Role of Beta Blockers and Band Ligation in upper gastrointestinal tract bleeding.

Objective: To sort out the combine role of beta blockers and band ligation in upper gastrointestinal bleeding Methodology: In this prospective observational study 563 patients were included, (mean age 47 ±6 years, males 69%) with liver cirrhosis and deterioration from Medical ward Mayo hospital Lahore. All the patients had cirrhosis and esophageal varices confirmed by endoscopy. In hospital cirrhotic patients with hypertension and liver cell deteriorations. All the record of betablocker use and band ligation was carefully recorded. Data regarding patient presentation and characteristics were keenly monitored and observe with treatment and improvement as major variables. Mortality was taken as major influential factor. Linear regression model was used. Results: Overall, there were 426 patients getting pharmacological treatment and have band ligation treatment simultaneously. One Hundred and thirty-seven had gastrointestinal bleeding during study time. Standard deviation of patients who had no recurrence of bleeding from last two years was 67±4. Low level of serum albumin, presence of ascites, and treatment with betablockers were the only independent variables that directly influenced the bleeding. The percentage of patients who had only once bleeding during study period was 23±2 percent. The major effects by be ta blockers were preserving after band ligation of source of bleeding. Conclusion: This study demonstrates that best treatment of bleeding in upper gastrointestinal tract is beta blockers, with the use of b and ligation where it is needed. Strict monitoring and guidelines should be under consideration before stop the beta blockers upper gastrointestinal bleeding patients.  Keywords: Beta blockers, Band Ligation, Upper Gastrointestinal Trac

Complete Chloroplast Genomes of Anthurium huixtlense and Pothos scandens (Pothoideae, Araceae) : Unique Inverted Repeat Expansion and Contraction Affect Rate of Evolution

The subfamily Pothoideae belongs to the ecologically important plant family Araceae. Here, we report the chloroplast genomes of two species of the subfamily Pothoideae:Anthurium huixtlense(size: 163,116 bp) andPothos scandens(size: 164,719 bp). The chloroplast genome ofP. scandensshowed unique contraction and expansion of inverted repeats (IRs), thereby increasing the size of the large single-copy region (LSC: 102,956 bp) and decreasing the size of the small single-copy region (SSC: 6779 bp). This led to duplication of many single-copy genes due to transfer to IR regions from the small single-copy (SSC) region, whereas some duplicate genes became single copy due to transfer to large single-copy regions. The rate of evolution of protein-coding genes was affected by the contraction and expansion of IRs; we found higher mutation rates for genes that exist in single-copy regions as compared to those in IRs. We found a 2.3-fold increase of oligonucleotide repeats inP. scandenswhen compared withA. huixtlense, whereas amino acid frequency and codon usage revealed similarities. The ratio of transition to transversion mutations was 2.26 inP. scandensand 2.12 inA. huixtlense. Transversion mutations mostly translated in non-synonymous substitutions. The phylogenetic inference of the limited species showed the monophyly of the Araceae subfamilies. Our study provides insight into the molecular evolution of chloroplast genomes in the subfamily Pothoideae and family Araceae.Peer reviewe

The Pakistan risk of myocardial infarction study: A resource for the study of genetic, lifestyle and other determinants of myocardial infarction in south Asia

The burden of coronary heart disease (CHD) is increasing at a greater rate in South Asia than in any other region globally, but there is little direct evidence about its determinants. The Pakistan Risk of Myocardial Infarction Study (PROMIS) is an epidemiological resource to enable reliable study of genetic, lifestyle and other determinants of CHD in South Asia. By March 2009, PROMIS had recruited over 5,000 cases of first-ever confirmed acute myocardial infarction (MI) and over 5,000 matched controls aged 30-80 years. For each participant, information has been recorded on demographic factors, lifestyle, medical and family history, anthropometry, and a 12-lead electrocardiogram. A range of biological samples has been collected and stored, including DNA, plasma, serum and whole blood. During its next stage, the study aims to expand recruitment to achieve a total of about 20,000 cases and about 20,000 controls, and, in subsets of participants, to enrich the resource by collection of monocytes, establishment of lymphoblastoid cell lines, and by resurveying participants. Measurements in progress include profiling of candidate biochemical factors, assay of 45,000 variants in 2,100 candidate genes, and a genomewide association scan of over 650,000 genetic markers. We have established a large epidemiological resource for CHD in South Asia. In parallel with its further expansion and enrichment, the PROMIS resource will be systematically harvested to help identify and evaluate genetic and other determinants of MI in South Asia. Findings from this study should advance scientific understanding and inform regionally appropriate disease prevention and control strategies

Effects of antibiotic resistance, drug target attainment, bacterial pathogenicity and virulence, and antibiotic access and affordability on outcomes in neonatal sepsis: an international microbiology and drug evaluation prospective substudy (BARNARDS)

Background Sepsis is a major contributor to neonatal mortality, particularly in low-income and middle-income countries (LMICs). WHO advocates ampicillin–gentamicin as first-line therapy for the management of neonatal sepsis. In the BARNARDS observational cohort study of neonatal sepsis and antimicrobial resistance in LMICs, common sepsis pathogens were characterised via whole genome sequencing (WGS) and antimicrobial resistance profiles. In this substudy of BARNARDS, we aimed to assess the use and efficacy of empirical antibiotic therapies commonly used in LMICs for neonatal sepsis. Methods In BARNARDS, consenting mother–neonates aged 0–60 days dyads were enrolled on delivery or neonatal presentation with suspected sepsis at 12 BARNARDS clinical sites in Bangladesh, Ethiopia, India, Pakistan, Nigeria, Rwanda, and South Africa. Stillborn babies were excluded from the study. Blood samples were collected from neonates presenting with clinical signs of sepsis, and WGS and minimum inhibitory concentrations for antibiotic treatment were determined for bacterial isolates from culture-confirmed sepsis. Neonatal outcome data were collected following enrolment until 60 days of life. Antibiotic usage and neonatal outcome data were assessed. Survival analyses were adjusted to take into account potential clinical confounding variables related to the birth and pathogen. Additionally, resistance profiles, pharmacokinetic–pharmacodynamic probability of target attainment, and frequency of resistance (ie, resistance defined by in-vitro growth of isolates when challenged by antibiotics) were assessed. Questionnaires on health structures and antibiotic costs evaluated accessibility and affordability. Findings Between Nov 12, 2015, and Feb 1, 2018, 36 285 neonates were enrolled into the main BARNARDS study, of whom 9874 had clinically diagnosed sepsis and 5749 had available antibiotic data. The four most commonly prescribed antibiotic combinations given to 4451 neonates (77·42%) of 5749 were ampicillin–gentamicin, ceftazidime–amikacin, piperacillin–tazobactam–amikacin, and amoxicillin clavulanate–amikacin. This dataset assessed 476 prescriptions for 442 neonates treated with one of these antibiotic combinations with WGS data (all BARNARDS countries were represented in this subset except India). Multiple pathogens were isolated, totalling 457 isolates. Reported mortality was lower for neonates treated with ceftazidime–amikacin than for neonates treated with ampicillin–gentamicin (hazard ratio [adjusted for clinical variables considered potential confounders to outcomes] 0·32, 95% CI 0·14–0·72; p=0·0060). Of 390 Gram-negative isolates, 379 (97·2%) were resistant to ampicillin and 274 (70·3%) were resistant to gentamicin. Susceptibility of Gram-negative isolates to at least one antibiotic in a treatment combination was noted in 111 (28·5%) to ampicillin–gentamicin; 286 (73·3%) to amoxicillin clavulanate–amikacin; 301 (77·2%) to ceftazidime–amikacin; and 312 (80·0%) to piperacillin–tazobactam–amikacin. A probability of target attainment of 80% or more was noted in 26 neonates (33·7% [SD 0·59]) of 78 with ampicillin–gentamicin; 15 (68·0% [3·84]) of 27 with amoxicillin clavulanate–amikacin; 93 (92·7% [0·24]) of 109 with ceftazidime–amikacin; and 70 (85·3% [0·47]) of 76 with piperacillin–tazobactam–amikacin. However, antibiotic and country effects could not be distinguished. Frequency of resistance was recorded most frequently with fosfomycin (in 78 isolates [68·4%] of 114), followed by colistin (55 isolates [57·3%] of 96), and gentamicin (62 isolates [53·0%] of 117). Sites in six of the seven countries (excluding South Africa) stated that the cost of antibiotics would influence treatment of neonatal sepsis

Real Sector Growth owed to Islamic Finance

Islamic finance is growing rapidly not only in Islamic world but also around the globe. Foreseeing the popularity of Islamic finance, the current study intends to explore the relationship between Islamic financing and economic growth. To entertain the objectives, the study used data of United Arab Emirates, Malaysia, and Indonesia for the years 1980-2018. The ARDL approach to co-integration was used in order to obtain the empirical results for exploring the relationship between the Industrial Production Index, Islamic banks deposits, Islamic bank financing, gross fixed Capital formation, trade openness, government expenditures, and inflation. Industrial production index is taken as a proxy of growth that represents real sector growth. Study findings illustrated a strong positive relationship between industrial production indices, Islamic bank deposits & financing, gross fixed capital formation and negative significant relation with trade openness in the study period. Whereas, government expenditure has insignificant relation and inflation has shown negative relation. It is recommended that Islamic banks should design their deposit instruments in terms of long-run. The Islamic banks may follow the path of conventional banking in this regard. Deposit’s negotiable certificates should be issued similar to the conventional banks

A performance comparison of supervised machine learning models for Covid-19 tweets sentiment analysis.

The spread of Covid-19 has resulted in worldwide health concerns. Social media is increasingly used to share news and opinions about it. A realistic assessment of the situation is necessary to utilize resources optimally and appropriately. In this research, we perform Covid-19 tweets sentiment analysis using a supervised machine learning approach. Identification of Covid-19 sentiments from tweets would allow informed decisions for better handling the current pandemic situation. The used dataset is extracted from Twitter using IDs as provided by the IEEE data port. Tweets are extracted by an in-house built crawler that uses the Tweepy library. The dataset is cleaned using the preprocessing techniques and sentiments are extracted using the TextBlob library. The contribution of this work is the performance evaluation of various machine learning classifiers using our proposed feature set. This set is formed by concatenating the bag-of-words and the term frequency-inverse document frequency. Tweets are classified as positive, neutral, or negative. Performance of classifiers is evaluated on the accuracy, precision, recall, and F1 score. For completeness, further investigation is made on the dataset using the Long Short-Term Memory (LSTM) architecture of the deep learning model. The results show that Extra Trees Classifiers outperform all other models by achieving a 0.93 accuracy score using our proposed concatenated features set. The LSTM achieves low accuracy as compared to machine learning classifiers. To demonstrate the effectiveness of our proposed feature set, the results are compared with the Vader sentiment analysis technique based on the GloVe feature extraction approach

Assessment of frequency, risk category and intervention needs in psychoactive drug users by using WHOASSIST Questionnaire among medical students in Karachi

Objectives: To determine the frequency of use of various psychoactive drugs among medical students in an urban setting, and to assess the risk category and intervention needs. Methods: The descriptive cross-sectional study was conducted from January to June 2018 at four medical education institutions of Karachi; 2 each randomly selected from registered public and private sectors. From the clinical classes of each institution, fourth year was randomly chosen by lottery method. Data was collected using the Alcohol, Smoking and Substance Involvement Screening Test version 3.0. Data was analysed using SPSS 20. ---Continu

ISOLATION AND STRUCTURAL CHARACTERIZATION OF NOVEL TERPENOIDS FROM DIFFERENT PLANT SPECIES: A REVIEW.

Terpenoids are the most essential compounds biosynthesized by plants as secondary metabolites. It is a diverse and vast class of naturally occurring organic compounds and are the derivatives of terpenes having simple and multi-cyclic rings in their structure. These are though found in small/trace amounts in plants, but they play an indispensable role in the survival of plants in the environment. These are used by the plants as a shield against internal and external stresses and for many of the basic functions in the development and growth and by humans as anti-bacterial agents, as anti-carcinogenic agents, as flavors, fragrances and drugs. This review paper will explain the extraction and isolation of terpenoids from different parts of plants i.e. leaves, stem, roots and other vegetal parts of plants. Further the review will focus on the structural characterization of terpenoids extracted from plants by different researchers and the methods they used for the separation and structural characterization of these compounds and their structures drawn with the help of NMR data. The extracted and characterized compounds were terpenoids, triterpenoids, nortriterpenoids, monoterpenes, sesquiterpenes and macro cyclic monoterpenes. These compounds were checked for their medicinal activity, cytotoxicity and their bioassay were also considered, where these compounds showed that they can be used as medicinal compounds as well as the bioassay confirmed their role as protective agents of the plants. Overall, eleven research articles have been considered in this review and the focus is on the novel terpenoids that have been extracted, isolated and characterized by different means. Apart from novel terpenoids the other known compounds have been studied and their activity has also been reported. Keywords: Terpenoids, Characterization, Extraction, NMR, Plant

Management of Vegetable Leaf Miner, <i>Liriomyza</i> Spp., (Diptera: Agromyzidae) in Vegetable Crops

Vegetables are considered high value crops based on their growing areas and productivity, even if they are affected by a variety of insect pests throughout the whole growing season. Leaf miner is an immature of an insect that lives inside and consumes the leaf tissues of vegetable plants. Adult females of leaf miner puncture the leaf with their ovipositor, forming tube pattern, and feed on the punctured parts. Host plants survey of leaf miner in Multan (Pakistan) area was conducted. Twenty host plants were found in 2017, whereas twenty-four host plants were found infested with Liriomyza spp. (Diptera) in 2022 i.e., watermelon (24% infestation), long melon (75%), pumpkin (71%), round gourd (67%), snake melon (70%), bitter gourd (50%), long gourd (89%), bottle gourd (93%), pointed gourd (80%), snap gourd (86%), ridge gourd (83%), cucumber (98%), mung bean (98%), eggplant (60%), Petunia alba (88%), Zinnia elegies (30%), cotton (10%), okra (5%), berseem (7%), tomato (89%), Pea (52%) and Canola (28%). No infestation of leaf miners was observed on potato, chilies, and sweet potatoes. Color attraction results in 2017 and 2022 showed that there was maximum attraction of tomato leaf miner towards yellow sticky cards as compared to blue sticky cards. Varietal preference of tomato crop showed that Baby red variety was the most preferred by leaf miner (Liriomyza spp.), and comparatively Sehar was the least preferred variety. Field efficacy of four different insecticides against leaf miner were also tested. Insecticidal effects attributed as percent reduction of leaf miner infestation that showed the highest reduction values were observed after 7 DOA for Spinetoram (76.98%), whereas Bifenthrin (57%). Deltaphos (43 %) was the least toxic insecticide against Liriomyza spp. Integrated approaches are recommended to manage vegetable leaf miner like application of yellow sticky traps, discouraging preferred host plants, application of insecticides with novel modes of actions like spintoram and spinosad for effective management