The article describes a new species of nematode Rhabdochona pakistanica from the stomach of a fish, Cyprinion watsoni, at river Bolan, Balochistan, Pakistan. It is characterized by thin and smooth cuticle, rounded anterior, roughly pentagonal oral aperture, funnel-shaped prostom and very long esophagus. It has post-equatorial vulva, beak-like vulval lips and strongly muscular vagina. The species is easily distinguished by its trophy-shaped smaller spicule. It is also different from other nematodes because its deirids are very close to the posterior extremity of muscular esophagus.

The article describes a new species of Rhabdochona as an intestinal parasite of Mahseer, Tor putitora from a river basin in Pakistan. It is characterized by the presence of prostomal teeth, simple deirids and different length ratio between spicules. It also seems to be specific to freshwater cyprinids. A total of 33 carps were collected in September 2007 and nematode parasites were preserved in 70% ethanol. R. annai is known as delicate worms with smooth body, prominent cephalic papillae and longer glandular esophagus in females.

The article discusses a study which described a new subfamily Heckmanninae with a new genus Heckmannia channai from the intestine of Channa striatus. The name of the subfamily was given in honor of Professor Richard A. Heckmann from Brigham Young University who is a well known parasitologist. It is characterized with elongated body, oral sucker subterminal, very small prepharynx and the presence of pharynoesophageal gland cells between pharynx and esophagus. In addition, vitellarial consists of follicles that are scattered from ovary to the posterior end of body.

The article discusses a study which described a new Lepocreadiid digenenan Neodiploproctadaeum karachiensis from the intestine of the Tetradontiformes Lagocephalus linaris from Karachi coast. It is characterized by smooth, elongated body with wing-like lateral expansions at postacetabular level and subterminal oral sucker smaller than acetabulum. A total of 79 Lagocephalus lunaris from Karachi were collected for parasitological analysis in February 2006-January 2007. The new species is also known to have submarginal geniotal pore and slightly submedian ovary.

The article presents a study which describes the parasitizing of a new species of rhabdochonid nematode Rhabdochona (Rhabdochona) bifurcatum in the intestine of the fish host Cyprinion -watson in the valley of Bolan, Pakistan. The study measured the body length of the nematode, and characterized caudal papillae and prostomal teeth. Results show that Rhabdochona consist of small spicule bifurcated into to unequal arms, having nine pairs of caudal papillae and eight prostomal teeth. It adds that the nerve ring of the nematode palce almost in the middle of its glandular esophagus in male, while more anterior with female.

The article presents a study that described a new nematode species, Rhabdochona spinicauda, based on fifth stage larvae. The nematode was taken from the intestine of a freshwater fish, the putitor mahasheer Tor putitora which is found in Pakistan. The new nematode has a spine at the tail tip of female specimens and has square-shaped eggs with cuticular floats on four sides of its surface. The study focused on 36 individuals of putitor mahaseer Tor putitora captured in a stream at Bolan valley in Balochistan.

The article presents a study which examined the new helminth parasite species Genarchopsis gibsoni that were collected from the small intestine of the fish, Channa (Ophiocephalus) striatus (Bl.) and Channa (Ophiocephalus) maculatos (Bl.). The characteristics of the new species include a body rounded at anterior extremity, bluntly pointed at posterior extremity, and without prepharynx and esophagus. The parasite species, Genarchopsis kalriai, were also collected from the fish species. The fish species were from the Keenjhar Lake in Sindh, Pakistan.

The article presents a study on the new species of the genus Tubulovesicula Yamaguti that was taken from the stomach of Pomadasys olivaceum, a fish which was taken off the Karachi coast in Pakistan. The researchers observed fishes that were bought from West Wharf at the Fish Harbour in Karachi coast, in which two out of the 15 fishes were infected with trematodes. They concluded that the new species is different from the previously described species because it has a uterus that does not reach in ecsoma, a larger ventral sucker and a relatively short tail.

The article describes a trematode Conica trilobata n.gen n.sp from the intestine of the fish Otolithus argenteus of Karachi coast in Pakistan. This trematode, with unique characters not previously known in family hemiuridae is characterized by having the oral sucker covered with a large cone, a trilobed, subterminal oral sucker, a long cecae, reaching posteriorly almost to the tail end, an acetabulum four to five times larger than oral sucker, and a prominent pharynx and esophagus. This species has a vitellaria that consist of 7 long tubes.

The article presents a study that describes the R. (F.) gubernaculus, a new specie of nematode genus Rhabdochona Railliet found from the stomach of cyprinid fish Cyprinon watsoni in River Bolan, Balochistan in Pakistan. It mentions that the R. (F.) gubernaculus belongs to the subgenous Filochona Saidov. It states that the species have ten prostomal teeth, eight pairs of preanal, one adanal, and six postanal caudal papillae. The deirids in male species are located in second half of muscular esophagus while posterior to the middle of muscular esophagus in females. The females are also found to be larger than males and that the female species have unifilamented eggs.

The article discusses a study which reported and described a new trematode species Tubulovesicula dorabi from the intestine of the fish Chirocentrus dorab collected from West Wharf, Karachi coast in Pakistan. The characteristics of the species include having a flattened, plump body with tail poorly demarcated, oral sucker terminal, caeca wide reaching to near posterior end of the body and two testes, among others. Its ovary is described as elliptical or bean-shaped, submedian in the anterior of posterior half of body and receptaculum seminis is very small. It also has numerous, small and almost rounded eggs.

The article discusses a study which examined a trematode Plagioporus gibsoni from the freshwater fish Labeo gonius from Keenjhar lake, Sindh, Pakistan. The study characterized the species by having oval, elliptical body, round oral sucker, small pre-pharynx, short esophagus, oval testes and uterus winding between anterior testis, ovary and acetabulum. It compared the species with the similar species of the genus Plagioporus Stafford and demonstrated the differences in diagnostic features between the two species.

The article presents a study that identifies and describes a new species of the trematode Temiorchis Mehra et Negi, 1925 from the small intestine of frog (Rana cyanophlyctis) which is named Temiorchis sindhensis. It mentions that the genus Temiorchis Mehra et Negi, 1925 is known to occur in amphibians and reptiles of which two species of the genus have been recorded from Pakistan. The new species is identified through collecting six frogs from Oderolal Station, and Sindh in Pakistan and examined them for helminth parasites. The examination reveled that the new species is of elliptical body, elongated and spinulated. Its oral sucker is smaller as compared to acetabulum and its pharynx are well-developed.

Objective: To compare the effectiveness of oral intermittent Isotretinoin treatment vs daily Isotretinoin therapy in patients with moderate to severe acne vulgaris. Study Design: Randomized controlled trial. Place and Duration of Study: The study was conducted for 06 months (1st March to 30thAugust 2021) at department of Dermatology, Pakistan railway hospital, Rawalpindi. Materials and Methods: A total of 100 patients with moderate to severe acne selected through random sampling were divided into two groups A & B, each having 50 patients. In Group A, a daily dose of 0.5-0.75mg/kg of oral Isotretinoin was given only for 01 week, every 4th week for 04 months. Group B patients were given the same dose of oral Isotretinoin once daily regularly for 04 months. The clinical improvement was measured as difference in GAGS score calculated before and after the treatment using Global Acne Grading System (GAGS). The results were compared & analysed by using paired t-test. Results: The age, weight, and GAGS scores of the patients in both groups were comparable at the baseline. The GAGS score at baseline was 29.94 + 4.42 in group A, while in group B, the score was 29.84 + 4.69. After 04 months of treatment, the difference in GAGS from baseline in group A was 17.44 + 4.07 in group A compared to 19.09 + 5.02 in group B. The P value of 0.006 was significant to prove the association of results. Conclusion: The oral intermittent Isotretinoin therapy is more effective than daily continuous Isotretinoin therapy in patients with moderate to severe acne vulgaris.

A new nematode species, Rhabdochona kharani sp. nov., has been isolated from the intestine, stomach and swim bladder of the fish Labeo gedrosicus Zugmayer, 1912 (Fam. Cyprinidae: Cypriniformes) from spring water at Garruk, District Kharan, Balochistan. The new species is characterized largely by the presence of eight anterior teeth in the prostom, inconspicuous deirids, by the shape and length of unequal spicules (0.08 - 0.09 and 2.9 - 3.1 mm), and by 17-18 pairs of caudal papillae including 6-7 postanal, one adanal, and 10 -11 preanal. Other characteristics include a pointed tail tip, non filamented eggs, a bulbous, voluminous, vaginal complex that is directed backward, and a vulva that is post-equatorial with a triangular large anterior lip and a smaller posterior lip.

Cutaneous leishmaniasis is found in all the four provinces of Pakistan; these are NWFP, Balochistan, Sindh and Punjab. In Balochistan the areas from where the patients came are Uthal, Quetta and Ormara. The highest number of patients came from Quetta and least from Ormara. The patients included in this study were from the Mangopir and Chakewara, areas of Karachi. The infection is endemic in this country and the recent epidemics in the Dadu District and Nawabshah indicate its importance in the locality. The sand fly vector is found in all four provinces of Pakistan that are listed here. It is quite obvious that presence of leishmaniasis indicates the presence of sand flies and cutaneous leishmaniasis is more common.

A nematode Pseudomazzia macrolabiata of a new genus and a new species is described here from the intestine of the fish Pomadasys olivaceus of Karachi coast. The new genus is characterized by having an enlarged head region with three large prominent lips protruding externally from the head, a prominent buccal cavity and with a proboscis. The esophagus is not clearly divided into muscular and glandular parts and the intestine is simple. The male has very unequal spicules, dissimilar in shape. The caudal alae are prominent supported by several pedunculate papillae including 5 pre anal pairs and two pairs including one pro-anal and one post-anal. The female vulva is near the middle of the body. The tail is elongate, bluntly pointed and is provided with a terminal forked spike. The eggs are thin shelled and oval in shape.