Compatibility and synergistic interactions of fungi, Metarhizium anisopliae, and insecticide combinations against the cotton aphid, Aphis gossypii Glover (Hemiptera: Aphididae).

Aphids are major pests affecting cereals, vegetables, fruit, forestry and horticultural produce. A multimodal approach may be an effective route to controlling this prolific pest. We assessed the individual and combined effect of eight insecticides and the entomopathogenic fungi, Metarhizium anisopliae (Metschin.) against the cotton aphid, Aphis gossypii Glover (Hemiptera: Aphididae), under laboratory conditions. Six of the insecticides tested were found to be highly compatible (flonicamid, imidacloprid, nitenpyram, dinotefuran, pyriproxyfen and spirotetramat), showing positive integration with the fungus and were selected for bioassays. The combination mixtures (1:1 ratio of M. anisopliae: insecticide) were significantly more toxic to A. gossypii than individual treatments. Maximum mortality (91.68%) of A. gossypii was recorded with combination of flonicamid and M. anisopliae (2.4 × 106 cfu/ml) 72 h after application. While minimum mortality (17.08%) was observed with the individual treatment of M. anisopliae (2.4 × 106 cfu/ml). The insecticides revealed toxicity consistent with their compatibility with M. anisopliae, ranking for efficacy exactly as they did for compatibility. In addition, the synergy factor (SF) and co-toxicity coefficient (CTC) values indicated synergistic interactions at different time intervals. The synergistic efficacy revealed the potential of fungus-insecticide integration against sucking insect pests.

Pregnant women perceptions regarding their husbands and in-laws' support during pregnancy: a qualitative study.

INTRODUCTION: pregnancy is a stressful condition during which women require family and in-laws´ support. This study was aimed to explore the women´s perceptions regarding their husband and in-law´s support during pregnancy. METHODS: by using qualitative exploratory design ten pregnant women in third trimester of pregnancy and living in joint family system were recruited through purposive sampling technique from a village of district Nowshehra, Khyber Pakhtunkhwa, Pakistan. Approval for conducting this study was obtained from Ethics Review Committee of Khyber Medical University. Data were collected from the recruited participants through face to face in-depth interviews. Data were analyzed through thematic analysis. One hundred open codes were generated from the data. Through axial coding, extra and unnecessary codes were omitted and then eleven categories were identified from open codes. RESULTS: the identified categories were kept under three salient themes of lack of comprehensive support mechanism, physical and mental strain, and barriers to antenatal services. Perceived support of husbands and in-laws, needs and barriers to maternal and child health were discussed by the participants. CONCLUSION: the study findings suggest that family relationship quality might not be improved by taking interventions i.e. making policies only but the incorporation of health professionals´ support with family member´s behavior can improve maternal health.

Assessment of hospitalized patients awareness of their rights: a cross-sectional descriptive study.

INTRODUCTION: in this modern era and in the speedily changing atmosphere of health care, health care practice and patients has affected by many factors. These days, in many states the patient rights has become the pivot of the national attention in medical culture. Awareness of health rights is important to achieve the best level of health care. The study was aimed to assess the awareness of hospitalized patients about the rights. METHODS: a cross-sectional descriptive study was conducted in different wards of public sector tertiary care hospitals of Peshawar, over four months duration from February to May 2018. Hospitalized patients who were being admitted for at least two days from 17 to 70 years of age were included. Before asking the patients to answer the questionnaire, consent from the patients was acquired. A self-administered semi-structured questionnaire was adopted. Data analysis was done through SPSS version 22. RESULTS: among 200 participants 46% were male and 54% were female, 35.5% were from urban and 64.5% were from rural areas. Patients were less aware of their individual rights, like 65.5% of clients were not cognizant of the patients special bill of rights while 59% were aware to receive non-discriminatory and timely health services. CONCLUSION: most of the clients were not conscious of their individual health rights. About half of the sample knew that the patients will receive respectful care and the patients will receive care in clean and medically safe environment.

Efficacy of biorational insecticides against Bemisia tabaci (Genn.) and their selectivity for its parasitoid Encarsia formosa Gahan on Bt cotton.

The toxicity of seven biorational insecticides [five insect growth regulators (Buprofezin, Fenoxycarb, Pyriproxyfen, Methoxyfenozide, and Tebufenozide) and two oil-extracts of neem and bitter gourd seeds] against Bemisia tabaci and their selectivity for its parasitoid, Encarsia formosa were evaluated in laboratory and field conditions for 2 years (2018-2019) in Pakistan. Toxicity results demonstrate that Pyriproxyfen, Buprofezin, and Fenoxycarb proved to be effective (80-91% mortality and 66.3-84.2% population-reduction) against B. tabaci followed by Methoxyfenozide, Tebufenozide (50-75% mortality and 47.8-52.4% population-reduction), and then oil-extracts of neem and bitter gourd (25-50% mortality and 36.5-39.8% population-reduction) in the laboratory [72 h post-application exposure interval (PAEI)] and field trails (168 h PAEI), respectively. All tested biorationals, except Methoxyfenozide [(slightly-harmful/Class-II), i.e., causing mortality of parasitoids between a range of 25-50%] and Tebufenozide [(moderately-harmful/Class-III), i.e., causing mortality of parasitoids between the ranges of 51-75%], proved harmless/Class-I biorationals at PAEI of 7-days in the field (parasitism-reduction < 25%) and 3-days in the lab (effect < 30%). In laboratory bioassays, exposure of parasitized-pseudopupae and adult-parasitoids to neem and bitter gourd oils demonstrated that these compounds proved harmless/Class-I biorationals (< 30% mortality). Alternatively, Pyriproxyfen, Buprofezin, Fenoxycarb, Methoxyfenozide, and Tebufenozide were slightly-harmful biorationals (30-79% mortality) against the respective stages of E. formosa. We conclude that most of the tested biorationals proved harmless or slightly harmful to E. formosa, except tebufenozide after PAEI of 7-days (168 h) in the field and, therefore, may be used strategically in Integrated Pest Management (IPM) of B. tabaci.

Comparative bio-efficacy of nuclear polyhedrosis virus (NPV) and Spinosad against American bollwormm, Helicoverpa armigera (Hubner)

ABSTRACT American bollworm (ABW), Helicoverpa armigera (Hubner), is considered as a major pest of cotton, Gossypium hirsutum, all over the globe. Due to its destructive feeding nature and continuous consumption of the same chemicals, it devolved resistant against many insecticides. Therefore, a combined application of bio- and synthetic-pesticide need to evaluate against this pest. The entomopathogenic viruses like nuclear polyhedrosis virus (NPV), a member of baculoviruses, can be the potential candidates for better control against ABW. The present study was conducted to assess the comparative efficacy of NPV and Spinosad 240SC (with the concentration of 250 mL · ha-1) against ABW in the controlled environment. The ABW was treated with different concentrations of NPV and Spinosad separately and in a combination of NPV with 0.1% Spinosad. The results revealed that highest concentrations showed highest mortality (95%) followed by 95%, 92%, 84%, 82% and 78% mortality at 1 × 109, 1 × 108, 1 × 107, 1 × 106 and 1 × 105 POBs, respectively. Spinosad when mixed in diet give 100% mortality at 0.8% followed by 50.87%, 42.10%, 29.82%, 26.31% and 22.80% mortality at 0.4%, 0.2%, 0.1%, 0.5% and 0.025% respectively. The results of this study revealed that microbial control of ABW through NPV is an effective tool. The repeated use of synthetic pesticides caused the resurgence of many insect pests, and this study results would provide useful insight to build a framework for future investigations for the management of many major insect pests.

What Are We Doing For Injuries? The Burden And Level Of Preparedness For Mass Emergencies In Khyber Pakhtunkhwa Province Of Pakistan.

BACKGROUND: Injuries are one of the highly prevalent public health problems of Pakistan but still we are unable to develop a mechanism for its quantification and management. To understand the reasons of not doing so we need detailed discussion among the leaders of different stakeholders working in area of injuries. In this study, a focus group discussion (FGD) of provincial health leaders was conducted to explore challenges and gaps and identify opportunities for quantification and management of injuries in the province of Khyber Pakhtunkhwa (KP). METHODS: This was a descriptive qualitative study conducted in Khyber Medical University, Peshawar, Pakistan. Study participants were policy makers, academia, senior level health mangers and representatives from international organizations. Purposive sampling was applied to select respondents for FGD from relevant areas to capture diversity of opinions among participants. The data were transcribed verbatim and analyzed thematically through open-coding process. RESULTS: One FGD was conducted in this study with a total of 11 participants. The study participants identified a number of challenges and gaps regarding quantification of injuries' burden in KP province of Pakistan and preparedness of existing health system to cope with mass emergencies. The discussion yielded four areas of detailed discussion which are; developing a surveillance system for injuries, capacity of District Health Information System, existing level of preparedness at provincial and district level and suggestions for improvement of existing situation with plans for capacity improvement. CONCLUSIONS: In countries like Pakistan routine health information system is the better option for quantification of injuries' burden, but needs review of existing indicators and sheer commitment from field level to higher authorities with due consideration of technology assimilation. A multipronged approach is required for preparedness including; trainings on emergency medicine and skills, incentives for staff to fill vacant posts, well equipped ambulances and provision of other supplies on regular basis..

Epidemiology, Clinical Features and Consequences of Spinal Cord Injury in Children.

OBJECTIVE: To describe epidemiology, clinical features and clinical consequences of Spinal Cord Injury (SCI) in children. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Paraplegic Centre, Hayatabad, Peshawar, from July 2011 to March 2017. METHODOLOGY: SCI patients having age up to 15 years, admitted to Paraplegic Centre, were inducted in 2017. Exclusion criteria was foreign-national SCI patients, and/or SCI patients re-admitted to paraplegic centre. List of all SCI patients admitted to the centre was retrieved and 102 patients were identified. Data of these patients was evaluated for demographic information, physiological intactness (complete SCI/incomplete SCI), neurological level and complications. RESULTS: A total of 102 patients (66 males and 36 females) with mean age 10.9 ±3.7 years were included in this study. Firearm injury was the most common cause (n=39, 38.2%) of SCI in these patients, followed by fall from height (n=23, 22.5%), road traffic accidents (n=14, 13.7%), and weight fallen over (n=14, 13.7%). Bomb blast injury (n=7, 6.9%), diving accident (n=3, 2.9%), and sports related injuries (n=2, 2.0%). Majority of the patients (n=82, 80.4%) had complete SCI (ASIA A); the commonest SCI level was thoracic region (n=59, 57.8%) and the least reported region was (n=14, 13.7%) cervical. Out of the total, 50 (49.0%) patients had pressure ulcer in which 15 (30.0%) patients were having grade IV pressure ulcer, 9 (18.0%), 15 (30.0%) and 11 (22.0%) patients were had grade I, grade II and grade III pressure ulcer, respectively. CONCLUSION: Majority of causes of SCI in children are similar to those reported in adult population. However, the commonest causes of SCI in children in Pakistan were firearm injury and bomb blast, which are rarely reported in other countries. Like adult population, these children with SCI are prone to developing pressure ulcer.