Role of fibreoptic bronchoscopy in the management of immunocompromised patients with pulmonary infiltrates

Immunocompromised patients are prone to develop various pulmonary complications. The range of diagnostic possibilities is wide, infection being the commonest cause. Non-invasive diagnostic tests are often unrewarding. In this study, we have evaluated the diagnostic efficacy and safety of fibreoptic bronchoscopy in immunocompromised patients with pulmonary infiltrates. Patients tolerated the procedure well. This technique identified the etiology in up tp 75% of cases. After treatment based on the result of bronchoscopy, 63% patients improved and were discharged

Tuberculosis diagnosis and treatment practices of private physicians in Karachi, Pakistan

In a densely populated urban area of Karachi, Pakistan, a questionnaire survey was made of the knowledge and practices of 120 private general practitioners about the diagnosis and treatment of tuberculosis (TB). The majority knew that cough, fever and weight loss were the main symptoms of TB, but less than half knew that blood in sputum, poor appetite and chest pain were associated with the disease. Only 58.3% of physicians used sputum microscopy for diagnosing TB and 35.0% used it as a follow-up test. Only 41.7% treated TB patients themselves, the remaining referring their patients to specialists. Around 73.3% of the doctors were aware of the 4 first-line anti-TB drugs. Efforts to improve the knowledge of private practitioners, and strategies to enhance public-private collaboration forTB control in urban areas are urgently required

Effect of tannery effluents on seed germination and growth of two sunflower cultivars

The wastewater of a tannery in Multan, Pakistan, was alkaline with high biochemical oxygen demand (BOD) and chemical oxygen demand (COD) values along with much higher concentrations of total settle able salts and suspended solids, sodium adsorption ratio and high amount of sodium having the water quality class C3S1. Effluent was examined for its chemical constituents and the effect of its various dilutions was examined in greenhouse on two newly recommended sunflower cultivars (FH-330 and FH- 245) during their whole growth period. Percentage of germination, chlorophyll, carbohydrates and protein contents of both the sunflower cultivars showed significant (p = 0.05) decreasing trend with increasing effluent concentrations. Vegetative growth parameters like plant height and number of leaves per plant were significantly (p = 0.05) reduced with the increasing levels of effluents. Rate of leaf senescence of both cultivars was higher under higher effluent concentrations. Yield of sunflower crop in both cultivars was significantly (p = 0.05) reduced due to effluent concentrations. Seeds per capitulum were decreased to 49%, seeds weight per plant to 61 - 66% and 100-seed weight to 49 - 59%. The appearance of pale yellowish color of the affected plants was due to reduction in photosynthetic material under higher effluent concentration. Full strength effluent concentration caused the reduction in biomass accumulation and reproductive growth of sunflower cultivars. The results revealed that cultivar FH-330 was relatively resistant to varying effluent concentrations as compared to the cultivar FH- 245. However, the tannery effluents due to the presence of chemicals are not suitable for inclusion in irrigation system.Key words: Tannery effluents, sunflower, seed germination, growth, adverse effect, reduced yield

Prevalence of vitamin D deficiency in Pakistan and implications for the future

Background and aims: Vitamin D deficiency (25-hydroxyvitamin D - VitDD) affects over one billion people worldwide. VitDD results in progression of osteoporosis as well as other conditions. Previous studies have shown high rates of VitDD in Pakistan despite appreciable levels of sunshine. However, none have assessed VitDD across all age groups, genders, incomes and locations to guide future strategies. Methods: Questionnaire and blood sampling among 4830 randomly selected citizens. Results: High levels of VitDD among all age groups, genders, income levels and locations. 53.5% had VitDD, 31.2% had insufficient Vitamin D and only 15.3% normal Vitamin D. Conclusion: High rates of VitDD in Pakistan despite high levels of sunshine and previous Food Acts asking for food fortification with Vitamin D. Public health strategies are needed to address high VitDD rates, including food fortification, i.e. nurture, alongside increasing exposure to sunlight, i.e. nature. This will involve all key stakeholder groups

Cost-effectiveness of household contact investigation for detection of tuberculosis in Pakistan

Objectives Despite WHO guidelines recommending household contact investigation, and studies showing the impact of active screening, most tuberculosis (TB) programmes in resource-limited settings only carry out passive contact investigation. The cost of such strategies is often cited as barriers to their implementation. However, little data are available for the additional costs required to implement this strategy. We aimed to estimate the cost and cost-effectiveness of active contact investigation as compared with passive contact investigation in urban Pakistan. Methods We estimated the cost-effectiveness of ‘enhanced’ (passive with follow-up) and ‘active’ (household visit) contact investigations compared with standard ‘passive’ contact investigation from providers and the programme’s perspective using a simple decision tree. Costs were collected in Pakistan from a TB clinic performing passive contact investigation and from studies of active contact tracing interventions conducted. The effectiveness was based on the number of patients with TB identified among household contacts screened. Results The addition of enhanced contact investigation to the existing passive mode detected 3.8 times more cases of TB per index patient compared with passive contact investigation alone. The incremental cost was US$30 per index patient, which yielded an incremental cost of US$120 per incremental patient identified with TB. The active contact investigation was 1.5 times more effective than enhanced contact investigation with an incremental cost of US$238 per incremental patient with TB identified. Conclusion Our results show that enhanced and active approaches to contact investigation effectively identify additional patients with TB among household contacts at a relatively modest cost. These strategies can be added to the passive contact investigation in a high burden setting to find the people with TB who are missed and meet the End TB strategy goals.publishedVersio

Thermal, electrochemical and mechanical properties of shape memory alloy developed by a conventional processing route

A Cu based shape memory alloy (Cu-Al-Ni) having a composition 83% Cu, 14% Al, 3% Ni, was developed and studied to determine the shape memory effect. Powder of Cu, Al and Ni was melted in a pit furnace at about 15500C, and casted alloy was heat treated at 8500C for a period of 50 minutes followed by water quenching. Microstructure characterization of alloy (Cu-Al-Ni) was carried out to determine the pre-quenched (cast structure) and quenched martensitic structure. The microstructure analysis of developed samples showed needle like structure of quenched martensite after heat treatment. It has a very good resemblance with structure of casted shape memory alloy obtained from the vacuum induction process. The Vickers hardness test was also performed. Quenched microstructure with improved hardness than pre-quenched structure was observed.Keywords: Shape Memory Alloy, Microstructure, Mechanical Propertie

May Measurement Month (MMM) 2017: an analysis of blood pressure screening results in Bangladesh-South Asia

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. Based on the findings of the non-communicable disease Risk Factors Survey Bangladesh 2010, the prevalence of hypertension in adults 25 years or older in Bangladesh is 20.1%. The Bangladesh Demographic Health Survey, 2011 showed that approximately 50% of those affected are unaware of their hypertensive condition. The May Measurement Month 2017 (MMM17) is a global initiative of the International Society of Hypertension (ISH) aimed at raising awareness of high BP. We participated in MMM17 to raise awareness of hypertension screening and identify those with elevated BP who were unaware, and those on treatment with still uncontrolled hypertension. Following the standard protocol designed by the ISH, we participated in MMM17, an opportunistic cross-sectional survey of volunteers aged ≥18. It was carried out in May 2017. BP measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. Data were collected from 35 screening sites in 33 districts in Bangladesh. Personnel from several government and non-government organizations volunteered in this huge event. A total of 11 418 individuals were screened during MMM17, of which 5401 (47.3%) were found to have hypertension. Of 8365 individuals not receiving anti-hypertensive medication, 2348 (28.1%) were hypertensive. Of 3053 individuals receiving anti-hypertensive medication, 1594 (52.2%) had uncontrolled BP. MMM17 was the largest BP screening campaign undertaken in Bangladesh. This study suggests that opportunistic screening can identify significant numbers of people with raised BP. A periodic public health programme at a national level needs to be initiated to increase hypertension detection and control rate and thus for the prevention of cardiovascular diseases

Growth and yield response of two cultivars of mungbean (vign radiata l.) to different potassium levels. The

ABSTRACT Potassium application is directly related to growth, plant biomass and yield in crops. While the deficiency of Potassium is in Pakistan is becoming nutritional limiting factor in most of areas. A study was carried out at experimental area of ) was obtained with the application of 90 Kg potash per hectare. Genotype M-06 produced higher seed yield than that of NM-92. The interactive effect of Mungbean varieties and Potassium level was found significant in parameter of protein contents (%). Maximum protein contents were observed in case of Mung-06 with application of 90 Kg potash per hectare. It is concluded that the application of Potash fertilizer gave higher yield of mungbean cultivars under agro-climatic conditions of Faisalabad

Phylogeography of cliff racer (Platyceps rhodorachis Jan, 1865) from Punjab, Pakistan

The present study reports the existence of cliff racer, Platyceps rhodorachis from the plains of Punjab, Pakistan. A total of 10 specimens were captured during the field surveys from June to September, 2018 from different sites of Punjab. Platyceps rhodorachis was identify on the basis of morphology and confirmed through COI gene sequences. The obtained DNA sequences have shown reliable and exact species identification. Newly produced DNA sequences of Platyceps rhodorachis were submitted to GenBank and accession numbers were obtained (MK936174.1, MK941839.1 and MT790210.1). N-J tree based on COI sequences of Platyceps rhodorachis clearly separated as out-group with other members of family Colubridae based on p-distance. The intra-specific genetic variation ranges from 12% to 18%. The DNA sequences of Platyceps rhodorachis kashmirensis, Platyceps rhodorachis ladacensis, Platyceps ventromaculatus, Platyceps ventromaculatus bengalensis and Platyceps ventromaculatus indusai are not available at NCBI to validate their taxonomic positions. In our recommendations, a large scale molecular based identification of Pakistan’s herpetofauna is required to report more new or subspecies from country.S. Malika, A. Javida, Hamidullahb, M. A. Iqbalc, A. Hussaina, S. M. Bukharia, A. L. Chaberd, F. Hemmatzadehd, N. Ismate, A. Alif, S. M. Azamg, G. Mustafaa, S. Hussaina, U. Ahmada, A. Ahmadh, and W. Ali

Security lies in obedience - Voices of young women of a slum in Pakistan

<p>Abstract</p> <p>Background</p> <p>Existing literature shows that young people, especially women, have poor knowledge about sexuality and reproductive health. Many of the difficulties young women experience are related to beliefs and expectations in society making them more vulnerable to reproductive ill health. The objective of this study was to explore how young women living in a slum in Islamabad are prepared for marriage and how they understand and perceive their transition to marriage and the start of sexual and childbearing activity.</p> <p>Methods</p> <p>Twenty qualitative interviews and three focus group discussions were conducted with young women residing in a slum of Islamabad. Content analysis was used to explore how the participants represented and explained their situation and how decisions about their marriage were made.</p> <p>Results</p> <p>The main theme identified was <it>security lies in obedience</it>. The two sub-themes contributing to the main theme were <it>socialization into submissiveness </it>and <it>transition into adulthood in silence</it>. The theme and the sub-themes illustrate the situation of young women in a poor setting in Pakistan.</p> <p>Conclusion</p> <p>The study demonstrates how, in a culture of silence around sexuality, young women's socialization into submissiveness lays the foundation for the lack of control over the future reproductive health that they experience.</p