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Agriculture involves multiple risks of which environmental and production threats are major ones. Farmers' risk attitudes and risk perceptions have a significant role in dealing with their decisions, farm-relevant practices and management exposure to risk. Developing countries have carried out limited research work on the variety of risk management issues. This research work quantifies farmers' attitudes and perceptions of different types of risks, such as which wheat crop is grown. The study relies on a survey of six wheat-producing districts containing household farms with 402 wheat-producing farmers in Punjab, Pakistan. To discover farmer' attitudes toward risks, the Equally Likely Certainty Equivalent approach has been employed, with the ranking of farmers' perceptions of four disastrous risk sources, storm rainfall and hail, drought, high input prices and wheat diseases, using a risk matrix. A probit model was employed to analyze the empirical estimation of factors affecting farmers' attitudes and perceptions. The findings of the study indicate that the majority of the farmers have a risk-averse nature and consider storm rainfall and hail, drought, high input prices and wheat diseases as major threats to their wheat crops. Empirical findings of the study show that gender, religion, age, farming experience, education, credit, farming area, livestock numbers and off-farm income have significant (positive or negative) effects on farmers' attitudes toward risk and risk perceptions. The study provides a convenient analysis for farmers, researchers, extension services, the agricultural insurance sector, and agriculture policy makers. Policy makers and researchers need to understand farmers' risk attitudes and risks, providing them with precise knowledge regarding risks and refined risk management tools, and ensuring the provision of agricultural financing and contemporary agricultural extension services. [ABSTRACT FROM AUTHOR]

Background: Hand hygiene is one of the primary measures to reduce healthcare-associated infections (HCAIs). There is a need to explore the concept of hand hygiene among the medical graduates. Objective: To assess the knowledge and perception of hand hygiene among house officers in a tertiary health care centre. Patients and Methods: This cross sectional survey was conducted in the departments of Paediatrics, Internal Medicine, Surgery and Obstetrics / Gynaecology, in affiliated hospitals of King Edward Medical University / Mayo Hospital, Lahore from October to December 2015. World Health Organization's validated hand hygiene knowledge and perception questionnaire was used. A total of 100 fresh medical graduates, who passed their MBBS in March - April 2015, working as house officers were included in the study by non-probability convenient sampling. The data were entered in SPSS 20 for statistical analysis. Chi square test was used for comparison. Results: Of 100 house officers approached, 67 participated in this study. Only 20 (29%) had received formal training in hand hygiene and 40 (59%) practiced routine use of alcohol hand rub. The study did not document satisfactory level of knowledge regarding hand hygiene. Overall, 27 (40.3%) house officers had correct knowledge of main route of transmission of potential harmful germs, while 23 (34.3%) house officers had correct knowledge of main source of germs in HCAI. Only, 41 (61.2%) house officers correctly knew of 20 seconds as the minimum time required for effective alcohol-based hand rub. The house officers were of the opinion that alcohol - based hand rub must be available at health - care facility at each point of care and awareness posters should be displayed at same points as reminders. Actions taken by leaders and managers regarding effective measures towards hand hygiene were considered effective in improving the hand hygiene practices. Conclusion: The unsatisfactory level of knowledge regarding hand hygiene indicates that the house officers require increased emphasis on hand hygiene education and improvement in their current primary training as well as undergraduate curricula. [ABSTRACT FROM AUTHOR]

A retrospective study was performed to report the case occurrence of cystic echinococcosis (CE) in three hospitals of north-eastern region in Punjab Province, Pakistan. We reviewed retrospectively the clinical records of patients in 4 hospitals which were diagnosed with CE during 2012-2017. A total of 198 cases, 82 (41.4%) male and 116 (58.6%) females were detected as CE. The most Highest incidence was revealed in . . . . 21-30 years-old group (24.2%) followed by 41-50 (22.7%), 31-40 (16.2%), 11-20 (13.6%), 51-60 (8.1%), below 10 (5.5%), over 71 (5.1%) and 61-70 year-old group (4.5%). CE was detected in various organs of infected individuals. However, most of CE cases were detected in the liver (47.4%) and lung (18.6%). The present study indicated that CE is more or less prevalent in surveyed areas and one of the most important public health problems in Punjab Province, Pakistan. [ABSTRACT FROM AUTHOR]

In Pakistan, around 11 million people are infected with, at least, six circulating genotypes and subtypes of hepatitis C virus (HCV). The viral burden is still on rise. HCV genotype determination is necessary to devise appropriate antiviral therapy. Previous reports highlight the prevalence circulating untypable (in diagnostic perspectives) HCV subtype in local Pakistani patients. Present study was designed to investigate the epidemiological distribution of genotypes in different districts of Punjab, Pakistan and focuses on prevalence of diagnostically untypable subtype and its possible antiviral therapy. A total of 8,353 HCV patients were included through 2011 to 2016 for determination of HCV prevalent genotypes in the local community. HCV genotyping was carried out using Ohno et al. method, and five cases of diagnostically untypable patients were treated with interferon-based antiviral regimen to find the possible treatment strategy. Of the 8,353 patients, the genotype 3a ( n  = 6,650, 79.6%) was most significantly prevalent throughout the study period followed by undetermined genotype that is, untypable ( n  = 1,377, 16.5%). The presence of untypable variants suggested that there are some novel or quasi species prevailing among HCV patients in local community. Five HCV patients infected with untypable genotype had been treated effectively with interferon alpha plus ribavirin therapy for 24 weeks at standard doses and achieved sustained virological response. This study highlighted an important aspect of HCV treatment for local Pakistani HCV patients. Untypable HCV variants could be treated with interferon-based antiviral regimens such as 3a genotype. The study raises the need of characterization of diagnostically untypable HCV variant. On the basis of these results, it can be proposed that until the availability of pangenotypic direct-acting antiviral for HCV treatment in Pakistan, interferon-based antiviral regimens will be of choice for majority of patients infected with 3a or untypable genotypes. [ABSTRACT FROM AUTHOR]