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

The many guises of primary hyperparathyroidism… an unchanged scenario

Abstract OBJECTIVE: To study the causes, characteristics and outcome of treatment of patients with primary hyperparathyroidism. METHODS: This retrospective cohort analysis was conducted at the Jinnah Postgraduate Medical Centre, Karachi, and comprised data of patients with primary hyperparathyroidism between 2004 and 2014. .SPSS 17 was used for data analysis. RESULTS: Of the 25 patients,1(4%)was male and 24(96%) were female. The overall mean age was 41.72±15.9 years, with a mean duration of symptoms of 4.1±3.3 years. The mean pre-operative parathyroid hormone level was 879.48±793.51 pg/ml. Skeletal manifestations were reported in 17(68%) patients, whereas 4(16%) patients had renal stone disease. Besides, 2(8.0%) patients presented with severe abdominal pain, 1(4%) had asymptomatic hypercalcaemia and 1(4%) patient presented with headache and was diagnosed as parathyroid adenoma in the context of multiple endocrine neoplasia type 2A. All patients underwent parathyroidectomy. A solitary adenoma was reported in 23(92%) patients, carcinoma in 1(4%) and an adenoma with hyperplasia of other glands in 1(4%) patient. CONCLUSIONS: A high index of suspicion is required for early diagnosis of primary hyperparathyroidism

Carbapenem Resistant Pseudomonas aeruginosa, Enterobacteriaceae, and Acinetobacter baumannii , Prevalence, Biochemical Identification and Clinical Characteristics in Karachi, Pakistan

Antibiotic resistant pathogens are affecting the community and healthcare institutions all over the world. Pakistan is a developing country and resistance to drugs is the main issue and is of great importance. Current study is focused on isolation and identification of bacterial pathogens, i.e. member of Enterobacteriaceae, Pseudomonas aeruginosa and Acinetobacter baumannii for the evaluation of prevalence, distribution of sensitivity and antibiogram of different antibiotics and carbapenem resistance isolates with phenotypic detection of resistant gene. Total 200 samples of different sources were collected and tested for bacterial pathogens. Out of 200 samples, 83 (41.5%) were found positive for different bacterial pathogens while 117 (58.5%) were negative. Among these 83 positive samples, Urine 43 (51.8%), Pus 22 (26.5%), Blood 8 (9.8%), Tissue 3 (3.6%), wound swab 2 (2.4%), Sputum 3 (3.6%) and HVS 2 (2.4%). E. coli 37 (44.6%), Klebsiella species 23 (27.7%), Proteus vulgaris 8 (9.6%), Ps. aeruginosa 4 (4.8%), Acinetobacter baumannii 4 (4.8%), C. freundii 2 (2.4%), S. typhi 2 (2.4%), P. mirabilis 1 (1.2%), M. morganii 1 (1.2%) and member of Enterobacteriaceae 1 (1.2%) were identified. Out of 83 (41.5%) positive samples there are 17 samples which showed resistance against Imipenem (IPM) and were further processed by phenotypic method Modified Hodge Test MHT. After Modified Hoge Test (MHT) among all these 17 samples there were only 07 (39%) positive and the remaining 11 (61%) were negative, its mean there was no gene involve in 11 samples

Interactions between visual and semantic processing during object recognition revealed by modulatory effects of age of acquisition

The age of acquisition (AoA) of objects and their names is a powerful determinant of processing speed in adulthood, with early-acquired objects being recognized and named faster than late-acquired objects. Previous research using fMRI (Ellis et al., 2006. Traces of vocabulary acquisition in the brain: evidence from covert object naming. NeuroImage 33, 958–968) found that AoA modulated the strength of BOLD responses in both occipital and left anterior temporal cortex during object naming. We used magnetoencephalography (MEG) to explore in more detail the nature of the influence of AoA on activity in those two regions. Covert object naming recruited a network within the left hemisphere that is familiar from previous research, including visual, left occipito-temporal, anterior temporal and inferior frontal regions. Region of interest (ROI) analyses found that occipital cortex generated a rapid evoked response (~ 75–200 ms at 0–40 Hz) that peaked at 95 ms but was not modulated by AoA. That response was followed by a complex of later occipital responses that extended from ~ 300 to 850 ms and were stronger to early- than late-acquired items from ~ 325 to 675 ms at 10–20 Hz in the induced rather than the evoked component. Left anterior temporal cortex showed an evoked response that occurred significantly later than the first occipital response (~ 100–400 ms at 0–10 Hz with a peak at 191 ms) and was stronger to early- than late-acquired items from ~ 100 to 300 ms at 2–12 Hz. A later anterior temporal response from ~ 550 to 1050 ms at 5–20 Hz was not modulated by AoA. The results indicate that the initial analysis of object forms in visual cortex is not influenced by AoA. A fastforward sweep of activation from occipital and left anterior temporal cortex then results in stronger activation of semantic representations for early- than late-acquired objects. Top-down re-activation of occipital cortex by semantic representations is then greater for early than late acquired objects resulting in delayed modulation of the visual response

Magnetoencephalographic (MEG) Investigation of the Neural Correlates of Age-of-Acquisition effects

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Video based learning vs instructor led training for optimizing personal protective equipment use to prevent Covid-19 infection- a comparative study

Objective: To evaluate two different types of education and training aids to improve compliance with guidelines related to personal protective equipment in healthcare workers. Methods: The quasi-experimental study was conducted at the Department of Gynaecology and Obstetrics, Combined Military Hospital, Rawalpindi, from July 1 to December 31, 2020, and comprised healthcare personnel who were divided into two equal groups. Group A received weekly instructor-led training session of donning and doffing for two hours. Group B was assigned to watch 30-min training videos weekly. After one month, an independent instructor evaluated both the groups using validated checklists, with maximum score 8 for donning and 14 for doffing. Data was analysed using SPSS 22. Results: Of the 60 subjects, 34(56.6%) were females and 26(43.3%) were males. There were 30(50%) subjects in group A with a mean age of 35.35±5.67years, and the remaining 30(50%) were n group B with a mean age of 33.12±4.13 years. There was no significant difference in donning and doffing scores between the groups (p>0.05). Conclusion: Both types of education and training aids could be used to improve compliance with guidelines related to personal protective equipment in healthcare workers. Key Words: Covid-19, Donning, Doffing, Personal protective equipment

The neural basis of the right visual field advantage in reading: an MEG analysis using virtual electrodes

Right-handed participants respond more quickly and more accurately to written words presented in the right visual field (RVF) than in the left visual field (LVF). Previous attempts to identify the neural basis of the RVF advantage have had limited success. Experiment 1 was a behavioral study of lateralized word naming which established that the words later used in Experiment 2 showed a reliable RVF advantage which persisted over multiple repetitions. In Experiment 2, the same words were interleaved with scrambled words and presented in the LVF and RVF to right-handed participants seated in an MEG scanner. Participants read the real words silently and responded “pattern” covertly to the scrambled words. A beamformer analysis created statistical maps of changes in oscillatory power within the brain. Those whole-brain maps revealed activation of the reading network by both LVF and RVF words. Virtual electrode analyses used the same beamforming method to reconstruct the responses to real and scrambled words in three regions of interest in both hemispheres. The middle occipital gyri showed faster and stronger responses to contralateral than to ipsilateral stimuli, with evidence of asymmetric channeling of information into the left hemisphere. The left mid fusiform gyrus at the site of the ‘visual word form area’ responded more strongly to RVF than to LVF words. Activity in speech-motor cortex was lateralized to the left hemisphere, and stronger to RVF than LVF words, which is interpreted as representing the proximal cause of the RVF advantage for naming written words

An Integrated Approach for Developing an Urban Livability Composite Index—A Cities’ Ranking Road Map to Achieve Urban Sustainability

Livability is a concept that assesses the quality of life and relative performance of different regions and communities, based on various qualitative and quantitative factors. The assessment of urban livability is a complex and multidimensional task, which is of utmost importance for informed and transparent policy and decision making. The present study aimed to develop a road map for cities’ ranking on the bases of their livability. We have used a case study of eight major cities of Punjab, Pakistan. Indicators of cities’ sustainability considered for the cities’ ranking were spatial planning and growth, individual wellbeing, urban economy, connectivity and infrastructure, quality of life, and the urban environment. In the first stage, after the consolidation of socio-economic, environmental, and other indicators, they are converted into dimension indices by taking geometric means. In the second stage, the Analytical Hierarchical Process (AHP) has been employed for assigning weights to each dimension into a composite index. The results of the study depict the disparities among cities through a multidimensional analysis. Lahore is ranked as first overall from the bottom. Thus, the study recommends that, despite the high standing of Lahore on the livability ladder, it must address the issue of connectivity and traffic congestion and per capita needs of the public infrastructure for a growing mega metropolitan city of over 10 million people. Similarly, Rawalpindi is ranked as the second-best city with regard to livability in Punjab. The main contributing factors for Rawalpindi city are ‘individual well-being’, ‘urban economy’, and ‘urban environment’. Moreover, the current study also suggests important policy implications for decision makers to highlight the areas that must be reconsidered for improvement in terms of the selected indicators and dimensions

An Integrated Approach for Developing an Urban Livability Composite Index—A Cities’ Ranking Road Map to Achieve Urban Sustainability

Livability is a concept that assesses the quality of life and relative performance of different regions and communities, based on various qualitative and quantitative factors. The assessment of urban livability is a complex and multidimensional task, which is of utmost importance for informed and transparent policy and decision making. The present study aimed to develop a road map for cities’ ranking on the bases of their livability. We have used a case study of eight major cities of Punjab, Pakistan. Indicators of cities’ sustainability considered for the cities’ ranking were spatial planning and growth, individual wellbeing, urban economy, connectivity and infrastructure, quality of life, and the urban environment. In the first stage, after the consolidation of socio-economic, environmental, and other indicators, they are converted into dimension indices by taking geometric means. In the second stage, the Analytical Hierarchical Process (AHP) has been employed for assigning weights to each dimension into a composite index. The results of the study depict the disparities among cities through a multidimensional analysis. Lahore is ranked as first overall from the bottom. Thus, the study recommends that, despite the high standing of Lahore on the livability ladder, it must address the issue of connectivity and traffic congestion and per capita needs of the public infrastructure for a growing mega metropolitan city of over 10 million people. Similarly, Rawalpindi is ranked as the second-best city with regard to livability in Punjab. The main contributing factors for Rawalpindi city are ‘individual well-being’, ‘urban economy’, and ‘urban environment’. Moreover, the current study also suggests important policy implications for decision makers to highlight the areas that must be reconsidered for improvement in terms of the selected indicators and dimensions

Hydrazinyl thiazole linked indenoquinoxaline hybrids: Potential leads to treat hyperglycemia and oxidative stress; Multistep synthesis, alpha-amylase, and antioxidant activities

A library of hydrazinyl thiazole-linked indenoquinoxaline hybrids 1-36 were synthesized via a multistep reaction scheme. All synthesized compounds were characterized by various spectroscopic techniques including EI-MS (electron ionization mass spectrometry) and 1H NMR (nuclear magnetic resonance spectroscopy). Compounds 1-36 were evaluated for their inhibitory potential against alpha-amylase, and alpha-glucosidase enzymes. Among thirty-six, compounds 2, 9, 10, 13, 15, 17, 21, 22, 31, and 36 showed excellent inhibition against alpha-amylase (IC50 = 0.3-76.6 mu M) and alpha-glucosidase (IC50 = 1.1-92.2 mu M). Results were compared to the standard acarbose (IC50 = 13.5 +/- 0.2 mu M). All compounds were also evaluated for their DPPH (1,1-diphenyl-2-picrylhydrazyl) radical scavenging activity and compounds 2, 9, 10, 17, 21, 31, and 36 showed (SC50 = 7.58-125.86 mu M) as compared to the standard ascorbic acid (SC50 = 21.50 +/- 0.18 mu M). Among this library, compounds 9 and 10 with a hydroxy group on the phenyl rings and thiosemicarbazide bearing intermediate 21 were identified as the most potent inhibitors against alpha-amylase, and alpha-glucosidase enzymes. The remaining compounds were found to be moderately active. The molecular docking studies were conducted to understand the binding mode of active inhibitors and kinetic studies of the active compounds followed competitive modes of inhibition.Sindh Higher Ed-ucation Commission (SHEC) , Pakistan SHEC/1-14/2014 SHEC/SRSP/Med-3/15/2021-