Distinctive Cultural and Geographical Legacy of Bahawalpur

This article will throw light on unique cultural and geographical heritage of Bahawalpur, in the context of regional heritage. This place has pedigree in Ancient world, yet to discover its ancestor age. This region was integral part of Hakra civilization, which underwent Alexander and Hindus domination afterwards. Nevertheless, Bahawalpur sustains its importance when it was a Princely state, and even when it merged with Pakistan in 1954. Its culture is amalgamation of customs of urban and rural areas which also consist of plain and desert lives’ time-honored traditions. Geographically, it has three shads; it comprises desert, Bar or Pat (high land) and fertile land. All of these have their own norms, mores and ethnicities. But they are also silhouetted by a united culture of Bahawalpur. The adherence of Islam in day to day life and regional language (Sariki) are significantly important binding force of the natives of this vicinity. Â

Germ Cell Tumor and Takotsubo Cardiomyopathy: A Treatment Dilemma

Germ cell tumors (GCT) are uncommon malignancies in adult males and comprise less than 1% of male cancers. Due to highly curative nature and productive life years gained after treatment; reduction of chemotherapy related toxicities becomes vital. Cisplatin is the backbone of GCT chemotherapy, & is related to myocardial injury, thromboembolism & vasculitis. Though it should not be replaced with Carboplatin, however in certain circumstances, its use maybe unsafe; especially in cases when patient have prior myocardial infarction. We report a case of Takotsubo cardiomyopathy (TCM)secondary to GCT diagnosis in a young male. This patient presented withsymptoms of myocardial infarction however, coronary angiography was normal and a diagnosis of TCM was made. Though, it is rare but a unique challenge, as whether Cisplatin use would be safe in this particular scenario? On one hand patient had stress related myocardial injurywhile he was also at risk of further Cisplatin induced complications.There are no clear cut guidelines, so after informed consent his treatment regimen was modified to EC (Etoposide/Carboplatin) instead of EP (Etoposide/Cisplatin). Patient has completed 4.6 years of follow-up without any evidence of relapse. We suggest informed decisions and to weigh the pros and cons of using an inferior regimen, in order to achieve same long term prognosis while preventing any acute complications,in younger patients with curable cancers

Effects of Exposure Time to Sun on Hair Fall During Lockdown in Covid Pandemic

OBJECTIVES The study aimed to assess the effects of quarantine on non-scarring hair fall and to determine the relationship between sun exposure and hair fall. METHODOLOGY This cross-sectional study was conducted in Karachi from January to June 2022 . Ethical approval was taken from the institutional ethical review committee. Participants were recruited by non-probability convenience sampling technique after obtaining informed consent. Those with dermatologic diseases of the scalp (cicatricial alopecia, alopecia areata, seborrheic dermatitis, infections), high-stress levels, post-pregnancy, thyroid disorders, hormonal disorders and COVID-19 were excluded from the study. Hair loss was assessed using a self-filled questionnaire regarding the history of comorbidities, demographics, education, institute status during quarantine, hair fall experience and personal habits. RESULTSThe study consisted of 137 participants after exclusion criteria were applied. Among these, 95.6% complained of increased hair fall during quarantine. Most participants were women (63.4%) compared to men (36.6%). The average age of the hair fall group was 20 years. Only 15.3% of participants spent more than 1-2 hours in the sun, and the majority had their hair covered when going out during quarantine. CONCLUSION Hair fall is high during quarantine, particularly among women of young age group. Personal habits and exposure to the sun for a short time at noon can affect hair fall in quarantine, although no direct correlation was found. Hair fall during lockdown is inversely related to certain comorbidities

ACTUAL INTAKE VERSES RECOMMENDED INTAKE AMONGST FEMALE ADOLESCENTS

Background: The study was conducted to determine the dietary intake patterns of young females and to compare them with recommended servings. It was a descriptive quantitative study, in which a total of 100 girls of age 18-22 years participated from the Kinnaird College for Women, Lahore. Methods: Data was collected by taking dietary recall of the previous day using a 24 recall form. A food frequency questionnaire was also handed out to determine the dietary intake patterns and in order to validate the 24 hour recall. Before giving them a four day food diary which was collected after four days, they were explained about the serving sizes of different foods. Results: Approximately 50% of the respondents met the requirements of the food groups with the exception of vegetable group as only 2 % were taking according to the standards. When the validity of 24 hour with the food diary was checked, the insignificant p values being more than 0.05 indicated that their daily consumption was similar to the 24 hour recall. Conclusions: There should be more focus on eating a well balanced diet. Half of the young female adults are meeting the recommendations of the food groups with the exception of vegetable groups. It was concluded that the individuals had wrong perceptions about portion sizes and serving sizes thus awareness programs should also focus on that. A revised tool for the implementation of the dietary guidelines was recommended

The impact of financial development on economic indicators: a dynamic panel data analysis

The study investigates the effect of financial development on major economic indicators, i.e., economic growth, inflation, and employment by applying System GMM estimation technique for a panel of 120 countries for the period 1997 to 2017. Four distinct proxies of financial development are used, i.e., private sector credit, liquid liabilities, money and quasi money, and bank credit. The results contradict the traditional supply-lending hypothesis and reveal negative impact of financial development on economic growth. Moreover, financial development is found to be positively associated with inflation and employment growth. It is suggested that there is need to reform and strengthen the supervision of financial intermediaries to ensure sound prudential lending practices. Furthermore, more credit needs to be allocated to highly productive firms

Maternal and fetal outcome in pregnancy with heart disease in tertiary care hospital in India

Background: Cardiac disease is an important cause of maternal mortality and morbidity both in antepartum and postpartum period. The overall incidence of heart disease in pregnancy is <1%. Objective of present study was to determine maternal outcome in pregnant women with heart diseases in terms of fetal complication, maternal complication and Mode of delivery.Methods: This study was conducted in the Department of Obstetrics and Gynaecology at Government Lalla Ded Hospital, an associated of Government Medical College, Srinagar which is the sole tertiary care referral centre in the valley. 90 women with heart disease which were previously established   or diagnosed during pregnancy were enrolled in the study.Results: In 90 women pregnancies was complicated by heart disease in the study. The prevalence of heart disease amongst all pregnancies found in hospital was 4.3%. The principal cause of cardiac lesion was Rheumatic heart disease (RHD) (56.6%) while congenital heart disease was seen in 13.3%. Among the women who had RHD, mitral stenosis seen in 21 (23.3%) was most common lesion and Multiple cardiac lesions 21 (24.4%) women. Among the women with congenital cardiac disease, mitral valve prolapse was most common constituting 5 (5%) cases. Cardiomyopathy was the most common constituting 7 (7.3%). Heart failure developed in 10 (11.1%) whose NYHA class changed from class I/II to class III/IV. Majority of the women delivered by caesarean section 33 (36.7%) while (35.6%) had a normal vaginal delivery with spontaneous onset of labour. 7% had assisted instrumental vaginal delivered.  9% women had first trimester abortion. There were 4 maternal deaths. 85.6% live births were observed in these women. No baby had congenital heart disease.  72.8% babies born weighed more than 2kg.Conclusions: This study concluded that pre- pregnancy diagnosis, counselling, appropriate referral, antenatal supervision and delivery at equipped centre improve the pregnancy with heart disease outcome for both mother and baby

Anaerobic Co-digestion of Catering and Agro-Industrial Waste: A Step Forward Toward Waste Biorefinery

In the present study, a biorefinery system is proposed using catering and agro industrial waste for biogas and low phytotoxic digestate. Anaerobic co-digestion of catering waste with partially pre-treated (microwave 800 J/g/min + steam 121 °C 40 min) maize crop residues was conducted under different composition (20–50%) of feedstock. The results showed that the biogas production was increased by 2.03 times in co-digestion experiment (40% partially pre-treated maize crop residue + 60% catering waste: TCM3) as compared to catering waste alone (control). The increment in accumulative methane 116.7 m3 t−1 was recorded in TCM3 which is due to improvement in biodegradation under co-digestion process. The post digestion byproduct (residual digestate) was evaluated for its phytotoxicity which is supplied with aerobic post treatment. The post treatment has improved the digestate quality by decreasing VS/TS ratio from 259 to 173 g/L and slightly increase the pH from 7.29 to 8.32. Seed germination assay showed that the germination percentage (G%), germination index (GI) and vigor index (VI) were relatively higher with post treated digesate as compared to un-treated digestate. In the germination test using wheat seeds, the post treated digestate (5% sol. extract) achieved higher values of GI and VI (46 and 609) whereas in un-treated, values for these indices were 14 and 62, respectively. Overall the findings of the present study identify the significance co-digestion based waste biorefinery, in order to development of value added bio-products such as biogas and biofertilizers

Clinical and echocardiographic features of children with rheumatic heart disease and their serum cytokine profile

Acute rheumatic fever (ARF) and rheumatic heart disease (RHD) constitute important public health problems in developing countries. Children with ARF and RHD seen at Children’s Hospital-Sudan from May 2008-2009 were examined clinically and by echocardiography. Blood cytokines (interleukin 10 (IL10), Tumor necrosis factor alpha (TNF- alpha) and interferon gamma (IFN-gamma) were done. Thirty six children were enrolled; 63% had established RHD, and 37% ARF. Mitral regurgitation (MR) was the most common lesion (94%).Ninety five percent of the valve lesions were severe. The serum interleukin IL10 level ranged between 3-6 pg/ml. TNF alpha levels were 9- 100 pg/ml in 12 patients (40%), 101-1000 pg/ml in 10 patients (33%) , more than 1000 in 8 patients (26%). The level of IFN gamma ranged between 2-7 pg/m in all patients except 2 (84 and 135 pg/ml). RHD is manifested with severe valvular lesions and a high TNF alpha indicating and ongoing inflammation.Pan African Medical Journal 2012; 13:3

The relation between calcaneus stiffness index as a measure of bone density and body mass index in an Egyptian cohort

Background: Obesity and osteoporosis are two conditions that are associated with morbidity and mortality; there is contradictory evidence regarding this association. Purpose: The aim of the current study was to explore further the association between obesity and calcaneus stiffness index (CSI), as a measure of bone density, in a community-based cross-sectional study in an Egyptian population. Methods: A cross-sectional study was conducted among active subjects, aged ≥20 years old, over one year. CSI was measured by Quantitative ultrasound (QUS), in addition; QUS T-score and Z-score of the non-dominant heel scan were recorded. Results: Two hundred and eighty participants were recruited; 7 subjects were excluded because of Z score more than −2, mean age was 61 (± 11.9) years, and mean BMI was 29.7 (±5.6). Female participants were 77.7%, with mean of age 60.3 (± 11.6); and age range 20–82 years. Male participants were 22.3%, with mean of age 63.6 (± 12.7); and age range 30–80 years. Older subjects (>55 years) had significantly lower CSI and worse T-score than the younger subjects (P < 0.001 for both). In the younger age group, BMI was not significantly associated with CSI, even after adjustment for gender (P= 0.52). However, in the older age group, BMI was significantly associated with stiffness index (P= 0.049, O.R.= 1.73), even after adjustment for gender (P= 0.041, O.R.= 1.7). Conclusion: Compared to young subjects, older subjects (≥55 years) had significantly lower bone strength as measured by CSI, and their BMI was significantly positively associated with bone density. In younger people (<55 years), BMI was not associated with bone strength

Impact of Macro Specific Factor and Bank Specific Factor on Bank Liquidity using FMOLS Approach

By applying the fully modified ordinary least square (FMOLS), this study examines the impact of bank-specific factor and macro-specific factors on bank liquidity, for the period of 2000 to 2017. The bank specific factors include bank crises, bank size, total deposit, and profitability. While it considers a macro-specific factors GDP, inflation, monetary policy and unemployment. Findings reveal that based on time series data, we suggest that bank-specific and macro-specific factor significantly effect on bank liquidity. Empirical results reported that at 5 percent level of significance total deposit, GDP, bank size and unemployment have a negative impact on liquidity of the bank. While monetary policy, bank crisis and profitability have a positive impact on liquidity. Inflation has an insignificant relation with liquidity. The study reported new facts for increase more clear understanding of liquidity in a developing country like Pakistan