Incidence of local breast cancer recurrence with delayed radiation therapy.

BACKGROUND: The purpose of this research was to examine the probability of ipsilateral breast cancer recurrence in individuals whose RT was delayed after the first chemotherapy and surgery. PURPOSE: To analyze the effect of delaying RT for breast cancer patients (by more than 6 weeks after treatment). METHODOLOGY: A retrospective analysis comprised 136 female breast cancer patients treated at the Baghdad Centre for Radiation Oncology and Nuclear Medicine from 2021 to May 2022. External beam radiation was started more than 6 weeks after chemotherapy was finished for all patients who also had surgery. Clinical examination and ultrasound were part of the follow-up process. RESULTS: Patients' ages varied from 28 to 71, and the majority (83%) had a mastectomy. The majority of cases (95.5%) were diagnosed as invasive ductal carcinoma on histopathology, with 49.6% being at stage 2 and 42.6% being at stage 3. Seventy-six percent of patients tested positive for hormones. Although 10 patients (7.35%) acquired distant metastases within 5 years, only 2 (1.47%) had local recurrence because of the delay in RT. Specifically, 91.1% had complete local control with no evidence of disease spread. CONCLUSION: Delaying RT by more than 6 weeks in patients with breast cancer did not substantially affect local control, according to the results of a new research, the first of its type in Iraq.

A NiO-nanostructure-based electrochemical sensor functionalized with supramolecular structures for the ultra-sensitive detection of the endocrine disruptor bisphenol S in an aquatic environment.

Herein, NiO nanoparticles (NPs) functionalized with a para-hexanitrocalix[6]arene derivative (p-HNC6/NiO) were synthesized by using a facile method and applied as a selective electrochemical sensor for the determination of bisphenol S (BPS) in real samples. Moreover, the functional interactions, phase purities, surface morphologies and elemental compositions of the synthesized p-HNC6/NiO NPs were investigated via advanced analytical tools, such as Fourier-transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD), scanning electron microscopy (SEM), transmission electron microscopy (TEM) and energy dispersive X-ray spectroscopy (EDX). Additionally, the synthesized p-HNC6/NiO NPs were cast on the surface of a bare glassy carbon electrode (GCE) via a drop casting method, which resulted in uniform deposition of p-HNC6/NiO/GCE over the surface of the GCE. Additionally, the developed p-HNC6/NiO/GCE sensor demonstrated an outstanding electrochemical response to BPS under optimized conditions, including a supporting electrolyte, a Briton-Robinson buffer electrolyte at pH 4, a scan rate of 110 mV s-1 and a potential window of between -0.2 and 1.0 V. The wide linear dynamic range was optimized to 0.8-70 µM to obtain a brilliant linear calibration curve for BPS. The limit of detection (LOD) and limit of quantification (LOQ) of the developed sensor were estimated to be 0.0059 and 0.019 µM, respectively, which are lower than those of reported sensors for BPS. The feasibility of the developed method was successfully assessed by analyzing the content of BPS in waste water samples, and good recoveries were achieved.

Migraine headache (MH) classification using machine learning methods with data augmentation.

Migraine headache, a prevalent and intricate neurovascular disease, presents significant challenges in its clinical identification. Existing techniques that use subjective pain intensity measures are insufficiently accurate to make a reliable diagnosis. Even though headaches are a common condition with poor diagnostic specificity, they have a significant negative influence on the brain, body, and general human function. In this era of deeply intertwined health and technology, machine learning (ML) has emerged as a crucial force in transforming every aspect of healthcare, utilizing advanced facilities ML has shown groundbreaking achievements related to developing classification and automatic predictors. With this, deep learning models, in particular, have proven effective in solving complex problems spanning computer vision and data analytics. Consequently, the integration of ML in healthcare has become vital, especially in developing countries where limited medical resources and lack of awareness prevail, the urgent need to forecast and categorize migraines using artificial intelligence (AI) becomes even more crucial. By training these models on a publicly available dataset, with and without data augmentation. This study focuses on leveraging state-of-the-art ML algorithms, including support vector machine (SVM), K-nearest neighbors (KNN), random forest (RF), decision tree (DST), and deep neural networks (DNN), to predict and classify various types of migraines. The proposed models with data augmentations were trained to classify seven various types of migraine. The proposed models with data augmentations were trained to classify seven various types of migraine. The revealed results show that DNN, SVM, KNN, DST, and RF achieved an accuracy of 99.66%, 94.60%, 97.10%, 88.20%, and 98.50% respectively with data augmentation highlighting the transformative potential of AI in enhancing migraine diagnosis.

Mobile Health Interventions: A Frontier for Mitigating the Global Burden of Cardiovascular Disease.

Mobile health (mHealth) interventions have emerged as a promising approach for cardiovascular disease (CVD) prevention and management. The proliferation of smartphones and wearable devices enables convenient access to health monitoring tools, educational resources, and communication with healthcare providers. mHealth interventions encompass mobile apps, wearables, and telehealth services that empower users to monitor vital signs, adhere to medication, and adopt healthier lifestyles. Their effectiveness hinges on user engagement, leveraging behavioral science principles and gamification strategies. While mHealth offers advantages such as personalized support and increased reach, it faces challenges pertaining to data privacy, security concerns, and resistance from healthcare providers. Robust encryption and adherence to regulations like the Health Insurance Portability and Accountability Act (HIPAA) are crucial for safeguarding sensitive health data. Integrating mHealth into clinical workflows can enhance healthcare delivery, but organizational adjustments are necessary. The future of mHealth is closely intertwined with artificial intelligence (AI), enabling remote monitoring, predictive algorithms, and data-driven insights. Tech giants are incorporating advanced health-tracking capabilities into their devices, paving the way for personalized wellness approaches. However, mHealth grapples with ethical dilemmas surrounding data ownership, privacy breaches, and inadvertent data capture. Despite its potential, mHealth necessitates a concerted effort to overcome obstacles and ensure ethical, secure, and practical implementation. Addressing technical challenges, fostering standardization, and promoting equitable access are pivotal for unlocking the transformative impact of mHealth on cardiovascular health and reducing the global burden of CVD.

Murphy's Law and Ophthalmic Complications in a Patient With Type 1 Diabetes Mellitus.

Diabetes can lead to various acute clinical complications, although the occurrence of ophthalmic signs and symptoms is uncommon. Neovascular glaucoma (NG), a rare complication associated with diabetes mellitus, is one such condition. Additionally, anti-vascular endothelial growth factor (VEGF)-induced toxic anterior segment syndrome (TASS) is a rare complication of intravitreal bevacizumab. In this case report, we present a unique case of a patient with juvenile diabetes (type 1 diabetes mellitus) who presented to the emergency room (ER) with typical features of diabetic ketoacidosis (DKA) accompanied by bilateral ocular pain. Subsequent investigation revealed secondary angle-closure neovascular glaucoma as the underlying cause. The patient received management for DKA in the ER and subsequent medicine ward. Various interventions were performed for glaucoma in the right eye, including addressing cataracts, which ultimately resulted in TASS. The patient was successfully treated with cryo-diode laser therapy.

A cross-sectional survey on fruit bat-human interaction in Pakistan; one health perspective.

OBJECTIVE: Several factors, such as residential area topography, population density, and lack of infrastructure, were hypothesized to contribute toward respondents' knowledge, attitude, and practice regarding disease transmission. The present study was designed to investigate the knowledge, attitudes, and perception of human-fruit bat interaction by student respondents located in ten districts within the Punjab and Khyber Pakhtunkhwa provinces in Pakistan. METHOD: A cross-sectional survey was conducted by trained enumerators in academic institutions using a structured questionnaire among student respondents (n = 1466), living in two topographically distinct (Mountainous and Plain) residential regions of the Punjab and Khyber Pakhtunkhwa (KPK) provinces in Pakistan regarding their history of bat encounters. RESULTS: Our study revealed that 71.4% of the 1466 respondents had observed bats in their geographic region. 21% of our survey respondents reported bat bites incidents over their lifetime, but only 40% actively sought medical care for wound management despite reporting they had a close family member that had contracted rabies (27-35%). Our generalized linear models (GLMs) highlighted that a respondent residing in a residential region had a greater association with reporting a suspected bat bite over their lifetime and reported rabies victims in both near and extended family members (OR = -0,85, p-value = 0.03, 95% CI). This appeared to be due to delaying consulting a doctor or medical facility for treatment following a suspected bat bite in the topographic residential group as compared to the respondents in the provincial residential group (OR 1.12, p-value = 0.04, 95% CI). CONCLUSION: Our findings indicate the necessity of a One Health comprehensive surveillance system in Pakistan for emerging and re-emerging zoonotic pathogens in Pteropodidae.

A highly selective sensor based on p-tetranitrocalix[4]arene-capped copper nanoparticles for colorimetric and bare-eye detection of cyclophosphamide.

In the current study, one of the outstanding facile and simple protocols is proposed for the synthesis of copper nanoparticles (CuNPs) using NaBH4 as a reducing agent and p-tetranitrocalix[4]arene (p-TNC4) as a capping agent. According to our knowledge, no such technique is available in the literature for colorimetric detection of cyclophosphamide (CPA) using CuNPs at the trace level. The well-organized synthesis was confirmed via advanced spectroscopic techniques. The crystallite size, shape, phase purity, and morphological characteristics were determined via XRD, AFM, FT-IR, and UV-visible spectroscopy. At the optimal conditions for CPA detection, the sensor reveals an excellent sensitivity, selectivity, as well as stability with LOD and LOQ 20 nM and 60 nM, respectively. However, the proposed sensor showed excellent potential and selectivity for the sensing of colorimetric detection of CPA that can be effectively applied to real blood serum samples. The proposed approach is better suited as compared to reported protocols in terms of handling, simplicity, economic, energy consumption, reproducibility, and excellent performance in a very short time.

Fabrication of para-dimethylamine calix[4]arene functionalized self-assembled graphene oxide composite material for effective removal of 2, 4, 6-tri-Cholorphenol from aqueous environment.

Water pollution caused by the release of organic pollutants is a major environmental concern worldwide. These pollutants can have harmful effects on aquatic ecosystems and the organisms living within them, as well as on human health when contaminated water is consumed. It is essential to implement proper treatment and management strategies to prevent and mitigate water pollution. Moreover, the major untreated industrial effluents are synthetic organic compounds especially 2,4,6-trichlorophenol (TCP) which cause several environmental issues and heath related problems in humans. To cope with this problem, an excellent 2D porous material based on p-DMAC4/GO composite has been synthesized as adsorbent material for the effective removal of 2,4,6-trichlorophenol pollutant from wastewater. In this regard, the advanced analytical tools such as Fourier-Transform infrared (FT-IR), X-ray Diffraction (XRD), Scanning Electron Microscopy (SEM) and Energy-Dispersive X-ray spectroscopy (EDS) were used for its characterization. The results justified the chemical composition, excellent crystalline nature, surface morphology and elemental composition of the synthesized composite material. The synthesized adsorbent material showed 95% adsorption of TCP from wastewater system at optimal conditions i.e., pH (6), adsorbent dosage (30 mg) and shaking time (60 min). The mathematical models such as isotherms, thermodynamics and kinetics studies validate the nature of adsorption process of TCP pollutant. The adsorption data found to be best fitted with Langmuir isotherms (R2 = 0.99); whereas kinetic study suggested the pseudo-second-order nature of reaction with R2 = 0.99. The thermodynamics study confirmed the spontaneous and endothermic nature of the TCP pollutant onto the surface of p-DMAC4/GO material. Moreover, the results of current work were also compared with existing reported adsorbents and data suggested the higher efficiency, feasibility, and reusability of p-DMAC4/GO material to remove the TCP pollutant from the wastewater system.

Future of Decellularized Dental Pulp Matrix in Regenerative Endodontics.

With the advancements in tissue engineering, the repair and regeneration of oral/dental tissue are becoming possible and productive. Due to periodontal diseases, the tooth loses bone support resulting in tooth loss, but bone grafting stabilizes with new bone. It is seen that due to the progression of dental caries, pulp damage happens, and the vitality of the tooth is compromised. The current theme of dental pulp regeneration through biological and synthetic scaffolds, is becoming a potential therapy for pulp revitalization.

Social, economic and environmental implications of the COVID-19 pandemic.

The COVID-19 pandemic led to global lockdowns that severely curtailed economic activity. In this study, we set out to examine the social, economic, and environmental ramifications of the COVID-19 pandemic. This is a rare project that will have far-reaching consequences for the field. There are five sets of issues: short-term effects on oil and economic and agricultural policies, including regulations and COP26; long-term implications of monetary and fiscal intervention and investment in green agreements on future generations; prospects for further de-globalization and its effect on climate change and nature; and intergenerational environmental consequences, including debt and polling.

Euphorbia neriifolia Leaf Juice on Mild and Moderate COVID-19 Patients: Implications in OMICRON Era.

Coronavirus disease-2019 (COVID-19) has shattered the public health delivery system of most of the countries of the world. COVID-19 displays variable clinical presentations. The severe COVID-19 represents a fulminant pathological condition and most of the patients run a downhill course if extensive medical measures are not adopted. The major challenges about COVID-19 are related to develop strategies to manage huge populations of mild and moderate cases of COVID-19 with two realistic purposes: (1) early negativity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus and (2) arrest of progression of moderate COVID-19 patients from developing severe complications. Although several medications have been repurposed for these purposes, none of these have passed the test of time in global perspective. Thus, there remains a pressing need to develop new and novel innovative management strategies for these patients as new variants of SARS-CoV-2 have been destroying the normal public health delivery system of different countries from time to time. The study presented here has checked the safety and efficacy of a herbal medication, leaves of Euphorbia neriifolia Linn (E. neriifolia), in mild and moderate COVID-19 patients. Sixty patients (30 mild COVID-19 and 30 moderate COVID-19) were enrolled in the study. Fifteen mild COVID-19 patients received standard of care (SOC) management, and the remaining 15 patients received SOC plus E. neriifolia. The moderate COVID-19 patients similarly received either SOC (N = 15) or SOC plus E. neriifolia (N = 15). Although there were marked diversity regarding biochemical parameters of these patients at entry, the moderate COVID-19 patients receiving E. neriifolia showed decrease in C-reactive protein and D-dimer and increase in oxygen saturation 7 days after trial commencement. However, these improvements were not detected in moderate COVID-19 patients receiving SOC. Hospital staying was significantly lower in both mild and moderate COVID-19 patients receiving SOC plus E. neriifolia than those receiving only SOC. Taken together, it may be proposed that usage of E. neriifolia may have beneficial effects regarding management for COVID-19 patients, especially for those in developing and resource-constrained countries, although a conclusive statement may not be given due to small sample size. This herbal medication is also pertinent in the context of emergence of OMICRON variant of COVID-19 as the overload of SARS-CoV-2-infecetd patients may be addressed considerably by this medication without hospitalization, if proper communication between patients and physicians can be ensured. How to cite this article: Pramanik MEA, Miah MMZ, Ahmed I, et al. Euphorbia neriifolia Leaf Juice on Mild and Moderate COVID-19 Patients: Implications in OMICRON Era. Euroasian J Hepato-Gastroenterol 2022;12(1):10-18.

A review on detection of heavy metals from aqueous media using nanomaterial-based sensors.

The extensive release of heavy metals into the natural water bodies has become globally prevalent from past few decades. Heavy metal toxicity is becoming a serious threat to human and the environment. Due to their prolonged half-life, potential accumulation in different parts of body, and non-biodegradability, metal ions are being obvious entities that can cause several hazardous health risks. A number of methods have been developed for the detection of heavy/toxic metals based on sensors. Among the various new technologies, chemical and optical nano sensors are emerging technology to detect toxic heavy metals. Several nano sensors have been developed using nano materials, synthesized from green or chemical methods. The nano sensors are convenient to prepare and provide enhanced limit of detection, limit of quantification, and onsite detection. This review covers the recent work reported from 2013 to 2019 for the detection of heavy metals using sensors based on nano materials synthesized by different routes. Graphical abstract.

Use of public health emergency operations center (PH-EOC) and adaptation of incident management system (IMS) for efficient inter-sectoral coordination and collaboration for effective control of Dengue fever outbreak in Pakistan - 2019.

Public Health Emergency Operations Center (PH-EOC) and Incident Management System (IMS) provides a platform for inter-sectoral coordination, and collaboration to enhance efficiency of response activities and help in effective control of disease outbreaks. Dengue fever (DF) is an emerging serious public health threat with a potential to transform into a public health emergency. Pakistan faced a heavy outbreak of Dengue fever (DF) from August to December 2019. National Institute of Health (NIH), Islamabad activated its Public Health Emergency Operations Center (PH-EOC) with an objective to implement principles and practices of IMS for control of the outbreak. The challenges during inter-sectoral collaboration for response activities were also identified. PH-EOC was activated on 16th September 2019, and remained operational for next 81 days till 05th December 2019. Incident management structure, incident action plan (IAP), and risk communication plan was developed and executed during this phase. Daily morning and evening meetings were held during all operational days. Federal and provincial health departments, district health offices (DHO), and government/private hospitals were coordinated for collection of the data pertaining to Dengue confirmed cases and deaths. As of 05th December 2019, a total of 52,877 confirmed Dengue cases were reported from all across Pakistan with maximum cases reported from Rawalpindi and Islamabad collectively i.e. 20,988 (40%), followed by Karachi 14,768 (28%), and Peshawar 2,699 (5%), while AJK reported 1,690 (3%). A total of 92 deaths happened all across Pakistan, out of which 43 (47%) happened in Karachi, 23 (25%) in Rawalpindi, and 22 (24%) in Islamabad. The response was coordinated through NIH based PH-EOC, but was carried out by relevant federal and provincial district health offices, vector surveillance programs, dengue control programs and sanitation departments respectively. As a part of response plan, vector surveillance, larva source management, and insecticidal spraying i.e. both fogging and indoor residual spraying activities were carried out in hotspots or the areas where confirmed cases were reported. Sanitation departments daily reported the removal of additional 80-100 ton of solid waste from hotspot areas. Hospitals were coordinated for reporting of isolation of DF patients and provision of quality clinical management for admitted patients. The International Federation for Red Cross/Crescent conducted community awareness, and covered 28,800 households in affected areas of Islamabad. Conversely, the DF outbreak was controlled 02-03 weeks ahead of previous years trends. All the coordinated activities were incorporated in a daily situation report (SitRep) and this was widely distributed among all the stakeholders through emails. Additionally, the data was displayed on the dashboard in PH-EOC. The data dashboard at PH-EOC served as an information management hub that visually mapped, tracked, analyzed, and displayed clusters of DF cases and hotspots. Accordingly, SitRep substantiated as the main reporting tool to monitor response activities initiated by rapid response teams at the national and subnational level. The inter-sectoral coordinating efforts made among concerned line departments resulted in a timely response leading to effective handling of a national public health threat. The information distilled from this experience was that the early and judicious activation of PH-EOC with adaptation of IMS under decision making leadership resulted in a well-managed and prompt response executed by different departments/stakeholders, and effective control of the outbreak before its transformation into a public health event/emergency of national or international concern.

Thiamine Level in Type I and Type II Diabetes Mellitus Patients: A Comparative Study Focusing on Hematological and Biochemical Evaluations.

Objective Diabetes has been found to be associated with low levels of thiamine stores in the body, as thiamine directly affects carbohydrate metabolism. Amplified renal clearance of thiamine has been found in both type I and type II diabetic patients. It has been shown that high-dose thiamine therapy may have a therapeutic effect on early-stage diabetic nephropathy. The aim of this study was to evaluate various biochemical parameters and serum thiamine levels in type I and type II diabetic patients and compare them with a healthy control group. Methods A case-control study was carried out in the diabetic out-patient multi-centers in Karachi. A total of 90 participants were selected by using a non-probability convenient sampling technique and divided into three groups, each with 30 subjects. Group A included healthy non-diabetic subjects, while group B included subjects with type I diabetes mellitus (DM), and group C included subjects with type II DM. After receiving informed consent, blood samples were collected from all the participants for hematological and biochemical evaluation. The duration of the study was eight months. Results The study results revealed that the patients with type II DM had significantly higher mean fasting blood sugar (FBS), random blood sugar (RBS), and hemoglobin A1c (HbA1c) levels than those with type I DM or the control group (p<0.001 for all). Furthermore, the patients with type I or II DM had significantly higher mean levels of triglyceride (p<0.001) and total cholesterol (0.013) while significantly lower mean levels of high-density lipoprotein (HDL) (p=0.014) than controls. The study results further revealed that the patients with type I or II DM had significantly lower serum thiamine levels than controls (14.89±4.82 and 7.35±1.90 vs. 69.56±12.75, p<0.001). Conclusion The study results revealed that FBS, RBS, HbA1c, triglyceride, and total cholesterol levels were significantly higher in both type I and type II diabetes patients compared to controls. Furthermore, HDL and serum thiamine levels were found to be significantly lower in both type I and type II diabetic patients than in controls.

Correlation Between Body Mass Index and Blood Pressure Levels Among Hypertensive Patients: A Gender-Based Comparison.

Objective Blood pressure (BP) has been found to rise among populations due to the high body mass index (BMI). Overweight and persons who have high BP are prone to develop heart diseases. The objective of this study was to evaluate the correlation between BMI and BP among hypertensive patients in both males and females aged 18 years and above. Methodology A cross-sectional study was carried out among patients with a self-reported history of hypertension and anti-hypertensive medication. After taking ethical approval, a total of 337 patients aged 18 or above were selected by using convenience sampling. The duration of the study was six months. A detailed history was taken from each patient about hypertension associated symptoms with the help of a self-designed questionnaire. The BMI of the patients was assessed. Statistical Package for Social Sciences (SPSS) Version 20.0 (IBM Corp., Armonk, NY, USA) was used to analyze the collected data. Spearman correlation was used, and p-value <0.05 was considered significant. Results In a total of 337 patients, the mean age of the patients was 45.87±13.38 years. In which 176 (52.2%) were males and 161 (47.8%) were females. Their mean BMI level was 26.83±5.83 kg/m2, and the mean systolic blood pressure level was 141.78±13.00 mm Hg whereas the diastolic blood pressure was 85.21±10.03 mm Hg. The results also showed that among males the BMI had a significant negative correlation with both systolic blood pressure level (ρ = -0.212, p = 0.011) and diastolic blood pressure level (ρ = -0.208, p = 0.013), while in females the correlation was insignificant. Conclusion Our study results concluded that the BMI of the patients had a significant weak negative correlation with both systolic blood pressure level and diastolic blood pressure level in males; however, no significant correlation was found in females.

Status of essential trace metals in biological samples of diabetic mother and their neonates.

OBJECTIVE: There is accumulating facts that the metabolism of essential trace elements is altered in diabetic patients. The aim of present study was to compare the status of essential trace elements, chromium (Cr), manganese (Mn), and zinc (Zn) in biological samples (whole blood, urine and scalp hair) of insulin dependent diabetic mothers (age ranged 30-40) and their newly born infants (n = 76). An age matched 68 non-diabetic mothers and their infants, residing in the same locality, were selected as referents. For a comparative study, the biological samples of non-diabetic and diabetic pregnant and non pregnant of same age group and socio-economics status were also analysed. METHODOLOGY: The biological samples (scalp hair, blood and urine) were collected from study and referent groups. The Cr, Mn and Zn concentrations in all three biological samples were determined by a flame/electrothermal atomic absorption spectrometer, prior to microwave assisted acid digestion. The validity and accuracy of the methodology was checked by certified reference materials (CRMs) and using conventional wet acid digestion method on same CRMs. RESULTS: The mean values of Cr, Mn and Zn in scalp hair and blood samples of diabetic mothers and their infants were significantly lower as compared to the referent mothers-infants pairs (p < 0.01), while urinary excretion of all these elements were high in diabetic mother-infant pair samples. CONCLUSION: The deficiencies of essential trace elements, Cr, Mn and Zn in biological samples of diabetic women, may play role in the pathogenesis of diabetes mellitus and impacts on their neonates.

Employers' perspective of workplace breastfeeding support in Karachi, Pakistan: a cross-sectional study.

BACKGROUND: Breastfeeding is considered to be an important measure to achieve optimum health outcomes for children, women's return to work has frequently been found to be a main contributor to the early discontinuation of breastfeeding. The aim of the study is to assess workplace breastfeeding support provided to working mothers in Pakistan. METHOD: A workplace based cross-sectional survey was conducted from April through December 2014. Employers from a representative sample of 297 workplaces were interviewed on pre-tested and structured questionnaire. The response rate was 93.7 %. Prevalence of workplace breastfeeding facilities were assessed in the light of World Alliance for Breastfeeding Action (WABA) guidelines. RESULTS: Among non-physical facilities, all workplaces offered 3 months paid maternity leave, 45 % of the sites were offering task adjustment to mothers during lactation period. Only 15 % of the sites were offering breastfeeding breaks to working mothers. Physical facilities that include a breastfeeding corner, refrigerator for storing breast milk, breast milk pump and nursery for childcare were provided in less than 7 % of the sites. Multinational organizations provided better support compared to national organizations. CONCLUSION: Support for continuation of breastfeeding by working women at workplaces is inadequate; hence, women discontinue breastfeeding earlier than planned. Policies need to be developed and enforced, employers and employees need to be educated and supportive environment needs to be created to encourage and facilitate breastfeeding friendly worksite environment.

A study of medicinal plants used as ethnoveterinary: harnessing potential phytotherapy in Bheri, District Muzaffarabad (Pakistan).

ETHNOPHARMACOLOGICAL RELEVANCE: Medicinal plants are utilized for handling health care system and in preventing a variety of diseases. A survey was conducted to document the rapidly disappearing traditional knowledge of medicinal plants in union council Bheri, District Muzaffarabad, Azad Kashmir, Pakistan. MATERIALS AND METHODS: Questionnaire format was used to collect the medicinal uses of plants. The 180 informants were interviewed from six villages in total, 30 from each village (20 male and 10 female) regarding the ethnoveterinary uses of plants in several ailments. For the reliability of ethnoveterinary knowledge, the informant consensus factor (FIC), and fidelity level (FL) were calculated and the literature cited was surveyed. The medicinal information was gathered from local inhabitants, healers, shepherds and old men and women of different age groups. RESULTS: A total of 24 medicinal plant species used as ethnoveterinary were found belonging to 22 genera and 19 families. The most dominant family was Polygonaceae (3 species) followed by Araceae, Asteraceae, Lamiaceae each with 2 species and remaining families having one species. The important medicinal plant species showed the highest fidelity level (FL) such as: Rumex nepalensis, Primula denticulata, (100%) used for dysuria, red urination, Skimmia laureola (100%), Swertia paniculata (99%), and Angelica glauca (97%), used for ague, cold, shivering, gastric ailments, Melia azedarach (100%), used to reduce intestinal worm load in cattle showing the conformity of knowledge on these species. Highest FIC was recorded for foot and mouth diseases and ectoparasite (1) followed by ague (0.98) and dysuria (0.99) depicting that a few species were used to cure various animals׳ ailments. CONCLUSIONS: The findings of the research revealed that merely a few species are used as ethnoveterinary medicine supported by pharmacology study. Due to anthropogenic pressure the extinction of each species from the areas could result in disappearing knowledge regarding century׳s old traditional methods of curing diseases from these plant species.

Comparison of vertical with lateral condensation technique in obturation of root canal system.

OBJECTIVE: To compare vertical condensation with laterally condensed gutta-percha technique in obturation of root canal system. DESIGN: A comparative study. PLACE AND DURATION OF STUDY: The Armed Forces Institute of Dentistry (Operative Deptt), Rawalpindi. SUBJECTS AND METHODS: Fifty six human permanent extracted teeth were collected from central incisor to second molar from the both arches and in vitro root canal procedure was carried out. RESULTS: Warm vertical technique resulted in a uniform smooth surface and least observable space between gutta percha and canal wall, especially in middle and apical region. CONCLUSION: Root canal obturation by warm vertical condensation is better than cold lateral condensation.

Autotransplantation of endodontically treated third molars.

OBJECTIVE: To determine the success rate in autotransplantation of endodontically treated third molars. DESIGN: A descriptive study. PLACE AND DURATION OF STUDY: This study was carried out at Armed Forces Institute of Dentistry (AFID), Rawalpindi (Pakistan) from January 2002 to December 2002. PATIENTS AND METHODS: A total of 50 patients meeting the inclusion criteria were selected who had their first or second molars in unrestorable condition with intact third molars. The donor teeth were extracted after the preparation of recipient site. After endodontically treated in vitro the donor teeth were carried to the recipient site and immobilized. Postoperative variables were recorded and analyzed on SPSS version 10. RESULTS: The overall success rate after six months of the transplantation of third molars was 88% with complete root formation after endodontic treatment. All the patients(12%) who had complaints were more than 35 years of age. CONCLUSION: Third molars are good substitute for the unrestorable first or second molars and would be as effective as endosseous implants. The procedure is likely to have complications in the advanced age group.