CHRONIC KIDNEY DISEASE – A MULTI-CENTER STUDY IN KARACHI, PAKISTAN

Objective: Chronic kidney disease is growing at alarming rate in developing countries like Pakistan. The aim of the study was to find out the major factors leading to this disease and to carry out the comparative analysis of the effectiveness of allopathic and homoeopathic medicines in treatment of chronic kidney disease.Methods: A multi-center study was carried out in five different centers from 2009-2014. The study was carried out by interviewing the patients, noting down their vitals and reviewing their records. Evaluation of the data was done considering age, sex and co-morbidities associated with renal failure.Results: Significant results were observed. Patients of age groups 46 to 60 (48%) and 30 to 45 (21%) were found to suffer more from chronic kidney disease. Hypertension was found as the most frequently occurring co-morbidity along with chronic renal failure followed by diabetes.Conclusion: The current study will be beneficial in bringing awareness in general public and thereby reducing the increasing burden of end-stage kidney disease

Formulation and evaluation of fluconazole loaded nanospongies for improved topical drug delivery

Fluconazole (an antifungal drug) loaded nanosponges (NS) were prepared by an emulsion solvent diffusion method using ethyl cellulose as the polymer. Prepared formulations were evaluated for various physicochemical parameters and in-vitro drug release. NS of fluconazole were discrete, free flowing nanosized particles with perforated orange peel-like morphology as shown by SEM analysis. A topical hydrogel formulation based on the drug loaded NS showed a prolonged release profile for the drug. Kinetic modelling on release data showed that the best fitted model was Higuchi model and release mechanism was by Fickian diffusion. FTIR and PXRD results confirmed the absence of any drug polymer interaction and stability of drug in the delivery system

National cervical cancer burden estimation through systematic review and analysis of publicly available data in Pakistan

Abstract Background Cervical cancer is a major cause of cancer-related deaths among women worldwide. Paucity of data on cervical cancer burden in countries like Pakistan hamper requisite resource allocation. Objective To estimate the burden of cervical cancer in Pakistan using available data sources. Methods We performed a systematic review to identify relevant data on Pakistan between 1995 to 2022. Study data identified through the systematic review that provided enough information to allow age specific incidence rates and age standardized incidence rates (ASIR) calculations for cervical cancer were merged. Population at risk estimates were derived and adjusted for important variables in the care-seeking pathway. The calculated ASIRs were applied to 2020 population estimates to estimate the number of cervical cancer cases in Pakistan. Results A total of 13 studies reported ASIRs for cervical cancer for Pakistan. Among the studies selected, the Karachi Cancer Registry reported the highest disease burden estimates for all reported time periods: 1995–1997 ASIR = 6.81, 1998–2002 ASIR = 7.47, and 2017–2019 ASIR = 6.02 per 100,000 women. Using data from Karachi, Punjab and Pakistan Atomic Energy Cancer Registries from 2015–2019, we derived an unadjusted ASIR for cervical cancer of 4.16 per 100,000 women (95% UI 3.28, 5.28). Varying model assumptions produced adjusted ASIRs ranging from 5.2 to 8.4 per 100,000 women. We derived an adjusted ASIR of 7.60, (95% UI 5.98, 10.01) and estimated 6166 (95% UI 4833, 8305) new cases of cervical cancer per year. Conclusion The estimated cervical cancer burden in Pakistan is higher than the WHO target. Estimates are sensitive to health seeking behavior, and appropriate physician diagnostic intervention, factors that are relevant to the case of cervical cancer, a stigmatized disease in a low-lower middle income country setting. These estimates make the case for approaching cervical cancer elimination through a multi-pronged strategy

A study of ticks and tick-borne livestock pathogens in Pakistan

As obligate blood-feeding arthropods, ticks transmit pathogens to humans and domestic animals more often than other arthropod vectors. Livestock farming plays a vital role in the rural economy of Pakistan, and tick infestation causes serious problems with it. However, research on tick species diversity and tick-borne pathogens has rarely been conducted in Pakistan. In this study, a systematic investigation of the tick species infesting livestock in different ecological regions of Pakistan was conducted to determine the microbiome and pathobiome diversity in the indigenous ticks.A total of 3,866 tick specimens were morphologically identified as 19 different tick species representing three important hard ticks, Rhipicephalus, Haemaphysalis and Hyalomma, and two soft ticks, Ornithodorus and Argas. The bacterial diversity across these tick species was assessed by bacterial 16S rRNA gene sequencing using a 454-sequencing platform on 10 of the different tick species infesting livestock. The notable genera detected include Ralstonia, Clostridium, Staphylococcus, Rickettsia, Lactococcus, Lactobacillus, Corynebacterium, Enterobacter, and Enterococcus. A survey of Spotted fever group rickettsia from 514 samples from the 13 different tick species generated rickettsial-specific amplicons in 10% (54) of total ticks tested. Only three tick species Rhipicephalus microplus, Hyalomma anatolicum, and H. dromedarii had evidence of infection with "Candidatus Rickettsia amblyommii" a result further verified using a rompB gene-specific quantitative PCR (qPCR) assay. The Hyalomma ticks also tested positive for the piroplasm, Theileria annulata, using a qPCR assay.This study provides information about tick diversity in Pakistan, and pathogenic bacteria in different tick species. Our results showed evidence for Candidatus R. amblyommii infection in Rhipicephalus microplus, H. anatolicum, and H. dromedarii ticks, which also carried T. annulata