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In this article, we present the transmission dynamic of the acute and chronic hepatitis B epidemic problem and develop an optimal control strategy to control the spread of hepatitis B in a community. In order to do this, first we present the model formulation and find the basic reproduction number . We show that if then the disease-free equilibrium is both locally as well as globally asymptotically stable. Then, we prove that the model is locally and globally asymptotically stable, if . To control the spread of this infection, we develop a control strategy by applying three control variables such as isolation of infected and non-infected individuals, treatment and vaccination to minimize the number of acute infected, chronically infected with hepatitis B individuals and maximize the number of susceptible and recovered individuals. Finally, we present numerical simulation to illustrate the feasibility of the control strategy.

Objectives: To describe the simplicity, efficacy and safety of A. Chohan Continuous Squeezing Suture (ACCSS) for controlling haemorrhage from the lower uterine segment at caesarean section for placenta Praevia and accrete spectrum disorders. Methods: This prospective study was conducted on 47 patients with placenta Praevia and accreta spectrum disorders from February 2019 to May 2022 in two teaching hospitals of Lahore and ACCSS was applied. The outcome measures were peripartum hysterectomy procedure time, estimated blood loss, number of blood transfusions, duration of stay in the hospital, bladder trauma, uterine necrosis, pelvic abscess formation, secondary postpartum haemorrhage and maternal mortality. Descriptive statistics were calculated by using SPSS version 21. Results: Out of 47 patients, 7 (15%) had placenta creta, 29 (61.7%) increta, 11 (23.3%) percreta (grade 3a), and 36 (76.6%) central anterior dominant placenta. Peripartum hysterectomy was prevented in 97.8% of patients. ACCSS procedure time was 5-10 minutes (87.2%), with mean blood loss 2500±485 ml, mean blood transfusion 1.85±1.02 units and mean hospital stay of 3.3±0.84 days. One patient had bladder trauma. There was no case of uterine necrosis, pelvic abscess formation, secondary postpartum haemorrhage or maternal mortality. Conclusion: ACSS appears to be a simple, effective and safe treatment option for placenta praevia and accreta spectrum disorders, as an alternative to hysterectomy. Registration: ClinicalTrial.gov NCT04660578, NCT05070689. doi: https://doi.org/10.12669/pjms.39.1.6990 How to cite this: Chohan MA, Butt F, Imran M, Zahra S, Chohan MA. Placenta Accreta Spectrum Disorders: A. Chohan Continuous Squeezing Suture (ACCSS) for Controlling Haemorrhage from the Lower Uterine Segment at Caesarean Section. Pak J Med Sci. 2023;39(1):---.   doi: https://doi.org/10.12669/pjms.39.1.6990 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

This paper demonstrates how person-focused, prevention-based, risk/needs-related, team-delivered, minimum intervention oral care (MIOC) principles and approaches can be integrated into the dental profession for the delivery of environmentally sustainable, optimal care to high-needs and high caries-risk/susceptibility patients. It highlights the potential for NHS remuneration for prevention-based, phased, personalised care pathways/plans (PCPs) within a reformed NHS dental contract system. It emphasises the importance of comprehensive and longitudinal patient risk/susceptibility assessments, prevention and stabilisation of the oral environment before considering more complex, definitive restorative work. This paper forms the first of several components of a suite of educational/information materials needed to instil confidence and implementation protocols within primary care clinical oral health care teams delivering MIOC through phased PCPs, especially when managing patients with high needs and/or disease susceptibility. Key points The development of a team-delivered, prevention-based, person-focused, susceptibility/needs-related phased care approach to modern caries management using the minimum intervention oral care delivery framework in primary care is proposed. Using personalised care plans within phased courses of treatment, aligned to periodontal management guidelines, caries prevention in primary care can be incentivised. The potential for NHS remuneration for prevention-based, phased, personalised care pathways/plans (PCPs) within a reformed NHS dental contract system is outlined.

(2) Flaxseed also contains fibre which plays a key role in lowering postprandial blood glucose levels. In a randomized cross-over design, 32 healthy volunteers (21 female, 11 male; age 29 SD 5·8 years) consumed three different muffins (control, whole flaxseed and ground flaxseed) and the effects on GR and IR were measured over 2-hours using capillary blood samples. [...]there is a limited amount of literature on the effect of flaxseed on GR and IR among healthy individuals.

Purpose Flaxseed can be effective at lowering and stabilising blood glucose responses. The aim of this study was to determine whether flaxseed could lower blood glucose response more effectively when consumed as a single portion of 30 g, or a split portion consumed three times per day (10 g flaxseed per portion). Methods The study was a randomised, repeated measures, cross-over design. Fifteen healthy participants consumed either (1) three flaxseed muffins containing a total of 30 g of flaxseed once in the morning, (2) three flaxseed muffins consumed at three different timepoints across the day (10 g flaxseed per muffin) or (3) three control muffins consumed at three different timepoints across the day (0 g flaxseed). The 24-h blood glucose response was measured using a continuous glucose monitor. Results The results of this study demonstrated that flaxseed muffins given three times a day were effective at lowering and maintaining blood glucose levels over 24 h, compared to the control muffins and that both flaxseed treatments resulting in a lower blood glucose iAUC during the night. Conclusion The results of this study indicated that adding flaxseed to a daily diet produced a lower glucose profile over 24 h in a free-living context compared to the control muffins.

Spices are often subjected to both cooking (C) and digestion (D), however, there is little if any data on the impact of these factors on their polyphenolic antioxidant activity. [...] the extent to which these processes impact the antioxidant capacity (AC) and total phenolic content (TPC) of spices were examined in the present study.

Upland cotton ( Gossypium hirsutum L.) is an important crop in the world due to its natural fiber production. As a result of climate change, its production is affected due to frequent occurrence of water-deficit conditions during its growth period. Five cotton varieties, namely FH-114, FH-142, FH-152, CIM-473 and CIM-496 were evaluated under limited irrigation conditions to characterize water-deficit tolerance. The data were recorded for plant height, content of biochemical parameters (carotenoid, chlorophyll, wax, proline) and seed cotton yield per plant. The plant material was genotyped with 23 highly polymorphic simple sequence repeats markers. The cotton varieties, CIM-473 and FH-142, with higher content of carotenoid, chlorophyll, epicuticular wax, and proline maintained sustained vegetative growth and development due to osmoregulation; optimal photosynthesis and photochemical efficiency; and maintenance of balance in the C/N metabolism and energy homeostasis; which resulted in better seed cotton yield (> 30% than the drought susceptible varieties) under limited irrigation conditions. Significant associations of simple sequence repeat DNA markers with plant height, carotenoid content, chlorophyll content, wax content, and seed cotton yield were identified. Especially, the DNA markers BNL1153 (chromosome 25) and BNL3031 (chromosome 9) might be the markers flanking the genes involved in the biosynthesis of proteins/enzymes (such as Late Embryogenesis Abundant proteins; chaperones; antioxidants; L-ascorbate peroxidase; enzymes in the ABA, proline, carotenoids and epicuticular wax biosynthesis) catalyzing the metabolic pathways leading to water-deficit tolerance in cotton and thus would be valuable resources for molecular breeding programs to develop water-deficit-tolerant cotton cultivars.