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This paper evaluates the Government-to-Business (G2B) aspect of Dubai e-government. The research revealed that while businesses are generally aware of Dubai e-government services, they do not often use them for transactions. Another finding was that responses to businesses' queries made online or via e-mail are not rapid enough. A single e-business portal for the business community is recommended, which would shift the service approach from department-centric to customercentric. It is further suggested that in order to stay current, Dubai should use CiRM principles in providing an improved level of service for businesses. This will enhance its position among the world's city and municipal websites. Since Dubai is considered a leader in e-government implementation in the Arab world, it is hoped that the findings will guide regional decision makers as they improve their G2B e-government initiatives. [ABSTRACT FROM AUTHOR]

Introduction: Photodynamic Therapy (PDT) is an emerging treatment for a variety of conditions including ocular and extra ocular diseases. The porphyrins have been used extensively, as dyes, which are laser-activated to achieve desired clinical effects. Commonly used agents are verteporfin and porfimer sodium.Methods: We performed a literature search of the PubMed database using the medical search headings: photodynamic therapy, photosensitizer verteporfin, visudyne, porfimer sodium and photofrin. We also performed a manual search using references from these articles, review articles and manufacturers' product monographs.Results: Verteporfin and porfimer sodium are commonly used photosensitizing agents with their wide applications in different fields of medicine. Both have well established safety profiles. They are most commonly used in wet age-related macular degeneration, gastrointestinal diseases and bronchial cancers.Conclusion: PDT is a well established treatment entity in ophthalmology and other medical fields. In ophthalmology, it has rekindled interest and hopes in the common yet sight-threatening problem of age-related macular degeneration (AMD). This problem is still considered to be a serious issue as far as management is concerned. However in selective cases of AMD, it has shown success in restoring sight, especially in the 'classic' form of the disease. PDT is also being used to treat a range of solid cancers and non malignant conditions [ABSTRACT FROM AUTHOR]

Fourier harmonic analysis (FHA) is a robust method for identification of minute changes in sperm nuclear shape that are indicative of reduced fertility. The current study was designed to develop a fertility prediction model for Nili-Ravi buffalo bulls through FHA of sperm. In experiment I, FHA technique was standardized, average sperm nuclear perimeter was measured and sperm nuclear shape plot of buffalo bull was constructed. Sperm of buffalo bulls (n = 10) were stained with YOYO-1 and Hoechst-33342 to differentiate live and dead, and digital images were captured using phase contrast and fluorescent microscopy. The images were analyzed by ImageJ software and 100 sperm/bull were evaluated. The results are described as mean ± SEM values of mean harmonic amplitude (mharm), skewness harmonic amplitude (skharm), kurtosis harmonic amplitude (kurharm) and variance harmonic amplitude (varharm) at Fourier frequencies 0-5 along with the cartesian and polar coordinate plots of buffalo bull sperm. In experiment II, a fertility prediction model was developed based on FHA of buffalo bull sperm. Semen samples of low (n = 6), medium (n = 3) and high (n = 8) fertility bulls were investigated for FHA of sperm and harmonic amplitudes (HA) were generated. Firstly, to determine if live and dead sperm population have unique nuclear shape distribution; the mean, skewness, kurtosis and variance HA 0-5 of 1700 live and 1294 dead spermatozoa of 17 bulls were evaluated. T-test signified a difference in the mharm0 (2.363 ± 0.01 vs. 2.439 ± 0.02), skharm0 (-0.0002 ± 0.07 vs. -0.266 ± 0.09), kurharm0 (-0.156 ± 0.07 vs. 0.260 ± 0.18), kurharm2 (0.142 ± 0.11 vs. 1.031 ± 0.32) and varharm4 (0.109 ± 0.00 vs. 0.082 ± 0.00) of live vs. dead sperm population (p < 0.05). Therefore, 100 live sperm/bull were further evaluated for mean, skewness, kurtosis and variance HA 0-5 values among high (n = 6) and low-fertility (n = 6) groups. Results of T-test showed higher values of mharm2 (0.739 ± 0.01 vs. 0.686 ± 0.00), mharm4 (0.105 ± 0.001 vs. 0.007 ± 0.001), and skharm0 (0.214 ± 0.109 vs. -0.244 ± 0.097) in high vs. low-fertility group (p < 0.05). In next step, five significantly different combinations of discriminant measures between high and low-fertility groups were obtained by discriminant analysis. In conclusion, mharm4, skharm0 and varharm2 correctly identified 91.7 % of bulls into their respective fertility groups, and upon cross validation the value of the canonical correlation was 0.928., Competing Interests: Declaration of competing interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Beyond Bias was an intervention introduced in Burkina Faso, Pakistan and Tanzania, with the aim of reducing health worker bias toward young, unmarried and nulliparous women seeking family planning services. This study used qualitative methods - based on interviews with health workers who participated in the intervention, managers at health facilities that participated in the intervention, and policy and program stakeholders at the national level - to understand implementation experiences with the intervention. The results offer insights for organizations or countries seeking to implement Beyond Bias or similar programs, and point to some other key implementation challenges for multi-component interventions in lower-resource settings. The intervention, developed using a human-centered design approach, was seen as key for successful implementation but there were logistical challenges. The digital intervention was disruptive and distracting to many. In addition, the non-financial rewards intervention was perceived as complex, and some participants expressed feeling discouraged when they did not receive a reward. Beyond Bias did not sufficiently attend to the "outer setting," and this was perceived as a major implementation barrier as it limited individuals' capacity to fully achieve the desired behavior change; for example, space constraints meant that some health facilities could not ensure private services for all clients. There were scalability concerns related to cost, and there is uncertainty whether diversity of contexts (within and across countries) might constrain implementation of Beyond Bias at scale., (© 2024. The Author(s).)

Background: High-quality contraceptive counselling can accelerate global efforts to reduce the unmet need for and suboptimal use of modern contraceptives. This study aims to identify a package of interventions designed to strengthen in Pakistan and Nigeria and determine their effectiveness in increasing client-level decision-making, autonomy and meeting of contraceptive needs., Methods: A multisite, two-stage and five-phase intervention design will start with a pre-formative, formative, design, experimental and reflective phase. The pre-formative phase will map potential study sites and establish the sampling frame. The two-part formative phase will first use participatory approaches to identify clients' perspectives, including young couples and providers, to ensure research contextualisation and address each interest group's needs and priorities followed by clinical observations of client-provider encounters to document routine care. The design workshop in the third phase will result in the development of a package of contraceptive counselling interventions. In the fourth experimental phase, a multi-intervention, three-arm, single-blinded, parallel cluster randomised-controlled trial will compare routine care (arm 1) with the contraceptive counselling package (arm 2) and the same package combined with wider methods availability (arm 3). The study aims to enrol a total of 7920 participants. The reflective phase aims to identify implementation barriers and enablers. The outcomes are clients' level of decision-making autonomy and use of modern contraceptives., Ethics and Dissemination: Ethical approval for this study was obtained from the WHO Scientific and Ethics Review Committee (Protocol ID Pakistan: ERC 006232 and Nigeria ERC: 006523). Each study site is required and has obtained the necessary ethical and regulatory approvals that are required in each specific country. Findings will be presented at local, national and international conferences and disseminated by peer-review publications., Trial Registration Number: NCT06081842., Competing Interests: Competing interests: None declared., (© World Health Organization 2024. Licensee BMJ.)

Introduction and Aim: Pakistan has a mixed-health system where up to 60% of health expenditures are out of pocket. Almost 80% of primary healthcare (PHC) facilities are in the private sector, which is deeply embedded within the country's health system and may account for the unaffordability of healthcare. Since 2016, the existing national health insurance program or Sehat Sahulat Program (SSP), has provided invaluable coverage and financial protection to the millions of low-income families living in Pakistan by providing inpatient services at secondary and tertiary levels. However, a key gap is the non-inclusion of outpatient services at the PHC in the insurance scheme. This study aims to engage a private provider network of general practitioners in select union councils of Islamabad Capital Authority (ICT) of Pakistan to improve access, uptake, and satisfaction and reduce out-of-pocket expenditure on quality outpatient services at the PHC level, including family planning and reproductive health services., Methods and Analysis: A 24-month research study is proposed with a 12-month intervention period using a mixed method, two-arm, prospective, quasi-experimental controlled before and after design with a sample of 863 beneficiary families from each study arm, i.e., intervention and control groups ( N = 1726) will be selected through randomization at the selected beneficiary family/household level from four peri-urban Union Councils of ICT where no public sector PHC-level facility exists. All ethical considerations will be assured, along with quality assurance strategies. Quantitative pre/post surveys and third-party monitoring are proposed to measure the intervention outcomes. Qualitative inquiry with beneficiaries, general practitioners and policymakers will assess their knowledge and practices., Conclusion and Knowledge Contribution: PHC should be the first point of contact for accessing health services and appears to serve as a programmatic engine for universal health coverage (UHC). The research aims to study a service delivery model which harnesses the private sector to deliver an essential package of health services as outpatient services under SSP, ultimately facilitating UHC. Findings will provide a blueprint referral system to reduce unnecessary hospital admissions and improve timely access to healthcare. A robust PHC system can improve population health, lower healthcare expenditure, strengthen the healthcare system, and ultimately make UHC a reality., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Azmat, Thom, Arshad, Hamza, Aabroo, Balal, Awan, Rifaq, Hemachandra and Qudsia.)

Purpose: To evaluate the effect of mean ocular perfusion pressure on the foveal avascular zone (FAZ) area in eyes with successful retinal detachment (RD) surgery. Methods: This prospective pilot fellow eye-controlled study measured the intraoperative mean ocular perfusion pressure in eyes having surgery for rhegmatogenous RD (RRD). Postoperatively, the FAZ area was measured; the change was calculated as the difference in the FAZ area between the operated eye and the contralateral control eye. Results: The study comprised 8 patients with a mean age (±SD) of 53.38 ± 13.92 years. The mean superficial FAZ area was not different between operated eyes and control eyes, while the deep FAZ area was significantly larger in operated eyes. There was a strong negative correlation between the mean ocular perfusion pressure and the change in the deep FAZ area (Spearman ρ, -0.73; P  = .04); the correlation between the mean ocular perfusion pressure and the change in the superficial FAZ area was not significant (Spearman ρ, -0.24; P  = .57). A significant linear regression was found between the mean ocular perfusion pressure and the change in the deep FAZ area ( R 2  = 0.388). The predicted enlargement of the deep FAZ area was 0.03 mm with every 1 mm Hg decrease in the mean ocular perfusion pressure. Conclusions: Lower intraoperative mean ocular perfusion pressure is associated with enlargement of the deep FAZ area in eyes having successful RRD surgery., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Uchalli Lake is an internationally significant Ramsar site that needs protection for supporting migratory birds. The current study aimed to assess wetland health by examining water and sediments utilizing total and labile heavy metals concentration, pollution indices, ecological risk assessment, water recharge and pollution induction sources through isotope tracer techniques. Al concentration in water was of serious concern as it was 440 times higher than the maximum acceptable concentration of Environmental Quality Standard of the UK for aquatic life in saline waters. Labile concentration predicted very severe enrichment of Cd, Pb, and moderate enrichment of Cu. Modified ecological risk index predicted very high ecological risk in sediments. The δ 18 O, δ 2 H and D-excess values indicate that the lake was mainly recharged by local meteoric water. Enriched values of δ 18 O and δ 2 H suggest a high evaporation of lake water, making lake sediments more enriched with metals. Isotopic and D-excess values of groundwater suggest a quick rainwater recharge to groundwater around the Uchalli Lake. Nitrates isotopes indicate that the rainwater runoff is main source of induction of fertilizers, pesticides and soil bonded metals in the lake system. The lake is recharged by rainwater runoff, from catchment areas, that erode the soil particles and agricultural residual waste dumped in the lake., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Abdul Ghaffar reports financial support was provided by International Atomic Energy Agency., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Objective: Molecular detection and co-presence of carbapenem-resistant genes in the isolates of Pseudomonas aeruginosa are less commonly reported from Quetta. In the present study, we determined to highlight the antibiotic sensitivity profile and genetic mechanism of carbapenem resistance., Methods: The cross-sectional study was conducted from May to September 2018 at the Hi-tech laboratory, Centre for Advance Studies in Vaccinology and Biotechnology, University of Baluchistan, Quetta. Biochemical and molecular methods were ascertained for the recognition of the isolates and minimum inhibitory concentration was performed using E-test and broth microdilution methods. The molecular basis of carbapenemase activity was determined by identifying carbapenemase genes in the isolates., Results: Of the (n=23) P. aeruginosa isolated from pus aspirates obtained from surgical/burn units, we have detected bla IMP (n=7/8) 87.5%, bla NDM-1 (n=5/8) 62.5%, and bla SHV (n=4/8) 50%. The co-existence of multiple antibiotic-resistant genes, bla IMP , bla NDM-1 and bla SHV was found in (n=2/8) 25% isolates. These isolates displayed resistance against a range of antimicrobials from β-lactams, tetracyclines, cephalosporins, quinolones, monobactams, aminoglycosides, sulphonamides, phosphoric acid, macrolides, and polypeptide groups, suggesting extensive-drug resistance., Conclusion: The emergence of MBL and ESBL producers is an alarming threat in the region. It is of great importance to determine the resistance mechanism of bacterial bugs. The lack of new antimicrobials particularly against gram-negative bacteria is quite alarming worldwide., Competing Interests: Conflict of Interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

Carboxylated poly-l-lysine (CPLL) is an anti-freeze agent having pronounced non-permeating yet membrane stabilizing cryoprotective capabilities. The objective was to evaluate the CPLL supplementation in extender in terms of post-thaw quality (sperm), total anti-oxidant activity (milt) and fertilization potential of cryopreserved Labeo rohita sperm. For this purpose, male brood fish reared at a fish seed hatchery, Rawal Town Islamabad, Pakistan were captured from different rearing ponds and acclimatized in hatchery ponds for 6 h. The brooder was injected with Ovaprim (0.2 mL/kg), and milt was collected after 8 h in cooled sterilized falcon tubes, maintained at 4°C and evaluated for sperm motility. The milt collected from three brooders (n = 3) was diluted in extenders viz., modified Kurokura-2 extender having 10% methanol (control); experimental extenders with CPLL supplementation at the rate of 0.5%, 1% and 1.5%. Diluted milt was filled in 0.5 mL straws, exposed to liquid nitrogen vapours and cryopreserved. Cryopreserved milt was thawed at 25°C and assessed for post-thaw sperm quality. Sperm motility, motility duration, viability, total anti-oxidant capacity and DNA integrity was significantly higher (p < 0.05) in the extender having 1.5% CPLL than control. To evaluate the fertilization rates, male and female brooders were injected with Ovaprim at 0.2 mL/Kg and 0.5 mL/Kg body weight respectively. Fresh eggs and milt were collected through abdominal stripping. Batches of 10 g of eggs from each female (n = 2) were fertilized with one straw, each from frozen sperm with KE + methanol (control), KE + methanol + 1.5% CPLL and 50 μL fresh milt (negative control). After 1.5 h of fertilization, eggs were collected from all jars and a total of 200 eggs were counted. The fertilized eggs appeared clear and transparent while unfertilized eggs looked opaque with disintegrated nuclei. Sperm fertilization rate (%) was higher (p < 0.05) in extender KE + methanol + 1.5% CPLL (78.7 ± 0.5) compared to control (KE + methanol) (52.0 ± 0.4) however, it was lower compared to that of negative control, the fresh milt (85.2 ± 0.6). In conclusion, supplementation of carboxylated poly-l-lysine (1.5%) to modified Kurokura-2 extender having 10% methanol improves post-thaw motility, motility duration, viability, DNA integrity, anti-oxidant capacity (milt) and fertilizing ability of cryopreserved L. rohita sperm., (© 2023 Wiley-VCH GmbH. Published by John Wiley & Sons Ltd.)

Objective The objective of this article was to report the clinical and surgical outcomes of diabetic tractional retinal detachment (TRD) with 27-gauge plus pars plana vitrectomy (27G+ PPV) Methods This is a retrospective, consecutive cohort study of 196 eyes of 176 patients that underwent 27G+ PPV for TRD from July 2015 to June 2019 at the ophthalmology department of Shifa International Hospital, Islamabad. The outcomes include primary and secondary anatomical attachment of the retina, best-corrected visual acuity, and post-operative complications. Results The mean age of the patients in this study was 55.3 ± 11.3 years. Out of 176 patients, there were 47.2% (n=83) females. The mean operating time calculated was 60 ± 36 min (range 22-130 min). Of 196 eyes, 64.3% (n=126) also combined phacoemulsification with lens implantation. Internal limiting membrane peeling was done in 11.7% (n=23) of the cases. Post-operatively, 98% (n=192) achieved primary retinal attachment, and 1.5% (n=3) underwent a second procedure to achieve retinal attachment. At three months follow-up, the mean best corrected visual acuity (BCVA) remarkably improved from 1.86 ± 0.59 to 0.54 ± 0.32 logarithm of the minimal angle of resolution (logMAR) (p-value<0.001). Among complications, one patient had intra-operative suprachoroidal oil migration, which was managed successfully, while post-operatively, 11 patients (5.6%) developed a transient rise in intraocular pressure, which was controlled with anti-glaucoma drugs, and one patient had vitreous cavity hemorrhage which resolved on its own with time. Conclusion This study strongly suggests that the 27G+ PPV offers successful repair of eyes with diabetic TRD with statistically significant improvement in visual acuity and minimal rate of complications., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Awan et al.)

Titanium foams have potential applications in orthopedic and dental implants because of their low elastic modulus and good bone in-growth properties. In the present study, a novel method for the preparation of three-dimensional interconnected microporous titanium foams has been developed. This method is based on the insertion of a filler metal into the titanium metal by arc melting, followed by its removal by an electrochemical dealloying process for the development of foams. Complete removal of the filler metal by the electrochemical dealloying process was confirmed by an X-ray diffractometry (XRD) analysis, whereas scanning electron microscopy (SEM) analysis of the developed foams showed the development of interconnected porosity. Ti foams with different levels of porosities were successfully developed by varying the amount of the filler metal. Mechanical and thermal characterizations of the developed foams were carried out using compression testing and laser flash apparatus, respectively. The yield strength and elastic modulus of the developed foams were found to decrease by increasing the volume fraction of pores. The elastic modulus of the developed titanium foams (15.5-36 GPa) was found to be closer to that of human bones, whereas their yield strength (147-170 MPa) remained higher than that of human bones. It is therefore believed that the developed Ti foams can help in reducing the problem of stress shielding observed in orthopedic implants. The thermal diffusivity of the developed foams (4.3-0.69 mm 2 /s) was found to be very close to that of human dentine., Competing Interests: The authors declare no competing financial interest., (© 2023 The Authors. Published by American Chemical Society.)

The present study was designed to develop Nutrition Education Program (NEP) based on PRECEDE-PROCEED model (PPM) to address healthy eating behavior among middle school girls aged between 4 and 12 years. For this, middle school girls from grade 1 to 8 ( n  = 900) were consulted for their eating behaviors, followed by the analysis of their health problems. From 15 different schools of three large cities (Faisalabad, Lahore, and Rawalpindi) of Pakistan, students were divided into two groups: control group ( n  = 30) and intervention group ( n  = 30) from each school. The data were collected through interview-based questionnaires according to the phases of PRECEDE Model and evaluated based on PROCEED model. Implementation of NEP was carried out through lectures. Lessons were prepared to enhance student's awareness about nutritious food and healthy lifestyle through educational pamphlets and influenced their attitude towards selection of food choices from My-Plate. Results showed that NEP was quite successful for long-term results. A significant increase in total caloric intake was observed after 8 weeks of NEP intervention (1694 ± 217 Kcal) as compared to before intervention (1329 ± 318 Kcal). Similarly, carbohydrate, protein, and fat content was also increased in daily diet. Conclusively, NEP based on PPM has great impact on healthy lifestyle of middle school girls. Significant difference was observed in score of health variables before and after NEP intervention., Competing Interests: All authors declare no conflict of interest in this manuscript., (© 2022 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Objective: To describe the frequency and outcome of Retinopathy of prematurity (ROP)., Study Design: Observational study., Place and Duration of Study: Ophthalmology Department, Shifa International Hospital (SIH) Islamabad from May 2014 to December 2019., Methodology: All preterm infants with gestational age ≤35 weeks and/or birth weight ≤2000g were included while those born at greater than 35 weeks of gestation and having a gestational weight more than 2000g were excluded from this study. Studied variables included gender, gestational age, birth weight, form and duration of supplemental oxygen, systemic diseases, presence or absence of ROP, ROP stage, treatment, and outcome., Results: Six hundred and twenty-two met the inclusion criteria out of whom 316 were screened. The majority (n=202, 64%) of the screened infants were males. Supplemental oxygen was given to 244 (77.2%) infants. The mean gestational age was 31.94 ± 2.2 weeks. The mean birth weight was 1632 ± 446 g. ROP was diagnosed in 10 (3.2%) infants with stage 1 in 3 (0.9%) infants, stage 2 in 1 (0.3%), stage 3 in 5 (1.5%), and stage 4B in 1 (0.3%) infant. In the infants diagnosed with ROP, mean gestational age was 30.4 ± 2.9 weeks, and mean birth weight was 1393 ± 416 g. ROP regressed spontaneously in 3 infants with stage 1 and 1 infant with stage 2 disease. Infants with stage 3 disease also had disease regression after treatment with intravitreal Ranibizumab (n=3) or intravitreal Bevacizumab (n=2) injection along with concurrent laser photocoagulation (n=1). The infant with 4B ROP underwent bilateral vitrectomy with the complete attachment of retina on follow-up., Conclusion: There was a low frequency of 3.2 % of ROP reported in this study. The infants diagnosed with ROP had favorable outcomes following timely treatment of this dreadful disease., Key Words: Retinopathy of prematurity, Eye, Retina, Supplemental oxygen, Screening.

Objective To report the clinical, visual, and safety outcomes of 27 gauge pars plana vitrectomy (27G PPV) in eyes with full thickness and lamellar macular hole (MH).  Methodology This retrospective cross-sectional study, conducted at the ophthalmology department of Shifa International Hospital, Islamabad, was done on 89 eyes of 85 patients who underwent 27G PPV for full-thickness and lamellar MH with a postoperative follow-up period of six months.  Results The mean age was 61.9 ± 17.3 years with 57.3% being males. Most of the eyes had idiopathic stage III full-thickness MH (n=34, 38.2 %). The total mean operating time was 42.5 ± 19.8 minutes. During surgery, 48 (53.9%) eyes had concurrent phacoemulsification. Hexafluoroethane was the most commonly used tamponade agent (n=81, 91%). Postoperatively, the primary closure rate was 93.2% (n=83) while the final closure rate was 100% (n=6) either by prolonged posturing (n=3, 3.3%) or by an additional procedure involving autologous internal limiting membrane (ILM) transplant (n=3, 3.3%). The complication rate was 2.2% including iatrogenic retinal tear (n=1, 1.1%) and raised IOP (n=1, 1.1%). The overall best-corrected visual acuity (BCVA) improved significantly from 1.20 ± 0.67 to 0.31 ±0.17 (p=<0.001). Conclusion As per this study, 27G PPV is a practical and efficient surgical system with substantial anatomical success, minimal complication, and considerable visual recovery rates in eyes with full thickness and lamellar MH. We suggest 27G PPV with ILM peeling and medium-acting intraocular gas as the standard procedure for MH., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Awan et al.)

In the past few years, a tremendous advancement in the outcome of biomedical circuits and systems has been reported. Unfortunately, at the time of the sudden outbreak of COVID-19, the electronic engineering researchers felt dearth on their side to combat the pandemic, as no such immediate cutting-edge solutions were ready to recognize the virus with some standard and smart electronic devices. Likely, in this paper, a detailed comparative and comprehensive study on circuit architectures of the biomedical devices is presented. Mostly, this study relates the industry standard circuit schemes applicable in non-invasive health monitoring to combat respiratory illnesses. The trending circuit architectural schemes casted-off to tapeout non-invasive health-care devices available in the past literature are meticulously and broadly discussed in this study. Further, the comprehensive comparison of the state of art of the device performance in terms of supply voltage, chip area, sensitivity, dynamic range, etc. is also shown in this paper. The inclusive design processes of the health monitoring devices from Lab to Industry is thoroughly discussed for the readers. The authors think, that this critical review summarising all the trending and most cited health-care devices in a single paper will alternately help the industrialists to adapt and modify the circuit architectures of the health monitoring devices more precisely and straightforwardly. Finally, the demand for health monitoring devices particularly responsible to detect respiratory illnesses, measuring blood pressure and heart-rate is growing widely in the market after the the incident of COVID-19 and other respiratory diseases.

Introduction This study aims to evaluate the primary anatomical success and visual outcomes of 25-gauge pars plana vitrectomy (25g PPV) in patients with rhegmatogenous retinal detachment (RRD) in Pakistan. Design This is a five-year retrospective, interventional cohort study conducted at tertiary care hospitals in Pakistan from October 2013 to October 2018. Methods This is a retrospective, interventional cohort study of 418 consecutive patients with RRD who underwent 25g PPV. All surgeries were performed by two experienced surgeons at tertiary care hospitals in Pakistan. Consecutive patients who underwent 25g PPV surgery as the treatment for RRD from October 2013 to October 2018 were included. We excluded patients who had a history of previous retinal surgery or did not complete the 4-8 weeks of primary outcome visit. We used the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM Corporation, Armonk, NY, USA) for statistical analysis. A p-value of <0.05 was considered significant. Results We identified 452 patients through the coding system of our hospitals who underwent 25g PPV surgery for RRD during the study period. A total of 441 patient files were reviewed for the study, of which 418 patients met the criteria for final analysis. The mean age was 49 ± 15.8 years. There was a higher number of males (n = 284, 67.9%). In our study, 186 (44.4%) patients were phakic at the time of presentation. The macula was detached in 361 (86.4%) patients. At the primary outcome visit (4-8 weeks of follow-up), the primary anatomical success rate was 89.47%. The most common cause of failure was proliferative vitreoretinopathy (PVR) (n = 20), followed by missed breaks (n = 5). Conclusions The surgical outcomes of RRD with 25g PPV surgery in our study were similar to the outcomes reported in the developed world. We propose a prospective multicenter national study to prospectively evaluate the risk factors for RRD surgical failure in the Pakistani population., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Awan et al.)

Objective: To assess the reliability and validity of gray level co-occurrence matrices (GLCM) in the quantification of choriocapillaris and describe GLCM features in normal and eyes with resolved acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and serpiginous choroiditis (SC)., Methods: In this, multicenter, reliability, validity and comparative study; OCTA was performed on eyes with resolved APMPPE and SC and normal individuals. CC texture classification, low flow area measurements and GLCM feature extraction were performed., Results: A total of 13 normal, 8 APMPPE and 15 SC eyes were analyzed. All GLCM parameters demonstrated an excellent reliability. GLCM parameters were differently distributed across the three groups. Decision-tree based on the random forest predictive model provided an overall accuracy of 86% in classifying the three groups using GLCM features., Conclusion: These data demonstrated an excellent reliability and validity of GLCM features in quantifying the choriocapillaris in healthy and diseased eyes.

Our objectives were to determine the antioxidant effect of Moringa olifera leave extract (MLE) in tris extender on post-thaw quality, kinematics, lipid peroxidation, total antioxidant capacity and field fertility of water buffalo bull semen. Semen was collected on a weekly basis for 5 weeks (n = 5 bulls & n = 25). After collection, every sample was diluted individually with extender (tris egg yolk) containing MLE concentrations (0%, 5%, 10%, 15% and 20%) at 37°C. After dilution, semen was filled in 0.54 mL straws and frozen in automatic freezer. After thawing, sperm motility (%) (progressive & total), path velocity (µm/s), straight velocity (µm/s), curvilinear velocity (%), beat cross frequency (Hz), linearity (%), straightness (%), length of average path (µm), length of straight-line path (µm), length of curvilinear path (µm), plasma membrane integrity (%), acrosome membrane integrity (%), DNA integrity (%) and morphology (%) were higher (p < 0.05) in spermatozoa preserved in extender containing 15% MLE as compared to control. The fertility rate (60%, vs. 45%) was higher (p < 0.05) with semen doses frozen with 15% MLE in extender than the control. In conclusion, 15% MLE improves semen quality, kinematics and field fertility in water buffaloes., (© 2021 Wiley-VCH GmbH.)

Idiopathic retinal vasculitis, aneurysms, and neuroretinitis (IRVAN) syndrome is a rare spectrum of retinal vasculitis, aneurysms, and neuroretinitis affecting young individuals in their third decade. Most of our current knowledge is based on case reports, case series, and a handful of collaborative studies. There is much diversity in treatment approaches and outcomes in the reported literature. We have aggregated published case reports and case series into quantitative and narrative synthesis to draw evidence-based conclusions toward clinical features, atypical and rare findings, systemic associations, disease course, and treatment outcomes. The analysis suggested the disease mostly affects young individuals with a female predilection. Anterior chamber and vitreous inflammation are common than previously believed. The most prevalent pattern of retinal vasculitis in IRVAN eyes is mixed vasculitis, followed by arteritis and phlebitis. Most eyes at the time of presentation have capillary nonperfusion and require treatment. Most eyes retain good visual acuity; however, treatment is required to maintain visual function. Intravitreal antivascular endothelial growth factors administered as an adjunct to retinal laser photocoagulation are more likely to improve visual outcomes. Besides, we have discussed the different hypotheses on the etiopathogenesis of the disease and stronger evidence suggests an inflammatory origin of the disease., Competing Interests: Conflict of interest statement: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s), 2022.)

Herbal drugs play an imperative role in healthcare programs in developing countries. Curry leaves have wide medicinal importance and are used to treat various diseases traditionally. The current study was carried out to estimate the extent of mercury toxicity and the potential effect of curry leaves against defined toxicity. The study group comprised 24 rats weighing between 130 and150 g. Group 1 was kept normal, and group 2 was exposed to mercury at 0.4 mg/kg of body weight in the form of mercuric chloride (HgCl 2 ). The group 3 animals were treated with curry leaves with a dosage of 300 mg/kg of body weight. Group 4 was treated with curry leaves along with mercury with a dosage of 300 and 0.4 mg/kg consecutively. After 28 days, the rats were killed. Blood sample of all groups were evaluated separately to determine the results of different parameters. The results show that ALP, AST, ALT, urea, bilirubin, and creatinine increased with mercury application and decreased with curry leaf exposure. SOD, CAT, GPx, and GR of the liver as well as the kidney depleted on mercury exposure whereas they increased with curry leaf application. HDL increased with curry leaf application and decreased with mercury treatment, while LDL, triglyceride, and cholesterol decreased with curry leaves and increased with mercury exposure. Organ index in mercury along with curry leaf application got close to normal., Competing Interests: The authors do not have any conflict of interest., (© 2021 The Authors. Food Science & Nutrition published by Wiley Periodicals LLC.)

Objective: To explore and assess the contraceptive access, choices, and discontinuation among the urban users in Karachi using the last two Demographic and Health Surveys in Pakistan., Methods: A comparative analysis of the six districts of Karachi (Urban only) using Pakistan Demographic and Health Survey 2012-13 (sample size 2324) and 2017-18 (sample size 2896) of the currently married women of reproductive age 15-49 years was designed and conducted. For the current study, we used descriptive statistics on contraceptive use, method-mix, unmet need for family planning, method-specific discontinuation, sources of modern contraceptive use by channel (public and private), and exposure to family planning messaging., Results: The analysis of the PDHS indicated that the mCPR for Karachi Urban remained stagnant at 35%. However, CPR (all methods) improved from 48% to 52% mainly because of an increase in the traditional contraceptive methods. On the other hand, there was an increase in unmet need between the two DHS surveys from 13% to 16%. The possible explanation is inadequate resource allocations, affordability of the services, poor quality of care, and fear of side effects, among other factors. The supply-side situation indicates that the private sector holds a significant share of family planning service delivery. However, the decline of 15% in the current share of services from the private sector in Karachi's urban areas since 2012-13 PDHS data. The desire for pregnancy, method failure, and side effects remained three significant reasons for the method discontinuation., Conclusions: The present study reports a high unmet need for family planning and a stagnant mCPR for urban Karachi between the two demographic surveys. In addition, the data reveals private sector taking over the public sector for the delivery of modern contraceptive methods while the major reasons for method-specific discontinuation illustrates a similar trend at national and urban Karachi level.

Objective: To report outcomes of 27 gauge pars plana vitrectomy for the management of a variety of simple to complex posterior segment disorders., Methods: This retrospective cohort study was conducted at the Shifa International Hospital, Islamabad, Pakistan, and comprised data of all patients who underwent 27 gauge pars plana vitrectomy between July 1, 2015, and June 30, 2019, for a variety of indications. Data noted included age, gender, laterality, diagnosis, pre-operative visual acuity, date of surgery and surgical details, including operating time and complications. Best corrected visual acuity at 3 months was also recorded. Data was analysed using SPSS 21., Results: Of the 574 patients, 355(62%) were males and 219(38%) were females. The overall mean age was 55±16.9 years. There were total 665 eyes as 91(15.8%) patients underwent bilateral surgeries. The most common surgical indications were diabetic tractional retinal detachment 196(29.5%) and vitreous haemorrhage 191(28.7%). Mean operating time was 62± 37 minutes. With the exception of 0.34% cases where 20 gauge fragmatome was used, no case required conversion to 20 gauge system, while 25 gauge trocar was used for silicon oil injection. Per-operative complications included iatrogenic retinal tear 2(0.3%) eyes and supra choroidal silicon oil migration 1(0.15%) eye. Post-operative complications were raised intraocular pressure 7(1.05%), endophthalmitis 1(0.15%) eye, haemorrhagic occlusive retinal vasculitis 1(0.15%) eye and rhegmatogenous retinal detachment 2(0.3%) eyes. Mean best corrected visual acuity improved from 1.62± 0.68 to 0.4± 0.38 logarithm of minimum angle of resolution (p<0.001)., Conclusions: The 27 gauge pars plana vitrectomy was found to be a safe and effective procedure for both simple and complex retinal pathologies requiring significant surgical manipulation.

Objective: To report the uptake, satisfaction, and quality of family planning services in the clients of a private sector organisation during Covid-19 in Pakistan and compare it with the situation before Covid-19 pandemic., Methods: This paper is based on the client exit interview data collected before and then after the outbreak of Covid-19, using a structured questionnaire. Clients were chosen at the exit of the social franchise (SF) clinics, situated in rural and peri-urban areas, and beneficiaries of the outreach services delivery channel in the remote rural area. Descriptive analysis was carried out in SPSS, and frequencies and percentages were computed., Results: All respondents were married women of reproductive age (MWRA) with an average age of 30 years, with either no or very low literacy levels. During the pandemic, overall utilization of the intrauterine contraceptive devices (IUCDs) declined, while the condom remained popular. Client satisfaction remained high in both service delivery channels during a pandemic. However, some results varied vis-à-vis the residence of the client., Conclusions: All respondents were married women of reproductive age (MWRA) with an average age of 30 years, with either no or very low literacy levels. During the pandemic, overall utilization of the intrauterine contraceptive devices (IUCDs) declined, while the condom remained popular. Client satisfaction remained high in both service delivery channels during a pandemic. However, some results varied vis-à-vis the residence of the client.

Objectives: To determine the frequency and severity of surgical Vitreo-Retinal diseases during COVID-19 lockdown period (LP) and compare it with same period last year., Methods: Single hospital based retrospective Cohort Study. Data of the patients that underwent retinal surgeries during the COVID-19 LP i.e., 23-03-2020 till 23-06-2020 and same period last year i.e., 23-03-2019 till 23-06-2019 was analyzed., Results: One hundred thirty-six eyes of 105 patients were included. Among these eyes, 48 (35.3%) were operated during the COVID-19 LP while 88 (64.7%) were operated during the same time last year. A decline of 45.5% (p=0.023) was observed in the frequency of surgeries during the LP. Mean age of patients during the LP was 43.2 ± 20.3 years compared to 48.4 ± 17.9 years last year. There was reduction in the surgeries for Diabetic Tractional Retinal Detachment (11.4% vs 4.2% during LP, p=0.166), Vitreous hemorrhage (10.2 % vs 8.3% during LP, p=0.04), Full thickness macular hole (3.4% vs 0% during LP) and Epiretinal membrane (12.5% vs 0% during LP). While Rhegmatogenous retinal detachment (27.3% vs 58.3% during LP, p<0.001) among other disorders had a higher proportion during the LP., Conclusion: The decline in the frequency of retinal surgeries during the LP is indicative of complex pathologies presenting later with more advanced disease. However, earlier presentation and an increase trend in surgeries for RRD during the LP shows the positive impact of free time on the health concerns of our population., Competing Interests: Conflict of interest: None to declare., (Copyright: © Pakistan Journal of Medical Sciences.)

Background: Egg yolk is inevitably associated with risks of microbial contamination and anti-cryoprotectant agents that necessitate the investigation of some synthetic alternatives., Objective: To investigate the potential of carboxylated poly-L-lysine (CPLL) as a replacement for egg yolk during the cryosurvivability of Nili-Ravi buffalo sperm., Materials and Methods: Semen collected from four Nili-Ravi buffalo bulls (two ejaculates / bull / day; total 40 ejaculates for five replicates) was cryopreserved in different experimental extenders viz: Control (CPLL 0%, egg yolk 20%); E1 (CPLL 5%, egg yolk 15%); E2 (CPLL 10%, egg yolk 10%); E3 (CPLL 15%, egg yolk 5%) and E4 (CPLL 20%, egg yolk 0%). Post-thaw quality was assessed in terms of sperm motility, plasma membrane integrity (PMI), viability, live:dead ratio, lipid peroxidation of sperm and total antioxidant capacity of seminal plasma., Results: Sperm motility improved (P<0.05) in extenders replacing 5%, 10% and 15% egg yolk with CPLL. Sperm PMI, viability and live:dead ratio also improved (P<0.05) in extenders replacing 10%, 15% and whole (20%) egg yolk with CPLL. In contrast, sperm DNA integrity was not different (P>0.05) when CPLL replaced egg yolk at any level. The lipid peroxidation level decreased with a concomitant increase in total antioxidant activity of seminal plasma when CPLL replaced egg yolk at 5%, 10%, 15% and 20%., Conclusion: Replacement of 15% egg yolk in the extender with CPLL improves all sperm quality parameters: motility, PMI, viability, live:dead ratio, lipid peroxidation of sperm and total antioxidant activity of seminal plasma.

Background: von Hippel-Lindau (VHL) syndrome is a multisystem neoplastic disorder involving eyes, central nervous system, kidneys, spine, and other tissues. A retinal capillary hemangioma (RCH) is the earliest manifestation of the VHL disease in most cases. Areas covered: This paper aims to provide an up-to-date review of the current literature about von Hippel-Lindau syndrome. Molecular background, systemic and ocular features of the diseases as well as the utility of newer imaging modalities in diagnosis and monitoring of ocular VHL disease have been described. Besides, we have discussed newer treatment modalities and therapeutic targets. Conclusion: Modern imaging technologies like optical coherence tomography and optical coherence tomography angiography are tools of the trade, in making an appropriate diagnosis and monitoring disease activity and response to treatment. Peripheral RCH may be treated using laser photocoagulation in tumors up to 3000 µm. Vascular endothelial growth factor suppression can help in reducing tumor activity and stabilize the tumor size; however, it does not regress the RCH.

Asphaltum, a mineral exudate from the mountains, is an ayurvedic medicine believed to be a panacea for male reproductive health issues. The objective of the study was to evaluate asphaltum in terms of phytochemical components, radical scavenging activity (RSA), in vitro dose tolerability, and cryosurvivability of buffalo sperm. Asphaltum was procured from an authentic source and confirmed for the presence of flavonoids, terpenoids, saponins, tannins, alkaloids, steroids, and glycosides. It showed good RSA as confirmed by the DPPH (2,2-diphenyl-1-picrylhydrazyl) assay. In vitro dose tolerability of buffalo sperm ( n  = 3, replicate = 4, ejaculates = 24) for asphaltum was assessed at 0.75%, 1.5%, 2.25%, 3.0%, 3.75%, 4.5%, 5.25%, and 6.0% (w/v). Buffalo sperm showed good tolerance up to 3% of asphaltum in terms of sperm progressive motility and plasma membrane integrity. Buffalo semen ( n  = 3, replicates = 4, ejaculates = 24) was cryopreserved in extender supplemented with 0.0%, 0.75%, 1.5%, 2.25%, and 3.0% (w/v) asphaltum and sperm quality was assessed at post-dilution, post-cooling, and post-thaw. After dilution motility, viability and livability; post-cooling motility and plasma membrane integrity; and post-thaw motility, plasma membrane integrity, viability, livability, DNA integrity, sperm RSA, sperm total lipids, sperm mitochondrial activity, and total antioxidant activity of semen were improved by 3%. In conclusion, asphaltum supplementation in an extender at 3% improves the post-thaw quality and antioxidant activity of buffalo semen.

Objective: To assess the rate of infectious endophthalmitis with anti-vascular endothelial growth factor injection, and to evaluate institutional procedure protocol in this regard., Methods: The retrospective consecutive case series was conducted at Shifa International Hospital, Islamabad, Pakistan, from August 2018 to January 2019, and comprised 5-year data from August 2014 to July 2019 related to patients who underwent intravitreal anti-vascular endothelial growth factor injections. Data was analysed using SPSS 21., Results: Of the 7,542 injections administered to 2,734 patients, 5,976(79.2%) were bevacizumab, 1,081(14.3%) ranibizumab and 485(6.4%) aflibercept. There was 1(0.01%) case of infectious endophthalmitis which was treated with 25 gauge pars plana vitrectomy., Conclusions: The institutional procedure protocol was found to be effective as the rate of infectious endophthalmitis was lower than what is reported in literature.

This study reports the first evaluation of sperm hyaluronan binding assay (HBA) for predicting the fertility of Nili-Ravi buffalo bulls in relation to standard parameters of sperm quality. Cryopreserved semen doses of low (n = 6), medium (n = 3) and high fertility (n = 8) bulls based on their respective return rates were used. Significantly, more spermatozoa bound to hyaluronan from the most fertile bulls (57.15% ± 1.44) compared with medium (42.46% ± 1.08) and low fertility bulls (29.70% ± 0.78). A strongly positive correlation (r = .824, p < .01) was found between HBA and fertility that predicts a 67.9% variability (r 2  = .679, p < .01) in fertility. HBA was also strongly positively correlated with sperm viability (r = .679, p < .01) followed by their live/dead ratio (r = .637, p < .01), uncapacitated spermatozoa (r = .631, p < .01), normal apical ridge (r = .459, p < .01), motility (r = .434, p < .01), mature spermatozoa with low residual histones (r = .364, p < .01), high plasma membrane integrity (r = .316, p < .01) and nonfragmented DNA levels (r = .236, p < .05). It was negatively correlated with spermatozoa having reacted acrosome (r = -.654, p < .01). A fertility model built using a combination of sperm HBA and either sperm livability or viability predicts, respectively, 86.1% (r 2  = .861, p < .01) and 85.9% (r 2  = .859, p < .01) variability in buffalo bull fertility. In conclusion, sperm HBA may prove to be a single robust predictor of Nili-Ravi buffalo bull fertility., (© 2021 Wiley-VCH GmbH.)

The purpose of this survey was to evaluate the level of awareness and practices regarding macular ganglion cell complex (GCC) scans for early detection of glaucoma. The study design was descriptive cross-sectional and the sampling technique was non-probability convenient method. Data was collected through an online survey, from 100 practicing ophthalmologists and optometrists of Pakistan in two weeks, from January 20 to February 03 2019. Data were analysed using Microsoft Excel 2016. From the results it is strongly evident that significant number of respondents recorded the retinal nerve fibre layer (RNFL) to be the first layer affected as glaucoma progresses, which depicts lack of knowledge among eye care practitioners. Furthermore, both the groups (ophthalmologists and optometrists), used macular GCC scan the least as compared to the RNFL (optic nerve head) scan and visual field tests for early diagnosis of glaucoma. It demonstrated lack of knowledge and practices of macular GCC scan for glaucoma among eye care practitioners.

Carboxylated poly-l-lysine (CPLL), an ampholytic polymer, has remarkable cryoprotective properties. It was hypothesized that CPLL will reduce/replace glycerol in extender and improve the freezability of buffalo semen. The objective was to evaluate various combinations of CPLL and glycerol in extenders for any synergism toward cryosurvivability of Nili-Ravi buffalo sperm. Semen collected from four Nili-Ravi buffalo bulls (ejaculates = 40; replicates = 5) was diluted in tris-citric acid based extenders, Control: (0% CPLL +7% Glycerol); E1: (1% CPLL +6% Glycerol); E2: (2% CPLL +5% Glycerol); E3: (3% CPLL +4% Glycerol); E4: (4% CPLL +3% Glycerol); E5: (5% CPLL +2% Glycerol); E6: (6% CPLL +1% Glycerol), and E7: (7% CPLL +0% Glycerol), and cryopreserved using a programmable cell freezer. Percentages of post-thaw sperm motility, plasma membrane integrity, and acrosomal integrity were found to be higher ( p  < 0.05) in extenders E1, E2, E3, E4, and E5 compared to E6 and the control. Sperm livability (%; live/dead ratio) and viability (%; live sperm with intact acrosome) were higher ( p  < 0.05) in extender E4 compared to all the other extenders. Sperm DNA integrity was higher ( p  < 0.05) in extender E2, E3, E4, and E5 compared to control, E1, and E6 extenders. Sperm lipid peroxidation levels were lower ( p  < 0.05) in E3, E4, E5, and E6 compared to control, E1, E2, and E7 extenders. Total antioxidant capacity of seminal plasma was higher ( p  < 0.05) in extenders E5, E6, and E7 than control, E1, E2, E3, and E4 extenders. It is concluded that synergism between CPLL and glycerol (4% CPPL and 3% Glycerol) seems to improve the freezability of Nili-Ravi buffalo semen by reducing oxidative stress.

Aim: The study was designed to elucidate the effects of quercetin in an extender on oxidative stress, mitochondrial activity and quality of Indian red jungle fowl ( Gallus gallus murghi ) sperm during cryopreservation. Materials and Methods: Semen was collected from seven adult males through abdominal massage and evaluated for semen volume, concentration, and motility. The qualifying semen ejaculates having >80% motility were diluted in red fowl extenders with 0 (control), 5, 10, 15, and 20 mM quercetin. Diluted semen was frozen following a glycerol-based protocol. Semen quality (motility, plasma membrane integrity, viability, acrosome integrity, and chromatin condensation status) and biochemical parameters (mitochondrial activity, ferric reducing antioxidant power, and malondialdehyde [MDA]) were determined at various stages of cryopreservation. Results: Sperm motility, plasma membrane integrity, viability, acrosome integrity, and chromatin condensation were recorded highest ( p  < 0.05) with 15 mM quercetin compared with 5, 10, and 20 mM quercetin and control at post-dilution, cooling, equilibration, and freeze-thawing. Nevertheless, mitochondrial activity and antioxidant potential were recorded highest with 15 mM quercetin compared with all experimental extenders at post-equilibration and freeze-thawing. MDA concentration in sperm and seminal plasma were recorded lowest ( p  < 0.05) in the extender having 15 mM quercetin at post-equilibration and freeze-thawing. Cryopreservation stages showed negative effects ( p  < 0.05) on semen quality parameters, irrespective of experimental extenders. Conclusions: It is concluded that quercetin (15 mM) supplementation in red fowl extender improves sperm motility, plasma membrane integrity, viability, acrosome integrity, chromatin condensation, and mitochondrial activity by elevating the total antioxidant potential and ameliorating lipid peroxidation during cryopreservation.

Objectives: Urinary tract infections are the second most common bacterial infections occurring at all ages and both sexes. The increasing rate of antibiotic resistance is a global concern. The use of routinely used antibiotics is resulting in treatment failure. The objective of this study was to diagnose the urinary tract infections by routine culture sensitivity test and by molecular methods., Methods: This study was conducted in Microbiology laboratory, Bolan Medical Complex Hospital, Quetta, from July 1 st to 31 st March 2019. Isolates were identified biochemically by API20E & API20NE. Antibiogram was performed using disc diffusion Kirby Bauer technique. The 16S rDNA gene approach was used for molecular identification of bacterial isolates. The presence of the bla NDM-1 gene was identified by polymerase chain reaction (PCR)., Results: We isolated 146 bacterial isolates namely Escherichia coli (n=99) 67.80%, Klebsiella pneumoniae (n=33) 22.60%, Pseudomonas aeruginosa (n=11) 7.53% and Proteus mirabilis (n=3) 2.05% from 2032 urine samples. The resistance pattern was dominated by Multi Drug Resistance (MDR). Remarkably, four isolates of Escherichia coli (n=3) and Klebsiella pneumoniae (n=1) were displaying resistance against a range of antibiotics used in the study, including carbapenems but sensitive to tigecycline and polymyxins only, suggesting extensive drug resistance having bla NDM-1 gene., Conclusion: This is the first report on direct molecular detection of bacterial pathogens from urinary tract infected patients in Balochistan. The presence of bla NDM-1 in different bacterial species and their extensive drug resistance pattern poses a significant clinical threat. Molecular detection of bacteria and resistant gene may reduce the diagnostic time of patients., Competing Interests: Conflict of Interest: None., (Copyright: © Pakistan Journal of Medical Sciences.)

The antimicrobial properties of honey have stimulated interest in evaluating it as an alternative to antibiotics for cryopreserved buffalo semen. Acacia nilotica , Brassica campestris and Ziziphus jujuba honey were analyzed and Z. jujuba honey was found suitable in terms of quality and purity. Buffalo semen (24 ejaculates) was studied for in vitro dose tolerability to Z. jujuba honey (0.1%-1%), and up to 0.2% (v/v) was not toxic to buffalo spermatozoa. Afterward, semen from three bulls (24 ejaculates) was cryopreserved (four replicates) in tris-citric egg yolk extender supplemented with 0.1% or 0.2% honey, with or without streptomycin-penicillin (SP); extender with SP used as a control. After dilution and cooling, extender without antibiotics but with 0.2% honey was better ( p  < 0.05) than control in terms of sperm motility and plasma membrane integrity. After thawing, the extenders containing 0.1% honey with antibiotics and extender having 0.2% honey without antibiotics consistently yielded good results in terms of all parameters studied compared to control and other extenders. The extender containing 0.2% honey without antibiotics was better ( p  < 0.05) in terms of total aerobic bacterial count. In conclusion, 0.2% honey improves the post-thaw quality of buffalo spermatozoa and can replace the use of antibiotics in extender through its antimicrobial activity.

The free radical scavenging activity (RSA) of Nigella sativa extract and its efficiency for cryopreservation of buffalo spermatozoa was investigated. In experiment 1, Nigella sativa extract was prepared and evaluated for RSA using 2,2-diphenyl-1-picrylhydrazyl assay. The results showed increased pattern of RSA at 1%-5% of Nigella sativa extract. In experiment 2, buffalo semen from three bulls (24 ejaculates) was incubated at 0%, 0.1%, 0.3%, 0.5%, 1%, 1.5%, 2%, 3%, 4%, 5% and 6% extract to assess in vitro tolerability to Nigella sativa in terms of progressive motility (PM). Buffalo spermatozoa showed tolerance to all levels; rather, sperm PM was increased at 1%-4% extract. In experiment 3, semen from three bulls (24 ejaculates) was cryopreserved with 0%, 1%, 2%, 3%, 4% and 5% of Nigella sativa extract. Sperm PM and plasma membrane integrity (PMI) were evaluated after dilution and cooling, while PM, PMI, viability and DNA integrity were evaluated after thawing. Nigella sativa extract at 4% in extender improved (p < .05) post-dilution, post-cooling and post-thaw sperm quality. In conclusion, Nigella sativa extract at all concentrations (1%-6%) showed antioxidant activity and its supplementation at 4% in extender improved buffalo sperm quality at all stages of cryopreservation., (© 2018 Blackwell Verlag GmbH.)

Background: Studies have documented the impact of quality family planning services on improved contraceptive uptake and continuation, however, relatively little is known about their quality of service provision especially in the context of social franchising. This study examined the quality of clinical services and user experiences among two models in franchised service providers in rural Pakistan., Methods: This facility-based assessment was carried out during May-June 2015 at the 20 randomly selected social franchise providers from Chakwal and Faisalabad. In our case, a franchise health facility was a private clinic (mostly) run by a single provider, supported by an assistant. Within the selected health facilities, a total 39 user-provider interactions were observed and same users were interviewed separately., Results: Most of the health facilities were in the private sector. Comparatively, service providers at Greenstar Social Marketing/Population Services International (GSM/PSI) model franchised facilities had higher number of rooms and staff employed, with more providers' ownership. Quality of service indices showed high scores for both Marie Stopes Society (MSS) and GSM/PSI franchised providers. MSS franchised providers demonstrated comparative edge in terms of clinical governance, better method mix and they were more user-focused, while PSI providers offered broader range of non-FP services. Quality of counselling services were similar among both models. Service providers performed well on all indicators of interpersonal care however overall low scores were noted in technical care. For both models, service providers attained an average score of 6.7 (out of the maximum value of 8) on waste disposal mechanism, supplies 12.5 (out of the maximum value of 15), user-centred facility 2.7 (out of the maximum value of 4), and clinical governance 6.5 (out of the maximum value of 11) and respecting clients' privacy. The exit interviews yielded high user satisfaction in both service models., Conclusions: The findings seem suggesting that the MSS and GSM/PSI service providers were maintaining high quality standards in provision of family planning information, services, and commodities but overall there was not much difference between the two models in terms of quality and satisfaction. The results demonstrate that service quality and client satisfaction are an important determinant of use of clinical contraceptive methods in Pakistan.

Routinely, swim-up method is used to separate high-quality sperm; however, long processing time and close cell-to-cell contact during the centrifugation step are inevitable elements of oxidative stress to sperm. The objective was to evaluate Sephadex ™ and glass wool filtration to separate motile, intact and viable sperm for in vitro fertilization in buffalo. The cumulus-oocyte complexes (COCs) were collected from ovaries of slaughtered buffaloes by aspiration and matured for 24 hr in CO 2 incubator at 38.5°C and 5% CO 2 . Matured COCs were rinsed twice in fertilization TALP and placed in the pre-warmed fertilization medium without sperm. Cryopreserved buffalo semen was thawed at 37°C for 30 s and processed through Sephadex ™ , glass wool filtration and swim-up (control). Total and motile sperm recovery rates were assessed, resuspended in fertilization TALP and incubated for 15-20 min in CO 2 incubator. Samples prepared by each method were divided into two aliquots: one aliquot was studied for sperm quality (progressive motility, membrane integrity, viability, liveability), while the other was subjected to co-incubation with sets of 10-15 in vitro matured oocytes. Data on sperm quality were analysed by ANOVA, while in vitro fertilizing rates were compared by chi-squared test using SPSS-20. Least significant difference (LSD) test was used to compare treatment means. Glass wool filtration yielded higher total and motile sperm recovery rate, while Sephadex ™ filtration improved (p < .05) sperm quality (progressive motility, membrane integrity, viability, liveability). Sperm preparation through Sephadex filtration yielded higher in vitro fertilization rate in terms of cleavage rate compared to glass wool filtration and swim-up (control). In conclusion, cryopreserved Nili-Ravi buffalo sperm selected through Sephadex filtration showed improved quality and yielded better fertilization rates (cleavage rate) of in vitro matured/fertilized oocytes. Sephadex filtration could be a promising technique for use in in vitro fertilization in buffalo., (© 2017 Blackwell Verlag GmbH.)

Sperm sexing through flow-sorting technology is relatively expensive, requires considerable technical support and is actually not practicable in many developing countries. The aim of this study was to investigate the feasibility of producing enriched pools of X or Y chromosome-bearing sperm by a modified swim-up method. For this purpose semen was collected from five mature Nili-Ravi buffalo bulls for a period of six weeks. The qualifying ejaculates were divided into two aliquots for further processing through modified swim-up or control (untreated). After processing, semen was cryopreserved in tris citric acid extender using standard techniques. Semen quality was assessed at pre dilution, post dilution and post thawing. Validation of technique was done by using SYBR ® green real time PCR using two sets of primers, PLP and SRY for X and Y chromosome of buffalo genes, respectively. Sperm recovery rates, pre freeze and post thaw sperm quality were found significantly higher in X chromosome bearing sperm fraction than Y chromosome bearing fraction and control. Mean fold relative expression of X bearing sperm was significantly higher (4-5 fold) in X chromosome bearing fraction of supernatant than Y chromosome bearing fraction (0.06 fold), similarly mean fold relative expression of Y chromosome bearing sperm was significantly higher in Y chromosome bearing fraction (4 fold) of supernatant than X chromosome bearing fraction (0.15 fold) compared to control (1.00). In conclusion, a modified swim up method proved to be an effective method for Nili-Ravi buffalo sperm sexing as validated by real time PCR., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Workers in pesticide manufacturing industries are constantly exposed to pesticides. Genetic biomonitoring provides an early identification of potential cancer and genetic diseases in exposed populations. The objectives of this biomonitoring study were to assess DNA damage through comet assay in blood samples collected from industry workers and compare these results with those of classical analytical techniques used for complete blood count analysis., Methods: Samples from controls (n = 20) and exposed workers (n = 38) from an industrial area in Multan, Pakistan, were subjected to various tests. Malathion residues in blood samples were measured by gas chromatography., Results: The exposed workers who were employed in the pesticide manufacturing industry for a longer period (i.e., 13-25 years) had significantly higher DNA tail length (7.04 μm) than the controls (0.94 μm). Workers in the exposed group also had higher white blood cell and red blood cell counts, and lower levels of mean corpuscular hemoglobin (MCH), MCH concentration, and mean corpuscular volume in comparison with normal levels for these parameters. Malathion was not detected in the control group. However, in the exposed group, 72% of whole blood samples had malathion with a mean value of 0.14 mg/L (range 0.01-0.31 mg/L)., Conclusion: We found a strong correlation (R (2) = 0.91) between DNA damage in terms of tail length and malathion concentration in blood. Intensive efforts and trainings are thus required to build awareness about safety practices and to change industrial workers' attitude to prevent harmful environmental and anthropogenic effects.