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Synthetic drugs are taking the place of traditional drugs and have made headlines giving rise to serious social issues in many countries. In this work, a synthetic drug transmission model incorporating psychological addicts with two time delays is being developed. Local stability and exhibition of Hopf bifurcation are established analytically and numerically by taking the combinations of the two time delays as bifurcation parameters. The exhibition of Hopf bifurcation shows that it is burdensome to eradicate the synthetic drugs transmission in the population.

The present study aims to shed light on psychological intentions in some prophetic hadiths and present practical models and realistic applications that reveal the aim behind Prophet Mohammed’s actions and speech. This study relied on a descriptive and deductive approach. It included three demands. The first demand provided a glimpse of the theoretical and conceptual framework of psychological intentions and their most important classifications. The second request tackled the history of Makassed thought in the Prophet’s hadiths. The third requirement dealt with the presentation of the physical, mental, and psychological intentions in Sunnah. The results revealed that The Islamic religion seeks to achieve happiness for the human being in this world and hereafter. This leads to the spread of both psychological and societal peace. Hence, religion should be employed in what came for it. The study also concluded that it is necessary to choose the noble prophetic traditions since it stipulates the psychological values ​​and methods to return to the right path which are the Qur’an and Sunnah in light of the prevalence of current mental illnesses. The study reached many physical, mental and psychological purposes through inferring them from the Prophet‘s noble hadiths.

In this paper, an efficient vehicle tracking system is proposed that is used to track the location of any equipped vehicle with the help of an android application. The SIM808 module is used which incorporates GPS and GSM modules. The GPS module is used to get vehicle’s location coordinates. These coordinates are sent to the Smartphone with the help of a GSM module. On a Smartphone, an android based application is developed to plot the location of a vehicle on a Google map. The application also has the capability to keep the previous route history of the vehicle. The proposed system is implemented and tested in a practical environment. Experimental results have proved that the proposed tracking system is accurate and feasible for the vehicle owners.

Abstract Water with adequate quality and quantity is very important for irrigation to ensure the crop yields. Salinity is common problem in the coastal waters in Bangladesh. The intensity of salinity in the coastal zone in Bangladesh is not same. It fluctuates over the year. Sodium is another hazard which may hamper permeability and ultimately affects the fertility. It can reduce the crop yields. Although surface water is available in the coastal zone of Bangladesh, but its quality for irrigation needs to be monitored over the year. This paper will investigate the overall quality of coastal surface waters. Thirty-three water samples from different rivers were collected both in wet period (October–December) and in dry period (February–April). Different physical and chemical parameters are considered for investigation of the adequacy of water with respect to international irrigation water quality standards and Bangladesh standards. A comparison between the dry and wet period coastal surface water quality in Bangladesh will also be drawn here. The analysis shows that coastal surface water in Bangladesh is overall suitable for irrigation during wet period, while it needs treatment (which will increase the irrigation cost) for using for irrigation during dry period. Adaptation to this situation can improve the scenario. An integrated plan should be taken to increase the water storing capacity in the coastal area to harvest water during wet period.

In this research, we provide a mathematical analysis for the novel coronavirus responsible for COVID-19, which continues to be a big source of threat for humanity. Our fractional-order analysis is carried out using a non-singular kernel type operator known as the Atangana-Baleanu-Caputo (ABC) derivative. We parametrize the model adopting available information of the disease from Pakistan in the period 9 April to 2 June 2020. We obtain the required solution with the help of a hybrid method, which is a combination of the decomposition method and the Laplace transform. Furthermore, a sensitivity analysis is carried out to evaluate the parameters that are more sensitive to the basic reproduction number of the model. Our results are compared with the real data of Pakistan and numerical plots are presented at various fractional orders.

In this work, we present the analysis of a mixed weighted fractional Brownian motion, defined by ηt:=Bt+ξt, where B is a Brownian motion and ξ is an independent weighted fractional Brownian motion. We also consider the parameter estimation problem for the drift parameter θ>0 in the mixed weighted fractional Ornstein–Uhlenbeck model of the form X0=0;Xt=θXtdt+dηt. Moreover, a simulation is given of sample paths of the mixed weighted fractional Ornstein–Uhlenbeck process.

In the analysis in this article, we developed a scheme for the computation of a semi-analytical solution to a fuzzy fractional-order heat equation of two dimensions having some external diffusion source term. For this, we applied the Laplace transform along with decomposition techniques and the Adomian polynomial under the Caputo–Fabrizio fractional differential operator. Furthermore, for obtaining a semi-analytical series-type solution, the decomposition of the unknown quantity and its addition established the said solution. The obtained series solution was calculated and approached the approximate solution of the proposed equation. For the validation of our scheme, three different examples have been provided, and the solutions were calculated in fuzzy form. All the three illustrations simulated two different fractional orders between 0 and 1 for the upper and lower portions of the fuzzy solution. The said fractional operator is nonsingular and global due to the presence of the exponential function. It globalizes the dynamical behavior of the said equation, which is guaranteed for all types of fuzzy solution lying between 0 and 1 at any fractional order. The fuzziness is also included in the unknown quantity due to the fuzzy number providing the solution in fuzzy form, having upper and lower branches.

Abstract Background Since long, natural sources have been explored for possible managements of various diseases. In this context, the study is designed to evaluate Isodon rugosus Wall. ex Benth for biological potentials including antibacterial, anthelmintic, insecticidal, anti-termites and anti-Pharaoh activities followed by GC-MS analysis of active fraction to identify various bioactive compounds. Methods I. rugosus was investigated against eight bacterial strains using well diffusion method and microdilution method with ceftriaxone as positive control. Similarly, the insecticidal activity was carried out against Tribolium castaneum, Rhyzopertha dominica, Monomorium pharaonis and Heterotermis indicola following contact toxicity method. Likewise, anthelmintic activity was performed against Ascaridia galli and Pherethima posthuma using albendazole as positive control, in which the paralysis and death times of the worms were observed. The GC-MS analysis of the most active solvent fraction was performed for identifications of various bioactive compounds. Results Among the tested samples of I. rugosus, flavonoids and ethyl acetate fraction exhibited high antibacterial activities. The crude saponins showed highest anthelmintic activity against Pherethima posthuma and Ascaridia galli with death times of 27.67 and 29.22 min respectively at concentrations of 40 mg/ml. In insecticidal activity, chloroform fraction and saponins exhibited notable results against R. dominica (60 and 70%) and T. castaneum (70 and 76%) at concentration of 200 mg/ml. In anti-termite assay, all the plant samples showed overwhelming results, i.e. all the 25 termites were killed on the 3rd day. Similarly, in anti-Pharaoh activity, the chloroform, ethyl acetate and saponins fractions were most potent, each exhibiting LD50 of

Mathematical modeling is a tool that has a lot of applications in applied sciences. This has driven extensive investigations and the development of different methods in applied mathematics. Recently, neural networks have attracted a significant attention in various research areas owing to their promising application in signal and image processing, optimization solvers, intelligent control, quadratic optimization, and automatic control. In a recent paper [1], the authors discussed that the time delay has an important influence on the stability and Hopf bifurcation of the involved networks. The derived results in this paper are new and will play a key role in the future optimization of networks and the improvement of human life. However, the mathematical modeling discussed in [1] contains a wrong calculation in the early part of the paper related to the Hopf bifurcation, which is subsequently carried out throughout the manuscript. The purpose of this comment is to point out the calculation error in [1] and provide the correct calculation.

This article studies the dynamical behavior of the analytical solutions of the system of fraction order model of HIV-1 infection. For this purpose, first, the proposed integer order model is converted into fractional order model. Then, Laplace-Adomian decomposition method (L-ADM) is applied to solve this fractional order HIV model. Moreover, the convergence of this method is also discussed. It can be observed from the numerical solution that (L-ADM) is very simple and accurate to solve fraction order HIV model.

To evaluate the incidence of symptomatic anisometropia and aniseikonia requiring intervention following surgery with combined pars plana vitrectomy (PPV) and broad 276 style encircling scleral buckle (ESB) for the repair of rhegmatogenous retinal detachments (RRD) and to report axial length (AL) and keratometry changes, a retrospective review of consecutive RRD patients treated with combined PPV and ESB between June 2016 until September 2019 was performed. All patients with symptomatic optically induced aniseikonia requiring additional interventions or surgical procedures including clear lens exchanges, secondary intraocular lens implants or contact lenses were documented. Keratometry and AL measurements were recorded for each eye and changes calculated. In total, 100 patients underwent combined PPV, ESB and endotamponade with mean age of 59.47 years (SD 11.49). AL was significantly increased (25.39 mm [SD 1.27] to 26.54 mm [SD 1.16], p = 0.0001), with a mean change of 1.15 mm (SD 0.67). Mean corneal astigmatism increased by –0.95 D (SD 0.51) in control eyes preoperatively and –1.33 (SD 0.87) postoperatively (p = 0.03). Over half of phakic patients (39/61; 64%) developed a visually significant cataract, subsequently undergoing surgery. Six of 100 patients developed symptomatic anisometropia with aniseikonia postoperatively (6%). Four proceeded with clear lens exchange despite absence of visually significant cataract (4%). Two of these initially trialled contact lenses (2%). One was intolerant, while the other decided to proceed with clear lens exchange for convenience. Only one patient (1%), being pseudophakic in both eyes, had persistent anisometropia/aniseikonia. AL and keratometry changes induced by encirclement with broad solid silicone rubber buckles are acceptable and similar to those reported previously using narrow encircling components, being unlikely to induce troublesome symptomatic anisometropia/aniseikonia. Many patients are phakic and develop visually significant cataracts, allowing correction of changes induced with the aim of visual restoration. A minority require more prolonged methods of visual rehabilitation, such as contact lens wear or clear lens exchanges. Caution and appropriate consent should be made in patients that are pseudophakic in both eyes at presentation.

A project manager balances the resource allocation using resource leveling algorithms after assigning resources to project activities. However, resource leveling does not ensure optimized allocation of resources. Furthermore, the duration and cost of a project may increase after leveling resources. The objectives of resource allocation optimization used in our research are to (i) increase resource utilization, (ii) decrease project cost, and (iii) decrease project duration. We implemented three search-based software engineering algorithms, i.e. multiobjective genetic algorithm, multiobjective particle swarm algorithm (MOPSO), and elicit nondominated sorting evolutionary strategy. Twelve experiments to optimize the resource allocation are performed on a published case study. The experimental results are analyzed and compared in the form of Pareto fronts, average Pareto fronts, percent increase in resource utilization, percent decrease in project cost, and percent decrease in project duration. The experimental results show that MOPSO is the best technique for resource optimization because after optimization with MOPSO, resource utilization is increased and the project cost and duration are reduced.

Megacities rely on groundwater from aquifers that may be over-exploited and be at risk of contamination. Khan et al. evaluate the complex aquifers supplying Dhaka, Bangladesh and show that extensive groundwater pumping could lead to unpredictable future arsenic contamination in deep aquifers outside the city.

In this article, the impact of effective Prandtl number model on 3D incompressible flow in a rotating channel is proposed under the influence of mixed convection. The coupled nonlinear system of partial differential equations is decomposed into a highly nonlinear system of ordinary differential equations with aid of suitable similarity transforms. Then, the solution of a nonlinear system of ordinary differential equations is obtained numerically by using Runge–Kutta–Fehlberg (RKF) method. Furthermore, the surface drag force C f and the rate of heat transfer N u are portrayed numerically. The effects of different emerging physical parameters such as Hartmann number (M), Reynold’s number (Re), squeezing parameter ( β ), mixed convection parameter λ , and volume fraction ( φ ) are also incorporated graphically for γ — alumina. Due to the higher viscosity and thermal conductivity ethylene-based nanofluids, it is observed to be an effective common base fluid as compared to water. These observations portrayed the temperature of gamma-alumina ethylene-based nanofluids rising on gamma-alumina water based nanofluids.

Isodon rugosus Wall. ex. Benth is an important species and is used in folk medicine for different types of pains such as abdominal pain, earache, toothache, gastric, and generalized body pain. Recently, we also have reported the antinociceptive potential of chloroform fraction of I. rugosus. In this research, we have investigated the antinociceptive, antioxidant and anti-cholinesterase potentials of essential oils from I. rugosus (Ir.EO), and have determined a possible mechanism of anti-nociception. The Ir.EO was subjected to gas chromatography-mass spectroscopy analysis to find out its chemical constituents. The Ir.EO was assayed for analgesic potential following acetic acid induced writhing, formalin test and hot plate method in animal models. The antioxidant activity was conducted against DPPH and ABTS free radicals following spectroscopic analysis. The cholinesterase inhibitory assays were performed using Ellman's assay. The GC-MS analysis of Ir.EO revealed the identification of 141 compounds. Ir.EO demonstrated strong antinociceptive potential in all three in-vivo models. With the use of nalaxone, it was confirmed that the essential oil was acting on the central pathway of nociception. The Ir.EO also exhibited strong free radicals scavenging potential, exhibiting IC50 values of 338 and 118 μg/ml for DPPH and ABTS free radicals respectively. In AChE and BChE inhibitory assays, the observed IC50 values were 93.56 and 284.19 μg/ml respectively. The encouraging antinociceptive, antioxidant and anticholinesterase results revealed that Ir.EO is a rich source of bioactive compounds as obvious from the GC-MS results.

In this paper, we consider a delayed smoking model in which the potential smokers are assumed to satisfy the logistic equation. We discuss the dynamical behavior of our proposed model in the form of Delayed Differential Equations (DDEs) and show conditions for asymptotic stability of the model in steady state. We also discuss the Hopf bifurcation analysis of considered model. Finally, we use the nonstandard finite difference (NSFD) scheme to show the results graphically with help of MATLAB.

BACKGROUND: Atriplex laciniata L. was investigated for phenolic, flavonoid contents, antioxidant, anticholinesterase activities, in an attempt to explore its effectiveness in Alzheimer's and other neurological disorders. Plant crude methanolic extract (Al.MeF), subsequent fractions; n-hexane (Al.HxF), chloroform (Al.CfF), ethyl acetate (Al.EaF), aqueous (Al.WtF), Saponins (Al.SPF) and Flavonoids (Al.FLVF) were investigated for DPPH, ABTS and H2O2 free radical scavenging activities. Further these extracts were subjected to acetylcholinesterase (AChE) & butyrylcholinesterase (BChE) inhibitory activities using Ellman's assay. Phenolic and Flavonoid contents were determined and expressed in mg Gallic acid GAE/g and Rutin RTE/g of samples respectively. RESULTS: In DPPH free radicals scavenging assay, Al.FLVF, Al.SPF and Al.MeF showed highest activity causing 89.41 ± 0.55, 83.37 ± 0.34 and 83.37 ± 0.34% inhibition of free radicals respectively at 1 mg/mL concentration. IC50 for these fractions were 33, 83 and 82 μg/mL respectively. Similarly, plant extracts showed high ABTS scavenging potential, i.e. Al.FLVF (90.34 ± 0.55), Al.CfF (83.42 ± 0.57), Al.MeF (81.49 ± 0.60) with IC50 of 30, 190 and 70 μg/ml respectively. further, H2O2 percent scavenging was highly appraised in Al.FLVF (91.29 ±0.53, IC50 75), Al.SPF (85.35 ±0.61, IC50 70) and Al.EaF (83.48 ± 0.67, IC50 2 70 μg/mL). All fractions exhibited concentration dependent AChE inhibitory activity as; Al.FLVF, 88.31 ± 0.57 (IC50 70 μg/mL), Al.SPF, 84.36 ± 0.64 (IC50 90 μg/mL), Al.MeF, 78.65 ± 0.70 (IC50 2 80 μg/mL), Al.EaF, 77.45 ± 0.46 (IC50 2 70 μg/mL) and Al.WtF 72.44 ± 0.58 (IC50 2 63 μg/mL) at 1 mg/mL. Likewise the percent BChE inhibitory activity was most obvious in Al.FLVF 85.46 ± 0.62 (IC50 1 00 μg/mL), Al.CfF 83.49 ± 0.46 (IC50 160 μg/mL), Al.MeF 82.68 ± 0.60 (IC50 2 20 μg/mL) and Al.SPF 80.37 ± 0.54 (IC50 1 20 μg/mL. CONCLUSIONS: These results stipulate that A. laciniata is enriched with phenolic and flavonoid contents that possess significant antioxidant and anticholinestrase effects. This provide pharmacological basis for the presence of compounds that may be effective in Alzheimer's and other neurological disorders.

BACKGROUND: Isodon rugosus is used traditionally in the management of hypertension, rheumatism, tooth-ache and pyrexia. Present study was arranged to investigate I. rugosus for phytoconstituents, phytotoxic and cytotoxic activities to explore its toxicological, pharmacological potentials and to rationalize its ethnomedicinal uses. Briefly, qualitative phytochemical analysis of the plant extracts were carried out for the existence of alkaloids, flavonoids, saponins, oils, glycosides, anthraquinones, terpenoids, sterols and tannins. Plant crude methanolic extract (Ir.Cr), its subsequent fractions; n-hexane (Ir.Hex), chloroform (Ir.Chf), ethyl acetate (Ir.EtAc), aqueous (Ir.Aq) and saponins (Ir.Sp) in different concentrations were tested for phytotoxic and cytotoxic activities using radish seeds and brine shrimps (Artemia salina) respectively. The phytotoxic activity was determined by percent root length inhibition (RLI) and percent seeds germination inhibition (SGI) while the cytotoxicity was obtained with percent lethality of the brine shrimps. RESULTS: Ir.Cr was tested positive for the presence of alkaloids, glycosides, flavonoids, oils, terpenoids, saponins, tannins and anthraquinones. Among different fractions Ir.Sp, Ir.Chf, Ir.EtAc, and Ir.Cr were most effective causing 93.55, 89.32, 81.32 and 58.68% inhibition of seeds in phytotoxicity assay, with IC50 values of 0.1, 0.1, 0.1 and 52 μg/ml respectively. Similarly, among all the tested samples, Ir.Sp exhibited the highest phytotoxic effect causing 91.33% root length inhibition with IC50 of 0.1 μg/ml. Ir.Sp and Ir.Chf were most effective against brine shrimps showing 92.23 and 76.67% lethality with LC50 values of 10 and 12 μg/ml respectively. CONCLUSIONS: It may be inferred from the current investigations that I. rugosus contains different secondary metabolites and is a potential source for the isolation of natural anticancer and herbicidal drug molecules. Different fractions exhibited phytotoxic and cytotoxic activities, thus providing pharmacological basis for ethnomedicinal uses of this plant.

BACKGROUND: Based on the ethnomedicinal uses and the effective outcomes of natural products in various diseases, this study was designed to evaluate Isodon rugosus as possible remedy in oxidative stress, alzheimer's and other neurodegenerative diseases. Acetylecholinestrase (AChE) and butyrylcholinesterase (BChE) inhibitory activities of crude methanolic extract (Ir.Cr), resultant fractions (n-hexane (Ir.Hex), chloroform (Ir.Cf), ethyl acetate (Ir.EtAc), aqueous (Ir.Aq)), flavonoids (Ir.Flv) and crude saponins (Ir.Sp) of I. rugosus were investigated using Ellman's spectrophotometric method. Antioxidant potential of I. rugosus was determined using DPPH, H2O2 and ABTS free radicals scavenging assays. Total phenolic and flavonoids contents of plant extracts were determined and expressed in mg GAE/g dry weight and mg RTE/g of dry sample respectively. RESULTS: Among different fractions Ir.Flv and Ir.Cf exhibited highest inhibitory activity against AChE (87.44 ± 0.51, 83.73 ± 0.64%) and BChE (82.53 ± 0.71, 88.55 ± 0.77%) enzymes at 1 mg/ml with IC50 values of 45, 50 for AChE and 40, 70 μg/ml for BChE respectively. Activity of these fractions were comparable to galanthamine causing 96.00 ± 0.30 and 88.61 ± 0.43% inhibition of AChE and BChE at 1 mg/ml concentration with IC50 values of 20 and 47 μg/ml respectively. In antioxidant assays, Ir.Flv, Ir.Cf, and Ir.EtAc demonstrated highest radicals scavenging activities in DPPH and H2O2 assays which were comparable to ascorbic acid. Ir.Flv was found most potent with IC50 of 19 and 24 μg/ml against DPPH and H2O2 radicals respectively. Whereas antioxidant activates of plant samples against ABTS free radicals was moderate. Ir.Cf, Ir.EtAc and Ir.Cr showed high phenolic and flavonoid contents and concentrations of these compounds in different fractions correlated well to their antioxidant and anticholinestrase activities. CONCLUSION: It may be inferred from the current investigations that the Ir.Sp, Ir.Flv and various fractions of I. rugosus are good sources of anticholinesterase and antioxidant compounds. Different fractions can be subjected to activity guided isolation of bioactive compounds effective in neurological disorders.

Objective: To determine the sensitivity pattern of bacterial isolates in neonatal sepsis at a tertiary care hospital of Peshawar. Methodology: This cross sectional study was carried out at the department of paediatrics, Rehman medical institute Peshawar, from 1st January 2006 to 30th June 2012. Out of 4900 neonates admitted to the department of neonatology during the study period, 2256 (46.04%) neonates had clinical signs and symptoms of sepsis. Only 440/2256 (19.5%) neonates with positive blood cultures were selected for the study. All the blood cultures were done following a standard protocol. Results: Out of 440 cases of neonatal sepsis, 309 (70.2%) were males and 131 (29.8%) were females. Mean age of patients was 8.93 ± 8.70 days. Nineteen different micro-organism were isolated in which Staphylococcus Aureus (n=282; 64.1%), Enterococcus fecalis (n=61; 13.9%), Klebsiella pneumonia (n=30; 6.8%) and Escherichia coli (n=25; 5.7%) were most common organism. Gram positive organisms were mostly sensitive to vancomycin, imepenime, ceoftaxime, amikacin and amoxacillin, while gram negative organisms were mostly sensitive to amikacin and imepenime. Overall penicillin and cephalosporin has shown high resistance to gram negative organism, while ampicillin was found to be resistant to both gram positive and gram negative organism. Conclusion: Staphylococcus Aureus, Enterococcus Fecalis, Klebsiella pneumonia and Escherichia coli are the commonest pathogens in neonatal sepsis in our set up. In era of highly resistant micro-organism, vancomycin, amikacin, cefotaxime, and imepinime may be considered as drug of choice for empirical treatment of neonatal sepsis on the basis of highest sensitivity amongst tested drugs.

Objective: To detect the frequency of glucose 6-phosphate dehydrogenase (G6PD) and its association with neonatal jaundice. Methodology: This hospital based comparative study was conducted on neonatesadmitted for neonatal jaundice at Rehman Medical Institute Peshawar, Pakistan from 1st Jan, 2006 to 1 June, 2012. A total of 4900 patients were admittedduring this time period, of which 1695 (34.6%) neonates were treated for neonatal Jaundice. Estimation of serum bilirubin (both direct and indirect) was done in all cases and G6PD was done in cases with severe jaundice or with any absolute indication. Results: Out of the total 1695 patients admitted for neonatal jaundice, 152(9%) babies were found to be G6PD deficient. Majority of the patients presented with jaundice in the first 4 days of life. G6PD was found to be the most severe form of jaundice with 56% out all exchange transfused neonates were having no other risk factor but G6PD deficiency. ABO (31.97%) and sepsis (30%) were the common causes of neonatal jaundice. Conclusion: G6PD is one of the common causes of neonatal jaundice. Babies with G6PD can present earlier and can have serious consequences.

Objective: To determine the sensitivity and specificity of C-reactive protein (CRP) in diagnosing neonatal sepsis. Methodology: A cross sectional study of neonates suspected to have sepsis was carried out in the neonatology department of Rehman Medical Institute Peshawar Pakistan. The duration of study was from 1stJan, 2010 to 31st Dec, 2011. A total of 300 cases were selected who were fulfilling the criteria for neonatal sepsis. C-reactive protein and blood cultures were done in all cases following a standard protocol. Results: Among 300 neonates selected, sepsis was confirmed among 56 % (167 of 300) cases. This was done on the basis of positive blood culture. In 66% (198 of 300) cases C-reactive protein was positive with the Sensitivity, specificity, negative and positive predictive values of 94.01%, 69.17%, 79.29%, 90.19% respectively. The diagnostic accuracy of CRP was 83.0%. Conclusion: C-reactive protein is a good diagnostic test index and can identify the infection in neonates at the time of initial assessment. Key Words: Neonatal Sepsis, C-Reactive Proteins, Blood Cultures This article may be cited as: Jan AZ, Zahid SB, Ahmad S. Role of C-reactive protein in diagnosing neonatal sepsis. Khyber Med Univ J 2012; 4(4): 161-164.

Background: Megaloblastic anemia is common in clinical practice in children in Pakistan. Vitamin B12 and folate deficiency are the established causes. The aim of this study was to find the frequency of megaloblastic anemia, its clinical presentation and cause in children in our set-up. Material & Methods: This was a retrospective study conducted at Rehman Medical Institute, Peshawar. Forty-eight children between 6 months to 14 years were studied for the causes of megaloblastic anemia. Results: Among 48 patients there was male to female dominancy (1.64:1), mostly in the age group of 11-14 years. Megaloblastic erthyroid hyperplasia was the most common finding of bone marrow. Folate deficiency was seen in 33.34% of cases and vitamin B12 deficiency in 52.08% cases while 14.58% of cases had both folate and vitamin B12 deficiency. Conclusion: Vitamin B12 deficiency is the major cause of megaloblastic anemia in children in our population. Proper dietary care should be taken in order to avoid it.

In this work, we consider giving up smoking dynamic on adolescent nicotine dependence. First, we use the Caputo derivative to develop the model in fractional order. Then we apply two different numerical methods to compute accurate approximate solutions of this new model in fractional order and compare their results. In order to do this, we consider the generalized Euler method (GEM) and multi-step generalized differential transform method (MSGDTM). We also show the unique positive solution for this model and present numerical results graphically.

[This corrects the article DOI: 10.1371/journal.pone.0103617.].

Background: The spectrum of pediatric uropathogens keeps on changing frequently, particularly in tertiary care settings catering a diverse patient population. The present study was conducted to determine the causative organisms and anti-microbial sensitivity pattern of uropathogens in children at Rehman Medical Institute Peshawar, Pakistan. Material & Methods: This was a retrospective descriptive study from the patient records of 106 children aged 6 months to 14 years with confirmed diagnosis of urinary tract infection based on urine culture and sensitivity reports. The study was carried out from June 01 to July 15, 2013 and included data of children admitted to the Department of Pediatrics, Rehman Medical Institute, Peshawar, over a period of 6 years i.e. January 2007 to December 2012. Results: The male to female ratio was 1:1.8 (34.9% males, 65.1% female). The common presenting symptoms were dysuria, flank pain, fever, restlessness due to pain and weakness. The most common isolated organism was E. coli (65.1%) followed by E. fecalis (20.8%). Regarding sensitivity pattern; Vancomycin, Amikacin, Nitrofurantoin and Impinime showed good sensitivity while Ampicillin and Ceftriaxone showed highest resistance. Conclusion: The resistant pattern of uropathogens causing urinary tract infections to common antimicrobial agents is changing and it must be taken into consideration when selecting treatment strategies.

Background: This study was conducted to identify the different acquired causes of anemia on the basis of bone marrow examination in children admitted to the pediatric Unit of Rehman Medical Institute Peshawar. Material & Methods: It was a retrospective descriptive study conducted at Pediatric Department of Rehman Medical Institute Peshawar on data of 5 years from 1stJanuary, 2008 to 31stDecember, 2012. A total of 249 cases were included in the study that presented with anemia. Patients with hereditary blood disorders and recent history of blood transfusion were excluded from the study. They were assessed clinically by general physical and systemic examination. Complete blood count, peripheral smear and bone marrow examination was performed in all cases. Results: During the study period 14,642 patients were admitted, 249(1.7%) cases presented with hematological disorders on the basis of bone marrow examination. In the etiological pattern, aplastic anemia 71(28.51%) was the most common etiology followed by leukemia 59(23.69%), megaloblastic anemia in 48(19.27%), other less common problems like idiopathic thrombocytopenic purpura 19(7.63%), iron deficiency anemia 9(3.61%), visceral leishmaniasis 8(3.21%), anemia of chronic disorder 6(2.41%) and malaria in 6(2.41%) cases. Common clinical presentations were fever, pallor, body aches, petechial hemorrhages and epistaxis. Conclusion: Anemia secondary to acquired causes is a disorder with serious consequences. Bone marrow examination is helpful in the diagnosis of most of these cases.

Background: Early diagnosis of neonatal sepsis is often difficult because of the non-specific symptoms and signs. An attempt to set a screening test that can identify infected infants at the time of initial presentation, sparing others from invasive procedures, antimicrobial therapy and parent’s anxiety especially by mother infant separation is a challenging task for a neonatologist. The objective of this study was to determine the diagnostic value of C-reactive protein and other hematological marker in predicting early neonatal sepsis. Material & Methods: A retrospective study was conducted at the NICU of Rehman Medical Institute, Peshawar. A total of 700 neonates with age group of first 28 days of life were included in the study, all of which were suspected to have sepsis on clinical settings. All the neonates were investigated by sending blood to the laboratory for blood culture, CRP, and complete blood count and the final results were compared. Results: Sepsis was confirmed in 54% of cases on the basis of positive blood culture. Among the hematological markers, CRP was the most sensitive and specific test with sensitivity and specificity of 88.36% and 89.13% respectively, followed by platelet counts with sensitivity of 87.04%. Absolute Neutrophil Count and WBC had the sensitivity of 84.39% and 84.13%. Conclusion: There is no ideal test for the diagnosis of early or late-onset neonatal sepsis. Physical examination has an important role in identifying infants at low risk for sepsis. Sepsis markers like CRP and neutrophil indices are useful adjunct tests in identifying infants with a low probability of infection.

Sirenomelia (the Mermaid Syndrome) is a rare and lethal congenital anomaly with an incidence of one in 100,000 of normal pregnancies. It is an extremely rare set of birth defects, which can vary in expression. The condition gets its name from one of the defects present, which is a fusing of the legs. The fused nature of the legs has been compared to a mermaid in appearance, hence the name. The characteristic features Sirenomelia are complete fusion of the lower limbs, commonly associated with renal agenesis, absent external genitalia and other gastrointestinal defects. Another pathognomonic finding is the presence of single umbilical, persistent vitelline artery which is the chief distinguishing anatomic finding from Caudal Regression Syndrome. The termination of pregnancy is the choice of management as the case is diagnosed on the antenatal ultrasound which can show the features like renal agenesis with no liquor, fusion of the lower limbs. In our case report, the baby was delivered through Normal Vaginal Delivery with characteristic features of Sirenomelia on examination, the baby expired 8 hours after delivery.

Background: Neonatal period is the most susceptible period of life due to different diseases, which in most cases are preventable. The objective of this study was to assess frequency and pattern of neonatal mortality and morbidity. Material & Methods: A retrospective clinical audit was conducted at a grade IIIA NICU, Rehman Medical Institute, Peshawar. The data of all neonates was analyzed retrospectically from June, 2006 to June, 2012. Results: A total of 4900 patients were admitted in the study period. Among them males were 3104 (63.3%) and females were 1796 (36.71%). Sepsis neonatorum (NNS) accounted for 2027 (41.36%), Neonatal Jaundice (NNJ) 1777 (36.2%), intrauterine growth retardation (IUGR) 941 (19.2%), prematurity 515 (10.5%), birth asphyxia (BA) 446 (9.1%) and meconium aspiration syndrome (MAS) 362 (7.3%) accounted of total admissions. Among total admissions 4331 (88.4%) were sent home after complete recovery, 407 (8.3%) expired, while 162 (3.3%) left against medical advice (LAMA). Conclusions: There is a need for timely referral to a tertiary care hospital from peripheral and non-tertiary setups to prevent and control neonatal mortality and morbidity.