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INTRODUCTION: Despite evidence on the effectiveness of tobacco cessation interventions in dental settings, the implementation remains low, especially for smokeless tobacco (ST). The purpose of this study was to develop an understanding of the influences governing the implementation of ST cessation support in dental hospitals. AIMS AND METHODS: A multicenter qualitative study was conducted at two tertiary-care dental hospitals, in Pakistan. Semi-structured interview guide, guided by the Capability-Opportunity-Motivation-Behavior (COM-B) model, were used to capture the views of dentists (nâ =â 12) and dental patients (nâ =â 12), regarding ST cessation support in dental hospitals. Framework approach was used to thematically analyze the data. RESULTS: Screening of ST users in routine dental practice was seldom practiced and the cessation support offered was brief advice. Barriers identified by dentists included: Fear of offending and stereotyping patients; lack of knowledge and skills; lack of privacy; lack of belief in the effectiveness of behavioral support; lack of time and workload pressure; ST use amongst dentists; lack of referral systems and; the absence of a mandatory requirement of offering ST cessation support. Facilitators included: Delivering support through junior dentists and the length of interaction between the dentist and the patient. Naswar was the most common ST product used by dental patients. Patients reported receiving negligible cessation support from any healthcare provider. CONCLUSIONS: A range of influences governing the implementation of ST cessation support in dental hospitals were identified. These findings can inform the implementation of behavioral interventions for ST cessation in dental and other clinical settings, in low and middle-income countries. IMPLICATIONS: Smokeless tobacco control considerably lags, in comparison to the control of combustible tobacco. This is the first study that qualitatively explores the implementation of ST cessation support in dental settings in Pakistan. Utilizing the "Capability-Opportunity-Motivation-Behavior" model, it provides an in-depth understanding of the inability of dentists in implementing effective behavioral interventions for ST cessation support in routine dental practice. Highlighting the striking discrepancy between the patient's need for and receptivity towards cessation support and the dentists' concerns over their patients' receptivity towards cessation support, it calls for the need for effective implementation strategies to optimize dentist-led tobacco cessation interventions in low-resource settings.
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Abandono do Uso de Tabaco , Tabaco sem Fumaça , Humanos , Atitude do Pessoal de Saúde , Aconselhamento , Odontólogos , Hospitais , Paquistão , Pesquisa QualitativaRESUMO
INTRODUCTION: Regulatory compliance in the retail environment is integral to the success of tobacco control. We assessed compliance among naswar (smokeless tobacco product widely used in South Asia) vendors with tobacco control laws. We also assessed their awareness of tobacco-related harms and policies and perceived effect of policies on their sales. METHODS: We surveyed 286 naswar vendors in three districts of the Khyber Pakhtunkhwa province of Pakistan. We recruited general and specialty vendors from urban and rural areas through multistage cluster sampling. Compliance was measured for promotion, sale to/by minors and tax paid on naswar. We used logistic regression analyses for assessing the association between the outcome variables (awareness of tobacco harms and laws, perceptions about the effect of policies on business and compliance with laws) and their predictors. RESULTS: Most vendors (70%) were aware of tobacco-related harms of naswar. Although educated vendors were more aware of tobacco control policies, the greatest awareness was for a ban on sales to/by minors (21% overall). The majority of vendors (76%) violated this policy (measured by self-report), and violations were more common among rural than urban vendors (OR 2.27, 95% CI 1.05 to 4.96). Most vendors (71%) violated a ban on promotion of naswar. Vendors perceived tax increases and sales ban to/by minors as most detrimental for business. CONCLUSIONS: There was poor awareness and compliance among naswar vendors in Pakistan with tobacco control laws. This study finds potential areas for policy interventions that can reduce urban/rural disparities in implementation of and compliance with tobacco control laws.
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Nicotiana , Produtos do Tabaco , Humanos , Paquistão , Comércio , Política PúblicaRESUMO
Cultured fisheries of developing countries are continously challenged by a number of pathogenic microbes. Among microbial diseases, fungal and fungal like pathogen outbreaks lead to negative social and economic impacts on stakeholders. The cultured fisheries of Kashmir valley are also facing challenge from fungal pathogens, leading to tremendous socio-economic lossess to the fish farmer community hence, yearns to boost the sector with efficient management strategy. Our study was aimed at investigating the diversity of fungal communities infecting cultured rainbow trout and carp fish species. We employed classical microbiology, macro and micro morphological characteristics, and molecular analysis (multilocus typing) for fungal identification. Also histopathological approach was used to examine the pathogenicity patterns of diverse fungal groups. The study revealed that the infection in fish was predisposed to both superficial as well as visceral organs. However, skin, gills and head were predominantly infected compared to internal organs. The microbiological investigation of infected fish by culture dependent approach helped us to obtain the total of 250 fungal isolates. Out of these isolates, 21 different species were identified belonging to three diverse fungal groups which mostly included 14 species among Ascomycetes, 03 species of Oomycetes and 04 species of Zygomycetes. The majority of fungi which were infectious to cultured fish of valley are biotrophic or opportunistic soil fungi, and some of them being exclusive pathogens of fish.
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Doenças dos Peixes , Micobioma , Oncorhynchus mykiss , Animais , Doenças dos Peixes/epidemiologia , Índia/epidemiologia , VirulênciaRESUMO
INTRODUCTION: Provision of alternate livelihoods to smokeless tobacco (SLT) supply chain (SC) actors can help in curtailing SLT business and its consumption. We explored the reasons for SC actors' engagement in Naswar (SLT used in South Asia) business and their willingness to switch to other alternatives. AIMS AND METHODS: We conducted an equal-status concurrent mixed-methods study in four districts of Khyber Pakhtunkhwa province of Pakistan. We surveyed 286 general points of sale (GPOS) and exclusive Naswar (EN) vendors through multistage cluster sampling. Additionally, we interviewed 15 tobacco farmers interpretively, being distinct from other SC actors. We assessed the association between vendors' willingness to switch and their awareness about tobacco-harms, profit margin, Naswar as a family business, length of business, education level, and shop type using logistic regression. Qualitative data assessed the farmer's viable alternatives to switch and were analyzed using deductive-inductive thematic analysis. RESULTS: Product demand-77% and profit margins-75% were the main drivers for selling SLT by EN vendors. Half of the GPOS and 25% EN vendors expressed willingness to stop Naswar's sale. Vendors aware of tobacco-harms were more willing to switch, but less likely to switch if Naswar was perceived to bring "good profit." Farmers were mainly cultivating tobacco because of profitability, family-run farm, and perceived land-suitability for tobacco. Lack of government support was main constraint for farmers looking to switch. CONCLUSIONS: A considerable portion of Naswar SC actors in Pakistan are willing to switch to viable alternatives, with profitability of alternatives, support from authorities, and social obligations as key considerations in doing so. IMPLICATIONS: This study highlights that good profit margins in the Naswar business, lack of awareness of tobacco-related health harms, and absence of the government's support are key detriments to switching to alternative businesses among Naswar SC actors in Pakistan. These findings are the first to come out in the context of both Pakistan and Naswar product, making a case for policy interventions focusing on tax increases, awareness campaigns about tobacco-harms, and a proactive role by the government to provide support for the security of livelihoods to those tobacco SC actors who want to switch to other alternatives.
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Tabaco sem Fumaça , Comércio , Escolaridade , Humanos , Paquistão , Uso de TabacoRESUMO
INTRODUCTION: Smokeless tobacco (ST) is a significant South Asian public health problem. This paper reports a qualitative study of a sample of South Asian ST users. METHODS: Interviews, using a piloted topic guide, with 33 consenting, urban dwelling adult ST users explored their ST initiation, continued use, and cessation attempts. Framework data analysis was used to analyze country specific data before a thematic cross-country synthesis was completed. RESULTS: Participants reported long-term ST use and high dependency. All reported strong cessation motivation and multiple failed attempts because of ease of purchasing ST, tobacco dependency, and lack of institutional support. CONCLUSIONS: Interventions to support cessation attempts among consumers of South Asian ST products should address the multiple challenges of developing an integrated ST policy, including cessation services. IMPLICATIONS: This study provides detailed understanding of the barriers and drivers to ST initiation, use, and cessation for users in Bangladesh, India, and Pakistan. It is the first study to directly compare these three countries. The insight was then used to adapt an existing behavioral support intervention for ST cessation for testing in these countries.
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Abandono do Uso de Tabaco , Tabagismo , Tabaco sem Fumaça , Adulto , Humanos , Paquistão , Uso de TabacoRESUMO
OBJECTIVE: To obtain insights into the perceptions of barriers and facilitators to implementation of the WHO Framework Convention on Tobacco Control (FCTC) among smokeless tobacco (SLT) supply chain actors in the Khyber Pakhtunkhwa province of Pakistan. METHODS: We conducted a qualitative study to investigate the perceptions about SLT control policy formulation and implementation among exclusive Naswar sellers and point of sale vendors. We conducted five focus group discussions in three districts of Khyber Pakhtunkhwa using combined deductive-inductive thematic analyses. RESULTS: We identified three central themes that potentially impact policy formulation, its implementation and application. The first theme examines the role of children in the Naswar business: as potential customers, and as potential heirs to a Naswar-selling business. A second theme targets the 'business of Naswar', which includes a specific identity of Naswar sellers, its potential to generate profits and the special case of Naswar regulation as a socially accepted and culturally rooted product. The third theme addresses the unusual ingredients of Naswar and its production process, making Naswar a health risk for consumers and producers. We also report conflicting views regarding SLT control among the supply chain actors. CONCLUSIONS: This study provides insights into the perceptions of important SLT supply-side stakeholders regarding various SLT control policy options based on the FCTC. While there is some opposition to policy approaches like taxation and switching of business, implementing a ban on selling SLT to minors may be a viable option for policymakers in the short term.
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Tabaco sem Fumaça , Criança , Comércio , Humanos , Paquistão , Política Pública , Uso de TabacoRESUMO
INTRODUCTION: Smokeless tobacco (SLT) is a significant contributor to tobacco-related harm in Pakistan but its control has lags behind that of combustible tobacco. We assessed the compliance of Naswar's (a widely used SLT product in the Southeast Asia) packaging and sales practices with the national legislations and relevant articles of the WHO framework convention on tobacco control (FCTC). AIMS AND METHODS: A cross-sectional observational audit was conducted in three districts of Pakistan. We recruited 286 general point of sale (GPOS) and exclusive Naswar sellers (ENS) through a multistage cluster sampling strategy. Data were gathered on packaging and labeling practices of Naswar and advertisement and promotion practices inside and outside the shops. Statistical tests for association between the dependent variable-advertisement practices, and independent variables-area and vendor types were conducted. RESULTS: We analyzed 133 and 49 unique Naswar products sold in 229 GPOS and by 57 ENS, respectively. None of the local products had any written or pictorial health warning. More than half of retailers used one or two methods of advertising Naswar inside the shops while only 9% advertised outside the shops. ENS were more likely to be noncompliant with tobacco advertisement and promotion compared with GPOS. CONCLUSIONS: The study presents first insights on the compliance of Naswar packaging and sale practices with local regulations and WHO FCTC provisions in Pakistan. Almost all products were on display in the shops and none of the local products had any health warning or contents disclosure on the packages. IMPLICATIONS: Naswar is a form of SLT used extensively in Pakistan, Central Asia, and Pashtun populations across the globe. This study provides an important insight into the Naswar retail environment in a geographical setting where the use of Naswar is endemic. The study brings to fore previously unreported issues like an urban-rural disparity, and differences between exclusive and nonENS, with regards to Naswar advertisement and promotion. These findings have potential implication on the implementation of tobacco control retail policies. The lack of health warnings and free display of Naswar brands call for alignment of tobacco control efforts with the FCTC.
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Comércio/legislação & jurisprudência , Marketing/legislação & jurisprudência , Embalagem de Produtos/legislação & jurisprudência , Fumar Tabaco/epidemiologia , Tabaco sem Fumaça/provisão & distribuição , Estudos Transversais , Humanos , Paquistão/epidemiologiaRESUMO
The current study focuses on the detection and characterization of potentially pathogenic Aeromonas sobria from fish silver carp (Hypophthalmichthys molitrix). Assessment of clinical, microbiological, pathological and biochemical characteristics of A. sobria were taken into account in order to understand the epidemiology, frequency and occurrence of this infection. Clinically the infected fish (H. molitrix) was observed for various types of symptoms. A total of 33 colonies of A. sobria strain were isolated from 20 cultured H. molitrix, collected from controlled fish pond. Microscopic examination revealed that the strains were rod-shaped, Gram negative bacteria. The revealed percent probability identification of A. sobria from the biochemical characterization in VITEK system was 93% with gram negative (GN) card. The histopathology of Gills caused by this bacterium, A. sobria indicate haemorrhagic gill epithelia and epithelial hyperplasia. Lamelar epithelial hypertrophy and hyperplasia with degenerative changes of the epithelium and hypertrophic epitheliocystis infected cells on gills of H. molitrix were observed during the present study.
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Aeromonas/isolamento & purificação , Carpas/microbiologia , Doenças dos Peixes/microbiologia , Infecções por Bactérias Gram-Negativas/veterinária , Aeromonas/classificação , Aeromonas/genética , Aeromonas/patogenicidade , Animais , Infecções por Bactérias Gram-Negativas/microbiologia , VirulênciaRESUMO
Trichodina heterodentata Duncan, 1977 and Ichthyophthirius multifiliis Fouquet, 1876 obtained from gills during a parasitological survey conducted for the protozoan parasitic fauna of Schizothorax niger a snow trout in Dal Lake, Kashmir, India during the period October 2013 and March 2015. Thirty out of 180 fish were found infected with protozoan parasites. During the study of their pathogenecity the most common deteriorating signs observed in gill tissue were necrosis, hypertrophy, hyperplasia and fusion of secondary lamellae. Prevalence of infection was found to be 16.66%. This is the first record of the protozoan fauna of the schizothoracines from Kashmir valley, India.
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Infecções por Cilióforos/veterinária , Cilióforos/isolamento & purificação , Cilióforos/patogenicidade , Cyprinidae/parasitologia , Doenças dos Peixes/parasitologia , Animais , Cilióforos/classificação , Cilióforos/genética , Infecções por Cilióforos/parasitologia , Infecções por Cilióforos/patologia , Doenças dos Peixes/patologia , Brânquias/parasitologia , Brânquias/patologia , Índia , Lagos/parasitologia , VirulênciaRESUMO
INTRODUCTION AND OBJECTIVES: There is an unmet need to develop high-quality evidence addressing tuberculosis (TB)-related mental health comorbidity, particularly in the context of lower-middle-income countries. This study aims to examine the effectiveness and cost-effectiveness of cognitive behavioural therapy (CBT) versus enhanced treatment as usual (ETAU) in improving depressive symptoms in people with TB and comorbid depression, enhancing adherence with anti-TB treatment (ATT) and its implementation in the real-world setting of Pakistan. METHODS: We will conduct a pragmatic parallel arm randomised control trial with an internal pilot. A brief psychological intervention based on CBT has been developed using a combination of qualitative and ethnographic studies. The inbuilt pilot trial will have a sample size of 80, while we plan to recruit 560 (280 per arm) participants in the definitive trial. Participants who started on ATT within 1 month of diagnosis for pulmonary and extrapulmonary TB or multidrug resistant TB (MDR-TB) and meeting the criteria for depression on Patient Health Questionnaire-9 (PHQ-9) will be randomised with 1:1 allocation to receive six sessions of CBT (delivered by TB healthcare workers) or ETAU. Data on the feasibility outcomes of the pilot will be considered to proceed with the definitive trial. Participants will be assessed (by a blinded assessor) for the following main trial primary outcomes: (1) severity of depression using PHQ-9 scale (interviewer-administered questionnaire) at baseline, weeks 8, 24 and 32 postrandomisation and (2) ATT at baseline and week 24 at the end of ATT therapy. ETHICS AND DISSEMINATION: Ethical approval has been obtained from Keele University Research Ethics Committee (ref: 2023-0599-792), Khyber Medical University Ethical Review Board (ref: DIR/KMU-EB/CT/000990) and National Bioethics Committee Pakistan (ref: No.4-87/NBC-998/23/587). The results of this study will be reported in peer-reviewed journals and academic conferences and disseminated to stakeholders and policymakers. TRIAL REGISTRATION NUMBER: ISRCTN10761003.
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Terapia Cognitivo-Comportamental , Depressão , Humanos , Terapia Cognitivo-Comportamental/métodos , Projetos Piloto , Paquistão , Depressão/terapia , Ensaios Clínicos Pragmáticos como Assunto , Tuberculose/terapia , Estudos Multicêntricos como Assunto , Análise Custo-Benefício , Antituberculosos/uso terapêutico , AdultoRESUMO
This paper deals largely with the dynamics and changes in the helminth parasite communities of fish along the trophic gradient of lakes. The use of parasitological community data as a bioindicator of environmental health underlines the need to study parasite communities at comparable localities with known pollution levels. The comparison of the conditions in different habitats might be helpful to differentiate between normal fluctuations in ambient conditions and pollution-mediated effects. Therefore, the present study was designed to examine the community structure of parasites in snow trout (Schizothorax niger Heckel) inhabiting 3 lakes of contrasting trophic status in Kashmir. The idea of selecting the lakes, namely Anchar (strongly hypereutrophic), Dal (eutrophic) and Manasbal (mesotrophic) for this study was intentional as they depict different trophic gradients and exhibit the desirable pattern which was a prerequisite for this study. The findings presented in this article suggest an apparent lake-wise gradient in community structure, as the increase in trematode and cestode infections in Anchar was markedly greater, to levels clearly distinguishable from those in the other two water bodies. We conclude that human-induced eutrophication of lakes modifies the parasite community at component level and community-level studies on parasites may provide information on health status of lakes.
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Ecossistema , Doenças dos Peixes/parasitologia , Helmintíase Animal/parasitologia , Helmintos/crescimento & desenvolvimento , Lagos/química , Truta/parasitologia , Animais , Eutrofização , Helmintos/isolamento & purificação , Humanos , Lagos/análiseRESUMO
Seasonal population dynamics of the monogenean, Diplozoon kashmirensis Kaw, on the gills of two cyprinid fish species, Schizothorax niger Heckel and Carassius carassius (Linnaeus), was investigated in three limnologically distinct trophic habitats located along the flood plain of River Jhelum in Kashmir from June 2006 to May 2008. The parasite infrapopulations exhibited a marked seasonal regime in infestation pattern as the infection indices increased to a much higher plateau during summer season at all the lakes, while the lows were recorded in winter. The heterogeneity in infection pattern indicates that water temperature is an important determinant of the seasonality of infrapopulations at all the localities. Furthermore, the results of our work clearly indicate that the parasite infrapopulations increased proportionally with eutrophication level and, as such, the highly eutrophic habitat, Anchar Lake, was significantly more favourable for parasite infrapopulations than the less eutrophic ones. However, the lakes presented no significant interlake differences in water temperature. Therefore, we could argue that interlake differences in the infestation pattern of parasite can be safely attributed to respective water quality in the lakes rather than water temperature. We propose that infrapopulations of the diplozoid studied herein do respond to differences in water quality of lakes and, thus, could qualify as simple and reliable indicator species in short-term comparative assays by lake managers.
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Cyprinidae/parasitologia , Doenças dos Peixes/parasitologia , Platelmintos/fisiologia , Infecções por Trematódeos/veterinária , Animais , Ecossistema , Doenças dos Peixes/epidemiologia , Brânquias/parasitologia , Índia/epidemiologia , Lagos , Modelos Lineares , Platelmintos/crescimento & desenvolvimento , Dinâmica Populacional , Prevalência , Estações do Ano , Temperatura , Infecções por Trematódeos/epidemiologia , Infecções por Trematódeos/parasitologia , Qualidade da ÁguaRESUMO
This report addresses the possible impacts of local habitat characteristics on the metacercariae of Clinostomum schizothoraxi Kaw, 1950 infecting crucian carp, Carassius carassius (Linnaeus), from three lakes in Kashmir. The lakes chosen encompass an extremely wide gradient in trophic status--Manasbal (less polluted and mesotrophic), Dal (moderately polluted and eutrophic) and Anchar (strongly polluted and hypertrophic). The results indicate that infrapopulation-level descriptors of abundance of C. schizothoraxi in fish differed between the three lakes and revealed that the infection levels were greater at Anchar Lake. Furthermore, the prevalence, mean abundance and mean intensity of infection also changed during the period of investigation along the seasonal gradient of water temperature. The fact that the abundance patterns of the parasite differed in different populations of the same host provided a unique opportunity for a comparative study on the temporal variations in infection patterns attained during different seasons. In particular, the lake environments showed a high degree of variability in the density profiles of mollusc intermediate hosts and, thus, the differences in the infection status of crucian carp were derived on the basis of intermediate host population size which, in turn, was influenced by the trophic characteristics of the three lakes.
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Carpas/parasitologia , Doenças dos Peixes/parasitologia , Caramujos/parasitologia , Trematódeos/isolamento & purificação , Infecções por Trematódeos/veterinária , Animais , Ecossistema , Doenças dos Peixes/epidemiologia , Interações Hospedeiro-Parasita , Índia/epidemiologia , Lagos , Larva , Metacercárias , Densidade Demográfica , Prevalência , Estações do Ano , Temperatura , Infecções por Trematódeos/epidemiologia , Infecções por Trematódeos/parasitologia , Poluição da ÁguaRESUMO
Plant transformation based on Agrobacterium-mediated transformation is a technique that mimics the natural agrobacterium system for gene(s) introduction into crops. Through this technique, various crop species have been improved/modified for different trait/s, showing a successful genetic transformation so far. This technique has many advantages over other transformation methods such as stable integration of transgene, cost effective. However, there are many limitations of this technology such as mostly the crops are recalcitrant to agrobacterium, low transformation efficiency, transgene integration as well as off targets. So, it's very important to explore the major limitations and possible solutions for Agrobacterium-mediated transformation in order to increase its genetic transformation efficiency. Therefore, the present review article gives a comprehensive study how the transgenic crops are developed using Agrobacterium-mediated transformation, crops that have already been modified through this method, and risks associated with transgenic plants based on Agrobacterium-mediated transformation. Moreover, the challenges and problems associated with Agrobacterium-mediated transformation and how those problems can be solved in future for a successful genetic transformation of crops using modern biotechnology techniques such as CRISPR/Cas9 systems. The present review article will be really helpful for the audience those working on Genome editing of crops using Agrobacterium-mediated transformation and will opens many ways for future plant genetic transformation.
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BACKGROUND: Neonatal seizures (NS) affect approximately 1% of neonates. Clonic, tonic, myoclonic and subtle seizures are the common types. Birth asphyxia, sepsis, metabolic derangements, intracranial bleed, kernicterus, tetanus and 5th day fits are the common aetiologies. This study was planned to evaluate the types and causes of neonatal seizures. METHODS: It was a descriptive case series conducted at Ayub Teaching Hospital, Abbottabad from 12th December 2006 to 25th September 2007 on neonates having seizures. Serum chemistry, blood counts, cerebrospinal fluid examination and cranial ultrasound were done in all patients. Blood culture, renal and liver function tests, computerised tomography scan, metabolic and septic screening was done in selected patients. Descriptive statistics were applied for analysis. RESULTS: Tonic clonic seizure was the commonest type (28%) followed by multi-focal clonic, and focal tonic seizures (25% each). Birth asphyxia was found to be the main aetiology (46%). CONCLUSION: Tonic clonic seizure was the commonest type and birth asphyxia the main aetiology identified in the majority of neonatal seizures.
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Convulsões/etiologia , Asfixia Neonatal/complicações , Feminino , Hospitais de Ensino , Humanos , Recém-Nascido , Masculino , PaquistãoRESUMO
An accurate therapeutic diet can help people improve their medical condition. Any discrepancy in this regard could jeopardize a patient's clinical condition. This study was aimed to determine prevalence of dietary errors among in-patients at an international private hospital's food department, and to explore causes of error to suggest strategies to reduce such errors in the future. Thus, a sequential explanatory mixed-methods study was carried out. For the quantitative part, secondary data were collected on a daily basis over one-month. For qualitative data, errors arising during the meal flow process were traced to the source on the same day of error followed by qualitative interviews with person responsible. Quantitative data were analyzed in SPSS v.25 as percentages. Qualitative data were analyzed by deductive-inductive thematic analysis. Out of a total of 7041 diets, we found that only 17 had errors. Of these, almost two-thirds were critical. Majority of these errors took place during diet card preparation (52.94%), by dietitians (70.59%), during weekdays (82.35%), breakfasts (47.06%), and in the cardiac care ward (47.06%). The causes identified through interviews were lack of backup or accessory food staff, and employee's personal and domestic issues. It was concluded that even though the prevalence of dietary errors was low in this study, critical errors formed majority of these errors. Adopting organizational behavior strategies in the hospital may not only reduce dietary errors, but improve patients' well-being, and employee satisfaction in a long run.
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Dieta , Hospitais , Causalidade , HumanosRESUMO
There is interrelationship of the environmental conditions and fish health. Decrease or increase of pollution in aquatic ecosystem have direct impact on presence or absence of parasites. Fish living under optimum environmental, well-nourished conditions are more resistant to diseases than fish weakened by malnutrition caused by parasite infestation or due to deterioration of environmental conditions because ofpollution. Fish encounters common parasites in wild and in culture systems. Parasites attach to the host through suckers and hooks and make their way inside the host through different means, which include skin, through mouth along with food, by means of gills. The hosts were collected during Jan 2019 to Jan 2020 from river Veshaw. During this study it was observed that presence of parasites causes some changes in fish which can serve as indicators of deterioration in aquatic habitat. Clinical signs were noticed in fish hosts collected from sites which received waste due to anthropogenic activities. Parasitic anomalies in the host collected from polluted site was observed to include body deformaties, gastric distention, lesions in gut, increased mucus production, damage in gill filaments etc.
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Fungal diseases of fish are a significant economic problem in aquaculture. Using high-throughput expression analysis, we identified potential transcript markers in primary head kidney and secondary embryonic cells from salmonid fish after stimulation with the inactivated fungi Mucor hiemalis and Fusarium aveneacium and with purified fungal molecular patterns. The transcript levels of most of the 45 selected genes were altered in head-kidney cells after 24 h of stimulation with fungal antigens. Stimulation with the inactivated fungus M. hiemalis induced the most pronounced transcriptional changes, including the pathogen receptor-encoding genes CLEC18A and TLR22, the cytokine-encoding genes IL6 and TNF, and the gene encoding the antimicrobial peptide LEAP2. In parallel, we analyzed the total GlcNAcylation status of embryonic salmonid cells with or without stimulation with inactivated fungi. O-GlcNAcylation modulates gene expression, intracellular protein, and signal activity, but we detected no significant differences after a 3-h stimulation. A pathway analysis tool identified the "apoptosis of leukocytes" based on the expression profile 24 h after fungal stimulation. Fluorescence microscopy combined with flow cytometry revealed apoptosis in 50 % of head-kidney leukocytes after 3 h stimulation with M. hiemalis, but this level decreased by > 5% after 24 h of stimulation. The number of apoptotic cells significantly increased in all blood cells after a 3-h stimulation with fungal molecular patterns compared to unstimulated controls. This in vitro approach identified transcript-based parameters that were strongly modulated by fungal infections of salmonid fish.
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Acetilglucosamina/química , Fusarium/imunologia , Mucor/imunologia , Micoses/imunologia , Oncorhynchus mykiss/microbiologia , Salmão/microbiologia , Animais , Peptídeos Catiônicos Antimicrobianos/genética , Apoptose/fisiologia , Doenças dos Peixes/microbiologia , Regulação da Expressão Gênica no Desenvolvimento/genética , Rim Cefálico/metabolismo , Interleucina-6/genética , Lectinas Tipo C/genética , Processamento de Proteína Pós-Traducional , Receptor 3 Toll-Like/genética , Fator de Necrose Tumoral alfa/genéticaRESUMO
OBJECTIVES: The primary objective of this study was to evaluate the effectiveness of a half-day training on de-escalation of violence against healthcare personnel regarding prevention and management of violence incidents versus a similar tertiary-level hospital with no such training. Secondary objectives were to compare the overall satisfaction, burnout, fear of violence and confidence in coping with patients' aggression of the healthcare personnel in the two hospitals. DESIGN: Mixed method design, with a comparative cross-sectional (quantitative) and focus group discussions (qualitative) components. SETTING: Emergency departments of the two tertiary care hospitals in district Peshawar over 6 months starting from May 2018. PARTICIPANTS: Healthcare personnel in the emergency departments of the two hospitals (trained vs untrained). OUTCOME MEASURES: Violence exposure (experienced/witnessed) assessed through a previously validated tool in the past 5 months. Burnout, confidence in coping with patient aggression and overall job satisfaction were also assessed through validated tools. The qualitative component explored the perceptions of healthcare personnel regarding the management of violence and the importance of training on de-escalation of violence through focus group discussions in the two hospitals. RESULTS: The demographic characteristics of the healthcare personnel within the two hospitals were quite similar. The de-escalation training did not lead to a reduction in the incidences of violence; however, confidence in coping with patient aggression and the overall satisfaction were significantly improved in the intervention hospital. The de-escalation training was lauded by the respondents as led to an improvement in communication skills, and the healthcare personnel suggested for scale-up to all the cadres and hospitals. CONCLUSION: The study found significant improvements in the confidence of healthcare personnel in coping with patient aggression, along with better job satisfaction and less burnout in the intervention hospital following the de-escalation training.
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Violência , Violência no Trabalho , Agressão , Atitude do Pessoal de Saúde , Estudos Transversais , Serviço Hospitalar de Emergência , Humanos , Paquistão , Violência/prevenção & controle , Violência no Trabalho/prevenção & controleRESUMO
INTRODUCTION: South Asia is home to more than 300 million smokeless tobacco (ST) users. Bangladesh, India and Pakistan as signatories to the Framework Convention for Tobacco Control (FCTC) have developed policies aimed at curbing the use of tobacco. The objective of this study is to assess the compliance of ST point-of-sale (POS) vendors and the supply chain with the articles of the FCTC and specifically with national tobacco control laws. We also aim to assess disparities in compliance with tobacco control laws between ST and smoked tobacco products. METHODS AND ANALYSIS: The study will be carried out at two sites each in Bangladesh, India and Pakistan. We will conduct a sequential mixed-methods study with five components: (1) mapping of ST POS, (2) analyses of ST samples packaging, (3) observation, (4) survey interviews of POS and (5) in-depth interviews with wholesale dealers/suppliers/manufacturers of ST. We aim to conduct at least 300 POS survey interviews and observations, and 6-10 in-depth interviews in each of the three countries. Data collection will be done by trained data collectors. The main statistical analysis will report the frequencies and proportions of shops that comply with the FCTC and local tobacco control policies, and provide a 95% CI of these estimates. The qualitative in-depth interview data will be analysed using the framework approach. The findings will be connected, each component informing the focus and/or design of the next component. ETHICS AND DISSEMINATION: Ethical approvals for the study have been received from the Health Sciences Research Governance Committee at the University of York, UK. In-country approvals were taken from the National Bioethics Committee in Pakistan, the Bangladesh Medical Research Council and the Indian Medical Research Council. Our results will be disseminated via scientific conferences, peer-reviewed research publications and press releases.