Frequency of JAK2 and MPL Mutation in BCR/ABL Negative Myelofibrosis in KPK

Introduction: BCR-ABL1-negative myeloproliferative disorders are a sub-group of myeloproliferative neoplasms (MPNs) that consist of polycythemia Vera (PV), Essential thrombocythemia (ET) and Primary Myelofibrosis (PMF). Over the past decade, the morphological and clinical division of myeloproliferative neoplasms (MPN) has changed to a classification that describes the molecular heterogeneity and is unique to this subgroup of haematological malignancies. This includes alterations in Janus kinase 2 (JAK2), and MPL genes. Objective: To determine the frequency of JAK2 (p.V617F) and MPL (p.W515L) mutation in primary myelofibrosis in KPK province of Pakistan. Methodology: Fifty patients with PMF were enrolled in the study. JAK2 mutation status was determined using allele specific primers and MPL mutation was detected by direct Sanger sequencing technique. The data was analyzed using BioEdit by aligning the sequence data with reference genome hg19 assembly. Results: Among 50 patients, 41 patients were diagnosed with PMF, while 9 patients had secondary myelofibrosis i.e. Post PV-MF and Post ET-MF. Out of the 41 PMF patient 2 patients had MPL gene variation, while one of the Post ET –MF had a MPL gene variation.  Forty eight (96%) were positive for JAK2 mutation. Five patients who had MPL mutation also showed JAK 2 mutation. Two of the MPL positive patients were also positive for JAK2 mutation. Conclusion: We reported rate of recurrence of JAK2 mutation in 96% of the cases and MPL exon 10 mutations in 6% of the cases. Keywords: JAK2, MPL, Myeloproliferative neoplasms

Frequency of JAK2 and MPL Mutation in BCR/ABL Negative Myelofibrosis in KPK

Introduction: BCR-ABL1-negative myeloproliferative disorders are a sub-group of myeloproliferative neoplasms (MPNs) that consist of polycythemia Vera (PV), Essential thrombocythemia (ET) and Primary Myelofibrosis (PMF). Over the past decade, the morphological and clinical division of myeloproliferative neoplasms (MPN) has changed to a classification that describes the molecular heterogeneity and is unique to this subgroup of haematological malignancies. This includes alterations in Janus kinase 2 (JAK2), and MPL genes. Objective: To determine the frequency of JAK2 (p.V617F) and MPL (p.W515L) mutation in primary myelofibrosis in KPK province of Pakistan. Methodology: Fifty patients with PMF were enrolled in the study. JAK2 mutation status was determined using allele specific primers and MPL mutation was detected by direct Sanger sequencing technique. The data was analyzed using BioEdit by aligning the sequence data with reference genome hg19 assembly. Results: Among 50 patients, 41 patients were diagnosed with PMF, while 9 patients had secondary myelofibrosis i.e. Post PV-MF and Post ET-MF. Out of the 41 PMF patient 2 patients had MPL gene variation, while one of the Post ET –MF had a MPL gene variation.  Forty eight (96%) were positive for JAK2 mutation. Five patients who had MPL mutation also showed JAK 2 mutation. Two of the MPL positive patients were also positive for JAK2 mutation. Conclusion: We reported rate of recurrence of JAK2 mutation in 96% of the cases and MPL exon 10 mutations in 6% of the cases. Keywords: JAK2, MPL, Myeloproliferative neoplasms

Usability Evaluation of an Educational Website in Saudi Arabia

Despite the widespread use of online applications and websites, inadequate attention is paid to their usability aspect. Always there is a need to evaluate the usability of these applications and website specially the educational one to improve their user friendliness. The idea behind this research is to evaluate the usability of an educational website in Saudi Arabia. For this research we have considered a number of ways of usability evaluation, but find user based method [7] specifically Heuristic evaluation method to be easier and more cost-effective way to evaluate the usability of educational websites. A questionnaire was developed to accumulate the data. Then survey is conducted based on this questionnaire, by providing this questionnaire to different undergraduate students in one of the universities in Saudi Arabia.Despite the widespread use of online applications and websites, inadequate attention is paid to their usability aspect. Always there is a need to evaluate the usability of these applications and website specially the educational one to improve their user friendliness. The idea behind this research is to evaluate the usability of an educational website in Saudi Arabia. For this research we have considered a number of ways of usability evaluation, but find user based method [7] specifically Heuristic evaluation method to be easier and more cost effective way to evaluate the usability of educational websites. A questionnaire was developed to accumulate the data. Then survey is conducted based on this questionnaire, by providing this questionnaire to different undergraduate students in one of the universities in Saudi Arabia

Gestational Weight Gain and Its Relation to Maternal, Fetal and Neonatal Sequelae: A Future Dilemma

OBJECTIVES This study aimed to determine the frequency of women with gestational weight gain (GWG) from recommended values in pregnancy and to establish the association of GWG with the mode of delivery (vaginal delivery (VD), instrumental delivery(ID), cesarean section(CS) and neonatal outcomes( low birth weight (LBW), low APGAR score, macrosomia, stillbirth (SB) and neonatal intensive care unit admissions(NICU). METHODOLOGY The prospective study was done in the Department of Obstetrics & Gynaecology LRH Peshawar. A total of 140 women were included in this study by non-probability consecutive sampling technique. Those with congenital anomalies having known medical disorders were excluded. Ethical approval and Informed consent were obtained before the examination. Data were collected and analysed on SPSS version 22.RESULTSThe mean age was 29.4 ± 5.1 years. The mean first trimester BMI of the study sample was 25.2 ± 3.4kg/m2, while the mean BMI in 3rd trimester was 27.7± 2.3 kg/m2. GWG was recorded in 52 (37.1%) women. The mean GWG was calculated to be 12.9 kg ± 2.5. Mode of delivery was VD in 60(42.9%) women, ID in 50 (35.7%), and CS was done in 30(21.4%0) women. LBW in 15(10.7%), low APGAR score was recorded in 32(22.9%), macrosomia in 14(10%), SB in 12 (8.6%) and NICU admission in 39(27.9%). CONCLUSION GWG is common in pregnant women; however, there was no statistically significant association between GWG and mode of delivery or neonatal outcomes.

Economics of Wheat Production in Mohmand Agency, Khyber Pakhtunkhwa, Pakistan

The central theme of this research endeavour was to compute the cost and net returns of wheat crop. This study has also highlighted the significant variables contributing in wheat productivity. The study universe was two focused villages namely Malok-Korona and Peer-Qila of Ekaghund Tehsil, Mohmand Agency. The proportional allocation sampling technique was used to get the required sample size of 70 respondents. However, 26 respondents from Malok-Korona and 44 respondents from Peer-Qila were interviewed through face to face interview technique. The marked findings of this study divulge that vast majority of the farmers (61.43%) were using certified seed and the study area was predominantly dependent upon rainfall as reported by 60 % of the respondents. It is further revealed that the mean cost of production incurred by the sampled growers was estimated as Rs. 30,000 per acre. Income trend observed by 70 per cent of the respondent through wheat crop was found Rs.40000 per acre. The average income of farmers through wheat crop was Rs.35286 per acre. The estimated results of regression analysis corroborate the expected sign of the majority of coefficient of explanatory variables. Among explanatory variables seed, irrigation and labor days were significant while urea and FYM were found insignificant for crop yield. The study recommends that attempts for awareness, supply of loans, inputs like fertilizer, pesticide, apt agriculture approaches, demonstration plots and training programs should be made available to farmers for higher wheat production in Mohmand Agency

A CRITICAL REVIEW OF THE GHAZAL OF JOSH MALIHABADI

Josh Malih Abadi's name has a unique place in the history of Urdu literature as a shining and brilliant chapter in terms of poetic aspects and creative energy. While Josh is a poet with a lively heart and mind and an open eye. With its free nature and a vast sea of words and phrases. Like the great poets, his style of using words and phrases is unparalleled and unique, and his great place in Urdu poetry is established with all distinctions. Josh wrote modern and ancient Ghazal like Hali and if there is anything wrong with the Ghazal, he tried to write it in a new style. It is as if Josh claimed to have included glorious subjects in the Ghazal, leaving out the general themes. Due to this effort, the new style of Ghazal has more resemblance to the poem. However, this ode-like Ghazali also has its own style and it has a very deep color of the individuality of passion. If think about it, in the Ghazal of passion, you can see beautiful and intoxicating performances about the beauty of the beloved, the colorful and charming nature of attractive nature, and the head of pleasure and fun

Importance of estimation of follicular output rate (FORT) in females assisted by intracytoplasmic sperm injection

Background: We aimed to estimate pregnancy outcome after ICSI in terms of oocyte parameters, embryo quality, endometrial thickness, hormone and cytokine levels in women stratified on the basis of follicular output rate (FORT).Methods: Quasi experimental design was carried out after approval from “Ethical review board of Islamabad clinic serving infertile couples” from July 2010 to August 2013. One thousand and fifty females were selected with the criteria of age between 21-40 years, infertility of more than 2 years, body mass index of 18-35 kg/m2, menstrual cycle of 25 ± 7 days, both ovaries present with normal uterine cavity, serum FSH levels less than 8 IU/ml and normal thyroid-stimulating hormone levels. Females on short agonist or antagonist protocol with diagnosis of polycystic ovarian syndrome, fibroids or in their male partner sperms retrieved by testicular biopsy were excluded from the study. Down regulation of ovaries was followed by controlled ovarian stimulation, Ovulation Induction (OI), oocyte pick up, in vitro fertilization, Embryo Transfer (ET) and confirmation of pregnancy was done by serum beta hCG of more than 25 mIU/ml and  cardiac activity on trans vaginal scan. Enzyme linked immuno sorbent assay was used for peak and mid luteal estradiol (E2), progesterone (P) and interleukin I-β estimation on OI and ET days respectively. FORT (ratio of preovulatory follicle count to antral follicle count × 100 on OI day) stratified females into low under the 33rd percentile, medium between the 33rd and the 67th percentile and high above the 67th percentile. Characteristics   of groups were compared by one way analysis of variance.  Results: Females 276 (33%), 288 (34%) and 282 (33%) comprised of low, medium and high FORT groups respectively. The number of retrieved, mature and fertilized oocytes, cleaved embryos, endometrial thickness and number of gestational sacs in the high FORT group was significantly high (P <0.001). High peak and midluteal E2 (P = 0.0025, 0.0001), low P (P = 0.0001) and high peak interleukin-1β (P = 0.0001) was observed in high FORT in comparison with medium FORT with resultant greater number of clinical pregnancies 183 (65%).  Conclusions: The FORT in non PCOS patients may reflect good reproductive outcome after ICSI with maximum clinical pregnancies in high FORT group.

Intracytoplasmic sperm injection and advanced maternal age: Success or treatment failure

Infertility rate documented in Pakistan is 21.9% with only 25% success rate even after procedures like intracytoplasmic sperm injection (ICSI). This rate is further on the decline with enhancement of female age. We aimed to observe the effect of female age on oocyte parameters and reproductive outcome after ICSI. It was done by retrospective analysis of a quasi- experimental design carried out after approval from Ethical review board of Islamabad clinic serving infertile couples from July 2010 to August 2011. The response to ovarian stimulation in (282) females was assessed on the basis of groups, A, B, C and D with age ranges up to 25years; 25.1 to 30years; 30.1 to 35years and \u3e35years, respectively. The outcome was assessed as non-pregnant, preclinical abortion and clinical pregnancy groups on the basis of beta hCG and cardiac activity by trans-vaginal scan. We observed that maximum number of pregnancies 32 (38%) occurred in C group, and least 10 (10%) in group A. There was a statistical reduction in the number of mature and fertilized oocytes as the age advanced from group C to D (p\u3c0.05).This shows that reduction in maturity and fertilization of oocytes with advancement of age recommends early referral of couples to assisted reproductive clinics