Agricultural Productivity Impact of a Mini-Dam: A Case Study of Ziarat, Balochistan

Water is the most important constituent of life without which, life cannot exist. Water is a natural resource which is also used as an input for producing different goods in factories for industrial use, productivity of crops for agriculture use also used in our daily life for domestic purpose. Despite such an importance, still the World is experiencing the issue of water scarcity [WCD (2000)]. The supply of water does not meet its demand [Bengali (2009)]. Pakistan is an agrarian economy which is also heavily dependent on water. About 45 percent of the total employment is generated from Agriculture sector [Pakistan (2011)]. Main sources of water are rivers and rainfall. Balochistan is the largest province of Pakistan. Land size is 44 percent of the total land of Pakistan [Balochistan (2010)]. Land is fertile and provides conducive environment for Agriculture. Agriculture productivity is high in Balochistan. Many vegetables and crops are grown which results in many farmers and labours livelihood. It has got varieties of species of many fruits, particularly Apple. Important fruit crops grown are Apple, Grapes, Cherry and Peach. Climate is also suitable for crops growth particularly the deciduous fruits like apple, which requires low temperature during summer season. As far as quality is concerned, apple produced in Balochistan, especially at high altitude (1600 meters to 2000 meters) are superior in quality than that produced in the rest of the country. The main reason is that due to dryness of the climate in apple producing areas like Ziarat, Killa Abdullah, Pishin, Quetta etc. Apple is one of the most popular fruit. It is delicious and crunchy and is mostly liked by health conscious and fitness lovers as it is filled with rich phyto-nutrients, which is very essential for optimal health. It also contains antioxidants, which promotes health as well as prevents several diseases. Thus, apple truly justifies the famous sayings, “An apple a day keeps the doctor away.” One of the distinguishing features is that there are no fungal diseases and disease free apple can be stored for a longer period in cold storage. Also the abundance of sunshine in the growing season improves the colour of apple which fetches a good price in the domestic and foreign market

Measuring service quality in Public Sector using SERVQUAL: A case of Punjab Dental Hospital, Lahore

This paper describes the method, named SERVQUAL which is a twenty two items model, to show the reliability and applicability of this methodology to measure the service quality of different organizations. It tells how applicable this instrument is in measuring the service quality of different organizations including, the health sector. After the proper discussion of the conceptualization and operationalization of this methodology, this paper carries a logical conclusion. The conclusion is evidence based since the reliability and the validity of this methodology is backed by the data which was taken from the library data and the practical implementation of the method for measuring the service quality of The Punjab Dental Hospital, Lahore. Key words: Service, Quality, Gaps, SERVQUAL Model, Consumer’s Expectations, Consumer’s Perceptions

Polypoid adenomyoma of the uterus.

Polypoid adenomyoma is a rare uterine endometrial polypoid tumor of mixed epithelial and mesenchymal origin. Although the clinical and pathologic features of polypoid adenomyomas have been described extensively, imaging findings for these tumors have not been frequently reported in the literature. On imaging, their features may be confused with prolapsed leiomyomas or malignancy. Hemorrhagic cystic spaces in a prolapsed uterine tumor within the vagina should raise consideration of a diagnosis of polypoid adenomyoma. Such blood-containing cystic spaces would be unusual findings in leiomyomas and malignancy. Diagnosing polypoid adenomyoma is vital because it can potentially be managed by hysteroscopic resection, unlike an ordinary form of adenomyosi

Microbiological safety of areca nut-containing, ready-to-eat chewing substances common among Pakistani paediatric population: A pilot study

Objective: To evaluate microbiological contamination of areca nut-containing, ready-to-eat chewing substances easily accessible to vulnerable paediatric population.Methods: A pilot study was conducted at the Aga Khan University Medical College from June to October 2016 on twelve samples of areca nut-containing chewing substances (four supari, paan masala and gutka each) collected from various localities of Karachi. These were evaluated individually for total colony counts, hygiene indicator organisms, pathogenic organisms, and levels of aflatoxin. Microbial contamination was analysed using pour-plate method. Fungal aflatoxin levels were measured by enzyme-linked immunosorbent assay (ELISA)..Results: Wet gutka preparations were contaminated by Escherichia coli and Enterobacteriacaea. High levels of fungal aflatoxin (range: 0.43-1.84 mg/kg), a proven carcinogen, were identified in all the 12(100%) products. No sample contained pathogenic bacteria. However, 1(8.33%) sample did not meet hygiene criteria cut-off.Conclusions: Habitual use of unhygienic chewing substances containing fungal toxins is a public health concern that needs to be addressed through a preventative, behaviour-changing strategy.

Cesarean scar pregnancy: an experience of three cases with review of literature

Cesarean scar pregnancy (CSP), often considered the rarest form of ectopic pregnancy, is a result of implantation of the gestational sac into the fibrous tissue scar of a previous cesarean section. With an increase in the rate of cesarean sections, along with better awareness and improvement in sonographic diagnosis, the number and detection of scar pregnancies are on the rise. Because of its early invasion of the myometrium, usually in the first trimester, CSP is considered to be potentially lethal, leading to high risks of uterine rupture. We report a series of three cases of scar pregnancy that presented at different gestational ages and were managed by different methods. The aim of this case series is to share our experience with CSP, review previous literature, and emphasize on the radiological criteria to making a confident diagnosis. Diagnosis and management of CSP needs considerable expertise and a multidisciplinary approach to prevent complications. KEYWORDS

Comparison of sampling adequacy between OPD based pipelle biopsy and in- patient conventional D&C, presented with abnormal uterine bleeding

Objective: To determine agreement on adequacy of sample by pipelle biopsy and conventional dilatation and curettage in patients with abnormal uterine bleeding. Study design: Cross sectional studySetting and Duration of Study: Department of Obstetrics and Gyneacology, Islamic International Medical College Trust, Railway Hospital Rawalpindi. Study was carried out over a period of six months (11-07-2012 to 14-01-2013). Patients and Methods: 84 patients presented with abnormal uterine bleeding age 45 years and older, attended Gynecology department of Railway Hospital Rawalpindi. Who qualified the inclusion criteria were enrolled in this study by non-probability consecutive sampling technique. The diagnostic intervention for endometrial sampling was by pipelle device and by conventional D&C. Both procedures were performed in the OT at the same time.First the pipelle sample was taken and was labeled as “A” then conventional D&C was performed and was labeled as “B”. Both samples were sent to the pathologist, who was blinded as to the method of sample collection for histopathology assessment. Adequacy of the sample was assessed as per operational definition. A data base was made in SPSS version 17. Kappa statistics was applied to assess the agreement. Results: Out of 84 patients, 80 (98.8%) of the patients had adequate sample with Pipelle Biopsy as compared to conventional curettage and dilatation (D & C). We therefore recommend the use of pipelle biopsy as a first line tool for endometrial assessment for our setups instead of D&C. Conclusion: Our study concluded that the Pipelle biopsy is a useful and convenient method to the patients and physicians as ompared to D&C performed in the operating theatre. It is useful in obese and high-risk patients with minimum chances of perforation of uterus due to its soft flexible tip

Variability of breast density assessment and the need for additional imaging: A comparison between computed mammography and digital mammography

Objective: To determine the variability of breast density assessment and the need for additional imaging using computed radiography (CR) mammography versus digital radiography (DR) mammography.Study design: Cohort study.Place and duration of study: Department of Radiology, The Aga Khan University Hospital, Karachi from March to June 2018.Methodology: Patients who underwent screening CR mammography, followed by DR mammography a year later, were selected. Only disease-free individuals were included in the study. Evaluation of breast density was done subjectively, using the breast imaging reporting and data system (BI-RADS) by two independent experienced radiologists. Statistical analysis was performed using the Wilcox Signed Rank-sum test to compare both modalities. Fisher Exact method was used to compare the need for ultrasound imaging.Results: A total of 295 patients were included in the study. The mean age of the patients was 52.76 ± 0.64 years. There was a significant difference in the change of breast density when comparing both modalities (Z= -11.839, p \u3c0.001). A statistically significant reduction in the need for further breast ultrasound was observed after DR mammography than with CR mammography (p \u3c0.001).Conclusion: Use of DR mammography, especially in patients with dense breast parenchyma, is a better screening tool overall. It translates to better feasibility for the radiologist and is more economical for the patient. DR mammography decreases unnecessary imaging and leads to better visualisation, thus providing a more accurate categorisation of breast density. Key Word: Computed radiography mammography, Breast density, Screening, Breast cancer, Digital mammography, Ultrasound

Manual loop in laparoscopic appendectomy: A retrospective cohort study and literature review

Objectives: To determine the incidence of complications [Surgical site infection (SSI), intra-abdominal abscess (IAA), stump leak] related to stump ligation with manual loop of sliding extracorporeal suture knot in laparoscopic appendectomy. Methods: This cohort study was conducted on patients who underwent laparoscopic appendectomy from June 2014 to November 2020 performed by the same surgeon with almost similar technique. Stump was ligated with manual loops, applied by the surgeon or trainee or both (one by surgeon and other by trainee). SSI and IAA were classified according to Centers for Disease Control and Prevention (CDC) criteria. Results: Total 120 patients were included with median (Interquartile range, IQR) age of 24 (19-35) years and male predominance i.e. 81 (67.5%). Median (IQR) for the duration of symptoms, time from presentation to surgery and duration of surgery was 2(1-4) days, 10 (4-15) hours and 60 (44-70) minutes, respectively. SSI was documented in 9(7.5%) patients, managed by wound hygiene and antibiotics. IAA was observed in one(0.8%) patient who required readmission for antibiotics and radiology guided drain placement. No stump leak was observed.Conclusions: Manual endo-loop is a safe, reliable and cost effective technique for stump ligation in LA, and can safely be incorporated into teaching of surgical trainees

Bellerochea malleus (Brightwell) Van Heurk: a new record from North Arabian Sea after Tasman Spirit Oil Spill

Present report is a first record from the area of North Arabian Sea which describes morphological features of marine centric diatom Bellarochea malleus isolated after 1.5 year of Tasman Spirit Oil Spill during Bioremedial Project (BP). Hydrographic parameters, cell count along with comparison of morphometric data with other reports has also been documented