Knowledge of primary paediatric care providers regarding attention deficit hyperactivity disorder and learning disorder: a study from Pakistan

Introduction: Attention deficit hyperactivity disorder (ADHD) and learning disorder (LD) remain prevalent globally and are also speculated to have a high occurrence in Pakistan. An early diagnosis and intervention in these disabilities is imperative for achieving good clinical and functional outcomes. This can be ensured by an effective screening at the level of primary paediatric care in the developing countries. We aimed to explore the ability of general practitioners (GPs) and paediatricians in Pakistan to screen for ADHD and LD based on their awareness regarding the risk factors and symptomatology of ADHD and LD. Methods: A total of 96 paediatricians and 98 GPs practising in Karachi, Pakistan were included in the study. Data was collected employing a self-administered questionnaire. Results: Only 13.7 percent of the GPs and 21.6 percent of the paediatricians were shown to have knowledge sufficient to effectively screen for / diagnose ADHD. Alarmingly, not a single GP was adequately familiar with the established risk factors and clinical symptoms of LD. The level of knowledge was not influenced by age, gender, and clinical practice attributes of the physicians. Doctors who regularly read medical journals and attend medical education seminars showed slightly better trends. Conclusion : We hypothesise that this demonstrated lack of knowledge at the level of primary care in Pakistan prevents an early screening of ADHD and LD. A multipronged strategy targeted at the provision of objective screening tools for primary paediatric care providers, regular continuing medical education seminars and an emphasis on paediatric mental health in undergraduate and postgraduate curricula may ensure an early detection of ADHD and LD in Pakistan

Search Bias Quantification: Investigating Political Bias in Social Media and Web Search

Users frequently use search systems on the Web as well as online social media to learn about ongoing events and public opinion on personalities. Prior studies have shown that the top-ranked results returned by these search engines can shape user opinion about the topic (e.g., event or person) being searched. In case of polarizing topics like politics, where multiple competing perspectives exist, the political bias in the top search results can play a significant role in shaping public opinion towards (or away from) certain perspectives. Given the considerable impact that search bias can have on the user, we propose a generalizable search bias quantification framework that not only measures the political bias in ranked list output by the search system but also decouples the bias introduced by the different sources—input data and ranking system. We apply our framework to study the political bias in searches related to 2016 US Presidential primaries in Twitter social media search and find that both input data and ranking system matter in determining the final search output bias seen by the users. And finally, we use the framework to compare the relative bias for two popular search systems—Twitter social media search and Google web search—for queries related to politicians and political events. We end by discussing some potential solutions to signal the bias in the search results to make the users more aware of them.publishe

Anaesthesia for surgical correction of scoliosis with spinal cord monitoring--a case series

Objective: To share our experience of anaesthetic management of scoliosis with intra-operative somatosensory evoked potential monitoring and wake up test.Methods: All the cases of scoliosis surgery scheduled during a period of two years in which SSEP and intra-operative wake-up test was planned were included in the study. The patient in which intra-operative wake-up test was not planned were excluded from this case series.Results: We managed a series of sixteen cases of scoliosis in our hospital. Eleven patients were female and five were male with the age ranging from six to twenty two years. SSEPs were monitored throughout the procedure and wake up test was done intra-operatively after surgical manipulation of spinal cord. Intra-operative wake-up test was completed successfully in all the patients. None of the patients had any neurological damage and were also successfully extubated at the end of procedure.CONCLUSION: Intra-operative wake up test and SSEP monitoring are reliable methods for detection of intra-operative spinal cord ischemia during scoliosis surgery

The maintenance of elevated active chlorine levels in the Antarctic lower stratosphere through HCl null cycles

The Antarctic ozone hole arises from ozone destruction driven by elevated levels of ozone destroying ("active") chlorine in Antarctic spring. These elevated levels of active chlorine have to be formed first and then maintained throughout the period of ozone destruction. It is a matter of debate how this maintenance of active chlorine is brought about in Antarctic spring, when the rate of formation of HCl (considered to be the main chlorine deactivation mechanism in Antarctica) is extremely high. Here we show that in the heart of the ozone hole (16–18 km or 85–55 hPa, in the core of the vortex), high levels of active chlorine are maintained by effective chemical cycles (referred to as HCl null cycles hereafter). In these cycles, the formation of HCl is balanced by immediate reactivation, i.e. by immediate reformation of active chlorine. Under these conditions, polar stratospheric clouds sequester HNO3 and thereby cause NO2 concentrations to be low. These HCl null cycles allow active chlorine levels to be maintained in the Antarctic lower stratosphere and thus rapid ozone destruction to occur. For the observed almost complete activation of stratospheric chlorine in the lower stratosphere, the heterogeneous reaction HCl + HOCl is essential; the production of HOCl occurs via HO2 + ClO, with the HO2 resulting from CH2O photolysis. These results are important for assessing the impact of changes of the future stratospheric composition on the recovery of the ozone hole. Our simulations indicate that, in the lower stratosphere, future increased methane concentrations will not lead to enhanced chlorine deactivation (through the reaction CH4 + Cl  ⟶  HCl + CH3) and that extreme ozone destruction to levels below  ≈ 0.1 ppm will occur until mid-century

Event by Event Analysis of High Multiplicity Events Produced in 158 A GeV/c 208 Pb- 208 Pb Collisions

An extensive analysis of individual high multiplicity events produced in 158 A GeV /c 208Pb- 208Pb collisions is carried by adopting different methods to examine the anomalous behavior of these rare events. A method of selecting the events with densely populated narrow regions or spikes out of a given sample of collision events is discussed.Employing this approach two events with large spikes in their eta- and phi- distributions are selected for further analysis. For the sake of comparison, another two events which do not exhibit such spikes are simultaneously analyzed. The findings suggest that the systematic studies of particle density fluctuations in one- and two-dimensional phase-spaces and comparison with those obtained from the studies of correlation free Monte Carlo events, would be useful for identifying the events with large dynamical fluctuations. Formation of clusters or jet like phenomena in multihadronic final states in individual events is also discussed and the experimental findings are compared with the independent particle emission hypothesis by carrying out Monte Carlo simulations

Fine needle aspiration cytology in parotid lumps

Over a period of two years, Fine Needle Aspiration Cytology (FNAC) was performed on 33 patients presenting with a parotid lump. Five patients were excluded as they were treated medically after FNAC report. The FNAC results of 28 cases were compared with histopathological diagnoses of surgically resected specimens. There were 8 true positive, 17 true negative, 1 false positive and 2 false negative cases. Sensitivity was 80%, specificity 94.4% and diagnostic accuracy 89.3%. FNAC is a simple quick, accurate and virtually complications free investigative modality. It is also helpful adjunct to assess preoperatively the suitability and extent of the surgical treatment

Recent developments in the reduction of oxidative stress through antioxidant polymeric formulations

Reactive oxygen and nitrogen species (RONS) are produced endogenously in our body, or introduced through external factors, such as pollution, cigarette smoke, and excessive sunlight exposure. In normal conditions, there is a physiological balance between pro-oxidant species and antioxidant molecules that are able to counteract the detrimental effect of the former. Nevertheless, when this homeostasis is disrupted, the resulting oxidative stress can lead to several pathological conditions, from inflammation to cancer and neurodegenerative diseases. In this review, we report on the recent developments of different polymeric formulations that are able to reduce the oxidative stress, from natural extracts, to films and hydrogels, and finally to nanoparticles (NPs)

Socio-economic and Demographic factors associated with injecting drug use among drug users in Karachi, Pakistan

Objective: To identify the socio-economic and demographic factors associated with injecting drug users (IDUs) in Karachi. Methods: We recruited 242 IDUs (taking drugs through sub-dermal routes) and 231 non-IDUs (taking drugs other than sub-dermal routes) from February through June 1996. IDUs were interviewed regarding sociodemographic factors, economic condition, and social network (marital status, living with spouse). In addition, information regarding location of drug users within the city (districts of Karachi) and current history of sexually transmitted diseases (STDs) were gathered. Moreover, blood samples were also obtained for HIV testing .Results: Multivariate analysis showed that the income generation via illegal modes [AOR 1.6, 95% CI 1.0-2.6], non-sharing of income with family [AOR 1.7, 95% CI 1.1-2.7] and presence of suicidal thoughts [AOR 2.0, 95% CI 1.1-3.8] were associated with the use of drugs through injections. Further, drug users from districts West, East and Central were more likely to use drug through injection as compared to drug users from district South. The history of genital herpes was also found to be associated with injecting drug use. One IDU was found seropositive for HIV. Conclusion: The high-risk behaviors, such as illegal modes of earning and presence of suicidal thoughts, among IDUs suggest that the group needs rehabilitation programme. Moreover, non-sharing of income suggest that IDUs are isolated from social network, therefore primary prevention activities with focus on improving socioeconomic conditions and social networking can reduce drug use through injections. Focused interventions on target districts would be helpful in reducing IDU (JPMA 53:511;2003)

Motion of a Vector Particle in a Curved Spacetime. II First Order Correction to a Geodesic in a Schwarzschild Background

The influence of spin on a photon's motion in a Schwarzschild and FRW spacetimes is studied. The first order correction to the geodesic motion is found. It is shown that unlike the world-lines of spinless particles, the photons world-lines do not lie in a plane.Comment: 14 pages, LaTeX2e, second paper in the series (the first one: gr-qc/0110067), replaced with typos and style corrected version, accepted in MPL

Development of male sterility by silencing Bcp1 gene of Arabidopsis through RNA interference

The development of male sterility is one of the most important steps in hybrid seed production. Several methods for the abortion of pollens based on conventional as well as genetic engineering are reported for the various crop species. Here we have investigated the use of RNA interference (RNAi) technology to silence a male specific gene, Bcp1 in the model host Arabidopsis thaliana. Bcp1 is active in both diploid tapetum and haploid microspores. Three batches of explants (A. thaliana) were selected onherbicide glufosinate ammonium and putative transgenes were confirmed through PCR and Southern hybridization. About 49 out of 58 Arabidopsis lines transformed with RNAi construct containing Bcp1 sequences were male sterile. Transgenic plants were phenotypically indistinguishable from nontransgenic plants and by crossing with non-transgenic fertile pollens successful seed set was observed. The Bcp1 gene was also amplified from chilies, tomato and brassica. The present study resulted in developing male sterile A. thaliana (Eco. Columbia) line through genetic engineering. The diversity of Bcp1 gene will help us to produce transgenic male sterile plants in crop plants