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Background: During the COVID-19 pandemic, migrant workers in India have gone through many hardships. After the lockdown, many construction sites, factories, and workplaces shut down, and innumerable migrant workers faced a loss of income, shortage of food, and uncertain future. This massive change in their living conditions made them vulnerable to psychological problems. Aim: To screen for depression, anxiety, stress, alcohol dependence, and resilience in migrant workers during the COVID-19 crisis. Materials and Methods: Migrant workers at seven camps in the Pimpri Chinchwad Municipal Corporation, Maharashtra, were surveyed with the help of the Depression Anxiety Stress (DASS-21) Scale to assess depression, anxiety, and stress levels, AUDIT C for assessing alcohol use disorders, and Connor–Davidson resilience scale short form (CD RISC) for assessing resilience. Results: A total of 1053 migrant workers were surveyed. It showed that 57.54% of workers had depressive symptoms, 64.96% had anxiety symptoms, and 39.32% had subjective stress. Female migrant workers had more severe depression, anxiety, and stress symptoms as compared to males while male workers were more at risk of alcohol use disorder as compared to females. Migrants without family had more symptoms of severe depression and alcohol use disorder as compared to those with family. Regression analysis showed that levels of anxiety were independently associated with female gender, unmarried status, stress, depression, and alcohol use disorder while resilience negatively predicted anxiety in these migrant workers. Conclusion: During the COVID-19 pandemic, migrant workers were at risk of depression, anxiety, stress, and alcohol use disorder. Females and migrants without families came out to be more vulnerable to these psychological problems. Hence during the pandemic situation, identifying this vulnerable population and special preventive or therapeutic programs for them can be of crucial importance.

The implementation of differentiated curriculum (DC) in junior high schools has been gaining momentum in recent years as a means to address the diverse needs of students. However, more information about how English as a foreign language (EFL) teachers perceive this change is needed. This study explored English teachers' attitudes and factors that affected the introduction of DC in junior high schools. Data were collected through DC questionnaire administration and interviews using a mixed-method approach. The quantitative data were statistically analyzed using SPSS 23, while the qualitative data were thematically analyzed. The participants were the EFL teachers who actively participated in the MGMP (Musyawarah Guru Mata Pelajaran, or Subject Teacher Forum) of English Subject at the junior high school level in Batu City, East Java, Indonesia. The findings showed that all participants depicted a positive attitude toward DC implementation. However, they found some support needed from all related parties due to some challenges they met during their attempts to implement DC. This study suggests that EFL teachers' positive attitudes drive increased efforts in successfully implementing DC. However, identified challenges necessitate collaborative support from educators, administrators, and policymakers, including professional development and resource provision, for successful DC integration in EFL classrooms.

Background: Typhoid fever, caused by Salmonella enterica serovar Typhi, is a significant public health concern due to the escalating of antimicrobial resistance (AMR), with limited treatment options for extensively drug-resistant (XDR) S. Typhi strains pose a serious threat to disease management and control. This study aimed to investigate the genomic characteristics, epidemiology and AMR genes of XDR S. Typhi strains from typhoid fever patients in Pakistan. Methodology: We assessed 200 patients with enteric fever symptoms, confirming 65 S. Typhi cases through culturing and biochemical tests. Subsequent antimicrobial susceptibility testing revealed 40 cases of extensively drug-resistant (XDR) and 25 cases of multi-drug resistance (MDR). Thirteen XDR strains were selected for whole-genome sequencing, to analyze their sequence type, phylogenetics, resistance genes, pathogenicity islands, and plasmid sequences using variety of data analysis resources. Pangenome analysis was conducted for 140 XDR strains, including thirteen in-house and 127 strains reported from other regions of Pakistan, to assess their genetic diversity and functional annotation. Results: MLST analysis classified all isolates as sequence type 1 (ST-1) with 4.3.1.1. P1 genotype characterization. Prophage and Salmonella Pathogenicity Island (SPI) analysis identified intact prophages and eight SPIs involved in Salmonella's invasion and replication within host cells. Genome data analysis revealed numerous AMR genes including dfrA7, sul1, qnrS1, TEM-1, Cat1, and CTX-M-15, and SNPs associated with antibiotics resistance. IncY, IncQ1, pMAC, and pAbTS2 plasmids, conferring antimicrobial resistance, were detected in a few XDR S. Typhi strains. Phylogenetic analysis inferred a close epidemiological linkage among XDR strains from different regions of Pakistan. Pangenome was noted closed among these strains and functional annotation highlighted genes related to metabolism and pathogenesis. Conclusion: This study revealed a uniform genotypic background among XDR S. Typhi strains in Pakistan, signifying a persistence transmission of a single, highly antibiotic-resistant clone. The closed pan-genome observed underscores limited genetic diversity and highlights the importance of genomic surveillance for combating drug-resistant typhoid infections.

The current study aimed to investigate the influence of taxifolin on depression symptoms alleviation in Male Sprague-Dawley rats by targeting underlying pathways of depression. Molecular docking analyses were conducted to validate taxifolin's binding affinities against various targets. In silico analysis of taxifolin revealed various aspects of post docking interactions with different protein targets. Depression was induced in rats via intraperitoneal injection of Lipopolysaccharide (LPS; 500 μ g/Kg) for 14 alternative days. Rats (n = 6/group) were randomly assigned to four groups: (i) Saline/Control, (ii) Disease (LPS 500 μg/kg), (iii) Standard (fluoxetine 20 mg/kg), and (iv) Treatment (taxifolin 20 mg/kg). At the end of the in vivo study, brain samples were used for biochemical and morphological analysis. Taxifolin exhibited neuroprotective effects, as evidenced by behavioral studies, antioxidant analysis, histopathological examination, immunohistochemistry, ELISA and RT PCR, indicating an increase number of surviving neurons, normalization of cell size and shape, and reduction in vacuolization. Taxifolin also decreased inflammatory markers such as TNF-α, NF-κb, IL-6 and COX-2, while significantly upregulating and activating the protective PPAR-γ pathway, through which it reduces the oxidative stress, neuroinflammation, neurodegeneration, thereby ameliorating depression symptoms in experimental rat model of depression. Our finding suggests that taxifolin act as neuroprotective agent partially mediated through PPAR-γ pathway.

Wide bandgap semiconductors such as Zinc Oxide (ZnO) have earned much attention on account of its interesting optical and electrical properties. Also, doping ZnO with suitable transition elements enables to tune its properties, making it suitable for applications like transparent conducting oxides and LEDs. To this aim, Vanadium-doped ZnO (V:ZnO) thin films are fabricated using the SILAR method and studied the structural, optical, vibrational, photophysical and electrical properties. Introducing vanadium creates lattice relaxation in the ZnO wurtzite structure, influencing its electronic band structure. The X-ray diffraction (XRD) analyses have verified the structural integrity of the vanadium-doped zinc oxide (V:ZnO) films, revealing their polycrystalline composition. The Raman spectroscopy shows the reduced phonon line widths due to the improved crystallite quality with the presence of vanadium. Furthermore, it has been noted that optical characteristics such as the bandgap and refractive index are sensitive to vanadium doping as a consequence of modified electronic structures. Hall-effect experiments have shown that undoped ZnO films possess a mobility of 1.31 cm2/Vs and a charge carrier density of 5.58 × 1013 cm−3. It has been observed that doping with V markedly influences these parameters of ZnO films. Then, the time-resolved photoluminescence measurements reveal the increased carrier lifetimes, suggesting the introduction of dopants mitigates carrier-phonon interactions. Such interactions need to be minimized to prevent the dissipation of carrier energy. In essence, the reported work demonstrates the potential of V:ZnO for optoelectronic applications.

This paper presents a case of a 35-year-old female patient diagnosed with Complex Regional Pain Syndrome (CRPS) type I and treated over a two-month period with a novel low-frequency sound-transduced focal pulsed stimulus. The patient received 21 treatments consisting of focally applied sound sweeps in the 15–100 Hz range. Outcome measures included the Visual Analogue Scale for pain, five physical assessment parameters, medication, and the Pain Catastrophizing Scale. A follow-up was conducted at six months. The results show that the patient’s low-back pain level was substantially reduced after treatment and after six months. CRPS-related peripheral pain was strongly reduced but had some rebound after six months. The low-frequency sound-transduced focal pulsed stimulus shows potential as a non-invasive treatment for CRPS and deserves controlled clinical trials.

Onion purple blotch is the most indispensable foliar disease of crop and has become a major concern for farmers and research fraternity. An attempt to investigate the role of injury in parasitism by Alternaria porri indicated that disease incidence and severity enhance considerably with injury. Thrips injured plants inoculated with A. porri presented 100% incidence and 52–72% severity while mechanically injured plants inoculated with A. porri showed 60–70% incidence and 28–34% severity. The uninjured plants showed considerably less disease incidence (30–40%) and severity (10–16%). Injured inoculated plants presented reduced leaf length and leaf area while the leaf diameter remained unaffected. The lesion number, lesion length and size was substantially enhanced with concomitant infestation of pest and pathogen. Thrips tabaci injury led to more pronounced symptoms of purple blotch compared to Thrips parvispinus injury. There was substantial decrease in photosynthetic rate and chlorophyll content with stress imposed on plant whilst the relative stress injury was enhanced. The induction of injury and inoculation of A. porri had an impact on the concentration of total phenolics, total soluble sugars, total proteins and hydrogen peroxide in onion leaves. A. porri combined with injury caused a more pronounced decrease in total soluble sugars and total protein content while enhancement in total phenolics and hydrogen peroxide content compared to uninjured plants. The dynamic nature of morpho-physiological and biochemical changes owing to stress conditions imposed on onion plant adds an extra layer of complexity in understanding the onion plant physiology and their ability to work out in response to challenging environment conditions.

In a solid-state dye-sensitized solar cell, a fast-ion conducting (σ25°C > 10−4 S cm−1) solid redox mediator (SRM; electrolyte) helps in fast dye regeneration and back-electron transfer inhibition. In this work, we synthesized solid Co2+/3+ redox mediators using a [(1 − x)succinonitrile: x poly(ethylene oxide)] matrix, LiX, Co(tris-2,2′-bipyridine)3(bis(trifluoromethyl) sulfonylimide)2, and Co(tris-2,2′-bipyridine)3(bis(trifluoromethyl) sulfonylimide)3 via the solution-cast method, and the results were compared with those of their acetonitrile-based liquid counterparts. The notation x is a weight fraction (=0, 0.5, and 1), and X represents an anion. The anion was either bis(trifluoromethyl) sulfonylimide [TFSI−; ionic size, 0.79 nm] or trifluoromethanesulfonate [Triflate−; ionic size, 0.44 nm]. The delocalized electrons and a low value of lattice energy for the anions made the lithium salts highly dissociable in the matrix. The electrolytes exhibited σ25°C ≈ 2.1 × 10−3 (1.5 × 10−3), 7.2 × 10−4 (3.1 × 10−4), and 9.7 × 10−7 (6.3 × 10−7) S cm−1 for x = 0, 0.5, and 1, respectively, with X = TFSI− (Triflate−) ions. The log σ–T−1 plot portrayed a linear curve for x = 0 and 1, and a downward curve for x = 0.5. The electrical transport study showed σ(TFSI−) > σ(Triflate−), with lower activation energy for TFSI− ions. The anionic effect increased from x = 0 to 1. This effect was explained using conventional techniques, such as Fourier transform infrared spectroscopy (FT-IR), X-ray diffractometry (XRD), X-ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), UV–visible spectroscopy (UV-vis), differential scanning calorimetry (DSC), and thermogravimetric analysis (TGA).

The most common cause of infertility and metabolic problems among women of reproductive age is polycystic ovary syndrome (PCOS), a multifaceted disorder. It is an endocrine disorder that occurs in approximately one in seven women. Among these PCOS patients, two thirds will not ovulate on a regular basis and seek treatment for ovulation induction. The symptoms vary in their severity, namely ovulation disorders, excessive androgen levels, or polycystic ovarian morphology. All these symptoms require a therapeutic approach. Many drugs are used to eradicate PCOS symptoms, like metformin, clomiphene citrate, spironolactone, and pioglitazone. Long-term treatment is required to achieve the desired outcome, which is often accompanied by significant adverse reactions. Some herbs and phytochemicals are equally effective for treating PCOS and produce minimal side effects. Recently, herbal products are gaining popularity due to their wide biological activities, safety, availability, and efficacy. The present review covers aetiology, current treatment, pathophysiology, and detailed pre-clinical and clinical studies on plants and phytochemicals that are proven to be useful for the treatment of symptoms associated with PCOS.

Abstract Malaria, chikungunya virus (CHIKV), and dengue virus (DENV) are endemic causes of fever among children in Kenya. The risks of infection are multifactorial and may be influenced by built and social environments. The high resolution overlapping of these diseases and factors affecting their spatial heterogeneity has not been investigated in Kenya. From 2014-2018, we prospectively followed a cohort of children from four communities in both coastal and western Kenya. Overall, 9.8% were CHIKV seropositive, 5.5% were DENV seropositive, and 39.1% were malaria positive (3521 children tested). The spatial analysis identified hot-spots for all three diseases in each site and in multiple years. The results of the model showed that the risk of exposure was linked to demographics with common factors for the three diseases including the presence of litter, crowded households, and higher wealth in these communities. These insights are of high importance to improve surveillance and targeted control of mosquito-borne diseases in Kenya.

BackgroundNumerous reviews of the epidemiology and risk factors for breast cancer have been published previously which heighted different directions of breast cancer.AimThe present review examined the likelihood that incidence, prevalence, and particular risk factors might vary by geographic region and possibly by food and cultural practices as well.MethodsA systematic review (2017-2022) was conducted following Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines, reporting on epidemiological and risk factor reports from different world regions. Medical Subject Heading (MeSH) terms: “Breast neoplasm” “AND” country terms such as “Pakistan/epidemiology”, “India/epidemiology”, “North America/epidemiology”, “South Africa/epidemiology” were used to retrieve 2068 articles from PubMed. After applying inclusion and exclusion terms, 49 papers were selected for systematic review.ResultsResults of selected articles were summarized based on risk factors, world regions and study type. Risk factors were classified into five categories: demographic, genetic and lifestyle risk factors varied among countries. This review article covers a variety of topics, including regions, main findings, and associated risk factors such as genetic factors, and lifestyle. Several studies revealed that lifestyle choices including diet and exercise could affect a person’s chance of developing breast cancer. Breast cancer risk has also been linked to genetic variables, including DNA repair gene polymorphisms and mutations in the breast cancer gene (BRCA). It has been found that most of the genetic variability links to the population of Asia while the cause of breast cancer due to lifestyle modifications has been found in American and British people, indicating that demographic, genetic, and, lifestyle risk factors varied among countries.ConclusionThere are many risk factors for breast cancer, which vary in their importance depending on the world region. However, further investigation is required to better comprehend the particular causes of breast cancer in these areas as well as to create efficient prevention and treatment plans that cater to the local population.

Binary PdM-based nanocrystals are efficient electrocatalysts for a wide range of renewable and green fuel cell applications; however, their poisoning by CO is a great barrier for commercialization, so it is pivotal to solve this issue. Herein, we fabricated support-free PdM alloys (M = Fe, Co, and Ni) by a prompt one-step aqueous-solution co-reduction with sodium borohydride driven by the coalescence growth mechanism. This forms support-free PdM porous foam-like nanostructures with well-defined compositions from the ICP-OES analysis and clean surface without any hazardous chemicals or multiple reaction steps. The as-prepared PdM foam-like nanostructures were demonstrated for carbon monoxide oxidation (COOxid) electrocatalysis at varied electrolyte pH compared with commercial Pd/C catalyst. The foam-like PdFe nanocrystals achieved an excellent electrochemical COOxid activity that was at least 2.18-times of PdCo, 4.35-times of PdNi, and 1.56-times of Pd/C in both alkaline (KOH) and acidic (HClO4) electrolytes, but PdCo was the best in neutral (NaHCO3) medium. The superior activity of PdM is due to the strain and alloying effect, which promoted the superb CO oxidation durability for 1000 cycles than Pd/C catalyst. This study demonstrated the superiority of support-free bimetallic PdM alloys than Pd/C catalyst in all electrolytes, which may open new gates for understanding CO-poisoning in alcohol-based fuel cells.

The opto-photocatalytic applications of Mn-doped NiO nanoparticles (NPs) are discussed. A facile synthesis of NiO doped with different Mn contents is performed and studied using experimental techniques. The structural properties and microstructural parameters of Mn:NiO NPs were examined by X-ray diffraction patterns. The average crystallite sizes of the pure NiO and 1.0-, 2.5-, 5.0-, 10-wt.% Mn-doped NiO NPs were found to be 25–19 nm by Williamson–Hall plots and 23–18 nm by the Debye–Scherer method. The crystallite size decreases with increasing doping concentration in the NiO host lattice. The optical bandgaps are found to be 3.53, 3.46, 3.39, 3.24, and 3.12 eV for pure NiO and 1.0-, 2.5-, 5.0-, and 10-wt.% Mn:NiO NPs, respectively, using the Kubelka–Munk function. X-ray photoelectron spectroscopy spectra of 2.5-wt.% Mn:NiO NPs were recorded for Mn, Ni, and O to determine the oxidation states. The photocatalytic performances of pure NiO and Mn:NiO NPs are examined. The 2.5-wt.% Mn:NPs exhibit the best photocatalytic performance owing to the greatest activation sites. The mechanism of the photocatalytic decolorization reaction is also investigated. The results demonstrate the high ability of Mn:NiO NPs as photocatalysts for methylene blue dye degradation, with 92% removal.

Background: Use and abuse of alcohol is well known. Its abuse, predominantly its dependence, can cause medical, psychological, and social issues. Excessive alcohol intake over time is linked to cognitive problems, including memory loss. Excessive alcohol use has been linked to significant cognitive deficits that can last even after the person stops drinking. Executive functioning impairments are most likely to impact rehabilitation outcomes in people with cognitive impairment. Aim: To study the cognitive impairments in alcohol dependence and comparing with healthy individuals. Methods: An observational, analytical case–control study was done on 30 alcohol-dependent patients after stabilization and 25 healthy individuals from July 2019 to July 2021 in a tertiary care center in Pune; all subjects after diagnosis were assessed with Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), Barratt Impulsiveness Scale, Stroop Test, and the Wisconsin card sorting test (WCST). Results: The mean score on MMSE of the case group was 28.60 and the controls—29.72. The mean score on FAB of the case group was 16.45 and the controls—17.4. The mean score on BIS of the case group was 16.45 and in control 17.4. Stroop Effect score of the case group was 187.16 seconds and in control it was 146.92 seconds, all being statically significant in comparison. On the WCST, all the findings were statistically significant. Conclusion: Long-term alcohol consumption affects executive functions considerably. The current study showed significant cognitive deficits in individuals with alcohol dependence mainly in executive functions, working memory, and high impulsiveness.

Background: Improved healthcare extends life expectancy, but social and economic issues including poverty, family breakdown, and insufficient help for the elderly put people's mental health in danger. Because of feelings of loneliness and natural age-related decline in physiological and physical performance, the elderly are more prone to psychological disorders. With this aim in mind, the study of the prevalence of psychiatric morbidity in elderly hospitalized patients was taken up. Methods: A cross-sectional analytical study was carried out in a tertiary hospital in Pune on 200 hospitalized patients of 65 years of age and more from July 2019 to July 2021. Subjects with known psychiatric disorders were excluded. Subjects were evaluated with a sociodemographic proforma, mini-international neuropsychiatric interview (MINI), depression anxiety stress scale-21 (DASS-21), and the multidimensional scale of perceived social support (MSPSS). Results: A total of 35.5% of elderly subjects admitted to non-psychiatric wards were found to be suffering from psychiatric disorders, most commonly major depressive disorder, generalized anxiety disorders (GADs), and social anxiety disorders. On DASS-21, 55.5% of patients had stress, 24% anxiety, and 15.5% had depression. On the MSPSS scale, 53% had a high level of support. A mean score of 5.94 was obtained for family support, 5.413 for support from friends, and 3.486 for support from significant others. Males received higher support. Conclusion: We found that elderly patients admitted in non-psychiatric wards had psychiatric disorders. The most common psychiatric disorders were GAD (16.5%) and major depressive disorder (15%). It is more beneficial when physicians/surgeons also screen or refer their elderly patients to their psychiatrist colleagues to help alleviate their suffering to the extent possible.

Abstract Background Herbal medicines, derived from medicinal plants, are among the most popular alternative remedies around the globe. In Saudi Arabia, herbal medicines are extensively used by public as part of the culture as well as religious norms. Therefore, this study aimed to evaluate knowledge, attitudes, and practices regarding herbal medicines among the general population in Saudi Arabia. Methods A descriptive cross-sectional survey study was conducted on the general population of Jeddah city with the help of a validated and self-administered questionnaire. Sample size was calculated to be 450 with subjects between 20 and 60 years of either gender. Descriptive and inferential statistical analysis was performed using SPSS. Results Results of our data showed that 173 (42.2%) of the total participants used herbal medicines, however, significant association was found between female gender and the usage of herbal medicines (p

BackgroundMicronutrient deficiencies including vitamin A, vitamin D, and zinc are highly prevalent in children below 5 years of age in low and –middle-income countries. We aimed to evaluate the effectiveness of ready-to-use Lipid-based Nutrient Supplement—Medium Quantity (LNS-MQ) local name “Wawa-mum” on plasma micronutrient status, hemoglobin concentration and anthropometric measurements.MethodsA community-based non-randomized trial was conducted in the Kurram district of Khyber Pakhtunkhwa from January 2018 to June 2019. A total of 110 children aged 6 to 23 months old were recruited and allocated to the intervention and control arm of the study. A total of 57 children in the intervention arm received a daily ration of 50 g of Wawa-mum, for one year. To assess the impact of the intervention on primary outcome measures, i.e., serum vitamin A, D concentration, plasma zinc, and hemoglobin concentration. Blood samples were collected at baseline and after one year following the intervention. The vitamins concentration in serum were assessed using Enzyme-Linked Immunosorbent Assay (ELISA) and plasma zinc by atomic absorption spectrometry. The hemoglobin concentration was measured by an automated hematology analyzer. A 24-h dietary recall interview was used to assess the nutrient intake adequacy. Multivariate Linear regression models were used to analyze the outcomes while controlling for potential confounders.ResultsIn the intervention arm, children had on average 6.2 μg/dL (95% CI 3.0–9.3, value of p

Porous polymeric frameworks have received great interest over the past few years because of their nonstop growth as crystalline porous polymeric materials connected through covalent bonds and versatile utilities in diverse fields. The production of high-value organic compounds via sustainable and environment-friendly methods is an uphill struggle for researchers. The elegant strategy of using carbon dioxide as a C1 building block is an intriguing platform owing to its non-toxicity, easy accessibility, natural abundance, recyclability, non-flammability, and cheapness. Additionally, CO2 levels are regarded as the main contributor to the greenhouse effect (the most abundant greenhouse gas across the globe) and the aforementioned strategy needs to mitigate CO2 emissions. This present study describes the synthesis of silver nanoparticles (AgNPs) embedded in a porous polymeric framework, a reusable heterogeneous catalyst (recyclable over 5 times), TpMA (MC)@Ag. The synthesized catalyst is characterized by using FT-IR, PXRD, XPS, FE-SEM, TEM, EDAX, TGA DTA, and N2 sorption studies. Additionally, the catalysts can be easily recycled to generate the desired α-alkylidene cyclic carbonates and oxazolidinone compounds under solvent-free conditions. This research demonstrates the potential of nanoporous 2D porous polymeric framework-based materials in the area of catalysis, specially, in CO2 capture and chemical fixation. These findings offer a promising approach for the chemical fixation of CO2 into α-alkylidene cyclic carbonates and oxazolidinones from propargylic alcohols utilizing AgNPs embedded in a 2D catalyst, which functions as a potential heterogeneous catalyst under mild conditions (e.g., solvent-free approach).

Power is a critical factor in several types of diplomacy. India-EU relations are a classic case of how changing geopolitics prompted diplomatic acumen. This scoping review assesses the changing relations of both partners as a manifestation of Smart Power. The dynamic relations from normative-based to pragmatic and inclusive interests based are evaluated. Their value-based relations are put under international relations theories. Their changing factors of cooperation are used to justify their smart diplomacy, where contemporary relations are less likely to be affected by multilateral interests. To solidify claims of smart power in their relations, the recent TRIPS waiver schism illuminated health diplomacy between the two regions. This health diplomacy discourse promotes smart power diplomacy between India and the EU, where new avenues of cooperation emerge despite pandemic disagreements. The article explores how hybrid power is better than soft and hard power in silos by systematically searching and selecting the existing knowledge in the contemporary context.

In the current study, the quality of groundwater used for drinking purposes was assessed in Taluka Ghorābāri, Sindh, Pakistan. Twenty-five sampling locations were selected for the collection of groundwater. Samples were analyzed for physicochemical and heavy metal analysis, followed by standard methods. Detection of heavy metals was conducted using Atomic Absorption Spectrophotometer. Heavy metals which exceeded the WHO safe limit included Cr (28%), Fe (16%), Mn (48%), and Ni (16%) from the drinking water of the study area. The Cu and Zn were found within the safe limit in all drinking water samples of the study area. The Daily Intake of heavy Metals (DIM) and Health Risk Indexes (HRI) Assessments were calculated to determine risk assessments; the order of mean DIM values was observed as Ni > Cu > Fe > Zn > Cr while HRI was observed in the order of Cu > Mn > Zn > Fe > Cr. The HRI values were observed less than one for both adults and children, which shows the lack of possible health hazards for the people of the study area.

Background: Percutaneous coronary intervention (PCI) has been effective in increasing the longevity of patients with cardiovascular disease. Notwithstanding paucity of Indian studies on the psychological effects of PCI, there have been conflicting evidences with regard to improvement of quality of life in patients undergoing angioplasty. Aim: To evaluate change in the quality of life and emotional factors like depression, stress, and anxiety in patients undergoing angioplasty. Methods: This prospective longitudinal study was carried out at a tertiary care hospital and research centre in the western part of Maharashtra in a semi-urban location on 70 consecutive patients undergoing angioplasty from July 2019 to July 2021. Besides sociodemographic data patients were assessed with Type D Scale-14 (DS14), Depression Anxiety Stress Scale, and The MacNew heart disease health-related quality of life Questionnaire. After 15 days of the procedure, patients were re-evaluated with the same scales. Results: Mean age of our study population was 58.67 years of which 77.14% were men. The prevalence of Type D personality was 28.57%. There was a significant reduction in anxiety and stress scores and significant improvement in emotional and physical sub scales of Quality of life post angioplasty. On multiple regression analysis, anxiety and social inhibition emerged as predictors of depression. Conclusion: Angioplasty is associated with significant improvement in anxiety, stress, and emotional and physical subscales of Quality of life. Social inhibition, which is a component of Type D personality, anxiety, and loss of libido are significant predictors of depression in patients undergoing angioplasty.

This prospective quasi-experimental study from the NASAM (National Approach to Standardize and Improve Mechanical Ventilation) collaborative assessed the impact of evidence-based practices including subglottic suctioning, daily assessment for spontaneous awakening trial (SAT), spontaneous breathing trial (SBT), head of bed elevation, and avoidance of neuromuscular blockers unless otherwise indicated. The study outcomes included VAE (primary) and intensive care unit (ICU) mortality. Changes in daily care process measures and outcomes were evaluated using repeated measures mixed modeling. The results were reported as incident rate ratio (IRR) for each additional month with 95% confidence interval (CI). A comprehensive program that included education on evidence-based practices for optimal care of mechanically ventilated patients with real-time benchmarking of daily care process measures to drive improvement in forty-two ICUs from 26 hospitals in Saudi Arabia (>27,000 days of observation). Compliance with subglottic suctioning, SAT and SBT increased monthly during the project by 3.5%, 2.1% and 1.9%, respectively (IRR 1.035, 95%CI 1.007-1.064, p = 0.0148; 1.021, 95% CI 1.010-1.032, p = 0.0003; and 1.019, 95%CI 1.009-1.029, p = 0.0001, respectively). The use of neuromuscular blockers decreased monthly by 2.5% (IRR 0.975, 95%CI 0.953-0.998, p = 0.0341). The compliance with head of bed elevation was high at baseline and did not change over time. Based on data for 83153 ventilator days, VAE rate was 15.2/1000 ventilator day (95%CI 12.6-18.1) at baseline and did not change during the project (IRR 1.019, 95%CI 0.985-1.053, p = 0.2812). Based on data for 8523 patients; the mortality was 30.4% (95%CI 27.4-33.6) at baseline, and decreased monthly during the project by 1.6% (IRR 0.984, 95%CI 0.973-0.996, p = 0.0067). A national quality improvement collaborative was associated with improvements in daily care processes. These changes were associated with a reduction in mortality but not VAEs. Registration The study is registered in clinicaltrials.gov (NCT03790150).

The structural, optical, and dielectric properties of pure NiO and yttrium (Y) doped NiO (Y: NiO) were studied in the present article for optoelectronic application. The pristine and different concentrations of 1.0, 2.5, 5.0, 7.5, and 10 wt.% doped Y: NiO nanoparticles (NPs) were synthesized by flash combustion route. X-ray diffraction patterns (XRD), Raman spectroscopy and scanning electron microscopy (SEM) images were used to study the structural properties of as-prepared nanoparticles. The average crystallite sizes (29.8–6.7 nm) and grains size (159.2–17.9 nm) were found to be decreased with an increase in Y contents. The dislocation density (1.12–21.75 × 10−3 1/nm2), lattice strain (2.79–12.46 × 10−3) and surface area (29.48–131.13 cm2/g) were increased on increasing Y contents. Direct optical band gaps of prepared samples were estimated using the Tauc's relation in the range of 3.52–3.37 eV. Photoluminescent spectra of prepared samples exhibit spectra at 355 nm, 451–482 nm, and 493 nm emission bands, which confirm the existence of oxygen and nickel vacancies. The improvement in the dielectric constant (143), dielectric loss (1233), and loss tangent (8.67) were observed for 5.0 wt.% Y doped NiO from the dielectric analysis of the samples. The electrical conductivities of Y: NiO NPs were also improved compared to pure NiO NPs. The improvement in the optical and dielectric properties of NiO in the substitution of yttrium (Y) can be used for optoelectronics applications.

Abstract A medical error is a preventable adverse effect of medical care. Errors can happen in the hospital at the doctor’s office, at the pharmacy, laboratory and ward. These can also occur at home by the patient or the attendant. These errors may lead to death or major/minor injuries or can also be harmless. However these should be recorded, analysed and remedial measures implemented to reduce the risk of being committed in the future. We are reporting the medical care of our patient in persistent vegetative state over nineteen years due to medical error at our hospital resulting in brain anoxia. The key issues faced during the care were recurrent respiratory and urinary tract infections and in last one year kidney calculi leading to chronic kidney disease and its complications. There are no contractures or thrombo-embolic events and above all no bed sore over this period.

Abstract Men with castration-resistant prostate cancer (CRPC) face poor prognosis and increased risk of treatment-incurred adverse effects resulting in one of the highest mortalities among patient population globally. Immune cells act as double-edged sword depending on the tumor microenvironment, which leads to increased infiltration of pro-tumor (M2) macrophages. Development of new immunomodulatory therapeutic agents capable of targeting the tumor microenvironment, and hence orchestrating the transformation of pro-tumor M2 macrophages to anti-tumor M1, would substantially improve treatment outcomes of CRPC patients. We report, herein, Mangiferin functionalized gold nanoparticulate agent (MGF-AuNPs) and its immunomodulatory characteristics in treating prostate cancer. We provide evidence of immunomodulatory intervention of MGF-AuNPs in prostate cancers through observations of enhanced levels of anti-tumor cytokines (IL-12 and TNF-α) with concomitant reductions in the levels of pro-tumor cytokines (IL-10 and IL-6). In the MGF-AuNPs treated groups, IL-12 was elevated to ten-fold while TNF-α was elevated to about 50-fold, while IL-10 and IL-6 were reduced by two-fold. Ability of MGF-AuNPs to target splenic macrophages is invoked via targeting of NF-kB signaling pathway. Finally, therapeutic efficacy of MGF-AuNPs, in treating prostate cancer in vivo in tumor bearing mice, is described taking into consideration various immunomodulatory interventions triggered by this green nanotechnology-based nanomedicine agent.

BackgroundEthnopharmacological relevance: Brugmansia, a genus of the Solanaceae family, has historically been utilized in many different parts of the world as an anti-inflammatory for treating skin infections, wounds, and bodily aches and pains. The current study aimed to investigate the potential benefits of a methanolic extract of Brugmansia aurea in the management of diabetes and underlying complications in alloxanized-induced diabetic rats.Materials and methodsAnimals were divided into nine groups (n = 6). Four groups received different standard oral hypoglycemic agents; three groups received 100, 200, and 400 mg/kg of B. aurea leaf extract for six consecutive weeks, and the remaining two were normal and disease control groups. All groups received alloxan (150 mg/kg) except for the normal control. Only those animals whose glucose levels were raised to 200 mg/dl were selected for the study. After a 6-week dosage period, various biochemical parameters, as well as HbA1c, antioxidant profile, oral glucose tolerance test (OGTT), insulin sensitivity, histopathology, and insulin resistance, were measured and compared with the untreated diabetic group.ResultsBrugmansia aurea leaf extract at a dose of 400 mg/kg showed potent antidiabetic activity by reducing blood glucose levels (p < 0.001) after 6 weeks of treatment. OGTT data showed that B. aurea exhibited significant (p < 0.001) glucose tolerance by significantly reducing blood glucose levels in just 2 h post-treatment. Other tests showed that plant extract significantly increased (p < 0.001) insulin sensitivity and decreased (p < 0.001) insulin resistance. The biochemical profile showed reduced triglyceride and cholesterol, while the antioxidant profile showed restoration of antioxidant enzymes in the pancreas, kidney, and liver tissues of treated rats.ConclusionThe present study indicated that crude extracts of B. aurea increase insulin sensitivity and reduce hyperlipidemia in diabetic rats, which rationalizes the traditional medicinal use of this plant as an antidiabetic agent.

The study discusses the climate of Balochistan with a special focus on the variation of weather condition taking into account the mean monthly precipitation, temperature, humidity, atmospheric circulation, air pressure, evapotranspiration and solar energy covering the time duration of 1931-2020 (normal data). The physical barriers that bring variations in the climate of Balochistan contain geographical location, ocean, geomorphology, land use, natural vegetation, and continental extent. Based on precipitation, the province has been divided into two main regions that are arid and semi-arid, while the temperature zones are hot, warm, mild and cool. The southern and eastern part of the province receives heavy rain in the summers (monsoon), whereas it is from the western depressions during the winter season. Balochistan experiences four rainy seasons in winter (cold), pre-monsoon season (warm), monsoon season (hot), and post-monsoon season (mild). Owing to tropical (coastal) and sub-tropical continental characteristics, the area familiarizes two foremost seasons namely winter and summer. The summers of the area long for 5 months in hilly areas while 7 months in continental plains and coastal regions; whereas, winters cover five months in the plains and seven months in the mountains. Based on the appropriationand fluctuation in climate constituents, Balochistan has been classified into two main, 6 meso, and 9 microclimate and weather zones. According to Global Climate Risk Index, 2021, Pakistan has been ranked at 8th in the list of top ten global climate high-risk countries, which are exposed to the ongoing climate change and requires attention to resolve the issue.

Since March 2020, SARS-CoV-2 has plagued the world with COVID-19 and individuals of all ages have experienced varying symptoms of disease. Older adults were experiencing more severe disease compared to children and were prioritized by vaccination efforts. While biologic therapies and vaccinations were implemented, there were changes in public health restrictions with subsequent surges resulting in more infected children. During these surges there was a rise of different SARS-CoV-2 variants with the dominant variant initially alpha (B.1.1.7 and other Pango lineages) and epsilon (B.1.427/B.1.429) in early 2021 and a dramatic shift to delta (B.1.617.2 and other Pango lineages) by mid-summer 2021. In this study we aimed to characterize the clinical severity and host factors associated with disease by SARS-CoV-2 variant and evaluate if there are differences in disease severity by circulating variant. We retrospectively included all individuals 0–25 years of age who presented to our center and had a positive SARS-CoV-2 RT-PCR, SARS-CoV-2 variant mutation testing, and documented clinical notes from 1 January 2021 through 31 December 2021. We identified 745 individuals who met inclusion criteria and found the delta variant was associated with severe/critical disease compared to the other variants studied. The results of the model showed that underlying respiratory disease and diabetes were risk factors for progression to severe disease. These insights are important when evaluating public health measures and treatment options for children as more variants arise.

The utilization of heterogeneous catalysts during the production of biodiesel potentially minimize the cost of processing due to the exclusion of the separation step. The (X wt%)Ni–ZrO2 (where X = 10, 25 and 50) catalysts prepared through a hydrothermal process were tested for the production of biodiesel by the transesterification of waste cooking oil (WCO) with methanol. The influences of various reaction parameters were systematically optimized. While the physicochemical characteristics of the as-synthesized catalysts were examined using numerous techniques such as FTIR, XRD, TGA BET, EDX, SEM, and HRTEM. Among all the catalysts, (10 wt%)Ni–ZrO2 exhibited high surface area when compared to the pristine ZrO2, (25 wt%)Ni–ZrO2 and (50 wt%)Ni–ZrO2 nanocatalysts. It may have influenced the catalytic properties of (10 wt%)Ni–ZrO2, which exhibited maximum catalytic activity with a biodiesel production yield of 90.5% under optimal conditions. Such as 15:1 methanol to oil molar ratio, 10 wt% catalysts to oil ratio, 8 h reaction time and 180 °C reaction temperature. Furthermore, the recovered catalyst was efficiently reused in several repeated experiments, demonstrating marginal loss in its activity after multiple cycles (five times).

Cost-effective interventions are needed to address undernutrition, particularly micronutrient deficiencies, which are common in children under the age of five in low- and middle-income countries. A community-based, non-randomized clinical trial was undertaken in the Kurram district of Khyber Pakhtunkhwa from January 2018 to June 2019, to evaluate the effect of locally produced micronutrient powder (local name: Vita-Mixe) on plasma micronutrient status, hemoglobin level, and anthropometric outcomes. Children aged 24–48 months old were recruited and allocated to the intervention and control arm of the study. The enrolled children in the intervention arm received one micronutrient powder (MNP) sachet for consumption on alternate days for 12 months. To assess the impact of the intervention on plasma levels of zinc, vitamin D, vitamin A, and hemoglobin level, blood samples were taken at baseline and after one year following the intervention. The analysis was conducted using Enzyme-Linked Immunosorbent Assay (ELISA), atomic absorption spectrometry, and an automated hematology analyzer. For the impact on growth parameters, the anthropometric assessment was performed using WHO standard guidelines. A 24 h dietary recall interview was used to assess the nutrient intake adequacy. Results showed that in the intervention arm, children had on average a 7.52 ng/mL (95% CI 5.11–9.92, p-value < 0.001) increase in the plasma level of vitamin A, 4.80 ng/mL (95% CI 1.63–7.95, p-value < 0.002) increase in vitamin D levels and 33.85 µg/dL (95% CI 24.40–43.30, p-value < 0.001) increase in the plasma zinc level, as well as a 2.0g/dL (95% CI 1.64–2.40, p-value < 0.001) increase in hemoglobin level. Statistically significant improvement was observed in the weight-for-height z-score (WHZ) (from −1.0 ± 0.88 to −0.40 ± 1.01, p < 0.001) and weight-for-age z-score (WAZ) (from −1.40 ± 0.50 to −1.05 ± 0.49, p < 0.001) in the intervention group compared to the control group. No statistically significant change was observed in the height-for-age z-score (HAZ) in the intervention group (p = 0.93). In conclusion, micronutrient powder supplementation is a cost-effective intervention to improve the micronutrient status, hemoglobin level, and growth parameters in under-five children, which can be scaled up in the existing health system to address the alarming rates of undernutrition in Pakistan and other developing countries.

Objective: To assess the frequency of thrombocytopenia among the patients of trauma at an intensive care unit and to look for its relationship and other socio-demographic factors with the outcome. Study Design: Cross-sectional study. Place and Duration of Study: Intensive Care Unit, Combined Military Hospital Peshawar, from Mar to Aug 2017. Methodology: Thrombocytopenia was defined as platelet count of

Background: Rheumatoid arthritis (RA) is a disabling condition that results in considerable suffering and negatively impacts an individual's psychological, financial, social, and quality of life (QoL). Pain, fatigue, and disabilities, which may be considered as stress factors, are common challenges that may subsequently lead to psychological distress. Aim: Assessment of Depression, Anxiety, Stress, and QoL in RA patients and Comparison with healthy individuals. Materials and Methods: This cross-sectional analytical study included 50 RA patients who have reported to a tertiary health care center on outpatient basis and an equal number of age- and sex-matched healthy individuals. The study was conducted after obtaining Institutional Ethics Committee approval and informed consent of the participants. Patients were assessed based on Disease Activity Score incorporating erythrocyte sedimentation rates, Depression Anxiety Stress Scale (DAS21), Health Assessment questionnaire, Visual Analog Scale, and Multidimensional scale of Perceived Social Support. Results: Levels of anxiety, depression, and stress in patients with RA were significantly higher as compared to age- and sex-matched healthy controls. RA patients had significantly lower scores on total social support, as well as social support of family and friends. However, there was no difference between RA patients and healthy controls on social support from significant others. Conclusion: Patients with RA had significantly higher levels of anxiety, depression, and stress and significantly lower levels of social support compared to age- and sex-matched healthy controls. The therapeutic implications of these findings need further evaluation.

Background: The worldwide COVID-19 pandemic has significantly altered our life. Doctors more so than the general public because of their involvement in managing the COVID-infected individuals, some of them 24/7 end in burnout. Burnout in doctors can lead to reduced care of patients, increased medical errors, and poor health. Burnout among frontline health-care workers has become a major problem in this ongoing epidemic. On the other hand, doctors in preclinical department have a lack of interaction with patients, with not much nonclinical professional work to boot, find the profession less gratifying which perhaps increase their stress level. Aim: The aim was to study the prevalence of burnout and measure resilience in doctors in clinical and in preclinical departments. Materials and Methods: This observational, cross-sectional, comparative study was carried out in a tertiary care teaching hospital and COVID care center. By purposive sampling 60 preclinical and 60 clinical doctors in a tertiary health care center were included in the study. After obtaining the Institutional Ethics Committee approval and informed consent, the doctors were administered a self made socio-demographic questionnaire, the Copenhagen Burnout Inventory, and the Connor–Davidson Resilience Scale. Doctors were given a self-made questionnaire, the Copenhagen Burnout Inventory, and the Connor–Davidson Resilience Scale. Results: The prevalence of burnout was seen more in clinical doctors (55.47) and the resilience was observed more in preclinical doctors (88.9). Discussion: Resident doctors are a major force to combat COVID-19 as frontline health workers; hence, one can visualize burnout amongst them. On an individual basis, the work-related burnout was severely high in the clinical group owing to the workload which has been corresponding to a number of western studies. Nonclinical department doctors from pathology, community medicine, and microbiology did show burnout but showed a greater score in resilience. Psychological resilience has been identified as a component in preventing burnout. Conclusion: Therapy sessions can be used in clinical doctors facing burnout to build up their resilience.

A comprehensive investigation of the physical characteristics of any material provides beneficial information regarding its application viewpoint in different industries. Herein, we report the tunable mechanical and optoelectronic properties of cubic CdZrO3 under variable pressure up to 80 GPa using density functional theory (DFT). The pressure-induced band gap engineering reveals a fantastic fact of transformation of the indirect to direct band gap with increasing pressure. The dielectric response disclosed that optical parameters dragged towards higher energy with an increase of pressure, which unveiled the potential of CdZrO3 for optoelectronic applications. Effective change in optoelectronic is attributed to indirect to direct band gap transition. This study provides a gateway to how the optoelectronic properties of cubic CdZrO3 could be tuned by employing external pressure.

The effect of cold high pressure densification (CHPD) on anisotropy of the critical current density (Jc) in « in situ » single core binary and alloyed MgB2 tapes has been determined as a function of temperatures at 4.2 K, 20 K and 25 K as well as at applied magnetic fields up to 19 T. The study includes binary and C4H6O5 (malic acid) doped MgB2 tapes before and after CHPD. It is remarkable that the CHPD process not only improved the Jc values, in particular at the higher magnetic fields, but also decreased the anisotropy ratio, Γ = Jc///Jc┴. In binary MgB2 tapes, the anisotropy factor Γ increases with higher aspect ratios, even after applying CHPD. In malic acid (C4H6O5) doped tapes, however, the application of CHPD leads only to small enhancements of Γ, even for higher aspect ratios. This is attributed to the higher carbon content in the MgB2 filaments, which in turn is a consequence of the reduced chemical reaction path in the densified filaments. At all applied field values, it was found that CHPD processed C4H6O5 doped tapes exhibit an almost isotropic behavior. This constitutes an advantage in view of industrial magnet applications using wires with square or slightly rectangular configuration.

From 1975-2009, the WHO guidelines classified symptomatic dengue virus infections as dengue fever, dengue hemorrhagic fever, and dengue shock syndrome. In 2009 the case definition was changed to a clinical classification after concern the original criteria was challenging to apply in resource-limited settings and not inclusive of a substantial proportion of severe dengue cases. Our goal was to examine how well the current WHO definition identified new dengue cases at our febrile surveillance sites in Kenya. Between 2014 and 2019 as part of a child cohort study of febrile illness in our four clinical study sites (Ukunda, Kisumu, Msambweni, Chulaimbo) we identified 369 dengue PCR positive symptomatic cases and characterized whether they met the 2009 revised WHO diagnostic criteria for dengue with and without warning signs and severe dengue. We found 62% of our PCR-confirmed dengue cases did not meet criteria per the guidelines. Our findings also correlate with our experience that dengue disease in children in Kenya is less severe as reported in other parts of the world. Although the 2009 clinical classification has recently been criticized for being overly inclusive and non-specific, our findings suggest the 2009 WHO dengue case definition may miss more than 50% of symptomatic infections in Kenya and may require further modification to include the African experience.

Terrorism has emerged as one of the major challenges for the Eurasian regional peace, security, and cooperation. Keeping these challenges in perspective, the Shanghai Cooperation Organization (SCO) was established to eliminate the menace of terrorism, fundamentalism, and secessionism. Against this background, the main objectives of this paper are to examine how terrorism emerged as a major determining factor in the Indo-Pak relations and how the Shanghai Cooperation Organization (SCO), was failed to play its effective role in the Indo-Pak conflict given the Pulwama terror attack. For this research, descriptive and analytical methods were used and the data was collected from secondary sources. The major findings of this article are that terrorism has emerged as one of the major determinants of Indo-Pak relations and the same has become a major challenge for the SCO to resolve the issue. Against the background of terror attacks, it was anticipated that the SCO would play a crucial role to pacify the situation. However, the role played by the SCO in this situation proved marked as a Whack-a-Mole.

Objective: To determine the frequency of acute kidney injury (AKI) and impact of socio-demographic factors to it, among the patients of trauma at an intensive care unit (ICU) of a tertiary care hospital of Pakistan Study Design: Perspective comparative study. Place and Duration of Study: Combined Military Hospital (CMH) Peshawar, from Mar 2018 to Aug 2018. Methodology: This study was conducted on patient admitted after a traumatic event in the intensive care unit of CMH Peshawar. On the basis of Global Outcome Clinical Practice Guidelines (KDIGO) patients admitted in intensive care unit were recruited. Demographic profile included age, gender, co-morbidity, use of mechanical ventilation and length of stay in the intensive care unit. Results: A total of 102 patients were admitted in the intensive care unit with traumatic injuries during the study period. Out of them 33 (31.4%) were diagnosed with the acute kidney injury during the intensive care unit stay. Extremities were the commonest site of trauma among the target population followed by head and neck. Mean age of patients included in the study was 38.13 ± 4.925. Conclusion: Long duration of intensive care unit stay was associated with the presence of acute kidney injury in our sample population.

Currently, highly luminescent colloidal upconversion nanoparticles (UCNPs) have expanded an increasing interest of researchers because of their facilitating lability in the biomedical/clinical field. In this study, NaYF4:Yb,Er UCNPs are prepared by eco-friendly metal complexation-based thermal decomposition method at a lower temperature in aqueous media. The phase structure, crystallinity, phase purity, morphology, colloidal dispersibility, surface structure, surface charge, and optical and luminescent properties were evaluated carefully by X-ray diffraction (XRD), scanning electron microscope (SEM), transmission electron microscope (TEM), energy dispersive x-ray analysis (EDX), Thermogravimetric analysis (TGA), zeta potential, Fourier transform infrared (FTIR), UV/visible and photoluminescent spectroscopic techniques. XRD pattern shows a pure single-phase cubic structure with an average grain size of 30–35 nm. TEM and SEM micrographs exhibited irregularly shaped spherical morphologies, porous surface structures highly aggregated UCNPs with the narrow-size distribution. Positive zeta potential has shown value signifying high absorption in the visible region which indicates particle's good colloidal stability in aqueous media. Under NIR-laser light excitation, the UCNPs emit strong UC emission transitions in the visible region. A broad infrared absorption peak of hydroxyl groups (–OH) in FTIR spectrum and mass loss at a lower temperature in TGA verified the surface functionality of UCNPs, with high colloidal stability, and excellent biocompatibility in aqueous media. In terms of their surface characteristics and high luminescent properties, the NaYF4:Yb,Er UCNPs could be interestingly applied in tagging of biomolecules, drug delivery, proteins labeling, and therapeutic and thermostats applications.

Psychogenic vomiting is a syndrome in of recurrent vomiting without any organic pathology. It must be differentiated from cyclical vomiting syndrome, functional vomiting, and chronic idiopathic nausea. It occurs as a result of an emotional or psychic disturbance. This condition is highly disabling, increasingly recognized, and under-researched. In India, the number of patients reporting to the psychiatric outpatient department with eating disorders is comparatively very less. We describe how two patients with diagnostic dilemmas who were treated successfully after psychiatric intervention.

People with intellectual disability (ID) have a greater frequency of psychiatric illnesses, ranging from 10% to 80%, as compared to the general population. It has been proven that mood stabilizers are beneficial in the management of behavior issues in people with ID. Here, we report a series of five cases with mild and moderate ID with behavioral disturbances including mood and psychotic symptoms managed successfully with sodium valproate as the part of the treatment.

Nigeria is the most populous black nation in the world, member of the UN Security Council and largest economy of Africa. In addition to its globally acknowledged qualitative oil, it also has large deposits of mineral resources including tin, coal and gypsum, gold and lead. The country is not only engaged in a passionate competition with South Africa to attain the position of a continental superpower preparatory towards becoming a globally acknowledge giant but also comfortably playing a big-brother role among Africa nations. This paper uses documentary analysis to examine Nigeria's social, economic and global potentials of fulfilling its dreams vis-a-vis the potentials of its competitor(s). The paper found out that Nigeria faces multidimensional challenges on its path towards continental leadership ranging from domestic problems of rising crime, incessant insurgency, dilapidated infrastructure, growing unemployment, over-reliance on dwindling oil income and leadership crises among others to intense competition from other strong African countries like South Africa, Egypt and Ethiopia. The paper concludes that the country's goal of a regional superpower status is achievable but Nigeria must address its domestic challenges to win the race of attaining continental hegemony.

Abstract In this study dibenzylidene ketone derivatives (2E,5E)-2-(4-methoxybenzylidene)-5-(4-nitrobenzylidene) cyclopentanone (AK-1a) and (1E,4E)-4-(4-nitrobenzylidene)-1-(4-nitrophenyl) oct-1-en-3-one (AK-2a) were newly synthesized, inspired from curcuminoids natural origin. Novel scheme was used for synthesis of AK-1a and AK-2a. The synthesized compounds were characterized by spectroscopic techniques. AK-1a and AK-2a showed high computational affinities (E-value > − 9.0 kcal/mol) against cyclooxygenase-1, cyclooxygenase-2, proteinase-activated receptor 1 and vitamin K epoxide reductase. AK-1a and AK-2a showed moderate docking affinities (E-value > − 8.0 kcal/mol) against mu receptor, kappa receptor, delta receptor, human capsaicin receptor, glycoprotein IIb/IIIa, prostacyclin receptor I2, antithrombin-III, factor-II and factor-X. AK-1a and AK-2a showed lower affinities (E-value > − 7.0 kcal/mol) against purinoceptor-3, glycoprotein-VI and purinergic receptor P2Y12. In analgesic activity, AK-1a and AK-2a decreased numbers of acetic acid-induced writhes (P

Defining and classifying nymphomania has been a challenge for clinicians. It is characterized by an unquenchable urge to engage in repeated sexual contact with many partners without a deep emotional involvement. The sexual drive is unvarying, voracious, impetuous, and unrestrained. The case report describes a young female who presented with increased sexual desires and engaging in excessive sexual activity leading to divorce and marital disharmony in her second marriage. There was a history of childhood sexual abuse. Women developed nymphomania out of engagement in the behavior due to a genetic predisposition or from an environmental stressor such as trauma or sexual abuse. Since sex addiction is not a recognized disorder in DSM-5 or ICD-11 , women who have this disorder have difficulty receiving treatment. Proper diagnosis and treatment of such patients will lead to better functioning and quality of life.

Iron nanoparticles are used as a targeted drug delivery system. The nanocarrier itself can be genotoxic, trigger oxidative stress or cell death. Therefore, we developed an AC/DC magnetic syringe for injecting, stimulating drug release and safe removing of the nanocarrier. Alongside we optimized the method for nanoparticles’ drug release kinetics and testing cytotoxicity in vitro. • This paper presents detailed instructions for construction of AC/DC magnetic syringe device for stimulated drug release, injection and ejection of magnetic nanoparticles; nanoparticles preparation; adsorbing methylene blue on nanoparticles; determination of drug release kinetics from nanocarriers on the example of methylene blue • Gomori´s Prussian blue reaction for differentiated SH-SY5Y human neuroblastoma cell line; MTT viability assay optimized for differentiated SH-SY5Y human neuroblastoma cell line and antioxidant enzymes activities assay and lipid peroxidation methods are optimized for cell analyses cell cultivation for nanoparticles cytotoxicity testing in vitro. • Those protocols are the first step toward further testing the effect of nanoparticles in vivo, on brain tissue.

Nigeria is the most populous black nation in the world, a member of the UN Security Council, and the largest economy of Africa. In addition to its globally acknowledged qualitative oil, it also has large deposits of mineral resources including tin, coal and gypsum, gold, and lead. The country is not only engaged in a passionate competition with South Africa to attain the position of a continental superpower preparatory towards becoming a globally acknowledge giant but also comfortably playing a big-brother role among Africa nations. This paper uses documentary analysis to examine Nigeria’s social, economic, and global potentials of fulfilling its dreams vis-a-vis the potentials of its competitor(s). The paper found out that Nigeria faces multidimensional challenges on its path towards continental leadership ranging from domestic problems of rising crime, incessant insurgency, dilapidated infrastructure, growing unemployment, over-reliance on dwindling oil income and leadership crises among others to intense competition from other strong African countries like South Africa, Egypt, and Ethiopia. The paper concludes that the country’s goal of a regional superpower status is achievable but Nigeria must address its domestic challenges to win the race of attaining continental hegemony.

Objective: To assess clinical presentation and outcome of patients with thrombotic thrombocytopenic purpura (TTP) in our setup. Study Design: Descriptive study. Place and Duration of Study: Combined Military Hospital (CMH) Peshawar, from Feb 2016 to Aug 2017. Patients and Methods: In a prospective design, patients diagnosed to be suffering from TTP, were included in this study. Detailed history along with physical examination and thorough investigation of all cases was carried out and collected on proformas. The diagnosis of TTP in our study was done by demonstration of significant schistocytes (more than 1 percent) on peripheral blood film. The patients were treated with steroids and plasma pheresis and in some cases with weekly Rituximab for 4 weeks. The patients were followed up in outdoor clinic on monthly basis. Results: Being a very rare disease, only 11 patients suffering from TTP reported during the study period. They were followed prospectively with a mean duration of follow-up of 11.23 months (± SD 5.57). All patients (100 percent) had anaemia, thrombocytopenia and acute kidney injury. Fever was seen in 54.4% patients and 63.6% patients had neurological involvement. A likely secondary cause of precipitation of TTP was found in 54.5% cases. The mortality rate was 18.2 percent. Conclusion: TTP is a challenging disease for intensive care specialists and can be fatal without effective treatment. A high index of suspicion followed by early diagnosis and prompt treatment can save life. Documentation of deficiency of plasma ADAMTS13 activity is not essential for the diagnosis of TTP and plasmapheresis is the treatment of choice.

Objective: To evaluate the diagnostic accuracy of Endo-bronchial ultrasound guided transbronchial needle Aspiration in patients with mediastinal lymphadenopathy and mass lesions especially in the context of granulomatous versus non granulomatous lung disorders. Study Design: Open label, unblended prospective observational cohort. Place and Duration of Study: Department of Pulmonology, Pak Emirates Military Hospital Rawalpindi, from Jul 2015 to Mar 2016. Patients and Methods: All patients presented during study periods with meditational lymphadenopathy or lesions in which the initial bronchoscopy did not reveal any diagnosis were included in the study. Endobronchial ultrasound-guided transbronchial needle aspiration was performed in the bronchoscopy suit under conscious sedation and local anesthesia. Rapid on site evaluation was available for most of the cases. The procedure was performed using an integrated fibreoptic bronchoscopy with 22G TBNA needle by an experienced Bronchoscopist. The data was analyzed by using SPSS version 21 Results: A total of 53 patients with mean age of 44 years underwent endobronchial ultrasound-guided transbronchial needle aspiration for evaluation of meditational or hilar lesions between Jul 2015 to Apr 2016. There were 43 (81.1%) male and 10 (18.8%) female patients. A total of 108 Lymph nodes were sampled in 53 patients, rapid on site evaluation was available in 41 (77.3%) patients. Adequate representative sample could be obtained in 45 of 53 (84.9%) patients. The overall diagnosis were chronic granulomatous lesion in 27 (50.9%) patients, squamous cell carcinoma in 10 (18.8%), lymphoproliferative disorder in 2 (3.7%), thymoma in 1 (1.3%) and reactive hyperplasia in 5 (9.4%) of cases. No major complication of the procedure was observed. Conclusion: End bronchial ultrasound-guided transbronchial needle aspiration was found useful diagnostic modality for lymph nodes sampling in patients with lymphadenopathy and mass like lesions in mediastinum.