Economic and Social Impact Assessment of Chronic Diseases Among the Low-Income Population in Southern Punjab,Pakistan

Introduction:Chronic diseases are becoming more prevalent worldwide.The effects of chronic illnesses are disastrous not only for the diagnosed person but also for their entire family.This study explores chronic diseases’social and economic impact on low-income families.The study aims to determine the economic and social implications of various chronic diseases and the loss of income due to these conditions among low-income individuals in Southern Punjab,Pakistan.Methodology:A sample of 424 patients was selected from different areas of Southern Punjab.Data were collected using a questionnaire that included questions about economic status,self-reported health status,social status,management strategies,and health insurance,among other factors.Results:The mean monthly income of the respondents was found to be 57,097.6 Pakistani rupee(PKR),and the mean monthly expenses for treatment were 8,256.1 PKR.The loss of income was calculated at 15%.Additionally,62%of patients spent more than 10%of their monthly income on managing their disease.Approximately 85%of the respondents reported that chronic diseases affected their social life.Furthermore,80%of patients lacked health insurance.Conclusion:Chronic diseases impose significant economic and social burdens on patients and their families in Southern Punjab.To reduce the burden of chronic diseases,the government should enhance healthcare services in this region and provide health insurance to low-income families.

Risk of metabolic abnormalities in osteoarthritis:a new perspective to understand its pathological mechanisms

Although aging has traditionally been viewed as the most important risk factor for osteoarthritis(OA),an increasing amount of epidemiological evidence has highlighted the association between metabolic abnormalities and OA,particularly in younger individuals.Metabolic abnormalities,such as obesity and typeⅡdiabetes,are strongly linked to OA,and they affect both weightbearing and non-weight-bearing joints,thus suggesting that the pathogenesis of OA is more complicated than the mechanical stress induced by overweight.This review aims to explore the recent advances in research on the relationship between metabolic abnormalities and OA risk,including the impact of abnormal glucose and lipid metabolism,the potential pathogenesis and targeted therapeutic strategies.

海藻糖氧钒对小鼠胃肠道的氧化损伤以及Vc和GSH的抗氧化保护作用

目的探讨海藻糖氧钒(VT)对小鼠胃肠道的氧化应激损伤、GSH/GSTs通路基因表达的影响以及维生素C(Vc)和还原型谷胱甘肽(GSH)的保护作用。方法 30只雄性昆明小鼠随机分组:VT组(B组)、Vc+VT组(C组)、GSH+VT组(D组)、Vc+GSH+VT组(E组),每天灌服VT(125mg/kg),而正常对照组(A组)灌服等量生理盐水,Vc和GSH在VT给药前1h灌服,连续15d。取各组小鼠胃和十二指肠,DTNB法测定GSH含量,谷胱甘肽氧化法测定谷胱甘肽过氧化物酶(GSH-Px)活力,实时荧光定量PCR法检测GSH/GSTs通路相关基因GCLC、GSS、GSR和GSTpi的表达。结果 VT组胃、十二指肠的GSH含量、GSH-Px活性及GCLC、GSS、GSR和GSTpi的表达均低于A组(P<0.05)。C、D、E组各指标显著提高,但仅E组小鼠胃组织的指标恢复到正常对照组水平。C组和D组除十二指肠中GSR表达显著差异外,其余指标差异均无统计学意义。结论灌服VT对小鼠胃肠道产生一定的氧化应激损伤,并可影响GSH含量和GSH-Px活性以及GSH/GSTs通路相关基因的正常表达。外源补充Vc、GSH及两者联用有一定的抗氧化保护作用,降低了VT的毒性,且两者联用的效果更优,使胃中的相关指标达到正常水平。

Numerical Solutions of a Novel Designed Prevention Class in the HIV Nonlinear Model

The presented research aims to design a new prevention class(P)in the HIV nonlinear system,i.e.,the HIPV model.Then numerical treatment of the newly formulated HIPV model is portrayed handled by using the strength of stochastic procedure based numerical computing schemes exploiting the artificial neural networks(ANNs)modeling legacy together with the optimization competence of the hybrid of global and local search schemes via genetic algorithms(GAs)and active-set approach(ASA),i.e.,GA-ASA.The optimization performances through GA-ASA are accessed by presenting an error-based fitness function designed for all the classes of the HIPV model and its corresponding initial conditions represented with nonlinear systems of ODEs.To check the exactness of the proposed stochastic scheme,the comparison of the obtained results and Adams numerical results is performed.For the convergence measures,the learning curves are presented based on the different contact rate values.Moreover,the statistical performances through different operators indicate the stability and reliability of the proposed stochastic scheme to solve the novel designed HIPV model.

A Paleogeographic and Depositional Model for the Neogene Fluvial Succession, Pishin Belt, Northwest Pakistan: Effect of Post Collisional Tectonics on Sedimentation in a Peripheral Foreland Setting

Detailed facies analysis of the Neogene successions of the Pishin Belt （Katawaz Basin） has enabled documentation of successive depositional systems and paleogeographic settings of the basin formed by the collision of the northwestern continental margin of the Indian Plate and the Afghan Block. During the Early Miocene, subaerial sedimentation started after the final closure of the Katawaz Remnant Ocean. Based on detailed field data, twelve facies were recognized in Neogene successions exposed in the Pishin Belt. These facies were further organized into four facies associations i.e. channels, crevasse splay, natural levee and floodplain facies associations. Facies associations and variations provided ample evidence to recognize a number of fluvial architectural components in the succession e.g., low-sinuosity sandy braided river, mixed-load meandering, high-sinuosity meandering channels, single-story sandstone and/or conglomerate channels, lateral accretion surfaces （point bars） and alluvial fans. Neogene sedimentation in the Pishin Belt was mainly controlled by active tectonism and thrusting in response to the oblique collision of the Indian Plate with the Afghan Block of the Eurasian Plate along the Chaman-Nushki Fault. Post Miocene deformation of these formations successively caused them to contribute as an additional source terrain for the younger formations.

Swarming Computational Approach for the Heartbeat Van Der Pol Nonlinear System

The present study is related to design a stochastic framework for the numerical treatment of the Van der Pol heartbeat model(VP-HBM)using the feedforward artificial neural networks(ANNs)under the optimization of particle swarm optimization(PSO)hybridized with the active-set algorithm(ASA),i.e.,ANNs-PSO-ASA.The global search PSO scheme and local refinement of ASA are used as an optimization procedure in this study.An error-based merit function is defined using the differential VP-HBM form as well as the initial conditions.The optimization of the merit function is accomplished using the hybrid computing performances of PSO-ASA.The designed performance of ANNs-PSO-ASA is implemented for the numerical treatment of the VP-HBM dynamics by fluctuating the pulse shape adjustment terms,external forcing factor and damping coefficient with fixed ventricular contraction period.To perform the correctness of the present scheme,the obtained numerical results through the designed ANN-PSO-ASA will be compared with the Adams numerical method.The statistical investigations with larger dataset are provided using the“mean absolute deviation”,“Theil’s inequality coefficient”and“variance account for”operators to perform the applicability,reliability,and effectiveness of the designed ANNs-PSO-ASA scheme for solving the VP-HBM.

Non-performing loans(NPLs),liquidity creation,and moral hazard:Case of Chinese banks

This study analyzes the impact of non-performing loans(NPLs)on bank liquidity creation to investigate the existence of moral hazard problem in Chinese banks.It uses data from 197 listed and unlisted Chinese banks,spanning the period 2005 to 2014.Total liquidity creation by Chinese banks is declining,and NPLs ratio has started to increase following a continuous decline between 2005 and 2012.Using one-step system GMM estimation,fixed and random effect model,and pool data analysis,we find that liquidity creation by Chinese banks does not depend on NPLs ratio,i.e.,we did not find the evidence of moral hazard problem in Chinese banks.We repeated the analysis for small and large banks and the results of these sub-samples reinforced our findings for the aggregate sample.

Efficacy and safety of generic daclatasvir +sofosbuvir ± ribavirin in treatment of genotype 3infected hepatitis C patients - a real life experience from Pakistan

Aim: Genotype 3 is the most prevalent genotype in Pakistan. Despite a revolution in the treatment of Hepatitis C, genotype 3 is still thought to be difficult to treat genotype. The price of patent direct acting antivirals was thought to a great limiting factor especially for low income countries. In Pakistan low cost generics of daclatasvir and sofosbuvir are easily available for treatment. The aim of our study is to provide real life local data to determine their efficacy and safety. Methods: This open-label, non-randomized, uncontrolled study was carried out at Center for Liver and Digestive Diseases, Holyfamily Hospital, Rawalpindi. We enrolled patients from March 2016 through March 2018 who were 18 years or older having chronic hepatitis C infection with detectable polymerase chain reaction (PCR), regardless of whether they were treatment na?ve or have experienced Interferon in the past. The patients were offered generic sofosbuvir 400 mg and daclatasvir 60 mg once daily with or without ribavirin for a period of 12 to 24 weeks. Follow-up PCRs were performed at 4th week of treatment, end of treatment and 12 weeks post treatment. All those patients were included in the study that had at least one follow-up PCR during or after the course of treatment. Results: A total of 102 patients were enrolled in the study with a mean age of 48.11 ± 12.70 including 63% males and 37% females. All patients were genotype 3. On 4th week follow up, 31/36 (86.11%) patients had quantitative PCR negative. Out of 102 patients 78 patients had follow up PCR at the completion of therapy with an end of treatment response of about 96.1%. Thirty patients had a follow up at 12 weeks post treatment with a SVR12 of&nbsp;83.33% (25/30) amongst which treatment Na?ve had a response rate of 84% (21/25), treatment experience 80%(4/5), non-cirrhotics 85.71% (12/14), cirrhotics 81.25% (13/16) and decompensated chronic liver disease patients have a SVR12 of about 83.33% (10/12) respectively. The combination was well tolerated with few side effects, 18.6% patients had itching, 10.8% had insomnia, 8.8% had oral ulcers and 6.9% had fatigue. Conclusion: Generic sofosbuvir and daclatasvir are cheap, safe and efficacious with a SVR12 of about 83.33%amongst genotype 3 patients. These generics will act as a pivot in the eradication of hepatitis C infection from developing world.