Catastrophic Effects of Floods on Environment and Health: Evidence from Pakistan

Torrential rains and floods have been causing irreplaceable losses to both human lives and environment in Pakistan. This loss has reached to an extent of assively aggrieved situation to reinstate life at operationally viable position. This paper unfolds the notion that only constructive paradigm shift to overcome this phenomenon is vital as a strategy. Multiple levels of observations and on-site assessment of various calamity-prone venues were considered to probe into this scenario. Some of the grave site in Sindh and Punjab were observed and necessarily practicable measures were recommended to avoid loss to human health and environment. The paper finds that a consistent drastic management authority on national level with appropriate caliber and forecasting expertise can reduce the damage to human life and environment to great extent. Weather forecasting system need to be installed at many appropriately observed cities and towns in the country with adequate man power, funds and technical recourses. By implementing the proper frame work of prevention and mitigation of floods country can save the major costs cleanup and recovery. These measures are expected to reduce operational cost of state in terms of GDP and GNP to restore life and environment

Prevalence of Neural tube defects at PUMHS Hospital.

Introduction: Spina bifida, anencephaly, and encephalocele are neural tube defects (NTD) and result from failure of closure of the neural tube between 21and 28 days following conception. Encephaloceles are possibly post-closure defects. NTDs are an important cause of mortality and morbidity globally. NTD encompasses about one-tenth of the burden of all congenital conditions and make up the third largest congenital burden after congenital heart disease and Down’s syndrome. In low income countries, NTDs may account for 29% of neonatal deaths in observable birth defects Objective: To know the prevalence of neural tube defects at PUMHS Benazirabad.. Methodology: All pregnant ladies when diagnosed to have fetus with neural tube defect through ultrasound examination were counselled for termination of pregnancy. Data collected through proforma with details of demography, gynecological history, and type of neural tube defect evaluated by senior gynecologist and neonatologist. NTDs were defined as cases of anencephaly, spina bifida, encephalocele and meningocele among infants of any gestational age. Results: A total of 7152 deliveries took place in the obstetrics department of PUMHS Hospital from January 2018 to September 2019. 38 (thirty-eight) pregnancies were terminated at different gestational ages, diagnosed as cases of neural tube defects, making a prevalence of 5.313 per 1000 births. Among the NT defects, 22/38 (57.89%) were anencephaly and 12/38 (31.57%) were spina bifida with hydrocephalus. Conclusion: The most common neural tube defect is anencephaly followed by spina bifida with hydrocephalus. Overall prevalence of NTD is comparable published literature from South East Asia.   Keywords: Neural tube defects, Anencephaly, Spina bifida, Hydrocephalus. &nbsp

Ultrasound-guided Intralesional Bleomycin Injection (IBI) for Treatment of Cutaneous Hemangiomas and Vascular Malformations

Purpose: To report the therapeutic outcome of ultrasound-guided intralesional injection of bleomycin in the treatment of cutaneous hemangiomas and vascular malformations. Material & Methods: The medical records of patients with cutaneous hemangiomas and vascular malformations treated with the intralesional injection of bleomycin under ultrasound guidance between August 2009 and June 2013 at the Indus Hospital, Karachi were reviewed retrospectively using a computerized medical record information management system. Data were extracted using a pre-coded performa that included patient demographics, type and location of lesion, number of treatments, presenting/pre- and post-treatment clinical symptoms (pain, swelling, heaviness, size, discoloration), ultrasound appearance and vascularity, and post-treatment side effects. The dose range of bleomycin was 0.5-1.0 mg/kg, but not exceeding 15 mg in a single session. A maximum of four treatments were given in any given patient except for one, who presented with recurrence after a year of complete resolution. Therapeutic outcome was determined using review of ultrasound images and recorded clinical assessment. Treatment response was categorized as: (i) complete resolution [more than 90% reduction]; (ii) substantial reduction [more than 50% reduction]; (iii) mild reduction [25% reduction]; or, (iv) no improvement [ \u3c 10% reduction]. Results: A total of 30 patients (16 female, 14 male), ranging in age from 8 months to 48 years (mean age 10.2 years), were treated from 2009 to 2013. There were 23 hemangiomas. Seven were vascular malformations, of which five were lymphatic malformations and two were venous malformations. Twenty-eight lesions were located in the head and neck region, and two were peripheral.. In 24 of the 30 patients (76%), treatment had been completed. In six patients (21%) treatment was ongoing at the time of this report. Seventeen of the 23 hemangiomas (74%) were completely resolved clinically and on ultrasound, five (22%) showed substantial improvement and one (4%) showed mild improvement. In five of the seven vascular malformations (71%) lymphatic malformations resolved completely, and two (29%) venous malformations showed substantial improvement. Of the 13 patients presenting with discoloration, there was complete resolution in one (7.7%), marked reduction in 11 (84.6%) and mild reduction in one (7.7%). Of seven patients presenting with pain, there was complete resolution in two (28.6%), marked reduction in two (28.6%), mild reduction in two (28.6%), and no improvement in one (14.3%). There were no pulmonary complications. Conclusion: Ultrasound-guided intralesional injection of bleomycin is an option to consider for the treatment of certain types of cutaneous hemangiomas and vascular malformations. Prospective studies should be undertaken to understand the various factors contributing to therapeutic success

Accuracy of computed tomography in diagnosing malignancy in solitary pulmonary lesions

OBJECTIVE: To evaluate accuracy of Computed Tomography (CT) for diagnosing malignancy in solitary pulmonary lesions (SPLs). METHODS: A prospective cross-sectional study was conducted from 20-01-2007 to 30-06-2008 at the Radiology department, Aga Khan University Hospital (AKUH) Karachi. Fifty-three patients with solitary pulmonary lesions (SPLs) seen in prior chest x-rays or chest CT scans were referred to radiology department for CT guided biopsy. CT scan was performed for each patient prior to biopsy and CT evaluation of the SPLs was performed followed by CT guided Biopsy. Histopathological diagnosis of the lesion was taken as the gold standard. RESULTS: CT was found to be 100% sensitive, 30% specific and 87% accurate for diagnosing malignancy in solitary pulmonary lesions while PPV and NPV were 86% and 100% respectively. CONCLUSION: CT scan is highly sensitive yet non-specific and cannot be used as the definitive diagnostic modality for diagnosing malignancy in solitary pulmonary lesions

Total parotidectomy under local anesthesia: A novel technique

Parotidectomy is a common procedure usually done for a parotid mass necessitating a histological diagnosis. Operation is normally performed under General anesthesia with a nerve stimulator to facilitate facial nerve stimulation. We describe a new technique with reports of three cases, making total parotidectomy under local anesthesia possible. The ascending cervical branch of cervical plexus and the auriculotemporal nerve were anesthetized by bupivacaine 0.25% (2mg/kg) and lignocaine with adrenaline 7 mg/kg. Effective onset of anesthesia was within 15-25 minutes and the operations lasted between 2-3 hours without any complications. This offers advantage in high-risk patients where general anesthesia is contraindicated. The facial nerve can be easily identified with on command movements by the patient rendering the use of nerve stimulator or injection of the dye superfluous. This technique makes total parotidectomy an outpatient procedure and facilitates an early discharge

A study of how English is taught in government schools in Karachi

English is considered to be one of the core subjects in secondary schools in Pakistan. But it is observed that the way it is taught is through the cascading approach rather than the development of language as a whole. Teachers provide few opportunities to students to relate their learning with their experiences in daily life. Students are mostly asked to copy down the answers from the chalkboard or from the textbooks and memorize the grammatical rules and reproduce them as it is, in the examination. However English is seen as an international language and a very powerful means of global communications and a sign of personal and national development in the society. This study is aimed to understand how English is taught in our secondary schools in Pakistan. It also identifies the challenges related to teaching English as a foreign language in government secondary schools in Pakistan. The study is divided into five chapters. Chapter one highlights the background and rationale, context, significance and purpose of the study, while chapter two offers a critical review of some relevant literature available in the area of the importance of English language teaching. Chapter three explains the research methodology and data collection. Chapter four presents an analysis of the data and research findings. Finally chapter five outlines some recommendations, implications, lessons learnt and possibilities for further research

Synergistic use of nitrogen and zinc to bio-fortify zinc in wheat grains

Our daily diet is largely contributed by cereals, which have low genetic abilities to amass higher concentrations of micronutrients in their grains. Hence, wide spread deficiencies iron, zinc and other essential nutrients have prevailed. Present study focuses the bio-fortification of Zn in wheat grains, taking advantage of nutrient-nutrient synergy between Zn and N. Three wheat genotypes (NIA-Amber, BWQ-4 and SD-998) were tested in a field experiment following randomized complete block factorial design with three replicates. Urea fertilizer was applied at the rates of 120 (recommended), 150 and 180 kg N ha-1 in combination with three levels of Zn (0, 5 & 10 kg ha-1). Outcomes of the experiment revealed that NIA-Amber had the highest grain yield of 6.03 tons/ha against 150 kg N ha-1 and 10 kg Zn ha-1. Maximum Zn contents of 447.86, 429.56 and 395.56 g ha-1 were observed in BWQ-4, SD-998 and NIA-Amber at 180 kg N ha-1 in combination with 10 kg Zn ha-1. Maximum enhancement in protein contents was observed in BWQ-4 (743 kg ha-1) at 180 kg N ha-1and combined with 5 kg Zn ha-1. For NIA-Amber, 180 kg N ha-1 in combination of 10 kg Zn ha-1 proved the most suitable in terms of Zn concentration and other quality attributes. Nitrogen @ 180 kg N ha-1 with 5 kg Zn ha-1 depicted appreciable zinc and protein contents in grains of BWQ-4 and SD-998

Postoperative Intrahepatic Calculus: The Role of Extracorporeal Shockwave Lithotripsy

Bile duct stones are a known complication after a Roux-en-Y hepaticojejunostomy. Different minimally invasive stone extraction techniques, including endoscopic retrograde cholangiopancreatography with basket removal or the use of a choledocoscope through a mature T-tube tract, can be used. However, in some cases, they are unsuccessful due to complicated postsurgical anatomy or technical difficulty. In this report, we present a case where extracorporeal shockwave lithotripsy was used in conjunction with standard interventional techniques to treat bile duct stones

Grain Yield, Nutrient Accumulation and Fertilizer Efficiency in Bread Wheat under Variable Nitrogen and Phosphorus Regimes

Balanced crop nutrition is one of the important tools necessary for sustaining crop productivity, maintaining soil fertility and ensuring food security worldwide. Nitrogen and phosphorus are essential plant macronutrients, nevertheless, most of the Pakistani soils exhibit moderate to severe deficiency of these nutrients. Furthermore, considerable genetic variations exist among wheat genotypes for nutrient acquisition and utilization which illustrate their differential nutrient requirements to produce higher yields. A field experiment was conducted in order to formulate balanced fertilizer recommendations for newly evolved wheat genotype SD-998 to achieve maximum yield potential. Ten treatments viz., 0-0 (control), 90-23, 90-45, 90-70, 120-30, 120-60, 120-90, 150-40, 150-75 and 150-110 kg N-P2O5 ha-1 were applied according to randomized complete block design with three replications. Analysis of variance revealed that growth, yield and yield related attributes as well as nutrient accumulation were significantly (P ? 0.05) influenced by varying N and P rates. The maximum plant height (100.8 cm), number of tillers per plant (10), spike length (10.3 cm), number of grains per spike (66), 100-grain weight (4.10 g) and grain yield (4990 kg ha-1) was recorded in treatment having 150-110 kg N-P2O5 ha-1. The highest P recovery efficiency (20.8 %), agronomic N efficiency (19.4 kg kg-1) and agronomic P efficiency (36.8 kg kg-1) were attained at 120-30, 90-70 and 150-40 kg N-P2O5 ha-1, respectively. However, the highest total N accumulation (140.8 kg ha-1), P accumulation (21.0 kg ha-1), N recovery efficiency (71.1 %) and profit (Rs. 73625 ha-1) were noticed at 150 kg N plus 110 kg P2O5 ha-1. Thus, 150-110 kg N-P2O5 ha-1 (N:P2O5 in 4:3 ratio) was suggested as the most balanced and economical dose for the tested wheat genotype