delay in diagnosis of motor neuron disease. a tertiary care experience

Motor Neuron Disease is a progressive neurological disorder with poor prognosis. Inability to correctly recognize the disease, leads to undue agony and diagnostic dilemma. Studies have been done to look at the average duration taken to diagnose the disease from the onset of symptoms. The literature shows that latency from symptom onset to diagnosis range from 10.6–17.5 months. No such study has been conducted in our region. We reviewed 62 patients referred to the neurophysiology lab from year 2009 to 2013 with quarry of MND. Only 40 patients were identified to fulfill the El Escorial criteria for MND. The median time of diagnosis from onset of symptoms was one year. This is almost similar to that of world literature. We conclude that in spite of paucity of heath service and high rate of illiteracy the timeliness of diagnosis was consistent with the rest of the world

Capparis decidua Edgew (Forssk.) Stem Extract Alleviates the Water Stress Perturbations in Wheat (Triticum aestivum L.) at Early Growth Stage

Water shortage is one of the major limiting factors of crop productivity worldwide. This study was planned to explore the impact of Capparis decidua stem extract on wheat varieties (FSD-2008, 12066 and 13348) under water stress condition. Water deficit condition negatively impacted the seedling germination, growth, photosynthetic pigments and ions uptake capacity. Water limited condition significantly (p≤0.05) increased time to attain 50% germination, lipid peroxidation, H2O2 and enhanced the antioxidant mechanism to overcome the oxidative stress. Different concentrations of C. decidua extract i.e. Not Soaking (NS), 10%, 20%, 30% and 40% were used for seed priming. It improved the negative effects of water stress and amended plant germination and growth by enhancing photosynthesis and reactive oxygen species (ROS) scavenging mechanism. The 20% and 30% C. decidua stem extract remained effective in mitigating the induced water stress effects in the tested cultivars. It was found that C. decidua stem extract significantly (p≤0.05) improved germination, growth Mg+2 and Fe+2 uptake in the wheat varieties under study. It is concluded that C. decidua phytoextract is an influential agent to ameliorate water stress effects in wheat at early growth stage

Time to endoscopy for acute upper gastrointestinal bleeding: results from a prospective multicentre trainee-led audit

Background: Endoscopy within 24 hours of admission (early endoscopy) is a quality standard in acute upper gastrointestinal bleeding (AUGIB). We aimed to audit time to endoscopy outcomes and identify factors affecting delayed endoscopy (>24h of admission).Methods: This prospective multicentre audit enrolled patients admitted with AUGIB who underwent inpatient endoscopy between Nov-Dec 2017. Analyses were performed to identify factorsassociated with delayed endoscopy, and to compare patient outcomes, including length of stay and mortality rates, between early and delayed endoscopy groups.Results: Across 348 patients from 20 centres, the median time to endoscopy was 21.2h (IQR 12.0- 35.7), comprising median admission to referral and referral to endoscopy times of 8.1h (IQR 3.7- 18.1) and 6.7h (IQR 3.0-23.1) respectively. Early endoscopy was achieved in 58.9%, although this varied by centre (range: 31.0% - 87.5%, p=0.002). On multivariable analysis, lower Glasgow-Blatchford score, delayed referral, admissions between 7am-7pm or via the Emergency Department were independent predictors of delayed endoscopy. Early endoscopy was associated with reduced length of stay (median difference 1d; p= 0.004), but not 30-day mortality (p=0.344).Conclusions: The majority of centres did not meet national standards for time to endoscopy. Strategic initiatives involving acute care services may be necessary to improve this outcome

Participation of Healthy Volunteers in Clinical Trials - Motives, Barriers, and Ethical Issues

Recruitment of adequate number of healthy volunteers is vital for success of clinical trials but there is limited research on factors motivating the healthy volunteers to participate in clinical trials especially in developing countries. Pakistani researchers also faced the problems in enrollment of enough healthy volunteers during COVID-19 pandemic when a number of clinical trials began in Pakistan. Around 117 research proposals were processed by the National Bioethics Committee (NBC) of Pakistan in last two years. A major proportion of these clinical research studies target healthy populations as primary research subjects or as controls. Numerous studies have investigated factors such as motives, barriers, risks. benefits and ethical values affecting recruitment and participation of healthy volunteers in clinical trials. We have reviewed the literature to learn about factors that motivate or prevent the healthy persons to volunteer along with the pertaining ethical issues. Financial incentive is the principal motive for healthy volunteers to participate in clinical trials along with altruism, contribution to sciences, research and other people&rsquo;s health, desire to take part in something important, learning more about science and medicine, access to healthcare &amp; free medical checkup and prospects of one&rsquo;s social network expansion whereas time inconvenience, confidentiality, possible side effects &amp; route of administration of drug and fear of contacting the disease were identified as important barriers. Application of knowledge of these motives and barriers will help Pakistani researchers to enroll adequate number of healthy volunteer for their clinical trials.</p

Capparis decidua Edgew (Forssk.) Stem Extract Alleviates the Water Stress Perturbations in Wheat (Triticum aestivum L.) at Early Growth Stage

Water shortage is one of the major limiting factors of crop productivity worldwide. This study was planned to explore the impact of Capparis decidua stem extract on wheat varieties (FSD-2008, 12066 and 13348) under water stress condition. Water deficit condition negatively impacted the seedling germination, growth, photosynthetic pigments and ions uptake capacity. Water limited condition significantly (p≤0.05) increased time to attain 50% germination, lipid peroxidation, H2O2 and enhanced the antioxidant mechanism to overcome the oxidative stress. Different concentrations of C. decidua extract i.e. Not Soaking (NS), 10%, 20%, 30% and 40% were used for seed priming. It improved the negative effects of water stress and amended plant germination and growth by enhancing photosynthesis and reactive oxygen species (ROS) scavenging mechanism. The 20% and 30% C. decidua stem extract remained effective in mitigating the induced water stress effects in the tested cultivars. It was found that C. decidua stem extract significantly (p≤0.05) improved germination, growth Mg+2 and Fe+2 uptake in the wheat varieties under study. It is concluded that C. decidua phytoextract is an influential agent to ameliorate water stress effects in wheat at early growth stage

Print And Electronic Media: Cause Of Depression

Objective: To assess depression in normal people and associate it with print and electronic media of Pakistan. Methodology: The study was descriptive, cross-sectional and conducted from July to November 2011. Three hundred and twenty men and women, with age range of 20-70 years were included in study following informed consent. A structured questionnaire with five items of Yes and No category relating media to depression was used. To assess the severity of depression Zung self –rating depression scale was used. Subjects with score of 80-90 were excluded as this score is of clinical depression. Data analysis was done by SPSS version 13.0. Pearson Chi-square was applied with p&lt;0.01 considered statistically significant. Results: Depression was seen in 55 % of subjects on reading newspaper. Watching television caused depression in 59.7% (p&lt;0001). In 68% subjects daily routine life was disturbed (p&lt;0.01). The highest rate of depression 32.6% was due to watching political news, while 28.3 % were by photographs and visuals of dead bodies and 24.6% by news of terrorism. Prevalence of mildly and moderately depressed individuals was 56.3 % and 15.8% respectively. Conclusion: Reading newspaper and watching television causes depression. The content of news on media in particular leads to depression

Enhanced concept-level sentiment analysis system with expanded ontological relations for efficient classification of user reviews

Background/introduction: Concept-level sentiment analysis deals with the extraction and classification of concepts and features from user reviews expressed online about products and other entities like political leaders, government policies, and others. The prior studies on concept-level sentiment analysis have used a limited set of linguistic rules for extracting concepts and their associated features. Furthermore, the ontological relations used in the early works for performing concept-level sentiment analysis need enhancement in terms of the extended set of features concepts and ontological relations. Methods: This work aims at addressing the aforementioned issues and tries to bridge the literature gap by proposing an extended set of linguistic rules for concept-feature pair extraction along with enhanced set ontological relations. Additionally, a supervised a machine learning technique is implemented for performing concept-level sentiment analysis. Results and conclusions: Experimental results depict the effectiveness of the proposed system in terms of improved efficiency (P: 88%, R: 88%, F-score: 88%, and A: 87.5%)