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The district Toba Tek Singh is located in the center of Punjab province. It occupies 2nd important position in national citrus production after Sargodha, with citrus orchard area of 11412 hectares and annual production of 160758 tons. Citrus productivity in Pakistan, in general, and Toba Tek Singh, in particular, is far below its its potential which could be attributed to several factors but poor soil health and inadequate soil fertility may be considered an important reason. A comprehensive nutrient indexing survey of thirty citrus orchards grown in different parts of district Toba Tek Singh was conducted to evaluate the soil characteristics and plant nutrient status. GPS coordinates of selected sites were recorded prior to sampling. Soil samples were coll ected at 0-20 cm, 21-40 cm and 41-60 cm depth using standard procedure. Five soil samples were collected from each site to get a composite sample for each depth. The leaf samples were collected from the 7-month-old non-fruiting branches of plants around the tree canopy during the month of September, 2022. Five healthy and uniform citrus trees were sampled from each site to get a composite leaf sample. The soil samples were analyzed for pH, electrical conductivity (EC), soil organic matter (SOM) and calcium carbonate (CaCO3). The soil and leaf samples were analyzed for macro and micronutrients. It was found that most of orchard soils of district Toba Tek Singh were moderately alkaline (pH 7.52-8.90), slight to strong calcareous (2-15% CaCO3), non-saline (0.77-3.0 dS m-1 EC) and low in SOM (0.23-1.49%) with low to medium nitrogen (0.01-0.06%) and phosphorus (0.58-10.52 mg kg-1) while medium to high potassium (56.47-315.34 mg kg-1). The sampled soils were low to marginal in boron (0.09-0.72 mg kg-1), copper (0.05-0.59 mg kg-1), iron (0.23-10.75 mg kg-1) and zinc (0.03-1.83 mg kg-1) while adequate in manganese (1.35-26.20 mg kg-1). Leaf analysis revealed that almost 50% orchards were deficient in phosphorus (0.05-0.23%) and potassium (0.40-1.76%), while having low to marginal values of copper (1.96-20.99 mg kg-1), zinc (4.13-31.96 mg kg-1), boron (3.12-95.40 mg kg-1), manganese (42.62- 96.46 mg kg-1) but adequate iron (171-552 mg kg-1). The surveyed orchard soils were mostly alkaline calcareous, deficient in organic matter and having low to moderate macro and micronutrients. [ABSTRACT FROM AUTHOR]

Background: Accurate and precise diagnosis is central to treating central nervous system (CNS) tumors, yet tissue diagnosis is often a neglected focus in low- and middle-income countries (LMICs). Since 2016, the WHO classification of CNS tumors has increasingly incorporated molecular biomarkers into the diagnosis of CNS tumors. While this shift to precision diagnostics promises a high degree of diagnostic accuracy and prognostic precision, it has also resulted in increasing divergence in diagnostic and management practices between LMICs and high-income countries (HICs). Pathologists and laboratory professionals in LMICs lack the proper training and tools to join the molecular diagnostic revolution. We describe the impact of a 7-year long twinning program between Canada and Pakistan on pathology services. Methods: During the study period, 141 challenging cases of pediatric CNS tumors initially diagnosed at Aga Khan University Hospital (AKUH), Karachi, were sent to the Hospital for Sick Children in Toronto, Canada (SickKids), for a second opinion. Each case received histologic review and often immunohistochemical staining and relevant molecular testing. A monthly multidisciplinary online tumor board (MDTB) was conducted to discuss the results with pathologists from both institutions in attendance. Results: Diagnostic discordance was seen in 30 cases. Expert review provided subclassification for 53 cases most notably for diffuse gliomas and medulloblastoma. Poorly differentiated tumors benefited the most from second review, mainly because of the resolving power of specialized immunohistochemical stains, NanoString, and targeted gene panel next-generation sequencing. Collaboration with expert neuropathologists led to validation of over half a dozen immunostains at AKUH facilitating diagnosis of CNS tumors. Conclusions: LMIC-HIC Institutional twinning provides much-needed training and mentorship to pathologists and can help in infrastructure development by adopting and validating new immunohistochemical stains. Persistent unresolved cases indicate that molecular techniques are indispensable in for diagnosis in a minority of cases. The development of affordable alternative molecular techniques may help with these histologically unresolved cases. [ABSTRACT FROM AUTHOR]

This essay highlights the significance of cross-cultural religious literacy (CCRL) initiatives that foster interfaith understanding and peace in Pakistan. It sheds light on the obstacles encountered in promoting CCRL, such as the prevalence of extremism and prejudices in educational settings, while underscoring the pivotal role of education in countering divisive narratives. The essay advocates for integrating CCRL courses and modules into secular and religious educational institutions, emphasizing the importance of inclusive policies and community involvement. Furthermore, it highlights the positive impact of CCRL education on various professional fields, ranging from clergy members to policymakers, in cultivating a more cohesive and tolerant society. [ABSTRACT FROM AUTHOR]

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Pediatric high-grade glioma (pHGG) is highly malignant central nervous system tumor and constitute 10% of the pediatric gliomas. Effective treatment needs a functioning multi-disciplinary team including pediatric neuro oncologist, neurosurgeon, neuroradiologist, neuropathologist and radiation oncologist. Despite surgical resection, radiotherapy and chemotherapy, most HGG will recur resulting in early death. A significant proportion of HGG occurs in context of cancer predisposition syndromes like Constitutional Mismatch Repair Deficiency (CMMRD) also known as Biallelic Mismatch Repair Deficiency (bMMRD) characterized by high mutational burden. The incidence of HGG with CMMRD is one per million patients. bMMRD is caused by homozygous germline mutations in one of the four Mis Match Repair (MMR) genes (PMS2, MLH1, MSH2, and MSH6). The use of TMZ is now avoided in CMMRD related HGG due to its limited response and known ability to increase the accumulation of somatic mutations in these patients, increasing the risk of secondary tumors. HGG should be managed under the care of multidisciplinary team to receive optimum treatment. This is particularly important for low middle-income countries (LMIC) with limited resources like Pakistan. [ABSTRACT FROM AUTHOR]

Background: Review of the published articles does not show any study done to see if children with torus fracture are with Vitamin D deficiency. The aim of this study was to determine association of inadequacy of Vitamin D level with torus fracture and its predictors in children in Karachi Pakistan. Methods: Patient underage of 13 years came with torus fracture were included in study, and managed non-operatively with below elbow cast. Proforma was made which includes demographic data (age, gender, nutritional status) and exposure to sunlight, dietary habits, kind to apparel and type of accommodation they were living at. All participants underwent measurement of serum vitamin D level. Results: Out of 558 children presented with limb fractures in emergency department, 190 (34.05%) had torus fracture, with mean age of 6.0 ± 4.2 years. 93 (48.94%) in pre-school group, 59 (31.05%) in school and 38 (20%) were breast-fed. On nutritional status, malnourished were 72 (37.89%), out of which 32 (44.44%) had first-degree malnutrition. On vitamin D level status only 52 (27.36%) participants had Vitamin D within normal range while 86 (45.26%) were found Vitamin D deficient. We found that vitamin D level is directly related to nutritional status, duration of sun exposure maternal vitamin d levels and not significantly related to age, gender, type of accommodation and different fabric types. Conclusion: In this study torus fracture in children is significantly associated with Vitamin D deficiency, with common predictors including nutritional status, maternal Vitamin D level for lactating mothers and duration of exposure of sunlight. Vitamin D supplementation in children can prevent a significant number of fractures via national programs for food fortification and increase the awareness of general population on the importance of sunlight exposure and intake of food rich in Vitamin D. [ABSTRACT FROM AUTHOR]

This paper examines the implications of terrorism and extremism as non-traditional security threats on Pakistan's society and politics in the post-9/11 era. The objective of the study is to gain a comprehensive understanding of how these threats have influenced societal dynamics and political structures within the country. The background section provides context on the rise of terrorism and extremism globally, particularly after the September 11, 2001 attacks. The methodology involves a comprehensive analysis of scholarly literature, government reports, and data to assess the impact of terrorism and extremism on various sectors of Pakistani society. The results indicate that these threats have significantly affected social cohesion, religious tolerance, and political stability in Pakistan. Based on the findings, the paper presents recommendations to address these challenges effectively, emphasizing the need for inclusive governance, deradicalization programs, and counterterrorism strategies that focus on both military and socio-economic dimensions. [ABSTRACT FROM AUTHOR]

The current study was carried out to isolate, identify and characterized fresh water green algae species from ecologically diverse habitats of Tehsil Gujar Khan, District Rawalpindi. A microscopic image data was used to identify algal species. A total of 30 species were recorded that belonged to 4 orders, 11 families, and 14 genera. Clamydomonas reinardtii, Acutodesmus obliquus and Cosmarium isthmocondrum are new record from Pakistan. Among identified taxa, Scenedesmus was the dominant genus with 8 species and their contribution was 26.6%. The 2nd most dominant genus was Cosmarium with 6 species and their contribution was 20%. The other genera Chlorococcum, Ankistrodesmus, Coelastrum, and Closterium were (6.6%). Some genera represented only one (3.3%) species that were Chlamydomonas, Eudorina, Tetraspora, Chlorella, Westella, Pediastrum, Acutodesmus, and Stigeoclonium. Hence, the current study reveals that Gujar Khan, District Rawalpindi is a rich source of green algae and an ideal place for their cultivation. [ABSTRACT FROM AUTHOR]

Background: Globally, there is an increased risk of COVID-19 infection among front-line health workers (FHW). This study aimed to evaluate the knowledge, attitude, and practices of FHW of Pakistan after receiving the COVID-19 vaccine. Methods: A population web-based survey on COVID-19 vaccine was conducted on 635 FHW in Pakistan between April 15, 2021, and July 15, 2021. The survey focused on four main sections consisting of socio-demographic data, knowledge, attitude, and practices after receiving the COVID-19 vaccine. The data was analyzed on SPSS. p < 0.05 was considered significant. Results: Overall, 60% of FHW were nervous before getting vaccinated, with the leading reason to get vaccinated being their concern to protect themselves and their community (53.4%). A majority of FHW had fear about the unseen side effects of the COVID-19 vaccine (59.7%) used in Pakistan, with the most common side effect reported as soreness at the injection site (39%). It has been noted that almost all of the FHW observed preventive practices after getting vaccinated. The results showed that married respondents had favorable practices towards COVID-19 vaccines (B = 0.53, p < 0.01) (B, unstandardized regression coefficient). It was also found that more informational sources (B = 0.19, p < 0.01), higher knowledge of vaccination (B = 0.15, p < 0.001), and favorable attitude toward vaccine (B = 0.12, p < 0.001) significantly predicted favorable practices toward COVID-19 vaccination. Conclusion: The findings reflect that FHW, though they were worried about its side effects, have good knowledge and a positive attitude after getting the COVID-19 vaccine. This study is significant as the FHWs are a symbol for guidance, a reliable source of information, and an encouraging means of receiving COVID-19 vaccine for the general public. This study also reported that post-vaccination side effects were mild which will aid in reducing the vaccine hesitancy among the general Pakistani population. [ABSTRACT FROM AUTHOR]

Background: The development of oral and oropharyngeal cancers is associated with human papillomavirus (HPV) infection. However, debate exists about the prevalence of high‐risk oral HPV (HR‐HPV) and its associated risk factors. This study evaluated the distribution of genotypes and associated risk factors of oral HR‐HPV infection in the normal oral mucosa of the Pakistani female population with general gynecological problems. Methods: A total of 200 females from a regional gynecological hospital in Pakistan were included in this cross‐sectional study. A self‐administered questionnaire was carried out, followed by the study participants' oral and dental examinations. Whole saliva was collected by a drooling method. The viral DNA extraction and oral HR‐HPV genotyping were detected via real‐time polymerase chain reaction. Results: Among the 200 females (mean age, 37.76 years), 22 females (11%) were positive for oral HR‐HPV DNA. Single oral HR‐HPV infection was seen in 8%, whereas co‐infection was observed in 3% with HPV16 and HPV18 most common genotypes. Comparison of the risk factors like oral sex history odds ratio (OR 8.21, 95% confidence interval [CI] 1.85–28.16; p < 0.005), and open‐mouth kissing (OR, 5.17; 95% CI 1.48–27.41; p = 0.005) with oral HR‐HPV infection was found to be significantly associated. Conclusion: In Pakistan, oral HR‐HPV‐positive infection is not uncommon; HPV16 and HPV18 are the most frequent genotypes. Furthermore, this study also provides data that oral HR‐HPV positive infection was significantly associated with sexual behaviors. Therefore, preventive health efforts, like health education and vaccination, should be practiced. [ABSTRACT FROM AUTHOR]

Islam stipulates its adherents to abide by religious principles in their economic transactions. The aim of this study is twofold. First, it accounts for the adherence of Shariah board members of Islamic banks with the Fit and Proper Criteria (FAPC) promulgated by State Bank of Pakistan (SBP). Second, it explores the current state of provision of Islamic finance education in the universities and madaris (i.e., Islamic seminaries) in Pakistan. This is the unique study in a sense because it draws attention of the stakeholders concerned (i.e., SBP, Higher Education Commission, Ittehad-e-Tanzimat Madaris-e-Deeniya & Ministry of Education) to revisit and make strategic milestones in congruent with the demand-supply gap of Islamic professional experts. Total sample consists of 21 banks, out of which the first five are full-fledged Islamic and remaining 16 are the commercial banks with Islamic banking branches. Descriptive research design has been employed to examine the supply of Shariah experts from madaris and universities in Pakistan. Our findings reveal the following: (1) Profiles of all the Shariah board members fully comply with the FAPC of SBP, and more than 50% of members represent multiple boards of Islamic banks. (2) With 26,000 madaris across Pakistan, 75% of the Shariah experts received their education from one Madrisa named Jamia-dar-ul-uloom, Karachi. Notably, province-wise stats highlight Punjab atop in terms of madaris (45% to 56%) in the country, though it produces less than 10% scholars for the Islamic banks' Shariah boards. A similar situation persists in Khyber Pakhtunkhwa that has 1354 to 3136 madaris and only one Shariah scholar received education from this province. Karachi, the capital of Sindh province and hub of Islamic seminaries, solely contributed more than 85% SB members to the Islamic banks. (3) Among the top fifteen business schools of Pakistan, only four are offering a degree in Islamic finance. Moreover, these four schools have only eight full-time faculty members with a core degree in Islamic finance. This study suggests the practitioners to increase the supply of Shariah scholars and also strengthen the capabilities and skills of human capital regarding Islamic finance education through education, training, social awareness and capacity building. [ABSTRACT FROM AUTHOR]

Pakistan and other South Asian countries rely on wheat for human nutrition. However, wheat yield is declining in the region due to several biotic and abiotic constraints. Weeds are among the major factors responsible for yield decrease and farmers manage them by intensive tillage practices. Several studies have investigated the impact of various tillage practices on weed management in wheat. However, weed suppression abilities of different mulch types are rarely tested. This three-year (2019–20, 2020–21 and 2021–22) study investigated the impact of different mulch types (prepared from different crops) on weed infestation, soil properties and productivity of wheat under conventional and conservation production systems at three locations (Multan, Hafizabad and Faisalabad) in Punjab, Pakistan. The mulches included in the study were cotton sticks mulch, mungbean straw mulch, sorghum straw mulch, rice straw mulch, sunflower straw mulch, plastic mulch, and no mulch (as control). The production systems opted for wheat cultivation were conventionally tilled wheat (CTW), zero-tilled wheat (ZTW) and zero-tilled wheat sown with happy seeder machine (HSW). The CTW resulted in the lowest soil bulk density and the highest soil porosity after wheat harvest, while ZTW behaved oppositely. Similarly, incorporation of crop mulches resulted in the highest soil porosity and the lowest soil bulk density, while no-mulch incorporation and plastic mulch recorded the highest bulk density and the lowest soil porosity. Regarding mulches by production systems' interaction, CTW with sorghum straw- and plastic mulches recorded the lowest weed density and biomass, while ZTW with no-mulch recorded the highest weed density and biomass at all locations. The CTW with mungbean straw- and plastic mulches resulted in the highest yield due to significant improvement in yield-related traits. However, ZTW with sorghum straw mulch and no-mulch resulted in the lowest wheat yield. Although sorghum straw mulch suppressed weed infestation, it negatively affected wheat growth. Economic analysis revealed that CTW with mungbean straw mulch resulted in the highest gross and net incomes and benefit:cost ratio (BCR), while the ZTW with rice straw- and sorghum straw mulches produced the lowest gross and net incomes and BCR at all locations. Therefore, mungbean straw mulch is a viable option to improve wheat productivity and net economic returns under different agro-climatic conditions of Punjab, Pakistan. [ABSTRACT FROM AUTHOR]

This research work investigates the association between psychological ownership and innovative behaviour with knowledge hiding and knowledge sharing as mediators. The latter variables are presented as focal antecedents of preventive and promotive psychological ownership. To conduct the study, a theoretical framework was proposed, and data was collected from professionals working in complex management systems in Pakistan. The analysis revealed that knowledge hiding and knowledge sharing can exist simultaneously, and psychological ownership can evoke both positive and negative feelings in employees, which poses a challenge for the management. The results illustrate that psychological ownership has significant associations with knowledge hiding, knowledge sharing, and innovative behaviour. Consequent theoretical contributions and important managerial implications are discussed at the end. [ABSTRACT FROM AUTHOR]

Acinetobacter baumannii is a notorious bacterial pathogen that can cause an array of nosocomial infections in clinical settings. However, the data from the veterinary settings is limited and especially in Pakistan, no such study is conducted so far. To investigate the prevalence, antimicrobial resistance, and distribution of specific sequence types of A. baumannii in cattle, a total of 1,960 samples were collected from cattle over 18 months from Punjab, Pakistan. The isolates obtained were identified using the API20NE system and confirmed through PCR. The isolated A. baumannii isolates were further screened for antimicrobial susceptibility and the presence of resistance genes. Multilocus sequence typing was carried out to characterize the carbapenem-resistant A. baumannii (CRAB) isolates. Results revealed an overall prevalence of A. baumannii at 3.31% (65/1,960) with a higher prevalence of 7.38% (54/731) in dairy cattle compared to beef cattle at 4.41% (11/249). Among 65 A. baumannii isolates, 27.7% (18/65) were CRAB. All CRAB isolates harbor class D β-lactamases genes blaOXA-23 and blaOXA-51, whereas 94.4% (17/18) CRAB isolates carried class B β-lactamases gene blaIMP, and only one isolate had blaNDM-1 gene. The commonly found sequence types for CRAB isolates were ST2 and ST642 corresponding to 10 and 05 isolates, respectively. The presence of CRAB in cattle indicates an alarming situation that necessitates an urgent and efficient surveillance system to limit the transmission of CRAB among the cattle population and its possible transmission to humans and the environment. [ABSTRACT FROM AUTHOR]

Counterfeiting has become a prevalent business worldwide, resulting in high losses for many businesses. Considerable attention has been paid to research an individual attitude toward purchasing luxury counterfeit products in the offline context. However, there is currently lesser-known literature on the given phenomenon in the context of social commerce. Moreover, researchers observed that counterfeiting consumption is associated with consumer ethical values or beliefs. Practitioners and researchers are keen to find those factors that affect consumers’ ethical consumption behavior to reduce pirated products’ demand. However, the role of religion in shaping ethical behavior is less documented in the counterfeiting context. Therefore, this study investigated the effect of religiosity on the counterfeiting of luxury products in Pakistan. A five-dimensional Islamic religiosity model was adopted to understand the consumption phenomena. For quantitative research, cross-sectional data were collected from the generation M of Pakistan through self-administrative questionnaires. A total of 394 valid responses from active online users were collected to empirically examine the conceptual model by employing the partial least square structural equation model (PLS-SEM). The results reveal that all five dimensions of religiosity negatively affect the attitude of generation M. Moreover, it is found that knowledge has the highest negative effect on attitude, followed by orthopraxis, experience, central duties, and basic duties. The study also explains the theoretical and practical implications of the research. Finally, limitations and future research were also discussed. [ABSTRACT FROM AUTHOR]

During the COVID-19 epidemic, personal safety has received increasing attention, leading to behavioral changes. Mobile-wallet (m-wallet) makes it easier for people to keep social distance, which helps stop the spread of the COVID-19 virus. Evolving Internet technology has brought about changes in consumer lifestyle. The current situation of COVID-19 has created a business environment to shift from traditional ways and adopt e-commerce solutions worldwide. Grounded in technology acceptance model (TAM) theory, this study’s objective is two-fold: First, this study intends to examine perceived susceptibility to COVID-19, perceived severity of COVID-19, insecurity and discomfort as the predictors of perceived usefulness (PU) and perceived ease of use (PEOU). Second, the current research intends to test the moderating effect of electronic words-of-mouth (eWOM) on the relationship between attitude and usage intention. Using survey methods, 226 usable responses were collected through a mall intercept survey in Pakistan. Data were analyzed using partial least square (PLS). The results revealed that PEOU and PU positively influence attitude toward M-wallet. This study has found that attitude positively influences the usage intention in adopting M-wallet. The results also support the moderating role of eWOM. These findings contribute to the marketing literature in several ways, particularly in Pakistan. This is the first study to use eWOM as a moderating variable in the TAM theory. In addition, this study adds to the current body of knowledge by considering eWOM as a multi-dimensional construct novel in m-wallet literature. [ABSTRACT FROM AUTHOR]

This study examines the influence of financial distress on corporate restructuring decisions and whether this restructuring varies across the Firm Life Cycle (FLC) stages of Pakistani non-financial listed firms for the 12 years from 2005 to 2016 inclusive. FLC stages and financial distress are measured using the Dickinson model and Altman Z-score, respectively. Corporate restructuring is segregated into equity and debt restructuring. The data are analyzed using a panel logistic regression model. The results reveal that financial distress is negatively associated with corporate debt restructuring decisions and positively associated with corporate equity restructuring decisions. Further analysis shows that new, growing and mature firms have positive associations with equity restructuring decisions and negative associations with debt restructuring decisions, while declining firms prefer debt restructuring. This study has important implications for corporate managers and policy makers. [ABSTRACT FROM AUTHOR]

Background: Child and adolescent mental health problems are a global public mental health priority. However, there is a lack of evidence-based scalable psychological interventions for adolescents living in low resource settings. This trial was designed to evaluate the feasibility and acceptability of delivering the World Health Organization's Early Adolescent Skills for Emotions (EASE) intervention at public schools in a rural sub-district in Rawalpindi, Pakistan. Methods: A two arm, single blinded, feasibility cluster randomized controlled trial with mixed-methods evaluation was conducted with 59 adolescents and their caregivers from 8 public schools. In the 4 intervention arm schools, 6 non-specialist facilitators delivered the culturally-adapted EASE group sessions to the adolescents (n = 29) and their caregivers with desired fidelity under the supervision of in-country supervisors. Results: The participation rate of adolescents in the intervention sessions was 83%. The intervention strategies were implemented by the adolescents. However, attending biweekly sessions at schools was challenging for caregivers with only 50% caregivers attending the sessions. Conclusions: The results of this study support the feasibility and acceptability of delivering this culturally adapted intervention through non-specialist facilitators in school settings in Pakistan and pave the way to conduct a fully powered cluster randomized controlled trial to test the effectiveness of intervention to improve psychological outcomes in adolescents. Trial registration Trial registered with Clinicaltrials.gov prospectively; NCT04254393. [ABSTRACT FROM AUTHOR]

AN experiment conducted on the guar crop had three main objectives. Choosing the ideal time to sow, determining the appropriate plant density, and examining the effects of various planting dates and plant densities on the yield and yield-related factors of various guar varieties. The field experiment was conducted at the Agricultural Research Station in Bahawalpur in 2019 and 2020. Two guar genotypes (BR-2017 and S-6384) were used in a splitsplit plot design with three replications to evaluate the three plant densities (D1: 15, D2: 25, and D3: 40 plants/m2) and six planting dates (from 1st May to 15th July). The results showed that the early sowing dates (1st May to 1st June) improved the plant height, pod length, clusters per plant, number of pods per cluster, grain per pod, and seed yield. The late planting dates (15th June to 15th July) produced the lowest values of these attributes. The results showed that the yield was not affected by the plant density, but other morphological traits were varied. The study found a significant difference in the yield between the two guar varieties at all the sowing times and plant densities tested. In 2019, BR-2017 had the best yield, and S-6384 had the best yield in 2020. It is concluded that farmers in Pakistan should sow their guar crop between the 1st of May to the 1st of June. It is important to note that plant density has a marginal effect on yield. In two years, both guar genotypes performed admirably. [ABSTRACT FROM AUTHOR]

Objective: To compare the effectiveness of Team-based learning and flipped classrooms in terms of test scores in undergraduate medical education. Study Design: Quasi-experimental study. Place and Duration of Study: Federal Medical College, Islamabad Pakistan, from Mar to Jun 2020. Methodology: A total of 100 first-year MBBS students were randomly equally allocated to either team-based learning or flipped classroom for biochemistry class. In the former technique, students were assigned a topic from the textbook as prereading material. In contrast, in the latter technique, they were given an audio-based power-point lecture before class. Then, students were asked to review the material and prepare at least three questions to ask during class in the flipped classroom while they followed a modified team-based learning class. In the first session, there were (n=43) and (n=39) students in the Team-based Learning and Flipped Classroom group, whereas in the second session, 40 students each attended class. However, in the third and fourth sessions, attendance was 100.0%. Each session was given a pre and post-test based on 20 Multiple Choice Questions. Results: Females were in the majority (57%), and most students (72%) were 17 years of age. Team-based learning scored better than Flipped Classroom in each session. For example, in session 1, the mean scores were 67.0 ± 10.4 in Team-Based Learning and 48.3 ± 8.4 in Flipped Classroom group (p-value <0.001). The difference in marks obtained continued in sessions 2, 3 and 4. Conclusion: Team-Based Learning is more effective than Flipped classrooms in teaching biochemistry to medical students. [ABSTRACT FROM AUTHOR]

Context: The production of chickpea (Cicer arietinum L.) is negatively affected by boron (B) deficiency. In Pakistan, the crop grown under B deficiency produces grains with low B concentration. Application of B-tolerant bacteria (BTB) is a promising option to improve B supply to plants grown under B deficiency. Aims: This study was focused on determining the appropriate concentration of B for seed priming, and its effects with BTB inoculation on growth, productivity and grain B concentration of chickpea. Methods: Chickpea seeds were primed in aerated solutions of B concentrations in the range 0.01–0.5% (w/v), with hydroprimed and dry seeds as controls. Concentrations >0.1% proved toxic and seeds failed to germinate. Hence, B was further diluted to concentrations in the range 0.0001–0.1%. Pots containing chickpea seeds were divided into two sets having all B treatments. One set was inoculated with BTB (5 mL per pot of pure Bacillus sp. MN54 culture at 10 9 cfu mL−1); the other set was not inoculated. Key results: Seed priming with B along with BTB inoculation improved stand establishment, growth, nodulation, yield and grain B concentration of chickpea. Seed priming treatments with B at 0.001% and 0.0001% along with BTB inoculation were most effective for improving stand establishment, seedling growth and grain yield, whereas 0.1% B was more effective for improving grain B concentration. Conclusions: Seed priming with 0.001% B along with inoculation of Bacillus sp. MN54 improved seed germination, nodulation, yield and grain B concentration of chickpea under B-deficiency conditions. Implications: Seed inoculation with BTB i.e., Bacillus sp. MN54 coupled with seed priming in 0.001% B solution is a viable option to improve yield and grain B concentration of chickpea grown on B-deficient soils. Boron (B) deficiency is the leading constraint to chickpea productivity in Pakistan. Results of this study elucidated that B seed priming at lower rates (0.001% and 0.0001%) along with seed inoculation with B-tolerant bacteria (Bacillus sp. MN54) improved the productivity and grain-B biofortification of chickpea. Higher levels of B seed priming (>0.1% B solution) proved toxic, with no germination recorded. [ABSTRACT FROM AUTHOR]

Objective: to assess the impact of androgenetic alopecia (AGA)/female patterned hair loss (FPHL) on the quality of life of Pakistani patients using Skindex-29 scale. Study Design: Cross-sectional study. Place and Duration of Study: Outpatient Department of Dermatology, Combined Military Hospital, Lahore Pakistan, from Oct 2020 to Mar 2021. Methodology: Three hundred patients (150 males and 150 females) having androgenetic alopecia (AGA)/female patterned hair loss (FPHL) were selected by consecutive sampling. Skindex-19 questionnaire was used to assess the impact of alopecia on their quality of life. Results: Mean age of study participants was 41.6 ± 12.4 years (range: 18-72 years). Maximum patients (40.7%) had grade-1 severity of alopecia. Most of the patients (37.3%) had disease duration of 1-5 years. Mean global score, symptoms scale score, emotion scale score and function scale score were 31.3 ± 14.8, 22 ± 22.56, 41.67 ± 28.1 and 30 ± 26.5 respectively. Gender and disease duration were statistically significant (p=0.001 and p=0.013 respectively). Conclusion: Skindex-29 can be successfully used in our setup for quality of life studies in AGA/FPHL patients. Females were more severely affected than males as per global scores on Skindex-29. [ABSTRACT FROM AUTHOR]

Background Complete diagnostic autopsy (CDA) is considered to be the gold-standard procedure that aids in determination of cause of death in stillbirths and neonatal deaths. However, CDA is not routinely practiced in South Asian countries due to religious beliefs, lack of expertise, and lack of resources. Minimally invasive tissue sampling (MITS) has been recommended as a less mutilating and less expensive alternative to CDA for obtaining tissues for analysis. The present study aims to evaluate the yield of lung tissue and histological findings using MITS as part of a cause of death analysis for stillborns and preterm neonatal deaths. Methods Data were collected during an observational multicenter prospective study called the Project to Understand and Research Preterm birth and Stillbirth (PURPOSe) conducted in India and Pakistan. After obtaining written informed consent from parents, the eligible stillbirths and neonatal deaths were subjected to MITS using a standard protocol. The tissues were obtained from both lungs for histological and microbiological analysis. Results At both sites, a total of 453 stillbirths and 352 neonatal deaths underwent MITS. For stillbirths and neonatal deaths, the yield of lung tissue using MITS was high (92%). Intrauterine fetal distress and respiratory distress syndrome were the leading lung pathologies reported in stillbirths and neonatal deaths, respectively. Conclusions MITS appears to be a reasonable alternative to CDA in obtaining and evaluating lung tissue to inform accurate cause of death analysis in stillbirth and preterm deaths. [ABSTRACT FROM AUTHOR]

In Pakistan, wheat used as a staple food that provides necessary nutrients and has a wide adaptation in different environments. A set of 18 wheat (Triticum aestivum L.) genotypes were tested at 23 different locations (Environments) in all over Pakistan. The AMMI biplot analysis was used to identify the genotypes performance across the environments and Genotype Environment Interaction (GEI). The G5 and G6 genotypes performed excellent across the 23 environments, therefore their yield performance are stable at all locations of Pakistan during 2015-16. While, G4, G5, G11, G17 performed very well at all locations during 2016-17. The performance of G5 genotype remains stable in both year of study at all locations so we strongly recommend for cultivation in any region of Pakistan. The G1 (E13), G16 (E14), G11 (E2), G3 & G5 (E18), G14 (E15, E19), and G7, G10 (E10) these genotypes perform well in specific environment and so respective genotypes recommended for specific region where performance remains excellent. The selection of ideal environment in which performance of genotypes are excellent. The three environments (E4, E1 and E10) are best environment in which all genotypes perform very well during both years of study. [ABSTRACT FROM AUTHOR]

BACKGROUND: The rapid expansion in economies has resulted in overconsumption which is alarming for the environment. Patterns of consumption play a key role in the worsening environmental surroundings, causing consumers to seek sustainable features in their buying patterns. Therefore, it is vital to understand the elements that lead to sustainable purchase intentions (SPI). OBJECTIVES: This study investigates the impact of distinct green practices – environment (EnV), perceived environmental responsibility (PreR), environmental advertisement (AvT), and eco-labeling (EcL) – on SPI. The originality of the present study lies in the investigation of distinct practices on SPI which has been ignored in past studies. METHODS: The data were collected from the main cities of Pakistan (n = 300) and analyzed using the partial least square and CFA. RESULTS: The results demonstrate the positive nexus of such practices – EnV, PreR, AvT, and EcL – on SPI. They provide extensive input into the growing literature of psychology in terms of humans' sustainable consumption behavior with empirical evidence from a developing nation. CONCLUSIONS: This study provided the implications for the marketers along with future research directions for academicians and practitioners. [ABSTRACT FROM AUTHOR]

GUAR is a drought tolerant, summer annual legume, well adapted to arid and semi-arid regions of Pakistan. Guar gum is important product which is obtained from guar seed and has worldwide uses in different industries. Therefore, there is a dire need of evolution of new high yielding, short duration and early maturing varieties of guar. Keeping in view the above facts, Agricultural Research Station, Bahawalpur is conducting research to develop new varieties. The present newly developed variety BR-21 (strain name S-5823) is high yielding, short duration, non-hairy with a wider range of adaptability. Yield data (grain yield) were collected from the guar varietal performance trials conducted over eight consecutive years (2011-2020). This strain performed better when evaluated/tested in 7 different yield performance trails including commercial variety as a check from year 2013-2018. The BR-21 also performed excellent in the agronomic trials (Sowing date, fertilizer requirement, row spacing, and irrigation levels) compared to check variety in different years of study. Finally, it is concluded that BR-21 is a non-hairy and very easy to harvest than previous guar varieties. It contains high gum contents (34.9%) than check variety. It is high yielder, early maturing and requires very low inputs. It is comparatively resistant to insect pests and diseases. It is short duration variety, therefore, wheat, raya, chickpea and other Rabi crops can be sown well in time. [ABSTRACT FROM AUTHOR]

Background: Globally, there is a large documented gap between needs of families and children with developmental disorders and available services. We adapted the World Health Organization's mental health Gap-Intervention Guidelines (mhGAP-IG) developmental disorders module into a tablet-based android application to train caregivers of children with developmental disorders. We aimed to evaluate the effectiveness of this technology-assisted, family volunteers delivered, parents' skills training intervention to improve functioning in children with developmental disorders in a rural community of Rawalpindi, Pakistan. Methods: In a single-blinded, cluster randomized controlled trial, 30 clusters were randomised (1:1 ratio) to intervention (n = 15) or enhanced treatment as usual (ETAU) arm (n = 15). After screening, 540 children (18 participants per cluster) aged 2–12 years, with developmental disorders and their primary caregivers were recruited into the trial. Primary outcome was child's functioning, measured by Childhood Disability Assessment Schedule for Developmental Disorders (DD-CDAS) at 6-months post-intervention. Secondary outcomes were parents' health related quality of life, caregiver-child joint engagement, socio-emotional well-being of children, family empowerment and stigmatizing experiences. Intention-to-treat analyses were done using mixed-models adjusted for covariates and clusters. Results: At 6-months post-intervention, no statistically significant mean difference was observed on DD-CDAS between intervention and ETAU (mean [SD], 47.65 [26.94] vs. 48.72 [28.37], Adjusted Mean Difference (AMD), − 2.63; 95% CI − 6.50 to 1.24). However, parents in the intervention arm, compared to ETAU reported improved health related quality of life (mean [SD] 65.56 [23.25] vs. 62.17 [22.63], AMD 5.28; 95% CI 0.44 to 10.11). The results were non-significant for other secondary outcomes. Conclusions: In the relatively short intervention period of 6 months, no improvement in child functioning was observed; but, there were significant improvements in caregivers' health related quality of life. Further trials with a longer follow-up are recommended to evaluate the impact of intervention. Trial registration Clinicaltrials.gov, NCT02792894. Registered April 4, 2016, https://clinicaltrials.gov/ct2/show/NCT02792894 [ABSTRACT FROM AUTHOR]

Background: The novel coronavirus disease-2019 (COVID-19) has seriously affected the lives of millions of people across the world. It has also heavily burdened healthcare professionals and the virus poses serious risks for their personal and professional lives. Therefore, the present study examined the associations between fear of COVID-19 and workplace phobia among doctors in Pakistan during the COVID-19 pandemic.Methods: An online survey was conducted among 421 doctors in Pakistan between April 10 and May 25, 2020. The Workplace Phobia Scale (WPS) and the Fear of COVID-19 Scale (FCV-19S) were the main psychometric instruments used in this study.Results: There was a significant positive relationship between fear of COVID-19 and workplace panic anxiety and workplace avoidance behavior. Significantly higher fear of COVID-19 was found among (i) females compared to males, (ii) doctors with 5 years or less of work experience compared to those with more than 5 years, and (iii) postgraduate trainees compared with other ranks. Two groups (doctors who were above 30 years old and postgraduate trainees) were found to have higher levels of workplace phobia compared to their counterparts. Doctors with severe levels of fear of COVID-19 had significantly higher levels of workplace panic anxiety and workplace avoidance behavior.Conclusions: Fear of COVID-19 was significantly associated with workplace phobia which may negatively affect doctors' performance. Therefore, important steps are needed to protect doctors' health by providing sufficient resources to allay their fears and anxieties which consequently help them in carrying out their frontline duties in response to the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Efforts to build research capacity and capability in low and middle income countries (LMIC) has progressed over the last three decades, yet it confronts many challenges including issues with communicating or even negotiating across different cultures. Implementing global research requires a broader understanding of community engagement and participatory research approaches. There is a considerable amount of guidance available on community engagement in clinical trials, especially for studies for HIV/AIDS, even culturally specific codes for recruiting vulnerable populations such as the San or Maori people. However, the same cannot be said for implementing research in global health. In an effort to build on this work, the Pakistan Institute of Living and Learning and University College London in the UK sought to better understand differences in beliefs, values and norms of local communities in Pakistan. In particular, they have sought to help researchers from high income countries (HIC) understand how their values are perceived and understood by the local indigenous researchers in Pakistan. To achieve this end, a group discussion was organised with indigenous researchers at Pakistan Institute of Living and Learning. The discussion will ultimately help inform the development of a cultural protocol for researchers from HIC engaging with communities in LMIC. This discussion revealed five common themes; (1) religious principles and rules, (2) differing concepts of and moral emphasis on autonomy and privacy, (3) importance of respect and trust; (4) cultural differences (etiquette); (5) custom and tradition (gift giving and hospitality). Based on the above themes, we present a preliminary cultural analysis to raise awareness and to prepare researchers from HIC conducting cross cultural research in Pakistan. This is likely to be particularly relevant in collectivistic cultures where social interconnectedness, family and community is valued above individual autonomy and the self is not considered central to moral thinking. In certain cultures, HIC ideas of individual autonomy, the notion of informed consent may be regarded as a collective family decision. In addition, there may still be acceptance of traditional professional roles such as 'doctor knows best', while respect and privacy may have very different meanings. [ABSTRACT FROM AUTHOR]

Journalistic practices have always been remained a researchable debate among the researchers. The power in hand of the journalists to reveal the truth has increased the importance of the topic. This study is focused on exploring the issues faced by the journalists while their professional practices in Pakistan whereas, social issues in result of the journalistic practices. Primary and secondary sources were applied for the purpose of data collection. The method of exploratory quantitative survey was applied to reach out the results. The outcomes of the study found the journalists dissatisfied with their jobs due to the long working hours and hectic routines meanwhile, dissatisfaction level had badly affected their social circles. It was also contributed that the journalists were facing difficulties in their professional practices. [ABSTRACT FROM AUTHOR]

Background: In many low resource settings, the provision of government mental health care services is limited to specialized psychiatry units in urban hospital care facilities, where the most common treatment for common mental disorders (CMDs) is pharmacotherapy, occasionally with adjunct nonspecific psychological support. We aimed to evaluate the effectiveness of adding a low intensity, psychological intervention, Problem Management Plus (PM+) for CMDs into routine care in a specialized mental health care facility in Pakistan. Methods: A two arm, single-blind individual randomized controlled trial (RCT) was carried out with adults (N = 192), referred for psychological support by psychiatrists. The study participants were randomized (1:1) to PM + plus Treatment as Usual (TAU) (n = 96) or TAU only (n = 96). The primary outcomes were symptoms of anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS) and functional impairment as measured by WHO Disability Assessment Schedule (WHODAS 2.0) at 20 weeks after baseline. Results: The analysis was done on intention-to-treat principle. The linear mixed model analysis showed that at 20 weeks after baseline, there was a significant reduction in symptoms of anxiety and depression (mean [SD], 16.23 [8.81] vs 19.79 [7.77]; AMD, − 3.10; 95% CI, − 0.26 to − 5.76); p = 0.03 and improvement in functioning (mean [SD], 22.94 [9.37] vs 27.37 [8.36]; AMD, − 4.35; 95% CI, − 1.45 to − 7.24); p = 0.004 in PM + plus TAU versus TAU arm. The follow-up rate was 67% at primary end-point. Conclusions: Specialized care facilities in LMICs may consider adding brief, evidence-based psychological treatments for CMDs to their routine care. Trial Registration Australian New Zealand Clinical Trials Registry, ACTRN12616000381482. Registered March 23, 2016. Retrospectively registered, https://www.anzctr.org.au/Default.aspx/ ACTRN12616000381482 [ABSTRACT FROM AUTHOR]

Using the assumptions of Sternberg (2003) Duplex Theory of Hate, the present study reveals the combined effects of similar competitor offer and narcissistic personality on brand equity through the underlying mechanism of brand hate. Specifically, we hypothesize that brand hate mediates the relationship between similar competitor offer and brand equity. Moreover, we propose that similar competitor offer and brand hate relationship are stronger for narcissistic individuals. By employing a multi-wave time-lagged research design, we collected data from a sample of (N = 338) dairy product consumers in Pakistan. The findings of moderated-mediation regression analyses indicate that (a) Brand hate mediates the relationship between similar competitor offer and brand equity; and (b) Narcissistic personality moderates a similar competitor offer and brand hate relationship such that a high similar competitor offer led to greater brand hate when narcissism was high. Furthermore, conditional indirect effects reveal that brand hate mediates the relationship between similar competitor offer and brand equity only with individuals exhibiting narcissistic personality traits. The current study offers great insights to managers that by managing similar competitor offer, they can manage the development of brand hate, which can subsequently effect brand equity. Moreover, by profiling customers on the basis of their personalities, marketing managers can effectively invest only in customers with positive tendencies. The current study is unique in that it highlights new avenues in existing research by extending the nascent domain of brand hate in consumer–brand relationships. [ABSTRACT FROM AUTHOR]

Background: Ninety percent of children with mental health problems live in low or middle-income countries (LMICs). School-based programs offer opportunities for early identification and intervention, however implementation requires cross-sector collaboration to assure sustainable delivery of quality training, ongoing supervision, and outcomes monitoring at scale. In Pakistan, 35% of school-aged children are reported to have emotional and behavioral problems. As in many other LMICs, the government agencies who must work together to mount school-based programs have limited resources and a limited history of collaboration. The "Theory of Change" (ToC) process offers a way for new partners to efficiently develop mutual goals and long-term prospects for sustainable collaboration. Objective: Develop a model for scale-up of school based mental health services in public schools of Pakistan. Methods: We used ToC workshops to develop an empirically supported, 'hypothesized pathway' for the implementation of WHO's School Mental Health Program in the public schools of rural Pakistan. Three workshops included 90 stakeholders such as policy makers from education and health departments, mental health specialists, researchers, head teachers, teachers and other community stakeholders including non-governmental organizations. Results: The ToC process linked implementers, organizations, providers and consumers of school mental health services to develop common goals and relate them (improved child socioemotional wellbeing, grades and participation in activities) to interventions (training, monitoring and supervision of teachers; collaboration with parents, teachers and primary health care facilities and schools). Key testable assumptions developed in the process included buy-in from health care providers, education officials and professionals, community-based organizations and families. For example, teachers needed skills for managing children's problems, but their motivation might come from seeking improved school performance and working conditions. Poverty, stigma and lack of child mental health literacy among teachers, administration, and parents were identified as key hypothesized barriers. Children and their families were identified as key stakeholders to make such a program successful. Discussion: ToC workshops assisted in team building and served as a stakeholders' engagement tool. They helped to develop and support testable hypotheses about the structures, collaborations, and knowledge most important to scaling-up school based mental health services in Pakistan. [ABSTRACT FROM AUTHOR]

OBJECTIVE To study the performance of vortioxetine as a medication intervention in depression in Pakistan. STUDY DESIGN Non-interventional, multi-centred, cross-sectional, prospective study. PLACE AND DURATION OF THE STUDY The study was conducted in 16 psychiatry outpatient clinics in seven cities across Pakistan namely Rawalpindi, Faisalabad, Peshawar, Quetta, Wah, Multan, Lahore, Karachi and the state of Azad Jammu and Kashmir. SUBJECTS AND METHODS An opportunity sample of 498 patients aged 18 and over, attending out-patient psychiatric clinics in the study sites with a diagnosis of MDD were asked to participate in the study. The psychiatrists had prescribed vortioxetine to the study participants after assessment of variable included in table 1 as baseline record, later assessment was conducted at approximately 1 week (+/- 3 days), 1 month (+/- 7 days) and 3 months(+/- 14 days) after treatment initiation. CONCLUSION Vortioxetine experience in outpatient psychiatric clinics shows the therapeutic effectiveness of the compound. The claims of it to be efficacious in cognitive symptoms and cognitive functioning appears to stay substantiated. The drug also improves the social and occupational functioning as well as high tolerability. These features combine to improve treatment adherence. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization's (WHO) Eastern Mediterranean Regional Office (EMRO) developed a school mental health program (SMHP) to help reduce the burden of youth mental health problems. Designed in collaboration with international consultants, the SMHP draws on evidence-based interventions to train personnel to identify students in need, respond therapeutically, and engage families in seeking care.Methods: Teams from Pakistan, Egypt, Iran, and Jordan collaborated with the WHO EMRO and British and U.S. universities to form the School Health Implementation Network: Eastern Mediterranean Region (SHINE), a National Institute of Mental Health-funded global mental health hub. SHINE partners used a "theory of change" process to adapt the SMHP to be more readily adopted by school personnel and replicated with fidelity. The adapted SMHP more directly addresses teachers' priorities and uses technology to facilitate training.Results: A cluster-randomized implementation effectiveness trial enrolling 960 children ages 8-13 in 80 Pakistani schools will test the adapted SMHP against the original. Children who screen positive on first the teacher and subsequently the parent Strengths and Difficulties Questionnaires (SDQs) will be enrolled and tracked for 9 months. The primary trial outcome is reduction in parent-rated SDQ total difficulties scores. Secondary outcomes include children's well-being, academic performance, absenteeism, and perceived stigma; parent-teacher interaction; teachers' self-efficacy and subjective well-being; and school environment. Implementation outcomes include change in teachers' behavior and sense of program acceptability, cultural appropriateness, feasibility, penetration, and sustainability.Next Steps: The trial began in October 2019, and the expected completion date is March 2021. Outcomes will inform dissemination of the SMHP in Pakistan and elsewhere. [ABSTRACT FROM AUTHOR]

Globally there is a substantial burden of mental health problems among children and adolescents. Task-shifting/task-sharing mental health services to non-specialists, e.g. teachers in school settings, provide a unique opportunity for the implementation of mental health interventions at scale in low- and middle-income countries (LMICs). There is scant information to guide the large-scale implementation of school-based mental health programme in LMICs. This article describes pathways for large-scale implementation of a School Mental Health Program (SMHP) in the Eastern Mediterranean Region (EMR). A collaborative learning group (CLG) comprising stakeholders involved in implementing the SMHP including policymakers, programme managers and researchers from EMR countries was established. Participants in the CLG applied the theory of change (ToC) methodology to identify sets of preconditions, assumptions and hypothesized pathways for improving the mental health outcomes of school-aged children in public schools through implementation of the SMHP. The proposed pathways were then validated through multiple regional and national ToC workshops held between January 2017 and September 2019, as the SMHP was being rolled out in three EMR countries: Egypt, Pakistan and Iran. Preconditions, strategies and programmatic/contextual adaptations that apply across these three countries were drawn from qualitative narrative summaries of programme implementation processes and facilitated discussions during biannual CLG meetings. The ToC for large-scale implementation of the SMHP in the EMR suggests that identifying national champions, formulating dedicated cross-sectoral (including the health and education sector) implementation teams, sustained policy advocacy and stakeholders engagement across multiple levels, and effective co-ordination among education and health systems especially at the local level are among the critical factors for large-scale programme implementation. The pathways described in this paper are useful for facilitating effective implementation of the SMHP at scale and provide a theory-based framework for evaluating the SMHP and similar programmes in the EMR and other LMICs. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to review the psychosocial determinants of divorce and their effects on women for a social reform in Pakistan. Enigmatic societal standards vandalize social status of divorced women and stress them to experience psychological trauma that triggers psychosocial disorders. Design/methodology/approach: The study is categorized into three major determinants: the human emotional, the formal legal and societal aspect(s) in association with the deferential social status of divorced women. Rapid evidence assessment methodology was used to search the all-inclusive literature, collate the available descriptive evidences, critically analyze and evaluate it, sieve out studies of penurious quality and provide an aperçu of the evidence. Findings: The research evinces domestic violence and abuse as an endemic cause of divorce in Pakistan; emotional and psychological consequences of domestic abuse damage women's self-worth and well-being. Literature reported that all these determinants impacted the mental health stability of the divorced women. Divorce rates are climbing at a faster pace in the country and Punjab has been identified as a province of rocketing divorce rate. Lamentably, in various villages of other provinces, women risk face mutilation if they show courage to seek divorce. Practical implications: More research needs to be carried out on the issue nationwide. Fundamentally, cultural norms around women's roles in society need to be addressed and challenged where this research may become an impetus for further research. Originality/value: The paper contributes towards the redressal of the domestic abuse, social exclusion, marginalization and vilification of divorced women in Pakistan. The rising rates indicate an urgent need for social reforms to curtail offending behaviors toward them, to safeguard their mental health and well-being and to empower them with their legal rights to enjoy deferential social status in life. [ABSTRACT FROM AUTHOR]

Purpose - The purpose of this paper is to assess perception of the stakeholders about Islamic banking and find out approaches to make it closer to the Shari'ah. Methodology - The paper adopts direct survey approach to find out perception of stakeholders about Islamic banking. The survey results have been evaluated using Ordinary Least Square method. Findings-The paper reveals that respondents have negative perception about the present form of Islamic banking due to multiple similarities in conventional and Islamic banking products and operations. The respondents supported the idea of different model of Islamic banking. Research limitations - The study relies solely on the opinion of limited number of respondents, living in few major cities of Pakistan. It does not provide any empirical evidence for the proposed model of Islamic banking. Practical Implications - Riba is significantly condemned and prohibited in Islam. Therefore, avoiding riba in all business transactions is very important for our faith. Islamic world started practicing banking under the branding of Islam which has approval of a sizable group of Islamic scholars but still there is no consensus among the Islamic scholars on this issue. This paper helps in addressing perception issues and suggests a future direction of Islamic banking for the customers, practitioners and the regulators. [ABSTRACT FROM AUTHOR]

Background: In developing countries like Pakistan, it is essential for health care professionals to have comprehensive knowledge regarding cervical cancer. Methods: A cross-sectional self-administered paper-based questionnaire was administered to patients from 2016 to 2018. This study included 200 females who attended the gynecological OPD of Lady Willingdon Hospital Lahore, Punjab. We evaluated cervical cancer knowledge, screening, prevention, and acceptance towards the vaccination. Data entry and analysis were performed using SPSS version 20. Results: The perception and knowledge related to cervical cancer (28%), screening (3%), prevention (3%), and vaccination (1%) among the females were poor, but a positive attitude was observed towards cervical cancer screening, vaccination, and awareness programs. An extreme lack of knowledge was observed regarding the risk factors associated with cervical cancer and the availability of the cervical cancer vaccine (99%). A significant association (p > 0.005) was noted among the level of education and awareness of cervical cancer, its mode of transmission, and screening tests. Conclusion: The knowledge and perception of cervical cancer and its vaccine among the females of Punjab, Pakistan were inadequate. Efforts should be made to prevent and control cervical cancer in Pakistan by establishing proper strategies, such as health education programs through health care providers and media support. [ABSTRACT FROM AUTHOR]

Objective: To assess the results of hybrid and traditional teaching systems and their implementation based on student evaluation in anatomy. Study Design: Cross-sectional study. Place and Duration of Study: Anatomy Department, Central Park Medical College, Lahore Pakistan, from Jun 2022 to Jun 2023. Methodology: The study was conducted on the first-year medical students of 2021 who were taught via integrated modular systems at the level of temporal coordination. Teaching strategies were changed from didactic lectures to interactive large-group lectures and small-group discussions. The results of their continuous assessment and professional exams were compared and analysed. Results: The proportion of failed students in the Modular-Group was 20.8%, whereas 79.2% in the Non-Modular-Group. The learning system was statistically significantly related to performance in professional exams. A significant difference exists between internal assessment and professional exam scores of students in traditional and modular teaching. The relationship between the results of internal assessment and professional exams was highly positive (r=0.79) and statistically significant (p<0.001). Conclusion: Students' performance was better in assessment throughout the year in the traditional system, whereas the professional exam results were better in the modular system. [ABSTRACT FROM AUTHOR]

Malnutrition is among the biggest threats being faced globally, and Pakistan is among the countries having high malnutrition rate. Pulses grown in Pakistan have lower amounts of micronutrients, especially iron (Fe) in grains compared to developed world. Biofortification, -a process of integrating nutrients into food crops-, provides a sustainable and economic way of increasing minerals/micronutrients' concentration in staple crops. Mungbean fulfills protein needs of large portion of Pakistani population; however, low Fe concentration in grains do not provide sufficient Fe. Therefore, current study was conducted to infer the impact of different Fe levels and application methods on yield, economic returns and grain-Fe concentration of mungbean. Mungbean was sown under four levels of Fe, i.e., 0, 5, 10 and 15 kg Fe ha-1 applied by three methods, i) as basal application (whole at sowing), ii) side dressing (whole at 1st irrigation) and iii) 50% as basal application + 50% side dressing (regarded as split application). Iron levels and application methods significantly influenced the allometry, yield, economic returns and grain-Fe concentration of mungbean. Split application of 15 kg Fe ha-1 had the highest yield, economic returns and grain-Fe concentration compared to the rest of Fe levels and application methods. Moreover, split application of 15 kg Fe ha-1 proved a quick method to improve the grain-Fe concentration and bioavailability, which will ultimately solve the Fe malnutrition problem of mungbean-consuming population in Pakistan. In conclusion, split application of Fe at 15 kg ha-1 seemed a viable technique to enhance yield, economic returns, grain-Fe concentration and bioavailability of mungbean. [ABSTRACT FROM AUTHOR]

Present study was carried out to determine distribution and population status of Himalayan Monal pheasant (Lophophorus impejanus) in Salkhala Game Reserve. This game reserve is an Endemic Bird Area in the Neelum valley within Western Himalayas, situated along ceasefire line between Pakistan and India. For data collection, study area was divided into three localities with eleven sub-localities. Systematic surveys were conducted in each sub-locality from March to September 2014, early in the morning (5:00-9:00am) and half an hour before evening. Distribution was determined by direct and indirect evidences including sighting, ground scratching, feathers, fecal material, foot prints, information collected from hunters, locals and wildlife staff. Populationof the bird was estimated by line transect method, laid down in the habitat of Himalayan Monal. The results indicated that this pheasant is distributed in all localities of the study area, preferring high altitude mountains with different aspects and slopes between 1900 mand 2600 m above sea level (asl). Overall population density of Himalayan Monal in the study area was 5.63 birds/km2. The highest density (6.81 birds/km2) was recorded in locality Khikhre-dohre, followed by locality Tehar-chhamman (5.33 birds/km2) and Chitta-pani (4.76 birds/km2). The sub-locality Dohre had highest population density (8.15 birds/km2) among eleven sub-localities. [ABSTRACT FROM AUTHOR]

The primary aim of this research work is to investigate the factors which affect the modal choice and public transport usage among the commuters in an educational institute of a metropolitan city of Lahore, Pakistan. For this purpose the data was collected from 337 commuters and results were analyzed using Cross Tabulation and ANOVA using IBM SPSS. Results showed that the gender, age group, occupation, monthly income, daily travel distance and presence of driving license among the commuters are the most significant factors which affect their modal choice. Results also showed that the comfort level, ease of access, punctuality and improvement of seating capacity and condition of public buses can encourage the use of public transport among the commuters. [ABSTRACT FROM AUTHOR]

Human–black bear (Ursus thibetanus) conflict is one of the major conservation and rural livelihood issue in Azad Jammu and Kashmir (AJK). Mitigation strategies of such conflicts require a firm understanding of their underlying patterns. To understand these human-black bear conflict patterns with special reference to crop raiding, present study was conducted from April to December 2011 in Machiara National Park (MNP), Azad Jammu and Kashmir, Pakistan. Field (n=30) and questionnaires (n=108) surveys were conducted in three union councils of MNP to collect information on patterns of crop raiding by black bear, local tolerance and perception about black bear during 2007-2011. About 945 acres area with 53.88 metric tons estimated maize crop yield was damaged by black bears during five years. The maximum (33.94%) of crop raiding was reported between elevation range of 2164 and 2285 m above sea level (asl.) along the boundary of the national park (61%) during 1801-0200 hours (69%). Maximum crop raiding was recorded during year 2011 (18.2 metric tons), while the maximum incidences of crop raiding were reported in the month of October (68.51%). The financial value of the damaged crop, according to the local market, was estimated as 1.370 million PKR (US$=14732.258) as per the currency values during the study period. In response, 11 black bears were killed by the community during 1998-2011, while five incidents of bear attacks on human were also recorded. Accordingly, 82% of respondents disliked black bear and suggested its ex-situ conservation (95%). These conflicts are among the main issues, which not only affect the livelihood of poor local villagers but also create serious threats to the conservation of these threatened bears in the area. To improve the local livelihood prospects and black bear protection around the study area, a proper research-based conflict mitigation strategy is seriously required. [ABSTRACT FROM AUTHOR]

OBJECTIVE To explore the existence and impact of perceived cognitive dysfunction in patients suffering with major depressive disorder, to investigate the association between severity of depression and perceived cognitive dysfunction and finally to see whether there is an association between severity of depression and functionaldisability. STUDY DESIGN Correlational study PLACE AND DURATION OF STUDY This multi-centred study was conducted from April to October, 2018 in 19 Psychiatry outpatient clinics from all over Pakistan. SUBJECTS AND METHODS 2S99 patients with a positive diagnosis of Major Depressive Disorder were explored using scales measuring depression, perceived cognitive dysfunction and functional disability. RESULTS Results showed that a large majority of patients suffered from cognitive dysfunction and that there exists, a positive relationship between depression severity, perceived cognitive dysfunction and functional disability. CONCLUSION The study allowed valuable insight into how cognitive dysfunction relates to depression severity and everyday functioning of patients. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of conservative and operative management of diabetic foot having bone involvement. Study Design: Quasi-experimental study. Place and Duration of study: Combined Military Hospital, Rawalpindi Pakistan, from May to Dec 2022. Methodology: The study included all the patients with neuropathic diabetic foot ulcers worsened by bone involvement/osteomyelitis. All the included patients were divided randomly into two equal groups, A and B (Conservative and Operative Management Groups, respectively). They were followed up for the study period to assess the healing of the wound. All the participants of the study were given antibiotics. Outcome measures were the proportion of patients achieving primary wound healing, hospitalization time, and wound healing time. Results: In our study, we included 302 patients, amongst which 206(68.20%) were male subjects and 96(31.80%) were female subjects. The mean age was 33.89±7.57 years. The proportion of patients achieving primary wound healing in the Conservative Management-Group was 121(80.13%), and in the Operative Management-Group, it was 132(87.42%) (p=0.086). However, the difference between the duration of hospitalization and the time of wound healing was statistically insignificant (p-values of 0.199 and 0.538, respectively). Conclusion: Conservative management with antibiotics alone may be a good alternative to operative management, avoiding surgical complications and costs. [ABSTRACT FROM AUTHOR]

India's unilateral action of seizing Kashmiri's identity on Israeli model, has set ablaze the peace and stability in the South Asian region. Kashmiris have been robbed of their autonomy by Indian Prime Minister Modi and his hawkish government. The unilateral action by the Indian side is unprecedented, and demonstrates Indian stubbornness towards its neighbours in particular and world in general besides ridiculing the international institutions responsible for peace and security such as the United Nations Security Council (UNSC). Needless to remind, that Kashmir has been a bone of contention between Pakistan and India since their Independence in 1947. The Indian action of annexing Kashmir without taking into consideration sensitivities attached to it is likely to affect the contemporary world order, besides further strengthening realpolitik assumptions. The two neighbours, who are nuclear rivals, have already fought three full-fledged conventional wars over their tangent claims on Kashmiri territory, besides a limited war i.e. Kargil Conflict. If the Kashmir issue is not addressed in time, it may actualize yet another war between Pakistan and India which, if initiated, could spiral up into a 3rd World War having likely exchange of nuclear devices that might be the end of world due to the devastation attached. [ABSTRACT FROM AUTHOR]

The police are the frontline force for maintaining law and order in any modern civilized society. Unfortunately, the institution of the police in Pakistan has been far from ideal. In the pre- Partition era, the police were used as a tool to subdue those who questioned the British Raj. Adhering to the colonial tradition, the police in Pakistan have been exploited by the ruling elite to extend their power over the masses and protect their interests. The police in Pakistan, therefore, have been a target of criticism despite appreciable performance and valuable sacrifices rendered by them to maintain law and order. Over a period of time, many efforts have been made to bring structural reforms in the institution but they could not be fully materialized. A significant step was taken by Khyber Pakhtunkhwa (KPK) in formulating the new Police Act of 2017 which has contributed to building a positive police image among the population. Similarly, Sind and other provinces have taken measures to reform the police. The purpose of this article is to trace the evolution of police reforms and analyse various versions of the Police Act being followed in Pakistan, with a view to identifying the reasons behind inefficiency or low performance of the police department as a whole and offer a few recommendations on the basis of this analysis. [ABSTRACT FROM AUTHOR]