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The risk posed by the quantity of heavy metal lead present in Ca supplements is of grave concern. Some lead levels have been measured up to the extent of regulatory limit set by the United States. Calcium supplements inevitably get contaminated with lead as both are naturally occurring elements having the same charge density. Therefore, it is imperative to indicate the level of this toxic metal in these supplements in order to create awareness among consumers. The calcium in the supplements is derived from natural as well as synthetic/refined sources (chelated or non-chelated). In this study, a sophisticated analytical technique, atomic absorption spectrometer (both with FAAS and GFAAS modes of atomization), was used for the purpose of analyzing Pb contents in 27 commonly used Ca supplements manufactured by different national and multinational companies. The daily intake of lead through these supplements was calculated. Only 10% of the calcium supplements analyzed met the criteria of acceptable Pb levels (1.5 μg/daily dose) in supplements/consumer products set by the United States. It was also found that Pb intake was highest in chelated calcium supplements whereas lowest through calcium supplements with vitamin D formulation. The Pb concentration in calcium supplements was significantly increased (p < 0.001) according to their composition. In order to validate our results from the study conducted, IAEA-certified reference material (animal bone, H-5) was analyzed for Pb levels. The limit of detection of the method used was 0.05 μg/g and a 95% lead recovery of IAEA-certified reference material (animal bone, H-5).

A monoid S satisfies Condition (A) if every locally cyclic left S-act is cyclic. This condition first arose in Isbell's work on left perfect monoids, that is, monoids such that every left S-act has a projective cover. Isbell showed that S is left perfect if and only if every cyclic left S-act has a projective cover and Condition (A) holds. Fountain built on Isbell's work to show that S is left perfect if and only if it satisfies Condition (A) together with the descending chain condition on principal right ideals, MR. We note that a ring is left perfect (with an analogous definition) if and only if it satisfies MR. The appearance of Condition (A) in this context is, therefore, monoid specific. Condition (A) has a number of alternative characterisations, in particular, it is equivalent to the ascending chain condition on cyclic subacts of any left S-act. In spite of this, it remains somewhat esoteric. The first aim of this paper is to investigate the preservation of Condition (A) under basic semigroup-theoretic constructions. Recently, Khosravi, Ershad and Sedaghatjoo have shown that every left S-act has a strongly flat or Condition (P) cover if and only if every cyclic left S-act has such a cover and Condition (A) holds. Here we find a range of classes of S-acts $\mathcal{C}$ such that every left S-act has a cover from $\mathcal{C}$ if and only if every cyclic left S-act does and Condition (A) holds. In doing so we find a further characterisation of Condition (A) purely in terms of the existence of covers of a certain kind. Finally, we make some observations concerning left perfect monoids and investigate a class of monoids close to being left perfect, which we name left$\mathcal{IP}$a-perfect.

Let C be a class of algebras of a given fixed type τ . Associated with the type is a first order language L τ . One can then ask the question, when is the class C axiomatisable by sentences of L τ ? In this paper we will be considering axiomatisability problems for classes of left S-posets over a pomonoid S (that is, a monoid S equipped with a partial order compatible with the binary operation). We aim to determine the pomonoids S such that certain categorically defined classes are axiomatisable. The classes we consider are the free S-posets, the projective S-posets and classes arising from flatness properties. Some of these cases have been studied in a recent article by Pervukhin and Stepanova. We present some general strategies to determine axiomatisability, from which their results for the classes of weakly po-flat and po-flat S-posets will follow. We also consider a number of classes not previously examined.

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World Health Organization (WHO) recommends at least 6 months interpregnancy interval after an abortion. Pakistan has a low contraceptive prevalence rate and a high unmet need for contraception. Post-abortion women are the potential clients for contraception but national data reveal low uptake of the contraceptive methods by these clients. This study aimed to explore the barriers to adopting contraception among post-abortion clients in the district of Sargodha, Pakistan. A qualitative research design was used. Study participants were recruited from three private and three public sector hospitals in the district of Sargodha, Pakistan. The study was conducted from July 2018 to November 2018. Ninety-nine in-depth interviews (IDIs) of post-abortion women were conducted using an unstructured interview guide within the period of one month after abortion. Detailed field notes were made. Interviews continued until thematic saturation had reached. The content was organized into a matrix based on themes and sub-themes. A descriptive thematic analysis using both inductive and deductive coding was conducted. Reasons for not adopting contraceptive methods were explored Although many clients expressed a desire to limit fertility, some barriers were found to be hindering the uptake of contraception. Major barriers expressed by clients were the unwillingness of the husband, the resistance of other family members and real or perceived fear of side effects of contraceptive methods. Lack of adequate knowledge about fertility and contraception was another factor which contributed to the decision not to adopt contraception. Socio-cultural norms to have large family sizes were also reported by some clients. Other barriers include religious beliefs, focus on other health issues, financial unaffordability, infrequent intercourse and plan for tubal ligation. The study concluded that without addressing the barriers post-abortion contraceptive uptake is unlikely to improve. Identification of barriers is the first step to addressing the existing unmet need for contraception.

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Background Extra pulmonary tuberculosis (EPTB) constitutes 18% of all tuberculosis (TB) cases and tuberculous lymphadenitis (TBL) constitutes 20–40% of EPTB. Diagnosis of TBL is challenging because of the paucibacillary nature of the disease. Objective To investigate the diagnostic potential of a new antigen detection test based on the detection of M. tuberculosis complex specific antigen MPT64 from fine needle aspirate (FNA) cytology smears and biopsies obtained from patients with clinically suspected TBL using immunohistochemistry (IHC). Materials and methods This study was conducted at Khyber Teaching Hospital and Rehman Medical Institute, Peshawar, Pakistan, from January 2018 to April 2019. Samples, including FNA (n = 100) and biopsies (n = 8), were collected from 100 patients with presumptive TBL. Direct smears and cell blocks were prepared from the FNA samples. All samples were subjected to hematoxylin–eosin (H&E) staining, Ziehl-Neelsen (ZN) staining, and immunostaining with polyclonal anti-MPT64 antibody. The culture was performed only for biopsy specimens. All patients were followed until the completion of anti-TB treatment. The response to treatment was included in the composite reference standard (CRS) and used as the gold standard to validate the diagnostic tests. Results The sensitivity, specificity, positive and negative predictive values for ZN staining were 4.4%,100%,100%,56%, for culture were 66%,100%,100%,50%, for cytomorphology were 100%,90.91%,90%,100%, and for immunostaining with anti-MPT64 were all 100%,respectively. The morphology and performance of immunohistochemistry were better with cell blocks than with smears. Conclusion MPT64 antigen detection test performed better than ZN and cytomorphology in diagnosing TBL. This test applied to cell blocks from FNA is robust, simple, and relatively rapid, and improves the diagnosis of TBL.