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Background: Sufficient literature is available regarding Functional Electrical stimulation (FES) for its effects on the function of both the upper limb and lower limb. However, there is still a lack of literature that describes accurate frequency and time duration of FES in improving lower limb functions. Therefore, this review aimed to report the effects of FES regarding its various frequencies, duration, and intensity in improving lower limb muscle strength, gait, posture, and quality of life in patients with stroke. Methods: We included all those individuals with stroke (Hemiplegia) both acute and chronic irrespective of its type ischemic and hemorrhagic. All patients were well-oriented without cognitive impairments aged between 45 and 80 years old. Randomized controlled trials in which patients were provided FES either four channels or bi-channels on various muscles of the lower limb only were selected. In addition, we only included those RCTs, where FES was applied with specific frequencies and durations on the lower limb only. Results: The participants in the included studies ranged from 16 to 61 years of age. The majority of the studies were conducted with a population with post-stroke duration of ≥ 6 months. It was evident that functional electrical stimulation with low frequencies is effective in improving various outcomes related to function in the stroke population (P < 0.05). Conclusion: Functional electrical stimulation with low frequency improves activities of daily living, balance, gait, mobility, postural control, and range of motion, and reduces spasticity and foot drop. For rehabilitation, it would be important to replicate the findings by conducting highly randomized control trials with high quality and a larger number of samples.

Background: Acute poisoning is a major medical emergency that translates into morbidity and mortality across all age groups, it is a potentially preventable cause of illness and death. This study was carried out to assess the epidemiological information of acute poisoning among the general population presented to the three campuses of a private tertiary care teaching hospital in Karachi, Pakistan. Method: The cross-sectional study was conducted at three campuses of a private tertiary care teaching hospital, Dr. Ziauddin Hospital in Karachi, comprising of records from January 1, 2018, to December 31, 2022, of patients reporting acute poisoning. These records were accessed after getting approval from the Ethical review committee. Consecutive sampling technique was applied while data was collected. All cases of acute poisoning reporting to the emergency department with complete records were included. While data of those with any other diagnosis or incomplete record were excluded. Descriptive analysis was performed for quantitative variables. For categorical data frequency and percentages were extracted. The chi-square test was used to associate categorical variables. P value less than 0.05 was taken as statistically significant. Results: The total number of cases was n=518 out of which n=235 (45.4%) were males while n=283 (54.6%) were females and the maximum number of cases n=111 (21.4%) were associated with Benzodiazepines followed by insecticide poisoning and ingestion of rodenticides. Conclusions: The most susceptible groups to acute poisoning were found to be women and children. A prevalent agent that caused toxicity was benzodiazepines; the biggest number of cases occurred in April, while the lowest number occurred in December. The year 2020 was linked to the highest number of cases.

The rapid global emergence of antibiotic resistance genes (ARGs) is a substantial public health concern. Livestock manure serves as a key reservoir for tetracycline resistance genes (TRGs), serving as a means of their transmission to soil and vegetables upon utilization as a fertilizer, consequently posing a risk to human health. The dynamics and transfer of TRGs among microorganisms in vegetables and fauna are being investigated. However, the impact of different vegetable species on acquisition of TRGs from various manure sources remains unclear. This study investigated the rhizospheres of three vegetables (carrots, tomatoes, and cucumbers) grown with chicken, sheep, and pig manure to assess TRGs and bacterial community compositions via qPCR and high-throughput sequencing techniques. Our findings revealed that tomatoes exhibited the highest accumulation of TRGs, followed by cucumbers and carrots. Pig manure resulted in the highest TRG levels, compared to chicken and sheep manure, in that order. Bacterial community analyses revealed distinct effects of manure sources and the selective behavior of individual vegetable species in shaping bacterial communities, explaining 12.2% of TRG variation. Firmicutes had a positive correlation with most TRGs and the intl1 gene among the dominant phyla. Notably, both the types of vegetables and manures significantly influenced the abundance of the intl1 gene and soil properties, exhibiting strong correlations with TRGs and elucidating 30% and 17.7% of TRG variance, respectively. Our study delineated vegetables accumulating TRGs from manure-amended soils, resulting in significant risk to human health. Moreover, we elucidated the pivotal roles of bacterial communities, soil characteristics, and the intl1 gene in TRG fate and dissemination. These insights emphasize the need for integrated strategies to reduce selection pressure and disrupt TRG transmission routes, ultimately curbing the transmission of tetracycline resistance genes to vegetables.

Objective: To identify patterns in cases of acute toxicity reported at an urban poison control centre. Method: The cross-sectional, retrospective study was conducted at the National Poison Control Centre, Karachi, and comprised data from January 1, 2017, to December 31, 2021. Data was collected from the institutional database which is part of the Jinnah Postgraduate Medical Centre, Karachi. Data of all patients diagnosed with acute poisoning was included. Data was analysed using SPSS 22. Results: Of the 4,936 cases reported, 2,449(49.6%) were males and 2,487(50.3%) were females. Pesticide was the most common cause of toxicity 1254(25.4%). Regarding outcomes, 351(7.1%) patients expired, 3,585(72.6%) were discharged after appropriate treatment, 366(7.4%) were given outpatient and psychiatric referrals, and 634(12.8%) patients left against medical advice. Conclusion: The most common agent causing toxicity was pesticides, and overall mortality across the study period was 7.1%. Key Words: Poisoning, Toxicology, Pesticides, Forensic toxicology.

In Antarctic terrestrial ecosystems, dominant plant species (grasses and mosses) and soil physicochemical properties have a significant influence on soil microbial communities. However, the effects of dominant plants on bacterial antagonistic interactions in Antarctica remain unclear. We hypothesized that dominant plant species can affect bacterial antagonistic interactions directly and indirectly by inducing alterations in soil physicochemical properties and bacterial abundance. We collected soil samples from two typical dominant plant species; the Antarctic grass Deschampsia antarctica and the Antarctic moss Sanionia uncinata, as well as bulk soil sample, devoid of vegetation. We evaluated bacterial antagonistic interactions, focusing on species from the genera Actinomyces, Bacillus, and Pseudomonas. We also measured soil physicochemical properties and evaluated bacterial abundance and diversity using high-throughput sequencing. Our results suggested that Antarctic dominant plants significantly influenced bacterial antagonistic interactions compared to bulk soils. Using structural equation modelling (SEM), we compared and analyzed the direct effect of grasses and mosses on bacterial antagonistic interactions and the indirect effects through changes in edaphic properties and bacterial abundance. SEMs showed that (1) grasses and mosses had a significant direct influence on bacterial antagonistic interactions; (2) grasses had a strong influence on soil water content, pH, and abundances of Actinomyces and Pseudomonas and (3) mosses influenced bacterial antagonistic interactions by impacting abundances of Actinomyces, Bacillus, and Pseudomonas. This study highlights the role of dominant plants in modulating bacterial antagonistic interactions in Antarctic terrestrial ecosystems.

Introduction: The increase in sedentary behaviour and decrease in physical activity levels are some of the contributing factors to many of the non-communicable diseases. These non-communicable diseases included obesity, type-II diabetes and cardiovascular problems. Apart from causing financial burden on health care system, these diseases have been reported to cause nearly 1.9 million premature deaths per year. The aim of the study was to measure sedentary behaviour and physical activity levels among employees of Khyber Medical University, Peshawar. Material & Methods: A cross-sectional survey was conducted on employees of Khyber Medical University, Peshawar. The total sample size was 172 and the data was collected through convenience sampling by using International Physical Activity Questionnaire (IPAQ) long form. This questionnaire measures physical activity levels and sedentary behaviour at work. Results: Out of 172 participants, 154 (89.5%) were male and 18 (10.4%) were female with a mean age of 34.4 ± 2 years. According to the levels of physical activity, 49 (28.5%) were less active, 63 (36.6%) were moderately active and 60 (34.9%) were highly active. The average time spent by the participants for sitting was (8.93 ± 2.35) hours per day. A total of 73.8%, 23.3 % and 2.9% participants could be categorised as having high, moderate and low sedentary behaviour, respectively. Conclusion: Majority of the participants (two-thirds of the participants) demonstrated a high sedentary behaviour and therefore, needed modification in their daily routine.

The primary objective of this investigation was to assess the viability of free and encapsulated Lactobacillus plantarum probiotics in mango juice and under simulated gastrointestinal conditions. Specifically, the probiotics were encapsulated using sodium alginate and alginate-soy protein isolate through the internal gelation method, and the obtained probiotics were characterized for various attributes. Both free and encapsulated probiotics were exposed to challenging conditions, including thermal stress, low temperature, and simulated gastrointestinal conditions. Additionally, both types of probiotics were incorporated into mango juice, and their survival was monitored over a 28-day storage period. Following viability under simulated gastrointestinal conditions, the count of free and encapsulated probiotic cells decreased from initial levels of 9.57 log CFU/mL, 9.55 log CFU/mL, and 9.53 log CFU/mL, 9.56 log CFU/mL to final levels of 6.14 log CFU/mL, 8.31 log CFU/mL, and 6.24 log CFU/mL, 8.62 log CFU/mL, respectively. Notably, encapsulated probiotics exhibited a decrease of 1.24 log CFU and 0.94 log CFU, while free cells experienced a reduction of 3.43 log CFU and 6.24 log CFU in mango juice over the storage period. Encapsulated probiotics demonstrated higher viability in mango juice compared to free probiotics throughout the 28-day storage period. These findings suggest that mango juice can be enriched with probiotics to create a health-promoting beverage. [ABSTRACT FROM AUTHOR]

Introduction: Physical therapists are required to perform tasks that predispose them to developing work related musculoskeletal disorders. The physical therapists personal and professional life can be affected by work related musculoskeletal disorders. High level evidence is lacking regarding work related musculoskeletal disorders. The purpose of this study was to combine information on prevalence, risk factors and the consequences of work-related musculoskeletal disorders in physical therapists. Material & Methods: A systematic review was conducted according to PRISMA guidelines.Three members independently searched the databases PubMed and other online sources including google scholar for relevant data from July 2014 to September 2020. Cross-sectional studies published in English language which reported work related musculoskeletal disorders in physical therapists were included. Studies involving physical therapy students and internees, having insufficient information about past or current work-related musculoskeletal disorders, sample size of physical therapists less than 50 and not published in peer reviewed journals were excluded. Results: Twenty one articles were included in current systematic review. The 1-year prevalence of workrelated musculoskeletal disorders among physical therapists ranged from 38.5% to 97.6%. The low back was the commonest affected body part. Treating large number of patients and manual therapy were the leading risk factors for developing work related musculoskeletal disorders. The most common consequences were modifying treatment techniques and reducing work hours. Conclusion: Prevalence of work related musculoskeletal disorders are high among physical therapists. The nature of physical therapy job presents significant risk factors which can lead to work related musculoskeletal disorders.

The human gut microbiota has been proposed to serve as a multifunctional organ in host metabolism, contributing effects to nutrient acquisition, immune response, and digestive health. Fasting during Ramadan may alter the composition of gut microbiota through changes in dietary behavior, which ultimately affects the contents of various metabolites in the gut. Here, we used liquid chromatography–mass spectrometry-based metabolomics to investigate the composition of fecal metabolites in Chinese and Pakistani individuals before and after Ramadan fasting. Principal component analysis showed distinct separation of metabolite profiles among ethnic groups as well as between pre- and post-fasting samples. After Ramadan fasting, the Chinese and Pakistani groups showed significant differences in their respective contents of various fecal metabolites. In particular, L-histidine, lycofawcine, and cordycepin concentrations were higher after Ramadan fasting in the Chinese group, while brucine was enriched in the Pakistani group. The KEGG analysis suggested that metabolites related to purine metabolism, 2-oxocarboxylic acid metabolism, and lysine degradation were significantly enriched in the total subject population pre-fasting vs. post-fasting comparisons. Several bacterial taxa were significantly correlated with specific metabolites unique to each ethnic group, suggesting that changes in fecal metabolite profiles related to Ramadan fasting may be influenced by associated shifts in gut microbiota. The fasting-related differences in fecal metabolite profile, together with these group-specific correlations between taxa and metabolites, support our previous findings that ethnic differences in dietary composition also drive variation in gut microbial composition and diversity. This landscape view of interconnected dietary behaviors, microbiota, and metabolites contributes to the future development of personalized, diet-based therapeutic strategies for gut-related disorders.

Increased bacterial translocation in the gut and bloodstream infections are both major comorbidities of heart failure and myocardial infarction (MI). However, the alterations in the microbiome of the blood of patients with MI remain unclear. To test this hypothesis, we conducted this case-control study to explore the microbiota compositions in the blood of Chinese patients with MI. Using high-throughput Illumina HiSeq sequencing targeting the V3–V4 region of the 16S ribosomal RNA (rRNA) gene, the microbiota communities in the blood of 29 patients with MI and 29 healthy controls were examined. In addition, the relationship between the blood microbiome and clinical features of MI was investigated. This study revealed a significant reduction in alpha diversity (Shannon index) in the MI group compared with the healthy controls. Also, a significant difference was detected in the structure and richness between the patients with MI and healthy controls. The members of the phylum Actinobacteria, class Actinobacteria, order Bifdobacteriales, family Bifidobacteriaceae, and genus Bifidobacterium were significantly abundant in the MI group, while the members of the phylum Bacteroidetes, class Bacteroidia, and order Bacteroidales were significantly enriched in the healthy controls (p < 0.05). Moreover, the functional analysis revealed a significant variation between both groups. For instance, the enrichment of genes involved in the metabolism pathways of three amino acids decreased, that is, nucleotide transport and metabolism, coenzyme transport and metabolism, and lipid transport and metabolism, among others. Our study will contribute to a better knowledge of the microbiota of blood, which will further lead to improved MI diagnosis and therapy. Further study is needed to determine the role of the blood microbiota in human health and disease.

Objective: The purpose of this study is to find out awareness levels about legislation/authorization and objectives of autopsy amongst the general public, in addition to their opinions about the topic based on the different levels of education. Methods: A cross-sectional questionnaire-based study design was implemented to collect data on their knowledge, perceptions and concerns regarding autopsy from a sample population of 260 citizens aged 18 and above from all educational backgrounds of District South Karachi, Pakistan. Results: Out of total respondents 47.1% (n=122) fell within the age range of 18-25. Males were 41.7% (n=106) and females were 56.3% (n=143) in the study. Out of the 82% (n=208) who marked “Yes” to knowing the meaning of autopsy, 55.3% (n=115) of the respondents belonged to high educational level, 44.7% (n=93) belonged to low educational level. Only 44.7% (n=93) participants correctly knew the purpose for conducting an autopsy. For concerns regarding autopsy a vast majority of respondents marked “Organ removal” (21.7%, n=135) and “Disfigurement of body” (18.3%, n=114) as the top two concerns across regardless of educational level. Conclusion: Although most people held positive perception of autopsy, in depth questioning revealed a clear lack of correct information amongst the general public regarding autopsies. This has led to many falsely held beliefs including fear of body disfigurement and organ removal and less faith in the medicolegal system, irrespective of educational background. Continuous....

The present outbreak of COVID-19 is a worldwide calamity for healthcare infrastructures. On a daily basis, a fresh batch of perplexing datasets on the numbers of positive and negative cases, individuals admitted to hospitals, mortality, hospital beds occupied, ventilation shortages, and so on is published. Infections have risen sharply in recent weeks, corresponding with the discovery of a new variant from South Africa (B.1.1.529 also known as Omicron). The early detection of dangerous situations and forecasting techniques is important to prevent the spread of disease and restart economic activities quickly and safely. In this paper, we used weekly mobility data to analyze the current situation in countries worldwide. A methodology for the statistical analysis of the current situation as well as for forecasting future outbreaks is presented in this paper in terms of deaths caused by COVID-19. Our method is evaluated with a multi-layer perceptron neural network (MLPNN), which is a deep learning model, to develop a predictive framework. Furthermore, the Case Fatality Ratio (CFR), Cronbach’s alpha, and other metrics were computed to analyze the performance of the forecasting. The MLPNN is shown to have the best outcomes in forecasting the statistics for infected patients and deaths in selected regions. This research also provides an in-depth analysis of the emerging COVID-19 variants, challenges, and issues that must be addressed in order to prevent future outbreaks.

The structure and diversity of human gut microbiota are directly related to diet, though less is known about the influences of ethnicity and diet-related behaviors, such as fasting (intermittent caloric restriction). In this study, we investigated whether fasting for Ramadan altered the microbiota in Chinese and Pakistani individuals. Using high-throughput 16S rRNA gene sequencing and self-reported dietary intake surveys, we determined that both the microbiota and dietary composition were significantly different with little overlap between ethnic groups. Principal Coordinate Analyses (PCoA) comparison of samples collected from both groups before and after fasting showed partial separation of microbiota related to fasting in the Pakistani group, but not in the Chinese group. Measurement of alpha diversity showed that Ramadan fasting significantly altered the coverage and ACE indices among Chinese subjects, but otherwise incurred no changes among either group. Specifically, Prevotella and Faecalibacterium drove predominance of Bacteroidetes and Firmicutes in the Pakistani group, while Bacteroides (phylum Bacteroidetes) were the most prevalent among Chinese participants both before and after fasting. We observed significant enrichment of some specific taxa and depletion of others in individuals of both populations, suggesting that fasting could affect beta diversity. Notably, Dorea, Klebsiella, and Faecalibacterium were more abundant in the Chinese group after fasting, while Sutterella, Parabacteroides, and Alistipes were significantly enriched after fasting in the Pakistani group. Evaluation of the combined groups showed that genera Coprococcus, Clostridium_XlV, and Lachnospiracea were all significantly decreased after fasting. Analysis of food intake and macronutrient energy sources showed that fat-derived energy was positively associated with Oscillibacter and Prevotella, but negatively associated with Bacteroides. In addition, the consumption of sweets was significantly positively correlated with the prevalence of Akkermansia. Our study indicated that diet was the most significant influence on microbiota, and correlated with ethnic groups, while fasting led to enrichment of specific bacterial taxa in some individuals. Given the dearth of understanding about the impacts of fasting on microbiota, our results provide valuable inroads for future study aimed at novel, personalized, behavior-based treatments targeting specific gut microbes for prevention or treatment of digestive disorders.

A complex structural geology generally leads to significant consequences for hydrocarbon reservoir exploration. Despite many existing wells in the Kadanwari field, Middle Indus Basin (MIB), Pakistan, the depositional environment of the early Cretaceous stratigraphic sequence is still poorly understood, and this has implications for regional geology as well as economic significance. To improve our understanding of the depositional environment of complex heterogeneous reservoirs and their associated 3D stratigraphic architecture, the spatial distribution of facies and properties, and the hydrocarbon prospects, a new methodology of three-dimensional structural modeling (3D SM) and joint geophysical characterization (JGC) is introduced in this research using 3D seismic and well logs data. 3D SM reveals that the field in question experienced multiple stages of complex deformation dominated by an NW to SW normal fault system, high relief horsts, and half-graben and graben structures. Moreover, 3D SM and fault system models (FSMs) show that the middle part of the sequence underwent greater deformation compared to the areas surrounding the major faults, with predominant one oriented S30°–45° E and N25°–35° W; with the azimuth at 148°–170° and 318°–345°; and with the minimum (28°), mean (62°), and maximum (90°) dip angles. The applied variance edge attribute better portrays the inconsistencies in the seismic data associated with faulting, validating seismic interpretation. The high amplitude and loss of frequency anomalies of the sweetness and root mean square (RMS) attributes indicate gas-saturated sand. In contrast, the relatively low-amplitude and high-frequency anomalies indicate sandy shale, shale, and pro-delta facies. The petrophysical modeling results show that the E sand interval exhibits high effective porosity (∅eff) and hydrocarbon saturation (Shc) compared to the G sand interval. The average petrophysical properties we identified, such as volume of shale (Vshale), average porosity (∅avg), ∅eff, water saturation (SW), and the Shc of the E sand interval, were 30.5%, 17.4%, 12.2%, 33.2% and, 70.01%, respectively. The findings of this study can help better understand the reservoir’s structural and stratigraphic characteristics, the spatial distribution of associated facies, and petrophysical properties for reliable reservoir characterization.

Objective: Variances in ABO blood groups frequencies across world populations make them valuable markers for studying population genetics. In this study, phenotype and gene frequencies of ABO blood group were investigated to delineate relationships across major linguistic subpopulations of Pakistan. Materials and Methods: This is a prospective multiple cohort study design conducted during 2009-2014. Karachi with population from diverse linguistic and ethnic backgrounds was chosen as the study area. Cohorts were formed on the basis of mother tongue and termed as linguistic subpopulations. There were five major cohorts namely Balochi, Punjabi, Pashto, Sindhi and Urdu. Blood samples were collected from 2,327 unrelated individuals through random sampling within each cohort. ABO blood groups were determined using antisera. ABO gene frequencies were estimated through Bernstein methods. Cluster and Correspondence analyses were performed to explore relationships between linguistic subpopulations. Results: Gene B was the most common across all the subpopulations except Balochi subpopulation that showed relatively higher frequency of gene A. Dendrogram of cluster analysis and biplot of correspondence analysis showed closeness of three subpopulations namely Punjabi, Sindhi and Urdu. Conclusions: Apart from describing the frequencies of ABO blood groups, this study asserts the importance of ABO blood group in delineating the relationships between the subpopulations of Pakistan. ABO blood group has long been used as identification markers in medico-legal investigation. It is interesting to know that these markers are also efficient in delineating population genealogical structure. Randomization within a cohort, un-relatedness and a larger sample size enhance the reliability of the results.

With the increasing day-to-day acceptance of IOT computing, the issues related to it are also getting more attention. The current IOT computing infrastructure brings some security challenges concerned with the users/customers and CSP. The users can store their confidential data at IOT storage and can access them anytime when they need. Lack of trust exists among IOT users and between IOT users and CSP. The prevention of this risk is a big research issue and it needs to be solved. There is a need for trusted IOT computing in recent times to provide trusted services. Here, we propose the integration of TPM in IOT computing to performs cryptographic operations and provide hardware-based security. In this domain, different schemes and methods have been proposed to build trust in IOT computing, but the suitable solution has not been presented by these schemes because these schemes lack in terms of some security services. A comparative study based on trusted computing schemes has also been presented in this paper along with different implementations of critical analysis. Our study is based on an overview of the main issues and summarizing the literature along with their strengths and limitations. In the end, we integrated the trusted platform module in the IOT architecture to establish the trust in IOT computing and to enhance the cybersecurity challenges and evaluated it with the help of mathematical/algorithms/graph theory/matrices and logical diagrams.