Psychological Morbidity in patients with Idiopathic Hirsutism presenting for Laser Treatment at a Tertiary Care Hospital

Objective: The objective of our study was to determine the frequency of depression, anxiety, and stress in females presenting for laser treatment of hirsutism at a dermatology clinic. Materials and Methods: This was a cross-sectional descriptive study. 152 female participants of all ages presenting for laser treatment of hirsutism to the dermatology department –removed for blind review--from June 2019 to Dec 2019, were included using a consecutive convenient sampling technique. Patients having an FG (Ferriman and Gallwey) score of 8 or more, were included whereas those having any underlying cause (as assessed by history and examination and laboratory investigations where required) for both hirsutism and psychological disorder were excluded. The participants were given an Urdu version of the DASS 21 (depression, anxiety, and stress scale) to complete. Results: The participants had a mean age of 30.22 (SD = 9.17). The prevalence of depression, anxiety, and stress in the sample was found to be 13.2%, 23.7%, and 17.8%, respectively. Mean depression, anxiety, and stress scores on DASS 21 were 4.43(SD=4.87, Cut-off= 10), 4.34(SD=5.12, Cut-off= 8), and 8.21(SD=6.26, Cut-off=15), respectively, indicating that the scores were within the normal range. Anxiety was the most common illness in the sample and both depression and stress showed a decline with advancing age up till 45years of age. No statistically significant association was found between the severity of hirsutism and depression, stress, and anxiety scores. Conclusion: Psychological morbidity was found to be lower in patients of idiopathic hirsutism presenting for laser treatment. The long-term efficacy of laser treatment needs further evaluation in future research

A novel approach to intrusion detection using zero-shot learning hybrid partial labels

Computer networks have become the backbone of our interconnected world in today's technologically driven landscape. Unauthorized access or malicious activity carried out by threat actors to acquire control of network resources, exploit vulnerabilities, or undermine system integrity are examples of network intrusion. ZSL(Zero-Shot Learning) is a machine learning paradigm that addresses the problem of detecting and categorizing objects or concepts that were not present in the training data. . Traditional supervised learning algorithms for intrusion detection frequently struggle with insufficient labeled data and may struggle to adapt to unexpected assault patterns. In this article We have proposed a unique zero-shot learning hybrid partial label model suited to a large image-based network intrusion dataset to overcome these difficulties. The core contribution of this study is the creation and successful implementation of a novel zero-shot learning hybrid partial label model for network intrusion detection, which has a remarkable accuracy of 99.12%. The suggested system lays the groundwork for future study into other feature selection techniques and the performance of other machine learning classifiers on larger datasets. Such research can advance the state-of-the-art in intrusion detection and improve our ability to detect and prevent the network attacks. We hope that our research will spur additional research and innovation in this critical area of cybersecurity

Comparison of Closed Reduction and Plaster Cast versus Kirschner Wire Fixation for the Management of Colle’s Fracture

Objective: To evaluate the functional outcomes of closed reduction and plaster cast versus kirschner wire fixation in treatment of colle’s fracture.Study Design:  Randomized Control Trial.Place and Duration: Study was conducted in the department of Orthopedic surgery Bahawal Victoria Hospital Bahawalpur from April 2017 to April 2018.Methodology: A total of sixty patients with colle’s fracture enrolled in the study. Adult patients of age more than 20 years, both genders with unstable distal radius end fracture were included in the study. Patients unfit for medical treatment, compound fracture with vascular injury and who were not willing for surgery were excluded from the study. Patients were divided into two groups with lottery method. Complications after surgery and outcomes (excellent, good, and poor) were assessed. SPSS version was used to analyze data. P value ≤ 0.05 was considered as significant.Results: mean age and time of union of Group A was 42.90±3.53 years and 3.80±1.58 respectively. There were more males than females i.e. 70% and 30% respectively. Majority of the patients’ outcome was good in both the groups’ i.e. 46.7% and 53.3% respectively. The differences were statistically insignificant.Conclusion:Results of our study reveals that both treatment methods are equally effective less costly mode of treatment should be adopted for management of colle’s fracture. Keywords: Close Reduction, Plaster Cast, Kirschner Wire, Collles’ Fractur

Problem Management Plus (PM plus ) in the management of common mental disorders in a specialized mental healthcare facility in Pakistan; study protocol for a randomized controlled trial

Additional file 1. Appendix A

Evaluating effectiveness and cost-effectiveness of a group psychological intervention using cognitive behavioural strategies for women with common mental disorders in conflict-affected rural Pakistan: study protocol for a randomised controlled trial

The impact of humanitarian disasters upon mental health is well recognised. The evidence for psychological interventions for mental health is mounting, but few interventions have been rigorously tested in humanitarian settings. To be sustainable in humanitarian settings interventions need to be short, simple, deliverable by nonspecialists under supervision, and adopt a transdiagnostic approach where an array of mental health outcomes are addressed simultaneously. These elements have been incorporated into the newly developed WHO Problem Management Plus (PM+) Group intervention. The aim of this trial is to evaluate the locally adapted PM+ Group intervention for women in Swat, Pakistan. This PM+ Group trial is a two-arm, single-blind, cluster randomised controlled trial conducted in a community-based setting with women in rural Pakistan. PM+ is delivered in partnership with the Lady Health Worker (LHW) Programme which provides community-based health care to women in Pakistan. Thirty-four LHW clusters will be randomised in a 1:1 allocation ratio using a permuted-block randomisation method. Participants screened and found to meet the inclusion criteria will be allocated to either the PM+ intervention group (n = 306), or the control arm (n = 306). The manualised PM+ intervention involves five sessions, each lasting 3 h, and introduces four strategies applied by participants to problems that they are facing. It is delivered by local female facilitators with a minimum of 16 years of education who are provided with targeted training and supervision. The primary outcome is individual psychological distress, measured by levels of anxiety and depression on the Hospital Anxiety and Depression Scale at 20 weeks after baseline. Secondary outcomes include major depression, post-traumatic stress disorder, levels of social support, levels of functioning, and economic effectiveness. Intervention acceptability will be explored through an embedded qualitative study. The PM+ Group trial will provide important evidence on the effectiveness of an empirically supported psychological treatment delivered by nonspecialists in a humanitarian setting. If proven effective, the qualitative component will inform strategies for PM+ Group scale-up in health systems in other humanitarian settings. Australian New Zealand Clinical Trials Registry, identifier: ACTRN12616000037404. Registered on 19 January 2016; WHO Protocol ID RPC705, v.4, 2 November 2015

Effect of adding a psychological intervention to routine care of common mental disorders in a specialized mental healthcare facility in Pakistan: a randomized controlled trial

Abstract Background In many low resource settings, the provision of government mental health care services is limited to specialized psychiatry units in urban hospital care facilities, where the most common treatment for common mental disorders (CMDs) is pharmacotherapy, occasionally with adjunct nonspecific psychological support. We aimed to evaluate the effectiveness of adding a low intensity, psychological intervention, Problem Management Plus (PM+) for CMDs into routine care in a specialized mental health care facility in Pakistan. Methods A two arm, single-blind individual randomized controlled trial (RCT) was carried out with adults (N = 192), referred for psychological support by psychiatrists. The study participants were randomized (1:1) to PM + plus Treatment as Usual (TAU) (n = 96) or TAU only (n = 96). The primary outcomes were symptoms of anxiety and depression, measured by the Hospital Anxiety and Depression Scale (HADS) and functional impairment as measured by WHO Disability Assessment Schedule (WHODAS 2.0) at 20 weeks after baseline. Results The analysis was done on intention-to-treat principle. The linear mixed model analysis showed that at 20 weeks after baseline, there was a significant reduction in symptoms of anxiety and depression (mean [SD], 16.23 [8.81] vs 19.79 [7.77]; AMD, − 3.10; 95% CI, − 0.26 to − 5.76); p = 0.03 and improvement in functioning (mean [SD], 22.94 [9.37] vs 27.37 [8.36]; AMD, − 4.35; 95% CI, − 1.45 to − 7.24); p = 0.004 in PM + plus TAU versus TAU arm. The follow-up rate was 67% at primary end-point. Conclusions Specialized care facilities in LMICs may consider adding brief, evidence-based psychological treatments for CMDs to their routine care. Trial Registration Australian New Zealand Clinical Trials Registry, ACTRN12616000381482. Registered March 23, 2016. Retrospectively registered, https://www.anzctr.org.au/Default.aspx/ ACTRN12616000381482 </jats:sec

Effectiveness of a technology-assisted, family volunteers delivered, brief, multicomponent parents' skills training intervention for children with developmental disorders in rural Pakistan: a cluster randomized controlled trial.

BACKGROUND Globally, there is a large documented gap between needs of families and children with developmental disorders and available services. We adapted the World Health Organization's mental health Gap-Intervention Guidelines (mhGAP-IG) developmental disorders module into a tablet-based android application to train caregivers of children with developmental disorders. We aimed to evaluate the effectiveness of this technology-assisted, family volunteers delivered, parents' skills training intervention to improve functioning in children with developmental disorders in a rural community of Rawalpindi, Pakistan. METHODS In a single-blinded, cluster randomized controlled trial, 30 clusters were randomised (1:1 ratio) to intervention (n = 15) or enhanced treatment as usual (ETAU) arm (n = 15). After screening, 540 children (18 participants per cluster) aged 2-12 years, with developmental disorders and their primary caregivers were recruited into the trial. Primary outcome was child's functioning, measured by Childhood Disability Assessment Schedule for Developmental Disorders (DD-CDAS) at 6-months post-intervention. Secondary outcomes were parents' health related quality of life, caregiver-child joint engagement, socio-emotional well-being of children, family empowerment and stigmatizing experiences. Intention-to-treat analyses were done using mixed-models adjusted for covariates and clusters. RESULTS At 6-months post-intervention, no statistically significant mean difference was observed on DD-CDAS between intervention and ETAU (mean [SD], 47.65 [26.94] vs. 48.72 [28.37], Adjusted Mean Difference (AMD), - 2.63; 95% CI - 6.50 to 1.24). However, parents in the intervention arm, compared to ETAU reported improved health related quality of life (mean [SD] 65.56 [23.25] vs. 62.17 [22.63], AMD 5.28; 95% CI 0.44 to 10.11). The results were non-significant for other secondary outcomes. CONCLUSIONS In the relatively short intervention period of 6 months, no improvement in child functioning was observed; but, there were significant improvements in caregivers' health related quality of life. Further trials with a longer follow-up are recommended to evaluate the impact of intervention. Trial registration Clinicaltrials.gov, NCT02792894. Registered April 4, 2016, https://clinicaltrials.gov/ct2/show/NCT02792894

A study of PTF1 interaction with phosphorus stress inducing genes and its influence on root architecture of transgenic Arabidopsis

Background: Phosphorus; an essential macronutrient needed by the plant for its robust growth is inaccessible to the plant as required. Hence, a need arises to develop smart crops capable of utilizing maximum phosphorus from soil. PTF1(Inorganic Phosphorus Starvation Induced Transcription Factor 1) is overexpressed during phosphorus stress and regulates number of genes to combat this abiotic stress.Methods: The current study is the first ever reported case of transforming Arabidopsis thaliana with plant expression binary vector pSB219 harboring PTF1 via floral dip method and analyzing phosphorus stress induced genes interaction, through yeast-one-hybrid. Yeast-one-hybrid analysis was performed on four selected genes namely LPR1 (Low Phosphate Response), PDR2 (Phosphate Deficiency Response 2), PHT1;2 (Phosphate Transporter) and RNS1 (Ribonuclease). The positive transformed lines were expression analyzed for PTF1 by real time PCR and further studied for their root morphology.Results: The results clearly showed direct interaction of LPR1 with PTF1 while other genes, although being overexpressed, were indirectly regulated. Transformation efficiency of 1% was achieved and a maximum 2.5-fold increase in PTF1 expression was observed. Root morphological studies exhibited significantly enhanced root hair and lateral surface area when grown in phosphorus deficient MS medium.Conclusion: The results of the current study may pave path for improved comprehension of gene interactions and root architecture modifications under phosphorus limiting conditions.Keywords: Phosphorus; Arabidopsis; Yeast one hybrid; Roots