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Background: Drug addiction is a social problem that affects people all over the world, Increased manufacturing, distribution, promotion, availability, and social values contribute to this issue. Aims and Objectives: The aim of this study was to explore the causes of substance abuse among users and its impacts. Materials and Methods: The study’s findings were derived through primary research. In-depth interviews with substance users undergoing treatment at a de-addiction center in Srinagar were carried out in June 2022–July 2022. This study included a thematic analysis of the stories of 20 participants. Results: Data gathered through participant narratives revealed personal experiences as well as common themes. A total of 3 themes emerged from the codes, the themes include (1) Initiation of substance abuse (2) Causes associated with substance abuse (3) Consequences of substance abuse. Conclusion: We conclude that the problem of substance abuse in Kashmir has assumed rising dimensions: curiosity, academic pressure, increasing economic stress, and easy accessibility are leading to initiation into substance abuse. It also reveals the harmful effects of substance abuse. Heroin is mostly used substance by abusers for the first time; substance abuse is on the rise, which is highly concerning for every member of society.

Providencia rettgeri has increasingly been responsible for several infections, including urinary tract, post-burn wounds, neonatal sepsis, and others. The emergence of drug-resistant isolates of P rettgeri , accompanied by intrinsic and acquired antibiotic resistance, has exacerbated the challenge of treating such infections, necessitating the development of novel therapeutics. Hypothetical proteins (HPs) form a major portion of cellular proteins and can be targeted by these novel therapeutics. In this study, 410 HPs from a pan-drug-resistant (PDR) P rettgeri strain (MRSN845308) were functionally annotated and characterized by physicochemical properties, localization, virulence, essentiality, druggability, and functionality. Among 410 HPs, the VirulentPred 2.0 tool and VICMpred combinedly predicted 33 HPs as virulent, whereas 48 HPs were highly interacting proteins based on the STRING v12 database. BlastKOALA and eggNOG-mapper v2.1.12 predicted 13 HPs involved in several metabolic pathways like Riboflavin metabolism and Lipopolysaccharide biosynthesis. Overall, 83 HPs were selected as primary drug targets; however, only 80 remained after nonhomology searching and essentiality analysis. In addition, all were detected as novel drug targets according to DrugBank 5.1.12. Considering the potential of membrane and extracellular proteins, 29 HPs (extracellular, outer, and inner membrane) were selected based on the combined prediction from PSORTb v3.0.3, CELLO v.2.5, BUSCA, SOSUIGramN, and PSLpred. According to the prevalence of those HPs in different strains of P rettgeri sequences in National Center for Biotechnology Information Identical Protein Groups (NCBI-IPG), 5 HPs were selected as final drug targets. In addition, 5 other HPs annotated as transporter proteins were also added to the list. As no crystal structures of our targets are present, 3-dimensional structures of selected HPs were predicted by the AlphaFold Server powered by AlphaFold 3. Our findings might facilitate a better understanding of the mechanism of virulence and pathogenesis, and up-to-date annotations can make uncharacterized HPs easy to identify as targets for novel therapeutics.

Accidental injuries in the pediatric population are common. The response to injury also differs owing to anatomical and physiological differences in children. While such injuries carry a risk of lifelong morbidity, some cases may follow a benign course despite their distressing appearance. We report two cases of accidentally incurred penetrating trauma in the pediatric population with unusual objects, including a pencil and a toy wheel. Despite their intracranial extension, neither of the patients exhibited any discernible neurological deficits. Penetrating brain injuries require early removal and meticulous perioperative care to minimize the risk of long-term adverse neurological events in children.

Basilar tip aneurysms are the commonest aneurysms of the posterior circulation and constitute around 5-8% of all cerebral aneurysms. Ruptured basilar tip aneurysms may present with signs and symptoms of subarachnoid hemorrhage (SAH) with sudden, extremely severe headache, nausea and vomiting, stiff neck, blurred or double vision, sensitivity to light, seizure, drooping eyelid and loss of consciousness. At times, the hemorrhage could be fatal, reaching mortality beyond 20%. Basilar tip aneurysms have complex anatomy and have always been considered difficult to treat. Two well-known options to treat basilar tip aneurysms include the microsurgical approach and the endovascular approach. Endovascular treatment is now a cost-effective, preferred and logical rationale for the management of intracranial aneurysms. This case reports the first ever coiling procedure that was performed at Ziauddin Hospital (North Campus) for a basilar tip aneurysm and the other major challenge faced at our center was that the neck was wide, hence requiring a supporting balloon. Keywords: Aneurysm; Subarachnoid Hemorrhage; Cerebral Aneurysms.

Background: Hyponatremia is considered as a common electrolyte imbalance in hospitalized patients. Cerebral salt wasting syndrome (CSWS) is an abnormality in the renal sodium transport in patients with intracranial disease, in the face of preserved thyroid and adrenal function. However, treatment of CSW and syndrome of inappropriate antidiuretic hormone (SIADH) varies, making an accurate diagnosis significant. In order to differentiate CSWS from syndrome of inappropriate antidiuretic hormone (SIADH), this study aimed to detect CSWS related hyponatremia (benign and reversible condition) in its early stages. Methods: This retrospective cross-sectional study was conducted at the Department of Neurosurgery, Ziauddin Medical University Hospital, Karachi, Pakistan from August 2016 to August 2019. All patients who had a cerebral lesion along with hyponatremia and natriuresis were included. Patients with SIADH, though considered in the differential diagnosis, were not included in the study. Data was analyzed by using SPSS (Statistical Package for the Social Sciences) and p

IntroductionInitiated in June 2019, this collaborative effort involved 15 public and private sector hospitals in Pakistan. The primary objective was to enhance the capacity for pediatric neuro-oncology (PNO) care, supported by a My Child Matters/Foundation S grant.MethodsWe aimed to establish and operate Multidisciplinary Tumor Boards (MTBs) on a national scale, covering 76% of the population (185.7 million people). In response to the COVID-19 pandemic, MTBs transitioned to videoconferencing. Fifteen hospitals with essential infrastructure participated, holding monthly sessions addressing diagnostic and treatment challenges. Patient cases were anonymized for confidentiality. Educational initiatives, originally planned as in-person events, shifted to a virtual format, enabling continued implementation and collaboration despite pandemic constraints.ResultsA total of 124 meetings were conducted, addressing 545 cases. To augment knowledge, awareness, and expertise, over 40 longitudinal lectures were organized for healthcare professionals engaged in PNO care. Additionally, two symposia with international collaborators and keynote speakers were also held to raise national awareness. The project achieved significant milestones, including the development of standardized national treatment protocols for low-grade glioma, medulloblastoma, and high-grade glioma. Further protocols are currently under development. Notably, Pakistan's first pediatric neuro-oncology fellowship program was launched, producing two graduates and increasing the number of trained pediatric neuro-oncologists in the country to three.DiscussionThe initiative exemplifies the potential for capacity building in PNO within low-middle income countries. Success is attributed to intra-national twinning programs, emphasizing collaborative efforts. Efforts are underway to establish a national case registry for PNO, ensuring a comprehensive and organized approach to monitoring and managing cases. This collaborative initiative, supported by the My Child Matters/Foundation S grant, showcases the success of capacity building in pediatric neuro-oncology in low-middle income countries. The establishment of treatment protocols, fellowship programs, and regional tumor boards highlights the potential for sustainable improvements in PNO care.

Abstract Background Penetrating trauma to the brain is a rare mode of self-harm in individuals with depressive psychosis. It may have variable presentations ranging from intact neurological status to non-survivable damage and the subjects may be surprisingly apathetic to pain. It is even unusual for such an injury to have an excellent prognosis despite coming late to clinical attention. Case presentations We report two cases of patients with psychotic depression who attempted suicide by hammering nails into their heads. On imaging, deep penetration within the brain parenchyma was noted; however, neither case had any neurological deficit or symptoms attributable to brain trauma. Conclusions Self-inflicted penetrating brain injuries with peculiar objects such as nails are rarely encountered in practice. They need prompt management for their removal and addressing the underlying mental health illnesses.

Emotions are a complex multi-faceted phenomenon. To assess the complexity of emotions from different facets, multi-modal approaches are necessary. However, multi-modal approaches are rarely used for assessing emotions, especially in the context of computer programming. This study adopts a multi-modal approach to understand the changes in students' perception of emotions before and after working on programming problems. Understanding these changes in students' perceptions may enable educators to devise interventions that help students adjust their perceptions and regulate their emotions as per their skills. We conducted a one-on-one programming session and retrospective think-aloud interview with 17 students from an introductory programming course. During the programming session, students filled surveys and performed four programming tasks. While working on these tasks, students' eye gaze, video of face and screen, and electrodermal activity data were also collected using a non-invasive device. The data collection for this study was multi-modal, with a mix of both qualitative and quantitative data collection methods. Data analysis was primarily qualitative, with additional triangulation of qualitative and biometric data for select exemplars. The findings of this study suggest that students experience changes in emotions because of many reasons, for instance, they encountered repeated errors, they set high standards for their performance, or they could not manage time. For some students, negative emotions changed to positive emotions when they solved errors without any external help or achieved more than what they expected going into the task. Moreover, the triangulation of qualitative and biometric data of two participants provides a fine-grained analysis of their emotions and behaviors and confirmed the change in the perception of their emotions while performing the programming tasks.

Eucalyptus camaldulensis is a multifunctional tree and is globally used for the reclamation of problematic lands. Eucalyptus camaldulensis is prone to attack by a number of pathogens, but the most important threat is the Fusarium wilt (Fusarium oxysporum). Keeping in view the importance of E. camaldulensis and to manage this disease, five plant activators, i.e., salicylic acid (C7H6O3), benzoic acid (C7H6O2), citric acid (C6H8O7), dipotassium phosphate (K2HPO4), monopotassium phosphate (KH2PO4) and nutritional mixture namely Compound (NPK) and nutriotop (Fe, Zn, Cu, B, Mn) were evaluated in the Fusarium infested field under RCBD in the Research Area, Department of Forestry and Range Management, University of Agriculture, Faisalabad (UAF). Among plant activators, salicylic acid and a combination of compound + nutriotop exhibited the lowest disease incidence and enhanced fresh and dry weight of leaves compared to other treatments and control. Results of the environmental study indicated maximum disease incidence between 35-40 °C (max. T), 6-25 °C (mini. T), 70-80% relative humidity and 1.5-2.5 km/h wind speed while pan evaporation expressed weak correlation with disease development. It was concluded that Fusarium wilt of Eucalyptus camaldulensis could be managed through activation of the basal defense system of the host plant with provision of salicylic acid and balanced nutrition by considering environmental factors. Recent exploration is expected to be helpful for future research efforts on epidemiology and ecologically sound intervention of Fusarium wilt of Eucalyptus camaldulensis.

Evidence shows that biomedical engineering students face unique challenges in entering the workforce compared to peers in other engineering majors. The purpose of this study is to explore the factors impacting undergraduate engineering students' career attainment, or the acquisition of employment in a chosen field, and how the students experienced these factors in their pathways towards post-graduate employment. By studying differences in processes towards career attainment, there is an opportunity to promote equity and better support the inclusion and persistence of women and racially minoritized groups in engineering, particularly their readiness to enter the engineering workforce. We sought to answer two research questions: (RQ1) What contextual factors are identified by engineering students as supports and barriers to their attainment of a career in the engineering field? (RQ2) How are engineering students experiencing inequities in their processes toward career attainment? We conducted six focus groups with undergraduate engineering students at a large Midwestern University. Participants were purposefully sampled based on demographics from four engineering disciplines: biomedical engineering and the three preferred majors for students transferring out of biomedical engineering at our university, chemical engineering, materials science and engineering, and mechanical engineering. We used social cognitive career theory (SCCT) to inform our data collection and analysis and interpret the findings. The transcripts were analyzed by developing a codebook containing theory-driven codes from SCCT and emergent codes from the data. We identified five themes representing the contextual factors impacting engineering students' processes toward career attainment: implications of (1) interpersonal relationships; (2) institutional infrastructure; (3) academics; (4) social identity; and (5) out-of-class experiences. We also found that these contextual factors may act as either a support or barrier depending on personal factors such as demographics, personality, or identity. The nuance revealed in this study, that a contextual factor may be both a support and barrier, presents implications for universities to provide more individualized career preparedness resources and recognize the ways that students' positionalities impact their processes toward career attainment.

Objective: To determine the factors affecting surgical outcome of traumatic intracranial extradural hematoma in Civil Hospital Karachi. Head injury is a leading cause of death in young age group. Extradural hematoma, a complication of head injury, is often fatal if not treated in time. The surgical outcome of EDH is dependent upon many variables including preoperative GCS, time between injury and surgery, associated intracranial injuries, anisocoria and hematoma volume. In order to reduce the mortality near to nil, it is essential to determine the magnitude of effect of affecting factors on surgical outcome which will also help us in preoperative counseling and prioritizing the operative candidates. Study Design: Cross sectional study. Six months from 28th May 2012 to 27th November 2012. Materials and Methods: The study was conducted on the patients admitted through emergency and diagnosed as extradural hematoma. These patients underwent surgical evacuation of EDH on emergent basis and outcome was measured by Glasgow Outcome Scale (GOS) after 48 hours of surgery. Results: Using GOS, good surgical outcome was observed in 80.9% (157 out of 194) patients. Preoperative GCS, anisocoria, hematoma volume, associated intracranial injuries and time between injury and surgery were the factors affecting the outcome significantly (p value=0.000) while age and sex of the patient had no significant effect. Conclusion: Good surgical outcome is associated with patients with solitary extra dural hematoma of volume less than 60ml, preoperative GCS more than 8, absence of anisocoria and undergoing surgical evacuation within 6 hours of injury.

A new species of cicada, Cicadatra ziaratica sp. n., is described from Pakistan. Male genitalia, timbal and opercula are described and illustrated as important diagnostic characters. Biological notes are also provided. A key to the known Cicadatra of Pakistan is provided.

Objective: To describe the changes of Glasgow Outcome Scale (GOS) and Glasgow Coma Scale (GCS) aftersurgical and / or conservative management of patients with contusions based on Contusion Index (C. I.). Study Design: Descriptive StudySetting: Department ofNeurosurgery, Dow University ofHealth Sciences/ Civil Hospital, Karachi. Duration of Study: Two years and five months between August 2006 and January 2009.Subjects and Methods: 50 patients of ages between 6 to 75 years, including both sexes were evaluated on thebasis of contusion index as determined by computerized tomographic scan (C.T. Scan) findings and theirGlasgow outcome scores were established. Results: Patients with contusion index 0 - 3 should be conservatively managed. Patients with contusion index6 should be given the benefit of some sort of surgical procedure first, which showed best results with surgicalmanagement and poor results with conservative management. Patients with contusion index 9, no matter what,always show a poor outcome. Conclusion: We recommend that a future study should be done to arrive at a decision regarding conservativeversus surgical management of patients with cerebral contusions based on Contusion Index which will help usavoid unnecessary surgeries and vice versa.

Metabolic acidosis (MA) is a highly prevalent disorder in a significant proportion of the population, resulting from imbalance in blood pH homeostasis. The heart, being an organ with very low regenerative capacity and high metabolic activity, is vulnerable to chronic, although low-grade, MA. To systematically characterize the effect of low-grade MA on the heart, we treated male and female mice with NH4Cl supplementation for 2 weeks and analyzed their blood chemistry and transcriptomic signature of the heart tissue. The reduction of pH and plasma bicarbonate levels without an associated change in anion gap indicated a physiological manifestation of low-grade MA with minimal respiratory compensation. On transcriptomic analysis, we observed changes in cardiac-specific genes with significant gender-based differences due to MA. We found many genes contributing to dilated cardiomyopathy to be altered in males, more than in females, while cardiac contractility and Na/K/ATPase-Src signaling were affected in the opposite way. Our model presents a systems-level understanding of how the cardiovascular tissue is affected by MA. As low-grade MA is a common ailment with many dietary and pharmaceutical interventions, our work presents avenues to limit chronic cardiac damage and disease manifestation, as well as highlighting the sex differences in MA-induced cardiovascular damage.

The coronavirus disease (COVID-19) pandemic has led to a significant change in the way healthcare is dispensed. During the pandemic, healthcare inequities were experienced by various sections of society, based on gender, ethnicity, and socioeconomic status. The LGBTQ individuals were also affected by this inequity. There is a lack of information on this topic especially in the developing countries. Hence this issue requires further exploration and understanding. Previous literature briefly explored the mental, physical, and emotional turmoil faced by the LGBTQ community on a regular basis. They feared rejection by family and friends, bullying, physical assault, and religious biases. These issues prevented them from publicly speaking about their sexual orientation thereby making it difficult to collect reliable data. Although they require medical and psychological treatment, they are afraid to ask for help and access healthcare and mental health services. Being mindful of these difficulties, this article explores the various underlying causes of the mental health problems faced by LGBTQ individuals, especially, in the Indian subcontinent. The article also examines the status of healthcare services available to Indian sexual minorities and provides recommendations about possible remedial measures to ensure the well-being of LGBTQ individuals.