Frequency Of Depression In Patients With Vitamin B12 Deficiency

Objective: To determine the frequency of depression in patients with vitamin B12 deficiency. Methodology: This cross-sectional study was carried out from January 2020 to March 2021 on a total sample size of n=100 patients (age 49.84 ± 0.91 years) using a simple random sampling technique, visiting the medical department of the federal government polyclinic hospital, in Islamabad. Patients presenting with macrocytic anaemia secondary to vitamin B12 deficiency were included while the patients with previously diagnosed depression were excluded from the study. Serum vitamin B12 levels were measured through the ELISA technique. Patient Healthcare Questionnaire-9 (PHQ-9) was designed and presented to patients with vitamin B12 deficiency for depression assessment. Patients with PHQ-9 score ≤5 were rated as having no depression and the patients with score ≥5 were rated as having depression. Data were analyzed using GraphPad Prism and the correlation coefficient was measured through non-linear fit and linear regression curves while ordinary ANOVA (non-parametric) was applied for study variables. Results: The average level of vitamin B12 in the serum and PHQ-9 score were recorded as 158 ± 4.94 (pg/uL) and 5.85 ± 0.30, respectively. Vitamin B12 levels and PHQ-9 score depicted an inverse correlation, however, no association was found between gender and PHQ-9 score. Conclusion: Data depicted that the patients presenting low levels of vitamin B12 in their serum have shown corresponding high PHQ-9 scores which is an indicator of depression. However, depression prevails in all age groups without any discrimination of gender

Determination of genotype differences through restriction endonuclease in Camels (Camelus dromedarius)

Tyrosinase gene or C locus has long been implicated in the coat colour determination. This gene a copper-containing enzyme located on chromosome 11q14.3 is expressed in melanocytes and controls the major steps in pigment production. In camel, C locus a restriction site provoked by the T variant of the mutation was used in a special restriction fragment length polymorphism analysis (PCR-RFLP) for genotyping of camels from six different Pakistani camel breeds (Marecha, Dhatti, Larri, Kohi, Campbelpuri and Sakrai). Significant differences in the genotype frequency between the breeds were estimated. The Sakrai breed showed in comparison to other studied breeds a distinctly higher frequency of the homozygous with restriction genotype. The objective of the present study was to screen the camel breeds using modern genetic technique that have been so far classified on the basis of performance and tribal ownership.Keywords: Camel, genotype, restriction endonucleas

Third-Party Verification Immunization Coverage Survey (TPVICS) - 2021

• Background• Survey Design and Methodology• Implementation of Survey• Survey Results• Referenceshttps://ecommons.aku.edu/pakistan_coe-wch_survey_report/1000/thumbnail.jp

Arsenic speciation and biotransformation pathways in the aquatic ecosystem: The significance of algae

© 2020 Elsevier B.V. The contamination of aquatic systems with arsenic (As) is considered to be an internationally-important health and environmental issue, affecting over 115 countries globally. Arsenic contamination of aquatic ecosystems is a global threat as it can enter the food chain from As-rich water and cause harmful impacts on the humans and other living organisms. Although different factors (e.g., pH, redox potential, iron/manganese oxides, and microbes) control As biogeochemical cycling and speciation in water systems, the significance of algal species in biotransformation of As is poorly understood. The overarching attribute of this review is to briefly elaborate various As sources and its distribution in water bodies and factors affecting As biogeochemical behavior in aqueous ecosystems. This review elucidates the intriguing role of algae in biotransformation/volatilization of As in water bodies under environmentally-relevant conditions. Also, we critically delineate As sorption, uptake, oxidation and reduction pathways of As by algae and their possible role in bioremediation of As-contaminated water (e.g., drinking water, wastewater). The current review provides the updated and useful framework for government and water treatment agencies to implement algae in As remediation programs globally

Effect of Ajwa date pits powder (Phoenix dactylifera L.) on body composition, lipid profile and blood pressure in patients with hyperlipidemia: A randomized clinical trial

Objective: To evaluate the effect of Ajwa dates pit powder (ADP) on lipid profile, body composition and blood pressure in patients with hyperlipidemia.Materials and Methods: This randomized controlled clinical study was carried out on 40 patients with total cholesterol >200 mg/dl, triglycerides >150 mg/dl and BMI >25, of either sex, aged 30-50 years, who were recruited through written consent. The patients were divided into two groups (n=20 each): the ADP and the control group (CG). All patients received the doctor’s prescribed class A statin (Rosuvastatin/ Atorvastatin) 10 mg/day, while 2.7 g ADP was given on daily basis before breakfast with lukewarm water for 40 days and the control group received the same amount of wheat flour. Body composition, blood pressure and lipid profile were determined at baseline, and after 20 and 40 days. Data were analyzed by using SPSS and GraphPad Prism.Results: ADP significantly reduced body weight (p<0.001), BMI (p<0.001), fat mass, body fat percentage, visceral fat area and waist circumference compared to the control group. Similarly, ADP significantly (p=0.000) decreased the serum level of total cholesterol and low-density lipoprotein. Conclusion: ADP may have the potential to improve dyslipidemia and obesity

Insights into the formation mechanism of two-dimensional lead halide nanostructures

We present a colloidal synthesis strategy for lead halide nanosheets with a thickness of far below 100 nm. Due to the layered structure and the synthesis parameters the crystals of PbI2 are initially composed of many polytypes. We propose a mechanism which gives insight into the chemical process of the PbI2 formation. Further, we found that the crystal structure changes with increasing reaction temperature or by performing the synthesis for longer time periods changing for the final 2H structure. In addition, we demonstrate a route to prepare nanosheets of lead bromide as well as lead chloride in a similar way. Lead halides can be used as a detector material for high-energy photons including gamma and X-rays

Finishing the euchromatic sequence of the human genome

The sequence of the human genome encodes the genetic instructions for human physiology, as well as rich information about human evolution. In 2001, the International Human Genome Sequencing Consortium reported a draft sequence of the euchromatic portion of the human genome. Since then, the international collaboration has worked to convert this draft into a genome sequence with high accuracy and nearly complete coverage. Here, we report the result of this finishing process. The current genome sequence (Build 35) contains 2.85 billion nucleotides interrupted by only 341 gaps. It covers ∼99% of the euchromatic genome and is accurate to an error rate of ∼1 event per 100,000 bases. Many of the remaining euchromatic gaps are associated with segmental duplications and will require focused work with new methods. The near-complete sequence, the first for a vertebrate, greatly improves the precision of biological analyses of the human genome including studies of gene number, birth and death. Notably, the human enome seems to encode only 20,000-25,000 protein-coding genes. The genome sequence reported here should serve as a firm foundation for biomedical research in the decades ahead

Surviving Sepsis Campaign: international guidelines for management of severe sepsis and septic shock, 2012

OBJECTIVE: To provide an update to the "Surviving Sepsis Campaign Guidelines for Management of Severe Sepsis and Septic Shock," last published in 2008. DESIGN: A consensus committee of 68 international experts representing 30 international organizations was convened. Nominal groups were assembled at key international meetings (for those committee members attending the conference). A formal conflict of interest policy was developed at the onset of the process and enforced throughout. The entire guidelines process was conducted independent of any industry funding. A stand-alone meeting was held for all subgroup heads, co- and vice-chairs, and selected individuals. Teleconferences and electronic-based discussion among subgroups and among the entire committee served as an integral part of the development. METHODS: The authors were advised to follow the principles of the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to guide assessment of quality of evidence from high (A) to very low (D) and to determine the strength of recommendations as strong (1) or weak (2). The potential drawbacks of making strong recommendations in the presence of low-quality evidence were emphasized. Recommendations were classified into three groups: (1) those directly targeting severe sepsis; (2) those targeting general care of the critically ill patient and considered high priority in severe sepsis; and (3) pediatric considerations. RESULTS: Key recommendations and suggestions, listed by category, include: early quantitative resuscitation of the septic patient during the first 6 h after recognition (1C); blood cultures before antibiotic therapy (1C); imaging studies performed promptly to confirm a potential source of infection (UG); administration of broad-spectrum antimicrobials therapy within 1 h of the recognition of septic shock (1B) and severe sepsis without septic shock (1C) as the goal of therapy; reassessment of antimicrobial therapy daily for de-escalation, when appropriate (1B); infection source control with attention to the balance of risks and benefits of the chosen method within 12 h of diagnosis (1C); initial fluid resuscitation with crystalloid (1B) and consideration of the addition of albumin in patients who continue to require substantial amounts of crystalloid to maintain adequate mean arterial pressure (2C) and the avoidance of hetastarch formulations (1B); initial fluid challenge in patients with sepsis-induced tissue hypoperfusion and suspicion of hypovolemia to achieve a minimum of 30 mL/kg of crystalloids (more rapid administration and greater amounts of fluid may be needed in some patients (1C); fluid challenge technique continued as long as hemodynamic improvement is based on either dynamic or static variables (UG); norepinephrine as the first-choice vasopressor to maintain mean arterial pressure ≥65 mmHg (1B); epinephrine when an additional agent is needed to maintain adequate blood pressure (2B); vasopressin (0.03 U/min) can be added to norepinephrine to either raise mean arterial pressure to target or to decrease norepinephrine dose but should not be used as the initial vasopressor (UG); dopamine is not recommended except in highly selected circumstances (2C); dobutamine infusion administered or added to vasopressor in the presence of (a) myocardial dysfunction as suggested by elevated cardiac filling pressures and low cardiac output, or (b) ongoing signs of hypoperfusion despite achieving adequate intravascular volume and adequate mean arterial pressure (1C); avoiding use of intravenous hydrocortisone in adult septic shock patients if adequate fluid resuscitation and vasopressor therapy are able to restore hemodynamic stability (2C); hemoglobin target of 7-9 g/dL in the absence of tissue hypoperfusion, ischemic coronary artery disease, or acute hemorrhage (1B); low tidal volume (1A) and limitation of inspiratory plateau pressure (1B) for acute respiratory distress syndrome (ARDS); application of at least a minimal amount of positive end-expiratory pressure (PEEP) in ARDS (1B); higher rather than lower level of PEEP for patients with sepsis-induced moderate or severe ARDS (2C); recruitment maneuvers in sepsis patients with severe refractory hypoxemia due to ARDS (2C); prone positioning in sepsis-induced ARDS patients with a PaO (2)/FiO (2) ratio of ≤100 mm Hg in facilities that have experience with such practices (2C); head-of-bed elevation in mechanically ventilated patients unless contraindicated (1B); a conservative fluid strategy for patients with established ARDS who do not have evidence of tissue hypoperfusion (1C); protocols for weaning and sedation (1A); minimizing use of either intermittent bolus sedation or continuous infusion sedation targeting specific titration endpoints (1B); avoidance of neuromuscular blockers if possible in the septic patient without ARDS (1C); a short course of neuromuscular blocker (no longer than 48 h) for patients with early ARDS and a PaO (2)/FI O (2) 180 mg/dL, targeting an upper blood glucose ≤180 mg/dL (1A); equivalency of continuous veno-venous hemofiltration or intermittent hemodialysis (2B); prophylaxis for deep vein thrombosis (1B); use of stress ulcer prophylaxis to prevent upper gastrointestinal bleeding in patients with bleeding risk factors (1B); oral or enteral (if necessary) feedings, as tolerated, rather than either complete fasting or provision of only intravenous glucose within the first 48 h after a diagnosis of severe sepsis/septic shock (2C); and addressing goals of care, including treatment plans and end-of-life planning (as appropriate) (1B), as early as feasible, but within 72 h of intensive care unit admission (2C). Recommendations specific to pediatric severe sepsis include: therapy with face mask oxygen, high flow nasal cannula oxygen, or nasopharyngeal continuous PEEP in the presence of respiratory distress and hypoxemia (2C), use of physical examination therapeutic endpoints such as capillary refill (2C); for septic shock associated with hypovolemia, the use of crystalloids or albumin to deliver a bolus of 20 mL/kg of crystalloids (or albumin equivalent) over 5-10 min (2C); more common use of inotropes and vasodilators for low cardiac output septic shock associated with elevated systemic vascular resistance (2C); and use of hydrocortisone only in children with suspected or proven "absolute"' adrenal insufficiency (2C). CONCLUSIONS: Strong agreement existed among a large cohort of international experts regarding many level 1 recommendations for the best care of patients with severe sepsis. Although a significant number of aspects of care have relatively weak support, evidence-based recommendations regarding the acute management of sepsis and septic shock are the foundation of improved outcomes for this important group of critically ill patients

Diversity and Ethnobotanical Importance of Pine Species from Sub-Tropical Forests, Azad Jammu and Kashmir

A general investigation of sub-tropical forests, from Pir Chinasi National Park, Tolipir National Park, Dhirkot Nature Reserve and Banjosa Game Reserve was carried out during different months from February 2008 to May 2010. The relative abundance of species was calculated using line transects of 50m. A total of five different species (Abies pindrow. Cedrus deodara, Pinus wallichiana, Pinus roxburgii and Picea smithiana) from the Pinaceae family were recorded. The main reported use of Cedrus deodara and Pinus wallichiana by the local people was for furniture and construction purposes. Pinus wallichiana was observed as the dominant species from all the selected sites

An Annotated Checklist of Butterflies at Elevated Protected Areas of Pakistan

Different vegetation types, cater to the needs of butterflies at different stages of their life cycle. Some caterpillars are specific in their diet and egg-laying, such as the caterpillar of the Monarch butterfly, which mainly consumes leaves of milkweed and hence prefers laying eggs on this plant (Faldyn et al., 2018). This entomological research was undertaken at protected areas of Pakistan that include Dhirkot Nature Reserve, Pir Chanasi National Park, Banjosa Game Reserve, Pir Lasura National Park and Tolipir National Park. Forty-four different species of butterflies were recorded from the study area. The highest diversity of butterflies was observed from PCNP (34) and least from PLNP (15)