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The purpose of this study was to empirically evaluate and study the misconceptions hovering in the minds of people regarding the broiler chicken and its meat. In this study, quantitative data was collected through questionnaire surveys from 498 consumers randomly from nine towns of Lahore by adopting a cluster sampling technique. The data were analyzed through Excel software by using a pivot table technique. The results showed that consumers have many reservations regarding broiler meat available in the market. These include reservations regarding the type of feed given, usage of antibiotics/hormones, and speedy growth, etc. The results are presented in the form of tables, graphs, and pie charts. It is recommended that a national campaign must be launched to educate the consumers about the realities of the broiler industry to overcome prevailing misperceptions of consumers otherwise these consumers will gradually leave broiler meat. Finally, this situation will lead to severe protein deficiency among the general public of Pakistan leading to aggravating food insecurity. The findings of this study will guide industrialist, poultry farmers and marketers to develop and refine their marketing strategies to reduce misperceptions and increase the acceptability of broiler meat. [ABSTRACT FROM AUTHOR]

Background: Lameness in dairy cattle is prevalent worldwide and has serious economic and welfare implications. Nevertheless, it is an overlooked and least studied dairy problem in Pakistan. Aims: This study was executed for in vivo and in vitro evaluation of antimicrobials and disinfectants against bacterial pathogens from hoof lesions of commercial dairy cattle. Methods: For in vitro studies, 23 bacterial isolates (n=10 Staphylococcus aureus, n=8 Fusobacterium necrophorum, and n=5 Bacteroides) from hoof lesions were used for antimicrobial and disinfectants susceptibility testing. In vivo trials were carried out among 4 groups of dairy cows suffering from hoof lesions using different combinations of antimicrobials, non-steroidal anti-inflammatory drugs (NSAIDs), and disinfectants either parenterally or topically. Results: Results indicated that most of the isolates of S. aureus, F. necrophorum, and Bacteroides were resistant to penicillin, amoxicillin, trimethoprim + sulphamethoxazole, oxytetracycline, and tylosin. Ciprofloxacin and gentamicin were the most effective antimicrobials (in vitro) against all three bacterial pathogens. Comparison of in vitro efficacy of disinfectants showed that copper sulfate was the most effective disinfectant against the three pathogens followed by povidone-iodine and chloroxylenol. In vivo trials revealed that ciprofloxacin at 5 mg/kg/day intramuscular (IM) for 7 days, flunixin meglumine at 2.2 mg/kg/day IM for 7 days, and copper sulfate (5% solution) as foot-bath twice daily for 21 days was the most effective treatment regimen to treat lameness in commercial dairy cows. Conclusion: It was concluded that in vitro antibiogram and disinfectant studies were useful tools to assess the effectiveness of routinely used antimicrobials and disinfectants for the treatment of lameness. [ABSTRACT FROM AUTHOR]

The present study was undertaken to evaluate the effect of non-genetic factors such as the period of calving, season of calving, and parity on economically important productive and reproductive traits in crossbred cows (Holstein Friesian × Sahiwal) maintained at livestock experiment station Qadirabad Sahiwal, Pakistan. The study ranged from 1995 to 2014 (20 years). The duration of 20 years was divided into 4 periods (P1, P2, P3, and P4) with each period consisting of five years. Each year was further divided into three seasons winter (November-February), summer (March-June), and spring (July-October) based on geo-climatic conditions prevailing in the region. The parameters used as indicators of reproductive performance in this study were age at first calving (AFC), days open (DO), dry period (DP) and calving interval (CI). The overall least squares mean and standard errors for these reproductive parameters were 1235.23±45.81, 202.08±6.75, 178.4±6.85 and 482±5.97 days, respectively. While productive parameters were lactation milk yield 305 d(LMY), daily milk yield, and Lactation length (LL), and the least squares mean and standard errors of these were 2471.44±78.44 kg,8.07±0.27kg and306.22±4.84 days, respectively. Twenty years (20) data of 641 lactation records of crossbred cows representing the variance analyses indicated that significant (P≤0.05) effect of season of calving on age at first calving (AFC), days open (DO), lactation length (LL), and lactation milk yield (LMY). Least-squares means illustrated that the period of calving also significantly (P≤0.00) affects lactation milk yield (LMY) lactation length (LL) and dry period (DP). Similarly, a significant (P≤0.00) effect of parity on lactation milk yield (LMY), dry period (DP), days open (DO), and calving interval (CI) was noted. It is therefore concluded that the reproductive and productive performance of these crossbred cows is affected by some non-genetic factors and breeders must consider the season of calving, period of calving and parity in the management program because they greatly affect the farm productivity and profitability and they must select animals with higher breeding values to be the parent of the next generation. [ABSTRACT FROM AUTHOR]

The Chilo infuscatellus (Pyralidae, Lepidoptera; Snellen) caused significant losses in production and quality of sugarcane in Pakistan. The deficiency of easily discrete morphological and quantitative characters makes it remarkable to identify these characters in pest management. Present study; investigates the impact of morphological and quality traits of pest infestation during different stages of plant growth. Results revealed that varieties US-312, 1491, 718, 133 and CPF-246 performed better in terms of brix, POL, CSS, fiber, recovery, carbohydrates, moisture and fat contents percentage. Correlation values of different varieties in terms of qualitative factors were positive and significant. All plants traits in terms of qualitative factors including plant girth (cm), leaf area (cm), leaf sheath hairiness (cm²) and leaf thickness (mm) showed positive and had highly significant correlation with pest infestation. The coefficient of determination value R² = 0.821 was obtained by computing brix, fiber contents, POL and CCS factors mutually from multivariate regression models. It was concluded, that morphological and qualitative plant factors could be helpful for management of sugarcane shoot borer. [ABSTRACT FROM AUTHOR]

Potato virus X (PVX) a most devastating pathogen of potato, tomato and tobacco all over the world was surveyed for its epidemics in Pakistan. A 891bp amplicon covering full capsid protein gene of potato virus X was amplified through reverse transcription-polymerase chain reaction by using gene specific primers from the samples collected all over Punjab, Pakistan. Deduced sequence of full capsid protein gene of PVX was reported as the first full length coat protein gene of potato virus X from Pakistan in NCBI database (Accession # KC757709). In phylogenetic analysis, Pakistani PVX isolate was found to be clustered closely with European sub linage while distinctly with Australian PVX and South American isolates. In contrast to the nucleotide sequence the amino acid sequence dendrogram of PVX, Pakistani isolate showed 100% homology with American isolates. Conclusively, a new isolate of PVX was identified from Pakistan which surprisingly exhibited close lineage with European isolate. [ABSTRACT FROM AUTHOR]

Drought is a normal, recurrent climatic feature which has caused distress since the known history of mankind. Pakistan has been suffering serious droughts periodically due to below-normal precipitation, especially in arid and semi-arid regions. Although drought affects nearly all the climatic regimes and has pronounced consequences in both developed and developing countries but its effects are noticeably devastating in developing nations like Pakistan where rain-fed farming predominates. Assessing the onset of drought, extent, intensity and duration can limit drought-induced impacts and can provide a base to develop an effective drought mitigation response. Previous drought events in Pakistan and the magnitude of drought losses indicate the continuing vulnerability of Pakistan to drought due to lack of contingency planning. The integration of existing drought monitoring tools for Pakistan is essential to reduce the vulnerability of drought in this region. In order to reduce vulnerability to drought event in Pakistan, it is inevitable to assess relevant effects and identify their potential reasons. Due to spatial and temporal variability, it is imperative to enhance the data availability for mapping and monitoring this phenomenon on all scales. Drought related multidisciplinary information can be handled by using GIS. Government institutions look after potential drought-stricken victims and others living in potential drought areas by using spatial analysis in GIS that can lead to a decision support system. [ABSTRACT FROM AUTHOR]

The agriculture sector is the blood line for Pakistan's economy. The subsidies in the form of loaning-schemes facilitate the flow of funds from areas of surplus to areas of deficit. The result shows the significant impact of all variables towards customer satisfaction (P<0.01). An attempt has been made in the study to ascertain the amount of gratification for farmers about agricultural finance schemes provided by public sector banks to fulfill timely needs of farmers with reference to Zarai Taraqiati Bank, Limited. In present study, erection of banking as regards to SERVQUAL measurements via satisfaction of the farmers from the loan was studied. The relationship of service quality dimensions were examined using structural equation modeling (SEM) analysis. The F-value (64.17) of alterations is good which suggests the model is robust and fit, that means variation among all variables are up to the mark. The study exposed that SERVQUAL dimensions (reliability, tangibility, responsiveness, empathy, assurance) have influenced the customer satisfaction. [ABSTRACT FROM AUTHOR]

A field experiment was conducted at Agronomic Research Area, University of Agriculture, Faisalabad, Pakistan during kharif, 2011 to evaluate the impact of different nitrogen and zinc sulphate levels on the phenology, yield and quality of maize. Maize hybrid "Pioneer (SS-2525)" was subjected to four rates of N (0, 200, 250 and 300 kg/ha) and ZnSO4 (0, 9, 18 and 27 kg/ha). The experiment was laid out in a RCBD with factorial arrangement having net plot size of 3m x 5m. The results showed that nitrogen and zinc sulphate application significantly affected the growth, yield and quality parameters of maize. Maximum days to 50 percent tasseling (53.1) and silking (56.7) were recorded at 300 kg N level. Minimum number of days for 50 percent completion of tasseling (45.5) and silking (49.1) were recorded in application of 27 kg ZnSO4. In case of interaction of N and Zn, minimum days to 50 percent tasseling and silking (44.3 and 48.3) alongwith maximum plant height (242.3 cm), number of grains per cob (539.6), 1000-grain weight (316.0g), grain yield (7.9 t/ha) and protein contents (9.9%) were noted in N3Zn3 level (300 kg N + 27 kg ZnSO4). These results indicated that these traits linearly increased with increasing levels of N and ZnSO4 upto their maximum rate. [ABSTRACT FROM AUTHOR]

Bt and non-Bt cotton (Gossypium hirsutum L.) cultivars were compared for different earliness indicators in the Department of Agronomy, University of Agriculture, Faisalabad, Pakistan during the year 2010. In this study two cotton cultivars MNH-786 (non-Bt) and IR-1524 (Bt), three nitrogen levels (115, 145 and 175 kg/ha) and two sowing dates (mid March and mid May) were included. Layout system was RCBD with split split plot arrangement in a plot measuring 6.0 x 4.5 m. Nitrogen levels and sowing dates showed significant effect on earliness related parameters. Nitrogen level of 115 kg per hectare showed more earliness index (59.2) than 145 kg (51.1) and 175 kg N (48.5). Nitrogen level of 115 kg also took less number of days for floral bud initiation (30.5), flowering (50.1), first boll splition (93.1) and also less number of days to node above white flower (95.9). With regards to sowing date, May sowing produced more earliness index (57.5) and less number of days for floral bud initiation (30.5), flowering (49.6), first boll splition (91.1) and less number of days to node above white flower (99.4) than mid March sowing. Both cultivars showed nonsignificant differences in earliness related parameters with relatively more earliness in non-Bt cultivar than Bt cultivar. The study concludes that 115 kg N per hectare and mid May sowing produced early maturity in cotton. [ABSTRACT FROM AUTHOR]

Skeletal dysplasias are a heterogeneous group of disorders presenting mild to lethal defects. Several factors, such as genetic, prenatal, and postnatal environmental may contribute to reduced growth. Fourteen families of Pakistani origin, presenting the syndromic form of short stature either in the autosomal recessive or autosomal dominant manner were clinically and genetically investigated to uncover the underlying genetic etiology. Homozygosity mapping, whole exome sequencing, and Sanger sequencing were used to search for the disease-causing gene variants. In total, we have identified 13 sequence variants in 10 different genes. The variants in the HSPG2 and XRCC4 genes were not reported previously in the Pakistani population. This study will expand the mutation spectrum of the identified genes and will help in improved diagnosis of the syndromic form of short stature in the local population., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Diabetic peripheral neuropathy (DPN) occurs in >50% of diabetic patients and is a high risk-factor of balance problems and risk of falls. Impaired balance can lead to reduced function, which has a detrimental effect on patients' quality of life. Structured strength and balance training can result in sustained improvements in muscle strength, coordination, balance, functional status and quality of life., Objective: To determine the combined effects of strength and balance training versus aerobic training on balance, severity of symptoms of DPN, and quality of life in patients with DPN., Methods: This double blinded, two arm parallel design Randomized Clinical Trial. The study was conducted from March to December 2020 in the AIMS diabetic center Peshawar, Pakistan. Participants were selected through convenience sampling technique and randomly allocated into strength plus balance and aerobic training groups. Type 2 diabetic patients of both sexes, aged 40 to 80 years, with a Toronto neuropathy score ≥6 recruited, while patients with ulceration/infection of feet, medical/Surgical conditions, and non-ambulatory patients were excluded from this study. Intervention was applied 3 days a week for 8 weeks. The Toronto clinical neuropathy system was used to assess neuropathy severity, SF-36 to assess quality of life and the Berg balance scale was used for assessment of balance. Assessment was done at the baseline and after 8 weeks of intervention using SPSS. Version 22 was used for analysis., Results: The mean age of the participants was 60.80 ± 9.73. Between group analysis, which showed were statistically insignificant for neuropathy severity, balance and all domains of quality of life (p-value >0.05) except SF-36 General Health Perception Score, with Mean ± SD of 62.50 ± 7.54 in group A versus Mean ± SD of in group B 60.00 ± 15.98 (p-value = 0.05). Within group analysis showed statistically significant results for neuropathy severity, balance and all domains of quality of life (p-value<0.05)., Conclusion: This study concluded that there is a statistically significant effect of structured balance and strength training and aerobic training on severity of DPN, balance and quality of life. But there was no statistically significant difference in improvement between the two intervention groups., (© 2024 John Wiley & Sons Ltd.)

Objective: To evaluate the clinical, radiological, and biochemical features of glutaric aciduria Type 1 (GA1) patients identified through urine organic acid testing at a biochemical genetics laboratory (BGL) in Pakistan., Study Design: Observational study. Place and Duration of the Study: Department of Pathology and Laboratory Medicine, The Aga Khan University Hospital, Karachi, Pakistan, from January 2013 to December 2022., Methodology: Medical charts and urine organic acid (UOA) chromatograms of the patients presenting at the BGL from January 2013 to December 2022 were reviewed. Brain imaging was obtained where available. Variables were noted as per the objective and descriptive statistics were obtained., Results: GA1 was found in 64 (0.4%) patients out of a total of 16,094 UOA requests for high-risk screening cases. The age of diagnosis ranged between one month and three years. The brain MRI findings revealed characteristic abnormalities such as cerebral atrophy, expanded CSF spaces, white matter abnormalities, and a distinct bat wings appearance, in cohesion with the results of biochemical testing., Conclusion: Sixty-four cases of GA1 from a single centre indicate a high frequency of the disorder in Pakistan. Late diagnosis emphasises the need for increased clinical awareness and preferably newborn screening to ensure optimal outcomes., Key Words: Glutaric aciduria Type 1 (GA1), Brain imaging, UOA analysis, Glutaryl-CoA dehydrogenase (GCDH), Pakistan.

Background: Biotinidase deficiency (BTD) is a rare autosomal recessive metabolic disease, which develops neurological symptoms because of the impaired biotin recycling. Pathogenic mutations on BTD gene cause BTD deficiency. The clinical features and mutation analysis of Pakistani children with BTD deficiency have rarely been described. Herein, for the first time, we report the clinical features, BTD gene mutations and biochemical analysis of seven symptomatic children with BTD deficiency from Pakistan., Methods: Seven suspected BTD-deficient patients who presented abnormal organic acid profiles and clinical features were subjected to Sanger sequencing to identify pathogenic mutations in the BTD gene. The results were analyzed by Mutation Surveyor Software., Results: All seven patients exhibited common biotinidase deficiency symptoms including hypotonia, developmental delay and seizures. Biochemical analysis shows marked excretion of 3-hydroxy isovalerate in all cases, followed by 3-hydroxy propionate and methyl citrate. Sanger sequencing revealed one frame-shift mutation, c.98&#95;104delinsTCC (p.Cys33Phefs), and two missense mutations, c.1612C>A (p.Arg538Ser) and c.1330G>C (p.Asp444His). All mutations were in the homozygous state and classified as pathogenic in published studies and mutation databases., Conclusions: This study has validated the BTD variants as the underlying cause of biotinidase deficiency in which molecular testing of BTD is supported by urinary organic acid analysis and clinical diagnosis. Secondly, the strength of the local availability of this test in Pakistan will paved the way for the neonatal screening of biotinidase deficiency., (© 2023 John Wiley & Sons Ltd.)

This study extends the foundations of the natural resource-based view (NRBV) by introducing a mediation-moderation framework by analyzing the influence of green intellectual capital (GIC) on both green innovation performance (GIP) and environmental performance (EP) while simultaneously considering the mediating role of green absorptive capacity (GAC) and the moderating influence of the green innovation climate (GICL). The data for this study was gathered from a sample of 575 participants employed within small and medium enterprises' (SMEs') manufacturing firms. This dataset was utilized to evaluate the proposed model; this study uses the PLS-SEM approach to comprehensively examine the complex interactions among these variables. This model adds to the theoretical understanding of NRBV and enhances its practical applicability. The findings of this study reveal a positive relationship between GIC, GAC, GIP, and EP within organizations. Furthermore, our investigation reveals a positive correlation between a GICL and the relationships involving GIC, GAC, GIP, and EP. Importantly, this research introduces a novel perspective by clarifying the complex relations among these variables and highlighting the positive correlation between a GICL and the relationships involving GIC, GAC, GIP, and EP. This novel approach enhances the theoretical understanding of NRBV and its practical applicability in fostering GIP and EP within manufacturing SMEs operating in Pakistan., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The present study evaluated the presence of Salmonella enterica in Pakistani backyard poultry. A total 48 chickens from 4 backyard poultry breeds with the clinical presentation of S. enterica infection were randomly selected from villages in the Punjab Province. Cloacal swabs from live poultry and liver samples from the dead birds were collected for bacterial culture and biochemical identification. Liver and spleen samples from dead birds were evaluated for gross and histopathological changes. Bacterial isolates were subjected to PCR and sequencing of ratA gene. Biochemical identification revealed 5/48 (10.42%) chickens positive for S. enterica. Gross pathology included enlarged, discoloured and congested liver and congested spleen. Histopathology demonstrated congestion of sinusoidal capillaries, cellular swelling and cellular/ballooning degeneration, congestion of central hepatic vein, granular hepatocytic cytoplasm and the presence of variable-sized vacuoles in hepatocytes. The PCR yielded a S. enterica specific amplicon (1047 bp). All liver samples that were positive for S. enterica by biochemical tests, were also positive by PCR. The ratA gene sequencing revealed a close resemblance with S. enteritidis isolates from humans. The present study highlights zoonotic risk from backyard poultry and suggests that PCR can be used as an alternate method for rapid detection of Salmonella serovars.

Morphometric measurement and roosting ecology of Pteropus medius were aimed to find out in Mansehra district of KP, Pakistan. Total 3149 numbers of bats were found in eight biological spots visited; Baffa Doraha, Darband, Dadar, Jallu, Hazara University, Garhi Habibullah Chattar Plain and Jabori, in total 299 numbers of different species of trees including; Morus alba, Pinus raxburghi, Eucalyptus camaldulensis, Morus nigra, Grevillea robusta, Brousonetia papyrifera, Platanus orientalis, Ailanthus altissima, Hevea brasiliensis and Populus nigra. Morphometric features were measured and found vary according to sex of the bats. The average wing span, wing`s length from tip of wing to neck, from thumb to tip of wing and the body`s length from head and claws were recorded to be 102.98 cm, 49.07cm, 28.7 cm and 22.78 cm respectively in males while 93.67 cm, 44.83cm, 24.78cm and 22.78 cm respectively in female bats. Mean circumference of the body including wings and without wing were measured as 22.78 cm and 17.29 cm in males and that of female were 20.07 cm and 16.9 cm. Average length of thumb 3.64 cm, ear`s length 3.1 cm, snout 5.62cm, eye length were 1.07 cm for both sexes and length between the feet in extended position were16.3 cm. Generally different measurement of males bodies were found to be greater than female such as mean body surface area, mass, volume and pressure were found to be 2691.79 cm2, 855.7gm,1236.4 ml and 295.77 dyne/ c m 3 for male and 2576.46 cm2, 852.71gm,1207 ml and 290.2 dyne/ c m 3 respectively for female. While weight and density for both males and females bats were same with mean of 8.59 newton and 0.701 g/m3. Findings of current reports can add valued information in literature about bats, which can be used for species identification and conservation.

Nitrogen dioxide (NO 2 ) and sulfur dioxide (SO 2 ) are two major atmospheric pollutants that significantly threaten human health, the environment, and ecosystems worldwide. Despite this, only some studies have investigated the spatiotemporal hotspots of NO 2 and SO 2 , their trends, production, and sources in Asia. Our study presents a literature review covering the production, trends, and sources of NO 2 and SO 2 across Asian countries (e.g., Bangladesh, China, India, Iran, Japan, Pakistan, Malaysia, Kuwait, and Nepal). Based on the findings of the review, NO 2 and SO 2 pollution are increasing due to industrial activity, fossil fuel burning, biomass burning, heavy traffic movement, electricity generation, and power plants. There is significant concern about health risks associated with NO 2 and SO 2 emissions in Bangladesh, China, India, Malaysia, and Iran, as they pay less attention to managing and controlling pollution. Even though the lack of quality datasets and adequate research in most Asian countries further complicates the management and control of NO 2 and SO 2 pollution. This study has NO 2 and SO 2 pollution scenarios, including hotspots, trends, sources, and their influences on Asian countries. This study highlights the existing research gaps and recommends new research on identifying integrated sources, their variations, spatiotemporal trends, emission characteristics, and pollution level. Finally, the present study suggests a framework for controlling and monitoring these two pollutants' emissions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Systems thinking is an approach that views systems with a holistic lens, focusing on how components of systems are interconnected. Specifically, the application of systems thinking has proven to be beneficial when applied to health systems. Although there is plenty of theory surrounding systems thinking, there is a gap between the theoretical use of systems thinking and its actual application to tackle health challenges. This study aimed to create a framework to expose systems thinking characteristics in the design and implementation of actions to improve health., Methods: A systematised literature review was conducted and a Taxonomy of Systems Thinking Objectives was adapted to develop the new 'Systems Thinking for Health Actions' (STHA) framework. The applicability of the framework was tested using the COVID-19 response in Pakistan as a case study., Results: The framework identifies six key characteristics of systems thinking: (1) recognising and understanding interconnections and system structure, (2) identifying and understanding feedback, (3) identifying leverage points, (4) understanding dynamic behaviour, (5) using mental models to suggest possible solutions to a problem and (6) creating simulation models to test policies. The STHA framework proved beneficial in identifying systems thinking characteristics in the COVID-19 national health response in Pakistan., Conclusion: The proposed framework can provide support for those aiming to applying systems thinking while developing and implementing health actions. We also envision this framework as a retrospective tool that can help assess if systems thinking was applied in health actions., Competing Interests: Competing interests: None declared., (© World Health Organization 2023. Licensee BMJ.)

Microplastics (MP) pollution is an emerging threat to life and the environment. These particles are not restricted to human-inhabited lands but also found in different mountains and glaciers where the human population is relatively low. These MPs make their way to the river ecosystem from glaciers, rains, and municipal and industrial effluents. The current study was designed to highlight MPs' pollution in water, sediments, and fishes of the Swat River: originating from the Hindu Kush Mountain Range. These samples were collected from eight different sites across the river. An average concentration of MPs detected in water samples (305.79 ± 289.66 MPs/m 3 ), fish (12.54 ± 8.02 MPs/individual), and sediments (588.29 ± 253.95 MPs/kg). The highest concentration was observed among water samples at Mingora city and the lowest at the confluence point of the rivers near Charsadda being 753.71 ± 330.08 MPs/m 3 and 57.64 ± 31.98 MPs/m 3 , respectively. MP concentrations in the sediment samples were also the highest at Mingora city (834.0 ± 367.21 MPs/kg), and lowest at Chakdara (215.0 ± 20.0 MPs/kg). Among the fish samples, Schizothorax plagiostomus contained the highest while Wallago attu contained the lowest MP concentrations corresponding to 17.08 ± 8.27 MPs/individual and 5.0 ± 2.36 MPs/individual, respectively. Fibers were the most prevalent MPs in all the matrices representing 80%, 92%, and 85% of the total MP count in water, sediments, and fish samples. These findings highlighted that freshwater ecosystem are not free from MPs and are as much vulnerable to anthropogenic activities as marine ecosystem. Therefore, need attention not less than marine ecosystem awareness, education, ecotourism, sustainable reduction in plastic use, and strict rules and regulations could be helpful to prevent the anthropogenic menace., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The aim of this study was to estimate the size at first sexual maturity (Lm) for 36 species belonging to 24 families from the marine habitat of Balochistan and Sindh in Arabian Sea, Pakistan through maximum length based an empirical and logistic model using commercial catch during June 2020 to May 2021. Individual total length (TL) was noted up to 0.1 cm using measuring broad. The Lm was calculated using two formulae; (i) log (Lm) = - 0.1246 + 0.9924 * log (Lmax) for Elasmobranchs and (ii) log (Lm) = -0.1189 + 0.9157* log (Lmax) for ray-finned fishes. The minimum Lm was recorded as 10.27 cm TL for Caranx malabaricus and 108.38 cm TL for Isurus oxyrinchus, respectively. Around Lm with 58.33% species were ranges from 19.00 cm to 25.00 cm TL. This study was estimated 16 newly Lm which is globally absent and rest 20 Lm are absent in the Arabian Sea (Pakistan coastal habitats). Therefore, the results will be helpful for the sustainable management and conservation of these marine fishes through the establishment of mesh size of trawl nets based on the size at sexual maturity (Lm).

This paper is based on qualitative research carried out in a diabetic retinopathy (DR) programme in three districts of Pakistan. It analyses the organisation and delivery of DR services and the extent to which the interventions resulted in a fully functioning integrated approach to DR care and treatment. Between January and April 2019, we conducted 14 focus group discussions and 37 in-depth interviews with 144 purposively selected participants: patients, lady health workers (LHWs) and health professionals. Findings suggest that integration of services was helpful in the prevention and management of DR. Through the efforts of LHWs and general practitioners, diabetic patients in the community became aware of the eye health issues related to uncontrolled diabetes. However, a number of systemic pressure points in the continuum of care seem to have limited the impact of the integration. Some components of the intervention, such as a patient tracking system and reinforced interdepartmental links, show great promise and need to be sustained. The results of this study point to the need for action to ensure inclusion of DR on the list of local health departments' priority conditions, greater provision of closer-to-community services, such as mobile clinics. Future interventions will need to consider the complexity of adding diabetic retinopathy to an already heavy workload for the LHWs., Competing Interests: The authors have read the journal’s policy and have the following competing interests: Standard Chartered Bank provided support for this study in the form of a Seeing is Believing (SiB) grant awarded to Sightsavers (14/75061/V), where all authors are employees. This does not alter our adherence to PLOS ONE policies on sharing data and materials. There are no patents, products in development or marketed products associated with this research to declare.

Reports abound on Lernaea parasitizing the brood stock, fingerlings, and marketable-sized culturable freshwater fish species in various parts of the world. We investigated seven small-scale aquaculture farms and how the prevailing Lernaea is impacting them. Randomly seven fish farms were selected to determine the prevalence percentage of lernaeid ectoparasites. Relevant information of the fishponds to estimate the various aspects such as effects of water source and quality, feed, stocking density, treatment used, and weight and length of fish, concerned with Lernaea infestation and prevalence was gathered. The results indicated that Catla catla (F. Hamilton, 1822) showed highest prevalence (41.7%) among the seven fish species, whereas Oreochromis niloticus showed zero. Other five fish species Ctenopharyngodon idella, Cirrhinus cirrhosis, Cyprinus carpio, Labeo rohita and Hypophthalmichthys molitrix showed 13.2%, 8.1%, 7.7%, 7.4%, 0.9% prevalence, respectively. In Royal Fish Farm 84.3% lernaeid infestation was observed, while no parasite was observed in the Vicent's Chunnian fish farm. The water source, quality, feed, fertilizers, stocking density, water temperature, and potential treatment options displayed varying tendencies among fish farms and prevalence. Depending on the weight and length, the highest prevalence (56.7%, and 66.7%) was observed in 3501-4000 g and 81-90 cm groups. The infestation rate varied in various fish body parts with the dorsal fin the most vulnerable organ and showed 2.3% overall prevalence (while 18.4% contribution within total 12.6% infestation). Out of 147 infected fish samples, 45 were extensively contaminated by Lernaea spread. In conclusion, our findings confirm that Lernaea could pose a considerable threat to marketable fish, and various treatment options should be educated to the farmers to help mitigate the spread and potential losses. Furthermore, Catla catla is more vulnerable to Lernaea infestation (41.7%), so are the fish species being cultured at higher stocking densities.

Aim of this study is to quantify the impacts of climate change on phenology and yield of winter wheat in rainfed and irrigated regions of Pakistan by using integration of two well-known crop models including STICS and APSIM with CORDEX-SA regional climate models (RCMs). A number of different adaptation strategies based on early sowing (i.e. S1:10 and S2:20 days), irrigation (I1:15% and I2:30% additional water) and a combination of sowing and irrigation adaptations were examined to recover the potential losses that would occur due to climate change. The data for the wheat phenology, biomass (t/ha) at different stages and yield (t/ha) was obtained from several experiments at national research institutes in Pakistan under both rainfed and irrigated conditions. After calibration and validation of both crop models (STICS and APSIM), the current climate data were replaced with the CORDEX-SA RCM-projections for climate change impact analysis. A significant rising and declining trends were observed in temperature and precipitation patterns, respectively, for the selected study regions. Consequently, a substantial impact of climate change on wheat phenology (anthesis stage, maturity stage, growing length), biomass (t/ha) and yield (t/ha) was observed under scenario periods for RCP4.5 and RCP8.5. Additionally, the adaptation strategies on wheat for rainfed regions showed a substantial improvement in wheat biomass and yield simulated by STICS model particularly for sowing-2 under RCP4.5. Irrigated regions showed more improvement for irrigation-2 (I2) and combination of sowing-1 + irrigation-2 (S1 + I2) using the STICS model under both RCPs. Overall, it was observed that changes in crop phenology had a stronger impact in terms of crop yield for RCP8.5 as compare to RCP4.5. This study provides a valuable understanding and way forward for the better wheat management under changes in precipitation and temperature patterns. The study also discuss in detail, the adaptation strategies to cope with potential damage, over two different irrigation zones (rainfed and irrigated) in Pakistan., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2021 Elsevier B.V. All rights reserved.)

In this study, industrial wastewater and groundwater were comparatively investigated for their physicochemical properties, concentrations of potentially toxic elements (PTEs), human health risks and pollution source(s). Every month, 34 wastewater samples and 26 groundwater samples were collected, for a duration of one year. The results showed that the physicochemical parameters and concentrations of PTEs in the industrial wastewater exceeded the maximum permissible limits of Pakistan Environmental Protection Agency (2000). Specifically, it was found that total dissolved solids (5%), total suspended solids (190%), chemical oxygen demand (107%), five-days biochemical oxygen demand (5.7 times), grease/oil (27.1 times), Fe (67%), Zn (29%), Mn (32%), Cu (27%), Ni (16%), Cr (8%), Pb (106%), and Cd (80%) were higher than the permissible limits. The carcinogenic and non-carcinogenic dermal health risks for wastewater irrigation group were significantly higher than the groundwater irrigation group. The hazard index of irrigation with industrial wastewater was 180 times higher than the groundwater. The principal component analysis indicated that industry was the main polluting source. The cluster analysis results of all PTEs (except Fe) were found in the same clade in the dendrogram, which showed a strong similarity within the monthly data set of the whole year. The study recommends using adjacent groundwater instead of industrial wastewater for irrigation purposes., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Good-quality water and food are the basic needs of humans, plants, and animals. Polluted groundwater and soil directly and indirectly affect organisms, which is the main environmental concern. In the current study, standard protocols of atomic absorption spectrometry were adopted for the investigation of selected metals (lead, chromium, and iron) in the collected groundwater and soil samples. The Pearson correlation coefficient (r) applied to groundwater and soil samples shows a positive perfect correlation among water parameters (conductivity and total dissolved solids) in all three sources. In the hand pump samples between water table (WT) and water source depth (WSD), Pearson correlation coefficient (r) value was found (r = 0.87) while between EC and TDS, it was r = 1. Similarly, in the bore hole samples between WT and WSD (r = 0.66), EC and TDS (r = 1), EC and Cr (r = 0.70), and TDS and Cr (r = 0.70), which showed weaker correlation. In the tube well samples, correlation between EC and TDS was high (r = 1). The correlation coefficient (r) values of the soil parameters in the hand pump (soil) samples between Fe and Cr (r = 0.86), in bore hole samples between Fe and Cr (r = 0.77), in tube well samples between Fe and Cr (r = 0.69), while all the other parameter correlations were found lower (r = 0.60). Between electrical conductivity and total dissolved solids, high relation has been observed between them (r = 1). Overall, results showed that in most of the studied samples, contents of the target metals were found above the allowable limit set by the World Health Organization (WHO) and the United States Environmental Protection Agency (USEPA)., (© 2021. The Author(s), under exclusive licence to Springer Nature Switzerland AG.)

Background: Studies on ticks infesting equids are lacking in various parts of the world, including Khyber Pakhtunkhwa (KP), Pakistan. The aim of this study was to investigate the diversity of ticks infesting equids, associated risk factors and rickettsial detection in ticks from equids in KP., Methods: Inspection of 404 equid hosts from November 2018 to October 2019 resulted in the collection of 550 ticks. Data on tick-associated risk factors were collected from equid owners by means of a questionnaire. After morphological identification, partial DNA sequences of the tick mitochondrial 16S rRNA gene were used for taxonomic confirmation of species. Partial sequences of the gltA and ompA genes were used for Rickettsia detection in ticks., Results: A total of 550 tick specimens were collected on 324 (80.2%) of the equids inspected, of which 161 were horses (50%), 145 (45%) were donkeys and 18 were mules (5%). The ticks were identified as belonging to the following five species: Rhipicephalus microplus (341 specimens, 62% of the total ticks), Rh. haemaphysaloides (126, 23%), Rh. turanicus (39, 7%), Rh. sanguineus (s.l.) (33, 6%) and Hyalomma anatolicum (11, 2%). The most prevalent tick life stage was adult females (279, 51%) followed by adult males (186, 34%) and nymphs (85, 15%). Higher tick infestations were observed on male equids (relative risk [RR] 0.7432, P < 0.0005) and adult equids (RR 1.268, P < 0.0020). Ticks were frequently attached to the axial region of horses (55, 21%), sternum of donkeys (44, 21%) and belly of mules (19, 23%) (P < 0.04). Temporal patterns of tick infestation in association with temperature and humidity were highly significant (P < 0.05). Risk factors, such as animal housing (P < 0.0003), living management (P < 0.006), grazing type (P < 0.01) and location in hilly areas (P < 0.02), significantly enhanced the chances for tick infestation. Tick species analyzed in this study were phylogenetically related to species from Afghanistan, China, South Africa and Taiwan. Partial sequences of the gltA and ompA genes obtained from Rh. microplus and Rh. haemaphysaloides were 100% identical to the spotted fever group pathogen Rickettsia massiliae., Conclusions: Equids exposed to significant risk factors were infected by one or more of at least five tick species in KP, Pakistan, and some of the ticks harbored the human pathogen R. massiliae., (© 2021. The Author(s).)

Hepatitis C virus (HCV) is a heterogenetic infectious agent that affects a huge proportion of population around the globe. Diverse distribution of multiple subtypes of HCV makes it mandatory and remarkably imperative to understand the genotypic distribution in target population. It could serve as an indictive guideline for the improvement of diagnostic methodologies, and development of effective therapies against this viral infection, in order to improve the infected patients' quality of life. This study included HCV infected patients presented to the diagnostic facility of the Centre for Applied Molecular Biology, University of Punjab, Lahore, between 2016 and 2019. During the 4 years of study, samples were collected from 4177 subjects. Our data revealed no significant differences regarding the prevalence of various genotypes between genders in the adult population. Genotyping was carried out by following the Ohno protocol. The obtained results shown that genotype 3a is the most frequent genotype and accounts for 66.29% of cases. Among other genotypes, 1a is 2.11%, 1b is 0.07%, 3b is 1.89%, 5a is 0.02%, while genome of 28.23% patients was untypable; 1.22% of the samples were non-detectable as viremic. An important concern is that this untypable genome in HCV infected patients may indicate possible mutation of HCV., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: Visual impairment in children is a significant public health problem affecting millions of children globally. Many eye problems experienced by children can be easily diagnosed and treated. We conducted a qualitative study with teachers and optometrists involved in a school-based vision screening programme in Quetta district of Pakistan to explore their experiences of training, vision screening and referrals and to identify factors impacting on the effectiveness of the programme., Methods: Between April 2018 and June 2018, we conducted semi-structured in-depth interviews with 14 teachers from eight purposefully selected schools with high rates of inaccurate (false positive) referrals. Interviews were also conducted with three optometrists from a not-for profit private eye care hospital that had trained the teachers. Interviews were audio recorded and professionally transcribed. NVIVO software version 12 was used to code and thematically analyze the data., Results: Findings suggest that the importance of school-based vision screening was well understood and appreciated by the teachers and optometrists. Most participants felt that there was a strong level of support for the vision screening programme within the participating schools. However, there were a number of operational issues undermining the quality of screening. Eight teachers felt that the duration of the training was insufficient; the training was rushed; six teachers said that the procedures were not sufficiently explained, and the teachers had no time to practice. The screening protocol was not always followed by the teachers. Additionally, many teachers reported being overburdened with other work, which affected both their levels of participation in the training and the time they spent on the screening., Conclusions: School-based vision screening by teachers is a cost-effective strategy to detect and treat children's vision impairment early on. In the programme reviewed here however, a significant number of teachers over referred children to ophthalmic services, overwhelming their capacity and undermining the efficiency of the approach. To maximise the effectiveness and efficiency of school-based screening, future initiatives should give sufficient attention to the duration of the teacher training, experience of trainers, support supervision, refresher trainings, regular use of the screening guidelines, and the workload and motivation of those trained.

The focus of the present study was to assess the quality of different drinking water sources, impacts of poor water quality on human health, and to apportion pollution source(s) of the district Bajaur, Pakistan. Drinking water samples (n = 331) were randomly collected from springs, hand pumps, open wells, and tube wells and analyzed for physicochemical parameters including toxic elements, and bacteriological contamination (i.e., Escherichia coli). Furthermore, a questionnaire survey was conducted to record the cases of waterborne diseases in the study area. The results showed that total suspended solids and bacteriological contamination exceeded the permissible limits of the WHO in all four of the water sources. Among the potentially toxic elements, Cd, Pb, and Mn were above the permissible limits of the WHO in some samples. The hazard index for spring water was found to exceed the toxicity level (i.e., HI > 1) set by US EPA for both adults and children, while the sources from hand pumps, open wells, and tube wells were within the safe limit. The order for the overall safety level for water quality in the study area was tube wells > open wells > hand pumps > springs. The pollution source apportionment statistics revealed that both geogenic and anthropogenic activities are the sources of drinking water contamination. The results of the questionnaire survey indicated that reports of waterborne diseases were highest in respondents who took their drinking water from springs, whereas reports of diseases were moderate in respondents taking their water from open wells and hand pumps and lowest in respondents taking their water from tube wells. Based on the findings of the study, the tube well source of water is recommended for drinking water purposes.

Rapid economic growth, urban sprawl, and unplanned industrialization has increased socioeconomic statuses but also decreased air quality in South Asian developing countries. Therefore, severe increase in air pollution has been a threat of local population, regarding health statuses, livability and quality of life. It is necessary to estimate fine-scale spatiotemporal distribution of ambient PM 2.5 in a national context so that the environmental planners and government officials can use it for environmental protocol development and policy-making. In this study, a spatiotemporal land use regression (LUR) model is developed to refine global air quality data to the national-scale ambient PM 2.5 exposure in a high-density country in South Asia - Pakistan. Combining with transport network, patterns of land use, local meteorological conditions, geographic characteristics, landscape characteristics, and satellite-derived data, our resultant model explains 54.5% of the variation in ambient PM 2.5 concentration level. Furthermore, tree coverage and road transport are identified to be two influential factors of the national-scale spatial variation of PM 2.5 in Pakistan, which implied that urbanization might be the major cause of air pollution across the country. In conclusion, our resultant LUR model as well as the spatial map of ambient PM 2.5 concentration level can be used as a supporting tool for national health risk management and environmental planning, and could also contribute to the air quality management and pollution reduction actions of Pakistan., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Aims: Split-hand/split-foot malformation (SHFM) is a developmental and congenital limb malformation characterized by variable degrees of medial clefting or absence of one or more digits in hands and/or feet. The aim of this study was to identify the underlying cause of three consanguineous Pakistani families showing various types of SHFM-related features. Materials and Methods: Standard molecular methods, including whole-genome sequencing (WGS), whole-exome sequencing (WES), microsatellite markers-based genotyping, and Sanger sequencing were performed to search for the likely causative variants. Results: In family A, WES revealed a novel homozygous missense variant [c.338G>A, p.(Gly113Asp)] in the WNT10B gene. In family B, microsatellite-based genotyping followed by Sanger sequencing revealed a novel homozygous 13 base pairs deletion [c.884-896delTCCAGCCCCGTCT, p.(Phe295Cysfs*87)] in the same gene. In family C, WGS divulged a previously reported heterozygous missense variant [c.956G>A, p.(Arg319His)] in the TP63 gene. Conclusions: Mapping and sequencing genes and variants for severe skeletal disorders, such as SHRM, will facilitate establishing specific genotype-phenotype correlations and providing genetic counseling for the families suffering from such conditions.

Urbanization is playing a key role in big cities of developing countries, which, in effect, is increasing the population. This study takes care of the mega infrastructure project (Orange Line Metro Train (OLMT)) to explore and identify the H&S (Health and Safety) factors that affect the local residents and the main key stakeholders working on the project. A Sequential Mixed-Method approach of the OLMT-project includes qualitative and quantitative methods were adopted. The data have been collected from the targeted population working on the OLMT-project through a questionnaire. The main key finding of the study indicates that poor planning and a lack of communication between the public and government led to frustration. The most significant factors that identified in the study were unsafe to work practice, project scope constraints, lack in technical and material support, unsafe/bad condition, health/environment degradation, declination and loss of resources and time, no proper emergency system, and negligence in adopting safety rules and laws. The study also revealed that the consensus should also be noticed between the key stakeholders (e.g., contractors, clients, safety officials, academia) in the second round of the Delphi survey of the project. The study findings will help the key stakeholders to prioritize their energies towards attaining zero levels of inadequate health and safety practices in infrastructure projects. The study outcomes can also be generalized for the other developing countries having a similar work scenario.

Background: Greig cephalopolysyndactyly syndrome (GCPS) is a disorder of autopod and craniofacial abnormalities. Autopod anomalies include preaxial and/or postaxial polydactyly together with or without syndactyly while craniofacial features include hypertelorism and macrocephaly. GCPS is inherited in an autosomal dominant manner and is caused by sequence variants in GLI3 . Methodology and Results: In this study, we examined four unrelated families with GCPS segregating in an autosomal dominant manner. Sanger sequencing revealed three novel (p.Tyr146Leufs*19, p.Glu99Serfs*60, and p.Thr541Arg) and one previously reported non-sense variant (p.Arg792*) in GLI3 . Conclusion: The study expands the spectrum of the variants in the GLI3 gene linked to GCPS, and should also facilitate genetic counseling of GCPS patients in the Pakistani population.

This study is based on self-reported information collected from selected farmers of Vehari District, Punjab, Pakistan, to determine their technical knowledge and awareness about pesticide use and associated environmental and health risks. Moreover, soil contamination by routinely used persistent organochlorine pesticide, endosulfan, was also evaluated. Survey data revealed very low literacy rate (on an average 9th grade education) and technical knowledge (almost missing) of the farmers in Vehari District. The farmers are unable to fully read and understand the instructions about the use of pesticide marked on the containers. They are not fully aware of pesticide persistence and toxicity (73%), unable to identify cotton pests and diseases (86%), and do not know which crop to grow in cotton adjacent fields (100%). Data also revealed that the farmers (100%) do not follow safety measure during pesticide application and are unaware of pesticide toxicity symptoms in human as well as the basic first-aid practices (89%).Poor literacy rate and lack of technical knowledge of farmers in Vehari regarding pesticide use and handling are posing serious environmental and health risks among the local inhabitants, particularly among farmers. Soil analysis results showed that concentration of α- and β-endosulfan ranged from 0-14 to 0-14.64 μg/mg, respectively. Principal component analysis showed that soil organic matter is the key soil parameter controlling the occurrence and fate of endosulfan under sandy loam soil conditions of Vehari District. There is a serious need of improving technical and environmental knowledge of farmer about pesticide risks on human health in the studied area, in particular, and the entire country in general. Findings are of great use for policymaking in Pakistan to minimize pesticide risks in Pakistan.

Acromesomelic dysplasia is genetically heterogeneous group of skeletal disorders characterized by short stature and acromelia and mesomelia of limbs. Acromesomelic dysplasia segregates in an autosomal recessive pattern and is caused by biallelic sequence variants in three genes (NPR2, GDF5, and BMPR1B). A consanguineous family of Pakistani origin segregating a subtype of acromesomelic dysplasia called Hunter-Thompson was clinically and genetically evaluated. Genotyping of microsatellite markers and linkage analysis revealed a 7.78 Mb homozygous region on chromosome 4q22.3, which harbors BMPR1B. Sequence analysis of the gene revealed a novel homozygous missense variant (c.1190T > G, p.Met397Arg) that segregates with the disease phenotype within the family and produced a Logarithm of odds (LOD) score of 3.9 with the disease phenotype. This study reports on the first familial case of acromesomelic dysplasia Hunter-Thompson type. It is also the first report of BMPR1B underlying the etiology of acromesomelic dysplasia Hunter-Thompson type., (© 2018 John Wiley & Sons Ltd/University College London.)

Objective: To find out any differences in free flow of internal mammary artery among different ethnic groups., Methods: This observational, cross-sectional study was conducted at the Civil Hospital, Karachi, from January 2013 to December 2015, and comprised patients who underwent coronary artery bypass grafting. The participants were divided into 5 groups, i.e. Sindhi, Muslim migrants from India, Punjabi, Pathan and Balochi patients. Free flow of internal mammary artery was measured immediately after harvesting within a syringe, and its flow was measured in 30 seconds. SPSS 18 was used for data analysis., Results: Of the 158 patients, 44(27.8%) were Sindhi, 33(20.9%) Punjabi, 8(5%) Baloch, 21(13.3%) Pathan and 52(32.9%) were migrants. The overall mean age was 52±8 years and the mean flow was 11.6±9.6ml per 30 seconds. The flow was 9.3±6 ml, 10±8ml, 13±11ml, 17±14ml and 15±13 ml in 30 seconds among migrants, Sindhi, Punjabi, Pathan and Baloch patients, respectively, with significant higher flow in Pathan patients compared to Sindhi and migrant patients (p<0.05). A flow of less than 5ml/30 sec was mostly found in migrants or Sindhi subjects 30/40(75%), and flow more than 30ml/ 30 seconds was found mostly in Baloch or Pathan patients 4/8(50%). Low flow internal mammary artery, which was used on left anterior descending artery, showed significantly higher need of inotropic support as compared to high flow internal mammary artery (p=0.004), more low cardiac output syndrome (p=0.022) and more use of intra-aortic balloon pump (p=0.028)., Conclusions: Internal mammary artery flow was higher in Pathan and Baloch patients and low in migrants and Sindhis.

Objective: This study was performed to assess the knowledge of CAD risk factors and post management of coronary intervention among sample of population who were hospitalized for PCI., Methodology: A cross-sectional, descriptive survey was conducted in Cardiology ward of a tertiary care hospital from July 2013 to May 2015 on 600 patients. A structured questionnaire was used to interview the patients. In univariate analysis, t-tests were employed to assess association of knowledge of CAD risk factors with gender, education level and monthly household income., Results: The mean score of participants with no education was 4.42 and patients with education of bachelors or higher was 8.59 (p-value: 0.01). Similarly, the mean score for participants with monthly household income less than 5000 was 3.32 and participants with income higher than 50,000 had a score of 8.31 (p-value: 0.01). Furthermore, only 28% (N=168) claimed aerobic exercise as a key part of angioplasty recovery., Conclusions: Our results indicate the lack of good level of knowledge of risk factors for CAD and post management of coronary intervention among PCI patients of Pakistan. There is urgent need for targeted educational programs on national basis to reduce mortality associated with CAD in Pakistani population.

Introduction: Blood donation is necessary in order to maintain an adequate supply of blood to patients who are suffering from any kind of disease or trauma, which requires them to have blood transfusion. Female non-blood donors are generally low in number. Therefore, this research was carried out to assess the main reasons behind the lack of blood donations made by females, and their knowledge, attitude and perceptions towards voluntary blood donation., Methodology: A cross-sectional study was conducted on 664 female health professionals, who were selected by non-probability convenience sampling from two tertiary care hospitals. A pretested questionnaire was presented to the sample population, and the data was entered and analyzed on SPSS (V17)., Results: 94.6 % were aware with the fact that blood is screened for AIDS, Hepatitis B and C before transfusion. Moreover, 83.7% said that they will only donate blood if a family, relative or friend would need it and similarly 83.4%  suggested that they would donate blood if blood donation camps are arranged in hospital premises. 81.8 % thought that blood donors can contract Hepatitis B after donation where as only 29.5% did not blood due already blood loss in menstrual cycle., Conclusion: The participants had adequate knowledge about the benefits of blood donation. The most important reason identified for not donating blood is the lack of facilities within the workplace or lack of approach by responsible authorities. The results of the study may help in minimizing the misconceptions of the participants about blood transfusion, which would increase their contribution towards blood donation.

Introduction: The main aim of this study was to determine the frequency of Enterobius vermicularis infections and other unique histopathological findings in patients diagnosed with acute appendicitis., Materials: This retrospective study was conducted in a tertiary care hospital of Karachi, Pakistan over a time period of 9 years from 2005 to 2013. The recorded demographic and histopathological data for the 2956 appendectomies performed during this time frame were extracted using a structured template form. Negative and incidental appendectomies were excluded from the study., Results: Out of the 2956 patients diagnosed with acute appendicitis, 84 (2.8%) patients had Enterobius vermicularis infections. Malignancy (n=2, 0.1%) and infection with Ascaris (n=1, 0.1%) was found very rarely among the patients.Eggs in lumen (n=22, 0.7%), mucinous cystadenoma (n=28, 1.0%), mucocele (n=11, 0.4%), lymphoma (n=9, 0.3%), obstruction in lumen (n=17, 0.6%) and purulent exudate (n=37, 1.3%) were also seldom seen in the histopathological reports., Conclusion: Enterobius vermicularis manifestation is a rare overall but a leading parasitic cause of appendicitis. Steps such as early diagnosis and regular de worming may help eradicate the need for surgeries.

The present study was conducted on rehabilitation and social adjustment of people with burns in society with the main objective to determine the relationship between social adjustment of people with burns and their psychosocial rehabilitation. The study was limited to the Burn Unit, Khyber Teaching Hospital, Peshawar, Pakistan. At bi-variate level, the following were observed: the relationship of psychosocial rehabilitation was highly significant (P=0.000) considering that people with burns feel shame in the society, a highly significant relation (P=0.000) was found between psychosocial rehabilitation and burn as the hurdle to contact other members of the society, a highly significant (P=0.000) relation was found between psychosocial rehabilitation and perception that society provides social support to people with burns, a highly significant (P=0.000) relationship between psychosocial rehabilitation and people with burns feel alienated from the society, a significant association (P=0.024) was found between psychosocial rehabilitation and loss of social network, and a significant (P=0.002) association between psychosocial rehabilitation and society insult toward people with burns. Regular provision of treatment, quota in job allocation for people with burns, initiation of stipend through Benazir Income Support Program, and keeping and updating record of burns at the district level in census centers were suggested as recommendations in light of the study., (Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.)

Constructed wetland (CW) with monoculture of Arundo donax L. was investigated for the posttreatment of anaerobic bioreactor (ABR) treating combined industrial wastewater. Different dilutions of combined industrial wastewater (20, 40, 60, and 80) and original wastewater were fed into the ABR and then posttreated by the laboratory scale CW. The respective removal efficiencies of COD, BOD, TSS, nitrates, and ammonia were 80%, 78-82%, 91.7%, 88-92%, and 100% for original industrial wastewater treated in ABR. ABR was efficient in the removal of Ni, Pb, and Cd with removal efficiencies in the order of Cd (2.7%) > Ni (79%) > Pb (85%). Posttreatment of the ABR treated effluent was carried out in lab scale CW containing A. donax L. CW was effective in the removal of COD and various heavy metals present in ABR effluents. The posttreatment in CW resulted in reducing the metal concentrations to 1.95 mg/L, 0 mg/L, and 0.004 mg/L for Ni, Pb, and Cd which were within the permissible water quality standards for industrial effluents. The treatment strategy was effective and sustainable for the treatment of combined industrial wastewater.

Background: Studies of the molecular epidemiology and risk factors for hepatitis C virus (HCV) in health care workers (HCWs) of Peshawar, Khyber Pakhtunkhwa region are scarce. Lack of awareness about the transmission of HCV and regular blood screening is contributing a great deal towards the spread of hepatitis C. This study is an attempt to investigate the prevalence of HCV and its possible association with both occupational and non-occupational risk factors among the HCWs of Peshawar., Results: Blood samples of 824 HCWs, aged between 20-59 years were analysed for anti-HCV antibodies, HCV RNA and HCV genotypes by Immunochromatographic tests and PCR. All relevant information was obtained from the HCWs with the help of a questionnaire. The study revealed that 4.13% of the HCWs were positive for HCV antibodies, while HCV RNA was detected in 2.79% of the individuals. The most predominant HCV genotype was 3a and 2a., Conclusion: A program for education about occupational risk factors and regular blood screening must be implemented in all healthcare setups of Khyber Pakhtunkhwa province in order to help reduce the burden of HCV infection.

Background: Alanine Aminotransferase (ALT) is an enzyme found in liver and indicates injury to hepatocytes. It is influenced by various factors. The objectives of this study were to identify the correlates of ALT activity among healthy medical students of Army Medical College, National University of Sciences and Technology, aged 18-22 years. This was to establish the mean ALT levels of the students and compare them with those in various parts of the world and observe various correlations that exist and factors that may influence ALT levels., Methods: This population included 143 volunteer students (93 men and 50 women) selected on the basis of negative answers to a detailed medical questionnaire including past medical history, drug and alcohol consumption, on the absence of clinical signs of liver disease, on the negativity of serological testing for Hepatitis B and C virus., Results: The mean ALT level of the entire population was 28.7 IU/L. A major sex-difference in ALT value was observed, the mean ALT value being higher in men than in women (32.1 +/- 21.7 vs. 22.6 +/- 9.7 IU/L, p<0.004). According to WHO criteria for Asians, normal BMI was taken from 18.5-23.0 Kg/m2. There was a positive significant correlation between serum ALT level and BMI (p<0.002). ALT level strongly correlates with body mass index and gender. There was no significant variation in ALT levels among Punjabis and Sindhis, Balochis, Pathans, and Kashmiris., Conclusion: We suggest the need of taking into account these parameters in a clinical interpretation of ALT level.

The objective of the study was to determine the level of beta2-microglobulin (beta2-m) in hemodialysis (HD) patients and the factors affecting it. This cross sectional, hospital based study was conducted between September and December 2008 at the Hemodialysis unit of Shalamar Hospital, Lahore. All patients with end-stage renal disease (ESRD) who were on maintenance HD for more than three months were included in the study. Patients with acute renal failure and on dialysis for less than three months were excluded. Demographic data were collected and details of dialysis (type of dialyzers, dialysate bath, membrane used) were recorded. Blood samples of the patients were drawn for hematological (hemoglobin, hematocrit), biochemical (urea, creatinine, uric acid, albumin) and beta2-m level measurement. The total number of patients studied was 50. The major causes of ESRD included diabetes mellitus and hypertension seen in 37 (74%) and 10 patients (20%), respectively. The beta2-m levels were significantly elevated in the study patients; 92.6 +/- 17.1 mg/L with a range of 54 to 130 mg/L as compared to 2.0 +/- 1.29 mg/L in the control group. The patients' age had a statistically significant relationship with the beta2-m level. The major reason for increased beta2-m level was use of low-flux dialyzers. Synthetic polysulphone membrane, bicarbonate, ultra pure dialysate and duration on HD were not asso-ciated with high beta2-m levels. Also, we found an inverse relationship between beta2-m levels and serum albumin of the study patients. Our study suggests that the beta2-m levels are significantly high in dialysis patients. Use of low-flux dialyzer seems to be the major reason for the high beta2-m levels. Age and albumin have statistically significant relationship with beta2-m levels.