Narcissism, perfectionism, and self-promoting behavior on social networking sites among university students in Pakistan / Narcisismo, perfeccionismo y comportamiento de autopromoción en sitios de redes sociales entre estudiantes universitarios en Pakistán

Existe un debate considerable en la literatura sobre cómo el narcisismo predice diversos comportamientos asociados con la utilidad de los sitios de redes sociales, pero los investigadores han prestado menos atención a explorar los mediadores potenciales de esta relación. Con base en la literatura existente, anticipamos que el narcisismo predice comportamientos de autopromoción en los sitios de redes sociales. El estudio actual también investigó el papel mediador del perfeccionismo multidimensional entre el narcisismo y el comportamiento de autopromoción. Se recopiló un total de 605 cuestionarios completos de estudiantes de universidades de Rawalpindi e Islamabad, Pakistán, mediante un muestreo conveniente. El estudio utilizó el Inventario de Personalidad Narcisista (Ames et al., 2006), un cuestionario de desarrollo propio sobre comportamiento de autopromoción en sitios de redes sociales y la Escala de Perfeccionismo Multidimensional (Hewitt et al., 1991). Los hallazgos indicaron que las mujeres en comparación con los hombres y las solteras en comparación con las casadas obtuvieron puntuaciones más altas en narcisismo. Los niveles educativos más altos se asociaron con tasas más altas de narcisismo. Los resultados también sugieren que el narcisismo se correlaciona con el perfeccionismo orientado a uno mismo y, más significativamente, con el narcisismo orientado a los demás. El perfeccionismo orientado a uno mismo y a los demás medió significativamente la relación entre el narcisismo y el comportamiento de autopromoción en los sitios de redes sociales.(AU)

There is considerable debate in the literature about how narcis-sism predicts various behaviors associated with the utility of social net-working sites, but researchers have paid less attention to exploring the po-tential mediators of this relationship.Based on the existing literature, we anticipated that narcissism predicts self-promoting behaviors on social networking sites. The current study also investigated the mediating role of multidimensional perfectionismbetween narcissism and self-promoting behavior. A total of 605 complete questionnaires weregathered fromstu-dents from universities from Rawalpindi and Islamabad, Pakistan using convenient sampling. The study used Narcissistic Personality Inventory (Ames et al., 2006), self-developed Self-promoting Behavior on social net-working sites questionnaire, and the Multidimensional Perfectionism Scale (Hewitt et al., 1991). Findings indicated that females as compared to males and single as comparedto married individuals scored higher on narcissism. Higher educational levels were associated with higher rates of narcissism. The results also suggestthat narcissism correlated with self-oriented per-fectionism, and more significantlywith others-oriented narcissism. Self-oriented and others-oriented perfectionism significantly mediated the rela-tionship between narcissism and self-promoting behavior on social net-working sites.(AU)

Risk Factors of Oral Squamous Cell Carcinoma with Special Emphasis on Areca Nut Usage and Its Association with Clinicopathological Parameters and Recurrence.

Introduction: Oral squamous cell carcinoma (OSCC) is the most prevalent type of head and neck cancer and is associated with high mortality, particularly in Southeast Asian countries. Areca nut usage, smoking, and alcohol consumption are the most common risk factors for OSCC. Areca nut chewing is highly prevalent in Pakistan and has been attributed to an increase in OSCC cases. This study aimed to determine the association between areca nut usage and various clinicopathological features of OSCC and further evaluate the association of clinicopathological parameters of OSCC with tumor recurrence. Materials and Methods: The study was conducted using the data of 228 patients with OSCC resected at Liaquat National Hospital, Karachi, Pakistan, over 5 years between 2018 and 2022. Clinicopathological data were collected from hospital archives, and associations between various risk factors and clinicopathological parameters were determined. Results: Males were more commonly affected (77.2%), and the most common age group was <50 years (54.4%). Areca nut usage was reported in 59.6% of cases, and the buccal mucosa was the most common site (62.7%). Areca nut usage was significantly associated with male gender, greater tumor size, greater depth of invasion (DOI), higher tumor stage, nodal stage, presence of perineural invasion (PNI), and recurrence. In addition, multivariate analysis revealed that OSCC recurrence was significantly associated with older age, larger tumor size and DOI, nodal metastasis, and areca nut usage. Conclusion: Areca nut-related OSCCs were associated with poor prognosis and recurrence in our study population. Furthermore, OSCC recurrence was associated with various clinicopathological parameters, such as larger tumor size, a higher DOI, and nodal metastasis.

Prevalence and associated factors of non-adherence to antihyperlipidemic medication: a nationwide cross sectional survey in Pakistan.

Hyperlipidemia significantly contributes to the risk of developing cardiovascular diseases. However, about half of the patients do not adhere to their antihyperlipidemic medications, leading to healthcare costs and premature mortality. This study's objective was to determine the prevalence and associated factors of non-adherence to antihyperlipidemic medications. The study covered hypertensive patients (21,451) aged 21-75 years, presenting to the primary and secondary healthcare facilities across Pakistan (covering 21 divisions) from January 2022 to April 2023. The outcome intended was non-adherence to antihyperlipidemic medication, which was assessed by SEAMS and pill-counting methods (non-adherence < 80%). The study found overall non-adherence to antihyperlipidemic medication of 60.6% across Pakistan, with the highest non-adherence rates found in Azad Jammu and Kashmir (71.9%) and the lowest in Islamabad (47.7%). Multivariable logistic regression analysis revealed that female, no health card (Sehat Sahulat Program government insurance), < 5 years of illness, < 5 daily medications, and dose frequency of twice daily revealed a positively significant association with non-adherence. While monthly income 51,000-100,000, graduation level of education, Muhajir, and hyperlipidemia with one comorbid condition had a significant negative association with the non-adherence. Antihyperlipidemic non-adherence is a multifaceted, multifactorial, profound problem requiring a multipronged approach.

A retrospective analysis of tuberculosis in livestock farmers in Lahore district, Pakistan.

INTRODUCTION: Mycobacterium tuberculosis is the main cause of tuberculosis in humans, accounting for numerous illnesses and thousands of fatalities globally. Data regarding the association of various risk factors and TB in livestock farmers in Pakistan is scarce. METHODOLOGY: A retrospective matched case-control study of TB cases was performed in Lahore, Pakistan to investigate the potential risk factors that lead to the development of TB in Pakistani livestock farmers. A total of 170 participants were included in the study. The case was matched with control based on neighborhood and the case-control ratio was kept 1:1. Data were statistically analyzed using R version 4.2.1. Conditional logistic regression was conducted to identify biologically and statistically plausible risk factors associated with the TB outcome among livestock farmers. RESULTS: In univariable analysis, 10 risk factors were identified (p < 0.05). Gender, age, being married, family type, living in a big family, BCG vaccination status, history of smoking, working at a cattle farm, co-housing with cattle at night, , consumption of raw milk. The multivariable model identified four risk factors i.e., consumption of raw milk (Odds Ratio [OR]: 7.7; 95% Confidence Interval [CI]: 1.95-30.68), living in big family (OR: 6.2; 95% CI: 1.25-30.82) and working at cattle farm (OR: 4.2; 95% CI: 1.08-16.56), while gender was found to be a protective factor with OR < 1 (OR: 0.06; 95% CI: 0.01-0.26). CONCLUSIONS: This study demonstrated that sociodemographic risk factors and exposure to infected cattle can influence the development of TB in farmers.

Effects of COVID-19 Illness and Vaccination Infodemic Through Mobile Health, Social Media, and Electronic Media on the Attitudes of Caregivers and Health Care Providers in Pakistan: Qualitative Exploratory Study.

BACKGROUND: The COVID-19 pandemic has had a significant impact on different countries because of which various health and safety measures were implemented, with digital media playing a pivotal role. However, digital media also pose significant concerns such as misinformation and lack of direction. OBJECTIVE: We aimed to explore the effects of COVID-19-related infodemics through digital, social, and electronic media on the vaccine-related attitudes of caregivers and health care providers in Pakistan. METHODS: This study employs a qualitative exploratory study design with purposive sampling strategies, and it was conducted at 3 primary health care facilities in the province of Sindh, Pakistan. Seven focus group discussions with health care providers and 60 in-depth interviews with caregivers were conducted using semistructured interviews through virtual platforms (ConnectOnCall and Zoom). Transcripts were analyzed through thematic analysis. RESULTS: Our study reveals the pivotal role of electronic media, mobile health (mHealth), and social media during the COVID-19 pandemic. Four major themes were identified: (1) sources of information on COVID-19 and its vaccination, (2) electronic media value and misleading communication, (3) mHealth leveraging and limitations during COVID-19, and (4) social media influence and barriers during COVID-19. Health care providers and caregivers reported that the common sources of information were electronic media and mHealth, followed by social media. Some participants also used global media for more reliable information related to COVID-19. mHealth solutions such as public awareness messages, videos, call ringtones, and helplines promoted COVID-19 prevention techniques and vaccine registration. However, the overwhelming influx of news and sociobehavioral narratives, including misinformation/disinformation through social media such as WhatsApp, Facebook, and Twitter, were found to be the primary enablers of vaccine-related infodemics. Electronic media and mHealth were utilized more widely to promote information and communication on the COVID-19 pandemic and vaccination. However, social media and electronic media-driven infodemics were identified as the major factors for misinformation related to COVID-19 and vaccine hesitancy. Further, we found a digital divide between the urban and rural populations, with the use of electronic media in rural settings and social media in urban settings. CONCLUSIONS: In a resource-constrained setting like Pakistan, the usage of mHealth, social media, and electronic media for information spread (both factual and mis/disinformation) related to COVID-19 and its vaccination had a significant impact on attitudes toward COVID-19 vaccination. Based on the qualitative findings, we generated a model of digital communications and information dissemination to increase knowledge about COVID-19 and its prevention measures, including vaccination, which can be replicated in similar settings for other disease burdens and related infodemics. Further, to mitigate the infodemics, both digital and nondigital interventions are needed at a larger scale.

BRAF mutations and the association of V600E with CD133 and CDX2 expression in a Pakistani colorectal carcinoma cohort.

BACKGROUND: Despite a high incidence of colorectal carcinoma, data regarding genetic aberrations in colorectal carcinoma (CRC) patients in Pakistan is scarce. This study aimed to determine the frequency of BRAFV600E mutations in colorectal carcinoma tissue in the Pakistani population and to associate BRAFV600E expression with CD133, a marker of colorectal stem cells, and CDX2 marker of differentiation. METHODS: Sanger Sequencing of exon 15 (426 bp) including the hotspot V600E was performed on formalin-fixed-paraffin-embedded (FFPE) CRC tissue samples of 115 patients. The samples were subjected to immunohistochemistry (IHC) to assess the expression of BRAFV600E, CDX2, and CD133. Additionally, homology modelling and docking were performed to investigate novel deletions revealed in sequencing. RESULTS: Twenty-four (20.8%) BRAF variants were identified in the coding region, with V600E mutations detected in 14 (12.2% )cases (GenBank: PP003258.1; Pop Set: 2678087296). Moreover, a wide spectrum of novel non-V600E mutations (8.6%) were identified, including deletions and missense variations. In-silico analysis revealed that due to large deletions in the coding region of three samples, the affinity of the anti-BRAF drugs (Encorafenib and Vemurafenib) for the active site decreased in comparison to the wild type. The IHC analysis showed that BRAFV600E expression was significantly associated with CD133 expression (χ2(1, n=115) = 26.351; p = < 0.001) and with CDX2 expression (χ2(1, n=115) = 14.88; p = 0.001). Multivariate analysis using binary logistic regression revealed association of BRAFV600E mutations with age (OR = 1.123; CI = 1.024-1.232; p = 0.014), gender (OR = 0.071; CI = 0.006-0.831; p = 0.035), grade (0.007; CI = 0-0.644) and CD133 expression (OR = 65.649; CI = 2.153-2001.556; p = 0.016). CONCLUSION: The present study demonstrates a notably high V600E frequency (12.2%) in comparison to global reported data, which ranges from 0.4 to 18%. This finding reflects the importance of upfront BRAF testing of the genetically distinct population of Pakistan. Previously unreported mutations identified in the sample may be of clinical significance and warrant further investigation. The concomitant high expression and significant association between CD133 and BRAFV600E represent vital actionable genes that may be targeted together to improve CRC patient management.

Association of precipitation extremes and crops production and projecting future extremes using machine learning approaches with CMIP6 data.

Precipitation extremes have surged in frequency and duration in recent decades, significantly impacting various sectors, including agriculture, water resources, energy, and public health worldwide. Pakistan, being highly susceptible to climate change and extremes, has experienced adverse events in recent times, emphasizing the need for a comprehensive investigation into the relationship between precipitation extremes and crops production. This study focuses on assessing the association between precipitation extremes on crops production, with a particular emphasis on the Punjab province, a crucial region for the country's food production. The initial phase of the study involved exploring the associations between precipitation extremes and crops production for the duration of 1980-2014. Notably, certain precipitation extremes, such as maximum CDDs (consecutive dry days), R99p (extreme precipitation events), PRCPTOT (precipitation total) and SDII (simple daily intensity index) exhibited strong correlations with the production of key crops like wheat, rice, garlic, dates, moong, and masoor. In the subsequent step, four machine learning (ML) algorithms were trained and tested using observed daily climate data (including maximum and minimum temperatures and precipitation) alongside model reference data (1985-2014) as predictors. Gradient boosting machine (GBM) was selected for its superior performance and employed to project precipitation extremes for three distinct future periods (F1: 2025-2049, F2: 2050-2074, F3: 2075-2099) under the SSP2-4.5 and SSP5-8.5 derived from the CMIP6 (Coupled Model Intercomparison Project Phase 6) archive. The projection results indicated an increasing and decreasing trend in CWDs (maximum consecutive wet days) and CDDs, respectively, at various meteorological stations. Furthermore, R10mm (the number of days with precipitation equal to or exceeding 10 mm) and R25mm displayed an overall increasing trend at most of the stations, though some exhibited a decreasing trend. These trends in precipitation extremes have potential consequences, including the risk of flash floods and damage to agriculture and infrastructure. However, the study emphasizes that with proper planning, adaptation measures, and mitigation strategies, the potential losses and damages can be significantly minimized in the future.

Investigating the genetic basis of hereditary spastic paraplegia and cerebellar Ataxia in Pakistani families.

BACKGROUND: Hereditary Spastic Paraplegias (HSPs) and Hereditary Cerebellar Ataxias (HCAs) are progressive neurodegenerative disorders encompassing a spectrum of neurogenetic conditions with significant overlaps of clinical features. Spastic ataxias are a group of conditions that have features of both cerebellar ataxia and spasticity, and these conditions are frequently clinically challenging to distinguish. Accurate genetic diagnosis is crucial but challenging, particularly in resource-limited settings. This study aims to investigate the genetic basis of HSPs and HCAs in Pakistani families. METHODS: Families from Khyber Pakhtunkhwa with at least two members showing HSP or HCA phenotypes, and who had not previously been analyzed genetically, were included. Families were referred for genetic analysis by local neurologists based on the proband's clinical features and signs of a potential genetic neurodegenerative disorder. Whole Exome Sequencing (WES) and Sanger sequencing were then used to identify and validate genetic variants, and to analyze variant segregation within families to determine inheritance patterns. The mean age of onset and standard deviation were calculated to assess variability among affected individuals, and the success rate was compared with literature reports using differences in proportions and Cohen's h. RESULTS: Pathogenic variants associated with these conditions were identified in five of eight families, segregating according to autosomal recessive inheritance. These variants included previously reported SACS c.2182 C > T, p.(Arg728*), FA2H c.159_176del, p.(Arg53_Ile58del) and SPG11 c.2146 C > T, p.(Gln716*) variants, and two previously unreported variants in SACS c.2229del, p.(Phe743Leufs*8) and ZFYVE26 c.1926_1941del, p.(Tyr643Metfs*2). Additionally, FA2H and SPG11 variants were found to have recurrent occurrences, suggesting a potential founder effect within the Pakistani population. Onset age among affected individuals ranged from 1 to 14 years (M = 6.23, SD = 3.96). The diagnostic success rate was 62.5%, with moderate effect sizes compared to previous studies. CONCLUSIONS: The findings of this study expand the genotypic and phenotypic spectrum of HSPs and HCAs in Pakistan and emphasize the importance of utilizing exome/genome sequencing for accurate diagnosis or support accurate differential diagnosis. This approach can improve genetic counseling and clinical management, addressing the challenges of diagnosing neurodegenerative disorders in resource-limited settings.

Spatial distribution and air-soil exchange of short and medium chain chlorinated paraffins in Lahore, Pakistan.

This study provides the first systematic data on the distribution of short- (SCCPs) and medium chlorinated paraffins (MCCPs) in the atmosphere and surface soils of Lahore, Pakistan. The spatial distribution of SCCPs and MCCPs in air (n = 12) and soil (n = 15) was investigated from industrial, residential, commercial, conventional e-waste burning and background areas of Lahore. The concentrations ranged from below the limit of detection (

Judicious and evidence-based use of radiosurgery - recommendations for low-middle income countries.

Surgical removal remains the primary treatment for most brain tumours. However, radiosurgery presents an effective, less invasive alternative or additional treatment for certain types. Our goal was to explore radiosurgery's roles in treating various brain tumours, focussing on its application in low- and middle-income countries (LMICs). We reviewed all relevant systematic reviews, metaanalyses, and guidelines to determine the most effective radiosurgical approaches. Additionally, we consulted a panel of experts with over ten years of experience in LMICs, such as Pakistan. For brain tumours, stereotactic radiosurgery should generally follow a confirmed histopathological diagnosis. Exceptions include tumours identified through Magnetic Resonance Imaging (MRI), like Vestibular Schwannoma (VS), pre-diagnosed Neurofibromatosis type 2 (NF2), multiple typical meningiomas, and metastases with a known histology from another site. While radiosurgery is gaining traction as a primary and adjunct treatment in some LMICs, the lack of regional guidelines, trained personnel, and collaboration among specialists hinders its wider adoption. Addressing these gaps is crucial for expanding radiosurgical care in these regions.

Comparative study of the sequential extraction methodologies for fractionation analysis of mercury in coal of Thar coalfield.

The primary objective of this study was to evaluate the bound fractions of mercury (Hg), physicochemical parameters, and mineral composition of coal. Coal samples were collected from various depths within Block-VII of the Thar coalfield in Pakistan. The Hg associated with different chemical fractions of coal was extracted using a sequential extraction scheme as per the community bureau of reference (BCR) protocol. This study utilized both the BCR-sequential extraction method (BCR-SEM) and a single-step sequential extraction based on an ultrasonic-assisted method (SSE-UAM) for the fractionation analysis of Hg in coal. The extraction methodologies, BCR-SEM and SSE-UAM, were specifically designed for analyzing Hg fractionation in coal samples. The SSE-UAM offers an operational advantage, requiring only 2 h compared to the 51 h needed for BCR-SEM. The analyses were validated using standard reference material (SRM-1635a) and the spiking addition method, achieving a recovery percentage of 97.1% for total Hg concentrations using the pseudo-extraction method in SRM-1635A. Total Hg content in the coal samples ranged from 0.60 to 2.34 µg g-1 across four different coal seams from Block-VII of the Thar coalfield. Additionally, Hg concentration was observed to decrease with increasing depth, attributed to changes in mineralogical composition. The highest concentration of Hg was detected at a depth of 200-203 m, while the lowest concentration was at a depth of 152-154 m. The concentration of Hg in various fractions was 32-60% in the acid-soluble fraction, 1.72-4.92% in the reducible fraction, and 9.58-50.8% in the oxidizable fractions. The coal sample characteristics were analyzed using an elemental analyzer and scanning electron microscopy with energy-dispersive spectroscopy. Cold vapor atomic absorption spectrometry (CV-AAS) was used to measure the extracted fractional concentration of Hg in coal.

The impact of renewable and non-renewable energy consumption on aggregate output in Pakistan: robust evidence from the RALS cointegration test.

Over the past three decades, Pakistan's energy consumption has surged due to industrialization, population growth, and development activities. To meet the escalating energy demands, the country has primarily relied on thermal power projects, which are financially burdensome and environmentally detrimental, compared to hydropower projects. This reliance exposes Pakistan to global oil price shocks and environmental degradation. To address this dilemma, this empirical research investigates the impact of both non-energy factors (labour and capital) and energy-specific factors (renewable and non-renewable) on Pakistan's aggregate output, using annual time-series data from 1980 to 2021. The analysis employs the newly established Residual Augmented Least Square (RALS) cointegration test and the Autoregressive Distributed Lag (ARDL) methodology to estimate the long-term cointegrating relationship among the examined variables. The empirical findings demonstrate that both non-energy and energy-specific factors positively and significantly influence Pakistan's long-term aggregate output. However, petroleum consumption exerts a positive but insignificant influence on Pakistan's long-term aggregate output. The study recommends diversifying the energy supply mix to include more hydroelectricity, non-hydroelectric renewables (mainly solar and wind), and natural gas. Specifically, transitioning from imported, expensive, and more greenhouse gas (GHG)-generating petroleum products to domestically produced natural gas could potentially reduce Pakistan's trade deficit and its vulnerability to global oil price shocks. Besides the economic benefits, shifting from non-renewable energy sources (specifically oil) to renewable energy would enhance Pakistan's image and increase its geopolitical influence over neighboring countries. Additionally, the study emphasizes the need to encourage private sector participation in renewable energy projects and suggests implementing effective carbon tax policies to mitigate CO2 emissions and foster economic growth.

The impact of liquidity risk and credit risk on bank profitability during COVID-19.

The COVID-19 outbreak caused a massive setback to the stability of financial system due to emergence of several other risks with COVID, which significantly influenced the continuity of profitable banking operations. Therefore, this study aims to see that how differently the liquidity risk and credit risk influenced the banking profitability during Covid-19 (Q12020 to Q42021) than before COVID (Q12018 to Q42019). The study employs pooled OLS, and OLS fixed & random effects models, to analyze the panel data on a sample of 37 banks currently operating in Pakistan. The results depict that liquidity risk has a positive and significant relationship with return on assets and return on equity, but insignificant relationship with net interest margin. Credit risk has a negative and significant relationship with return on assets, return on equity, and net interest margin. The study also applies quantile regression to address the normality issue in data. The quantile regression results are consistent with pooled OLS, and OLS fixed and random effects results. The study makes valuable suggestions for regulators, policymakers, and others users of financial institutional data. The current study will help to set policies for efficient management of LR and CR.

Impact of psychological entitlement on engagement in learning activities and psychological anxiety: the mediating role of envy.

Psychological entitlement has appeared as a significant topic for research in the field of management and Psychology. From the perspective of social comparison theory, the present study aimed to investigate the impact of psychological entitlement on engagement in learning activities and psychological anxiety in the hotel industry. Furthermore, benign and malign envy were examined as an explanatory mechanism between psychological entitlement and its outcomes. Based on a three-wave time-lagged design, data were obtained from 242 employees working in the different hotels in Pakistan. We found that psychological entitlement's has no direct influence on hotel employees engagement in learning activities, and psychological anxiety. In addition, the indirect effect of psychological entitlement on both outcomes (engagement in learning activities and psychological anxiety) was found significant through the mediating effect of benign and malign envy. The implications for research theory and practice are discussed.

Genetic polymorphisms in FABP2, CYP2E1, and TP53 genes are potentially associated with colorectal cancer susceptibility.

Colorectal cancer (CRC) is among the most prevalent cancers with a high mortality rate. Both genetic and environmental factors contribute to CRC development. This study aimed to assess the association of single nucleotide polymorphisms (SNPs) in the fatty acid binding protein-2 (rs1799883), Cytochrome P450 2E1 (rs3813865), TP53 (rs1042522), and Murine double minute 2 (rs1042522) genes with CRC. A cross-sectional case-control study was conducted at the Institute of Molecular Biology and Biotechnology from May 2020 to March 2021, involving CRC patients (N = 100) and controls (N = 100) recruited from the Multan district in Pakistan. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and tetra-primer amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) were employed to investigate the studied SNPs. The association of SNPs in all genes with CRC was examined either individually or in various combinations. Genotypes at three SNPs, rs1799883 in FABP2, rs3813865 in CYP2E1, and rs1042522 in TP53, were found to be associated with the development of CRC, while rs1042522 in MDM2 was not. Patients who were married, smoked, lacked exercise habits or had a family history of CRC were at a greater risk of acquiring the disease. FABP2 gene rs1799883, CYP2E1 gene rs3813865, and TP53 gene rs1042522 polymorphisms are significant in the development of CRC in Pakistani participants.

Behavioural Problems in Preadolescence: Does Nutritional Status Have a Role?

INTRODUCTION: Malnutrition in children and adolescents is a global issue particularly in low- and middle-income countries, while behavioural problems are becoming a growing public health concern in the area of child and adolescent mental health, with very few studies examining their association in preadolescence. This study aimed to assess the epidemiological relationship between malnutrition and behavioural problems in preadolescence. METHODS: A school based, cross-sectional survey was conducted in Karachi, Pakistan. Total 660, 11- to 12-year-old preadolescents were selected from a middle-class, coeducational school chain. Sociodemographic questionnaires and an officially adapted version of Youth Self-Report Form (YSR), which is the child and adolescent reported version of the Child Behavior Checklist (CBCL), were used to collect data, along with anthropometric assessments following the WHO protocol. RESULTS: Thin and stunted preadolescents had significantly higher odds of internalizing problems (AOR = 2.05, p = 0.003 and AOR = 2.09, p = 0.039, respectively) than normal ones. Overnutrition was not associated with any behavioural issues. According to the Composite Index of Anthropometric Failure, 40% of preadolescents had at least one type of malnutrition and among them about 3% had co-occurring malnutrition (stunted and thin or overweight). They significantly had higher risk of being associated with the internalizing problems (AOR 2.92, p = 0.027). The effect was considerably higher than that associated with stunted or thin only, highlighting the cumulative impact of the co-occurring malnutrition on the internalizing problems. CONCLUSION: Our study concludes that overnutrition and undernutrition are prevalent in preadolescents, with significant association of undernutrition with internalizing problems. Moreover, our study is the first that reports that the co-occurrence of malnutrition is significantly associated with increased risk of internalizing problems. This study highlights the importance of the link between physical and mental health and emphasizes the need for holistic interventions and programmes for addressing preadolescents' issues.

Expansion of distribution ranges and current population status of Cheer pheasant (Catreus wallichii) in Northern Pakistan (AJ&K).

We studied the distribution and population status of the Cheer pheasant (Catreus wallichii) in Azad Jammu and Kashmir (AJ&K). Study was mainly conducted in four localities Jhelum Valley (JV), Machiara National Park (MNP), Haveli and Nar Sher Ali Khan (NSAK) from 2016-2020, for five breeding seasons. Population status of Cheer pheasant was determined by the call counts method. In total 105 breeding pairs (210 birds) were estimated highest (134) being recorded from Jhelum valley followed by MNP, Haveli and Nar Sher Ali Khan While applying correction factor 158 birds were recorded. Extensive surveys were carried out in an area of 19.23 km2. Our results indicate an expansion in distribution ranges of Cheer pheasant and population has established in several new sites. Highest Mean population density of 6.11pair/km2 was recorded in Qazi Nag area of Jhelum Valley. The mean population density of Cheer pheasant was slightly higher in the month of May. Furthermore, 58% of the calling birds were detected at elevations ranging from 2300-2600m, while 17% were found at elevations between 1900-2200m. Expansion in distribution ranges of Cheer might be due to reason that bird might have been underestimated in the past or conservation measures and community awareness programs taken by the Department of Wildlife and Fisheries, AJ&K.

Leadership competencies for dentists: What do undergraduate students think?

Dentists face difficult situations and challenges every day, but undergraduate dental students in Pakistan are not formally taught leadership skills or assessed for these skills. This study aims to explore the perception of undergraduate dental students on various leadership competencies. A multi-institutional cross-sectional observational study was conducted on undergraduate students in five institutions by using universal sampling technique. Students were asked to self-assess various leadership competencies for dentists based on 15 competencies using a validated questionnaire utilizing Likert scale response format. Responses to these items were presented as frequency and percentage. The overall scores were presented in mean and standard deviation and median and interquartile range. The differences in median scores of all items of the questionnaire between male and female students were determined with Mann Whitney U tests. The year-wise differences in the median of all response items of the questionnaire were determined using Kruskal Wallis H test. A total of 750 students, of which 570 (76%) were females and 180 (24%) were males, participated in the study. Most of the students (n = 708, 94.4%) did not attended any leadership course or workshop in the last five years. Majority of the students perceived that their leadership competencies were fair to excellent. Empathy was perceived as 'excellent' by the majority of the students (n = 294, 39.2%). Majority of the students (n = 319, 42.5%) perceived that their 'authenticity' skills were 'good'. Statistically significant differences were reported between male and female students in most of the leadership skills including 'compassion', 'advocacy skills', 'inquiry skills', 'empathy', 'integrity', 'ability to build trust with others', 'managing conflict', 'leading groups/teams', 'dealing with difficult personalities', and 'likelihood to exercise leadership during a crisis' (p < 0.05). There were also significant differences in the median item scores in 13 out of 15 leadership domains and the year of study (p < 0.05). The study identified the perceptions of students regarding different leadership competencies. It gives indications that which leadership competencies need to be incorporated, promoted, and enhanced in leadership curriculum to make them effective dental practitioners and leaders in future. Incorporating these targeted leadership courses into the curriculum can provide participants with the opportunity to refine their existing leadership strengths and develop a well-rounded set of competencies essential for making a significant contribution in their chosen fields.

NOTCH3 p.Arg1231Cys is markedly enriched in South Asians and associated with stroke.

The genetic factors of stroke in South Asians are largely unexplored. Exome-wide sequencing and association analysis (ExWAS) in 75 K Pakistanis identified NM_000435.3(NOTCH3):c.3691 C > T, encoding the missense amino acid substitution p.Arg1231Cys, enriched in South Asians (alternate allele frequency = 0.58% compared to 0.019% in Western Europeans), and associated with subcortical hemorrhagic stroke [odds ratio (OR) = 3.39, 95% confidence interval (CI) = [2.26, 5.10], p = 3.87 × 10-9), and all strokes (OR [CI] = 2.30 [1.77, 3.01], p = 7.79 × 10-10). NOTCH3 p.Arg231Cys was strongly associated with white matter hyperintensity on MRI in United Kingdom Biobank (UKB) participants (effect [95% CI] in SD units = 1.1 [0.61, 1.5], p = 3.0 × 10-6). The variant is attributable for approximately 2.0% of hemorrhagic strokes and 1.1% of all strokes in South Asians. These findings highlight the value of diversity in genetic studies and have major implications for genomic medicine and therapeutic development in South Asian populations.