An observational study on congenital talipes equinovarus.

Introduction: Clubfoot or Congenital Talipes Equinovarus (CTEV) is a congenital ab-normality characterized by the permanent foot morphological alteration, conse-quently individual is unable to lean the foot properly on the floor in an appropriate physiological manner.Objective: To execute an observational study on Congenital Talipes Equinovarus (CTEV) in the Orthopedic Department of Indus Medical College Hospital, Tando Mu-hammad Khan.Methodology: Study conducted from Jan 2018 to Jan 2019 at Orthopedic Depart-ment of Indus Medical College Hospital, Tando Muhamad Khan. Medial Crease (MC), Curved Lateral Border (CLB), and Lateral Head of Talus (LHT) assessed based on the Mid Foot Contracture Score (MFCS). Also, an assessment of the Posterior Crease (PC), Empty Heel (EH) and Right Equinus (RE) made as part of the Hind-foot Contracture Score (HFCS). Data collected from 100 participants through conven-ience sampling technique and quantitative analysis performed.Results: Of all participants, Pirani score was calculated from 0 to 1. Scoring is based on the average values. It has been found that the incidence of curved lateral border was 30%, medial crease as 55% and lateral head of talus as 15%. Additionally, it has been found that the empty heel incidence is 35%, posterior crease is 60% and rigid Equinus as 15%. These results reveal that there is a high incidence of CTAV in the given sample.Conclusion: The study revealed that the exact cause (s) of CTEV are still unknown. Keywords: Congenital Talipes Equinovarus (CTEV), Pirani score, Pediatric Orthope-di

Relationship of Family Members’ Support with Practice of Community Midwives in Rural Sindh, Pakistan

Background: Pakistan has one of the highest maternal mortality rates in the world. Community Midwives (CMWs) were introduced in 2006 as a new cadre of birth attendants who would bring midwifery services to rural areas by being based in designated communities. The CMWs face many obstacles and retaining them in practice is a challenge. This study aimed to examine whether there was a relationship between family support and CMWs retention in midwifery practice. We hoped to learn about influences on retention that might improve the Maternal Newborn and Child Health (MNCH) programme. Methods: This was a cross-sectional survey conducted in five districts of rural Sindh, a province in Pakistan. A list of all CMWs who graduated between 2007 and 2012 was obtained from the MNCH programme Sindh. The CMWs were tracked by MCHIP (Maternal Child Health Integrated Program) clinical supervisors posted in the respective districts to gather information about families’ support of CMWs. Findings: Of the 148 CMWs in the MNCH list, 112 (76%) were tracked. Of 112, 44 (39%) CMWs were in active practice while 69 (61%) had completed their training but had not started a practice. Of the 44 practising CMWs, 82% had family members who worked in a health-related field or previously were traditional birth attendants (TBAs). Only 18% of those who established a practice had a family without this profile. Conclusion: These preliminary findings indicate a strong relationship between family engagement in health care work and the capacity of CMWs to establish a midwifery practice. A further comparative analysis of practising and non-practising CMWs is warranted

Ampicillin and Gentamicin Are a Useful First-line Combination for the Management of Sepsis in Under-five Children at an Urban Hospital in Bangladesh

The study evaluated the commonly-used drugs for the management of sepsis and their outcome among under-five children. We evaluated the hospital-records of all paediatric sepsis patients (n= 183) in the intensive care unit (ICU) and longer-stay unit (LSU) of the Dhaka Hospital of icddr,b. These records were collected from the hospital management system (SHEBA) during November 2009 to October 2010. A total of 183 under-five children with clinical sepsis were found during the study period, and 14 (8%) of them were neonates. One hundred and eighty-one patients had received a combination of injection ampicilin and injection gentamicin, and two patients had received the combination of injection ceftriaxone and injection gentamicin. Only 46 (25%) patients required a change of antibiotics to the combination of intravenous ceftriaxone plus gentamicin after non-response of injection ampicilin and injection gentamicin combination; 7/181 (4%) patients died who received injection ampicilin and injection gentamicin whereas none died among the other two patients who received injection ceftriaxone and injection gentamicin (p=1.00). The combination of injection ampicilin and injection gentamicin as the first-line antibiotics for the management of sepsis in children even beyond the neonatal age is very effective, resulting in lower mortality

Seed priming with different agents mitigate alkalinity induced oxidative damage and improves maize growth

Soil alkalinity is a severe threat to crop production globally as it markedly retards plant growth. Different techniques are used to mitigate alkaline stress, but priming techniques are considered the most appropriate. The current study was carried out in complete randomized design (CRD) to evaluate the effect of different priming techniques on maize crop grown under different levels of alkalinity stress. The experiment was comprised of different treatments of alkalinity stress (AS) including, control, 6 dS m-1 and 12 dS m-1 and different priming techniques including control, hydro-priming (HP), osmo-priming (OP) with potassium nitrate: KNO3) and redox-priming (RP) with hydrogen peroxide (H2O2). Results indicated that alkalinity stress significantly reduced plant growth and biomass production and induced severe alterations in physiological attributes and antioxidant activities. Soil alkalinity significantly reduced the root and shoot growth and subsequent biomass production by increasing electrolyte leakage (70.60%), hydrogen peroxide (H2O2: 31.65%), malondialdehyde (MDA: 46.23%) and sodium (Na+) accumulation (22.76%) and reduction in photosynthetic pigments, relative water contents (RWC), total soluble proteins (TSP) and free amino acids, potassium (K+) accumulation. However, priming treatments significantly alleviated the alkalinity-induced toxic effects and improved plant growth. OP (KNO3) remained the top performing. It appreciably improved plant growth owing to the improved synthesis of photosynthetic pigments, better RWC (16.42%), TSP (138.28%), FAA (178.37%), and K+ accumulation (31.385) and improved antioxidant activities (APX and CAT) by favoring the Na+ exclusion and maintenance of optimum Na+/K+. In conclusion, KNO3 priming is an imperative seed priming practice to improve maize growth and biomass production under alkalinity stress

Biallelic Variants in Seven Different Genes Associated with Clinically Suspected Bardet-Biedl Syndrome

Bardet-Biedl syndrome (BBS) is a rare clinically and genetically heterogeneous autosomal recessive multi-systemic disorder with 22 known genes. The primary clinical and diagnostic features include six different hallmarks, such as rod-cone dystrophy, learning difficulties, renal abnormalities, male hypogonadism, post-axial polydactyly, and obesity. Here, we report nine consanguineous families and a non-consanguineous family with several affected individuals presenting typical clinical features of BBS. In the present study, 10 BBS Pakistani families were subjected to whole exome sequencing (WES), which revealed novel/recurrent gene variants, including a homozygous nonsense mutation (c.94C>T; p.Gln32Ter) in the IFT27 (NM_006860.5) gene in family A, a homozygous nonsense mutation (c.160A>T; p.Lys54Ter) in the BBIP1 (NM_001195306.1) gene in family B, a homozygous nonsense variant (c.720C>A; p.Cys240Ter) in the WDPCP (NM_015910.7) in family C, a homozygous nonsense variant (c.505A>T; p.Lys169Ter) in the LZTFL1 (NM_020347.4) in family D, pathogenic homozygous 1 bp deletion (c.775delA; p.Thr259Leufs*21) in the MKKS/BBS5 (NM_170784.3) gene in family E, a pathogenic homozygous missense variant (c.1339G>A; p.Ala447Thr) in BBS1 (NM_024649.4) in families F and G, a pathogenic homozygous donor splice site variant (c.951+1G>A; p?) in BBS1 (NM_024649.4) in family H, a pathogenic bi-allelic nonsense variant in MKKS (NM_170784.3) (c.119C>G; p.Ser40*) in family I, and homozygous pathogenic frameshift variants (c.196delA; p.Arg66Glufs*12) in BBS5 (NM_152384.3) in family J. Our findings extend the mutation and phenotypic spectrum of four different types of ciliopathies causing BBS and also support the importance of these genes in the development of multi-systemic human genetic disorders

خیبرپختونخوا کے جامعات کا بی-ایس اُردو نصاب اور کالج سطح کے اساتذہ کی مشکلات، ان کا حل اور عصری تقاضے

The B.S Degree Program recognized worldwide was started in 2001 in Pakistan. At the level of fertility this system in Khyber Pakhtunkhwa although does not face too much problems at Universities Level. But at the very beginning various difficulties took place at Colleges Level, which is becoming the obstacle to the success of this system. The major difficulties faced were lack of qualified teacher, difficulties in arranging staff for Major subjects of English and Computer Science, different curriculum of different universities and colleges of Khyber Pakhtunkhwa although all are according to HEC standard. The article will highlight such problems and solution will be recommended for the success of B.S program in the Universities and Colleges of Khyber Pakhtunkhwa

Major Depressive Disorder: Existing Hypotheses about Pathophysiological Mechanisms and New Genetic Findings

Major depressive disorder (MDD) is a common mental disorder generally characterized by symptoms associated with mood, pleasure and effectiveness in daily life activities. MDD is ranked as a major contributor to worldwide disability. The complex pathogenesis of MDD is not yet understood, and this is a major cause of failure to develop new therapies and MDD recurrence. Here we summarize the literature on existing hypotheses about the pathophysiological mechanisms of MDD. We describe the different approaches undertaken to understand the molecular mechanism of MDD using genetic data. Hundreds of loci have now been identified by large genome-wide association studies (GWAS). We describe these studies and how they have provided information on the biological processes, cell types, tissues and druggable targets that are enriched for MDD risk genes. We detail our understanding of the genetic correlations and causal relationships between MDD and many psychiatric and non-psychiatric disorders and traits. We highlight the challenges associated with genetic studies, including the complexity of MDD genetics in diverse populations and the need for a study of rare variants and new studies of gene-environment interactions

Major Depressive Disorder: Existing Hypotheses about Pathophysiological Mechanisms and New Genetic Findings

Major depressive disorder (MDD) is a common mental disorder generally characterized by symptoms associated with mood, pleasure and effectiveness in daily life activities. MDD is ranked as a major contributor to worldwide disability. The complex pathogenesis of MDD is not yet understood, and this is a major cause of failure to develop new therapies and MDD recurrence. Here we summarize the literature on existing hypotheses about the pathophysiological mechanisms of MDD. We describe the different approaches undertaken to understand the molecular mechanism of MDD using genetic data. Hundreds of loci have now been identified by large genome-wide association studies (GWAS). We describe these studies and how they have provided information on the biological processes, cell types, tissues and druggable targets that are enriched for MDD risk genes. We detail our understanding of the genetic correlations and causal relationships between MDD and many psychiatric and non-psychiatric disorders and traits. We highlight the challenges associated with genetic studies, including the complexity of MDD genetics in diverse populations and the need for a study of rare variants and new studies of gene-environment interactions

Ampicillin and Gentamicin Are a Useful First-line Combination for the Management of Sepsis in Under-five Children at an Urban Hospital in Bangladesh

The study evaluated the commonly-used drugs for the management of sepsis and their outcome among under-five children. We evaluated the hospital-records of all paediatric sepsis patients (n= 183) in the intensive care unit (ICU) and longer-stay unit (LSU) of the Dhaka Hospital of icddr,b. These records were collected from the hospital management system (SHEBA) during November 2009 to October 2010. A total of 183 under-five children with clinical sepsis were found during the study period, and 14 (8%) of them were neonates. One hundred and eighty-one patients had received a combination of injection ampicilin and injection gentamicin, and two patients had received the combination of injection ceftriaxone and injection gentamicin. Only 46 (25%) patients required a change of antibiotics to the combination of intravenous ceftriaxone plus gentamicin after non-response of injection ampicilin and injection gentamicin combination; 7/181 (4%) patients died who received injection ampicilin and injection gentamicin whereas none died among the other two patients who received injection ceftriaxone and injection gentamicin (p=1.00). The combination of injection ampicilin and injection gentamicin as the first-line antibiotics for the management of sepsis in children even beyond the neonatal age is very effective, resulting in lower mortality