Consanguinity and Its Sociodemographic Differentials in Bhimber District, Azad Jammu and Kashmir, Pakistan

Kashmiri population in the northeast of Pakistan has strong historical, cultural and linguistic affinities with the neighbouring populations of upper Punjab and Potohar region of Pakistan. However, the study of consanguineous unions, which are customarily practised in many populations of Pakistan, revealed marked differences between the Kashmiris and other populations of northern Pakistan with respect to the distribution of marriage types and inbreeding coefficient (F). The current descriptive epidemiological study carried out in Bhimber district of Mirpur division, Azad Jammu and Kashmir, Pakistan, demonstrated that consanguineous marriages were 62% of the total marriages (F=0.0348). First-cousin unions were the predominant type of marriages and constituted 50.13% of total marital unions. The estimates of inbreeding coefficient were higher in the literate subjects, and consanguinity was witnessed to be rising with increasing literacy level. Additionally, consanguinity was observed to be associated with ethnicity, family structure, language, and marriage arrangements. Based upon these data, a distinct sociobiological structure, with increased stratification and higher genomic homozygosity, is expected for this Kashmiri population. In this communication, we present detailed distribution of the types of marital unions and the incidences of consanguinity and inbreeding coefficient (F) across various sociodemographic strata of Bhimber/Mirpuri population. The results of this study would have implication not only for other endogamous populations of Pakistan but also for the sizeable Kashmiri community immigrated to Europe

Lipid A-Ara4N as an alternate pathway for (colistin) resistance in Klebsiella pneumonia isolates in Pakistan

Objectives: This study aimed to explore mechanism of colistin resistance amongst Klebsiella pneumoniae isolates through plasmid mediated mcr-1 gene in Pakistan. Carbapenem and Colistin resistant K. pneumoniae isolates (n = 34) stored at - 80 °C as part of the Aga Khan University Clinical Laboratory strain bank were randomly selected and subjected to mcr-1 gene PCR. To investigate mechanisms of resistance, other than plasmid mediated mcr-1 gene, whole genome sequencing was performed on 8 clinical isolates, including 6 with colistin resistance (MIC \u3e 4 μg/ml) and 2 with intermediate resistance to colistin (MIC \u3e 2 μg/ml).Results: RT-PCR conducted revealed absence of mcr-1 gene in all isolates tested. Whole genome sequencing results revealed modifications in Lipid A-Ara4N pathway. Modifications in Lipid A-Ara4N pathway were detected in ArnA_ DH/FT, UgdH, ArnC and ArnT genes. Mutation in ArnA_ DH/FT gene were detected in S3, S5, S6 and S7 isolates. UgdH gene modifications were found in all isolates except S3, mutations in ArnC were present in all except S1, S2 and S8 and ArnT were detected in all except S4 and S7. In the absence of known mutations linked with colistin resistance, lipid pathway modifications may possibly explain the phenotype resistance to colistin, but this needs further exploration

Hardships of drugs monitoring – Ambiguities in pharmacovigilance (PV) rules 2018 and guidelines 2019 in the Pakistan

Introduction: Pharmacovigilance is the monitoring of drugs in and after post marketing surveillance phase of drug development and clinical trials. The phases in clinical trials is restricted to a certain population size under some conditions therefore all effects of medicine which is under trials is limited to the involved participants and it needs to be monitored through a constant channel later for eliminating the adverse events of drugs, when it is ready to be used by general consumers. In a country like Pakistan where self-medication and over the counter (OTC) medicine rate is already very high 25-75%, the regulations to control this health threat is weak due to the weak regulations. This paper is aimed to address the critical analysis on the pipeline draft of Pharmacovigilance Rules 2018 and Guidelines 2019 of Pakistan. Methodology and Rationale: The qualitative document analysis has been done by using National PV guidelines and Rules 2018 draft of Pakistan. The culture of reporting adverse events of medicines in Pakistan is not followed because of no awareness and no PV training of Pharmacists and Physicians in healthcare settings who could disseminate PV and understand the need of this hence. Pharmaceutical industries also do not adopt and accept this subject properly because of no regulations by the government and regulatory authorities. They do not have proper workforce and departments for PV. Continuous..

Financing mechanisms applied for successful universal health coverage in Malaysia, Thailand and Singapore - Lessons for Pakistan

Universal health coverage is a global agenda and, currently for Pakistan, achieving this goal is a challenge because of a number of constraints. The current narrative review was planned to describe an overview of the provision of health insurance in Malaysia, Thailand and Singapore that have achieved universal health coverage, and to propose a roadmap for Pakistan. Literature search was conducted on Google Scholar and PubMed databases as well as on the World Bank website to retrieve relevant articles. The three studied countries achieved universal health coverage by gradually increasing allocation for health and through various mechanisms, such as health insurance schemes which covered different segments of the population, and partnerships with private-sector care-providers. Pakistan needs to prioritise health in policy agenda because health insurance is negligible in Pakistan. Additionally, Pakistan also needs to efficiently utilise partnerships with the private sector to further increase healthcare coverage

بیگم اختر ریاض الدین کے سفرناموں میں ماحولیاتی تانیثی شعور کا تنقیدی جائزہ

The 20th century was the century of women rights through feminism movement to raise the voice against patriarchy and for the equal rights of men and women. On the other hand, a movement also against environmental degradation knew as environmental movement. These two movements lead to the creation of eco feminism movement. Begum Akhtar Riazuddin enlightens eco feminism awareness in both of her travel literatures. During travel she discovers those elements that degrade the environment and also observes the environmental economics and finance. Begum Akhtar Riazuddin provides feminism consciousness and raises the voice for the women rights. Begum Akhtar Riazuddin observes those elements that are destroying the nature. According to her whatever the technology and development it always contributes in destruction of nature. This study is that of Begum Akhtar Riazuddin's travel literatures that reflect the environmental motherhood. This term is new in Urdu literature but woman gets this sense from heritage and Begum Akhtar Riazuddin uses this sense in her travelogue. 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Hermetic storage of okra seed maintains seed longevity under changing environment.

Okra seed is vulnerable to loss of germination and vigor in variable storage conditions. High seed moisture contents (SMC) accelerate seed deterioration during storage thus keeping low seed moisture contents by storing seed in hermetic bags may help to retain seed longevity. Okra seed was equilibrated to four initial moisture levels including 8,10, 12 and 14% SMC. Seed was then packed and stored in traditional storage bags (Paper, cloth, polypropylene and jute bag) and hermetic Super Bag for 12 months under ambient conditions. Seed stored in hermetic Super Bag at 8 and 10% moisture contents maintained higher germination due to low seed moisture contents. Moreover, activities of α-amylases and total soluble sugars were higher while electrical conductivity of seed leachates, malondialdehyde (MDA) and reducing sugar contents were less in the seeds stored in hermetic Super Bag at 8 and 10% SMC as compared to seed stored in traditional storage bags. Hermetic storage at 14% moisture negatively influenced the seed quality. Moisture adsorption isotherms of okra seeds were developed at constant temperature of 25°C and varying levels of relative humidity from 60 to 90%. Moisture isotherms indicated no significant increase in seed moisture contents at 60 and 70% relative humidity (RH) in hermetic bags whereas a minor increase in seed moisture at 80 and 90% RH has been observed for the seeds incubated in hermetic bags. SMC significantly increased in traditional storage bags particularly in jute bag at high RH. In conclusion, storage in hermetic bags, maintain low seed moisture and high seed quality. Okra seed storage in hermetic bags at 8 and 10% SMC maintains seed longevity under ambient storage conditions

Facilitators and barriers in acceptance of telemedicine among healthcare providers in Pakistan: A cross-sectional survey

Objectives: This study aimed to assess healthcare professionals\u27 awareness and acceptance of telemedicine residing in Pakistan.Materials and methods: A cross-sectional study was conducted across Pakistan from November 2021 to March 2022. Data entry was done through a self-administered questionnaire. In this survey, the non-probability purposive sampling method was adopted. Medical doctors from all specialties that fall into the age category of 20-60 years were included in this study. Statistical Package for Social Sciences (SPSS) version 22.0 was used for univariate data analysis.Results: Among the 860 healthcare professionals who received the survey, 198 responded (23.0% response rate). The mean ± SD age of the participants was 31.16 ± 8.56. The results were found to be statistically significant for knowledge about telemedicine among healthcare professionals workplace, that is, healthcare professionals working in the private sector indicated a high level of awareness regarding telemedicine as compared to those in the public sector (p = 0.03). A significant difference (p-value ⩽ 0.05) in knowledge was seen among doctors working in the public sector and those working in a private setup. Results indicate significant positive associations between telemedicine utilization and perceived benefits over disadvantages (β = 1.03, p = 0.017), reliance among healthcare professionals (β = 1.22, p = 0.008), and enhancement in healthcare quality (β = 1.42, p = 0.001). Moreover, familiarity with telemedicine correlates strongly with its usage (β = 2.56, p \u3c 0.000).Conclusion: Overall, healthcare professionals exhibited satisfactory knowledge regarding telemedicine and showed an accepting attitude toward telemedicine. Our study recommends enhancing the importance of Telemedicine training at the Healthcare professionals\u27 level to produce quality service delivery in healthcare organizations

Macronutrient application affects morphological, physiological, and seed yield attributes of Calendula officinalis L.

Effects of N, P and K applications alone or in various combinations and ratios were studied on the morphological, physiological, yield attributes and seed production of calendula. Treatment combinations were control (no NPK application), 150 kg ha-1 N, 80 kg ha-1 P, 150 kg ha-1 K, N + P, N + K, P + K and N + P + K, while in a second experiment, different ratios of NPK were compared to determine the best combination and ratio of tested nutrients for optimal growth, quality, yield and seed production. Plants supplied with NPK had vigorous growth, higher leaf total chlorophyll content and flowered earlier with greater flower fresh and dry weight along with improved photosynthetic performance. Plant biomass and seed yield along with leaf N and K was also higher in plants fertilized with NPK. In the second experiment, application of 200:100:100 kg ha-1 NPK resulted in maximum growth, flowering and seed yield along with higher photosynthetic activity. Leaf area and improved leaf nutrients status was observed at 150:150:150 kg ha-1, while 200:200:200 kg ha-1 NPK increased stomatal conductance, photosynthetic rate, leaf P and flower weights. Results demonstrated that higher level of nitrogen along with lower level of P and K are vital for quality calendula flower and seed production.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Synthetic Transformations and Medicinal Significance of 1,2,3-Thiadiazoles Derivatives: An Update

The 1,2,3-thiadiazole moiety occupies a significant and prominent position among privileged heterocyclic templates in the field of medicine, pharmacology and pharmaceutics due to its broad spectrum of biological activities. The 1,2,3-thiadiazole hybrid structures showed myriad biomedical activities such as antifungal, antiviral, insecticidal, antiamoebic, anticancer and plant activators, etc. In the present review, various synthetic transformations and approaches are highlighted to furnish 1,2,3-thiadiazole scaffolds along with different pharmaceutical and pharmacological activities by virtue of the presence of the 1,2,3-thiadiazole framework on the basis of structure–activity relationship (SAR). The discussion in this review article will attract the attention of synthetic and medicinal researchers to explore 1,2,3-thiadiazole structural motifs for future therapeutic agents