Osteomalacia in a Case of Adult-Onset Bartter Syndrome

Bartter syndrome is a rare heterogeneous disease characterised by a deficiency in sodium and chloride absorption. Gain-of-function mutations in the CASR gene have been described in some patients with Bartter syndrome associated with hypocalcaemia and hypercalciuria. We describe a case of adult-onset Bartter syndrome with hypocalcaemia severe enough to cause osteomalacia

Doing Taxes Better: Simplify, Open and Grow Economy

Taxes have been the cornerstone of IMF-led adjustment programs for Pakistan for over four decades. During this period, long term growth and productivity have declined while the tax policy has become more contentious and fragmented. Measures multiply as unrealistic targets are chased with mini budgets every quarter. The following arose from a high-level conference arranged by PIDE to outline future directions in tax policy

Prevalence of work related musculoskeletal disorders among physiotherapists of Multan

Background: Work related musculoskeletal disorders are increasing day by day in hospitals and clinics due to high demand activities. These disorders decline the efficiency of therapists and result in social as well as economic losses. These injuries mostly occur due to abnormal postures and poor ergonomics. Aim and objectives: The purpose of this study was to rule out pain which disturbs the daily living of physiotherapists due to work related musculoskeletal disorder. This study also helps physiotherapists to improve their skills, technique, posture, ergonomics and all the other factors that are related to these disorders. Method: Survey was performed among physiotherapists that are performing duties in government hospitals, private clinics and all the other settings in Multan. This study included 100 physiotherapists of Multan. Self-design questionnaire as well as a Nordic questionnaire was used to collect data about WRMSK disorders. Data was gathered and was observed statistically. Results: 89% of physiotherapist were having had work related musculoskeletal disorder & 11% had no complaint, 75% female and 25% male & 23 to 50 years age population data was taken & the study observed that novice practitioner are at the increased risk of developing work-related musculoskeletal disorder & 45% were non specialized and 55% were specialized. The most commonly affected regions were upper back, low back and hip joint respectively. Conclusion: Upper back pain, lower back pain and hip pain were the most common complications among physiotherapists. Manual therapy shows association with the prevalence of MSK disorder

Mitigating Salt-Induced Damages in Wheat with Foliar-Applied Nigella sativa Seed Extract: A Comprehensive Study

Nigella sativa, a medicinal plant, known for its diverse bioactive compounds, including antioxidants and phytohormones, have shown potential in mitigating salt stress in various plant species. Amongst naturally occurring plant growth stimulants, it has attained enormous attention being rich in thymoquinineand carvacrol in seeds for scavenging free radicals. This research aimed to investigate the effect of Nigella sativa seed extract (NSE) as foliar spray (0, 50, 100 and 150g seeds per liter each) on wheat growth under salt stress (0mM, 75mM and 150mM). Results revealed that salinity decreased growth attributes and accumulation of photosynthetic pigments. On the other hand, salinity stress boosted the contents of malondialdehyde, hydrogen peroxide, glycinebetaine, leaf free proline, Na+ and Cl-. Foliar application of NSEameliorated the negative effects of salinity to considerable extent by enhancing growth traits, chlorophyll contents, glycinebetaine and prolineand decreased Na+, Cl-,malondialdehyde andhydrogen peroxide. This research provides valuable insights into the potential use of NSE as natural and sustainable solution to alleviate salt stress in wheat crop. These findings contribute to the development of eco-friendly strategies for enhancing crop resilience in saline environments, ultimately addressing the global challenge of food security in the face of increasing soil salinity

Recent Advances in Tungsten-Oxide-Based Materials and Their Applications

Among several active photothermal nanomaterials, tungsten-oxide-based materials have received considerable attention recently because of their ability to absorb near-infrared (NIR) light and their efficient light-to-heat conversion properties. In addition, tungsten-oxide-based materials have an unusual oxygen defect structure and strong local surface plasma resonance (LSPR), which offers strong photoabsorption in a broad wavelength range of the NIR region. In the past, several light-absorbing nanomaterials such as noble metals, polymeric materials, and other inorganic nanomaterials were of interest for their use in photothermal therapy for cancer treatment. In this study, we review the synthesis, properties, and applications of tungsten-oxide-based nanomaterials as a new type of photothermal material. The basic ideas behind photothermal nanomaterial development as well as the factors that influence their structural designs are also discussed in this study. In addition, recent progress in various fields such as NIR light-shielding, pyroelectric, water evaporation, photocatalysis, gas sensors, and energy-related applications for WO3−x- and MxWO3-based nanomaterials (including their hybrids) are highlighted. Finally, this review presents promising insights into this rapidly growing field that may inspire additional research leading to practical applications

Substantial and sustained reduction in under-5 mortality, diarrhea, and pneumonia in Oshikhandass, Pakistan : Evidence from two longitudinal cohort studies 15 years apart

Funding Information: Study 1 was funded through the Applied Diarrheal Disease Research Program at Harvard Institute for International Development with a grant from USAID (Project 936–5952, Cooperative Agreement # DPE-5952-A-00-5073-00), and the Aga Khan Health Service, Northern Areas and Chitral, Pakistan. Study 2 was funded by the Pakistan US S&T Cooperative Agreement between the Pakistan Higher Education Commission (HEC) (No.4–421/PAK-US/HEC/2010/955, grant to the Karakoram International University) and US National Academies of Science (Grant Number PGA-P211012 from NAS to the Fogarty International Center). The funding bodies had no role in the design of the study, data collection, analysis, interpretation, or writing of the manuscript. Publisher Copyright: © 2020 The Author(s).Peer reviewedPublisher PD

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation

Oil-Water Separation of Electrospun Cellulose Triacetate Nanofiber Membranes Modified by Electrophoretically Deposited TiO2/Graphene Oxide

Recycled waste industrial cellulose triacetate (TAC) film, which is one of the key materials in polarizers, was used to produce nanofiber membranes by electrospinning and synergistic assembly with graphene oxide (GO) and titanium dioxide (TiO2) for oil-water separation. In this study, GO and TiO2 coated by an electrophoretic deposition method introduced super hydrophilicity onto the recycled TAC (rTAC) membrane, with enhanced water permeability. The results indicate that when the outermost TiO2 layer of an asymmetric composite fiber membrane is exposed to ultraviolet irradiation; the hydrophilicity of the hydrophilic layer is more effectively promoted. Moreover, this coating could efficiently repel oil, and demonstrated robust self-cleaning performance during the cycle test, with the aid of the photocatalytic properties of TiO2. The rTAC membrane of networked hydrophobic fibers could also increase the speed of the filtrate flow and the water flux of the oil-water emulsion. The permeate carbon concentration in the water was analyzed using a total organic carbon analyzer. Incorporation of TiO2/GO onto the rTAC membrane contributed greatly towards enhanced membrane hydrophilicity and antifouling performance. Therefore, the novel TiO2/GO/rTAC asymmetric composite fiber has promise for applications in oil-water separation

Existentialism in Girish Karnad’s Plays: A Study of Yayati, Hayavadana and Tughlaq

Girish Karnad is a playwright, an actor, a script writer, a director and a scholar. Born on 19 May, 1938 at Matheran, a town near Bombay his childhood was spent in a small village Siri in Karnataka where he had his schooling. Here at Siri village he had the first-hand experience of the native folk theatre that left a lasting impression on his mind. Karnad moved to Dharwad, Karnataka University to do his graduation and in 1958 moved from Dharwad to Bombay to pursue his post-graduation. In Bombay he had an experience that proved to be a turning point in his life. For the first time he watched a modern theatre and got an altogether different experience from those he had watched earlier in his village. The play was Strindberge’s Miss Julie directed by Ebrahim Alkazi