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The release of pollutants into water reservoirs is harmful to aquatic life and poses serious health risks to humans, which is a significant issue everywhere in the world. Photocatalytic degradation of organic dyes has attracted the attention of researchers in order to purify industrial wastewater. In this work, ZnO is incorporated with Co3O4 using the template-free hydrothermal method and co-precipitation method. After studying the structural and morphological characteristics with XRD and FESEM, optical properties and bandgap were investigated using UV-visible spectroscopy and PL spectroscopy, which gives information about the alterations in the band gap of nanocomposite while revealing defects in the materials. The photocatalytic activity was investigated for methylene blue (MB) over the tenure of 60 min. The composite exhibited 3.6- and 9.3-times better degradation as compared to pristine Co3O4 and ZnO, respectively. The cyclic stability test and the scavenger experiments were also performed. The results suggest that the material can be used for industrial effluent purification purposes. [ABSTRACT FROM AUTHOR]

An improved damage detection index for a structural component is proposed, using eigenvalues estimated by means of frequency domain decomposition (FDD) and mode contribution subjected to ambient excitation. It is based on vibration measurements obtained from the acceleration data of a simple steel beam. Since the extraction of modal parameters involves practical limitations and, in general, it is difficult to obtain accurate results, therefore in the proposed method a derivative value of the time series acceleration response, termed modal contributing parameter (MCP), is used in combination with eigenfrequencies. The damage is indicated by element stiffness reduction (ESR). Different damage cases for various stiffness reduction values of 1% to 15% were investigated. Damage identification indices for every single damage and multiple damage cases were calculated. The modified MCP damage detection index showed a high index value, even for low-level damage with an element stiffness reduction of as low as 1% over the existing frequency drop and indices based on mode shape change. MCP index derived from the modal response, considering modal contributions to the entire structural response and eigenvalues for damage detection, improved overall sensitivity and reliability of index results. Both single and multiple cases of damage provided equally accurate results based on the MCP index value. [ABSTRACT FROM AUTHOR]

To control the cracks and to increase the serviceability of concrete members, different types of fibers are used. The present research is conducted to study the behavior of hybrid-fiber reinforced concrete (HFRC) to enhance the load carrying capacity of concrete in compression and tension. Two different types of fibers are studied in this research; one is steel fibers (SF), and the other is polypropylene fibers (PPF). By using a different volumetric combination of SF and PPF, 42 concrete cylinders are cast in order to study the compressive and tensile behavior of concrete. The results exhibited the physical changes in the concrete due to the addition of different low-volume fractions of SF and PPF. The maximum compressive strength was achieved using 0.7% SF along with 0.3% PPF and the maximum tensile strength was achieved at 0.8% SF and 0.9% PPF by the total volume of the sample. A comparative study was also made for the previously proposed equations of the elastic modulus of concrete in order to obtain an equation which predicts the elastic modulus of HFRC accurately. [ABSTRACT FROM AUTHOR]

In this investigation, carbon fiber reinforced polymers (CFRP) were used for repairing of six damaged reinforced concrete (RC) beam-column T joints. Two different types of CFRP configurations (1 & 2) were employed to reinstate the seismic capacity of joints. The specimens were tested under cyclic axial loading till failure. Load deflection relationships of tested specimens were used to draw hysteresis loops and backbone curves. In order to assess the seismic performance this data was then used to calculate energy dissipation values at selected intervals. Finite element modelling of all three types was also done in ANSYS to validate model. It was concluded that seismic capacity of repaired specimen is affected by CFRP configuration techniques. It was found that the relative energy dissipation capacity of specimens repaired with CFRP configuration-2 was 25.43% higher than CFRP configuration-1.Cumulative energy dissipation capacity was 5.24% higher in CFRP configuration-2 as compared to CFRP configuration-1. It was also found that the prevailing cracking pattern of repaired columns largely affects response of repaired specimen. Study also concluded that performance of Beam-column joints can be improved by appropriately selecting CFRP configuration without altering other parameters. [ABSTRACT FROM AUTHOR]

Objective: To estimate the incidence and characteristics of coronary artery ectasia in patients undergoing coronary angiography. Study Design: A prospective analysis. Place and Duration of Study: This study was conducted at Army Cardiac Center, Lahore over a period of two years from Jan 2018 to Dec 2019. Methodology: Its prospective analysis of all coronary angiograms performed in our catheterization laboratory during study period. Markis classification was the basis to define and classify coronary artery ectasia. Demographical, clinical, and laboratory data were collected for each patient in this study. Results: A total of 172 (3.9%) out of 4,372 coronary angiograms showed coronary artery ectasia. Among coronary artery ectasia group, mean age 58 ± 10 years, 90% were male, 47% were current smokers, 32% were hypertensive, 15% had diabetes Mellitus and 37% had dyslipidemia. The most common clinical presentation was Non STsegment elevation myocardial infarction (31%), followed by Stable ischemic heart disease in 28%. Right coronary artery was the most frequent coronary artery involved (57%) while Markis Class 3 pattern was seen as most common type of coronary artery ectasia. Conclusion: The frequency of coronary artery ectasia among our patients undergoing coronary angiography was about 4%. Right coronary artery remained the most common affected artery.

Objective: To determine the frequency of congenital cardiac lesions in pregnant women reporting for fetal echocardiogram and correlate with obstetrical risk factors. Study Design: Descriptive cross-sectional study. Place and Duration of Study: To be conducted at pediatric cardiology and obstetrical unit of AFIC/NIHD and CMH Rawalpindi, from Jan 2009 to Jan 2020. Methodology: Pregnant women referred for fetal echocardiogram from 19-49 years of age were enrolled. Echo was done between 20 to 36 weeks gestation. Primary outcome was the nature of cardiac lesion and gestation at diagnosis. Neonatal scan was done at follow up to confirm cardiac diagnosis. Secondary outcome was obstetrical risk factors which were the reason for referral. This included age consanguinity, family history, previous history of intrauterine death or early neonatal death, maternal and paternal diseases. Data was collected and analyzed n frequencies and percentage. Chi-square was applied for association between variable and p-valve 0.05 was considered significant. Results: A total of n=967 pregnant women referred to outpatient department for fetal echocardiogram. Congenital cardiac lesion were detected in n=83 patients. Majority of patients had CAVSD (1.2%) CCAVB (1.2%) followed by ASD (1.1%) VSD (0.9%) Abnormal heart rate (0.8%) Single ventricle (0.3%). Most significant maternal age group was between 21 to 30 and 30-40 years (43.7 and 46.2%). Only 3% below 20 years and 6.7% above 40 years of age. Most important maternal risk factor was previous off spring 0.5% past family history 0.3% and abnormal obstetrical ultrasound 0.3% Followed by maternal diabetes 0.1% and maternal hypertension 0.1%. The yield of detection of congenital cardiac lesions was 8.3%. Conclusions: Congenital cardiac diseases are the second most common congenital anomaly and huge burden n pediatric population. Timely diagnosis and referral can be lifesaving.

Abstract. Life insurance is a major contributor to the insurance industry's expansion in Pakistan. From the standpoint of the overall growth of the insurance industry is critical. At the same time, there are numerous issues in this industry that affect its performance. The study provides insight into Pakistan's life insurance sector's performance. This research aims to determine the impact of life insurance premium earned on profitability. Regression analysis is done to analyze the outcomes. According to the study's findings, there is a significant relationship between earned premium and underwriting profit. Premium earn is increasing but underwriting profit is decreasing instead of generating more profit for the insurance industry. [ABSTRACT FROM AUTHOR]

Introduction: Vitamin D has been shown to have a strong association with both ischaemic stroke and cardiovascular disease. There is a scarcity of published data from Indian subcontinent on vitamin D status and its association with acute ischaemic stroke. Aim: To study the association between serum 25- hydroxyvitamin D and Carotid Intima-Media Thickness (CIMT) in acute ischaemic stroke. Materials and Methods: One hundred ten consecutive subjects with acute ischaemic stroke were selected as cases and 55 healthy age and gender match subjects were included as controls. Quantitative measurement of 25-OH vitamin D in serum and plasma samples was done. Common Carotid Artery (CCA) doppler images were obtained to measure Intima-Media Thickness (IMT) by using three different angle views for each vessel. Student’s t-test was used for comparison of continuous variables. The results of comparing the correlation between two continuous variables were indicated by the correlation coefficient (r) using correlation analysis. Results: In the study population i.e., both in cases and controls, 59.39% subjects had vitamin D insufficiency, 34.44%had vitamin D deficiency and only 6.06% had Vitamin D levels within normal limits. The difference between the mean Vitamin D levels of cases (13.35±5.58 ng/mL) and controls (18.78±9.28 ng/mL) was found to be statistically significant (p

Bi-functional materials provide an opportunity for the development of high-performance devices. Up till now, bi-functional performance of NiCo 2 O 4 @SnS 2 nanosheets is rarely investigated. In this work, NiCo 2 O 4 @SnS 2 nanosheets were synthesized on carbon cloth by utilizing a simple hydrothermal technique. The developed electrode (NiCo 2 O 4 @SnS 2 /CC) was investigated for the detection of L-Cysteine and supercapacitors applications. As a non-enzymatic sensor, the electrode proved to be highly sensitive for the detection of L-cysteine. The electrode exhibits a reproducible sensitivity of 4645.82 μ A mM -1 cm -2 in a wide linear range from 0.5 to 5 mM with a low limit of detection (0.005 μ M). Moreover, the electrode shows an excellent selectivity and long-time stability. The high specific surface area, enhanced kinetics, good synergy and distinct architecture of NiCo 2 O 4 @SnS 2 nanosheets produce a large number of active sites with substantial energy storage potential. As a supercapacitor, the electrode exhibits improve capacitance of 655.7 F g -1 at a current density of 2 A g -1 as compare to NiCo 2 O 4 /CC (560 F g -1 ). Moreover, the electrode achieves 95.3% of its preliminary capacitance after 10 000 cycles at 2 A g -1 . Our results show that NiCo 2 O 4 @SnS 2 /CC nanosheets possess binary features could be attractive electrode material for the development of non-enzymatic biosensors as well as supercapacitors., (© 2024 IOP Publishing Ltd.)

A 54-year-old man developed altered mental state and generalised tonic-clonic seizures after 1 week of upper respiratory tract symptoms and diarrhoea, having been previously well. His MR scan of brain showed multifocal progressive T2 cortical signal changes. He was diagnosed with new-onset refractory status epilepticus (NORSE), initially treated as being secondary to autoimmune/paraneoplastic limbic encephalitis, although subsequent investigations were negative. His seizures and electrographic epileptiform activity continued despite escalating doses of antiseizure medications, immunosuppression with corticosteroids, immunoglobulins, plasma exchange and rituximab, and thereafter anaesthetic agents. A vagus nerve stimulator (VNS) was implanted 6 weeks after admission and its voltage rapidly increased over 4 days; his seizure activity resolved in the third week after VNS implantation. This case highlights the role of VNS in the early management of NORSE., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Background: Minimally invasive tissue sampling (MITS) has increasingly been used to improve the diagnosis of disease and identification of the cause of death, particularly in underserved areas. However, there are multiple barriers to accessing those who die within the community, our study aimed to explore the perceptions and insights of community members and healthcare providers regarding the feasibility of implementing MITS in community settings., Methods: A qualitative exploratory study was conducted. A total of twenty one in-depth interviews were conducted with deceased infants' parents, elders of the family, religious leaders, community leaders, and funeral workers. Focus group discussions were conducted with health care providers (n = 14) in two peri-urban slum areas of Karachi, Pakistan. The duration of this study was from August to October 2020. Data was analyzed using thematic analysis and was coded and merged into categories forming eight major themes., Results: In general, participants viewed minimally invasive tissue sampling (MITS) as beneficial for improving child health, though some had concerns about disrespecting the deceased during sample collection. Misinformation, fear of needles, and medical procedures were major barriers to MITS implementation. To enhance acceptance, community and religious leaders suggested using religious rulings, obtaining parental consent, ensuring confidentiality, and increasing efforts of community engagement. Community healthcare providers, along with funeral workers, recommended providing community members with grief counseling to increase study participation. Besides concerns about sampling interfering with respect for the decease, community members also raised concerns about misinformation. Further, participants provided feedback on the design and appearance of the mobile van used to collect MITS samples from children under the age of five., Conclusion: This study is critical for understanding the challenges associated with implementation of community-based MITS sampling in Pakistan. Integrating the use of a mobile van for sample collection, grief counseling along with community engagement sessions and advocacy will help address community-based misinformation and develop community trust., (© 2023. The Author(s).)

The application of green synthesis for silver nanoparticles in nanomedicine has experienced significant growth. Strobilanthes glutinosus , a plant primarily located in the Himalayas, remains largely unexplored. Considering the biomedical value of S. glutinosus , phytochemicals from this plant were used for the biosynthesis of silver nanoparticles. Silver nanoparticles were synthesized from aqueous extract of root and leaves of Strobilanthes glutinosus . The synthesized silver nanoparticles were characterized using UV-Vis spectrophotometry, Fourier-transform infrared spectroscopy, transmission electron microscopy, and X-ray diffraction. Total phenolic and flavonoid contents of plants were determined and compared with nanoparticles. The biomedical efficacy of plant extracts and silver nanoparticles was assessed using antioxidant and antibacterial assays. The UV-Vis spectra of leaf- and root-extract-mediated AgNPs showed characteristic peaks at 428 nm and 429 nm, respectively. TEM images revealed the polycrystalline and spherical shapes of leaf- and root-extract-mediated AgNPs with size ranges of 15-60 nm and 20-52 nm, respectively. FTIR findings shown the involvement of phytochemicals of root and leaf extracts in the reduction of silver ions into silver nanoparticles. The crystalline face-centered cubic structure of nanoparticles is depicted by the XRD spectra of leaf and root AgNPs. The plant has an ample amount of total phenolic content (TPC) and total flavonoid content (TFC), which enhance the scavenging activity of plant samples and their respective AgNPs. Leaf and root AgNPs have also shown good antibacterial activity, which may enhance the medicinal value of AgNPs.

Purpose: The aim of our study was to validate a German translation of the post-acute (long) COVID-19 quality of life (PAC-19QoL) instrument among German patients with long COVID-19 syndrome., Patients and Methods: The PAC-19QoL instrument was translated into the German language and administrated to patients with long COVID-19 syndrome. Cronbach's alpha coefficient was used to analyze the internal consistency of the instrument. Construction validity was evaluated by using Pearson's correlation coefficient and Spearman's rank correlation. Scores of patients and controls were compared using the Mann-Whitney U -test., Results: A total of 45 asymptomatic and 41 symptomatic participants were included. In total, 41 patients with long COVID-19 syndrome completed the PAC-19QoL and EQ-5D-5L questionnaires. PAC-19QoL domain scores were significantly different between symptomatic and asymptomatic participants. All items achieved a Cronbach's alpha >0.7. There was a significant correlation between all domains on the test ( p < 0.001), with the highest correlation between total ( r = 0.994) and domain 1 ( r = 0.991). Spearman's rank correlation analysis confirmed that the instrument items correlated with the objective PAC-19QoL examination findings., Conclusion: The German version of the instrument is valid and reliable and can be a suitable tool for research and daily clinical practice among patients with long COVID-19 syndrome., 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 © 2023 Umakanthan, Monice, Mehboob, Jones and Lawrence.)

BACKGROUND : Since the pandemic of SARS-CoV-2 began, our understanding of the pathogenesis and immune responses to this virus has continued to evolve. It has been shown that this infection produces natural detectable immune responses in many cases. However, the duration and durability of immunity and its effect on the severity of the illness are still under investigation. Moreover, the protective effects of antibodies against new SARS-CoV-2 variants still remain unclear., Objectives: To assess the incidence and associated demographic features of SARS-CoV-2 infection in anti-nucleocapsid IgG-positive and anti-nucleocapsid IgG-negative healthcare workers., Material and Methods: This prospective longitudinal cohort study was conducted in Peshawar Medical College group of hospitals of Prime Foundation. Anti-nucleocapsid IgG sero-positive and anti-nucleocapsid IgG sero-negative healthcare workers were followed for a period of 6 months (from 1 Aug 2020 to 31 Jan 2021), and the incidence of SARS-CoV-2 was confirmed by RT-PCR., Results: A total number of 555 cohorts were followed for a period of 6 months; of them 365 (65.7%) were anti-nucleocapsid-negative (group A) and 190 (34.3%) were anti-nucleocapsid-positive (group B) healthcare workers. The mean age of the study cohort was 33.85 ± 9.80 (anti-N (-), 34.2 ± 10.58; anti-N ( +), 33.5 ± 9.50). The median antibody level in anti-nucleocapsid-positive HCWs was 15.95 (IQR: 5.24-53.4). Male gender was the majority in both groups (group A, 246 (67%), group B, 143 (48%)) with statistically significant difference (P < 0.05). Majority of the HCWs were blood group B in both groups (34% each). None of the 190 anti-nucleocapsid-positive HCWs developed subsequent SARS-CoV-2 re-infection, while 17% (n = 65) HCWs developed infection in anti-nucleocapsid-negative group during the 6-month follow-up period., Conclusion: In conclusion, none of the anti-nucleocapsid-positive HCWs developed SARS-CoV-2 re-infection in this study, and the presence of IgG anti-nucleocapsid antibodies substantially reduce the risk of re-infection for a period of 6 months., (© 2022. The Author(s), under exclusive licence to Royal Academy of Medicine in Ireland.)

Objective: Gene-environment interactions might play a significant role in the development of bipolar disorder (BD). The objective of the current study was to investigate the association between tumor necrosis factor (TNF)-α -308 G/A polymorphism and BD and conduct a bioinformatics analysis of the protein-protein network of TNF-α. Gene-environment interactions and the relationship between stressful life events (SLEs) and substance abuse with TNF genotypes and other characteristics were analyzed., Methods: The genomic deoxyribonucleic acid (DNA) of 400 patients with BD and 200 control subjects were extracted and genotyped for TNF-α -308 G/A polymorphism. SLEs and substance abuse were evaluated using the Life Event and Difficulty Schedule (LEDS) and a self-designed substance abuse questionnaire for the events six months prior to the onset of the disease, respectively. Gene-environment interactions were assessed by multiple statistical tools. Bioinformatics analysis of the TNF-α network and its interacting proteins was carried out using STRING and Cytoscape softwares., Results: Genotyping analysis revealed a significant association between TNF-α -308 G/A polymorphism and BD ( p <0.009). Furthermore, analysis of gene-environment interaction revealed a significant association between TNF-α -308 G/A and SLEs ( p =0.001) and TNF-α -308 G/A and substance abuse ( p =0.001). Three distinct proteins, RELA, RIPK1, and BIRC3, were identified through hub analysis of the protein network., Conclusion: TNF-α -308 G/A polymorphism is positively associated with BD. SLEs and substance abuse might trigger the early onset of BD. Proteins identified through bioinformatics analysis might contribute to the TNF-α mediated pathophysiology of BD and can be the potential therapeutic targets., Competing Interests: DISCLOSURES: The authors have no conflicts of interest relevant to the contents of this article., (Copyright © 2023. Matrix Medical Communications. All rights reserved.)

Background: Studies in the United States have shown a genetic predisposition to hypertension in individuals of African descent. However, studies on the associations between ethnic groups and hypertension in Latin America are lacking and the limited results have been inconsistent. The objective of this study is to determine whether Afro-Colombian ethnicity increases the risk of hypertension., Methods: This study is a secondary data analysis of a cross sectional study from five provinces in Northern Colombia. Randomly selected individuals (N = 2613; age-range 18-74 years) enrolled in a health care insurance company underwent physical examinations and completed questionnaires regarding ethnicity, lifestyle, and other risk factors. Hypertension in these patients was determined. Unadjusted and adjusted logistic regression analysis were calculated to determine the association between ethnicity and hypertension., Results: No association between Afro-Colombian ethnicity and hypertension was found (odds ratio [OR], 0.85; 95% confidence interval [CI], 0.66-1.09). As expected, people with a body mass index (BMI) of 30 or higher were at a greater risk of having hypertension (OR, 3.12; 95% CI, 2.35-4.16) compared with those with a normal BMI., Conclusions: Findings from this study suggest no independent association between Afro-Colombian ethnicity and hypertension. Further research should focus on genotyping or socioeconomic factors such as income level., (© 2022. The Author(s).)

Chronic suppurative otitis media (CSOM) is chronic infection of middle ear which is usually managed with antibiotic therapy. This infection may cause the depression and cognitive changes in patients. The aim of present study was to evaluate the effect of antibiotic (ciprofloxacin and co-amoxicillin) with antidepressant or without antidepressants (bromazepam and imipramine) at low doses on rats with induced with CSOM. Pseudomonas aeruginosa was used to induce CSOM by in rat ear (tympanic bulla). The rats were divided into eight groups having six animals in each group. Neuropharmacological activities and gross behavior were observed in open field activity, force swimming cage, maze test, light and dark activity box and traction test. Observations were noted weekly after the administration of ciprofloxacin (15.3mg/kg), co-amoxicillin (15.3mg/kg), imipramine (1.15mg/kg) and bromazepam (0.09mg/kg) intraperitoneally. The altered behavior and depression was observed in control positive but reverted back in groups maintained on antidepressants with antibiotics with significant improved locomotor activity, memory in memory cage, muscular co-ordination and body balance and decreased anxiety. On the other hand, groups treated with only antibiotics showed significant improvement only in force swimming and traction test at day 14. Therefore, the antidepressant effects of the drugs can be employed to attenuate stress and depression in patients with CSOM.

Objective: To determine the serum immunoglobulin E and serotonin levels of patients with chronic suppurative otitis media (CSOM) with and without treatment., Methods: This is a case-control study carried out in ENT ward of Jinnah Postgraduate Medical Centre Karachi Pakistan from May to September 2018.. Sample (n=160) was divided into four groups (40 individuals per group) as G1: control negative (group-1 without any disease), G2: positive control (patients didn't received medicines), G3: group (patients treated with co-amoxicillin 1000mg per day) and G4: group (patients treated with ciprofloxacin1000mg per day). After treatment period of One week serum immunoglobulin E and serotonin concentrations were evaluated by Elisa method at 450nm.Statistical evaluation was carried out using one-way ANOVA ( p <0.05) followed by post hoc (tukey test) for further group comparison. In order to find out correlation between IgE and serotonin with CSOM Pearson's correlation was applied., Results: There was no significant ( p > 0.05) association found between genders with serotonin as well as with IgE levels in CSOM patients. One way ANOVA showed significant difference ( p <0.05) for IgE and serotonin levels and post hoc (tukey test) showed significant higher of IgE levels in CSOM patients of G2 positive control (diseased patients) was observed when compared to the control negative group (healthy individuals) and also from treated groups of G3 and G4. This also showed that serotonin levels were significantly low in G2 (positive control) as well as in treated groups of G3 and G4 in contrast with healthy individuals of group G1., Conclusion: Antibiotics may revert the higher levels of IgE but cannot attenuate the decreased levels of neurotransmitter (serotonin) like healthy individuals, therefore, depression levels of CSOM patients should be monitored, scored and attenuated with proper intervention of antidepressants or counseling., (Copyright: © Pakistan Journal of Medical Sciences.)

Non insulin dependent diabetes mellitus (NIDDM) drugs such as glibenclamide and metformin is employed to heterogeneous disorder characterized by alteration in production of glucose due to impairment of both insulin secretion and insulin action. These patients might suffer with allergic rhinitis and in this case, there is a possibility to maintain patient on levocetirizine, an anti-allergic drug commonly used in rhinitis. The object of the present study is to detect possible interaction between glibenclamide or metformin with levocetirizine Current study was performed using UV spectroscopic technique sing simultaneous equation in pH simulated to gastric juice (pH 1), pH 4, pH 7.4 and in pH 9. All drugs followed Beer Lambert's Law. Results showed that glibenclamide and metformin can increase or decrease availability of levocetirizine and in the same way levocetirizine can alter availabilities of glibenclamide and metformin in different pH. Hence, drug interaction between glibenclamide or metformin with levocetirizne occurred. This may be due to his may be due to the charge transfer or binding capabilities of these drugs which resulted in significantly changed availability of NIDDIM as well as levocetirizine. Therefore, co-administration of these drugs should be avoided and furtherinvestigations at clinical and pre-clinical levels should be done.