Screening for cystic fibrosis: The importance of using the correct tools

Background: Cystic Fibrosis (CF) is a potentially lethal genetic disorder. The most frequent mutation worldwide in the Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) gene is designated as the Delta F508 mutation. This mutation was found in only 33% of Pakistani patients studied. Since the common Pakistani mutations remain to be identified, appropriate screening tools are required to identify disease. Sweat chloride determinations remain the gold standard for diagnosing CF. This study was done to emphasize the importance of using the correct tests.Methods: The study was conducted at the Aga Khan University Hospital. The CFTR delta F508 mutation was tested on blood samples from patients suspected with CF. Sweat chloride analysis using pilocarpine iontopharesis was done with a positive value of greater than 60 meq/L.Results: 57 pediatric samples were screened for the delta F508 mutation and were positive in only 10.6% of all patients tested. 12/57 (21%) had a preliminary sweat test. 6/12 (50%) of these patients had an abnormal sweat test and 3/6 patients with an abnormal sweat chloride (50%) had deltaF508 mutations-- 2/6 (33%) were homozygotes and 1 was a compound heterozygote. Since 79% did not have a sweat test, it was difficult to assess whether this subset of patients had cystic fibrosis with a CFTR mutation other than the delta F508 tested or no CF.Conclusion: Sweat chloride analysis is critical to distinguish CF from other causes of severe pulmonary and pancreatic insufficiencies and to define patients requiring further analysis

Role of Diversity-Focused HR Practices in Mitigating Deviant Workplace Behavior: A Review

Organizations in today's scenario are faced with a large number of HRM challenges resulting from workforce diversity. Workforce diversity has become one of the most pertinent management issues in organizations from all sectors and changing workforce has required organizations to change how they think about HRM. It is quite evident that all organizations are impacted by diversity either directly or indirectly, which has made it significant for organizations to manage diversity for which HRM plays a very significant role. Thus, due to the diverse nature of workforce, it has become significant for organizations to make their HR practices diversity-oriented so that deviant workplace behaviors are reduced to minimal. It is believed that employees will not indulge in deviant workplace behaviors when they perceive their organizations to be adopting adequate and diversity-oriented HRM methods and practices. Given this contention, the purpose of this paper is to examine the role that diversity-focused HR practices play in mitigating the deviant workplace behaviors in organizations. An extensive literature review on the said constructs was conducted where both variables were studied independently and the relationship that both variables exhibit together was also studied. A systematic review of the literature was carried out with the keywords like diversity management, diversity-focused HR practices and deviant workplace behavior from several electronic databases like Google scholar, emerald insight, Springer, Taylor, and Francis

The 1:1 adduct of caffeine and 2-(1,3-dioxoisoindolin-2-yl)acetic acid

In the crystal structure of the title adduct [systematic name: 2-(1,3-dioxoisoindolin-2-yl)acetic acid–1,3,7-trimethyl-1,2,3,6-tetra­hydro-7H-purine-2,6-dione (1/1)], C8H10N4O2·C10H7NO4, the components are linked by an O—H⋯N hydrogen-bond and no proton transfer occurs

catena-Poly[[diaqua­calcium]bis­[μ-2-(1,3-dioxoisoindolin-2-yl)acetato]-κ3 O,O′:O;κ3 O:O,O′]

In the title complex, [Ca(C10H6NO4)2(H2O)2]n, the CaII atom lies on a twofold rotation axis and adopts a dodeca­hedral geometry. The CaII atom is octa­coordinated by two O atoms from two water mol­ecules and six O atoms from four acetate ligands. Each acetate acts as a tridentate ligand bridging two CaII atoms, resulting in a chain running along the c axis. O—H⋯O and C—H⋯O hydrogen bonds connect the chains into a two-dimensional network parallel to [011]. π–π inter­actions between adjacent isoindoline-1,3-dione rings [centroid–centroid distance = 3.4096 (11) Å] further consolidate the structure. One of the carboxylate O atoms is disordered over two sites in a 0.879 (12):0.121 (12) ratio

Survival Analysis of Dialysis Patients Under Parametric and Non-Parametric Approaches

Dialysis is a recommended way of treatment for end stage kidney diseases and it provides a life saving procedure. Transplantation can also be useful source but it is restricted by financial limitations especially in developing countries like Pakistan. Censoring is an important part of the survival data which causes insensitivity to the usual procedures of analysis. A little work has been done in literature regarding the estimated survival time of dialysis patients in Pakistan. So, this study has estimated the median survival time of male/females patients separately by parametric and non-parametric approaches. Moreover, comparison of survival time to patients (50 years) was also compared. Frequently, in modeling the survival data, most of the time we have no prior information about the theoretical distribution of survival time is available, that’s why, and non-parametric methods are commonly used. The significance of this study is the fitting of probability distribution of real life time data of dialysis patients which is not done before. It is very laborious job to fit an appropriate distribution of the data. We find that the probability distribution of our real life time data is weibull distribution. Finding suggested that the Kaplan-Meier method and weibull model based on Anderson-Darling test provided a very close estimate of the survival function in both genders and age groups. On the average survival time in males is relatively high but not statistically different from females

Laparoscopic adjustable gastric banding – should a second chance be given?

Background: Obesity is a chronic relapsing-remitting disease and a global pandemic, being associated with multiple comorbidities. Laparoscopic adjustable gastric banding (LAGB) is one of the safest surgical procedures used for the treatment of obesity, and even though its popularity has been decreasing over time, it still remains an option for a certain group of patients, producing considerable weight loss and improvement in obesity-associated comorbidities. Methods: The aim of this study was to evaluate the impact of weight loss following LAGB on obesity-associated comorbidities, and to identify factors that could predict better response to surgery, and patient sub-groups exhibiting greatest benefit. A total of 99 severely obese patients (81.2% women, mean age 44.19 ± 10.94 years, mean body mass index (BMI) 51.84 ± 8.77 kg/m2) underwent LAGB in a single institution. Results obtained 1, 2, and 5 years postoperatively were compared with the pre-operative values using SPPS software version 20. Results: A significant drop in BMI was recorded throughout the follow-up period, as well as in A1c and triglycerides, with greatest improvement seen 2 years after surgery (51.8 ± 8.7 kg/m2 vs 42.3 ± 9.2 kg/m2, p < 0.05, 55.5 ± 19.1 mmol/mol vs 45.8 ± 13.7 mmol/mol, p < 0.05, and 2.2 ± 1.7 mmol/l vs 1.5 ± 0.6 mmol/l). Better outcomes were seen in younger patients, with lower duration of diabetes before surgery, and lower pre-operative systolic blood pressure. Conclusions: Younger age, lower degree of obesity, and lower severity of comorbidities at the time of surgery can be important predictors of successful weight loss, making this group of patients the ideal candidates for LAGB

Effectiveness of 17-Alpha-Hydroxyprogesterone in the Prevention of Preterm Labour

Objective: To compare the effectiveness of 17-Alpha- Hydroxyprogesterone in preventing preterm labour. Study Design: Prospective longitudinal study. Place and Duration of Study: Department of Obstetrics and Gynecology, Combined Military Hospital, Sakardu Pakistan, from Jun to Dec 2019. Methodology: A total of 208 patients (104 in each group) were recruited in this study. Group-A 17-alpha-hydroxyprogesterone (250mg) intramuscular injection was given weekly from 20-36 weeks of gestation or delivery, whichever occurred first. GroupB (Control Group) received no treatment except routine antenatal care but was treated actively with tocolytic drugs and corticosteroids if they presented with preterm labour. Results: Mean age of the patients was 26.1±4.9 and 25.7±4.5 in Group-A and B, respectively. In Group-A (17-alphahydroxyprogesterone), the mean gestational age at delivery was 36.8±3.8; in Group-B (control), the mean gestational age was 35.7±1.3. Treatment was efficacious in 82 patients (78.8%) in Group-A and 65(62.5%) in Group-B. The difference was statistically significant between the two groups (p=0.009). Conclusion: 17 Alpha-Hydroxyprogesterone caproate preventive therapy likely plays an important role in reducing the risk of recurrent preterm birth

Biochar affects growth and biochemical activities of fenugreek (Trigonella corniculata) in cadmium polluted soil

Cadmium (Cd) has no defined biological role and may enter the food chain from polluted soils. Biochar has been proposed as an organic amendment to minimize the toxic effects of Cd for plants grown on contaminated soils. In this study, biometric and biochemical attributes of fenugreek (Trigonella corniculata) grown on artificially cadmium (Cd) contaminated soil (0, 25, 50, 75 and 100 mg Cd/kg soil) at three levels of cotton-sticks derived biochar (CSB; 0, 3 and 5 %) were studied. Data show significant decline in the growth, photosynthetic pigments (chlorophyll a, b and total, carotenoids, anthocyanin and lycopene), and physiological attributes (sub-stomatal CO2 concentrations, photosynthetic and transpiration rate) in the presence of high Cd concentrations (50 and 100 mg Cd/kg soil). However, the decline was reduced in the presence of CSB. A steady amplification in lipid peroxidation (assessed via Malondialdihyde (MDA)) and ascorbic-acid assembly was noted with increasing Cd. The concentration of Cd in the root and shoot also decreased with increasing CSB application rates from 3 % - 5 %.Overall, the greater production of protein, amino acids and sugar contents in response to higher application rates of CSB seems to be due to alleviation in Cd toxicity. Thus, cotton-sticks can be safely utilized in the form of biochar as amendment with additional benefit of reducing Cd bioavailability and toxicity to crop plants

Beta-Blocker Use Is Associated With Impaired Left Atrial Function in Hypertension

BACKGROUND: Impaired left atrial (LA) mechanical function is present in hypertension and likely contributes to various complications, including atrial arrhythmias, stroke, and heart failure. Various antihypertensive drug classes exert differential effects on central hemodynamics and left ventricular function. However, little is known about their effects on LA function. METHODS AND RESULTS: We studied 212 subjects with hypertension and without heart failure or atrial fibrillation. LA strain was measured from cine steady-state free-precession cardiac MRI images using feature-tracking algorithms. In multivariable models adjusted for age, sex, race, body mass index, blood pressure, diabetes mellitus, LA volume, left ventricular mass, and left ventricular ejection fraction, beta-blocker use was associated with a lower total longitudinal strain (standardized beta=-0.21; P=0.008), and lower LA expansion index (standardized beta=-0.30; P \u3c 0.001), indicating impaired LA reservoir function. Beta-blocker use was also associated with a lower positive strain (standardized beta=-0.19; P=0.012) and early diastolic strain rate (standardized beta=0.15; P=0.039), indicating impaired LA conduit function. Finally, beta-blocker use was associated with a lower (less negative) late-diastolic strain (standardized beta=0.15; P=0.049), strain rate (standardized beta=0.18; P=0.019), and a lower active LA emptying fraction (standardized beta=-0.27; P\u3c 0.001), indicating impaired booster pump function. Use of other antihypertensive agents was not associated with LA function. CONCLUSIONS: Beta-blocker use is significantly associated with impaired LA function in hypertension. This association could underlie the increased risk of atrial fibrillation and stroke seen with the use of beta-blockers (as opposed to other antihypertensive agents) demonstrated in recent trials

Bio-techniques for improvement of qualitative and quantitative traits in walnut (Juglans regia)

Walnut, Juglans regia (L.) is an economically significant plant for its immense nutritive and economic value. The breeding character of walnut has lent it a wide diversity in genetic characteristics. The principal vegetative and common traditional agronomic traits together with biochemical characterization i.e., karyotyping and isoenzyme expression have been the early research methods. However, these techniques are time-consuming and susceptible to the environmental variations. Literature is meager in the distribution, applied applications in general and the use of agriculture biotechnology in particular in case of walnut plants. The bio-techniques like molecular markers are adequate in number and there is little or no diversity in the method employed for research on walnuts. Despite basic research method, the organization of information, its retrieval and presentation structures, form elaboration experienced immense advancement via molecular markers such as RFLP, ISSR, RAPD AFLP, SSR and SNP. This appraisal in its first part provides detailed information regarding the present scenario of data on biogeographical distribution, health benefits of walnut worldwide and current applications in the agroforestry management, biochemical evaluations and applied uses of a walnut tree which is relevant for both basic and applied research. The review in its second part sheds light on the application of sophisticated agricultural biotechnology techniques such as use of molecular markers to evaluate, realize the full potential of walnut for increasing its quality, quantity and for its sustainable production which cannot be obtained through usual breeding techniques to meet the demands of a projected world population