Nesting material adaptation of native bird species with anthropogenic litter along an urbanization gradient in Pakistan.

Rapid urbanization and associated waste generation have become a mounting ecological concern for wildlife, especially avian communities. Research has primarily focused on investigating the impacts of human activities on marine birds with comparatively less focus on terrestrial species that live in far more anthropized environments and are at significant risk. Our study has explored the abundance and characteristics of anthropogenic litter in 70 nests of four generalist bird species: Bank Myna (Acridotheres ginginianus), Common Myna (Acridotheres tristis), Black Kite (Milvus migrans) and House Crow (Corvus splendens), within the city of Lahore (Pakistan) and its surroundings, by determining and following an urbanization gradient. The overall frequency of litter occurrence (FLO%) for all the sampled nests was 89%. Over 80% of the recorded litter items consisted of plastic materials, primarily dominated by sheet-like plastics. There was a strong association between fabric and Black Kite nests, and metal and House Crow nests. Litter incorporation increased across the gradient from rural to urban habitats. The highest FLO% was found in nests sampled from waste dumping sites and urban sites (95%-100%), where anthropogenic influence was more intense. The high level of litter incorporation is potentially indicative of a species' adaptive response to urbanization, associated with the decline in natural nesting material and availability of anthropogenic litter. These findings highlight the need for strengthening the existing global database for terrestrial litter and its effect on wildlife and devising policy actions for better waste management and conservation of natural ecosystem balance.

Incidental Finding of Post-Transplant Erythrocytosis After Renal Transplantation in a Patient With Chronic Kidney Disease: A Case Report.

Renal transplant aims to provide a healthy substitute for the chronically damaged kidney while also correcting the anemia of chronic disease by producing erythropoietin for effective erythropoiesis. However, in a small number of renal transplant patients, the hematocrit continues to rise even after correction of the anemia, ultimately leading to abnormally increased hemoglobin and hematocrit. This condition is termed "post-transplant erythrocytosis" (PTE). We present a case of a 50-year-old male who was diabetic, positive for hepatitis B surface antigen, and negative for polymerase chain reaction. He presented with symptoms of acute hepatitis. During the work-up, PTE was diagnosed. Our case sheds light on a common complication of renal transplant known as PTE, its possible complications in the patient, and the necessary interventions to prevent untoward outcomes. PTE, although a less common complication of renal transplant, can become serious and potentially fatal due to its sequelae of thromboembolism. The complications can range from simple thrombophlebitis and thrombosis of digital and brachial arteries to more severe events such as pulmonary embolism or stroke and cardiovascular events. Regular post-transplant follow-ups with frequent bloodwork will aid in the early diagnosis of PTE, allowing for timely intervention with appropriate treatment options such as venesection or angiotensin receptor blockers (ARBs)/angiotensin-converting enzyme (ACE) inhibitors.

An Empirical Investigation of Virtual Networking Sites Discontinuance Intention: Stimuli Organism Response-Based Implication of User Negative Disconfirmation.

The study's prime objective is to investigate the user discontinuance intention in the shed of the negative disconfirmation of user expectation. The study has derived the theoretical structure from the expectancy disconfirmation theory (EDT) enacted through the stimuli organism response (SOR) framework to study the actual cause and effect relationship of human behavioral response. To investigate the user discontinuance intention behavioral response, a total of 434 correct and complete answers were shortlisted for analysis. To examine the data set, the study has used the modern partial least square method technique or simply SmartPLS service package to run the structural equation modeling (SEM). Moreover, the study has implied the 80/20 rule run the mediating analysis of the SOR framework. The statistical results show that all three stimuli make significant positive disconfirmation of the user beliefs in terms of dissatisfaction and the anxiety that ultimately leads to the discontinuance intention in virtual network users. Further, these results are validated through the six mediating relationships, which partially mediate the relationship between the stimuli and response. Besides all these findings, this study has made some practical and realistic theoretical and practical implications for both researchers and service-providing managers.

Incidence of drug interactions in intensive care units in tertiary care settings: Classification, facts and measures.

Drug-drug interactions (DDIs) are extremely significant concern, particularly in sensitive population including pediatric and geriatric. Propensity for the development of DDIs is high in patients admitted at intensive care units (ICU). This study was conducted to evaluate the DDIs incidence, facts and measures in ICU. From a total of 150 cases studied for ICU patients, with the mean age of 56.37±12.45 years, 55.33% were male and the rest were female 44.66%. The demographic information like age, gender and main diagnosis details of study participants that were extracted from the patients' clinical record. A statistically significant association between the drug interaction and the number of drugs prescribed per prescription was observed (p<0.0001). Concerning the onset of outcome, 52% of DDIs distinguished as delayed onset of effect (past 24 hours) and 35% were categorized as rapid onset (within 24 hours). Despite the facts regarding patient safety and minimizing DIs error, polypharmacy is still frequent in critically ill patients admitted in ICU attributed high risk of adverse reactions due to use of multiple interventions to treat severity of disease condition. Such studies may be used to develop an effective tool for the diagnosis and management of DDIs.

Drug utilization and prescribing pattern of antibiotics in a tertiary care setups; trends and practices.

Irrational, over and misuse of antibiotics arise as global concern in both hospital and community settings and lead to adverse events including antimicrobial resistance, associated health problems, amplified hospitalization stay and cost. Hence, Drug Utilization Evaluation (DUE) studies are designed to evaluate and improve the prescribing, administration and the rational use of medications. The present study was designed to assess the pattern of antimicrobial drug utilization in in-patients cohort of tertiary care setup in Karachi, Pakistan. This cross sectional observational study was conducted in retrospective manner. World health organization (WHO) guidelines and criteria are considered to evaluate the appropriateness of drug use in various disease conditions. ATC/DDD system was applied to determine the study outcome. High frequency of antibiotics utilization found in respiratory tract infections of both lower (LRTI) 16.8% (n=42) and upper (UTI) 13.2% (n=33). The estimated total number of drug units administered per month was greater with cefixime (46) and ciprofloxacin (45) both. DDD/100 bed days drug utilization of antibiotics was higher with ciprofloxacin, cefexime and meropenem (47, 46 and 29.25) correspondingly. In conclusion, the current investigation signifies extensive scope for progress in prescribing trend. Drug adherence to customary guidelines of disease management and constraint policies to endorse judicious drug use may be considered vital in healthcare setup.

Assesment of predictor variables and clinical consequences associated with surgical site infection in tertiary care setting, Karachi, Pakistan.

Among the well-known Health care-associated infections (HAIs), surgical site infections (SSIs) contribute to considerable high mortality and morbidity rate, substantial prolongation in hospitalization period and extra expenses in terms of treatment cost. This study was aimed to evaluate the predictive variables associated with surgical site infections, and their clinical consequences. This was a prospective, cross sectional study conducted in the surgical department of tertiary care setting in Karachi, Pakistan. Each patient was followed up from the time of admission until time of the discharge postoperatively for 30 days. A total of 554 surgical procedures were performed and 81 SSIs were identified. The predictor variable/risk factors significantly associated with the presence of SSI were age, gender, BMI, ASA score, co-morbid condition, surgical wound class, emergency surgeries, duration of surgery, type of anesthesia, prosthetic implant, pre operative length of stay and pre operative blood transfusion. Outcomes of such studies may be utilized in the design of a multi factorial practice to get better patient's safety and clinical outcomes.

Reversal of haloperidol induced motor deficits in rats exposed to repeated immobilization stress.

Stress is defined as a non specific response of body to any physiological and psychological demand. Preclinical studies have shown that an uncontrollable stress condition produces neurochemical and behavioral deficits. The present study was conducted to test the hypothesis that a decrease in the responsiveness of somatodendritic 5-hydroxytryptamine (5-HT)-1A receptors following adaptation to stress could attenuate haloperidol induced acute parkinsonian like effect. Results showed that single exposure (2h) to immobilization stress markedly decreased food intake, growth rate and locomotor activity but these stress-induced behavioral deficits were not observed following repeated (2h/day for 5 days) exposure of immobilization stress suggesting behavioral tolerance occurs to similar stress. An important finding of present study is a reversal of haloperidol-induced motor deficits in animals exposed to repeated immobilization stress than respective control animals. It is suggested that stress induced possible desensitization of somatodendritic 5-HT-1A as well as 5-HT-2C receptors could release dopamine system from the inhibitory influence of serotonin. On the other hand, an increase in the effectiveness of postsynaptic 5-HT-1A receptors elicits a direct stimulatory influence on the activity of dopaminergic neuron and is possibly involved in the reversal of haloperidol-induced parkinsonian like symptoms in repeatedly immobilized rats.