ENDOSCOPIC BIOPSY PROVEN CO-INFECTION OF HELICOBACTER PYLORI AND GIARDIA LAMBLIA IN ADULT POPULATION OF KARACHI CITY

Background: Worldwide, the prevalence of pathogenic bacterium Helicobacter pylori (H.pylori) and the protozoan parasite Giardia lamblia (G. lamblia) is well known. It is more common in densely populated area with poor sanitation in developing countries as compared to developed countries. Although the prevalence of these organisms is widely studied in our population but our study is a unique kind in its way where we have determined co-infection of H.pylori and G. lamblia in gastric and duodenal biopsies respectively. To know the prevalence of H. pylori, G. lamblia and their co-infection in endoscopic biopsy specimen received at Dr. Tahir laboratory, Hamdard Medical University, Karachi. Methods: This prospective study was conducted in the department of Histopathology at Dr. Tahir Laboratory, Hamdard Medical University, Karachi during January 2016 - December 2017. All the consecutive cases of gastric and duodenal biopsies from the same patient received during 2 years were reviewed. The data obtained were subjected to descriptive statistical analysis using SPSS version 22. Results: A total of 187 gastric and duodenal biopsies (males = 99/52.9%, females = 88/47.0%) (age range = 22 to 71 years) were received through 2 years of duration. Out of 187 cases, H.pylori was found in 120 (64.1%) gastric biopsies, torphozoites of G.lamblia were seen in 42 (22.4%) duodenal biopsies, co-infection of H.pylori and G.lamblia was positive in 15 (8.0%)cases whereas no infection was observed by these organisms in 10 (5.3%) cases. Conclusion: This study concludes a high prevalence of H. pylori & G. lamblia in our population. Moreover, the study also noted co-infection of these organisms in the study area

Retinoblastoma tells the story of our health care system

Objective: To review cases of retinoblastoma. Setting: Department of Pathology Aga Khan University Hospital Karachi. Method: Twenty three specimens from cases of retinoblastoma received over a period of eight years were routinely processes and stained with haematoxylin and Eosin stain Other stains were used for tuberculosis and melanin. Immunochemistry was resorted to in undifferentiated tumors. Results: Over 60% cases of retinoblastoma were diagnosed after 5 years and nine cases showed involvement of opti-nerve. Conclusion: Late diagnosis of retinoblastoma effects the stage of the tumors and the prognisis

Convergent synthesis of new N -substituted 2-{[5-(1H -indol-3-ylmethyl)-1,3,4-oxadiazol-2-yl]sulfanyl}acetamides as suitable therapeutic agents

abstract A series of N-substituted 2-{[5-(1H-indol-3-ylmethyl)-1,3,4-oxadiazol-2-yl]sulfanyl}acetamides (8a-w) was synthesized in three steps. The first step involved the sequential conversion of 2-(1H-indol-3-yl)acetic acid (1) to ester (2) followed by hydrazide (3) formation and finally cyclization in the presence of CS2 and alcoholic KOH yielded 5-(1H-indole-3-yl-methyl)-1,3,4-oxadiazole-2-thiol (4). In the second step, aryl/aralkyl amines (5a-w) were reacted with 2-bromoacetyl bromide (6) in basic medium to yield 2-bromo-N-substituted acetamides (7a-w). In the third step, these electrophiles (7a-w) were reacted with 4 to afford the target compounds (8a-w). Structural elucidation of all the synthesized derivatives was done by 1H-NMR, IR and EI-MS spectral techniques. Moreover, they were screened for antibacterial and hemolytic activity. Enzyme inhibition activity was well supported by molecular docking results, for example, compound 8q exhibited better inhibitory potential against α-glucosidase, while 8g and 8b exhibited comparatively better inhibition against butyrylcholinesterase and lipoxygenase, respectively. Similarly, compounds 8b and 8c showed very good antibacterial activity against Salmonella typhi, which was very close to that of ciprofloxacin, a standard antibiotic used in this study. 8c and 8l also showed very good antibacterial activity against Staphylococcus aureus as well. Almost all compounds showed very slight hemolytic activity, where 8p exhibited the least. Therefore, the molecules synthesized may have utility as suitable therapeutic agents

An IoT-Based Thermoelectric Air Management Framework for Smart Building Applications: A Case Study for Tropical Climate

This study investigates the performance of the thermoelectric air conditioning (TE-AC) system smartly controlled by the Internet of Things (IoT)-based configuration for real tropical climatic application. Air cooling management was done through thermoelectric coolers, and an Arduino microcontroller with various sensors such as a temperature sensor, simple RF modules, and actuators was used to control the indoor climatic conditions based on outdoor conditions. The result shows that when the input power supply to the IoT-based TE-AC system is increased, the cooling capacity of the framework is also enhanced. Significant power and carbon emission reduction was observed for the IoT-based TE-AC system as compared to the TE-AC system without IoT. The IoT-incorporated system also ensures better microclimatic temperature control. Additionally, the system cooling capacity improves by 14.0%, and the coefficient of performance is increased by 46.3%. Thus, this study provides a smart solution to the two major energy harvesting issues of traditional air conditioners—an increase in energy efficiency by employing a TE-AC system and a further improvement in efficiency by using an IoT-based thermal management system

Comparative Overview of the Performance of Cementitious and Non-Cementitious Nanomaterials in Mortar at Normal and Elevated Temperatures

Nanotechnology has emerged as a field with promising applications in building materials. Nanotechnology-based mortars are examples of such building materials that have widespread applications in the construction industry. The main nanomaterials used in mortars include nano-silica, nano-magnesium oxide, nano-alumina, nano-titanium oxide, nano-zinc oxide, nano-clay, and nano-carbon. This review paper presents a summary of the properties and effects of these nanomaterials on cement mortar in terms of its fresh-state and hard-state properties. The fresh-state properties include the setting time, consistency, and workability, while the hard-state properties include mechanical properties such as compressive, flexural, tensile strengths, as well as the elasticity modulus, in addition to durability properties such as water absorption, shrinkage strain, strength loss due to freeze–thaw cycles, and chloride penetration, among others. Different nanomaterials cause different physical and chemical alterations within the microstructures of cement mortar. Therefore, the microstructural characterization and densification of mortar are discussed in detail at varying temperatures. In general, the involvement of nanomaterials in cement mortar influences the fresh-state properties, enhances the mechanical properties, and impacts the durability properties, while reducing the porosity present in the mortar matrix. Cementitious nanomaterials can create a pathway for the easy injection of binding materials into the internal microstructures of a hydration gel to impact the hydration process at different rates, whereas their non-cementitious counterparts can act as fillers. Furthermore, the research gaps and future outlook regarding the application of nanomaterials in mortar are discussed

Influence of synthesis parameters of N-doped graphene quantum dots and polymer composite layer on the performance of CIGS solar cells

In this work, N-doped graphene quantum dots (N-GQDs) are used as luminescent downshifting layers, which enhanced the performance of the CIGS solar cells. For providing mechanical strength and chemical stability, a poly(methyl methacrylate) (PMMA) polymer-based matrix is used. However, the PMMA layer creates photoluminescence (PL) quenching, so N-GQDs/PMMA layer is annealed at various temperatures (20–80 °C) to obtain the best performance. These layers were applied on the top of the CIGS solar cells and the performance of the cell is evaluated. The best value of η is obtained for 60 °C. The Jsc and η values are enhanced to 36.03 mA/cm2 and 16.13% from 34.05 mA/cm2 and 14.70%, respectively. Furthermore, the PV cell parameters (photogenerated current density (Jph), shunt resistance (Rsh), series resistance (Rs), diode ideality factor (n), and reverse saturation current density (J0)) were also determined and analyzed to investigate the reduction in losses in the cell. © 2022 Elsevier B.V.FALS

Incentivisation practices and their influence on physicians\u27 prescriptions: A qualitative analysis of practice and policy in Pakistan

Focus on profit-generating enterprise in healthcare can create conflicts of interest that adversely impact prescribing and pricing of medicines. Although a global challenge, addressing the impacts on quality of care is particularly difficult in countries where the pharmaceutical industry and physician lobby is strong relative to regulatory institutions. Our study characterises the range of incentives exchanged between the pharmaceutical industry and physicians, and investigates the differences between incentivisation practices and policies in Pakistan. In this mixed methods study, we first thematically analysed semi-structured interviews with 28 purposively selected for-profit primary-care physicians and 13 medical sales representatives from pharmaceutical companies working across Pakistan\u27s largest city, Karachi. We then conducted a content analysis of policies on ethical practice issued by two regulatory bodies responsible in Pakistan, and the World Health Organization. This enabled a systematic comparison of incentivisation practices with what is considered \u27prohibitive\u27 or \u27permissive\u27 in policy. Our findings demonstrate that incentivisation of physicians to meet pharmaceutical sales targets is the norm, and that both parties play in the symbiotic physician-pharma incentivisation dynamics. Further, we were able to categorise the types of incentive exchanged into one of five categories: financial, material, professional or educational, social or recreational, and familial. Our comparison of incentivisation practices with policies revealed three reasons for such widespread incentivisation linked to sales targets: first, some clear policies were being ignored by physicians; second, there are ambiguous or contradictory policies with respect to specific incentive types; and third, numerous incentive types are unaddressed by existing policies, such as pharmaceutical companies paying for private clinic renovations. There is a need for policies to be clarified and updated, and to build buy-in for policy enforcement from pharmaceutical companies and physicians, such that transgressions on target-driven prescribing are seen to be unethica

What happens when private general practitioners receive incentivisation offers from pharmaceutical sales representatives? A qualitative study in Pakistan

Objectives: Pharmaceutical incentivisation of physicians for profit maximisation is a well-documented health system challenge. This study examined general practitioners\u27 (GPs) reactions to pharmaceutical incentivisation offers in one region in Pakistan.Methods: We used the Standardised Pharmaceutical Sales Representative (SPSR) method and qualitative interviews with GPs. SPSRs were field researchers representing mock pharmaceutical companies who recorded their observations of 267 GPs\u27 responses to pharmaceutical incentivisation offers. We triangulated SPSR data using qualitative interviews with a subset of the same GPs to gather information about how they interpreted different interaction outcomes.Results: We found four major outcomes for GPs being offered incentives by pharmaceutical companies for prescribing medications. GPs might agree to make incentivisation deals, reject incentivisation offers, disallow PSRs to access them, or remain indeterminate with no clear indication of acceptance or rejection of incentivisation offers. GPs rejecting SPSRs\u27 incentivisation offers indicated having active commitments to other pharmaceutical companies, not being able to work with unheard-of companies, and asking SPSRs to return later.Conclusions: The GP-pharmaceutical sales representative interaction that centres on profit-maximisation is complex as offers to engage in prescribing for mutual financial benefit are not taken up immediately. The SPSR method helps understand the extent of distortion of practices impacted by incentivisation. Such an understanding can support the development of strategies to control unethical behaviours

BA9 lineage of respiratory syncytial virus from across the globe and its evolutionary dynamics

<div><p>Respiratory syncytial virus (RSV) is an important pathogen of global significance. The BA9 is one of the most predominant lineages of the BA genotype of group B RSV that has acquired a 60bp duplication in its G protein gene. We describe the local and global evolutionary dynamics of the second hyper variable region in the C- terminal of the G protein gene of the BA9 lineage. A total of 418 sequences (including 31 study and 387 GenBank strains) from 29 different countries were used for phylogenetic analysis. This analysis showed that the study strains clustered with BA (BA9 and BA8) and SAB4 genotype of group B RSV. We performed time-scaled evolutionary clock analyses using Bayesian Markov chain Monte Carlo methods. We also carried out glycosylation, selection pressure, mutational, entropy and Network analyses of the BA9 lineage. The time to the most recent common ancestor (tMRCA) of the BA genotype and BA9 lineage were estimated to be the years 1995 (95% HPD; 1987–1997) and 2000 (95% HPD; 1998–2001), respectively. The nucleotide substitution rate of the BA genotype [(4.58×10⁻³ (95% HPD; 3.89–5.29×10⁻³) substitution/site/year] was slightly faster than the BA9 lineage [4.03×10⁻³ (95% HPD; 4.65–5.2492×10⁻³)]. The BA9 lineage was categorized into 3 sub lineages (I, II and III) based on the Bayesian and Network analyses. The local transmission pattern suggested that BA9 is the predominant lineage of BA viruses that has been circulating in India since 2002 though showing fluctuations in its effective population size. The BA9 lineage established its global distribution with report from 23 different countries over the past 16 years. The present study augments our understanding of RSV infection, its epidemiological dynamics warranting steps towards its overall global surveillance.</p></div