ANCA-negative Granulomatosis with Polyangiitis: A Difficult Diagnosis

Granulomatosis with polyangitiis (GPA) is a systemic small and medium vessel vasculitis, commonly associated with anti-neutrophil cytoplasmic antibodies (ANCAs). Presenting signs and symptoms in GPA are varied and patients may present with constitutional, nonspecific symptoms, which can delay the diagnosis. Tissue biopsy of the site of active disease can confirm the diagnosis of GPA, in which necrotising granulomatous inflammation is seen. However, surrogate markers may be used for diagnosis without a tissue biopsy. They include upper and lower airway symptoms, signs of glomerulonephritis and a positive ANCA. However, approximately 10–20% of patients with GPA are ANCA negative, allowing for the diagnosis to be overlooked, particularly in those patients with non-specific findings. The reason for the absence of ANCAs is unclear

Genetska raznolikost Mareecha i Barela pasmina jednogrbih deva iz Pakistana na temelju mikrosatelitskih markera

The genetic diversity of Pakistani dromedary camels is poorly documented. The present study evaluated the genetic variations of two well-known Pakistani camel breeds, Mareecha and Barela, that are well-adapted to the Cholistan desert climate. Camel can serve as a beneficial participant in the food supply chain by providing milk, meat and other food products for the livelihood of pastoral peoples. To explore a new world of resources, greater attention to needed to create standard procedures to genetically characterize, classify and identify camel breeds in the country. For this purpose, 66 unrelated animals of the Mareecha (n=35) and Barela (n=31) breeds were genotyped using a set of 12 labelled microsatellite loci. DNA fragment sizes were determined in an ABI 3130 Genetic Analyzer. All microsatellite markers were successfully amplified and exhibited a polymorphic nature, with an average Polymorphic Information Content (PIC) of 0.72 and 0.70 in Mareecha and Barela, respectively. A total of 107 alleles with an average of 8.91 alleles per locus were identified by these markers in both breeds. CMS15 was highly polymorphic with 13 alleles, while VOLP-032 was the lowest with two loci. The Fit and Fis values were low but high population differentiation (17%) was observed in both breeds, due to the migrations of pastoral people to different remote areas during climate fluctuations.Genetska raznolikost pakistanskih jednogrbih deva slabo je dokumentirana. Ova studija procijenila je genetske varijacije dviju dobro poznatih pasmina pakistanskih deva - mareecha i barela - koje su vrlo dobro prilagođene klimi pustinje Cholistan. Deva može poslužiti kao koristan sudionik u lancu opskrbe hranom, osiguravajući mlijeko, meso i druge prehrambene proizvode za život pastira. Da bi se istražio novi svijet resursa, potrebno je više pozornosti za obavljanje standardnih postupaka za genetsku karakterizaciju, razvrstavanje i identifikaciju pasmina deva u zemlji. U tu svrhu, ukupno 66 životinja koje nisu u srodstvu pasmine mareecha (n=35) i barela (n=31) genotipizirane su uporabom 12 označenih mikrosatelitskih lokusa. Veličine fragmenata DNK određene su u ABI 3130 genetskom analizatoru. Svi mikrosatelitski markeri uspješno su pojačani i pokazali su polimorfnu narav s prosječnim sadržajem polimorfnih informacija (PIC) od 0,72 i 0,70 za mareecha, odnosno barela pasminu. Ukupno 107 alela s prosječno 8,91 alelom po lokusu u obje pasmine identificirano je tim markerima. CMS15 bio je vrlo polimorfan s 13 alela dok je VOLP-032 bio najniži s 2 lokusa. Fit i Fis vrijednosti bile su niske, ali je uočena velika diferencijacija populacije (17 %) za obje pasmine koje su posljedica migracije pastira u različite udaljene krajeve tijekom promjena klime

Quality of life perceptions in school-going adolescents with social anxiety

Introduction: Social anxiety is common among adolescents with a prevalence range of 9-34%. People with social anxiety have intense fear of being evaluated negatively when they come in contact with strangers and as a result they are less satisfied with their life experiences. Our study aimed to screen school going adolescents for social anxiety disorder and to estimate their perceptions about quality of life. Methods: This cross-sectional study was conducted in Karachi, Pakistan from January to February 2016. We recruited 450 high-school students of ages 14-17 using a self-administered questionnaire based on the Liebowitz Social Anxiety Scale for Children and Adolescents (LSAS-CA-SR) and the brief version of the World Health Organization Quality of Life (WHOQOL-BREF) questionnaire. Results: In this school-based study, 23.8% screened positive for social anxiety with a preponderance of adolescents from public than private schools (33% vs. 18%, p\u3c0.001). Social anxiety status, however, was not associated with gender and age. Screening positive for social anxiety was found to be associated with a significant difference in mean scores on all four domains (physical health, psychological health, social relationships, and environment) of WHOQOL-BREF. Conclusion: Social anxiety is prevalent among Pakistani school adolescents with a substantial negative effect on quality of life. Adolescents must be targeted with interventions such as group treatment and mentorship programs that are effective in tackling the menace of social anxiety

Classification of adaptation measures and criteria for evaluation Case studies in the Indus River-Basin

This work was carried out by the Himalayan Adaptation, Water and Resilience (HI-AWARE) consortium under the Collaborative Adaptation Research Initiative in Africa and Asia (CARIAA) with financial support from the UK Government’s Department for International Development and the International Development Research Centre, Ottawa, Canada.This working paper is aimed at finding out the climate change adaptations going on across the three HI-AWARE Project Sites in Indus Basin, namely Hunza (High mountains), Soan Basin (Mid hill) and Chaj Doab ( Flood plains). Both autonomous and planned adaptations have been enlisted after thoroughly reviewing published and grey literature. Some focus group discus-sions and key informant interviews were also held in order to know about people experiences, perceptions and existing practices that they are carrying out to sustain their livelihood

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Integrated application of metal tolerant P. fluorescens and press mud for conferring heavy metal tolerance to aloe vera (Aloe barbadensis)

Soil pollution due to heavy metal (HM) contamination has emerged as a global issue worldwide owing to their adverse impacts on plant growth. Bioremediation approaches employing living organisms for HM alleviation have gained considerable attention among scientific community. Biological agents such as plant growth-promoting rhizobacteria (PGPR) offer a sustainable way to restore soil health, and their combination with different organic amendments such as press mud (PM) can serve as potential approach for immobilizing HMs in soil. We performed a pot experiment to evaluate the role of individual and combined application of press mud and PGPR strain ‘FQ6’ (identified as Pseudomonas fluorescens) in the phytoremediation of different HMs (Pb, Ni and Cd) and growth promotion of aloe vera. Combined application of FQ6 strain and PM yielded more significant outcomes in terms of all the growth and yield attributes such as leaf length (123 %), plant height (57 %), number of leaves (115 %), fresh and dry weights of gel (246 and 280 %), gel contents (96 %), root length (164 %), root diameter (220 %), no. of root tips (138 %) and root area (315 %), as compared to control. Combined application of FQ6 and PM also led to a significant improvement in different antioxidant activities i.e., CAT (129 %), SOD (48 %), APX (17 %) and POD (83 %) as compared to control. Contrastingly, mobility of these HMs was reduced under combined application of Pseudomonas strain ‘FQ6’ and PM, as there existed a considerable difference between HMs concentrations in soil and plant body. We concluded that joint application of HM-tolerant Pseudomonas FQ6 strain and PM could be an ideal option to alleviate the HM induced adverse impacts on aloe vera by immobilizing them in soil, and subsequently, improving plant growth

Analysis of variance for Fe in water.

Analysis of variance for Fe in water.</p

Scatter plot for Fe concentration in crops at S_1 vs S_2, S_1 vs S_3, and S_2 vs S_3.

Scatter plot for Fe concentration in crops at S_1 vs S_2, S_1 vs S_3, and S_2 vs S_3.</p

Bioconcentration factor (BCF), pollution load index (PLI), enrichment factor (EF), daily intake of metals (DIM), health risk index (HRI), and target hazard quotient (THQ) values at three sites (S_1, S_2, and S_3) and treatments (T_1, T_2, and T_3).

Bioconcentration factor (BCF), pollution load index (PLI), enrichment factor (EF), daily intake of metals (DIM), health risk index (HRI), and target hazard quotient (THQ) values at three sites (S_1, S_2, and S_3) and treatments (T_1, T_2, and T_3).</p