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Haider Ali Malakzai,1 Ahmed Maseh Haidary,1 Saleema Gulzar,2 Mujtaba Haidari,1 Abdul Sami Ibrahimkhil,3 Ramin Saadaat,1 Ahmadullah Hakimi,1 Sayed Murtaza Sadat Hofiani,4 Soma Rahmani,5 Jamshid Abdul-Ghafar1 1Department of Pathology and Clinical Laboratory, French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan; 2School of Nursing and Midwifery, Aga Khan University (AKU), Karachi, Pakistan; 3Central Public Health Laboratories (CPHL), Kabul, Afghanistan; 4Department of Academics and Research, Postgraduate Medical Education (PGME), French Medical Institute for Mothers and Children (FMIC), Kabul, Afghanistan; 5World Health Organization (WHO), United Nations Office for the Coordination of Humanitarian and Economic Assistance Programmes Relating to Afghanistan (UNOCA) Compound, Kabul, AfghanistanCorrespondence: Jamshid Abdul-Ghafar, Tel +93 792827287, Email jamshid.jalal@fmic.org.afPurpose: Cancer is one of the leading causes of mortality and morbidity, and therefore, tremendous research work is continuously being done around the world with consideration of etiopathogenesis as well as identification of therapeutic targets. Decades of continuous war in Afghanistan has left the medical infrastructure of the country in a miserable situation. There is a serious deficiency in research work in the fields of pathology and oncology at the moment with minimal data available to elaborate about the demographic characteristics of various malignant disorders in the country, which would be indispensable to pave the way for further research and development.Patients and Methods: A descriptive cross-sectional study was conducted to describe the prevalence, distribution, and important histopathological features of malignant tumors reported at tertiary level in Afghanistan.Results: Out of 2328 consecutive cases of solid malignant tumors included in our study, 93.8% were primary and 6.2% were metastatic. Breast was the most common site of origin for primary malignancy (29.5%) in females; however, in males, esophagus was the leading site for primary malignant tumors (16.3%). Invasive ductal carcinoma was the most common histologic type of malignancy in females (87.9%). However, in both genders, squamous cell carcinoma of esophagus and skin, osteosarcoma of bone and soft tissue, and glioblastoma of central nervous system were the most common histologic types of malignancies diagnosed. Small intestine was a frequently involved site affected by extranodal non-Hodgkin lymphomas. Overall, the majority of the cancers were diagnosed in stage-II.Conclusion: Findings in our study were somewhat similar to data presented elsewhere in the world, with some significant differences that could be related to the local factors. Our study revealed that most of the malignant tumors were diagnosed in later stages of the disease, attributable to scarcity of specialized oncology institutions and public awareness.Keywords: cancer, prevalence, lymphoma, sarcoma, Afghanistan

In this research work, surface-modified nano zerovalent copper (nZVC) was prepared using a simple borohydride reduction method. The spectroscopic and crystallographic results revealed the successful synthesis of surface-modified nano zerovalent copper (nZVC) using solvents such as ethanol (ETOH), ethylene glycol (EG) and tween80 (T80). The as-synthesized material was fully characterized for morphological surface and crystal structural properties. The results indicated that EG provides an excellent synthesis environment to nZVC compared to ETOH and T80 in terms of good dispersion, high surface area and excellent catalytic properties. The catalytic efficiency of nZVC/EG was investigated alone and with peroxymonosulphate (PMS) in the absence of light. The degradation results demonstrated that the involvement of PMS synergistically boosted the catalytic efficiency of synthesized nZVC/EG material. Furthermore, the degradation products (DPs) of CBZ were determined by GC−MS and subsequently, the degradation pathways were proposed. The ecotoxicity analysis of the DPs was also explored. The proposed (nZVC/EG/PMS) system is economical and efficient and thus could be applied for the degradation of CBZ from an aquatic system after altering the degradation pathways in such a way that results in harmless products.

Objective This study aimed to explore bereaved parents’ and healthcare providers experiences of care after stillbirth. Study design Qualitative in-depth interviews with 55 women, men, female elders, healthcare providers and key informants in Kabul province, Afghanistan between October and November 2017. Results Inadequate and insensitive communication and practices by healthcare providers, including avoiding or delaying disclosing the stillbirth were recurring concerns. There was a disconnect between parents’ desires and healthcare provider’s perceptions. The absence of shared decision-making on seeing and holding the baby and memory-making, manifested as profound regret. Health providers’ reported hospitals were not equipped to separate women who had a stillbirth and acknowledged that psychological support would be beneficial. However, the absence of trained personnel and resource constraints prevented provision of such support. Conclusion Findings can inform future provision of perinatal bereavement care. Given resource constraints, communication training can be considered with longer term goals to develop context-appropriate bereavement care guidelines.

Kisspeptin has an important role in the stimulation of hypothalamic-pituitary-gonadal axis in term of pubertal development, release of reproductive and metabolic hormones and ultimately affecting the fertility. The aim of the present study was to evaluate the serum kisspeptin level and its correlation with semen quality and selected hormones in buffalo bulls during the summer and spring seasons. Semen and blood samples from eight Nili-Ravi buffalo bulls (age: 9.21 ± 1.02 years) were collected. Semen was analysed using computer-assisted semen analysis. Serum concentrations of kisspeptin, gonadotropin releasing hormone (GnRH), follicle-stimulating hormone (FSH), luteinizing hormone (LH), testosterone, cortisol, triiodothyronine (T3), thyroxin (T4) and insulin like growth factor (IGF-1) were estimated using enzyme-linked immunosorbent assay kits. Kisspeptin was neither affected by seasons and nor correlated with semen parameters and hormones. Higher levels of GnRH, LH, cortisol, IGF-1, total motility (TM), average path velocity (VAP), straight-line velocity (VSL), curvilinear velocity (VCL) and linearity (LIN) were recorded in summer compared to spring. Correlations of GnRH versusIGF-1 and LH, LH versus IGF-1 and cortisol, FSH versus T4 and testosterone, testosterone versus T3 and T4 and T3 versus T4 were observed. The GnRH and IGF-1 were positively associated with TM, VAP, VSL, VCL and LIN. The LH was correlated with VSL, straightness and LIN. In conclusion, GnRH, LH, and IGF-1 correlations with semen parameters can be used to indicate semen quality. The buffalo bulls are well-adapted and can give quality semen in the summer season.

Background The underlying pathways leading to stillbirth in low- and middle-income countries are not well understood. Context-specific understanding of how and why stillbirths occur is needed to prioritise interventions and identify barriers to their effective implementation and uptake. Aim To explore the contribution of contextual, individual, household-level and health system factors to stillbirth in Afghanistan. Methods Using a qualitative approach, we conducted semi-structured in-depth interviews with women and men that experienced stillbirth, female elders, community health workers, healthcare providers, and government officials in Kabul province, Afghanistan between October-November 2017. We used thematic analysis to identify contributing factors and developed a conceptual map describing possible pathways to stillbirth. Findings We found that low utilisation and access to healthcare was a key contributing factor, as were unmanaged conditions in pregnancy that increased women’s risk of complications and stillbirth. Sociocultural factors related to the treatment of women and perceptions about medical interventions deprived women of interventions that could potentially prevent stillbirth. The quality of care from public and private providers during pregnancy and childbirth was a recurring concern exacerbated by health system constraints that led to unnecessary delays; while environmental factors linked to the ongoing conflict were also perceived to contribute to stillbirth. These pathways were underscored by social, cultural, economic factors and individual perceptions that contributed to the three-delays. Discussion Efforts are needed at the community-level to facilitate care-seeking and raise awareness of stillbirth risk factors and the facility-level to strengthen antenatal and childbirth care quality, ensure culturally appropriate and respectful care, and reduce treatment delays.

In this study the radiation-induced degradation of crystal violet (CV) dye under various experimental conditions has been investigated. D0.5, D0.9 and D0.99 values suggests that lower doses are required for 50%, 90% and 99% removal of CV dye when the sample solution contains excessive amount of �OH radicals. The removal efficiency of CV dye in terms of G-values was also calculated under each reaction conditions. The results showed that �OH radicals are playing effective role in the degradation of CV dye as compared to e aq‒ and .H radicals. The gamma irradiation process effectively degraded CV dye at all pH values. The organic byproducts were examined and accordingly degradation pathway was proposed.

Background: Stillbirth rates in Afghanistan have declined little in the past decade with no data available on key risk factors. Health care utilisation and maternal com- plications are important factors influencing pregnancy outcomes but rarely captured for stillbirth in national surveys from low‐ and middle‐income countries. The 2010 Afghanistan Mortality Survey (AMS) is one of few surveys with this information. Methods: We used data from the 2010 AMS that included a full pregnancy history and verbal autopsy. Our sample included the most recent live birth or stillbirth of 13 834 women aged 12‐49 years in the three years preceding the survey. Multivariable Poisson regression was used to identify sociodemographic, maternal, and health care utilisation risk factors for stillbirth. Results: The risk of stillbirth was increased among women in the Central Highlands (aRR: 3.01, 95% CI 1.35, 6.70) and of Nuristani ethnicity (aRR: 9.15, 95% CI 2.95, 28.74). Women who did not receive antenatal care had three times increased risk of stillbirth (aRR: 3.03, 95% CI 1.73, 5.30), while high‐quality antenatal care was impor- tant for reducing the risk of intrapartum stillbirth. Bleeding, infection, headache, and reduced fetal movements were antenatal complications strongly associated with stillbirth. Reduced fetal movements in the delivery period increased stillbirth risk by almost seven (aRR: 6.82, 95% CI 4.20, 11.10). Facility births had a higher risk of still- births overall (aRR: 1.55, 95% CI 1.12, 2.16), but not for intrapartum stillbirths. Conclusions: Targeted interventions are needed to improve access and utilisation of services for high‐risk groups. Early detection of complications through improved quality of antenatal and obstetric care is imperative. We demonstrate the potential of household surveys to provide country‐specific evidence on stillbirth risk factors for LMICs where data are lacking.

This study investigates the phenol degradation by pulsed high-voltage discharge (PHVD). The effect of solution pH, temperature, treatment time and initial phenol concentration on phenol degradation were examined. The results showed that the phenol removal efficiency was increased with the rise of pH, temperature and treatment time. The phenol removal efficiency was 48%, 46%, 42% and 34%, respectively at 10, 40, 90 and 160 ppm phenol solutions. The phenol degradation rate was increased markedly when H2O2 was added into the solution. Almost complete phenol degradation (100%) was achieved when 20-40 mM of H2O2 was added into phenol solutions of 40, 90 and 180 ppm.

Quality concerns exist with stillbirth data from low- and middle-income countries including under-reporting and misclassification which affect the reliability of burden estimates. This is particularly problematic for household survey data. Disclosure and reporting of stillbirths are affected by the socio-cultural context in which they occur and societal perceptions around pregnancy loss. In this qualitative study, we aimed to understand how community and healthcare providers' perceptions and practices around stillbirth influence stillbirth data quality in Afghanistan. We collected data through 55 in-depth interviews with women and men that recently experienced a stillbirth, female elders, community health workers, healthcare providers, and government officials in Kabul province, Afghanistan between October-November 2017. The results showed that at the community-level, there was variation in local terminology and interpretation of stillbirth which did not align with the biomedical categories of stillbirth and miscarriage and could lead to misclassification. Specific birth attendant practices such as avoiding showing mothers their stillborn baby had implications for women’s ability to recall skin appearance and determine stillbirth timing; however, parents who did see their baby, had a detailed recollection of these characteristics. Birth attendants also unintentionally misclassified birth outcomes. We found several practices that could potentially reduce under-reporting and misclassification of stillbirth; these included the cultural significance of ascertaining signs of life after birth (which meant families distinguished between stillbirths and early neonatal deaths); the perceived value and social recognition of a stillborn; and openness of families to disclose and discuss stillbirths. At the facility-level, we identified that healthcare provider’s practices driven by institutional culture and demands, family pressure, and socio-cultural influences, could contribute to under-reporting or misclassification of stillbirths. Data collection methodologies need to take into consideration the socio-cultural context and investigate thoroughly how perceptions and practices might facilitate or impede stillbirth reporting in order to make progress on data quality improvements for stillbirth.

Copolymer microgel composed of N-isopropyl acrylamide and methacrylic acid, poly(NIPAM-MAA), was synthesized by free radical emulsion polymerization using N,N-(1,2-dihydroxyethylene) bisacrylamide as cross-linking agent. The hybrid microgels poly(NIPAM-MAA)-Au and poly(NIPAM-MAA)-Ag, were synthesized by in-situ reduction of metal ions using sodium borohydride (NaBH4) as reducing agent. The temperature and pH sensitivity of pure and hybrid microgels were studied by dynamic light scattering (DLS) and UV-Visible spectroscopy. The existence of gold and silver nanoparticles inside the microgel network was confirmed by transmission electron microscopy (TEM). Poly(NIPAM-MAA)-Au and poly(NIPAM-MAA)-Ag hybrid microgels were tested for the comparative catalytic activity towards the reduction of 4-nitrophenol to 4-aminophenol. The apparent rate constant (k app) for poly(NIPAM-MAA)-Au was found superior than poly(NIPAM-MAA)-Ag.

This study reports the degradation of ciprofloxacin (CIP) by means of ionizing radiations. Kinetic studies with aqueous concentrations of 4.6, 10, 15, 17.9 mg/L reveals that degradation of CIP follows pseudo-first order kinetics and the decay constant increased with decrease in initial concentration of CIP. The removal efficiency, represented by G-value, decreased with increasing absorbed dose and increased with higher [CIP]0 concentration at a given absorbed dose. The effects of bubbling CIP solution with N2, N2O or air on CIP degradation were also studied. The influence of various radical scavengers like tert-butanol, iso-propanol, HCO3- , CO3(2-) , NO3- and NO2- as radical scavengers in N2- saturated solutions of CIP indicated that 'OH were more closely associated with the radiolytic decomposition of CIP than other radicals, such as e-aq or ·H. The pH value of aqueous media played a crucial role in the degradation of CIP. It was observed that degradation efficiency was higher under acidic condition compared to degradation in natural or alkaline media. F-, CH3COO- and HCOO- were formed as a result of CIP degradation that were analyzed by ion-chromatography.

The study was conducted to evaluate the quality of cryopreserved buffalo and zebu semen thawed and held at low temperature. Progressive motility of frozen semen thawed in a 37 °C water bath for 45 s (control) was compared with that of semen held in ice water (3-5 °C) for 180 min. Semen collected from 3 buffalo and 2 zebu bulls was used for this purpose over 3 weeks (replicates). Fertility was compared after performing 28 inseminations with buffalo semen and 100 inseminations with zebu semen either after control thawing or thawing straws in ice water for 30-60 min. Progressive motility of buffalo and zebu semen thawed and held in ice water for 30 and 90 min, respectively, was not different from that of semen thawed at 37 °C. The conception rate of buffaloes and zebu cows (69.2% and 60.0%) inseminated after control thawing was higher than that of animals inseminated with semen kept in ice water for 30-60 min (53.3% and 47.7%). However, the difference between conception rates after insemination with the 2 thawing methods was not significant in either case. It is concluded that there was a trend for decreased fertility for both buffalo and zebu semen when inseminations were performed after thawing and holding semen for 30-60 min in ice water.

Conditions for in vitro maturation (IVM) of primary oocytes without conventionally used fetal calf serum and hormones were optimized in order to reduce the cost of laboratory produced buffalo embryos. Comparisons were made between oocyte recovery methods (aspiration vs. slicing) and IVM in medium 199 (static culture method vs. flux culture method) supplemented with 4-5 × 106 granulosa cells mL-1 that contained either estrus buffalo serum (EBS) or fetal calf serum (FCS). Recovery methods were compared according to yield, i.e. cumulus oocyte complexes per ovary (COCs/ovary), the expansion rate (% of COCs that expanded), and nuclear maturation rate (% of germinal vesicle breakdown [GVBD]), following IVM for 22-24 h. In vitro maturation methods (static culture with EBS or FCS and Flux culture with EBS or FCS) were compared on the basis of the expansion rate and in vitro fertilization rate (cleavage rate). COC recovery with the slicing method (2.2 COCs/ovary) was better (P < 0.05) than with aspiration (0.9 COCs/ovary). However, the IVM rate was better (P < 0.05) based on expansion (86% vs. 63%) and GVBD (85% vs. 62%) with aspiration than with the slicing method. The cleavage rate (37%) was significantly better with the static culture containing EBS than with the static culture with FCS or the flux culture with either EBS or FCS. It was concluded that aspiration of oocytes and subsequent IVM with static culture containing EBS would be a potential method to reduce the cost of laboratory produced buffalo embryos.

Due to the importance of remediating polluted environments, many mathematical models have been developed to describe population-toxicant interactions. This article considers the situation where the amount of pollution in the environment is restricted to lie below a certain value M. A model is presented and viewed as a control problem in which the toxicant input into the environment is the controllable variable. An explicit formula is computed for the input function that meets certain restrictions. By analytically studying the dynamics of the population, it is possible to provide conditions on how to set M in order to guarantee survival of the population without a significant reduction of its carrying capacity. Numerical and experimental data are described that support these results.