Background The role of a pharmacist in primary health care settings of Pakistan is still obscure. Thus, we aimed to demonstrate the pharmacist-led improvements in glycemic, blood pressure and lipid controls in type 2 diabetes mellitus (T2DM) patients of Lahore, Pakistan. Methods The first open label, randomized control trial conducted at a primary health care facility of Lahore, Pakistan by enrolling 244 uncontrolled type 2 diabetes (hemoglobin A1 c, (HbA1c); 10.85 ± 1.74) patients. The pharmacological intervention included identification of drug related problems, drug interactions, change in dose, frequency and therapy switches in collaboration with physician, while non-pharmacological intervention consisted of diet, lifestyle and behavior counseling. Outcome measures were glycemic (HbA1c), blood pressure and lipid controls. Results In intra-group comparison, compared to control arm ( C , n = 52), subjects in the intervention arm ( I , n = 83) demonstrated significant differences in process outcome measures; baseline vs final, such as HbA1c ( C ; 10.3 ± 1.3 vs 9.7 ± 1.3, p <  0.001, I ; 10.9 ± 1.7 vs 7.7 ± 0.9, p <  0.0001), systolic blood pressure (SBP) ( C ; 129.9 ± 13.9 vs 136 ± 7.1, p = 0.0001, I ; 145 ± 20.4 vs 123.9 ± 9.9 mmHg, p <  0.0001), diastolic blood pressure (DBP) ( C ; + 4, p = 0.03, I ; − 7 mmHg, p <  0.0001), cholesterol ( C ; 235.8 ± 57.7 vs 220.9 ± 53.2, p = 0.15, I ; 224 ± 55.2 vs 153 ± 25.9 mg/dL, p < 0.0001), triglycerides ( C ; 213.2 ± 86.6 vs 172.4 ± 48.7, p = 0.001, I ; 273 ± 119.4 vs 143 ± 31.6 mg/dL, p < 0.0001) and estimated glomerular filtration rate (eGFR) ( C ; 77.5 ± 18.6 vs 76 ± 14.2, p = 0.5, I ; 69.4 ± 21.3 vs 93.8 ± 15.2 ml/min/1.73m 2 , p < 0.0001). Likewise, inter-group improvements were more significant in the subjects of intervention group at final follow up in comparison to control for various process outcome measures; HbA1c ( p < 0.001), SBP ( p < 0.0001), DBP ( p = 0.02), cholesterol ( p < 0.0001), triglycerides ( p < 0.0001), SCr ( p < 0.001), eGFR ( p ...

The present study describes the characterization of carbonaceous species including elemental carbon (EC), organic carbon (OC), total carbon (TC), crustal (Al, Ca, Mg, Fe, S, and Ti) and trace metals (As, Ba, Cd, Cr, Cu, Mn, Ni, Pb, Sn and Zn) in PM 10 samples collected from an urban site in Lahore, Pakistan. Sources of various pollutants and their characterization positive matrix factorization (PMF) model. The carbonaceous species (TC, OC, EC) and metals were measured in PM 10 samples by NIOSH protocol using Sunset lab instruments and ICP-OES respectively. PM 10 concentrations varied from 254 to 555 µg/m 3 with an average of 406 ± 87 µg/m 3 . The elemental carbon (EC) concentration varied from 3 to 56 µg/m 3 with an average of 21 ± 15 µg/m 3 . While the organic carbon (OC) concentrations varied from 21 to 212 µg/m 3 with an average of 63 ± 42 µg/m 3 . The OC/EC ratio varied from 1.5-7.6 with an average of 3.9 ± 1.6, indicating a contribution of both biogenic and secondary aerosol formation. A good correlation was also observed between EC and OC (R 2 = 0.81) indicating their common origin. PMF has identified industrial dust (18.2% of PM 10 ), vehicular emission (26.5% of PM 10 ), bio mass fuel (24.3% of PM 10 ) and re-suspended dust (4.6% of PM 10 ) as major sources of PM 10 in urban environment of Lahore.

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The Internet of Things (IoT) is an exponentially growing emerging technology, which is implemented in the digitization of Electronic Health Records (EHR). The application of IoT is used to collect the patient’s data and the data holders and then to publish these data. However, the data collected through the IoT-based devices are vulnerable to information leakage and are a potential privacy threat. Therefore, there is a need to implement privacy protection methods to prevent individual record identification in EHR. Significant research contributions exist e.g., p+-sensitive k-anonymity and balanced p+-sensitive k-anonymity for implementing privacy protection in EHR. However, these models have certain privacy vulnerabilities, which are identified in this paper with two new types of attack: the sensitive variance attack and categorical similarity attack. A mitigation solution, the θ -sensitive k-anonymity privacy model, is proposed to prevent the mentioned attacks. The proposed model works effectively for all k-anonymous size groups and can prevent sensitive variance, categorical similarity, and homogeneity attacks by creating more diverse k-anonymous groups. Furthermore, we formally modeled and analyzed the base and the proposed privacy models to show the invalidation of the base and applicability of the proposed work. Experiments show that our proposed model outperforms the others in terms of privacy security (14.64%).

Purpose To study the association between gut microbial abundance and sight-threatening diabetic retinopathy among patients with a history of type 2 diabetes mellitus. Methods An observational case-control study was performed using a sample population of diabetics referred to a tertiary eye institute. Sample subjects were identified as cases if they were diagnosed with sight-threatening diabetic retinopathy and controls if they were not but had at least a 10-year history of diabetes. Fecal swabs for all patients were collected for enumeration and identification of sequenced gut microbes. Statistical analyses were performed to associate the clinically relevant Bacteroidetes to Firmicutes relative abundance ratio (B/F ratio) with sight-threatening diabetic retinopathy and an optimal cutoff value for the ratio was identified using Youden's J statistics. Results A sample size of 58 diabetic patients was selected (37 cases, 21 controls). No statistically significant difference in the relative abundance among the predominant phyla between the groups were found. In our univariate analysis, the B/F ratio was elevated in cases compared to controls (cases, 1.45; controls, 0.94; P = 0.049). However, this statistically significant difference was not seen in our multivariate regression model. Optimal cutoff value of 1.05 for the B/F ratio was identified, and significant clustering of cases above this value was noted in beta diversity plotting. Conclusions No difference in gut microbial abundance for any particular phylum was noted between the control and diseased population. Increased gut microbial B/F ratio can be a potential biomarker for the development of sight-threatening diabetic retinopathy among type 2 diabetic patients.

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Privacy preserving data publishing (PPDP) refers to the releasing of anonymized data for the purpose of research and analysis. A considerable amount of research work exists for the publication of data, having a single sensitive attribute. The practical scenarios in PPDP with multiple sensitive attributes (MSAs) have not yet attracted much attention of researchers. Although a recently proposed technique (p, k)-Angelization provided a novel solution, in this regard, where one-to-one correspondence between the buckets in the generalized table (GT) and the sensitive table (ST) has been used. However, we have investigated a possibility of privacy leakage through MSA correlation among linkable sensitive buckets and named it as “fingerprint correlation fcorr attack.” Mitigating that in this paper, we propose an improved solution “c,k-anonymization” algorithm. The proposed solution thwarts the fcorr attack using some privacy measures and improves the one-to-one correspondence to one-to-many correspondence between the buckets in GT and ST which further reduces the privacy risk with increased utility in GT. We have formally modelled and analysed the attack and the proposed solution. Experiments on the real-world datasets prove the outperformance of the proposed solution as compared to its counterpart.