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Objective: To determine the frequency of mortality of patients with Acute Pancreatitis having bedside index for severity in acute pancreatitis (BISAP). Material and Methods: This was a Cross sectional descriptive study, conducted at Department of Surgery of Khyber Teaching Hospital, Peshawar-Pakistan, from January 2014 to June 2016 on patients after diagnosing the disease severity of the acute pancreatitis and expected mortality of patients were calculated on bedside index for severity in acute pancreatitis (BISAP) >3 and analyzed using Statistical Package for Social Sciences 20. Results: In this study, 65 patients presenting with acute pancreatitis were observed, in which male to female ratio was 1.24:1. The study included age ranged from 16 up to 75 years. Average age was 52.85 years + 12.99 SD. Mortality was observed in 51(78.46%) patients having acute pancreatitis by using BISAP score. Conclusion: The BISAP score represents a simple way to accurately identify patients at risk of developing severe acute pancreatitis within 24 hours of presentation in our setup. Its components are clinically relevant and easy to obtain. This risk stratification capability can be utilized to improve clinical care. [ABSTRACT FROM AUTHOR]

One of the world's largest irrigation networks, based on the Indus River system in Pakistan, faces serious scarcity of water in one season and disastrous floods in another. The system is dominated both by monsoon and by snow and glacier dynamics, which confer strong seasonal and inter-annual variability. In this paper two different forecasting methods are utilized to analyse the long-term seasonal behaviour of the Indus River. The study also assesses whether the strong seasonal behaviour is dominated by the presence of low-dimensional nonlinear dynamics, or whether the periodic behaviour is simply immersed in random fluctuations. Forecasts obtained by nonlinear prediction (NLP) and the seasonal autoregressive integrated moving average (SARIMA) methods show that the performance of NLP is relatively better than the SARIMA method. This, along with the low values of the correlation dimension, is indicative of low-dimensional nonlinear behaviour of the hydrological dynamics. A relatively better performance of NLP, using an inverse technique, may also be indicative of the low-dimensional behaviour. Moreover, the embedding dimension of the best NLP forecasts is in good agreement with the estimated correlation dimension. This provides evidence that the nonlinearity inherent in the monthly river flow due to the snowmelt and the monsoon variations dominate over the high-dimensional components and might be exploited for prediction and modelling of the complex hydrological system. Citation Hassan, S. A. & Ansari, M. R. K. (2010) Nonlinear analysis of seasonality and stochasticity of the Indus River. Hydrol. Sci. J. 55(2), 250-265. [ABSTRACT FROM AUTHOR]

The principal aim of this paper is to study and compare some of the statistical characteristics of local temperature dynamics, taking mega-city Karachi (24.51 N, 67.01 E) as a case study, with global temperature fluctuations. Therefore, temperature fluctuations are examined graphically for distributive properties and correlations. It seems that the statistical nature of local and global temperature fluctuations are similar and can be expressed by Markov processes. As correlations between the two are found to be statistically significant and high, a Bayesian regression is also established between local and global annual temperature fluctuations. [ABSTRACT FROM AUTHOR]

Abstract: Stratospheric ozone has an essential role in terrestrial life particularly in climatic variability and protects earth biosphere from the harmful UV radiations. The present study investigates the variation of the stratospheric ozone layer over Pakistan and China for the period from 1984 to 2010. For this purpose a probability distribution approach is applied. In this regard the adequacy of Normal, Gamma and Log-Normal distributions are tested with the help of Kolmogorov–Smirnov D-test. It is found that most of the months, Pakistan region follow Log-normal while China region exhibits Normal probaility distribution. In addition, mean and standard deviations of monthly ozone are also calculated. It gives more eminence to stratospheric ozone variability behavior. Furthermore, trend models are used to compute the ozone variations for the above mentioned regions.Most of the months show increasing trend except the decreasing trend in Februery and May for Pakistan and Januray and September for China. Trend analysis contributes the economic development and hydrological planning. This research is a part of a larger research project which compares the climatic variability of Pakistan with the climatic variability of neighboring countries and the other countries of the region which are considered important in this regard. Such comparisons will appear in other communications. [Copyright &y& Elsevier]

Multiple ticks (Acari: Ixodoidea) carrying Rickettsiales bacteria have significant importance for both human and animal health. Thus, the purpose of this work was to genetically analyze tick species and their associated Rickettsiales bacteria in animal hosts. In order to achieve these objectives, various animals (including camels, cattle, goats, sheep, dogs, and mice) were inspected in four districts (Mardan, Peshawar, Kohat, and Karak) of Khyber Pakhtunkhwa to collect ticks, while blood samples were collected from all the symptomatic and asymptomatic cattle in all four districts. A total of 234 ticks were obtained from 86 out of 143 (60.14%) host animals, which were morphologically identified as Rhipicephalus turanicus , Rhipicephalus microplus , Haemaphysalis cornupunctata , and Hyalomma asiaticum . Among these, their representative ticks (126/234, 53.85%) were processed for molecular confirmation using cytochrome c oxidase ( cox1 ) gene. Obtained cox1 sequences of four different tick species showed 99.72%-100% maximum identity with their corresponding species reported from Pakistan, China, India, and Kazakhstan and clustered phylogenetically. This study presented the first genetic report of Hy. asiaticum ticks in Pakistan. Moreover, genetically confirmed tick species were molecularly analyzed by PCR for detection of Rickettsiales DNA using partial fragments of 16S rDNA , 190-kDa outer membrane protein A ( ompA ), and 120-kDa outer membrane protein B ( ompB ) genes. In addition, blood samples were analyzed to identify Rickettsiales bacteria using the aforementioned genes. Rickettsiales bacteria were found in 24/126 (19.05%) ticks and 4/16 (25.00%) in symptomatic cattle's blood. The obtained ompA and ompB sequences from Hy. asiaticum ticks showed 99.73%-99.87% with Candidatus Rickettsia shennongii and unidentified Rickettsia sp., whereas the obtained 16S rDNA sequences from cattle's blood and ticks ( Hae. cornupunctata ) showed 99.67% highest identity with Anaplasma phagocytophilum . The 16S rDNA sequence of Rickettsiales DNA from Rh. turanicus ticks showed 100% identity with Ehrlichia canis and unidentified Ehrlichia sp. Obtained sequences of Rickettsiales bacteria were grouped along with their respective species in phylogenetic trees, which were previously reported in Greece, Cuba, Iraq, Turkey, Pakistan, South Korea, and China (mainland and Taiwan). This extensive study explores the wide range of damaging ticks and their corresponding tick-borne bacteria in the area, suggesting a possible danger to both livestock and human communities., 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., (Copyright © 2024 Obaid, Shehla, Guan, Rashid and Shams.)

This study assessed the knowledge, beliefs, and hesitancy toward COVID-19 vaccination among medical (MS) and nonmedical students (NMS) in Punjab, Pakistan. An online cross-sectional survey was conducted by enrolling 624 MS and 476 NMS in the largest province of Pakistan, i.e ., Punjab. Chi-square tests were used to determine significant frequency distributions, and logistic regression to determine associations. The majority of students, males and females, were between 18-25 years of age and had good self-reported health. MS demonstrated adequate knowledge and positive beliefs about COVID-19. Fewer MS were indecisive about the vaccination; nonetheless, overall, 71.5% of MS and 78.2% of NMS were willing to receive the vaccine. A greater number of MS students were concerned about vaccine safety or side effects. A greater number of NMS demonstrated misconceptions about the COVID-19 vaccine - its effect on fertility and alterations in genomic DNA. The binary logistics regression exhibited a significant association between students' knowledge in the medical sciences ( OR;1.53,p = 0.002 ) and area of residence ( OR;1.60,p = 0.008 ). Compared to NMS, MS had a better understanding of the COVID-19 vaccine and were concerned about the acceptability of the vaccine, although NMS had misconceptions about the COVID-19 vaccine. Knowledge was significantly associated with the field of study.

Despite economic growth and poverty reduction, under-5 child undernutrition is still rampant in South Asian countries. This study explored the prevalence and risk factors of severe undernutrition among under-5 children in Bangladesh, Pakistan, and Nepal for comparison using the Composite Index of Severe Anthropometric Failure. We utilised information on under-5 children from recent Demographic Health Surveys. We used multilevel logistic regression models for data analysis. The prevalence of severe undernutrition among under-5 children was around 11.5%, 19.8%, and 12.6% in Bangladesh, Pakistan, and Nepal, respectively. Children from the lowest socioeconomic quintile, and children born with low birth weight were key factors associated with severe undernutrition in these countries. The factors, parental education, maternal nutritional status, antenatal and postnatal care, and birth order were not homogeneous in explaining the determinants of child severe undernutrition across the countries. Our results suggest that the poorest households, and low birth weight of children have significant effects on severe undernutrition among under-5 children in these countries, which should be considered to formulate an evidence-based strategy to reduce severe undernutrition in South Asia., (© 2023. The Author(s).)

Intestinal parasitism is the main cause of disease all over the world and described as a significant community health problem. The current study intended to find out the occurrence and identification of hazard factors linked with IPIs among 4-12 years aged shool-age children residing in Lower Dir district, Pakistan during 2019 - 2020. A cross-sectional school-based study was conducted using a pre-arranged pre-tested survey. Anthropometric data and stool collection were done to obtain the findings. The direct wet mount preparation in saline/iodine/methods was used for stool examination. Data were investigated using the GraphPad Prism 5. A total of 400 children studied (mean age of 8.6±3.6 years) the total incidence rate for the intestinal parasitic disease was established to be 71.75%. Of the 400 children studied, the overall prevalence rate for intestinal parasitic infections was found to 71.75% Ascaris lumbricoides (33.1%), Trichuris trichiura (1.04%), E. vermicularis (1.39%), Hookworm (19.86%) were identified in children living in the study area. We concluded that there is a mass scale campaigns were required to generate alertness about health and sanitation in children and the need for the development of effective poverty control programs because deworming (killing of worm with drugs) alone is not adequate to control parasitic infections.

Intellectual disability (ID) represents an extremely heterogeneous group of disorders, characterized by significant limitations in intellectual function and adaptive behavior. Among the monogenic causes, autosomal recessive genes (ARID) are responsible for more than 50% of ID. Here, we report a novel in-frame homozygous deletion variant [c.730_753del; p.(Ala244_Gly251del)] in SOX4 (sex-determining region Y-related high-mobility group box 4), segregating with moderate to severe ID, hypotonia, and developmental delay in a Pakistani family. Our identified variant p.(Ala244_Gly251del) is predicted to remove evolutionarily conserved residues from the interdomain region and may destabilize the protein secondary structure. SOX4 belongs to group C of the SOX transcription regulating family known to be involved in early embryo development. Single-cell RNA data analysis of developing telencephalon revealed highly overlapping expression of SOX4 with SOX11 and DCX, known neurogenesis regulators. Our study expands the mutational landscape of SOX4 and the repertoire of the known genetic causes of ARID., (© 2021. The Author(s), under exclusive licence to European Society of Human Genetics.)

Background: To investigate the track of Gujrat, a District of Pakistan is very essential, either it follow-up World Health Organization (WHO) Hepatitis C Virus (HCV) elimination plan or not. This study aimed to find out HCV extinction analysis by time series forecast from District Gujrat, Pakistan., Methods: From January 1, 2016 to December 31, 2020 total n-5,111 numbers of HCV real-time polymerase chain reaction (RT-PCR) tests were performed in Gujrat. For extinction analysis we used 2 different models, the first model was seasonal auto-regressive integrated moving average (SARIMA) and the second linear regression (LR) model. First, we fitted both models then these fitted and valid models were used to predict future HCV percentage in District Gujrat., Results: In District Gujrat, the men HCV infected ratio is high with a higher viral load as compared with women, from year 2016 to 2020 male to female ratio was (53.75:53.19), (45.67:43.84), (39.67:39.36), (41.94:35.88), (37.70:31.38) respectively. HCV percentage is decreasing from 2016 to 2020 with an average of 4.98%. Our both fitted models SARIMAX (0,1,1)(0,1,1,6) at 95% confidence intervals and LR model Y = -0.379 X + 53.378 at 99% confidence intervals (P-value = .00) revealed that in June 2029 and in August 2027 respectively HCV percentage will be 0 from district Gujrat, Pakistan., Conclusions: This study concluded that both SARIMA and LR models showed an effective modeling process for forecasting yearly HCV incidence. District Gujrat, Punjab, Pakistan is on track to achieve the WHO HCV elimination plan, before 2030 HCV will be extinct from this region., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

During the present study, specimens were collected from selected sites of Cholistan desert and Kalabagh Game Reserve, Punjab province, Pakistan. Each captured specimen was tagged with voucher number and morphometric measurements were taken. The average snout to vent length was 172.559±1.40 mm and average weight was 92.1±1.30 g. The DNA of Uromastyx hardwickii was amplified and sequenced using 16S rRNA primer set. The obtained DNA sequence has shown reliable and clear species identification. After trimming ambiguous bases, the obtained 16S rRNA fragment was 520 bp while 16S rRNA fragments aligned with closely matched sequence from NCBI comprised of 510 bp. Closely matched sequences of genus Uromastyx were retrieved from NCBI in blast searches. Neighbour-joining tree of genus Uromastyx was constructed based on p-distance using MEGA X. The mean intraspecific variation was 0.095±0.01 while intraspecific variation was ranging from 0-1%. Similarly, interspecific variation of Uromastyx hardwikii with Saara asmussi, Uromastyx alfredschmidti, Uromastyx geyri, Uromastyx thomasi, Uromastyx alfredschmidti was 0-12%, 0-19%, 0-19%, 0-20%, 12-19% respectively. The newly produced DNA was submitted to NCBI and accession number was obtained (MW052563.1). Results of current study provided information about the molecular and morphological identification of Genus Uromastyx. In our recommendation, comprehensive molecular based identification of Pakistan's reptiles is required to report any new or subspecies from country.

Introduction: District Sheikhupura encountered its first dengue outbreak in 2014 but lacked serological evidence and reports of risk factors associated with it. To assess this, a hospital-based study was conducted from January 2014 to December 2017., Methodology: Blood from 333 participants was collected, the serum obtained was tested for IgG and IgM antibodies against DENV using a commercially available ELISA kit., Results: The results showed that out of all (n= 333) samples tested, 120 were turned up positive for DENV, making an overall prevalence of 36%. Of the 120 confirmed cases, 55% (n = 66) were recorded in 2014, 10% (n = 12) in 2015, 27.5% (n = 33) in 2016, and 7.5% (n = 9) in 2017. It was found that 68.3% (n = 82) were male and 31.7% (n = 38) were female, with 61% (n = 74) patients aged between 11-30 years. The highest prevalence of infection, 94.2% (n = 113), was noted after the rainy season. During the study, the highest number of cases appeared in Ferozewala Tehsil. The factors age, gender, and season were found statistically significant with the prevalence of infection (p < 0.05)., Conclusions: The study is the first report on the detection of dengue in the Sheikhupura district. The survey anticipated its geographical expansion, determined associated risk factors, and suggests active disease surveillance in the area., Competing Interests: No Conflict of Interest is declared, (Copyright (c) 2021 Muhammad Uzair Mukhtar, Maria Mukhtar, Naveed Iqbal, Zeeshan Nawaz, Adil Bhatti, Fatima Haq, Ali Arslan, Muhammad Rashid.)

Present study was planned to determine variations in external and internal quality egg parameters of different avian species including ostrich Struthio camelus, ducks Anas platyrhynchos, chicken Gallus gallus, turkeys Meleagris gallopavo and grey francolin Francolinus pondicerinus. All the birds were kept under similar rearing conditions. A total of 150 eggs were collected for each species to record external features of these eggs. Statistically significant (p<0.05) variations were recorded in egg weight, egg length and egg width between ostrich, ducks, chicken, turkey and quail eggs. Significantly (p<0.05) higher egg weight, egg length and egg width was observed for ostrich eggs while the same was lowest for grey francolin eggs. Similarly, significantly (p<0.05) greater shape index and egg volume values were observed for ostrich eggs while lowest shape index values were recorded for turkey eggs and egg volume was lowest for grey francolin. Significantly, higher (p<0.05) values of egg density were noted for eggs of the quail and the same were lowest for ostrich eggs. Non-significant variations in egg density values were observed between eggs of the ducks, chicken, turkey and grey francolin. It has been concluded that the positive correlations between the internal and external egg quality traits indicated that the traits can be improved through selection.

Drinking water supplies in the developing world often serve as a biosphere for various organisms. Viral gastroenteritis is a neglected area of research in Pakistan, there are no data for the prevalence of enteric viruses in drinking water of the largest city of Karachi. The present study aimed to provide a survey of the existence of enteric viruses: human adenovirus (HAdV), human enteroviruses (hEV), and genotype A rotavirus (GARV) in tap water. Using a simple PCR approach, we detected 20%, 43%, and 23% of HAdV, hEV, and GARV in tap water samples, respectively. We have also shown an overall quality deficit of tap water at the pumping station and consumer tap. We have found no sample free from bacterial contaminations. The ranges for a total number of the heterotrophic plate count and coliform were found 8.7 × 10 2 -4.5 × 10 6  CFU/mL and 210 to uncountable coliforms/100 mL, respectively. Moreover, we assessed the efficiency of small-scale water treatment methods for the removal of viruses.

Significant number out of 2.2 billion vision impairments in the world can be attributed to genetics. The current study is aimed to decipher the genetic basis of Leber congenital Amaurosis (LCA), Anterior Segment dysgenesis (ASD), and Retinitis Pigmentosa (RP), segregating in four large consanguineous Pakistani families. The exome sequencing followed by segregation analysis via Sanger sequencing revealed the LCA phenotypes segregating in families GCUF01 and GCUF04 can be attributed to c.465G>T (p.(Gln155His)) missense and novel c.139&#95;140delinsA p.(Pro47Trhfster38) frameshift variant of AIPL1 and GUCY2D, respectively. The c.1843A>T (p.(Lys615*) truncating allele of MERTK is homozygous in all the affected individuals, presumably suffering with RP, of the GCUF02 family. Meanwhile, co-segregation of the ASD phenotype and the c.289A>G (p.(Ile97Val)) variant of FOXE3 was found in the GCUF06 family. All the identified variants were either absent or present in very low frequencies in the control databases. Our in-silico analyses and 3D molecular modeling support the deleterious impact of these variants on the encoded proteins. Variants identified in MERTK, GUCY2D, and FOXE3 were categorized as "pathogenic" or "likely pathogenic", while the missense variant found in AIPL1 was deemed to have "uncertain significance" based upon the variant pathogenicity guidelines from the American College of Medical Genetics and Genomics (ACMG). This paper highlights the genetic diversity of vision disorders in the Pakistani population and reports the identification of four novel mutations in families who segregate clinically heterogeneous eye diseases. Our results give insight into the genotype-phenotype correlations of AIPL1, FOXE3, MERTK, and GUCY2D variants., Competing Interests: No authors have competing interests.

Background: Classical MPNs including ET and PMF have a chronic course and potential for leukaemic transformation. Timely diagnosis is obligatory to ensure appropriate management and positive outcomes. The aim of this study was to determine the mutational profile, clinical characteristics and outcome of ET and PMF patients in Pakistani population., Methods: This was a prospective observational study conducted between 2012 and 2017 at NIBD. Patients were diagnosed and risk stratified according to international recommendations. Response to treatment was assessed by IWG criteria., Results: Of the total 137 patients analysed, 75 were ET and 62 were PMF. JAK2 positivity was seen in 51 cases (37.2%), CALR in 41 cases (29.9%), while triple-negative in 17 (12.4%) cases. None of the patients in the present study were MPL positive. Overall survival for patients with ET and PMF was 92.5 and 86.0% respectively and leukaemia free survival was 100 and 91.6% respectively, at a median follow-up of 12 months. Leukaemic transformation occurred in 6.5% of MF patients; among them, JAK2 mutation was frequently found. Molecular mutations did not influence the OS in ET whereas in PMF, OS was shortest in the triple-negative PMF group as compared to the JAK2 and CALR positive patient groups., Conclusion: This study shows a different spectrum of molecular mutations in ET and PMF patients in Pakistani population as compared to other Asian countries. Similarly, the risk of leukaemic transformation in ET and PMF is relatively lower in our population of patients. The factors responsible for these phenotypic and genotypic differences need to be analysed in large scale studies with longer follow-up of patients.

Coeliac disease is a common disorder worldwide but its impact in Pakistan is unknown. We reviewed the literature to investigate what is published on coeliac disease and gluten-free diet in Pakistan. Search engines including Medline, Embase, Google were used to retrieve information. Only articles published in a medical journal were included. A total of 34 articles were retrieved, 28 of which were clinical. Of these, 14 pertained to adults and 14 described paediatric patients. Most consisted of descriptions of small series of patients or individual case reports. Five articles addressed treatment issues including gluten-free diet. Most (65%) were from Pakistani journals. All publications were from Sindh or Punjab. For a common disorder, there is a paucity of high quality scientific literature on coeliac disease from Pakistan. Systematic, prospective research studies are needed to investigate the impact of coeliac disease in Pakistan including prevalence, clinical presentations and challenges of gluten-free diet.

Background: Delayed diagnosis of Oral Cancer (OC) can mean a difference in quality and expectancy of life for the patient. This delay could be from the healthcare side, or more importantly from the patient's side. Globally, there are studies enumerating the causes for delays from the patients' side in seeking healthcare for Oral Cancer; however, no similar research is found in the context of Pakistan. This study endeavoured to understand the health seeking behaviour, reasons for delay in consultation and the impact on OC patients' lives., Methods: In-depth interviews were conducted with randomly selected OC patients at a private sector tertiary care facility in Islamabad (who met the inclusion criteria of having successfully been treated for Oral Cancer) which caters to the most diverse population for the treatment of Oral Cancer. Theoretical saturation was achieved at 14 interviews. All participants gave verbal consent for participation, which was recorded prior to the interviews., Results: Patients (age range 43-68 years) had received the surgical treatment and radiation. The reported delay before seeking a proper medical advice ranged from 1 month to 2 years. Lack of awareness about OC risk factors, symptoms, and whom to approach for treatment were the main reasons. Most respondents relied on self-treatment considering the non-healing wound/ulcer to be a minor issue until they were advised a consultation with a specialist. Treatment started within 1-3 months after a confirmed diagnosis on biopsy. The reported average expenditure on treatment was US$5000-10,000, mostly covered through a private health insurance and others borrowed the money., Conclusion: A socio-behavioural change campaign for the general population can result in earlier presentation of the OC, minimizing the financial burden on the patient as well as the health system, and improving the quality of life of the patients.

Background: Insulin resistance (IR), known to reduce the response to insulin action, develops with obesity leading to type 2 diabetes mellitus (T2DM). The PC-1 gene has been associated with dyslipidemia, polycystic ovarian disease and T2DM in different regions of the world. The objective of the present study was to investigate the genetic association of PC-1 rs1044498 polymorphism with insulin resistance in type 2 diabetes in the Punjabi population of Pakistan., Methods: This study was carried out on 161 healthy controls and 161 patients of T2DM with insulin resistance. Whole blood was collected for DNA extraction and molecular studies. PCR-RFLP with AvaII was performed to determine the genotype in cases and controls. Chi-square and Hardy Weinberg analyses were carried out. Statistical analysis was performed by SPSS software., Results: The demographic data of cases and controls showed significant differences for different parameters like glucose, insulin, Homeostatic model assessment-insulin resistance (HOMA-IR) and lipid profiles (p < 0.000). Different statistical models revealed that all the dominant models were found associated in between alleles for disease risk (p < 0.001) while no association of PC-1 rs1044498 (K121Q) polymorphism was found with insulin-resistant parameters in T2DM cases., Conclusion: Overall, the results indicate that the K121Q polymorphism was not found associated with insulin resistance in type 2 diabetes in a Pakistani Punjabi population. This is the first-ever report about the genotype of PC-1 gene in this population., (© 2019 The Authors. Molecular Genetics & Genomic Medicine published by Wiley Periodicals, Inc.)

Coccidiosis is one of the most economically important diseases of the poultry, around the globe. In order to assess seasonal and age-wise prevalence of coccidiosis individually and with concurrent infections, this study was conducted on commercial poultry farms in and around Multan division, province of Punjab, Pakistan. A total of 28,126 boilers, 4,052 layers and 7,699 golden bird samples, provided by regional farmers and consultants, were examined by microscopy for the diagnosis of coccidiosis. Based on postmortem lesions, several infections including coccidiosis, viral, and miscellaneous diseases were catalogued, whereas samples were cultured to identify concurrent bacterial diseases. Cumulative analysis of this large set of samples revealed a prevalence of 14.16, 11.01, and 19.57% in broiler, layer and golden birds, respectively. Ascaridia galli (A. galli) showed a higher prevalence in layer (2.47%) compared to golden (0.21%) birds (P < 0.01). Amongst all concurrent infections investigated, bacterial infections were identified in highest percentage of samples (59.24%; P < 0.05). The age-wise and season-wise prevalence of coccidiosis and A. galli was found to be significant (P < 0.05). During the study period, an estimated of 10.69 (coccidiosis) and 0.29 (A. galli) million poultry birds were treated or provided prophylaxis and supportive therapy at Pakistani commercial poultry farms. Depending upon the prevailing market conditions, the total economic losses (treatment, prophylaxis, and supportive therapy) from coccidiosis and A. galli were estimated to be US $45,405.00 and 2,638.50, respectively, while production (weight and eggs) losses for broiler (US$ 2,750,779.00), layer and golden, young (US$ 13,974.98 and 50,228.76) and adult (US$ 104.74 and 203.77) were estimated. Unit loss of coccidiosis with concurrent diseases and intestinal worm was estimated to be US$ 0.005 and 0.01, respectively. These results highlight the potential impact of coccidiosis individually and with concurrent infections on the poultry productivity and will inform farmers, policy makers, and other governmental and non-governmental stakeholders on the use of control and management measures in containing these infections., (© 2018 Poultry Science Association Inc.)

Purpose: Primary congenital glaucoma (PCG) is a clinically and genetically heterogeneous disease. The present study was undertaken to find the genetic causes of PCG segregating in 36 large consanguineous Pakistani families., Methods: Ophthalmic examination including fundoscopy, or slit-lamp microscopy was performed to clinically characterize the PCG phenotype. Genomic nucleotide sequences of the CYP1B1 and LTBP2 genes were analyzed with either Sanger or whole exome sequencing. In silico prediction programs were used to assess the pathogenicity of identified alleles. ClustalW alignments were performed to determine evolutionary conservation, and three-dimensional (3D) modeling was performed using HOPE and Phyre2 software., Results: Among the known loci, mutations in CYP1B1 and LTBP2 are the common causes of PCG. Therefore, we analyzed the genomic nucleotide sequences of CYP1B1 and LTBP2 , and detected probable pathogenic variants cosegregating with PCG in 14 families. These included the three novel (c.542T>A, c.1436A>G, and c.1325delC) and five known (c.868dupC, c.1168C>T, c.1169G>A, c.1209InsTCATGCCACC, and c.1310C>T) variants in CYP1B1 . Two of the novel variants are missense substitutions [p.(Leu181Gln), p.(Gln479Arg)], which replaced evolutionary conserved amino acids, and are predicted to be pathogenic by various in silico programs, while the third variant (c.1325delC) is predicted to cause reading frameshift and premature truncation of the protein. A single mutation, p.(Arg390His), causes PCG in six (~43%) of the 14 CYP1B1 mutations harboring families, and thus, is the most common variant in this cohort. Surprisingly, we did not find any LTBP2 pathogenic variants in the families, which further supports the genetic heterogeneity of PCG in the Pakistani population., Conclusions: In conclusion, results of the present study enhance our understanding of the genetic basis of PCG, support the notion of a genetic modifier of CYP1B1 , and contribute to the development of genetic testing protocols and genetic counseling for PCG in Pakistani families.

Background: Pakistan ranks 149th in the maternal mortality ratio (MMR) and has failed to keep pace with other countries in the region, except Afghanistan, with respect to health indicators. Home deliveries are linked to a higher risk of maternal death; therefore, discouraging home deliveries is imperative to improve maternal health. This study provides a holistic view and analyses factors affecting home birth decisions within the context of maternal socio-demographic characteristics in Pakistan., Methods: The study exploits the latest data from the Pakistan Demographic and Health Survey (2012-2013), which includes a nationally representative sample of 13,558 women aged 15-49 years. However, the sample was reduced to 6977 women who had given birth in the 5 years preceding the survey. Statistical techniques, including bi-variate and multivariate logistic regression, were used to analyse the data. The dependent variable was dichotomous and coded as 0 for home deliveries and 1 for deliveries at a health facility. The dependent variable was constructed based on information regarding the most recent birth in the 5 years preceding the survey., Results: The study reveals that giving birth at home is highly prevalent among mothers in Pakistan (Baluchistan, 74%; Khyber-Pakhtunkhwa, 53%; Gilgit Baltistan, 46%; Punjab, 45% and Sindh, 34%) because of their difficulty obtaining permission to visit a health facility, financial barriers, the distance to health facilities and transportation. Substantial variation is observed when geo-demographic characteristics are considered. Higher home childbirth rates have been recorded in rural areas compared with those in urban areas (OR 1.32; p ≤ 0.000). The likelihood of home birth is highest (OR 2.67; p = 0.000) among women in Baluchistan province and lowest (OR 0.48; p = 0.000) among mothers in Punjab province. After controlling for all odds ratios and demographic characteristics, the parents' education levels remain a significant factor (p = 0.000) that affects women's decisions to deliver at home rather than at a health facility., Conclusion: The study findings provide a better understanding of why women prefer to give birth at home. These results can help policymakers to introduce appropriate interventions to increase the number of deliveries at health facilities. These findings are expected to reduce maternal and neonatal mortality in Pakistan.

The dairy industry in Pakistan is booming, and investors are anxious to fund dairy farms that are using high-milk-producing (exotic) cattle breeds such as Holstein Friesians that are not native to the country. Unfortunately, the benefits of increased milk production do not provide resistance to pathogens present in regions where the exotic breeds are introduced. Therefore, the current study was conducted to evaluate the economic impact of Theileria annulata on a commercial Holstein Friesian dairy farm in the District of Ranjanpur, in the Province of Punjab, Pakistan. The economic impact of T. annulata infection was calculated for cattle with subclinical and clinical theileriosis. Losses were estimated based on milk production, morbidity, mortality, and tick control costs (organophosphate sprays). Animals were classified into groups after screening for mastitis, teat abnormality, abnormal parturition, intestinal parasites, and hemoparasites ( T. annulata, Babesia spp., and Anaplasma spp.). Microscopy was done for hemoparasites and intestinal parasites. PCR was used to confirm microscopic identification of T. annulata. Animals were classified into 3 groups: group A (normal), group B (subclinical theileriosis), and group C (acute theileriosis). Hemoparasites were observed microscopically in 28.7% of cows. Theileria annulata was found in 8%, and the herd incidence (new cases) of T. annulata was 2.8%. Milk production, animal rectal temperature, and body condition scores between group A and groups B and C were significantly different ( P < 0.05). But the enlargement of sub-scapular lymph node and interval of body condition score of the 3 groups were not significant ( P > 0.05). The total expenditure incurred due to theileriosis was US $74.98 per animal and 13.83% of total farm costs. Hence theileriosis caused significant economic loss of US $18,743.76 (0.02 million) on this Holstein Friesian dairy.

Aim of the Study: Medicinal plants are regional treasures for the treatment of many ailments. The present research investigated and documented knowledge of indigenous commonly used medicinal plants, including traditional names, preparations and uses, in the Lakki Marwat District of Pakistan. The information gathered was statistically analyzed using the ICF method to establish baseline data for more comprehensive investigations of bioactive compounds of indigenous medicinal plants., Materials and Methods: Direct interviews of 78 informants were conducted during 2013-2014 to identify the preparations and uses of indigenous medicinal plants. Data were analyzed using various quantitative tools, such as use value, factor informant consensus and fidelity level., Results: A total of 62 species of flowering plants belonging to 34 families and 57 genera were reportedly used as ethnomedicines in the study area. Fabaceae, Brassicaceae, Apocynaceae, Solanaceae, Apiaceae, Poaceae, Zygophyllaceae, Asteraceae and Euphorbiaceae were the main plant families that comprised ethnobotanically important plant species. Traditional healers most frequently used aerial parts of plants. The following medicinal species were the most important in the present study with the highest use values (UV): Plantago ovata Forsk.(F. Plantaginaceae), Lawsonia inermis L.(F. Lythraceae), Calotropis procera (Aiton) Dryand.(F. Apocynaceae), Peganum harmala L.(F. Zygophyllaceae), Fagonia indica Burm.f. (F. Zygophyllaceae), Carthamus oxyacantha M.Bieb. (F. Asteraceae), Datura metel L. (F. Solanaceae) and Eruca vesicaria (L.) Cav. (F. Brassicaceae). Respiratory, otic, gastrointestinal and neurological ailments were the main categories that were classified as per factor informant consensus (Fic). The greatest number of species was used to cure gastrointestinal and andrological/gynecological problems. The highest fidelity level (Fl=100%) was achieved by Plantago ovata Forsk. (F. Plantaginaceae) to cure cardiovascular disorders., Conclusion: The results of present study reveal that this enormous wealth of medicinal plants played an important role in the health care of the villagers in the study area. In addition, species with high use values (UV) might provide valuable leads for further pharmacological investigations., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)

Proteomic assay was carried out to asses genetic diversity in relation to geographic pattern in 97 genotypes of Pisum sativum L., collected from all over Pakistan. In total 34 bands were observed and among these, 26.7% bands were monomorphic, while 73.5% bands showed polymorphism. Based on both Province Wise Analysis (PWA) and Agro-ecological Zones (AEZ) the genotypes collected from Punjab, North West Frontier Province (NWFP) exhibited 70.6%, and 64.7% variation respectively. The germplasm collected from Azad Kashmir showed the lowest level of genetic diversity. Cluster analysis exhibited, moderate level of association, between genetic diversity and geographic pattern of the genotypes.

Objective: To analyze the results of reconstruction in terms of complications, functional restoration and cosmetic restoration of lateral cheek rotation flap., Methods: A cross sectional study was conducted between April 2004 and January 2005. Patient's particulars and history were documented. The cause, whether trauma or tumor resection, and dimensions of the defects were recorded. All the patients underwent a "cheek rotation flap" procedure to reconstruct the defect. Post-operative complications like haematoma formation, infection and flap necrosis were noted. Results were assessed in terms of functional as well as aesthetic restoration., Results: A total of 30 patients were included with a male to female ratio of 3:1 and an average age of 46 +/- 14.7. The majority of the defects (76%) were post tumour excision, while the rest (24%) followed trauma. The average defect diameter was 7.5 cms. There was no peri-operative mortality or total flap loss. There were three cases (10%) of transient facial nerve palsy who recovered spontaneously. The final reconstruction was deemed satisfactory in terms of functional and cosmetic restoration in the majority of cases (93%)., Conclusion: Our results with the lateral cheek rotation flap to reconstruct the defects involving medial cheek have prompted us to recommend it as a first line reconstructive option for many varieties of defects in this area.

During a 10-year period (December 1984 to December 1994), 1500 cases of frostbite were treated at a tertiary care medical facility. They were all males with their ages ranging from 17 to 43 years. All the patients sustained the frostbite injury in the northeastern part of Pakistan known as the Karakoram range of mountains. They included a large number of porters and guides employed by various mountaineering expeditions (approximately 250-300 expeditions per year) in that region, as well as local inhabitants. This retrospective study included the heights at which frostbite occurred (range 11,000-22,000 feet above sea level). Of the patients, 15% (n = 225) got frostbitten within 1 h of exposure, whereas the majority (71%) had an exposure of 1-3 h. The effect of seasonal variations (relative hypothermia) on the extent and depth (degree) of frostbite and the distribution of lesions as per body surface subunits (areas) was noted and found to be statistically significant with P < 0.05 for both. The occurrence of frostbite at various heights showed a very steep upward curve beyond a height of 17,000 feet above sea level. This has been termed the 'cut-off' point for frostbite by the authors, the increase depicting the true picture of 'high altitude frostbite'. Tobacco smoking and peripheral vascular disease were found to be important contributing factors. The feet were involved most frequently (64%) followed by the hands (32%), the head and neck region (3%) and the perineum (1%). Independent effects of the height (relative hypoxia) on the depth of frostbite lesion (degree) and on the involvement of multiple body areas (surface subunits) showed significant correlation with P values well below 0.05 for each. Of cases, 92% (n = 1386) had second- or third-degree frostbite necessitating definitive surgical intervention. Total frostbite-related mortality spanned over 10 years was 11%.