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Background: The Directly Observed Treatment-Short Course (DOTS) Programme was implemented by WHO and includes a combination of four anti-tuberculosis (TB) drugs (isoniazid, pyrazinamide, ethambutol and rifampicin) for a period of six months to eradicate the TB infection completely. Diabetes mellitus (DM) is recognized as one of a strong contributor of TB according to World Health Organization (WHO). The presence of diabetes mellitus type 2 (DM type 2) makes TB treatment complicated. Thus, the objective of the current meta-analysis was to identify and quantify the impact of type 2DM on treatment outcomes of TB patients treated under the DOTS Programme. Methods: This meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Through a systematic review of relevant literature, we focused on studies investigating treatment outcomes including extended treatment duration and recurrence for individuals with both TB and DM undergoing DOTS therapy. The extracted information included study designs, sample sizes, patient characteristics and reported treatment results. Results: In 44 studies from different parts of the world, the pooled HR for the impact of DM on extended treatment duration and reoccurrence were HR 0.72, 95% CI 0.56-0.83, p < .01 and HR 0.93, 95% CI 0.70-1.04, p = .08, respectively. The pooled HR for impact of DM on composite TB treatment outcomes was calculated as 0.76 (95% CI 0.60-0.87), p < .01 with an effect size of 41.18. The heterogeneity observed among the included studies was moderate (I² = 55.79%). Conclusions: A negative impact of DM was found on recurrence and extended treatment duration in TB patients treated with DOTS therapy. DM type 2 is responsible for the TB treatment prolongation and TB recurrence rates. By implementing effective management strategies and advancing research, the challenges can be mitigated, arising due to the complex interaction between DM and TB. [ABSTRACT FROM AUTHOR]

Abstract Green solvents (GSs) has gained significant attention in recent years due to their potential as safer and more sustainable alternatives to traditional organic solvents. Solvents are used in a wide range of applications, from industrial processes to everyday products. Solvent emissions and losses can have a significant impact on the environment and human health, which is why many initiatives are being undertaken to get rid of or switch to eco-friendly alternatives. A key area of green chemistry that led to the concept of “green” solvents is the development of alternative solvents that are less toxic and more environmentally friendly than traditional organic solvents. The advantages of using green solvents over conventional ones are their environmental friendliness, biocompatibility, biodegradability, and simplicity of preparation. Different sample preparation techniques have successfully utilized green solvents to offer a sustainable separation media for the extraction of a variety of inorganic and organic compounds which are crucial for research in environmental samples. Recent developments in green analytical chemistry (GAC) have focused on how to prepare and use samples using environmentally sustainable solvents. The current study covers the advance and currently used green solvents with an emphasis on environmentally friendly sample preparation methods. This review aims to briefly summarize the current state of knowledge about the use of green solvents particularly ionic liquids, deep eutectic solvents and switchable solvents (SSs) with the perspective of GAC in sample preparation methods. [ABSTRACT FROM AUTHOR]

In the era of globalization, information and communication technology (ICT) plays a crucial role in economic development and environmental sustainability. ICT enables economies to interact with each other around the globe, and the current fast ICT mode makes globalization a reality in today's technological world. However, its abrupt rise in installation and operation may increase energy demand and environmental degradation. Thus, this study embarks upon the role of ICT and financial development in shaping a low-carbon environment for sixty Belt and Road Initiative (BRI) economies using balanced panel data spanning 1990–2018. This study adopts the Driscoll–Kraay standard error long-run estimation technique and the Dumitrescu–Hurlin panel causality approach. The results reveal that ICT, financial development, and globalization are negatively related to CO2 emissions; however, economic growth and electricity consumption stimulate CO2 emissions, threatening environmental sustainability. Interestingly, a U-shaped relationship is observed between economic growth and CO2 emissions for BRI economies. Moreover, the causality results reveal bidirectional causal relationships between ICT, financial development and globalization with CO2 emissions. The findings urge the adoption of advanced ICT in the industrial sector for efficient energy use and socioeconomic development. [ABSTRACT FROM AUTHOR]

The emergence of antimicrobial resistance (AMR) is a threat to public health. In 2015, the World Health Organization (WHO) introduced a global action plan to tackle AMR in the World Health Assembly. Pakistan's national action plan (NAP) for AMR was released in May 2017 by the Ministry of National Health Services. Based on the NAP, strategies have been initiated on a national and provincial scale in Pakistan. This narrative review of the five components of the Pakistan NAP has been undertaken to discuss some of the challenges in implementation of the NAP for AMR in Pakistan including different opinions and views of key stakeholders, combined with suggestions on potential ways to reduce the burden of the AMR. Going forward, healthcare authorities should focus on screening and monitoring of all the objectives of the NAP by establishing proper policies as well as promoting antimicrobial stewardship interventions and Infection prevention and control (IPC) practices. Overall, the comprehensive strengthening of the healthcare system is required to adequately implement the NAP, tackle continued inappropriate antimicrobial use and high AMR rates in Pakistan. [ABSTRACT FROM AUTHOR]

Objective: To examine the effect of age on procedural and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) lesions. Methods: Literature search was conducted across PubMed, Google Scholar and Web of science, databases till March 2019. Results: Seven studies including 7671 patients with an overall follow-up period of 1.5 to 5 years were included in our review. A total of 6299/1372 patients were included in non-elderly and elderly groups, respectively, with mean age and 67%/61% male patients. CTO-PCI was similarly successful in younger and older patients (82.8%, n = 5070 vs. 78.1%, n = 1010). The incidence of short-term outcomes was low across the studies and comparable between the two groups (all-cause mortality: 0.4% younger vs. 0.85% elderly, cerebrovascular accidents: 0.3% vs. 0.4%, major adverse cardiovascular events (MACE): 1.53% vs. 3.72% and major bleeding: 0.57% vs. 2.18%). Long-term outcomes including all-cause mortality (8.89% vs. 29.5%), cardiac mortality (3.72% vs. 15%) and MACE (24.9% vs. 40%) occurred with a higher incidence in elderly patients. When results were segregated according to the success of CTO-PCI, reduced clinical events were noted with successful revascularization in either age group. Conclusion: Compared with the younger age group, CTO-PCI in elderly patients is safe and feasible with a comparable incidence of short-term outcomes. In either population, the incidence of long-term outcomes including survival remains a concern but when successful, CTO-PCI may be associated with improvement in terms of multiple patient-important clinical end-points. [ABSTRACT FROM AUTHOR]

A greenhouse experiment was conducted to evaluate the effects of wheat straw and its biochar on tomato seedling growth and soil physicochemical properties under different moisture levels. Treatments included control (no amendments, CK), three biochar amendments (B1: 1%, B2: 3% and B3: 6% w/w) and three straw amendments (S1: 1%, S2: 3% and S3: 6% w/w), under two moisture levels (M1: 40% water holding capacity (WHC) and M2: 70% WHC). The straw and biochar had contrasting effects on soil physiochemical properties and physiology of tomato seedlings. The B1 treatment significantly increased the soil urease activity (15%) and decreased the activity of dehydrogenase and β glucosidase enzymes (67% and 56%), as compared to the S1 treatment, especially for the high moisture condition. Biochar significantly improved shoot and root dry weights, biomass and altered chlorophyll contents. Plant antioxidants, superoxide dismutase (SOD), Peroxidase (POD) activities and malondialdehyde (MDA) were significantly decreased in biochar treatments, however, an increasing trend was observed for straw treatments. The current findings suggest that application of high amount of biochar (6%) or low amount of straw (1%) would be a reasonable management practice in semi-arid regions to improve soil physiochemical properties and the physiology of tomato seedlings. [ABSTRACT FROM AUTHOR]

Few studies have reported on the distribution, food choices, general behaviour, and interactions of the Asiatic black bear (Ursus thibetanus) with humans. We explored the conservation status of the species and its conflicts with humans in the Kaghan Valley, northwest Pakistan. From September 2013 to December 2015, residents from 24 villages in three major regions of the Kaghan Valley were interviewed about human-bear conflicts. In parallel, a survey for signs of bear presence was conducted to assess bear presence, including bear attacks and crop damage that occurred during the survey period. Most interviewees (70%) confirmed that human-bear conflicts exist, and that they arise primarily from crop raiding (n = 40), followed by attacks on livestock (n = 32) and humans (n = 15). Most interviewees stated that they actively disliked bears (47.3%), or had a generally negative perception of bears (63.3%). Such responses were strongly associated with living close to or within bear habitat. Bears raided approximately 3.8 ha of maize per year, mainly from July to September. Our survey revealed that bears used habitats ranging from dense forest to scrub lands, but preferred steep, high-altitude habitats with dense tree cover. Anthropogenic activities (such as hunting, clear-cutting, expansion of infrastructure, and conversion of forest to agricultural land) were the main causes of conflict between humans and bears. Future studies should collect data on the movement and habitat use of individual bears to facilitate the development of appropriate management strategies to conserve this species effectively. We also recommend training Wildlife Department employees to interact with the local communities to implement acceptable mitigation measures to reduce the currently high conflict levels and thus improve acceptance for bear presence and conservation. [ABSTRACT FROM AUTHOR]

In this article, the author discusses the role of health education in addressing uncertainity about health and cell phone use. It highlights the role of health educators when scientific uncertainty exists about the emerging topics including emerging health risks associated with lifestyle changes. It investigates the incidence of cancer initiated by hand-held cellular phone use and other health impacts.