Comparison of foeto-maternal outcome in pregnant women with hepatitis E - A review of 12 years.

Objective: To compare adverse maternal and foetal outcome in pregnant women with hepatitis E immunoglobulin M reactive versus non-reactive.Methods: This retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised records of pregnant patients at any gestational age with clinical and biochemical evidence of hepatitis E from January 2002 and December 2014. . Maternal and perinatal outcome of the subjects were analysed. SPSS 20 was used for data analysis.Results: Out of the 200 subjects, 168(84 %) were hepatitis E immunoglobulin M reactive and 32(16%) were non-reactive. The overall mean age was 26.7±4.5 years. Also, 12(7%) patients in the immunoglobulin M reactive group were admitted to intensive care unit compared to no one from the non-reactive group. Similarly fulminant hepatic failure was seen in 12(7.1%) patients in the immunoglobulin M reactive group compared to no one in the other group. Post-partum haemorrhage was more frequent in the immunoglobulin M reactive group compared to the non-reactive group. There were 5(3%) maternal deaths in the reactive group compared to no death in the other group.Moreover, 34(20.2%) neonates of the immunoglobulin M reactive group needed neonatal intensive care unit admission compared to none in the non-reactive group. There were 4(2.4%) neonatal deaths in the reactive group.Conclusion: Participants in the immunoglobulin M reactive group had a higher percentage of adverse foeto-maternal outcomes compared to the non-reactive group

Isolation, characterization, pharmacological evaluation and in silico modeling of bioactive secondary metabolites from Ziziphus oxyphylla a member of Rhamnaceae family

Purpose: To investigate the pharmacological properties of the medicinally active metabolites of Ziziphus oxyphylla. Methods: Compound I-IV were isolated form the root of Ziziphus oxyphylla (compound I = Stigmasterol, II = Betulinic acid, III = 1,2,3 benzene triol and IV = 5-Pentadecanoic acid). Various spectroscopic techniques were used to identify and characterize the isolated compounds. DPPH (2,2-diphenyl-1- picrylhydrazyl) and ABTS (2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) assays were employed to determine the antioxidant potentials of these compounds. The acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) inhibition potential of the isolated compounds were also evaluated. Results: Amongst the isolated compounds, compound IV was the most potent antioxidant against DPPH and ABTS free radicals, exhibiting half-maximal concentration (IC50) values of 64 and 65 μg/mL, respectively. All the compounds exhibited good inhibition of acetylcholinesterase and butyrylcholinesterase. However, stigmasterol was more potent than the other isolated compounds, showing IC50 of 85.10 ± 1.45 and 84.81 ± 1.17, respectively, against AChE and BChE. Conclusion: Although, all isolated compounds inhibited the selected free radicals (DPPH and ABTS) and cholinesterases, stigmasterol and 5-penatadecanoic acid were more potent than other two compounds. Thus the former can potentially be used to treat oxidative stress and neurodegenerative diseases. Keywords: Ziziphus oxyphylla, Stigmasterol, 5-Pentadecanoic acid, Antioxidant, Acetyl Cholinesterase, Butyryl cholinesteras

MODERATING ROLE OF NEUROTICISM BETWEEN TOKOPHOBIA AND MENTAL HEALTH AMONG PRIMIGRAVIDAS

ABSTRACT OBJECTIVE: To explore the relationship between tokophobia, neuroticism and mental health; and to examine the role of neuroticism as a moderator between tokophobia and mental health. METHODS: This cross-sectional study was conducted from September, 2019, to January, 2020, at different hospitals. Three instruments Eysenck Personality Questionnaire (EPQ), Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), and The Wajima Delivery Expectancy Questionnaire (WDEQ) were administered on 100 women along with a demographic sheet to collect data and were analyzed using SPSS V 23. RESULTS: Results showed that tokophobia had a significant positive relationship with neuroticism and significant negative relationship with mental health ({β = -0.23, t = -2.20, p = 0.030}). Neuroticism also predicted Mental health {β = -0.51, t = 5.45, p = 0.001} and create 22% in it {ΔR2 = 0.22, ΔF (1,97) = 29.72, p = 0.001}. The interaction of tokophobia and neuroticism significantly predicted mental health {β = -0.17, t = 2.85, p = 0.48} and about 30% change {ΔR2 = 0.30, ΔF (1,96) = 3.42, p = 0.048} in mental health. Neuroticism significantly moderates the relationship between tokophobia and mental health in negative direction. Residential areas do not have significant differences on neuroticism, tokophobia and mental health among primigravidas. CONCLUSION: Primigravida women with neuroticism personality have higher tendency to develop tokophobia and both significantly affect mental health of pregnant women

Comparison of pre and post foley catheter bishop’s score: A retrospective record review at Aga Khan University Hospital Karachi, Pakistan

Objective: To compare pre and post Foley\u27s catheter Bishop Score during labour induction.Methods: This study was a retrospective study conducted at the Aga Khan University Hospital Karachi, Pakistan after approval from ethical review board. All women who underwent induction of labour with Foley\u27s Catheter at gestation of 37 weeks or more from September 2014-October 2015 were included. Data was entered and analyzed in Statistical Package for Social Sciences (SPSS) version 19.0. The comparison between pre and post Foley\u27s catheter Bishop Score during labour induction will be calculated by Wilcoxon sign test.Results: There were 981 cases of inductions of labour, 749 (76.3%) received Foley\u27s catheter, in combination with prostaglandins and oxytocin. About 68% were vaginal deliveries while 32% underwent C-section. Two third of women had bishop Conclusion: Foley\u27s is the better and safer option. In view of our results, It has been recommended to keep the Foley\u27s for 10-12 hours to get significant improvement in bishop score

Risk Factors Associated with Ischemic Heart Diseases in Different Age Groups Patients of Tertiary Care Hospitals of Peshawar

Objectives:To determine different risk factors associated with ischemic heart diseases in different age group patients of tertiary care hospitals of Peshawar.Methodology:A cross sectional study conducted on 350 patients of different age groups presented with ischemic heart diseases in tertiary care hospitals of Peshawar. Study was conducted for duration of 3 months from December 2013 to February 2014. Non probability convenient sampling technique was used. Sample size was calculated using standard sample size calculator. Semi structured questionnaire was used as data collection tool. Patient’s record and investigations were used as adding tools. Standard definition was made for ischemic heart disease. Different modifiable and non-modifiable factors were assessed and were analyzed using SPSS version 16.Results:This study contains 350 patients in which female patients were 133(38%) and male were 217(62%).The mean age was 57.23±11.36 years. The age of the patients ranges from 22 to 80 years. The frequencies of risk factors were stress (73.1%) followed by hypertension (65.7%), sedentary life style (59.4%), family history (57.1%), smoking (50.6%), over weight and obese (39.1%), below normal HDL (30.3%), high LDL (29.1%), hypertriglyceridemia (28%), hypercholesterolemia (23.7%). 64.3% patients were presenting with acute IHD and 35.7% were with chronic IHD. Stress, HTN, DM and sedentary life style were found to be significantly associated with male gender (p- value <0.05). Age was divided into two groups, <45 years and >45 years. Stress, HTN, DM and hypercholesterolemia had a significant association with >45 years of age group. (P-value <0.05).Conclusion:Stress, HTN, DM, sedentary life styles were the major risk factors. And they were found to be more in male gender and in equal to more than 45 years of age group

Comparison of Postmodernist Historians of Pakistan

History of Pakistan has been really complex and every time a historian tried to write about a historical event, it did come under fire of criticism. Critiques roused questions whether history or the events a historian gives off are right, based on solid truths or delusions. The historians tried their best to write down the historical events of Pakistan. There have been conventional or traditional writers and also there are writers who have marked history in a postmodern approach. At the end it is always up to the readers that how they perceive history depending on what approach they believe in. But there has always been a need to compare the historians of Pakistan in order to differentiate between their works and make it easier for the common men to choose in what they believe is true and what is not according to literature they have. Pakistan has made both conventional and modernist writers of history. There are famous names that have extraordinary work regarding the history of Pakistan. There is much appreciated and can be compared in regarding their postmodernist approach to history. Critics have criticized their work one way or other but there has been very less positive comparison between these renowned historians. Although there work is really deep and puts realities portrayed already into question but there is a need for a comparison among the works of these historians. It is necessary to have a deeper look into the frame works of the historians of Pakistan individually and then compare it with each other. A framework of comparison has been provided to conclude the approaches used by historians of Pakistan and which was better or not in writing the history of Pakistan. It’s up to readers in the end and their outlook on history after studying the available literature about the history

Hydrothermal synthesis, structural and impedance studies of nanocrystalline zinc chromite spinel oxide material

Zinc chromite (ZnCr2O4) nanocrystalline spinel material was synthesized through hydrothermal method by using zinc nitrate 6-hydrate and chromium nitrate 9-hydrate as precursors. The synthesized material was characterized for phase identification, crystallinity and surface morphology by X-ray diffraction (XRD) and scanning electron microscopy (SEM). XRD results showed that hydrothermally as-synthesized products remained poorly crystalline up to 300 °C. Zinc chromite cubic spinel structure developed after calcination at 600 °C for 4 h. Formation of single-phase cubic structure of ZnCr2O4 was also confirmed by Rietveld refinement study with lattice parameter a = 8.2874 Å, and Fd3m space group. Thermal stability of the developed material was observed by thermogravimetry (TG) and differential thermal analysis (DTA). Thermal study reveals that ZnCr2O4 is thermally stable above 700 °C. The Fourier transform infrared (FTIR) spectra show the two absorption bands of Cr–O and Zn–O at 490 and 616 cm−1 respectively. These bonds were associated with ZnCr2O4 and indicate the formation of cubic spinel ZnCr2O4 material. The band gap energy of ZnCr2O4 powder was determined by absorption spectroscopy in ultraviolet–visible range and was found to be 3.771 eV and 3.147 eV for direct and indirect band gap respectively. SEM images show well-faceted crystals of ZnCr2O4, with the grain size of 50–80 nm. An equivalent circuit model (R1Q1)(R2Q2)(R3Q3) was employed to explain three relaxation processes associated with bulk and grain boundaries in ZnCr2O4 nanoparticles, and electrodes. Conductivity of the nanoparticles increased with frequency, and dielectric constant of the material showed dispersion at comparatively lower frequencies. At higher frequencies, the dielectric constant remained independent of frequency as attributable to the atomic and electronic polarizations

Obstetric triage improvement process using the Donabedian model of quality care: A quality improvement initiative

Obstetric triage has become one of the most crucial innovations in the field of perinatal care in the past 15 years. In lower- middle- income countries (LMICs), the pregnant patients are seen in a conventional way based on the time of their arrival; this divergent, unbalanced and inequitable approach results in delayed initial evaluation, prolonged length of stay (LOS) and affected clinical outcomes.This project aimed at implementing an effective and efficient obstetric triage system with improved throughput and care processes within six months to facilitate timely decision making according to the individualized needs of pregnant patients.A pre-implementation audit was completed for the core evaluation of existing obstetric triage services, followed by a fishbone analysis. Following the Donabedian model for quality care, a quality improvement project was initiated to redesign the obstetric triage system. The project strategy was implemented as part of six PDSA (Plan- Do -Study- Act) cycles to optimize the structure, processes, and obstetric triage outcomes. The triage paradigm moved from time-based care delivery to priority care, and processes were improved based on Angelini\u27s recommendations of best practices in obstetric triage. During the initial phase of improvement, the identified outcome measures were waiting time of 5 minutes from arrival to initial assessment, LOS of 120 minutes, and acuity-based care for at least 50% of patients. A post-implementation audit was conducted to assess improvements. The results showed that the LOS at triage reduced from 240 min (4 hours) to 60 min (1 hour) within 6 months. Furthermore, wait times for triage decreased significantly to 5 min in 65% of patients, compared with 6% in traditional triage practice.The results indicate that the traditional triage model of the \u27order of arrival\u27 process is inefficient in providing adequate obstetric care. This quality initiative facilitated the successful incorporation of the Donabedian model and best practice triage practices and helped achieve desired outcomes of improved LOS and reduced waiting time with acuity-based care. Therefore, the design of an efficient,and the appropriate obstetric triage system can be adopted by other healthcare institutions in a local setting that can facilitate patient centric care

Structural, impedance and Mössbauer studies of magnesium ferrite synthesized via solâgel auto-combustion process

Crystalline magnesium ferrite (MgFe2O4) spinel oxide powder was synthesized by nitrateâcitrate solâgel auto-combustion process with stoichiometric composition of metal nitrate salts, urea and citric acid. The study was focused on the modification of synthesis conditions and effect of these modified conditions on the structural and electrical properties of synthesized MgFe2O4 ceramic materials. Phase composition, crystallinity, structure and surface morphology were studied by X-ray diffraction, FTIR and SEM. Pure single phase MgFe2O4 spinel ferrite was obtained after calcination at 850 °C. Rietveld refinement of XRD result confirmed the single cubic phase spinel oxide with the lattice constant of a = 8.3931 à and Fd3m symmetry. UVâvisible absorption study of calcined powder revealed an optical band gap of 2.17 eV. SEM images of sintered specimens (1050â1450 °C) showed that the grain size increased with the increase in sintering temperature. From the impedance results of the sintered MgFe2O4 specimens, it was found that the resistance of grain, grain boundary and electrode effect decreased with an increase in sintering temperature and associated grain growth. In the intermediate frequency region lowering of impedance and dielectric values was observed due to the decrease in grain boundary areas. Mössbauer studies indicated that magnesium ferrite had a mixed spinel structure in calcined and sintered samples, however, the well refined single phase MgFe2O4 was observed due to well developed high crystalline structure at 1350 °C and 1450 °C. Keywords: Solâgel auto-combustion, Magnesium ferrite, X-ray diffraction, SEM, Mössbauer spectroscopy, Impedance spectroscop

Diversification of the Islamic stock market, Bitcoin, and Bullions in response to the Russia-Ukraine conflict and the COVID-19 outbreak

This study investigates the interconnectedness of the Islamic stock market, Bullion, and Bitcoin as diversifiers for portfolios, exploring their role as hedges and safe havens. The analysis covers the period from January 2015 to December 2022, with a particular focus on the influence of the COVID-19 pandemic and the Russia-Ukraine War on the MSCI World Islamic Index, bullions (Gold, Silver, Platinum, Nickel, Palladium, and Aluminium), and Bitcoin, employing a time-varying parameter vector autoregression (TVP-VAR) model. During crisis periods, our findings reveal that the transmission and reception of shocks among these assets varied, with a heightened level of co-movement observed during the pandemic and war periods. These results emphasise the importance of considering the dynamic nature of financial assets' connectedness in asset investment decisions, particularly in times of crisis. Furthermore, the findings suggest that Bullion can serve as a hedge for both Bitcoin and the Islamic stock market. The study also explores the optimal diversification of investment portfolios and highlights the importance of adhering to Islamic principles in portfolio diversification. By integrating Islamic rules into the diversification process, investors can enhance the effectiveness and relevance of their investment strategies