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Aim: To determine the visual outcome and factors influencing visual outcome after cataract surgery in an urban charity hospital in Pakistan. Methods: A series of selected outpatients were examined who [...]

Abstract Background Regardless of attaining adequate knowledge regarding oral hygiene, physical activity, and healthy eating habits, dental students still face oral health problems. This study was aimed to assess the association of oral hygiene habits, physical activity, and eating habits with the BMI in the dental students. Method This multi centric cross-sectional study was conducted from January to May 2021 in Pakistan. Three hundred and eighty-six study participants enrolled as undergraduate dental students, both males and females, were included in the study. A questionnaire used to gather data, was modified from a study conducted by Jouhar et al. Chi-square testing was used in order to assess the relationship between two categorical variables. Linear regression was performed to assess the association with putative confounders. Statistical significance was considered for p value

By and large, authentication systems employed for web-based applications primarily utilize conventional username and password-based schemes, which can be compromised easily. Currently, there is an evolution of various complex user authentication schemes based on the sophisticated encryption methodology. However, many of these schemes suffer from either low impact full consequences or offer security at higher resource dependence. Furthermore, most of these schemes don’t consider dynamic threat and attack strategies when the clients are exposed to unidentified attack environments. Hence, this paper proposes a secure user authentication mechanism for web applications with a frictionless experience. An automated authentication scheme is designed based on user behavior login events. The uniqueness of user identity is validated in the proposed system at the login interface, followed by implying an appropriate user authentication process. The authentication process is executed under four different login mechanisms, which depend on the profiler and the authenticator function. The profiler uses user behavioral data, including login session time, device location, browser, and details of accessed web services. The system processes these data and generates a user profile via a profiler using the authenticator function. The authenticator provides a login mechanism to the user to perform the authentication process. After successful login attempts, the proposed system updates database for future evaluation in the authentication process. The study outcome shows that the proposed system excels to other authentication schemes for an existing web-based application. The proposed method, when comparatively examined, is found to offer approximately a 10% reduction in delay, 7% faster response time, and 11% minimized memory usage compared with existing authentication schemes for premium web-based applications.

Objective: To deteremine the incidence, nature and management of extra-biliary complications of laparoscopic cholecystectomy. Materials and Methods: This study presents a retrospective analysis of extra-biliary complications occuring during 1046 laparoscopic cholecystectomies performed from August 2003 to December 2006. The study population included all the patients with symptomatic gallstone disease in whom laparoscopic cholecystectomy was performed. The extra-biliary complications were divided into two distinct categories: (i) Procedure related and (ii) Access related. Results: The incidence of access-related complications was 3.77% and that of procedure-related complications was 6.02%. Port-site bleeding was troublesome at times and demanded a re-do laparoscopy or conversion. Small bowel laceration occurred in two patients where access was achieved by closed technique. Five cases of duodenal and two of colonic perforations were the major complications encountered during dissection in the area of Calot′s triangle. In 21 (2%) patients the procedure was converted to open surgery due to different complications. Biliary complications occurred in 2.6% patients in the current series. Conclusion: Major extra-biliary complications are as frequent as the biliary complications and can be life-threatening. An early diagnosis is critical to their management.

Objective: To find out the safety profile of laparoscopic cholecystectomy in empyema of gallbladder. Background: Empyema of gall bladder is a severe form of acute cholecystitis with superadded suppuration. It has been considered a contraindication for the laparoscopic cholecystectomy (LC) because of fear of life-threatening complications. This study aimed to determine the safety and feasibility of LC in empyema of gallbladder. Materials and Methods: LC was attempted in 67 patients of empyema of gallbladder within 24h. However in few cases there was a delay because of reluctance for surgery or delay in giving consent etc. The procedure was performed by standard four-port technique with few changes made to facilitate dissection according to situation. Results: Between April 2003 to June 2006, 970 LC performed for gallstone disease at surgical unit-1 of LUMHS by the same surgical team. Among these, 67 (6.90%) patients were diagnosed to have empyema gall bladder. LC successfully completed in 54 (80.59%) patients. In 13 (19.40%) patients the procedure was converted to open cholecystectomy (OC) due to various operative difficulties of which the most serious injuries included bleeding from cystic artery (four cases), common bile duct injury (two cases) and duodenal injury in one case. Maximum operating time was up to 160 minutes (one case). Postoperative complications occurred in 10 (18.51%) successfully operated patients. Maximum patients (n=45, 83.33%) were discharged in 48-96 hours while three patients were discharged after two weeks. Conclusion : Laparoscopic cholecystectomy can be performed in empyema of gallbladder keeping in mind a slightly increased risk of complications even in the best hands. However, the experience of the surgeon plays a key role in the overall outcome.

Background/Aim: To study the changing pattern of acute intestinal obstruction at a teaching institute. Patients and Methods: It is a prospective descriptive study conducted at a teaching hospital during the period from June 2004 to June 2009. All patients with clinical or radiological evidence of acute intestinal obstruction were included in this study regardless of the gender of the patient. Patients below the age of 10 years were excluded from the study. The treatment strategy was planned ranging from conservative treatment to emergency laparotomy after resuscitation and rehydration of the patient. Details of individual patients were recorded on a pro forma sheet and data analyzed statistically on SPSS version 14. Results: A total of 229 patients with acute intestinal obstruction were admitted and treated. The mean age of the study population was 43.08 ± 13.07 years. Postoperative adhesions accounted for 41% (n= 95) of the total cases, followed by abdominal tuberculosis (25%, n= 58), obstructed/ strangulated hernias of different types (18%, n= 42). There was an obvious change in the pattern of etiology of acute intestinal obstruction as the common causes were postoperative adhesions and abdominal tuberculosis instead of obstructed inguinal hernias. Conclusion: An increase in the adhesive obstruction and a concomitant decrease in the incidence of obstructed hernias indicate a changing trend towards early operation before it gets complicated. Abdominal tuberculosis is emerging as another common cause of acute bowel obstruction.

A 60-year-old male, laborer by occupation, presented with an ulcerative lesion of medial canthus in the left eye along with infiltration and adhesion of lids to globe. He had decreased vision and restricted extraocular movements. Exenteration with skin grafting was done. Histopathologically it was diagnosed as periocular metatypical cell carcinoma with scleral infiltration. Any suspicious lesion should be diagnosed and treated early so as to prevent such extensive damage.

A 58-year-old-man presented with painful rapidly progressive bilateral proptosis with restricted ocular movements of 15 days duration. There was history of significant weight loss in the recent past. Computed tomography scan of the head and orbit revealed bilateral multiple, well-defined, round, soft tissue masses, isointense with muscles in intraconal and extraconal space. Fine needle aspiration cytology and incision biopsy from the lesion, urine for Bence-Jones proteins and immunofixation clinched the diagnosis of multiple myeloma. Skeletal survey did not reveal any bony involvement. The diagnosis of multiple myeloma should be kept in mind in cases of bilateral proptosis. Bony involvement is not universal in cases of orbital myeloma. Early diagnosis can be established with extensive biochemical and histopathological investigations and timely treatment is life saving for these patients.

Abstract Background To report a case of spontaneous corneal melting in pregnancy. We reviewed the literature on corneal melting and the effect of pregnancy on cornea and collagen containing tissues. Case presentation A 29-year-old woman who underwent radial keratotomy in both eyes followed by trabeculectomy in her left eye developed corneal melting in the same eye, in her seventh month of pregnancy. Despite screening, no infectious or immune mediated condition could be identified. She was managed conservatively with cyanoacrylate glue, bandage contact lens, lubricants and antibiotics. Conclusion It may not always be possible to find the underlying cause of corneal melting but the more common underlying causes should be ruled out by proper investigations. Pregnancy with its host of hormonal changes could potentially have some effect on corneal collagen leading to corneal melting in compromised corneas.

ABSTRACT Salt stress is the most significant constraint for agricultural production in arid and semi-arid regions. Thus, genetically improved stress-tolerant varieties are needed for the future. The identification of salt-tolerant genotypes is the starting point for such breeding studies. This study was conducted to determine and assess the tolerance of different watermelon genotypes under saline conditions. Twenty-two watermelon genotypes and accessions were grown in pots with 3 kg of soil in four saline stress conditions (0 mmol kg-1 as the control, 25, 50 and 100 mmol kg-1 NaCl). The detrimental effects of salt stress on the plants were evident with increasing doses of NaCl. Stress indices calculated over the plant dry weights under the 100 mmol kg-1 salinity level were used to assess the salt tolerance of the genotypes. Stress intensity was calculated as 0.76. Such a value indicated that the highest dose of salt exerted severe stress on the plants. The G04, G14 and G21 genotypes were considered to be salt tolerant, since these genotypes showed the highest values of K/Na and Ca/Na ratios in the plant tissue. The losses in dry mass at severe salt stress reached 75.48%. In principal component analyses, the genotypes had positive correlations with stress tolerance indices of MP (mean productivity), GMP (geometric mean productivity) and STI (stress tolerance index). The GMP and STI indices indicated that G04 (a member of Citrullus colocynthis), G14 and G21 could be prominent sources to develop salt tolerance.

The present study was aimed to determine the effect of ultrasound pretreatment and different drying methods viz sun drying, solar drying, cabinet drying, vacuum drying, microwave assisted drying and freeze drying on physicochemical, phytochemical activity, rehydration ratio and drying time of the purslane. The purslane was ultrasonicated for 15, 30, 45 and 60 min following by drying. The ultrasound pretreatment (60 min) combined with freeze drying retained the highest antioxidants (95.59 %), phenolic content (7.85 mgGAE/100 g), total carotenoid content (99.74 mg/100 g), ascorbic acid (399.94 mg/100 g) and rehydration ratio (6.80). Moreover, the same combination revealed higher L and a* values when compared with other drying methods. However, the purslane pretreated with ultrasonication for 60 min and then dried via microwave took less time for drying. This study suggests that Ultrasound pretreatment (60 min) followed by freeze drying is recommended for preserving the nutritional and functional properties of purslane. It could be scaled up for commercial applications in the functional food and nutraceutical industries, where high-quality preservation is crucial., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier B.V. All rights reserved.)

The activation of immune cells by pro-inflammatory or immunosuppressive stimuli is followed by the secretion of immunoregulatory cytokines which serve as messengers to activate the immune response in target cells. Although the mechanisms that control the secretion of cytokines by immune cells are not yet fully understood, several key aspects of this process have recently emerged. This review focuses on cytokine release via exocytosis and highlights the routes of cytokine trafficking leading to constitutive and regulated secretion as well as the impact of sorting receptors on this process. We discuss the involvement of cytoskeletal rearrangements in vesicular transport, secretion, and formation of immunological synapses. Finally, we describe the non-classical pathways of cytokine release that are independent of vesicular ER-Golgi transport. Instead, these pathways are based on processing by inflammasome or autophagic mechanisms. Ultimately, understanding the molecular mechanisms behind cytokine release may help to identify potential therapeutic targets in diseases associated with altered immune responses., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The endocytic adaptor protein 2 (AP-2) complex binds dynactin as part of its noncanonical function, which is necessary for dynein-driven autophagosome transport along microtubules in neuronal axons. The absence of this AP-2-dependent transport causes neuronal morphology simplification and neurodegeneration. The mechanisms that lead to formation of the AP-2-dynactin complex have not been studied to date. However, the inhibition of mammalian/mechanistic target of rapamycin complex 1 (mTORC1) enhances the transport of newly formed autophagosomes by influencing the biogenesis and protein interactions of Rab-interacting lysosomal protein (RILP), another dynein cargo adaptor. We tested effects of mTORC1 inhibition on interactions between the AP-2 and dynactin complexes, with a focus on their two essential subunits, AP-2β and p150 Glued . We found that the mTORC1 inhibitor rapamycin enhanced p150 Glued -AP-2β complex formation in both neurons and non-neuronal cells. Additional analysis revealed that the p150 Glued -AP-2β interaction was indirect and required integrity of the dynactin complex. In non-neuronal cells rapamycin-driven enhancement of the p150 Glued -AP-2β interaction also required the presence of cytoplasmic linker protein 170 (CLIP-170), the activation of autophagy, and an undisturbed endolysosomal system. The rapamycin-dependent p150 Glued -AP-2β interaction occurred on lysosomal-associated membrane protein 1 (Lamp-1)-positive organelles but without the need for autolysosome formation. Rapamycin treatment also increased the acidification and number of acidic organelles and increased speed of the long-distance retrograde movement of Lamp-1-positive organelles. Altogether, our results indicate that autophagy regulates the p150 Glued -AP-2β interaction, possibly to coordinate sufficient motor-adaptor complex availability for effective lysosome transport., (© 2024. The Author(s).)

SorLA, encoded by the gene SORL1, is an intracellular sorting receptor of the VPS10P domain receptor gene family. Although SorLA is best recognized for its ability to shuttle target proteins between intracellular compartments in neurons, recent data suggest that also its microglial expression can be of high relevance for the pathogenesis of brain diseases, including glioblastoma (GBM). Here, we interrogated the impact of SorLA on the functional properties of glioma-associated microglia and macrophages (GAMs). In the GBM microenvironment, GAMs are re-programmed and lose the ability to elicit anti-tumor responses. Instead, they acquire a glioma-supporting phenotype, which is a key mechanism promoting glioma progression. Our re-analysis of published scRNA-seq data from GBM patients revealed that functional phenotypes of GAMs are linked to the level of SORL1 expression, which was further confirmed using in vitro models. Moreover, we demonstrate that SorLA restrains secretion of TNFα from microglia to restrict the inflammatory potential of these cells. Finally, we show that loss of SorLA exacerbates the pro-inflammatory response of microglia in the murine model of glioma and suppresses tumor growth., (© 2024. The Author(s).)

Objective: The purpose of this study is to find out the level of awareness and acceptance of artificial intelligence (AI) in Pakistan's medical community so as to comment on its future in our healthcare system., Methods: A survey consisting of 15 close-ended questions was conducted. The questions inquired about awareness about AI and discovered the opinions of healthcare professionals regarding its benefits and expected problems. The data were analyzed using SPSS version 26, and descriptive statistics for percentage and frequency were computed. χ 2 test was used to analyze the subgroups (Significant p value <0.05)., Results: A total of 351 participants were included in this study. General familiarity with AI was low. Only 75 (21.3%) participants answered that they had good familiarity with AI, and only 56 (16%) of them had good familiarity with the role of AI in medicine. One hundred sixty-eight (47.9%) participants disagreed that AI would out-compete the physician in the important traits of professionalism. Only 71 (20.2%) participants believed AI to be diagnostically superior to the physician. Two hundred fourteen (61.0%) were worried about completely trusting AI in its decisions, and 204(58.1%) believed that AI systems lacking human traits would not be able to mirror the doctor-patient relationship. Two hundred sixty-one (74.4%) participants believed that AI would be useful in Administrative tasks. A majority, 162 (46.2%), do not believe that AI would replace them. Finally, a huge majority of participants [225 (64.1%)] demanded the integration of AI in Pakistan's healthcare system., Conclusion: This study suggests that a majority of healthcare professionals in Pakistan do not believe that they are sufficiently aware of the role of AI in healthcare. This was corroborated by their answers to various questions regarding the capabilities of AI. This study indicates the need for a more comprehensive ascertainment of healthcare professionals' perceptions regarding the role of Artificial Intelligence in medicine and bridging the gap between doctors and technology to further promote a patient-centred approach to medicine., Competing Interests: There was no conflict of interest between authors.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)

Glioblastoma (GBM) is the most aggressive and prevalent primary brain malignancy in adults. Current treatments provide limited benefit, and thus, the median overall survival of GBM patients is only 15 months. GBM progression is highly dependent on its ability to evade immune response, so understanding the mechanisms behind GBM-driven immunosuppression seems crucial for designing more efficient therapies. Animal models of GBM constitute a convenient tool in glioma research, and several different approaches have been already developed to model this disease in vivo, including genetic and xenograft models. Here, we describe a murine syngeneic model of glioma which recapitulates many of the key features of human disease, including complex tumor microenvironment. We present an optimized protocol for stereotactic intracranial implantation of GL261 cells into C57BL/6 mice which results in tumor growth in the striatum. This model has been widely used to get insight into glioma biology, as well as in the studies aiming at the development and validation of new therapeutic approaches., (© 2024. The Author(s), under exclusive license to Springer Science+Business Media, LLC, part of Springer Nature.)

The study aimed at evaluating the influence of water-chestnut starch-based coatings loaded with rosemary essential oil (REO) at concentrations of 0.10%, 0.25% and 0.50% (w/v) on postharvest cold storage stability of apple var. Golden delicious for 120 days. Average droplet diameter of nanoemulsions was in range of 315-450 nm and it increased with increase in the REO concentration. Minimum weight loss was observed in fruits treated with coating material containing 0.50% REO. Samples coated with starch+0.50% REO exhibited highest firmness value of 68.22 ± 1.02 N under controlled atmosphere storage (CAS). Anthocyanins, ascorbic acid, total phenolic content and antioxidant activity were retained in all samples coated with formulated emulsion. Antifungal assay against Pencillium expansum indicated that 0.50% REO had maximum antifungal activity. Increase in REO concentration from 0.10 to 0.50% in starch coating formulations resulted in reduced lesion diameter in coated samples under both the storage conditions. Lesion diameter (LD) was found highest in control (39.40 ± 0.20 mm) under ambient conditions. Coated fruit samples showed a significant (p≤0.05) reduction in LD under both the ambient and CAS conditions however, more pronounced effect was reported under CAS. Fruits coated with edible coatings enriched with different REO concentrations under CAS exhibited significantly (p≤0.05) lower chilling injury index (ST+0.50%REO < ST+0.25%REO<0.10%REO) compared to control., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Authors.)

The ever-increasing demand for healthy diet by consumers has prompted the research adopting cutting-edge methods that can maintain the quality of fruits and vegetables without the use of preservatives. Emulsion based coating approach has been regarded as a viable way to extend the shelf life of fresh produce. New opportunities are being created in a number of industries, (medicines, cosmetics and food) because of new advancements in the developing field of nanoemulsions. Nanoemulsion based methods are efficient for encapsulating the active ingredients including antioxidants, lipids, vitamins and antimicrobial agents owing to the small droplet size, stability and improved biological activity. This review provides an overview of recent developments in preserving the quality and safety of fresh-cut fruits & vegetables with nanoemulsion as a carrier of functional compounds (antimicrobial agents, antibrowning/antioxidants and texture enhancers). In addition, material and methods used for fabrication of the nanoemulsion is also described in this review. In addition, material and methods used for fabrication, of the nanoemulsion is also present., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Aim: To study the outcome of simultaneous angioembolization and nephron sparing surgery in large renal angiomyolipomas., Materials and Methods: A prospective study of carried out from 2016 to 2019. A total of 15 patients were included in the study with a lesion (angiomyolipoma) more than 10 cm in size, suitable for nephron sparing surgery. The workup of the patients included history, baseline blood investigations, ultrasonography, and CT urography including angiographic films. All the patients were taken up for selective of angioembolization of the feeding vessels of the AML carried out by the interventional radiologist followed by nephron sparing surgery in the same sitting. The short term outcomes studied were warm ischemia time, average blood loss, and length of post-operative hospital stay. The oncological outcome was evaluated by noting the surgical margins of histopathological specimen and functional outcome by assessing the function of the preserved renal parenchyma., Results: Twelve out of fifteen cases were female. The mean age was 42.25 years. All the patients had lesion more than 10 cm with seven tumors located at the lower pole, four at mid-pole, and four at upper pole. Eight patients had low complexity score on RENAL score (i.e. 4-6), five patients medium complexity score (i.e. 7-9), and two had high complexity score (i.e. ⩾10). Average blood loss was 200 ml, warm ischemia time was 18.46 min and postoperative stay was 3.55 days. All the 15 specimens sent for histopathology were confirmed as AML (angiomyolipomas) with margins free of tumor. Follow up CECT done at 4 months postoperatively revealed functioning residual renal parenchyma with prompt excretion of contrast., Conclusion: Large AML's are also amenable to nephron sparing surgery. However patient should always be warned about the possibility of total nephrectomy. Selective angioembolization helps in reducing the blood supply and risk of torrential bleeding thus facilitates in the removal of the tumor and increasing the chances of nephron sparing surgery.

In the present study, chitosan (CH) based biodegradable films were developed enriched with thyme essential oil (TEO) incorporated with different additives including zinc oxide (ZnO), polyethylene glycol (PEG), nano clay (NC), and calcium chloride (CaCl 2 ) and characterize the postharvest quality of 'collard greens' during refrigerated storage. The results indicated that the incorporation of ZnO/PEG/NC/CaCl 2 in CH-based films significantly decreased water vapor transmission rate, increased tensile strength, and were water soluble and biodegradable in nature. Moreover, CH-TEO based films incorporated with ZnO/PEG/NC/CaCl 2 were significantly effective in reducing physiological weight loss, retained total soluble solids, titratable acidity, and preserved chlorophyll contents as well as showed lesser a* values, suppressed microbial growth, and preserving appearance/sensory quality of collard greens for 24 days than LDPE and other biodegradable films. Our results suggest that CH-based films enriched with TEO and additives such as ZnO/CaCl 2 /NC/PEG are an ecological, environmental friendly, and effective alternative approach to retain shelf life of collard greens during refrigerated storage., (© 2022. The Author(s).)

Background: Transmissible Infections (TTI's) are a cause of significant burden on health care facilities by imposing a threat of infection transmission through disease reservoirs in asymptomatic donors. This eventually leads to a serious challenge in acquiring blood bags in a country like Pakistan where transfusion dependent disease are of high prevalence. The objective of this study is to determine the seroprevalence of TTI's in blood donors in Rawalpindi District through a multi-center approach., Materials and Methods: This is an observational descriptive retrospective study based on 6 transfusion centers in the Rawalpindi District. The time frame of the study was from January 2015 to December 2018. A total of 223,242 donors were consecutively included and data on donor type, the purpose of transfusion, and seroprevalence (HBV, HCV, HIV, Syphilis, and Malaria) were collected through a structured questionnaire and laboratory investigation results. The collected data were entered in SPSS version 21.0 for analysis., Results: The seroprevalence of blood borne infections was 7,897 (3.537%) of which HBV, HCV, HIV, Syphilis and Malaria accounted for 2410 (1.080%), 3105(1.391%), 0(0.000%), 2017 (0.933%) and 365 (0.171%), respectively. Reactive samples reduced from 4.850% to 3.537% over 4 years, while there was a rise of 37.478% of blood donors from 2015 to 2018. The total number of voluntary donors and replacement donors was 22079 (9.890%) and 201156 (90.107%), with a rising incidence in voluntary donors from 2015 to 2018. A considerable number of donor bags were transfused to Thalassemia, Anemia, Leukemia and Hemophilia patients, 28156 (12.612%). This number also showed increasing rates from 11.654% to 14.017%., Conclusion: In conclusion, our study suggests that the risk of transmission through transfusion is still considerable. Targeting donors with a low-risk profile, a screening questionnaire, an ample supply of quality screening tests, and awareness campaigns for the diseases in question must be carried to further decrease the risk of transmission of TTIs in Pakistan., (© 2022 Ghazanfar S et al.)

Background: The impact and management of subclinical hypoxia during hemodialysis is a significant medical challenge. As key determinants of O 2 availability and delivery, proposed mechanisms contributing to hypoxia include ischemia, alkalemia and pulmonary leukocyte sequestration. However, no study has comprehensively investigated and compared these interrelated mechanisms throughout a typical hemodialysis treatment week. This study aimed to comprehensively assess the physiological mechanisms that contribute to hypoxia during hemodialysis., Methods: In 76 patients, we measured arterial blood gases and pH at four time-points during hemodialysis (start, 15 min, 60 min, end) over the course of a standard treatment week. For the mid-week hemodialysis session, we additionally measured central hemodynamics (non-invasive cardiac output monitoring) and white blood cell count., Results: Linear regression modelling identified changes in pH, but not central hemodynamics or white blood cell count, to be predictive of changes in PaO 2 throughout hemodialysis (e.g. at 60 min, β standardized coefficient pH = 0.45, model R 2  = 0.25, P  < .001). Alkalemia, hypokalemia, decreased calcium and increased hemoglobin-O 2 affinity (leftward shift in the oxyhemoglobin dissociation curve) were evident at the end of hemodialysis. pH and hemoglobin-O 2 affinity at the start of hemodialysis increased incrementally over the course of a standard treatment week., Conclusion: These data highlight the important role of pH in regulating O 2 availability and delivery during hemodialysis. Findings support routine pH monitoring and personalized dialysate bicarbonate prescription to mitigate the significant risk of alkalemia and subclinical hypoxia., (© The Author(s) 2022. Published by Oxford University Press on behalf of the ERA.)

The deliberate killing of a foetus in the womb, or a child from the first 24 h of birth to one month of age, or within the first year of life, is called foeticide, neonaticide and infanticide, respectively. Socioeconomic stress, mental illness, gender selection, shame or fear of punishment of adultery or illegitimacy, grudge and jealousy with parents and negligent delivery by dai are major causative factors in such cases. This is a retrospective, descriptive, observational study, and the sample pool consisted of 35 cases. Foeticide cases were 42.9% of the total and the same percentage of cases were neonaticides, while 14.3% of cases were of infanticide. The male-to-female ratio was 1.26:1 and the major cause of death was head injury. The study shows a prevalence of foeticide and neonaticide as compared to infanticide. It also displays the prevalence of males in overall cases and a higher number of unknown cases in our setting.

This study aimed to examine the effect of canning and storage on physicochemical, mineral, and antioxidant properties and phenolic composition of apricot wholes, halves, and pulp. The findings for physicochemical properties revealed that the total soluble solids, titratable acidity, total sugars, and ascorbic acid were found higher in apricot pulp (37.15, 1.39, and 20.74% and 7.21 mg/100 g FW, respectively) followed by apricot wholes and halves throughout the storage period. The remarkable contents of potassium, phosphorous, zinc, copper, iron, and manganese were found in the apricot pulp which revealed that canning and storage slightly affected the mineral composition. Bioactive substances were identified and quantified by reversed-phase high-performance liquid chromatography, which indicated a higher presence of chlorogenic acid (34.45 mg/kg FW), quercitin-3-glucoside (16.78 mg/kg FW), neochlorogenic acid (26.52 mg/kg FW), gallic acid (5.37 mg/kg FW), kaempferol (14.22 mg/kg FW), ellagic acid (6.02 mg/kg FW), procyanidin B 2 (8.80 mg/kg FW), and epicatechin (9.87 mg/kg FW) in apricot pulp followed by apricot wholes and halves throughout the storage period. The total phenolic content was found highest in apricot pulp (13.76 GAE mg/100 g FW) followed by wholes (8.09 GAE mg/100 g FW) and halves (6.48 GAE mg/100 g FW) which decreased significantly throughout the storage period. Antioxidant properties were assessed by DPPH, ABTS + , MCA, and BCBA, which were found higher in the apricot pulp (92.23 TEAC μg/g DW, 92.33 TEAC μg/g DW, 33.80 TEAC μg/g DW, and 68.40 TEAC μg/g DW, respectively) that is correlated with the higher presence of bioactive compounds. Thus, apricot pulp containing excellent sources of nutrients, minerals, phytochemicals, and antioxidant components could be used for consumption purposes that provide nutraceuticals and antioxidants globally., 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 © 2022 Jan, Anjum, Wani, Mir, Malik, Wani, Hussein, Rasheed and Gatasheh.)

Copper-substituted nickel manganites Ni (1-x) Cu x Mn 2 O 4 (Ni-TCE-NPs) were produced by co-precipitation route (sol-gel) at room temperature. Ni (1-x) CuxMn 2 O 4 -Bio (NCB) NPs were studied by powder X-ray diffraction technique, scanning electron microscopy and Raman spectroscopy. XRD spectra authenticated the copper-doped nickel manganites' formation with particle size 23-28 nm. A significant decrease in the lattice parameter confirmed the doping of copper ions into the nickel manganites. Microscopy (SEM) was used to estimate the grain size, shape and uniformity, revealing the non-uniform agglomerated polygon and plate-like microstructure. The NCB-NPs showed anticoagulant activity by enhancing the coagulation time of citrated plasma of human beings. NCB-NPs with x = 0.35 and 0.45 have increased clotting time from control 133 ± 4 s to 401 ± 7 s and 3554 ± 80 s, respectively, and others around 134 s. Additionally NCB-NPs with x = 0.35, 0.45 inhibited the platelet aggregation by 80% and 92%, while remaining inhibited with only 30%. NCB-NPs did not show hemolytic activity in RBC cells intimate its non-toxic nature. Finally, NCB-NPs were non-toxic and known to exhibit anti-blood-clotting and antiplatelet activities, which can be used in the field of biomedical applications, especially as antithrombotic agents.

Sortilin is a neuronal receptor for apolipoprotein E (apoE). Sortilin-dependent uptake of lipidated apoE promotes conversion of polyunsaturated fatty acids (PUFA) into neuromodulators that induce anti-inflammatory gene expression in the brain. This neuroprotective pathway works with the apoE3 variant but is lost with the apoE4 variant, the main risk factor for Alzheimer's disease (AD). Here, we elucidated steps in cellular handling of lipids through sortilin, and why they are disrupted by apoE4. Combining unbiased proteome screens with analyses in mouse models, we uncover interaction of sortilin with fatty acid-binding protein 7 (FABP7), the intracellular carrier for PUFA in the brain. In the presence of apoE3, sortilin promotes functional expression of FABP7 and its ability to elicit lipid-dependent gene transcription. By contrast, apoE4 binding blocks sortilin-mediated sorting, causing catabolism of FABP7 and impairing lipid signaling. Reduced FABP7 levels in the brain of AD patients expressing apoE4 substantiate the relevance of these interactions for neuronal lipid homeostasis. Taken together, we document interaction of sortilin with mediators of extracellular and intracellular lipid transport that provides a mechanistic explanation for loss of a neuroprotective lipid metabolism in AD., Competing Interests: Competing interests The authors declare no competing or financial interests., (© 2021. Published by The Company of Biologists Ltd.)

Background: Due to the COVID-19 pandemic, many countries have implemented nationwide lockdowns. While this leads to a decrease in disease transmission, there is a concurrent increase in the levels of psychological distress. To estimate the levels of psychological distress in school- and college-going adolescents currently under lockdown and to determine the factors associated with this psychological distress., Materials and Methods: A cross-sectional study conducted in Army Public School and College (APSAC) Sibi, Balochistan province of Pakistan between March and May 2020. Students of APSAC Sibi were enrolled in this research. Modified Kuppuswamy Socioeconomic Scale, Godin Leisure-Time Exercise Questionnaire, and Kessler-10 were used for data acquisition. Chi-square and t -tests and univariate analysis (nonparametric test) were performed using the Statistical Package for the Social Sciences (SPSS) version 23.0 (IBM, Armonk, US)., Results: Out of 225 participants, 57.4% were studying at school. Sixty-four percent of the participants were likely to be suffering from psychological distress. There is a significant effect of physical activity, sleep duration, bedtime at night, screen-time duration, and COVID-19 positive family member on the levels of distress. A moderate positive correlation was between psychological distress and bed-time at night ( rho [223] = 0.328, P < 0.001) and screen time duration ( rho [223] = 0.541, P < 0.001). A moderate negative correlation of physical activity ( rho [223] = -0.340, P < 0.001) and a weak negative correlation of sleep duration hours ( rho [225] = -0.158, P = 0.018) was found with psychological distress levels., Conclusions: The COVID-19 lockdown and pandemic have had a considerable psychological impact on both school-going and college-going students, showing increased level of stress. A strong public health campaign along with mental and physical and social support programs are the need of the hour., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Journal of Education and Health Promotion.)

Effect of edible coatings of gum Arabic, carrageenan and xanthan gum containing lemon grass essential oil 1% w/v on postharvest quality of strawberry was studied under refrigeration for a period of 12 days. Results showed all the three coatings maintained fruit quality parameters during storage compared to control. Among all the coatings, carrageenan coated fruits showed delayed weight loss (10.1 to 8%), decay percentage (78.42 to 14.29%), retained ascorbic acid (0.15 to 0.27 g kg -1) , antioxidant activity (18.17 to 25.85%), firmness (9.07 to 12.43 N), L* (32.38 to 40.42), a* (16.08 to 17.22) and b* (27.36 to 33.54). Carrageenan gum also showed lowest cellulase activity (0.03 units h -1  mg protein -1 ), pectin methylesterase activity (1.13 A620 min -1 mg protein -1 ) and β-galactosidase activity (0.51 μmol min -1  mg protein -1 ), while showed maximum reduction in polygalacturonase activity (0.07 units h -1  mg protein -1 ) at the end of storage. Carrageenan gum was found effective in retention of anthocyanins and phenolic compounds during storage. Coatings loaded with antimicrobial agent inhibited psychrophilic bacteria, yeast and mold growth. It is concluded that carrageenan gum could better retain strawberry quality up to 12 days under refrigeration., (Copyright © 2021. Published by Elsevier B.V.)

Background: Cardiovascular diseases are a leading cause of death worldwide and result in significant economic costs to health care systems. The prevalence of cardiovascular conditions that require monitoring is expected to increase as the average age of the global population continues to rise. Although an accurate cardiac assessment can be performed at medical centers, frequent visits for assessment are not feasible for most people, especially those with limited mobility. Monitoring of vital signs at home is becoming an increasingly desirable, accessible, and practical alternative. As wearable devices are not the ideal solution for everyone, it is necessary to develop parallel and complementary approaches., Objective: This research aims to develop a zero-effort, unobtrusive, cost-effective, and portable option for home-based ambient heart rate monitoring., Methods: The prototype seat cushion uses load cells to acquire a user's ballistocardiogram (BCG). The analog signal from the load cells is amplified and filtered by a signal-conditioning circuit before being digitally recorded. A pilot study with 20 participants was conducted to analyze the prototype's ability to capture the BCG during five real-world tasks: sitting still, watching a video on a computer screen, reading, using a computer, and having a conversation. A novel algorithm based on the continuous wavelet transform was developed to extract the heart rate by detecting the largest amplitude values (J-peaks) in the BCG signal., Results: The pilot study data showed that the BCG signals from all five tasks had sufficiently large portions to extract heart rate. The continuous wavelet transform-based algorithm for J-peak detection demonstrated an overall accuracy of 91.4% compared with electrocardiography. Excluding three outliers that had significantly noisy BCG data, the algorithm achieved 94.6% accuracy, which was aligned with that of wearable devices., Conclusions: This study suggests that BCG acquired through a seat cushion is a viable alternative to wearable technologies. The prototype seat cushion presented in this study is an example of a relatively accessible, affordable, portable, and unobtrusive zero-effort approach to achieve frequent home-based ambient heart rate monitoring., (©Ahmed Raza Malik, Jennifer Boger. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 31.05.2021.)

Background Changes in hematological parameters, such as neutrophils, leukocytes, neutrophil-lymphocyte ratio, platelet lymphocyte ratio, and mean platelet volume, have been observed during laparoscopic surgeries. Objectives The objectives of this research were to assess the changes in hematological parameters and liver enzymes during laparoscopic cholecystectomy (LC). Methods This prospective observational study included patients undergoing laparoscopic cholecystectomy for symptomatic cholelithiasis. Patients with comorbidities, including hepatitis, diabetes, and where laparoscopic cholecystectomy was converted to open cholecystectomy, were excluded. Preoperative and postoperative baseline hematological parameters and liver function tests (LFTs) were recorded. Characteristics like age, gender, body mass index (BMI), indication for surgery, duration of surgery, the pressure of pneumoperitoneum, and the duration of hospital stay were noted. A paired sample t-test was applied to assess the difference between the mean pre and postoperative values of different hematological parameters. Results It was observed that hemoglobin (Hb), hematocrit (Hct), platelets, and alkaline phosphatase (ALP) decreased postoperatively. However, mean corpuscular volume (MCV), mean platelet volume (MPV), leukocytes, and alanine transaminase (ALT) increased postoperatively. The difference in mean Hb, MCV, Hct, leukocytes, MPV, and ALT was statistically significant (p<0.05). Conclusion There were significant changes in the levels of hematological parameters and liver enzymes during LC., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Ashraf Butt et al.)

Psychological distress is a generic term which refers to "feeling of emotional strain" that affects our normal mental and physical functioning. The aim of this study is to investigate the psychological distress perceived by the Pakistani students living in quarantine and to determine risk and protective factors, including knowledge of COVD-19, among this population. It is a descriptive cross-sectional study conducted from February to May 2020. Students enrolled at different colleges and universities of Pakistan participated in this survey. One-way analysis of variance (ANOVA) is computed for comparing knowledge scores of participants having different levels of psychological distress. A total of 937 participants completed the survey questionnaire, with slightly more male respondents (60.6%) than female (39.4%). The average age of survey participants is 22.0 years (SD = 3.01), with majority (76.2%) belonging to urban areas. The mean COVID-19 knowledge score is 8.91 (SD = 1.69, range: 1-12), suggesting an overall 74.25% precision rate for this knowledge test for individual participant. The participants scored least knowledge regarding the disease transmission, showing a percentage correctness of only 40%. Majority of the participants (57.3%) are likely to be well, while others (42.7%) have shown symptoms of mental distress. The analysis reveals that participants with moderate mental distress (M = 8.81, SD = 2.37) and those with severe mental distress (M = 8.75, SD = 2.69) scored lower than participants who were likely to be well (M = 9.49, SD = 1.71). Our study concludes that a higher knowledge base regarding the disease will help to mitigate distress levels. Our study suggests that in order to deal with this pandemic effectively, the knowledge regarding COVID-19 should be properly conveyed to general public. It is need of the hour to address mental issues of the population aggressively along with providing awareness about COVID-19., Competing Interests: Conflict of interests: The authors declare no conflict of interest., (© 2021 the Author(s), licensee AIMS Press.)

Introduction The prolonged fluoroscopic time during coronary angiography results in a higher radiation dose delivered to patients. Similarly, a higher contrast volume used is associated with higher rates of contrast-induced nephropathy. This study was designed to identify the better technique in terms of lesser fluoroscopic time and volume of contrast used during the procedure. Objective To compare mean fluoroscopic time and mean contrast volume used in patients undergoing coronary angiography through the transfemoral versus transradial route. Methods A randomized controlled trial (RCT) was conducted at the department of cardiology, Pakistan Institute of Medical Sciences (PIMS) Islamabad between June 2017 and December 2017. Ninety (n=90) patients planned for coronary angiography between 30 and 70 years of age were enrolled. Patients were randomly allocated to Group A (transfemoral route group) and Group B (transradial route group). Fluoroscopic time (minutes) and contrast volume (milliliters) used were measured in each patient. Results The mean contrast volume used in Group A was 70.4 ml (SD=8.7) and in Group B, it was 90.1 ml (SD=9.8) (P<0.001). The mean fluoroscopic time in Group A was 5.1 min (SD=1.2), and in group B, it was 8.6 min (SD=1.2) (P<0.001). Similar trends were noted when data were stratified with respect to age and gender. Conclusion The mean fluoroscopic time and the mean contrast volume were significantly less in patients where coronary angiography was performed through the transfemoral route than through the transradial route in this study., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2020, Hasrat et al.)

VPS10P (vacuolar protein sorting 10 protein) domain receptors are neuronal sorting receptors that direct cargo proteins to their destined location in subcellular compartments of the soma, dendrites, and the axon. Protein sorting by receptors such as SORLA, sortilin, and SorCS2 controls functional integrity and viability of neurons, whereas sorting receptor dysfunctions are linked to acute, psychiatric, and neurodegenerative diseases. Here, we discuss molecular mechanisms that define ligand repertoire and sorting path and that control plasticity of VPS10P domain receptor expression in the healthy brain and in response to injury. These findings highlight important concepts in neuronal protein sorting and why aberrant sorting contributes to the progression of devastating diseases of the human brain, including epilepsy, Alzheimer's disease, and frontotemporal dementia., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Healthcare providers have disparate views of family presence during cardiopulmonary resuscitation; however, the attitudes of physicians have not been investigated systematically. This study investigates the patterns and determinants of physicians' attitudes to FP during cardiopulmonary resuscitation in Saudi Arabia. A cross-sectional design was applied, where a sample of 1000 physicians was surveyed using a structured questionnaire. The study was conducted in the southern region of Saudi Arabia for over 11 months (February 2014-December 2014). The collected data was analyzed using the Pearson chi-square test. Spearman's correlation analysis and chi-square test of independence were used for the analysis of physicians' characteristics with their willingness to allow FP. 80% of physicians opposed FP during cardiopulmonary resuscitation. The majority of them believed that FP could lead to decreased bedside space, staff distraction, performance anxiety, interference with patient care, and breach of privacy. They also highlight FP to result in difficulty concerning stopping a futile cardiopulmonary resuscitation, psychological trauma to family members, professional stress among staff, and malpractice litigations. 77.9% mostly disagreed that FP could be useful in allaying family anxiety about the condition of the patient or removing their doubts about the care provided, improving family support and participation in patient care, or enhancing staff professionalism. Various concerns exist for FP during adult cardiopulmonary resuscitation, which must be catered when planning for FP execution., Competing Interests: The author declares that there is no conflict of interest regarding the publication of this paper., (Copyright © 2020 Ali A. Al bshabshe et al.)

Introduction: Apolipoprotein E (apoE) is a carrier for brain lipids and the most important genetic risk factor for Alzheimer's disease (AD). ApoE binds the receptor sortilin, which mediates uptake of apoE-bound cargo into neurons. The significance of this uptake route for brain lipid homeostasis and AD risk seen with apoE4, but not apoE3, remains unresolved., Methods: Combining neurolipidomics in patient specimens with functional studies in mouse models, we interrogated apoE isoform-specific functions for sortilin in brain lipid metabolism and AD., Results: Sortilin directs the uptake and conversion of polyunsaturated fatty acids into endocannabinoids, lipid-based neurotransmitters that act through nuclear receptors to sustain neuroprotective gene expression in the brain. This sortilin function requires apoE3, but is disrupted by binding of apoE4, compromising neuronal endocannabinoid metabolism and action., Discussion: We uncovered the significance of neuronal apoE receptor sortilin in facilitating neuroprotective actions of brain lipids, and its relevance for AD risk seen with apoE4., (© 2020 The Authors. Alzheimer's & Dementia published by Wiley Periodicals LLC on behalf of Alzheimer's Association.)

SorCS2 is an intracellular sorting receptor of the VPS10P domain receptor gene family recently implicated in oxidative stress response. Here, we interrogated the relevance of stress-related activities of SorCS2 in the brain by exploring its role in ischemic stroke in mouse models and in patients. Although primarily seen in neurons in the healthy brain, expression of SorCS2 was massively induced in astrocytes surrounding the ischemic core in mice following stroke. Post-stroke induction was likely a result of increased levels of transforming growth factor β1 in damaged brain tissue, inducing Sorcs2 gene transcription in astrocytes but not neurons. Induced astrocytic expression of SorCS2 was also seen in stroke patients, substantiating the clinical relevance of this observation. In astrocytes in vitro and in the mouse brain in vivo, SorCS2 specifically controlled release of endostatin, a factor linked to post-stroke angiogenesis. The ability of astrocytes to release endostatin acutely after stroke was lost in mice deficient for SorCS2, resulting in a blunted endostatin response which coincided with impaired vascularization of the ischemic brain. Our findings identified activated astrocytes as a source for endostatin in modulation of post-stroke angiogenesis, and the importance of the sorting receptor SorCS2 in this brain stress response., (© 2020 The Authors. Glia published by Wiley Periodicals, Inc.)

Excitatory amino acid transporters (EAATs) encompass a class of five transporters with distinct expression in neurons and glia of the central nervous system (CNS). EAATs are mainly recognized for their role in uptake of the amino acid glutamate, the major excitatory neurotransmitter. EAATs-mediated clearance of glutamate released by neurons is vital to maintain proper glutamatergic signalling and to prevent toxic accumulation of this amino acid in the extracellular space. In addition, some EAATs also act as chloride channels or mediate the uptake of cysteine, required to produce the reactive oxygen speciesscavenger glutathione. Given their central role in glutamate homeostasis in the brain, as well as their additional activities, it comes as no surprise that EAAT dysfunctions have been implicated in numerous acute or chronic diseases of the CNS, including ischemic stroke and epilepsy, cerebellar ataxias, amyotrophic lateral sclerosis, Alzheimer's disease and Huntington's disease. Here we review the studies in cellular and animal models, as well as in humans that highlight the roles of EAATs in the pathogenesis of these devastating disorders. We also discuss the mechanisms regulating EAATs expression and intracellular trafficking and new exciting possibilities to modulate EAATs and to provide neuroprotection in course of pathologies affecting the CNS., Competing Interests: The authors declare no conflict of interest.