Complexation of BaCl 2 with glutathione (GSH) in blood components

Barium is a divalent alkaline earth metal and can exist only in combination forms. Studies have proved that barium can cause different toxic effects. The human body can be exposed to barium in drinking water, food and air. In medical field, barium is used in diagnostic procedure. Among its various combinations, barium chloride is considered most important in its related toxicities, because of its water solubility. In the human body, glutathione is present in almost all type of cells and acts as an antioxidant and also arrests the toxic xenobiotics like metals and drugs through conjugate formation. This study was designed to investigate the possible interaction of barium with extracellular (separatedplasma) glutathione (GSH) and intracellular (separated-cytosolic fraction) GSH. The renowned Ellman's method of thiol quantification was used to determine the effect of barium chloride on the levels of extracellular and intracellular GSH. The results showed that a decrease in the concentration of GSH was affected by barium chloride. This decrease was enhanced by increasing the concentrations of barium chloride and also by the time elapsed. Hypothetically, this decrease in the levels of GSH may be attributed to the conjugation formation of GSH with barium metal

Gendered immobility: influence of social roles and local context on mobility decisions in Pakistan

This paper examines the instances of one-day immobility in Pakistan and reports its socio-demographic determinants using the nationally representative dataset of the 2007 Pakistan Time Use Survey. Of 37,830 time diary respondents, nearly 30% did not report travel during the diary day. Homemakers and those out of the workforce were more likely to be immobile than employed or student respondents. Immobility rates were very high among women (55%) as compared to men (4%). Among women, those between 20 and 34 years of age, married, with children, having better education, dependent on other household members and those living in higher income households were more likely to be immobile. The excessive gender nature of immobility seems to be triggered by a gender-based sociocultural environment, which restricts female mobility due to family honor concerns. Other than this, those living in the provinces of Sindh and Khyber Pakhtunkhwa or in urban areas were more likely to be immobile than those living in Punjab and Sindh provinces or in rural areas. The significant geographic effect at broader spatial scale is caused by the demographic structure as well as due to differences in the social and cultural context of these areas. Finally, questions regarding the measurement of immobility and the potential implications of increased female immobility are discussed

Are children with tuberculosis in Pakistan managed according to National programme policy guidelines? A study from 3 districts in Punjab

<p>Abstract</p> <p>Background</p> <p>The adherence to policies of National TB Control Programme (NTP) to manage a case of tuberculosis (TB) is a fundamental step to have a successful programme in any country. Childhood TB services faces an unmet challenge of case management due to difficulty with diagnosis and relatively new policies. For control of childhood TB in Pakistan, NTP developed and piloted its guidelines in 2006-2007. The objective of this study was to compare the documented case management practices of pediatricians and its impact on the outcome before and after introducing NTP policy guidelines.</p> <p>Findings</p> <p>An audit of case management practices of a historical cohort study was done in children below 15 years who were put on anti-tuberculosis treatment at all nine public hospitals in three districts in province of Punjab. The study period was two years pre-intervention (2004-05) and two years post-intervention (2006-07) after implementation of new NTP policy guidelines for childhood TB. There were 920 childhood TB cases registered during four years, 189 in pre-intervention period and 731 in post-intervention period. The practices changed significantly in post-intervention period for use of tuberculin skin test (63% of pulmonary cases, 19% of extrapulmonary cases and 67% for site unknown), and for the use of chest x-ray (69% of pulmonary cases, 16% of extrapulmonary cases and 74% for site unknown). Diagnostic scores were recorded for only a minority of cases (18%). The proportion of correct drugs pre- and post-intervention remained same. There were unknown treatment outcomes in 38 out of 141 cases (27%) in pre-intervention and in 483 out of 551 cases (87%) post-intervention, all among the 692 cases without documented treatment supporter.</p> <p>Conclusions</p> <p>The study has shown that pediatricians have started following parts of the national policy guidelines for management of childhood TB. The documented use of diagnostic tools is increased but record keeping of case management practices remained inadequate. This seems to increase case finding substantially but the treatment outcomes were poor mainly due to unknown outcomes. Development and implementation of standardized operational tools and regular monitoring system may improve the services.</p

Addressing disparities in maternal health care in Pakistan: gender, class and exclusion

Background: After more than two decades of the Safe Motherhood Initiative and Millennium Development Goals aimed at reducing maternal mortality, women continue to die in childbirth at unacceptably high rates in Pakistan. While an extensive literature describes various programmatic strategies, it neglects the rigorous analysis of the reasons these strategies have been unsuccessful, especially for women living at the economic and social margins of society. A critical gap in current knowledge is a detailed understanding of the root causes of disparities in maternal health care, and in particular, how gender and class influence policy formulation and the design and delivery of maternal health care services. Taking Pakistan as a case study, this research builds upon two distinct yet interlinked conceptual approaches to understanding the phenomenon of inequity in access to maternal health care: social exclusion and health systems as social institutions. Methods/Design: This four year project consists of two interrelated modules that focus on two distinct groups of participants: (1) poor, disadvantaged women and men and (2) policy makers, program managers and health service providers. Module one will employ critical ethnography to understand the key axes of social exclusion as related to gender, class and zaat and how they affect women’s experiences of using maternal health care. Through health care setting observations, interviews and document review, Module two will assess policy design and delivery of maternal health services. Discussion: This research will provide theoretical advances to enhance understanding of the power dynamics of gender and class that may underlie poor women’s marginalization from health care systems in Pakistan. It will also provide empirical evidence to support formulation of maternal health care policies and health care system practices aimed at reducing disparities in maternal health care in Pakistan. Lastly, it will enhance inter-disciplinary research capacity in the emerging field of social exclusion and maternal health and help reduce social inequities and achieve the Millennium Development Goal No. 5

Reproductive health and access to healthcare facilities: risk factors for depression and anxiety in women with an earthquake experience

<p>Abstract</p> <p>Background</p> <p>The reproductive and mental health of women contributes significantly to their overall well-being. Three of the eight Millennium Development Goals are directly related to reproductive and sexual health while mental disorders make up three of the ten leading causes of disease burden in low and middle-income countries. Among mental disorders, depression and anxiety are two of the most prevalent. In the context of slower progress in achieving Millennium Development Goals in developing countries and the ever-increasing man-made and natural disasters in these areas, it is important to understand the association between reproductive health and mental health among women with post-disaster experiences.</p> <p>Methods</p> <p>This was a cross-sectional study with a sample of 387 women of reproductive age (15-49 years) randomly selected from the October 2005 earthquake affected areas of Pakistan. Data on reproductive health was collected using the Centers for Disease Control reproductive health assessment toolkit. Depression and anxiety were measured using the Hopkins Symptom Checklist-25, while earthquake experiences were captured using the Harvard Trauma Questionnaire. The association of either depression or anxiety with socio-demographic variables, earthquake experiences, reproductive health and access to health facilities was estimated using multivariate logistic regression.</p> <p>Results</p> <p>Post-earthquake reproductive health events together with economic deprivation, lower family support and poorer access to health care facilities explained a significant proportion of differences in the experiencing of clinical levels of depression and anxiety. For instance, women losing resources for subsistence, separation from family and experiencing reproductive health events such as having a stillbirth, having had an abortion, having had abnormal vaginal discharge or having had genital ulcers, were at significant risk of depression and anxiety.</p> <p>Conclusion</p> <p>The relationship between women's post-earthquake mental health and reproductive health, socio-economic status, and health care access is complex and explained largely by the socio-cultural role of women. It is suggested that interventions that consider gender differences and that are culturally appropriate are likely to reduce the incidence.</p

Outcomes from elective colorectal cancer surgery during the SARS-CoV-2 pandemic

This study aimed to describe the change in surgical practice and the impact of SARS-CoV-2 on mortality after surgical resection of colorectal cancer during the initial phases of the SARS-CoV-2 pandemic

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

XVII th World Congress of the International Commission of Agricultural and Biosystems Engineering (CIGR) IMPACTS OF THE CHASHMA RIGHT BANK CANAL ON LAND USE AND CROPPING PATTERN IN CSBE100093 -Presented at ASABE&apos;s 9th International Drainage Symposium (IDS

ABSTRACT This paper attempts to determine the ex post impact of Chashma Right Bank Canal (CRBC) on the land use and cropping pattern of D.I.Khan district. CRBC commands 250,000 ha and spread over two provinces. The CRBC project was completed in three stages. Stage I was commissioned in 1987-1988, whereas stage II and III in 1989 and 2001. CRBC brought radical changes in the land use and cropping pattern of D.I.Khan district. For this study, three variables were selected including land use, cropping pattern and land values. To determine these changes at micro-level, five sample villages were randomly selected, four from within the CRBC command area and one off the command area. The analysis found that after commissioning of CRBC, prime cultivable land was brought under non-agricultural use. The area under net sown was also enhanced. The dry farming crops were replaced by water intensive cash crops, which in effect caused the twin problem of waterlogging and salinity, particularly in stage I. Likewise, the land values increased considerably. This study is a sort of ex post evaluation of CRBC and provides policy guidelines for decision makers not to repeat the weaknesses of Chashma Right Bank Irrigation Project. The guidelines will be valuable for the proposed Chashma Right Bank 1st Lift Irrigation Projec