Bowled over by cricket: impact of tape-ball injuries on the eyes

Abstract PURPOSE: The aim of this study was to describe the type and severity of tape-ball cricket-related eye injuries seen at a tertiary care hospital. DESIGN: A descriptive case series. METHODS: This study included all cases of tape-ball cricket-related eye injuries presenting to the Section of Ophthalmology, Aga Khan University Hospital, Karachi, from January 2014 to January 2015. RESULTS: A total of 20 patients with tape-ball cricket-related eye injuries were treated during this period. The right eye was involved in most (14/20) of the cases. The commonest presenting symptoms included reduced/blurred vision, ocular pain, redness, and floaters. Sixty percent (12/20) of the affected eyes had a best corrected visual acuity of less than 20/200 at presentation, with the retina being the most commonly involved ocular structure. All patients reported that they were not wearing protective eyewear at the time of trauma. Despite standard management, half of the eyes had severe or total vision loss at the last follow-up (minimum, 3 months), mainly due to retinal damage. CONCLUSIONS: Our study calls for the compulsory use of protective eyewear by cricket players and for countrywide surveillance data on the true burden of this unnoticed preventable cause of unilateral eye injuries and associated vision loss

An Audit of Documentation relating to Decision-Making Capacity at an Old Age Psychiatric Hospital in England

The Mental Capacity Act 2005 (MCA) guides clinicians in England and Wales in how to support patients to make a capacitous decision. Documentation of patients’ capacity is mandatory for certain decisions in psychiatric hospitals so as to evidence the use of the MCA guidance. Given the importance of decisions such as where to live and what medication to take, the quality of clinician interview and documentation is important to monitor.Method: The quality and quantity of decision-making capacity (DMC) documentation was reviewed in a psychiatric hospital in England for older adults. The clinical records of 49 discharged patients were examined retrospectively. All DMC documentation found was compared with existing legal guidance on capacity assessment.Results: 46/58 DMC documents were found to be insufficient. There was little evidence of what information had been given to patients to enable autonomous decision making, what actions had been undertaken to optimise capacity and what alternative decision options were presented.Conclusions: Consideration should be given by hospital managers to support DMC assessment by staff. Further reflection is needed on the part of regulators regarding the optimum DMC documentation standard, particularly regarding physical health medication for psychiatric inpatients. Guidance and training for all staff involved in the assessment and documentation of DMC should be made available

Translating knowledge for action against stroke--using 5-minute videos for stroke survivors and caregivers to improve post-stroke outcomes: study protocol for a randomized controlled trial (Movies4Stroke).

Background: Two thirds of the global mortality of stroke is borne by low and middle income countries (LMICs). Pakistan is the world’s sixth most populous country with a stroke-vulnerable population and is without a single dedicated chronic care center. In order to provide evidence for a viable solution responsive to this health care gap, and leveraging the existing \u3e70 % mobile phone density, we thought it rational to test the effectiveness of a mobile phone-based video intervention of short 5-minute movies to educate and support stroke survivors and their primary caregivers. Methods: Movies4Stroke will be a randomized control, outcome assessor blinded, parallel group, single center superiority trial. Participants with an acute stroke, medically stable, with mild to moderate disability and having a stable primary caregiver will be included. After obtaining informed consent the stroke survivor-caregiver dyad will be randomized. Intervention participants will have the movie program software installed in their phone, desktop, or Android device which will allow them to receive, view and repeat 5-minute videos on stroke-related topics at admission, discharge and first and third months after enrollment. The control arm will receive standard of care at an internationally accredited center with defined protocols. The primary outcome measure is medication adherence as ascertained by a locally validated Morisky Medication Adherence Scale and control of major risk factors such as blood pressure, blood sugar and blood cholesterol at 12 months post discharge. Secondary outcome measures are post-stroke complications and mortality, caregiver knowledge and change in functional outcomes after acute stroke at 1, 3, 6, 9 and 12 months. Movies4Stroke is designed to enroll 300 participant dyads after inflating 10 % to incorporate attrition and noncompliance and has been powered at 95 % to detect a 15 % difference between intervention and usual care arm. Analysis will be done by the intention-to-treat principle. Discussion: Movies4Stroke is a randomized trial testing an application aimed at supporting caregivers and stroke survivors in a LMIC with no rehabilitation or chronic support systems

Dissemination of Bt cotton in cotton growing belt of Pakistan

AbstractBackground: Adoptability of biotech crops has climbed up dramatically in the world from 1.7 million hectares in its introductory period in 1996 to 170 million hectare in 2012. Area planted to biotech crop increased to over one-fourth of the world total in 2005-06. The data collected also demonstrates that developing countries like Pakistan are making tremendous development in production of Biotech crops especially cotton.Methodology: Random samples have been collected and received from different cotton growing areas of Pakistan from 2007 to date for Bt gene confirmation and expression. Genomic DNA was isolated and analyzed through internal reference primers from SadI gene of cotton genome. Samples were analyzed by PCR for detection of Bt genes including CEMB Cry1Ac+2A double Bt gene. ELISA was done for confirmation of Bt protein by using Envirologix Quantiplate ELISA kit Cry1Ab/Ac Cat # AP003 and Quantiplate ELISA kit Cry2A Cat # AP005 according to manufacturer instruction.Results: Development of Bt Cotton in Pakistan is as old as in advanced countries of the world. Pakistan has become the fourth country of the world for production of indigenous Bt cotton by utilizing their local cotton varieties for genetic modifications. The support of various documentary proofs like research articles, patents, projects, Ph. D and M.Phil studies generated by Centre of Excellence in Molecular Biology (CEMB) greatly strengthen the data of Bt cotton development in Pakistan. Pakistan Central Cotton Committee (PCCC)declared locally developed Bt cotton as the best performing of all over Pakistan among other international product.Conclusion: Progress made in development of indigenous Bt cotton variety by CEMB Pakistan and their excellent performance in field determined their increased adoptability ratio in farmers. The formal approval process which is going to be completed in near future will open the doors for farmers and breeders to utilize this material for better economy of Pakistan

Translating knowledge for action against stroke – using 5-minute videos for stroke survivors and caregivers to improve post-stroke outcomes: study protocol for a randomized controlled trial (Movies4Stroke)

Participant timeline. (DOCX 48 kb

Beyond climate change : Examining the role of environmental justice, agricultural mechanization, and social expenditures in alleviating rural poverty

Extreme weather events and extreme poverty are two sides of the same coin, with far-reaching consequences for emerging nations like Pakistan. Rural people are more likely to experience poverty and inequality as climate change worsens. This research aspires to close the gap between environmental ethics and justice by investigating how climate change issues contribute to poverty in Pakistan. The study used Robust Least Squares (RLS) regression to analyze the impact of water scarcity, extreme temperatures, and excessive rainfall on rural poverty in Pakistan from 1990Q1 to 2022Q4. Further, the study examines the effect of environmental justice in�terventions, access to healthcare and education, agricultural value-added and agricultural mechanization on the country’s rural poverty. Results reveal that climate change contributes to rural poverty in Pakistan, while environmental justice initiatives, healthcare access, and agricultural automation alleviate poverty incidence. The Impulse Response Function (IRF) estimates suggested that rural poverty will be exacerbated over the next decade by water scarcity, high temperatures, and low agricultural value added but alleviated by excessive rainfall, environmental justice intervention, healthcare access, and agricultural mechanization. According to Variance Decomposition Analysis (VDA) projections, agricultural value added will substantially impact rural poverty by 2032, increasing it by 11.431%. Addressing these problems requires policymakers to prioritize the interests of the most marginalized groups by fostering fair results. Policies should cut GHG emissions and encourage sus�tainable development to combat climate change. Modernizing farming techniques and expanding access to healthcare are also necessary for increasing efficiency and production. It is essential to execute environmental justice interventions so that all communities have access to environmental resources and protections equitably. Promoting equitable outcomes and reducing poverty in Pakistan’s climate change context may be achieved by closing the gap between environmental ethics and justice

Effect of 5-minute movies shown via a mobile phone app on risk factors and mortality after stroke in a low- to middle-income country: Randomized controlled trial for the stroke caregiver dyad education intervention (Movies4Stroke)

Background: Pakistan is the sixth most populous nation in the world and has an estimated 4 million stroke survivors. Most survivors are taken care of by community-based caregivers, and there are no inpatient rehabilitation facilities.Objective: The objective of this study was to evaluate the effectiveness and safety of locally designed 5-min movies rolled out in order of relevance that are thematically delivered in a 3-month program to deliver poststroke education to stroke survivor and caregiver dyads returning to the community.Methods: This study was a randomized controlled, outcome assessor–blinded, parallel group, single-center superiority trial in which participants (stroke survivor-caregiver dyads) with first-ever stroke (both ischemic and hemorrhagic) incidence were randomized within 48 hours of their stroke into either the video-based education intervention group or the control group. The video-based education intervention group had health education delivered through short videos that were shown to the participants and their caregivers at the time of admission, before discharge, and the first and third months of follow-up after discharge. The control group had standardized care including predischarge education and counseling according to defined protocols. All participants enrolled in the video education intervention and control groups were followed for 12 months after discharge for outcome assessment in the outpatient stroke clinics. The primary outcome measures were the proportion of participants achieving control of blood pressure, blood sugar, and blood cholesterol in the video intervention versus the control group. Several predefined secondary outcomes were included in this study, of which we report the mortality and functional disability in this paper. Analysis was by performed using the intention-to-treat principle.Results: A total of 310 stroke survivors and their caregiver dyads (participant dyads) were recruited over a duration of 6 months. In total, 155 participant dyads were randomized into the intervention and control groups, each. The primary outcome of control of three major risk factors revealed that at 12 months, there was a greater percentage of participants with a systolic BP(18/54, 33% vs 11/52, 21%; P=.16), diastolic BP(44/54, 81% vs 37/52, 71%; P=.21), HbA1c levelP=.32), and low-density lipoprotein level/dL (36/51, 70% vs 30/45, 67%; P=.68) in the intervention group than in the control group. The secondary outcome reported is the mortality among the stroke survivors because the number of stroke-related complications was higher in the control group than in the intervention group (13/155, 8.4% vs 2/155, 1.3%), and this difference was statistically significant (P\u3c.001).Conclusions: The Movies4Stroke trial failed to achieve its primary specified outcome. However, secondary outcomes that directly related to survival skills of stroke survivors demonstrated the effectiveness of the video-based intervention on improving stroke-related mortality and survival without disability

Trackable CEMB-Klean Cotton Transgenic Technology: Affordable Climate Neutral Agri-biotech Industrialization for Developing Countries

Background: Transgenic technology reflects the incorporation of novel useful traits in crop plants like cotton for economic benefits by overcoming the problems including insects’ pests and weeds in special. The present study is the success story of the continuous effort of CEMB team started back in the 1990s.Methods: This study includes characterization of a large number of Bacillus thuringiensis (Bt) strains taken from local soil and subjected to direct transformation of isolated BT genes into local cotton cultivars. Protocols for transformation into cotton plants were optimized and validated by the development of double gene codon optimized (Cry1Ac and Cry2A) transgenic cotton varieties.Results: The resulting GMOs in the form of CEMB-33, CA-12, CEMB-66 have been approved by Punjab Seed Council in 2013 and 2016 respectively. Double Bt and weedicide resistant cotton harboring CEMB-Modified and codon optimized cp4EPSPS (GTGene). These varieties can tolerate glyphosate spray @ 1900ml per acre without the appearance of necrotic spots/shedding and complete removal of all surrounding weeds in the cotton field is a significant advance to boost cotton production without spending much on insecticides and herbicides.Conclusion: In the current report, two unique sets of primers which amplify 1.1 Kb for CEMB-double Bt genes and 660 bp product for CEMB-Modified cp4EPSPS (GTGene) were tested. CEMB cotton variety CKC-01 is specially designed as low cost and easy to use by local farmer’s technology has the potential to revolutionize the cotton growing culture of the country.Keywords: Event detection; Bt Cotton; CEMB transgenic technology; GTGen

A systematic review on COVID-19 vaccine strategies, their effectiveness, and issues

COVID-19 vaccines are indispensable, with the number of cases and mortality still rising, and currently no medicines are routinely available for reducing morbidity and mortality, apart from dexamethasone, although others are being trialed and launched. To date, only a limited number of vaccines have been given emergency use authorization by the US Food and Drug Administration and the European Medicines Agency. There is a need to systematically review the existing vaccine candidates and investigate their safety, efficacy, immunogenicity, unwanted events, and limitations. The review was undertaken by searching online databases, i.e., Google Scholar, PubMed, and ScienceDirect, with finally 59 studies selected. Our findings showed several types of vaccine candidates with different strategies against SARS-CoV-2, including inactivated, mRNA-based, recombinant, and nanoparticle-based vaccines, are being developed and launched. We have compared these vaccines in terms of their efficacy, side effects, and seroconversion based on data reported in the literature. We found mRNA vaccines appeared to have better efficacy, and inactivated ones had fewer side effects and similar seroconversion in all types of vaccines. Overall, global variant surveillance and systematic tweaking of vaccines, coupled with the evaluation and administering vaccines with the same or different technology in successive doses along with homologous and heterologous prime-booster strategy, have become essential to impede the pandemic. Their effectiveness appreciably outweighs any concerns with any adverse events