Sensitivity and specificity of CT scan in small bowel obstruction among children

Objective: To determine the sensitivity and specificity of computed tomography scan for diagnosing small bowel obstruction among children.Methods: The retrospective diagnostic test accuracy study was carried out at the Aga Khan University Hospital, Karachi, and comprised data of all patients aged 2-16 years who presented with clinical features of small bowel obstruction and underwent computed tomography scan of abdomen from January 2001 to December 2015Data was analyzed using SPSS19.Results: Of the 98 subjects, 65(66.0%) were males and 33(34.0%) were females. Overall mean age of the patients was 7.67±4.33 years and mean duration of symptoms was 2.84±1.17 days. Sensitivity, specificity, positive and negative predictive values as well as accuracy of computed tomography scan was 97.4%, 81.8%, 94.9%, 90.0% and 93.9% respectively.Conclusions: CT scan was found to have a high sensitivity, fairly good specificity and accuracy in revealing small bowel obstruction. However, the scan is known to have its limitations in sub-acute intestinal obstruction and primary peritoniti

Frequency of cognitive impairment in patients with parkinson\u27s disease

Introduction More than its motor symptoms, cognitive impairment is being increasingly identified as a cause of worse functional outcome, morbidity and mortality, and caregiver dependence in Parkinson\u27s disease (PD). The aim of this study was to identify the frequency of cognitive decline and evaluate the factors associated with it. Methods In this cross-sectional study, 124 PD patients fulfilling the United Kingdom Parkinson\u27s Disease Society Brain Bank Clinical Diagnostic Criteria were included. Motor and non-motor symptoms were recorded. Disease duration, age at the time of onset, and severity of disease on Hoehn and Yahr Scale (HY scale) were recorded. Data was entered and analyzed using SPSSs v. 22.0. Results The ratio of men to women was 7.2:1. The mean age of the participants was 64 ± 10 years (range: 38-82 years). Rigidity (n = 121; 97.5%), bradykinesia (n = 119; 95.9%), and tremor (n = 11; 90.3%) were the three most common symptoms. Cognitive impairment was present in 45 (36.3%) patients. Cognitive decline was more frequent in patients of age less than 50 years at the time of disease onset (p \u3c 0.00001) and in those with disease duration more than 10 years (p = 0.00001). Patients with longer disease duration had more severe disease (stage III or above on HY scale; p = 0.008). Conclusion Motor symptoms such as rigidity, bradykinesia, and tremor remain the most frequent clinical presentation among Pakistani Parkinson\u27s patients. One-third of these patients have cognitive dysfunction. Early age at the time of disease onset and longer duration of disease were associated with cognitive impairmen

A Comprehensive Review on Impact of Microorganisms on Soil and Plant

Soils have the most diversified microbial communities of any environment on the planet. Bacteria, fungi, algae, and protozoa are all found in abundance in soil. Maintaining a healthy environment for crops requires a strong link between plants and soil microorganisms that are essential for good crop development. Soil bacteria are key regulators of the nutrient cycle. Mineralization, legume nitrogen fixation, and ammonia conversion to plant-available nitrate would all be impossible without bacteria. Effective microorganisms have the ability to boost crop growth and yield. When used in conjunction with organic amendments, these bacteria performs better than to the sole application. It also contributes to soil health and provides a variety of ecological services. They also help in the cleaning of the environment, landfill disinfection, and the development and implementation of sustainable, closed-cycle organic waste treatment processes across the globe. The whole study remarks a conclusion that the application or presence of effective microbes to soil not only enhance the nutritional capacity, fertility and productivity of soils but also helps to remediate soil problems cost effectively

Do Anti-Epilepsy Drugs Increase Suicide Ideation Risk In Epilepsy Patients?

Objective: To determine the frequency of suicide risk within first six months after starting anti-epilepsy treatment. Methodology: This Descriptive cross-sectional study conducted at department of Medicine, Jinnah Hospital Allama Iqbal Medical College Lahore Pakistan from January 2019 to January 2020.The Scale of Suicidal Ideation (SCI)consists of 19 items which were used to evaluate patients’ suicidal intentions and to monitor patients’ response tointerventions over time. Patients with diagnosed psychiatric illness such as depression and schizophrenia, past historyof suicidal attempts and patients with poor drug compliance were excluded. After informed consent, 140 epilepticpatients, who had been recently started on anti-epilepsy medicines, aged 20 to 55 years of both gender were enrolled using non-probability consecutive sampling technique. Demographic information and detailed medical history were noted and patients were assessed for suicide risk using the Scale of Suicidal Ideation (SCI). All data was recorded and analyzed using SPSS version 23.0. Results: Mean age was 28.9±6.3 years with 104 (74.3%) males and 36 (25.7%) females. Sixty-eight (48.6%) patients belonged to low socio-economic status whereas 29 (20.7%) and 43 (30.7%) patients were from middle and high Socio-economic Status respectively. Sixty-eight (48.6%) patients were illiterate while 42 (30.0%) and 30 (21.4%) patients had educational status of up to matriculation and graduate or above respectively. In the present study, 46 (32.8%) patients had suicidal ideation with low socio-economic status  (p-value 0.013)  and illiterate educational status (p-value 0.002) having statistically significant association with suicidal ideation. Conclusion: Suicidal ideation was seen in almost one-third epilepsy patients on anti-epileptic drugs with low socioeconomic status and illiterate educational status being significant risk factor

Chemical Characterisation, Antidiabetic, Antibacterial, and In Silico Studies for Different Extracts of Haloxylon stocksii (Boiss.) Benth: A Promising Halophyte

The objective of the study is to evaluate the chemical characterisation, and biological and in silico potential of Haloxylon stocksii (Boiss.) Benth, an important halophyte commonly used in traditional medicine. The research focuses on the roots and aerial parts of the plant and extracts them using two solvents: methanol and dichloromethane. Chemical characterisation of the extracts was carried out using total phenolic contents quantification, GC-MS analysis, and LC-MS screening. The results exhibited that the aerial parts of the plant have significantly higher total phenolic content than the roots. The GC-MS and LC-MS analysis of the plant extracts revealed the identification of 18 bioactive compounds in each. The biological evaluation was performed using antioxidant, antibacterial, and in vitro antidiabetic assays. The results exhibited that the aerial parts of the plant have higher antioxidant and in vitro antidiabetic activity than the roots. Additionally, the aerial parts of the plant were most effective against Gram-positive bacteria. Molecular docking was done to evaluate the binding affinity (BA) of the bioactive compounds characterised by GC-MS with diabetic enzymes used in the in vitro assay. The results showed that the BA of γ-sitosterol was better than that of acarbose, which is used as a standard in the in vitro assay. Overall, this study suggests that the extract from aerial parts of H. stocksii using methanol as a solvent have better potential as a new medicinal plant and can provide a new aspect to develop more potent medications. The research findings contribute to the scientific data of the medicinal properties of Haloxylon stocksii and provide a basis for further evaluation of its potential as a natural remedy

Improving psychosocial distress for young adolescents in rural schools of Pakistan: study protocol of a cluster randomised controlled trial.

Introduction Emotional problems are leading contributors to health burden among adolescents worldwide. There is an urgent need for evidence-based psychological interventions for young people. This study aims to evaluate the effectiveness of a school-based, group psychological intervention, Early Adolescent Skills for Emotions (EASE) developed by the WHO to improve psychosocial distress in Pakistani adolescents. Method and analysis A two-arm, single-blinded, cluster randomised controlled trial, with a wait-list control arm is being conducted in school settings of rural Pakistan. Forty eligible public-school clusters have been randomised (stratified by gender) on a 1:1 allocation ratio into intervention (n=20) and control arm (n=20). Following informed consent, 564 adolescents with psychosocial distress (Youth-reported Paediatric Symptoms Checklist, cut-off ≥28) from 40 schools have been enrolled into the trial (14±3 average cluster size) between 2 November 2021 and 30th November 2021. Participants in the intervention arm will receive EASE in 7-weekly adolescents and 3-biweekly caregivers group sessions in schools. The adolescent sessions involve the components of psychoeducation, stress management, behavioural activation, problem-solving and relapse prevention. Caregivers will receive training to learn and implement active listening; spending quality time and using praise as a strategy to help their children. The primary outcome is reduction in psychosocial distress at 3 months postintervention. Secondary outcomes include symptoms of depression and anxiety, caregiver–adolescent relationship and caregivers’ well-being. Outcomes will be assessed at baseline, immediate 1 week and 3-months postintervention. Qualitative process evaluation will explore barriers and facilitators to programme implementation in low-resource school settings. Ethics Ethics approval has been obtained from Central Ethics Committee of University of Liverpool, UK, Ethics Review Committee of WHO Geneva and from the Institutional Review Board of Human Development Research Foundation (HDRF), Pakistan. Dissemination The findings of the study will be disseminated by WHO and through peer-reviewed publications

Evaluation of the anti-inflammatory, antioxidant, and cytotoxic potential of Cardamine amara L. (Brassicaceae): A comprehensive biochemical, toxicological, and in silico computational study

Introduction:Cardamine amara L. (Brassicaceae) is an important edible plant with ethnomedicinal significance. This study aimed at evaluating the phytochemical composition, anti-inflammatory, antioxidant and cytotoxicity aspects of the hydro-alcoholic extract of C. amara (HAECA).Methods: The phytochemical composition was evaluated through total phenolic contents (TPC), total flavonoid contents (TFC) determination and UPLC-QTOF-MS profiling. Anti-inflammatory evaluation of HAECA was carried out through the carrageenan induced paw edema model. Four in vitro methods were applied in the antioxidant evaluation of HAECA. MTT assay was used to investigate the toxicity profile of the species against human normal liver cells (HL7702), human liver cancer cell lines (HepG2) and human breast cancer cell lines (MCF-7). Three major compounds (Gentisic acid, skullcapflavone and conidendrine) identified in UPLC-Q-TOF-MS analysis were selected for in silico study against cyclooxygenase (COX-I and COX-II).Results and Discussion: The findings revealed that HAECA is rich in TPC (39.32 ± 2.3 mg GAE/g DE) and TFC (17.26 ± 0.8 mg RE/g DE). A total of 21 secondary metabolites were tentatively identified in UPLC-Q-TOF-MS analysis. In the MTT cytotoxicity assay, the extract showed low toxicity against normal cell lines, while significant anticancer activity was observed against human liver and breast cancer cells. The carrageenan induced inflammation was inhibited by HAECA in a dose dependent manner and showed a marked alleviation in the levels of oxidative stress (catalase, SOD, GSH) and inflammatory markers (TNF-α, IL-1β). Similarly, HAECA showed maximum antioxidant activity through the Cupric reducing power antioxidant capacity (CUPRAC) assay (31.21 ± 0.3 mg TE/g DE). The in silico study revealed a significant molecular docking score of the three studied compounds against COX-I and COX-I. Conclusively the current study encourages the use of C. amara as a novel polyphenolic rich source with anti-inflammatory and antioxidant potential and warrants further investigations on its toxicity profile

Exploring the themes for Quality Assurance at Secondary Level in Punjab: A Document Analysis

Quality assurance (Q.A.) in education is the process of ensuring that educational programs and services meet established standards and expectations. This study aimed to explore themes for quality assurance in secondary schools at the Punjab level to enhance and evaluate the quality assurance process. In order to support in-depth realities, the exploration study is grounded in the interpretivism research paradigm. Data were collected by using the document analysis technique on quality assurance standards documents implemented in different countries around the world; In-depth qualitative analysis was performed with the use of NVivo 12 software. The study's various themes have been confirmed via the use of numerous methods, including Coding Nodes, Word Trees, Word Tag Clouds, and Treemaps. Documents from eleven countries were selected to achieve the study’s objective; the most updated and relative themes were extracted and presented diagrammatically and in tabular form. A total of twelve themes were found through a thematic analysis process. Twelve themes were explored and named 1)assessment;2)community involvement; 3)curriculum; 4)early childhood education;5)school environments; 6)school ethos and value;.7)Facilities for schools;8)H)school administration and management, 9)school quality management and improvement. 10)School Mission, Vision, and Objectives ,11)Teacher Standards,12)Student Standards This research study is applicable at the secondary school level in the quality assurance process. The research finding highlighted the most relevant themes/factors used in quality assurance process; to enhance or evaluate the quality assurance practices. The outcome of this research study bridges the gap in the existing literature by offering empirical knowledge on the school quality assurance process at the secondary school level. This is the first research done in an Asian setting to focus specifically on quality assurance and its associated themes and processes. This study may eventually improve educational standards and student performance