Elderly musculoskeletal disease burden in Karachi, Pakistan: Associations and implications for developing countries

Objective: The global rise in the older population has increased the rates of osteoporosis and osteoarthritis, conditions that impact mobility and functionality. There is limited data on musculoskeletal disease in older populations residing in developing countries.Methods: A community-based study using multistage cluster random sampling of older individuals was conducted in Karachi. Predefined criteria were used for osteoporosis and osteoarthritis. Gait assessment was performed.Results: More than half of the participants were females and 53% reported illiteracy. Around 30% had osteoporosis and two-thirds had osteoarthritis. Multivariate analysis showed associations of female sex, Pashtun ethnicity, illiteracy, and hypertension with the combined variable of osteoporosis and osteoarthritis.Conclusions: The prevalence of osteoarthritis was higher than in other regional studies. Presence of both osteoporosis and osteoarthritis increased the risk of certain geriatric syndromes. High rates of musculoskeletal morbidity are seen in the elderly in Pakistan. Measures at a health-system level are required for better outcomes in older adults

Assessing L2 Argumentation in the UAE Context

In this rapidly changing world, argumentation and critical thinking skills are undeniably crucial for new generations of Emirati students. These skills lay the groundwork for a competitive economy, which is a priority for the UAE in its Vision 2021. Specifically, today’s modern workplaces require workers to evaluate different propositions and develop their own after weighing up these various ideas, and thus the ability to defend arguments in English has become increasingly important for UAE university students in English-medium universities as well as their future professional contexts. Despite this importance, research regarding argumentation and the related critical thinking skills is sorely lacking in the UAE. This chapter delineates how written argumentation was assessed in a timed essay in a mandatory argumentative writing course taken by university freshmen in a government university in the UAE, and how the feedback gleaned from this common assessment was mapped to the teaching curriculum to shed light on the teaching effectiveness and to provide directions for future teaching

Effect Of Incubation Temperature On Ikta’s Quail Breed With New Rolling Mechanism System / Mohd Badli Ramli...[et al.]

Successful of hatching rates in incubation quails IKTA(Institut Kemahiran Ternakan Ayam) may differ between each hatchery. There is numerous factor that influence embryonic development, among the parameter is temperature, humidity, air movement, eggs placement etc., This factor may lead to high percentage of embryo hatching and healthy DOQ (day one quail). Nine incubations were performed with 3 set of different temperature to examine the effect of different setting temperature. For eggs placement, eggs were turns using rolling mechanism 360° for every hour. Eggs obtained from local breeder with same age broiler flocks and stored for 1 to 4 days prior to intimate other commercial ideal condition. All in and all out system was used in all incubation set, eggs were place 40 piece in tray from day one until day 17. Overall it was determined that the best setting temperature is 37°c 14day then 38°c 3day that can produce average 89.17% hatching, average first hatch is in the end of day 15 complete hatch in 16 day. Temperature set 38°c 14day, then 39°c3day is 84.17%, average first hatch is day 15.5 end 16 day, not harmful compared to 39°c14day, then 40°c3day with 76.67% hatching with average first hatch is day 15.5 end 16 day. With increasing setting temperature, up to 39°c to 40°c still not successful as 37°c to 38°c, excessive temperature did not affect hatchability neither drastically speed up the hatching days, but can cause detrimental effect, embryonic mortality to eggs development. First hatch in the end of day 14, average in day 15, complete hatching in the end of day 16 , this is faster than other incubator in the market that average 17 day/ cycle. This new faster cycle cause by the consistent heat flow and humidity inside incubation chamber surrounding the eggs shell. In conclusion, ideal setting temperature 37°c 14day 38°c 3day is the best setting temperature to incubate IKTA species quails, with the efficiency of machine supply consistence temperature, humidity and eggs movement are the main parameter to ensure high hatching rates of IKTA quails

In silico modeling of the specific inhibitory potential of thiophene-2,3-dihydro-1,5-benzothiazepine against BChE in the formation of β-amyloid plaques associated with Alzheimer's disease

<p>Abstract</p> <p>Background</p> <p>Alzheimer's disease, known to be associated with the gradual loss of memory, is characterized by low concentration of acetylcholine in the hippocampus and cortex part of the brain. Inhibition of acetylcholinesterase has successfully been used as a drug target to treat Alzheimer's disease but drug resistance shown by butyrylcholinesterase remains a matter of concern in treating Alzheimer's disease. Apart from the many other reasons for Alzheimer's disease, its association with the genesis of fibrils by β-amyloid plaques is closely related to the increased activity of butyrylcholinesterase. Although few data are available on the inhibition of butyrylcholinesterase, studies have shown that that butyrylcholinesterase is a genetically validated drug target and its selective inhibition reduces the formation of β-amyloid plaques.</p> <p>Rationale</p> <p>We previously reported the inhibition of cholinesterases by 2,3-dihydro-1, 5-benzothiazepines, and considered this class of compounds as promising inhibitors for the cure of Alzheimer's disease. One compound from the same series, when substituted with a hydroxy group at C-3 in ring A and 2-thienyl moiety as ring B, showed greater activity against butyrylcholinesterase than to acetylcholinesterase. To provide insight into the binding mode of this compound (Compound A), molecular docking in combination with molecular dynamics simulation of 5000 ps in an explicit solvent system was carried out for both cholinesterases.</p> <p>Conclusion</p> <p>Molecular docking studies revealed that the potential of Compound A to inhibit cholinesterases was attributable to the cumulative effects of strong hydrogen bonds, cationic-π, π-π interactions and hydrophobic interactions. A comparison of the docking results of Compound A against both cholinesterases showed that amino acid residues in different sub-sites were engaged to stabilize the docked complex. The relatively high affinity of Compound A for butyrylcholinesterase was due to the additional hydrophobic interaction between the 2-thiophene moiety of Compound A and Ile69. The involvement of one catalytic triad residue (His438) of butyrylcholinesterase with the 3'-hydroxy group on ring A increases the selectivity of Compound A. C-C bond rotation around ring A also stabilizes and enhances the interaction of Compound A with butyrylcholinesterase. Furthermore, the classical network of hydrogen bonding interactions as formed by the catalytic triad of butyrylcholinesterase is disturbed by Compound A. This study may open a new avenue for structure-based drug design for Alzheimer's disease by considering the 3D-pharmacophoric features of the complex responsible for discriminating these two closely-related cholinesterases.</p

Diagnosis of enteric fever in the emergency department: a retrospective study from Pakistan

Background:Enteric fever is one of the top differential diagnoses of fever in many parts of the world. Generally, the diagnosis is suspected and treatment is initiated based on clinical and basic laboratory parameters.Aims: The present study identifies the clinical and laboratory parameters predicting enteric fever in Patients visiting the emergency department of a tertiary care hospital in Pakistan.Methods:This is a retrospective chart review of all adult Patients with clinically suspected enteric fever admitted to the hospital through the emergency department during a 5-year period (2000-2005).Results:A total of 421 emergency department Patients were admitted to the hospital with suspected enteric fever. There were 53 cases of blood culture-positive enteric fever and 296 disease-negative cases on culture. The mean age in the blood culture-positive group was 27 years (SD: 10) and in the group with negative blood culture for enteric fever, 35 years (SD: 15) with a male to female ratio of 1:0.6 in both groups. Less than half (48%) of all Patients admitted with suspected enteric fever had the discharge diagnosis of enteric fever, of which only 13% of the Patients had blood culture/serologically confirmed enteric fever. None of the common clinical and laboratory parameters differed between enteric fever-positive Patients and those without it.Conclusion:Commonly cited clinical and laboratory parameters were not able to predict enteric fever

Use of smokeless tobacco among groups of Pakistani medical students – a cross sectional study

<p>Abstract</p> <p>Background</p> <p>Use of smokeless tobacco is common in South Asia. Tobacco is a major preventable cause of morbidity and mortality. Doctors make one of the best avenues to influence patients' tobacco use. However, medical students addicted to tobacco are likely to retain this habit as physicians and are unlikely to counsel patients against using tobacco. With this background, this study was conducted with the objective of determining the prevalence of smokeless tobacco among Pakistani medical students.</p> <p>Methods</p> <p>A cross sectional study was carried out in three medical colleges of Pakistan – one from the north and two from the southern region. 1025 students selected by convenient sampling completed a peer reviewed, pre-tested, self-administered questionnaire. Questions were asked regarding lifetime use (at least once or twice in their life), current use (at least once is the last 30 days), and established use (more than 100 times in their life) of smokeless tobacco. Chi square and logistic regression analyses were used.</p> <p>Results</p> <p>Two hundred and twenty (21.5%) students had used tobacco in some form (smoked or smokeless) in their lifetime. Sixty six (6.4%) students were lifetime users of smokeless tobacco. Thirteen (1.3%) were daily users while 18 (1.8%) fulfilled the criterion for established users. Niswar was the most commonly used form of smokeless tobacco followed by paan and nass. Most naswar users belonged to NWFP while most paan users studied in Karachi. On univariate analysis, lifetime use of smokeless tobacco showed significant associations with the use of cigarettes, student gender (M > F), student residence (boarders > day scholars) and location of the College (NWFP > Karachi). Multivariate analysis showed independent association of lifetime use of smokeless tobacco with concomitant cigarette smoking, student gender and location of the medical college.</p> <p>Conclusion</p> <p>The use of smokeless tobacco among medical students cannot be ignored. The governments should add the goal of eliminating smokeless tobacco to existing drives against cigarette smoking. Drives in Karachi should focus more on eliminating paan usage while those in NWFP should focus more on the use of naswar. Medical colleges should provide greater education about the myths and hazards of smokeless tobacco.</p

An experimental study investigating the effect of pain relief from oral analgesia on lumbar range of motion, velocity, acceleration and movement irregularity

Background Movement alterations are often reported in individuals with back pain. However the mechanisms behind these movement alterations are not well understood. A commonly cited mechanism is pain. The aim of this study was to investigate the effect of pain reduction, from oral analgesia, on lumbar kinematics in individuals with acute and chronic low back pain. Methods A prospective, cross-sectional, experimental repeated-measures design was used. Twenty acute and 20 chronic individuals with low back pain were recruited from General Practitioner and self-referrals to therapy departments for low back pain. Participants complained of movement evoked low back pain. Inertial sensors were attached to the sacrum and lumbar spine and used to measure kinematics. Kinematic variables measured were range of motion, angular velocity and angular acceleration as well as a determining movement irregularity (a measure of deviation from smooth motion). Kinematics were investigated before and after administration of oral analgesia to instigate pain reduction. Results Pain was significantly reduced following oral analgesia. There were no significant effects on the kinematic variables before and after pain reduction from oral analgesia. There was no interaction between the variables group (acute and chronic) and time (pre and post pain reduction). Conclusion The results demonstrate that pain reduction did not alter lumbar range of motion, angular velocity, angular acceleration or movement irregularity questioning the role of pain in lumbar kinematics

The association between misperceptions around weight status and quality of life in adults in Australia

Objective: Limited evidence supports a possible association between a person’s perception of their weight status and their quality of life (QoL). This study evaluates whether misperception around weight status is associated with QoL and the impact of gender on this association. Methods: A cross-sectional survey of Australian adults (n=1,905 analysed) collected selfreported height and weight (used to estimate BMI), gender and QoL (described using the AQoL-8D). Participants reported whether they perceived their weight status to be ‘underweight’, ‘healthy weight’, ‘overweight’ or ‘obese’. Misperception around weight status was categorised based on perceived weight status and self-reported BMI. Ordinary least squares regression was used to test associations between self-reported overall, physical and psychosocial QoL, misperception of weight status, and gender, across different BMI categories, after controlling for income, education, relationship status and health conditions. Results: Compared to accurate perception, underestimation of weight status was associated with higher overall QoL for obese males and females and for overweight males. Overestimation of weight status was associated with higher overall QoL for underweight females and lower overall QoL for healthy weight males and females. The same pattern was seen for psychosocial QoL. Physical QoL was less sensitive to misperception than psychosocial QoL. Conclusions: Self-reported misperception around weight status is associated with overall, psychosocial and to a lesser extent physical QoL in Australian adults, although its role depends on BMI category and gender. Generally misperception in the direction of “healthy weight” is associated with higher QoL and overestimation of weight status by those who are of healthy weight is associated with lower QoL. Findings should be confirmed in datasets that contain measured as opposed to self-report height and weight