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Khunsa Junaid,1 Hassan Ali,2 Ali Akram Khan,3 Taimoor Akram Khan,4 Aabish Mehreen Khan,5 Amjad Khan,6 Rabia Nazim,7 Khadija Tahira8 1Department of Public Health, Institute of Social and Cultural Studies, University of Punjab, Lahore, Pakistan; 2Department of Public Health, Institute of Social and Cultural Studies, University of Punjab, Lahore, Pakistan; 3Department of Community Medicine, King Edward Medical University, Lahore, Pakistan; 4Department of Community Medicine, King Edward Medical University, Lahore, Pakistan; 5Department of Community Medicine, King Edward Medical University, Lahore, Pakistan; 6Department of Public Health, University of Haripur, Khyber Pakhtunkhwa, Pakistan; 7Department of Community Medicine, King Edward Medical University, Lahore, Pakistan; 8Department of Public Health, Institute of Social and Cultural Studies, University of Punjab, Lahore, PakistanCorrespondence: Khunsa JunaidDepartment of Public Health, Institute of Social and Cultural Studies, University of Punjab, Lahore, 75500, PakistanEmail khunsajunaidmir@gmail.comBackground: Depression is defined as a psychiatric disorder characterized by depressed mood, lack of concentration, diminished energy, disturbed sleep, and low self-esteem. Depression is more prevalent in HIV/AIDS patients than the general population. There is no published study available that reveals the present status of depression among HIV patients in Pakistan. As such, the present study was conducted to determine the prevalence and associated factors of depression among HIV/AIDS patients attending the HIV clinic of Jinnah Hospital, Lahore, Pakistan.Methods: A hospital-based cross-sectional study was carried out from February to March 2019 in Lahore. Data were collected from 158 HIV/AIDS patients using a pretested, standardized, structured interviewer-administered questionnaire. Nonprobability convenience sampling was used to recruit the study participants. Depression was evaluated using the Patient Health Questionnaire. SPSS version 23 was used to analyze the data. Binary logistic regression models were used to determine the various factors associated with depression. AORs with 95% CIs were used to assess the magnitude of associations between depression and associated factors.Results: The mean age of the study participants was 35.03 years± 9.123. Prevalence of depression among HIV/AIDS patients was 32.2%. Living in a rural area (AOR 5.60, 95% CI 2.20, 14.15), fear of stigma and discrimination (AOR 3.505, 95% CI 1.364, 9.008), having worked abroad (AOR 3.017, 95% CI 1.134, 8.031), and history of substance abuse (AOR 4.147, 95% CI 1.673, 10.28) were significantly associated with depression.Conclusion: The prevalence of depression among HIV/AIDS patients is very high in Pakistan. Therefore, it is suggested that guidelines formulated to screen and treat depression among HIV patients.Keywords: depression, HIV/AIDS, convenience sampling, PHQ9 scale

Nazeer Hussain Khan,1,2 Faiz Ullah,3 Taskin Aman Khan,4 Ujala Zafar,5 Muhammad Farhan Ali Khan,6 Muhammad Mustaqeem,7 Syed Sakhawat Shah,3 Dong-Dong Wu,1,8 Xin-Ying Ji1 1Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Henan 475001, People’s Republic of China; 2School of Life Sciences, Henan University, Kaifeng, Henan, 475004, People’s Republic of China; 3Department of Chemistry, Quaid-I-Azam University, Islamabad 44000, Pakistan; 4Department of Chemistry, University of Sargodha, Sargodha 40100, Pakistan; 5School of Natural Sciences, National University of Science and Technology, Islamabad, 44000, Pakistan; 6Department of Pharmacy, Quaid-I-Azam University, Islamabad 44000, Pakistan; 7Department of Chemistry, University of Sargodha Sub-Campus, Bhakkar 30000, Pakistan; 8School of Basic Medical Sciences, Henan University College of Medicine, Henan 475001, People’s Republic of ChinaCorrespondence: Dong-Dong Wu Email ddwubiomed2010@163.comXin-Ying Ji Email 10190096@vip.henu.edu.cnAbstract: To look superior and acceptable in society, people from all over the world use various types of cosmetic products to enhance or alter their facial appearance and body texture. In recent times, an exponential surge in cosmetic use has been observed in Pakistan, and hence spending money on personal-care products is high. However, there are many reported facts about high loads of lead, mercury, copper, and others hazardous and cancerous elements in local Pakistani cosmetic brands. Consumers of these brands are at high risk of many clinical issues, including cancer. As such, it is a necessity to make people aware of the devastating harmful effects related to cosmetic use. The aim of this study was to provide information for stakeholders and raise awareness in the general public about the use of these local unauthorized personal-care cosmetic products, along with government strategies to stop this cosmetic blight on human health.Keywords: cosmetics, cancer, health issues, mercury, Pakistan

Water is an essential element on earth, which provides human a variety of services in domestic use, agriculture, or industries. However, some serious health risks of drinking water are associated with microbial contamination, particularly with fecal matter. Therefore, microbial quality assessment is considered to be a necessary component of water quality assessment. This study investigates microbial contamination of water distributary system around the city by comparing groundwater (GW) and tap water (TW) quality in Quetta city. 31 GW samples and 31 TW samples were collected in the study area during the months of September, October, and November. Fecal coliform test was carried out in laboratory and their average total coliform contamination was computed. Results showed that the TW sample were all contaminated by coliform except for Chiltan town, hence are not considered suitable for drinking without any treatment according to WHO drinking water quality standards. The average coliform concentrations were 12 in Quetta main city, 11.6 in Jinnah town, 5.3 in Satallite town, 10 in Shahbaz town and 5 in Brewery town (0/100 mL CFU) and the TW samples from the three towns were even more contaminated with E.coli. Whereas among the GW, average microbial concentrations were 1.8 in Quetta main city, 2 in Satallite town, 1.4 in Shahbaz town, and 0.4 in Chiltan town (0/100 mL CFU), respectively, which shows that the contamination is occurring within the water distributary pipeline system when the water flows through the pipelines. Moreover, this research will be valuable for researchers and administrative authorities to conduct elaborative studies, and develop new policies to prevent further deterioration of drinking water in the water distribution system by pathogenic microorganisms and ensure safe drinking water to the public of Quetta city.

Nano-crystalline titanium dioxide (TiO2) photocatalyst has been extensively utilized in the last few decades because of its strong oxidizing power, redox selectivity, and higher photocatalytic performance. In this work, TiO2 nanoparticle (NPs) was synthesized, characterized, and applied for the degradation of methyl orange (MO) dye in an aqueous solution under UV and solar light irradiations. The XRD results showed dominated anatase phase (82%) with a smaller crystalline size (18.23 nm). A rough surface with a uniform spherical shape was observed by SEM analysis. FTIR and UV–Vis/DRS spectroscopy confirmed the stretching vibration of the hydroxyl groups and higher absorption edge towards longer wavelength with smaller bandgap energy (3.12 eV) of TiO2 lattice structure. The activity of TiO2 NPs was carried out from the degradation of MO dye as a model contaminant for textile effluent in presence of UV/solar irradiation. The photodegradation efficiency of MO dye (15 mg L−1) was observed at 85.90% and 96.38% for 0.150 g and 0.030 g of TiO2 NPs at natural pH (7.0), after 5 h of UV and solar light irradiation. The respective rate constants were determined to be 0.0063 min−1 and 0.01 min−1 for UV and simulated solar light irradiation respectively, and exhibited the best-fitted kinetic model of pseudo-first-order. The photodegradation efficiency was increased with the decrease of pH, while efficiency decreased with an increase in initial dye concentration. The obtained result from TiO2 NPs was compared with commercially available Degussa P25 catalyst. The photocatalyst reusability test and reaction mechanism were also evaluated. The study suggests that TiO2 NPs are a promising photocatalyst that can be used for the degradation of organic dye compounds from textile wastewater towards the sustainable management of environment.

To understand the protective capacity of aquifers, anisotropic nature and fracture geometry of dyke infested terrain in parts of Nandurbar region, Maharashtra, data from 39 vertical electrical soundings using Schlumberger configuration were acquired. Analysis suggests 3–5 layered structure in the study area. Further, the Dar-Zarrouk and other geoelectric indices were computed utilizing resistivity and layer thickness at each station. The Inverse Distance Weighted (IDW) algorithm was used to interpolate data spatially. Longitudinal conductance values suggest that the area has poor to moderate aquifer protective capacity, indicating that weaker zones may be prone to infiltrating contaminants. The high electrical anisotropy (λ) signifies EW and NS oriented dykes, suggesting heterogeneous and anisotropic nature of the subsurface. A direct relationship involving λ and fracture porosity indicate porous medium. The IDW algorithm, used for the first time in this region, provided an accurate and reliable estimate of spatial distribution and the underlying heterogeneities.

The aim of this study was to elucidate the protective action mechanism of 4-4(hydroxyl-3-methoxyphenyl)-2-butane against Sodium tellurite (ST) induced nephrotoxicity in rats. ST is a hazardous substance used in metallurgical and glassware industries, but its renal toxicities have not been well established before. Rats were distributed into four groups, six rats contain in each group. Normal control group given only vehicles only, toxic group given ST 8.5 mg/kg p o, treated groups given ST and 4-(hydroxyl-3-methoxyphenyl)-2-butane(100 mg/kg bwt), and positive control given only treatment drug 4-(hydroxyl-3-methoxyphenyl)-2-butane (100 mg/kg bwt) daily for 14 days. ST administration increases an alteration in biochemical, oxidative stress, cytokines markers, and morphological changes in toxic group. When it was treated with 4-(hydroxyl-3- methoxyphenyl)-2-butane significantly (p 0.05) changes have been seen in positive control as compared to normal control. In conclusion, 4(hydroxyl-3 methoxyphenyl)-2-butane successfully defended the kidney from oxidative stress, inflammatory cytokines and necrosis against ST intoxication. Thus, significant improvements were reflected and confirms with the improvement in histopathological changes.

The current research aimed to evaluate in vitro biological activities of green-synthesized silver nanoparticles using the Allium sativum clove extract. The stability of green-synthesized silver nanoparticles was evaluated via storage at 4°C, room temperature (37°C), and calcined at 300°C, 500°C, and 700°C. The antibacterial effect was evaluated using agar well, spread plate, biofilm reduction, and cell proliferation inhibition assays. The cytotoxic and antidiabetic effects were determined via brine shrimp lethality, protein kinase inhibition, and α-amylase inhibition assays. DPPH scavenging, iron-chelating, anticoagulant, and hemolytic effects were evaluated. The highest inhibition of Klebsiella pneumoniae was observed when freshly prepared, calcined (300°C), and stored nanoparticles (4°C and 37°C) were applied (9.66, 9.55, 7.33, and 6.65 mm) against freshly prepared and calcined at 700°C which showed the highest inhibition of Pseudomonas aeruginosa (8.55 and 7.66 mm). Cell viability assay, biofilm reduction assay, and spread plate method showed a significant antibacterial effect of freshly prepared silver nanoparticles. Freshly prepared and calcined nanoparticles at 300°C and 500°C possessed strong antioxidant and iron-chelating activity. Among all the synthesized silver nanoparticles, freshly prepared and calcined nanoparticles (300°C and 500°C) increases the prothrombin time. Silver nanoparticles possessed significant anticoagulant properties and less toxic at least concentration toward human RBCs. In brine shrimp lethality assay, freshly prepared nanoparticles showed a stronger toxic effect and caused high mortality of larvae. Protein kinase inhibition assay revealed that freshly prepared nanoparticles had the highest zone of inhibition (18.0 mm) at 50 µg/disc. Green-synthesized nanoparticles would be used as potential therapeutic agents to overcome both infectious and noninfectious diseases.

Steroids remain an essential part of immunosuppressive therapy for renal transplant patients since the start of transplant era. Different immunosuppressive regimens are prescribed so as to minimize the side effects. The purpose of our study is to compare the outcome of early steroid withdrawal with steroid maintenance protocol. It is a prospective nonrandomized study. All patients that received renal transplants from January 2011 to December 2013 were included in the study. Early steroid withdrawal at day 5 was done in low immunological risk patients, and the results were compared with the steroid maintenance group, at one-year, posttransplant. Outcome measures included acute rejection (AR), slow graft function and delayed graft function (SGF and DGF), patient and graft survival, and new-onset diabetes after transplant (NODAT), dyslipidemia, hypertension, and obesity. A total of 249 patients were divided into two groups – 105 patients had early steroid withdrawal and 144 patients were maintained on steroid therapy. Outcome measures were compared one-year posttransplant. There was no significant difference in AR, patient and graft survival, creatinine level, and weight gain. However, a significant difference in systolic and diastolic blood pressure, lipid profile, NODAT, SGF, and DGF was found in the steroid group. Our study shows that early steroid withdrawal is a safe standard of care in low immunological risk patients.

The main difference between Islamic and conventional banking is that Islamic banking works on profit and loss while conventional banking work is interest based. The aim of this research study is to measure and compare the financial performance of Islamic and conventional banking in Pakistan during 2006 to 2015. This study is to examine and to evaluate the performance of 5 Islamic banks (Meezan Islamic Bank, Bank Islami Limited, Al Baraka Islamic Bank, Dubai Islamic Bank Limited and Burj Bank Limited) and 5 conventional banks (Muslim Commercial Bank Limited, United Bank Limited, Askari Bank Limited, Allied Bank Limited, Habib Bank Limited) in terms of profitability, liquidity, risk, capital and efficiency. We used quantitative and qualitative data for comparison of Islamic and conventional banks. Collection of data consists on both primary as well as secondary sources. Primary data has been gathered from interviews and Secondary data has been gathered from the balance sheets and income statements of the sampled banks for the period of 2006 to 2015.Financial ratios such as profitability ratios, liquidity ratios, solvency ratios, capital ratios and efficiency ratios are used for measure of the financial performance of both banking sector. The results indicate that Islamic banks are less profitable, more liquid, less risky and less efficient. There is no significant difference in terms of capital between Islamic and conventional banks.

In this paper, we present several new and generalized Hermite-Hadamard type inequalities for s-convex as well as s-concave functions via classical and Riemann-Liouville fractional integrals. As applications, we provide new error estimations for the trapezoidal formula.

Oculocutaneous albinism (OCA) is a genetic disorder of melanin synthesis that results in hypopigmentation in hair, skin and eyes. OCA has been reported in individuals from all ethnic backgrounds but it is more common among those with Europeans ancestry. OCA is heterogeneous group of disorders and seven types of OCA are caused by mutations in TYR (OCA1), OCA2 (OCA2), TYRP1 (OCA3), SLC45A2 (OCA4), SLC24A5 (OCA6) and C10oRF11 (OCA7) genes. However, MC1R gene variants have been reported that modify OCA2 phenotype but the knowledge about the function ofMC1R gene in melanogenesis, and genotype-phenotype association, in case of OCA, is limited. In this review article we present a comprehensive description of classification of OCA, role of MSH-R in melanin synthesis, the sequence variations in MC1R and their association with OCA. This review will enhance our understanding of MC1R gene variants involved in human OCA2 phenotype.

The combination of near-field microscopy along with nonlinear optical spectroscopic techniques is presented here. The scanning near-field imaging technique can be integrated with nonlinear spectroscopic techniques to improve spatial and axial resolution of the images. Additionally, ultrafast dynamics can be probed down to nano-scale dimension. The review shows some examples for this combination, which resulted in an exciton map and vibrational contrast images with sub-wavelength resolution. Results of two-color femtosecond time-resolved pump-probe experiments using scanning near-field optical microscopy (SNOM) on thin films of the organic semiconductor 3,4,9,10 Perylenetetracarboxylic dianhydride (PTCDA) are presented. While nonlinear Raman techniques have been used to obtain highly resolved images in combination with near-field microscopy, the use of femtosecond laser pulses in electronic resonance still constitutes a big challenge. Here, we present our first results on coherent anti-Stokes Raman scattering (fs-CARS) with femtosecond laser pulses detected in the near-field using SNOM. We demonstrate that highly spatially resolved images can be obtained from poly(3-hexylthiophene) (P3HT) nano-structures where the fs-CARS process was in resonance with the P3HT absorption and with characteristic P3HT vibrational modes without destruction of the samples. Sub-diffraction limited lateral resolution is achieved. Especially the height resolution clearly surpasses that obtained with standard microCARS. These results will be the basis for future investigations of mode-selective dynamics in the near-field.

Aim: Objective of this study is to report our experience with sigmoid vaginoplasty in adolescents. Materials and Methods: A retrospective study of children with vaginal atresia and Mayer-Rokitansky-Kuster-Hauser syndrome. The sigmoid segment was used for vaginoplasty in all the cases. Results: Eight children were studied over a period of 7 years. The postoperative complications were ileus in 2, mucosal prolapse of the neovagina in 1, and minor wound infection in 1 patient. Seven patients are on regular follow-up. All the neovaginas were patent and functional. One patient had unacceptable perineal appearance, that is, badly scarred perineum as a late complication. None of the patients had vaginal stenosis or excessive mucus discharge, during follow-up visits. Out of the 7 patients, 2 patients are sexually active and satisfied. Conclusions: Sigmoid vaginoplasty is a safe and acceptable procedure for vaginal agenesis with good cosmetic results and acceptable complications rate. Sigmoid colon vaginoplasty is the treatment of choice because of its large lumen, thick walls resistant to trauma, adequate secretion allowing lubrication, not necessitating prolonged dilatation, and short recovery time.

Background: Anterior urethral valves (AUVs) are rare congenital anomalies causing lower urinary tract obstruction in children. Although they are referred to as valves, these obstructive structures often occur in the form of a diverticulum. The urethra in these cases shows saccular or bulbar dilatation known as anterior urethral diverticulum (AUD). They typically occur where there is a defect in the corpus spongiosum, leaving a thin-walled urethra. This segment of the urethra balloons out during voiding, simulating a mass that is sometimes visible along the ventral wall of the penis. The swelling is fluctuant and urine dribbles from the meatus on compression. The present study highlights the clinical approach in identifying the condition and its treatment options, especially for those, presenting with urethral diverticula. Materials and Methods: We have studied children with congenital anterior urethral valves and diverticula. Six patients of AUVs with diverticula were admitted during the period of 2000-2007 and were prospectively evaluated. The mean age of presentation was 16 months (15 days to 4 years). Straining at micturition and a palpable penile swelling were the most common presenting features. The diagnosis was established by voiding cystourethrogram (VCUG) and supported by ultrasonography (USG). All patients were treated with single-stage open surgical excision except one who died preoperatively due to urosepsis. Initial lay opening of the penoscrotal urethra and delayed repair were done in one patient. Results: The surgical outcome was successful in all but one patient, who died of delayed presentation with severe back pressure changes, urinary ascitis and urosepsis. On long-term follow-up, all patients demonstrated good stream of urine. The renal functions were normal and the patients had no evidence of urinary infections. Conclusion: We propose that, the patients of AUVs, if not excessively delayed for treatment are otherwise well in terms of general condition as opposed to patients of posterior urethral valves. The diagnosis is easily established by VCUG and the severity is revealed by a sonogram. Open surgical excision is the method of choice for patients with a urethral diverticulum; however, cystoscopic fulguration is also feasible in selected patients. The outcome is excellent with minimal morbidity and mortality.

Objective : To evaluate the role of fine needle aspiration cytology (FNAC) in the distinction between neoplastic and nonneoplastic ovarian masses. Materials and Methods : One hundred and twenty patients with ovarian masses were studied. After detailed history and clinical examination, ultrasound (USG)-guided FNAC was performed in 92 clinical benign cases while FNAC and/or imprints of surgically resected ovarian masses was performed in 28 clinically suspected malignant cases. The smears were stained with Papanicolaou stain and histopathological sections were stained with hematoxylin and eosin stain with inclusion of special stain whenever required. Serum b-human chorionic gonadotrophin and a-fetoprotein estimations were carried out in cytologically diagnosed germ cell tumors. Results : The overall sensitivity, specificity and diagnostic accuracy of FNAC in diagnosing various ovarian masses were 79.2%, 90.6% and 89.9%, respectively. Conclusions : The clinical examination, pelvic ultrasound and FNAC were complementary and none of the methods was, in itself, diagnostic. However, USG-guided FNAC was found to be a fairly specific and accurate technique and should be employed as a routine, especially in young females with clinically benign ovarian lesions. The reasons for false diagnosis and limitations of USG and FNAC have been analyzed.

A 26 years old lady with End Stage Renal Disease who received a cadaveric renal trans-plant, presented with ureteral stenosis as well as calyceal rupture due to hydronephrosis that was unresponsive to balloon dilation and the allograft was salvaged by a side to side ureteroneo-cystostomy. The symptoms and renal function improved and patency of the side to side uretroneo-cystostomy was confirmed post operatively and also at seventeen month follow-up. It may be rea-sonable to treat post-transplant ureteral stenosis resistant to balloon dilation with this technique. However, long-term follow-up is required to evaluate the efficacy of this treatment.

Abstract Background Anonychia/hyponychia congenita is a rare autosomal recessive developmental disorder characterized by the absence (anonychia) or hypoplasia (hyponuchia) of finger- and/or toenails frequently caused by mutations in the R-spondin 4 (RSPO4) gene. Methods Three hypo/anonychia consanguineous Pakistani families were ascertained and genotyped using microsatellite markers spanning the RSPO4 locus on chromosome 20p13. Mutation screening of the RSPO4 gene was carried out by direct sequencing of the entire coding region and all intron-exon boundaries. Results Mutations in the RSPO4 gene were identified in all families including a novel missense mutation c.178C>T (p.R60W) and two recurrent variants c.353G>A (p.C118Y) and c.3G>A (p.M1I). The c.3G>A variant was identified in unaffected family members and a control sample in a homozygous state. Conclusions This study raises to 17 the number of known RSPO4 mutations and further expands the molecular repertoire causing hypo/anonychia. The c.353G>A emerges as a recurrent change with a possible founder effect in the Pakistani population. Our findings suggest that c.3G>A is not sufficient to cause the disorder and could be considered a polymorphism.

Abstract Background Knowledge of the rate of action of compounds against cultured malaria parasites is required to determine the optimal time-points for drug mode of action studies, as well as to predict likely in vivo parasite clearance rates in order to select optimal hit compounds for further development. In this study, changes in parasite ATP levels and transgenic luciferase reporter activity were explored as means to detect drug-induced stress in cultured parasites. Methods In vitro cultures of Plasmodium falciparum 3D7 wild-type or firefly luciferase-expressing parasites were incubated with a panel of six anti-malarial compounds for 10 hours and parasite ATP levels or luciferase activity determined at two-hour intervals using luminescence-based reagents. For comparative purposes, parasite morphology changes were evaluated by light microscopy, as well as the extent to which parasites recover after 48 hours from a six-hour drug treatment using a parasite lactate dehydrogenase assay. Results Changes in parasite ATP levels displayed three phenotypes: mild or no change (chloroquine, DFMO); 2–4 fold increase (mefloquine, artemisinin); severe depletion (ritonavir, gramicidin). The respective phenotypes and the rate at which they manifested correlated closely with the extent to which parasites recovered from a six-hour drug treatment (with the exception of chloroquine) and the appearance and severity of morphological changes observed by light microscopy. Luciferase activity decreased profoundly in parasites treated with mefloquine, artemisinin and ritonavir (34-67% decrease in 2 hours), while chloroquine and DFMO produced only mild changes over 10 hours. Gramicidin yielded intermediate decreases in luciferase activity. Conclusions ATP levels and luciferase activity respond rapidly to incubation with anti-malarial drugs and provide quantitative read-outs to detect the appearance and magnitude of drug-induced stress in cultured parasites. The correlation between the observed changes and irreversible parasite toxicity is not yet sufficiently clear to predict clinical clearance rates, but may be useful for ranking compounds against each other and standard drugs vis-à-vis rate of action and for determining early time-points for drug mode of action studies.

Abstract Background Sexually transmitted Infections (STIs) rank among the most important health issues for the people especially the young adults worldwide. Young people tend to engage in sexual activity at younger ages in the past decade than in the 1970s, and 1980s. Knowledge is an essential precursor of sexual risk reduction. A cross-sectional study was conducted in Pulau Pinang, Malaysia, to produce the baseline information about school students' awareness and perception about sexually transmitted Infections (STIs) and their sexual activity to help establish control and education programmes. Methods Students from form 4 (aged between 15 to 16 years), form 5 (aged between 16 to 17 years) and form 6 (aged between 18 to 20 years) in their class rooms were approached and asked to complete self administered and anonymous pre-validated questionnaires. SPSS for windows version 13 was used to analyze the results statistically and results were presented in tabular form. Results Data was collected from 1139 students aged between 15 to 20 years, 10.6% of which claimed that they never heard about STIs. Sexual experience related significantly with gender, race, and education level. Approximately 12.6% claimed to have sexual experience of which 75.7% had their sexual debut at 15-19 years and 38.2% were having more than 3 partners. Sexual experience was found to be significantly associated with gender (p = 0.003), ethnicity (p = 0.001) and education level (p = 0.030). However, multiple partner behaviour was significantly associated only with gender (p = 0.010). Mean knowledge score was 11.60 ± 8.781 and knowledge level was significantly associated with religion (p = 0.005) education level (p = 0.000), course stream (p = 0.000), socioeconomic class (p = 0.000) and sexual experience (p = 0.022). Conclusions It was concluded that school students have moderate level of knowledge about STIs although they are sexually active. Interventions such as reinforcing the link between STIs and HIV/AIDS, assessing the current status of sexuality education in schools and arranging public talks and seminars focusing on STIs prevention education are needed to improve their awareness.

Abstract Background Ulcerative colitis disease activity is determined by measuring symptoms and signs. Our aim was to determine which symptom domains are frequent and responsive to change in the evaluation of disease activity, which are those defined by three criteria: 1) they occur frequently during flares; 2) they improve during effective therapy for ulcerative colitis; and 3) they resolve during remission. Methods Twenty-eight symptom domains, 16 from standard indices and 12 novel domains identified by ulcerative colitis patient focus groups, were evaluated. Sixty subjects with ulcerative colitis were surveyed, rating each symptom on the three criteria with a 100 mm Visual Analogue Scale. Frequent and responsive symptoms were defined a priori as those whose median Visual Analogue Scale rating for all 3 criteria was significantly greater than 50. Results Thirteen of the 28 symptom domains were identified as both frequent in ulcerative colitis flares and responsive to changes in disease activity. Seven of these 13 symptom domains were novel symptoms derived from ulcerative colitis patient focus groups including stool mucus, tenesmus, fatigue, rapid postprandial bowel movements, and inability to differentiate liquid or gas from solid stool when rectal urgency occurs. Ten of the 16 symptom domains from standard indices were either infrequent or unresponsive to changes in disease activity. Conclusion Only some of the symptoms of ulcerative colitis that are important to patients are included in standard indices, and several symptoms currently measured are not frequent or responsive to change in ulcerative colitis patients. Development of survey measures of these symptom domains could significantly improve the assessment of disease activity in ulcerative colitis.