Using ensemble modeling to predict breeding habitat of the red-listed Western Tragopan (Tragopan melanocephalus) in the Western Himalayas of Pakistan

Quantifying a species geographic range is a necessary requirement for targeted and effective conservation management and planning. The Western Tragopan (Tragopan melanocephalus) is a globally threatened Galliformes, endemic to the Western Himalayas. The breeding habitat of the species is believed to be exposed to increased anthropogenic pressures. There is a general lack of empirically-based approaches to protect the breeding habitat of this species. To this end, we used recent records of breeding tragopan to develop an ensemble model of the breeding habitat in Pakistan for this Vulnerable species. The model predicted a total area of 10,410 km2 as potential breeding habitat for the species nationally. Of this, 2979 km2 (28.6%) were potentially highly suitable (P > 0.4), 2544 km2 (24.4%) were moderately suitable (0.2 >P < 0.4), and 4887 km2 (46.9%) were of low suitability (P < 0.2). The breeding sites of the species were recorded with mean global human modification gradient of 0.33 ± 0.06 which implies that habitat suitability for the Tragopan now appears associated with areas of moderate land modification. Therefore, the predicted highly suitable area (core breeding area) was only 79 km2 (or 2.6%) of the total predicted area suitable for breeding. Hence, the potential breeding habitat of this species may be degraded owing to human habitat interference. We propose that the remaining pockets of high suitability for breeding which remain free from human impacts are declared as protected areas with immediate effect. Areas of high suitability with already existing human disturbance should receive high attention by conservation managers and policy makers, attempting to reduce further human impact. Our model further suggests that more detailed studies at a landscape level should be carried out urgently to successfully protect this globally threatened species from further habitat deterioration

A review of medicinal herbs in the management of male infertility

Male infertility can be caused by a variety of factors, including neurohormonal imbalances, reproductive tissue disturbances, and qualitative and quantitative degradation of semen. There is a global decline in male reproductive health, and modern therapeutic options to tackle male infertility are expensive, less accessible and have extended treatment durations and adverse effects. When it comes to male reproductive health, herbal therapies are in a much better position to provide more holistic approaches. As aphrodisiacs, a unique class of herbs defined in herbal pharmacology, nourish and stimulate the body's sexual tissues. A careful evaluation of the current information on drugs and their probable functions in treating male infertility is the purpose of this paper

Effect of Blood Pressure Lowering Therapy in Stroke Patients

Objective: The objective of the study is to assess the effect of blood pressure lowering with Candesartan in patients with stroke and elevated blood pressure admitted in this hospital.Study Design: Prospective descriptive observational study.Setting: Neurosurgery, Medical Emergency / OPD, Lady Reading Hospital, Peshawar.Materials and Methods: This descriptive study was done at the Department of Medicine and Neurosurgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar from January 2013 to May 2014 (for One year and 5 months period) in a total of 357 patients. In this descriptive study, patients presenting to Emergency department or OPD with stroke and elevated blood pressure, presenting within 30 hours of symptom onset and with SBP ≥ 140 mmHg, diastolic &gt; 90 mmHg, were eligible for inclusion. Exclusion criteria were contraindicat-ions to or ongoing treatment with an angiotensin receptor blocker, markedly reduced consciousness, patients with chronic heart failure and intolerance to ACE inhibitors, patient unavailability for follow-up and pregnancy or breast – feeding. The acute phase treatment was a fixed dose of 4 mg on day 1, 8 mg on day 2 and 16 mg on days 3 to 7. Blood pressure was measured daily with the patient in the supine position using a blood pressure monitor. All patients were follow-up on day 7 and at 1 and 6 months after discharged from hospital.Results: Among 357 cases, 68.06% were males and 31.93% females. Majority (37.25%) belongs to age group of 61 – 70 years. Out of these, 66.10% patients were found to have ischemic and 33.89% patients had hemorrhagic stroke. Highest (40.05%) patients belonged to severe hypertensive group i.e. ≥ 180/110 mmHg. Target was achieved in 75.91% patients.Conclusions: Our data suggests that lowering BP in acute ICH is probably safe; however, it remains to be seen if this decreases hematoma expansion or improves outcome

Determining the potential scalability of transport interventions for improving maternal, child, and newborn health in Pakistan

Background: Pakistan is far behind in achieving the Millennium Development Goals regarding the reduction of child and maternal mortality. Amongst other factors, transport barriers make the requisite obstetric care inaccessible for women during pregnancy and at birth, when complications may become life threatening for mother and child. The significance of efficient transport in maternal and neonatal health calls for identifying which currently implemented transport interventions have potential for scalability. Methods: A qualitative appraisal of data and information about selected transport interventions generated primarily by beneficiaries, coordinators, and heads of organizations working with maternal, child, and newborn health programs was conducted against the CORRECT criteria of Credibility, Observability, Relevance, Relative Advantage, Easy-Transferability, Compatibility and Testability. Qualitative comparative analysis (QCA) techniques were used to analyse seven interventions against operational indicators. Logical inference was drawn to assess the implications of each intervention. QCA was used to determine simplifying and complicating factors to measure potential for scaling up of the selected transport intervention. Results: Despite challenges like deficient in-journey care and need for greater community involvement, community-based ambulance services were managed with the support of the community and had a relatively simple model, and therefore had high scalability potential. Other interventions, including facility-based services, public-sector emergency services, and transport voucher schemes, had limitations of governance, long-term sustainability, large capital expenditures, and need for management agencies that adversely affected their scalability potential. Conclusion: To reduce maternal and child morbidity and mortality and increase accessibility of health facilities, it is important to build effective referral linkages through efficient transport systems. Effective linkages between community-based models, facility-based models, and public sector emergency services should be established to provide comprehensive coverage. Voucher scheme integrated with community-based services may bring improvements in service utilization

A Hybrid Duo-Deep Learning and Best Features Based Framework for Action Recognition

Human Action Recognition (HAR) is a current research topic in the field of computer vision that is based on an important application known as video surveillance. Researchers in computer vision have introduced various intelligent methods based on deep learning and machine learning, but they still face many challenges such as similarity in various actions and redundant features. We proposed a framework for accurate human action recognition (HAR) based on deep learning and an improved features optimization algorithm in this paper. From deep learning feature extraction to feature classification, the proposed framework includes several critical steps. Before training fine-tuned deep learning models – MobileNet-V2 and Darknet53 – the original video frames are normalized. For feature extraction, pre-trained deep models are used, which are fused using the canonical correlation approach. Following that, an improved particle swarm optimization (IPSO)-based algorithm is used to select the best features. Following that, the selected features were used to classify actions using various classifiers. The experimental process was performed on six publicly available datasets such as KTH, UT-Interaction, UCF Sports, Hollywood, IXMAS, and UCF YouTube, which attained an accuracy of 98.3%, 98.9%, 99.8%, 99.6%, 98.6%, and 100%, respectively. In comparison with existing techniques, it is observed that the proposed framework achieved improved accuracy

Surveillance of molecular markers of antimalarial drug resistance in Plasmodium falciparum and Plasmodium vivax in Federally Administered Tribal Area (FATA), Pakistan

This molecular epidemiological study was designed to determine the antimalarial drug resistance pattern, and the genetic diversity of malaria isolates collected from a war-altered Federally Administered Tribal Area (FATA), in Pakistan. Clinical isolates were collected from Bajaur, Mohmand, Khyber, Orakzai and Kurram agencies of FATA region between May 2017 and May 2018, and they underwent DNA extraction and amplification. The investigation of gene polymorphisms in drug resistance genes (dhfr, dhps, crt, and mdr1) of Plasmodium falciparum and Plasmodium vivax was carried out by pyrosequencing and Sanger sequencing, respectively. Out of 679 PCR-confirmed malaria samples, 523 (77%) were P. vivax, 121 (18%) P. falciparum, and 35 (5%) had mixed-species infections. All P. falciparum isolates had pfdhfr double mutants (C59R+S108N), while pfdhfr/pfdhps triple mutants (C59R+S108N+A437G) were detected in 11.5% of the samples. About 97.4% of P. falciparum isolates contained pfcrt K76T mutation, while pfmdr1 N86Y and Y184F mutations were present in 18.2% and 10.2% of the samples. P. vivax pvdhfr S58R mutation was present in 24.9% of isolates and the S117N mutation in 36.2%, while no mutation in the pvdhps gene was found. Pvmdr1 F1076L mutation was found in nearly all samples, as it was observed in 98.9% of isolates. No significant anti-folate and chloroquine resistance was observed in P. vivax; however, mutations associated with antifolate-resistance were found, and the chloroquine-resistant gene has been observed in 100% of P. falciparum isolates. Chloroquine and sulphadoxine-pyrimethamine resistance were found to be high in P. falciparum and low in P. vivax. Chloroquine could still be used for P. vivax infection but need to be tested in vivo, whereas a replacement of the artemisinin combination therapy for P. falciparum appears to be justified

OUTCOME OF PERCUTANEOUS NEPHROLITHOTOMY IN RENAL ANOMALIES: SINGLE CENTER EXPERIENCE

Background: PCNL is standard surgical treatment for renal stone > 2.0 cm and stone resistant to Extracorporeal Shock Wave Lithotripsy. This study was conducted to evaluate the outcome of percutaneous nephrolithotomy in renal anomalies. Methods: This cross sectional study was conducted at The Kidney Center postgraduate training institute Karachi from January 2010 to June 2017, comprised of 60 patients of stone size (median, IQR) 2.75,1.2. Percutaneous nephrolithotomy was done under general anesthesia; intra operative flouroscopy was done for stone clearance. Post-operative x-ray KUB was done to verify the clearance of stone. Results: Out of the 60 patients, most patients had horseshoe kidney 35 (58.3%) with right sided renal stone and majority of the stones are located in pelvis 37 (61.7%). 48 (80.0%) patients required nephrostomy while only 24 (40%) required Double J Stent insertion. In 42 (70%) patients 100% clearance was achieved and only 20 (33.3%) patients needed secondary procedures. Double J Stent insertion was done in both types of renal abnormality. In case of 100% clearance Double J Stent was inserted in 3 (33.3%) patients with malrotation while 7 (46.7%) horseshoe kidneys required Double J Stent insertion. Conclusion: Percutaneous nephrolithotomy is a safe treatment option in renal anomalies patients with renal stones

The Effectiveness of Protected Areas in Conserving Globally Threatened Western Tragopan Tragopan melanocephalus.

Protected areas are a critical tool to conserve biodiversity in the face of the global crisis of species extinction. Here, we present the first ever management effectiveness assessment of Pakistan's Protected Areas (PAs). We link these assessments to the delivery of conservation outcomes focusing on the threatened Western Tragopan (Tragopan melanocephalus) endemic to Pakistan and India. We used two approaches, first mapping the spatial distribution of potential habitat coverage using machine learning ensemble models and second, an assessment of the management effectiveness of protected areas. Our results show that only Machiara National Park scored just above 40% (indicating relatively weak management), 22 of the PAs fell within the 25-50% quantile (indicating weak management), and 3 scored below 25% (indicating poor management). PAs within the species distributional range covered 92,387 ha which is only 2% of the total potential habitat of the Tragopan. Scoring of Planning element was insufficient both in term of the site and species. Likewise, inputs (e.g., research and monitoring program, staff numbers, staff training, current budget, security of budget, and management after process) were also inadequate. Finally, we recommend the establishment of more protected areas within the species potential habitat and inclusion of species-specific plans in Pakistan's PAs management