Bio-net dataset: AI-based diagnostic solutions using peripheral blood smear images.

Peripheral blood smear examination is one of the basic steps in the evaluation of different blood cells. It is a confirmatory step after an automated complete blood count analysis. Manual microscopy is time-consuming and requires professional laboratory expertise. Therefore, the turn-around time for peripheral smear in a health care center is approximately 3-4 hours. To avoid the traditional method of manual counting under the microscope a computerized automation of peripheral blood smear examination has been adopted, which is a challenging task in medical diagnostics. In recent times, deep learning techniques have overcome the challenges associated with human microscopic evaluation of peripheral smears and this has led to reduced cost and precise diagnosis. However, their application can be significantly improved by the availability of annotated datasets. This study presents a large customized annotated blood cell dataset (named the Bio-Net dataset from healthy individuals) and blood cell detection and counting in the peripheral blood smear images. A mini-version of the dataset for specialized WBC-based image processing tasks is also equipped to classify the healthy and mature WBCs in their respective classes. An object detection algorithm called You Only Look Once (YOLO) with a refashion disposition has been trained on the novel dataset to automatically detect and classify blood cells into RBCs, WBCs, and platelets and compare the results with other publicly available datasets to highlight the versatility. In short the introduction of the Bio-Net dataset and AI-powered detection and counting offers a significant potential for advancement in biomedical research for analyzing and understanding biological data.

Comparison of thrombomodulin, vWF, and ADAMTS13 levels between preeclampsia and normal pregnancy

Objectives: To determine and compare plasma thrombomodulin, von Willebrand factor and von Willebrand factorcleaving protease levels between pre-eclamptic and healthy pregnant females. METHODS: The cross-sectional, comparative study was conducted at the Department of Haematology, University of Health Sciences, Lahore, Pakistan, from November 2019 to December 2020, and comprised pregnant females who were divided into healthy pregnant group A and pre-eclamptic group B. Plasma thrombomodulin and von Willebrand factor-cleaving protease levels were determined by using commercially available enzyme-linked immunosorbent assay kit, and von Willebrand factor level was determined by using immuno-turbidimetric assay kit. Data was analysed using SPSS 25. RESULTS: Of the 88 participants, there were 44(50%) females with mean age 25.5±6 years in group A and 44(50%) in group B with mean age 26±5 years. Median thrombomodulin level in group B was significantly higher than group A (p=0.003). Median von Willebrand factor-cleaving protease levels were lower in group B compared to group A (p=0.838). A significant difference in von Willebrand factor level was observed between the groups (p=0.038). Conclusion: Females with pre-eclampsia had significantly higher plasma levels of von Willebrand factor and thrombomodulin than healthy pregnant subjects.

How Covid-19 literacy influences fear, protective behaviour, and conspiracy beliefs among university students in Pakistan?

Background: Covid-19 literacy, a social vaccine, is crucial to cope pandemic situations as it helps individuals to manage panic situations, adopt health preventive behaviours and adapting to the new normal. Objectives: This research examined the effects of Covid-19 literacy on fear, protective behaviour, and conspiracy beliefs of university students using an online questionnaire. Methods: A cross-sectional survey was conducted at two universities from Lahore with permission from concerned authorities. A total of 301 received responses were analyzed by applying descriptive as well as inferential statistics in SPSS. Results: The results indicated that Covid-19 literacy appeared to predict negatively fear of Covid-19 and conspiracy beliefs and positively health-protective behaviours. In other words, the university students with better Covid-19 literacy appeared to have less fear of Covid-19, more likely to adopt health-protective behaviours and believe less in conspirative information. Conclusions: These results demonstrated the potential benefits of Covid-19 literacy to respond proactively to the fear caused by the Covid-19 pandemic, managing infodemic and adoption of health-protective behaviours. These results would be useful for policymakers, NGOs, health professionals, and university librarians in planning health education and promotion for not only university students but also for general public. This research contributed to the existing research on health literacy related to the Covid-19 pandemic in general and Covid-19 literacy in particular as limited studies have been published so far.

How information literacy influences creative skills among medical students? The mediating role of lifelong learning.

This research investigated the influence of information literacy on the creative skills of medical students through the mediation of lifelong learning. A cross-sectional survey was conducted for data collection among medical students, recruited through a stratified convenient sampling procedure, of Khyber Pakhtunkhwa, Pakistan. The questionnaire was personally administered by visiting each college with written permission. A total of 473 survey responses were collected and analysed using the partial least squares structural equation modelling. The results revealed that the information literacy of medical students had a direct and indirect but positive influence on their creative skills. Lifelong learning not had a direct but positive effect on creative skills but also mediated the relationship between information literacy and creative skills. The empirical evidence for how information literacy influences creative skills through the mediated role of lifelong learning may inform policy and practice for information literacy instructions. These results may help academicians and information specialists to initiate a credited or integrated course on information literacy in the curriculum of medical students not only in Pakistan but also in other developing countries. This research would be a worthwhile contribution to the existing research on information literacy as the mediated role of lifelong learning between information literacy and creative skills has never been examined so far.

Genetic Alterations, DNA Methylation, Alloantibodies and Phenotypic Heterogeneity in Type III von Willebrand Disease.

Type III von Willebrand disease is present in the Punjab province of Pakistan along with other inherited bleeding disorders like hemophilia. Cousin marriages are very common in Pakistan so genetic studies help to establish protocols for screening, especially at the antenatal level. Factors behind the phenotypic variation of the severity of bleeding in type III vWD are largely unknown. The study was conducted to determine Mutations/genetic alterations in type III von Willebrand disease and also to determine the association of different mutations, methylation status, ITGA2B/B3 mutations and alloimmunization with the severity of type III vWD. After informed consent and detailed history of the patients, routine tests and DNA extraction from blood, mutational analysis was performed by Next Generation Sequencing on Ion Torrent PGM. DNA methylation status was also checked with the help of PCR. In our cohort, 55 cases were detected with pathogenic mutations. A total of 27 different mutations were identified in 55 solved cases; 16 (59.2%) were novel. The mean bleeding score in truncating mutations and essential splice site mutations was relatively higher than weak and strong missense mutations. The mean bleeding score showed insignificant variation for different DNA methylation statuses of the VWF gene at the cg23551979 CpG site. Mutations in exons 7,10, 25, 28, 31, 43, and intron 41 splice site account for 75% of the mutations.

Epidemiology, Clinico-Pathological Characteristics, and Comorbidities of SARS-CoV-2-Infected Pakistani Patients.

SARS-CoV-2 is a causative agent for COVID-19 disease, initially reported from Wuhan, China. The infected patients experienced mild to severe symptoms, resulting in several fatalities due to a weak understanding of its pathogenesis, which is the same even to date. This cross-sectional study has been designed on 452 symptomatic mild-to-moderate and severe/critical patients to understand the epidemiology and clinical characteristics of COVID-19 patients with their comorbidities and response to treatment. The mean age of the studied patients was 58 ± 14.42 years, and the overall male to female ratio was 61.7 to 38.2%, respectively. In total, 27.3% of the patients had a history of exposure, and 11.9% had a travel history, while for 60% of patients, the source of infection was unknown. The most prevalent signs and symptoms in ICU patients were dry cough, myalgia, shortness of breath, gastrointestinal discomfort, and abnormal chest X-ray (p < 0.001), along with a high percentage of hypertension (p = 0.007) and chronic obstructive pulmonary disease (p = 0.029) as leading comorbidities. The complete blood count indicators were significantly disturbed in severe patients, while the coagulation profile and D-dimer values were significantly higher in mild-to-moderate (non-ICU) patients (p < 0.001). The serum creatinine (1.22 µmol L-1; p = 0.016) and lactate dehydrogenase (619 µmol L-1; p < 0.001) indicators were significantly high in non-ICU patients, while raised values of total bilirubin (0.91 µmol L-1; p = 0.054), C-reactive protein (84.68 mg L-1; p = 0.001), and ferritin (996.81 mg L-1; p < 0.001) were found in ICU patients. The drug dexamethasone was the leading prescribed and administrated medicine to COVID-19 patients, followed by remdesivir, meropenem, heparin, and tocilizumab, respectively. A characteristic pattern of ground glass opacities, consolidation, and interlobular septal thickening was prominent in severely infected patients. These findings could be used for future research, control, and prevention of SARS-CoV-2-infected patients.

Impact of Refractive Errors on the Academic Performance of High School Children of Lahore.

Introduction: The process of learning begins in childhood and accurate vision can greatly affects a child's learning capacity. It is documented that visual impairment in children can have a significant impact on their performance at school as well as their social interaction and development. Objective: This research aimed to study the impact of refractive corrections on the academic performance of high school children in Lahore. Methodology: A total of 2,000 students with equal distribution of gender, public, private school, and locality were included in the study. All students were screened for defective vision. The academic performance before and after corrections was recorded on the prescribed proforma. Results: The prevalence of refractive error was high among the public high schools 244 (59.2%) as compared to the private schools 168 (40.8%). The area-based prevalence was higher among the students in urban settings 255 (62%) while in rural it was 157 (38%). It was found that in the public sector, the average score of academic results before the intervention was 56.39 ± 13.24 which was increased to 60.27 ± 14.94 after the intervention while in the private sector, before the intervention, the average score was 63.53 ± 17.50 which was improved to 67.12 ± 18.48. It was found to be statistically significant at p-value < 0.05. Conclusion: A significant impact was observed in the average academic scores of the results after refractive corrections.

Health literacy predicts Covid-19 awareness and protective behaviours of university students.

BACKGROUND: Health literacy is expected to help individuals deal with the required infection control and knowledge to cope with the COVID-19 pandemic. OBJECTIVES: This study examined the impact of health literacy on Covid-19 awareness and protective behaviours of university students in Pakistan. METHODS: An online questionnaire was used to collect data from students at three universities in Punjab. The approved questionnaire contained 12 statements related to HL, 21 items towards Covid-19 awareness, and 11 statements related to protective behaviours, along with some demographic data. Data analysis used Pearson correlation and simple linear regression. RESULTS: Health literacy of university students positively predicted their Covid-19 awareness and protective behaviours indicating that students with high health literacy were likely to be more aware of Covid-19 and adopt health protective behaviours. There were gender and rural/urban differences. CONCLUSIONS: The results demonstrated an urgent need for planning a needs-based health literacy programme focusing specifically on Covid-19 literacy in Pakistan. This research might help policy-makers, NGOs, and health librarians devise suitable programme.

Information Literacy as a Predictor of Work Performance: The Mediating Role of Lifelong Learning and Creativity.

This study examined the effect of information literacy (IL) on work performance with mediating role of lifelong learning and creativity among journalists in Pakistan. A cross-sectional survey using an online questionnaire was conducted in the press clubs of four provinces (e.g., Punjab, Sindh, Khyber Pakhtunkhwa, and Baluchistan) and the federal capital Islamabad for data collection. The received 1084 responses were analyzed using the partial least squares structural equation modelling. The results indicated that IL of journalists had a direct and indirect but positive influence on their work performance. The lifelong learning and creativity skills also mediated the relationship between IL and work performance. This study provided empirical evidence for how IL directly influence work performance and indirectly with the mediated role of lifelong learning and creativity. These pragmatic insights may inform academicians and enterprises about the IL importance at workplace for enhancement of organizational performance and achieving a competitive advantage. Such results may also initiate an instruction program for existing as well as for prospective journalists to impart IL education. This study could be a worthy contribution to the existing IL research in the workplace context in general and of journalists' workplace in particular as no such study has appeared so far.

Myelofibrosis in Patients of Chronic Myeloid Leukemia in Chronic Phase at Presentation.

OBJECTIVE: To determine the frequency and grading of myelofibrosis in patients of chronic myeloid leukaemia in chronic phase, and the association of cytopenias/cytosis with the degree of fibrosis. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: King Edward Medical University, Lahore, from March 2015 to April 2017. METHODOLOGY: Patients of both genders and all age groups with Philadelphia chromosome/BCR-ABL positivity were included in the study. Detailed medical history and examination findings were recorded. Sample for CBC was taken in EDTA and run on automated haematology analyser. Bone marrow aspirate and trephine biopsy was done from posterior iliac crest. Bone marrow aspirate slides were stained with Giemsa stain. The trephine biopsy was processed and stained with haematoxilyn and eosin. Silver (reticulin) and trichrome staining was done on trephine biopsy to assess the degree of fibrosis. Grading of fibrosis was done according to WHO revised classification 2016. RESULTS: Among the 82 cases, 65% (n=53) were having WHO Grade MF 1 myelofibrosis, 27% (n=22) WHO Grade MF 2 myelofibrosis; whereas, 08% (n=07) WHO Grade MF 3 myelofibrosis. CBC counts were analysed to see any association between anemia, thrombocytocytosis and leucocytosis with advanced fibrosis (p=0.148, 0.413 and 0.174, respectively). CONCLUSION: Some degree of bone marrow fibrosis was present in all patients of chronic myeloid leukemia, while advance fibrosis (WHO Grade MF 2 and 3) is also common. Peripheral blood counts are not predictor of increased fibrosis. Therefore, bone marrow biopsy with special staining should be done in all cases of chronic phase of CML.