Patterns, control and complications of diabetes from a hospital based registry established in a low income country.

Background: Diabetes registry enables practitioners to measure the characteristics and patterns of diabetes across their patient population. They also provide insight into practice patterns which can be very effective in improving care and preventing complications. The aim of this study was to assess the patterns, control levels and complications at the baseline of the patients attending clinic at the large tertiary care hospital in Karachi, Pakistan with the help of the registry. This can be used as a reference to monitor the control and also for a comparison between peer groups. Methods: This was a cross sectional study with the data obtained from diabetes registry collected with the help of pre-designed questionnaire. HbA1c was used as a central diabetes measure and other related factors and complications were assessed with it. Results: Only 16.6% of the participants had optimal HbA1c≤7.0%. 52.9% of the patients were classified as having poor control defined by HbA1c of \u3e8%. Three fourth of the study population were obese according to Asian specific BMI cutoffs and majority had type 2 diabetes with duration of diabetes ranging from less than one to about 35 years, mean(SD) duration being 7.6 years (7.1). Overall only 4% of the patients were on combine target of HbA1c, LDL and BP.Results of multivariable logistic regression showed that the odds of having optimal glycemic control increased by 3% with every one year increase in age. In addition, having longer duration of diabetes was associated with 56% lower odds of having good glycemic control. Moreover, having higher triglyceride levels was associated with 1% lower odds of having good glycemic control. Conclusion: This highlights the large burden of sub optimally controlled people with diabetes in Pakistani population, a low income country with huge diabetes prevalence and ineffective primary health care system creating enormous health and economic burden

Frequency of primiparous mother initiated breastfeeding earlier after birth and factors associated with it in Sindh, Pakistan: A secondary analysis

Background: Initiation of breastfeeding within one hour after delivery plays a vital role in a newborns life by not only increasing their survival rate but also reducing many life-threatening diseases in the newborn. The aim of the study was to determine frequency of early initiation of breastfeeding among primiparous mothers in a rural district of Thatta, Pakistan.Methods: This study was conducted using survey data extracted from a cross-sectional study conducted in 2019 on prevalence of exclusive breastfeeding and factors associated with it among women in Thatta. The outcome was early initiation of breastfeeding. To determine factors associated with it, multi variable logistic regression was carried out.Results: The study showed that 30.3% of primiparous mothers in Thatta initiated breastfeeding within one hour of birth and knowledge of mothers (OR=9.76, 95% CI: 1.99-17.59), place of birth (OR=3.51, 95% CI: 1.32-9.31) and support of health care professional at health facility (OR=2.93, 95% CI: 1.09-7.86) are the factors significantly associated with early initiation of breastfeeding among primiparous mothers.Conclusions: In order to enhance the early initiation of breastfeeding, it is important for health care professionals to emphasize on the effect of pre-lacteal feeding during and support breastfeeding immediately after delivery, especially among women who had given birth for the first time

Silene conoidea L.: A Review on its Systematic, Ethnobotany and Phytochemical profile

Silene conoidea L. is a weed commonly grown in subtropical and temperate zone of western Eurasia, and some part of Himalaya. S. conoidea is a small herb height from 20 to 40cm mostly grow as weed in different crops like wheat, barley, mustard, roquette and lentil pea. This is the first attempt to gather utmost information about the species distribution, taxonomy, ethno-medicines, phytochemical analysis, biological activity etc. of Silene conoidea. The present review aim was to collect fragmented information about the species in addition to explore its therapeutic importance in future research opportunities. A total of 100 research articles were reviewed using different sources like; Scopus, web of science, Science direct, google scholar and PubMed. The species are used as multipurpose in different biological activities against microbes, bacteria and as insecticidal. Silene is also important due to high contents of various chemicals compounds. Chemical extracts contain flavones, glycosides, saponins, sterols and glycosides. A research study shows that S. conoidea can be used as an indicator species of gold. Traditional therapeutic values of the species for treating respiratory, antioxidant, anti-diabetic and anticancer are needed to be validated through more research. Ethno-pharmacological and clinical trial research can be subjected for future studies

Diversity of medicinal plants used as male contraceptives: An initiative towards herbal contraceptives

In the recent era, population control is a global issue as well as national community health concern. Plants are being used as a source of medicines by human beings since ancient time. This study highlights the collection, identification and diversity of medicinal plants concerning their traditional knowledge to get better access to the herbal male contraception. Local informants and traditional health practitioners were consulted for information about the local names, distribution, part used and mode of utilization of the medicinal plant. To select plants with high medicinal uses, different quantitative measurements i.e. Relative Frequency of Citation (RFC), Disease Consensus Index (DCI) and descriptive methods of Jaccard Index (JI) was performed. A total of 100 plant species (used for infertility by the local communities) belonging to 50 families and 91 genera were collected. Jaccard Index results showed that 28 plant species were reported for the first time used as male contraceptives in Pakistan. The frequency of citation (FC) value ranged from 35 to 56. Plants with high Relative frequency of citation (RFC) and Disease Consensus index (DCI) values showed a high consensus for the antifertility among informants and THPs. Our study is focused on the diversity and priority of medicinal plants as male contraceptives.

Convalescent plasma in patients admitted to hospital with COVID-19 (RECOVERY): a randomised controlled, open-label, platform trial

SummaryBackground Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatoryactions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19.Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospitalwith COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients wererandomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once perday by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatmentgroups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment andwere twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants andlocal study staff were not masked to the allocated treatment, but all others involved in the trial were masked to theoutcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treatpopulation. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936.Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) wereeligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomlyallocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall,561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days(rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days(rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, nosignificant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilationor death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24).Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or otherprespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restrictedto patients in whom there is a clear antimicrobial indication

Ecosystem carbon sustainability under different C-equivalence inputs and outputs in dry land

The efficient use of carbon is the principle goal of achieving the agricultural and environmental sustainability. Thus, study was aimed to compare the C-equivalence (Ceq) of inputs and outputs and the C index of sustainability (Is). Five cropping sequences were; fallow–wheat (FW, Triticum aestivum) (control), mungbean (Vigna radiata)–wheat (MW), sorghum (Sorghum bicolor)–wheat (SW) green manure–wheat (GW) and mungbean-chickpea (Cicera rietinum, MC). Tillage systems included moldboard 14 plough (MP), deep tillage (DT) and minimum tillage (MT). The primary data collected were crop yield and the above-ground biomass. Fuel utilization in MP was 15.2 kg Ceq ha-1 with two ploughing per year, C input was 30.4 kg Ceq ha-1. In DT it was 11.6 kg Ceq ha-1. Herbicide used based input was 27.3 kg Ceq ha-1. The Ceq of outputs differed among tillage treatments, and were: 135, 112 and 80.47 kg Ceq ha-1 for MP, DT and MT, respectively. On the average of two years, the highest grain Ceq was measured under MP and under SW in winter (1040 kg Ceq ha-1). The maximum Ceq biomass was estimated in winter with MC (2867 kg Ceq ha-1). However, the highest root Ceq under MT was calculated in winter with MW (9500 kg Ceq ha-1). Under MT, the maximum Is was obtained with MC for both years in summer (77 and 130). In winter of the second year, the highest Is was estimated for FW (82). These results showed that the efficient use of fertilizers, herbicides and farm machinery in the field under MT, with legume based cropping system, could be the best option to enhance the carbon Is in dry lands

The Plant Fatty Acyl Reductases

Fatty acyl reductase (FAR) is a crucial enzyme that catalyzes the NADPH-dependent reduction of fatty acyl-CoA or acyl-ACP substrates to primary fatty alcohols, which in turn acts as intermediate metabolites or metabolic end products to participate in the formation of plant extracellular lipid protective barriers (e.g., cuticular wax, sporopollenin, suberin, and taproot wax). FARs are widely present across plant evolution processes and play conserved roles during lipid synthesis. In this review, we provide a comprehensive view of FAR family enzymes, including phylogenetic analysis, conserved structural domains, substrate specificity, subcellular localization, tissue-specific expression patterns, their varied functions in lipid biosynthesis, and the regulation mechanism of FAR activity. Finally, we pose several questions to be addressed, such as the roles of FARs in tryphine, the interactions between transcription factors (TFs) and FARs in various environments, and the identification of post-transcriptional, translational, and post-translational regulators