Functional neurological disorder: a faith and cultural perspective

Section A: A systematic review of research that can contribute to knowledge of understandings and use of Cultural Competence (CC) initiatives in UK healthcare settings. A search of databases found ten studies. The findings were integrated to identify six themes relevant to understanding the term CC and CC initiatives. The review highlights inconsistencies in conceptualisations of CC and problems were found in the implementation of CC initiatives which often go unmonitored. Section B: An empirical paper exploring the role of family, faith and culture in Black and Asian individuals experiencing functional neurological symptoms. Seven semi-structured interviews were conducted and analysed using Interpretive Phenomenological Analysis (IPA). The results indicate that individuals largely understood their symptoms from a Eurocentric medical lens, but that the diagnosis was difficult to come to terms with. Cultural influences such as help-seeking behaviours, symptom and suffering perceptions, upbringing and language were found to play a part in how one experiences FND. Stigma and faith were found to play a significant role in individual’s experiences

Vaginal discharge during pregnancy and associated adverse maternal and perinatal outcomes

Objectives: To observe the effects of vaginal discharge during pregnancy on maternal and fetal outcomes. Methods: This observational study was undertaken form June 2018 to 31 May 2019 period in the Department of Obstetrics and Gynaecology at Liaquat University of Medical and Health Sciences hospital Jamshoro Unit IV. Data were collected from a convenience sample of 85 pregnant women. All the pregnant women with vaginal discharge were included in the study, while the women with bleeding and other medical disorders during pregnancy were excluded. Data was analyzed. Results: Women’s mean age as 27.4 (±4.7) years and most were 28-35 weeks pregnant (n=29, 34%) and primigravida (n=35, 41%). Seventy six women (89%) presented with vaginal discharge while nine women (11%) reported no vaginal discharge. Of those with vaginal discharge,53 women (69.7%) had vaginal infections: bacterial vaginosis (n=21, 39.6%), vaginal candidiasis (n=17, 32.1%) and vaginal trichomoniasis (n=15, 28.3%). Pathological vaginal discharge (PVD) was associated with vaginal irritation (n=30, p<0.0001), vaginal pain (n=50, p<0.0001), fever (n=12, p=0.015), uterine contractions (n=31, p<0.0001), premature membrane rupture (n=29, p<0.0001), abortion (n=13, p=0.009), pre-term delivery (n=24, p<0.0001) and post-partum endometritis (n=19, p=0.0006). PVD was associated with neonatal outcomes i.e. low birth weight (n=24, p<0.0001), low Apgar score at birth (n=22, p=0.0001), neonatal respiratory distress syndrome (n=21, p=0.0002), neonatal intensive care hospitalisation (n=20, p=0.002) and early neonatal death (n=16, p=0.003). Conclusion: Pathological vaginal discharge (PVD) during pregnancy is more frequent and is associated with adverse maternal and perinatal outcomes

Menstrual irregularities, hormonal imbalances and obesity in teenage and adolescent girls in Hyderabad, Sindh, Pakistan

Background: Obesity in young girls adversely affects reproductive health later in life and it is a serious public health issue. The objective was to study the association of obesity with menstrual irregularities and hormonal imbalance in teenage and adolescent girls. Method: Participants comprised a convenience sample of 12-19 years old girls (N=83). The study was conducted in outpatient clinics at a university hospital. Data were collected through medical history by interview, physical examination and blood tests. Data were analysed using frequencies, descriptive statistics, Chi Squared tests of Independence and Binary Logistic Regression. Results: The median age was 16 years (mean 15.9, SD 2.2) and the median BMI was 31.14 (mean 32.04, SD 4.51). Most of the girls were obese (95.2%) and some had a family history of obesity (33.7%), diabetes (28.9%) and cardiovascular disease (20.5 %). Clinical presentations included secondary amenorrhea (34.9%), heavy and irregular periods (22.9%) and oligomenorrhea (16.9%). Girls with a polycystic ovary (54.2%, n=45) had a reversed follicle stimulating hormone (FSH) / luteinizing hormone (LH) ratio (OR 11.33, 95% CI 2.98, 43.04, p < 0.001), an upper limit or raised fasting insulin (OR 7.20, 95% CI 2.33, 22.22, p < 0.001), a raised testosterone (OR=5.16, 95% CI 1.56, 17.11, p = 0.007 and a disturbed lipid profile (OR 5.67, 95% CI 1.72, 18.73, p = 0.004). Obesity was not statistically significantly associated with either polycystic ovary syndrome (PCOS) or any of the measured hormone levels. Conclusion: Adolescent girls presenting with obesity, menstrual irregularities and hormonal imbalance may suggest manifestation of PCOS, which needs early investigation and proper management

Enhancing the corrosion resistance of a commercial magnesium alloy using polyaniline coating

Magnesium alloys are attractive materials for structural engineering applications due to their high strength-to-weight ratios and formability. However, the widespread use of magnesium alloys has been hindered by their poor corrosion resistance. Generally, magnesium alloys containing low amounts of impurities (iron and silicon) have acceptable atmospheric corrosion resistance, but the corrosion resistance deteriorates in chloride-containing environments. Many surface engineering/coating techniques, such as electroplating, anodisation, microarc oxidation, chemical conversion and polymer coatings, have been studied to enhance the corrosion resistance of magnesium and magnesium-based alloys. However, in recent years, conducting polymers have gained high interest for use as corrosion protection coatings on engineering materials such as steel, copper and magnesium due to their unique electrical properties. Furthermore, these conducting polymers can be easily processed and are economically viable for use as metal coatings. Polyaniline and polypyrrole are the conducting polymers most commonly studied for use as coating materials for the corrosion protection of metals. In recent years, electrochemical polymerisation techniques have been widely used due to their characteristics of being environmentally friendly, easy to process, rapid and requiring few chemical additives. However, synthesis of polymer coatings is challenging when forming coatings on active metals, due to oxidation or prior dissolution of the metal substrate. In this study, following cyclic voltammetry coating, the voltammetric curves for the alloy in the polyaniline sodium salicylate electrolyte (PASS) showed that the first-forward cycle had strong magnesium oxidation until ~0.75 V and, above that, oxidation of aniline started to occur. However, in subsequent forward cycles, magnesium oxidation was insignificant due to the formation of polyaniline, which occurred during the reverse cycles. In contrast, in the polyaniline potassium hydroxide electrolyte (PAPH), which contained strongly alkaline potassium hydroxide, there was little dissolution of magnesium during the first-forward cycle. Based on the anodic peak current density, it can be said that the oxidation of aniline in PAPH electrolyte was significantly lower than in the PASS electrolyte. Further, it was noted that the peak current increased as the number of cycles increased in the PAPH electrolyte, which is in contrast to that observed in the PASS electrolyte. The corrosion rates of the bare metal, and the PASS- and PAPHcoated alloy samples were 2.02, 0.34 and 4.92 mpy, respectively. The degree of protection (DP) provided by the PASS coating was ~83%. The second phase of coating testing was performed using the galvanostatic technique at current densities of 14, 18 and 20 mA/ cm2. Potentiodynamic polymerisation tests of bare samples and samples coated with aniline and sodium salicylate were carried out in a chloride-containing solution. The corrosion tests showed substantial decreases in the corrosion currents of samples coated in aniline and sodium salicylate electrolyte. The systematic decrease in corrosion current revealed that the sample coated at 20 mA/cm2 had better corrosion resistance than those coated at 18 and 14 mA/cm2. The DPs of the samples coated at 20, 18 and 14 mA/ cm2 were ~97%, ~48% and ~5%, respectively. The corrosion rates for the bare alloy and alloys coated at 14, 18 and 20 mA/cm2 were 6.27, 5.96, 3.27 and 0.113 mpy, respectively. For all the samples, coating was carried out for 600 seconds. However, at high current densities and high coating times, samples started substantial hydrogen evolution. Severe bubble formation hindered the coating process, causing blisters in the coating. Alkaline pre-treatment of the magnesium alloy prior to electropolymerisation of aniline was carried out to enhance corrosion resistance. Pre-treatment of the alloy was done in 3 M sodium hydroxide solution at constant potentials o f − 750mV and −195mV. Electropolymerisation was performed using a cyclic voltammetry technique in an acidic electrolyte containing aniline and sodium salicylate. The corrosion protection provided by the polyaniline coating on the alloy was evaluated using potentiodynamic polarisation in a chloride-containing solution. The electrochemical results showed that the polyaniline coating reduced the alloy's corrosion rate by almost an order of magnitude. However, post-corrosion analysis revealed delamination of the coating. It is suggested that polyaniline did not adhere well to the hydroxide/oxide layer that formed on alloys during pre-treatment. This study found that aniline, as a conducting polymer, formed better coatings in acidic electrolytes than in alkaline ones. The propagation of aniline in the emeraldine state (dark green colour coating) produced good coatings on the surfaces of magnesium alloy samples. The coating obtained at 20 mA/cm2 by the galvanostatic technique provided the highest corrosion protection. However, at current densities higher than 20 mA/cm2, hydrogen evolution hindered coating formation. The effect of coating time is also important in the galvanostatic coating technique; hydrogen evolution increased with coating time. Alkaline pre-treatment of magnesium alloy did not enhance the coating morphology. During potentiodynamic polarisation tests, polyaniline coatings tended to peel off due to weak adhesion with the metal substrate. The outcomes of this study may help improve the coating quality of magnesium alloy used in small gadgets and automotive industry. However, there is still more work needs to be done to form pore free coating on the metal for commercial use

Comparative Efficiency of Soil and Foliar Applied Zinc in Improving Yield and Yield Components of Wheat (Triticum aestivum L.) Variety Kiran-95

A field study was undertaken to evaluate the comparative efficacy of zinc application through soil and foliar spray on growth and yield of wheat variety Kiran-95 at Soil Chemistry Section, Agriculture Research Institute, Tandojam during Rabi 2013-14. The experiment was laid out in three replicated randomized complete block design. The treatments comprised Control (No Zinc), Soil applied Zinc 5.0 kg ha-1 at tillering stage, Soil applied Zinc 10.0 kg ha-1 at tillering stage, Soil applied Zinc 5.0 kg ha-1 at tillering + 5.0 kg ha-1 at booting stage, Foliar applied Zinc 0.2% at tillering stage, Foliar applied Zinc 0.4% at tillering and Foliar applied Zinc 0.2% at tillering stage + 0.2% at booting stage. The statistical analysis of data suggested that soil and foliar applied zinc affected significantly (P&lt;0.05) growth and yield traits of wheat variety Kiran-95. The results illustrated that Soil applied Zinc 5.0 kg ha-1 at tillering + 5.0 kg ha-1 at booting stage produced maximum plant height (99.0 cm), tillers (410.7 m-2), spike length (13.1 cm), spikelets per spike (23.0), grains per  spike (45.1), seed index (43.4 g), biological yield (9354.4 kg ha-1) and grain yield (5123.4 kg ha-1), closely followed by Foliar applied Zinc 0.2% at tillering stage + 0.2% at booting stage with 97.6 cm plant height, 408.8 tillers m-2, 13.0 cm spike length, 22.8 spikelets per spike, 45.0 grains per spike, 43.2 g seed index, 9273.4 kg ha-1 biological yield and 5080.7 kg ha-1 grain yield. The performance of wheat variety Kiran-95 ranked 3rd, 4th, 5th and 6th almost in all the growth and yield parameters particularly grain yield (kg ha-1) when fertilized with Soil applied Zinc 10.0 kg ha-1 at tillering stage, Foliar applied Zinc 0.4% at tillering, Soil applied Zinc 5.0 kg ha-1 at tillering stage and Foliar applied Zinc 0.2% at tillering stage.  However, minimum growth and yield traits were registered in Control (No Zinc). Furthermore, the results concluded that although numerically maximum growth and yield values were recorded in Soil applied Zinc 5.0 kg ha-1 at tillering + 5.0 kg ha-1 at booting stage but statistically the differences between Soil applied Zinc 5.0 kg ha-1 at tillering + 5.0 kg ha-1 at booting stage and Foliar applied Zinc 0.2% at tillering stage + 0.2% at booting stage were non-significant. Hence, Foliar applied Zinc 0.2% at tillering stage + 0.2% at booting stage were found the most economical treatment for obtaining optimum yield of wheat variety Kiran-95. Keywords: Wheat, Comparative Efficiency, Soil, Foliar, Zinc, Improving Yield and Yield Component

Genetic Variation of Flowering Trait in Maize (Zea mays L.) under Drought Stress at Vegetative and Reproductive Stages

A study was conducted under water stress in vegetative and reproductive growth stages at two locations (Shambat and Medani) in Sudan during the season (2003/2004). Genotypic and phenotypic variability, genetic advance and heritability in a broad sense were estimated in a split-plot layout within randomized complete block design with three replications. Fifteen genotypes of maize were used for the study.  Phenotypic correlation coefficient between grain yield and 25%, 50% and 95% of flowering trait anthesis and silking were evaluated. All flowering stages were found significant differences among the genotypes, except days to 95% anthesis. Significant differences among water treatments were observed for days to 25% silking at Medani. High heritability, genotypic coefficient of variation and genetic advance were exhibited by days to 25% silking. Grain yield was significantly and negatively associated with days to (50% and 95%) silking. Based on the results drought stress at vegetative and reproductive stages of maize results in a drastic reduction in grain yield, and flowering character would be the important selection, creation for maize improvement under drought stress. Keywords: Maize (Zea mays L.), Genetic variability, heritability, correlation, flowering, drought

Verification and Application of Finite Element Model Developed for Flood Routing in Rivers

Flood wave propagation in river channel flow can be enunciated by nonlinear equations of motion for unsteady flow. However, it is difficult to find analytical solution of these complex non-linear equations. Hence, verification of the numerical model should be carried out against field data and numerical predictions. This paper presents the verification of developed finite element model applying for unsteady flow in the open channels. The results of a proposed model indicate a good matching with both Preissmann scheme and HEC-RAS model for a river reach of 29 km at both sites (15 km from upstream and at downstream end) for discharge hydrographs. It also has an agreeable comparison with the Preissemann scheme for the flow depth (stage) hydrographs. The proposed model has also been applying to forecast daily discharges at 400 km downstream from Sukkur barrage, which demonstrates accurate model predictions with observed daily discharges. Hence, this model may be utilized for predicting and issuing flood warnings about flood hazardous in advance

Phenotypic Variations of Drought Tolerance Parameters in Maize (Zea mays L.) under Water Stress at Vegetative and Reproductive Stages

Two field experiments were conducted at Shambat and Medani in Sudan under water stress in vegetative and reproductive growth stages during the season (2003/2004). The objective of the study was to assess phenotypic variability and phenotypic correlation between drought tolerance parameters in maize genotypes. A split-plot layout within randomized complete block design with three replications was used for the experiment. Fifteen genotypes of maize were examined through the study. The effect due to genotypes x location was highly significant for all drought tolerance parameters studied. Highly significant and favorable correlation for Yw with SSI2, SSI3, GMP2, GMP3, STI2 and STI3, while highly significant and negative with Yd2/Yw and Yd3/Yw. Based on the result's drought stress at vegetative and reproductive stages of maize results in a drastic reduction in grain yield, and the strong positive correlation of Yw with SSI, GMP and STI, indicates that selection for high values of these parameters improves yield under stress and non-stress environments. Drought tolerance parameters can be used for improving grain yield and facilitate further efforts in maize breeding programs. Keywords: Correlation, drought, genetic variability, heritability, Maize (Zea mays L.).

Corticosteroids and Their Use in Respiratory Disorders

Corticosteroids are adrenal hormones that play important physiologic roles including modulation of glucose metabolism, protein catabolism, alteration of calcium metabolism, regulation of bone turnover, suppression of immune system, and down-regulation of the inflammatory cascade. Because of their diverse effects, corticosteroids have been used therapeutically for treating a wide variety of auto-immune, rheumatologic, inflammatory, neoplastic and infectious diseases. In the field of pulmonology, corticosteroids have been used for the treatment of reactive airway diseases (such as asthma and allergic bronchopulmonary aspergillosis), chronic obstructive pulmonary disease, sarcoidosis, collagen vascular diseases (such as vasculitic disorders), eosinophilic pneumonitis, idiopathic interstitial pneumonias and infectious disorders (such as laryngotracheobronchitis). Different formulations of corticosteroids are commercially available including tablets, intravenous injections, intramuscular formulations and inhaled preparations. Long-term use of corticosteroids is often limited by their adverse effects, which include abnormal fat deposition, weight gain, diabetes mellitus, cataracts, glaucoma, osteoporosis, osteonecrosis, elevated risk of fractures, increased susceptibility to infections, proximal myopathy, depression, psychosis, adrenal atrophy with risk of Addisonian crisis, abdominal striae, acne vulgaris, delayed wound healing, easy bruising, electrolyte abnormalities and increased risk of peptic ulcer disease. As our understanding of corticosteroids advances, we may be able to identify individuals at higher risk of experiencing adverse effects