Search

Copyright of Brazilian Journal of Biology is the property of Instituto Internacional de Ecologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Brazilian Journal of Biology is the property of Instituto Internacional de Ecologia and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cotoneaster afghanicus G.Klotz, indigenous to mountainous parts of China, Afghanistan and Pakistan is also present in Baluchistan region of Pakistan and has medicinally important fixed oils and essential oils. The oils and chemical compounds extracted from Cotoneaster afghanicus were subjected to chemical analyses and evaluation of antioxidant, antibacterial, biofilm inhibiting, thrombolytic and cytotoxic effects. Fixed and essential oils were characterized by gas chromatography-mass spectrometry, which enabled identification of 4 and 14 compounds. Fixed oil showed significant antioxidant (64.67 % scavenging of 2,2-diphenyl-1-picrylhydrazyl radical) and antibacterial (7 mm zone of inhibition for Gram-positive bacteria) activities. Ethanol extract (355 mg/100 g of sample) showed highest biofilm inhibitory activity (54.63 %) among the extracted compounds. Essential oil and ethanol extract also showed notable antioxidant effect with less cytotoxic effect indicating that these are good biologically active agents. The results of this study suggest to further investigate the use of extracted oils and chemical compounds as treatments for local ailments. [ABSTRACT FROM AUTHOR]

Among different properties of active constituents of medicinal plants, antioxidant properties are of primary importance which permits them to perform their function as reducing agents. Extracts from medicinal plants are utilised by pharmaceutical companies in the synthesis of allopathic medicines and then these are used against human and animal infections. In the present report, we have conducted a comparative study among seeds of fifteen medicinal plants collected from local market. The antioxidant potential of fifteen medicinal plant seeds was assessed in methanol, ethanol, acetone, ethyl acetate, n-hexane and aqueous extracts. The antioxidant activities were determined by evaluating reducing power, peroxidation inhibition through linoleic acid system, 2,2-diphenyl-1-1-picrylhydrazyl radical (DPPH) scavenging activity, total phenolics (TP), total flavonoids (TF) contents and DNA anti-damaging activity. Maximum percentage yield was obtained in ethyl acetate extracts of R. communis seed. The TPC, TFC, reducing power, DPPH (IC50) and percentage inhibited oxidation of linoleic acid values were found to range within 40.22–745.34 μg GAE/g, 20.73– 705.11 μg catechin equivalents (CE)/g, 0.121–2.73, 2.9–89.172 and 9.24–78.54%, respectively. The seed extracts were also found to be active against DNA damage by H2O2. Therefore, medicinal plant seeds under study can be used as a rich source of antioxidants. Irrespective of their antioxidant properties, DNA protective effects of medicinal plant extracts were also considered and highlighted. [ABSTRACT FROM AUTHOR]

The current study highlights the occurrence, spatial distribution, and risk assessment of 16 endocrine-disrupting chemicals (EDCs) including their transformation products (TPs) in the wastewater and surface water of Lahore, Pakistan, using solid-phase extraction followed by liquid chromatography-mass spectrometry and gas chromatography-mass spectrometry. The parent EDCs include bisphenol A (BPA), triclosan (TCS), triclocarban (TCC), estrone (E1), estradiol (E2), estriol (E3), ethinylestradiol (EE2), 4-n-octylphenol (4n-OP), and 4-n-nonylphenol (4n-NP). The TPs include two TPs each of BPA, TCC, and estrogens along with a TP of TCS. Most EDCs showed 100% detection frequency in the wastewater with highest median concentration of 1310 ng/L for E3. In the surface water, the highest median concentration was, however, observed for BPA (54.6 ng/L). Spatial variations in terms of sum of concentration due to all EDCs and their TPs were observed at different sampling points which suggest contamination due to industrial waste from nearby industrial estate. Risk evaluation in terms of risk quotient (RQ) and estradiol equivalent factor (EEQ) showed that most of EDCs and their TPs could pose high risk and estrogenicity to the surrounding environment. From the results of the current study, it is observed that the environment of Pakistan is deteriorating and is potential risk for endocrine disruption. It is, therefore, recommended to take stringent measures to make it sustainable for current as well as for future generations., (© 2023. The Author(s), under exclusive licence to Springer Nature B.V.)

Aim: The present study aimed to develop age- and sex-specific anthropometric reference growth curves for the Pakistani children, aged 1-60 months., Methods: The weight and height of 60 595 children including 30 885 (50.96%) boys and 29 710 (49.04%) girls from Pakistan were collected through a cross-sectional study. Growth reference charts about weight-for-age, length/height-for-age, and body BMI-for-age were constructed for boys and girls using the generalised additive model for location, scale and shape (GAMLSS) with the Box-Cox power exponential distribution., Results: The 3rd, 5th, 15th, 25th, 50th, 75th, 85th, 95th and 97th smoothed percentile values with L, M and S for weight, length/height, and BMI for boys and girls from aged 1 to 60 months are presented. The median percentile for all indicators increases as the age increases in both sexes. The median percentiles of the Pakistani children are lower than the WHO 2006 standards for both sexes., Conclusion: This study provides the first references for the Pakistani children from 1 to 60 months. The reference values could be taken as a starting point for examining the secular change in the Pakistani population., (© 2023 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Otitis media with effusion (OME) is a type of otitis media (OM) characterized by the presence of fluid behind intact tympanic membrane and is one of the most common diseases of early childhood. It is an infectious disease associated with the presence of many pathogenic bacteria in the middle ear of affected individuals. This study was aimed to determine the prevalence of Gram-positive bacteria from the middle ear of OME patients in the population of Southern Punjab, Pakistan. The incidence of OME under comprehensive healthcare setting was investigated in patients who consulted at the department of ear, throat and nose, Bahawal Victoria Hospital (BVH), Bahawalpur, from December, 2019 to May, 2021. Ear swabs were taken from affected and normal individuals. After culturing bacteria from the ear swabs, microscopic analysis and biochemical tests were performed to characterize the cultured Gram-positive bacteria. Out of 352 patients examined, 109 (30.9%) patients had OME. Age of the participants ranged from 14 to 50 years; individuals between the ages of 14 and 22 years had the highest infection rates, while individuals between 40 and 50 years had the lowest rate of infection. Tympanic membrane perforation, fever, cough, sore throat, ear pain and hearing problem showed association with symptoms of OME. Microscopic analysis and biochemical characterization showed the presence of streptococci and staphylococci in all the studied samples. The most frequently isolated bacteria were Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus with percentage of 53.3%, 20% and 13.3% respectively. Enterococcus faecalis (6.6%) and Staphylococcus epidermidis (6.6%) were also identified in the studied samples. This study will help in the better medical administration of OME affected individuals.

Objective: To observe vitamin K epoxide reductase complex subunit 1-1639 G>A polymorphism in patients resistant to warfarin therapy, and to calculate the allele frequency of the polymorphism in local patients., Methods: The cross-sectional case-control study was conducted at the Punjab Institute of Cardiology, Lahore, from 2013 to 2014 and comprised patients with heart valve replacement. Thy were divided into warfarin-resistant group 1 taking 10mg/day, 70mg/week and control group 2 taking a standard dose of 5mg/day, 35mg/week. The vitamin K epoxide reductase complex subunit 1-1639 G>A polymorphism analysis was done by polymerase chain reaction, followed by restriction fragment length polymorphism technique. Data was analysed using SPSS 20., Results: Of the 146 patients, there were 73(50%) in each of the two groups. In group 1, there were 37(50.68%) males and 36(49.32%) were females with an overall mean age of 33±12 years, while group 2 had 36(49.32%) males and 37(50.68%) females with an overall mean age of 37±13 years. There were no significant differences in mean values of age, serum cholesterol, triglycerides and albumin levels between the groups (p>0.05). The G allele was the most frequently found in both groups, with 140(96%) in group-1 and 137(94%) in group-2. Overall, the homozygous GG genotype was significantly higher in the sample 132(90.4%) (p<0.05)., Conclusions: There was evidence found that vitamin K epoxide reductase complex subunit 1-1639 G>A polymorphism alone may not be the dominant genetic factor associated with warfarin response variability.

During the present study, specimens were collected from selected sites of Cholistan desert and Kalabagh Game Reserve, Punjab province, Pakistan. Each captured specimen was tagged with voucher number and morphometric measurements were taken. The average snout to vent length was 172.559±1.40 mm and average weight was 92.1±1.30 g. The DNA of Uromastyx hardwickii was amplified and sequenced using 16S rRNA primer set. The obtained DNA sequence has shown reliable and clear species identification. After trimming ambiguous bases, the obtained 16S rRNA fragment was 520 bp while 16S rRNA fragments aligned with closely matched sequence from NCBI comprised of 510 bp. Closely matched sequences of genus Uromastyx were retrieved from NCBI in blast searches. Neighbour-joining tree of genus Uromastyx was constructed based on p-distance using MEGA X. The mean intraspecific variation was 0.095±0.01 while intraspecific variation was ranging from 0-1%. Similarly, interspecific variation of Uromastyx hardwikii with Saara asmussi, Uromastyx alfredschmidti, Uromastyx geyri, Uromastyx thomasi, Uromastyx alfredschmidti was 0-12%, 0-19%, 0-19%, 0-20%, 12-19% respectively. The newly produced DNA was submitted to NCBI and accession number was obtained (MW052563.1). Results of current study provided information about the molecular and morphological identification of Genus Uromastyx. In our recommendation, comprehensive molecular based identification of Pakistan's reptiles is required to report any new or subspecies from country.

The present study reports the existence of cliff racer, Platyceps rhodorachis from the plains of Punjab, Pakistan. A total of 10 specimens were captured during the field surveys from June to September, 2018 from different sites of Punjab. Platyceps rhodorachis was identify on the basis of morphology and confirmed through COI gene sequences. The obtained DNA sequences have shown reliable and exact species identification. Newly produced DNA sequences of Platyceps rhodorachis were submitted to GenBank and accession numbers were obtained (MK936174.1, MK941839.1 and MT790210.1). N-J tree based on COI sequences of Platyceps rhodorachis clearly separated as out-group with other members of family Colubridae based on p-distance. The intra-specific genetic variation ranges from 12% to 18%. The DNA sequences of Platyceps rhodorachis kashmirensis, Platyceps rhodorachis ladacensis, Platyceps ventromaculatus, Platyceps ventromaculatus bengalensis and Platyceps ventromaculatus indusai are not available at NCBI to validate their taxonomic positions. In our recommendations, a large scale molecular based identification of Pakistan's herpetofauna is required to report more new or subspecies from country.

Present study was planned to determine variations in external and internal quality egg parameters of different avian species including ostrich Struthio camelus, ducks Anas platyrhynchos, chicken Gallus gallus, turkeys Meleagris gallopavo and grey francolin Francolinus pondicerinus. All the birds were kept under similar rearing conditions. A total of 150 eggs were collected for each species to record external features of these eggs. Statistically significant (p<0.05) variations were recorded in egg weight, egg length and egg width between ostrich, ducks, chicken, turkey and quail eggs. Significantly (p<0.05) higher egg weight, egg length and egg width was observed for ostrich eggs while the same was lowest for grey francolin eggs. Similarly, significantly (p<0.05) greater shape index and egg volume values were observed for ostrich eggs while lowest shape index values were recorded for turkey eggs and egg volume was lowest for grey francolin. Significantly, higher (p<0.05) values of egg density were noted for eggs of the quail and the same were lowest for ostrich eggs. Non-significant variations in egg density values were observed between eggs of the ducks, chicken, turkey and grey francolin. It has been concluded that the positive correlations between the internal and external egg quality traits indicated that the traits can be improved through selection.

Objectives: To evaluate liver and inflammatory biomarkers in occupationally exposed radiology workers., Methods: The descriptive study was conducted at Mufti Mehmood Memorial Teaching Hospital and Gomal Centre of Biochemistry and Biotechnology, Gomal University, Dera Ismail Khan, Pakistan, from September 2017 to May 2018, and comprised X-ray technicians working 48-72 hours per week, and a group of age- and gender-matched unexposed healthy controls. The exposed group was divided into three sub-groups based on their radiation work duration. Liver health status involved estimation of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase GGT and bilirubin through automated chemistry analyser, while serum tumour necrosis factor-alpha and interleukin- 6 levels through enzyme-linked immunosorbent assay technique. Relative gene expression analysis of tumour necrosis factor-alpha and alkaline phosphatase was performed through reverse transcription-polymerase chain reaction. Data was analysed using SPSS 20., Results: Of the 70 subjects, 50(71.4%) were cases with a mean age of 36.98±8.07 years and 20(28.6%) were controls with a mean age of 36.80±7.78 years. Serum alanine aminotransferase and alkaline phosphatase levels showed significant elevation in the cases compared to the controls (p<0.0001), although alanine aminotransferase levels were within the normal range. The difference in aspartate aminotransferase, gamma-glutamyl transferase and bilirubin levels was not significant (p>0.05). Tumour necrosis factor-alpha concentration was significantly high in the cases compared to the controls (p<0.0001). In contrast with proteomic analysis, relative gene expression analysis revealed reduced level of alkaline phosphatase and tumour necrosis factor-alpha in the cases compared to the controls (p<0.05)., Conclusions: Serum proteomic analysis of X-ray technicians indicated acute inflammatory conditions, while genomic analysis exhibited down-regulation of alkaline phosphatase and tumour necrosis factor-alpha genes.

Due to the lack of wastewater treatment facility in Pakistan, the wastewater is directly discharged via urban drains, which might cause a high load of contaminants of emerging concerns and potential environmental risks. The present study focused on the occurrence and risk assessment of 52 pharmaceuticals and personal care products (PPCPs) of diversified classes in the water and sediment samples of urban drains and canal of Lahore, Pakistan. Non-steroidal anti-inflammatory drugs were the predominant PPCPs detected in the wastewater of urban drains and surface water of canal. The highest concentration was observed for acetaminophen, with median concentration of 13,880 ng/L followed by caffeine with median concentration of 6200 ng/L. Antibiotics were the predominant PPCPs in the sediment samples with highest concentration of ofloxacin (median value of 1980 μg/kg) followed by ciprofloxacin and oxytetracycline. Spatial variation showed that the population density has significant correlation with the level of many PPCPs in surface water while one of the drainage systems is affected by the direct wastewater discharge from the nearby industrial area. Ecological risk assessment in terms of risk quotient revealed that most of the PPCPs may cause high risk to the aquatic community. This high risk may lead to further contamination of food and crops, therefore enforcement of environmental legislations for treatment of wastewater is recommended., (Copyright © 2019 Elsevier B.V. All rights reserved.)

During current project, antibacterial and antibiofilm properties of traditional medicinal plant Ziziphus nummularia leaf extract and various fractions was investigated. The plant leaves were dried and extracted using 90% methanol followed by sequential fractionation using liquid-liquid fractionation. The fractions of a diverse polarity including chloroform, n-hexane, methanol and ethyl acetate and aqueous extracts were obtained that was further analysed by using HPLC. The phytochemical screening indicated presence of saponins, triterpenes and flavonoids. During DPPH assay, the methanolic fraction presented highest activity (IC 50 193.1μg/mL), followed by ethyl acetate (IC 50 220μg/mL) and chloroform (IC 50 263μg/mL) fractions respectively. During FRAP assay, FRAP value for Z. nummularia extract 20.43μM. Among fractions, ethyl acetate fraction presented highest FRAP value (370.2μM), followed by chloroform (204μM) and methanolic (249μM) fractions. The antimicrobial activity of chloroform fraction was significantly high against P. aureginosa (6mm), L. monocytogenes, S. aureus (5mm), K. pneumoniae, B. Subtillus and E. coli (4mm). The ethyl acetate part presented significant activity (MIC 4mg/mL) against S. aureus, B. Subtillus and L. monocytogenes. The total extract and fractions were further tested for MBC and the MBC for ethyl acetate fractions was 4mg/mL, whereas all other fractions exhibited MBC >10mg/mL. No activity was recorded against Aspergillus niger. During antibiofilm assay, n-hexane fraction presented highest inhibition (88%) followed by ethyl acetate (69%) chloroform (65%) fractions. It was concluded that Z. nummularia possess moderate antimicrobial and antibiofilm activities. Further a synergistic effect is suggested in formulation having Z. nummularia.

Background: The maternal 25-hydroxy vitamin D (25OHD) insufficiency is related to adverse maternal and neonatal outcome. The 25OHD content of breast milk is dependent on 25OHD status of the mothers. We undertook this study to ascertain the 25OHD status and its determinants in the nursing mothers of the south Punjab, Pakistan., Methods: We recruited 67 mothers for this cross-sectional study by convenience sampling from August 2010 to June 2011 to ascertain their serum 25OHD level & its determinants. We used SPSS 23.0 for analyses., Results: The mean age of the mothers was 25.75 ± 4.4 years. The median age (and mode) was 25 years (range 18-37 years). The majority of mothers were less than 25 years of age (62.7%), uneducated (68.7%), from rural area (70.1%), lived in open houses with ample sun exposure (85.1%) and belonged to low socioeconomic strata (71.6%). Serum 25OHD ranged from 7.2 to 43.8 nmol/L with a mean of 20.87 ± 7.69 nmol/L. The median and mode were 21.8 nmol/L & 24.0 nmol/L, respectively. The proportion of mothers with 25OHD < 20 nmol/L (severe deficiency) was 44.8%, < 30 nmol/L (deficiency) 49.3% and < 50 nmol/L (insufficiency) 5.9%. All had 25OHD below 50 nmol/L. The oral supplementation with vitamin D (vD) was the only significant determinant of vitamin D sufficiency., Conclusions: The majority of Pakistani mothers in south Punjab are vD deficient & universal vD supplementation is the need of the hour to improve health outcomes in mothers & infants.

Rhizobacteria are an active part of microbial population in the rhizosphere of plants. In this study, twenty rhizobacteria were isolated from the rhizosphere of a perennial grass, Haloxylon salicornicum, found in Cholistan desert, an arid landmass near Bahawalpur Pakistan, in one set of experimental conditions. Colony characteristics, biochemical and molecular analyses of these isolates were performed. All isolates were bacilli, gram positive with off-white colonies and exhibited typical bacilli colony morphology. None of the isolates was gelatinase, urease, indole, H2S and catalase producer. Eleven isolates were amylase producers and 8 isolates were acid producers. All isolates fermented glucose, 3 fermented lactose and 19 fermented fructose. Molecular data revealed that out of twenty isolates, 14 isolates showed 91-99% identity with Brevibacillus borstelensis, 4 with Bacillus subtilis (97-98%) and 2 with Bacillus licheniformis (94-99%) through BLAST analysis. All identified bacterial isolates cladded with their respective groups in the phylogenetic tree. Many (11-15 out of 20) of the isolates were more effective in inhibiting growth of the tested bacterial strains as compared to the positive control (Ampicillin 50 μg/disc). We conclude that bacilli are the predominant form populating rhizosphere of this desert grass. Among the isolated bacteria Brevibacillus borstelensis, Bacillus subtilis and Bacillus licheniformis are the most predominant species.

Objective: To predict pulmonary function test values in children., Methods: This cross-sectional study was carried out at Nishtar Medical College, Multan, Pakistan, from August 2014 to March 2015, and comprised school-going children aged 5-14 years. After noting their gender, age, height and weight, the pulmonary function test measures, force vital capacity, forced expiratory volume in 1 second and peak expiratory flow rate were taken. Simple and multiple regression models were used for the prediction of pulmonary function test values. SPSS 19 was used for statistical analysis., Results: Of the 3,275 participants, 1,809(55.2%) were boys and 1,466 (44.8%) were girls. The overall mean age was 10.27±2.41 years. The means height, weight, forced expiratory volume in 1 second, force vital capacity and peak expiratory flow rate were 137.37±13.41cm, 30.44±8.56kg, 1.56±0.58, 1.72±0.50 and 3.66±1.10, respectively. Generally, no significant difference between the mean pulmonary function test values was noted for boys and girls (p>0.05), except that the boys of age 13 and 14 had higher mean values (p<0.05). All the three variables - age, height and weight - had significant linear relationship with the pulmonary function test values (p<0.05)., Conclusions: The pulmonary function test values tended to increase with increase in age, height and weight.

Background: Complementary and alternative medicine (CAM) comprises a variety of health care systems, practices, and products that are not usually thought to be part of allopathic medicine. This study investigated the parental beliefs and practices for use of spiritual methods in the treatment and early recovery of their children., Methods: We performed a cross-sectional, descriptive study with convenience sampling of parents/caregivers of sick children who were admitted to the Children's Hospital in Multan. A trained interviewer collected the data., Results: A total of 1280 forms were analyzed. The majority of respondents were mothers (1053, 82.4%), they resided in Multan (817, 63.8%), and were not educated (754, 58.9%). A total of 420 (32.8%) respondents had a low socioeconomic background, 601 (47%) were middle class, and 259 (20.2%) were upper class. Grandmothers/mothers advised spiritual methods in the majority of respondents (605, 85.9%). The parents used a variety of spiritual methods in 704 (55%) children. Economic status and education showed an inverse relation with the use of CAM. A total of 809 (63.2%) respondents believed that only a drug would heal the disease, while 575 (44.9%) believed that spiritual methods have a 25%-50% role in healing. A total of 1269 (99.1%) respondents believed that allopathic drugs are needed for healing, while only 0.9% considered otherwise., Conclusion: The majority of people believe that CAM is a contributory factor towards healing and does not interfere with allopathic treatment.

Background: Pakistan observes a very high i.e. 37 percent modern contraceptive method related discontinuation rates within 12 months of their initiation. And almost 10 percent of these episodes of discontinuation happened due to the side effects or health concerns experienced by the women. Most importantly, it was noted that more than 12,000 first-level care facilities are located in the rural areas, including rural health centers, basic health units, and family welfare centers, but more than 30% of these facilities are nonfunctional. This paper presents a study protocol and participants' profiling of a prospective cohort follow-up to compare the effectiveness of household based and telephonic approaches in sustaining the use of Long Acting Reversible Contraceptives (LARC) whilst to facilitate lowering method related discontinuation and increasing switching amongst the contraceptive users., Methods: A 12-month multi-centre, non-inferiority prospective user follow-up is employed using three different study categories: a) household based follow-up; b) telephonic follow-up; and c) passive or need-based follow-up along with the hypothetical assumption that the telephonic client follow-up is not inferior to the household based follow-up by continuation rate of LARC and the telephonic follow-up is less-costly than the household based client follow-up. This follow-up will be conducted in 22 health facilities - (16 rural and 6 urban based facilities) in district Chakwal. The first two study categories will receive scheduled but different follow-up from the field workers at 1, 3, 6, 9, and 12 month while the third one i.e. the 'passive or need-based follow-up' will serve as a control group. Using sampling software PASS 11, it was estimated to have 414 clients in each study category and around 1366 clients will be recruited to account for 10% attrition rate., Discussion: The study will help us to examine a more convenient method of effective follow-up for managing side effects, decreasing method discontinuation and increasing switching amongst users. The study information will also facilitate to develop a robust, effective and efficient mechanism for client follow-up to promote the continuation rates of LARC methods. The follow-up results and lessons learnt will be widely shared with stakeholders for their implementation and streamlining in health system.

Background: High fertility rates, unwanted pregnancies, low modern contraceptive prevalence and a huge unmet need for contraception adversely affect women's health in Pakistan and this problem is compounded by limited access to reliable information and quality services regarding birth spacing especially in rural and underserved areas. This paper presents a study protocol that describes an evaluation of a demand-side financing (DSF) voucher approach which aims to increase the uptake of modern contraception among women of the lowest two wealth quintiles in Punjab Province, Pakistan., Methods/design: This study will use quasi-experimental design with control arm and be implemented in: six government clinics from the Population Welfare Department; 24 social franchise facilities branded as 'Suraj' (Sun), led by Marie Stopes Society (a local non-governmental organization); and 12 private sector clinics in Chakwal, Mianwali and Bhakkar districts. The study respondents will be interviewed at baseline and endline subject to voluntary acceptance and medical eligibility. In addition, health service data will record each client visit during the study period., Discussion: The study will examine the impact of vouchers in terms of increasing the uptake of modern contraception by engaging private and public sector service providers (mid-level and medical doctors). If found effective, this approach can be a viable solution to satisfying the current demand and meeting the unmet need for contraception, particularly among the poorest socio-economic group.

Background: Pakistan has had a low contraceptive prevalence rate for the last two decades; with preference for natural birth spacing methods and condoms. Family planning services offered by the public sector have never fulfilled the demand for contraception, particularly in rural areas. In the private sector, cost is a major constraint. In 2008, Marie Stopes Society - a local NGO started a social franchise programme along with a free voucher scheme to promote uptake of IUCDs amongst the poor. This paper evaluates the effectiveness of this approach, which is designed to increase modern long term contraceptive awareness and use in rural areas of Pakistan., Methodology: We used a quasi-experimental study design with controls, selecting one intervention district and one control district from the Sindh and Punjab provinces. In each district, we chose a total of four service providers. A baseline survey was carried out among 4,992 married women of reproductive age (MWRA) in February 2009. Eighteen months after the start of intervention, an independent endline survey was conducted among 4,003 women. We used multilevel logistic regression for analysis using Stata 11., Results: Social franchising used alongside free vouchers for long term contraceptive choices significantly increased the awareness of modern contraception. Awareness increased by 5% in the intervention district. Similarly, the ever use of modern contraceptive increased by 28.5%, and the overall contraceptive prevalence rate increased by 19.6%. A significant change (11.1%) was recorded in the uptake of IUCDs, which were being promoted with vouchers., Conclusion: Family planning franchise model promotes awareness and uptake of contraceptives. Moreover, supplemented with vouchers, it may enhance the use of IUCDs, which have a significant cost attached. Our research also supports a multi-pronged approach- generating demand through counselling, overcoming financial constraints by offering vouchers, training, accreditation and branding of the service providers, and ensuring uninterrupted contraceptive supplies.

Introduction: Community-based distribution (CBD) has been successfully applied to family planning (FP) services worldwide. It forms the basis for the large lady health worker (LHW) programme in Pakistan which serves a limited number of women with contraception services. Thus, the concept has seen limited application in Pakistan. We present the outcomes of a CBD model that was implemented in 49 districts across Pakistan by a non-government organization (NGO)., Methods: The Marie Stopes Society (MSS) developed a CBD model around its fixed centres and reached around half a million married women of reproductive age (MWRA) with services. The services provided included outreach, counselling, condoms, pills, injections, and referrals for intrauterine contraceptive devices (IUCDs) and other reproductive health services. Services were provided in peri-urban locations for a subsidized fee using a businesslike target setting approach. The results of the programme were assessed by triangulating inception records against a cross-sectional end-of-project survey and service delivery records., Results: The contraceptive prevalence rate (CPR) had increased from 38% to 51% by project-end with modern method use increasing by 50-200% and traditional method use remaining unchanged. Unmet need and self-reported pregnancy rates fell correspondingly. Approximately 73,500 new users were added to the initial user registered numbers to a total of 132,300; MSS accounted for 53,000 per year at the end of the project, which matched the commodities supplied by the NGO., Conclusions: The MSS CBD model presents a viable option for scaling effective FP services that may be replicated and scaled up with either donor support or by contracting out by the government. Triangulation of multiple data sources can provide more in-depth assessment of service delivery programmes and provide inferences that can inform service delivery.

Background: The overall use of modern contraception in Pakistan is quite low, especially in rural areas. Several studies have demonstrated the effectiveness of social franchising (SF) approaches in increasing access to modern contraception and improving the quality of healthcare in resource-poor areas in Asia and Africa. Drawing on best practices in SF, the Marie Stopes Society (MSS) implemented an SF model in certain rural areas of Pakistan to increase access to affordable and quality family planning (FP) services. The model was branded as Suraj (sun) and complemented with an innovative voucher scheme for intrauterine contraceptive devices (IUCDs). This paper describes the perspectives of Suraj clients, field workers mobilization (FWMs), and providers on various components of the Suraj model., Methodology: A qualitative exploratory study was conducted in six randomly selected intervention districts in the Sindh and Punjab provinces. Data were collected using focus group discussions (FGDs) with clients and in-depth interviews (IDIs) with providers and FWMs. Data were manually analyzed using constant comparison and the thematic analysis approach., Findings: Clients showed positive attitudes towards modern contraceptive methods and identified Suraj FWMs and signboards as sources of information. Almost all clients reported IUCDs as effective methods as they have manageable side effects and require fewer visits to clinics. They spoke highly of voucher schemes as these enabled them to avail free IUCD services. Clients also appreciated many components of Suraj clinics, including cleanliness, privacy, confidentiality, the sterilization of instruments, and courteous Suraj providers and FWMs. Most Suraj providers said that IUCD insertion and infection-prevention training enhanced their ability to provide IUCD services and increased their standing in local communities. They reported that the role of FWMs was crucial in mobilizing the community and increasing their FP clientele. The FWMs said that attitudes towards FP were changing because of economic pressure at the household level, increases in literacy, and community mobilization efforts., Conclusion: The Suraj intervention influenced attitudes towards FP and modern contraception, positively. Women using IUCDs showed greater satisfaction with the method. The findings emphasize that SF approaches like Suraj, when complemented with vouchers and community mobilization efforts, can improve the utilization of long-term contraceptive methods among rural and underserved women. The study also identified the need for integrating FP, antenatal care, and safe delivery services.

Background: This paper reflects the empirical findings of an ethnobotanical survey which was undertaken in Patriata (New Murree) of district Rawalpindi in Pakistan. The aims and objectives of the study were to document indigenous knowledge of plants particularly of medicinal, veterinary, fruit, vegetable, fodder, fuel etc., Methods: For this purpose, the whole area was surveyed for documenting folk knowledge using a semi-structured questionnaire. A total of 93 plants species belonging to 80 genera and 56 families were found in a variety of uses by the local people for the accomplishment of their basic needs. The study further employs binary logit regression model of medicinal uses of these plants so as to identify the probability of occurrence of medicinal use of woody or non-woody plants keeping other plant characteristics in view., Results: Ethnobotanical data shows that most plants are used for medicinal and fodder purposes (27.93% each), followed by fuel (16.90%), fruit (6.55%), vegetable (5.52%) and ethno-veterinary (3.79%). There is also an established association of medicinal use of plants to the fruits use. Non-woody plants have high tendency towards medicinal use of the plants as compared to woody plants. Annual plants are less likely to be directly associated with medicinal use of plants in the surveyed vegetation. Underground plant parts are more likely to be used for medicinal purposes as revealed from the Logit expressions., Conclusions: The study revealed that most of the plants are used for medicinal and fodder purposes. The results of Logit Model showed that the probabilities of plant species for their medicinal use are associated to the woody or non-woody, aerial or underground, perennial or annual characteristics of plants. One should be careful in completely generalizing the results as the survey findings are sensitive to the plant species and the vegetation under consideration. But it can be specified that there exists either some positive or negative association of medicinal use of plants to the various characteristics of plant species.

Background: The number of unsafe abortions is increasing across South Asia, also in Pakistan, where abortion is only permitted under special circumstances. The law on abortion is vaguely interpreted by the legal community., Methods: Using Grounded Theory, 33 in-depth interviews of representatives of the legal profession and law enforcement agencies were conducted in 2010., Results: Abortion is perceived as forbidden by both law and religion, and a punishable crime. Respondents believed that sentences are highly dependent on the social status of the woman who had the abortion. A few consider the current law as relevant and sufficient whereas the majority would support amendments. A number of them agreed that the high abortion rate reflects the denial of women's rights, social injustice, and a failure of public health intervention., Conclusion: To facilitate access of women to abortion and related care, the knowledge of the existing law among legal professionals must improve. The implications of abortion for maternal health and its repercussions on a community governed by the Islamic dogmas must be publicised. The legal community could have an instrumental role in bringing about attitudinal changes vis-à-vis abortions in the society.

Objective: To determine the coagulation abnormalities and relationship between abnormal clotting tests and the risk of gastrointestinal bleeding (GI) among chronic liver disease (CLD) patients admitted at a tertiary care hospital in Pakistan., Methods: Adult CLD patients admitted at Liaquat University Hospital Jamshoro, during Nov 2004-Oct 2005, were included in the study. The patients blood were tested for coagulation abnormalities including prothrombin time (PT), activated partial thromboplastin time (aPTT), platelet count and plasma fibrinogen. Association was seen between the abnormal clotting tests and the gastrointestinal bleeding by calculating relative risk (RR) with 95% confidence interval., Results: PT was prolonged in 88% and aPTT was raised in 71% cases of CLD. Both PT and aPTT were prolonged in 67% CLD cases. Approximately 37% CLD cases had decreased platelet count and 15% cases had decreased serum fibrinogen level. Relative risk of GI bleeding with abnormal clotting tests in CLD cases were weakly positive for PT (RR = 1.02; 95% CI, 0.49-2.10), negative for aPTT (RR = 0.83; 95% CI, 0.47-1.45), strongly positive for decreased platelet counts (RR = 1.96; 95% CI, 1.08-3.56) and also for decreased fibrinogen level (RR = 1.47; 95% CI, 0.64-3.35)., Conclusion: Coagulation abnormalities were profound in CLD. Decrease platelet counts and fibrinogen levels were related with GI bleeding but PT and aPTT were not significantly related with GI bleeding in patients with chronic liver disease. Nevertheless, these parameters (PT and aPTT) were still used as prognostic markers.

Background: At the present time, the epidemiology of the childhood asthma is of considerable interest. There is an understandable concern that changes in the geographical area, lifestyle, and environment. This study was conducted to find the prevalence of nocturnal asthma, in school children of south Punjab, Pakistan., Methods: It was a cross sectional, questionnaire based, descriptive survey of the children aged 3-18 years, in randomly selected primary and secondary schools, from October 2002 to March 2003. The data was analysed with Statistical Analysis System (SAS)., Results: Of 6120 questionnaire sent to the parents/guardians, we received 3180 back (52%). Of the 3180 respondents, 1767 (56%) were for boys and 1413 (44%) were for girls. The median age was 8.25 years. Around 71% of children were between 4 to 11 years of age. The parents reported nocturnal asthma in 177 (6%) of their children with an equal prevalence in boys and girls, i.e., (3% each, rounded off to nearest whole number). Of these 177 children with nocturnal asthma, 99 (56%) were boys and 78 (44%) were girls. Of the 1767 boys, and 1413 girls, the nocturnal asthma reported by parents was 6% each (99 and 78 respectively). The nocturnal asthma was not reported in 14-18 years age group of females., Conclusion: The asthma is taken as a stigma in our society and as such is not reported or disclosed rather denied. An extensive educational media campaign is required for awareness of the masses.

Pentacyclic triterpenes (1) and (2) have been isolated from Mimusops elengi and assigned structures 3beta,6beta,19alpha,23-tetrahydroxy-urs-12-ene and 1beta-hydroxy-3beta-hexanoyllup-20 (29)-ene-23, 28-dioic acid, respectively, on the basis of spectroscopic studies including 2D-NMR. The compound 1 showed moderate inhibiting activity against beta-glucuronidase enzyme