Search

In Morocco, although it is often classified as a country with a semi-arid climate, floods are very frequent. Like other basins in the kingdom, the Sebou basin with a total area of 40 000 km² has experienced more catastrophic flooding in the past and these floods have caused enormous economic and even human losses. The objective of this study is to apply different methods to calculate a Curve Number values to estimate the potential runoff for this basin. The techniques used are boils down to the different steps. Firstly, the approach was to extract automatically the sub-basins and drainage network, using Geographical Information Systems (GIS) and Digital Elevation Model (DEM) to determine all the physical characteristics of the basin. Then, preparing the land use map using remote sensing and the soil map for determining hydrologic soil Group. Thirdly, the combination of elaborated data for development of a map of Curve Number (CN) and finally, the interpolation of precipitation data recorded at rainfall stations at 30 minutes time steps to the Hydrologic Modeling System (HEC-HMS ) model. The results obtained in the above steps are used for the purpose to get a spatial hydrological model and subsequently its calibration.

Competing Interests: None disclosed.

Background: Delay in care of suspected stenosis or thrombosis can increase the chance of losing a functioning hemodialysis access. Access to care and resources were restricted during the COVID-19 pandemic. To evaluate the impact of the pandemic on arteriovenous fistula (AVF) and arteriovenous graft (AVG) procedures we have assessed the number and success of thrombectomies done before and during the COVID-19 pandemic., Methods: We examined all AVF and AVG angiograms with and without interventions, including thrombectomies, performed at a single center during April 2017-March 2021 (pre-COVID-19 era) and April 2020-March 2021 (COVID-19 era)., Results: The proportion of procedures that were thrombectomies was higher during the COVID-19 era compared to the pre-COVID-19 era (13.3% vs 8.7%, p = 0.009). The proportion of thrombectomy procedures was higher during COVID-19 for AVF (8.2% vs 3.0%, p < 0.001) but there was no difference for AVG (26.5% vs 27%, p = 0.99). There was a trend toward a higher likelihood of unsuccessful thrombectomy during COVID-19 (33.3% vs 20.4%, p  = 0.08)., Conclusions: More dialysis access thromboses and unsuccessful thrombectomies were noted during the COVID-19 pandemic. This difference could be due to a delay in patients getting procedures to maintain their dialysis accesses., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Coelogyne suaveolens has been used as a traditional medicine for many years, and its potential as a natural source of antibacterial agents is of great interest. This investigation aimed to identify the bioactive compounds in the plant extract and assess their antibacterial properties. To achieve this, we identified the bioactive compounds using Gas chromatography mass spectrometry (GCMS) analysis on the extract's ethyl acetate fraction and used the disc diffusion method to determine the antibacterial effect. Additionally, molecular docking were performed to predict the binding affinities of selected phytochemicals against specific proteins in order to identify the root cause of bacterial inhibition. Our results revealed that the extract exhibited significant antibacterial activity against Pseudomonas aeruginosa, Staphylococcus aureus , Escherichia coli, and Klebsiella pneumoniae , which are common and problematic pathogens. Furthermore, molecular docking studies identified eight best-selected compounds, of which {androstan-17-one, oxime, (5.alpha.)-}, diethofencarb, tetraconazole, {3,6-dimethyl-2,3,3a,4,5,7a-hexahydrobenzofuran}, and geranyl acetate showed a significant binding affinity with best binding interaction with the target enzymes. This suggests that binding to these specific proteins might lead to the mechanism of action of the evaluated antibacterial action. In conclusion, the present study contributes to the growing body of knowledge on natural antimicrobial agents and could have significant implications for the development of new and effective antibacterial agents., Competing Interests: The authors declare that they have no conflict of interest regarding the publication of this., (© 2024 Published by Elsevier B.V.)

Autism spectrum disorder (ASD) is the assorted uneven conditions of the human brain that lead to developmental disabilities. This cross-sectional study aimed to identify the substantial risk factors of ASD among children in Bangladesh. The data were collected using convenience sampling through a questionnaire filled up by the trained interviewers. Mann-Whitney U and Kruskal-Wallis H tests were applied as bivariate analysis, and generalized beta regression was performed to determine the significant risk factors of autism spectrum disorder. The odds ratio (OR) along with 95% confidence interval (CI) were the measuring parameters of the risk factors of ASD. The result revealed that later birth order children have more risk of ASD (OR = 1.13, CI: 1.014-1.264, p = 0.027) compared to the children whose birth order is first. Premature birth of the child (OR: 0.87, CI: 0.76-1.00, p = 0.05) and father's age (OR: 0.86, CI: 0.76-0.97, p = 0.020) substantially affects ASD. The maternal history of specific illness (diabetes, thyroiditis, and hypertension) during pregnancy also significantly affect ASD (OR: 1.34, CI: 1.14-1.61, p = 0.002). The results of this study would assist policymakers in taking necessary steps to reduce the incidence of this disorder by targeting the potential risk factors., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Faruk et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Generally, cardiac masses are initially suspected on routine echocardiography. Cardiac magnetic resonance (CMR) imaging is further performed to differentiate tumors from pseudo-tumors and to characterize the cardiac masses based on their appearance on T1/T2-weighted images, detection of perfusion and demonstration of gadolinium-based contrast agent uptake on early and late gadolinium enhancement images. Further evaluation of cardiac masses by CMR is critical because unnecessary surgery can be avoided by better tissue characterization. Different cardiac tissues have different T1 and T2 relaxation times, principally owing to different internal biochemical environments surrounding the protons. In CMR, the signal intensity from a particular tissue depends on its T1 and T2 relaxation times and its proton density. CMR uses this principle to differentiate between various tissue types by weighting images based on their T1 or T2 relaxation times. Generally, tumor cells are larger, edematous, and have associated inflammatory reactions. Higher free water content of the neoplastic cells and other changes in tissue composition lead to prolonged T1/T2 relaxation times and thus an inherent contrast between tumors and normal tissue exists. Overall, these biochemical changes create an environment where different cardiac masses produce different signal intensity on their T1- weighted and T2- weighted images that help to discriminate between them. In this review article, we have provided a detailed description of the core CMR imaging protocol for evaluation of cardiac masses. We have also discussed the basic features of benign cardiac tumors as well as the role of CMR in evaluation and further tissue characterization of these tumors., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (© 2023 Haider, Ullah, Fatima, Karim, Haq, Majid, Anwar, Nawaz, Ehsan, Ali, Sarwar, Anwar, Khan, Humayun and Alam.)

Stewardship theory suggests that CEO duality can provide strong leadership and facilitate the development and coordination of firm strategy. These benefits should affect firm risk and financial performance, particularly when the firm has high information-gathering costs. We use the 2020 coronavirus outbreak as a natural experiment to determine whether CEO duality is beneficial during crisis periods. We find that in 2020, S&P 1500 firms with CEO duality exhibit smaller increases in default probability risk than firms with non-duality in the presence of high information costs. Firms with CEO duality experience a smaller decrease in profitability when information costs are high. We also find that firms with CEO duality offer cumulative abnormal returns significantly higher than those of other firms. CEO duality is more valuable in firms with higher information costs. Our results indicate that CEO duality is valuable during crisis periods, particularly when information costs are high. These results are consistent with stewardship theory and indicate that the concentration of power from CEO duality is beneficial during crisis periods., Competing Interests: The authors whose names are given below certify that they have no connections with or involvement in any organisation or institution that has a financial or non-financial interest in the subject matter or materials covered in this manuscript., (© 2022 Published by Elsevier B.V.)

Composite materials used in the prosthetic and orthotic fields have helped improve the fabrication of sockets. Laminated sockets proved to be stronger than conventional thermoplastic sockets. The internal surface of a laminated socket plays an important role in patient comfort and is influenced by the material used to fabricate the socket. This study analyzes the internal surface profile of five different materials, that is, Dacron felt, fiberglass, Perlon stockinette, polyester stockinette, and elastic stockinette. All sockets were fabricated using an acrylic resin mix with hardener powder at a ratio of 100:3. The internal surface of the sockets was tested using the Mitutoyo SurfTest SJ-210 series for 20 trials. The overall R a values were 2.318, 2.380, 2.682, 2.722, and 3.750 µm for fiberglass, polyester, Perlon, elastic stockinette, and Dacron felt. Dacron felt yielded the lowest R a value, thus, producing the smoothest internal surface but requiring high skill and the correct technique during the fabrication of a laminated socket. Fiberglass is considered the best material for the internal surface despite not producing the lowest value individually but overall is the lowest and most consistent, indicating that it is easy to use to laminate prosthetic sockets.

Although alcohol consumption may produce effects that can be beneficial or harmful, alcohol consumption prevails among communities around the globe. Additionally, alcohol consumption patterns may be associated with several factors among communities and individuals. Numerous technologies and methods are implemented to enhance the detection and tracking of alcohol consumption, such as vehicle-integrated and wearable devices. In this paper, we present a cellular-based Internet of Things (IoT) implementation in a breath analyzer to enable data collection from multiple users via a single device. Cellular technology using hypertext transfer protocol (HTTP) was implemented as an IoT gateway. IoT integration enabled the direct retrieval of information from a database relative to the device and direct upload of data from the device onto the database. A manually developed threshold algorithm was implemented to quantify alcohol concentrations within a range from 0 to 200 mcg/100 mL breath alcohol content using electrochemical reactions in a fuel-cell sensor. Two data collections were performed: one was used for the development of the model and was split into two sets for model development and on-machine validation, and another was used as an experimental verification test. An overall accuracy of 98.16% was achieved, and relative standard deviations within the range from 1.41% to 2.69% were achieved, indicating the reliable repeatability of the results. The implication of this paper is that the developed device (an IoT-integrated breath analyzer) may provide practical assistance for healthcare representatives and researchers when conducting studies involving the detection and data collection of alcohol consumption patterns.

Background and objectives Microalbuminuria prevalence is high in patients with type 2 diabetes mellitus (T2DM) all over the world and its prevalence is affected by several factors. In Pakistan, microalbuminuria and factors that play a role in its development in patients with T2DM are under-researched. This study aimed to determine the incidence of microalbuminuria and the factors affecting it in patients with T2DM. Material and methods This descriptive cross-sectional study was performed on 129 diagnosed patients with T2DM in the outpatient department of Benazir Bhutto Hospital, Rawalpindi, for approximately six months from August 2021 to January 2022. Patients were recruited in the study through a non-probability consecutive sampling technique and established inclusion and exclusion criteria. Ethical approval was obtained from the relevant hospital ethical review board (ERB). After explaining the study's aims, informed consent was also taken from all patients before the start of data collection. A self-structured and interview-based questionnaire was used for the collection of data. Descriptive statistics and a chi-square test were applied for the data analysis using Statistical Package for the Social Sciences (SPSS) version 25 (Armonk, NY: IBM Corp.). Results The incidence of microalbuminuria in the study population was 31.78%. The association between microalbuminuria and age (p = 0.002), gender (p = 0.003), duration of diabetes mellitus (p = 0.001), therapy type (p = 0.03), control of diabetes mellitus, (p = 0.001), and hypertension (p = 0.002) was statistically significant. Higher age group, male gender, longer duration of diabetes mellitus, oral hypoglycemic agents, poorly controlled diabetes mellitus, and history of hypertension, all were found to raise the incidence of microalbuminuria. Even though being overweight was also found to raise the incidence of microalbuminuria, the association between microalbuminuria and nutritional status was statistically insignificant (p = 0.05). Conclusion Microalbuminuria incidence is significantly high in the study population. The factors such as increasing age, male gender, longer duration of the diabetes mellitus, oral hypoglycemic agents, poorly controlled diabetes mellitus, and history of hypertension, all raise the incidence of microalbuminuria in patients with T2DM to a statistically significant extent. Screening of microalbuminuria patients with T2DM should be added to the routine investigations for diabetes mellitus for the early detection of renal and cardiovascular complications., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Khan et al.)

Background: Excessive alcohol consumption has negative effects not only on the drinkers' health but also on others around them. Previous studies suggest that excessive alcohol consumption can be related to a combination of factors such as age, family background, religiosity, etc. Investigating and clarifying these roots of alcohol consumption is crucial so that the right type of interventions can be designed in a specific and targeted manner., Objectives: This work was conducted as a systematic review to reveal the factors associated with alcohol consumption and to heighten the understanding of the differences among various communities and segments of the population regarding their usage of alcohol., Data Sources: A systematic search of Web of Science, PubMed, ScienceDirect, and Google Scholar was performed., Results: Forty-five studies were included in the review after excluding irrelevant records and duplicates., Conclusions: Alcohol consumption patterns can be associated with several factors related to communities and individuals, and our review revealed demographic factors, including age and proximity to alcohol outlets, as well as social factors, including family background, socioeconomic background, and religious influence. These findings can be used to establish a guideline for further studies in understanding alcohol consumption patterns among individuals according to their personal characteristics and sociocultural backgrounds.

Background Nephrolithiasis (renal stones) is the most common urological disease. Its prevalence is high in every part of the world. Several factors lead to renal stone formation. In Pakistan, nephrolithiasis prevalence is also high as Pakistan is located in a region which is known as the salt belt. However, nephrolithiasis and its possible risk factors are under-researched in Pakistan. Objective This study aims to identify the risk factors for nephrolithiasis among admitted patients with renal stones. This may lead to a reduction in renal stone incidence and its allied complications by the prevention of risk factors that would have a major role in renal stone formation. Material and methods This descriptive cross-sectional study was performed among the 143 admitted patients with renal stones in the urology ward of Benazir Bhutto Hospital, Rawalpindi, for approximately six months from November 2021 to April 2022. Non-probability convenient sampling and developed inclusion and exclusion criteria were used for the recruitment of patients. After elaborating on the objectives, the study data were collected by interviewers through a self-structured questionnaire. Descriptive analysis was carried out using SPSS version 25.0 (IBM Corp., Armonk, NY). Results Nephrolithiasis was more prevalent among patients who had an age group range of 15-30 years (47.55%), male gender (56.65%), illiterate educational status (53.14%), lower socioeconomic status (66.43%), inadequate intake of water (61.53%), used tap water (56.64%), a habit of daily vegetable intake (65.04%), sedentary lifestyle (51.74%), family history of renal stones (57.34%), no diabetes mellitus (62.94%), no hypertension (52.45%), and overweight (48.23%). Conclusion In brief, the age group of 15-30 years, male gender, illiteracy, lower socioeconomic status, insufficient water intake, tap water, high vegetables, inactive lifestyle, family history of nephrolithiasis, and a high BMI all increase the risk of nephrolithiasis., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Khan et al.)

We examine the immediate impact of COVID-19 on the performance of FDIC chartered banks. Our experimental design analyses the performance of community banks and large banks before and during the COVID-19 pandemic. Community banks significantly outperform large banks in several key measures in the first three-quarters of COVID-19. Findings are consistent with the view that the advantages of solid customer relationships and a greater understanding of local businesses are invaluable during periods of high externalities. This result is more pronounced for community banks located in metropolitan areas. We also find that the pandemic's adverse effects on bank performance are minimized in states with higher quality healthcare facilities, as measured by our healthcare index. In addition, the performance of community banks varies across geographical regions during this pandemic period. Finally, our study expands the understanding of how community banks' performance and risk-taking change during a pandemic., (© 2021 Elsevier B.V. All rights reserved.)

Competing Interests: None disclosed.

This article highlights Australia's interaction with Asian countries in the development of an international legal instrument on marine biodiversity in areas beyond national jurisdiction (ABNJ). An intergovernmental conference with four planned sessions is currently going on under the auspices of the United Nation's General Assembly (UNGA) for the adoption of a new legal instrument under the United Nations Convention on the Law of the Sea (UNCLOS). Although there is literature on how Australia and Asia have forged closer engagement on matters of trade, security and culture, literature is scarce on how and in what way they can engage in promoting the conservation of ABNJ. In terms of marine environmental discussion, Australia appears to date overall to have aligned itself closely to other western countries and some developed Asian countries. This article examines the potential scope for increased collaboration with Asia on reaching future legal agreement with respect to ABNJ., (© Crown 2021.)

A mega fistula can be defined as generalized aneurysmal dilatation of arteriovenous fistula. Mega fistulae can lead to complications like high output cardiac failure, steal syndrome, skin ulceration and rupture. We describe a series of ten patients who were referred to our interventional nephrology practice for evaluation of mega fistula which had not been in use for a long time. Nine out of ten patients were post-transplant while one was pre dialysis. Five patients had Radiocephalic while four had Brachiocephalic and one had Brachial artery to Median Cubital vein fistula. All except one patient had severe outflow stenosis. The most common site of stenosis in Radiocepahlic and Brachiocepahlic fistula was cephalic vein at the elbow and cephalic arch respectively. Half of the patients had chronic total occlusion of the outflow vein. Successful angioplasty was done in only two patients. Seven patients underwent ligation while one had spontaneous thrombosis of the fistula. None of the patients had regular surveillance of their access for a long time as they were not on dialysis. Unrecognized and uncorrected outflow stenosis over a long time period can lead to creation of mega fistula. Once a mega fistula develops there are not many treatment options other than ligation. This leads to loss of the access which might be needed in future. Continuous access surveillance in patients who are not on dialysis is important to prevent complications like mega fistula.

Numerous stages of organismal development rely on the cellular interpretation of gradients of secreted morphogens including members of the Bone Morphogenetic Protein (BMP) family through transmembrane receptors. Early gradients of BMPs drive dorsal/ventral patterning throughout the animal kingdom in both vertebrates and invertebrates. Growing evidence in Drosophila, zebrafish, murine and other systems suggests that BMP ligand heterodimers are the primary BMP signaling ligand, even in systems in which mixtures of BMP homodimers and heterodimers are present. Signaling by heterodimers occurs through a hetero-tetrameric receptor complex comprising of two distinct type one BMP receptors and two type II receptors. To understand the system dynamics and determine whether kinetic assembly of heterodimer-heterotetramer BMP complexes is favored, as compared to other plausible BMP ligand-receptor configurations, we developed a kinetic model for BMP tetramer formation based on current measurements for binding rates and affinities. We find that contrary to a common hypothesis, heterodimer-heterotetramer formation is not kinetically favored over the formation of homodimer-tetramer complexes under physiological conditions of receptor and ligand concentrations and therefore other mechanisms, potentially including differential kinase activities of the formed heterotetramer complexes, must be the cause of heterodimer-heterotetramer signaling primacy. Further, although BMP complex assembly favors homodimer and homomeric complex formation over a wide range of parameters, ignoring these signals and instead relying on the heterodimer improves the range of morphogen interpretation in a broad set of conditions, suggesting a performance advantage for heterodimer signaling in patterning multiple cell types in a gradient., Competing Interests: The authors have declared that no competing interests exist.

Blood-brain barrier (BBB) disruption following ischemic stroke (IS) contributes to hemorrhagic transformation, brain edema, increased neural dysfunction, secondary injury, and mortality. Brain endothelial cells form a para and transcellular barrier to most blood-borne solutes via tight junctions (TJs) and rare transcytotic vesicles. The prevailing view attributes the destruction of TJs to the resulting BBB damage following IS. Recent studies define a stepwise impairment of the transcellular barrier followed by the paracellular barrier which accounts for the BBB leakage in IS. The increased endothelial transcytosis that has been proven to be caveolae-mediated, precedes and is independent of TJs disintegration. Thus, our understanding of post stroke BBB deficits needs to be revised. These recent findings could provide a conceptual basis for the development of alternative treatment strategies. Presently, our concept of how BBB endothelial transcytosis develops is incomplete, and treatment options remain limited. This review summarizes the cellular structure and biological classification of endothelial transcytosis at the BBB and reviews related molecular mechanisms. Meanwhile, relevant transcytosis-targeted therapeutic strategies for IS and research entry points are prospected.

The Indian Ocean hosts a wide range of living resources including fish stocks. Marine resources contribute significantly to economies and livelihoods, and seafood is a major source of protein in Indian Ocean nations. Fisheries resources in the Indian Ocean have started showing symptoms of depletion. Several regional fisheries management organisations (RFMOs) have been established for sustainable management of the fisheries resources in the Indian Ocean region. These RFMOs were created at different times with various particular mandates, and in some cases prior to the emergence of contemporary scientific concepts and legal approaches to marine environmental governance. In this article, eight such RFMOs are studied to determine the implementation of ecosystem-based fisheries management (EBFM) and the precautionary approach (PA), which are now widely accepted norms of fisheries management and international law. This article argues that there is a mismatch between the legal and governance frameworks, and the fisheries science and management., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Vascular access is an important element in the overall care provided to kidney transplant recipients. The transplanted kidney is not indestructible, and chronic kidney disease after transplantation may result in needing another transplant or beginning dialysis. Commonly used vascular accesses, like peripheral and central lines, can preclude the creation of future, permanent dialysis access. Therefore, there is urgent need to preserve vessels for the future access needs for hemodialysis among kidney transplant recipients without functional vascular access for dialysis. Moreover, the proper care of functional vascular access among kidney transplant recipients is crucial. In this review article, we will address the common vascular access procedures and complications among kidney transplant recipients., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Introduction: Vascular access dysfunction is a major cause of morbidity in patients with end-stage renal disease (ESRD) on chronic hemodialysis. The effects of abnormalities in mineral metabolism on vascular access are unclear. In this study, we evaluated the association of mineral metabolites, including 25-hydroxy vitamin D (25(OH)D) and fibroblast growth factor-23 (FGF-23), with vascular access complications., Methods: We included participants from the Choices for Healthy Outcomes in Caring for ESRD (CHOICE) Study who were using an arteriovenous fistula (AVF; n = 103) or arteriovenous graft (AVG; n = 116). Serum levels of 25(OH)D, FGF-23, parathyroid hormone (PTH), calcium, phosphorus, C-reactive protein (CRP) and interleukin-6 (IL-6) were assessed from stored samples. Participants were followed for up to 1 year or until a vascular access intervention or replacement., Findings: A total of 24 participants using an AVF and 43 participants using an AVG experienced access intervention. Those with 25(OH)D level in the lowest tertile (<11 ng/mL) had an increased risk of AVF intervention compared to those with higher 25(OH)D levels (adjusted relative hazard [aHR] = 3.28; 95% confidence interval [CI]: 1.31, 8.20). The highest tertile of FGF-23 (>3750 RU/mL) was associated with greater risk of AVF intervention (aHR = 2.56; 95% CI: 1.06, 6.18). Higher PTH was associated with higher risk of AVF intervention (aHR = 1.64 per SD of log(PTH); 95% CI: 1.02, 2.62). These associations were not observed in participants using an AVG. None of the other analytes were significantly associated with AVF or AVG intervention., Discussion: Low levels of 25(OH)D and high levels of FGF-23 and PTH are associated with increased risk of AVF intervention. Abnormalities in mineral metabolism are risk factors for vascular access dysfunction and potential therapeutic targets to improve outcomes., (© 2019 International Society for Hemodialysis.)

Bangladesh is host to a major cetacean habitat. The country declared its first marine protected area, namely, the Swatch-of-No-Ground Marine Protected Area, for conservation of some species of dolphins, porpoises, whales and sharks. However, this declaration has not been supported with an effective and robust legal, policy and institutional framework. Against this backdrop, this article critically examines the existing legal and institutional framework for management of this marine protected area. A study on the existing legal framework shows the absence of a robust national legal system for prevention of marine pollution and protection of marine biodiversity. This lack of national legal framework will have a significant impact on the future success of the Marine Protected Area. Moreover, an analysis of the relevant national institutions shows that they are not fully capable of enforcing the law and policy in the marine protected area. Through this analysis, this paper proposes that preparation of a management plan, provision of adequate resources to the relevant agencies, ensuring interagency cooperation, engagement of stakeholders and implementation of international marine environmental law are crucial for the future success of this marine protected area., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

This pioneering study involved the fabrication of a new class of nanohybrid-based electrochemical glucose biosensor. First, three-dimensional (3D) graphene was fabricated as a platform of multiwalled carbon nanotube (MWCNT). Then, it was used to immobilize glucose oxidase (GOD) on nanohybrid thin film via the entrapment technique. The modified glucose biosensor indicated excellent biocatalytic activity toward the glucose measurment with a sensitivity of up to 49.58 μA mM -1 cm -2 and a wide linear dynamic range up to 16 mM. The fabricated biosensor shows an excellent stability of 87.8%, with its current diminishing after 3 months. This facile and simple electrochemical method for glucose monitoring using a modified glassy carbon electrode (GCE) by 3DG-MWCNT-GOD could open new avenues in producing of a inexpensive and sensitive glucose nanobiosensors.

Chili shrimp paste (CSP) is an exotic traditional Southeast Asian condiment prepared using mainly fresh chilies and fermented shrimp paste (belacan) which attributed to strong pungent fishy odor. This study aims to evaluate the effectiveness of electron beam irradiation (EBI) exposure on CSP for microorganisms decontamination, and its physicochemical qualities changes. Changes in capsaicinoid contents and volatile compounds were analyzed using HPLC and GC-MS. Mesophilic bacteria, yeast, mold and pathogenic Enterobacteriaceae decreased as irradiation dose increasing from 0 to 10kGy. EBI at 10kGy effectively decontaminated the samples with no significant effects on phenolic and capsaicinoids contents compared to the fresh samples. From 24 compounds, irradiated CSP retained 23 volatile compounds, while thermally treated CSP has only 19 compounds. EBI at 10kGy is effective for decontamination in CSP with lesser destructive effect on volatile compounds and texture compared to thermal treatment., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Background: Caryota urens is a member of the Arecaceae family and a common plant in the Southeast Asian region. This plant has been reported as an anti-microbial agent in recent years. Thus, we aimed to find out the MIC (minimum inhibitory concentration) against different pathogenic microorganism., Methods: The leaves of C. urens were extracted and fractioned using different reagents (chloroform, n -hexane and carbon tetrachloride). Disc diffusion method was implemented for the assessment of in vitro anti-microbial potency (500 and 250 µg/disc)., Result: The entire fraction showed good effect (with the zone of inhibition 19-25 mm) against both gram positive ( Bacillus subtilis , Bacillus megaterium , Bacillus cereus , Sarina lutea ) and gram negative ( Vibrio mimicus , Shigella boydii , Escherichia coli , Pseudomonas aeruginosa ) bacterial pathogens and fungal strains ( Aspergillus niger , Saccharomyces cerevisiae ). The plants also possess effective free radical scavenging potency with an IC 50 of 130.32 µg/mL., Conclusion: This finding reflects a link between the presence of anti-oxidative material and a substantial anti-microbial activity, and substantiates all previous claims against C. urens .

Objective: The aim of the study was to determine the functional status and level of physical activity and their association with depression in the elderly population (age 60 and above) in Karachi, Pakistan., Methods: This was a cross-sectional study. Subjects were recruited through multi-stage cluster sampling technique. Questionnaire-based interviews were conducted from July to September 2008. Functional status and physical activity were assessed using activities of daily living (ADL) and physical activity questionnaires, respectively. Depression was evaluated using the 15-item geriatric depression scale (GDS)., Results: Both mean ADL score (9.9±0.2 vs. 9.6±0.2) as well as time spent in physical activity/week (377.3±26.9min vs. 251.7±15.4min) was higher in men than women, respectively. Subjects spending more than 310min (>5.2h) per week in physical activity were 60% less likely to be depressed compared to those who spent less than 120min (<2h) per week (Adjusted OR=0.4, 95% CI=0.2-0.7). A one unit increase in ADL score showed a 10% decrease in depression after adjusting for other variables (Adjusted OR=0.9, 95% CI=0.8-0.9)., Conclusions: We found a strong association between depression and time spent in physical activities as well as activities of daily living. Our results indicate the potentially important positive role of higher functional status and physical activity in prevention of depression in the elderly in Karachi., (Copyright © 2014 Elsevier B.V. All rights reserved.)

Effects of controlled-temperature fermentation on several physico-chemical properties, lactic acid bacteria (LAB) counts and aroma of durian pulp were examined by storing fresh durian pulp was mixed with 2 % (w/w) salt and stored at 15 °C, 27 °C and 40 °C for 10 days. Storage at 15 °C did not affect the properties of the pulp much. However, at 27 °C and 40 °C, pH and total soluble solids decreased up to 60 % and 52 %, respectively, with greater losses at 27 °C. Titratable acidity, which increased at 27 °C, was due to lactic and acetic acids formation. Loss of sucrose and increases in glucose were greater at 27 °C. LAB population increased up to Day 3 of storage, and then decreased slightly. Principal component analysis based on aroma examination using a zNose(TM) showed better retention of aroma profile at 27 °C. Overall, durian fermented at 27 °C was more acceptable than the one prepared at 40 °C, and it is ready to be consumed between Day 4 and 6.

Karachi is the only mega city in the world with persistent poliovirus transmission. We determined routine childhood immunization rates in Karachi and identified predictors of vaccine completion. A population-based cross-sectional survey was conducted in Karachi between August and September 2008. Data on demographics, socioeconomic, and DTP3 vaccination status in children 12 to 23 months old were collected. Logistic regression was used to identify predictors of vaccination completion. Overall, 1401 participants were approached; 1391 consented to participate. Of these, 1038 (75%) were completely vaccinated. Punjabi families had the highest DTP3 coverage (82%), followed by Urdu-speaking families (79%). Pashtun (67%) and Bengali (48%) families had the lowest vaccine coverage. Children of mothers with ≥ 12 years of schooling (OR = 25.4; 95% CI = 5.7-113.1) were most likely to be vaccinated. A quarter of study participants were unvaccinated. Targeted strategies for boosting DTP3 rates in communities with low immunization coverage are essential for polio eradication in Karachi.

Background: As part of the mid-term evaluation of a Women's Health Care Project, a study was conducted to compare the utilization of maternal and neonatal health (MNH) services in two areas with different levels of service in Punjab, Pakistan., Methods: A cross-sectional survey was conducted to interview Married Women of Reproductive Age (MWRA). Information was collected on MWRA knowledge regarding danger signs during pregnancy, delivery, postnatal periods, and MNH care seeking behavior. After comparing MNH service utilization, the two areas were compared using a logistic regression model, to identify the association of different factors with the intervention after controlling for socio-demographic, economic factors and distance of the MWRA residence to a health care facility., Results: The demographic characteristics of women in the two areas were similar, although socioeconomic status as indicated by level of education and better household amenities, was higher in the intervention area. Consequently, on univariate analysis, utilization of MNH services: antenatal care, TT vaccination, institutional delivery and use of modern contraceptives were higher in the intervention than control area. Nonetheless, multivariable analysis controlling for confounders such as socioeconomic status revealed that utilization of antenatal care services at health centers and TT vaccination during pregnancy are significantly associated with the intervention., Conclusions: Our findings suggest positive changes in health care seeking behavior of women and families with respect to MNH. Some aspects of care still require attention, such as knowledge about danger signs and neonatal care, especially umbilical cord care. Despite overall success achieved so far in response to the Millennium Development Goals, over the past two decades decreases in maternal mortality are far from the 2015 target. This report identifies some of the key factors to improving MNH and serves as an interim measure of a national and global challenge that remains a work in progress.

Background: Depression in elderly is a major global public health concern. There has been no population-based study of depression in the elderly in Pakistan. The aim of the study was to estimate the prevalence of depression and its association with family support of elderly (age 60 years and above) in Karachi, Pakistan., Methods: A population based cross-sectional study was carried out in Karachi from July-September 2008. Questionnaire based interviews were conducted with individuals (n = 953) recruited through multi-stage cluster sampling technique, using the 15- item Geriatric Depression Scale (GDS)., Results: Prevalence of depression was found to be 40.6%, with a higher preponderance in women than men (50% vs. 32%). Elderly currently not living with their spouses were 60% more depressed than those living with their spouses (Adjusted OR = 1.6, 95% CI = 1.3-2.1). Elderly who did not consider their children as future support were twice as likely to be depressed as those considering their children to be old age security (Adjusted OR = 2.1, 95% CI = 1.4-3.1). An increase in one male adult child showed 10% decrease in depression after adjusting for other variables (Adjusted OR = 0.9, 95% CI = 0.8-0.9)., Conclusion: A relatively high prevalence of depression was found in the elderly in Karachi. There appeared to be a strong association between depression and family support variables such as living with spouse, considering children as future security and number of male adult children in the sample studied. Mental wellbeing of the elderly in Pakistan needs to be given consideration in the health policy of the country. In collectivistic societies like Pakistan family support plays an important part in mental health of the elderly that needs to be recognized and supported through various governmental and non-governmental initiatives., Keypoints: Assessment of depression in elderly, Cross-sectional study in Karachi-Pakistan.

Morphogens are secreted molecules that specify cell-fate organization in developing tissues. Patterns of gene expression or signalling immediately downstream of many morphogens such as the bone morphogenetic protein (BMP) decapentaplegic (Dpp) are highly reproducible and robust to perturbations. This contrasts starkly with our expectation of a noisy interpretation that would arise out of the experimentally determined low concentration (approximately picomolar) range of Dpp activity, tight receptor binding and very slow kinetic rates. To investigate mechanisms by which the intrinsic noise can be attenuated in Dpp signalling, we focus on a class of secreted proteins that bind to Dpp in the extracellular environment and play an active role in regulating Dpp/receptor interactions. We developed a stochastic model of Dpp signalling in Drosophila melanogaster and used the model to quantify the extent that stochastic fluctuations would lead to errors in spatial patterning and extended the model to investigate how a surface-associated BMP-binding protein (SBP) such as Crossveinless-2 (Cv-2) may buffer out signalling noise. In the presence of SBPs, fluctuations in the level of ligand-bound receptor can be reduced by more than twofold depending on parameter values for the intermediate transition states. Regulation of receptor-ligand interactions by SBPs may also increase the frequency of stochastic fluctuations providing a separation of timescales between high-frequency receptor equilibration and slower morphogen patterning. High-frequency noise generated by SBP regulation is easily attenuated by the intracellular network creating a system that imitates the performance of a simple low-pass filter common in audio and communication applications. Together, these data indicate that one of the benefits of receptor-ligand regulation by secreted non-receptors may be greater reliability of morphogen patterning mechanisms.

Background: During the 1980s, approximately three million people migrated from Afghanistan to Pakistan and sought refuge in several cities including the city of Karachi. After the initial settlement of the refugees, the international organizations transitioned the health care of these refugees to the two local non-profit service agencies in Karachi. One of these agencies subsidized health care to the refugees under their care and the other agency encouraged the refugees under their care to utilize governmental and non-governmental private health resources at the disposal of general public. Our objective was to measure the effect of health subsidy on the uptake of contraception among Afghan refugee women and compare them to the group of Afghan women without such a subsidy., Methodology/principal Findings: A randomly selected group of 650 married Afghan women--325 women in each group--participated in a detailed survey regarding the knowledge, attitude and practices of family planning and contraceptive use. 90 percent of the women in the health subsidy group had had heard of family planning, compared to the 45 percent in the non-subsidized group. The use of contraceptives was greater than two-fold in the former versus the latter. Results of logistic regression analysis revealed that the refugee women who had had access to subsidized healthcare were significantly more likely to use the contraceptive methods with advancing age as compared to the women in the non-health subsidy group. The difference remained significant after adjusting for other variables., Conclusions/significance: Refugee women who are provided subsidized healthcare are more inclined to use contraceptives. It is therefore important that Afghan refugee women living elsewhere in Pakistan be provided healthcare subsidy, whereby their reproductive health indicators could improve with reduced fertility. We strongly encourage facilities introducing such subsidies to refugees in resource poor settings to assess the impact through similar inquiry.

Objective: To assess the knowledge, attitudes and practices regarding sexuality, high risk sexual behaviors and methods of contraception, among college/university students of Karachi, Pakistan., Study Design: Cross-sectional observational study., Place and Duration of Study: Higher Education Commission-recognized government and private colleges/universities in Karachi from 2005-2006., Methodology: Two colleges/universities were randomly selected from each category i.e. government medical, government non-medical and private medical and non-medical colleges/universities. Three stage cluster sampling was employed to draw a representative sample of students. A self administered questionnaire was used to elicit information on knowledge, attitudes and practices regarding high risk sexual behaviors, methods of contraception and sources to obtain information about sexual issues., Results: A total of 957 students were interviewed. They comprised 542 (56.6%) males and 415 (43.4%) females with mean age of 21 ± 1.8 years. Bivariate analysis showed that students enrolled in medical colleges/universities were less likely to watch adult films (O.R. 0.7, CI; 0.5-0.9) to acquire sex related knowledge and go out on dates (O.R. 0.6, CI; 0.4- 0.8). Similarly, medical students were less likely to consider contraception as being against Islamic teachings (O.R. 0.7, CI; 0.5-0.9)., Conclusion: The curricula of non-medical studies at undergraduate level should include education regarding sexual health and contraception.

Background: Abdominal computed tomography (CT) scans are frequently performed for a variety of abdominal complaints. Not infrequently, bowel wall thickening noted on these radiographic studies of the gastrointestinal (GI) tract prompt further endoscopic evaluation. It is unclear whether the costs and risks of endoscopy are justified given the subsequent yield on endoscopic examination of this radiological finding., Materials and Methods: A retrospective study was done on patients referred to the Digestive Diseases section of a tertiary level hospital for abnormal findings seen on CT during the study period. These patients were seen over one year and their charts reviewed. The items reviewed in the charts were: age, gender, chief complaint, physical findings, ordering location, CT scan indication, CT scan abnormality, endoscopic findings, and the time interval between CT scan and endoscopic procedure., Results: A total of 169 patients with bowel wall thickening that proceeded to an endoscopy were identified. The average age for the patients was 18 to 89 with a mean of 55 years. Females comprised 59% of the patients. The mean period from the time of the CT scan to endoscopy was 32 days. In the upper GI tract, 39 patients had bowel wall thickening. Of these, 25 had abnormal pathology on subsequent endoscopy correlating with the radiological findings. In the lower GI tract, 109 patients had bowel wall thickening. Of these, 36 had abnormal findings on the subsequent endoscopy. In this group, 10% was found to be of neoplastic origin upon further work-up. The positive predictive value (PPV) for bowel wall thickening in the UGI tract was 64%. In the lower GI tract, the PPV was 33%., Conclusion: Thickening of the gastrointestinal tract is not uncommonly noted on abdominal CT scans. The resultant endoscopic evaluations of these findings appear to yield more when these changes are seen in the upper GI tract as compared to the lower GI tract. Luminal wall thickening in the upper GI tract seen on CT is a very useful predictor of pathology (PPV = 64%). For colonic wall thickening seen on CT, the PPV was only 33%. Nevertheless, we recommend direct visualization as 10% of these findings were found to be malignancies on follow-up.

Unlabelled: Repair of anterior palate after repairing the cleft lip in complete cleft lip and palate patient is sometimes very difficult. It needs wide, extensive and difficult dissection, and has later chances of wound infection, wound dehiscence, complete wound disruption, recurrent oronasal fistula formation and also maxillary hypoplasia. In this study, we compare the outcome of simultaneous repair of cleft lip and cleft hard palate with vomer flap against cleft lip repair alone in patients with unilateral complete cleft lip and palate (UCLP)., Methods: A prospective study was carried out in 43 patients with UCLP. In Group A, 23 patients underwent cleft lip and cleft hard palate repair with vomer flaps simultaneously, and only cleft lip repair was done in another 20 patients in Group B at the first sitting. After 3 months in both groups, repair of the cleft soft palate and cleft entire palate was done. The gaps of the cleft alveolus and posterior border of the cleft hard palate were measured during the first and second operation, and duration of operations, postoperative complications and requirement of blood transfusion during the operation were also recorded., Results: The procedure of simultaneous repair of cleft lip and closure of cleft hard palate with a vomer flap is easy to perform. Cleft alveolar and gap of the posterior border of the cleft hard palate were reduced remarkably. No fistula formation occurred and no blood transfusion was needed, but the procedure took some extra operating time. These were compared with simple cleft lip repair., Conclusion: Repairs of cleft lip and simultaneous closure of cleft hard palate with vomer flaps are safe in patients with UCLP, and it makes easy the closure of the soft palate later on and decreases the chance of oronasal fistula.

Acute experimental hydronephrosis induces increased output of renin from ipsilateral kidney. In most clinical presentation of unilateral hydronephrosis the patients are however, normotensive with normal circulating plasma renin activity. In consideration of this argument we undertook this prospective study of ipsilateral renal vein renin activity in children with congenital Pelvic Ureteric Junction Obstruction (PUJO) and compared with other wise normal children. In this prospective cross-sectional study, started from July 99 to June 2001, twenty patients, age upto 12 years, with unilateral hydronephrosis and in control group ten patients without hydronephrosis were taken. 2ml blood was taken from the renal vein in study group and from infrarenal portion of inferior vena cava during exploratory laparotomy from the control group. All the patients had advanced grade of hydronephrosis and two patients (13%) had mild hypertension. In this study the mean plasma renin activity (PRA) was 45.58 ng/ml/hr (range: 11.69-67.56 ng/ml/hr) in study group. The mean PRA in control group was 5.9ng/ml/hr. The result of study group was significantly higher than normal (P value 0.0003). In Bangladesh we are doing more conservative kidney preserving surgery for PUJO, but need long term follow up of the patients undergoing surgery for PUJO in childhood for potential of developing renin-angiotensin induced hypertension in later life.

Background: There are limited data on TB among prison inmates in Bangladesh. The aim of the study was to determine the prevalence of pulmonary tuberculosis (TB), its drug resistance and risk factors in Dhaka Central Jail, the largest prison in Bangladesh., Methods: Cross sectional survey with, active screening of a total number of 11,001 inmates over a period of 2 years. Sputum samples from TB suspects were taken for acid- fast bacilli (AFB) microscopy, culture and drug susceptibility testing., Results: Among 1,781 TB suspects 245 (13.8%) were positive for AFB on microscopy and/or culture. The prevalence rate of sputum- positive pulmonary TB was 2,227/100,000. Fifty three cases (21.6% of 245 cases) were AFB- negative on microscopy but were found positive on culture. Resistance to isoniazid, rifampicin, streptomycin and ethambutol was 11.4%, 0.8%, 22.4% and 6.5% respectively. No multidrug resistance was observed. The main risk factors of TB in prison were exposure to TB patients (adjusted odds ratio 3.16, 95% CI 2.36-4.21), previous imprisonment (1.86, 1.38-2.50), longer duration of stay in prison (17.5 months for TB cases; 1.004, 1.001-1.006) and low body mass index which is less than 18.5 kg/m(2) (5.37, 4.02-7.16)., Conclusions: The study results revealed a very high prevalence of TB in the prison population in Dhaka Central Jail. Entry examinations and active symptom screening among inmates are important to control TB transmission inside the prison. Identifying undiagnosed smear-negative TB cases remains a challenge to combat this deadly disease in this difficult setting.

Background: The objectives of the present study were to determine the magnitude and factors associated with sexual intimate partner violence (SIPV) in women presenting to tertiary-care hospitals of Karachi, Pakistan., Methods: Five hundred women who presented to four tertiary-care hospitals to deliver were interviewed from September to December 2005. SIPV was assessed by using questions on sexual abuse in WHO Domestic Violence Module designed to determine intimate partner violence. Multiple logistic regression analysis was applied to determine factors associated with SIPV., Results: Twenty-one percent of women reported experiencing sexual violence in their married life. Gravida with five or more pregnancies [adjusted odds ratio (AOR) = 2.78; 95% confidence interval (CI) 1.12-6.96], index pregnancy as unwanted (AOR = 2.64; CI 1.16-6.02) and conflict with in-laws (AOR 1.9 CI 1.14-3.16) were independently associated with sexual abuse. Women who had social support were less likely to be abused by their intimate partners (AOR 0.76; CI 0.58-0.98)., Conclusion: One in five women reported spousal sexual abuse in their married life. Women having more than five children, unwanted pregnancies or reporting differences with in-laws are more likely to be subjected to such abuse. Social support protects women from sexual abuse by intimate partner.

Background: In recent years suicide has become a major public health problem in Pakistan., Aims: To identify major risk factors associated with suicides in Karachi, Pakistan., Method: A matched case-control psychological autopsy study. Interviews were conducted for 100 consecutive suicides, which were matched for age, gender and area of residence with 100 living controls., Results: Both univariate analysis and conditional logistic regression model results indicate that predictors of suicides in Pakistan are psychiatric disorders (especially depression), marital status (being married), unemployment, and negative and stressful life events. Only a few individuals were receiving treatment at the time of suicide. None of the victims had been in contact with a health professional in the month before suicide., Conclusions: Suicide in Pakistan is strongly associated with depression, which is under-recognised and under-treated. The absence of an effective primary healthcare system in which mental health could be integrated poses unique challenges for suicide prevention in Pakistan.

Objectives: To determine the magnitude of and factors associated with spousal abuse during pregnancy in women presenting to tertiary care hospitals in Karachi, Pakistan., Methods: Five hundred women who delivered a live singleton baby were interviewed. Physical and/or emotional abuse during pregnancy (PEAP) was the primary outcome measure as determined by the World Health Organization's domestic violence module. Frequencies of different forms of abuse were measured and the relationship between PEAP and the risk factors was determined using multiple logistic regression., Results: Of the women interviewed, 44% reported abuse during the index pregnancy; and of these, 43% experienced emotional abuse and 12.6% reported physical abuse. Factors independently associated with PEAP were number of living children (adjusted odds ratio [AOR] 1.34; CI, 1.08-1.65), interfamilial conflicts (AOR 3.03; CI, 1.85-4.96), husband's exposure to maternal abuse (AOR, 2.38; CI, 1.41-4.02), and husband's use of tobacco (AOR 1.59; CI, 1.05-2.42). Women who had adequate social support were less likely to be abused by their husbands (AOR 0.65; CI, 0.51-0.82)., Conclusions: Almost half of the pregnant women interviewed were either physically or emotionally abused. Strong social support helps protect against abuse.