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Sleep Apnea is a mutual disorder of sleep caused by obstructing airflow due to collapse of the soft tissue surrounding the upper airway of mouth or throat, and normal breathing would start again with a loud snort or choking sound. A traditional identification process of Sleep Apnea is polysomnography, which can only be accompanied in sleep centre with specific announcements, thus it is costly and problematic. In addition, it is utilized for understanding the conditions, without treatment work. Supplementary detecting techniques are Electrocardiogram (ECG), Pulse Oximeter, microphone or taking a video. A few strategies or gadgets have been created to lighten Sleep Apnea, such as; Continuous Positive Airway Pressure(CPAP), APAP (Automatic Positive Airway Pressure), BiPAP(Bilevel Positive Airway Pressure), intraoral mandibular advancement device and surgery. There are some parameters which help lower the chance of Sleep Apnea are; Surgery(uvulopalatopharyngoplasty), Intra-oral mandibular advancement, use of anti-snore pillows, weight control, sleeping in sideways position (Night Balance) and positional Therapy. In this paper, we propose and implement IoT based real time auto adjustable smart pillow system, we targeted only obstructive Sleep Apnea, initially it detects the attack and adjust the pillow accordingly if patient does not recover due to high Apnea attack it produces an alarm, so that the person lying beside the patient would awake to cater the situation and doctor would also be notified through IoT. Likened with current analysis or usage devices, the pillow is comfortable, non-invasive, inexpensive and portable, which can be used at home or during travelling.

Iliopsoas abscess (IPA) is rare in children but exceptional in neonates. Fewer than 30 cases have been reported in literature. We present a case of 11-day neonate who was brought with left inguinal swelling along with significantly raised white cell count and positive C-reactive protein (CRP). Ultrasound and CT scan confirmed the diagnosis of IPA. Drainage of abscess was done by open method through extraperitoneal approach. Systemic antibiotics, according to culture and sensitivity, were given and the neonate recovered well and was sent home. IPA can be primary or secondary. Primary IPA is more common in neonates unlike adults, who have secondary IPA in majority of the cases. Primary IPA spreads by hematogenous route from distant occult source in the body. Staphylococcus aureus is the causative organism in most cases of primary IPA. Septic arthritis of hip joint is among important differentials. Ultrasound and CT scan are helpful in diagnosis in the presence of raised white cell count and positive CRP. Drainage of pus by open method and through extraperitoneal approach is preferred method although ultrasound-guided percutaneous drainage has also been done with successful outcome. In conclusion, neonatal IPA is extremely rare entity and can easily be overlooked. High index of suspicion is required for its diagnosis in cases where a neonate presents with groin swelling, limited or painful motion of leg and fever.

Part 10: Interactive Posters; International audience; This paper examines a novel approach to the problem of bullying by employing Child-Robot Interaction to attempt to understand the causes of perpetrators behaviour. A comparative study was undertaken to understand the efficacy of such an approach. Children aged 9–10 years were first identified on the basis of their bullying perpetration record and characteristics. Half the children were made to interact individually with a social robot and the other half with a human agent over the span of 3 weeks. Our results exhibit that while children opened up to both kinds of agents, interaction with the human agent led to more insightful conversations that enhanced understanding of causes for the perpetrator’s behaviour. As expected, the interactions varied from child to child and are to be considered on an individual basis. This is an ongoing study and shall be later extended to employ a hybrid of a within-subject and an in-between subject approach in order to examine the experience of each child individually and holistically.

INTRODUCTION Household air pollution (HAP) from burning of biomass smoke has been recognised as the third leading risk factor for death worldwide, 1 and it is estimated to affect 3 billion people each year. Exposure to biomass smoke is a major cause of illness and death in developing countries.2 Its exposure has been linked with increased risk of various diseases like acute and chronic pulmonary tract infections in children and adults3 , emphysema, 4 tuberculosis5 and cardiovascular disease (CVD)6 A healthy endothelium is essential for proper functioning of the vasculature. The inflammatory response is a key mechanism in the pathogenesis of atherosclerosis and its progression.7 Neutrophils secrete inflammatory mediators that can cause vascular wall degeneration. Conversely, lymphocytes regulate the inflammatory response and thus have an anti-atherosclerotic role. Therefore, the neutrophil to lymphocyte ratio (NLR) has been proposed as an inflammatory biomarker8 and potential predictor of risk and prognosis in CVD. Different lipoproteins have particular effects on vessel health. In the clinical context high levels of LDL and low levels of HDL are particularly important risk factors for CVD and are considered good for vascular health.9Highly sensitive-C reactive protein (hs-CRP) also has pro atherogenic effects: it facilitates plaque deposition, transmigration of monocytes and macrophages. 10Many studies have proposed a relationship between exposure to particulate matter (PM) and initiation of endothelial inflammation leading to an increased risk of cardiovascular events11 . Specifically, observational studies have found higher blood pressure, a thicker carotid intima–media complex and an increased prevalence of coronary heart disease, stroke and diabetes in populations chronically exposed to biomass fuel smoke. 12The mechanisms proposed include pulmonary inflammation with release of cytokines in systemic circulation, oxidative stress, endothelial dysfunction and thrombogenesis, -------------------------------------------------------------------------------- Received on 07-04-2019 Accepted on 17-07-2019 all of which could lead to atherosclerosis and adverse health outcomes13 . Recent research has focused on identifying markers of early endothelial inflammation which could help assess CVD risk earlier in the exposed population. MATERIALS AND METHODS Seventy two females in the age range of 20-40 years were included in this study from Tejgarh Yadgar Shaheedan. It is a small village near Manawa, Lahore. There is no natural gas supply in this village. Poor class use cow dunk cake or grass as a source of energy And affording class use LPG cylinder for cooking and heating purpose. The study protocol was approved by the Ethics committee of the University of Health Sciences, Lahore. Inclusion Criteria: The inclusion criteria were (i) Apparently healthy women, (ii) non-smokers, nonconsumption of alcohol and non-chewers of tobacco and (iii) cook regularly with either biomass or LPG at least 2 h/day, 5 days/week for greater than or equal to 10 years. These women were divided into two groups. Group 1: women who cook exclusively with biomass fuel. Group 2: women who cook exclusively with LPG fuel. Exclusion criteria: Mixed fuel user (biomass + LPG + Kerosene), (ii) pregnant, (iii) currently under medication, (iv) family history of Tuberculosis or complicated cardiovascular disease and (v) History of chronic respiratory diseases like asthma, Chronic Obstructive Pulmonary Disease. After taking informed consent from the subject. Following sampling was done. Blood Sampling: Six cc venous blood sample was drawn from antecubital vein of each subject. Four ml was added in serum tube i.e. red top vacutainer and other 2ml was added in EDTA added purple coloured top vacutainer. Blood in red vacutainer was centrifuged (1600g for 15 minutes), serum was separated, divided into aliquots and frozen at -80 °C to be used later for analysis. Complete Blood Count Analysis: For complete blood count, 2cc blood taken in purple top vacutainer (containing ethylene Nabiha Saeed, Hamdah Saeed, Mehr-Un-Nisa Fatima Gondal et al P J M H S Vol. 13, NO. 3, JUL – SEP 2019 694 diamine tetra acetic acid) was used, mixed for 5 minutes on rotator and used for complete blood analysis. Estimation of lipid profile: Serum cholesterol levels and serum high density lipoprotein (HDL) were estimated by total enzymatic colorimetric method endpoint. Results were read by calorimetric analyser micro lab 300 (USA) at 500 nm Serum triglyceride levels were estimated by the use of enzyme lipoprotein lipase. Serum Low density lipoprotein (LDL) was estimated by the formula Low density lipoprotein (LDL) = Total cholesterol – HDL – (Triglyceride/5).14 Estimation of serum hs-CRP Serum hs-CRP estimation was done by High Sensitivity C - reactive protein (hs-CRP) ELISA Kit Results were analysed by stipreader, USA. Data analysis was carried out through computer software IBM SPSS version 21.Quantitative variables were compared by Mann Whitney U test which were non-normally distributed normally distributed were compared by independent t-test as they were normally distributed and presented in the form of mean ± SD. Correlation between years of cooking wth bomass fuel and markers of endothelial inflammation was checked by Spearman’s rank correlation. p≤ 0.05 was considered statistically significant. RESULTS Median (IQR) of neutrophil count, lymphocyte count, neutrophil lymphocyte ratio NLR and platelet count was higher in group 1 biomass users as compared to LPG users as shown in table-4. When compared by Mann Whitney U test both groups show statistically significant different neutrophil, lymphocyte count, NLR and Platelet count as shown in Table 1. Mean ± SD total leukocyte count of Biomass user was higher than LPG user but didn’t show statistically significant difference when compared by independent t-test. Lipid profile of study population: Table-2 both groups had significant difference in lipid profile. Levels of triglycerides (pvalue < 0.001) and Cholesterol (p-value < 0.001) showed significant difference when compared by Mann Whitney U test. Serum LDL (p-value= 0.007) and serum HDL (p-value< 0.001) also showed significant difference when compared by Independent t-test. Levels of serum triglyceride, serum cholesterol, serum LDL were significantly higher n biomass users and serum HDL levels were significantly lower in biomass user when compared with LPG users (Fig.1) Correlation between years of cooking with biomass fuel and markers of endothelial inflammation: When markers of inflammation were correlated with years of cooking. All markers showed positive correlation except serum HDL which showed negative correlation as shown in table 3. Comparison of serum hs-CRP in both groups: Levels of hsCRP (inflammatory marker) was significantly different among two groups as compared by Mann Whitney U test (p-value

Purpose: To determine the risk of ocular infections due to topical multi-dose anaesthetic eye drops in patients one month after opening the bottle. Study Design: Quasi experimental study. Place and duration of study: Department of Ophthalmology DHQ Teaching Hospital, Gujranwala from 22nd May 2018 to 22nd June 2018. Materials and Methods: In this study topical anaesthetic eye drops containing proparacaine hydrochloride 0.5% as main ingredient and benzalkonium choride as preservative (Alcaine�) were tested daily to see if any bacterial/fungal growth occurs in the bottle containing eye drops or not. Same bottle was used in patients presenting in outdoor and indoor departments. Samples taken from the bottle contents were cultured on different media to see growth of fungi or bacteria. Patients who already had keratitis, conjunctivitis, corneal opacities, thin corneas and having dry eyes which were prone to get infected were excluded from this study. Results: There were 60 patients included in our study and they were divided in two groups. Group A included those who presented in the outdoor department and group B comprised of those admitted for various operative procedures. There were 30 patients in each group. All patients were adults (18-60 years). After 1 month of daily culturing on agar plates, no micro-organism growth was seen in both groups. Conclusion: Topical anaesthetic eye drops can be used safely for 1 month in different patients after opening the bottle without any risk of causing infectious keratitis, conjunctivitis or endophthalmitis. Keywords: Proparacaine, Culture medium, Endophthalmitis.

Rapidly developing resistance against different therapeutics is a major stumbling block in the standardization of therapy. Tumor necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL)-mediated signaling has emerged as one of the most highly and extensively studied signal transduction cascade that induces apoptosis in cancer cells. Rapidly emerging cutting-edge research has helped us to develop a better understanding of the signaling machinery involved in inducing apoptotic cell death. However, excitingly, cancer cells develop resistance against TRAIL-induced apoptosis through different modes. Loss of cell surface expression of TRAIL receptors and imbalance of stoichiometric ratios of pro- and anti-apoptotic proteins play instrumental roles in rewiring the machinery of cancer cells to develop resistance against TRAIL-based therapeutics. Natural products have shown excellent potential to restore apoptosis in TRAIL-resistant cancer cell lines and in mice xenografted with TRAIL-resistant cancer cells. Significantly refined information has previously been added and continues to enrich the existing pool of knowledge related to the natural-product-mediated upregulation of death receptors, rebalancing of pro- and anti-apoptotic proteins in different cancers. In this mini review, we will set spotlight on the most recently published high-impact research related to underlying mechanisms of TRAIL resistance and how these deregulations can be targeted by natural products to restore TRAIL-mediated apoptosis in different cancers.

Water stress is a major threat against wheat growth. The effects of induced stress can be reduced after by fortified fertilizer treated by Plant Growth Promoting Bacteria (PGPB). With the objective to combat the water stress, two different experiments under net house and field condition were conducted. Three different states of fertilizer [F0: Control (no fertilizer application); F1: PGPB-coated fertilizer (urea and phosphorous) &F2: uncoated fertilizer (urea and phosphorous)]. In a pot experiment, wheat plants were applied fertilizer in raised and well-watered (60 percent of field capacity) and water stressed (40 percent of field capacity) conditions in soil filled pots. In experiment-II (field study), similar treatments of fertilizer were revised, but well-watered and water stress treatments/plots were irrigated for 60 seconds and 30 seconds respectively. At maturity plants were harvested and various morphological (number of tillers/plant, number of spikelet/spike, number of grains/spike, weight of grains, biological yield, economic yield and harvest index) and biochemical parameters (leaf nitrogen, phosphorous & potassium contents) of crop were recorded. Leaf chlorophyll and relative water contents of crop were also measured 60 days after sowing. In this study, it was demonstrated that the water stress adversely affected all the above mentioned parameters. The PGPB coated fertilizer application in wheat significantly increased (p

Terpenoids are the most essential compounds biosynthesized by plants as secondary metabolites. It is a diverse and vast class of naturally occurring organic compounds and are the derivatives of terpenes having simple and multi-cyclic rings in their structure. These are though found in small/trace amounts in plants, but they play an indispensable role in the survival of plants in the environment. These are used by the plants as a shield against internal and external stresses and for many of the basic functions in the development and growth and by humans as anti-bacterial agents, as anti-carcinogenic agents, as flavors, fragrances and drugs. This review paper will explain the extraction and isolation of terpenoids from different parts of plants i.e. leaves, stem, roots and other vegetal parts of plants. Further the review will focus on the structural characterization of terpenoids extracted from plants by different researchers and the methods they used for the separation and structural characterization of these compounds and their structures drawn with the help of NMR data. The extracted and characterized compounds were terpenoids, triterpenoids, nortriterpenoids, monoterpenes, sesquiterpenes and macro cyclic monoterpenes. These compounds were checked for their medicinal activity, cytotoxicity and their bioassay were also considered, where these compounds showed that they can be used as medicinal compounds as well as the bioassay confirmed their role as protective agents of the plants. Overall, eleven research articles have been considered in this review and the focus is on the novel terpenoids that have been extracted, isolated and characterized by different means. Apart from novel terpenoids the other known compounds have been studied and their activity has also been reported. Keywords: Terpenoids, Characterization, Extraction, NMR, Plant.

This study was carried out to assess the power generation capacity of 4 types of waste material. In this study combustion temperature, steam temperature, steam pressure, mass reduction, gaseous emission and ash content production was calculated for wood, yard, mixed and combined waste at various time interval. In this study fabricated direct flame incinerator was used. This study is based on the cycle from waste collection to waste combustion then to steam formation and further more to electricity production and at end to the gaseous emission. From the study experimental work it was obtained that the combustion of wood, yard, mixed and combined waste produced 482.2 °C, 121 °C and 35 psi as highest combustion temperature, steam temperature and steam pressure respectively at different time line for all the waste material. Moreover from combustion of wood waste produced 66g of ash content and 98.35% mass reduction was calculated. For the yard waste incineration, 54g of ash produced and mass reduction was 98.65%. While for mixed waste the amount of ash produced was 151g and mass reduction was 96.22% and similarly for combined waste, 97g of ash was obtained and mass reduction was 97.57%. The incineration treatment technology is cost effective, easy to operate as compare to other waste treatment technologies.

The research was carried out with the end goal to give a detailed survey of current research to use Algae in order to remove nutrients such as Phosphorus (P) and Nitrogen (N) and also to determine treatment of synthetic waste water by using Algae. In this study, a Photobioreactor was fabricated on the basis of utilization of minimum space and suitable materials to maintain the quality and objective of this project. Total numbers of tank in Photobioreactor were 5 and total volume of water was 60 liters. Synthetic wastewater was produced using different quantities of Dextrin, Yeast extra, Sodium Carbonate, Soluble Starch, Sodium Dihydrogen Phosphate, Washing Powder, Potassium Sulfate, Settled sewage, Shampoo etc since the domestic wastewater contains a number of unwanted constituents. The Photobioreactor helped in storing synthetic waste water, providing growth medium for algae, settle down the sediments, filter out the remaining sediments and finally storing the clean water. The results obtained from the study showed considerable decrease in pH, Chemical oxygen demand (COD), biochemical oxygen demand (BOD), phosphates, sulfates and nitrates. The initial pH was determined to be 7.8 whereas after treatment it reduced to 7.5. BOD reduced from 22 mg/L to 15.5 mg/L, COD reduced from 15 mg/L to 9.5 mg/L, Nitrates reduced from 39.5 mg/L to 20 mg/L, Sulfates reduced from 14.5 mg/L to 10 mg/L and Phosphates reduced from 12 mg/L to 7 mg/L. Thus the reduction in various numbers of nutrients indicated that wastewater treatment using Algae is quite favorable in terms of economic and ecological point of view. Water collected at the end of the process was clean enough to be used in daily life routines.The research was carried out with the end goal to give a detailed survey of current research to use Algae in order to remove nutrients such as Phosphorus (P) and Nitrogen (N) and also to determine treatment of synthetic waste water by using Algae. In this study, a Photobioreactor was fabricated on the basis of utilization of minimum space and suitable materials to maintain the quality and objective of this project. Total numbers of tank in Photobioreactor were 5 and total volume of water was 60 liters. Synthetic wastewater was produced using different quantities of Dextrin, Yeast extra, Sodium Carbonate, Soluble Starch, Sodium Dihydrogen Phosphate, Washing Powder, Potassium Sulfate, Settled sewage, Shampoo etc since the domestic wastewater contains a number of unwanted constituents. The Photobioreactor helped in storing synthetic waste water, providing growth medium for algae, settle down the sediments, filter out the remaining sediments and finally storing the clean water. The results obtained from the s...

The usage of tobacco (in any form) among the youngsters of lower-middle income countries has hither remained as an underexplored research area. Even though 80% of the smokers around the world reside in lower and middle-income countries, and falls within the age group of 18-26 years, the predictors of smoking appear to have contextual nuances. World Bank categorizes Pakistan as a lower-middle income country. Therefore, the current study aims to explore the predictors of smoking among students in the context of Pakistan. We conduct a cross-sectional study to collect data from both medical and non-medical students in Lahore, Pakistan. 384 close-ended questionnaires administered to both medical and non-medical students using the convenience-sampling technique. The findings of the current study recommend policymakers to invest time and resources to create awareness among students that could eradicate the potential factors of smoking. Keywords: Tobacco and Smoking

Objective: To determine attitude of undergraduate medical student's towards immigration, including preferred choice and reasons for immigration. Study Design: Cross-Sectional Study. Place and Duration of Study: The study was carried out on students of Wah Medical College, from January 2019 to June 2019. Materials and Methods: All students at medical college were included in the sampling frame. A sample of 300 students was taken by random sampling using random number generator. A questionnaire was formulated comprisingoftwoparts.Thefirstpartofquestionnairecomprisedofcloseended questionsabouttheageof students their gender, year of education, preferred choice for specialization, desire to migrate or not and preferred destination for migration The second part included reasons for migration and non-migration. The data was analyzed on SPSS version 21. Results: Almost half of the students (48.3%) showed intention towards migration. Those who wanted to migrate, United Kingdom was the top choice (27.9%). Better job opportunities, family reasons and medical facilities were the most common reasons for migration while intention to serve the country, family issues and lack of financial resources were the main reasons to stay in the country. Conclusion: Half of the students intend to migrate to other countries and favorite destination for work is United Kingdom.

Most of organic compounds being hydrophobic in nature are insoluble or sparingly soluble in water. The improvement in solubility is one of the major challenges in their industrial applications. Said issue can be addressed using micellar solutions of surfactants. Surfactants, owing to their inherent amphiphilic nature, have invited the interest of many researchers. It has, however, been observed that the stability and solubilizing capability of a single surfactant-based colloidal system is not up to the mark. To overcome this problem, we have formulated and applied composite micelles of CTAB/TX-100 and CPC/TX-100 as carriers of direct red 28 molecules to aid dispersion, solubility and stability of the dye in aqueous medium. Herein, thermodynamics of micellization and degree of the dye partitioning have been quantified conductometrically and spectroscopically. Results suggest that blend of different surfactants act synergistically to augment the dye partitioning. Furthermore, it has also been noted that micellization of surfactants, counterion binding and the dye partitioning are spontaneous processes.

This experiment was conducted to determine standardized ileal amino acid digestibility (SIAAD) of commonly used feed ingredients in poultry diets in Pakistan. These feed ingredients included corn, rice broken (RB), rice polishings (RP), wheat bran (WB), sunflower meal (SFM), cottonseed meal (CSM), guar meal (GM), soybean meal (SBM) from India and Argentine and fish meal (FM). The SIAAD of each ingredient was determined in triplicate using 21-days-old broilers. Day-old male broiler chicks (Hubbard× Hubbard) were reared on corn-SBM based diet from 1 to 13 days and thereafter birds were fed experimental diets from day 14 to 21. Each diet was fed to 36 birds kept in six replicate cages, each cage had six birds. In cereals, the SIAAD of corn’s amino acid (AA) (90.1%) was similar (p>0.05) to RB (89.0%). Isoleucine (97.8%) and lysine (96.9%) were highly digestible AA in corn and RB, respectively. Among cereal-by products, WB’s SIAAD (76.9%) was same (p>0.05) as RP (71.9%). Arginine from WB (82.5%) and RP (83.2%) was highly digestible. However, threonine in WB (72.7%) and leucine in RP (69.6%) were the lowest digestible AAs. In plant protein meals, AAs from Argentine-SBM (85.1%) and Indian-SBM (83.4%) had higher (p0.05). The SBM from plant protein meals had higher (p

The present study reports the enhanced solubilizing power of mixed micellar media in comparison to single micellar media. The solubilization of anionic direct dye, Direct Brown 2 (DB-2) has been investigated in micellar media of cationic surfactants; cetyltrimethyl ammonium bromide (CTAB), cetylpyridinium chloride (CPC) and in mixed micellar media of each with nonionic surfactant Triton X-100 (TX-100) using UV–visible spectroscopy and conductometry. The UV–visible spectroscopy has been used to evaluate the degree of solubilization in terms of binding constant, Kb, Gibbs energy of binding, ΔGb, partition coefficient, Kx, and Gibbs energy of partition, ΔGp. Furthermore, electrical conductivity data, taken at different temperatures, has been employed to find out critical micelle concentration (CMC) and different thermodynamic parameters like enthalpy, ΔHm, entropy, ΔSm and Gibbs energy of micellization, ΔGm of reported surfactants in presence of dye. Results reveal spontaneous nature solubilization and binding of dye in both micellar and mixed micellar solutions of surfactants. The micellar system of CTAB as well as mixed micellar solutions of CTAB/TX-100 are recommended to be used to achieve higher degree of solubilization.

In present study, the solubility of anionic dye, Direct Red 13, has been, spectroscopically and conductometrically, investigated in micellar media of cationic surfactants; Cetylpyridinium chloride (CPC), Cetyltrimethylammonium bromide (CTAB) and mixed micellar media of each with nonionic surfactant, Tritron X-100. The spectral behavior of dye in presence of surfactants was regularly monitored from pre- to post-micellar region of concentration. The UV–vis spectroscopy was applied for estimation of extent of solubilization in terms of partition coefficient (Kx), binding constant (Kb) and Gibbs free energy of corresponding processes. The addition of nonionic surfactant in ternary solution of dye was made to elucidate the role of mixed micelles on solubility of dye. The electrical conductivity data, measured at different temperatures, was used for detection of CMC and calculation of different thermodynamic parameters like; entropy (ΔSm), enthalpy (ΔHm) and Gibbs free energy change (ΔGm) of micellization of selected surfactants. Results reveal the spontaneity of binding and partitioning of dye in aqueous and micellar phase for all the used surfactant systems.

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A new series of 1,3,4-oxadiazoles derivatives was synthesized, characterized, and evaluated for their in vitro and in vivo anti-thrombotic activity. Compounds (3a&ndash, 3i) exhibited significant clot lysis with respect to reference drug streptokinase (30,000 IU), and enhanced clotting time (CT) values (130&ndash, 342 s) than heparin (110 s). High affinity towards 1NFY with greater docking score was observed for the compounds (3a, 3i, 3e, 3d, and 3h) than the control ligand RPR200095. In addition, impressive inhibitory potential against factor Xa (F-Xa) was observed with higher docking scores (5612&ndash, 6270) with Atomic Contact Energy (ACE) values (&minus, 189.68 to &minus, 352.28 kcal/mol) than the control ligand RPR200095 (Docking score 5192, ACE &minus, 197.81 kcal/mol). In vitro, in vivo, and in silico results proposed that these newly synthesized compounds might be used as anticoagulant agents.

Social capital and privilege, along with the constrictions of social stereotypes, can adversely impact a child's perception of the world. This paper describes the development and implementation of an interactive tangible tool for children aged 7--9, to be played with in schools across Pakistan to assess levels of socioeconomic and gender biases among them, as well as to gauge its comparative benefits over traditional detection methods. In order to obtain more concrete results, the tool has been developed as a theme-based game board for obfuscation, to divert the users' attention from the attributes being evaluated so that the investigative nature of the tool does not significantly hinder users from responding naturally.

A novel serie of escitalopram triazoles (60-88) and a tetrazole (89) have been synthesized and subjected to a study to establish the inhibitory potential of these compounds toward acetylcholinesterase (AChE) and butyrylcholinesterase (BChE). Some selectivity in inhibition has been observed. The 4-chlorophenyl- (75, IC50, 6.71 ± 0.25 μM) and 2-methylphenyl- (70, IC50, 9.52 ± 0.23 μM) escitalopram triazole derivatives depicted high AChE inhibition, while 2-fluorophenyl- (76, IC50 = 4.52 ± 0.17 μM) and 4-fluorophenyl- (78, IC50 = 5.31 ± 0.43 μM) have found to be excellent BChE inhibitors. It has also been observed that ortho, meta and para substituted electron donating groups increase the inhibition, while electron withdrawing groups reduce the inhibition. Docking analyses of inhibitors with AChE have depicted the binding energies for 70 and 75 as ΔG(bind) -6.42 and -6.93 kcal/mol, respectively, while ligands 76 and 78 have shown the binding affinity ΔG(bind) -9.04 and -8.51 kcal/mol, respectively, for BChE.

A series of opioid and serotonin re-uptake inhibitors (SSRIs) bifunctional ligands have been designed, synthesized, and tested for their activities and efficacies at μ-, δ- and κ opioid receptors and SSRIs receptors. Most of the compounds showed high affinities for μ- and δ-opioid receptors and lower affinities for SSRIs and κ opioid receptors. A docking study on the μ-opioid receptor binding pocket has been carried out for ligands 3-11. The ligands 7 and 11 have displayed the highest binding profiles for the μ-opioid receptor binding site with ΔGbind (−12.14 kcal/mol) and Ki value (1.0 nM), and ΔGbind (−12.41 kcal/mol) and Ki value (0.4 nM), respectively. Ligand 3 was shown to have the potential of dual acting serotonin/norepinephrine re-uptake inhibitor (SNRI) antidepressant activity in addition to opioid activities, and thus could be used for the design of multifunctional ligands in the area of a novel approach for the treatment of pain and depression.

Nurses who are educationally prepared can make a difference in the outcome of health care. It is a consensus that nurses need to possess advanced up-to-date knowledge that enable them to analyze complex problems, take critical decisions, and move on to appropriate actions. The objective of this study was to identify, the demographic profile of the selected respondents and the barriers to higher education in nursing as perceived by the respondents selected from private and public hospitals.

We studied bacterial blomass and production in 3 t ~ d a l creeks (Isaro, Gharo and Ph~tt l Creeks) in the mangrove forests in the Indus R~ver delta, Pakistan, to assess the signif~cance of bacteria-mediated carbon fluxes in the creek ecosystem. Bacterial biomass, bacterial carbon production (BCP) and primary productivity (PP) were measured periodically for over a year during 1991-92. BCP was high, generally 50 to 300 pg C 1-' d-l. Despite such high BCP, bacterial abundance remained between 1 X 106 ml-' and 4 X 106 ml-' (20 to 80 p g C I-') indicating tight coupling between bacter~al production and removal. Specific growth rates generally ranged from 1 to 7 d.' but the rate reached 24 d.' during a phytoplankton bloom, apparently a red tide, and this was an unprecedented growth rate for a natural assemblage The abundance of attached bacteria exhlblted a large variation, ranglng from 4 to 9 2 % (mean 35 2 21 ",,, n = 41) in Isaro Creek and from 14 to 84 "L. (mean 37 -t 28%,, n = 10) in Gharo Creek Bacterial production due to attached bacteria was 73 to 96'Y" of the total Thus, a major fract~on of BCP may have been directly ava~lab lc to m.etazoan grazers. BCP was generally much higher than net PP, the yearly integrated average BCP/13P for all sites was 2.0. Thus, the growth of bacteria, attached and free, probably represented the major pathway of the production of high quality (low C:N) biomass potentially available to the grazers. Average yearly integrated bacterial carbon demand (BCD), estimated conservatively by assuming a 30-0 growth efficiency for all sites, was 6.9 times net PP. Thus, the creek water columns were strongly and persistently net heterotrophic. Data integrated over the entire study period show that even if all phytoplankton production was utilized by bacteria it would satisfy only 7 to 20':0 of the BC:D; the remaining 80 to 93% of BCD would be met by reduced carbon from other sources. Phytoplankton production was l ~ g h t limited due to high turbidity and, apparently, the majority of BCP could be supported by the input of mangrove detritus. Estimates of utilizable dissolved organic carbon (UDOC) in selected samples were 97 to 656 pg C I-', indicating that In order to sustain the measured BCD (643 + 671 pg C I ' d') the UDOC pool would turnover in < l d to a few days. Limited data suggest that bacterial production was carbon rather than N or P limited. consistent w ~ t h sustained high levels of Inorganic N and P in the surface water. Since mangrove de t r~ tus provides most of the energy for bacterial production, which in turn is a significant source of high quality lood for grazers, particularly via ingestion of attached bacteria, w e predict that the ongoing destruction of mangrove forests in the Indus delta and elsewhere could have a major impact on mangrove ecosystem structure and functioning and the production of economically important flsh and shrimp in mangrove creeks.

Unsafe abortion is one of the leading causes of maternal mortality and morbidity which impede the nation in achieving the targets of MDG 5. In the developing world, it is estimated that 13% of all maternal deaths are due to unsafe abortions. Despite having certain liberty in the law and religion, Pakistan has a relatively high prevalence of unsafe abortion. Poverty, unintended pregnancies, ineffective use of contraceptive methods and unawareness about the law are the root causes for the rise in the number of women seeking abortions. Nonetheless, with all these opening points of having permission in the law and religion could direct us that if we just follow them we can reduce the number of unsafe and illegal abortions.Therefore, there is a strong interventions would be required in health and legal aspects, which would decrease maternal mortality and morbidity.

In the title compound, C16H22Cl2N2O2, the substituted piperidine ring adopts a chair conformation with both substituents in equatorial positions. In the crystal, N—H...O and C—H...O hydrogen bonds connect molecules into ribbons along thea-axis direction.

A number of quinolone-3-acetic acids were synthesized by cyclocondensation of substituted anilines with diethyl acetylsuccinate in the presence of phosphorous pentoxide and followed by base hydrolysis of the resultant esters to form respective acids. All synthesized compounds were found to exhibit antibacterial activities against a range of gram-positive (Bacillus subtilis, Staphylococcus aureus) and gram-negative bacteria (Shigella sonnei, Escherichia coli, Pseudomonas aeruginosa and Salmonella typhi) by broth dilution method. All the compounds exhibited antibacterial activities comparable to fluoroquinolones and in some cases even better activity was found. These findings suggest a great potential of these compounds for screening and use as antibacterial compounds for further studies with a battery of bacteria.

In contrast to females, male faecal incontinence has received little attention. We investigate its pattern and management at a large UK teaching hospital.Men presenting with faecal incontinence between January 2006 and December 2008 were identified from a gastrointestinal physiology database and classified into faecal leakage or faecal incontinence on the basis of symptomatology. Demographics, Cleveland Clinic incontinence score (CCIS), aetiological factors, investigations and treatments were collected by case note review and compared to clinical outcomes.Forty-three symptomatic patients were identified with faecal incontinence, in which 33 were classified as having faecal leakage (FL) and ten as faecal incontinence (FI). The mean CCIS was 10.7 (range, 4-14) and 14.2 (8-20) for FL and FI, respectively. The FL group had normal anal sphincter pressures, whilst the FI group had significantly lower mean resting pressure, 45 mmHg (8-90 mmHg), and mean squeeze pressure, 62.1 mmHg (18-110 mmHg). Thirteen out of 33 patients in the FL group and seven out of ten in the FI group had undergone previous anorectal surgery and had demonstrable sphincter defects whilst in the remainder, no definite aetiological factor could be identified. All patients in the FL group improved with lifestyle changes (28/33) or biofeedback (5/33). Six patients in the FI group required surgical intervention (3/6, collagen injection; 1/6, graciloplasty; 1/6, sacral nerve stimulation; 1/6, rectopexy).Patients presenting with FL characteristically have normal anorectal physiology and respond to non-operative measures, as compared to patients with FI who tend to have weakened anal sphincters, previous history of anorectal surgery, and more often require surgical intervention.

To study the maternal outcome in terms of morbidity and mortality with the use of magnesium sulphate in eclampsia for seizure control and prophylaxis.A quasi experimental study.This study was conducted in Obstetrics and Gynaecology Unit of Hayatabad Medical Complex, Peshawar, from 1st September 2002 to 31st December 2003.All the patients admitted with eclampsia during this period were included in the study. A detailed history and clinical examination were recorded. Patients were monitored for number of fits, rise in blood pressure (BP), dose of magnesium sulphate administered and its side effects, development of complications of eclampsia, duration of labour, mode of delivery and use of other medications as well as maternal and perinatal outcome.During this period, 52 patients were admitted with eclampsia. Majority were unbooked. Primigravida were 31 (59.6%). Common age group was between 21 and 30 years having 34 (65.4%) patients while 16 (30.7%) patients were 20 years or less than 20 years of age. Thirty-three (63.4%) patients had antenatal fits, 9 (17.3%) intrapartum fits and 11 (19.2%) had postpartum eclampsia. Twenty-six patients had term pregnancy, 22 patients with 28-36 weeks gestation while 4 patients developing eclampsia before 28 weeks gestation. Eighteen patients had spontaneous vaginal delivery; labour was induced in 21 patients while 6 patients underwent cesarean section. Maternal complications included pulmonary oedema, tongue bites, HELLP syndrome, placental abruption and coagulopathy. Side effects of magnesium sulphate were low. There were 4 (7.6%) maternal deaths due to eclampsia. Perinatal outcome was good with 33 (63.4%) live births, 3 IUDs and 10 still births, mostly due to prematurity.Magnesium sulphate was found to be an effective anti-convulsant both for control and prophylaxis of seizures in eclampsia and improved maternal and fetal outcome.