Complete Heart Block in Association With Dengue Hemorrhagic Fever

Dengue virus infection affects the heart structurally and functionally. Clinical manifestations of cardiac complications secondary to dengue virus infection vary from self-limiting arrhythmias to severe myocardial infarction, leading to hypotension, pulmonary edema, and cardiogenic shock. However, we report a case of dengue hemorrhagic fever (DHF) complicated by a complete heart block. A female with DHF due to dengue virus serotype 2, presented to the emergency department with fever, headache, rash, and fatigue followed by an episode of syncope. She was found to have a third-degree atrioventricular block, with pulseless polymorphic ventricular tachycardia. Patient was resuscitated and a temporary trans-venous pacemaker was placed. She reverted back to normal sinus rhythm after 4 days of syncope and was subsequently discharged from the hospital after complete resolution of symptoms, without the need for a permanent pacemaker. Physicians are warranted to have high index of suspicion for dengue virus infection as an etiology in patients with acute cardiovascular compromise, especially in tropical areas

Ethnoveterinary Therapeutic Practices and Conservation Status of the Medicinal Flora of Chamla Valley, Khyber Pakhtunkhwa, Pakistan

Domestic animals play a very important role in the human civilization. Besides human being, plants are used as medicines for many domestic animals. The therapeutic practices are very common among the tribes of Chamla, rich in ethnoveterinary medicinal plants. Due to poor availability of modern healthcare facilities and poverty of indigenous people, they depend on local medicinal plants for the healthcare of their domestic animals. This study is the first attempt to document the indigenous knowledge and evaluate the conservation status of medicinal plants and practices of herbal remedies by the local people of Chamla Valley in the treatment of their livestock. Semi-structured questionnaire was used and 120 local inhabitants were interviewed to note the traditional practices regarding plant species uses. Well-known statistical indices, Use Value formula and Relative Frequency Citations were used for quantification of the recorded data. It was observed that 50 medicinal plants belonging to 38 families were reported, where Poaceae was the most cited. The common livestock are goats, sheep, buffalos, cows, bulls, and donkeys. Most of the herbs, which are used in livestock treatment, are wild and few plants are cultivated. The common livestock diseases are red water, 3 days sickness, diarrhea, tympany, and indigestion among others. Most of the plants are used in fresh condition. According to the results, Brassica nigra was used for placenta retention, Butea monosperma for constipation, Calotropis procera for indigestion and 3 days sickness. Canabis sativa, Cedrella serrata, Allium sativum, and Origanum vulgare were used for fever. The traditional plant collection techniques have resulted in huge losses of these valuable plant resources. The ethnobotanical conservation assessment revealed that due to increased exploitation and un-sustainable harvesting, 49% of these economically valued medicinal plant species are decreasing in last 30 years. Some of the plants are only present on high altitudes while they had been finished in the foothills like Paeonia emodi and Berberis lycium. Lack of scientific knowledge, ignorance, poverty, and joblessness, as well as land development, construction and fires, add more pressure on flora and fauna of the area and various species are under the threat of extinction

Perception of Doctors towards Relationship with Pharmaceutical Industry

Doctors and the pharmaceutical companies are the main component of health care system which is also essential for each other. Their interdependency on such a large scale calls for a better relationship between these two stakeholders of the health care system. But most of the time this relationship is used in a negative way which not only has a bad impact on the reputation of this prestigious medical profession but also affects the health of the patient which are the ones to bear the effects of this malafied relationship.              In order to see how this relationship works in the hospitals of Azad Kashmir, this study was conducted on the doctors of Abbas Institute of Medical Sciences, Muzaffarabad. Due to shortage of time and limited resources only one hospital was selected for the study to be carried out. This was a mixed study carried out from January through June 2017. In our study 100 doctors were selected for data collection in questionnaire method. While three different focus groups involving doctors from different specialties were made. Out of 100 doctors, 36 doctors agreed that the doctors in AIMS are aware of such guidelines, 92 doctors agreed that there is need of national guidelines to monitor the doctor and pharmaceutical company’s relationship, 67 responded that doctor’s prescription is influenced by the gifts given by pharmaceutical companies, 52 doctors agreed that pharmaceutical companies should be banned from giving gifts to physicians, 88 responded that the information provided by those representatives is only superficial and they don’t know the core information like side effects and mode of action of the drugs, 15 thought that yes it is ethical to accept the gifts from the pharmaceutical companies but only to the extent of samples of medicines and out of 100, 89 doctors responded in favor of incorporation of bioethics in the curriculum of the medical education. During focus group discussion on the topic, three themes which were finalized after detailed deliberation and these themes were, Doctor-Pharma Regulations, Accepting the gifts from Pharmaceutical Companies and influence of these Interactions on Physicians’ drug prescribing Behaviors and how the prescribing behaviors of doctors. Conclusion: It is concluded that pharmaceutical companies have hijacked our whole health system to some extent and our whole health system is polluted because of these Pharmaceutical company’s representatives and there is a need to ascertain the fact that if this phenomenon is not controlled, in near future we will have to face very severe consequences and our patients will be at the mercy of pharmaceutical companies rather than the doctor

Perception of Doctors towards Relationship with Pharmaceutical Industry

Doctors and the pharmaceutical companies are the main component of health care system which is also essential for each other. Their interdependency on such a large scale calls for a better relationship between these two stakeholders of the health care system. But most of the time this relationship is used in a negative way which not only has a bad impact on the reputation of this prestigious medical profession but also affects the health of the patient which are the ones to bear the effects of this malafied relationship.              In order to see how this relationship works in the hospitals of Azad Kashmir, this study was conducted on the doctors of Abbas Institute of Medical Sciences, Muzaffarabad. Due to shortage of time and limited resources only one hospital was selected for the study to be carried out. This was a mixed study carried out from January through June 2017. In our study 100 doctors were selected for data collection in questionnaire method. While three different focus groups involving doctors from different specialties were made. Out of 100 doctors, 36 doctors agreed that the doctors in AIMS are aware of such guidelines, 92 doctors agreed that there is need of national guidelines to monitor the doctor and pharmaceutical company’s relationship, 67 responded that doctor’s prescription is influenced by the gifts given by pharmaceutical companies, 52 doctors agreed that pharmaceutical companies should be banned from giving gifts to physicians, 88 responded that the information provided by those representatives is only superficial and they don’t know the core information like side effects and mode of action of the drugs, 15 thought that yes it is ethical to accept the gifts from the pharmaceutical companies but only to the extent of samples of medicines and out of 100, 89 doctors responded in favor of incorporation of bioethics in the curriculum of the medical education. During focus group discussion on the topic, three themes which were finalized after detailed deliberation and these themes were, Doctor-Pharma Regulations, Accepting the gifts from Pharmaceutical Companies and influence of these Interactions on Physicians’ drug prescribing Behaviors and how the prescribing behaviors of doctors. Conclusion: It is concluded that pharmaceutical companies have hijacked our whole health system to some extent and our whole health system is polluted because of these Pharmaceutical company’s representatives and there is a need to ascertain the fact that if this phenomenon is not controlled, in near future we will have to face very severe consequences and our patients will be at the mercy of pharmaceutical companies rather than the doctor

Carbon sequestration, biomass and soil carbon pool estimation in Oak-dominated forests of Hindu-Kush Range Mountains of Pakistan

The present study aimed to determine the vegetation biomass, soil carbon stocks and carbon sequestration potential of Oak-dominated forests. Thirty forest stands having 10 quadrats of 20×20 were randomly sampled. Out of eighteen tree species, twelve species were associated with Group II followed by Groups I and III, with eight species each. Quercus dilatata was the only Oak species recorded in all three groups having maximum density in Group II (56.14). Quercus semecarpifolia accounted the highest proportion of carbon (235 MgC/ha) in Group II. Quercus baloot, being the dominant species of Group I, is found to accommodate the highest quantities of BMC (335±43 Mg/ha) for all size classes. The highest nitrogen content, total nitrogen and carbon-nitrogen ratio were 0.185%, 8.23 and 59.64, respectively, in Group II. The mean bulk density was 1.519 g/cm3 in Group III. The highest soil organic carbon (SOC) was recorded in Group II (2.69%, 119.82 tons/ha). Because of their large aerial scale and high carbon density, Oak-dominated forests in Group II store most of the carbon. These results suggest that organic carbon is a major source of forest carbon with significant climate change mitigation potential that must be conserved and improved by sustainable forest management

Faculty Satisfication Regarding Modular Teaching

Introduction: Recently many medical institutes have been shifted to integrated curriculum; however, the implementation of integrated curriculum has faced problems due to both faculty and student’s satisfaction. Though faculty gives value to it, still certain believe that it’s not as effective as the traditional system. This study aims to evaluate the satisfactory level regarding modular teaching among faculty members at three different medical institutes in Pakistan. Material and Methods: This was a descriptive study where the senior faculty members from three different medical institutes were included. After written consent from participants the data was collected through semi-structured questionnaire. Total of 88 faculty members were included through convenient sampling technique. Data analyzed by SPSS version-22. Results: Overall 50% participants agreed that strength of modular teaching is the integration process & clinical application. 38% agreed that modular teaching provides better understanding & clarity of concepts. Regarding weaknesses 44% agreed that modular teaching requires more trained faculty, 27% said that more resources are required. On the other hand, 84% showed satisfaction that students get more benefits from modular teaching as compare to conventional teaching & 72% agreed that teacher biasness is less, 82% agreed that students become a lifelong learner, 85% agreed that more applied knowledge is delivered through this system.Conclusion: The majority of participating faculties were satisfied with modular teaching as it has a good clinical application, provides better understanding & a student-centered approach. &nbsp

Aquaculture in Brazil and worldwide: overview and perspectives

Aquaculture is the cultivation of aquatic organisms through a controlled cultivation process. Currently, half the fish consumed by the world population is produced by aquaculture activity. This review, and informed data, trends, and the general panorama of aquaculture in Brazil and worldwide, as well as the scenario of the tilapia (Oreochromis niloticus) production, in order to provide specific directions for future investments and researches. Globally, fish aquaculture productivity is approximately 110 million tons in 2016, with China being the country with the highest productivity (49 million tons). Brazil occupies the 13th place with about 700 thousand tons of aquaculture fish, where tilapia is one of the most cultivated. Furthermore, the ration production for aquaculture is one of the fastest-growing sectors in the country (930 thousand tons of ration represents 1.33% concerning the total feed produced to cultivation of the animals – data of 2016), with emphasis on the biofloc system, which represents a productive method with better cost-benefit and low environmental impact. In general, aquaculture trends are the real progress of this activity, but so that social, economic, and environmental aspects are interconnected and progressing concomitantly