Investigating vertical transmission and maternofoetal outcomes in pregnant women with COVID-19: a case-control study from Pakistan.

Objectives: To estimate the frequency of severe acute respiratory syndrome coronavirus-2 among pregnant women, the impact in terms of obstetrical and clinical outcomes and vertical transmission to the neonates. METHODS: The prospective, case-control study was conducted at Zainab Panjwani Memorial Hospital, Karachi, from March to December 2021, and comprised pregnant women regardless of gestational age who exhibited symptoms or had a suspicion of exposure to any confirmed coronavirus disease-2019 individual. They were screened for severe acute respiratory syndrome coronavirus-2 infection using polymerase chain reaction or serology. Those who tested negative were designated as control group A, while who had a positive serology result along with a negative polymerase chain reaction were taken as recovered case group B1, and those who tested positive for polymerase chain reaction were called the positive case group B2. Groups B1 and B2 were followed up till delivery. The clinical presentation of coronavirus disease-2019 infection in pregnancy and its obstetrical and neonatal outcomes was assessed. Products of conception were tested for the detection of the severe acute respiratory syndrome coronavirus-2 genome. The viral genome from group B2 cases was sequenced to confirm vertical transmission. Data was analysed using GraphPad Prism V8. RESULTS: Of the 139 pregnant women, 74(53.2%) were in group A with mean age 25.87±6.90 years, 49(35.3%) were in group B1 with mean age 25.53±7.02 years, and 16(11.5%) were in group B2 with mean age 27.12±5.03 years. The gestational age at which termination of pregnancy occurred was 38.3±1.26 weeks in group B1 and 38.3±1.85 weeks for group B2. There were 96 neonates across the 3 groups. Of the 11(11.45%) neonates in group B2, 1(9.09%) had postnatal transmission of severe acute respiratory syndrome coronavirus-2 and this mother-neonate case was taken as the Indexed case. The severe acute respiratory syndrome coronavirus-2 genome isolated from the neonate showed similar mutations as the viral strain infecting the mother. Conclusion: The risk of vertical transmission was found to be low. The severe acute respiratory syndrome coronavirus-2 genome was the same for both the mother and the neonate.

Composite substrate of graphene/Ag nanoparticles coupled with a multilayer film for surface-enhanced Raman scattering biosensing.

In this paper, we designed a surface-enhanced Raman scattering (SERS) substrate for graphene/Ag nanoparticles (Ag NPs) bonded multilayer film (MLF) using the hybrid nanostructures composed of graphene and plasmonic metal components with significant plasmonic electrical effects and unique optical characteristics. This paper achieved the advantages of efficient utilization of electromagnetic field and reduction of fluorescence background based on the electromagnetic enhancement activity of Ag NPs and unique physical/chemical properties of graphene with zero gap structures. Au/Al2O3 was stacked periodically to construct MLF. As indicated by the electric field intensity at the Au/Al2O3 interface of the respective layer, bulk plasmon polariton (BPP) in the MLF was excited and coupled with localized surface plasmon (LSP) in the Ag NPs, which enhanced the electromagnetic field on the top-layer of SERS substrate. To measure the performance of the SERS substrate, rhodamine 6G (R6G) and malachite green (MG) were used as the probe molecules, with the detection limits of 10-11 M and 10-8 M, respectively. The SERS substrate had high sensitivity and uniformity, which indicated that it has a broad application prospect in the field of molecular detection.

LSPR optical fiber sensor based on 3D gold nanoparticles with monolayer graphene as a spacer.

Localized surface plasmon resonance (LSPR) optical fiber biosensing is an advanced and powerful label-free technique which gets great attention for its high sensitivity to refractive index change in surroundings. However, the pursuit of a higher sensitivity is still challenging and should be further investigated. In this paper, based on a monolayer graphene/gold nanoparticles (Grm/Au NPs) three-dimensional (3D) hybrid structure, we fabricated a D-shaped plastic optical fiber (D-POF) LSPR sensor using a facile two-step method. The coupling enhancement of the resonance of this multilayer structure was extremely excited by the surface plasmon property of the stacked Au NPs/Grm layer. We found that the number of plasmonic structure layers was of high importance to the performance of the sensor. Moreover, the optimal electromagnetic field enhancement effect was found in three-layer plasmonic structure. Besides, the n*(Grm/Au NPs)/D-POF sensor exhibited outstanding performance in sensitivity (2160 nm/RIU), linearity (linear fitting coefficient R2 = 0.996) and reproducibility. Moreover, the sensor successfully detected the concentration of glucose, achieving a sensitivity of 1317.61 nm/RIU, which suggested a promising prospect for the application in medicine and biotechnology.

SERS enhancement induced by the Se vacancy defects in ultra-thin hybrid phase SnSex nanosheets.

Improving the photo-induced charge transfer (PICT) efficiency by adjusting the energy levels difference between adsorbed probe molecules and substrate materials is a key factor for boosting the surface enhanced Raman scattering (SERS) based on the chemical mechanism (CM). Herein, a new route to improve the SERS activity of two-dimensional (2D) selenium and tin compounds (SnSex, 1 ≤ x ≤ 2) by the hybrid phase materials is researched. The physical properties and the energy band structure of SnSex were analyzed. The enhanced SERS activity of 2D SnSex can be attribute to the coupling of the PICT resonance caused by the defect energy levels induced by Se vacancy and the molecular resonance Raman scattering (RRS). This established a relationship between the physical properties and SERS activity of 2D layered materials. The resonance probe molecule, rhodamine (R6G), which is used to detect the SERS performance of SnSex nanosheets. The enhancement factor (EF) of R6G on the optimized SnSe1.35 nanosheets can be as high as 2.6 × 106, with a detection limit of 10-10 M. The SERS result of the environmental pollution, thiram, shows that the SnSex nanosheets have a practical application in trace SERS detection, without the participation of metal particles. These results demonstrate that, through hybrid phase materials, the SERS sensitivity of 2D layered nanomaterials can be improved. It provides a kind of foreground non-metal SERS substrate in monitoring or detecting and provide a deep insight into the chemical SERS mechanism based on 2D layered materials.

SERS Sensing Using Graphene-Covered Silver Nanoparticles and Metamaterials for the Detection of Thiram in Soil.

Multilayer hyperbolic metamaterial (HMM)-based SERS substrates have received special consideration because they accommodate various propagation modes such as surface plasmonic polaritons (SPP). However, the SPP modes are difficult to generate in HMM due to their weak electric field enhancement. In this article, we designed novel SERS substrates consisting of graphene-covered AgNPs and HMM. The graphene-covered AgNPs work as an external coupling structure for hyperbolic metamaterials due to this structure exhibiting significant plasmonic effects as well as unique optical features. The localized surface plasmonic resonance (LSPR) of the graphene-covered AgNPs excited the SPP and thus formed a strong hot spot zone in the nanogap area of the graphene. The Raman experiment was performed using rhodamine 6G (R6G) and crystal violet (CV), which showed high stability and a maximum enhancement factor of 2.12 × 108. The COMSOL simulation further clarified that enhanced SERS performance was due to the presence of monolayer graphene and provided an atomically flat surface for organic molecules in a more controllable manner. Interestingly, the proposed SERS structure carries out quantitative detection of thiram in soil and can satisfy the basic environmental need for pesticide residue in the soil.

Plasmonic optical fiber gratings based on few-layer Ta2C MXenes for refractive index sensing.

Tilted fiber Bragg grating (TFBG) is a widespread approach for developing refractive index (RI) sensors. The unique optoelectronic properties exhibited by MXene are expected to enhance the performance of TFBG-SPR sensors. In this study, a Ta2C coating appropriate for sensing was obtained by optimizing the photo-deposition time, which addressed the challenge of preparing large areas of MXene. The uniform coating of the few-layer Ta2C increases the wavelength sensitivity and FOM of the sensor to 229.5 nm/RIU and 2228.15 respectively. This significant enhancement was attributed to an ordered MXene phase of the grown Ta2C. The energy band theory verified the metallic nature of the Ta2C and the amplification effect on the RI response. Finite element analysis demonstrated that the stronger absorption band of Ta2C facilitated the generation of surface plasmon polariton. Based on the above benefits, the sensor detected melamine in milk with a detection limit of 7.9 × 10-9M. The TFBG/Au/Ta2C sensor is a promising approach for biochemical analysis and trace detection.

Subsurface groundwater aquifer mapping and quality characterization in Matiari district, Sindh, Pakistan.

Groundwater, is an alternative resource, is used as a supplement for irrigation as well as drinking purposes in Pakistan. This paper aims to determine the quantum and quality of groundwater in Matiari district of Sindh, Pakistan, through Electrical Resistivity Survey (ERS). The ERS was conducted at 52 location points using the ABEM Terrameter SAS 4000. The quantity of good quality groundwater has also been evaluated with ArcGIS interpolation techniques, i.e., the maximum percentage of fresh groundwater is 34% the marginal fresh groundwater 43% at the depth of with few patches of saline groundwater aquifers. Moreover, at 50-m depth, the percentage of fresh groundwater reduces to 21% and the marginal has increased to 48%. However, groundwater below the depth from 50 to 100 m was found only 8% fresh groundwater, 29% marginal, 49% salt water, and 14% high salt water. Analysis of groundwater samples for quality showed a good agreement with the quality obtained from VES results. In addition, a socio-economic survey of 55 tube well owners were conducted through interviews related to groundwater suitability and usage. According to the survey, about 62% of respondents are using good quality groundwater; however, 36% consuming the marginal and the remaining 2% are utilizing the hazardous quality of groundwater. The consumer satisfaction survey showed most farmers (89%) were satisfied with the groundwater usage, while 11% were unsatisfied due to poor-quality groundwater. The crop productivity could be enhanced through awareness and conjunctive use of marginal quality groundwater with the canal water.

Meaningful in-training and end-of-training assessment: The need for implementing a continuous workplace-based formative assessment system in our training programs.

Objectives: To analyze the systems and tools involved in assessment of skill procurement and demonstrating workplace skills in postgraduate medical training. Methods: This cross-sectional survey was carried out by enrolling trainee doctors currently working in Medical, Surgical, Dental and Allied specialties of the country by sending a validated and piloted questionnaire through email. Data collection was done from 20th April to 20th May 2021. Data was analysed using SPSS v. 21.0. Results: A total of 351 completed responses were received from 10 major cities of the country. Multiple aspects of entry-into-training, in-training and end-of-training evaluation showed poor correlation with the required training goals. A comparison of assessment for entry-into-supervised training (FCPS-I) versus independent practice (FCPS-II) showed a dismal situation regarding assessing affective skills like leadership, teamwork, coping with pressure and self-awareness. The concept of maintaining portfolios was completely alien to the trainees and the assessment tools used for demonstrating workplace skills were outdated. The lack of a continuous, periodic and balanced assessment (65%); detailed feedback (61.5%); fair exams (59%); variability in scoring system (58%) and professionalism of the examiners (57.5%) were the most frequently selected perceived flaws in the assessment system by the participants. Conclusion: There are multiple lacunae regarding competency-based assessment systems in our training programs and a massive scope for improvement. Assessment systems should be implemented as continuous process of learning, self-reflection, feedback and revalidation throughout the training tenure at regular and multiple points.

Surface-enhanced Raman scattering by the composite structure of Ag NP-multilayer Au films separated by Al2O3.

In the present study, a nanoparticle-multilayer metal film substrate was presented with silver nanoparticles (Ag NPs) assembled on a multilayer gold (Au) film by employing alumina (Al2O3) as a spacer. The SERS performance of the proposed structures was determined. It was suggested that the SERS effect was improved with the increase in the number of layers, which was saturated at four layers. The SERS performance of the structures resulted from the mutual coupling of multiple plasmon modes [localized surface plasmons (LSPs), surface plasmon polaritons (SPPs), as well as bulk plasmon polaritons (BPPs)] generated by the Ag NP-multilayer Au film structure. Furthermore, the electric field distribution of the hybrid system was studied with COMSOL Multiphysics software, which changed in almost consistency with the experimentally achieved results. For this substrate, the limit of detection (LOD) was down to 10-13 M for the rhodamine 6G (R6G), and the proposed SERS substrate was exhibited prominently quantitatively detected capability and high reproducibility. Moreover, a highly sensitive detection was conducted on toluidine blue (TB) molecules. As revealed from the present study, the Ag NP-multilayer Au film structure can act as a dependable SERS substrate for its sensitive molecular sensing applications in the medical field.

Comparison of efficacy of combination therapy of an Intravitreal injection of bevacizumab and photocoagulation versus Pan Retinal Photocoagulation alone in High risk Proliferative Diabetic Retinopathy.

OBJECTIVE: To compare efficacy of intravitreal bevacizumab augmented with Panretinal photocoagulation versus Panretinal photocoagulation alone in high risk proliferative diabetic retinopathy. METHODS: This is Randomized clinical control trial study conducted at ISRA University Hospital, Hyderabad from July 2018 to December 2018. A total of 76 eyes were randomized into two groups, 38 eyes undergone PRP plus intravitreal bevacizumab, while 38 eyes had PRP alone. Status of neovessels was assessed before and after treatment with the help of fundus fluorescein angiography. Neovessels at disc (NVD's) and neovessels elsewhere (NVE's) were assessed with the disc surface diameter. RESULTS: Seventy-six eyes were enrolled in this randomized clinical trial into two groups consecutively, that all completed the six months follow-up. In the PRP group mean BCVA (logMAR) worsened significantly from mean 0.30±0.07 to mean 0.40±0.04 at a 30th day and mean 0.40±0.04 at day 90. While BCVA become improved from 0.30±0.05 to 0.1±0.03 at week four and 0.1±0.02 at week 12 in PRP-Plus group. There was significant change in regression of NVES in PRP only group at week 4 is 2.25±0.75 (p=0.00004) and at 12 weeks 2.00±0.50 (p=0.00002), while in PRP + intravitreal bevacizumab group at 4th week was 1±0.5 (p =0.0001) and at 12th week was 0.75±0.25 (p=0.0001). CONCLUSION: Intravitreal Bevacizumab augmented with PRP is more effective in early regression of neovessels in high risk PDR patients.

Preferred teaching styles of medical faculty: an international multi-center study.

BACKGROUND: In the current wave of educational reforms, understanding teaching styles of medical faculty can help modify instructional strategies for effective teaching. Few studies have probed distinctive teaching styles of medical faculty. We compared preferred teaching styles of faculty from seven medical schools in United Arab Emirates, the Netherlands, Saudi Arabia, Malaysia, Pakistan, and Sudan. METHODS: The validated Grasha-Riechmann teaching style inventory was administered online for data collection and used SPSS version 20.0 for statistical analysis. RESULTS: Of the 460 invitees, 248 responded (response rate; 54%). Delegator teaching style was most common with a highest median and mean of 2.38 and 2.45, respectively. There was a significant correlation between expert and authority teaching styles, correlation coefficient 0.62. Similarly, we found a significant correlation between authority teaching style and nature of curriculum, correlation coefficient 0.30. Multiple regression analysis showed that only authority teaching style and male gender had significant correlation. Interestingly, 117 (47%) teachers disagreed with the teaching philosophy of delivering course contents by strictly following learning outcomes. Female teachers (114/248) were more willing to negotiate with their students regarding how and what to teach in their course, while male teachers tended to allow more autonomy by allowing students to set their learning agenda. CONCLUSIONS: This study showed that the medical teachers preferred delegator teacher style that promotes students' collaboration and peer-to-peer learning. Most teachers are conscious of their teaching styles to motivate students for scientific curiosity. These findings can help medical educators to modify their teaching styles for effective learning.

Role of Montelukast in Asthma and Allergic rhinitis patients.

OBJECTIVES: Our objective was to evaluate the effect of Montelukast on the symptoms of asthma and allergic rhinitis (AR), assess its effect on the individual quality of life (QoL), and estimate the proportion of participants having adverse effects. METHODS: This prospective, open-label study conducted at Dow University of Health Sciences, Ankle Saria Hospital and Sindh Government Hospital Liaquatabad, Karachi, from August 2018 to September 2019, included patients aged >18 years with a clinical diagnosis of Asthma, AR, or both. Patients were given a 10 mg Montelukast tablet each day and then called for follow-up in the fourth week, where the questions related to the improvement in the symptoms of asthma or AR were asked. Patients were also asked about the improvement in QoL and any adverse effects. RESULTS: A total of 694 patients were registered of which 138(19.8%) had AR, 294(42.4%) had asthma, while 273(39.3%) had both. Mean age was 41.1±14.63 years and 352 (50.7%) were male and 342(49.3%) were females. On a follow-up visit, there was a sufficient improvement in 351 asthmatics (63.9%), and 288 patients with AR (70.1%) overall, strong or marked improvement in the day (n=342,62.3%) and night time (n=331,60.3%) asthma symptoms. Overall improvements in QoL were very good or good in 419 patients. Montelukast was well-tolerated here with adverse effects (like abdominal discomfort, fever, fatigue, headache, rash, and upper respiratory tract symptoms) seen in 125 patients (18.01%). CONCLUSION: Montelukast was very effective in improving the symptoms and QoL of the individuals suffering from asthma and/or AR.

Decontamination of poultry feed from ochratoxin A by UV and sunlight radiations.

BACKGROUND: Mycotoxin-contaminated feed is very dangerous for the growth and even life of poultry. The objective of the current study was to investigate the efficacy of ultra-violet irradiation for decontamination of ochratoxin A (OTA) in spiked and naturally contaminated poultry feed samples. Spiked and naturally contaminated feed samples were irradiated with ultra-violet light (UV) at distance of 25 cm over the feed samples. In vitro, the effect of UV intensity (0.1 mW cm(-2) at 254 nm UV-C) on different types of poultry feeds contaminated with OTA was evaluated. The same samples were also irradiated with sunlight and analysed for OTA by an indirect enzyme linked immunosorbent assay method. RESULTS: Poultry feed samples containing 500 µg kg(-1) were 100% decontaminated in 180 min with UV radiation while OTA was decreased to 70-95 µg kg(-1) using the same poultry feed samples after 8 h sunlight irradiation. Therefore, UV light was found to be more effective. Only 1 h of UV irradiation was found to be sufficient to bring the OTA level to the maximum regulatory limit suggested for poultry feeds (100 µg kg(-1) ), while 8 h were needed to obtain this level using sunlight radiations. CONCLUSION: The proposed approach is a viable option to reduce the level of OTA in contaminated poultry feeds. © 2015 Society of Chemical Industry.

Comparative analysis of serum iron, serum ferritin and red cell folate levels among breast fed, fortified milk and cow's milk fed infants.

OBJECTIVE: Iron and folic acid are essential nutrients needed for hematopoiesis. Infants' diet is commonly deficient in these micronutrients that lead to nutritional anemia. Aim of this study was to determine serum iron, serum ferritin and red cell folate levels among healthy breast fed, fortified milk and cow's milk fed infants. METHODS: A total of 120 infants of 4-9 months of age were enrolled in this study. It included 40 normal breast fed controls, 40 fortified milk fed (FM) and 40 cow's milk fed (CM) infants. Serum iron, serum ferritin and red cell folate concentrations were determined using colorimetric and enzyme immunoassay techniques. RESULTS: Mean serum iron, serum ferritin and red cell folate concentrations of breast fed control group were 120.9±68.4µg/dl, 109±71.7ng/ml and 1044.1±409.2ng/ml respectively. Fortified milk (FM) group showed significantly decreased serum iron (p<0.003) as compared with controls whereas serum ferritin and red cell folate values showed insignificant change (p=0.25 and p=0.85 respectively). However serum iron, serum ferritin and red cell folate were significantly decreased in cow's milk fed (CM) group as compared with control subjects (p<0.04, p<0.006, p<0.02 respectively). Comparison of these biochemical parameters between FM and CM groups showed statistically significant difference of serum ferritin and red cell folate among cow's milk group (p<0.0001 and p<0.02) whereas serum iron level showed no significant difference, a p-value being 0.38. CONCLUSION: Healthy breast fed infants do not need any supplementation and fortification of iron and folic acid. Fortified milk appears to be an acceptable alternative in the absence of breast milk whereas cow's milk is a poor source of iron and folic acid in infants.

Malabsorption of iron as a cause of iron deficiency anemia in postmenopausal women.

OBJECTIVE: Malabsorption is one of the causes of iron deficiency anemia in postmenopausal women. The main objective of this study was to access the frequency of malabsorption in iron deficient anemic postmenopausal women. METHODS: A total of 123 postmenopausal women were enrolled in the study. Of these 123 women, 50 were included as 'control group' and 73 patients with comparable severity of anemia were the 'patient group'. Two tablets of ferrous sulfate (200 mg/tablet) along with one tablet of vitamin C (500 mg) were given to all participants. Serum iron levels were determined on samples collected from all participants before and after the administration of ferrous sulfate. Difference between before and after serum iron levels of normal and patients were compared. RESULTS: No change in serum iron between sample one and sample two represented malabsorption. Out of 73, 5 postmenopausal anemic patients showed no change in their serum iron level after the administration of ferrous sulfate. This study shows that frequency of malabsorption of iron in postmenopausal women is 6.8%. CONCLUSION: Malabsorption should be considered as a prevalent cause of iron deficiency anemia in postmenopausal women. It should be properly diagnosed and iron response should be monitored properly in postmenopausal women with IDA after oral iron therapy. If a postmenopausal woman does not show any response to oral iron therapy, she should be evaluated for iron loss (blood loss and/or malabsorption). Intravenous route should be used for the administration of iron in these patients.

Touch or click friendly: Towards adaptive user interfaces for complex applications.

This study evaluated the usability of a direct manipulation device (touchscreen) vs. indirect manipulation devices (mouse and touchpad) on the selected Microsoft (MS) Word tasks as per ISO-9241-11 standard. MS Word was taken as an example of a complex application. The tasks were evaluated in terms of touch-friendly or click-friendly using efficiency, effectiveness, and satisfaction parameters to propose a customized task menu. The experiment was conducted with fifty-four participants, divided into three MS Word usage-based expertise groups. Each participant performed fifty-six tasks using a mouse, a touchpad, and a touchscreen. To assess task-level usability, individual one-way ANOVAs were performed for each task to gauge both efficiency and effectiveness. It's worth noting that the touchscreen significantly outperformed other input methods in just one specific task regarding effectiveness. Consequently, an ANCOVA was employed, with task completion time as the independent variable and the number of errors as a covariate, to further investigate effectiveness. A total of 19 (34%) of the total tasks were found to be significantly efficient with a mouse, while 21 (37.5%) were significantly efficient with a touchscreen. Based on the results, a customized menu is recommended for MS Word-like applications that combine actions in touch-friendly tasks and mouse-friendly tasks separately.

LSP-SPP Coupling Structure Based on Three-Dimensional Patterned Sapphire Substrate for Surface Enhanced Raman Scattering Sensing.

Although the fabrication of controllable three-dimensional (3D) microstructures on substrates has been proposed as an effective solution for SERS, there remains a gap in the detection and manufacturability of 3D substrates with high performance. In this study, photolithography is adopted to obtain a pyramid-like array on a patterned sapphire substrate (PSS), with Al2O3 as the dielectric layer. In addition, silver nanoparticles (AgNPs) are used to decorate Au films to obtain mass-producible 3D SRES substrates. In the case of low fluorescence, the substrate realizes the coupling of localized surface plasmon polaritons (LSPs) and surface plasmon polaritons (SPPs), which is consistent with the simulation results obtained using the finite element method. The performance of the SERS substrate is evaluated using rhodamine 6G (R6G) and toluidine blue (TB) as probe molecules with detection limits of 10-11 M and 10-9 M, respectively. The substrate exhibits high hydrophobicity and excellent light-capturing capability. Moreover, it shows self-cleaning ability and long-term stability in practical applications. Allowing for the consistency of the composite substrate in the preparation process and the high reproducibility of the test results, it is considered to be promising for mass production.

Evaluation of medication errors in patients with kidney diseases in Quetta, Pakistan.

BACKGROUND: Medication errors represent a significant challenge in healthcare, as they can lead to enduring harm for patients and impose substantial financial burdens on the healthcare system. To effectively mitigate medication errors, it is imperative to gain a comprehensive understanding of their frequency and the contributing variables. Thus, the primary objective of this study was to evaluate the occurrence of medication errors among patients with kidney diseases in Quetta, Pakistan. METHODS: The objective of this study was to assess medication errors in patients diagnosed with kidney diseases in Quetta, Pakistan. The research was conducted at the Balochistan Institute of Nephro-Urology Quetta (BINUQ) Hospital, which serves as a tertiary care center specializing in the treatment of kidney diseases. A cross-sectional descriptive study design was employed over a period of six months. The study population consisted of patients admitted to the Nephro-urology wards at BINUQ Hospital during the specified duration. Data collection encompassed various methodologies, including checklist-guided observation, review of prescription order forms, documentation of drug administration, and comprehensive analysis of patient medical records. Descriptive and analytical analyses were conducted using SPSS version 23. Univariate analysis was employed to identify independent variables associated with medication errors, employing a significance level of p<0.01. The multivariate logistic regression analysis incorporated variables that exhibited a significant association with medication errors during the univariate analysis. Only those variables demonstrating a p-value of less than 0.05 at a 95% confidence level were considered significant predictors of medication administration errors within the final multivariate model. RESULTS: Among the 274 medication errors identified in the study, documentation errors accounted for 118 cases (12.06%), administration errors for 97 cases (9.91%), prescribing errors for 34 cases (3.47%), and dispensing errors for 25 cases (2.55%). Statistical analysis revealed significant associations (p<0.05) between forgetfulness and duty shift, and medication errors in the documentation process. Similarly, inattention was significantly associated (p<0.05) with both prescribing and dispensing errors. Furthermore, the number of medications received emerged as the most influential factor associated with medication errors. Patients receiving 4-6 medications exhibited an odds ratio of 9.08 (p<0.001) compared to patients receiving 1-3 medications, while patients receiving more than 6 medications had an odds ratio of 4.23 (p<0.001) in relation to patients receiving 1-3 medications. CONCLUSION: In conclusion, this study determined that documentation errors were the most prevalent medication errors observed in patients with kidney disease in Quetta, Pakistan. Forgetfulness and duty shift were associated with documentation errors, whereas inattention was linked to prescribing and dispensing errors. The significant risk factor for medication errors was found to be a high number of prescribed medications. Therefore, strategies aimed at reducing medication errors should prioritize enhancements in documentation practices, alleviating medication burden, and increasing awareness among healthcare providers.

A review on extraction, composition, structure, and biological activities of polysaccharides from different parts of Nelumbo nucifera.

Nelumbo nucifera (lotus plant) is an important member of the Nelumbonaceae family. This review summarizes the studies conducted on it since the past 15 years to provide an understanding on future areas of focus. Different parts of this plant, that is, leaves, roots, and seeds, have been used as food and for the treatment of various diseases. Polysaccharides have been extracted from different parts using different methods. The manuscript reviews the methods of extraction of polysaccharides used for leaves, roots, and seeds, along with their yield. Some methods can provide better yield while some provide better biological activity with low yield. The composition and structure of extracted polysaccharides have been determined in some studies. Although monosaccharide composition has been determined in various studies, too little information about the structure of polysaccharides from N. nucifera is available in the current literature. Different useful biological activities have been explored using in vivo and in vitro methods, which include antioxidant, antidiabetic, antitumor, anti-osteoporotic, immunomodulatory, and prebiotic activities. Antitumor activity from polysaccharides of lotus leaves is yet to be explored, besides lotus root has been underexplored as compared to other parts (leaves and seeds) according to our literature survey. Studies dedicated to the successful use of combination of extraction methods can be conducted in future. The plant provides a therapeutic as well as nutraceutical potential; however, antimicrobial activity and synergistic relationships of polysaccharides from different parts of the plant need further exploration.

Transgenerational effect of Afidopyropen on Bemisia tabaci Gennadius (Homoptera: Aleyrodidae).

Bemisia tabaci Gennadius (Homoptera: Aleyrodidae) is the most devastating insect-pest in cotton crop. It is vector of the cotton leaf curl virus (CLCV) and is responsible for huge losses to cotton industry in Pakistan and worldwide. It is mainly controlled by insecticides but the injudicious use of insecticides has resulted in insecticide resistance and population resurgence in addition to various harmful effects on the humans, non-target organisms and the environment. Transgenerational studies are very helpful to choose a best insecticidal option. In the current study, age-stage two-sex life table analysis was used to identify transgenerational effects of sublethal doses of afidopyropen. The adults of B. tabaci were treated with three concentrations of afidopyropen i.e., LC10, LC30 and LC50. The results indicated significant changes in the progeny i.e. the fecundity decreased in treated population; and female and male longevity of their progeny were more in control as compared to treated populations. Similarly, population parameters like intrinsic rate of growth (r), net reproductive rate (R0) and limiting rate of growth (λ) were significantly decreased in the treated adult progeny with values of 0.08-0.11, 4.85-7.46 and 1.09-1.12 per day, respectively. Based on the reduced biotic potential, afidopyropen can be suggested as an effective alternative option for the management of B. tabaci.