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Objective: To evaluate the effect of tracheostomy on COVID positive patients and the risk included in the procedure for the patient and health care workers. Study Design: Retrospective Observational Study. Setting: Shifa International Hospital Islamabad, Pakistan. Period: 30th May 2020 to 15th February 2022. Material & Methods: The tracheostomies were performed in COVID ICU at bed side by ENT team. This is a study of 22 patients mostly with multiple comorbidities who presented to the hospital with symptoms of SARS-COVID-19. The changes in their ventilation were recorded before and after the tracheostomy. The health care workers included in the study were also kept under observation for any possible cross infection. Results: Eight out of twenty two patients were weaned off from ventilator. There was decrease in partial pressure of oxygen after the procedure but the mortality rate was high. None of the members of operating team, ICU team, anaesthesia team was infected with the virus. Conclusion: Our study shows that although tracheostomy helps in weaning off from ventilator, it has no role in weaning off COVID patients. There is no benefit of tracheostomy for a COVID positive patients. Furthermore, if adequate personal protective equipment's are used, there is no risk of spread of infection from patient during the procedure of tracheostomy. [ABSTRACT FROM AUTHOR]

Mucopolysaccharidoses (MPSs) are inherited lysosomal storage disorders (LSDs). MPSs are caused by excessive accumulation of mucopolysaccharides due to missing or deficiency of enzymes required for the degradation of specific macromolecules. MPS I-IV, MPS VI, MPS VII, and MPS IX are sub-types of mucopolysaccharidoses. Among these, MPS III (also known as Sanfilippo) and MPS IV (Morquio) syndromes are lethal and prevalent sub-types. This study aimed to identify causal genetic variants in cases of MPS III and MPSIV and characterize genotype-phenotype relations in Pakistan. We performed clinical, biochemical and genetic analysis using Whole Genome Sequencing (WGS) in 14 Pakistani families affectedwithMPS III orMPS IV. Patientswere classified intoMPSIII by history of aggressive behaviors, dementia, clear cornea and into MPS IV by short trunk, short stature, reversed ratio of upper segment to lower segment with a short upper segment. Data analysis and variant selections weremade based on segregation analysis, examination of known MPS III and MPS IV genes, gene function, gene expression, the pathogenicity of variants based on ACMG guidelines and in silico analysis. In total, 58 individuals from 14 families were included in the present study. Six families were clinically diagnosed withMPS III and eight families with MPS IV. WGS revealed variants in MPS-associated genes including NAGLU, SGSH, GALNS, GNPTG as well as the genes VWA3B, BTD, and GNPTG which have not previously associated with MPS. One family had causal variants in both GALNS and BTD. Accurate and early diagnosis of MPS in children represents a helpful step for designing therapeutic strategies to protect different organs from permanent damage. In addition, pre-natal screening and identification of genetic etiologywill facilitate genetic counselling of the affected families. Identification of novel causal MPS genes might help identifying new targeted therapies to treat LSDs. [ABSTRACT FROM AUTHOR]

Nitrogen is the most important and widely applied nutrient in sweet pepper production as it improves vegetative growth as well as fruit production. Therefore, the present research was aimed to evaluate promising sweet pepper cultivars as a function of different nitrogen fertilizer levels for semi-arid conditions of Pakistan during 2018 and 2019. Four nitrogen levels (75, 100, 125 and 150 kgha−1) and three sweet pepper cultivars (Ganga, Winner and Savio) were adopted in this study. Vegetative growth as well yield attributes were found highest during the cropping season of 2019 as compared with 2018. Plant height, stem diameter, canopy diameter, fresh and dry biomass of sweet pepper enhanced by the increased application of nitrogen from 75 to 125 kgha−1. All the yield contributing traits including number of fruits per plant, fruit fresh weight per plant and fruit yield per hectare were found the highest with nitrogen application of 150 kgha−1. In most of the crop traits, application of 125 kg Nha−1 and 150 kg Nha−1 produced statistically similar results. Cultivars respond differently to the nitrogen application. Ganga and Savio behaved similarly in response to nitrogen application. They had a quadratic response to nitrogen application; maximum growth and yield were at 125 kg Nha−1 and then decreased at 150 kg Nha−1. In contrast, Winner showed a somewhat linear response to nitrogen application and maximum growth, biomass and yield were recorded at 150 kg Nha−1. Planting a pepper cultivar with improved nitrogen use efficiency can result in maximum yield in a semi-arid region. [ABSTRACT FROM AUTHOR]

Background: The ongoing coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) and the Omicron variant presents a formidable challenge for control and prevention worldwide, especially for low- and middle-income countries (LMICs). Hence, taking Kazakhstan and Pakistan as examples, this study aims to explore COVID-19 transmission with the Omicron variant at different contact, quarantine and test rates. Methods: A disease dynamic model was applied, the population was segmented, and three time stages for Omicron transmission were established: the initial outbreak, a period of stabilization, and a second outbreak. The impact of population contact, quarantine and testing on the disease are analyzed in five scenarios to analysis their impacts on the disease. Four statistical metrics are employed to quantify the model's performance, including the correlation coefficient (CC), normalized absolute error, normalized root mean square error and distance between indices of simulation and observation (DISO). Results: Our model has high performance in simulating COVID-19 transmission in Kazakhstan and Pakistan with high CC values greater than 0.9 and DISO values less than 0.5. Compared with the present measures (baseline), decreasing (increasing) the contact rates or increasing (decreasing) the quarantined rates can reduce (increase) the peak values of daily new cases and forward (delay) the peak value times (decreasing 842 and forward 2 days for Kazakhstan). The impact of the test rates on the disease are weak. When the start time of stage II is 6 days, the daily new cases are more than 8 and 5 times the rate for Kazakhstan and Pakistan, respectively (29,573 vs. 3259; 7398 vs. 1108). The impact of the start times of stage III on the disease are contradictory to those of stage II. Conclusions: For the two LMICs, Kazakhstan and Pakistan, stronger control and prevention measures can be more effective in combating COVID-19. Therefore, to reduce Omicron transmission, strict management of population movement should be employed. Moreover, the timely application of these strategies also plays a key role in disease control. [ABSTRACT FROM AUTHOR]

Ginger (Zingiber officinale Rosc; Zingiberaceae family) is an herb commonly used as a spice and remedy for a broad spectrum of diseases. The essential oil extracted from ginger is an effective antioxidant, anti-inflammatory, and antifungal agent. The present study has investigated the variations in yield and chemical composition of essential oils of two cultivars (Chinese and Thailand) of ginger locally available in Pakistan. Two different drying pretreatments were employed to observe the changes in compositional variations of the essential oils of ginger. The essential oil extracted from fresh, oven-dried, and sun-dried samples of two different cultivars of ginger was analyzed using gas chromatography-mass spectrometry (GC-MS). The essential oil yield was found to be highest for the sun-dried sample of each variety. The major compounds (>4%) overall in the essential oil of fresh, oven-dried, and sun-dried ginger samples from Thailand origin were camphene, 3-carene, o-cymene, caryophyllene, α-curcumene, sabinol trans, citral, and santalol. Major compounds overall in the essential oil of fresh, oven-dried, and sun-dried ginger samples of Chinese origin were α-pinene, Camphene, limonene, longicyclene, copaene, longifolene, β-sesquiphellandrene, alloaromadendrene, γ-muurolene, α-curcumene, α-farnesene, and citral. The inter-varietal variations and pretreatment methods considerably affected yield and chemical composition. Cluster analysis was performed to validate the results further. Significantly varying compounds responsible for the significant variation among varieties and treatments of the ginger were identifies by using the heat map. There was clear differentiation among Chinese and Thailand varieties due to the variation in the concentrations of the volatile compounds. The results obtained can be helpful for the ginger growers and end users to choose the ginger variety and the way of use that is more beneficial. [ABSTRACT FROM AUTHOR]

The present study reports the association of climatic determinants with the abundance of Aedes (Ae.) aegypti larvae in indoor and outdoor niches. The respondents were asked about the use of containers and water type present in containers and other relevant variables i.e., vegetation, location of container, etc. The meteorological data was analyzed through multiple linear regression to establish the association between prevalence of Aedes immatures and climatic determinants. The Chi-square analyses were done to determine the association between seasonal variation and abundance of Ae. aegypti immatures in various types of breeding containers and Odds Ratio (OR) was calculated. Irrespective of study districts and seasons, the results indicated a significant association of climatic determinants with the prevalence of Ae. aegypti immatures in different breeding containers. However, non-significant (X2=18.10, P=0.1127) association was observed between summer season and prevalence of Ae. aegypti immatures in different breeding containers in district Faisalabad only. A significant association of climatic determinants was observed irrespective of the season and locality throughout the year in districts DG Khan and Chakwal. The study is a maiden attempt to investigate the prevalence of Ae. aegypti immatures and their preferred breeding containers. The findings of the study will add up in the existing knowledge regarding the preferred larval breeding habitats of Ae. aegypti immatures in the study districts. Present findings will facilitate the policy makers to formulate strategies for the effective control of Ae. aegypti. [ABSTRACT FROM AUTHOR]

Q fever remains a neglected zoonosis in many developing countries including Pakistan. The causing agent Coxiella (C.) burnetii is resistant to environmental factors (such as drying, heat and many disinfectants), resulting in a long-lasting infection risk for both human and animals. As the infection is usually asymptomatic, it mostly remains undiagnosed in animals until and unless adverse pregnancy outcomes occur in a herd. In humans, the infection leads to severe endocarditis and vascular infection in chronic cases. Limited data are available on molecular epidemiology and evolution of this pathogen, especially in ruminants. Genomic studies will help speculating outbreak relationships in this scenario. Likewise, pathogenesis of C. burnetii needs to be explored by molecular studies. Awareness programs and ensuring pasteurization of the dairy milk before human consumption would help preventing Q fever zoonosis. [ABSTRACT FROM AUTHOR]

Background: A frequent reason of mortality and severe disability is pulmonary embolism (PE). High death rates continue to be a prevalent issue even with advancements in diagnosis and treatment. Objective: The objective of the study was to explore the Incidence and outcome of pulmonary embolism in trauma and orthopedic patients. Methodology: This retrospective study was conducted at the Department of Pulmonology and Orthopedic Saidu Teaching Hospital, Swat from January 2017 to December 2019 after obtaining approval from the ethical committee of the institute. All the participants admitted for acute trauma or elective orthopaedic procedures during the study period were included. All the individuals with suspected PE were examined through (CT-PA) to conform PE, within 6 months following the operation or the injury. The study conducted a retrospective examination of case notes and computerized databases to determine the risk factors for venous thromboembolism (VTE), therapy type, thromboprophylaxis, and death of each patient. Results: Only 88 (0.48%) of the 18,153 patients hospitalized over the research period reported PE (positive CT-PA). Of these, 62 received acute trauma and 26 received elective surgery. Out of these approximately 75% of these individuals were given thromboprophylaxis. The three most often identified risk factors were being overweight, cardiovascular illness, and high blood pressure. After PE, the mortality rate was 0.07%. The death rate in the trauma group was 0.15 percent, whereas it was 0.02 percent for elective orthopaedic surgical procedures. The frequency of death was substantially correlated with the presence of at least two co-morbidities (unadjusted OR = 3.52, 95% confidence interval (CI) (1.34, 18.99), P = 0.034). Conclusion: The frequency of VTE was in parallel to previously reported results but there was a lower death rate. The treatment protocols were most effective performed in this study. [ABSTRACT FROM AUTHOR]

Burkholderia (B.) mallei is a host-adapted equine pathogen that causes glanders, a re-emerging zoonotic disease, which is endemic in Pakistan and other developing countries and seriously impacts the global equine movement. Due to globalization, the geographical restriction of diseases vanishes and the lack of awareness of and experience with eradicated diseases in industrialized countries also promotes the re-introduction of infections in these regions. Owing to the high equine population, the Pakistani province Punjab is a potential hotspot where several glanders outbreaks have been seen over last two decades. For determining the genomic diversity of B. mallei in this and other equine-populated prefectures, the genomes of 19 B. mallei strains isolated between 1999 and 2020 in different locations were sequenced and their genotypes were determined. Particularly, for genetically highly homogenous pathogens like B. mallei genotyping techniques require a high discriminatory power for enabling differentiation on the strain level. Thus, core-genome single nucleotide polymorphism (cgSNP) analysis was applied for distinguishing the highly similar strains. Furthermore, a whole-genome sequence-based core genome multi locus sequence typing (cgMLST) scheme, specific to B. mallei, was developed and additionally applied to the data. It was found that B. mallei genotypes in Pakistan persisted over time and space and genotype clusters preferred connection with a time point rather than the place of isolation, probably due to frequent equine movement, which promotes the spread of glanders. The cgMLST approach proved to work in accord with SNP typing and may help to investigate future glanders outbreaks. [ABSTRACT FROM AUTHOR]

The trend of early retirement has increased over the last few years. Many teachers applied for early retirement after experiencing a 'strict' academic environment in the schools. The purpose of the present study was to grasp an in-depth understanding of the early retired teachers' life in the province of Punjab, Pakistan. The study aims to seek the answers to the questions: How did the school teachers decide to take early retirement and what were their personal and social activities after early retirement? Participants' description of life after early retirement was explored through narrative research while interviewing fourteen teachers who took retirement at least three years before retiring and approached through snowball sampling. The results were presented thematically (business to live happily, health and home, and joy and freedom). Most participants started or expanded their business, lived a happy life, paid attention to health and enjoyed freedom after early retirement. The research will help understand teachers' lives after taking early retirement through their life experiences and their activities. The study has implications for the school department on how they can better the teachers' social and personal lives during the service to enjoy life and feel happy while working in schools. [ABSTRACT FROM AUTHOR]

This study surveyed the existence of the Coxiella burnetii in ticks removed from camels in three different regions of the Punjab, Pakistan. A total of 325 ixodid ticks were analyzed for the occurrence of C. burnetii DNA by real-time polymerase chain reaction. Before analyses, all ticks were pooled into 30, 20 and 15 pools from Southern, Northern and Central Punjab, correspondingly. Each pool was comprised of five engorged or semi-engorged ticks according to species. Pooled based prevalence in Southern Punjab was eighteen from 30 pools (60%), leading to maximum-likelihood of true prevalence of 0.56% (95% CI 0.23-1.31), while pooled prevalence in Northern Punjab was eight from 20 pools (40%), leading to maximumlikelihood of the true prevalence of 0.44% (95% CI 0.31-0.89) and none of the pooled samples from Central Punjab were found positive for C. burnetii. During classification of tick pools based on species, infection was diagnosed in 75% (09/12) of H. dromedary, 42.8% (03/07) of H. anatolicum, 50% (01/02) of H. scupense, 60% (03/05) of R. microplus, and 50% (02/04) of R. annulatus in Southern Punjab. In comparison, infection was detected in 37.5% (03/08) of H. dromedary, 23% (01/04) of H. anatolicum, 0% of H. scupense, 66.7% (02/03) of R. microplus and 66.7% (02/03) of R. annulatus in Northern region. The detection of C. burnetii implies important role of ticks in the dissemination of this bacterium in Punjab, Pakistan and reveals that ticks have a major contribution to the epidemiology of coxiellosis in this ecological system. These judgments warrant further molecular investigations for better perception about C. burnetii epidemiology and its contributions to humans and animal disease in Pakistan. [ABSTRACT FROM AUTHOR]

Genetic characterization of maize genotypes is of great importance in maize breeding program to identify diverse populations and divergent genotypes. Divergence and genetic diversity were assessed in a set of 20 maize genotypes representing popcorn, white corn, sweet corn and yellow corn, through morphological characteristics and Random Amplified Polymorphic DNA (RAPD) markers. Field experiment was conducted in randomized complete block design with three replications. Morphological data revealed that sweet corn genotype SCLY-1 was earlier in days to 50% pollen shedding than other genotypes while white corn genotype WL-3 was earlier in days to 50% silking. Maximum plant height was recorded for PCLY-5 (133.3 cm) while lowest for WL-4 (92.8 cm), whereas highest ears height was recorded for popcorn PCLY-1 (64.4 cm) and lowest (29.4 cm) for SCLY-5. The yellow corn had maximum (4.5 kg) grain yield at harvest as compared to sweet and popcorn (3.0 kg). Negative but weak correlation was recorded between ear height and grain yield. Cluster analysis based on yield related parameters grouped all the studied genotypes in to five sub clusters. Molecular genotyping based on four primers amplified 37 loci which were (100%) polymorphic. Maximum elven loci were identified by primer GLA-04, while minimum was reported for primer GLA-03. The loci GLD-18B1000, GLA-04B300 recorded highest gene diversity (0.500) followed by loci GLE-05B750, GLE-05B650 and GLE-05B550. The loci of primer GLD-18 (GLD-18B1000) detected highest alleles evenness and Simpson's diversity index of 1.00 and 0.526, respectively. Maximum gene diversity (0.354) among populations were recorded for yellow corn, while the minimum was detected for white corn (0.254), while genotypic diversity was same for all maize types. Cluster analysis based on molecular genotypic data grouped the maize genotypes into four distinct groups. Lack of concordance was observed while comparing the clustering based on phenotypic and molecular data. The overall diversity among the studied maize genotypes could be used in future maize breeding program. [ABSTRACT FROM AUTHOR]

Objectives: The study was designed to estimate daily salt intake, its discretionary use in healthy individuals and to validate three common methods for salt estimation in Pakistani population. Methodology: Information on demography and discretionary salt use was collected from healthy adults (>18 years) along with a blood sample, spot and 24 hour urine samples. Sodium, chloride, potassium levels and serum creatinine were measured using standard methods. For daily salt estimation, three common methods i.e. INTERSALT, Tanaka and Kawasaki were validated for their applicability in local settings. Results: Overall 24 h sodium excretion was 158 mmol/l indicating intake of 8.64 (±4.43) grams salt per day which was significantly associated with male gender (p. <0.004) and adding salt during cooking (p. <0.0001). Most (73%) of the participants know about hazardous effects of high salt intake, however, only 25% consider important to lower salt intake. None of three methods i.e. INTERSALT (bias: -19.64; CCC -0.79), Tanaka (bias: 167.35; CCC -0.37) and Kawasaki (bias: -42.49, CCC -0.79) showed any agreement between measured and estimated 24 hour sodium. Conclusion: Daily intake of salt was high which increases the risk for hypertension. Comparison of methods for estimation revealed that none of the three methods could be used for estimating daily intake of salt in local settings of Pakistan. [ABSTRACT FROM AUTHOR]

Background: Maturity onset diabetes of the young (MODY) is the genetic form of diabetes inherited in autosomal dominant pattern. The diagnosis of MODY is challenging and confirmed by genetic testing. The objective of this study was to investigate MODY in Pakistani patients using next-generation sequencing. Methods: The next-generation sequencing was performed to know the cause of disease in 07 patients phenotypically suspected for MODY from Pakistan. These patients were selected based on the high probability score through MODY probability calculator. Only those genetic variants were retained which were having low frequency as per available data bases and their potential effects on protein as assessed by bioinformatics prediction tools. Results: Four heterozygous variants were found among patients. This includes mutation in HNF1a gene (c.526+1G>A) that is already reported for causative for MODY type 3 which is most prevalent among all MODY sub-types. Other variants were identified in GCK (c.-45G>A), KLF11 (c.*96dupA), and CEL (c.1235C>T). Conclusion: This study was the first in Pakistan to investigate the MODY using next-generation sequencing for clinical applications. There is huge public health burden of diabetes in the country. The study identified mutation in one known MODY gene. More extensive studies involving large sample size are required in future. [ABSTRACT FROM AUTHOR]

Sweet pepper (Capsicum annuum L.) is one of the most popular and high value vegetable crops grown for its immature fruits throughout the world. In Pakistan it is cultivated as warm season crop in open fields during summer and in plastic tunnels during winter. Optimum planting date in sweet pepper production is key to better yield as it determines the period of maximum crop potential, efficient use of resources, lesser competition of plants with weeds and insect pests. It is the need of time to understand the negative impact of climate change on phenological development of sweet pepper. Therefore, the current study was designed to mitigate the effect of climate on growth and yield of sweet pepper cultivars at agro-ecological area of Multan, Pakistan by adjusting planting date. Three transplanting dates (viz. February 15th, March 2nd and March 16th) were evaluated during year 1 whereas five transplanting dates (viz. February 1st, February 15th, March nd, March 16th and April 1st) were assessed during year 2. There were three sweet pepper cultivars (Ganga, Winner and Savio) under study. Overall plant growth (stem height, average canopy diameter, number of leaves per plant and fresh and dry mass of plant parts) was significantly higher in the earliest planting dates (viz. February 15th in year 1 and February 1st in year 2) and it reduced as the planting was delayed. Plant yield, number of fruits and average fruit weight were also significantly greater in the earliest planting dates, and significantly lesser in later planting dates. During year 1, the effect of cultivar was prominent, and Winner performed better regarding growth characteristics while the effect was non-significant on yield attributes except average fruit weight which was also significantly higher in Winner as compared with other two cultivars. During year 2, cv. Winner performed better in growth attributes, whereas significantly greater number of fruits was found in cv. Savio, average fruit diameter was greater in cv. Winner and average fruit length was higher in cv. Ganga. It is concluded that nursery of sweet pepper should be planted in 1st week of February to achieve maximum growth and yield of fruits. In cultivar selection, cv. Winner should be preferred among sweet pepper hybrids. [ABSTRACT FROM AUTHOR]

Exceptional precautionary measures have been adopted to stop the transmission and control of COVID-19 through the world and Pakistan is facing lockdown in this scenario. Public loyalty to precautionary measures is affected by their knowledge, attitude, risk factors and practices (KAP) towards COVID-19. The present study was conducted among the Pakistani residents to observe the knowledge, attitude, practices and risk factors towards COVID-19 outbreak in Pakistan. A questionnaire was designed, and a cross-sectional survey was conducted among participants of the study area. Participants were asked the questions regarding knowledge, attitude, practices and risk factors towards COVID-19. Data were analyzed by SPSS and t/F test and correlation was applied among the knowledge, attitude, risk factors and practices. A total of 1060 questionnaires were received. 1004 were included while 56 were excluded. The highest representation was from Punjab province (65.6%), female (63%) and age group of 21–30 years (62.1%). Most participants were single (85%), Muslim (99.4%), Urdu speaking (45.6%) and were graduates (51.5%). Most of the participants were students (52.9%) and were from economically middle-class families (40.8%). The knowledge was positively correlated with attitude and practices whereas negatively correlated with risk factors (P < 0.05). The attitude was negatively correlated with risk factor and positively correlated with practices. The risk factors and practices were positively correlated with each other. Health education program to improve the COVID-19 knowledge, attitude, practices and risk factors should be initiated to combat current health challenge. [ABSTRACT FROM AUTHOR]

The study examines the relationship between poverty and forest cover degradation in rural areas of Pakistan. The area selected for the study District Upper Dir is a rural and relatively backward region located in northwestern Pakistan, in Khyber-Pakhtunkhwa province. The study area is undergoing severe deforestation and natural disasters in the recent past. The study consists of two stages, in first stage the traditional Geographical information system image was used to analyze the spatial–temporal situation of the surroundings. In the second stage, well-designed questionnaire was used to collect the primary information from 420 randomly selected households of research areas. A multidimensional poverty index has been used to measure the poverty profile of the population. It has been found that 55% households were below the poverty line. Almost, 95% households are using wood for cooking purposes. High dependence on natural resources causes forest cover degradation while burning off too much wood causes CO2 emission and leads to environmental degradation. A major portion of population is living on steeply sloped areas with certain risks. It is found that frequency of flash flood is 53% and agricultural land (54%) is at high risk and often flows with flash floods. It is concluded that there is strong correlation between multidimensional poverty and forest cover degradation which leads to climate and environmental risks. [ABSTRACT FROM AUTHOR]

The use of wastewater for growing vegetables has become a common practice in peri-urban areas of big cities of developing world including Pakistan. In addition to providing essential elements and organic matter for plant growth, wastewater may contain potentially toxic trace elements that could pose serious threat to animals and humans, if their concentrations in edible parts increase the permissible limits. To monitor the heavy metals contents in commercially available vegetables, vegetable samples were collected from three main vegetable stores designated as A, B and C, respectively of Faisalabad, Punjab, Pakistan. These samples were analyzed for dietary contents (protein, fat, fiber, and carbohydrates) and heavy metals such as cadmium (Cd), lead (Pb), copper (Cu), and nickel (Ni). The results revealed that among the three vegetables, spinach accumulated higher contents of heavy metals followed by lettuce and fenugreek. Multivariate analysis indicated that the vegetables collected from locations A and C had higher metal contents than the permissible limits. The samples collected from location B were safe for human consumptions. Due to high metal contents, vegetables collected from locations A and C could potentially pose carcinogenic and non-carcinogenic health hazards to human beings. It is concluded that proper monitoring and regulatory measures should be done regarding the source of irrigation and post-harvest handling of vegetables in order to limit the entry of toxic metals into human food chain. [ABSTRACT FROM AUTHOR]

Background: Self-expandable metallic stents have not only largely replaced surgical gastrojejunostomy for unresectable gastric cancers, but their role as bridging therapy for resectable obstructing tumours is also evolving. Objective: To evaluate the efficacy and safety of pyloric stents in gastric outlet obstruction in patients with gastric cancer and assess survival in patients with resectable obstructing gastric tumours in whom stents were inserted as a bridge to surgery. Methods: We retrospectively reviewed the electronic medical records of patients who underwent self-expandable metallic stent insertion for gastric outlet obstruction due to gastric cancer from January 2014 to March 2019. Results: Out of 161 patients, clinical improvement was observed in 159 (99%) and 156 (97%) at 1 and 12 weeks of stent placement, respectively. None of these patients experienced serious complications, such as perforation or aspiration pneumonia. Of these 161 patients, enteral stents were placed as bridging therapy prior to surgery in 40 (24.8%). Among these, 35 (87.5%) of 40 underwent neo-adjuvant chemotherapy followed by curative surgery. Of the 35 patients, 3 failed to follow-up. One-year survival following curative surgery was 87.5%. Stent helped to reduce vomiting and improve nutrition, measured by the body mass index (p = 0.36) and serum albumin (p = 0.05), over a 4-week period following stent insertion. Conclusion: Pyloric stents are useful in relieving malignant gastric outlet obstruction, maintaining nutrition during neo-adjuvant treatment and improving survival without additional risk of postoperative complications. They have traditionally been used for palliation, but should also be considered as bridging therapy for obstructing resectable gastric tumours during neo-adjuvant treatment. [ABSTRACT FROM AUTHOR]

The current study was carried out in order to assess the effects of micronutrients (B, Fe, Zn) on the yield and quality of Kinnow (Citrus reticulata Blanco). Citrus is an important fruit crop of Pakistan and micronutrients are not only important for yield and quality of citrus but also for the human health. This experiment consisted of different soil treatments and foliar applications of B, Zn and Fe either alone or in combinations. The results revealed that the highest concentrations of these three micronutrients in soil were found where 20 g B, 40 g Zn and 100 g Fe were applied per plant, respectively through soil application. The highest concentrations of these micronutrients in the leaves of Kinnow were found in the individual treatments of foliar spray of 0.03 % B, 0.1 % Zn and 0.25 % Fe, respectively, followed by the combined application of B, Zn and Fe with concentration of 0.03%, 0.1% and 0.25%. Soil that had combined treatment, B: 10 g plant-1, Zn: 20 g plant-1, Fe: 50 g plant-1 gave the highest yield of fruit and juice content. Fruit drop was the highest in control and the lowest for 20 g B soil application. Total sugars, reducing sugars and TSS were the highest for 40 g Zn as soil application, followed by the combined treatment of B:10 g plant-1, Zn:20 g plant-1, Fe:50 g plant-1 . The non-reducing sugars were the highest in the case of combined soil application of B, Zn and Fe. It is concluded that the micronutrients application is a suitable approach for increasing the quality and yield of Kinnow [ABSTRACT FROM AUTHOR]

Glanders is highly contagious and zoonotic bacterial disease of equines caused by Burkholderia mallei. Since many decades, glanders is endemic in eastern parts (Punjab) of Pakistan and has no information of disease in the north-western region (Khyber Pakhtunkhwa – KPK). Therefore, present study was aimed to determine the seroprevalence and associated risk factors in two draft equine populated districts (Charsada and Peshawar) of KPK. A total of 393 equine samples originating from different localities of study area were investigated for anti-B. mallei antibodies (glanders) using indirect enzyme linked immunosorbent assay (ID Vet, Grabels France). The overall seroprevalence was found to be 3.1% (95% CI: 1.6-5.3) which remained insignificantly (χ2 0.421, P=0.516) between the two districts. In Charsada, prevalence estimates varied significantly (χ2 11.986, P=0.017) among 5 localities and found insignificant (χ2 1.287, P=0.732) in different sampling areas of Peshawar district. Donkeys were more seropositive (4.1%; 4/195) than horses (2.1%; 8/194) which did not differ statistically (χ2 1.397, P=0.237) and all mules were tested negative. Prevalence slight increased with age of animals (>10 years) and with poor body conditions. Donkeys were more test positive (OR: 2.05, 95% CI: 0.61-6.94) than horses and similarly animals managed on communal feeding (OR: 1.84, 95% CI: 0.23-14.5) and water troughs (OR: 1.65, 95% CI: 0.21-13.04) had more chances of contracting glanders. Multivariable model indicated donkeys (OR: 4.58, 95% CI: 1.0, 20.9) and equines above 10 years of age (OR: 3.10, 95% CI: 0.7-13.3) were more likely to test positive for glanders. In conclusion, present study provides prevalence estimates of equine glanders in KPK regions, which appears to be an area of endemicity. Future large-scale investigations are seriously warranted in other equine populated districts before implementing an effective control plan for glanders. [ABSTRACT FROM AUTHOR]

Background: Pleural effusion is a common clinical problem encountered in both the developed as well as in developing countries. They can develop either due to a pulmonary or an extra pulmonary disease. Even use of various medications can lead to development of pleural effusion. Parapneumonic effusions are frequently seen in patients with Complicated pneumonia. Objective: To compare the frequency of pleural fluid culture sensitivity by using blood culture bottles and sterile syringes in patients having parapneumonic effusions and empyema thoracis. Methodology: It was a Cross sectional analytical Prospective study conducted at the Department of Pulmonology, Sheikh Zayed Hospital, Lahore. The duration of study was 6 months from July 2016 till December 2016. Pleural fluid was aspirated under ultrasound guidance and was sent to the laboratory. Reports were assessed and pleural fluid culture was labeled as positive or negative and organism isolated along with their antibiogram was also mentioned. Results: The mean age of our patients was 43.34±11.73 years. The male to female ratio was 1.5:1. Empyema was documented in 27(30%) of our patients whereas 63(70%) had parapneumonic effusion. Positive aerobic infection in blood culture bottle was seen in 48 patients, as compared to 26 patients in the sterile syringes. Statistically significant difference was found between the culture positive rate in aerobic blood culture bottle with sterile syringes(pvalue= 0.001). Conclusion: It is concluded that the positivity of pleural fluid culture is higher in blood culture bottles as compared to sterile syringes in patients having parapneumonic effusions and empyema thoracis. [ABSTRACT FROM AUTHOR]

Objective  Pentavalent vaccine has been introduced in Pakistan against tetanus, diphtheria, Haemophilus influenzae type B (HiB), pertussis, and hepatitis B virus. Methods  This study was designed to determine protection against diphtheria, tetanus, and HiB in children of age 18 to 24 months from community which had received all three doses of pentavalent vaccine. Results  Overall, 97% were having immunity against HiB, 97% against tetanus, and 88% against diphtheria. Our study showed that children aged 18 to 24 months in Pakistan have high level of protection against HiB and tetanus. However, the protection for diphtheria was low in 40% of children which could be improved by adding a booster dose of diphtheria. Conclusion  By increasing the vaccine coverage among children, the burden of these diseases can be reduced in the future. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis (CE) is a serious tapeworm infection caused by Echinococcus granulosus (sensu lato) which infects a wide range of animals and humans worldwide. Despite the millions of livestock heads reared in Pakistan, only a few reports on CE prevalence and even fewer on the genetic diversity are available for the country. Meanwhile, the available reports on the genetic diversity are predominantly based on short sequences of the cox1 gene. Methods: To close this knowledge gap, this study was designed to investigate the genetic diversity and population structure of Echinococcus spp. in Pakistan using the complete mitochondrial cytochrome c oxidase subunit 1 (cox1) and NADH dehydrogenase subunit 1 (nad1) genes. Results: Based on BLAST searches of the generated cox1 and nad1 gene sequences from a total of 60 hydatid cysts collected from cattle (n = 40) and buffalo (n = 20), 52 isolates were identified as E. granulosus (s.s.) (G1, G3) and 8 as E. ortleppi (G5). The detection of the G5 genotype represents the first in Pakistan. The phylogeny inferred by the Bayesian method using nucleotide sequences of cox1-nad1 further confirmed their identity. The diversity indices indicated a high haplotype diversity and a low nucleotide diversity. The negative values of Tajima's D and Fu's Fs test demonstrated deviation from neutrality suggesting a recent population expansion. Conclusions: To the best of our knowledge, this report described the genetic variation of E. granulosus population for the first time in Pakistan using the complete cox1 and nad1 mitochondrial genes and confirms E. ortleppi as one of the causative agents of CE among livestock in Pakistan. While this report will contribute to baseline information for CE control, more studies considering species diversity and distribution in different hosts across unstudied regions of Pakistan are highly needed. [ABSTRACT FROM AUTHOR]

Climate change is a serious threat to agriculture and food security. The development of adaptation measures is one of the key strategies to offset the climate change impacts on rice crop. A study was planned to develop adaptation strategies for future rice crop through simulation model. This study was consisted of six transplanting dates and three seedling densities which were tested to develop adaptations at three locations, i.e., Faisalabad, Hafizabad, and Gujranwala during the years 2015 and 2016. Climate change scenarios were developed for selected locations through statistical downscaling by selecting five general circulation models under representative concentration pathways (RCPs 8.5) for mid-century (2039–2069). The APSIM-ORYZA model was calibrated well with experimental data which showed an error of 2.35% between observed and simulated grain yield. The impact of climate change was studied by calculating the difference of baseline (1980–2010) and future yield. Model simulated results indicated that the rise in temperature will reduce the rice yield by 7.3%. To overcome this decrease in rice yield, suitable adaptation strategies were tested for mid-century. The developed adaptations, i.e., increased in plant population, nitrogen amount, and early transplanting, improved the rice yield by 8.7% under RCPs 8.5 for mid-century scenarios. Overall, this study provide better understanding of the adaptation processes for sustainable rice yield under anticipated future climate change. [ABSTRACT FROM AUTHOR]

The present study was planned to determine the immunological response of Dera Din Panah (DDP) and Nachi breeds of goats towards artificial infection with Haemonchus (H.) contortus which is considered among the most widely prevalent gastrointestinal nematodes (GINs) associated with the lowered production, elevated morbidity and mortality in goats under various farming systems. To this end, a total of 48 goats of DDP and Nachi breeds (24 of each breed) were administered with third stage infective larvae of H. contortus through early and late infection protocols. The serum and plasma samples were tested for immunoglobulins isotypes and histamine concentration through ELISA test, respectively. Adult worm antigens were used to detect the different antibodies in infected and control goats while histamine concentration was measured through commercially available histamine-ELISA kit. Results revealed that both breeds reflected a significant (P<0.05) difference in expression of IgG, IgE antibodies and concentration of histamine. Nachi breed showed a compromised immune response towards artificial infection with H. contortus as compared to DDP. Overall, lower production of antibodies (IgG, IgE) and plasma histamine depicted that Nachi goats are comparatively more susceptible to H. contorts infection as compared to DDP goats. In conclusion, difference in immune response towards H. contortus infection may formulate the basis of selective breeding of resilient goat breed (DDP) in the area. [ABSTRACT FROM AUTHOR]

We detected Crimean-Congo hemorrhagic fever virus infections in 4 provinces of Pakistan during 2017-2018. Overall, seroprevalence was 2.7% in humans and 36.2% in domestic livestock. Antibody prevalence in humans was highest in rural areas, where increased contact with animals is likely. [ABSTRACT FROM AUTHOR]

Soil salinization is a serious environmental menace that reduces the development, growth and yield of most of the plants. Growing halophyte crops such as quinoa (Chenopodium quinoa Willd.) is a promising way of productive utilization of saline soils. The present study was conducted during 2018-19, in which we investigated the comparative salt tolerance potential of two genotypes of quinoa (Puno and A1) on the basis of growth, ionic and physiological attributes. Five-week-old seedlings of both genotypes were exposed to different levels of salinity (0, 100, 200 and 400 mM NaCl) developed in Hoagland's nutrient solution. Results revealed that root and shoot growth, chlorophyll contents, membrane stability and relative water content remained unchanged at lower level of NaCl (100 mM). However, these attributes decreased significantly at higher level of NaCl (400 mM). The Na+ concentrations increased, whereas K+ concentrations and the ratio of K+: Na+ showed an inverse relation to the increasing salinity levels. The comparison of both genotypes indicated that physiological attributes and plant biomass were higher in A1 than Puno due to less uptake of Na+ ions and higher K+: Na+ ratio. Therefore, A1 is more suitable genotype than Puno to be grown on saline soils in arid regions of Pakistan. [ABSTRACT FROM AUTHOR]

Objective: To determine the positivity rate of COVID-19 on pre-procedure screening and its impact on diagnosis and management of new cancer patients. Study Design: Cross-sectional study. Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital, Lahore Pakistan, from Sep 2020 to Aug 2021. Methodology: Data was retrospectively collected from electronic medical records of the patients, including their age, gender, PCR test result, date of first visit to the gastroenterology clinic, date of multidisciplinary team meeting and any adverse event reported due to delay in endoscopy procedure. Results: A total of 1273 patients underwent endoscopy procedures in the study period. Fifty-two patients were found to be COVID-positive (4.1%), and only one was symptomatic. The percentage of positivity in newly diagnosed 22 cancer patients was 1.72%. Of 52 patients, 31 were male (59.61%), and 21 were female (40.39%). Only 1 patient was presented with abdominal pain and revealed concealed perforation. No other adverse event was reported in any patient, and no new imaging was required before discussion in a multidisciplinary team meeting. Conclusion: The hospital policy of COVID PCR test 48 hours before the endoscopy procedure effectively isolates the asymptomatic positive COVID-19 patients. The two-week delay due to COVID-PCR positivity in newly diagnosed cancer patients was not associated with any adverse event, and no new imaging was required. [ABSTRACT FROM AUTHOR]

COVID-19 and Tuberculosis overlapping epidemics: A holistic review from Pakistan On January 30, 2020, World Health Organization (WHO) declared the International Public Health Emergency on coronavirus disease 2019 (COVID-19) outbreak, which is caused by novel severe acute respiratory syndrome coronavirus (SARS-CoV-2).1 Catastrophe of COVID-19 due to coinfection with other contagious diseases2,3 has already been highlighted in the low middle-income country Pakistan,4-6 which is still going on. Following the overlapping pattern of COVID 19 and TB, there is a significant chance of re-emerging of TB in Pakistan, which could disrupt all strategies of the National TB Control Program (NTP). [Extracted from the article]

The present study was conducted to determine the sero-prevalence of Q fever and associated risk factors in institutional dairy farms in Punjab, Pakistan. A total 11 dairy farms were investigated from different areas of Punjab province. Out of these farms, a total of 827 animals (cows n=419 and buffaloes n=408) were investigated. Presence of anti-Coxiella burnetii antibodies was determined by indirect ELISA. The overall prevalence in dairy animals (cattle and buffaloes) was 6.1% (95% CI: 4.5-7.9). In cattle prevalence was higher (7.6%; 95% CI: 5.3-10.6) than in buffaloes (4.4%; 95% CI: 2.6-6.9). The probability of occurrence of disease in cattle was higher (7.63%; OR=1.9, 95% CI: 0.99-3.25) than in buffalo (1.00%; OR=1.00) The difference in sero-prevalence between the two-dairy species was significant (p=0.052, x² = 3.786). Stratification of Q fever as per the breed of cattle indicated that the sero-prevalence was the highest (13%) in Cholistani followed by Sahiwal (7.5%) and cross bred (2.6%). Animals age between 2.1 to 5 year (OR=2.56, 95% CI 1.05, 6.20), contact with small ruminants (OR=1.43, 95% CI 0.63, 3.25), tick infestations (OR=4.91, 95% CI 2.40, 10.00), dry-dusty environment (OR=1.55, 95% CI 0.54, 4.43), retained fetal membranes (OR=1.68, 95% CI 0.94, 5.73) and abortion history (OR=2.17, 95% CI 0.88, 5.35) were risk factors for the seropositivity of Q fever. The results of the study indicated that Q fever is prevalent in cattle and buffalo managed at institutional dairy farms in Punjab. [ABSTRACT FROM AUTHOR]

The present study is based on idea of mineral supplementation in grazing animals through selected fodder which can indirectly reduce the threats of infections particularly of parasitic origin. To this end, correlation analysis of the trace elements including: copper (Cu), cobalt (Co), Manganese (Mn) and zinc (Zn) was done among feedstuffs, soils and grazing sheep. Moreover, the mineral analysis was compared to the gastrointestinal (GI) parasites during spring 2015 in grazing sheep of Sialkot district, Punjab, Pakistan. The overall prevalence of GI parasite species identified was 32.81%. A significant (P < 0.05) variation in the levels of Zn, Cu, Mn and Co was recorded in a total of eight collected forages. However, their levels in soils vary insignificantly. The results of present study indicated that, the burden of GI parasites was lower in animals having high level of Zn and Cu in sera. The trace element-rich forages (Cichorium intybus and Cynodon dactylon) preferably Zn and Cu found effective against parasitic infection, are advisable supplemental remedies to improve the trace element profile in grazing sheep. This mitigation strategy may ultimately improve the resilience against GI parasitic infections especially in the resource-poor countries like Pakistan. However, control studies are required to determine the exact mechanism of trace elements against GI parasites. [ABSTRACT FROM AUTHOR]

Objectives: To compare clinical retention of a low-shrinkage posterior resin composite by using incremental versus bulk placement technique in deep Class I cavities. Setting: Operative Dentistry Department, Altamash Institute of Dental Medicine, Karachi, Pakistan. Period: 6 months from 1st Oct 2017 - 30th March 2018. Study Design: Randomized control trial. Materials and Methods: This study was a randomized control trial study which consists of total of 94 teeth having class I cavity of 3mm minimum depth on occlusal surface. The restorative material evaluated in this study was Filtek Z250 (3M, ESPE) and the cavities were restored according to two different techniques. Patients in Group A were treated with bulk fill technique and patients in Group B were treated with incremental technique. The retention of the composite were clinically evaluated after 6 months (180 days) post-operatively. SPSS version 23 was used to analyze data. Results: The result of 6 months observation revealed retention of 43(91.4%) incremental fill composite and 39(85.4%) bulk fill composite resin restorations which was statistically insignificant. Conclusion: Outcomes of incremental fill composite resin in terms of retention is equal to bulk fill composite resin with Filtek Z250 (3M, ESPE) in class I restorations of permanent molar teeth. [ABSTRACT FROM AUTHOR]

Salinity is an important abiotic stress affecting agricultural productivity in Pakistan. In order to meet the country's requirement, the sustainability of crop production is pre-requisite. A hydroponic experiment was conducted to check the response of wheat cultivars against salinity with salicylic acid application. There were four wheat varieties (Lasani-2008, MH-97, SARC-1 and Iqbal-2008), two levels of NaCl (75 mM and 150 mM) and two levels of salicylic acid (0.25 mM and 0.50 mM) along with their respective controls. This experiment was conducted in a completely randomized design with factorial arrangement and five replications of each. After one month of transplanting in hydroponic culture, plant growth parameters and chlorophyll contents were determined. The results showed that plant growth was highly affected at both levels of NaCl treatments, while a decrease in chlorophyll contents and K+ concentration was observed. However, the application of salicylic acid (0.25 mM and 0.50 mM) overcame the adverse effects of salinity and improved the plant growth significantly (P≤0.05) by increasing superoxide dismutase and catalase activities. The application of 0.25 mM salicylic acid in the presence of 75 mM NaCl enhanced shoot dry weight by 21% and 30.68% in Lasani-2008 and Iqbal- 2008, respectively as compared to their respective control. The activity of superoxide dismutase was enhanced from 2.67 to 3.15 (gmol/g Fw) in SARC-1 when salicylic acid was applied in the presence of 150 mM NaCl. Under tested condition, SARC-1 performed better than others tested wheat genotypes. In conclusion, salicylic acid improved the performance of wheat varieties in saline conditions. [ABSTRACT FROM AUTHOR]

Introduction: The Global Adult Tobacco Survey (GATS) is the global standard for systematically monitoring adult tobacco use and tracking key tobacco control indicators.Methods: Using a multistage stratified cluster design, 9856 households were sampled, and one individual was randomly selected from each household. Standard GATS questionnaire was used to collect information on tobacco use, cessation, second-hand smoke, knowledge, attitudes, and perceptions. Data were analyzed per standard GATS protocol.Results: Of 9856 individuals, 7831 individuals completed the interview. The response rate was 81%. Overall, 19.1% adults were currently using tobacco products and among them, 12.4% smoked tobacco, and 7.7% smokeless tobacco. Exposure to second-hand smoke was seen in 86% in a restaurant while it was 76% on public transportation. A total of 24.7% smokers made a quit attempt in the past 12 months. Anticigarette smoking information was observed by 37.7% adults, while 29.7% current smokers thought about quitting after reading health warning labels on cigarette packages. Most (85%) adults favored no smoking in public places, and 74.8% favored increasing taxes on tobacco products. Current cigarette smokers spent Pakistani Rupees 767.3 per month (7.78 USD) on manufactured cigarettes and consumed 4500 cigarette sticks (225 packs) annually.Conclusions: Besides 19.1% tobacco users, the majority (86%) were exposed to second-hand smoke at public places indicating that ban on tobacco use in public places is not being followed. A quarter of current smokers wants to quit smoking who may be provided assistance to reduce tobacco burden.Implications: This study provides national-level data about tobacco use and its burden and also indicates weak implantation of tobacco control laws. There is need to devise a strategy for proper implementation of these laws to reduce the tobacco burden in the country. [ABSTRACT FROM AUTHOR]

COVID-19 and dengue virus coepidemics in Pakistan: A dangerous combination for an overburdened healthcare system We have read recent articles regarding coepidemics/coinfections of COVID-19 and other infectious diseases,1-4 these reports highlight the impact of coinfections on the health care system. Co-circulations of two genotypes of dengue virus in 2006 out-break of dengue hemorrhagic fever in Karachi, Pakistan. [Extracted from the article]

Background: Pakistan is the 2nd highest hepatitis C prevalent country while hepatitis B endemnicity is intermediate. Population has poor knowledge and understanding of these diseases therefore they face different types of stigmas. Stigmatization leads to barriers in the access of prevention and care of this disease. This study was conducted to evaluate the feelings and experiences of patients and their attendants (relatives) about hepatitis B and C and identify the gaps to ease access to treatment and care. Study design, settings and duration: Qualitative study conducted in Pakistan Institute of Medical Sciences and Federal Government Services Hospital, Islamabad for 08 months. Patients and Methods: Patients suffering from hepatitis B and C and their relatives who came to the OPDs of PIMS and Polyclinic were selected from the study. After taking consent from these 2 hospitals and consent from participants, the patients and relatives were grouped into 4 groups each comprising of 5-8 participants. Four focus group discussions (FGD's) were conducted for these patients and their attendants separately. Structured FGD guide was developed and special probes were used to stimulate discussion. Results: There were 06 participants in each of patient group and 07 subjects in relative groups. Among patients, majority had negative perceptions about disease and related the disease with fear. They had misconceptions about disease spread. Most of them experienced change in the attitude of family members, relatives and friends especially in sharing clothes, shoes, and utensils. Break up of relationships and discrimination in getting a job due to the disease was also reported resulting in social and financial problems. The attendants also had negative perception about the disease and its mode of transmission. Although they were cautious about the sharing of utensils and during patient care but they had positive feeling for their patient. Conclusion: Due to misconception about disease spread, the attendants/relatives were not sharing items of daily use items like cloths, crockery and bed linen with the patients thus giving them a feeling of dejection. Proper information about disease spread and its prevention along with the counseling of the patients and their attendants/relatives may build a positive relationship between them and thus ease help and care which is required for these patients. Policy message: There is need of public awareness about mode of transmission of hepatitis B and C and its preventive measures. [ABSTRACT FROM AUTHOR]

A new hepatitis E virus (HEV-7) was recently found in dromedaries and 1 human from the United Arab Emirates. We screened 2,438 dromedary samples from Pakistan, the United Arab Emirates, and 4 African countries. HEV-7 is long established, diversified and geographically widespread. Dromedaries may constitute a neglected source of zoonotic HEV infections. [ABSTRACT FROM AUTHOR]

Overview: Dengue fever, a viral illness transmitted by the Aedes mosquito, is capable of causing a range of serious complications, including fulminant hepatic failure, renal dysfunction, encephalitis, encephalopathy, neuromuscular and ophthalmic disorders, seizures, and cardiomyopathy. Case description: This report details the case of a 30-year-old lactating woman with no notable medical history who presented to the emergency department with symptoms of high-grade fever, altered mental status, and seizures. Upon imaging, bilateral infarcts in the thalami and cerebellar hemispheres were observed, consistent with cerebellitis and dengue encephalitis. Patient treatment and outcome: The patient was admitted to the intensive care unit and received appropriate treatment. Following a critical phase and successful patient stabilization, she was transferred to a high dependency unit for a week before being discharged with recommendations for follow-up care. Conclusion: This case illustrates the broad spectrum of complications that can arise as a result of dengue infection and the importance of timely diagnosis and management in improving patient outcomes. Further investigation is required to better understand the mechanisms underlying these complications and to formulate specific guidelines for the prevention and treatment of dengue shock syndrome. [ABSTRACT FROM AUTHOR]

Growth hormone cDNA of Beetal goat (Capra hircus), an indigenous breed of Punjab, Pakistan was amplified by RT PCR and gene including leader sequence was cloned in pTZR57 cloning vector. The cGH-pTZR57 clone was confirmed by restriction digestion and sequence analyses before finally sub-cloning the gene in pND - a mammalian expression vector. The clones were again confirmed by restriction digestion and PCR analyses. Highly purified, super coiled recombinant caprine growth hormone-pND (rcGH-pND) construct was used to transfect Vero cell lines for expression studies. The in vitro expression of cGH was determined by dot-ELISA. After confirming its in vitro cell line based expression, rcGH-pN, pND constructs and phosphate buffer saline (PBS) were separately injected to 4 weeks old balb/c female mice intramuscularly. Total forty five animals were used to determine the biological activity and randomly divided in to three groups with fifteen mice in each group. Five animals from each group were used to monitor the in vivo biological activity by evaluating the body weight gain and tibia epiphyseal width assays from zero week up to four weeks with one week gap. Significant increase (P<0.05) gain in body weight and in tibia epiphyseal width was observed in animals inoculated with rcGH-pN. Thus it is concluded that recombinant plasmid of cGH cDNA may be used as supplement to increase the meat production. The effects of the same plasmid on milk production may be checked in future experiments using Beetal goat. © 2014 Friends Science Publishers [ABSTRACT FROM AUTHOR]

Human cystic echinococcosis (CE) is a worldwide-distributed parasitic zoonotic disease, which represents a threat for both human and animals. The current study aimed at estimating the prevalence of human CE in Khyber Pakhtunkhwa (KPK) province of Pakistan. Clinical records from four major hospitals in this region were reviewed for CE human cases during the period of 2006–2021. Out of 251 (0.00071%) CE patients identified during the considered period, 142 (56.6%) were females, and 109 (43.4%) were males. The highest number of CE cases was recorded in the 21–30 (27.9%) age group, followed by 31–40 (23.1%) and 41–50 (16.3%). Most of the CE patients in KPK province were members of the Afghani ethnic group (17.1%); secondarily, they were Pakistani (6.4%), while for 76.5% ethnicity data were not available. The liver (41%) and the lungs (4.8%) were the most infected organs identified among CE patients in KPK province. The present study identified CE as a significant public health problem in KPK province, and the current findings demonstrated a constant endemicity of CE during the last 15 years. Further filed studies on the active search of CE carriers by means of ultrasound population-based surveys are needed to fill knowledge gaps on clinical and molecular epidemiology of human CE in Pakistan. [ABSTRACT FROM AUTHOR]

Soil salinity is a major problem of agriculture in Pakistan. Permanent solution of salinity problem is removal of salts by leaching and drainage whic is expensive. So research efforts should involve profitable utilization of these lands through biological approaches. Considering these observations, this study was designed with the objectives to explore changes in growth and physiological attributes of different sunflower genotypes under interactive effect of salinity and boron. Vigorous seeds of selected genotypes (two tolerant, two sensitive) were sown in gravels. One week old seedlings were transplanted to ½ strength Hoagland's nutrients solution. Three days after transplantation the requisite salinity (control and 100 mM NaCl) and boron levels (0.05 mM B, 0.5 mM B and 1.0 mM B as H₃BO₃) were established in three installments. The arrangement of the experiment was split plot with three replications. The data regarding shoot and root fresh weights, relative water contents (RWC), membrane stability index (MSI), and leaf area (LA) were recorded. The results revealed that salinity and boron adversely affected the growth and physiology of sunflower genotypes with a higher effect in the case of combined stress. This study also showed that the growth reduction was more in the salt susceptible genotypes (Hysun-33, Hysun-38) than in the salt tolerant genotypes (SF-187, S-278). [ABSTRACT FROM AUTHOR]

Abstract: Minimum inhibitory concentrations (MICs) of 20 antimicrobial agents for 41 isolates of Burkholderia mallei from natural outbreaks of equine glanders were determined by agar dilution. All isolates were intrinsically resistant to ampicillin (MIC90 ≥128). Resistance to other antimicrobials was as follows: 95.1% to amoxicillin and cephradine, 85.4% to cefuroxime and norfloxacin, 68.3% to ceftizoxime and ceftriaxone, 61.1% to ceftiofur, 58.5% to oxytetracycline, 41.5% to ciprofloxacin, 58.5% to roxithromycin, 17.1% cefotaxime, and 12.2% clarithromycin. Overall resistance patterns revealed that 17% of isolates were simultaneously resistant to amoxicillin, cephradine, cefuroxime, ceftizoxime, ceftriaxone and norfloxacin. None of the isolates were resistant to amoxicillin-clavulanic acid, doxycycline, chloramphenicol, gentamicin or trimethoprim-sulphadiazine. Mode MICs for these antimicrobials were 2, 1, 8, 4 and 1 μg/ml, respectively. A majority of the isolates (∼ 94%) were susceptible to both enrofloxacin and ofloxacin. These data provide an updated perspective on susceptibility profiles of current strains of B. mallei in an endemic area. [Copyright &y& Elsevier]

ABSTRACT Background and aims: Colorectal carcinoma is among the most frequently observed malignancies in Pakistan. The HER 2/neu protein is intimately involved in tumorigenesis and its receptor has been demonstrated as a therapeutic target in several carcinomas. This study was designed to assess the clinico-pathological pattern and the HER 2/neu immunohistochemical score with respect to the histological grades of colorectal carcinoma in our population. Methods: Tissue biopsies from 100 patients, with detailed documentation of their clinical account, were subjected to immunohistochemistry utilizing monoclonal anti- HER 2/neu antibody. Positive expression was assigned a score from 0-3+. Results: A distinct positive HER 2/neu scoring pattern was observed in n= 42 cases of non-mucinous, mucinous and signet ring cell adenocarcinomas, all with a specific histological grade. An inverse correlation ( P= 0.001) was observed between the two parameters. Conclusion: Colorectal carcinoma is a growing malignancy, even in the younger population and HER 2/neu protein is credibly expressed in colonic cancer cells in our patients especially where the histological grade is low or moderate. Therefore, it may be applied as a reasonably reliable immunohistochemical marker and a target for a new adjuvant monoclonal antibody-based immunotherapy. [ABSTRACT FROM AUTHOR]

Wheat yield of 37 wheat varieties along with a susceptible check, Morocco, was studied under yellow rust pressure across 3 locations of North West Frontier Province (NWFP), Pakistan during 2007. Considerable high disease pressure, as revealed by yellow rust severity, was observed at all locations with the maximum (100%) at Cereal Crop Research Institute (CCRI), Nowshera. Disease severity ranged from 0% to 70% for the tested varieties while reached 100% for Morocco with S type of host response. We report the presence of sufficient variability across locations for both yield potential and yellow rust severity. Locations with maximum disease pressure had lower mean grain yield and vice versa. NIFA followed by AUP had higher mean grain yield (5533 kg ha-1 and 4292 kg ha-1, respectively) with lower maximum disease severity values (70% and 80%, respectively). CCRI had higher disease pressure (100% severity for Morocco) with lower mean grain yield (3676 kg ha-1). Bahawalpur-95, Suleman-96, Kohsar-93, Fakhre-Sarhad, Tatara, and Frontana had relatively stable severity across locations in a range of 0% to 10%. Based on overall traits, Kohsar-93, Bakhtawar-92, Saleem-2000, Fakhre-Sarhad, Tatara, and Karwan had better yield and lower yellow rust severity and is recommended for cultivation and further breeding exploitation. [ABSTRACT FROM AUTHOR]

We collected epidemiologic and molecular data from Burkholderia mallei isolates from equines in Punjab, Pakistan from 1999 through 2007. We show that recent outbreaks are genetically distinct from available whole genome sequences and that these genotypes are persistent and ubiquitous in Punjab, probably because of human-mediated movement of equines. [ABSTRACT FROM AUTHOR]

Community-acquired pneumonia (CAP) is among the most commonly prevailing acute infections in children that may require hospitalization. Inconsistencies among suggested care and actual management practices are usually observed, which raises the need to assess local clinical practices. The current study was conducted to evaluate pediatricians' compliance with the standard clinical practice guidelines and their antibiotic-prescribing behavior for the management of CAP in children. Methods: A descriptive cross-sectional study was conducted using a self-administered questionnaire; which was provided to pediatricians by the researchers. Statistical analysis was performed with SPSS 25 Statistics; χ2 tests (or Fisher-exact tests) with the p-value set at < 0.05 as the threshold for statistical significance. Results: The overall response rate was 59.2%. Male respondents were (n = 101; 42.6%), and the respondents (n = 163; 68.7%) were under 30 years of age. Amoxicillin (n = 122; 51.5%) was considered as the most commonly used first-line treatment for non-severe pneumonia, whereas a smaller proportion (n = 81; 34.2%) of respondents selected amoxicillin–clavulanate. Likewise, amoxicillin (n = 100; 42.2%) was the most popular choice for non-severe pneumonia in hospitalized children; however, if children had used antibiotics earlier to admission, respondents showed an inclination to prescribe a macrolide (n = 95; 40.0%) or second-generation cephalosporin (n = 90; 37.9%). More than 90% responded that children <6 months old with suspected bacterial CAP will probably receive better therapeutic care by hospitalization. Restricting exposure to the antibiotic as much as possible (n = 71; 29.9%), improving antibiotic prescribing (n = 59; 24.8%), and using the appropriate dose of antimicrobials (n = 29; 12.2%) were considered the major factors by the respondents to reduce antimicrobials resistance. Conclusions: The selection of antibiotics and diagnostic approach was as per the recommendations, but indication, duration of treatment, and hospitalization still can be further improved. [ABSTRACT FROM AUTHOR]

Dry direct-seeded rice has been shown to save irrigation water and labor. Nonetheless, irrigation management in dry direct-seeded rice has received very little attention. Here, we examined the potential of different irrigation regimes: aerobic rice (AR), alternate wetting and drying (AWD) and continuous flooding (CF) in dry direct-seeded rice cultivation on two rice cultivars (Pride-1 (hybrid indica) and NB-1 (inbred indica)). Growth, yield attributes, grain yield, total water input, water productivity and benefit cost ratio were measured. Our results showed that AR saved 11.22 and 28.40%, and 5.72 and 32.98% water compared with AWD and CF during 2018 and 2020, respectively. There was a significant difference in grain yield among treatments and cultivars. AWD and CF produced statistically same total dry weight and grain yield, while AR reduced the total dry weight by 31.34% and 38.04% and grain yield by 34.82% and 38.16% in comparison to AWD and CF, respectively, across the years. Except for 1000-grain weight and harvest index in AWD and CF, further differences in total dry weight and grain yield among irrigation treatments were primarily correlated with variations in yield attributes. Among the cultivars, hybrid rice performed better than inbred rice. Over the two-year period, hybrid rice increased total dry weight, grain yield, and water productivity by 9.28%, 13.05%, and 14.28%, respectively, as compared to inbred rice. Regarding water productivity (WP), the maximum percentage (40.90 and 26.53%) was recorded for AWD compared to AR and CF. Among cultivars, more water productivity (14.28%) was calculated for hybrid rice than inbred one. Chlorophyll and carotenoid contents, leaf area index and crop growth rate contributed to higher grain yield of hybrid rice under AWD and CF. In contrast to WP, the maximum benefit cost ratio was estimated to be higher for CF than that of AR and AWD. For the cultivars, the maximum value (2.26 in 2018 and 2.32 in 2020) was calculated for hybrid rice compared with the inbred one. In conclusion, these results suggests that AWD with maximum WP and CF with maximum BCR could be more efficient approaches than AR. Under CF, hybrid rice cultivars with higher yield and yield-related attributes, WP and BCR performed better. [ABSTRACT FROM AUTHOR]

Background: The signs and symptoms of acute dengue infection are well defined and characterized. However, little data is available about the persistence of these symptoms which depends upon the disease management and patient care. This study was conducted to determine the persistence of dengue symptoms in admitted cases who were discharged from hospital. Materials and Methods: Data of dengue cases who were admitted in 2 public sector hospitals was retrieved along with their complete addresses. Patients were approached and interviewed after getting the written informed consent. A predesigned questionnaire was used to collect information about the persistence of dengue symptoms in the patients after they were discharged from hospital. Results: Of 41 cases interviewed, 31 were males and overall mean age was 31 years. The case record showed that 15 cases had dengue shock syndrome, 14 dengue hemorrhagic fever and 12 dengue fever. The average period of illness after getting discharged was 19 days which was significantly higher in females (23 days) as compared to males (18 days). Majority of the cases (except 04) reported persistence of dengue symptoms in which joint pain (29 cases), itching (17 cases) and exhaustion (14 cases) were more common. The persistence of joint pain after discharge was significantly associated with dengue shock syndrome. Conclusion: The current study showed significant association between joint pain and DSS which could be overcome through proper case management. Furthermore there is a need to follow admitted dengue cases after getting discharged from the hospital to avoid any complications. [ABSTRACT FROM AUTHOR]

Brucellosis, globally known bacterial zoonosis, is endemic to Pakistan. B. abortus in bovines, B. melitensis in small ruminants and B. canis in dogs mainly cause this disease. A total of 1821 sera (1196 from sheep and 625 from goats) from animal herds near the Pakistan–Afghanistan border were collected. In parallel testing of sera for anti-Brucella antibodies (B. abortus and B. melitensis) was carried out by RBPT and indirect ELISA. The presence of Brucella DNA in sera was tested by real-time PCR. The overall percentage of seropositive samples was 0.99 (18/1821) by both tests. All positive samples originated from Baluchistan territory which translated into 1.76% (18/1021). None of the positive sera had signals for Brucella DNA and none of sera from goats carried detectable antibodies. Both tests showed an almost perfect agreement with Kappa statistics. The flock size was found to be associated with the presence of anti-Brucella antibodies. The samples of Khyber Pakhtunkhwa (KPK) tested negative in both serological tests and hence were not processed for real-time PCR. The present study shows the presence of anti-Brucella antibodies in sheep in the Baluchistan region of Pakistan. Diagnostic services need to be improved and test and slaughter policies might be implemented for eradication of Brucella infection in these areas. Awareness about the infection is needed at the farmer's level. Isolation and molecular biology of the isolates could help with understanding the prevailing etiology in a better way. [ABSTRACT FROM AUTHOR]