Heavy metal-resistant rhizobacteria fosters to alleviate the cadmium toxicity in Arabidopsis by upregulating the plant physiological responses.

This study was designed to investigate the role of Morganella morganii strains in alleviating Cd stress in Arabidopsis seedlings under controlled conditions. Both M. morganii strains ABT3 (ON316873) and ABT9 (ON316874) strains isolated from salt-affected areas showed higher resistance against Cd and possess plant growth-promoting traits such as nitrogen fixation, indole-acetic acid production, ammonia production, phosphate solubilization, and, catalase, gelatinase and protease enzyme production. Plant inoculation assay showed that varying concentration of Cd (1.5 mM and 2.5 mM) significantly reduced Arabidopsis growth, quantum yield (56.70%-66.49%), and chlorophyll content (31.90%-42.70%). Cd toxicity also triggered different associations between lipid peroxidation (43.61%-69.77%) and enzymatic antioxidant mechanisms. However, when both strains were applied to the Arabidopsis seedlings, the shoot and root length and fresh and dry weights were improved in the control and Cd-stressed plants. Moreover, both strains enhanced the resistance against Cd stress by increasing antioxidant enzyme activities [catalase (19.47%-27.39%) and peroxidase (37.50%-48.07%)]that ultimately cause a substantial reduction in lipid peroxidation (27.71%-41.90%). Both strains particularly ABT3 also showed positive results in improving quantum yield (73.84%-98.64%) and chlorophyll content (41.13%-48.63%), thus increasing the growth of Arabidopsis seedlings. The study suggests that PGPR can protect plants from Cd toxicity, and Cd-tolerant rhizobacterial strains can remediate heavy metal polluted sites and improve plant growth.

In order to develop sustainable and effective agricultural techniques in areas polluted with heavy metals, it is important to have a deeper understanding of the characteristics of metal-resistant PGPR. Hence, this study focuses on the efficacy of M. morganii in promoting the growth and increasing the photosynthetic pigments of Arabidopsis seedlings under Cd toxicity.

Mycorrhizosphere bacteria inhibit greenhouse gas emissions from microplastics contaminated soil by regulating soil enzyme activities and microbial community structure.

Microplastics (MPs) accumulation in terrestrial ecosystems can affect greenhouse gases (GHGs) production by altering microbial and soil structure. Presently, research on the MPs effect on plants is not consistent, and underlying molecular mechanisms associated with GHGs are yet unknown. For the first time, we conducted a microcosm study to explore the impact of MPs addition (Raw vs. aged) and Trichoderma longibrachiatum and Bacillus subtilis inoculation (Sole vs. combination) on GHGs emission, soil community structure, physiochemical properties, and enzyme activities. Our results indicated that the addition of aged MPs considerably enhanced the GHGs emissions (N2O (+16%) and CO2 (+21%), respectively), C and N cycling gene expression, microbial biomass carbon, and soil physiochemical properties than raw MPs. However, the soil microbial community structure and enzyme activities were enhanced in raw MPs added treatments, irrespective of the MPs type added to soil. However, microbial inoculation significantly reduced GHGs emission by altering the expression of C and N cycling genes in both types of MPs added treatments. The soil microbial community structure, enzymes activities, physiochemical properties and microbial biomass carbon were enhanced in the presence of microbial inoculation in both type of MPs. Among sole and combined inoculation of Trichoderma and Bacillus subtilis, the co-applied Trichoderma and Bacillus subtilis considerably reduced the GHGs emission (N2O (-64%) and CO2 (-61%), respectively) by altering the expression of C and N cycling genes regardless of MPs type used. The combined inoculation also enhanced soil enzyme activities, microbial community structure, physiochemical properties and microbial biomass carbon in both types of MPs treatment. Our findings provide evidence that polyethylene MPs likely pose a high risk of GHGs emission while combined application of Trichoderma and Bacillus subtilis significantly reduced GHGs emission by altering C and N cycling gene expression, soil microbial community structure, and enzyme activities under MPs pollution in a terrestrial ecosystem.

Quality of life of patients undergoing chemotherapy: a tertiary care hospitalbased study from Karachi.

The quality of life (QoL) of cancer patients is of paramount concern due to the enduring effects of chemotherapy on the physical, emotional, spiritual, and social aspects of life. This study aims to examine the factors influencing QoL among cancer patients. A cross-sectional analysis encompassing 200 chemotherapy patients aged 18 and above was conducted, using self-reported surveys and clinical records. The results indicate higher social wellbeing and lower physical well-being scores. Significantly, patients in joint families, with income above Rs25,000, limited pre-diagnosis check-ups, over four chemotherapy cycles, showed better QoL. Engaging diversions like art and internet usage alleviated worries. Conversely, comorbidities correlated with lower FACT-G scores. QoL is still compromised, even with the developments of advanced cancer treatments. Managing mental, emotional, social, and physical health is vital. Future research should focus on evidence-based policies, innovative strategies, psychiatric assessments, mindfulness interventions, and exploring the impact of social interactions on QoL, aiming to enhance the wellbeing of newly diagnosed cancer patients.

Epidemiological and clinical characteristics of esophageal carcinoma: An experience from tertiary care hospital of Karachi, Pakistan.

Objectives: To describe current trends and characteristics of esophageal cancer (EC) over the past ten years largest tertiary care hospital of Karachi, Pakistan. Methods: This single center retrospective study was conducted at the Department of Gastroenterology and Oncology, Jinnah Postgraduate Medical Center, Karachi, Pakistan, between the period of ten years from 1st January 2010 to 31st December 2019. Patient data including epidemiological characteristics such as age, gender, education, residence, occupation, addictions, comorbidities, symptoms, location of EC, laboratory parameters and histopathological type were recorded. All patients with missing histological and radiological findings were excluded. Results: The mean age of all patients was 49.26±14.24 years and among them majority were females 566 (56.1%). Almost, 834 (82.7%) patients had SQC and 175 (17.3%) presented with ADS. Most common presenting symptom was dysphagia in both groups 327 (32.4%) followed by vomiting (22.8%) and weight loss 196 (19.4%). The Esophagogastroduodenoscopy (EGD) findings showed the distal esophagus involvement in most of the patients (36.3%) in both groups. CT scan findings showed that the lower region was the most involved region in 367 (36.4%) patients, followed by middle and upper in 227 (22.5%) and 156 (15.5%) patients respectively. The thickening of mass on CT- scan was circumferential in most of the patients (42.7%) in both groups. Conclusion: According to our findings, SQC is more prevalent than ADC. Female predominance especially at younger age was most common as compared to past studies. No significant association between a single risk factor has been found in our study however smoking and betel nut chewing were found as known putative risk factors.

Comparison of efficacy of neoadjuvant chemotherapy with gemcitabine plus cisplatin versus docetaxil, cisplatin, plus fluorouracil in locally advanced nasopharyngeal carcinoma.

Induction followed by concurrent chemoradiation (CCRT) is the standard of care for locally advanced nasopharyngeal carcinoma (LANPC). This study evaluated and compared the efficacy of two regimens of neoadjuvant chemotherapy along with CCRT in LANPC. Patients with LANPC were randomly divided in Group I (receiving neoadjuvant gemcitabine and cisplatin) and Group II (receiving neoadjuvant docetaxil, cisplatin and fluorouracil). Both groups also received concurrent single agent (i.e., cisplatin) chemotherapy and radiotherapy (70Gy). Treatment response was assessed at 8 weeks after the completion of CCRT using RECIST criteria. A total of 68 LANPC patients were enrolled. Group I comprised of 32 patients, with male to female ratio of 2.2, a mean (range, median) age of 38.6±11.3 (19-58, 36) years. Group II comprised of 36 patients, with male to female ratio of 3.5, mean (range, median) age of 40.9 ±11.6 (17-63, 40) years. The complete response was higher whereas the partial response was lower in Group I as compared to Group II (23/32 versus 16/36 and 06/32 versus 18/36, respectively). LANPC patients receiving gemcitabine plus cisplatin based neoadjuvant chemotherapy showed higher response, as compared with docetaxil, cisplatin and fluorouracil based neoadjuvant chemotherapy.

Unsteady Ohmic dissipative flow of ZnO-SAE50 nanofluid past a permeable shrinking cylinder.

The laminar boundary layer flow of a Zinc Oxide-Society of Automotive Engineers 50 alias nano-lubricant (ZnO-SAE50) past a permeable shrinking cylinder is investigated. The flow is unsteady, incompressible, and Ohmic dissipative. The present study holds immense significance in different engineering as well as scientific domains. It combines research on nanoparticle effects, unsteady flows, and solid surface interactions. The study claimed that the use ofZnO-SAE50nanofluid in the unsteady flow past a permeable shrinking cylinder led to significant heat transfer enhancement. The acquired results from the study would be fruitful in the fields of thermal engineering and heat transfer. The findings of the study can aid in optimizing cooling systems, heat exchangers, and energy-efficient designs. A governing model has been achieved for the flow and heat transfer by using conservation laws related to mass, momentum, and energy. Governing system of partial differential equations is solved to a nonlinear system of ordinary differential equations by using similarity transformation, which is later on solved with the help of the Shooting method and RK-Fehlberg duos. Plots are shown for both velocity and temperature profiles, to display the impacts of involved dimensionless parameters. Additionally, graphs for Nusselt Number have also been represented which shows the local rate of heat transfer. It is examined that the Ohmic dissipation as well as the volumetric ratio of the nanoparticles greatly influence the overall thermal performance of the system.

Different feedstocks of biochar affected the bioavailability and uptake of heavy metals by wheat (Triticum aestivum L.) plants grown in metal contaminated soil.

Heavy metals (HMs) contamination of agricultural soils is an emerging food safety challenge at world level. Therefore, as a possible treatment for the remediation of a HMs contaminated soil (sewage water irrigation for 20-years), the impact of biochar (BC) was investigated on the uptake of HMs by wheat (Triticum aestivum L.) plants. The BC was produced from seven different feedstocks (cotton stalks (CSBC), rice straw (RSBC), poultry manure (PMBC), lawn grass (LGBC), vegetable peels (VPBC), maize straw (MSBC), and rice husks (RHBC)). Each BC was applied at 1.25% (dry weight basis, w/w) in contaminated soil and a control was maintained without BC addition and wheat was grown in potted soil and harvested at maturity. Results revealed that the properties of different biochars regulated their effects on soil nutrient and HMs mobility and uptake by plants. The maximum plant phosphorous and potassium uptake and translocation to grain (173.4% and 341%, respectively) was found in RSBC treatment over control. The RHBC, PMBC, and MSBC treatments showed a maximum decrease in grain Cd concentration (32.9%, 33.8%, and 34.1%, respectively) compared to the control. The grain Pb (-41% to -51%, with no significant differences among different treatments) and Ni (-63%) concentrations were also reduced significantly following BC treatments compared to control. The daily intake and health risk index of Cd were significantly decreased due to PMBC (-28.1% and -33.8%, respectively), and MSBC (-28.3% and -34.1%, respectively) treatment over control. The BC treatments significantly increased the translocation factor of Cd in the order of VPBC (52.1%) > LGBC (25.4%) > CSBC (13.6%) > RSBC (12.1%) compared to control. The study demonstrated that the effects of BC on metal uptake in plants varied with feedstocks and suitable BC can be further exploited for the rehabilitation of contaminated soils and thereby ensuring food safety.

Spectrum of germline pathogenic variants using a targeted next generation sequencing panel and genotype-phenotype correlations in patients with suspected hereditary breast cancer at an academic medical centre in Pakistan.

BACKGROUND: Breast cancer is the most common malignancy in women, affecting over 1.5 million women every year, which accounts for the highest number of cancer-related deaths in women globally. Hereditary breast cancer (HBC), an important subset of breast cancer, accounts for 5-10% of total cases. However, in Low Middle-Income Countries (LMICs), the population-specific risk of HBC in different ethnicities and the correlation with certain clinical characteristics remain unexplored. METHODS: Retrospective chart review of patients who visited the HBC clinic and proceeded with multi-gene panel testing from May 2017 to April 2020. Descriptive and inferential statistics were used to analyze clinical characteristics of patients. Fisher's exact, Pearson's chi-squared tests and Logistic regression analysis were used for categorical variables and Wilcoxon rank-sum test were used for quantitative variables. For comparison between two independent groups, Mann-Whitney test was performed. Results were considered significant at a p value of < 0.05. RESULTS: Out of 273 patients, 22% tested positive, 37% had a VUS and 41% had a negative genetic test result. Fifty-five percent of the positive patients had pathogenic variants in either BRCA1 or BRCA2, while the remaining positive results were attributed to other genes. Patients with a positive result had a younger age at diagnosis compared to those having a VUS and a negative result; median age 37.5 years, IQR (Interquartile range) (31.5-48). Additionally, patients with triple negative breast cancer (TNBC) were almost 3 times more likely to have a positive result (OR = 2.79, CI = 1.42-5.48 p = 0.003). Of all patients with positive results, 25% of patients had a negative family history of breast and/or related cancers. CONCLUSIONS: In our HBC clinic, we observed that our rate of positive results is comparable, yet at the higher end of the range which is reported in other populations. The importance of expanded, multi-gene panel testing is highlighted by the fact that almost half of the patients had pathogenic or likely pathogenic variants in genes other than BRCA1/2, and that our test positivity rate would have only been 12.8% if only BRCA1/2 testing was done. As the database expands and protocol-driven referrals are made across the country, our insight about the genetic architecture of HBC in our population will continue to increase.

Frequency of French-American-British subtypes of acute myeloid leukaemia in a tertiary care hospital of Karachi.

The aim of this study was to determine the frequency of different subtypes of acute myeloid leukaemia (AML) cases that presented in a tertiary care hospital of Karachi. It was a retrospective cross-sectional study, conducted in the hospital's Oncology department. Data of patients admitted during 2018 was collected from the records. In this study, patients were included using the non-probable convenient sampling technique. Selected cases were classified according to the French-American-British (FAB) classification and data analysis was performed using the SPSS version 25.0. Among the 61 patients included in the study, 28 were males and 33 were females, with a male to female ratio of 1:1.2. The patients' age ranged between 15 and 92 years and the mean age of diagnosis was 36.13± 15.5 years. M2 was the most common FAB subtype in 14(29.8%) patients, followed by M1 in 11(23.4%) patients. Myeloperoxidase (MPO) was positive in 44 (71.4%) of those cases.

Morphological changes in the experimental model of polycystic ovary syndrome and effects of vitamin D treatment.

AIM: This research was designed to develop an animal model by inducing polycystic ovary syndrome (PCOS) with dehydroepiandrosterone (DHEA) and observe reproductive and morphological changes after treatment with vitamin D. MATERIALS AND METHODS: Thirty pre-pubertal female Sprague-Dawley (SD) dams were recruited. The animals were distributed 10 each in control, PCOS and vitamin D-treated groups. In control group 0.2 ml of sesame oil was given. PCOS group was administered DHEA by the daily dose of 6 mg/kg for 30 days. In vitamin D-treated group, animals were injected 6 mg/kg/day DHEA daily and 120 ng 1, 25(OH) 2D3/100 g subcutaneously once a week. The occurrence of reproductive phenotypic PCOS was evaluated by estrous cycle, morphology and histological changes of ovary, uterus on light microscope. RESULTS: The results of this study showed significant weight gain, obesity, and estrous irregularity in PCOs group as compared to control and vitamin D-treated group. CONCLUSION: Administration of vitamin D (120 ng 1, 25(OH) 2D3/100) improved the cycle characteristics, reduced body weight and morphological features in PCOS induced animals. The results support the effect of vitamin D treatment for metabolic and reproductive characteristic features in PCOS females.

Ethnic differences in the receptors status of estrogen, progesterone and Her2/Neu among breast cancer women: A single institution experience.

OBJECTIVE: To evaluate the Ethnic Differences in Estrogen (ER), Progesterone (PR) and Her 2/neu receptors among Women with Breast Cancer at JPMC, the largest public sector tertiary care hospital in Karachi. METHODS: The study was conducted at the oncology ward, JPMC Karachi from 1st July 2017 to 31st December 2018. During this period, more than 500 women with breast cancer of different ethnicities visited the oncology ward, however 450 patients were included in the study, as only they had the complete reports on the receptors status and tumour histology. The data collected included tumour histology, grade, receptors status, age and ethnicity. Data was analyzed with SPSS version 20 using the Chi-Square Test to observe statistical differences in the receptors status of different ethnicities. RESULTS: Analysis of receptors status as per ethnicity showed that ER was proportionately more positive in Pushtoon patients at the rate of 28 (75.7%) as compared to Urdu Speaking 116 (60.4%), Punjabis 48 (60%), Sindhis 38(38.7%) and Balochis 26 (61.1%). Similarly, PR and Her-2/neu receptor were also higher in Pushtoons at the rate of 24 (64.9%) and 15 (40.5%) respectively. The behaviour of Triple Positivity was also more prominent in Pushtoons at the rate of 9 (24.3%) and the Pushtoons were also proportionately less likely to be Triple Negative at the rate 05 (13.5%) as compared to other ethnicities. All the results were statistically non significant (p values>0.05). CONCLUSIONS: In this study we observed a relatively higher expression of ER, PR and Her 2/neu Receptors in Pushtoons as compared to other ethnicities. Understanding the factors underlying these differences may provide further insight into the breast cancer aetiology in different populations.

Association analysis and allelic distribution of deletion in CC chemokine receptor 5 gene (CCR5Δ32) among breast cancer patients of Pakistan.

Chemokine CC receptor type 5 (CCR5) is a cell surface receptor that has high affinity for chemotropic cytokines called chemokines. The CCR5 gene contains a 32 base pairs (bp) deletion (CCR5Δ32). This deletion may result in a malformed and nonfunctional receptor, reported to be responsible for the development and dissemination of different cancers. CCR5Δ32 exists in two allelic forms i.e. deletion (D) and wild type (WT). This study aims to detect the role of CCR5Δ32 in breast cancer development. Blood samples were collected from breast cancer patients (330) and controls of same gender (306). Along with this histopathologically diagnosed malignant tissue samples were also excised from breast lesions of 100 patients. Genetic variations within the blood and tissue samples were examined by PCR then observed through gel electrophoresis and confirmed by direct DNA sequencing. Obtained DNA sequences were aligned and analyzed by MEGA6 software. Genotypic and association analyses were done by SPSS software version 17.0. Deletion of 32 bp in CCR5 gene has been analyzed. Genotypic variations of CCR5Δ32 are; homozygous wild type (WT/WT), heterozygous deletion (WT/D) and homozygous deletion (D/D). Statistical analyses of CCR5Δ32 data revealed that WT/D was significantly higher in blood samples of breast cancer patients (7.27% (24/330)) as compare to controls (1.30% (4/306)). In tumor tissue samples WT/WT being the most frequent genotype (99.00% (99/100)) with 1.00 (1/100) of D/D which suggested that it may be acquired. Hence, association analysis showed that CCR5Δ32 is positively associated with breast cancer in Pakistan (p < 0.001). The risk ratio of CCR5Δ32 was 5.6610 (95% confidence interval: 2.0377 to 15.7267) and odds ratio was calculated to be 6.0335 (95% confidence interval: 2.1288 to 17.0999) which signifies that deletion also increases the risk of breast cancer development. Moreover, association analyses also revealed that clinicopathological features do not have any impact on the CCR5Δ32 genotype of breast cancer. This suggests that deletion of 32 bp in CCR5 gene may be associated with breast cancer. CCR5 signals the activation and migration of immune cells at the site of tumor formation. Because of deletion; deformed CCR5 receptor might be unable to express and function properly which may subdue the immunity against cancer hence, leading to its progression.

Addiction of tobacco chewing and smoking in the patients of head and neck squamous cell carcinoma: A descriptive epidemiological study in Pakistan.

OBJECTIVE: The associated risk factors for the majority of patients with head and neck squamous cell carcinoma (HNSCC) are tobacco and betel nut abuse, while there also seems to be a rising proportion of patients who report no history of tobacco or betel nut usage. Therefore, objective of the study was to find out potential risk factors and demographics of HNSCC patients addicted to tobacco and/or betel nut, as well as non-addicted patients. METHODS: This epidemiological study was conducted in Karachi Institute of Biotechnology and Genetic Engineering (KIBGE), University of Karachi, and Jinnah Postgraduate Medical Centre (JPMC) from January to December 2016. All subjects were participants in an epidemiological study of HNSCC. Demographics and clinical characteristics were obtained for 185 addicted and 26 non-addicted patients. RESULTS: Non-addicted patients were more likely to be females (χ2=19.0, p<0.001) and were significantly younger than addicted patients (χ2=21.0, p<0.001). Addicted patients more likely belonged to a lower income group (χ2=14.4, p=0.006) and had a higher proportion of oral cancers (χ2=30.0, p<0.001). Almost all addicted females had oral cancers (97%), whereas more than half of the non-addicted females had oral cancers (53%). CONCLUSIONS: Addicted patients commonly have oral cavity cancers. This might be due to the habit of chewing tobacco and/or betel nut that addicted patients have. Non-addicted patients are commonly young females. It is likely that no single known factor is responsible for HNSCC in non-addicted patients, and several occupational exposure studies in future may be important to the etiology of non-addicted patients.

Loss-to-follow-up and delay to treatment initiation in Pakistan's national tuberculosis control programme.

BACKGROUND: Researchers and policy-makers have identified loss to follow-up as a major programmatic problem. Therefore, the objective of this study is to quantify TB related pre-treatment loss to follow up and treatment delay in private sector health care facilities in Pakistan. METHODS: This was a retrospective, descriptive cohort study using routinely collected programmatic data from TB referral, diagnosis and treatment registers. Data from 48 private healthcare facilities were collected using an online questionnaire prepared in ODK Collect, for the period October 2015 to March 2016. Data were analysed using SPSS. We calculated the: (1) number and proportion of patients who were lost to follow-up during the diagnostic period, (2) number and proportion of patients with pre-treatment loss to follow-up, and (3) the number of days between diagnosis and initiation of treatment. RESULTS: One thousand five hundred ninety-six persons with presumptive TB were referred to the laboratory. Of these, 96% (n = 1538) submitted an on-the-spot sputum sample. Of the 1538 people, 1462 (95%) people subsequently visited the laboratory to submit the early morning (i.e. the second) sample. Hence, loss to follow-up during the diagnostic process was 8% overall (n = 134). Of the 1462 people who submitted both sputum samples, 243 (17%) were diagnosed with sputum smear-positive pulmonary TB and 231 were registered for anti-TB treatment, hence, loss in the pre-treatment phase was 4.9% (n = 12). 152 persons with TB (66%) initiated TB treatment either on the day of TB diagnosis or the next day. A further 79 persons with TB (34%) commenced TB treatment within a mean time of 7 days (range 2 to 64 days). CONCLUSION: Concentrated efforts should be made by the National TB Control Programme to retain TB patients and innovative methods such as text reminders and behavior change communication may need to be used and tested.

TB case notification by private health-sector; retrospective study in 13 metro districts of Pakistan.

OBJECTIVE: To evaluate the impact of structured engagement of private providers in tuberculosis case notification and to investigate demographic profile, disease pattern and treatment outcome of tuberculosis patients seeking care from private care providers. METHODS: This retrospective study was carried out in 13 districts of Pakistan with the data of tuberculosis patients registered and diagnosed from July 2015 to June 2016 at directly observed treatment, short-course trained private providers. These facilities in collaboration with Greenstar Social Marketing Pakistan, a private organisation and the National Tuberculosis Control Programme, Pakistan, provided free anti-tuberculosis drugs and sputum smear microscopy. Study variables included socio-demographic character, disease patterns and treatment outcomes of patients along with details of the registering facility. Data was analysed using SPSS 23. RESULTS: There were 1317 directly observed treatment, short-course trained private health facilities and 123 private laboratories. Of the health facilities, 880(67%) reported 13769 tuberculosis patients. Of them, 7388(53.65%) were females and 6381(46.34%) were males. Overall, 10232(74.31%) were diagnosed with pulmonary tuberculosis and 3537(25.68%) were extra pulmonary tuberculosis patients. Among the pulmonary patients, 4195(41%) were diagnosed through sputum smear microscopy as bacteriologically confirmed (B+ve), while the remaining 6037(59%) were diagnosed through X-ray or other tests. Out of all the diagnosed patients 13218(96%) were treated successfully.. CONCLUSIONS: Private healthcare sector has great potential of supporting tuberculosis control. Gender and age had critical implications in service utilisation.

Effectiveness of outreach chest camps in detection of missed TB cases in Pakistan.

OBJECTIVE: To determine the effectiveness of outreach chest camp intervention for detection of missed tuberculosis cases in Pakistan and to evaluate the demographic profile of those who are dependent on such doorstep healthcare services. METHODS: This retrospective study was carried out using data from the outreach chest camp intervention organised by Greenstar Social Marketing company from August 2015 till December 2016 in Lahore, Gujrat and Sheikhupura districts of Pakistan's Punjab province. The intervention involved a set of community mobilisation events in hard-to-reach areas and in healthcare facilities which are deprived of suitable settings, followed by free medical camps where medical consultation and tuberculosis diagnostic facility of sputum smear microscopy were provided to the camp attendees. The data was taken as per set variables and analysed using SPSS 23. RESULTS: A total of 399chest camps were conducted, where 22,399 patients were clinically assessed for the presence or absence of tuberculosis. Overall, 12,319(55%) of the attendees were females and 10,080(45%) were males. Of the total, 5,226(24.6%) had signs and symptoms of tuberculosis and were declared as tuberculosis presumptive cases. After diagnostic investigations, 831(3.7%) individuals were declared confirmed tuberculosis patients. Amongst the total confirmed cases, 439(52.8%) were diagnosed through sputum smear microscopy with percent bacteria positivity of 8. (95% confidence interval [CI] 7.54 - 9.02). CONCLUSIONS: Chest camp intervention was found to have great potential to detect missed tuberculosis cases, thus limiting the spread of disease in the community.

Association and implications in triple negative and triple positive breast cancer: Relationship with sociodemographic and reproductive factors in Pakistan.

BACKGROUND & OBJECTIVES: Triple negative and triple positive breast cancer have adverse effects than other types of breast cancer. However, triple negative has poor prognosis with short survival as compared with triple positive breast cancer. Good prognosis is one of the key factors for successful treatment trial. This study aimed to find out the association of sociodemographic and reproductive features like parity, menopause, number of child bearing as risk factors in the development and prognosis of triple negative and triple positive breast cancer. METHODS: This study is a part of an ongoing project which is being conducted in Karachi from 2013 to 2020. Informed consent from triple negative breast cancer (n=134) and triple positive breast cancer (n=87) patients were taken prior to their recruitment into the study. Demographic, anthropometric, reproductive and disease history of patients were recorded. Means, frequency distribution, data classification and association analyses were done by SPSS version 17.0. RESULTS: Statistical analyses revealed that delayed first child bearing age and lower number of children are associated with the development of triple negative breast cancer. However, no significant effect of these parameters has been observed on the outcomes of triple positive breast cancer. CONCLUSIONS: Reproductive factors have more pathological implications than sociodemographic factors in both triple positive and triple negative breast cancer development. These findings might prove to be beneficial for effective and better breast cancer management.

Studies on antihyperlipidemic and endothelium modulatory activities of polyherbal formulation (POL4) and its ingredients in high fat diet-fed rats.

A compound herbal formulation (POL4) is used traditionally in interior parts (Distt. Badin) of Sindh, Pakistan, for the treatment of metabolic disorders like diabetes and hyperlipidemia. This study is aimed to determine the effectiveness of POL4 and its ingredients in hyperlipidemia and associated endothelial dysfunction and hypertension. POL4 is composed of equal proportion of Nigella sativa, Cichorium intybus, Trigonella foenum graecum and Gymnema sylvestre mixed in powdered form. Chronic (6 to 7 weeks) administration of POL4 and its ingredients mixed in diet caused a notable attenuation in total cholesterol, low density lipoprotein cholesterol, triglycerides, atherogenic index, C-reactive protein and glucose, while it has increased high density lipoprotein levels. POL4 intervention markedly (p<0.01) reduced systolic blood pressure in rats to 127±1.92 vs. 145.4±1.07 mm of Hg using tail-cuff method and significantly (p<0.05) improved endothelium-dependent relaxation (75±2.88 vs. 82.75±1.22%) to acetylcholine in isolated aortae of rats in treatment groups using force transducer and PowerLab system. Similar activities were assessed on the part of ingredients of POL4. These findings indicate that POL4 and its ingredients possess antihyperlipidemic, endothelium-dependent modulatory and antihypertensive activities, thus providing an evidence to the vernacular use of POL4 in hyperlipidemia and hypertension.

Standard Extraction Methods May Underestimate Nitrate Stocks Captured by Field-Aged Biochar.

Biochar (BC) has been shown to increase the potential for N retention in agricultural soils. However, the form of N retained and its strength of retention are poorly understood. Here, we examined if the N retained could be readily extractable by standard methods and if the amount of N retained varied with BC field ageing. We investigated soil and field-aged BC (BC) particles of a field experiment (sandy soil amended with BC at 0, 15, and 30 t ha) under two watering regimes (irrigated and rain-fed). Throughout the study, greater nitrate than ammonium retention was observed with BC addition in topsoil (0-15 cm). Subsoil (15-30 cm) nitrate concentrations were reduced in BC treatments, indicating reduced nitrate leaching (standard 2 mol L KCl method). The mineral-N release of picked BC particles was examined with different methods: standard 2 mol L KCl extraction; repeated (10×) extraction in 2 mol L KCl at 22 ± 2°C and 80°C (M); electro-ultrafiltration (M); repeated water + KCl long-term shaking (M); and M plus one repeated shaking at 80°C (M). Nitrate amounts captured by BC particles were several-fold greater than those in the BC-amended soil. Compared with M, standard 2 mol L KCl or electro-ultrafiltration extractions retrieved only 13 and 30% of the total extractable nitrates, respectively. Our results suggest that "nitrate capture" by BC may reduce nitrate leaching in the field and that the inefficiency of standard extraction methods deserves closer research attention to decipher mechanisms for reactive N management.

PERFORATED DUODENAL ULCER ASSOCIATED WITH SITUS INVERSUS AND DEXTROCARDIA.

A 32 years old gentleman, presented in emergency department, with complaints of sudden onset of severe upper abdominal pain, associated with nausea and vomiting. He was a known case of acid peptic disease. His abdominal examination showed signs of peritonitis. X-ray chest showed pneumoperitoneum, with dextrocardia. Ultrasound showed situs inversus. Exploration confirmed the diagnosis of perforated ulcer and situs inversus. Grahm's patch repair of perforation was done. His postoperative recovery was smooth.