On the Bayesian network based data mining framework for the choice of appropriate time scale for regional analysis of drought Hazard

Data mining has a significant role in hyrdrologic research. Among several methods of data mining, Bayesian network theory has great importance and wide applications as well. The drought indices are very useful tools for drought monitoring and forecasting. However, the multi-scaling nature of standardized type drought indices creates several problems in data analysis and reanalysis at regional level. This paper presents a novel framework of data mining for hydrological research-the Bayesian Integrated Regional Drought Time Scale (BIRDts). The mechanism of BIRDts gives effective and sufficient time scales by considering dependency/interdependency probabilities from Bayesian network algorithm. The resultant time scales are proposed for further investigation and research related to the hydrological process. Application of the proposed method consists of 46 meteorological stations of Pakistan. In this research, we have employed Standardized Precipitation Temperature Index (SPTI) drought index for 1-, 3-, 6-, 9-, 12-, 24-, and ()month time scales. Outcomes associated with this research show that the proposed method has rationale to aggregate time scales at regional level by configuring marginal posterior probability as weights in the selection process of effective drought time scales

Frequency of colistin and fosfomycin resistance in carbapenem-resistant Enterobacteriaceae from a tertiary care hospital in Karachi

Introduction: Management of infections with carbapenem-resistant Enterobacteriaceae (CRE) is challenging. In recent times, agents such as colistin and fosfomycin have been used in combination with other antibiotics to treat such infections. In this study, we aim to seek frequency of colistin and fosfomycin resistance in CRE from Pakistan. Methods: This study was conducted at clinical laboratories, Aga Khan University Hospital. In total, 251 CRE were included in the study. Colistin minimum inhibitory concentrations (MICs) were performed using broth microdilution (BMD) method and VITEK 2 system, whereas fosfomycin susceptibility was performed using Kirby-Bauer method. MIC50 and MIC90 were calculated for colistin and agreement between VITEK and BMD was also calculated. Results: Out of 251 strains colistin MIC of ≥4 g/mL was seen in 40 (15.9%). Of these strains 20 (50%) were Klebsiella pneumoniae. Colistin MIC50 and MIC90 were found to be 0.5 and 16 g/mL, respectively. BMD and VITEK 2 showed 100% categorical agreement. Essential agreement was 88.5% with kappa score 0.733 indicating strong agreement between VITEK and BMD. 31 out of 251 (12.3%) CREs were resistant to fosfomycin. Conculsion: Study shows frequency of colistin and fosfomycin resistance to be 15.9% and 12.3%, respectively. In countries where rate of CREs is high, emerging resistance against these last resort antibiotics is alarming as it leaves clinicians with almost no options to manage such multidrug resistant and extensively drug resistant infections

Factors Leading To Early Versus Late Presentation In Patients With Neck Masses

Abstract Objective: To compare the factors that lead to early versus late presentation in patients with neck masses Study Design: Group Comparative Study. Study Setting & Duration: Department of Otorhinolaryngology and Head &Neck Surgery at Rawalpindi Teaching Hospital from 01-9-2022 to 01-03-2023. Methods: Approval of the study was obtained from the hospital's ethical committee. A total of 64 patients (32 in each group) were placed in two Groups A &  B. Group A included patients who presented early and Group B included patients who presented late. Both male and female patients were selected. In this study patients suffering from neck masses who have reported for work-up to the Department of ENT, Rawalpindi Teaching Hospital, and fulfil the complete inclusion and exclusion criteria were included. Patients were selected via consecutive nonprobability sampling. The data were analyzed for frequencies by SPSS 24. Results: A total of 64 patients were included in this study. The mean age of these patients was 48.67 ± 9.74 years, ranging from 25 to 70 years. The Frequency distribution of males at 65.63 % was found to be more than that of females at 34.36 %. In the majority of patients, the size of mass more than 1.5 cm (51.56%) revealed malignancy, while only a small percentage of patients (48.44%) had less than 1.5 cm neck mass. The majority of patients (93.75%) with addiction presented late, while just a small number (6.25%) had early presentation. The majority of patients (51.56%) with frequent visits to  Quacks /Hakeem per year were presented late. Regarding socioeconomic status, the majority of patients (28) from upper-class families presented early, compared to (11) patients from middle-class families who presented late, and all (21) patients from lower-class families who presented late. The education level reveals that the majority of patients (31), who were educated, attended a school for more than a year, but only up to ten (matriculate or similar) years, or advanced literacy: got a college- or university-level education, and they displayed early presentation. The 30 uneducated patients, who never attended an educational institution, or attended for less than one year, presented late. 31 patients had frequent visits to health care professionals and were presented early, 30 patients had fewer visits to health care professionals present late with advanced disease.  Conclusion: The majority of patients who were drug and alcohol addicts were presented late with advanced disease. Middle-class families, lower-class families, uneducated patients, and patients who did not see a healthcare provider four or more times per year, make up the majority of visits to Quacks and Hakeem each year and are presented late with advanced disease as compared to the group of patients who belong to upper class, were literate with no history of drug or alcohol addiction and have frequent visits to health care professionals. Both groups were considered to be significant (p=0.00) based on the probability ratio. This study helped to identify the role of various suspected risk factors for late presentation in head and neck cancers in an attempt to reinforce or negate their importance which will help to guide the formation of screening protocols thereby improving morbidity, and mortality and reducing financial costs.

Examining Relationship between Electricity Consumption and its Major Determinants in Pakistan

The objective of the study is to examine the relationship between electricity consumption and its major determinants; particularly economic growth, number of electricity customers, electricity prices and electricity shortages in Pakistan using time series data from 1972 to 2012. The study employed the Johansen cointegration test to examine relationship between electricity consumption and its determinants. Multivariate granger causality test is then applied to determine the causality direction between electricity consumption and its major determinants. The results reveal that determinants of electricity consumption function are cointegrated and economic growth, number of electricity customers are positively related to electricity consumption, while electricity price and electricity shortages are negatively related to electricity consumption in Pakistan. However, bidirectional causality found between electricity consumption, economic growth and electricity customers except electricity prices which is exogenous determined. The short run, long run elasticities and multivariate granger causality results implies that at different time frame there is need to implement different policies for Pakistan. There is need to revise electricity pricing policy and find alternative renewable sources to generate low cost electricity and  further need to enhance energy management expertise to cope with crises in an efficient way. Keywords:  Electricity consumption; Economic growth; Electricity customers; Pakistan JEL Classifications: Q4; Q4

Serum lipid profile as a marker of liver impairment in hepatitis B Cirrhosis patients

Representative GC chromatogram of serum total and free fatty acids of HBV patients and controls along with standards of fatty acid methyl esters.(DOCX 761 kb

Effects of Carica Papaya Leaf Extract on Blood Hematology, Serum Biochemistry and Immune Response of Broilers

Background: As an alternative of antibiotic growth promoters, medicinal plants are the most popular options. Papaya leaves are good source of vitamins, minerals, antioxidants and enzymes which provide aid in digestion of carbohydrates, proteins and fats and overcome the microbial load and used as a growth promoter and antibiotic in broiler performance. This study was carried out in order to evaluate the effect of papaya leaf extract in drinking water as a replacement of commercial antibiotic on blood hematology, serum biochemistry and immune response of broilers for the duration of 35 days.Methods: In this experiment, 180 one-day old chicks were randomly distributed into 6 treatments. Each treatment was divided into 3 replicates having 10 chicks each. Feed was offered ad-libitum to broilers. Six treatments; G1 {(basal diet + antibiotic growth promoter (enramycin) + coccidiostat (salinomycin)}, G2 (basal diet without antibiotic growth promotor and coccidiostat), G3 (basal diet + 0.5% papaya extract), G4 (basal diet + 1.0% papaya extract), G5 (basal diet + 1.5% papaya extract) and G6 (basal diet + 2.0% papaya extract) were designed. Blood samples were taken for serum biochemistry, hematology and titer against Newcastle disease. Data were analyzed using analysis of variance technique by completely randomized design using SAS and Tukey’s test were used for comparison of means.Results: Birds received various level of papaya extract had no effect on serum biochemistry and hematology parameters except triglyceride levels which were significantly lower in G2 (15.00±15.00, commercial diet) and G6 (17.43±9.87, commercial diet + 2% papaya extract) at 17th day and 35th day where it failed to show significant difference. However, Newcastle disease and infectious bursal disease titers were not affected by the treatments.Conclusion: It can be concluded that papaya leaf extract may be used in broiler diet as commercial antibiotics replacement.Keywords: Papaya leaf extract; Antibiotics; Immune response; Broile

Cytotoxic and antiviral potentials of Euphorbia milii var. splendens leaf against Peste des petits ruminant virus

Purpose: To determine the cytotoxic and antiviral potentials of Euphorbia milii var. splendens leaf against Peste des petits ruminants virus (PPRV). Methods: The methanol extract, as well as n- hexane, chloroform, ethyl acetate, and n- butanol fractions of E. milii leaves were screened for cytotoxic and antiviral activities against PPRV using Vero cell line and 3-(4,5-dimethylthiazol-2-yl)-2,diphenyltetrazolium bromide (MTT) assay. Results: Non-cytotoxic concentrations with cell survival rate (CSP) greater than 50 % were considered virucidal. Methanol extract and fractions produced significant (p < 0.05) effects at all test concentrations against PPRV. The 50 % cytotoxic concentration (CC50) calculated was ≤ 25 µg/mL for extract and fractions. In antiviral assay, ethyl acetate, n-hexane, and n-butanol fractions at all test concentrations ranging from 1.56 - 800 µg/mL were non-virucidal; even at their non-cytotoxic concentrations these fractions did not show antiviral activities. However, the methanol extract and its chloroform fractions showed significant (p < 0.05) virucidal potential. Conclusion: The results suggest that further isolation of antiviral constituents from the fractions may open new horizons for the development of new antiviral agents

Anticancer screening of medicinal plant phytochemicals against Cyclin-Dependent Kinase-2 (CDK2): An in-silico approach

Background: Cyclin-Dependent Kinase-2 (CDK2) is a member of serine/threonine protein kinases family and plays an important role in regulation of various eukaryotic cell division events. Over-expression of CDK2 during cell cycle may lead to several cellular functional aberrations including diverse types of cancers (lung cancer, primary colorectal carcinoma, ovarian cancer, melanoma and pancreatic carcinoma) in humans. Medicinal plants phytochemicals which have anticancer potential can be used as an alternative drug resource.Methods: This study was designed to find out anticancer phytochemicals from medicinal plants which could inhibit CDK2 with the help of molecular docking technique. Molecular Operating Environment (MOE v2009) software was used to dock 2300 phytochemicals in this study.Results: The outcome of this study shows that four phytochemicals Kushenol T, Remangiflavanone B, Neocalyxins A and Elenoside showed the lowest S-score (-17.83, -17.57, -17.26, -17.17 respectively) and binds strongly with all eight active residues Tyr15, Lys33, Ileu52, Lys56, Leu78, phe80, Asp145 and Phe146 of CDK2 binding site. These phytochemicals could successfully inhibit the CDK2.Conclusion: These phytochemicals can be considered as potential anticancer agents and used in drug development against CDK2. We anticipate that this study would pave way for phytochemical based novel small molecules as more efficacious and selective anti-cancer therapeutic compounds

Pneumococcal serotypes and serogroups causing invasive disease in Pakistan, 2005-2013

While pneumococcal conjugate vaccines have been implemented in most countries worldwide, use in Asia has lagged in part because of a lack of data on the amount of disease that is vaccine preventable in the region. We describe pneumococcal serotypes elicited from 111 episodes of invasive pneumococcal disease (IPD) from 2005 to 2013 among children and adults in Pakistan. Seventy-three percent (n = 81) of 111 IPD episodes were cases of meningitis (n = 76 in children 0-15 years and n = 5 among adults). Serotypes were determined by target amplification of DNA extracted from pneumococcal isolates (n = 52) or CSF specimens (n = 59). Serogroup 18 was the most common serogroup causing meningitis in children \u3c5 \u3eyears, accounting for 21% of cases (n = 13). The 10-valent pneumococcal conjugate vaccine (PCV 10) or PCV10- related serotypes were found in 61% (n = 47) of childhood (age 0-15 years) meningitis episodes. PCV-13 increased this coverage to 63% (one additional serotype 19A; n = 48). Our data indicate that use of PCVs would prevent a large proportion of serious pneumococcal disease

A retrospective study of laboratory-based enteric fever surveillance, Pakistan, 2012-2014

Introduction: The Surveillance for Enteric Fever in Asia Project (SEAP) is a multisite surveillance study designed to capture morbidity and mortality burden of enteric fever (typhoid and paratyphoid) in Bangladesh, Nepal, and Pakistan. We aim to describe enteric fever disease burden, severity of illness, and antimicrobial resistance trends in Pakistan.Methods: In this retrospective, cross-sectional study, laboratory records of hospitalized patients who received a blood culture in any of 3 Aga Khan University hospitals in Karachi and Hyderabad, Pakistan, from 2012 to 2014 were reviewed. A case was defined as having a positive blood culture for Salmonella Typhi (S. Typhi) or Salmonella Paratyphi (S. Paratyphi). Antimicrobial sensitivity patterns were characterized for all S. Typhi and S. Paratyphi isolates. Medical records were available for abstraction (demographics, clinical features, complications) only among hospitalized cases.Results: Of the 133017 blood cultures completed during the study period, 2872 (2%) were positive-1979 (69%) for S. Typhi and 893 (31%) for S. Paratyphi. Fluoroquinolone resistance was present in \u3e90% of both the S. Typhi and the S. Paratyphi isolates; almost none of the isolates were resistant to cephalosporins. Multidrug resistance (resistance to ampicillin, chloramphenicol, and cotrimoxazole) was observed in 1035 (52%) S. Typhi isolates and 14 (2%) S. Paratyphi isolates. Among S. Typhi and S. Paratyphi isolates, 666 (23%) were linked to hospitalized patients with medical records. Of the 537 hospitalized S. Typhi cases, 280 (52%) were aged 5-15 years, 133 (25%) were aged 2-4 years, 114 (21%) were aged \u3e15 years, and 10 (2%) were aged 0-1 years. Among the 129 hospitalized S. Paratyphi cases, 73 (57%) were aged \u3e15 years, 41 (32%) were aged 5-15 years, 13 (10%) were aged 2-4 years, and 2 (2%) were aged 0-1 years. Significant differences in symptomology between S. Typhi and S. Paratyphi cases were observed for nausea/vomiting, diarrhea, loss of appetite, and headache. Leukopenia, thrombocytopenia, and encephalopathy were the most commonly reported complications among enteric fever cases. No deaths were reported.Conclusion: Evidence of high antimicrobial resistance levels and disease severity support the need for continued surveillance and improved diagnostics for typhoid. Further prospective studies on vaccination as a tool for prevention of enteric fever in Pakistan are needed to inform disease intervention strategies