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Anthropogenic activities, such as industrial discharge, cargo handling, and untreated wastewater release, have led to significant heavy metal contamination along the Karachi coastline, posing risks to marine life and human health. Current study evaluated the health risks associated with consuming five fish species (Trichiurus lepturus, Sillago sihama, Acanthopagrus arabicus, Otolithes cuvieri, and Nemipterus japonicus) by analysing muscle tissues for arsenic, chromium, copper, and nickel accumulation. Nemipterus japonicus and Otolithes cuvieri exhibited hazard index (HI) values greater than 1, indicating potential non-carcinogenic risks to adults, particularly due to high arsenic levels. Other species were deemed safe for consumption. Present study emphasises the need for further investigation into contamination sources and recommends regular monitoring of heavy metal levels to mitigate health risks from fish consumption. [ABSTRACT FROM AUTHOR]

Shrimp are widely recognized as a nutritious and flavorful food choice due to their tender and delicious meat. This study evaluated the nutritional composition of three economically important shrimp species: Penaeus merguiensis, Penaeus monodon, and Penaeus indicus, collected from the coastal areas of Pakistan. All shrimp species were found to be high in protein and low in fat content. The ratio of essential amino acids (EAAs), non-essential amino acids (NEAAs), and total amino acids (TAAs) varied significantly (p ≤ 0.05) among species, with P. indicus showing slightly higher values. Regarding fatty acid analysis, total saturated fatty acid content was found to be 35.04% in P. merguiensis, 52.43% in P. monodon, and 44.77% in P. indicus. Similarly, the polyunsaturated fatty acid content was found to be 26.24%, 26.77%, and 24.74%, in P. merguiensis, P. monodon, and P. indicus, respectively. Based on nutrient yield, P. monodon stands out as the most nutrient-dense species, followed by P. indicus and P. merguiensis. Overall, the present study suggests that all shrimp species can be used as a healthy choice of food and a good source of animal protein for human consumption. These findings provide valuable insights into the role of shrimp in promoting a healthy and balanced diet. [ABSTRACT FROM AUTHOR]

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

Background: The accumulation of unusual fluids within the pleural cavity is known as a pleural effusion. Pleural effusions can be classified as either transudative or exudative. Objective: The aim of the study was to explore the Etiology and Clinical Impact of Pleural Effusion in Pediatric Patients. Methodology: This cross-sectional study was carried out at the Department of Pulmonology and Paediatric Medicine, Qazi Hussain Ahmad Medical complex, Nowshera from February 2019 to January 2020 after taking approval from the ethical committee of the institute. A total of 80 children aged less than 15 years old were included. All children underwent testing to determine the reasons of their pleural effusion. All the data was analyzed statistically. Results: A total of 80 children with pleural effusion were enrolled in this study. Out of them 50 (62.5%) were male and 30 (37.5%) were female. Cough was the most frequent symptom observed in these children. Heart failure was the most frequent reason for transudative pleural effusion. Out 47 children had done tube thoracotomies out of 49 cases of parapnemonic effusion, and in 35 of those cases, streptokinase was given. Of all 35 cases, 23 had satisfied response in regards to lung expansion and pleural fluid drainage, while 11 still had non-expanding lungs and a localized pleural effusion; as a result, the patients were sent to a thoracic surgeon underwent decortications. Conclusion: The most frequent reason for pleural effusion among children is parapneumonic effusion. Children responded well to intrapleural SK, which prevents many patients from undergoing surgery. [ABSTRACT FROM AUTHOR]

Among the huge diversity of ideas that show up while studying graph theory, one that has obtained a lot of popularity is the concept of labelings of graphs. Graph labelings give valuable mathematical models for a wide scope of applications in high technologies (cryptography, astronomy, data security, various coding theory problems, communication networks, etc.). A labeling or a valuation of a graph is any mapping that sends a certain set of graph elements to a certain set of numbers subject to certain conditions. Graph labeling is a mapping of elements of the graph, i.e., vertex and/or edges to a set of numbers (usually positive integers), called labels. If the domain is the vertex-set or the edge-set, the labelings are called vertex labelings or edge labelings respectively. Similarly, if the domain is V (G)[E(G), then the labeling is called total labeling. A reflexive edge irregular k-labeling of graph introduced by Tanna et al.: A total labeling of graph such that for any two different edges ab and a'b' of the graph their weights has ωtχ(ab) = χ(a) + χ(ab) + χ(b) and ωtχ(a'b') = χ(a') + χ(a'b') + χ(b') are distinct. The smallest value of k for which such labeling exist is called the reflexive edge strength of the graph and is denoted by res(G). In this paper we have found the exact value of the reflexive edge irregularity strength of the categorical product of two paths Pa × Pb for any choice of a ≥ 3 and b ≥ 3. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequency of failed spinal anesthesia during cesarean section. Material and Methods: Th is cross sectional study was conducted in Department of Anaesthesia, Khyber Teaching Hospital, Peshawar from January 2016 to December 2017. A total of 241-women were observed. 0.5% Bupivacaine with dose ranging from 1.8 to 2 ml were injected by lumbar punctures using a midline approach at L2/3, L¾ or L4/5. Th e level of spinal block was assessed with ice use by loss of cold and touch perception. Aft er determination of the height of sensory block, the surgeon observed for pain sensation using the non-tooth forceps to pinch the skin at the site of the incision. Th ose women experience pain aft er 10-min of administering spinal anaesthesia was classifi ed as failed spinal anaesthesia. Results: Th e over all mean age was 30±10.23 years. 32% patients had ASA grade-I and 68% patients had ASA grade-II. 25% patients had emergency caesarean section while 75% patients had elective caesarean section. 14(6%) patients had failed spinal anesthesia while 227(94%) patients didn't had failed spinal anesthesia. Conclusion: Our study concludes that the frequency of failed spinal anesthesia was 6% during cesarean section. [ABSTRACT FROM AUTHOR]

Background: Partial medial menisectomy has no adverse results. The objective of the study was to determine the demographic attributes of meniscal tears cases and to assess the radiological findings before and after partial medial menisectomy. Material & Methods: This cross-sectional study was conducted in department of Orthopedics, DHQ Teaching Hospital, DIKhan and DHQ Hospital Tank from January 2005 to December 2006. Sample size was 60 and sampling technique was non probability, consecutive. Adult, admitted patients with medial meniscus injury in whom conservative treatment failed to produce relief were included in the study. Patients with associated ligamentous injuries and those having grade 3 osteoarthritis were excluded. The demographic variables were sex and age groups. Research variables were; presenting symptoms, types of meniscal tears, mechanisum of injury, time interval between injury and surgery, duration of relief of symptoms after surgery and radiological findings before and after surgery. All the variables being categorical, were calculated by frequency and percentages. SPSS Version 20 was used for data analysis. Result: Out of 60 patients, 42(70%) were males and 18(30%) were females. Forty (66.7%) of our patients had age below 40 years. The presenting symptoms were pain in 37(61.7%), locking in 18(30%) and instability in 5(8.3%) patients. The mechanism of injury was history of slip in 16(26.7%), sport’s injury in 34(56.7%) and in the rest 10(16.7%) patients the cause was unknown. The right knee was found to be involved in 80% patients. Modal duration of time between injury and surgery was less than 1 month 20(33.3%). Modal type of meniscal tear was Bucket handle 42(70%). Modal duration of relief of symptoms after surgery was less than 1 month 40(66.7%) and modal radiological findings before and after 10 years of surgery were grade 0 55(91.7%) and 48(80%). Conclusion: Mostly the right knees undergo meniscal tears in young males engaged in physical activities including sports. The major presenting symptom is pain. Partial medial menisectomy is an alternative procedure to treat meniscal tear, after conservative management fails and indication for meniscus repair is not there. [ABSTRACT FROM AUTHOR]

Background: Phalangeal and metacarpal fractures are the most common skeletal injuries. Most of these fractures which are reducible and stable can be treated by non-operative methods like casts, splints or braces. However some fractures which are irreducible and unstable require open or closed reduction and fixation. The aim of this study was to evaluate the effectiveness of k-wire fixation in phalangeal and metacarpal fractures with minimal dorsal incision. Material & Methods: This descriptive study was conducted in Orthopedic Unit, DHQ Teaching Hospital D.I.Khan, Pakistan on 54 patients treated with k-wires through a minimal dorsal incision. First follow-up was done after second week, at this time stitches were removed and slab was discontinued. Follow-up was done monthly for 3 months and then every 3 months for one year. Results: Among 54 patients 41 (76%) were males and 13 (14%) were females, with male to female ratio of 3:1. Among these 37 (68%) were above forty years and 17 (32%) below forty years age. Regarding the types of fractures 37 (68.5%) were transverse, 12 (22.2%) oblique and 5 (9.3%) fractures were comminuted. The modal healing time was 6-8 weeks. Regarding the range of movements after the procedure; 100% of normal ROM was attained in 27, >90% of normal in 20, 75-90% of normal in 4, 50-75% of normal in 2 and <50% of normal in one case. In respect to complications there was only one case of infection and one case of non-union. Conclusion: If properly selected and timely managed excellent results can be achieved in phalangeal and metacarpal fractures with the simple procedure of k-wire fixation with a minimal dorsal incision. [ABSTRACT FROM AUTHOR]

Congenital insensitivity to pain with anhydrosis (CIPA) is a rare genetic disorder characterized by inability to feel pain and temperature, and decreased or absent sweating. Familiarity to this condition is important to avoid misdiagnosing it with leprosy and other peripheral nerve diseases. An inability to feel pain may lead to repeated self-trauma (tongue, lips and finger tips) ultimately leading to self-mutilation. We report a case of CIPA who presented with a non-healing ulcer on the heel with a history of fingers being eaten by the patient himself along with multiple fractures in different bones and inability to sweat. [ABSTRACT FROM AUTHOR]

Atrichia with papular lesions (APL) is a hair abnormality characterized by loss of hair on the scalp and rest of the body. In a few cases, hair loss is accompanied by the appearance of keratotic papules on the body. It is inherited in an autosomal recessive manner. Sequence variants in the HR (hairless) gene are responsible for this hair abnormality. Here, we present nine consanguineous families and one nonconsanguineous family with clinical manifestations of APL. Whole exome followed by Sanger sequencing and/or direct Sanger sequencing was performed to identify pathogenic variants. The study revealed seven novel pathogenic variants c.794del;p.(Pro265Argfs*98), c.2921-2936del;p.(Tyr974Leufs*16), c.2889C>A;p.(Cys963*), c.2689C>T;p.(Gln897*), c.3186&#95;3187dup;p.(Gln1063Profs*43), c.560dup;p.(Tyr188Ilefs*131), c.2203+5G>C, c.2776+5G>A, and the previously reported variant c.1837C>T;p.(Arg613*) in HR in these families. The study not only expands the mutational spectrum in the HR gene but also highlights the unusual phenotypic findings and will facilitate genetic counseling of families with members showing various types of hair loss disorders in the local population., (© 2024 Japanese Dermatological Association.)