Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan

INTRODUCTION: Globally, 80% of the burdenof major depressive disorder (MDD) pertains to low- and middle-income countries. Research into genetic and environmental risk factors has the potential to uncover disease mechanisms that may contribute to better diagnosis and treatment of mental illness, yet has so far been largely limited to participants with European ancestry from high-income countries. The DIVERGE study was established to help overcome this gap and investigate genetic and environmental risk factors for MDD in Pakistan. METHODS: DIVERGE aims to enrol 9000 cases and 4000 controls in hospitals across the country. Here, we provide the rationale for DIVERGE, describe the study protocol and characterise the sample using data from the first 500cases. Exploratory data analysis is performed to describe demographics, socioeconomic status, environmental risk factors, family history of mental illness and psychopathology. RESULTS AND DISCUSSION: Many participants had severe depression with 74% of patients who experienced multiple depressive episodes. It was a common practice to seek help for mental health struggles from faith healers and religious leaders. Socioeconomic variables reflected the local context with a large proportion of women not having access to any education and the majority of participants reporting no savings. CONCLUSION: DIVERGE is a carefully designed case-control study of MDD in Pakistan that captures diverse risk factors. As the largest genetic study in Pakistan, DIVERGE helps address the severe underrepresentation of people from South Asian countries in genetic as well as psychiatric research

جديد فارسى شاعرى اور اسكا ارتقأ اورعصرى شعور

اس مقالے میں تمام سیاسی،اجتماعی، ثقافتی اور اقتصادی حالات کومعتبر اور مستند علمی اور تاریخی شواہد کی روشنی میں دیکھ پرکھ کر پیش کیا ہےـ تحریک مشروطیت کی شاعری اور روایتی فارسی شاعری کے موضوع،اسلوب اور دیگر عناصر کا باہمی موازنہ کیا ہےـ اس دور کے نمائندہ شعراء جیسے بہار، پروین اعتصامی،عارف قزوینی اور ابوالقاسم لاہوتی کی شاعری پر تنقیدی بحث کی گئی ہےـ "شعر نو" کے تاریخی پس منظر پر مدلّل بحث کی گئی ہےـ شعر نو اور شعر مشروطیت کے تمام مشترکہ اور متضاد نکات کو زیر بحث لایا گیا ہےـ آخر میں ایران کے تمام اسلامی انقلاب کی شاعری کو زیر بحث لایا ہے اور ان تمام بنیادوں پر تنقیدی اور تجزیاتی تبصرہ کیا گیا ہے جن کی بدولت شعر نو اور شعر انقلاب میں ایک تضاد اور اختلاف موجود ہےـ اس میں دور انقلاب کے جن ممتاز شعراء کی شاعری پر روشنی ڈالی گئی ہے ان میں حسین لاہوری،محمد حسین شہریار،آیت اللہ خمینی کے نام قابل ذکر ہے

Effect of Garlic (Allium Sativum) Supplementation on Growth Performance and Serum Biochemistry of Broiler Chicks

The current study was conducted in the poultry shed of Livestock Research & Development, Khyber Pakhtunkhwa, Peshawar, Pakistan. A total of 120, day-old straight run broilers were procured from Big Bird Pvt. Ltd. The study was comprised of four experimental groups (G.S-0%, G.S-0.3%, G.S-0.6%, G.S-0.9%) having three replicates in each group with ten birds per replicate. Powdered garlic was supplemented @ 0, 0.3, 0.6 and 0.9% to different experimental groups in their basal diet. Zero level was kept as control group. Dietary intake, weight gain and feed conversion ratio (FCR) along with serum biochemical profile of birds were studied. The data in respect of feed intake, weight gain and feed conversion ratio were recorded for each week whereas serum biochemical profile was determined after the completion of the research trial. Dietary intake, was found statistically similar during all the four weeks and overall basis. Weight gain and FCR were statistically not different during the 1st three weeks of research trial whereas significantly different (p?0.05) at 4th week and also for overall growth performance in terms of above-mentioned parameters. Significantly improved weight gain was observed for treatment group (G.S-0.9%) whereas significantly improved FCR was found for group (G.S- 0.6%) as compared to control group. Overall antibody titer against Newcastle disease was non-significant among the experimental groups except G.S-0.6% which was statistically greater (p?0.05) than control. As far as, antibody titer against infectious bursal disease (IBD) is concerned, experimental group (GS-0.9%) shown significantly improved (p?0.05) antibody titer in comparison to other experimental groups. Garlic supplementation has shown positive impact on serum biochemical profile. Significantly lowered total serum cholesterol and triglycerides levels were recorded for group (GS-0.6%) as compared to other groups. Garlic supplementation @ 0.6% in basal diet is recommended for better and economic production in meat type birds

Self-reported health and smoking status, and body mass index: a case-control comparison based on GEN SCRIP (GENetics of SChizophRenia In Pakistan) data

Introduction Individuals with schizophrenia are at a high risk of physical health comorbidities and premature mortality. Cardiovascular and metabolic causes are an important contributor. There are gaps in monitoring, documenting and managing these physical health comorbidities. Because of their condition, patients themselves may not be aware of these comorbidities and may not be able to follow a lifestyle that prevents and manages the complications. In many low-income and middle-income countries including Pakistan, the bulk of the burden of care for those struggling with schizophrenia falls on the families.Objectives To determine the rate of self-reported physical health disorders and risk factors, like body mass index (BMI) and smoking, associated with cardiovascular and metabolic disorders in cases of schizophrenia compared with a group of mentally healthy controls.Design A case-controlled, cross-sectional multicentre study of patients with schizophrenia in Pakistan.Settings Multiple data collection sites across the country for patients, that is, public and private psychiatric OPDs (out patient departments), specialised psychiatric care facilities, and psychiatric wards of teaching and district level hospitals. Healthy controls were enrolled from the community.Participants We report a total of 6838 participants’ data with (N 3411 (49.9%)) cases of schizophrenia compared with a group of healthy controls (N 3427 (50.1%)).Results BMI (OR 0.98 (CI 0.97 to 0.99), p=0.0025), and the rate of smoking is higher in patients with schizophrenia than in controls. Problems with vision (OR 0.13 (0.08 to 0.2), joint pain (OR 0.18 (0.07 to 0.44)) and high cholesterol (OR 0.13 (0.05 to 0.35)) have higher reported prevalence in controls. The cases describe more physical health disorders in the category ‘other’ (OR 4.65 (3.01 to 7.18)). This captures residual disorders not listed in the questionnaire.Conclusions Participants with schizophrenia in comparison with controls report more disorders. The access in the ‘other’ category may be a reflection of undiagnosed disorders