Land use land cover and land surface temperature changes and their relationship with human modification in Islamabad Capital Territory, Pakistan.

Human activities are altering the existing patterns of Land Use Land Cover (LULC) and Land Surface Temperature (LST) on a global scale. However, long-term trends of LULC and LST are largely unknown in many remote mountain areas such as the Karakorum. . The objective of our study therefore was to evaluate the historical changes in land use and land cover (LULC) in an alpine environment located in Islamabad Capital Territory, Pakistan. We used Landsat satellite pictures (namely Landsat 5 TM and Landsat 8 OLI) from the years 1988, 2002, and 2016 and applied the Maximum Likelihood Classification (MLC) approach to categorize land use classes. Land Surface Temperatures (LST) were calculated using the thermal bands (6, 10, and 11) of Landsat series data. The correlation between the Human Modification Index (HMI) and LULC as well as LST was evaluated by utilizing data from Google Earth Engine (GEE). Over the study period, the urbanized area increased by 9.94%, whilst the agricultural and bare soil areas decreased by 3.81% and 3.94%, respectively. The findings revealed a significant change in the LULC with a decrease of 1.99% in vegetation. The highest LST class exhibited a progressive trend, with an increase from 12.27% to 48.48%. Based on the LST analysis, the built-up area shows the highest temperature, followed by the barren, agricultural, and vegetation categories. Similarly, the HMI for different LST categories indicates that higher LST categories have higher levels of human alteration compared to lower LST categories, with a strong correlation (R-value = 0.61) between HMI and LST. The findings can be utilized to promote sustainable urban management and for biodiversity conservation efforts. The work also has the potential of utilizing it to protect delicate ecosystems from human interference and to formulate strategies and regulations for sustainable urban growth, including aspects of land utilization and zoning, reduction of urban heat stress, and urban infrastructure.

Osmotic demyelination syndrome following slow correction of hyponatremia: Possible role of hypokalemia.

A 47-year-old male presented with hyponatremia that was corrected slowly as per the recommended guidelines. The patient improved initially but went on to develop a quadriparesis with a locked-in state due to a central as well as extrapontine myelinolysis and subsequently succumbed to an intercurrent infective illness. The patient had associated hypokalemia. Hyponatremia can result in central pontine myelinolysis even when the electrolyte disorder is treated slowly, and the concomitant hypokalemia seems to play a contributory role in the pathogenesis of the neurological disorder.

Adderall-induced Trichotillomania: A Case Report.

Adderall (dextroamphet-amine/amphetamine) is a psychostimulant medication approved by the United States Food and Drug Administration for the treatment of attention deficit hyperactivity disorder. This medication is usually well tolerated with minimal side effects. We report a case of a 12-year-old girl who was prescribed Adderall by her primary care physician to treat her attention deficit hyperactivity disorder and who subsequently developed trichotillomania. A short time following the initiation of the medication, the patient's family members noticed the patient displaying unusual hair-pulling behavior. The patient was referred to a psychiatrist for an evaluation of trichotillomania. Following a thorough evaluation, the decision was made to discontinue the Adderall and switch the patient to guanfacine. The urge to pull her hair along with her anxiety dissipated following this change. Close follow-up was maintained for over a year with both the psychiatrist and the primary care physician, and during this time the patient did not display any unusual hair pulling behaviors. This case appears to display a very unusual side effect of Adderall.

Helping the angels: a review of understanding and helping dying children.

According to the World Health Organization, 53,000 children die every year in United States because of a chronic medical condition. Physicians have to face various ethical and psychological challenges while managing these conditions. These challenges range from disclosure of diagnosis to effective grief counseling to the family. In this article we have discussed some of these challenges and strategies to effectively meet these challenges.

Topiramate-induced Dissociative Disorder.

Topiramate is associated with various psychiatric and neurocognitive side effects. We report a case of a 21-year-old woman who was prescribed topiramate for the treatment of migraine headaches by her neurologist. She developed episodes of dissociation while receiving topiramate. These episodes increased when the dose of medicine was increased. The frequency of these episodes decreased as the medicine dose was tapered down, and these episodes eventually stopped after the medicine was discontinued. There was no recurrence of symptoms during the 23-week follow-up period.

An elderly male with tubercular osteomyelitis of the chest wall.

Primary tuberculosis of the ribs is rare. A 70-year-old male presented with a 6-month history of a chest wall swelling that ruptured over few weeks to lead to a chronic discharging sinus. He had been administered multiple antibiotics, but the discharge continued. Clinical examination revealed anaemia, cervical lymphadenopathy and a 2-cm splenomegaly. Investigations revealed a normochromic and normocytic anaemia (Hb 7.0 g/dl), an ESR of 60 and a positive tuberculin sensitivity test of 25 mm. Surgical excision of the sinus along with the underlying revealed a caseous rib with histopathological features of a caseating granuloma. The patient was put on antitubercular therapy and is doing well on follow-up.

Thellungiella: an Arabidopsis-related model plant adapted to cold temperatures.

Thellungiella salsuginea, a wild crucifer that grows in subarctic Canada and is closely related to Arabidopsis thaliana, was examined for its suitability as a model plant for studies of tolerance to cold and freezing temperatures. Thellungiella completed its life cycle at 5 degrees C, demonstrating that temperature-sensitive processes such as seed germination and the production of pollen and seeds were resistant to cold temperatures. Moreover, the plant exhibited dramatically different vegetative and flowering phenotypes in response to growth at cold temperature and shifts to cold temperature. Northern analyses showed that genes induced by cold in Arabidopsis, including CBF1, the transcriptional activator for the cold-regulated (COR) genes COR15a and COR47, were also expressed in Thellungiella. Freezing tolerance, assayed by the regrowth of intact plants, increased from -13.0 to -18.5 degrees C after cold treatment. The plants lacked endogenous ice nucleation or anti-freeze activity, indicating a potential for supercooling. As a close relative to Arabidopsis, Thellungiella exhibits extreme cold tolerance and should be an important model system in the elucidation of stress tolerance mechanisms.

Pattern of development of hyperprolactinemia after initiation of haloperidol therapy.

OBJECTIVE: To determine the time it takes for prolactin (PRL) levels to increase after initiation of therapy with haloperidol (a neuroleptic medication) and the pattern and extent of the increase. METHODS: Seventeen individuals scheduled to be given treatment with neuroleptic drugs were enrolled. Baseline blood specimens were collected for PRL and TSH levels. Follow-up samples for PRL determinations were obtained every 3 days for 18 days after initiation of haloperidol therapy. RESULTS: There were 17 subjects: 14 women and three men. Two of the subjects were found to have hyperprolactinemia due to hypothyroidism and were excluded from the basic study. The 15 remaining subjects all had normal baseline PRL levels and normal TSH values. The PRL levels in all 15 showed a similar pattern: a rapid increase in PRL levels in the first 6-9 days, followed by a plateau that remained, with minor fluctuations, throughout the study. The highest mean peak level of PRL was 37.4 ng/mL and the maximum was 77 ng/mL. The two individuals with hypothyroidism had somewhat elevated baseline PRL levels; although they showed the same initial pattern of increase after haloperidol administration, their PRL levels reached values well above 100 ng/mL. CONCLUSION: There is a distinct pattern of response of PRL to haloperidol. The PRL level increases for 6-9 days, then plateaus, the peak being between 30 and 50 ng/mL, and always remains below 77 ng/mL. In our study, levels that continued to increase, or increased above 77 ng/mL, indicated the presence of hypothyroidism. The patterns and levels of the increase were uninfluenced by the therapeutic dose of the medication given. Given that the patients in our study with elevated levels of TSH had such high levels of PRL, all patients should have TSH determinations at the initiation of therapy with neuroleptic medications such as haloperidol.