Epilepsy in the rural areas of sindh: knowledge, beliefs and practices

Unfounded beliefs regarding epilepsy are still common and widespread. Visits to shrines and seeking help from faith healers goes along with thesebeliefs.This creates a major barrier in the timely diagnosis and treatment of epilepsy. Objective: To determine the knowledge, beliefs and practices relating to epilepsy in the rural areas of Sind and how do they differ between educated and uneducated families of patients with epilepsy. Methods: This was an observational study conducted at the Neurology Out-Patient Department of the Peoples Medical University Hospital Nawabshah during the period 1.1.2015 to 30.6.2015. A pro forma was designed incorporating questions pertaining to knowledge,beliefs and practices regarding epilepsy amongpatients and accompanying family members.Each case was considered as representing the whole family.Educational background was ascertainedand the comparison of study variablesbetween educated and uneducated families was evaluated. The questions were translated into their native spoken language (Sindhi). Results: A total of 120 cases were included in this study. Sixty nine (57.7%)were male and 51 (42.5%) were female. Age ranged from 1 to 55 years. Eighty one (67.5%) were the residents of rural villages and 39(32.5%)were residing in Nawabshah and adjoining towns.Of the 120 cases 80 (66.7%)families were educatedand 40 (33.3%) were uneducated. Majority 76 (63.3%) believed that epilepsy is a disease whereas 44(36.7%) considered epilepsy a “super naturalforce” (‘alamaat’: a native term) or possession by a ‘fakir’ (Jinaat). Of the80 educated families 56 (70.0%) had knowledge about the disease and of the 40 uneducated families 20 (50%) had no knowledge about the disease.Better awareness about the disease among families having educational background was statistically significant (p\u3c0.05). Of the 80 educated families 23 (28.8%) visited shrines and of the 40 uneducated families 26 (65.0%)visited shrines. Uneducated families visiting shrines wasstatistically significant (p\u3c0.01). Families having younger individuals (11 -30 years) were more inclined towards visiting shrines. Out of 120 cases 44 (36.6%) were being treated by faith healers (dagho-phenu: a native term for this kind of practice) and 76 (63.%) were receiving medical therapy. Of the 44 cases receiving faith healing 28 (63.6%)also visited shrines and of the 76 caseswho were receiving medical therapy 21 (27.6%) visited shrines.Followers of faith healing practices significantly visited shrines compared to those who were receiving medical therapy (p\u3c0.001). Those who went for faith healing at first place and did not get benefitout of it came to seek medical therapy. They also pledgedfor the strict complianceand thatin future they will not switch over to “other” forms of therapy. Conclusion: Misperceptions about epilepsy are common in the rural areas of Sindh, Possession by a “supernatural force” (Alamaat) was most common belief among those who did not consider epilepsy a disease.Knowledge about epilepsy was better among families having educational background. Uneducation and unawareness leads to unscientific practices like faith healingand visit to shrines. There iswillingness for receiving medical therapy once the proper guidelines are provi

Diagnostic Accuracy of Ultrasound for the Evaluation of Ureteric Calculi Taking Non-enhanced Computed Tomography as a Gold Standard

Objective: To find the diagnostic accuracy of ultrasound for the evaluation of ureteric calculi taking non enhanced Computed Tomography as gold standard. Study Design: An analytical cross-sectional prospective study was performed. Settings: The study was performed in National Hospital and Medical Center, Lahore. Period: An analytical cross-sectional study was conducted from 15 October, 2020 to 15 January, 2021. Material & Methods: In our study, all those patients with suspected ureteric calculi presenting to radiology department were included. Patients on dialysis, those with polycystic disease and ureteric stricture, as well as patients who declined to give consent and those who were uncooperative, were all excluded. Ultrasound was performed on both sides of the patient's kidney, concentrating on the ureters. Then were sent to a 64 slice CT scanner for a non-enhanced CT scan. Results: Total 121 Patients were reviewed in this research. Females were 82 (67.8%) while male was 39 (32.2%). On Ultrasound 61(50.4%) were positive for ureteric calculi while 60 (49.6%) were negative for stone in the ureter. On CT scan 110 (90.9%) patients were positive for ureteric calculi while 11 (9.1%) were negative for stone in ureter (p= 0.05). The trans-abdominal ultrasound with sensitivity 58.62%, Specificity 56.76%, Positive predictive value 51.52% and Negative predictive value of 63.64% and accuracy of 57.68%. Conclusion: The sensitivity of ultrasound is comparable to Computed Tomography findings, hence, it can be used as an option in cases where CT scans are not available or is contraindicated, such as in pregnant women. Moreover, Ultrasound modality is cheap, with no radiation dose and is readily available in our setups, making it suitable for initial diagnosis as well as for follow-up scans. Keywords: Non-enhanced Computed Tomography, Ultrasound, Ureteric Calculi, radiation, Computed Tomography. DOI: 10.7176/JHMN/90-04 Publication date:June 30th 2021

Impact of drought on assimilates partitioning associated fruiting physiognomies and yield quality attributes of desert grown cotton

Deficit irrigation has great significance for sustainable cultivation of cotton in water scarce arid regions, but this technique creates drought situation that induces stress adaptive changes in cotton plants due to indeterminate growth habit. In the present experiment, the impact of drought stress on assimilates partitioning associated vegetative and reproductive development, and yield quality attributes of cotton were examined under desert conditions. Four levels of drip irrigation including 100, 80, 60, and 40% replenishment of depleted water from field capacity were applied to develop drought stress regimes during two growing seasons (2015 and 2016). Results revealed that under limited water supplies, plant’s preference for allocation of photo-assimilates was roots > leaves > fruits that substantially increased root–shoot ratio and hampered reproductive growth. Consequently, boll density (m−2), fresh boll weight and lint yield (kg ha−1) were significantly reduced. An obvious change in partitioning of assimilates inside stressed bolls was observed that indicated relatively more accumulation in seeds than fiber, thus reducing the fiber quality. In addition, decreased starch, oil, and protein contents in seeds of stressed plants markedly reduced 100 seeds weight and also the vigor. Later, seed quality confirmatory tests of subsequent years (2016 and 2017) showed significant reduction in emergence counts (m−2) and seedling biomasses of seeds harvested from deficit drip irrigated cotton. These results suggest that deficit irrigation could necessarily be an appropriate yield optimization and water saving technique for cotton in desert environment but, for the best quality fiber and cottonseeds, full irrigation should be preferred

Application of Potassium along with Nitrogen under Varied Moisture Regimes Improves Performance and Nitrogen-Use Efficiency of High- and Low-Potassium Efficiency Cotton Cultivars

Low nitrogen-use efficiency (NUE) is a serious issue for cotton production and environmental sustainability in arid climates. A pot study was conducted to evaluate the effect of K nutrition on NUE and performance of low- and high-K-efficiency cotton cultivars under two moisture regimes. Treatments included two soil moisture levels—i.e., normal irrigation, 100% available water content (AWC); reduced irrigation, 50% AWC—three levels of nitrogen (N)—i.e., 0, 375, and 750 mg N pot−1—and two K levels, i.e., 0 and 208 mg K pot−1. Results reveal that 208 mg K pot−1 application with nitrogen significantly enhanced the N-use efficiency, growth, and yield attributes of both cotton cultivars compared with sole N fertilization. Similarly, the combined application of NK @ 375 N + 208 K mg pot−1 caused up to 83% increase in NUE under AWC50% and AWC100%, as compared with NK control (0 N + 0 K). Compared with the control, imposed low-moisture stress caused a decrease of 13.9% in stomatal conductance (gs), 2.5% in transpiration rate (E), and 6.5% in net photosynthetic rate (PN), respectively. The physiological water use efficiency (PN/E) decreased by 13.2% under AWC50%. Applied NK @ 375 N:208 K, mg pot−1 caused 27.39 and 27.56% improvement in the PN/E in HKE and LKE cultivars under AWC50%, respectively. The HKE cultivar, i.e., CIM-554, maintained the highest gs and PN than FH-901, that was low-K-efficiency cultivar. The study suggests that varietal selection and adequate K fertilization have the prospects to improve NUE and save considerable quantities of fertilizer and irrigation water in cotton production under arid environments

Understanding the interaction among enablers of quality enhancement of higher business education in Pakistan.

This study aims to generate a list of enablers of quality enhancement of higher business education in Pakistan and build a structural model of enablers to prioritize them. It also intends to impose direction and hierarchy on the inter-relationships of the enablers. The study's design consists of a literature review, data collection from primary sources, and qualitative analysis. Interpretive Structural Modeling (ISM) coupled with Matriced' Impacts Cruise's Multiplication Appliquée a UN Classement (MICMAC) is used as a research methodology. The classical procedure of ISM and MICMAC is applied to primary data collected by a field survey from a panel of experts recruited from folks of stakeholders of business education. Results of the literature show that eighteen critical enablers enhance the quality of higher business education in Pakistan. Results of ISM show that the enabler 'job placement of graduates' occupies the top-level of the ISM model being least critical. In contrast, the enabler 'intra-academia linkages' occupying the bottom of the model is the most vital. Results of MICMAC show that all enablers, except 'job placement of graduates, are classified into linkage clusters, whereas 'job placement of graduates' is classified as an independent cluster. Overall results of the study show that enablers of quality enhancement of higher business education in Pakistan are agile and not settled. The study has profound theoretical, managerial, and practical implications for all stakeholders of business education. It also provides a research framework for future studies concerning subject phenomena. The discussion about the structural model culminates into policy guidelines for the regulators. The study is subject to some methodological/data/resources limitations like the limited review of literature, collection of data from a medium-size panel of experts from Pakistan only, using majority rule for aggregating responses, answering only that what is related to what, other common limitations of qualitative studies, shot period and absence of financial support. The authors conduct this study in a real-life field setting is built on the original dataset and address the efficient issue of phenomenon understudy differently. It is theory-building research, therefore, does not require prior theory. It exploits simple elementary concepts of Boolean algebra, set theory, and graph theory that generates new in-depth information for stakeholders

Estimation of Sensible and Latent Heat Fluxes Using Flux Variance Method under Unstable Conditions: A Case Study of Tea Plants

Evapotranspiration is essential for precise irrigation and water resource management. Previous literature suggested that eddy covariance (EC) systems could directly measure evapotranspiration in agricultural fields. However, the eddy covariance method remains difficult for routine use, due to its high cost, operational complexity, and relatively multifaceted raw data processing. An alternative method is the flux variance (FV) method, which can estimate the sensible heat flux using high-frequency air temperature measurements by fine-wire thermocouples, at relatively low-cost and with less complexity. Additional measurements of the net radiation and soil heat flux permit the extraction of latent heat flux through the energy balance closure equation. This study examined the performance of the FV method and the results were compared against direct eddy covariance measurements. Data were collected from November 2018 to July 2019, covering seasonal variations. Due to the method’s limitation, only the data under unstable conditions were used for the analysis and days with rainfall were omitted. The results showed that the FV-estimated sensible heat flux was in good agreement with that of eddy covariance in the seasons of winter 2018 and summer 2019. The best agreement between the estimated and measured sensible heat fluxes was observed in the summer, with R2 = 0.83, RMSE = 34.97 Wm−2 and RE = 8.20%. The FV extracted latent heat flux was in good agreement with that measured by EC for both seasons. The best result was obtained in the summer, with R2 = 0.92, RMSE = 23.12 Wm−2, and RE = 6.37%. Overall estimations of sensible and latent heat fluxes by the FV method were in close relation with the eddy covariance data

Towards a Complete Set of Gym Exercises Detection Using Smartphone Sensors

Smartphones with gym exercises predictors can act as trainers for the gym-goers. However, various available solutions do not have the complete set of most practiced exercises. Therefore, in this research, a complete set of most practiced 26 exercises was identified from the literature. Among the exercises, 14 were unique and 12 were common to the existing literature. Furthermore, finding suitable smartphone attachment position(s) and the number of sensors to predict exercises with the highest possible accuracy were also the objectives of the research. Besides, this study considered the most number of participants (20) as compared to the existing literature (maximum 10). The results indicate three key lessons: (a) the most suitable classifier to predict a class (exercise) from the sensor-based data was found to be KNN (K-nearest neighbors); (b) the sensors placed at the three positions (arm, belly, and leg) could be more accurate than other positions for the gym exercises; and (c) accelerometer and gyroscope when combined can provide accurate classification up to 99.72% (using KNN as classifier at all 3 positions)

Structure–property investigations in urea tethered iodinated triphenylamines

Herein, we report structural, computational, and conductivity studies on urea-directed self-assembled iodinated triphenylamine (TPA) derivatives. Despite numerous reports of conductive TPAs, the challenges of correlating their solid-state assembly with charge transport properties hinder the efficient design of new materials. In this work, we compare the assembled structures of a methylene urea bridged dimer of di-iodo TPA (1) and the corresponding methylene urea di-iodo TPA monomer (2) with a di-iodo mono aldehyde (3) control. These modifications lead to needle shaped crystals for 1 and 2 that are organized by urea hydrogen bonding, π⋯π stacking, I⋯I, and I⋯π interactions as determined by SC-XRD, Hirshfeld surface analysis, and X-ray photoelectron spectroscopy (XPS). The long needle shaped crystals were robust enough to measure the conductivity by two contact probe methods with 2 exhibiting higher conductivity values (∼6 × 10−7 S cm−1) compared to 1 (1.6 × 10−8 S cm−1). Upon UV-irradiation, 1 formed low quantities of persistent radicals with the simple methylurea 2 displaying less radical formation. The electronic properties of 1 were further investigated using valence band XPS, which revealed a significant shift in the valence band upon UV irradiation (0.5–1.9 eV), indicating the potential of these materials as dopant free p-type hole transporters. The electronic structure calculations suggest that the close packing of TPA promotes their electronic coupling and allows effective charge carrier transport. Our results show that ionic additives significantly improve the conductivity up to ∼2.0 × 10−6 S cm−1 in thin films, enabling their implementation in functional devices such as perovskite or solid-state dye sensitized solar cells