A detailed biochemical characterization, toxicological assessment and molecular docking studies of Launaea fragilis: An important medicinal xero-halophyte.

Launaea fragilis (Asso) Pau (Family: Asteraceae) is a wild medicinal plant that has been used in the folklore as a potential treatment for numerous ailments such as skin diseases, diarrhea, infected wounds, inflammation, child fever and hepatic pain. This study explored the chemical constitution, in-vivo toxicity, antimicrobial, antioxidant, and enzyme inhibition potential of ethanolic extract of L. fragilis (EELF). Additionally, in-silico docking studies of predominant compounds were performed against in-vitro tested enzymes. Similarly, in-silico ADMET properties of the compounds were performed to determine their pharmacokinetics, physicochemical properties, and toxicity profiles. The EELF was found rich in TFC (73.45 ± 0.25 mg QE/g) and TPC (109.02 ± 0.23 mg GAE/g). GC-MS profiling of EELF indicated the presence of a total of 47 compounds mainly fatty acids and essential oil. EELF showed no toxicity or growth retardation in chicks up to 300 mg/kg with no effect on the biochemistry and hematology of the chicks. EELF gave promising antioxidant activity through the CUPRAC method with an IC50 value of 13.14 ± 0.18 µg/ml. The highest inhibition activity against tyrosinase followed by acetylcholinesterase and α-Glucosidase was detected. Similarly, the antimicrobial study revealed the extract with good antibacterial and antiviral activity. A good docking score was observed in the in silico computational study of the predominant compounds. The findings revealed L. fragilis as a biocompatible, potent therapeutic alternative and suggest isolation and further in vivo pharmacological studies.

Assessment of sustainable green financial environment: the underlying structure of monetary seismic aftershocks of the COVID-19 pandemic.

The study aims to assess a sustainable green financial environment by exploring the underlying structure of monetary seismic aftershocks of the COVID-19 pandemic. This study is qualitative and uses a review of literature, primary data collection methods, and qualitative analysis techniques as the study's overall design. The data is collected by one-to-one interview using a matrix style questionnaire from a panel of experts based on the purposive sampling technique. Interpretive structural modeling (ISM) combined with Matrices' Impacts Cruise's Multiplication Appliquée a UN Classement (MICMAC) is used for assessment, modeling, and analysis of data. The monetary aftershocks, namely, "more cash in hand required," "decreased travel costs," "shift to more certain or fixed revenue streams," "lower rent costs," "more zealous monitoring of cash collection cycle," and "decreased entertainment costs," occupy level I (top of the model being least critical shocks), and "tedious regulations" occupy level VIII (bottom of the model being the most vital). Other aftershocks form the middle of the model being moderate critical. Analysis of MICMAC shows that monetary seismic aftershocks high fees for assistance regarding SOPs, tedious regulations, and more downtime due to pandemic alerts are independent. This study addresses the core issue from within the aftermath of the COVID-19 pandemic. It provides new important information regarding the structure of a sustainable green financial environment that is useful for economists, financial analysts, commercial and central bankers, accountants and finance managers from the organization's public/and private sectors, local and international community, and researchers of the domain. It provides an informative structural model and classification of critical aftershocks. There are specific data/methodological/resource-related limitations of the study. The study's data are collected from a focus group; the study's methodology is qualitative and indicates relations among variables that do not quantify the associations. The study is a typical initiative of academic researchers with limited financial/physical resources; therefore, the generalizability of the study results is accordingly limited. The study is based on original, essential data and innovatively and creatively approaches the problem. It provides a unique model of an unprecedented phenomenon for reverberating the sustainable green financial environment.

Impact assessment of drought monitoring events and vegetation dynamics based on multi-satellite remote sensing data over Pakistan.

Drought is a complex hazard caused by the disruption of rainwater balance, and it always has an impact on ecological, farming and socio-economic. In order to protect farming land in Pakistan, effective and timely drought monitoring is extremely essential. Therefore, a regular drought monitoring is required to study drought severity, its duration and spread, to ensure effective planning and to help reduce their possible adverse impacts. In this study, multi-satellite data were used for reliable drought monitoring. For monitoring changing trend of drought in Pakistan, the NVSWI, DSI, VCI, and NAP indices were chosen as a tool incorporated with Moderate Resolution Imaging Spectroradiometer (MODIS)-based NDVI and ET/PET. Due to the low vegetation and significantly high changing trend of drought, NDVI, DSI and TVDI are useful to characterize drought frequency in Pakistan. The yearly DSI index shows that Pakistan suffered of drought with low vegetation during 2001, 2002 and 2006 study years. The seasonal DSI, VCI, NAP, NDVI, and NVSWI values confirmed that 2001, 2002 and 2006 led to severe drought years in Pakistan. The regression analysis between VHI, VCI, NDVI and NVSWI values are significantly positively correlated. The NAP, DSI, and NVSWI showed the positive signs for good drought monitoring indices for agricultural regions of Pakistan. The trend of drought change from 2001 to 2017 also showed characteristics. The results showed that from 2001 to 2017, the drought trend of the whole region changed obviously, and the overall drought frequency showed a downward trend. The good performance of DSI, and NVSWI could, explicitly, contribute progressively towards improving specific drought mitigation strategies and disaster risk reduction at regional and national levels.

Distributed renewable energy systems for resilient and sustainable development of remote and vulnerable communities.

More than 940 million people (13% of the world population) do not have any access to electricity. Most of these people live in rural and remote areas, where the lack of electricity access is significantly damaging the quality of life, economic development and the environment. Distributed energy systems (DESs) (based on clean energy technologies) for energy access offer a potentially important strategy for pursuing environment-friendly sustainable development and poverty alleviation; especially in rural and remote communities. DESs are also helpful in reducing deforestation and greenhouse gas (GHG) emissions as the fossil fuel-based energy production is among the largest contributors to GHG emissions. This paper presents the importance of energy access through DESs for resilient and sustainable development using two projects case studies from Pakistan. The first project case study is based on the Afghan refugee villages, where, currently, there is no electricity access. A baseline survey was conducted to assess the socio-economic conditions and energy demand of the refugees. This assessment is then used to devise clean energy solutions as per the local context. This project aims to improve the quality of life of the refugees by providing energy access. In the second case study, electricity access was provided to the local communities a few years ago. Analyses of primary data collected in this case study show that DES integrated with socio-economic and cultural systems can bring a significantly positive impact on the local communities, advancing all the sustainability development goals. This work concludes that DES can be significantly generative, if effectively integrated into socio-economic processes. This article is part of the theme issue 'Developing resilient energy systems'.

Inequalities in women's utilization of postnatal care services in Bangladesh from 2004 to 2017.

Postnatal care (PNC) is an essential component of maternity care. Appropriate and timely care immediately after childbirth can save lives and help to prevent or treat comorbidities resulting from pregnancy and childbirth. Despite its importance, PNC coverage is still low in Bangladesh. The aim of this study was to analyse the trends, inequalities, and factors associated with PNC for mothers in Bangladesh. Data from the last five Bangladesh Demographic and Health Surveys (BDHS) were used. Descriptive statistics were used to report PNC outcome rates and trends across six inequality indicators. Modified Poisson regression analyses were used to identify factors associated with PNC use in the most recent BDHS. A total of 21,240 women were included for the analysis. The rate of PNC by 'medically trained provider' within 2 days of birth increased between 2004 and 2017, from 16 to 52%. There were wide inequalities across socio-demographic factors. The regression analyses found women giving birth at home, women from the poorest wealth quintile and women receiving no antenatal care (ANC) were least likely to receive PNC. The findings emphasize the need to improve public health programs supporting women who have the least access to PNC. The identified inequalities can inform policy formulation to ensure more equitable provision of PNC to women in Bangladesh.

Advancing pharmacy and healthcare with virtual digital technologies.

Digitalisation of the healthcare sector promises to revolutionise patient healthcare globally. From the different technologies, virtual tools including artificial intelligence, blockchain, virtual, and augmented reality, to name but a few, are providing significant benefits to patients and the pharmaceutical sector alike, ranging from improving access to clinicians and medicines, as well as improving real-time diagnoses and treatments. Indeed, it is envisioned that such technologies will communicate together in real-time, as well as with their physical counterparts, to create a large-scale, cyber healthcare system. Despite the significant benefits that virtual-based digital health technologies can bring to patient care, a number of challenges still remain, ranging from data security to acceptance within the healthcare sector. This review provides a timely account of the benefits and challenges of virtual health interventions, as well an outlook on how such technologies can be transitioned from research-focused towards real-world healthcare and pharmaceutical applications to transform treatment pathways for patients worldwide.

A novel hybrid soft computing optimization framework for dynamic economic dispatch problem of complex non-convex contiguous constrained machines.

The reformations of the electrical power sector have resulted in very dynamic and competitive market that has changed many elements of the power industry. Excessive demand of energy, depleting the fossil fuel reserves of planet and releasing the toxic air pollutant, has been causing harm to earth habitats. In this new situation, insufficiency of energy supplies, rising power generating costs, high capital cost of renewable energy equipment, environmental concerns of wind power turbines, and ever-increasing demand for electrical energy need efficient economic dispatch. The objective function in practical economic dispatch (ED) problem is nonlinear and non-convex, with restricted equality and inequality constraints, and traditional optimization methods are incapable of resolving such non-convex problems. Over the recent decade, meta-heuristic optimization approaches have acquired enormous reputation for obtaining a solution strategy for such types of ED issues. In this paper, a novel soft computing optimization technique is proposed for solving the dynamic economic dispatch problem (DEDP) of complex non-convex machines with several constraints. Our premeditated framework employs the genetic algorithm (GA) as an initial optimizer and sequential quadratic programming (SQP) for the fine tuning of the pre-optimized run of GA. The simulation analysis of GA-SQP performs well by acquiring less computational cost and finite time of execution, while providing optimal generation of powers according to the targeted power demand and load, whereas subject to valve point loading effect (VPLE) and multiple fueling option (MFO) constraints. The adequacy of the presented strategy concerning accuracy, convergence as well as reliability is verified by employing it on ten benchmark case studies, including non-convex IEEE bus system at the same time also considering VPLE of thermal power plants. The potency of designed optimization seems more robust with fast convergence rate while evaluating the hard bounded DEDP. Our suggested hybrid method GA-SQP converges to achieve the best optimal solution in a confined environment in a limited number of simulations. The simulation results demonstrate applicability and adequacy of the given hybrid schemes over conventional methods.

IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045.

AIMS: To provide global, regional, and country-level estimates of diabetes prevalence and health expenditures for 2021 and projections for 2045. METHODS: A total of 219 data sources meeting pre-established quality criteria reporting research conducted between 2005 and 2020 and representing 215 countries and territories were identified. For countries without data meeting quality criteria, estimates were extrapolated from countries with similar economies, ethnicity, geography and language. Logistic regression was used to generate smoothed age-specific diabetes prevalence estimates. Diabetes-related health expenditures were estimated using an attributable fraction method. The 2021 diabetes prevalence estimates were applied to population estimates for 2045 to project future prevalence. RESULTS: The global diabetes prevalence in 20-79 year olds in 2021 was estimated to be 10.5% (536.6 million people), rising to 12.2% (783.2 million) in 2045. Diabetes prevalence was similar in men and women and was highest in those aged 75-79 years. Prevalence (in 2021) was estimated to be higher in urban (12.1%) than rural (8.3%) areas, and in high-income (11.1%) compared to low-income countries (5.5%). The greatest relative increase in the prevalence of diabetes between 2021 and 2045 is expected to occur in middle-income countries (21.1%) compared to high- (12.2%) and low-income (11.9%) countries. Global diabetes-related health expenditures were estimated at 966 billion USD in 2021, and are projected to reach 1,054 billion USD by 2045. CONCLUSIONS: Just over half a billion people are living with diabetes worldwide which means that over 10.5% of the world's adult population now have this condition.

NDSP 09: Risk Assessment of Pakistani Individual for Diabetes (RAPID) - Findings from Second National Diabetes Survey of Pakistan (NDSP) 2016-2017.

OBJECTIVE: To elucidate the effectiveness of Risk Assessment of Pakistani individuals with diabetes (RAPID) tool in epidemiological and population-based second National Diabetes Survey of Pakistan (NDSP) 2016-2017 for identifying risk of developing type 2 diabetes. METHODOLOGY: This observational study was a sub-analysis of the second National Diabetes Survey of Pakistan (NDSP) 2016-2017 conducted from February 2016 to August 2017 in all four provinces of Pakistan. Ethical approval was obtained from National Bioethics Committee Pakistan. RAPID score, a validated and published scoring scale to assess risk of diabetes, originally developed from community-based surveys was used. The risk score is assessed by parameters namely: age, waist circumference, and positive family history of diabetes. Subjects with score greater ≥4 were considered at risk of diabetes. RESULTS: A total of 4904 individuals were assessed (2205 males and 2699 females). Mean age of participants was 41.8±14.2 years. Positive family history of diabetes was seen in 1379 (28.1%) people. According to RAPID score 1268 (25.9%) individuals scored ≥4 and were at risk of diabetes. OGTT status of people at risk of diabetes according to RAPID score showed that 18.1% people with diabetes and 29.2% were prediabetic. Whereas, OGTT status of people not at risk of diabetes showed that only 7.6% people with diabetes, 20% were prediabetic. CONCLUSION: A simple diabetes risk score can be used for identification of high-risk individuals for diabetes so that timely intervention can be implemented. Community-based awareness programs are needed to educate people regarding healthy lifestyle in order to reduce risk of diabetes.

Electrochemical biosensors: a nexus for precision medicine.

Precision medicine is a field with huge potential for improving a patient's quality of life, wherein therapeutic drug monitoring (TDM) can provide actionable insights. More importantly, incorrect drug dose is a common contributor to medical errors. However, current TDM practice is time-consuming and expensive, and requires specialised technicians. One solution is to use electrochemical biosensors (ECBs), which are inexpensive, portable, and highly sensitive. In this review, we explore the potential for ECBs as a technology for on-demand drug monitoring, including microneedles, continuous monitoring, synthetic biorecognition elements, and multi-material electrodes. We also highlight emerging strategies to achieve continuous drug monitoring, and conclude by appraising recent developments and providing an outlook for the field.

Global and regional estimates and projections of diabetes-related health expenditure: Results from the International Diabetes Federation Diabetes Atlas, 9th edition.

AIMS: Diabetes and its complications have a significant economic impact on individuals and their families, health systems and national economies. METHODS: The direct health expenditure of diabetes was calculated relying on the following inputs: diagnosed and undiagnosed diabetes prevalence estimates, United Nations population estimates, World Health Organization health expenditure per capita and ratios of health expenditure for people with diabetes compared to people without diabetes. RESULTS: The estimated global direct health expenditure on diabetes in 2019 is USD 760 billion and is expected to grow to a projected USD 825 billion by 2030 and USD 845 billion by 2045. There is a wide variation in annual health expenditures on diabetes. The United States of America has the highest estimated expenditure with USD 294.6 billion, followed by China and Brazil, with USD 109.0 billion and USD 52.3 billion, respectively. The age group with the largest annual diabetes-related health expenditure is 60-69 years with USD 177.7 billion, followed by 50-59 years, and 70-79 years with USD 173.0 billion and USD 171.5 billion, respectively. Slightly higher diabetes-related health expenditure is seen in women than in men (USD 382.6 billion vs. USD 377.6 billion, respectively). The same difference is expected to be present in 2030 and 2045. CONCLUSIONS: There were large disparities between high-, middle- and low-income countries with total health expenditures in high-income countries being over 300 times those in low-income countries. The ratio for annual direct health expenditure per person between these groups of countries is more than 38-fold.

Current management strategies to target the increasing incidence of diabetes within Pakistan.

According to the recently published National Diabetes Survey of Pakistan (NDSP 2016-2017), the prevalence of diabetes is 26.3%. Hence, Pakistan has around 27.4 million people >20 years of age suffering with diabetes. Compared to previous estimation of having around 7 million diabetic patients based on a survey done in 1994-1998, the figures are disturbingly alarming. The four main strategies to tackle the rising incidence of diabetes in Pakistan are as follows: 1) creating multidisciplinary teams through capacity building of the health care professionals (HCPs), including doctors, dieticians, diabetes educators, diabetes foot assistants, and program managers in standardized evidence-based protocols, enhancing their knowledge and skills in managing diabetes and their related comorbidities; 2) promoting primary prevention and awareness all over Pakistan using screening methods such as Risk Assessment of Pakistani Individuals for Diabetes (RAPID); 3) defining strategies for the management and prevention of diabetes and its complication through forums such as the Pakistan Diabetes Leadership Forum (PDLF); and 4) implementing a nationwide diabetes care program including registration, treatment, and referral protocols. The epidemic of diabetes in an under-resourced and overburdened health care system of Pakistan poses a serious challenge not only for the doctors but also for the multiple stakeholders involved in the community systems. There is a need for promoting and screening the population using RAPID and registering people with diabetes through Diabetes Registry of Pakistan (DROP). Future priority areas and interventional strategies shall include the following: implementing a diabetes health care service model in both rural and urban population using evidence-based clinical guidelines along with lifestyle modifications (LSMs) and prevention policies. Current management strategies and proposed future directions may successfully target the increasing incidence of diabetes.

Improvement in Neuropathy Specific Quality of Life in Patients with Diabetes after Vitamin D Supplementation.

OBJECTIVE: To assess the effect of vitamin D supplementation on neuropathy specific quality of life (NeuroQoL) in patients with painful diabetic neuropathy. METHODS: This prospective, open label study was conducted between June 2012 and April 2013. Patients with symptomatic diabetic neuropathy were given a single dose of 600,000 IU intramuscular vitamin D, and NeuroQol was assessed at baseline and at five follow-up visits every 4 weeks. RESULTS: Of 143 participants, 41.3% were vitamin D deficient (vitamin D < 20 ng/ml). Treatment with vitamin D resulted in a significant increase in 25(OH)D (P < 0.0001) and a significant improvement in the NeuroQoL subscale score for emotional distress (P = 0.04), with no significant change in the other NeuroQoL domains of painful symptoms and paresthesia, loss of temperature and touch sensation, unsteadiness, limitation in daily activities, and interpersonal problems. There was a significant reduction in patient perception about foot problems on QoL of "quite a lot" (P < 0.05) and "very much" (P < 0.0001) with a significant reduction in the baseline response of having a "poor" QoL from 5.2% to 0.7% (P < 0.0001) and an increase in the response of an "excellent QoL" from 1.5% to 7.4% (P < 0.0001). CONCLUSION: Vitamin D is effective in improving quality of life in patients with painful diabetic neuropathy.

Implications of prognostic variables in the assessment of autoimmunity in hepatitis C patients receiving interferon therapy.

Systematic administration of interferon-alpha (INF-alpha) is considered as the backbone of HCV therapy since 1991. Interferon (IFN) therapy can cause vasculitis, glomerulonephritis, cryoglobulinemia and certain other autoimmune diseases such as sialoadentitis, lichen planus and thyroiditis. Related to the factors of interferons, extensively studied gland is thyroid gland. A strong association was observed between thyroid disease and HCV patient when they were exposed to IFN therapy. Vitamin D, malondialdehyde (MDA), thyroid hormones and auto antibodies were biochemically assessed from the venous blood of seventy five HCV patients and fifty healthy controls. The results of all parameters were analyzed by independent sample t-test. The results of the study demonstrated a clear picture that the levels of vitamin D decreased as compared to control but increases in case of MDA. The levels of antibody titer represent that thyroglobulin-antibody (TGAb) thyroid peroxidase-antibody (TPOAb) as well as thyroid stimulating hormone receptor-antibody (TSHRAb) were raised in the patients suffering from HCV with thyroid dysfunction as compared to control. Similarly, the levels of thyroid hormones were also elevated in the HCV patients. Antibodies generated against thyroidal enzymes leads to impaired function of these enzymes thus causing decreased synthesis of thyroid hormones. As exogenous INF triggers the release of cytokines that mediate the recruitment of immune cells with increased production of inflammatory markers lead to production of lytic granules which have direct toxic action on thyroid cells and ultimately increased lipid peroxidation of thyrocytes. The results of the present study clearly demonstrated that the decreased levels of vitamin D in HCV patients receiving IFN therapy were responsible to induce autoimmunity against thyroid gland and adjutant therapy may be helpful to alleviate the possible thyroid disorders.

Rapid evaluation of 25 key sphingolipids and phosphosphingolipids in human plasma by LC-MS/MS.

We report on a new, sensitive, and fast LC-MS/MS method for the simultaneous determination of 25 key sphingolipid components in human plasma, including phosphorylated sphinganine and sphingosine, in a single 9-min run. This method enables an effective and high-throughput coverage of the metabolic changes involving the sphingolipidome during physiological or pathological states. The method is based on liquid-liquid extraction followed by reversed-phase LC-MS/MS. Exogenous odd-chain lipids are used as cost-effective but reliable internal standards. The method was fully validated in surrogate matrix and naive human plasma following FDA guidelines. Sample stability and dilution integrity were also tested and verified.

Toward oral delivery of biopharmaceuticals: an assessment of the gastrointestinal stability of 17 peptide drugs.

A major barrier to successful oral delivery of peptide and protein molecules is their inherent instability in the lumen of the gastrointestinal tract. The aim of this study was to determine the stability of 17 disparate peptide drugs (insulin, calcitonin, glucagon, secretin, somatostatin, desmopressin, oxytocin, [Arg(8)]-vasopressin, octreotide, ciclosporin, leuprolide, nafarelin, buserelin, histrelin, [d-Ser](4)-gonadorelin, deslorelin, and goserelin) in gastric and small intestinal fluids from both humans and pigs, and in simulated gastric and intestinal fluids. In human gastric fluid, the larger peptides including somatostatin, calcitonin, secretin, glucagon, and insulin were metabolized rapidly, while the smaller peptides showed good stability. In human small intestinal fluid, however, both small and large peptides degraded rapidly with the exception of the cyclic peptide ciclosporin and the disulfide-bridge containing peptides octreotide and desmopressin, which showed good stability. The stability of peptides in both simulated gastric fluid and pig gastric fluid correlated well with stability in human gastric fluid. However, it was not possible to establish such a correlation with the small intestinal fluids because of the rapid rate of peptide degradation. This work has identified the molecular features in the structure of a wide range of peptides that influence their stability in the environment of the gastrointestinal tract, which in turn will allow for better selection of peptide candidates for oral delivery.

Personalised dosing: Printing a dose of one's own medicine.

Ink-jet printing is a versatile, precise and relatively inexpensive method of depositing small volumes of solutions with remarkable accuracy and repeatability. Although developed primarily as a technology for image reproduction, its areas of application have expanded significantly in recent years. It is particularly suited to the manufacture of low dose medicines or to short production runs and so offers a potential manufacturing solution for the paradigm of personalised medicines. This review discusses the technical and clinical aspects of ink-jet printing that must be considered in order for the technology to become widely adopted in the pharmaceutical arena and considers applications in the literature.

Use of locally made off-loading techniques for diabetic plantar foot ulcer in Karachi, Pakistan.

The aim of this study was to evaluate the effectiveness of applying locally made pressure off-loading techniques on plantar foot ulcer in individuals with diabetes. This prospective study of 70 diabetic patients was conducted at the foot clinic of Baqai Institute of Diabetology & Endocrinology. Plantar foot ulcer, stages 1A and 2A according to the University of Texas classification, was treated by using three off-loading techniques: modified foot wear (sandal), modified plaster of Paris cast with plywood platform and Scotchcast boot. The outcome was assessed at either complete wound healing (defined as complete epithelialisation) or at 12 weeks, whichever came first. Of the 70 patients, 24 were in modified foot wear group, 23 in modified plaster of Paris cast and 23 in Scotchcast boot group. There was almost equal proportion of patients healed within 12 weeks period treated with these three off-loading techniques, i.e. 22 (95·7%) for modified foot wear group, 19 (95%) for modified plaster cast and 18 (94·7%) for Scotchcast boot group. No significant difference was observed in median healing time and cumulative wound survival at 12 weeks in the three off-loading techniques. Modified foot wear group was the most cost effective ($7) amongst the three off-loading techniques. It is concluded that in this cohort, no significant difference in healing time was observed in the three off-loading techniques, although modified foot wear (sandal) was found to be a more cost-effective treatment modality.

Risk assessment of Pakistani individuals for diabetes (RAPID).

OBJECTIVE: To develop and evaluate a risk score to predict people at high risk of developing type 2 diabetes in Pakistan. METHODOLOGY: Cross sectional data regarding primary prevention of diabetes in Pakistan. Diabetes risk score was developed by using simple parameters namely age, waist circumference, and family history of diabetes. Odds ratios of the model were used to assign a score value for each variable and the diabetes risk score was calculated as the sum of those scores. RESULTS: We externally validated the score using two data from 1264 subjects and 856 subjects aged 25 years and above from two separate studies respectively. Validating this score using the first data from the second screening study gave an area under the receive operator characteristics curve [AROC] of 0.758. A cut point of 4 had a sensitivity of 47.0% and specificity of 88% and in the second data AROC is 0.7 with 44% sensitivity and 89% specificity. CONCLUSIONS: A simple diabetes risk score, based on a set of variables can be used for the identification of high risk individuals for early intervention to delay or prevent type 2 diabetes in Pakistani population.