A Review: Dermal Ailments Causing Microbiota

Though skin is protective shield of body still it is prone to not only wounds, burns but also to microbial invasion which may be mainly due to bacteria, fungi or various strains of viruses. Frequently reported dermal ailments are acne, measles, psoriasis, impetigo, cellulitis, molluscum contagiosum, tinea capitis, tinea pedis, atopic dermatitis, chronic wounds, ring worm, scabies, and onychomycosis which have broad spectrum pathophysiological effects. There are several root causes of the onset of development of infectious skin microbiota but major ones are intake of improper diet and lack of personal hygiene awareness and practice. To control these skin microbial diseases further research is required to find out low cost healthy food alternatives and programmed public awareness related to personal hygiene.      &nbsp

Coronary artery dissection after blunt chest trauma.

Blunt thoracic trauma may result in cardiac injuries ranging from simple arrhythmias to fatal cardiac rupture. Coronary artery dissection culminating in acute myocardial infarction (AMI) is rare after blunt chest trauma. Here we report a case of a 37-year-old man who had an AMI secondary to coronary dissection resulting from blunt chest trauma after involvement in a physical fight

Alarming frequency and after effects of maternal anemia in Pakistan

Anemia is caused due to usually iron based nutritional deficiency in blood. Its severity varies from mild to fatal. Recent reported data of Pakistan indicates that anemia cannot be ignored as it may affect fetus or maternal health or may cause death of any of them. The frequent symptoms are poor fetal growth, gastrointestinal bleeding, spontaneous abortion, low infant weight, less placental size and fetal or sometimes maternal death. Moreover, current data highlights that maternal anemia is common among females of province Sindh up to alarming level than in other provinces of Pakistan. As its diagnosis is usually delayed. People ignore the symptoms and still there is lack of awareness among masses. It should be controlled by government and concerned authorities by spreading general public awareness related to preventive measures, handling and cure of maternal anemia and to ensure the lives and health of both mother and developing fetus

The effects of behavioural factors in investment decision making at Pakistan stock exchanges

The present study is an endeavour to investigate the effect of behavioural elements such as Market Factors, Overconfidence Factor, Prospect Factors, Anchoring Factor, and Behavioural Factors on individual investors and institutional mangers in the stock exchanges of Pakistan. The study collected response from 50 equity managers of investment banks and investment companies that invest in Islamabad, Karachi and Lahore Stock Exchanges via adapted questionnaire. The individual investor plays a vital role in the stock market because of their good savings. The regulators of the stock market cannot ignore the behaviour of individual investors. Many individuals find investments to be fascinating because they can participate in the decision making process and see the results of their choice. Not all investments will be profitable, as investors’ whims not always result in fruitful returns. Recent studies on the behaviour of individual investors’ have shown that investors do not act in a rational manner. Several behavioural factors influence their investment decisions in stock markets. The current study practiced descriptive statistics, reliability, regression and correlation analysis. Investment triumph fits with best approach to investment decision making not with irrational investment behaviour on instant accessible information. Behavioural finance has given a unique opportunity to explore the effects of behavioural factors on investment decision-making process. The outcomes of the study exhibit that independent variables i.e. Market Factors, Overconfidence Factor, Prospect Factors, Anchoring Factor and Behavioural Factors is important for dependent variable Investment Decision Making

Factors leading to delayed and challenging presentation of benign breast lumps in young females

BACKGROUND AND OBJECTIVE: A delayed presentation of benign breast diseases may lead to a therapeutic challenge when they enlarge enormously or become multiple. Aim of this study was to evaluate the factors leading to delayed presentation of benign breast lumps. METHODS: This cross-sectional study was conducted at Madinah Teaching Hospital and Allied Hospital, Faisalabad from January 2019 to October 2021. One hundred and forty five female patients were selected by non-probability purposive sampling. Patients with large size (>5cm) or multiple benign breast lumps were included. An interview was conducted using structured questionnaire translated in Urdu. Factors leading to delayed presentation and social impact scale for stigma were evaluated. RESULTS: Patients had a mean age of 26.52 ± 6.90 years. The average delay of seeking medical care was 8.48 ± 8.41 months. Factors leading to delayed presentation were; lack of knowledge n=112 (77.2%) and parda (religious issues) n=112 (77.2%), followed by poverty n=109 (75.2%), and fear of cancer n=90 (62.1%). All the sub-scales of stigma, i.e., social rejection, financial insecurity, internalized shame and social isolation were high in late presenters, though, only financial insecurity was significantly high in late presenters (p=0.03). CONCLUSION: Lack of awareness, socioeconomic factors and disease related stigma were the main factors related to delayed presentation in young females with benign breast diseases. Addressing these factors may improve timely diagnosis and management of delayed and challenging cases

Free vibration of symmetric angly-plane layered truncated conical shells under classical theory

Truncated conical shell finds wide ranging of engineering applications. They are used in space crafts, robots, shelters, domes, tanks, nozzles and in machinery devices. Thus, the study of their vibrational characteristics has long been of interest for the designers. The use of the lamination for the structures leads to design with the maximum reliability and minimum weight. Moreover, the study of free vibration of laminated conical shells has been treated by a number of researchers. Irie et al. (1982) studied free vibration of conical shells with variable thickness using Rayleigh-Ritz method of solution. Wu and Wu (2000) provided 3D elasticity solutions for the free vibration analysis of laminated conical shells by an asymptotic approach. Wu and Lee (2001) studied the natural frequencies of laminated conical shells with variable stiffness using the differential quadrature method under first-order shear deformation theory (FSDT). Tripathi et al. (2007) studied the free vibration of composite conical shells with random material properties of the finite element method. Civalek (2007) used the Discrete Singular Convolution (DSC) to investigate the frequency response of orthotropic conical and cylindrical shells. Sofiyez et al. (2009) studied the vibrations of orthotropic non-homogeneous conical shells with free boundary conditions. Ghasemi et al. (2012) presented their study of free vibration of composite conical shells which was investigated under various boundary conditions using the solution of beam function and Galerkin method. Viswanathan et al. (2007, 2011) studied free vibration of laminated cross-ply plates, including shear deformation, symmetric angle-ply laminated cylindrical shells of variable thickness with shear deformation theory using the spline collocation method. In the present work, free vibration of symmetric angle-ply laminated truncated conical shells is analyzed and displacement functions are approximated using cubic and quantic spline and collocation procedure is applied to obtain a set of field equations. The field equations along with the equations of boundary conditions yield a system of homogeneous simultaneous algebraic equations on the assumed spline coefficients which resulting to the generalized eigenvalue problem. This eigenvalue problem is solved using eigensolution technique to get as many eigenfrequencies as required. The effect of circumferential mode number, length ratio, cone angle, ply angles and number of layers under two boundary conditions on the frequency parameter is studied for three- and five- layered conical shells consisting of two types of layered materials

Regional Co-operation among SAARC States: An Assessment of the Integrated Program of Action

This study provides a general overview of region‟s human development status, economic and trade structure, and sets a context for regional development challenges. Regional co-operation among SAARC States through an assessment of the Integrated Program of Action (IPA) recognizes 12 agreed areas of cooperation, each being covered by a designated Technical Committee (TC). These areas include Agriculture, Communications, Education, Culture and Sports, Environment, Health and Population Activities, Meteorology, Prevention of Drug Trafficking and Drug Abuse, Rural Development, Science and Technology, Tourism, Transport and Women in Development

The cost-effectiveness of incentive-based active case finding for tuberculosis (TB) control in the private sector Karachi, Pakistan

Background: In Asia, over 50% of patients with symptoms of tuberculosis (TB) access health care from private providers. These patients are usually not notified to the National TB Control Programs, which contributes to low notification rates in many countries. Methods: From January 1, 2011 to December 31, 2012, Karachi’s Indus Hospital - a private sector partner to the National TB Programme - engaged 80 private family clinics in its catchment area in active case finding using health worker incentives to increase notification of TB disease. The costs incurred were estimated from the perspective of patients, health facility and the program providing TB services. A Markov decision tree model was developed to calculate the cost-effectiveness of the active case finding as compared to case detection through the routine passive TB centers. Pakistan has a large private health sector, which can be mobilized for TB screening using an incentivized active case finding strategy. Currently, TB screening is largely performed in specialist public TB centers through passive case finding. Active and passive case finding strategies are assumed to operate independently from each other. Results: The incentive-based active case finding program costed USD 223 per patient treated. In contrast, the center based non-incentive arm was 23.4% cheaper, costing USD 171 per patient treated. Cost-effectiveness analysis showed that the incentive-based active case finding program was more effective and less expensive per DALY averted when compared to the baseline passive case finding as it averts an additional 0.01966 DALYs and saved 15.74 US$ per patient treated. Conclusion: Both screening strategies appear to be cost-effective in an urban Pakistan context. Incentive driven active case findings of TB in the private sector costs less and averts more DALYs per health seeker than passive case finding, when both alternatives are compared to a common baseline situation of no screening.publishedVersio

Geographic variation in access to dog-bite care in Pakistan and risk of dog-bite exposure in Karachi: prospective surveillance using a low-cost mobile phone system

Background: Dog-bites and rabies are under-reported in developing countries such as Pakistan and there is a poor understanding of the disease burden. We prospectively collected data utilizing mobile phones for dog-bite and rabies surveillance across nine emergency rooms (ER) in Pakistan, recording patient health-seeking behaviors, access to care and analyzed spatial distribution of cases from Karachi. Methodology and Principal: Findings A total of 6212 dog-bite cases were identified over two years starting in February 2009 with largest number reported from Karachi (59.7%), followed by Peshawar (13.1%) and Hyderabad (11.4%). Severity of dog-bites was assessed using the WHO classification. Forty percent of patients had Category I (least severe) bites, 28.1% had Category II bites and 31.9% had Category III (most severe bites). Patients visiting a large public hospital ER in Karachi were least likely to seek immediate healthcare at non-medical facilities (Odds Ratio = 0.20, 95% CI 0.17–0.23, p-value<0.01), and had shorter mean travel time to emergency rooms, adjusted for age and gender (32.78 min, 95% CI 31.82–33.78, p-value<0.01) than patients visiting hospitals in smaller cities. Spatial analysis of dog-bites in Karachi suggested clustering of cases (Moran's I = 0.02, p value<0.01), and increased risk of exposure in particular around Korangi and Malir that are adjacent to the city's largest abattoir in Landhi. The direct cost of operating the mHealth surveillance system was USD 7.15 per dog-bite case reported, or approximately USD 44,408 over two years. Conclusions: Our findings suggest significant differences in access to care and health-seeking behaviors in Pakistan following dog-bites. The distribution of cases in Karachi was suggestive of clustering of cases that could guide targeted disease-control efforts in the city. Mobile phone technologies for health (mHealth) allowed for the operation of a national-level disease reporting and surveillance system at a low cost.publishedVersio

Knowledge, awareness and practices regarding dengue fever among the adult population of dengue hit cosmopolitan.

Background: The World health Organization (WHO) declares dengue and dengue hemorrhagic fever to be endemic in South Asia. Despite the magnitude of problem, no documented evidence exists in Pakistan which reveals the awareness and practices of the country\u27s adult population regarding dengue fever, its spread, symptoms, treatment and prevention. This study was conducted to assess the level of knowledge, attitudes and practices regarding dengue fever in people visiting tertiary care hospitals in Karachi, Pakistan. Methods: A cross-sectional pilot study was conducted among people visiting tertiary care hospitals in Karachi. Through convenience sampling, a pre-tested and structured questionnaire was administered through a face-to-face unprompted interview with 447 visitors. Knowledge was recorded on a scale of 1-3. Results: About 89.9% of individuals interviewed had heard of dengue fever. Sufficient knowledge about dengue was found to be in 38.5% of the sample, with 66% of these in Aga Khan University Hospital and 33% in Civil Hospital Karachi. Literate individuals were relatively more well-informed about dengue fever as compared to the illiterate people (p\u3c0.001). Knowledge based upon preventive measures was found to be predominantly focused towards prevention of mosquito bites (78.3%) rather than eradication of mosquito population (17.3%). Use of anti-mosquito spray was the most prevalent (48.1%) preventive measure. Television was considered as the most important and useful source of information on the disease.Conclusion: Adult population of Karachi has adequate knowledge related to the disease \u27dengue\u27 on isolated aspects, but the overall prevalence of \u27sufficient knowledge\u27 based on our criteria is poor. We demonstrated adequate prevalence of preventive practices against the disease. Further studies correlating the association between knowledge and its effectiveness against dengue will be helpful in demonstrating the implications of awareness campaigns