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Synthesize of zinc nanoparticles adopted through a simple, and eco-friendly biosynthesis process, utilizing the eucalyptus ( Eucalyptus camaldulensis), river oak (Casuarina cunninghamiana) and dill (Anethum graveolens ) leaves as sources and evaluate the insecticidal effects of the produced zinc oxide nanoparticles against the mealworms Tenebrio molitor L.,1758.The produced ZnO nanoparticles were characterized by X-ray diffraction (XRD), UV–visible, and transmission electron microscopy (TEM). The laboratory research was carried out with feeding method (the leaf immersion in ZnO NPs solution with different concentrations). The mortality effects of all the three synthesized ZnO nanoparticles against the studied larval stage was recorded in various period of time. the results of the statistical analysis showed that there were significant differences in the average mortality rate according to plant consisting of zinc nanoparticle, in which the highest average of the larval mortality was obtained (61.83%) for river oak, with an average percentage of adult emergence (27.50 %). Similarly the LC50 values of the ZnO NPs derived from the used plants was showed a varying effect on the larvae of mealworm with feeding method and that this effect varied according to the plant species in which for the River oak was (396.27 ppm ), Eucalyptus plant (3630.78 ppm )and Dill plant was( 6280.58 ppm). This result concluded that Zinc Oxide Nanoparticles from plant sources has larvicidal properties but the most effective one was from River oak plant and they serve as eco-friendly an alternative to synthetic insecticides for controlling insect stages. Hence the biogenic Zinc Oxide Nanoparticles can be used as potential insecticidal agent for the studied insect.

Tayyba Saher,1 Rizwana Manzoor,1 Khizar Abbas,1 Jahanzeb Mudassir,2 M Asif Wazir,3 Ejaz Ali,4 Faheem Ahmad Siddique,5 Akhtar Rasul,6 Muhammad Imran Qadir,7 Ambreen Aleem,8 Naeem Qaiser,9 Adeel Usman,3 Muhammad Romman,10 Muhammad Sajid Ali11 1Department of Pharmacognosy, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan; 2Department of Pharmaceutics, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan; 3Department of Pharmacognosy, Faculty of Pharmacy and Pharmaceutical sciences,University of Karachi, Karachi, Pakistan; 4University College of Pharmacy, University of Punjab, Lahore, Pakistan; 5Department of Pharmacy, University of Central Punjab, Lahore, Pakistan; 6Department of Pharmaceutics, Faculty of Pharmaceutical sciences, GC University, Faisalabad, Pakistan; 7Institute of Molecular Biology and Biotechnology, Bahauddin Zakariya University, Multan, Pakistan; 8Department of Pharmacology, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan; 9College of Pharmacy, University of Sargodha, Sargodha, Pakistan; 10Pharmacognosy Lab,Department of Botany, University of Chitral, Chitral, KPK, Pakistan; 11Akson College of Pharmacy, Mirpur University of Science & Technology (MUST), Mirpur, AJ&K, PakistanCorrespondence: Khizar Abbas, Department of Pharmacognosy, Faculty of Pharmacy, Bahauddin Zakariya University, Multan, Pakistan, Tel +923228832872, Email khizarabbas@bzu.edu.pkBackground: Nature represents a basic source of medicinal scaffolds that can develop into potent drugs used in the treatment of many diseases.Aim: The present study was planned to evaluate the combined effects of polyherbal methanolic extract of the herbs (fruit of capsicum, bark of cinnamon, rhizome of turmeric and rhizome of ginger) that were individually well known for their analgesic and anti-inflammatory activities. Furthermore, we aimed to develop hydrogel formulation of this polyherbal extract and to characterize and evaluate its analgesic and anti-inflammatory potential.Materials and Methods: Zingiber officinale (R.), Capsicum annuum (L.), Curcuma longa (L.), and Cinnamomum verum (J.) polyherbal extract (GCTC) was prepared by maceration and evaluated for analgesic and anti-inflammatory potential. Then, two different types of hydrogel formulation were prepared. One is pH-based hydrogel in which carbopol-940 was used and the other is temperature-based gel in which methocel-K100 was used as gelling agent. Different concentrations of polyherbal extract (GCTC), at 1%, 3% and 5%, were used in hydrogel formulation. These prepared hydrogel formulations were characterized and evaluated for analgesic and anti-inflammatory potential.Results: Results show that polyherbal extract and all the developed formulations of polyherbal extract (GCTC), at concentrations of 1%, 3% and 5%, have significant analgesic and anti-inflammatory effects with good appearance, homogeneity, spreadability, extrudability and stability.Conclusion: It was concluded from this project that polyherbal extract (GCTC) and its hydrogel have significant analgesic and anti-inflammatory potential.Graphical Abstract: Keywords: inflammation, formulation, carbopol, methocel, carrageenan

Background: Tuberculosis is one of the deadliest diseases over the world. Diagnosis of pulmonary TB depends on combination various parameters. IGRA measure T cell release of IFN-γ in response to M.TB antigen. WHO policy statement as on IGRA use in low and middle income countries is not established yet. Objective: The present study aimed to compare between tuberculin skin test (TST) and interferon gamma release assay (IGRA) in the diagnosis of active tuberculosis infection and study the effect of 3 months of first line anti-TB therapy on the positivity of the IGRA test. Methods: 40 Egyptian patients were included in the study, and assigned as two groups; Group I comprised 20 patients with negative sputum for AFB by Ziehl-Neelsen stains with positive sputum culture for M.TB and Group II included 20 patients with positive sputum and Ziehl-Neelsen for AFB before and after 3 months of first line of anti-TB therapy. All patients were subjected to full history taking, clinical examination, X- ray chest, lab investigations, ESR measurements, microbiological tests and ELISA measurement of Quantiferon-TB Gold. Results: Lower significant values were found in group II after treatment than before treatment regarding clinical parameters and 1st and 2nd hours ESR. IGRA test and TST showed sensitivity (91.18%, 76.4%), specificity (83.33%, 66.67%), positive predictive value (96.88%, 92.86%), negative predictive value (62.5%, 33.3%) and accuracy of (90%, 75%) respectively. IGRA results had no statistical significant differences between the studied groups with poor agreement with TST ((κ) = 0.025). Conclusion: IGRAS test had high sensitivity and specificity in diagnosis of active TB. More studies are needed to evaluate the effect of anti-TB therapy on IGRA level.

Synthesize of zinc nanoparticles adopted through a simple, and eco-friendly biosynthesis process, utilizing the eucalyptus (Eucalyptus camaldulensis), river oak (Casuarina cunninghamiana) and dill (Anethum graveolens) leaves as sources and evaluate the insecticidal effects of the produced zinc oxide nanoparticles against the mealworms Tenebrio molitor L.,1758. The produced ZnO nanoparticles were characterized by X-ray diffraction (XRD), UV-visible, and transmission electron microscopy (TEM). The laboratory research was carried out with feeding method (the leaf immersion in ZnO NPs solution with different concentrations). The mortality effects of all the three synthesized ZnO nanoparticles against the studied larval stage was recorded in various period of time. the results of the statistical analysis showed that there were significant differences in the average mortality rate according to plant consisting of zinc nanoparticle, in which the highest average of the larval mortality was obtained (61.83%) for river oak, with an average percentage of adult emergence (27.50 %). Similarly the LC50 values of the ZnO NPs derived from the used plants was showed a varying effect on the larvae of mealworm with feeding method and that this effect varied according to the plant species in which for the River oak was (396.27 ppm), Eucalyptus plant (3630.78 ppm) and Dill plant was (6280.58 ppm). This result concluded that Zinc Oxide Nanoparticles from plant sources has larvicidal properties but the most effective one was from River oak plant and they serve as eco-friendly an alternative to synthetic insecticides for controlling insect stages. Hence the biogenic Zinc Oxide Nanoparticles can be used as potential insecticidal agent for the studied insect. [ABSTRACT FROM AUTHOR]

Numerous studies indicated that patients with tobacco use disorder (TUD) are inversely associated with mortality in what is known as the smoker's paradox. However, limited studies have been conducted on the impact of TUD on the in-hospital mortality rates of patients with secondary pulmonary hypertension (PH, Non-Group 1 PH). Using the 2019 National Inpatient Sample, we identified PH and divided it into TUD and non-TUD to compare the comorbidities and in-hospital mortality between the two after 1:1 propensity-score matching. Of 1,129,440 PH hospitalizations, 12.1 % had TUD. After matching (n=133545, each group), TUD had lower median age (62 vs. 63), higher females (49 vs. 46.6 %), blacks (25.9 vs. 25.3 %), lower household income (40.8 vs. 32.7 %), Medicaid (22.4 vs. 14.8 %), non-elective (93.5 vs. 89.8 %), rural (9.3 vs. 6.7 %), urban non-teaching (17.2 vs 15.8 %) admissions. All CV comorbidities and other substance use were higher in TUD except CHF and valvular heart disease, TUD+ cohort and lower mortality (3.3 vs. 4.2 %, OR 0.78, p

Open air three electrode (point-grid-plane) corona streamer counter with a preamplification gap has been utilized for detecting weakly ionizing beta rays. This is based on the fact that when the primary electrons produced by beta rays are multiplied in the external preamplification gap, they form a trigger electron swarm before entering the counter, produce the same effect as the direct incidence of strongly ionizing particle in the corona counter, and allow the counter to operate efficiently. However, operation of this counter in open air as one of its most attractive features requires a complete analysis of the counter response to the changes of ambient conditions. The effect of temperature on the beta particle corona counter performance is studied. A theoretical model is suggested to calculate the counter operating voltage as well as the beta particles triggered corona pulse characteristics at different temperatures (20 [degrees] C-50 [degrees] C). The temperature effects on the counter-energy response is explained. A compensation for the errors due to temperature effects is suggested. All the theoretical findings are confirmed by experiments.

Wadi Al-Batin alluvial fan starts from Wadi Al-Rummah in Saudi Arabia and passes through the Kuwait and Iraq borders. The fan represents the southern and northern limits of the Iraq and Kuwait national boundary, respectively, deposited by Wadi Al-Batin on the southern border of the main wide depression formed by the effectiveness of the Abu Jir-Euphrates Fault. The present study aims to evaluate the hydrological properties of the fan and perform a morphometric analysis to find the groundwater flow, structural, and drainage network of the study area based on fieldwork information and satellite images using remote sensing technique and GIS environment. The hydrological analysis shows that the drainage density pattern direction in Wadi Al-Batin alluvial fan is from the southwestern to the northeastern parts of the Wadi Al-Batin alluvial fan. The morphometric analysis results show that the Wadi Al-Batin fan is divided into five watersheds; each has seven stream orders, watershed 1 has the highest value of stream order, and watershed 2 has the lowest value of stream order. The drainage texture value range between fine, moderate, and very fine, which indicates the geological setting of the region consists of the Dibdibba Formation exposed in the study area. Watershed 3 has the highest value, and watershed 1 has the lowest value of stream frequency. The form factor value for all watersheds is less than 0.5 and has an elongated shape. The watershed 3 has the highest basin relief value, while the watershed 4 has the lowest value of basin relief.

This study aims to determine the firm and sector efficiency using data envelopment analysis for 121 listed firms, 3 from 2004 to 2016. Based on the efficiency score of 1 and 0, DEA analysis results indicate that 10% firm was highly efficient in the whole sample, 80% are semi-efficient in selected sectors and 10% slightly inefficient. Thus, we can conclude that all firms are not equally efficient. Also, the study used a Logit/ Probit Regression model, and results indicate that the brand value and type of sector has a positive impact on firm efficiency. The study concludes that Brand value increases firm efficiency, so managers should put more focus on building firm brand value.

Background: Tuberculosis is one of the deadliest diseases over the world. Diagnosis of pulmonary TB depends on combination various parameters. IGRA measure T cell release of IFN-γ in response to M.TB antigen. WHO policy statement on IGRA use in low and middle countries is not established yet. The present study aimed to compare between tuberculin skin test (TST) and interferon gamma release assay (IGRA) in the diagnosis of active tuberculosis infection and study the effect of 3 months of first line of anti-TB therapy on the positivity of the IGRA test. Methods: 40 Egyptian patients were included in the study, and assigned as two groups; Group I comprised 20 patients with negative sputum for AFB by Ziehl-Neelsen stains with positive sputum culture for M.TB and Group II (IIa and IIb) that included 20 patients with positive sputum and Ziehl-Neelsen for AFB before and after 3 months of first line of anti-TB therapy. All patients were subjected to full history taking, clinical examination, X-ray chest, lab investigations, ES R measurements, microbiological tests and ELISA measurement of Quantiferon-TB Gold . Results: lower significant values were found in group IIb than group IIa as regarding clinical parameters and 1st and 2nd hours ESR. IGRA test and TST showed sensitivity (91.18%, 76.4%), specificity (83.33%, 66.67%), positive predictive value (96.88%, 92.86%), negative predictive value (62.5%, 33.3%) and accuracy of ( 90%, 75%) respectively. IGRA results had no statistical significant differences between the studied groups with poor agreement with TST ( (κ) = 0.025). Conclusion: IGRAS test had high sensitivity and specificity in diagnosis of active TB. More studies are needed to evaluate the effect of anti-TB therapy on IGRA level [ABSTRACT FROM AUTHOR]

Background  Thrombotic microangiopathy encompasses a wide range of conditions, of which thrombotic thrombocytopenic purpura being a medical emergency requires prompt intervention, with schistocytes being a reliable morphological indicator of microvascular injury. However, there are conditions other than thrombotic microangiopathic anemia where schistocytes can be seen in large numbers. These nonthrombotic microangiopathic conditions are broadly grouped under cytoskeletal abnormalities, mechanical damage, and thermal injuries. Automated methods in schistocyte evaluation have shown varied reproducibility requiring manual identification. International Council for Standardization in Hematology (ICSH) recommends standardized morphological criteria and quantitative assessment as a percentage after counting at least 1,000 red blood cells in optimal areas of smear to reduce interobserver variability. Objectives  The aim of this study was to evaluate and quantitate schistocytes in thrombotic microangiopathic and nonthrombotic microangiopathic groups using ICSH guidelines and to evaluate interobserver reproducibility of manual schistocyte count. Materials and Methods  Overall, 157 peripheral blood smears showing schistocytes were studied by two independent observers using ICSH recommendations on light microscopy. The hematological findings were correlated with clinical diagnosis and other relevant investigations. Results  Schistocytes were observed in five cases of thrombotic microangiopathic anemia and 152 cases of nonthrombotic microangiopathic anemia. Schistocyte count in thrombotic microangiopathic anemia and nonthrombotic microangiopathic anemia groups with mean (±standard deviation) value was 2.28 ± 2.65% and 0.76 ± 0.67%, respectively ( p  < 0.001). The correlation coefficient between the two observers was 0.59 (confidence interval = 0.966-1.346) showing an excellent agreement on the reproducibility of schistocytes by application of ICSH guidelines. Conclusion  Percentage of schistocytes more than 1% is a robust morphological indicator for diagnosis of thrombotic microangiopathic anemia in adults. Strict application of ICSH guidelines reduces interobserver bias., Competing Interests: Conflict of Interest None declared., (The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)

Background: Poor control of diabetes mellitus (DM) is partly attributed to doctors' poor adherence to guidelines., Objective: To evaluate doctors' adherence to pharmacotherapeutic recommendations of DM management guidelines and factors associated with guidelines adherence and glycaemic control., Methods: This prospective observational study included 30 doctors who were treating DM patients in their private clinics in Quetta, Pakistan. On visit 1, a total of 600 prescriptions written by 30 enrolled doctors (20 patients per doctor) were noted along with patients' sociodemographic and clinical characteristics. American Diabetes Association guidelines was used as a reference. The prescriptions noted were judged for guidelines compliance. Of 600 enrolled patients, 450 patients (15 patients per doctor) were followed for one more visit and included in final analysis. Glycated hemoglobin (HbA1c) level noted one visit 2 was related with the respective prescription on visit 1. Data were analyzed by SPSS (version 23). A p -value <0.05 was considered statistically significant., Results: Patients received a median of two antidiabetic drugs (range: 1-5). A total of 73.1% patients were on polytherapy. Metformin was the most frequently prescribed (88.4%) antidiabetic followed by gliptins (46.2%). A total of 41.6% prescriptions were judged guidelines compliant. In multivariate binary logistic regressions (MVBLR) analysis, chronic kidney disease (CKD) (OR = 0.422) and polytherapy (OR = 0.367) had statistically significant negative associations ( p -value <0.05) with guidelines' compliant prescriptions. The group of doctors comprised of specialists and consultants wrote significantly ( p -value = 0.004) high number of guidelines adherent prescriptions (mean rank = 20.25) than the group comprised of medical officers (mean rank = 11.34). On visit 2, only 39.5% patients were on goal glycemic levels. In MVBLR analysis, suffering from dyslipidemia (OR = 0.134) and CKD (OR = 0.111), receiving sulfonylurea (OR = 0.156) and guidelines' compliant prescription (OR = 4.195) were significantly ( p -value <0 .05) associated with glycemic control., Conclusion: Although guidelines compliant prescriptions produced better glycemic control, but doctors' adherence to guidelines and glycemic control were poor. Polytherapy and CKD emerged as risk factors for guidelines divergent prescriptions. Dyslipidemia, CKD and reception of sulfonylureas had negative association with glycemic control., 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 Saher, Al-Worafi, Iqbal, Wahid, Iqbal, Khan, Atif and Ahmad.)

Objective: To determine the factors causing delayed referral for fetal echocardiography at a tertiary care hospital., Background: Timely referral for fetal echocardiogram is considered essential for identification of congenital heart diseases, interventions, and counseling of parents. The present study highlights the factors associated with delayed referral for fetal echocardiography., Material and Methods: This prospective study includes a total of 200 pregnant females who were referred for fetal echocardiography. The data collected included referral indications, gestational age, maternal age, educational status, referral personale, and final diagnosis on echocardiography., Results: The mean gestational age of presentation was found to be 33 weeks [standard deviation (SD), 4.8 weeks]. Among 200 females, 24% were referred at second trimester, 69% presented at third trimester, and 6% of the females presented at term. No female presented before 18 weeks of gestation. Our results showed that most of the females (94%) were referred by their gynecologist. Eighty-nine percent of the females were booked since the first trimester. The most common indication for referral was unexplained death of children (60%). Of 200 pregnant women, 40% were found to be illiterate and 60% were educated. However, the mean gestational age of presentation of illiterate females was 32.9 weeks (SD, 4.2 weeks), and for educated women it was 33 weeks (SD, 5 weeks). Congenital heart disease was diagnosed in 12% of the cases., Conclusion: On the basis of the results, it could be concluded that delayed presentation for fetal echocardiography was not associated with the educational status of females. By contrast, referral personnel were found to be responsible for the delayed referral of females. Therefore, we strongly recommend that both pregnant women and gynecologists be educated about the importance of timely diagnosis for identification of congenital heart diseases.