Determinants of Non-Adherence to Anti-Retroviral Therapy in HIV/AIDS Patients of HIV Centre Jinnah Hospital

Introduction: Human immunodeficiency virus is very harmful to human’s immune system. This virus can further cause specific contaminations and tumors in humans. The HIV-contaminated populace is at a higher danger of AIDS-characterizing tumors, for example, Kaposi sarcoma, non-Hodgkin lymphoma, and cervical malignant growth. Since the coming of exceptionally dynamic antiretroviral treatment (HAART) in 1996, the endurance of HIV-tainted populace in the United States has expanded significantly (Shiels et al., 2011).Methods: A descriptive study conducted at HIV centre Jinnah Hospital Allama Iqbal Medical College Lahore. Data was collected through questionnaire from patients of HIV clinic. Data was analysed by SPSS version 21.0, frequency, percentage and standard deviation was found with statistics of pie charts and histogram.Results: From one hundred participants 100(100%) shows forgetfulness , 29(29%) shows missing appointments, 33(33%) shows run out of medication, 11(11%) shows depression, anger, despair. 78(78%) don’t think that ART helps ,only 4(4%) shows side effects of ART and 1(1%) shows other reason for non-adherence. Conclusions:  The outcomes gave basic and valuable data that will help in decreasing the factors that are causing non-adherence to ART. Keywords: Antiretroviral therapy, Adherence, Determinants, Lahore, Pakistan DOI: 10.7176/JHMN/101-05 Publication date:June 30th 202

Effectiveness of Health Education Session on Knowledge of High School Students Regarding Plastic Use and Its Health Hazards

Introduction: Plastic is widely used due to its low cost and different functional properties but it has many severe adverse effects on consumer’s health in many direct and indirect ways. Plastic waste pollutes the environment and it is a threat to human life. So, there is a great need to reduce plastic use and plastic waste hazards. Methods: A quasi- experimental, quantitative, before and after study design was conducted  among the students total (n= 60) in the high school of Ali Raza Abad Raiwind Road Lahore, Pakistan from September 2018 to December 2018. The educational intervention involve three education session about plastic use and its health hazards in which the researcher educate the students about health hazards of plastics, prevention of plastic objects as well as health complications.  Results: A total of 60 children participated in the study, the majority of the participants were boys. The mean before the educational intervention is 8.98 (Standard deviation 3.281) and after the educational intervention is 16.85 (Standard deviation 3.036). The mean difference between the two mean is 7.867. There is a statistically significant difference before and after the educational intervention. The educational intervention is highly effective because the significant value is 0.00 Conclusions: The result of the study shows that students have adequate knowledge about health hazards of plastic use. The ill effects of plastic can be reduce by educational intervention among students. Keywords-Plastic use. Health education. Health hazards DOI: 10.7176/JHMN/72-09 Publication date:March 31st 202

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

A Socio-pragmatic Perspective of Hudaibiya Treaty in the light of Grice’s Maxims

The present research will analyze the presence of Grice’s maxims in the treaty of Hudaibiya. The perfect idea of communication is that people will cooperate with each other during a conversation. Treaty has a lot of historical value as it suggests and reflects the cooperation of two leaders for the benefit of their people. It is a qualitative research but descriptive approach will be used for the analysis. Paul Grice’s (1975) Cooperative Principle: maxim of quality, maxim of quantity, maxim of relation, maxim of manner will be used to draw inferences. It was found that treaty follows all the maxims. All the points of the treaty are reality based and no compromises over religion have been made. Treaty is without any ambiguity, false or vague statements by using appropriate and relevant phrases and words. Furthermore, it promotes peace, prosperity, freedom and security of the people of that time which shows the socio-pragmatic culture of Islam

“BOL”BY SHOAB MANSOOR PORTRYAL OF THIRD GENDER IN COMTEMPORARY CINEMA

This research paper throwsspotlight on theproblems of third gender people as depicted in the modern cinema with exclusive background to the Pakistani filmBol. This film highlightspublicdemeanor in Eastern society with them especially because of their gender identity.Its varioustraits are carefully chosen to search the height of the difficulties faced by transgender people in the chosen movie. Discourse analysis technique is adapted as a tool to create the rationale of the study. The selection of movie isgrounded withinEastern society as portrayed in the cinema. Theattitude of society with this marginalized group is the main cause that generateshostile environment in the lifespan of Saifi, who meetsterrible death by the hands of his father. It is because of lack of awareness about transgender people in the eastern environment; they are poorly treated as if they are not even human beings. So the major issues  hereare how the world perceivesthem in the society, and how he will be accepted in the society? To elucidate the problems of transgender, discriminatory behaviors adopted by the society towards Saifi(a transgender child), the main causes of Saifi’s death and the consequences of his death on other transgender community are discussed in this paper.Byemploying qualitative research methodologyit is revealed thatSaifi is betrothed in a struggle for life; his character is found weak which causes failure to save himself from societal disdain. Actually struggle for survival was a challenging task to show the viewers other side of a coin in case of transgender’s issues in all over the world

THE ROLE OF ERROR ANALYSIS IN TEACHING AND LEARNING ENGLISH AS FOREIGN AND SECOND LANGUAGE

The paper aims to explore the mistakes of students who learn English as a second and foreign language. Most of the time, errors are considered flaws or foibles that are cause of perturbation, agitation and embarrassment. In fact, errors are like a gadget that can be used to rectify the mistakes of learners while acquiring English as L2. Moreover, the study elaborates the attitude of students towards errors and mistakes that they commit in learning process of English as L2. Error analysis is a tool that gives a road map not only to teachers but also to students to learn from their mistakes. Error analysis is also pivotal for the tutors to enable them to devise new teaching strategies and make proper planning for better learning process and to teach English to students in better and organized way. The present work depends on the syntactic analysis of students‟ written composition and on the questionnaire delineated to the students of BS (Bachelor Science) to collect data in the sequel of peculiarity of error analysis. The findings and the discovery of the study endorse that students need to learn proper syntactic structure, linguistic precision and parts of speech.L1 of the learners also influence the learning curve of L2. The examination further recommends the proper spoken expression, listening skill and reading ability for refined written project as language learning is an intricate system of different building blocks. &nbsp

The financial toll of lumpy skin disease in Pakistan, and Whether or not vaccination is worth it for preventing Future outbreaks

Farmers may suffer significant financial losses as a result of lumpy skin disease (LSD). It is a major impediment to global commerce. The Capri poxvirus genus includes the lumpy skin disease virus (LSDV). The LSD greatly lowers milk output, which may range from 10% to 85%. Milk and meat consumption in Karachi (Pakistan) has fallen by 60% to 70% as a consequence of LSD use. calves of all kinds and ages are impacted, with nursing cows and young calves being the most vulnerable. Most LSD outbreaks occur in hot, humid areas, where the majority of the flies that serve as vectors are present. Animals may be able to transfer LSD more rapidly. While mortality rates are normally modest (between 0 and 7%), morbidity rates vary from 0.75 to 100%. There are lesions in the reproductive, respiratory, and digestive systems. Mastitis, pneumonia, skin infections, limping, diarrhoea, and myiasis are all potential side effects of severe LSD. It is reliable and safe to consume milk and meat from ill animals. It is critical to choose infection management and prevention methods. The limited movement of infected animals is one of the primary ways that LSD spreads in regions where it is not endemic. Another disease-control strategy is to minimize the quantity of insects and vectors. Furthermore, vaccination or immunization with the homologous strain of the LSDV may be the most efficient approach of disease control. To choose control measures in time for the LSD to be decreased, diagnosis is critical and should be quick and precise, especially in endemic areas. Keywords: Pathology, Lumpy skin disease, vaccination, economic effects, Pakista

Frequency and predictors of non-adherence to lifestyle modifications and medications after coronary artery bypass grafting: A cross-sectional study

Background: Non-adherence to dietary recommendations, exercise and prescribed drug regimens, in coronary heart disease (CHD) patients following coronary artery bypass grafting (CABG), is a major health care issue worldwide. Aims and objectives: The primary objective of this study was to investigate the frequency and predictors of non-adherence to lifestyle changes and medication among CHD patients after undergoing CABG surgery. Method: The sample of this cross sectional descriptive study was 265 patients who underwent isolated primary CABG. Participants who met the eligibility criteria were provided with a pre-coded questionnaire 4 weeks or more after surgery. Adherence was assessed on the basis of patient's self-report. Significance of results was analyzed using Chi square test. Results: Roughly half of the patients were non-adherent to dietary recommendations (n = 120, 45.3%) and exercise (n = 109, 41.1%) while about one third (n = 69, 26%) were non-adherent to prescribed medications. Unwillingness to adopt a new lifestyle and more than one social gathering per week, were found to be statistically significant predictors of non-adherence to diet (p-values < 0.001). Reluctance to follow exercise regimen, busy schedule, and fear that exercise will aggravate heart issues were commonly reported as reasons for non-compliance to exercise. As for non-adherence to medication, forgetfulness, affordability of drugs and too many medications to take were important predictors. Conclusion: Non-adherence to lifestyle modifications and medication is an emerging problem worldwide. It is essential for medical health professionals to discuss these predictors and address them individually. Our findings highlight the need for a healthy physician and patient relationship

Characteristics and outcomes of COVID-19 patients admitted to hospital with and without respiratory symptoms

Background: COVID-19 is primarily known as a respiratory illness; however, many patients present to hospital without respiratory symptoms. The association between non-respiratory presentations of COVID-19 and outcomes remains unclear. We investigated risk factors and clinical outcomes in patients with no respiratory symptoms (NRS) and respiratory symptoms (RS) at hospital admission. Methods: This study describes clinical features, physiological parameters, and outcomes of hospitalised COVID-19 patients, stratified by the presence or absence of respiratory symptoms at hospital admission. RS patients had one or more of: cough, shortness of breath, sore throat, runny nose or wheezing; while NRS patients did not. Results: Of 178,640 patients in the study, 86.4&nbsp;% presented with RS, while 13.6&nbsp;% had NRS. NRS patients were older (median age: NRS: 74 vs RS: 65) and less likely to be admitted to the ICU (NRS: 36.7&nbsp;% vs RS: 37.5&nbsp;%). NRS patients had a higher crude in-hospital case-fatality ratio (NRS 41.1&nbsp;% vs. RS 32.0&nbsp;%), but a lower risk of death after adjusting for confounders (HR 0.88 [0.83-0.93]). Conclusion: Approximately one in seven COVID-19 patients presented at hospital admission without respiratory symptoms. These patients were older, had lower ICU admission rates, and had a lower risk of in-hospital mortality after adjusting for confounders