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Objective: To compare the effect of pre-mixed human insulin with insulin analogue in diabetic control among type-2 Diabetes mellitus patients at tertiary care hospital. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital, Rawalpindi, Pakistan, from Jun 2021 to Apr 2022. Methodology: Eleven hundred and fifty-six patients with poorly controlled type-2 diabetes on oral hypoglycemic agents requiring insulin were recruited for the study. Patients were divided into two groups via a lottery method. Group-A received the pre-mixed human insulin, while Group-B received the Insulin analogue advised by the consultant endocrinologist or medical specialist according to the requirements based on recent investigations. Diabetes control was compared in both groups at the end of twelve weeks of treatment. Results: Out of 1156 patients with type-2 diabetes mellitus included in the study, 810(70.1%) were male, while 346(29.9%) were female. The mean duration of DM in the study participants was 3.42±4.44 years. At the end of three months, 978(84.6%) patients had good glycemic control, while 178(15.4%) patients had poor glycemic control. Statistical analysis revealed that the type of insulin used to manage these patients had no significant relationship with glycemic control in our study participants (p-value>0.05). Conclusion: No statistically significant difference was observed in the number of patients achieving adequate glycemic control between those using pre-mixed human insulin and those using insulin analogue in our study.

In this research article, the focus is on the idea of Muteness and Oppression of Women in the novel, The Wasted Vigil (2008). Two theories, i.e., Patriarchy and A Muted Group have been employed as a theoretical framework for the research. This research is qualitative in nature. The objectives are designed to find and dissect the factors that contribute to social oppression and muteness. In the light of A Muted Group and Patriarchy Theories, the research attempts to expound the aspects of gender oppression, muteness and social marginalization. MGT, pioneered by scholars like Ardener and later elaborated by Kramarae, serves as a crucial lens through which the silencing of women was examined. Simultaneously, the patriarchal tenets discussed by Connell and hooks offer a space to explore the systemic hierarchy that marginalizes women. Excerpts from the novel depicted women as not merely passive victims but also strong and resistant, subverting yet remaining entrapped within male-dominated structures. The findings revealed that the women characters in The Wasted Vigil (2008) depict muted groups whose attempts at resistance were both courageous and paradoxically constrained by patriarchal discourse. Secondly, the portrayal of oppressive factors ranged from physical violence to institutional forms of control. While acts of resistance were observed, they frequently occurred within boundaries established by the dominant male society, thereby questioning the efficacy of such resistance. This investigation contributes masterfully to the discourse on gender inequity and social oppression, employing meticulous textual analysis supported by influential theoretical paradigms.

Tomato leafminer, Tuta absoluta is an indigenous insect pest of solanaceous crops in South America, which is now an important quarantine insect pest in many other parts of the world. Geographical range of T. absoluta is rapidly increasing. It has been spreading in Asian countries since first reported from Turkey in 2009, Azarbaijan province in North Western Iran in 2010 and in 2014 it has reached India. Its damage is severe on tomatoes and possible threat to food production hence an emerging problem to food security. Tuta absoluta was not reported earlier in Pakistan. A high attack of Tuta absoluta in 2017-2018 in Multan on tomato crop was observed. Samples were recovered from tomatoes grown under plastic tunnels. Detection was carried out by incubated infested tomato leaves and fruits till adult eclosion in the mesh cages. Larvae were observed under microscope. Leaves and fruit damage symptoms were compared with available data. Adults were identified morphologically. Genitalia of adults proved that insect pest was tomato leafminer, Tuta absoluta. Furthermore, it was confirmed through sex pheromone traps where moths of Tuta absoluta were caught from same location from where samples were taken. Hence, it is confirmed first report of T. absoluta in Pakistan. Further studies are needed to confirm the occurrence of this emerging insect pest on alternative host plants in different areas of Pakistan. It's an alert for quarantine department to take strict measures for its entry points through trade before it emerges as threatening insect pest in Pakistan to tomato industry. [ABSTRACT FROM AUTHOR]

Cotton is an important cash and fiber crop of Pakistan. Cotton sucking insect pests cause major losses in yield of this crop. Chemical insecticides due to their quick mode of action are considered as the most effective way among the farmers for controlling these insect pests. Present study was designed to evaluate the compatibility of different insecticide mixtures against sucking insect pests i.e., whitefly and jassid. Compatibility of four insecticides combinations i.e., buprofezin + flonicamid, buprofezin + nitenpyram at recommended and half dose of recommended for two years. In separate experiment two combinations of pyriproxyfen + imidacloprid and pyriproxyfen + matrine applied at recommended doses (RD) and 1/2 of recommended doses (HD) were applied on cotton crop against whitefly and jassid in consecutive two years. Randomized complete block design (RCBD) was used for each experiment with three replications each year. Data were recorded 1 DBS (day before spray) and 3 DAS (days after spray) and 7 DAS of insecticides. The results revealed that buprofezin @ 500 ml + flonicamid @ 60 g (RD) was the most effective (79.24%) insecticide mixture against whitefly up to seven days followed by pyriproxyfen + matrine @ 250 and 500 ml (RD) with 74.13% reduction. While mixture of buprofezin + nitenpyram at recommended dose was effective against jassid and whitefly (76.47%) followed by pyriproxyfen + imidacloprid (71.03%). Therefore, application of insecticide mixtures reduced population of spiders, green lacewing and pirate bugs population as compared with control (untreated plot). Almost all combinations were effective as compared to control treatments even at half doses. So, these insecticides could be applied in rotation with each other to reduce insecticides resistance and combined attack of whitefly and jassid. However, it is recommended that integrated pest management approach using different control tactics for conservation of natural enemies, use of yellow sticky traps, botanicals, use of selective insecticides when needed could be the best strategy to overcome insecticides resistance problems. [ABSTRACT FROM AUTHOR]

Citrullus colocynthis has been used to treat obesity and hyperlipidemia. Nanoparticles, due to their nano size, phytochemical adsorption, improved systemic absorption and high bioavailability, can potentially improve the bioactivity of C. colocynthis. The present research focused on studying the effects of green synthesized calcium oxide nanoparticles (CaONPs) from C. colocynthis fruit extracts (CCFE) on the body weight, the atherogenic index of plasma (AIP), and the histopathology of male albino rats. Ethyl‐α-d-glucopyranoside was the major constituent of CCFE, along with phenols and fatty acids. The total phenolic and flavonoid contents of CCFE were 203.52 and 173.56 mg/g, respectively. Male albino rats (n=36) were divided into six groups (six rats per each group). Rats in different groups received a normal diet, a high‐fat diet (HFD), HFD with lovastatin (10 mg/kg), HFD with CCFE (20 mg/kg), HFD with CaONPs (2 mg/kg), and HFD with a synergistic solution of CCFE (10 mg/kg) and CaONPs (1 mg/kg), respectively. When CaONPs were administered in combination with CCFE, significant weight-lowering activity (36.36%), improved cardiovascular health as per AIP (0.12±0.01b), and fewer disturbances in liver function parameters were observed. Histological analysis at the end of the experiment showed that CaONPs were not toxic to the gastric mucosa and were slightly toxic to hepatocytes. It can be concluded that CaONPs synthesized from CCFE can be a potent weight-lowering and antilipidemic agent with fewer side effects.

In this research article, the Othering idea of Women is focused on The Wasted Vigil (2008), from the perspective of Muted Group and Patriarchy Theories. In this article, qualitative research method is used. The objective aims to scrutinize the aspects of gendered otherness and social marginalization. MGT, pioneered by scholars like Ardener and later elaborated by Kramarae, serves as a crucial lens through which the silencing of women was examined. Simultaneously, the patriarchal tenets discussed by Connell and Hooks offer a space to explore the systemic hierarchy that marginalizes women. The findings reveal that the women characters in The Wasted Vigil (2008) depict muted groups whose attempts at resistance were both courageous and paradoxically constrained by patriarchal discourse. Secondly, the portrayal of oppressive factors ranged from physical violence to institutional forms of control. Whereas the resistance’s acts were observed, they often fell within the margins established by the male’s dominant society, thereby questioning the effectiveness of such resistance.

An ethnobotanical (EB) research was conducted on the wild plants of Watala National Park (WNP) and allied villages of Barnala, District Bhimber, Azad Jammu and Kashmir (AJK), Pakistan. EB data have been collected by questionnaire method employing structured and semi-structured interviews. A total of 79 interviewees (47 male, 32 female) having age 25-65 years were included in the EB study. 92 plant species of 37 families were studied and the obtained data were compiled in an inventory form consisting of ethnomedicinal (EM) use, parts used, mode of application and EB use. For validation of EM data of plants different microstatistical tools like frequency of citation (FC), relative frequencies of citation (RFC), use value (UV), fidelity level (FL) and informant consensus factor (ICF) were used. Direct matrix ranking (DMR) and priority ranking (PR) were applied on EB data for quantitative analysis to find multiple use forms of plant(s) and calculate biotic threats for the plants. Study results depicted that FC ranged 59 to 11, RFC was 0.75 to 0.14 and UV was between 0.82 and 0.15. Leaves were the most frequently used (31%) part of plants and powder form (25%) was the most commonly used form. The highest FL was found for Senegalia modesta species (100%) and diseases such as fever, flu, headache, bronchitis and cough ranked first (0.94) in ICF analysis. DMR results showed that Senegalia modesta was the first regarding multifarious use. Fuel wood cutting and fire burning were top two threats for the flora of the area. Due to anthropogenic pressure and climatic dynamics plants of the area are under severe threats and there is urgent need to conserve the flora of WNP, District Bhimber for future generations and to introduce sustainable applications. [ABSTRACT FROM AUTHOR]

This paper presents the first quantitative ethnobotanical knowledge and practices of using native plants for different ailments from Namal Valley of Pakistan. Data was gathered by interviewing 350 informants through semi-structured questionnaires. A total of 217 taxa belonging to 166 genera and 70 families were documented. Fabaceae and Asteraceae families were found to be the most cited families (with 19 and 18 species receptively). Herbs represent the most cited life form (71%) and flower was the most widely used part (34.8%) with decoction as main mode of the utilization (41.5%). On the basis of use values, the most commonly used ethnobotanical taxa in the Valley were reported to be Euphorbia heterophylla (0.7) and Merremia dissecta (0.6). The highest RFC value was noted for Aloe vera (0.14) while highest ICF value was estimated for dental problems category (0.7). Maximum similarity index was found in the studies with Bana Valley (JI 23.9). Similarity percentage of plants uses ranges from 0% to 15.7 (Bana Valley), while dissimilarity percentage varies up to 32.5% (Soon Valley). This study highlights the medicinal flora of study area that will serve as baseline for conservation and sustainable utilization through future research on bio prospecting of potential species to develop novel drugs. [ABSTRACT FROM AUTHOR]

Abstract Patient–clinician concordance in behavior and brain activity has been proposed as a potential key mediator of mutual empathy and clinical rapport in the therapeutic encounter. However, the specific elements of patient–clinician communication that may support brain-to-brain concordance and therapeutic alliance are unknown. Here, we investigated how pain-related, directional facial communication between patients and clinicians is associated with brain-to-brain concordance. Patient–clinician dyads interacted in a pain-treatment context, during synchronous assessment of brain activity (fMRI hyperscanning) and online video transfer, enabling face-to-face social interaction. In-scanner videos were used for automated individual facial action unit (AU) time-series extraction. First, an interpretable machine-learning classifier of patients’ facial expressions, from an independent fMRI experiment, significantly distinguished moderately painful leg pressure from innocuous pressure stimuli. Next, we estimated neural-network causality of patient-to-clinician directional information flow of facial expressions during clinician-initiated treatment of patients’ evoked pain. We identified a leader–follower relationship in which patients predominantly led the facial communication while clinicians responded to patients’ expressions. Finally, analyses of dynamic brain-to-brain concordance showed that patients’ mid/posterior insular concordance with the clinicians’ anterior insula cortex, a region identified in previously published data from this study1, was associated with therapeutic alliance, and self-reported and objective (patient-to-clinician-directed causal influence) markers of negative-affect expressivity. These results suggest a role of patient-clinician concordance of the insula, a social-mirroring and salience-processing brain node, in mediating directional dynamics of pain-directed facial communication during therapeutic encounters.

Background Neonatal mortality remains unacceptably high in many countries. WHO recommends that all newborns be assessed during the postnatal period and should seek prompt medical care if there is any danger sign. However, in many developing countries, only a small proportion of women receive postnatal care. Also, the quality of care in public health facilities is sub-optimal. Methods We designed an intervention package that included community health worker-assisted pregnancy and birth surveillance, post-natal visits to assess newborns on the first, third, seventh and twenty-eighth days of birth, referral for facility-based care, and establishing a newborn stabilization unit at the first level referral health facility. We did a quasi-experimental, propensity-score matched, controlled study in the Sylhet region of Bangladesh. We used a cross-sectional survey method at baseline and endline to measure the effect of our intervention. We considered two indicators for the primary outcome–(a) all-cause neonatal mortality rate and (b) case fatality of severe illness. Secondary outcomes were the proportion of neonates with signs and symptoms of severe illness who sought care in a hospital or a medically qualified provider. Results Our sample size was 9,940 live births (4,257 at baseline, 5,683 at end line). Our intervention was significantly associated with a 39% reduction (aRR = 0.61, 95% CI: 0.40–0.93; p = 0.046) in the risk of neonatal mortality and 45% reduction (aRR = 0.55, 95% CI: 0.35–0.86; p = 0.001) in the risk of case fatality of severe illness among newborns in rural Bangladesh. The intervention significantly increased the care-seeking for severe illness at the first-level referral facility (DID 36.6%; 95% CI % 27.98 to 45.22; pInterpretation Our integrated community-facility interventions model resulted in early identification of severely sick neonates, early care seeking and improved treatment. The interventions led to a significant reduction in all-cause neonatal mortality and case fatality from severe illness.

Forests have pivotal role in life sustenance of indigenous people of the area and economy of any country at mass level. Forest health, diversity and richness depends various environmental parameters. In this study, impact of edaphic and physiographic factors on plant communities of reserved forest of Sathan Gali (Mansehra), Pakistan is analyzed. Quantitative and qualitative characteristics of plant species were studied dividing the area into 13 stands on physiognomic features. In this analysis 136 plant species of 58 families were classified into four prominent plant communities through TWINSPAN approach. The family index depicted that Asteraceae was dominant among 58 families. Biological spectrum (BS) expressed Therophytes as the dominant plants with 27.34% species, while leaf size spectrum (LSS) classification showed Mesophytes having 25.83% species contribution. Importance value index (IVI) analysis proved that Pinus wallichiana had highest value (351.69) followed by Fragaria nubicola (62.88). In analysis, maximum species diversity (MSD) was found in Pinus-Pteris-Sarcococca community (0.102) while species richness (SR) was in Pinus-Digitaria-Sarcococca community (1.87) whereas maximum species maturity (MSM) was found in Pinus-Cedrus-Vibernum community (65.74). In two statistical analyses; it was found that DCA ordination of reserved forest indicated that the maximum gradient length was 3.32 for axis 1 and 2.57 for axis II while CCA ordination revealed that the maximum eigenvalue was 0.49 for axis 1 and 0.40 for axis II. Among environmental variables the maximum positive strength and impact on composition of community was recorded for altitude and phosphorous (P) while maximum negative strength was recorded for barometric pressure and temperature. [ABSTRACT FROM AUTHOR]

In the study of chemical graph theory, an enormous number of research analyses have confirmed that the characteristics of chemicals have a nearby connection with their atomic structure. Topological indices were the critical tools for the analysis of these chemical substances to consider the essential topology of chemical structures. Topological descriptors are the significant numerical quantities or invariant in the fields of chemical graph theory. In this study, we have studied the crystal structure of copper oxide (Cu2O{{\rm{Cu}}}_{2}{\rm{O}}) chemical graph, and further, we have calculated the ev-degree- and ve-degree-based topological indices of copper oxide chemical graph. This kind of study may be useful for understanding the atomic mechanisms of corrosion and stress–corrosion cracking of copper.

Snakebite and scorpion sting are the most neglected public problems especially in the poor rural communities of South Asia including Pakistan. The frequency of snakebites and scorpion stings in Pakistan has increased tremendously due to destruction of habitats of snakes and scorpions as a result of deforestation and the consequent migration of these poisonous animals towards human settlements. The management of the frequency of snake bites and scorpion stings has been unsatisfactory in this region. In order to investigate and collect information from the inhabitants on the curative values of plants for treatment of snakebite and scorpion sting, an ethnobotanical survey of medicinal plants was carried out from September 2015 to July 2016 to document information from 14 villages of Namal Valley of District Mianwali, Punjab, Pakistan. The Martin method was followed for collecting information from informants about the medicinal plants used for these poisonous bites. A total of 68 plant species belonging to 37 families and 61 genera was recorded. Information obtained included the common names and their families while photographs of all plants recorded were obtained using the Olympus digital camera. The plants documented were herbs (54%), shrubs (26%) and trees (20%). The family Solanaceae was found to be the most frequently used. The dominant plant part in the recipes obtained is the leaf (22%). The most frequently used mode of preparation in the recipes was the paste. Calotropis procera, Arisaema jacquemontii, Albizia lebbeck and Portulaca oleracea were the major medicinal plants recorded. The present study is the first ethnobotanical survey of the area and the first report of the medicinal plants used in the treatment of poisonous snake bites and scorpion stings among the indigenous communities of Namal Valley of District Mianwali, Punjab, Pakistan. [ABSTRACT FROM AUTHOR]