Impact of Urbanization Growth on Land Surface Temperature using remote sensing and GIS: A Case Study of Gujranwala City, Punjab, Pakistan

Globally, urban temperature is gradually increasing day by day. The prominent climatic condition called Urban Heat Island (UHI), is rising especially in the rapidly developed cities. Gujranwala a city of Punjab, Pakistan is experiencing fast urbanization which has led to ultimately increase in the observable UHI. The objective of recent study is to determine the effects of increasing urbanization on surface temperature and vegetation cover by different techniques of remote sensing and GIS. For this purpose, different time series of Landsat images were selected through which land surface temperature and NDVI (Normalized Difference Vegetation Index) has been calculated and urban heat island effect is analyzed. It is found that built-up areas have high temperature as compared to vegetative areas. Surface radiant temperature has increased up to 8 ˚C in Gujranwala due to urbanization. There is negative correlation between NDVI and LST. Economic activities in study area have decreased the vegetated parts leading to an increase in surface temperature and change in urban microclimate

Clinical and Morphological Aspects of Celiac Disease

Objective: To assess the clinical and morphological aspects of celiac disease.Patients and Methods: This cross sectional study was conducted at Department of Pathology, Al Nafees Medical College & Hospital for a period of 8 months. After taking approval from Institutional review board, a written informed consent was taken from all the enrolled patients depending upon inclusion and exclusion criteria. Clinical data including the symptoms and signs and their severity was collected and entered on a specially designed proforma. Morphological data was collected with the help of patient’s endoscopic biopsy. Histopathological biopsies were graded according to modified Marsch grading system. For qualitative variables frequencies and percentages were calculated. Quantitative variables were measured in terms of mean and standard deviation.Results: There were 77 patients with suspicion of celiac disease whose endoscopic biopsy was done. Among these 42% were males and 58 % were females. Maximum number of patients were in the age group of 13-30 years. Among symptoms, diarrhea was present in 83.11% (n=64) patients, abdominal distention and pain was present in 53% and 63.6% patients respectively. Lesser frequent symptoms including vomiting and weight loss was significant in only 16.9% patients and constipation in 14.3% patients. According to modified Marsch grades, maximum celiac patients were graded in Marsch-3a (15.6%) and Marsch-3b (19.5%).Conclusion: Majority of patients with Celiac disease presented with typical gastrointestinal signs and symptoms in which diarrhea was the commonest complaint. The disease is more common in adults with female predominance. Majority of patients belong to the 3a and 3b type lesion of the modified Marsch grading system

Self-Medication Practice Among the General Community Of An Urban Squatter Settlement Near PNS Shifa Karachi

Objective: To assess the frequencyof self-medication amongst the residents of urban squatter settlement near PNS Shifa Karachiand to assess the factors leading to this practice. Materials and Methods: This cross-sectional descriptive study was conducted in the city of Karachi. The subjects were the community in general. A total of 60 subjects were enrolled and were either interviewed face-to-face or were asked to fill out the questionnaire relating to their self-medication practice. Results: Out of 60 subjects, 38 (63.3%) preferred the practice of self-medication. Minor ailment was the main reason for self-medication, 27 (45%) subjects responded headache as the most common reason and paracetamol was the most frequently used drug for self medication. It was used by 44(73.3%) of the subjects Conclusion: The practice of self medication is high in the community and there is a need to develop awareness of self-medication practice in the public along with restrictions for the pharmacies providing drugs without prescription

Potential of Indigenous Plants for Skin Healing and Care

The outer protective layer of body is skin which not only guards it from external fluctuations and effects but also performs its thermoregulation. Its functioning may get affected due to several factors like dermal wounds, injuries, aging and many other disorders. These dermal ailments can be cured with the help of indigenous flora to get economical pharamcognosal benefits with no side effects which is a serious concern of synthetic drugs now days. Furthermore, research efforts are necessary for their proper dose optimization and administration to achieve low cost and side effects free pharamcognosal skin cure and care gains

Perceptions of health professionals regarding minimally invasive tissue sampling (MITS) to identify the cause of death in stillbirths and neonates: Results from a qualitative study

Background: Pakistan is considered to be one of the riskiest places in the world for childbirth as measured by its high stillbirth and neonatal mortality rates. Complete diagnostic autopsy remains the gold standard to determine the cause of death (CoD); however, it is not routinely implemented due to religious objections, sociocultural beliefs, limited resources and low demand from physicians and families. Recently, minimally invasive tissue sampling (MITS) using needle biopsies of multiple tissues to obtain tissue for histological examination and organism identification with PCR has been developed and promoted to determine CoD in low-resource areas. To ensure successful implementation of MITS, it is important to understand health professionals\u27 attitudes and perceptions related to MITS.Methods: A qualitative study was conducted at the National Institute of Child Health (NICH), Karachi, Pakistan. Focus group discussions (FGDs) and Key-informant interviews (KIIs) were conducted with health professionals including doctors, nurses, trainees, clinicians, bioethics experts and public health experts to explore their perceptions and views on acceptability of MITS. Data were analyzed using NVivo 10 software.Results: A total of 12 interviews (FGDs = 4; KIIs = 8) were conducted. Four overarching themes were identified: (I) acceptability of MITS; (II) perceived benefits of the MITS procedure; (III) factors facilitating the implementation of MITS; and (IV) health system requirements for implementing the MITS procedure. Generally, MITS was considered as a positive development for the health system. Diagnostic accuracy and identification of less common causes of death were highlighted as two main benefits of the MITS procedure. The study highlighted a number of facilitators for the acceptability of MITS including effective counseling, building trust with parents, fast procedure time, and approaching families within a few hours of death. In addition, lack of skilled staff, poorly equipped healthcare facilities and the potential high cost to conduct MITS were identified as challenges for the implementation of MITS.Conclusions: This formative research provided a unique opportunity to explore health professionals\u27 views and attitudes towards the MITS procedure. Such insights are crucial to ensure successful implementation and integration of a new technique into the existing health system. The research identified the factors influencing the acceptability of MITS among health professionals in Pakistan. The study also informed factors that could help facilitate the implementation of the MITS procedures in the context of Pakistan and similar settings

Perceptions of parents and religious leaders regarding minimal invasive tissue sampling to identify the cause of death in stillbirths and neonates: Results from a qualitative study

Background: Recently, the minimal invasive tissue sampling (MITS) procedure has been developed to support determination of the cause of death as an alternate to conventional autopsy, especially in countries where complete diagnostic autopsy is not routine. To assess the feasibility of implementation of the MITS procedure for a study to determine cause of death in premature births and stillbirths in south Asia, we explored the views and perceptions of parents and religious leaders on the acceptability of MITS.Methods: A qualitative study was conducted at the National Institute of Child Health (NICH) hospital of Karachi, Pakistan. Focus group discussions (FGDs) were conducted with parents of newborns who visited well-baby clinics of the NICH hospital for post-natal check-ups. Key-informant interviews (KIIs) were conducted with religious leaders. Data were analyzed using NVivo 10 software.Results: A total of 13 interviews (FGDs = 8; KIIs = 5) were conducted. Three overarching themes were identified: (I) acceptability of MITS; (II) concerns affecting the implementation of MITS; and (III) religious and cultural perspectives. Participants\u27 acceptance of MITS was based on personal, religious, cultural and social beliefs. Parents widely recognized the need for this procedure in cases where the couple had experienced multiple stillbirths, neonatal deaths and miscarriages. Counseling of parents was considered vital to address emotional concerns of the parents and the family. Religious leaders indicated acceptability of the MITS procedure from a religious perspective and advised that respect for the deceased and consent of the guardians is mandatory when performing MITS.Conclusions: This qualitative study provided a unique opportunity to understand the views of parents and religious leaders towards the use of MITS. Generally, MITS appears to be an acceptable method for identifying the cause of death in neonates and stillbirths, provided that the deceased is respected and buried as soon as possible without any delays and parents are counseled appropriately. Findings from this research are essential in approaching families for consent for MITS

Effects of Fertilizers on Copper and Nickel Accumulation and Human Health Risk Assessment of Vegetables and Food Crops

Despite the fact that fertilizers have been used for millennia for sustainable crop production, this high and considerable dependence on fertilizers heightens environmental concerns with the indirect human exposure due to accumulation of toxins in food chain via soil contamination. The purpose of this study is to evaluate the application of fertilizers to the soil and their effect on the accumulation of copper and nickel in spinach (Spinacia oleracea), garlic (Allium sativum), wheat (Triticum aestivum), maize (Zea mays), and barley (Hordeum vulgare); as well as potential health concerns associated with consuming vegetables cultivated on this contaminated land. Samples of available soil, food crops, and human blood were collected from three different Tehsils: Bhalwal, Sahiwal, and Silanwali and were regarded as site 1, site 2 and site 3 respectively. Urea, farmyard manure, and potassium chloride were delivered to Site 1; urea phosphate, manure, and ammonium sulphate were delivered to Site 2; and superphosphate, ammonium phosphate, and nitrate phosphate were delivered to Site 3. Data was subjected to statistical analysis for computing out ANOVA and correlation. Analysis revealed that minimum copper concentration was found in the soil of T. aestivum grown at Site-1 while the inhabitants of Site 3 had the highest concentration of Cu in their blood. The highest level of HIR was found in the human beings that ate the S. oleracea grown at Site 3. It is strongly advised that fertilizers be used sparingly, as their excessive use can cause human health risks

Perceptions of health professionals regarding minimally invasive tissue sampling (MITS) to identify the cause of death in stillbirths and neonates: results from a qualitative study

Background Pakistan is considered to be one of the riskiest places in the world for childbirth as measured by its high stillbirth and neonatal mortality rates. Complete diagnostic autopsy remains the gold standard to determine the cause of death (CoD); however, it is not routinely implemented due to religious objections, sociocultural beliefs, limited resources and low demand from physicians and families. Recently, minimally invasive tissue sampling (MITS) using needle biopsies of multiple tissues to obtain tissue for histological examination and organism identification with PCR has been developed and promoted to determine CoD in low-resource areas. To ensure successful implementation of MITS, it is important to understand health professionals’ attitudes and perceptions related to MITS. Methods A qualitative study was conducted at the National Institute of Child Health (NICH), Karachi, Pakistan. Focus group discussions (FGDs) and Key-informant interviews (KIIs) were conducted with health professionals including doctors, nurses, trainees, clinicians, bioethics experts and public health experts to explore their perceptions and views on acceptability of MITS. Data were analyzed using NVivo 10 software. Results A total of 12 interviews (FGDs = 4; KIIs = 8) were conducted. Four overarching themes were identified: (I) acceptability of MITS; (II) perceived benefits of the MITS procedure; (III) factors facilitating the implementation of MITS; and (IV) health system requirements for implementing the MITS procedure. Generally, MITS was considered as a positive development for the health system. Diagnostic accuracy and identification of less common causes of death were highlighted as two main benefits of the MITS procedure. The study highlighted a number of facilitators for the acceptability of MITS including effective counseling, building trust with parents, fast procedure time, and approaching families within a few hours of death. In addition, lack of skilled staff, poorly equipped healthcare facilities and the potential high cost to conduct MITS were identified as challenges for the implementation of MITS. Conclusions This formative research provided a unique opportunity to explore health professionals’ views and attitudes towards the MITS procedure. Such insights are crucial to ensure successful implementation and integration of a new technique into the existing health system. The research identified the factors influencing the acceptability of MITS among health professionals in Pakistan. The study also informed factors that could help facilitate the implementation of the MITS procedures in the context of Pakistan and similar settings

Perceptions of parents and religious leaders regarding minimal invasive tissue sampling to identify the cause of death in stillbirths and neonates: results from a qualitative study

Background Recently, the minimal invasive tissue sampling (MITS) procedure has been developed to support determination of the cause of death as an alternate to conventional autopsy, especially in countries where complete diagnostic autopsy is not routine. To assess the feasibility of implementation of the MITS procedure for a study to determine cause of death in premature births and stillbirths in south Asia, we explored the views and perceptions of parents and religious leaders on the acceptability of MITS. Methods A qualitative study was conducted at the National Institute of Child Health (NICH) hospital of Karachi, Pakistan. Focus group discussions (FGDs) were conducted with parents of newborns who visited well-baby clinics of the NICH hospital for post-natal check-ups. Key-informant interviews (KIIs) were conducted with religious leaders. Data were analyzed using NVivo 10 software. Results A total of 13 interviews (FGDs = 8; KIIs = 5) were conducted. Three overarching themes were identified: (I) acceptability of MITS; (II) concerns affecting the implementation of MITS; and (III) religious and cultural perspectives. Participants’ acceptance of MITS was based on personal, religious, cultural and social beliefs. Parents widely recognized the need for this procedure in cases where the couple had experienced multiple stillbirths, neonatal deaths and miscarriages. Counseling of parents was considered vital to address emotional concerns of the parents and the family. Religious leaders indicated acceptability of the MITS procedure from a religious perspective and advised that respect for the deceased and consent of the guardians is mandatory when performing MITS. Conclusions This qualitative study provided a unique opportunity to understand the views of parents and religious leaders towards the use of MITS. Generally, MITS appears to be an acceptable method for identifying the cause of death in neonates and stillbirths, provided that the deceased is respected and buried as soon as possible without any delays and parents are counseled appropriately. Findings from this research are essential in approaching families for consent for MITS