Studies on the filtration, feeding and excretion rates in Perna viridis, Marcia cor and Crassostrea gryphoides (Mollusca: Bivalvia) using P³² labelled Ankistrodesmes

The study deals with a series of experiments to investigate feeding and excretion in three species of bivalves: Perna viridis (Linné), Marcia cor (Sowerby) and Cassostrea gryphoides (Gould) from Manora Channel, Karachi. Bivalves were fed with suspensions of Ankistrodesmes labelled with P³². These animals showed a considerable variation in the average filtration rates depending upon species and the body lenght. Exceptionally high content of the P³² introduced with Akistrodesmes, got excreted as pseudofaeces and faeces within first three days following its absorption as a meal. The assimilated P³² is partly released as faecal material and its major proportion is directly transferred to the solution. As expexted the gonad and kidney are the main organs found responsible for excretion as comared to other body parts. Although, the assimilated P³² is mostly concentrated in the digestive glands, the results also show a significant presence of P³² in the gonads. Accumulation of P³² was the least in the foot

Childhood acute iymphoblastic leukaemia: Experience from a single tertiary care facility of Pakistan

Objective: To evaluate the demographic features, outcome and prognostic factors seen in children with acute lymphoplastic leukaemia at a tertiary care hospital.Methods: The retrospective descriptive study was conducted at Aga Khan University Hospital, Karachi, comprising data related to children below 15 years of age and treated between January 1997 and December 2006. Kaplan Meir survival curves were used to describe overall and event-free survival rates. Cox Proportional Hazards model was used to describe factors associated with death and relapse. SPSS 16 was the main statistical tool.Results: Of the total 121 children diagnosed with the condition, 79 (65.3%) were males; 86 (71.1%) patients were between 1-9 years of age; Immunophenotyping was done in 99 (81.81%) patients: 86 (87%) cases had precursor B and 13 (13.13%) had precursor T. Of the total, 106 (87.6%) patients opted for treatment, while 15 (11.6%) were lost to follow-up. Besides, 26 (21.7%) patients had at least one relapse; the most common site being bone marrow in 13 (50%) followed by central nervous system in 9 (36.6%). There were 20 (16.5%) deaths in the sample. Infection was the most frequent cause of death. The event-free survival and overall survival was 63% (n = 76) and 65% (n = 79) respectively.Conclusion: Through the clinical characteristics of children with acute lymphoblastic leukamia were similar to those reported in literature, the outcomes were inferior. The high rate of infections and relapse warrant better supportive care and risk-based approach

A preliminary study for establishing Perna viridis (Mollusca:Bivalvia) as a biological monitor for pollution in Karachi coastal water

Adverse effects of toxic substances on the environmental quality have become a subject of concern in recent years. Toxicity of heavy metals has never been in dispute and therefore their presence in our natural environment is undesirable. This study was undertaken to establish the capability of Perna viridis as a monitor for pollution in the Manora channel. Accumulation of Zinc, Copper, Iron and Manganese by marine mussels, sampled from Manora channel, was determined. Metal load varied markedly between individuals from the same populatin. This variability was partly accounted for systematic relationship between metal load and body weight and age. The distribution of metal between the major organs was considered, but the analysis of separate organs showed no advantage for their use as a biological monitor. comparison between Iron, Manganese, Copper and Zinc concentration in ambient sea water and in the mussel showed no clear correspondence. The results suggest that the mussel is capable of acting as a biological monitor, although may not be a good short term monitor of Iron, Manganese, Zinc and Copper. It may have potential as a long term and site comparison monitor for metals, once inherent variability is taken into accoun

Aplastic Anemia: Clinicohaematological Features, Treatment and Outcome Analysis

Objective: To determine the clinicohaematological features, treatment and outcome of children diagnosed with aplastic anemia at a single institution. Study Design: Observational study. Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 1999 till December 2008. Methodology: Medical records of children aged less than 15 years of age diagnosed with aplastic anemia were reviewed. Clinicohaematological features, treatment and its response to therapy and outcome were recorded. Results were described in percentages. Results: Ninety patients were diagnosed to have aplastic anemia (AA); 65 were male during the study period. Age ranged from 1 to 15 years. Fever in 65 patients (72.2%), pallor in 53 (58.8%), skin bleeding in 49 (54.4%) and epistaxis in 31(34.4%) were the most common and frequent presenting features. Congenital (Fanconi’s) anemia was found in 15 (16.6%) and acquired idiopathic in 75 (83.4%) of patients. Very severe aplastic anemia (VSAA) was seen in 29 (32.2%), 26 (28.9%) had severe AA and 17 (18.9%) had moderate AA. Eight patients (8.9%) underwent haematopoietic stem cell transplantation (HSCT), 12 (13.3%) received immunosuppressive therapy (IST) and 70 patients (77.7%) received other and supportive therapy. Five (62.5%) patients showed complete response to HSCT and 3 (37.5%) failed to engraft. IST showed complete response in 3 (25%), partial response in 5 (41.6%) and no response in 4 (33.3%). Twenty two patients (24.4%) expired either due to infection in 16 (72.7%, fungal in 6, bacterial in 10) and intracranial haemorrhage in 6 (27.3%) cases. Conclusion: Majority of cases with AA were acquired and idiopathic in etiology. VSAA and SAA were frequent. Response to HSCT and IST was sub-optimal

Report: Interactions and conflicts of interests between prescribers and medical sales representatives (MSRs) regarding prescribing and drug promotion practices in Karachi, Pakistan.

Pharmaceutical drug promotion practices are found to have potentially controversial ethical standards. They may compromise on patient's wellbeing especially when it inordinately affects the clinical care and patient's interests by influencing the prescribing behavior of physicians. There is no proper system to keep a watch on the drug marketing and promotion strategies by the pharmaceuticals in Pakistan. A cross sectional study using a specially designed questionnaire and convenience sampling was conducted in Karachi for 6 months targeting prescribers and medical sales representative (MSRs). A total of 600 MSRs and prescribers consented to participate. 66% of MSRs highlighted that prescribers follow ethical prescribing but only (58%) seek evidence base behind promoted drug. This was contradictory to prescribers' response to same, which was 87%. Only (10%) of prescribers acknowledged demanding expensive gifts such as laptops, ACs, furniture and renovation of the clinic which was about 40% according to MSRs. This study offered intricate insights into the MSR and physicians interactions. It highlighted various aspects of these relationships from both MSRs' and prescribers' point of view. Although majority of the physicians negated the notion of expecting expensive favors from the sales representatives, responses by MSRs suggest that anticipation of gifts and incentives exists on part of the physicians. This has the potential to indulge in unethical promotion and irrational prescribing on part of MSRs and prescribers respectively that may further contribute to untoward patient outcomes such as increased treatment costs and adverse drug reactions

Clinical characteristics and treatment outcome of paediatric non-Hodgkin\u27s lymphoma at a tertiary care hospital in Pakistan

Objectives: To highlight the clinical characteristics of paediatric patients presenting with non-Hodgkin\u27s lymphoma, treatment toxicities, and outcome.Methods: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of all paediatric patients aged 0-18 years diagnosed with non-Hodgkin\u27s lymphoma from 2010 to 2020. Demographic characteristics, presentation, treatment provided, complications, if any, and treatment outcome were recorded. Data was analysed using SPSS 21.Results: Of the 92 patients, 69(75.0%) were males. The overall mean age was 14.35±5.80 years. The most common presenting complaint was pyrexia 42(45.7%), the most common diagnosis was Burkitt lymphoma 40(43.5%), the most common complication related to gastrointestinal issues 8(15.7%), and most toxicities were reported with the use of FAB-LMB96 (French American-British Mature B-Cell Lymphoma 96) for B-cell non-Hodgkin\u27s lymphoma 23 (45.1%). Mortality was the outcome in 17(18.5%) cases, while 19(20.7%) patients were lost to follow-up. PFS and OS was 60.4%, and OS 81.3% respectively at 10 years follow-up, median PFS was 17.5 months ([IQR]: 4.5-43.5 months) (p=0.011) and median OS was 33.5 months (IQR: 19.5-84 months) (p=0.007).Conclusions: Early recognition of symptoms, specialist care, and proper planning can decrease treatment-related complications that result in abandonment

Development and validation of a novel general medication adherence scale (GMAS) for chronic illness patients in Pakistan

Objective: This study aimed to develop and validate a self-reporting adherence tool termed as General Medication Adherence Scale (GMAS) in Urdu language for measuring adherence toward medication use among Pakistani patients with a chronic disease. Methods: A month-long study (December 2017) was conducted in three tertiary health care settings of Karachi, Pakistan. The tool underwent content and face validity as well as factor analyses, i.e., exploratory, partial confirmatory and confirmatory factor analyses. Random sampling was conducted, and sample size was calculated using item response theory. The item-to-respondent ratio was 1:15. Fit indices namely normed fit index (NFI), Tucker Lewis index (TLI), comparative fit index (CFI), goodness of fit index (GFI), absolute goodness of fit (AGFI), parsimony goodness of fit index (PGFI), root mean square error of approximation (RMSEA), and standard root mean square residual (SRMR) were calculated. Additionally, estimation of the convergent, discriminant and known group validities, was conducted. Internal consistency was analyzed by testretest reliability, McDonald’s and Pearson correlation coefficient. The factor analyses were conducted using IBM SPSS version 22 and IBM SPSS AMOS version 25. Results: Content validity index (CVI) was reported at 0.8 (SD 0.147) and the tool was content validated with three hypothetical constructs. Factor analyses highlighted a 3- factor structure. The fit indices were calculated with satisfactory results, i.e., PGFI, GFI, AGFI, NFI, TLI, and CFI were greater than 0.9 and PGFI > 0.5. The values of RMSEA and SRMR were less than 0.07. A Cronbach’s alpha value of 0.84 was obtained in reliability analysis. The test-retest Pearson’s correlation coefficient value was reported at 0.996 (p-value < 0.01). Convergent and discriminant validities for all constructs and, known group validity for two constructs, were established. A high response rate of 91% was achieved in respondents. Patients without insurance coverage appeared to be low adherent compared to those with insurance coverage (p-value < 0.05). Non-comorbid patients were more likely to be highly adherent as compared to comorbid patients (pvalue < 0.01). Conclusion: A novel tool GMAS was developed in Urdu language and was subsequently validated in patients with chronic diseases

Arbitrage Price Theory (APT) and Karachi Stock Exchange (KSE)

The intention of this study is to analyze the variability of Arbitrage price theory (APT) in case of KSE. The data from Jan 1985 to Dec 2008 is monthly based has been considered and two econometric methodologies, Johanson co integration and Error correction model are used to checkout the validity of APT in this study. The conclusion of this study illustrates that Quasi money responds negatively with KSE 100 index return while IIP (industrial index of production), exchange rate, petroleum price, domestic interest responds negatively with KSE 100 index return. On the Contrary bullion price and inflation rate are insignificant regarding to KSE 100 index return