Primary Signet-Ring Carcinoma (Linitus Plastica) of the Colorectum presenting as Subacute Intestinal Obstruction

Primary Signet-ring cell carcinoma (Linitus Plastica) of the colon and rectum is a rare form of adenocarcinoma of the large intestine and has been reported to have an extremely poor prognosis. We report a case of Primary Signet-ring cell carcinoma of the colorectum in a thirty one year old man presented in Surgical OPD of our hospital with chief complaints of persistent pain in abdomen and vomiting since two days. Since the prognosis of primary signet ring cell carcinoma (SRCC) is extremely poor (in view of more malignant behavior than ordinary colorectal carcinoma), early diagnosis and aggressive treatment strategy are necessary

The sum of the parts is greater than the whole: Multi-scalar socio-spatial definitions of identity in Karachi's Muhajir majority areas

Notions of identity and community like space consist of varying scales of definition and interaction ranging from concepts of nationhood and nationality through to local solidarities and affiliations of religion, trade, caste etc. Space Syntax research suggests that most people belong to communities that are both spatial and transpatial in nature where inhabitants of an area are bound not only to the people and spaces they physically inhabit but are simultaneously part of a larger transpatial community independent of the immediate physical context. In the context of Karachi's Muhajir community, an ethno-political entity that has evolved through spatio-political constraints applied to an amalgam of assorted post-Partition urban minority groups, these socio-spatial variations in definition of identity can be studied across the changing scale of the city. Using space syntax methodologies, this paper examines the spatial definitions of identity, i.e. how affiliations and solidarities vary across the changing scales of the city and, how the use and positioning of communal tools of identification organize and articulate spatial clusters. This study used a range of sources to map religious and political institutions as well as on-site documentation of political propaganda and related the location of these features to space syntax models of the city and four case study settlements. The intention was to analyse the accessibility and clustering of various communal spaces, how spatial configuration defines the social role communal spaces play within the community and how they may define the spatial limits of sub-clusters and internal social hierarchies of the community. This multi-scalar analysis will show that not only does the nature of the muhajir cluster change across the various scales of the city, the nature and scale of the interface between the community and the city changes too. At the city scale communal institutions articulate broad residential clusters often synonymous with political territories, indicative of spaces of dispute, at the scale of the settlement, the configuration of communal spaces describes and dictates the manner in which these communities interact, organize and define themselves internally. Identity is therefore multi-scalar; a group may present as one ethno-political entity at the scale of the city, it may simultaneously exist as multiple ethno-religious groups at the scale of the settlement. Whilst neither definition negates the other, analysis shows that broad political definitions hide richer, more nuanced definitions of identity that persist at the scale of the settlement

Karachi: The transformation and spatial politics of a Post-colonial migrant city

The partition of the Indian Sub-continent in 1947 resulted in the mass movement of people between India and Pakistan with a number of Urdu-speaking, Muslim communities choosing to re-settle in Karachi, Pakistan. These Muhajir or "refugee" communities have now been resident in the city for over 60 years and whilst the term traditionally means "refugee" in Urdu-their mother-tongue-in the context of Karachi today, it refers specifically to the descendants of these first wave (Partition, 1947) Urdu-speaking migrants from India. The community was initially seen as a landless, rootless people but, over time, they have become one of the key actors in the ethno-political landscape of urban Sindh, in Pakistan today. Whilst the political exploits of this community have been extensively reported and documented by anthropologists and journalist as part of Karachi's tumultuous political history, little has been written about the settlements and spatial practices of this amalgam of diverse, primarily North Indian migrant communities and how their arrival, and occupation has impacted and transformed the manner in which the city has developed. Using space syntax analysis and information drawn from master-plans, urban development reports, historical accounts, and political, religious and linguistic identity-markers associated with the Muhajir community, this study analyses how the city of Karachi has grown and developed through the last 65 years of its post-Partition history and tracks the settlement patterns of the Muhajir community into and around the city. The study shows that, whilst Karachi may be considered a Muhajir city, the community established clusters in very specific areas of the city at the time of their first settlement in the early 1950s and, whilst newer areas have been added to the city, these community-based clusters have persisted and densified over time. The manner in which the community has consolidated and marked its spaces in the city and the way their presence has impacted its growth seems to suggest that the community's identity has gone through a process of transformation and concretisation from Muhajirs as disadvantaged refugees to Muhajirs as a formidable ethnic group with considerable political clout that they exercise with regard to decisions that pertain to the growth and development of the city today

Understanding the Persistence of Caste: A Commentary on Cotterill, Sidanius, Bhardwaj and Kumar (2014)

We contextualise Cotterill, Sidanius, Bhardwaj, and Kumar’s (2014) paper within a broader literature on caste and collective mobilisation. Cotterill and colleagues’ paper represents a fresh and timely attempt to make sense of the persistence of caste from the perspective of Social Dominance Theory. Cotterill and colleagues, however, do not examine caste differences in the endorsement of karma, and take behavioural asymmetry among lower castes for granted. Cotterill and colleagues also adhere to a Varna model of the caste system that arguably is simplistic and benefits the upper castes of Indian society. We caution that emphasising behavioural asymmetry and endorsing the Varna model might further stigmatise lower castes, especially Dalits, and feed into a conformity bias already predominant in caste-related psychological research. We argue that the conceptualisation and operationalisation of Right-Wing Authoritarianism, Social Dominance Orientation and legitimising myths in the Indian context needs to take into account the particular meaning and functions of these constructs in specific intergroup contexts, and for identity positions salient within these contexts. We contend that any examination aimed at better understanding the nature of social hierarchy and oppression within the caste system and Indian society in general remains inconclusive without including a focus on the construction and contestation of social categories and social identities

Current prevalence of cattle trypanosomiasis and of its vector in Alme, the infested zone of Adamawa plateau Cameroon, two decades after the tsetse eradication campaign

Livestock diseases especially cattle trypanosomiasis remains a challenge and a call for concern. A Cross sectional study was carried out on the entomological and parasitological prevalence of cattle trypanosomiasis, in the tsetse fly infested zone-Alme in Faro and Deo division, Adamaoua region Cameroon. The aim of this study was to determine the prevalence of bovine trypanosomiasis, apparent density and distribution of its vectors. Blood samples were randomly collected from 504 selected cattle and analyzed using the Haematocrit Centrifugation Technique (HCT); identification of different trypanosomes was achieved using the method of May−Grünwald Giemsa. An entomological survey was conducted using laveissiére type blue biconical traps (n=11 traps; 9 traps in the Alme Ranch and 2 around the Faro Game Reserve). The overall prevalence of trypanosome infection in the study area was 29.4%. However, there was a statistical significant (P<0.05) difference of trypanosome species with site. There were single as well as mixed infections. The single infections identified were: Trypanosoma congolense (14.09%), Trypanosoma vivax (6.15%) and Trypanosoma brucei (3.37%) and mixed infections were Trypanosoma congolense+Trypanosoma vivax (2.38%), Trypanosoma congolense+Trypanosoma brucei (0.39%), Trypanosoma vivax+Trypanosoma brucei (0.39%) and Trypanosoma congolense+Trypanosoma vivax+ Trypanosoma brucei (2.57%). Entomological findings indicated that Glossina morsitans (47.27%) was the only tsetse fly species caught in the study area with others (44.5%), Stomoxys (4.50%) and Tabanus (3.59%). The overall apparent mean tsetses and biting flies’ density of 9.05 and 1.46 flies/trap were recorded respectively. Current prevalence is witnessing a decrease in this area due to improved farmer’s knowledge in the usage of barriers such as trypanocides and screens in disease management. Maintenance of these barriers can bring the disease to a bay in this trypanosomiasis risk zone of the Adamawa plateau.Keywords: Cattle trypanosomiasis, prevalence, Alme and Adamawa plateau Cameroon

The spatialisation of an ethno-political migrant identity: appropriation, adaptation, and contestation of Muhajir space in Karachi

Karachi today, is a city of migrants where both space and ethnicity are politicised and contested. The Muhajir community is the city’s largest and politically most significant migrant group. The development of community identity and their political trajectory has been extensively documented but little has been written about the spatialisation of this ethno-political identity and its impact on the city. This study endeavours to analyse the settlement patterns of the Muhajir community from their arrival in the city in 1947 to the present and how political mobilisation and subsequent access to power has shaped their post-colonial identity, their spaces and, their interactions with the city today. Due to the dearth of ethnographic data, this multi-scalar, diachronic, sociospatial investigation of Muhajir presence in Karachi uses a combination of quantitative and qualitative data sources. Master-plans, urban planning documents, historical and journalistic accounts were used to build space syntax models of the city, combining this information with open-content collaborative mapping sources, on-site interviews, questionnaires and observations to build a picture of the community’s socio-spatial behaviour and their patterns of occupation. The study shows that whilst the Muhajir community clusters and that these clusters have persisted and aided their political re-imagining which in turn has enabled them to influence urban development in the city to their strategic spatial advantage, the community is in fact not completely introverted and does engage and overlap with Karachi’s diverse array of communities through their socioeconomic interactions. And, that the term Muhajir encompasses a myriad of identities; a homogenous political block offset at the neighbourhood scale by spatial clustering determined by place-based, linguistic and religious solidarities. This socio-spatial analysis shows this to be a complex community identity that engages with the urban environment at varying degrees of definition to preserve and secure the rights of its members

Process evaluation of integrated early child development care at private clinics in poor urban Pakistan: a mixed methods study

Background: In poor urban Pakistan, private GP clinics lack adequate services to promote early child development (ECD) care. A clinic-based contextualised ECD intervention was developed for quarterly tool-assisted counselling of mothers. Aim: To explore the experience and implementation of ECD intervention by the private care providers and clients, for further adaptation for scaling of quality ECD care, at primary level private healthcare facilities in Pakistan. Design & setting: A mixed methods approach using quantitative records review and qualitative interviews at poor urban clinics in Rawalpindi and Lahore, Pakistan. Method: Quantitative data from study-specific records were reviewed for 1242 mother–child pairs registered in the intervention. A total of 18 semi-structured interviews with clinic staff, mothers, and research staff were conducted at four clinics. The interviews were audiorecorded and transcribed verbatim. Results: District Health Office (DHO) support allowed transparent and effective selection and training of clinic providers. Public endorsement of ECD care at private clinics and the addition of community advocates promoted ECD care uptake. Clinic settings were found feasible for clinic assistants, and acceptable to mothers, for counselling sessions. Mothers found ECD counselling methods more engaging compared to the usual care provided. Conclusion: In poor urban settings where public health care is scarce, minimal programme investment on staff training and provision of minor equipment can engage private clinics effectively in delivering ECD care

Is integrated private-clinic based early child development care effective? A clustered randomised trial in Pakistan

Background In Pakistan, high prevalence of delays in early child development (ECD) is associated with poverty and lack of mothers’ caregiving skills. GP clinics, the main sources of care in poor urban localities, lack quality ECD care delivery. A contextualised intervention was developed and tested to enable GPs to deliver clinic-based, tool-assisted ECD counselling of mothers on a quarterly basis. Aim To assess the effectiveness of delivering a contextualised ECD mother-counselling intervention. Design & setting Clustered randomised controlled trial, in poor urban localities of Pakistan. Locality clusters were allocated to intervention and control arm using simple randomisation. Method A total of 2327 mother–child pairs were recruited at 32 GP clinics, one from each cluster-locality; 16 GP clinics per arm. The clinic-based counselling intervention covering child stimulation, nutrition, and maternal mental health was delivered mainly by clinic assistants to mothers at ≤6 weeks, and 3, 6, and 9 months of child age. At 12 months of child age, each mother–child pair was assessed for the primary outcome, that is, delays in the five development domains (determined by Ages and Stages Questionnaire-3 [ASQ-3] score); and secondary outcomes, namely the prevalence of stunting and maternal depression (determined by Patient Health Questionnaire-9 [PHQ-9] score). The outcome assessors were blinded to the cluster–arm allocation. Outcome analyses were calculated on cluster-level. Results At 12 months, the number of children with delay in two or more development domains was significantly lower in the intervention arm (-0.17 [95% confidence interval {CI} = -0.26 to -0.09]; P<0.001) compared to the control arm. The difference in the prevalence of child stunting and maternal depression were also significant at -0.21% (95% CI = -0.30 to -0.13; P<0.001) and -0.23% (95% CI = -0.29 to -0.18; P = 0.000) respectively. Conclusion Contextualised ECD care, when delivered at GP clinics in poor urban localities, can effectively reduce the developmental delays during the first 12 months of the child's life

Isoflavones-Based Liposome Formulations as Anti-Aging for Skincare

Isoflavones commonly found in plants such as soya and red clover express many health benefits including skin healing and anti-aging properties. The capacity to counteract aging is due to isoflavones being both anti-oxidants as well as phytoestrogens, hence preventing both extrinsic as well as intrinsic aging processes. In skincare formulations their effects could be enhanced with the aid of advanced delivery systems. Isoflavones from soya bean source has successfully been incorporated into liposomes and further used in commercially available anti-aging creams. However different plants vary in isoflavone composition. Red clover isoflavones express less affinity for the estrogen receptor whilst simultaneously containing isoflavone structures that should be easier to encapsulate in liposome vehicles compared to soya bean derived isoflavones. If liposome entrapped isoflavones could successfully be obtained, the novel liposome could have a visible effect on the skin and reduce the visible adverse outcomes of aging and moreover be advantageous in terms of endocrinological safety and/or have a higher efficiency of delivering active when compared to the currently available products on the market

Bone turnover biomarkers in obese postmenopausal Saudi women with type-ІІ diabetes mellitus

Background: There is a high prevalence of diabetes mellitus type-2 (T2DM) and osteoporosis are problems worldwide. In this study, we evaluated the correlation between T2DM and bone turnover in diabetic obese postmenopausal Saudi women.Subjects and Methods: The present study included total of 65 T2-DM obese postmenopausal Saudi women, (36 uncontrolled, 29 controlled) .The following serum biochemical parameters were evaluated [fasting blood glucose (FBG),total calcium (Ca), phosphorus (Pi), parathyroid hormone (PTH), 1,25-(OH)2Vitamin D3 ,osteocalcin (OC), procollagen (PICP) and cathepsin k (Cath K) ].Results: Serum OC levels were significantly decreased in diabetic obese postmenopausal group compared to their respective healthy group (P &lt; 0.004). PICP and Cath K were significantly elevated in diabetic postmenopausal group compared to the healthy group ( P &lt; 0.024 &amp; 0.001). A significant elevation in 1,25(OH)2 Vitamin D3, Ca and Pi levels in diabetic obese postmenopausal patients group compared to the healthy group. However, a non-significant changes was observed in serum PTH level between different groups.Conclusion: In this study, the changes in the biochemical parameters and bone turnover markers in obese women are strong risk factors for diabetes development that may contribute to osteopenia and osteoporosis. The study showed the strong effect of T2DM on biochemical markers of bone turnover in obese postmenopausal Saudi women.Keyword: Diabetes mellitus type-2, Bone markers, Postmenopausa