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Background Food practices are influenced by cultural traditions which continue to be important among immigrant groups in their new homeland, especially during significant life events, such as marriage, pregnancy and funerals, as well as for religious ceremonies and festivities. Aim This study aims to explore pregnancy related food practices among first generation Pakistani women living in the UK. Methods A total of 10 first-generation immigrant women were recruited through a voluntary organisation following a convenience sampling technique and were interviewed. Findings The data revealed that the women attached different symbolic meanings to their food practices, particularly relating to pregnancy. These findings were based on 1) their understanding of the changes their body experienced during pregnancy and 2) responding to these changes through the consumption and/or avoidance of certain foods. Conclusion Understanding the cultural contexts of Pakistani women in the UK is important in order to promote healthy food patterns for that cohort during pregnancy.

Whiplash is a soft tissue injury of the cervical spine that is generally caused by trauma from a motor vehicle accident or gunshot. It is associated with a wide range of clinical symptoms, including neck pain and stiffness, pain and restricted movement in the upper arms. We report the manifestations of this trauma within the beliefs and psychological functioning based on a comprehensive psychological assessment that include a review of hospital records, clinical examinations, a structured clinical interview, an inventory of psychosocial function, and a post-traumatic maladaptive belief scale. The results show that the patient's traumatic cervical syndrome manifested as moderate impairment in friendships and romantic relationships which reveal severe daily impairment in work, parenting, and self-care activities. The study further suggests that the injury is associated with maladaptive beliefs and significant impairment in psychosocial functioning.

The blood–brain barrier (BBB) is an important physiological barrier that separates the central nervous system (CNS) from the peripheral circulation, which contains inflammatory mediators and immune cells. The BBB regulates cellular and molecular exchange between the blood vessels and brain parenchyma. Normal functioning of the BBB is crucial for the homeostasis and proper function of the brain. It has been demonstrated that peripheral inflammation can disrupt the BBB by various pathways, resulting in different CNS diseases. Recently, clinical research also showed CNS complications following SARS‐CoV‐2 infection and chimeric antigen receptor (CAR)‐T cell therapy, which both lead to a cytokine storm in the circulation. Therefore, elucidation of the mechanisms underlying the BBB disruption induced by peripheral inflammation will provide an important basis for protecting the CNS in the context of exacerbated peripheral inflammatory diseases. In the present review, we first summarize the physiological properties of the BBB that makes the CNS an immune‐privileged organ. We then discuss the relevance of peripheral inflammation‐induced BBB disruption to various CNS diseases. Finally, we elaborate various factors and mechanisms of peripheral inflammation that disrupt the BBB.

Improvement in outcome of Malignant solid tumor cases is credited to existence of well-defined guidelines and protocols and integrated treatment modalities involving chemotherapy, surgery and radiotherapy. The present case describes a rare case of Wilms tumor extending from the left kidney to left renal vein and then via inferior vena cava into the right atrium. This patients was 5 years of age and resident of Karachi presented to the outdoor of National Institute of Child Health (NICH) with the complaints of progressively increasing abdominal distension over the last two months that exacerbated with the agony of swelling in both lower limbs. On physical examination, a mass was palpable in the left abdominal area not crossing the midline. On initial scrutiny with haematological testing and the basic radiology workup in the form of ultrasound abdomen, the patient was found to have a mass originating in the left kidney and invading the left renal vein. CT scan abdomen with contrast revealed that the patient had a heterogeneously enhancing mass of 12 X 9 cm originating from the left kidney and invading the left renal vein. The size of the tumor encroaching into the right atrium cavity was 19.5 X 20.5 mm.

BACKGROUND: Type 2 diabetes mellitus (T2DM) is a global health tissue. We determined factors relating to the likelihood of developing T2DM in normal BMI individuals. METHODOLOGY: This was a cross-sectional community-based representative survey, of people aged ≥20 years in Pakistan, using HBA1c as the screening tool. The prevalence of T2DM/prediabetes in people having normal BMI together with associated risk factors was estimated. RESULTS: Of 6824 normal BMI individuals, there was still a high prevalence of T2DM 14.92% and in underweight at 10.14% (overall prevalence 16.96%). Corresponding rates for prediabetes for the normal BMI category: 9.79% and underweight 8.99%. Multivariate logistic regression modeling for normal BMI individuals, showed a significantly increased risk of T2DM with increasing age (odds ratio [OR] 2.1, 3.3, 4.5 and 4.8, P

Purpose There is increased social discussion of the emerging issues of opioid use, health and well-being of young adults within contemporary Asian society. The purpose of this study is to contribute new knowledge of opioid-using young adults through ethnographic perspectives of the five main cultures of Pakistan. Furthermore, it tried to explore the values of opioid users. Design/methodology/approach It is a qualitative study. Semi-structured interview and observation techniques were used to gain the participants’ information, in a non-judgmental environment. Observation and life focus history interview methodology were used for data collection. The sample consisted of 18 male opioid users (approximately three from each area including: Punjab, Khyber Pakhtoon Khah, Balochistan, Sindh, Gilgit Baltistan and Azad Jammu and Kashmir). An interview script was used in interviews after written informed consent. After the detailed interview and observation of non-verbal behaviours, the researchers analysed the data by using the content analysis of qualitative method. Findings The result showed that poor relationships, conflicts over property, lack of social support and family problems increased with the use of opioids by individuals. The individual’s mental health, such as hopelessness, curiosity, mistrust and lack of interest in social activities, was the major cause of opioid addiction. Moreover, peer influences and friends may also have played contributing roles in opioids use among men. Research limitations/implications The current study added to the understanding of the relationship of different environmental, behavioural and social factors involved in developing opioid use among young individuals. The homogeneity of the sample may have weakened the generalisability of the findings of the study as all participants in the study were male. Practical implications Clinicians and allied professionals have shown a great interest in early intervention with opioid users. At the same time, there is a lack of qualitative studies exploring the lived experiences of young opioid users. That is why this study was done, to empower counsellors. Social implications Opioids, including heroin, have strong addictive tendencies. They are easily available, particularly in unplanned urban areas of Pakistan. The present study tried to understand the lived experiences and beliefs of opioid users belonging to different cultures of Pakistan. Originality/value At the same time, there is a lack of qualitative studies exploring the lived experiences of adult opioid users. Therefore, this study presented 18 interview-based facts from the opioid users belonging to different areas of Pakistan residing in capital of Pakistan. The content of these vignettes was examined in the context of an ethnographic perspective, as it has a strong connection and contribution to drug abuse.

Objective: To study the prevalence of stroke and associated risk factors in Khyber Pakhtunkhwa (KP) province of Pakistan. Methods: This study was a part of cross-sectional KP Integrated Population Health Survey 2016-17 conducted on population aging ≥18 years at 24 districts of KP. Primary (n=1061) and secondary sampling units (n=15724) were developed, based on urban/rural and socio-economic status. Each primary-unit comprised of 250-300 households. Sample was selected through a multi-staged stratified systematic cluster sampling technique by taking every 16th household per rural and every 12th household per urban-unit. A validated “Cincinnati Stroke Scale” for identification of stroke patients in community was used along with demographics and potential risk factors. Results: Among the 15724 randomly selected households, 22500 participants (51.4% females; 74.6% rural areas, mean age 42±12.6 years) were interviewed. Stroke was identified in 271 cases (137 males, 134 females; Mean age=43.39±0.85 years) and prevalence of stroke was 1.2% (1200 per 100,000 population). Obesity/overweight (38.8%), hypertension (21.8%), smoking (6.6%) and known diabetes mellitus (5.9%) were the common associated risk factors of stroke. Age groups >60 years (adjusted OR=1.68; 95% CI: 1.05-2.68); urban area (adjusted OR=1.68; 95% CI: 1.29-2.19); unemployment (adjusted OR=3.78; 95% CI: 2.49-5.73) and lower formal (primary) education (adjusted OR 2.18; 95% CI: 1.30-3.64) were significantly associated with stroke (p

Microcephaly (MCPH) is a genetically heterogeneous disorder characterized by non-progressive intellectual disability, small head circumference, and small brain size compared with the age- and sex-matched population. MCPH manifests as an isolated condition or part of another clinical syndrome; so far, 25 genes have been linked with MCPH. Many of these genes are reported in Pakistani population, but due to a high rate of consanguinity, a significant proportion of MCPH cohort is yet to be explored. MCPH5 is the most frequently reported type, accounting for up to 68.75% alone in a genetically constrained population like Pakistan. In the current study, whole exome sequencing (WES) was performed on probands from 10 families sampled from South Waziristan and two families from rural areas of the Pakistani Punjab. Candidate variants were validated through Sanger sequencing in all available family members. Variant filtering andin silicoanalysis identified three known mutations inASPM, a MCPH5-associated gene. The founder mutation p.Trp1326*was segregating in 10 families, which further confirmed the evidence that it is the most prominent mutation in Pashtun ethnicity living in Pakistan and Afghanistan. Furthermore, the previously known mutations p.Arg3244*and p.Arg1019*were inherited in two families with Punjab ethnic profile. Collectively, this study added 12 more families to the mutational paradigm ofASPMand expanded the Pakistani MCPH cohort.

The blood–brain barrier (BBB) plays a vital role in maintaining the specialized microenvironment of the neural tissue. It separates the peripheral circulatory system from the brain parenchyma while facilitating communication. Alterations in the distinct physiological properties of the BBB lead to BBB breakdown associated with normal aging and various neurodegenerative diseases. In this review, we first briefly discuss the aging process, then review the phenotypes and mechanisms of BBB breakdown associated with normal aging that further cause neurodegeneration and cognitive impairments. We also summarize dementia such as Alzheimer's disease (AD) and vascular dementia (VaD) and subsequently discuss the phenotypes and mechanisms of BBB disruption in dementia correlated with cognition decline. Overlaps between AD and VaD are also discussed. Techniques that could identify biomarkers associated with BBB breakdown are briefly summarized. Finally, we concluded that BBB breakdown could be used as an emerging biomarker to assist to diagnose cognitive impairment associated with normal aging and dementia.

Association of fatness with chronic metabolic diseases is a well-established fact, and a high prevalence of risk factors for these disorders has increasingly been reported in the third world. In order to incorporate any preventive strategies for such risk factors into clinical practice, decision-makers require objective evidence about the associated burden of disease. A cross-sectional study of 1321 adults from one of the districts of Balochistan, among the most economically challenged areas of Pakistan, was carried out for the measures of fatness and self-reported comorbidities. Body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) were measured and demographic information and self-reported comorbidities were documented. The prevalence of obesity was 4.8% (95% CI: [3.8, 6.1]) and 21.7% (95% CI: [19.5, 24.0]), as defined by the World Health Organization (WHO) international and Asia/Asia-Pacific BMI cut-offs, respectively. The proportion exhibiting comorbidity increased with increasing levels of fatness in a dose-response relationship (p value < .001). An interaction of weight status with gender was observed to produce a significantly (p=.033) higher comorbidity among overweight women (odds ratio (OR) = 6.1 [1.2, 31.7]) compared with overweight men (OR = 1.1 [0.48, 2.75], p=.762).

Castleman's disease is a rare benign lymphoproliferative disorder, characterized by benign growths of the lymph node tissue. It is associated with a number of malignancies, including Kaposi sarcoma, non-Hodgkin's and Hodgkins lymphoma, and POEMS syndrome. This report describes the case of a 38 year old gentleman, presenting with painless hematuria. Initial investigations, including flexible cystoscopy were unremarkable. However, subsequent imaging including CT Urogram and MR pelvis revealed multiple prevesical lesions. Histology obtained from excision biopsy revealed histological features consistent with Castleman's disease. In this report we discuss the nature, presentation and treatment modalities of this rare condition.

The hearing is an important sensation of all living organism to maintain his or her life mainly in human. Any distortion to it leads to hearing impairment. Hearing loss (HL) can be congenital or acquired. It can be syndromic; HL associated with other abnormalities or non-syndromic, HL is not associated with any other anomalies. Hearing impairment have mostly autosomal recessive loci, but can be autosomal dominant, X-linked, and mitochondrial. Acquired HL can be genetic or environmental factors based. Age-related HL is acquired hearing loss occur in aged population. Its prevalence rate increases with age. Genetic of presbycusis is not well-known, but NAT2*6A polymorphism, SNPs in KCNQ4, grainy head-like 2 gene, Glutamate receptor-7 gene, 4977-bp mt-DNA deletion in human and 4834-bp mtDNA deletion in rodents were identified. Different strains of mice are developed like C57BL/6J, CBA/CaJ, DBA/2J, BALB/cJ and Fisher 344 albino rats mainly used as models to study HL and presbycusis. Like other disorders have complete treatment, but HL cannot be completely treated. However some attempts can be made for its betterment by using hearing aid devices, surgical and pharmaceutical treatments. In future stem cells and gene therapy will be the affective methods to treat congenital hearing impairment and presbycusis.

The human eye is an organ of vision. It plays a prime role in life, gives us the sense of sight, and enables to understand about the world around us. Visualization and interpretation of colors, shapes and dimensions of numerous objects is made possible by eye. Inherited eye diseases comprise 1/3 of all reported human genetic disorders. This review will focus on Glaucoma which comprises a predictable visual illnesses concerning optic nerve deterioration and if remains without any cure can result in failure in eyesight. The optical nerve injure comprises deterioration of the retinal ganglion cells (RGCs). Glaucoma represents a heterogeneous group of optic neuropathies with a complex genetic basis. These neuropathies gradually reduce vision without warning and often without symptoms. Different forms of glaucoma share some common clinical manifestations that usually include specific abnormal appearance of the optic nerve head, characteristic loss of visual field and chronic painless progression. Glaucoma is a progressive optical neuropathy considered by optical disc changes, nerve fiber film break, and visual field defects. Present-day treatment preferences predominantly targeting at reducing IOP by making use of pharmaceutical means, laser treatment and surgical procedure. Developed conducts target neuroprotection with vaccines, the hang-up of NO synthesis and apoptosis. Attaining a better appreciative of the pathogenesis can support in the improvement of novel handling options and, perhaps, even a remedy for glaucoma. There are more than 1.8million glaucoma patients in Pakistan and almost half of them have already lost their eyesight, permanently, due to delay in diagnosis and treatment. About 90% population in the country has no awareness about this disease, resultantly; more and more people are becoming permanently blind in Pakistan due to untreated glaucoma.