Efficacy of Arthrocentesis in Internal Derangement of Temporomandibular Joint

Abstrac

Religio-political Discourse and Jam’iyyat Ulema-i-Pakistan (JUP): A Careful Study of Different Narratives (1970-2003)

Barelvi Ulema, being active participants of the Pakistan Movement (1940-1947), very soon reached to the point that their objectives associated with the struggle for Pakistan could only be achieved through a constitutional and political struggle; and as per the need of the parliamentary system prevailed in the country, they must converge and consolidate their energies on a political platform. Hence, on 28th March 1948, in a 3-day meeting of Barelvi ulema at Madrasah-i-Islamiah Arabiah Anwar al ulum, Multan, the Markazi (Central) Jam’iyyatal-Ulema-i-Pakistan (MJUP) was formally established. A glance over the party objectives set at this meeting gives a clear picture of JUP’s Rightism sui generis. It was aspired that Pakistan would be a true Islamic state established through the promulgation of the Islamic constitution in the country and all the social and moral evils would be emulated as the founding father of the country had aspired in the inaugural session of the Constituent Assembly of Pakistan (CAP). Moreover, it was also hoped to propagate Islamic teachings among the Muslims by initiating the spirit of religious cum political awakening and the spirit of Jihad among them and direct their attention from western culture and civilization towards Islamic culture and civilization. Hence, the establishment of an Islamic state in the country was the destiny of JUP. In order to remind the higher authorities and other stakeholders responsible for the formation of the constitution, JUP held meetings and processions throughout the country. It pressed demands for the enforcement of Islamic jurisprudence through Islamic constitution. This religio-political as well as constitutional strife can be found in a number of indigenous narratives and beyond. The article presents a careful and curious study of different available narratives in this connection

Cerebral Palsy risk factors associated with pregnancy and delivery

Objective: To identify and analyze the risk factors associated with pregnancy and delivery that contribute to the development of cerebral palsy in children. Material and Methods: To better understand what factors lead to cerebral palsy in children, a cross-sectional study was conducted at the CRP pediatric hospital in Savar, Dhaka. The study's sample size of 56 was reached by a convenience sample of mothers of children with cerebral palsy. In-person interviews were conducted utilizing a survey instrument translated into Bengali or the native tongue and then pilot tested. Excel and SPSS were used for statistical analysis. Informed consent and confidentiality were ensured under ethical guidelines. Results: The data shows past socioeconomic variables. Population age distribution: 37.50% 29–35. 88.1% were Muslim. 59% rural residential areas. 35.70% SSC education.  85.7% had two or more children, 45.6% under three. 55% were males, 45% female. 41% of pregnancies had issues, and 24.9% of women underwent abortions. Normal births were 51.80% and cesarean sections 48.20%. Post-birth statistics included crying immediately (34%), yellowish eyes (50%), fever with seizures (61%), head injuries (48%), and birth hypoxia (38%). 35.70% were born at home, 30.40% in hospitals (17.90% public, 16.10% private). Figure 3 showed hypertension (20%), diabetes (16%), and anemia (23%). Age, religion, education, number of children, past abortions, delivery method, and birthplace were correlated. Diabetes, hypertension, anemia, and birthplace were unrelated. Conclusion: Awareness of cerebral palsy is poor despite its prevalence. In developed country physiotherapy is considered as an important treatment for cerebral palsy children. Quantitative research was used to survey pediatric patients and identify risk variables in this study. Factors shared by many were old age, illiteracy, and origins in rural areas. Risk recognition and mitigation must be prioritized

Evaluating the in vitro antituberculosis, antibacterial and antioxidant potential of fungal endophytes isolated from Glycyrrhiza glabra L

Abstract Endophytes, especially from medicinal plants and those from biodiversity rich ecoregions synthesize important bioactive molecules. The aim of the present study was to isolate and characterize the bioactive fungal endophytes from Glycyrrhiza glabra L. of Kashmir Himalayas-a biodiversity rich ecoregion in India. Plant material was collected from different location of Kashmir region for isolation of fungal endophytes. A total of thirty-three strains were isolated and their broth was screened for their antimicrobial activity by well diffusion assay. Potent endophytes were selected and identified by ribosomal gene sequence technique. The extracts of selected endophytes were evaluated for antibacterial as well as antimycobacterial and antioxidant activities by broth microdilution technique and DPPH assay, respectively. Thirteen isolates (40%) displayed antimicrobial activity against at least one pathogen. The extract of isolates identified as Fusarium solanistrain (KT16646), Fusarium oxysporum strain (KT166447), Colletotrichum gleosporoides strain (KT166445) and Alternaria alternate strain (KT166448) displayed strong antimicrobial activity with MIC ranging from <2.34 to 125 µg/ml against various tested bacterial pathogens. F. solani and C. gleosporoides showed good activity against Mycobacterium tuberculosis (M. tb) strain H37Rv with MIC of 18.5 and 75 µg/ml, respectively. F. oxysporum exhibited good antioxidant activity with IC 50 value of <100 µg/ml. To the best of our knowledge, this is the first study that reports antimycobacterial activity of any fungal endophyte isolated from G. glabra against the virulent strain of M tb. Thus, this study sets background towards the exploration of potential bioactive molecules that may have antituberculosis, antibacterial and antioxidant activity from the fungal endophytes of G. glabra

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

Background: Future trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050. Methods: Using forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline. Findings: In the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]). Interpretation: Globally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions

ASSESSMENT OF KNOWLEDGE OF MOTHERS, ATTENDING PAEDIATRICS OPD OF A TERTIARY CARE HOSPITAL DERA GHAZI KHAN REGARDING EPI

Objective: To assess the awareness of mothers about EPI, to promote importance of vaccination and motivating mothers to follow EPI schedule. Study Design: Study design: Observational descriptive, cross sectional study. Place and duration of study: Paediatric OPD, teaching hospital Dera Ghazi Khan from May 2017 to August 2017 Methodology: 100 mothers visiting paediatric OPD of teaching hospital D.G. Khan were interviewed. All mothers were approached and knowledge was collected by pretested questionnaire which was filled up by researchers. Results: 86% of mothers have awareness about importance of vaccination. 76% of mothers have completed the vaccination schedule according to EPI card.94% of mothers had knowledge that they should be vaccinated during pregnancy. Conclusion: The analyzed data reveals good awareness regarding EPI among mothers. Level of completion of EPI is satisfactory. Further knowledge regarding details of vaccination programme, detailed schedule and their storage is poor. Key words: EPI, expanded programme on immunization. GAVI, Global Alliance for Vaccine and Immunization

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population.The aim of this study was to inform vaccination prioritization by modelling the impact of vaccination on elective inpatient surgery. The study found that patients aged at least 70 years needing elective surgery should be prioritized alongside other high-risk groups during early vaccination programmes. Once vaccines are rolled out to younger populations, prioritizing surgical patients is advantageous