Knowledge and practices regarding cigarette smoking among adult women in a rural district of Sindh, Pakistan

OBJECTIVE: To determine the prevalence of cigarette smoking and to obtain information on socio-demographic factors and attitude regarding cigarette smoking among adult women in a rural district of Sindh Province, Pakistan. METHODS: A cross sectional community based survey was done in a rural district of Sindh province of Pakistan using a two stage cluster sampling design. A pre tested questionnaire was used to interview 502 adult women (aged 18- 60 years) from the study site. The study was approved by the ethical research committee and informed consent was taken from participants. RESULTS: A total of 502 women were interviewed for this study. Approximately 71% of women were illiterate and 44% of women were in the age group of 18-24 years. A high number (10%) of adult women were smokers. Age at initiation among women (18-24 years) was 42%. A significant difference for questions regarding smoking effects on health (p = 0.02) and knowledge regarding smoking causes respiratory disease (p = 0.02) was observed in this survey. CONCLUSION: It was concluded that the prevalence of smoking among women is on the rise in this rural district of Pakistan. Young age at initiation is an important finding that needs to be addressed

Possibility of converting indigenous Salvadora persica L. seed oil into biodiesel in Pakistan

In this research study, biodiesel has been successfully produced from vegetable seed oil of an indigenous plant Salvadora persica L. that meets the international biodiesel standard (ASTM D6751). The biodiesel yield was 1.57 g/5 g (31.4% by weight) and the in-situ transesterification ester content conversion was 97.7%. The produced biodiesel density was 0.894 g/mL, its kinematic viscosity 5.51 mm2/s, HHV 35.26 MJ/kg, flash point 210°C, cetane no. 61, and sulfur content 0.0844%. Thermal analysis of the biodiesel showed that 97% weight loss was achieved at 595°C with total oxidation of the biodiesel. The production energy efficiency was 0.46% with a lab scale setup, assuming the volume fraction ratio (volume of the sample/total volume of the equipment used). The results revealed that single-step in-situ transesterification method is suitable for the production of biodiesel from S. persica seed oil

Dermatofibrosarcoma protuberans: an unusual case of neck swelling

Dermatofibrosarcoma protuberans (DFSP) is a relatively intermediate to low grade malignant tumour with high proclivity for local recurrence if excised inadequately. It is a locally aggressive tumour and despite sharing some histological features with fibrohistiocytic tumours, it tends to grow in a more infiltrative manner. We are reporting this rare tumour in a 30-year-old woman where the diagnosis of DFSP was confirmed histologically and by positive immunomarkers at immunohistochemistry

Toluidine blue: Yet another low cost method for screening oral cavity tumour margins in Third World countries

Objective: To use toluidine blue intra-operatively to identify tumour involved margins after the removal of oral cavity squamous cell carcinoma, and to compare the findings with those of final histopathology.Methods: The study was conducted at the Aga Khan University Hospital from December 1, 2009, to March 14, 2010, and comprised 56 consecutive patients with biopsy-proven squamous cell carcinoma of oral cavity regardless of grade and stage of tumour. Intra-operatively toluidine blue was used on the resected tumour margins and the staining patterns were assessed. Results were then compared with the final histopathology report.Results: A total of 11(19.64%) margins were positive with toluidine blue staining out of which 8 (14.28%) were false positive. Sensitivity and specificity was found to be 100% and 84.9% respectively with a positive predictive value of 27.2%; a negative predictive value of 100%; and diagnostic accuracy of 85.71%.Conclusion: Toluidine blue costs only Rs25 (USD 0.30) and takes only 5 minutes for application and interpretation. It can be used with significant confidence in smaller lesions (T-I and T-II) as an alternative to frozen sections in developing countries where facilities are unavailable. Its use in larger lesions (T-III and TIV) remains the topic of controversy and awaits a multi centre trial with a larger cohort

Extraction of Protein from Chrome Shavings, Modification with Acrylic Monomers and Further Re-Utilization in Leather Processing

In this study, four  retanning products were synthesized by polymerization of  extracted  protein from chrome shavings waste with acrylic monomers in the presence of  initiators. These products were applied for retanning of goat skins to evaluate their effects on quality of leather. Prepared leather samples were tested according to standard test methods. The results revealed that the proteineous products from hydrolysis of chrome shavings waste had significant improvement in quality without inserting bad effect on leather. The polymer prepared from the redox initiators provided highest yield of polymer.  The prepared retanning polymers showed better results of  tensile strength, tear strength, etc. In this way, the protein from chrome shavings may be reutilized after chemical modification as a replacement of commercial hazardous retanning products

An Efficient Recovery of Chromium From Tanning Liquor waste and its Reutilization for the Production of Quality Leather

The conventional methods for the treatment of tannery effluents are highly expensive due to the presence of  large amount of chemicals used in the processing and their environmental toxicity. In this study, chromium has been recovered from tanning waste liquor which is discarded usually in the open streams. This tanning liquor has been treated with different concentrations of alkalies such as sodium hydroxide (NaOH), ferric chloride (FeCl3) and magnesium oxide (MgO) to recover chromium using the precipitation method. The precipitation of chromium at controlled range of pH  by MgO yielded the well concentrated sludge resulting  the total dissolved solids in low quantity in the supernatant when compared with the other two treatments (NaOH and FeCl3). The prepared chromium sulphate liquors from recovered chrome cake has been employed at similar conditions parallel to fresh  basic chromium sulphate to determine the effects on quality of leather. The resulted leathers showed almost very good properties e.g.  shrinkage, tear strength, tensile strength, bursting strength,  fullness, grain smoothness, etc

Early life child micronutrient status, maternal reasoning, and a nurturing household environment have persistent influences on child cognitive development at age 5 years: Results from MAL-ED

Background: Child cognitive development is influenced by early-life insults and protective factors. To what extent these factors have a long-term legacy on child development and hence fulfillment of cognitive potential is unknown. Objective: The aim of this study was to examine the relation between early-life factors (birth to 2 y) and cognitive development at 5 y. Methods: Observational follow-up visits were made of children at 5 y, previously enrolled in the community-based MAL-ED longitudinal cohort. The burden of enteropathogens, prevalence of illness, complementary diet intake, micronutrient status, and household and maternal factors from birth to 2 y were extensively measured and their relation with the Wechsler Preschool Primary Scales of Intelligence at 5 y was examined through use of linear regression. Results: Cognitive T-scores from 813 of 1198 (68%) children were examined and 5 variables had significant associations in multivariable models: mean child plasma transferrin receptor concentration (β: −1.81, 95% CI: −2.75, −0.86), number of years of maternal education (β: 0.27, 95% CI: 0.08, 0.45), maternal cognitive reasoning score (β: 0.09, 95% CI: 0.03, 0.15), household assets score (β: 0.64, 95% CI: 0.24, 1.04), and HOME child cleanliness factor (β: 0.60, 95% CI: 0.05, 1.15). In multivariable models, the mean rate of enteropathogen detections, burden of illness, and complementary food intakes between birth and 2 y were not significantly related to 5-y cognition. Conclusions: A nurturing home context in terms of a healthy/clean environment and household wealth, provision of adequate micronutrients, maternal education, and cognitive reasoning have a strong and persistent influence on child cognitive development. Efforts addressing aspects of poverty around micronutrient status, nurturing caregiving, and enabling home environments are likely to have lasting positive impacts on child cognitive development.publishedVersio

Early Life Child Micronutrient Status, Maternal Reasoning, and a Nurturing Household Environment have Persistent Influences on Child Cognitive Development at Age 5 years : Results from MAL-ED

Funding Information: The Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project (MAL-ED) is carried out as a collaborative project supported by the Bill & Melinda Gates Foundation, the Foundation for the NIH, and the National Institutes of Health/Fogarty International Center. This work was also supported by the Fogarty International Center, National Institutes of Health (D43-TW009359 to ETR). Author disclosures: BJJM, SAR, LEC, LLP, JCS, BK, RR, RS, ES, LB, ZR, AM, RS, BN, SH, MR, RO, ETR, and LEM-K, no conflicts of interest. Supplemental Tables 1–5 and Supplemental Figures 1–3 are available from the “Supplementary data” link in the online posting of the article and from the same link in the online table of contents at https://academic.oup.com/jn/. Address correspondence to LEM-K (e-mail: [email protected]). Abbreviations used: HOME, Home Observation for Measurement of the Environment inventory; MAL-ED, The Etiology, Risk Factors, and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development Project; TfR, transferrin receptor; WPPSI, Wechsler Preschool Primary Scales of Intelligence.Peer reviewe

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570