Spatial mapping of dengue fever prevalence and its association with geo-climatic factors in Lahore, Pakistan.

A vector-borne disease of concern for global public health, dengue fever has been spreading its endemicity and several cases in recent years, particularly in Lahore Pakistan. Dengue transmission is influenced by geo-climatic conditions. This study aimed to map the spatial prevalence of dengue fever in Lahore and its association with geo-climatic factors during the epidemic of the year 2021. In this study, geo-climatic factors that could potentially encourage the growth of the virus are chosen for this study, and their temporal and spatial changeability relate to dengue cases. The objective of this study is to use meteorological, satellite data and Geographic Information System (GIS) techniques to map dengue outbreaks and identify the risk-prone areas by relating geo-climatic factors with dengue outbreaks. The dengue patients and their locations data were collected from the Directorate General of Health Services (DGHS) Lahore. This study uses Google Earth and Landsat-8 OLI/TIRs images to extract geo-climatic and land use parameters. The dot density maps technique was used to represent the spatiotemporal distribution of dengue cases. The hotspot analysis was applied to show the hotspots of dengue cases in district Lahore at the Union Council (UC) level. The Normalised Difference Vegetation Index (NDVI), Normalised Difference Water Index (NDWI), built-up area, population density, precipitation, and Land Surface Temperature (LST) are the factors employed. In this study, correlation was performed to test the significance between precipitation and the prevalence of dengue fever in Lahore. The results show that the incidence and prevalence of dengue fever month-wise at the UC level in Lahore. The distribution pattern of dengue outbreaks in the Lahore area and its demographic factors were found to be associated. It concludes that the increase in the spread of dengue fever is associated with the monsoon rains. The prevalence of dengue is associated with water bodies and high land surface temperature, but it does not represent any significant relation with vegetation cover and land use in Lahore during the year 2021. The study pinpointed the locations that are most susceptible and require care to prevent such outbreaks in the future.

Determination of the Frequency of Celiac Disease in Patients Presenting With Chronic Diarrhea.

INTRODUCTION: Celiac disease (CD) is a chronic inflammatory disorder affecting mainly the digestive system and accounts for more than 50% of adult cases presenting to the gastrointestinal clinic with chronic diarrhea. Therefore, in our study, we aimed to determine the prevalence of CD in patients presenting with chronic diarrhea at the gastroenterology outpatient department of Jinnah Hospital, Lahore. METHODS: This cross-sectional study was conducted from December 9, 2021, to June 8, 2022, and included 140 patients aged 18 to 50 years with chronic diarrhea. Exclusion criteria were lack of informed consent and history of abdominal trauma or surgery. Data collected included age, gender, family history of CD, and clinical symptoms. Diagnostic measures involved serum tissue transglutaminase antibody IgA and IgG levels, endoscopy, and duodenal biopsy. Statistical analysis was performed using SPSS version 23 (IBM Corp, Armonk, NY), with a p-value of ≤0.05 considered significant. RESULTS: Among the 140 patients, 80 (57.14%) were males, with a mean age of 21 ± 4.35 years. Common symptoms included weight loss (73.5%), abdominal pain (20.7%), and stunted growth (5.7%). A family history of CD was reported in 14.29% of patients. Endoscopy findings included fissuring of the duodenal mucosa (77.9%), decreased height of duodenal folds (15.7%), and nodularity (6.4%). Histopathological examination revealed Marsh III b (65%), Marsh III c (21.4%), and Marsh III a (9.3%). CD was diagnosed in 23.57% of patients. Significant associations were found between CD and female gender, family history of CD, weight loss, stunted growth, and Marsh III c histopathology. CONCLUSION: CD was diagnosed in 23.57% of patients with chronic diarrhea. It was more prevalent in females and those with a family history of CD. These findings emphasize the need for considering CD in the differential diagnosis of chronic diarrhea to ensure early detection and management.

Assessing the determinants of crash propensity using structural equation modeling: Role of distractions caused by fellow drivers.

INTRODUCTION: Aggressive behavior of drivers is a source of crashes and high injury severity. Aggressive drivers are part of the driving environment, however, excessive aggressive driving by fellow drivers may take the attention of the recipient drivers away from the road resulting in distracted driving. Such external distractions caused by the aggressive and discourteous behavior of other road users have received limited attention. These distractions caused by fellow drivers (DFDs) may agitate recipient drivers and ultimately increase crash propensity. Aggressive driving behaviors are quite common in South Asia and, thus, it is necessary to determine their contribution to distractions and crash propensity. METHOD: Our study aimed to evaluate the effects of DFDs using primary data collected through a survey conducted in Lahore, Pakistan. A total of 801 complete responses were obtained. Various hypotheses were defined to explore the associations between the latent factors such as DFDs, anxiety/stress (AS), anxiety-based performance deficits (APD), hostile behavior (HB), acceptability of vehicle-related distractions (AVRD), and crash propensity (CP). Structural Equation Modeling (SEM) was employed as a multivariate statistical technique to test these hypotheses. RESULTS: The results supported the hypothesis that DFDs lead to AS among recipient drivers. DFDs and AS were further found to have positive associations with APDs. Whereas, there was a significant negative association between DFD, AS, and AVRD. As hypothesized, DFD and AS had positive associations with CP, indicating that distractions caused by aggressive behaviors leads to stress and consequently enhances crash propensity. PRACTICAL APPLICATIONS: The results of this study provide a statistically sound foundation for further exploration of the distractions caused by the aggressive behaviors of fellow drivers. Further, the results of this study can be utilized by the relevant authorities to alter aggressive driving behaviors and reduce DFDs.

Evaluating the impact of landscape configuration, patterns and composition on land surface temperature: an urban heat island study in the Megacity Lahore, Pakistan.

The urban heat island (UHI) phenomenon is negatively impacted by rapid urbanization, which significantly affects people's everyday lives, socioeconomic activities, and the urban thermal environment. This study focuses on the impact of composition, configuration, and landscape patterns on land surface temperature (LST) in Lahore, Pakistan. The study uses Landsat 5-TM and Landsat 8-OLI/TIRS data acquired over the years 2000, 2010 and 2020 to derive detailed information on land use, normalized difference vegetation index, LST, urban cooling islands (UCI), green cooling islands (GCI) and landscape metrics at the class and landscape level such as percentage of the landscape (PLAND), patch density (PD), class area (CA), largest patch index (LPI), number of patches (NP), aggregation index (AI), Landscape Shape Index (LSI), patch richness (PR), and mean patch shape index (SHAPE_MN). The study's results show that from the years 2000 to 2020, the built-up area increased by 17.57%, whereas vacant land, vegetation, and water bodies declined by 03.79%, 13.32% and 0.4% respectively. Furthermore, landscape metrics at the class level (PLAND, LSI, LPI, PD, AI, and NP) show that the landscape of Lahore is becoming increasingly heterogeneous and fragmented over time. The mean LST in the study area exhibited an increasing trend i.e. 18.87°C in 2000, 20.93°C in 2010, and 22.54°C in 2020. The significant contribution of green spaces is vital for reducing the effects of UHI and is highlighted by the fact that the mean LST of impervious surfaces is, on average, roughly 3°C higher than that of urban green spaces. The findings also demonstrate that there is a strong correlation between mean LST and both the amount of green space (which is negative) and impermeable surface (which is positive). The increasing trend of fragmentation and shape complexity highlighted a positive correlation with LST, while all area-related matrices including PLAND, CA and LPI displayed a negative correlation with LST. The mean LST was significantly correlated with the size, complexity of the shape, and aggregation of the patches of impervious surface and green space, although aggregation demonstrated the most constant and robust correlation. The results indicate that to create healthier and more comfortable environments in cities, the configuration and composition of urban impermeable surfaces and green spaces should be important considerations during the landscape planning and urban design processes.

Impact of automobile exhaust on biochemical and genomorphic characteristics of Mimusops elengi L. growing along roadsides of Lahore city, Pakistan.

Automobile exhaust releases different types of pollutants that are at great risk to the air quality of the environment and incidental distress to the nature of roadside plants. Mimusops elengi L. is an evergreen medicinal tree cultivated along the roadside of Lahore City. This research aimed to investigate physiological, morphological and genomorphic characteristics of M. elengi under the influence of air pollution from vehicles. Healthy and mature leaves were collected from trees on Canal Bank and Mall roads of Lahore as the experimental sites and control sites were 20 km away from the experimental site. Different physiochemical, morphological, air pollution tolerance index (APTI) and molecular analysis for the detection of DNA damage were performed through comet assay. The results demonstrated the mean accumulated Cd, Pb, Cu and Ni heavy metal contents on the leaves were higher than the control plants (1.27, 3.22, 1.32 and 1.46 µg mg-1). APTI of trees was 9.04. Trees in these roads significantly (p < 0.01) had a lower leaf area, petiole length and leaf dry matter content in comparison to control site. Increased comet tail showed that DNA damage was higher for roadside trees than trees in the control area. For tolerance of air pollution, it necessary to check the APTI value for the M. elengi at the polluted road side of Lahore city. For long-term screening, the source and type of pollutants and consistent monitoring of various responses given by the trees should be known.

Non-compliance of Spectacle Wear in School-Going Children With Refractive Errors.

Background Uncorrected refractive errors are the most common cause of avoidable visual impairment in children worldwide. The school screening of refractive errors is one of the most important initiatives outlined in WHO Vision 2020 targets for control of avoidable visual impairment in children. However, the benefit depends on the compliance of the spectacle worn by children. Objective To determine non-compliance of spectacle wear and its predisposing factors among school-going children in Lahore, Pakistan. Methods This cross-sectional analytical study was conducted among 200 school-going children (5-16 years), with spectacle prescription for at least the last six months studying in primary and secondary schools of Lahore, by using convenience sampling. We collected data with the help of a standardized, self-administered, close-ended questionnaire determining age, gender, class, and non-compliance and its reasons. Data were subjected to statistical evaluation using Statistical Product and Service Solutions (SPSS, version 26; IBM SPSS Statistics for Windows, Armonk, NY), and a chi-square test was applied to determine the statistical significance. p-value 0.05 was considered significant. Results Of the 200 children, 42 were boys, and 158 were girls, with a mean age of 12 years with a standard deviation of 2.6. The proportion of spectacle wear non-compliance was 19.5% (n=39). Children with non-compliance were more likely in the age group of 14-16 years (n=20{51.3%}; p=0.039). The main reasons for non-compliance were dislike to wear spectacles (28.2%), broken spectacles (23.1%), spectacles causing headache (20.5%), spectacles lost and parents' disapproval (20.5%), and peer pressure/teasing (15.4%). Significant difficulties faced while wearing spectacles were pressure on the nose due to worn-out nose pads (36.4%), pressure on ears causing pain in the temple and headache (34.1%), repeated cleaning of spectacles (29.5%), heavy spectacles (18.2%), excessive glare and pain in the eyes (12.5%), and improper fitting of spectacles (11.4%). Conclusions We found that non-compliance was more significant in school-going children aged 14-16 years and girls. The main reasons were unlikeness to wear, broken spectacles, headache, and spectacles lost. School children were not compliant because of many issues that should be addressed, and this information will be used for better eye care in school-going children with refractive errors.

Geo-spatial assessment of pluvial floods in city district Lahore, Pakistan.

This study is an effort of geo-spatial assessment of pluvial floods in District Lahore, Pakistan, caused by urban expansion and the growing frequency and intensity of high-intensity rainfall events. The use of geospatial techniques such as watershed modeling, maximum likelihood image classification, and weighted overlay analysis based on secondary data has enabled the researchers to assess the extent and severity of pluvial floods in the study area. The study's findings highlight the high risk of pluvial floods in the central part of the study area, which is dominated by built-up land and concrete roads. The increase in the area of built-up land from 34.913 km2 in 2018 to 37.442 km2 in 2022 has further intensified the risk of pluvial floods. The findings of this study can assist policymakers in developing effective strategies to reduce the risks associated with pluvial floods. Alongside, it also highlights the importance of geospatial techniques to better understand and address the complex challenges of urbanization and climate change. Flood risk zone-specific strategies are recommended to reduce the risk of pluvial floods.

Sources and Level of Nutrition Knowledge Among Adults in Lahore: A Cross-Sectional Descriptive Study.

OBJECTIVE: This study was aimed at identifying the sources and basic nutrition knowledge among the citizens of Lahore. METHODS: This cross-sectional study was conducted in the metropolis city of Lahore, Pakistan. Four hundred and seventy-six adult citizens of Lahore participated. A random sampling method was used to collect data through a food frequency questionnaire consisting of 23 questions. The questionnaire designed for this study contained questions about demographics, sources of nutrition information, the reliability of these sources of nutrition information, and basic nutrition knowledge. The highest possible score of the questionnaire was marked as 15, and a mean value of 7.5 was used to categorize the low and high values for variables like nutrition knowledge. RESULTS: The majority of participants (34.2%) took nutrition information from their families, healthcare professionals (23.9%), and online resources (23.5%). The most reliable source for nutrition information was healthcare professionals (78.6%). Many participants (65.30%) had high nutrition-related basic knowledge, and 34.70% had low knowledge. Although more than 50% of participants reported having high nutrition knowledge, but they were not aware of how to read food labels. Those citizens who referred to online resources for information about nutrition knowledge usually got better results regarding nutrition knowledge. CONCLUSION: There is a need for more extensive research to identify the quality of sources for nutrition information to form better policies and plans that can be integrated and adopted at the community and national levels to increase the overall nutrition knowledge of people.

Ecological monitoring of urban thermal field variance index and determining the surface urban heat island effects in Lahore, Pakistan.

Lahore is the second major metropolitan city in Pakistan in terms of urban population and built-up area, making the city a more ideal place to form the surface urban heat island (SUHI) effects. In the last two decades, the considerable land-use conversion from a natural surface (vegetation) and permeable (waterbody) surface into an impervious (built-up area) surface has lead to an increase in land surface temperature (LST) in Lahore. The human thermal comfort (HTC) of the residents is also impacted by the higher LST. The present study uses multi-temporal Landsat (5&8) satellite imageries to examine the ecological and thermal conditions of Lahore between 2000 and 2020. The ecological and thermal conditions of Lahore are assessed by calculating the urban heat islands and UTFVI (urban thermal field variance index), based on LST data which quantitatively assessed the UHI effect and the quality of human life. The outcomes establish that the urban built-up area has increased by 18%, while urban vegetation, vacant land, and waterbody decreased by 13%, 4%, and 0.04%, respectively. In the last 20 years, the mean LST of the study region has risen by about 3.67 °C. The UHI intensity map shows intensification and a rise in surface temperature variation from 4.5 °C (2000) to 5.9 °C (2020). Furthermore, the finding shows that the ecological and thermal conditions are worse in construction sites, transition zones, and urban areas in comparison to nearby rural areas. The lower UTFVI was observed in dense vegetation cover areas while a hot spot of higher UTFVI was predominantly observed in the areas of transition zones and built-up area expansion. Those areas with higher hot spots are more vulnerable to the urban heat island effect. The main conclusions of this study are essential for educating city officials and urban planners in developing a sustainable urban land development plan to reduce urban heat island effects by investing in open green spaces for urban areas of cities.

Impact of Covid-19 lockdown regulations on PM2.5 and trace gases (NO2, SO2, CH4, HCHO, C2H2O2 and O3) over Lahore, Pakistan.

The COVID-19 pandemic altered the human mobility and economic activities immensely, as authorities enforced unprecedented lock down regulations. In order to reduce the spread of COVID-19, a complete lockdown was observed between 24 March - 31 May 2020 in Pakistan. This paper aims at investigating the PM2.5, AOD and column amounts of six trace gases (NO2, SO2, CH4, HCHO, C2H2O2, and O3) by comparing periods of reduced emissions during lockdown periods with reference periods without emission reductions over Lahore, Pakistan. HYSPLIT cluster trajectory analyses were performed, which confirmed similar meteorological flow conditions during lockdown and reference periods. This provides confidence that any change in air quality conditions would be due to changes in human activities and associated emissions. The results show about 38% reduction in ambient surface PM2.5 levels during the lockdown period. This change also positively correlated with MODISDB and AERONETAOD data with a decrease of AOD by 42% and 35%, respectively. Reductions for tropospheric columns of NO2 and SO2 were about 20% and 50%, respectively during a semi lockdown period, while no reduction in the CH4, C2H2O2, HCHO and O3 levels occurred. During the lockdown period NO2, O3 and CH4 were about 50%, 45% and 25% lower, respectively, but no reduction in SO2, C2H2O2 and HCHO levels were noticed compared to the reference lockdown period for Lahore. HYSPLIT cluster trajectory analysis revealed the greatest impact on Lahore air quality through local emissions and regional transport from the east (agricultural burning and industry).

Bedbug infestation in Lahore hospitals.

Background: Bedbug infestation has been reported globally, but there are few reports about this parasite of public health importance in Pakistan. This is the first study on bedbug infestation in a healthcare setting in Lahore, Pakistan. Aims: To study bedbug infestation in public sector hospitals in Lahore, Pakistan. Methods: This cross-sectional study was conducted in 86 wards of 2 tertiary care hospitals in Lahore during October and November 2019, using nonprobability sampling technique. Ward supervisors were interviewed using a self-developed structured questionnaire and wards were examined for bedbugs or their markers. Results: Evidence of bedbug infestation was found in 72.1% of the wards. There was no significant difference in infestation rate between the 2 hospitals but there was a significantly lower incidence of infestation in wards that implemented control measures (25.8% vs 74.2%). No control measures were implemented in 53.4% of the wards sampled. Conclusion: Bedbug infestation was rife in the 2 hospitals studied and knowledge about identification and eradication of the pest among ward supervisors was inadequate. Control measures, where applied, were substandard and not evidence-based.

Personality, Religiosity and Satisfaction with Life in Young Muslim and Christian Women in Pakistan.

This study investigated the relationship between personality traits, religiosity and satisfaction with life in young Muslim and Christian women. The current research involved a convenience sample (N = 200; Mage = 21.26) that was drawn from Kinnaird College for Women University Lahore, and Youhanabad Town Lahore, Pakistan. The Big Five Inventory, Centrality of Religiosity Scale, and the Satisfaction with Life Scale were administered. Results of correlation analysis demonstrated a significant positive relationship between 'conscientiousness' and 'religious ideology' among Muslim women, whereas 'openness' and 'agreeableness' were strongly associated with all the dimensions of religiosity in Christian women. Findings of hierarchical linear regression analyses indicated that extraversion and agreeableness significantly predicted life satisfaction among Muslim and Christian participants respectively. Religiosity did not contribute to life satisfaction among both groups. Results of independent sample t-test showed that Christian women reported significantly higher degrees of extraversion and life satisfaction as compared to Muslim women who in contrast reported significantly higher level of agreeableness, neuroticism, and public religious practice. The findings are discussed in the context of gender, religion, culture and mental health.

Cytogenetic study of subtypes of Down syndrome and its relation with pattern of congenital cardiac defects.

OBJECTIVE: To determine the frequency of subtypes of Down syndrome by karyotyping, and to establish the frequency of congenital cardiac defects in this population. METHODS: The cross-sectional study was conducted at the Department of Genetics, Children Hospital, Lahore, Pakistan, from June 2016 to June 2017, and comprised of Down Syndrome patients aged <15 years. They were subjected to karyotypic analysis for determining the subtype of the syndrome, and echocardiography of all cases was done for the assessment of congenital cardiac defects. The two findings was subsequently used to establish a relation between the subtypes and congenital cardiac defects. Data collected, entered and analyzed by the SPSS version 20.0. RESULTS: Among the 160 cases, trisomy 21 was found in 154(96.2%), translocation 5(3.1%) and mosaicism 1(0.6%). Overall, 63(39.4%) children had cardiac defects. Among such patients, patent ductus arteriosus was most common 25(39.7%), followed by ventricular septal defects24(38.1%), atrial septal defects16(25.4%), complete atrioventricular septal defects 8(12.7%), and Tetralogy of Fallot3(4.8%), while 6(9.5%) children had other defects. Atrial septal defects was the most common double defect 9(56.2%) and had the highest coexistence with patent ductus arteriosus in Down syndrome cases with congenital cardiac defects. CONCLUSIONS: In Trisomy 21, the most common cardiac defect was patent ductus arteriosus, followed by ventricular septal defects in isolated defects, whereas in mixed defects, atrial septal defects and patent ductus arteriosus were the highest.

Patient Safety Culture: A Healthcare Provider's Prospect.

INTRODUCTION AND OBJECTIVE: Safe care is a challenge around the globe, especially in developing countries. In resource-limited settings achieving patient safety is an additional complexity. Patient safety is now considered a significant public health concern worldwide. Despite a vital role in delivering quality care, little attention has been given to describe healthcare professionals' perceptions of the patient safety culture in Pakistan. This study aimed to assess the patient safety culture at a tertiary care public hospital in Lahore from the perspectives of doctors and nurses. METHODS: During this cross-sectional study, data were collected from 290 nurses and doctors using a validated safety assessment survey tool of the Hospital Survey of Patient Safety Culture (HSOPSC). The respondent's demographic characteristics and study variables influencing patient safety culture were presented, and a chi-square test was applied to identify the variables influencing patient safety. RESULTS: A total of 114 medical doctors (39.3%) and 176 registered nurses (60.7%) participated in assessing patient safety culture (PSC) across tertiary care public healthcare centers in Lahore. The dimensions of organizational learning and continuous improvement (90.6%) and teamwork within units (86.6%) were the highest. Other dimensions include feedback and communication about the error (71.8%), teamwork across units (74.9%), management support for patient safety (67.3%), supervisor/manager expectations, and actions promoting patient safety (64.6%), communication openness (64.5%), overall perceptions of patient safety (65.3%), frequency of events reported (58.7%), and handoffs and transitions (60.9%) showed moderate status. The dimensions of staffing (35.8%) and non-punitive response to errors (39.1%) had the lowest score. CONCLUSIONS: The present public hospital survey results revealed that medical staff working in a healthcare setting have a less positive perception of patient safety culture.

Validity of the patient health questionnaires (phq-2 and phq-9) for screening depression among human immunodeficiency virus patients in Lahore, Pakistan.

BACKGROUND: Many human immunodeficiency virus (HIV) infected patients suffer from depr-ession, but a little focus is given to detecting and treating depression in primary health care. Detection of depression can be improved by introducing short, reliable, and valid screening instruments. AIM: To determine the psychometric properties of the patient health questionnaire-2 (PHQ-2) and patient health questionnaire-9 (PHQ-9) for depression screening and diagnosis, and the sensitivity and specificity of the PHQ-2 in HIV infected patients. METHODS: A cross-sectional study was conducted on 158 HIV-infected patients aged 18 years and above in Lahore, Pakistan. PHQ-2 was implemented to screen depression. PHQ-9 was implemented to diagnose major depressive disorder as a reference standard. Reliability, Validity tests and receiver operating characteristic curve were computed. RESULTS: The Cronbach's alpha of PHQ-2 and PHQ-9 were 0.732 and 0.759, respectively. The study results showed that the score of 2 on PHQ-2 indicates the highest Youden's index of 0.924, with both sensitivity and specificity of 0.96, and the area under the curve for PHQ-2 was 0.98 (95%CI: 0.953-0.998). CONCLUSION: Good psychometric properties for the PHQ-2 and PHQ-9 indicated their significant potential as tools for depression screening and diagnosis in the HIV-infected population.

The cholera outbreak in Lahore, Pakistan: challenges, efforts and recommendations.

The Punjab health authorities have declared a cholera outbreak with over 2000 acute diarrheal cases being reported in Lahore in April 2022 and 25 laboratory-confirmed cases as of 27 May 2022. Overpopulation, poor sanitation, and a substandard water drainage system contribute to the spread of cholera. The increasing hydro-toxicity of underground water is another challenge to the disease spread. The lack of public awareness about the disease and their poor hygiene practices serve as a portal for the disease to spread to humans. There is a need to establish an effective surveillance system, increase public awareness, and implement the WHO-recommended plan for cholera control. This includes the provision of drugs and diagnostic kits to healthcare centres, the supply of clean water, and the development of a drainage system for sewage and rainwater.

The Nexus Between Vegetation, Urban Air Quality, and Public Health: An Empirical Study of Lahore.

Global climate change and the deteriorating quality of urban air are the major issues affecting the atmospheric ecosystem of Pakistan. To avoid poor monitoring and management of air pollution, improvements through the latest technologies such as GIS and remote sensing are required. This research involves spatial analysis, which discusses the impact of vegetation on air quality and public health. Data of air quality at 20 different points, showing the concentration of four pollutants, namely NOx, CO, SO2, and PM10, with mean observations for 24-h, are taken from EPA, Lahore. The results show that the concentrations of SO2, CO, and PM10 are exceptionally high at the site of the Badshahi Mosque. The analysis shows that the highest polluted areas have the lowest vegetation levels, whereas areas with low pollution concentration have more vegetation cover. Moreover, less vegetation has a higher death rate attributable to household air pollution. The study suggests that greening strategies, vegetation screens, and vegetation barriers should mitigate urban heat air pollution and minimize the air pollution attributable deaths. For pollution and vegetation monitoring, strict laws and monitoring programs must be implemented in major cities.

Effects of safety pattern, cabin ergonomics, and sleep on work-related stress and burnout of city and transit bus drivers in Lahore, Pakistan.

The health and working environment of bus drivers is compromised in low-middle-income countries like Pakistan which leads to burnout and excessive Road Traffic Crashes. Hence, this study delves into factors affecting their safe operations from health and work environment perspectives and measures their associated stress and Burnout level. In a study of four hundred and ninety-nine (499), 86% city and 14% transit bus drivers are surveyed through a questionnaire. Stress is estimated for city and transit bus drivers, using the Effort/Reward Imbalance Model (ERI) of Siegrist, and burnout is calculated using the Copenhagen Burnout Inventory (CBI). For the determination of important determinants, descriptive and regression analyses are conducted. Findings show that stress has emerged as a negative factor for the physical and psychological health of city and transit bus drivers. Results based on bus drivers' responses suggest that organisational awareness and emphasis on health and safety levels can significantly reduce driver stress and burnout. Practitioner Summary: This study explores burnout and work-related stress of bus drivers in Lahore (Pakistan). City and transit bus drivers were interviewed through a questionnaire, containing three sections, using different subjective ratings based upon their past reliability. Results indicate that stress in bus drivers emerged as a physical and psychological health-damaging factor.

Analyzing Correlation of Clinical Severity of COVID-19 with Other Biochemical Parameters: A Retrospective Study from Pakistan.

The third wave of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing damage all over the world, especially in Pakistan and India. Although vaccines are available and preventive measures are being taken, but SARS-CoV-2 is unstoppable. Currently, there are around 841,636 positive cases in Pakistan and 18,429 deaths, whereas, in India, both are high. From April 8th to 12th, 2021, nasopharyngeal swabs of 190 patients were submitted to PRL (PACP) lab for the SARS-CoV-2 testing, and blood samples were collected at the Mayo Hospital lab for ferritin, D-dimers, lactate dehydrogenase (LDH), and C-reactive protein (CRP) testing. This study observed that coronavirus disease 2019 (COVID-19) was more likely in individuals aged 51-60 than 61-70. In addition, our study found that COVID-19 patients exhibited a statistically significant increase in levels of ferritin, D-dimers, LDH, and CRP. In addition, this study found that COVID-19 patients had significantly higher levels of ferritin, D-dimers, LDH, and CRP. Our study revealed that SARS-CoV-2 relapsed. Furthermore, we concluded that these biochemical parameters are useful indicators for severity of COVID-19.

Isolation and phylogenetic analysis of Avian orthoavulavirus 1 sub-genotypes VII.2 and XXI.1.2 from caged birds in the Lahore district, Pakistan - Short communication.

In this study, the prevalence of Avian orthoavulavirus-1 (AOAV-1) (also commonly known as Newcastle disease virus) was investigated in caged birds kept in bird markets in the Lahore district of Pakistan. A total of 354 swab samples were obtained from 14 different species of clinically healthy birds. The overall virus prevalence was 12.7% in 9 out of the 14 species. Phylogenetic analysis of the complete fusion protein (F) gene showed that 23 isolates from different avian species belonged to sub-genotype VII.2 while three isolates of pigeon origin clustered with sub-genotype XXI.1.2. The VII.2 viruses isolated had a high nucleotide identity to viruses repeatedly isolated from poultry in Pakistan from 2011 to 2018. To date, sub-genotype XXI.1.2 viruses have only been identified in Pakistan. These findings suggest that the Newcastle disease (ND) outbreaks occurring in Pakistan involve multiple hosts and environments. The study emphasises the importance of continuing to monitor multiple avian species for the presence of AOAV-1s and implementing effective ND control strategies.