Non-Pharmacological approach for the management of gastroesophageal reflux disease.

Treatment of Gastro-Esophageal Reflux Disease (GERD) is becoming a challenge. Proton pump inhibitors (PPIs) are commonly prescribed but have many risks, particularly in long-term use. In an earlier pilot study, we have reported benefits of short-term practice of a new life-style, two meals a day with only liquids in between, for management of GERD. Present case report demonstrates benefits of long-term practice of this dietary regimen. A 61 year old patient complaining of night refluxes was diagnosed to have severe GERD with ulcerations at gastroesophageal junction and was advised to take two meals a day with only water, fruit juice, tea, or milk in intervening period. His reflux symptoms improved within fortnight and he remained well for long-time. Endoscopy done after seven years revealed competent and clear gastroesophageal junction. It is concluded that suggested life-style, "Akram's life-style", for GERD is a useful alternate to risky medical and surgical interventions.

Food waste: causes and economic losses estimation at household level in Pakistan.

Food waste is one of the major sustainability issues that need to be addressed due to its negative impacts on the economy, environment, and food security. To develop food waste reduction policies on regional and global level, it is mandatory to have a clear understanding of the various factors prompting food waste at household level and the extent of the economic losses incurred by food waste. Reducing food waste can decrease household expenditure on food, freeing resources for health, education, and well-being. The current study was aimed to (1) examine the food waste behavior of the respondents and to (2) determine the level of monetary losses from food waste. To address these objectives, a questionnaire survey and sample of food waste generated during 24 h were collected from 51 households in Tehsil Kahror Pakka, District Lodhran, Punjab, Pakistan. The survey focus was on levels of food waste and respondents' knowledge and behaviors about food waste. Economic estimation of food waste was also done. In the survey, respondents from both high- and low-income households revealed that their fruit and vegetables (31%; 32%) and peel and scrap (53%; 48%) losses were higher while egg losses (4%; 4%) were lower among various food waste categories. Wanting to eat fresh food and having no time to save food were the reasons for food waste. Monetary losses from food waste (US$ 12.8/Rs. 3677.01 per capita per annum) were higher in high-income households compared to low-income households.

Chromium removal from aqueous solution using bimetallic Bi0/Cu0-based nanocomposite biochar.

Chromium (Cr), due to its greater contamination in aquifers and distinct eco-toxic impacts, is of greater environmental concern. This study aimed to synthesize nanocomposites of almond shells biochar (BC) with zerovalent bismuth and/or copper (Bi0/BC, Cu0/BC, and Bi0-Cu0/BC) for the removal of Cr from aqueous solution. The synthesized nanocomposites were investigated using various characterization techniques such as XRD, FTIR spectroscopy, SEM, and EDX. The Cr removal potential by the nanocomposites was explored under different Cr concentrations (25-100 mg/L), adsorbent doses (0.5-2.0 g/L), solution pH (2-8), and contact time (10-160 min). The above-mentioned advanced techniques verified successful formation of Bi0/Cu0 and their composite with BC. The synthesized nanocomposites were highly effective in the removal of Cr. The Bi0-Cu0/BC nano-biocomposites showed higher Cr removal efficiency (92%) compared to Cu0/BC (85%), Bi0/BC (76%), and BC (67%). The prepared nanocomposites led to effective Cr removal at lower Cr concentrations (25 mg/L) and acidic pH (4.0). The Cr solubility changes with pH, resulting in different degrees of Cr removal by Bi0-Cu0/BC, with Cr(VI) being more soluble and easier to adsorb at low pH levels and Cr(III) being less soluble and more difficult to adsorb at high pH levels. The experimental Cr adsorption well fitted with the Freundlich adsorption isotherm model (R2 > 0.99) and pseudo-second-order kinetic model. Among the prepared nanocomposites, the Bi0-Cu0/BC showed greater stability and reusability. It was established that the as-synthesized Bi0-Cu0/BC nano-biocomposite showed excellent adsorption potential for practical Cr removal from contaminated water.

Sofosbuvir For The Treatment Of Hepatitis C Genotype 3 Infected Patients In Pakistan.

BACKGROUND: This study was conducted to determine the viral responses of patients with chronic infection of Hepatitis C virus treated with sofubuvir. METHODS: This Quasi experimental study was conducted at Centre for Liver and Digestive Diseases, Holy Family Hospital, Rawalpindi from September 2014 to September 2016. 502 patients with HCV genotype 3 including treatment naive, non-responders or relapsers to previous interferon based therapy along with patients having decompensated cirrhosis (child class B or C) were included in the study. All patients were treated with Sofosbuvir 400 mg once daily along with Ribavirin for 6 months. Follow-up qualitative PCR (polymerase Chain Reaction) were performed at 4 weeks interval to assess RVR (Rapid virological Response), end of treatment to determine ETR (End of treatment response) and 3 months post treatment to determine SVR12 (Sustained viral response at 12 week). RESULTS: 91% of the patients had become PCR negative at completion of four weeks of treatment with Sofosbuvir, whereas at completion of treatment 96.5% had attained a negative PCR. Sustained virological response at 12 weeks post therapy (SVR12) was attained in 85.5% of patients. No statistically significant associations were found with attainment status of RVR, ETR and SVR based on previous treatment status or presence of Decompensated liver disease. However, attainment of SVR was slightly more in females (p value=0.03). The serological profiles of patients whether they attained PCR at week 4, 24 of treatment or 12 weeks' post treatment did not exhibit any statistically significant difference. CONCLUSION: Sofosbuvir is effective in eradicating hepatitis C virus irrespective of previous treatment or liver fibrosis status in genotype 3 HCV Pakistani patients.