26 research outputs found
Cytotoxic, antibacterial activity and physico-chemical properties of some acid catalyzed Schiff bases
Some novel Schiff bases have been derived using aromatic aldehydes and aromatic amine in ethanol under acidic conditions. The geometry of these Schiff bases was established using various spectroscopic methods like infrared (IR), nuclear magnetic resonance (NMR) and mass spectrometry. The conductivity studies reveal the non electrolytic behavior of Schiff bases. The synthesized Schiff bases were tested in vitro with the aim of identifying novel lead compounds active against various types of bacteria and shrimps.Keywords: Acid catalyzed, Schiff bases, NMR, antibacterial activity, brine shrim
Cost-effectiveness of household contact investigation for detection of tuberculosis in Pakistan
Objectives
Despite WHO guidelines recommending household contact investigation, and studies showing the impact of active screening, most tuberculosis (TB) programmes in resource-limited settings only carry out passive contact investigation. The cost of such strategies is often cited as barriers to their implementation. However, little data are available for the additional costs required to implement this strategy. We aimed to estimate the cost and cost-effectiveness of active contact investigation as compared with passive contact investigation in urban Pakistan.
Methods
We estimated the cost-effectiveness of âenhancedâ (passive with follow-up) and âactiveâ (household visit) contact investigations compared with standard âpassiveâ contact investigation from providers and the programmeâs perspective using a simple decision tree. Costs were collected in Pakistan from a TB clinic performing passive contact investigation and from studies of active contact tracing interventions conducted. The effectiveness was based on the number of patients with TB identified among household contacts screened.
Results
The addition of enhanced contact investigation to the existing passive mode detected 3.8 times more cases of TB per index patient compared with passive contact investigation alone. The incremental cost was US120 per incremental patient identified with TB. The active contact investigation was 1.5 times more effective than enhanced contact investigation with an incremental cost of US$238 per incremental patient with TB identified.
Conclusion
Our results show that enhanced and active approaches to contact investigation effectively identify additional patients with TB among household contacts at a relatively modest cost. These strategies can be added to the passive contact investigation in a high burden setting to find the people with TB who are missed and meet the End TB strategy goals.publishedVersio
Towards Sweetness Classification of Orange Cultivars Using ShortâWave NIR Spectroscopy
The global orange industry constantly faces new technical challenges to meet consumer demands for quality fruits. Instead of traditional subjective fruit quality assessment methods, the interest in the horticulture industry has increased in objective, quantitative, and non-destructive assessment methods. Oranges have a thick peel which makes their non-destructive quality assessment challenging. This paper evaluates the potential of short-wave NIR spectroscopy and direct sweetness classification approach for Pakistani cultivars of orange, i.e., Red-Blood, Mosambi, and Succari. The correlation between quality indices, i.e., Brix, titratable acidity (TA), Brix: TA and BrimA (Brix minus acids), sensory assessment of the fruit, and short-wave NIR spectra, is analysed. Mix cultivar oranges are classified as sweet, mixed, and acidic based on short-wave NIR spectra. Short-wave NIR spectral data were obtained using the industry standard F-750 fruit quality meter (310â1100 nm). Reference Brix and TA measurements were taken using standard destructive testing methods. Reference taste labels i.e., sweet, mix, and acidic, were acquired through sensory evaluation of samples. For indirect fruit classification, partial least squares regression models were developed for Brix, TA, Brix: TA, and BrimA estimation with a correlation coefficient of 0.57, 0.73, 0.66, and 0.55, respectively, on independent test data. The ensemble classifier achieved 81.03% accuracy for three classes (sweet, mixed, and acidic) classification on independent test data for direct fruit classification. A good correlation between NIR spectra and sensory assessment is observed as compared to quality indices. A direct classification approach is more suitable for a machine-learning-based orange sweetness classification using NIR spectroscopy than the estimation of quality indices
The phenomenological approach to modeling the dark energy
In this mini-review we discuss first why we should investigate cosmological
models beyond LCDM. We then show how to describe dark energy or modified
gravity models in a fluid language with the help of one background and two
perturbation quantities. We review a range of dark energy models and study how
they fit into the phenomenological framework, including generalizations like
phantom crossing, sound speeds different from c and non-zero anisotropic
stress, and how these effective quantities are linked to the underlying
physical models. We also discuss the limits of what can be measured with
cosmological data, and some challenges for the framework.Comment: 44 pages, 5 figures; accepted review article to appear in a special
volume of the "Comptes Rendus de l'Academie des Sciences" about Dark Energy
and Dark Matte
Omecamtiv mecarbil in chronic heart failure with reduced ejection fraction, GALACTICâHF: baseline characteristics and comparison with contemporary clinical trials
Aims:
The safety and efficacy of the novel selective cardiac myosin activator, omecamtiv mecarbil, in patients with heart failure with reduced ejection fraction (HFrEF) is tested in the Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (GALACTICâHF) trial. Here we describe the baseline characteristics of participants in GALACTICâHF and how these compare with other contemporary trials.
Methods and Results:
Adults with established HFrEF, New York Heart Association functional class (NYHA)ââ„âII, EF â€35%, elevated natriuretic peptides and either current hospitalization for HF or history of hospitalization/ emergency department visit for HF within a year were randomized to either placebo or omecamtiv mecarbil (pharmacokineticâguided dosing: 25, 37.5 or 50âmg bid). 8256 patients [male (79%), nonâwhite (22%), mean age 65âyears] were enrolled with a mean EF 27%, ischemic etiology in 54%, NYHA II 53% and III/IV 47%, and median NTâproBNP 1971âpg/mL. HF therapies at baseline were among the most effectively employed in contemporary HF trials. GALACTICâHF randomized patients representative of recent HF registries and trials with substantial numbers of patients also having characteristics understudied in previous trials including more from North America (n = 1386), enrolled as inpatients (n = 2084), systolic blood pressureâ<â100âmmHg (n = 1127), estimated glomerular filtration rate <â30âmL/min/1.73 m2 (n = 528), and treated with sacubitrilâvalsartan at baseline (n = 1594).
Conclusions:
GALACTICâHF enrolled a wellâtreated, highârisk population from both inpatient and outpatient settings, which will provide a definitive evaluation of the efficacy and safety of this novel therapy, as well as informing its potential future implementation
Governing Abuse of Free Speech during Elections in Pakistan
Election creates an environment of hate which may lead to potential of violence. Although there are enough laws relating to prohibition of hate speech under the Constitution of Pakistan and the ordinary law like Pakistan Penal Code and Anti Terrorism Act, however, there are special laws which control hate speech during Elections. Although International Instruments protected freedom of speech first but did not prohibit hate speech, however, it was permitted to be limited in certain cases. Similarly, the Constitution of Pakistan 1973 also guaranteed the freedom of speech but with list of exceptions to prohibit hate speech. For this purpose, all election laws were consolidated in the form of one piece of legislation: the Election Act 2017. It prohibited hate speech under corrupt practices and made it an offence. To assure a free and fair election, it is mandatory for the Election Commission of Pakistan to frame a Code of Conduct for the political parties and the candidates. The Commission is also bound to issue a separate Code of Conduct for the media. Both Codes provide effective legal regimes to control hate speech. However, the efforts to control it can only be successful if all stakeholders struggle to confront this monster
Hospital resources and practice patterns for congenital cardiac surgery in Pakistan: A nationwide status report
Objective: Low- and middle-income countries such as Pakistan bear the brunt of the global burden of congenital heart disease (CHD), This nationwide study assessed hospital resources and surgical practice patterns pertaining to CHD surgery across Pakistan.Methods: A nationwide hospital facility survey was conducted, targeting all health centers performing CHD surgery in Pakistan. Descriptive data analysis was performed, with categorical variables being presented as frequencies and percentages and continuous variables being reported as means and standard deviations.Results: Seventeen surgeons across 17 different centers participated in the study. Eight of 17 (47%) surgeons were under 45 years of age, while the rest were older than 45 years. More respondents were employed at public/government-owned hospitals (11/17, 65%) and at specialized cardiac centers (13/17, 76%), with a majority of centers reported as having a special ICU designated for congenital cardiac patients (11/17, 65%). With regard to operative volume, 7 of 17 (41%) centers reported more than 350 cases per year, with 7 of 17 reported \u3e10 neonatal cases per year (6/12, 50%). Only one center reported national and international collaborations for research, most centers carrying out less than five research projects in a year. Conclusion: This study has identified key areas that require the attention of local administrative bodies as well as international organizations and societies. The existing centers in Pakistan are unable to meet the demands of the population, leaving a large number of untreated patients, especially for neonatal lesions
Candidal infections as a cause of recurrent uretero-ileal anastomotic dehiscence
Fungal infections are common in immunocompromised patients. The presentation is often subtle and therefore treatment is delayed. Uretero-ileal anastomotic dehiscence due to candidal infection has never been reported before. This case represents an uncommon but potentially life-threatening complication in reconstructive surgery; that is, anastomotic dehiscence due to a unique etiology
IPT uptake among child contacts of TB patients: Experience from the Indus Hospital TB program, Karachi, Pakistan
Background: Infants and young children are particularly susceptible to developing tuberculosis (TB) following exposure and infection, and isoniazid preventive therapy can substantially reduce this risk. This evidence-base provides the rationale for the policy and guidelines to screen and manage children that are household contacts of TB cases, prioritizing those with sputum smear-positive TB. The guidelines have been in place for decades, but are rarely implemented. IPT programs in high-TB burden countries are rare and fraught with low uptake and low rates of therapy completion.
Methods: This study describes the demographics and outcomes of contact management and the IPT program for <5 years old at the Indus Hospital in Karachi, Pakistan from 2011 to 2014. Children <5 years old in contact with newly diagnosed sputum smear-positive pulmonary TB patients were referred by the counselor for contact evaluation. All children underwent a history, physical, CXR and TST. All contacts were started on IPT based on WHO recommendations after confirming that they had no TB disease. Outcomes were defined as children who were enrolled, started on IPT but never returned for follow-up (primary default), children who had one or more follow-up visits but did not complete treatment (default) and children who completed IPT (treatment completed).
Results: A total of 240 children were enrolled in the Indus IPT program from 2011 to 2014. Of these, data from 184 contacts was analyzed in detail as the remainder were still on IPT. All children enrolled were less than 5 years of age (mean age 3 years) and 96 (52%) were males. Of all the enrolled children, 76/240 (31.6%) were <5% weight for their age (underweight), of these 52% were female children. A symptom of either cough or fever was reported by 29/184 (15.7%) children; however, all responded to routine antibiotics and did not have CXR findings suggestive of TB disease. Of the enrolled who had a TST done, 12/209 (5.8%) had a positive result. Analysis of outcomes revealed that only 60/184 (32.6%) completed 6 months of IPT (with no gender predisposition). Among those who completed therapy, none developed TB disease during follow-up. Outcome trends revealed an increase in completion rate (40% in 2013 compared with 26% in 2012), which may reflect improvement in counseling services in 2013. Children who had an initial symptom or were underweight at the start of IPT were more likely to complete treatment (p<0.01).
Conclusion: Despite a large cohort of TB patients in the Indus TB program-5487 SS+ patients registered during the study period â this IPT program enrollment has been low. A high rate of patient default after the first visit indicates a lack of understanding about the benefit and safety of preventive therapy in young children among families of TB patients, and awareness enhancing efforts by community field teams will help improve outcomes. It is vital that the National TB Program strengthens and expands contact management with a community-based approach and incentives