Explore the vast range of titles available.

Background Visual impairment among school-aged children in low-resource settings can significantly impact their quality of life and education due to limited access to comprehensive eye care. This study reports outcomes of a school-based vision screening program using the Peek Capture smartphone app for vision screening and patient referral in two districts of Punjab, Pakistan. Methods This was a retrospective, observational study. We analyzed primary programmatic data collected from children undergoing vision screening by School Health and Nutrition Supervisors in the districts of Chakwal and Layyah in Punjab, from January 2022 to September 2024. The Peek Capture platform enabled real-time tracking of program data, including referrals and follow-ups. Primary outcome measures included referral rates and follow-up adherence rates, which were analyzed by age group and gender. Statistical comparisons were made using the z-test for proportions and the Chi-squared test of independence. Results Among 151,456 children screened (54% female), 5.7% ( n  = 8,682) were referred to Rural Health Centers (RHCs), with higher referral rates in females (6.3% vs. 5.0%, p  < 0.001) and older children aged 12–18 (7.9% vs. 4.2%, p  < 0.001). Follow-up was completed by 47.1% ( n  = 4,091), with no significant gender difference but lower rates in older children (45.6% vs. 49.2%, p  = 0.001). Among those who followed up, 73.3% ( n  = 2,999) were confirmed to have an eye condition. Glasses were prescribed in 71.5% of diagnosed cases. Hospital referrals were rare (1.8%) and did not vary by gender. Conclusion This study demonstrates the feasibility of high-volume, school-based vision screening using a smartphone-based platform in low-resource settings, with strong diagnostic yield among those who followed up. However, the 47.1% follow-up rate highlights a critical implementation challenge. Modest age- and gender-related differences point to areas for targeted programmatic strengthening. Further research is needed to assess the cost-effectiveness and long-term impact of such programs.

Age-related macular degeneration (AMD) is the most common cause of blindness and vision impairment in individuals over 60 years of age in the United States (US). Despite this, current treatment options have limitations related to drug efficacy and durability. Gene therapy provides a potential solution by providing a more durable and longer- acting treatment option that can decrease treatment burden and improve long-term visual outcomes. This review presents the current treatment approaches, routes of administration, and vectors being investigated for gene therapy delivery in AMD. It also provides an update on the ongoing gene therapy clinical trials for dry and wet AMD. As these therapies advance into later-stage clinical trials, ophthalmologists need to be mindful of the many challenges pertaining to gene therapy delivery, including safety, limitations related to immunogenicity, long-term ocular and systemic side effects, and potential barriers to drug manufacturing and access. Continued efforts are required to improve precision, safety, and efficacy, including identifying the safest and most effective vectors and delivery routes, and minimizing potential adverse effects. In addition, guidelines need to be established to guide appropriate patient selection before gene therapy can be integrated into clinical practice.

ObjectiveMacular retinal nerve fibre layer (mRNFL) and ganglion cell-inner plexiform layer thickness (GC-IPL) measurements are important markers of diabetic retinal neurodegeneration (DRN). In this cross-sectional study, we aimed to quantify the contribution of total retinal thickness (TRT) and other factors in the variation of mRNFL and GC-IPL thickness among participants with diabetes.Methods and analysisWe used macular-centred spectral domain-optical coherence tomography scans from participants with diabetes in the UK Biobank. Two multiple linear regression models (prior to and after adjusting for TRT) were used to determine factors associated with mRNFL and GC-IPL thicknesses. A p value of less than 0.05 was considered statistically significant.ResultsA total of 3832 eyes from 3832 participants with diabetes were analysed. Factors that explained the greatest variation in thickness were TRT (20.9% for mRNFL and 57.2% for GC-IPL), followed by spherical equivalent (8.0% for mRNFL only), gender (2.2% for mRNFL only) and age (1.4% for GC-IPL only). Other factors significantly associated with mRNFL and/or GC-IPL thickness explained less than 1% of the variation in their thicknesses. Self-reported ancestral background was not significantly associated with mRNFL thickness after accounting for TRT.ConclusionsAlthough many factors were significantly associated with mRNFL and GC-IPL thickness in participants with diabetes, they accounted for a fraction of the variation in the thickness of both layers. TRT explained most of the variation in these measurements, hence accounting for TRT is needed when using these metrics to evaluate DRN.

Introduction Electrical burn injuries are very common in the pediatric population and are usually accidental and sometimes occupational. The objective of our study was to evaluate the epidemiology of electrical burn injuries and prospectively evaluate the long-term psychosocial impact of electrical burn injuries in children. Materials and methods A qualitative interview study was conducted prospectively among sixty patients presented to Holy Family Hospital, Rawalpindi, Pakistan. Demographic details, mode of presentation, detail of injury, total body surface area, initial condition, and surgical interventions were noted during their stay at the hospital. Their physical and psychological outcomes were evaluated by administering the Strength and Difficulties Questionnaire (SDQ) and Body Dysmorphic Disorder Questionnaire (BDDQ) via telephonic interviews after six weeks of discharge from the hospital. The study was conducted over a span of 1 year from January 2021 to January 2022. Results There were 60 patients who presented to the department of pediatric surgery during the span of the study. The mean age was 9.9 years ± 3.133 years (SD) and 80% of the patients were above 8 years of age with a male-to-female percentage of 86.67% to 13.33%, respectively. Forty-two (70%) patients incurred high-voltage electrical burns while 18 (30%) suffered low-voltage electrical burns. Mortality was 13.33% (n=8). Out of 52 patients who survived, 35 (67.30%) were labeled as having Body Dysmorphic Disorder upon administration of BDDQ through a six-week follow-up. The majority of the patients had abnormal or borderline results in different scales of SDQ. Conclusion The long-term psychological stress and the varied spectrum of psychiatric disorders in electrical burn patients are profound. The prevention of burn injuries can be effectively achieved by educating parents about safety measures and improving health infrastructure. Implementation of a dedicated national program for psychological support of burn patients should be made accessible to all patients.

Routine medical checkup (RMC) is a screening and preventive technique that is implied to detect non-communicable diseases (NCDs). This study aims to assess the awareness in public regarding RMC, the association between education level and level of familiarity regarding RMC, and factors that prevent and encourage the practice of RMC by the public. This is a cross-sectional study carried out in Rawalpindi, Pakistan. Health professionals and individuals who refused to consent were excluded from the study. Data was collected using a mixed-mode questionnaire, and convenient sampling was used. The sample size was calculated to be 355 according to the WHO sample size calculator. A total of 356 individuals participated in this study after giving informed consent. Both male and female adults aged 18 or older and residents of Rawalpindi were included in the study. Individuals younger than 18 were excluded.  Results: Among the 356 study participants, 160 (45%) were males, and 196 (55%) were females. The mean age was 27.57±10.027. Among the total participants, 33 (9.3%) individuals had primary-level education, 100 (28.1%) individuals had secondary-level education, and 233 (62.6%) had graduate-level education. A total of 329 (92.9%) participants knew that RMCs could help in early diagnosis and treatment. On the contrary, only 154 (43.3%) people knew that RMCs involve screening all body tissues. Only 329 (92.4%) participants said that they were aware that timely diagnosis through RMC can lead to early treatment. Graduates were generally more aware of different aspects of RMCs, especially in the domains of awareness regarding what an RMC is and that RMC can help in timely diagnosis compared to participants who had primary or secondary level of education (p<0.001). Females had a greater overall awareness of RMCs than males (p<0.001). Graduates were more likely to undergo RMCs than people educated till the primary or secondary level (p<0.001). The most common reason for undergoing RMC was \"just concerned about health,\" which was selected by 130 (36.5%) participants. The most common reason mentioned by participants for not having an RMC was ''heavy cost,'' mentioned by 104 (29.2%) participants.  Conclusion: Most of the participants of this study were well educated and were students in terms of profession. The majority of the study population knew that RMCs could help in early diagnosis and treatment. Awareness regarding RMCs was linked to educational level. Females had overall better knowledge regarding RMCs than men. The most common reported reason to have an RMC was a health concern, and the most common reported reason for not having an RMC was its high cost.

Salinity is very common threatening issue regarding growth and yield of dry regions of the world and likewise in Pakistan. Silicon role in plant growth and especially strengthening of plant defence system is well documented particularly upon exposure to salt stress. Present research was performed using wheat variety Punjab-2011 with Randomized Complete Block Design (RCBD) under field conditions using three treatments and each replicated three times. Treatments were wheat florae were developed in plots having normal soil (EC= 2.32 dS/m) and salty soil (4.93 dS/m). Si as phosphate industry waste was applied @0, 50 and 100 µg Si/g soil. Results showed that application of Si reduced the adverse impact of salinity and significantly enhanced the nutrients status of wheat plant. Under normal soil conditions, sodium (Na) concentration (5.63 mg/g), potassium (K) concentration (9.20 mg/g), Na/K ratio (1.60 mg/g), relative water contents (56.49%) and total chlorophyll contents (2.74 mg/g) were observed when maximum concentration of Si was applied i.e. 100 µg Si/g and least was recorded when no Si was applied. Similarly, under saline soil conditions, maximum sodium concentration (6.72 mg/g), potassium concentration (16.6 mg/g), Na/K ratio (2.5 mg/g), relative water contents (53.63%) and total chlorophyll contents (2.50 mg/g) were observed when maximum concentration of Si was applied i.e. 100 µg Si/g.

As non-renewable conventional fossil fuel sources are depleting day by day, researchers are continually finding new ways of producing and utilizing alternative, renewable, and reliable fuels. Due to conventional technologies, the environment has been degraded seriously, which profoundly impacts life on earth. To reduce the emissions caused by running the compression ignition engines, waste cooking oil (WCO) biodiesel is one of the best alternative fuels locally available in all parts of the world. Different study results are reviewed with a clear focus on combustion, performance, and emission characteristics, and the impact on engine durability. Moreover, the environmental and economic impacts are also reviewed in this study. When determining the combustion characteristics of WCO biodiesel, the cylinder peak pressure value increases and the heat release rate and ignition delay period decreases. In performance characteristics, brake-specific fuel consumption increases while brake-specific energy consumption, brake power, and torque decrease. WCO biodiesel cuts down the emissions value by 85% due to decreased hydrocarbon, SO2, CO, and smoke emissions in the exhaust that will effectively save the environment. However, CO2 and NOx generally increase when compared to diesel. The overall economic impact of production on the utilization of this resource is also elaborated. The results show that the use of WCO biodiesel is technically, economically, environmentally, and tribologically appropriate for any diesel engine.

Background Anorectal malformations are congenital defects wherein there is defective development of the anus and rectum. For babies born with congenital anorectal malformations, prompt treatment is crucial which requires detection of the anomalies at the earliest. This study aimed to determine the epidemiology ofanorectal malformations in the Pediatric Unit of a tertiary care hospital in Pakistan over a period of 19 months. Methodology An analytical cross-sectional study was conducted retrospectively from January 2020 to September 2021 using a non-randomized consecutive sampling technique. Patients aged less than eight years were included, whereas burnt, torn, and incomplete records from the Hospital Management Information System (HMIS) were excluded. SPSS version 26 (IBM Corp., Armonk, NY, USA) was used for data entry and analysis. Binomial and multinomial logistic regression were applied for analyzing the association between explanatory and dependent variables. Results Of the 1,108 patients, 72 (6.5%) patients had anorectal malformations. Gastrointestinal diseases made up about 64.3% of all diseases. Among gastrointestinal causes, the prevalence of anorectal malformation was up to 10.1%. The mortality of anorectal malformation patients was low (2.85%) compared to mortalities due to other gastrointestinal abnormalities (8.25%). Anorectal malformation had significantly lower odds of mortality (adjusted odds ratio = 0.19, p < 0.05) compared to other gastrointestinal abnormalities. Conclusions This study has provided data about the prevalence of anorectal malformation and its mortality which were calculated as 6.5% and 2.58%, respectively. Female gender, neonates, and delayed presentation were seen to have higher mortality, highlighting the need to screen all neonates pre- and post-natally to avoid any misdiagnosis.

Phosphorus (P) is a limited natural reserve and a major limiting factor for global crop production. The adverse soil biogeochemical characteristics of alkaline-calcareous soils make P the least available macronutrient. Therefore, alternative P source such as rock phosphate (RP) can offer a promising choice for sustainable P supply under P stress environment. A pot research was executed to explore the response of sunflower (Helianthus annuus L.) to sparingly soluble P sources grown under P deficient environment at research area, College of Agriculture, University of Sargodha during 2018. The experiment was laid out in a Completely Randomized Design (CRD) with eight treatments replicated thrice. The treatments consisted of T1 = NK + P0 (Control); T2 = NPK (Recommended dose); T3 = NK + Rock phosphate at 7 g pot-1; T4 = NPK + Rock phosphate at 7 g pot-1; T5 = NK + Rock phosphate at 7 g pot-1 + Wheat straw at 14 g pot-1; T6 = NK + Rock phosphate at 7 g pot-1 + Wheat straw at 28 g pot-1; T7 = NK + Rock phosphate at 7 g pot-1 + Rice straw at 14 g pot-1; T8 = NK + Rock phosphate at 7 g pot-1 + Rice straw at 28 g pot-1. Observations on various growth and yield parameters of crop were recorded using standard procedures and noted data was examined with a statistical software Statistix 8.1 analysis of variance technique and significant of treatments was tested using LSD test at probability level of 5%. The maximum fresh biomass (95.50 g), dry biomass (25.73 g), plant height (110.90 cm), head size (21.36 cm), number of achene haed-1 (864) and achene yield plant-1 (32.16 g) of sunflower was observed with application of NK + Rock phosphate at 7 g pot-1 + Wheat straw at 28 g pot-1 (T6) in cultivar Hysun-33. While, lowest value of fresh biomass (72.73 g), dry biomass (15.72 g), head size (16.63 cm), achene head-1 (711), achene yield plant-1 (18.36 g) was noted under NK + P0 (T1) treatment in Agwara-3. Among the tested sunflower cultivars, Hysun-33 showed superiority over Agwara-4.

Pakistani soils are deficient in organic matter. Organic matter in the soil affects soil properties and processes. The adequate carbon level of the soil is 1.29% but in Pakistani soils carbon is less than the adequate level because of high temperature and low rainfall. Different sources of organic matters such as farm yard manure, poultry waste, rice husk etc. can increase productiveness of soil. Combined usage of poultry waste material and chemical fertilizer improved maize growth and health of soil. This experiment comprised of 11 treatments applied under completely randomized design like, T1 = chemical fertilizers at recommended rate, T2 = chemical fertilizers at half recommended rate, T3 = waste of poultry at the rate of 5 ton/ha, T4 = waste of poultry at the rate of 7.5 ton/ha, T5 = waste of poultry at the rate of 10 ton/ha, T6 = T1 + T3, T7 = T1 + T4, T8 = T1 + T5, T9 = T2 + T3, T10 = T2 + T4 and T11 = T2 + T5. At maturity and different agronomic and yield parameters were recorded before harvesting maize plants. Laboratory analysis for collected soil samples was carried out. Data were statistically analyzed. Results indicated that treatment (T8) produce maximum plant height (115.0 cm), biomass (64.34 g) and root length (27.083 cm) of maize. Organic matter content (1.78%), phosphorus (16.67 ppm) and potassium (213.0 ppm) concentration in soil was also increased in this treatment.