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Motivation: The motivation of this recent article is to study dusty Walter’s B fluid flow due to its wide range of applications in biology and polymer industry. The fluid is traveling peristaltically through an asymmetric channel with wall slip. A discussion is also presented to examine heat transfer effects with thermal radiation and slip. Methodology: The regular perturbation technique is employed to evaluate the mathematical model of the problem, which is first simplified by using stream functions. Mathematical results are simulated to illustrate flow characteristics of fluid and solid particles in salient quantities. Also, graphs of temperature distribution of fluid and dust particles have been discussed to study the impacts of various parameters. Outcomes: Walter’s B fluid parameter reduces speed of both fluid and dust particles. By increasing thermal slip parameter, temperature transference becomes slower through the fluid, while Brinkman number significantly raises the temperature profile of both fluid and particles. This article presents a theoretical analysis of the problem. Moreover, the characteristics of liquids involved in the plastic industry and medical science can also be understood using the current analysis. Originality/Value: Walter’s B fluid with dust particle suspension has not been investigated for slip and thermal radiation effects.

Background: Lack of sleep has a detrimental effect on the nervous system, which impairs brain function. Sleep deprivation not only affects students mental health but also academic performance due to the cognitive impairment that results from it. Objective: To explore effects of quality of sleep, psychological health and academic performance among students of various medical institutes of Lahore, Pakistan. Study type,settings & duration:This cross-sectionalstudy wasconductedat University of Health Sciences, Allama Iqbal Medical College, Services Institute of Medical Sciences and Shaikh Khalifa Bin Zayed Medical and Dental College,Lahore from July to October 2021. Methodology:Thestudy was conduct on 200 (boys=100 & girls=100) medical students. Data was collected using sleep quality scale, questionnaire for general health, an item of question assessing academic performance and demographic information sheet. Results:The mean age of participants was 21.84. Resultsshowed that 66.65% of students had poor sleep quality. The psychological health of medical students with good sleep quality was significantly good as compared to those with poor quality of sleep (t=-9.39, p

Abstract The objective of the study was to evaluate the performance of Pistia stratiotes for treatment of domestic wastewater in a free surface water flow constructed wetland. The objective of the study was to evaluate contaminants removal efficiency of the constructed wetland vegetated with P. stratiotes in treatment of domestic wastewater against Hydraulic retention time (HRT) of 10, 20 and 30 days was investigated. This asks for newer and efficient low-cost nature-based water treatment system which along with cost takes into consideration the sustainability of the ecosystem. Five constructed wetland setups improved the wastewater quality and purify it significantly by reducing the TDS by 83%, TSS by 82%, BOD by 82%, COD by 81%, Chloride by 80%, Sulfate by 77%, NH3 by 84% and Total Oil and Grease by 74%. There was an increase in pH of about 11.9%. Color and odor of wastewater was also improved significantly and effectively. It was observed that 30 days’ HRT was optimum for the treatment of domestic wastewater. The final effluent was found to be suitable as per national environmental quality standards and recycled for watering plants and crop irrigation but not for drinking purposes. The treatment in constructed wetland system was found to be economical, as the cost of construction only was involved and operational and maintenance cost very minimal. Even this research was conducted on the sole purpose of commuting the efficiency of pollutant removal in short span time.

The utilization of phytoconstituents in skin care products has emerged as a notable trend due to their recognized safety and therapeutic efficacy. However, the challenge lies in improving the effective delivery of phytoconstituents to specific tissues, primarily attributed to their poor solubility and low permeability. This study endeavors to address this challenge by developing, optimizing and characterizing Cucumis melo var. agrestis (CME) extract loaded nanoemulsion gel (CME-NEG), aiming to enhance the skin permeability and antifungal activity. Herein, nanoemulsions encapsulating the plant extract were prepared using ultrasonication technique and were characterized for droplet size, zeta potential, polydispersity index (PDI) and entrapment efficiency. Further, Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM) analysis were conducted to characterize the optimized CME extract loaded nanoemulsion (CME-NE 3) formulation. The optimized formulation was blended with Carbopol 940 gel to develop CME-NEG, which was evaluated for release kinetics, in vitro permeation and in vitro antifungal activity. High performance liquid chromatography (HPLC) analysis confirmed the presence of gallic acid, chlorogenic acid, 4-Hydroxy benzoic acid (HB acid), kaempferol, caffeic acid and quercetin. Findings of 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay showed that the ethanolic extract had highest antioxidant activity (88.88 %). The optimized formulation displayed smooth spherical nanodroplets with size of 175.5 ± 1.56 nm, zeta potential of −21.5 ± 0.12 mV, PDI of 0.192 ± 0.06, and highest entrapment efficiency (EE) of 91.35 ± 1.65 %. The release profile of CME-NE exhibited a controlled release characteristic and the release kinetic mechanism was best described by the Korsmeyer-Peppas (Kp) model. In a 24 h permeation study, it was observed that the in vitro permeation of CME-NEG was 58.63 %, significantly higher than that of CME extract loaded plain gel (CME-PG) with an enhancement ratio of 2.12. The prepared CME-NEG formulation also presented enhanced antifungal activity as compared to pure CME extract. In conclusion, the designed CME-NEG offers a promising topical drug delivery system with enhanced skin permeability and antifungal activity.

Sol–gel method was used to prepare Sr1-xCdxZn2Fe4O11 (x = 0.00, 0.02, 0.06, 0.1) R-type hexaferrite. The synthesized materials were sintered at 850oC and desired phase was obtained. X-ray diffraction analysis confirms that R-type hexaferrite exists only as a single phase. Using the Scherer formula, crystallite size for all of the prepared samples was found to be in the range of 10.39–12.62 nm. Crystallite size (D), the lattice parameters (a, c), and the cell volume (Vcell), d-spacing, bulk density, X-ray density, porosity, dislocation density and micro strain were determined in structural analysis. Fourier transform infrared spectroscopy method was used to identify the metal-oxygen vibrations at different locations. FT-IR verifies the presence of the Fe–O stretching vibration band at 743 and 867 cm−1. The typical grain size in surface morphology investigation ranges from 0.56 to 0.82 μm. Dielectric response of ferrite ceramic samples replaced with Cd2+ was investigated in the frequency range of 1 MHz–3 GHz. The AC conductivity rises with an increase in frequency because they are proportional to one another. This increasing tendency is effectively described by the theory of Maxwell-Wagner and Koop. Q-values remain constant as frequency rises and behaves independently of frequency as long as frequency reaches 1.7 GHz. These types of materials are utilized in high-frequency applications including frequency filters and resonant circuits. All of the magnetic properties determined by analyzing the M − H loops, including saturation magnetization (Ms), retentivity (Mr), and coercivity (Hc), exhibit an increasing trend as the substitution of Cd2+ rises. Ms (49.76–56.38 emu/g), Mr (15.82–18.30 emu/g) and Hc range from 203.20 Oe to 215.80 Oe. Grain size decreases cause arise in coercivity, which is caused by an enhancement in magneto-crystalline anisotropy. Overall results suggest that Cd2+ replaced R-type hexagonal ferrites are a great resource for longitudinal recording media; they have the potential to be used in a wide variety of electronic applications, including resonant circuits and high-frequency filters, security, detecting and switching.

The aim present work was to examined the alone and combined impact of press mud compost and fuller earth at 0.5 and 1 % dosage on immobilization of Pb and Cd in Sharafi Goth and Malir polluted soils and reduce their uptake by sorghum plant. The results revealed that sorghum dry biomass yield was observed by 41.47 and 58.8 % with press mud compost (PMC) 1 % + fuller earth (FE) 1 % in Sharafi Goth soil and in Malir polluted soils than control. The immobilization of Pb was observed by 88.0 and 93.52 % with PMC 1 % + FE 1 %, and Cd was immobilized by 90.36 with PMC 1 % + FE 1 % and 78.0 % with PMC 0.5 % + FE 0.5 % in Sharafi Goth and Malir polluted soils than control. The uptake of Pb and Cd in shoot and root by sorghum was reduced both soils with application additives. The studied amendments increased the soil chemical properties such as electrical conductivity (EC), pH, cation exchange capacity (CEC), organic matter (O.M) and CaCO3 than control soil. The results of redundancy analysis showed that soil O.M had positive correlation with plant dry biomass, whereas EC, pH, CEC, O.M and CaCO3 showed negative correlation with Pb and Cd in soil and Pb and Cd in plant soot and root biomass. The results of present study indicated that press mud compost alone and in combined form shown positive impact on plant growth, immobilize Pb and Cd in both soils and reduced their uptake by sorghum plant. Future long-term field experiments must be carried out in multi-metals polluted soils and cultivate different genotypes.

Abstract Background Pakistan has one of the highest burdens of Hepatitis C virus (HCV) infection globally. To achieve the World Health Organization’s goals for HCV elimination, there is a need for substantial scale-up in testing, treatment, and a reduction in new infections. Data on the population impact of scaling up treatment is not available in Pakistan, nor is there reliable data on the incidence of infection/reinfection. This project will fill this gap by providing important empirical data on the incidence of infection (primary and reinfection) in Pakistan. Then, by using this data in epidemic models, the study will determine whether response rates achieved with affordable therapies (sofosbuvir plus daclatasvir) will be sufficient to eliminate HCV in Pakistan. Methods This prospective multi-centre cohort study will screen 25,000 individuals for HCV antibody (Ab) and RNA (if Ab-positive) at various centers in Pakistan- Karachi (Sindh) and Punjab, providing estimates of the disease prevalence. HCV positive patients will be treated with sofosbuvir and daclatasvir for 12-weeks, (extended to 24-weeks in those with cirrhosis) and the proportion responding to this first-line treatment estimated. Patients who test HCV Ab negative will be recalled 12 months later to test for new HCV infections, providing estimates of the incidence rate. Patients diagnosed with HCV (~ 4,000) will be treated and tested for Sustained Virological Response (SVR). Questionnaires to assess risk factors, productivity, health care usage and quality of life will be completed at both the initial screening and at 12-month follow-up, allowing mathematical modelling and economic analysis to assess the current treatment strategies. Viral resistance will be analysed and patients who have successfully completed treatment will be retested 12 months later to estimate the rate of re-infection. Conclusion The HepFREEPak study will provide evidence on the efficacy of available and widely used treatment options in Pakistan. It will also provide data on the incidence rate of primary infections and re-infections. Data on incidence risk factors will allow us to model and incorporate heterogeneity of risk and how that affects screening and treatment strategies. These data will identify any gaps in current test-and-treat programs to achieve HCV elimination in Pakistan. Study registration This study was registered on clinicaltrials.gov (NCT04943588) on June 29, 2021.

Primary Choriocarcinoma of the lung is a rare malignant tumor in young patients. It is mostly misdiagnosed as primary or metastatic lung cancer. Poor outcome is seen due to delays in treatment and aggressive behavior of the tumor. We present an 18-year-old male the complaints of chest pain, backache, and hemoptysis. He denied any history of tuberculosis or malignancy though he confirmed to be an occasional smoker. He was tachypneic with decreased air entry bilaterally and the rest of the examination was normal. Investigations revealed multiple bilateral pulmonary nodules. Intraoperatively multiple brown sub-centimeters to more than one-centimeter lung nodules were observed. Histopathology was suggestive of Choriocarcinoma of the lung. Beta-HCG was positive with workup for distant metastasis suggestive of para-aortic lymph node invading left psoas muscle. He was referred to oncology where he expired due to widespread disease and chemotherapy side effects.

The primary focus of this article is on an electro-osmosis-based interpretation of the two-dimensional movement of an incompressible Sutterby nanofluid flow across a stretching wedge-shaped geometry. Thermal dissipation, double diffusivity, concentration and momentum association are also incorporated. Nanofluids are expected to improve the ability of heat-transfer fluids to convey heat more efficiently. Because the dimensionless equations related to our work are difficult to solve manually, we employ the MATLAB bvp4c technique to depict the graphical behavior of various parameters. The primary inquiry is that electro-osmosis causes a decrease in fluid velocity. The velocity field descends by an increment of the viscosity and magnetic field parameters but escalates against the inclined magnetic field parameter. The radiation variable parameter surges the temperature field while de-escalating the concentration and double diffusivity profile. Our investigation shows that the Brownian and thermophoresis diffusion coefficients encounter temperature increases at first, then slow down as both parameters are extended farther. The repercussion of an Inclined magnetic field is demarcated that how the occupancy of an Inclined magnetic field factor delays the velocity of Sutterby fluid. Electro-osmotic flow is a prevalent technology used in the chemical evaluationand microfluidic devices with high-voltage surfaces.

Objectives. This study aimed to analyze the inter-molar width and skeletal base class to predict maxillary canine impaction in permanent dentition. Methods. This cross-sectional study was carried out between September 2021 to March 2022. Patients aged between 13 and 20 years were recruited. These patients’ cone-beam computer tomography(CBCT), lateral cephalogram, and dental casts were collected and analyzed. For statistical analysis, T -test and Chi-square tests were applied. Results. A total of 92 patients were enrolled in this study. Inter-molar width was significantly decreased in patients with impacted canine( P

ABSTRACTDamage to body tissue either deeply or superficially causes pain sensation in response to which Inflammation occurs which is a normal protective natural response of the body to a variety of hostile agents. Different treatment options, including conventional and herbal therapies, are available for pain and inflammation. This study was designed to evaluate the polyherbal n-hexane and methanolic extracts and their hydrogel formulations prepared from commonly available medicinal plants for their analgesic and anti-inflammatory potential. Cinnamomum verum J. (bark), Moringa oleifera L. (leaves), Nigella sativa L. (seed), and Trigonella foenum graecum L. (seed) were collected and purchased from the vicinity and local market of Multan Punjab, Pakistan. After drying, extraction was carried out by maceration separately with two different solvents (methanol and n-hexane). An equal quantity of all methanolic and n-hexane extracts was used to formulate polyherbal methanolic and n-hexane extracts separately. Then 1%, 3%, and 5% pH-based hydrogel formulations of methanolic and n-hexane polyherbal extract were prepared. All prepared six formulations were evaluated for pH, rheological study, spreadability, extrudability, stability study, texture, color, and for toxicological study. Then analgesic and anti-inflammatory potential of methanol and n-Hexane polyherbal extracts at (200, 400 and 800.0 mg/kg) in comparison with diclofenac sodium (100 mg/kg) and prepared gel formulations (1%, 3%, and 5%) were also evaluated in comparison to diclofenac sodium 1% gel (standard drug). Both polyherbal extracts and their gel formulations have significant analgesic and anti-inflammatory potential but methanolic extract and its hydrogel have slightly more potential as compared to n-hexane extracts and its prepared hydrogel. Results also revealed that their gel formulations have more significant analgesic and anti-inflammatory potentials as compared to extracts. All pH-based gels have good texture, spreadability, extrudability, stability, and are safe to use. It is concluded that methanolic polyherbal extract and hydrogel prepared from methanolic extract have more analgesic and anti-inflammatory potential as compare to n-Hexane extract and hydrogel prepare from n-Hexane extract.

The objective of the present study was to investigate the impact of MgO 0.5 g/kg loaded in different organic waste materials on the properties of the modified biochars obtained. The waste materials included tea waste, wood waste, water chestnut peel, and pomegranate peel, which were used to create tea waste MgO-modified biochar (TWMgO-MBC), wood waste MgO-modified biochar (WSMgO-MBC), water chestnut peel MgO-modified biochar (WCMgO-MBC), and pomegranate peel MgO-modified biochar (PPMgO-MBC). All the MgO-modified biochars were prepared at 600 °C for 2 h and applied at 0.5 and 1% doses for the immobilization of Ni, Cu, Pb, and Cr in stone crushing and mining-polluted soil and the reduction in their uptake by pearl millet (Pennisetum glaucum) plant. The greatest fresh and dry biomasses were observed at 45.04% and 31.29%, respectively, with the application of TWMgO-MBC 1% in stone-crushing-polluted soil. The highest degree of immobilization of Ni (76.67%) was observed for the WSMgO-MBC 1% treatment, Cu (73.45%) for WCMgO-MBC 1%, Pb (76.78%) for WSMgO-MBC 1%, and Cr (70.55%) for WCMgO-MBC 1%, in comparison with the control. The maximum uptake of Ni, Cu, Pb, and Cr in the shoot of pearl millet was reduced by 78.43% with WSMgO-MBC 1%, 75.06% with WSMgO-MBC 1%, 90.81% with WCMgO-MBC 1%, and 85.71% with WSMgO-MBC 1% as compared with the control. The greatest reduction in Ni, Cu, Pb, and Cr in the root of pearl millet was observed at 77.81% with WSMgO-MBC 1%, 68.09% with WCMgO-MBC 1%, 84.03% with WCMgO-MBC 1%, and 88.73% with WCMgO-MBC 1%, in comparison with the control. The present study demonstrated that the TWMgO-MBC 1% treatment was highly effective for improving plant growth, while the WSMgO-MBC 1%, and WCMgO-MBC 1% treatments were found to be highly effective for immobilizing heavy metals in polluted soils, thus facilitating safe crop cultivation. Future studies should concentrate on the long-term application of MgO-modified biochars for the remediation of multimetal-polluted soils.

Driving while drowsy poses significant risks, including reduced cognitive function and the potential for accidents, which can lead to severe consequences such as trauma, economic losses, injuries, or death. The use of artificial intelligence can enable effective detection of driver drowsiness, helping to prevent accidents and enhance driver performance. This research aims to address the crucial need for real-time and accurate drowsiness detection to mitigate the impact of fatigue-related accidents. Leveraging ultra-wideband radar data collected over five minutes, the dataset was segmented into one-minute chunks and transformed into grayscale images. Spatial features are retrieved from the images using a two-dimensional Convolutional Neural Network. Following that, these features were used to train and test multiple machine learning classifiers. The ensemble classifier RF-XGB-SVM, which combines Random Forest, XGBoost, and Support Vector Machine using a hard voting criterion, performed admirably with an accuracy of 96.6%. Additionally, the proposed approach was validated with a robust k-fold score of 97% and a standard deviation of 0.018, demonstrating significant results. The dataset is augmented using Generative Adversarial Networks, resulting in improved accuracies for all models. Among them, the RF-XGB-SVM model outperformed the rest with an accuracy score of 99.58%.

Objective: To investigate the anticancer potential of a novel synthetic derivative of a naturally occurring diterpenoid against glioblastoma. Method: The in vitro study was conducted at the Ojha Campus of Dow University of Health Sciences, Karachi, from February to December 2021, and comprised U87 cells. The 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was used to determine the growth inhibitory effect of 16(R and S) – phenylamino-cleroda3, 13(14) Zdiene- 15, 16 olide and standard drug temozolomide against glioblastoma cells, and half-maximal inhibitory concentration was calculated. Microscopy and immunocytochemistry were used to investigate apoptotic morphology and active caspase-3 and B-cell lymphoma 2 (Bcl-2) expression. Quantitative real time polymerase chain reaction was used to investigate the expression of proliferation markers. Data was analysed using SPSS 21. Results: Both the synthetic derivative and the standard drug significantly inhibited growth of U87 cells (p0.05). Conclusion: The synthetic diterpene derivative PGEA-AN showed growth inhibitory actiity against glioblastoma. Key Words: Temozolomide, Caspase, Glioblastoma, Diterpenes.

Schiff-base fluorescent chemosensor (E)-N-(4-(dimethylamino)benzylidene)quinolone-3-amine (DBQA) was synthesized and characterized by FT-IR,1H NMR,13C NMR, ESI-MS spectrometry and Single X-ray crystallographic studies. The synthesized chemosensor (DBQA) was used for the detection of Fe3+ successfully. UV-visible and fluorescence spectra of (DBQA) exhibits a ratiometric behaviour along with a bathochromic shift upon the successive addition of Fe3+. The fluorescence spectra of chemosensor (DBQA) were recorded followed by addition of concentrations of different metal ions and NH3. The chemosensor (DBQA) showed a favourable linear relationship between the fluorescence intensity and concentration of Fe3+ ion. DBQA exhibits a ratiometric response and illustrates high sensitivity (with a detection limit of 0.4 ​μM) and good selectivity for the Fe3+ ion over other transition metal ions. DBQA shows 0.6 ​μM detection limit for NH3 along with ratiometric behaviour also. The association constant (Ka) of chemosensor (DBQA) was found to be 1.455×102 ​M-1/2 for Fe3+. The mechanism of sensing of the present ratiometric fluorescent chemosensor (DBQA) was explained by ICT (Intra-molecular charge transfer) using DFT calculations. The interaction model of chemosensor (DBQA) with Fe3+ was determined to be 2:1 stoichiometry using Job's plot analysis and ESI-MS spectra which further confirms DFT studies. Moreover, tested DBQA ​+ ​Fe3+ was showed that remarkable anticancer activity against the HCT116 colon cancer cells by MTT assay. Novelty and importance of DBQA as it can be investigate, test or analyse of detect Fe3+ rapidly as compared to other tested ions. Lastly, DBQA can be investigate, test or analyse of Fe3+ in environmental and biological samples.

ABSTRACT Root-associated microbiomes (RAMs) are complex microbial communities, essential for plant growth and development. The RAMs interact with the roots, maintain the root architecture, protect plants from a plethora of pathogens and biotic and abiotic stress and intensify nutrient uptake, i.e., improve plant growth and yield. A wide variety of microbial populations is usually found in the rhizosphere. Plant exudates also play a significant role in the establishment of rhizospheric microbial communities. This study deals with the approach of microbiome engineering to enhance the development of crops such as wheat. We focus on the idea of soil engineering to foster beneficial microbial communities that can improve plant growth effectively and reduce competition by gradually decreasing the number of pathogenic communities. This technique enables plants to thrive under adequate edaphic conditions. In the current study, the rhizosphere of Triticum aestivum L. was analyzed over four generations. Variations in the microbial diversity between batches one to four (B1-B4) were analyzed with regard to their capacity to improve plant growth. Microbial species richness in the rhizosphere microbiome of wheat was recorded in all investigated plant batches (B0 to B4). The major phyla across the four plant batches were Proteobacteria, Chloroflexi and Actinobacteria. Jaccard Similarity Coefficient indicated similarity between the batches B4-treated and B4-control. Taxonomic distances between the bacterial communities of Batches B0, B1 and B4 were the highest. Significant improvements in the growth parameters of plants treated with a microbiome-containing soil solution of the previous generation (batch) were recorded. Subsequently, their microbiome was also engineered, which facilitated plant growth effectively.

AbstractStudents of diverse abilities tend to be divided into groups that advocate academic homogeneity. Ability grouping practice is embedded within the contemporary hyper-accountability culture in education that has shifted the focus of the teaching community from promoting academic attainment in pupils to being highly ranked in the market-based education system. To maintain an ascending position and avoid “punitive measures, schools adopt stratification according to the pupils” academic abilities. Ability grouping strategy is commonplace in countries like the United States of America (USA), Canada, New Zealand, United Arab Emirates (UAE) and Australia, but the intensity of this practice is unfavourable. This study aims to visit the scholarly work of the authors of the western world to comprehend the history and the advances in the ability grouping practice. The collected data from several studies endorse that ability grouping leads educational establishments to inculcate diverse educational experiences and opportunities for learners. Thus, dividing learners into academic groups contributes to broadening the socioeconomic gap.

Acute myeloid leukemia (AML) are a diverse group of hematological malignancies, each with a distinct clinical, morphological, immunophenotypic, and molecular profile. The World Health Organization (WHO) classifies AML into various subtypes based on recurrent genetic abnormalities, each of which has clinico-pathological and prognostic significance. Inversion(16)(p13q22) or t(16;16)(p13q22) is a balanced structural chromosomal abnormality associated with complete remission and a favorable response to treatment. Trisomy 9 is a numerical chromosomal abnormality with an intermediate risk and is often seen in association with other cytogenetic abnormalities. We describe a case of a 36-year-old female patient who was diagnosed as AML-M4 on peripheral smear and bone marrow evaluation. Cytogenetic studies revealed concurrent presence of inv(16) and trisomy 9. To the best of our knowledge, this is the first case in published literature with simultaneous presence of inv(16)(p13q22) and trisomy 9 in de novo AML.

Introduction The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is one of the most used tools to measure health-related quality of life in heart failure. Despite extensive use in research, evidence on the MLHFQ’s internal structure validity remains heterogeneous and inconclusive. There are no known reviews that systematically summarise the evidence related to the MLHFQ’s factor structure (internal structure validity). This gap highlights a need to critically appraise, summarise and compare the available evidence on the internal structure and internal consistency reliability (ICR) of the MLHFQ.Methods and analysis The review will adhere to the reporting guidelines of the Cochrane Handbook for Systematic Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We will systematically search eleven electronic databases/search engines (Medline, EMBASE, Cumulative Index for Nursing and Allied Health Literature, PsycINFO, Global Health, Health and Psychosocial Instruments, Scopus, Journals, Web of Science, Google Scholar, and Dissertation and Theses Global) for quantitative studies assessing the MLHFQ’s factor structure and ICR. Two reviewers will then independently screen studies for eligibility and assess the quality of included studies using the COnsensus-based Standards for the selection of health status Measurement Instruments checklist. Throughout the review, discrepancies will be resolved through consensus or by the involvement of the third reviewer. We will analyse and present results using descriptive statistics (frequencies, proportions and ranges) and narrative synthesis. We will include all the relevant studies published within the timeframe covered by the database. We carried out the preliminary search in November 2022 except for Dissertation and Theses Global which was searched in September 2023; however, we will update the entire search right before the review completion in January 2024.Ethics and dissemination Ethical approval is not required as no primary data is being collected from individuals. We intend to share the findings of the review at international conferences and publish manuscripts in peer-reviewed journals.PROSPERO registration number CRD42023346919.

Objective: To assess the role of capillary blood ketone assay in managing Diabetic Ketoacidosis in the Paediatric Intensive Care Unit. Study Design: Prospective longitudinal study. Place and Duration of Study: Paediatric Intensive Care Unit of Children’s Hospital, University of Child Health Sciences, Lahore Pakistan, from Jul to Dec 2021. Methodology: Patients with Diabetic ketoacidosis fulfilling the inclusion criteria and admitted during the study period were enrolled, and treatment was given according to standard protocol. On admission, capillary blood ketones were measured after 4-6 hours, and serial blood glucose, serum electrolytes, serum creatinine and venous blood gas were done. Results: Out of 554 admissions, 55(9.9%) patients with diabetic ketoacidosis were enrolled. The mean age was 8.2±3.5 years, with 28(50.9%) females. Among 33(60%) newly diagnosed cases, 13(23.6%) were moderate and 41(74.5%) with severe diabetic ketoacidosis. 12(21.8%) cases developed AKI, 5(9.1%) required continuous renal replacement therapy, 10(18.2%) needed mechanical ventilation, and 2(3.6%) expired. A positive statistical correlation was observed between capillary blood ketones and standard acidosis markers on admission. Conclusion: Capillary blood ketone assay has a significant role in managing Diabetic Ketoacidosis by prompt diagnosis, early initiation of treatment and early stoppage of insulin infusion at resolution of ketosis without waiting for blood gas parameters to normalise. Its use should be encouraged in PICUs, especially in low-resource settings, because of its cost-effectiveness.

Nanofinishing is the process by which ultrafine dispersion of nanomaterials is applied to a textile for the development of functionalities. The utilization of nanometal oxides as antimicrobial agents have shown a substantial antimicrobial property in cotton. In the present study, previously synthesized powder containing ZnO nanoflowers (ZnO NFs) was characterized for morphology, surface composition, roughness, and charge using Transmission electron microscopy (TEM), Scanning transmission electron microscopy (STEM), Atomic force microscopy(AFM) and Zeta potential. Optical properties of crystalline ZnO were determined by Photoluminescence (PL), Diffused reflectance Spectroscopy (DRS), and bandgap energy determination. Highly crystalline, ZnO NFs bearing crystal defects and high surface charge were loaded onto the pristine cotton by a dip coating method using Triton X-100 as dispersant and iSys MTX fabric binder. The pristine cotton fabric of 125 g/m2 was nano finished by loading 20,42 and 58 µg/cm2 (1–3 dip cycles) ZnO NFs respectively. The loading of ZnO NFs onto the surface of cotton fabric was confirmed by SEM and used for antibacterial activity against E. coli as a photocatalytic reactor. The prepared samples were irradiated with a UV lamp of λmax = 254 nm (15 min, 30 min, 45 min) and D65 artificial sunlight (60 min, 120 min, 180 min) to investigate their photocatalytic activity against pathogenic E. coli using modified Breed Smear’s method. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of ZnO NFs@ cotton were determined as 19.53 µg/ml and 39.06 µg/ml respectively after exposure to UV light. After exposure to sunlight MIC and MBC observed were higher i.e. 156.25 µg/ml and 312.5 µg/ml respectively showing lesser activity in sunlight as compared to ionizing UV radiations. To verify the photocatalytic activity, hydroxyl radicals generated by ZnO NFs@ cotton were also determinedtime-resolved PL on exposure to a UV lamp and D65 artificial sunlight. This nano-finished cotton is a promising candidate to be used as a medical textile with high antibacterial activity even after 20 washing cycles with only a 5% decrease in efficiency.

Background: An increasing number of patients are using natural homemade remedies such as strawberries, banana peels, coconut oil rinse, basil, lemon, activated charcoal, apple cider vinegar, baking soda, and turmeric to obtain whiter teeth. However, studies on these natural whitening products are limited. Aim: To evaluate the effectiveness of different homemade tooth-whitening agents in vitro. Materials and methods: Ninety caries-free extracted anterior and premolar teeth were collected, cleaned, and sectioned at the roots. The teeth were mounted in epoxy resin (buccal surface) and stored in 0.2 % thymol solution, and were treated with one of the following six whitening agents: baking soda, activated charcoal, lemon juice, strawberries, Colgate Optic Whitening toothpaste, and Opalescence 20 % home-bleaching system. The enamel shade in each sample was measured four times using a spectrophotometer. Baseline measurements for ΔE and (L*, a*, b*) were obtained, and the second measurement was obtained after 5 days. The third reading was obtained on the 10th day, and the fourth reading was obtained at the 4th week to measure colour stability. One-way analysis of variance and post-hoc Tukey tests were used for statistical analysis. Results: ΔE measurements showed a significant difference on the 10th day in all groups except the lemon group (P = 0.164), while all groups showed a statistically significant difference at the 4th week. The mean colour change differed remarkably between the first and fourth readings. The highest change was observed in the lemon group (44.0 ± 2.9), closely followed by the Opalescence 20 % and Colgate Optic Whitening toothpaste groups. The lowest change was observed with strawberries (38.2 ± 4.8). ΔE showed a significant difference in all groups except the turmeric group. Conclusion: Statistically significant differences were obtained with baking soda, activated charcoal, strawberries, lemon juice, Colgate Optic Whitening toothpaste, and Opalescence 20%. Further studies are required to evaluate the effects of these agents on surface roughness and colour stability.

Objective: To synthesize zinc oxide nanoparticles (ZnONPs) and evaluate their antibacterial and wound healing effects against wounds infected with methicillin-resistant Staphylococcus aureus (MRSA). Methods: ZnONPs were prepared by sol-gel method and characterized by X-ray diffraction (XRD) analysis and scanning electron microscopy (SEM). A total of 18 rabbits were divided into three groups: the ZnONPs group, the gentamicin group and the control group. A wound of 3 cm2 was inflicted on each rabbit and contaminated with MRSA inoculum. Treatment was started from the fourth day post-surgery. Wound healing, microbiological analysis, and histopathological analysis were performed to assess the efficacy of ZnONPs ointment. Results: XRD analysis confirmed the hexagonal wurtzite structure of the ZnONPs with an average crystallite size of 29.23 nm. SEM revealed discoid-shaped ZnONPs with a rough surface and an average size of 48.36 nm. Energy-dispersive X-ray analysis confirmed the purity of ZnONPs. Moreover, the particle size ranged from 100-700 nm with a high agglomeration trend. Treatment with ZnONPs promoted MRSA-infected wound healing. In addition, ZnONPs showed a good antibacterial effect as evidenced by a dose-dependent increase in the zone of inhibition. Conclusions: ZnONPs accelerate the healing of MRSA-infected wounds. Therefore, it can be explored for the treatment of MRSA infection.

Denomination and ritual are subjects that have fascinated writers all around the world for many years. The denomination is a wide-ranging topic that cannot be included in concise books or writings. Poets, especially Urdu poets, express specific beliefs toward their denomination, ritual, and religious leaders. Denomination and ritual are involved effectively in human life and are evident in his speech and writing. The present study investigates the concerns and interests of the Urdu poet Iftikhar Arif. It studies his denomination and understanding and the influence of Islamic leaders. He has been able to take his name and his poems to the top of the literary sky in religious literature. His poems are full of a deep understanding of Islam, love for the Prophet (PBUH) of Islam, and his household. It can be said that he has a sufficient understanding of religion and has expressed the issues of the present age in the context of religion. IntroductionRitual literature is not apart from other common literature in the Persian language in terms of its verbal structure and appearance and the use of various styles, artistic techniques, and verbal and spiritual arrays. What distinguishes ritual literature is its spiritual form and content. Any prose text or verse that is influenced by the speech of the Holy Quran, the history of Islam and religious leaders, the speech of Imam Ali (AS) in Nahj al-Balagha, and prayers such as Sahifa Sajjadiyyah is placed in the realm of ritual literature.Ritual literature has been included in human institutions since the beginning of creation. It includes prayers to God, prayers and praises of religious and scholastic elders, the mourning of elders, local and religious rites, asking for rain, morals and education, waiting for relief and opening in religious and worldly matters, as well as verses that are full of Quranic teachings, school subjects, religious and divine teachings. Poets, by taking inspiration from the school of revelation and heavenly orders, have been able to create works in the field of Persian thought and literature and present them to the scientific and literary society (Ramadhan Khani, 2015). Materials and MethodsThe present descriptive-analytical research used printed books and online materials about poets’ life and works. Iftikhar Arif and his poems have always been the focus of discussions and critics, and many articles have been written about his theories and thoughts. Studying his works is the basis of this research, but so far, a review of ritual literature in the poems of Iftikhar Arif has not been written in the Persian language. In this study, an attempt has been made to examine the topics and content of religious literature, the influence of the poet on Islam, and the life of the pioneers of Islam. Since the poems by Iftikhar Arif have religious and ritual content and themes and have not yet been translated into Persian, in presenting examples of his works, translation and then collecting examples are used. Research FindingsIn the present study, we came to the conclusion that Islamic history, the forerunners of Islam, the Quran, and Hadith had a vast impact on the poet. The main topics we found in the verses are Prophet Mohammad (PBUH), the tragedy of Karbala, and the massage and the impact of Karbala. Further, we see that the poet used the sayings of Imam Ali (AS), especially from Nahj al-Balagha.Prophet Mohammad (PBUH) is an eternal character of the religion of Islam and humanity. The characters of Imam Ali and Imam Hussain (AS) are also the topics mentioned in Iftikhar’s poetry. Iftikhar Arif has beautiful poems praising the Prophet of Islam (PBUH), the Prophet's city, the importance of sending greetings and the desire to visit the Prophet's city and important events such as the ascension and migration of the Prophet. Moreover, the shining face of Imam Ali (AS) and his importance in Islam is the main part of the verses of the poet in the form of the one who gave life to the lifeless body of Islam.Discussion of Results and ConclusionBased on the results, we conclud that the poet has his own opinion in the field of religion and wrote poems in this regard, the language of which is simple and easy to understand for the general public. The poet has been able to attract the reader's attention with his new and fresh combinations and terms and the use of different topics in his poems. He has always been able to express long themes with the power of reciting poetry and his complete mastery of literary presentations using a minimum of words and without making his compositions long. In a verse or in short order, he has been able to express vast and extensive topics in one place with the simplicity of expression and fluency of words. Religious topics are mentioned in the poet's poems and the poet has been able to use religious topics not only to express religion but also to portray the situation of his society and the solution to the problems and oppression in religious messages, especially in the events of Karbala. The poet's imitation of the Karbala event and the bravery of the faithful companions of Ahl al-Bayt and the Prophet's family is very clear.

Kidney transplants (KT) from hepatitis C (HCV) viremic donors to HCV negative recipients has shown promising renal outcomes, however, high incidence of cytomegalovirus (CMV) viremia were reported. We performed a prospective cohort study of 52 HCV negative KT recipients from Methodist University Hospital including 41 receiving transplants from HCV aviremic donors and 11 from HCV viremic donors. CMV specific CD4+ and CD8 + T cell immunity was measured by intracellular flow cytometry assay. Primary outcome was the development of positive CMV specific CD4+ and CD8 + T cell immune response in the entire cohort and each subgroup. The association between donor HCV status and CMV specific CD4+ and CD8 + T cell immune response was analyzed by Cox proportional hazard models. Mean recipient age was 48 ± 13 years, with 73% male and 82% African American. Positive CMV specific CD4+ and CD8 + T cell immune response was found in 53% and 47% of the cohort at 1 month, 65% and 70% at 2 months, 80% and 75% at 4 months, 89% and 87% at 6 months, and 94% and 94% at 9 months post-transplant, respectively. There was no significant difference in the incidence of positive CMV specific T cell immune response between recipients of transplants from HCV aviremic donors compared to HCV viremic donors in unadjusted (for CD8+: HR = 1.169, 95%CI: 0.521–2.623; for CD4+: HR = 1.208, 95%CI: 0.543–2.689) and adjusted (for CD8+: HR = 1.072, 95%CI: 0.458–2.507; for CD4+: HR = 1.210, 95%CI: 0.526–2.784) Cox regression analyses. HCV viremia in donors was not associated with impaired development of CMV specific T cell immunity in this cohort.

Introduction: Diabetes mellitus causes hyperglycemia and associated complications to the brain. In current study, the traditionally reported remedial claims of Agave americana var. marginata has been scientifically investigated in diabetic rats. Methodology: The methanolic extract of leaves of Agave americana var. marginata (Aa.Cr) was characterized for total phenols, flavonoids, and antioxidant potential through in-vitro testing. The rats chronically pre-treated with Aa.Cr (400 and 600 mg/kg) for 45 days were challenged with alloxan-induced hyperglycemia. The dose-dependent effects of Aa.Cr on blood glucose levels and body weights were compared with diabetic rats using glibenclamide (0.6 mg/kg) as a standard. The animals were tested for diabetes-associated neurological comorbidities through behavioral and biochemical evaluation. Results: The phenols and flavonoids enriched Aa.Cr caused a significant dose-dependent hypoglycemic effect. Aa.Cr showed protection from comorbid anxiety, depression and cognitive impairment as compared to diabetic rats. The alanine aminotransferase, total cholesterol, triglycerides and low-density lipoprotein were prominently reduced, and high-density lipoprotein was increased in rats treated with Aa.Cr. Moreover, the oxidative stress in isolated brains was reduced by Aa.Cr. Conclusion: These findings suggest that Aa.Cr is enriched with antioxidant and anti-inflammatory phytoconstituents valuable for diabetes and related neurological complications.

Papillary thyroid carcinoma is the most prevalent endocrine malignancy of the head and neck region. It makes up to 80% of all thyroid cancers, and has a 10-year survival rate of up to 95%. Differentiated thyroid carcinomas have good prognosis after a complete surgical extirpation as long as it is not associated with invasion of the surrounding structures. The advanced papillary thyroid carcinoma can invade the neighbouring structures of the thyroid gland, such as strap muscles, recurrent laryngeal nerve, trachea, oesophagus, larynx, pharynx, and carotids. Whenever papillary thyroid carcinoma is associated with invasion of aerodigestive tract it is difficult to excise the tumour. We report a patient with stage IV invasive papillary thyroid carcinomas as per Shin Staging system. The surgery was deferred from several hospitals considering the advanced stage of the disease with tracheal extension making it a problematic airway for both the anaesthesiologist and the operating surgeon. ---Continue

Objective: This study assesses first-aid facilities within school premises and assessment of teach- ers on first aid training. The objective was to assess and compare the first aid knowledge, attitude and practice among teachers from both public and private sector of some schools in Karachi. Methods: The study was cross-sectional and was conducted from March 2018 to September 2019. All participants were included after the informed consent and all of them were full-time teachers from both public and private sector schools. All of them were below 70 years and had minimum one year experience at least. Data was collected through the questionnaire method. Results: Total 384 teachers were included, out of which, 106 were from the public sector and 278 from the private sector. Also, 53% of public and 54% of private- sector teachers had performed first aid in their professional life. Only 27% of public and 40% private teachers think that they are able to handle emergency situations and have enough first aid knowledge. Out of all the teachers partici- pated in, only 27% of public sector teachers think that they have sufficient knowledge regarding first aid, that they can handle emergency situation on their own. On the other hand, 40% of private-sector teachers have enough first aid knowledge to handle emergency cases on their own in schools. Conclusion: Knowledge and attitude regarding first aid training and management is unsatisfactory among the teachers at schools in Karachi. Public sector school teachers have a poor understanding of knowledge and practice of first aid as compared to the private sector. Although not enough but pri- vate sector schools do recognize the importance of first aid training more than public sector schools.

Rampant discharge of industrial wastes containing non-biodegradable colored dyes to water bodies has prompted the development of an environment-friendly photocatalytic process using nontoxic, photostable water soluble photocatalyst. In this work, bare undoped carbon dots (CDots) based photocatalyst has been reported. The carbon dots were synthesized via the pyrolysis method using a single source, ammonium citrate; the reported carbon dots were characterized using HR-TEM, XRD, FTIR, XPS, Photoluminescence (P.L.), TGA, and UV–Vis spectroscopy. The catalytic behavior of the synthesized carbon dots was tested against two water-soluble industrial dyes (Methylene Blue (M.B.) and Congo Red (C.R.)). The synthesized carbon dots exhibited excellent photocatalytic activity under visible light irradiation facilitating 96% degradation of MB within 55 min and 98% degradation of C.R. within 60 min. A plausible mechanism for the photocatalytic degradation of studied dyes was proposed based on comprehensive active species trapping experiments. The photogenerated holes (h+) and superoxide radicals (O2 .−) were the main active species responsible for the degradation of studied dyes. The kinetic studies revealed that the cationic methylene blue dye degradation by BUCDs followed the modified Freundlich kinetic model with rate constant 0.063 and anionic congo red dye depicted closed correlation with both parabolic diffusion model and modified Freundlich kinetic model with rate constants 0.256 and 0.196. The synthesized BUCDs showed no cytotoxicity in HCT human colon cancer cell lines, thus establishing their nontoxic nature.

Abstract In this article we study certain degenerations of the mirror curves associated with the Calabi–Yau threefolds $$X_{N,M}$$ X N , M , and the effect of these degenerations on the refined topological string partition function of $$X_{N,M}$$ X N , M . We show that when the mirror curve degenerates and become the union of the lower genus curves the corresponding partition function factorizes into pieces corresponding to the components of the degenerate mirror curve. Moreover we show that using degeneration of a generalised mirror curve it is possible to obtain the partition function corresponding to $$X_{N,M-1}$$ X N , M - 1 from $$X_{N,M}$$ X N , M .

Abstract Background Antiretroviral therapy (ART) has led to dramatic improvements in survival for people living with HIV, but is unable to cure infection, or induce viral control off therapy. Designing intervention trials with novel agents with the potential to confer a period of HIV remission without ART remains a key scientific and community goal. We detail the rationale, design, and outcomes of a randomised, placebo-controlled trial of two HIV-specific long-acting broadly neutralising antibodies (bNAbs): 3BNC117-LS and 10-1074-LS, which target CD4 binding site and V3 loop respectively, on post-treatment viral control. Methods RIO is a randomised, placebo-controlled, double-blinded prospective phase II study. Eligible individuals will have started ART within 3 months of primary HIV infection and have viral sequences that appear to be sensitive to both bNAbs. It will randomise 72 eligible participants 1:1 to the following arms via a two-stage design. In Stage 1, arm A participants are given dual long-acting (LS-variants) bNAbs infusions, followed by intensively monitored Analytical Treatment Interruption (ATI) (n = 36); in arm B, participants receive placebo infusions followed by ATI. The primary endpoint will be time to viral rebound within 36 weeks after ATI. Upon viral rebound, the participant and researcher are unblinded. Participants in arm A recommence ART and complete the study. Participants in arm B are invited to restart ART and enroll into Stage 2 where they will receive open-label LS bNAbs, followed by a second ATI 24 weeks after. Secondary and exploratory endpoints include adverse events, time to undetectable viraemia after restarting ART, immunological markers, HIV proviral DNA, serum bNAb concentrations in blood, bNAb resistance at viral rebound, and quality of life measures. Discussion The two-stage design was determined in collaboration with community involvement. This design allows all participants the option to receive bNAbs. It also tests the hypothesis that bNAbs may drive sustained HIV control beyond the duration of detectable bNAb concentrations. Community representatives were involved at all stages. This included the two-stage design, discussion on the criteria to restart ART, frequency of monitoring visits off ART, and reducing the risk of onward transmission to HIV-negative partners. It also included responding to the challenges of COVID-19. Trial registration The protocol is registered on Clinical.trials.gov and EudraCT and has approval from UK Ethics and MHRA.

Introduction: Diabetes mellitus is a widely recognized metabolic condition. Due to various side effects of currently available medicines, studies have reported the use of many plants in various areas for the traditional management of diabetes. Aims & Objectives: To determine the effects of Coriandum sativum seeds on lipid profile in diabetic rats. Place and duration of study: This experimental research was conducted at Physiology Department, Services Institute of Medical Sciences (SIMS), Lahore from August 2013 to January, 2014. Material & Methods: Ninety rats were randomly distributed into three groups of (n=30) each. Group A was healthy control, group B was disease control and group C was diabetic experimental which was treated with Coriandrum sativum with a single dosage of 250 mg/kg of body weight/day through a gavage tube for 28 days. On next day, 4-5ml blood was collected through heart from each rat. The markers evaluated were high density lipoprotein (HDL), triglycerides, total cholesterol, low density lipoprotein (LDL) and very low density lipoprotein (VLDL). Data was analyzed by using SPSS version16 , p value

Objectives: Maternal MTHFR and MTRR polymorphisms as a risk of CHD in DS fetus were studied along with maternal folic acid supplementation, which could influence the folate metabolism along with other risk factors. Material and Methods: A case-control study comprising of mothers of DS with and without CHD along with controls were recruited from a tertiary care center since 2018–2019. Genomic DNA was isolated followed by PCR-RFLP. Results: Mothers with age ≥35 years and having history of miscarriages have a higher risk of giving birth to DS with CHD (n = 35% and 42%, respectively). Mothers who carried the MTHFR 677CT/TT and MTRR 524CT/TT genotypes combination in the folic acid nonusers group during pregnancies had six-fold (OR = 6.909, p-value = 0.027; 95% CI—1.23 ± 38.51) and four-fold (OR = 4.75, p-value = 0.040; 95% CI—1.067 ± 21.44) increased odds of having a DS child with CHD, respectively, as compared to folic acid users. Conclusion: Maternal age, folic acid supplementation, and previous history of miscarriages is involved in the etiology of CHD in DS fetus in Indian population. Maternal MTHFR and MTRR polymorphisms are also involved in the occurrence of CHD and DS in Indian population when controlling for periconceptional folic acid supplementation. Limitations: Single-Centered Study

Recently, natural dyes are used because these are environment-friendly, less lethal, and do not have any detrimental effect on health. For the present study, the cotton fabric and the mixed powder (pomegranate rind and turmeric rhizome) have been irradiated for (1–5) min. It has been found that 3 min is the effective exposure time for improvement in dyeing behavior of cellulosic fabric. Good color strength was observed by dyeing fabric irradiated at 65°C for 40 min in dyeing bath having pH 6. For improvements in color fastness, the optimum concentration of pre-mordant (4% copper) and post-mordant (8% chrome) was employed. It is observed that microwaves increased the color strength as well as color fastness properties of irradiated cotton using aqueous solubilized mixed extract of irradiated pomegranate rind and turmeric rhizome powder.

Background. Manka canal’s metal concentration rises from human activities’ garbage. Untreated water from the canal is used by farmers for local crop irrigation. Immediate action is crucial to assess heavy metal levels and ensure soil suitability for agriculture as metal pollution persists. Purpose. The current study was conducted to assess the health risks associated with metal pollution at Manka Canal, Dera Ghazi Khan. Methods. A total of eighty-four wastewater, soil, and wheat samples were collected from study areas. The collected samples were analyzed for heavy metals (Cd, Cu, Fe, Mn, Ni, Pb, and Zn) using a flame atomic absorption spectrometer (FAAS). Results. The significant findings of the study revealed that the concentration of heavy metals in most of the collected samples of soil, water, and wheat was above the World Health Organization (WHO) permissible limits. The mean concentrations of Cd, Cu, Mn, Ni, Pb, and Zn were at relatively higher concentrations, i.e., 4.88, 22.03, 38.2, 89.2, 19.62, and 67.9 mg/kg, respectively, in collected wheat samples. The soil and irrigation water quality metrics had values that exceeded the acceptable thresholds, rendering them unfit for agricultural use. The local community faces an elevated health risk index for both children and adults due to the consumption of wheat crop as HRI is greater than 1 for nonessential elements like Cd and Pb. Conclusion. The study suggested that wastewater irrigation leads to the accumulation of heavy metals in foodstuffs, causing potential health risks to consumers. The gradual accumulation of these contaminants in biological systems finally gives rise to severe health-related issues. Therefore, it is crucial to implement robust wastewater treatment processes and stringent quality control measures to minimize health risks associated with the consumption of crops grown using reclaimed water. Prior to irrigating crops like wheat and vegetables, it is strongly advised to treat municipal wastewater to prevent soil and dietary toxicity from heavy metals.

Objective: The purpose of the study was to determine the association between the media exposure and the aggression levels in the students of 13-24 years residing in Wah Cantt. Study Design: Cross-sectional Place and Duration of Study: Educational Institutes of Wah Cantt for 1 year from i.e., January 2019 to January 2020. Materials and Methods: The standardized questionnaires i.e., CME-scale & Bus-perry scale were used to measure Media exposure and aggression levels besides basic demographic data. Data was analyzed by using SPSS version 20. Media exposure and aggression exhibited by the students was categorized into low, medium, and high levels. Results: Majority of students had low or medium levels of media exposure (59.4%) and low or medium aggression scores (84.1%). There was no difference in level of aggression between Males and Females (P=0.230). Association of aggression with Media exposure was significant (P=0.000) and the Pearson correlation was weakly positive (r= 0.393, p= 0.000). Although a majority (80.6%) of participants possessed electronic devices, but they were mostly (55.9%) monitored by parents. Hours spent per day on screen were positively skewed with mean hours of 4.58±3.8. Conclusion: There was a weak positive correlation between media exposure & aggression. A longitudinal study might be done to assess the possible effect of the cultural and societal values of indulgence in sports and scholarship by the citizens of this area on the levels of media exposure and aggression levels in youth.

Background: Nonsyndromic cleft lip with or without palate (NSCL/P) is a multifactorial and common birth malformation caused by genetic and environmental factors, as well as by teratogens. Genome-wide association studies found genetic variations with modulatory effects of NSCL/P formation in Chinese and Iranian populations. We aimed to identify the susceptibility of single-nucleotide polymorphisms (SNPs) to nonsyndromic cleft lip with or without palate in the Indian population. Material and Methods: The present study was conducted on NSCL/P cases and controls. Genomic DNA was extracted from peripheral blood and Axiom- Precision Medicine Research Array (PMRA) was performed. The Axiom-PMRA covers 902,527 markers and several thousand novel risk variants. Quality control-passed samples were included for candidate genetic variation identification, gene functional enrichment, and pathway and network analysis. Results: The genome-wide association study identified fourteen novel candidate gene SNPs that showed the most significant association with the risk of NSCL/P, and eight were predicted to have regulatory sequences. Conclusion: The GWAS study showed novel candidate genetic variations in NSCL/P formations. These findings contribute to the understanding of genetic predisposition to nonsyndromic cleft lip with or without palate.

Diabetes mellitus is a chronic metabolic complaint with numerous short- and long-term complications that harm a person’s physical and psychological health. Plumeria obtusa L. is a traditional medicine used in the treatment of diabetes to reduce complications related to behavior. Plumeria is a genus with antipsychotic activities. The objective of this study was to examine the effects of a methanolic extract of Plumeria obtusa L. in the attenuation of diabetes, on symptoms of Alzheimer disease, and on other associated behavioral aspects. A single dose of alloxan was administered to an experimental group of rats to induce development of diabetes (150 mg/kg, intraperitoneal) and the rats were then administered selected doses of methanolic extract of Plumeria obtusa L. (Po.Cr) or glibenclamide (0.6 mg/kg) for 45 consecutive days. Behavioral effects were evaluated using three validated assays of anxiety-related behavior: the open field test, the light and dark test, and the elevated plus maze. Anti-depressant effects of Plumeria obtusa L. were evaluated using the forced swim test (FST) and memory and learning were assessed using the Morris water maze (MWM) task. Po.Cr was also evaluated for phytochemicals using total phenolic content (TPC), total flavonoid content (TFC), and high-performance liquid chromatography assays, and antioxidant capability was assessed through assays of DPPH radical scavenging, total oxidation capacity, and total reducing capacity. In the alloxan-induced model of diabetes, the administration of Po.Cr and glibenclamide for 45 days produced a marked decrease (p < 0.001) in hyperglycemia compared to control animals. Po.Cr treatment also resulted in improvement in indicators, such as body weight and lipid profile (p < 0.05), as well as restoration of normal levels of alanine transaminase (ALT) (p < 0.001), a biomarker of liver function. Diabetic rats presented more Alzheimer-like symptoms, with greater impairment of memory and learning, and increased anxiety and depression compared to non-diabetic normal rats, whereas treated diabetic rats showed significant improvements in memory and behavioral outcomes. These results demonstrate that Po.Cr reversed alloxan-induced hyperglycemia and ameliorated Alzheimer-related behavioral changes, which supports additional study and assessment of conventional use of the plant to treat diabetes and associated behavioral complications.

The water microbial contamination is very common and different techniques are in practice for the decontamination purpose. The advance oxidation processes are being employed to mortify pathogens polluting drinking water. Heterogeneous photocatalysis under sunlight irradiation is a cost effective and remarkably proficient method for water purification. Zinc Oxide (ZnO) is a biocompatible material that has promising photo–oxidant activity. In this study, ZnO has been synthesized using Aloe vera (Av) extract assisted with hydrothermal approach. The nano disc structure of ZnO was characterized by XRD SEM, TEM, AFM, EDX, and FTIR techniques. The optical properties of ZnO@Av NDs (nano discs) evaluated by DRS and PL revealed their sunlight harvesting capability, as the calculated band gap value was 2.8 eV. The surface area and surface charge were measured by BET (5.34 m2g-1) and Zeta potential (+7.46 mV). The antibacterial activity of ZnO@Av NDs was studied against Salmonella typhimurium as a function of various process variables i.e., photocatalyst loading, sunlight exposure time, and bacterial inoculum size. The bactericidal reaction parameters were optimized statistically by Response Surface Methodology (RSM) on exposure to direct sunlight (average solar flux was 650 KWh/m2) at pH 7. As optimized conditions, 100 μL initial inoculum concentration of S. typhimurium was treated with 60 μg/mL of ZnO@Av NDs suspension under sunlight irradiation of 5 h, antibacterial index obtained was 6.8. The MIC and MBC for ZnO@Av NDs against S. typhimurium were 50 μL and 100 μL, respectively. It has been observed that ZnO@Av NDs lower the optical density of water that contains S. typhimurium. The photocatalytic purification of water using ZnO@Av NDs is safe and cost-effective method under sunlight irradiation, which could possibly be employed for the wastewater purification.

Background: Cardiovascular diseases are a common and increasing number of deaths in developing and developed countries. Heart diseases are considered chronic and affect blood flow that leads to a number of psychological issues. Cardiac issues cause a major disturbance in the quality of life of the patient. Objective: To find out the relationship among alexithymia, posttraumatic growth, and life satisfaction among cardiac sufferers at DHQ Teaching Hospital and Siddique Sadiq Memorial Trust Hospital Gujranwala (Punjab; Pakistan). Study type, settings & duration: A cross sectional study was conducted DHQ Teaching Hospital and Siddique Sadiq Memorial Trust Hospital, Gujranwala from February to August 2020. Methodology: One hundred patients of heart attack from both genders aged 21-60 years. Toronto alexithymia scale (TAS-20), Posttraumatic growth inventory (PGI), and Satisfaction with life scale was used to collect data from the heart attack patients. Results: The results of this study revealed that alexithymia including three sub-factors i.e. difficulty in identifying feelings, difficulty in describing feelings, and externally oriented thinking is significantly negatively correlated with life satisfaction while posttraumatic growth i.e. new possibilities and appreciations of life significant positive correlated with life satisfaction. Conclusion: It was concluded that alexithymia has negative association with the satisfaction of life while posttraumatic growth is positively correlated with life satisfaction.

OBJECTIVES:. Older age is a key risk factor for adverse outcomes in critically ill patients with COVID-19. However, few studies have investigated whether preexisting comorbidities and acute physiologic ICU factors modify the association between age and death. DESIGN:. Multicenter cohort study. SETTING:. ICUs at 68 hospitals across the United States. PATIENTS:. A total of 5,037 critically ill adults with COVID-19 admitted to ICUs between March 1, 2020, and July 1, 2020. INTERVENTIONS:. None. MEASUREMENTS AND MAIN RESULTS:. The primary exposure was age, modeled as a continuous variable. The primary outcome was 28-day inhospital mortality. Multivariable logistic regression tested the association between age and death. Effect modification by the number of risk factors was assessed through a multiplicative interaction term in the logistic regression model. Among the 5,037 patients included (mean age, 60.9 yr [± 14.7], 3,179 [63.1%] male), 1,786 (35.4%) died within 28 days. Age had a nonlinear association with 28-day mortality (p for nonlinearity

Introduction: Diabetes mellitus is characterized by hyperglycemia with impaired metabolism of carbohydrates, fats, and proteins resulting from insufficiency of secretion or action of insulin. The interplay of genes and environmental factors is believed to stress glucose homeostasis. Simple dietary and lifestyle modifications have a role in prevention and slow progression of the disease. The choice and role of sweeteners (sugars) such as ordinary cane sugar, honey, and jaggery have always been a difficult decision for patients with Type 2 diabetes. Aims & Objectives: Evaluation and comparison of the effects of cane sugar, honey, and jaggery on plasma glucose in the sera and body weights of alloxan-induced male Wistar rats with diabetes. Place and duration of study: The study was conducted at the animal house of Services Institute of Medical Sciences Lahore for a duration of 20 months approximately. Material & Methods: In this experimental study 120 male Wistar (albino) rats were randomly allocated into 4 groups of 30 each. After acclimatization, freshly prepared 2% alloxan monohydrate was administered to all the rats via intraperitoneal injection in a single dose of 120mg/kg body weight. Blood sample via tail tipping method was analyzed for fasting serum glucose at 4th post-diabetes induction day. Rodents having ? 200mg/dl serum glucose were regarded as type 2 diabetes models for further study. All animals had access to usual pelleted diet ad libitum. Diabetic controls in group I were fed with equivalent amount of distilled water. Group II, III and IV rats were fed freshly prepared sweetener containing cane sugar, honey and jaggery solutions respectively in a dose of 1g/kg body weight dissolved in 2ml distilled water on pre-scheduled time of the day for 28 days via oral syringe-dosing. Final serum glucose was estimated at 29th day of study by terminal blood sampling and final body weights were recorded. Data analysis was performed using SPSS version 20. Results: Group III (honey fed) rats had least hyperglycemia of 34.53±77.31mg/dL, followed by group II (cane sugar fed) rats (79.31±73.03 mg/dL) then group I diabetic control rats (88.11±92.56mg/dL) and maximal rise in jaggery fed rats with value of 134.50 mg/dL. Significant reduction (p=0.049) in body weight (-40.50g) was noted in group II rats whereas maximum weight gain occurred in group I (127.57 ±72.475), than those of group IV rats (69.13 ± 92.88) followed by II rats (38.42±89.43). Conclusion: The result demonstrates that honey in type 2 diabetes mellitus possess antidiabetic properties via minimum hyperglycemic and weight gaining effects than processed cane sugar. As it was presumed, minimally processed jaggery has not shown significant beneficial effects on serum glucose and body weight. Owing to the advantageous effects on metabolic profile, honey may be regarded as a relatively safer sweetener in diabetics.

Objective: To find out the prevalence of antibodies against cytomegalovirus and their association with adverse pregnancy outcome in women, at Isra University Hospital Hyderabad. Study Design: Cross-sectional study. Place and Duration of Study: Department of Gynaecology & Obstetrics, Isra University Hospital (IUH) Hyderabad, from Jan to Jun 2018. Methodology: Cytomegalovirus IgM and IgG antibodies in 305 women of reproductive age group were measured using the Enzyme Linked Fluorescent Assaysystem kit. Results: The combined positivity of anti cytomegalovirus IgG and IgM antibodies was 93 (30.40%). About 37 (37.37%) and 28 (34.14%) women were found to be seropositive for cytomegalovirus antibodies who had history of spontaneous miscarriage and recurrent miscarriages respectively. Conclusion: Higher association of seropositivity for cytomegalovirus IgM and IgG with bad obstetrical history and low economy was found.

Introduction: Diabetic Ketoacidosis (DKA) is the major source of mortality and morbidity in type 1 Diabetes Mellitus. Cautious fluid resuscitation, insulin and electrolyte replacement along with observation for complications is the mainstay of treatment. Early identification of complications lead to better management and outcome. Objective: To find out the complications of moderate to severe DKA in pediatric patients admitted in Pediatric Intensive Care Unit (PICU). Methods: Cross-sectional Study was conducted in PICU of University of Child Health Sciences & The Children’s Hospital, Lahore from Jan, 2015 to Dec, 2018.Data was collected from retrospective records of patients admitted in PICU. All patients with moderate/severe DKA were included. Patients with developmental delay were excluded. Data was analyzed using SPSS version 25. Chi-square test was used to find out p-value. Results: A total of 152 patients with moderate/severe DKA were included in the study, having mean age of 7.86 ± 4.06 years. Most patients 42% (n=64) were more than 10 years of age. Mean weight of the children was 19.89 ± 8.70 kg. Majority 59% (n= 89) were of new onset diabetes. Severe DKA was seen in 74% while moderate DKA in 26% patients. The complications seen were: hypokalemia 33% (n=50), cerebral edema 28% (n=42), hypernatremia 18% (n=27), hyponatremia 8% (n=12) and acute kidney injury (AKI) in 7% (n=11). Survival rate was 85% while mortality rate was 15%. Conclusion: Hypokalemia and cerebral edema were the most common complications observed. Complications were more common in those patients who presented with DKA in first presentation. Key words: complications, DKA severity, children, PICU.

Introduction: Mitral stenosis is most common among rheumatic valvular heart disease. The morphological severity of the mitral valve is assessed by Wilkins scoring on echocardiography. Substantial gender-related differences regarding mitral valve and other cardiovascular diseases are reported. Data showed men and women had a different risk for valvular heart diseases. This study aims to ascertain if there is any gender-specific difference in the morphological severity of mitral stenosis based on Wilkin’s scoring in a tertiary care Cardiology Center. Aims & Objectives: To report differences in morphological severity of mitral stenosis in male and female gender based on Wilkin’s scoring. Place and duration of study: Cardiology Department of Gulab Devi Teaching Hospital. This Study was completed in one year. Material & Methods: A descriptive cross-sectional study on 152 patients presenting in the Cardiology Department of Gulab Devi Teaching Hospital. The study was conducted after obtaining ethical approval from the Institutional Ethical Review Board. Results: A total of 152 subjects participated among which 80 male patients and 72 females. The severity of the disease was divided into mild, moderate and severe. No gender related difference was observed in echocardiographic parameters. Regarding morphological assessment based on Wilkin’s score, significant difference was observed only in the values of Valve leaflet thickness. Conclusion: The results of this study didn’t show a clear and significant difference in morphological severity of mitral stenosis when compared between male and female gender. So, each patient regardless of gender should be carefully screened and assessed while deciding treatment strategy.

Karachi has been facing various issues of municipal solid waste management. In the early 1960s, Karachi was the centre of leisure, now it has stretched out due to its increasing population. However, due to insufficient facilities and ineffective strategies, issues related to waste management are also increasing. For the problems related to waste management, the fundamental units available are municipal trash bins. In this study, 409 GPS point data of collection points of waste have been assembled from various areas of Karachi for assessment of the spatial distribution of waste bins. A spatial variation of distance between the trash bins is also identified through ArcGIS 10.3.1 cartography tool of generalization, which aggregates the points of trash bins by making polygon shape of the same distance. Globally, Geospatial techniques are used for changing the system of waste management. This is the first study that assessed the suitable distance of bins placement in the area under focus. The results revealed that there are no principles acquired by the government for the placement of trash bins with appropriate distance. In many towns of Karachi like Landhi and Korangi, bins are absent which impels people to throw their trash anywhere in the city.

Use of municipal waste water (both treated and untreated) has now become a common practice in urban and peri-urban areas. Mostly vegetables in urban cities like Karachi are being irrigated by sewerage water. In this study a comparison of sewage and fresh water-irrigated vegetables has been made with respect to trace metals. Among commonly used vegetables, green onion, cabbage, pumpkin, eggplant, bird’s eye chili and okra were selected. Two sets of these vegetables were collected, one from local farm where irrigation was done with well water and other set of samples was collected from Malir, Karachi where irrigation was done with waste water. Samples were analyzed for heavy metals i.e. K, Na, Pb, Zn, Cu, Cd, Fe, and As by Atomic Absorption Spectroscopy. It showed that both sets of samples were found to contain metal concentrations beyond the limits set by WHO/EU. Apart from tomato, the concentration of only Cd was near the standard value for both sets. Similar results were obtained for K except for pumpkin in which the concentration for waste water irrigated samples was fairly high. Amount of Cu and Fe were moderately higher than the standard in both samples. Arsenic in all the samples was considerably high while maximum concentration was obtained for Pd against the limits. These findings suggest waste water irrigated vegetables pose high risk to human health. The concentrations of As and Pb were high in fresh water samples possibly, the well water may contain metals, therefore it is important to know the source.