Fishes of Afghanistan; a revised and updated annotated checklist.

The current status of the ichthyofauna of Afghanistan is revised, and an updated checklist is presented. The confirmed fishes of Afghanistan comprise 121 species belonging to 11 orders, 22 families, and 68 genera. Among these, 18 species (14.9%) are alien, and 7 species (5.8%) are considered endemic to Afghanistan. The orders with the largest numbers of species in the ichthyofauna of Afghanistan are Cypriniformes (88 species), followed by Siluriformes (14 species), Anabantiformes (4 species), Acipenseriformes, Salmoniformes, and Cyprinodontiformes (3 species in each). At the family level, Cyprinidae have the greatest number of species (36 species; 29.8% of the total species), followed by Nemacheilidae (22 species), Leuciscidae (12 species), Danionidae (8 species), and Sisoridae (6 species). A total of 48 species previously reported from Afghanistan have been excluded from the checklist, either in the present study or in previous studies. According to the IUCN Red List criteria, among 121 listed fish species, 19 (15.7%) are in the threatened categories, with 4 (3.3%) CR, 6 (5.0%) EN, and 9 (7.4%) VU. Of the total number of taxa assessed, 5.0% (6 species) are NT and 51.2% (62 species) are LC. A total of 29 species are (24.0%) Not Evaluated (NE) and 5 species (4.1%) are classified as DD.

Basic life support knowledge among healthcare providers in Afghanistan: a cross-sectional study of current competencies and areas for improvement.

Basic life support (BLS) is a type of emergency care provided by healthcare workers and public safety professionals to individuals experiencing cardiac arrest, respiratory distress, or other cardiopulmonary emergencies. Despite having a high burden of cardiovascular disease and trauma from conflict in Afghanistan, little is known about the level of BLS knowledge Afghani healthcare workers have. A cross-sectional study was conducted in Kabul, Afghanistan, to assess healthcare workers' training and knowledge of BLS. The study, which took place from March to June 2022 across multiple public and private hospitals, was approved by the institutional ethics committee of Ariana Medical Complex. The sample size was calculated using a nonprobability convenience sampling method, and the study population consisted of healthcare workers actively working in a health center who were willing to complete a questionnaire. The results of the study showed that most participants (71.3%) were in the 21-30-year-old age range, and a third (32.3%) were doctors. 95.3% of participants had poor knowledge of BLS, with a mean score of 4.47±1.58 out of 13. Additionally, it was evident from questionnaire responses that providers are not adequately performing BLS. These findings suggest that further work, including regular BLS courses, is necessary to improve the knowledge and practice of BLS by healthcare workers in Afghanistan.

Lung and Infection CT-Scan-Based Segmentation with 3D UNet Architecture and Its Modification.

COVID-19 is the disease that has spread over the world since December 2019. This disease has a negative impact on individuals, governments, and even the global economy, which has caused the WHO to declare COVID-19 as a PHEIC (Public Health Emergency of International Concern). Until now, there has been no medicine that can completely cure COVID-19. Therefore, to prevent the spread and reduce the negative impact of COVID-19, an accurate and fast test is needed. The use of chest radiography imaging technology, such as CXR and CT-scan, plays a significant role in the diagnosis of COVID-19. In this study, CT-scan segmentation will be carried out using the 3D version of the most recommended segmentation algorithm for bio-medical images, namely 3D UNet, and three other architectures from the 3D UNet modifications, namely 3D ResUNet, 3D VGGUNet, and 3D DenseUNet. These four architectures will be used in two cases of segmentation: binary-class segmentation, where each architecture will segment the lung area from a CT scan; and multi-class segmentation, where each architecture will segment the lung and infection area from a CT scan. Before entering the model, the dataset is preprocessed first by applying a minmax scaler to scale the pixel value to a range of zero to one, and the CLAHE method is also applied to eliminate intensity in homogeneity and noise from the data. Of the four models tested in this study, surprisingly, the original 3D UNet produced the most satisfactory results compared to the other three architectures, although it requires more iterations to obtain the maximum results. For the binary-class segmentation case, 3D UNet produced IoU scores, Dice scores, and accuracy of 94.32%, 97.05%, and 99.37%, respectively. For the case of multi-class segmentation, 3D UNet produced IoU scores, Dice scores, and accuracy of 81.58%, 88.61%, and 98.78%, respectively. The use of 3D segmentation architecture will be very helpful for medical personnel because, apart from helping the process of diagnosing someone with COVID-19, they can also find out the severity of the disease through 3D infection projections.

Deciphering SARS CoV-2-associated pathways from RNA sequencing data of COVID-19-infected A549 cells and potential therapeutics using in silico methods.

BACKGROUND: Coronavirus (CoV) disease (COVID-19) identified in Wuhan, China, in 2019, is mainly characterized by atypical pneumonia and severe acute respiratory syndrome (SARS) and is caused by SARS CoV-2, which belongs to the Coronaviridae family. Determining the underlying disease mechanisms is central to the identification and development of COVID-19-specific drugs for effective treatment and prevention of human-to-human transmission, disease complications, and deaths. METHODS: Here, next-generation RNA sequencing (RNA Seq) data were obtained using Illumina Next Seq 500 from SARS CoV-infected A549 cells and mock-treated A549 cells from the Gene Expression Omnibus (GEO) (GSE147507), and quality control (QC) was assessed before RNA Seq analysis using CLC Genomics Workbench 20.0. Differentially expressed genes (DEGs) were imported into BioJupies to decipher COVID-19 induced signaling pathways and small molecules derived from chemical synthesis or natural sources to mimic or reverse COVID -19 specific gene signatures. In addition, iPathwayGuide was used to identify COVID-19-specific signaling pathways, as well as drugs and natural products with anti-COVID-19 potential. RESULTS: Here, we identified the potential activation of upstream regulators such as signal transducer and activator of transcription 2 (STAT2), interferon regulatory factor 9 (IRF9), and interferon beta (IFNß), interleukin-1 beta (IL-1ß), and interferon regulatory factor 3 (IRF3). COVID-19 infection activated key infectious disease-specific immune-related signaling pathways such as influenza A, viral protein interaction with cytokine and cytokine receptors, measles, Epstein-Barr virus infection, and IL-17 signaling pathway. Besides, we identified drugs such as prednisolone, methylprednisolone, diclofenac, compound JQ1, and natural products such as Withaferin-A and JinFuKang as candidates for further experimental validation of COVID-19 therapy. CONCLUSIONS: In conclusion, we have used the in silico next-generation knowledge discovery (NGKD) methods to discover COVID-19-associated pathways and specific therapeutics that have the potential to ameliorate the disease pathologies associated with COVID-19.

Antiplatelet response to clopidogrel is associated with a haplotype in CYP2C19 gene in Pakistani patients.

Clopidogrel, an antiplatelet drug, is frequently prescribed to patients diagnosed with ischemic diseases such as those suffering from acute coronary syndromes or ischemic stroke. Despite the drug being effective in majority of the patients, some still experience ischemic events early in the treatment which might be due to poor platelet inhibition. This study aims to investigate the association of cytochrome P450 2C19 (CYP2C19) loss-of-function polymorphisms, haplotypes as well as a wide range of clinical and demographic variables with platelet aggregation phenotypes to clopidogrel in a Pakistani cohort. The study comprised of a total of 120 patients diagnosed with cardiovascular diseases and were treated with clopidogrel. Antiplatelet response to clopidogrel was monitored by Helena AggRAM (HL-2-1785P) and patients with maximal platelet aggregation more than 50% were categorized as low responders and those with less than 50% as high responders. Our results show that 56.6% of patients were homozygous for the CYP2C19 wild-type allele, 38.3% of patients possessed one copy of the CYP2C19*2 allele and 5% of patients possessed both CYP2C19*2 alleles. No CYP2C19*3 allele was found in our patient cohort. There was no statistically significant difference between the high and low responder groups to clopidogrel in terms of extensive, intermediate and poor metabolizer genotypes. However, haplotype (H1), leukocyte count, random blood glucose, and history of diabetes mellitus was associated with the antiplatelet response to clopidogrel. The prevalence of clopidogrel resistance in our population was in line with that reported for other regional and global populations.

Inter-ethnic genetic variations and novel variant identification in the partial sequences of CYP2B6 gene in Pakistani population.

BACKGROUND: Some single nucleotide polymorphisms (SNPs) in the cytochrome P450 (CYP)2B6 gene lead to decreased enzyme activity and have an impact on drug metabolism. The present study was designed to investigate the patterns of genetic distinction across a hypervariable region of the CYP2B6 gene, known to contain important SNPs, i.e. rs4803419 and rs3745274, among five major ethnic groups of the Pakistani population. METHODS: Arlequin v3.5.DnaSPv6.12. and network 5 resources were used to analyze population genetic variance in the partial CYP2B6 gene sequences obtained from 104 human samples belonging to Punjabi, Pathan, Sindhi, Seraiki and Baloch ethnicities of Pakistan. The partial CYP2B6 gene region analyzed in the current study is previously known to possess important SNPs. RESULTS: The data analyses revealed that genetic variance among samples mainly came from differentiation within the ethnic groups. However, significant genetic variation was also found among the various ethnic groups. The high pairwise Fst genetic distinction was observed between Seraiki and Sindhi ethnic groups (Fst = 0.13392, P-value = 0.026) as well as between Seraiki and Balochi groups (Fst = 0.04303, P-value = -0.0030). However, the degree of genetic distinction was low between Pathan and Punjabi ethnic groups. Some SNPs, including rs3745274 and rs4803419, which are previously shown in strong association with increased plasma Efavirenz level, were found in high frequency. Besides, a novel SNP, which was not found in dbSNP and Ensemble databases, was identified in the Balochi ethnicity. This novel SNP is predicted to affect the CYP2B6 splicing pattern. CONCLUSION: These results may have significant implications in Pakistani ethnicities in the context of drugs metabolized by CYP2B6, especially in Seraiki and Balochi ethnicity. The novel heterogeneous SNP, found in the present study, might lead to altered drug-metabolizing potential of CYP2B6 and, therefore, may be implicated in non-responder phenomenon.

Nutrition transition - Pattern IV: Leads Bangladeshi youth to the increasing prevalence of overweight and obesity.

Fast food and soft drinks consumption leading to excess calorie intake coupled with lack of acceptable physical activity has augmented the prevalence of overweight and obesity among the world population for the past few eras. A cross-sectional study was carried out among 475 youth selected by systematic random sampling attending in 27 established public and private universities and colleges of Bangladesh. The study was aimed to evaluate habitual facts associated with the prevalence of overweight and obesity among Bangladeshi youth. The rates of fast food consumption (once/week) are 50.6%, 43.7%, and 53.3% in overweight, pre-obese and obese-1 respondents accordingly and the rates of soft drinks consumption (4-6 times/week) are 40.5%, 59.2%, and 73.3% respectively for the same subjects. Moreover, approximately 40.8% of the youth went to fast food restaurants at least once per week and 27.2% went regularly (2 times/week). Youth having fast foods 2 times/week, consuming soft drinks 3-4 times/week were more likely to be obese. Besides, obesity epidemic was observed among those who have not the habit of doing physical exercise. This study provides evidence of increasing trend and threat to overweight and obesity for the Bangladeshi youth.

Sleeping pattern before thoracic surgery: A comparison of baseline and night before surgery.

BACKGROUND: Sleep deprivation is considered a stress factor in the perioperative period. There are several studies on sleep disturbance after surgery but very limited literature available on preoperative sleep patterns, predictors of sleep disturbance and its effect on surgical outcome. METHODOLOGY: Patients scheduled for thoracic surgery were asked to fill out a written Pittsburgh Sleep Quality Index (PSQI) questionnaire. The primary investigator explained this form to all the patients. This was filled out before premedication for subjective assessment of sleeping pattern at two different time point. Only those patients included who spent the previous night at home. Participants were asked to respond to the questions regarding their baseline sleeping pattern and compare it with last night. RESULTS: Total eighty-three patients with a mean age of 47.83 ± 17.88 were included in the study. Overall mean PSQI scores were significantly higher (p-value < 0.01) during the night before surgery (6.94 ± 2.115) when compared with baseline (3.88 ± 1.877). Sleep latency was also significantly affected when last night-1 (the night before admission) was compared with usual sleep latency. Twenty patients were unable to sleep more than 5 hrs at night before admission which was significant when compared with their last month status (20 vs 3). Logistic regression model demonstrated the age and Timing of surgery as a strong predictors of poor sleep (defined as PSQI ≥ 5). CONCLUSION: Quality of sleep was profoundly affected at night before thoracic surgery, mainly due to a significant change in sleep latency and sleep duration. Although age and Timing of surgery were strong predictors of poor sleep we were unable to find any association between quality of sleep and type of surgery.

Promoter hypermethylation of estrogen receptor alpha gene is correlated to estrogen receptor negativity in Iranian patients with sporadic breast cancer.

OBJECTIVE: Breast Cancer is the most common cancer in Iranian women. Breast tumors are classified based on the estrogen receptor alpha (ERα) expression status into ER negative and ER positive tumors. ER negative tumors tend to have worse prognosis and less likely to respond to endocrine therapy. Aberrant methylation of gene promoter is one of the mechanisms for gene silencing in breast tumors. Because of its reversible nature, promoter methylation is a good target for new therapeutic strategies. We aimed to evaluate the frequency of this epigenetic event in ERα gene and its association to clinicopathological features in Iranian breast cancer patients. MATERIALS AND METHODS: In this case control study the patient series consisted of 100 sporadic primary breast cancer cases (51 ER negative and 49 ER positive tumors). None of the participants had chemo or radiotherapy before surgery. In breast tumors ERα promoter methylation were assessed with methylation specific polymerase chain reaction (MSP). Data was collected on clinicopathological features of the patients. Correlation between ERα methylation and clinicopathological characteristics of the patients was investigated by Pearson Chi-Square and Fisher's exact test. RESULTS: ERα methylation was detected in 98% of ER negative and 65% of ER positive breast tumors. A strong correlation was found between ERα methylation and ER negativity in tumors (p<0.0001). Also, ERα methylation has associated to progesterone receptor negativity (p<0.008) and double receptor negative status (p<0.0001) in breast tumors. CONCLUSION: ERα methylation occurs with high frequency in the breast tumors of Iranian breast cancer patients and may play a considerable role in pathogenesis of ERα negative tumors as a poor prognosis and more aggressive category. The reversible nature of DNA methylation may provide new therapeutic possibilities in ER negative breast tumors.

Spontaneous intracranial hypotension in a patient with Marfan's syndrome treated with epidural blood patch--a case report.

Spontaneous intracranial hypotension (SIH) is a well-defined clinical entity that is frequently misdiagnosed. We are reporting a case of 38 years old male who presented with severe headache and an episode of generalized tonic-clonic seizure. He was managed successfully with an epidural blood patch. Understanding of the characteristics, symptomatology, evaluation, treatment options, and prognosis is discussed.

Ventriculoperitoneal shunt blockage.

BACKGROUND: Hydrocephalus is the abnormal accumulation of cerebrospinal fluid within the ventricles and subarachnoid spaces, resulting in increased intracranial pressure. The treatment of choice is placement of ventriculoperitoneal shunt. Ventriculoperitoneal shunt blockage is not an uncommon complication. Objective of the study was to find out the frequency, causes and site of ventriculoperitoneal blockage and to compare it with other studies. METHODS: This case series study was conducted at Department of Neurosurgery Liaquat University Hospital, Jamshoro, from April 2008 to March 2012. The records of 53 patients between 40 days to 45 years age presenting with blocked ventriculoperitoneal shunt were included. All the patients underwent thorough clinical examination and radiological investigations, and shunt revision done. The retrieved data was collected on proforma. Frequencies and percentages were calculated for categorical data. RESULTS: Out of 53 patients 28 were males, 25 patients were females. Age of patients ranged from 40 days to 45 years. Time interval between the ventriculo-peritoneal shunt placement and blockage of shunt ranged from 2 weeks to 9 years. Out of 53 patients, 32 (69.37%) patients had obstruction at distal catheter, whereas 21 (39.62%) patients had ventricular catheter blockage. CONCLUSION: Ventriculo-peritoneal shunt blockage is one of the most common complications of shunt placement procedure. In this study most of the patients (69.37%) had distal catheter obstruction. Majority (35.84%) of the patients presented with shunt obstruction within one year of shunt placement. Shunt obstruction is common in children less than 3 years age.

Retrospective study of the long-term results of otoplasty using a modified Mustardé (cartilage-sparing) technique.

OBJECTIVE: To determine the long-term results and the complication rates of a cartilage-sparing otoplasty technique. PATIENTS AND METHODS: In our study, patients who had undergone otoplasty from 1990 to 2002 inclusively were evaluated retrospectively. The study consisted of a chart review and a telephone survey. The minimum follow-up for patients was 5 years. MAIN OUTCOME MEASURES: The main outcome measures were long-term satisfaction rates, early complications, late complications, and rate of revisional procedures. A detailed description of the surgical technique is included. RESULTS: The overall long-term satisfaction rate was 95.7%. Early complications (< 1 month) included one case of bleeding (1.0%) and five cases of asymmetry (4.9%) between both ears, two of which required reoperations. One case of early unilateral recurrence was noted owing to trauma inflicted by another child (1.0%) and necessitated a revisional procedure. Late complications (> 1 month) included five cases (4.8%) of suture granulomas/extrusions, three (2.9%) keloids, and one case of hypertrophic scarring (1.0%). Seven cases of partial recurrence of the deformity (10.3%) were noted, six of which were unilateral and one of which was bilateral, none requiring reoperation. There was only one case of overcorrection of the deformity (1.4%). Three cases within the sample of 104 patients underwent reoperation, yielding a 2.9% rate of revision procedures. CONCLUSIONS: On long-term follow-up, the otoplasty technique used in our institution yields a high satisfaction rate and a low complication rate.