Objective:To determine neonatal congenital hypothyroidism among neonates born in a tertiary care hospital of Lahore Pakistan.Methods:This cross-sectional study was carried out at Pathology Department of Allama Iqbal Medical College, Lahore in collaboration with Pediatrics and Gynecology & Obstetrics Department, Jinnah Hospital, Lahore Pakistan. A total of 770 babies were included in this study, both male and female. About 2 ml venous blood samples were collected aseptically from the neonates in sterile clotted tube. Serum was separated and serum TSH was determined by ELISA method.Results:Out of total 770 neonates, 48.9% were female and 51.0% were males with the ratio of 1:1.04. Neonatal congenital hypothyroidisim (TSH, >30 mIU/L), was observed in 0.4% (Frequency, 1:257) nenates, with the incidence rate of 1:257. Female to male ratio of hypothyroid neonates was 2:1. The mode of delivery vise distribution showed, among n=251 neonates born by normal delivery, only a single case of hypothyroidism was detected, and among n=519 neonates delivered by cesarean section, only two neonates were belong to hypothyroidism.Conclusion:The frequency of Congenital Hypothyroidism is notably higher in pediatric community than reported in most other countries. This result emphasizes the necessity of a nationwide screening program.

Honey is a nutritious substance produced by bees. Its quality and nutritional value is of great importance for consumers. Keeping this in view physicochemical and minerals determination as quality parameters of fresh floral Pakistani honeys produced by A. mellifera and branded honeys was conducted. The results of fresh honey indicated average means of Color as 48.78 mmPfund, pH 4.9, Total acidity 37.14 meq/kg, Moisture content 18.62%, Electrical conductivity 0.23 mS/cm, Ash content 0.49%, HMF content 30.85 mg/kg, Proline 365.84 mg/kg, Diastase activity 34.39(DN) and Invertase activity was 68.61(IN) comparable to honey standards. Natural honey were rich in k+ (408.46 ppm) and Na+ (405 ppm). Although Ca+ was very low. Whereas, Co, Mn and Ba concentrations exceed the 1 ppm. However, Pb, Cr, and Mo were unnoticeable. Similarly, Color, pH, MC, EC, T. Acidity, HMF, Proline, Ash content, Diastase and Invertase activity of branded honey samples average means found were 42.5 mmPfund, 5.05, 20.5%, 0.18 mS/cm, 15.34 meq/kg, 36.5 mg/kg, 181.6 mg/kg, 1.11%, 7.90(DN) and 36.97(IN) respectively. The findings showed that fresh honey samples were good and of consumable quality as per honey standards than branded honey. Higher HMF content and lower enzymatic activity in branded honey sample than the Codex standards revealed its either long or improper storage.

Introduction HIV continues to be one of the leading causes of infectious death worldwide and presentation with advanced HIV disease is associated with increased morbidity and mortality. Recommendations for the management of advanced HIV disease include prompt screening and treatment of opportunistic infections, rapid initiation of ART and intensified adherence support. We present treatment outcomes of a cohort of patients presenting with advanced HIV disease in a semi-urban Zimbabwean polyclinic. Methods Retrospective cohort analysis of adult patients enrolled for care at Epworth polyclinic, Zimbabwe between 2007 and end June 2016. Treatment outcomes at 6 and 12 months were recorded. Multivariate logistical regression analysis was undertaken to identify risk factors for presentation with advanced HIV Disease (CD4 count less than 200 cells/mm 3 or WHO stage 3 or 4) and risks for attrition at 12 months. Results 16,007 anti-retroviral therapy naive adult patients were included in the final analysis, 47.4% of whom presented with advanced HIV disease. Patients presenting with advanced HIV disease had a higher mortality rate at 12 months following enrollment compared to early stage patients (5.11% vs 0.45%). Introduction of a package of differentiated care for patients with a CD4 count of less than 100 cells/mm 3 resulted in diagnosis of cryptococcal antigenaemia in 7% of patients and a significant increase in the diagnosis of TB, although there was no significant difference in attrition at 6 or 12 months for these patients compared to those enrolled prior to the introduction of the differentiated care. Conclusions The burden of advanced HIV disease remained high over the study period in this semi-urban polyclinic in Zimbabwe. Introduction of a package of differentiated care for those with advanced HIV disease increased the diagnosis of opportunistic infections and represents a model of care which can be replicated in other polyclinics in the resource constrained Zimbabwean context.

Aedes mosquitoes are the most important group of vectors that transmit pathogens, including arboviruses, and cause human diseases such as dengue fever, yellow fever, Zika virus, and Chikungunya. Biosynthesis and the use of green silver nanoparticles (AgNPs) is a vital step to identify reliable and eco-friendly controls for these vectors. In this study, Aedes ( Ae .) aegypti larvae (2nd and 3rd instar) were exposed to leaf extracts of Ricinus communis (Castor) and AgNPs synthesized from the extract to evaluate their larvicidal potential. Synthesized AgNPs were characterized by UV–Vis spectroscopy, Fourier transform infrared spectroscopy (FTIR), and energy-dispersive X-ray spectroscopy (XRD). Ae. aegypti larvae were treated with different concentrations (50–250 ppm) of the leaf extract and synthesized AgNPs. There were five replicates per treatment, in addition to a positive (temephos) and negative control (dechlorinated water). Mortality was recorded after 12, 24, 36, and 48 h and the data were subjected to Probit analysis. The nanoparticles were more toxic (LC 50 = 46.22 ppm and LC 90 = 85.30 ppm) than the plant extract (106.24 and 175.73 ppm, respectively). The leaf extracts of Ricinus communis were subjected to HPLC analysis to identify their chemical constituents. This study suggests that plant extracts and synthesized nanoparticles are excellent alternatives to hazardous chemical pesticides used to control vector mosquitoes. This is a potentially useful technique that can reduce aquatic toxicity from insecticide use.

Background: To assess awareness levels of Hepatitis B virus infection, transmission, treatment and prevention in medical and nonmedical students of Karachi. Methods: Undergraduate students in 6 medical and non-medical universities were randomly approached to fill out a questionnaire. A sample size of 530 students was collected and data was analyzed using SPSS 20 software and chi square tests for significance. Results: Of the 530 students interviewed, 361(68.1%) and 169(31.9%) were identified as medical and non-medical students respectively. Significantly greater knowledge on modes of transmission were noted in medical students as well as overall levels of awareness of Hepatitis B virus, (p=0.001) and (p=0.003) respectively. Conclusion: Both medical and non-medical students showed a moderate level of awareness of Hepatitis B virus, its modes of transmission, treatment and preventive measures. Medical students showed an overall greater level of awareness.

Objectives: To assess the awareness of diabetic patients about diabetic retinopathy. Method: The cross-sectional study was conducted at the Ophthalmology Department, Fauji Foundation Hospital, Rawalpindi, Pakistan, from April 2018 to April 2019, and comprised diabetic patients of either gender aged 21-80 years. A pre-tested semi-structured questionnaire was used to collect data on socio-demographic, diabetes and diabetic retinopathy characteristics. Fundoscopic examination was done, and the presence and stage of diabetic retinopathy were documented. Data was analysed using SPSS 20. Results: Of the 132 subjects, 9(6.8%) were male and 123(93.2%) were females. The majority 64(48.5%) was aged 61-80 years. Overall, 74(56.1%) patients were aware that diabetes could affect their eyes, 57(43.2%) were never diagnosed with diabetic retinopathy, 76(57.6%)  had gained information about diabetic retinopathyfrom ophthalmologists, 61(46.2%) and 29(22%) respondents reported that eyes should be examined ‘only when vision is affected’ and ‘every 6 months’ respectively, 98(74.2%) said the biggest barrier in getting eyes examined earlier was ‘lack of knowledge’, 23(17.4%) believed surgery was done for diabetic retinopathy treatment and 33(25%) believed that surgery, laser and injections all can be used.  Significant relationship of diabetic retinopathy was found with duration of diabetes and the general health status (p<0.05). Conclusion: Though more than half the patients were aware that diabetes could affect the eyes, awareness of diabetic retinopathy and its consequences was low. Key Words: Awareness, Diabetes mellitus, Diabetic retinopathy, Continuous...

Fishmeal; being a limited and costly feed ingredient is continuously been substituted with locally available plant proteins. However, the occurrence of anti-nutritional factors in plant meal suppresses its potential to be fully replaced. Therefore, in this study we aimed to study the synergistic effects of dietary additives like citric acid and phytase enzyme supplementation on growth performance and nutrient digestibility of Cirrhinus mrigala fingerlings. Canola meal (CM) was used as a test ingredient to replace fishmeal (FM) as; 0%, 25%, 50% and 75%. These four diets were further supplemented by varying levels of phytase (0 and 750 FTU kg-1) and citric acid (0% and 2.5%) to formulate total sixteen test diets as T1, T2, T3, T4, T5, T6, T7, T8, T9, T10, T11, T12, T13, T14, T15 and T16. Each treatment contained three replicates; applied to fish groups having 15 fingerlings each; following 3×3 factorial arrangement. 1% of chromic oxide was added as an inert marker. Maximum weight gain% (288%) and the lowest value of FCR (1.07) were recorded when fish was fed on diet T12 as compared to fish fed control diet (T1). Similarly, optimum nutrient digestibility values such as crude protein (77%), crude fat (84%) and gross energy (70%) were noted on same level. It was concluded that 50% canola meal can optimally replace fishmeal when supplemented with phytase and citric acid at the levels of 750 FTU kg-1 and 2.5%, respectively.

BACKGROUND: Negative appendectomies result in unnecessary admissions, health care burden, and cost. This study was conducted to assess total leukocyte and neutrophil counts as preventive tools in reducing negative appendectomies.