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Background: Smoking is the non-communicable and chronic disease of lungs. This study determines the rate of prevalence and determinants of smoking among school students in rural community of Lahore. Significance: This study was conducted to determine the factors that effects on their health status include both physiological and psychological status and how it influences on their personality development. Methodology: Descriptive cross sectional quantitative study was conducted at Malikpur community Lahore. Researchers collected the sample by using simple random sampling technique. Total out of 90 students the 73 students voluntarily participated in this study. Result: The findings of the study showed that prevalence of smoking among school students was 30.1% in which the female students was excluded.15.1% students smoke for pleasure seeking while 5.5% smoke due to stress and 4.1% smoke because of peers pressure and 2.7% smoke due to curiosity. Conclusion: There is a need to conduct preventive programs to focus on various social and behavioral aspects to help in smoking cessation and reduce prevalence and determinants of smoking.

Background: Painful symptoms of diabetic neuropathy are more common in patients having type 2 diabetes. The objective in this trial was assessment of mean change in pain score upon giving Vit-D supplementation in patients with diabetic painful neuropathy. Methodology: This study was conducted from December 2019 to June 2020 in OPD of Fauji Foundation Hospital, Rawalpindi after the ethical approval. A total of 251 diagnosed cases of diabetes (both male and female patients), with high HbA1c and low Vit-D levels were included in the study. Patients having Vit-D deficiency and chronic diabetic neuropathy were given Vitamin supplementation and results were assessed after 1 month through change in pain score according to Douleur Neuropathique 4. A document of consent form was filled by patients who were recruited for this study. Data analysis was done on SPSS version 16.Paired sample t- test, was used to compare pain score where p value less than 0.05 was considered statistically significant. Results: Among the participants mean age was 48.22+17.06. There were 106 (42.2%) males and 145 (57.8%) female patients. A statistically significant (p

Granulomatosis with polyangiitis (GPA) is an uncommon pauci-immune small-vessel necrotising granulomatous vasculitis mostly seen in age 45–60 years. We present the case of a formerly healthy 44 years old male presenting with dysuria and intermittent urinary retention for 8 months, not responding to empirical antibiotic therapy and TURP. A prostate biopsy showed necrotising granulomatous prostatitis. Urinalysis demonstrated persistent pyuria and haematuria, but cultures showed no growth. Subsequently he complained of fever, cough, dyspnoea and skin ulcers. CT of the chest showed multiple cavitatory lesions and pleural effusion. On work up, c-ANCA was positive and a diagnosis of granulomatosis with polyangiitis was established. This depicts a rarely seen presentation of prostatitis as the initial feature of GPA.

Background: Child malnutrition is a major public health problem in most low income communities leading to high morbidity and mortality. According to National Nutrition Survey of Pakistan, 43% of children are stunted and 15% are wasted. Aim: To assess the nutritional status of the children attending the government schools in Islamabad. Methodology: A Descriptive cross-sectional survey was carried out on school going children 6-12 years of age (1st -5th grade) attending Islamabad Model School for Boys F.11/1, Islamabad. Sample Size of 80 was obtained by using Simple Random sampling. Data collection tools, weighing machine, height measuring tape, calculator and a questionnaire form containing socio-demographic data of a child (age, gender, height, weight, socioeconomic group etc.), BMI for age percentile growth chart and height age growth chart. Data analysis was done by using SPSS software version 23. Conclusion: Shorter heights of children may mask their poor nutritional status and deem them, to be healthy on a BMI scale. Economic, political and social changes should be made with special focus on mothers’ education to improve the nutritional status of children. Keywords: BMI, Nutritional status, Government schools, socio-economic status

Objective: This research study evaluated the perception of students of Mohtarma Benazeer Bhutto Shaheed Medical College Mirpur AJK (MBBSMC), towards newly adapted online university education during COVID-19 and the analysis of the performance of instructors during online lectures. Study Design: Cross Sectional study. Setting: Medical Education Department Shaheed Mohtarma Benazir Bhutto Medical University. Period: 19 May to 13th August 2020. Material & Methods: The information collected through feedback form was analysed using Statistical Package for Social sciences (SPSS) 21 software. The feedback form included 17 questions related to the performance of the instructor, effectiveness of the course and examination. The responses to questions included options of strongly agree, agree, uncertain, disagree and strongly disagree. Results: The findings of the study revealed that students have were satisfied with the performances of instructors during COVID-19 resulting online education sessions conducted by MBBSMC. Conclusion: It has been concluded that despite the commonly mentioned shortcomings of the online education such as lack of in person interaction with the instructor, lack of traditional lecture hall environment etc., students of MBBSMC were satisfied with the online education methods and performances of the instructor.

1*Amna, A., 1Imran, M., 1Sajid, M.S., 2Aqib, A.I., 1Sindhu, Z., and 1Siddique, A. 1*Research Focus: Zoonotic parasites of Fish 1*Student level: M.Phil. Scholar *Corresponding Author: vetamnaahmad@gmail.com 1Department of Parasitology, University of Agriculture, Faisalabad-38040, Pakistan 2Department of Medicine, the Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan However, these practices do not put an end to parasites completely, which is uneconomical and unaccepted by consumers. The intricacy of diagnosis, complicated human cultural behaviors, and incomprehension of potential economic costs have made this field scientifically dubious and unappealing to researchers. There is room for researchers to develop specific molecular or immunological methods to aid diagnosis. Morphological identification needs to be made by molecular approaches like molecular markers, genetic markers, phylogenetic analysis to solve the long due misunderstandings of the host associations and host ranges for several species of fish helminths, wrong taxonomy, and distribution. Keywords: Fish parasites, Helminths, Foodborne Zoonosis &nbsp

PurposeEvery year a huge amount of food is wasted from food production till its consumption. The activity of food wastage has become a daily routine practice and a huge portion of this loss is contributed by the consumers all around the world. With a total estimated population of 207.7m, 64 percent of the population of Pakistan is below the age of 30. The purpose of this paper is to investigate the factors that affect young consumer’s food waste behavior in a developing country context.Design/methodology/approachData were collected in the month of Ramadan and Eid primarily by means of a web-based questionnaire. A two-step approach of structural equation modeling was used as a data analysis technique.FindingsThe findings of this research confirm the hypothesis that environmental concern and time pressure influence the attitude toward food waste reduction. The results further reveal that although attitude and injunctive norms lead toward higher intentions to reduce food waste, moral norms and perceived behavioral control do not significantly impact this intent.Practical implicationsThis study contributes toward understanding the behavior of consumers in order to ensure the provision and execution of food waste prevention campaigns. This study has implications for policy makers and decision makers, and other stakeholders responsible for food waste reduction and environmental protection. Besides, social campaigns can be developed based on the results of this study, so as to improve the habits related to food wastage in consumers. Finally, the findings are beneficial to academics and scholars that are presently working on factors related to consumer behavior toward food waste.Originality/valueFood waste behavior in young consumers from developing countries in general and from Pakistan in particular has not been analyzed before. The present study aims at analyzing some of the important predecessors of food waste behavior and thus it significantly adds to the existing body of knowledge of consumer behavior toward food waste.

The global production of plastic has raised to 330 billion tons per year, which is a huge concern in terms of environmental crisis and health issues. Currently there are no devised mechanisms available on industrial scale and in nature by which plastics can be degraded completely into harmless residues. Water constitutes two-thirds of the planet, and almost 70–80% of it is polluted by plastic debris. Marine organisms are facing alarming situations and awful scenarios due to the water pollution caused by plastics. Micro- and macroplastics are the main entities involved in polluting the water bodies, which besides the generation of different health issues are a direct threat to the destruction of natural habitats to marine and fresh water flora and fauna. Human activities, industrialization, and population burst in recent years has contributed to high demands of plastics for the manufacturing of different products most of which end up in oceans and fresh water bodies resulting in their pollution.

Introduction Dysphagia is highly prevalent in patients with a history of recurrent acid peptic disease. Endoscopy is the mainstay of diagnostic workup of these patients to reach underlying cause and appropriate subsequent treatment. The objective of the study was to determine the frequency of various types of endoscopic findings in patients with dysphagia and the association of these findings with gender, age and duration of symptoms. Methods This cross-sectional study was carried out in the Department of Gastroenterology of a tertiary care hospital in Rawalpindi, Pakistan. A total of 137 patients who presented with a history of dysphagia for at least two weeks were enrolled in the study. Duration of symptoms was noted, and all patients underwent upper gastrointestinal endoscopy to find out the cause of dysphagia. Tissue biopsies were obtained, and further histopathological examination was performed to correlate the findings with symptoms of dysphagia. Results A total of 137 patients were enrolled for six months. The mean age of the patients was 56.9 ± 17.44 years, and the mean duration of symptoms was 15.96 ± 12.31 weeks. There were 65 (47.4%) males and 72 (52.6%) females in the study. Majority of them, 123 (89.8%), presented with a short duration of symptoms that varied between 2-24 weeks and were mainly middle-aged (31-60 years) and old-aged (61-80 years). The most commonly observed endoscopic findings were esophageal stricture in 25 (18.2%), achalasia cardia in 20 (14.6%), esophageal mass in 12 (8.8%) and reflux esophagitis in 7 (5%) patients. No association was seen between age, gender and duration of symptoms and findings on the endoscopy. Conclusion Dysphagia is associated with many endoscopic findings that are not related to demographic variables and must be evaluated earlier to reduce further morbidity and mortality.

Pesticides are most commonly used throughout the world for agriculture, even some of them, although forbidden due to their severe toxicity and ill health effects are being used in developing countries including Pakistan. Increased pesticide exposure, especially in cotton growing areas of Sindh and Punjab along with poverty, lack of education, poor hygiene and insufficient precautionary measures are leading to increasing health problems. Few investigations have been completed regarding this matter. This review has tried to identify the factors contributing to ill health effects of pesticides in agriculture worker’s suggestive preventive measures. Studies were located using Medline database. All Searches included the key headings Pesticides combined with agriculture workers and health effects. Inclusion criteria included studies carried out since 1997 related to pesticide exposure and its ill health effects on agricultural workers. A total of twenty studies was selected during search for four categories of health effects. The studies on acute human toxicity and animal toxicology were excluded. The effects of pesticide on health showed the strongest relationship with neurotoxicity. All the studies reviewed showed evidence of ill health effects mainly on the nervous system, skin, Respiratory and reproductive systems. The farmers working in agricultural fields should be monitored with a passage of time to avoid the spread of diseases due to pesticide residues. Keywords: Agricultural workers; Neurotoxicity; Pesticide residues http://dx.doi.org/10.19045/bspab.2019.80141

OBJECTIVE: Hypertension-associated parenchymal arteriole (PA) dysfunction reduces cerebral perfusion and impairs cognition. This is associated with impaired TRPV4-mediated PA dilation; therefore, we tested the hypothesis that TRPV4 channels are important regulators of cerebral perfusion, PA structure and dilation, and cognition. METHODS: 10–12-month-old male TRPV4 knockout (WKY-Trpv4(em4Mcwi)) and age-matched control WKY rats were studied. Cerebral perfusion was measured by MRI with arterial spin labeling. PA structure and function were assessed using pressure myography and cognitive function using the novel object recognition test. RESULTS: Cerebral perfusion was reduced in the WKY-Trpv4(em4Mcwi) rats. This was not a result PA remodeling because TRPV4 deletion did not change PA structure. TRPV4 deletion did not change PA myogenic tone development, but PAs from the WKY-Trpv4(em4Mcwi) rats had severely blunted endothelium-dependent dilation. The WKY-Trpv4(em4Mcwi) rats had impaired cognitive function and exhibited depressive-like behavior. The WKY-Trpv4(em4Mcwi) rats also had increased microglia activation, and increased mRNA expression of GFAP and tumor necrosis factor alpha suggesting increased inflammation. CONCLUSION: Our data indicate that TRPV4 channels play a critical role in cerebral perfusion, PA dilation, cognition and inflammation. Impaired TRPV4 function in diseases such as hypertension may increase the risk for the development of vascular dementia.

Ocular toxoplasmosis occurs subsequently after systemic infection with the protozoan parasite, Toxoplasma gondii (T. gondii). The parasite has a high affinity for retinal microvascular endothelium with the retina being the primary site of infection in the eye. Choroidal neovascular membrane (CNVM) is a late complication of ocular toxoplasmosis, mostly occurring in healed, inactive lesions and may be a cause of sudden loss of vision, especially in young patients. However, we report a case of a 22-year-old female who presented to our clinic with CNVM as an early complication. She complained of metamorphopsia and diminished vision in her right eye. Ocular examination, serological investigation and fundoscopy, fundus fluorescein angiography (FFA), axial optical coherence tomography (OCT), and optical coherence tomography angiography (OCTA) were carried out and a diagnosis of primary acquired Toxoplasma retinochoroiditis with active CNVM was made. Treatment was commenced with sulfamethoxazole and trimethoprim. Oral prednisolone and intravitreal injection of the anti-vascular endothelial growth factor (anti-VEGF), bevacizumab, were also given. This report describes the rare presentation of ocular toxoplasmosis as a primary lesion in which adjacent pre-existing fundal scarring was absent. The lesion had an acquired etiology in an immunocompetent patient and was complicated early by CNVM.

Heavy metals contamination of soil especially with cadmium (Cd) is a serious environmental concern in the current industrial era. Biochar serves as an excellent ameliorating agent depending upon its properties and application rates. In the pot scale study, effect of acid treated (AWSB) and untreated wheat straw biochar (WSB) was studied on physiology, grain yield, Cd accumulation, and tolerance of quinoa with possible health risks. Different levels of Cd (0, 25, 50 and 75 mg kg−1), AWSB and WSB (1% and 2% (w/w)) were applied in soil. Accumulation of Cd in control plant tissues led to oxidative stress which was shown in terms of increased lipid peroxidation. While biochar application relieved the oxidative damage as confirmed by the low production of H2O2 and TBARS contents. Application of AWSB improved plant growth, pigment contents and gas exchange attributes by limiting the accumulation of Cd in root, shoot and grain of quinoa. Results revealed a significant improvement in the activity of superoxide (SOD), catalase (CAT), ascorbate peroxidase (APX) and peroxidase (POD) with biochar at elevated levels of Cd in soil. Target Hazard Quotient (THQ) remained

Clinical questionA 78-year-old female presented with a pruritic rash on her legs for many years. A biopsy was taken from the right leg. Review the high-quality, interactive digital Aperio slide at http://virtualacp.com/JCP_Case/index.php and consider your diagnosis.What is your diagnosis? Atrophic lichen planusHyperkeratosis lenticularis perstansLichenoid drug reactionLichenoid keratosisPorokeratosis

Intracystic papillary carcinoma (IPC) of the breast is a rare malignant tumour, found mainly but not exclusively in elderly women. IPC may be asymptomatic or presents with a palpable mass or blood-stained nipple discharge. The tumour is encysted within a dilated duct with arborisation of the fibrovascular stroma and contains nodules of papillary carcinoma surrounded by a thick fibrous capsule. Frequently excisional biopsy is required for diagnosis. The mainstay of treatment is breast-conserving surgery or mastectomy. Sentinel node biopsy could be considered in invasive cases. Adjuvant radiotherapy (XRT) and/or endocrine therapy is considered in appropriate cases. Prognosis is excellent. We report three such cases of IPC, in elderly women, which were successfully treated.