First insights into per-and polyfluoroalkyl substance contamination in edible fish species of the Indus water system of Pakistan.

Per- and polyfluoroalkyl substances (PFASs) are a group of emerging contaminants, that have a wide range of applications in industrial and commercial products. The direct discharge of untreated industrial and domestic wastewater into freshwater bodies is a common practice in developing countries, which are the main contributors to PFASs in the aquatic environment. The situation is further worsened due to poor wastewater treatment facilities and weak enforcement of environmental regulations in countries like Pakistan.

Area-based determinants of outreach vaccination for reaching vulnerable populations: A cross-sectional study in Pakistan.

The objective of this study is to gain a comparative understanding of spatial determinants for outreach and clinic vaccination, which is critical for operationalizing efforts and breaking down structural biases; particularly relevant in countries where resources are low, and sub-region variance is high. Leveraging a massive effort to digitize public system reporting by Lady and Community Health Workers (CHWs) with geo-located data on over 4 million public-sector vaccinations from September 2017 through 2019, understanding health service operations in relation to vulnerable spatial determinants were made feasible. Location and type of vaccinations (clinic or outreach) were compared to regional spatial attributes where they were performed.

Unraveling Monkeypox: An Emerging Threat in Global Health.

Monkeypox, a viral zoonotic ailment originating in the Central and West African regions, has escalated into a global health issue of growing concern. The current analysis offers an exhaustive examination of monkeypox, emphasizing its historical progression, etiology, epidemiological patterns, pathophysiological mechanisms, clinical manifestations, diagnostic methodologies, treatment modalities, and preventive strategies. The worldwide discontinuation of smallpox vaccination has contributed to an increased incidence of monkeypox, driven by the expansion of vulnerable host populations.

Structural basis for the mechanism of interaction of SARS-CoV-2 B.1.640.2 variant RBD with the host receptors hACE2 and GRP78.

The inflicted chaos instigated by the SARS-CoV-2 (Severe acute respiratory syndrome coronavirus 2) globally continues with the emergence of novel variants. The current global outbreak is aggravated by the manifestation of novel variants, which affect the effectiveness of the vaccine, attachment with hACE2 (human Angiotensin-converting enzyme 2) and immune evasion. Recently, a new variant named University Hospital Institute (IHU) (B.

Burden of cardiovascular dysfunction and outcome among term newborns having birth asphyxia.

Objectives: To find out the burden of cardiovascular dysfunction and outcome among term newborns having birth asphyxia.

Methods: This prospective observational study was conducted at The Department of Neonatology, Children's Hospital and The Institute of Child Health, Multan from August 2020 to March 2021.A total of 171 term newborns having asphyxia were enrolled.

Neighborhood level chronic respiratory disease prevalence estimation using search query data.

Estimation of disease prevalence at sub-city neighborhood scale allows early and targeted interventions that can help save lives and reduce public health burdens. However, the cost-prohibitive nature of highly localized data collection and sparsity of representative signals, has made it challenging to identify neighborhood scale prevalence of disease. To overcome this challenge, we utilize alternative data sources, which are both less sparse and representative of localized disease prevalence: using query data from a large commercial search engine, we identify the prevalence of respiratory illness in the United States, localized to census tract geographic granularity.

Quantifying the localized relationship between vector containment activities and dengue incidence in a real-world setting: A spatial and time series modelling analysis based on geo-located data from Pakistan.

Increasing urbanization is having a profound effect on infectious disease risk, posing significant challenges for governments to allocate limited resources for their optimal control at a sub-city scale. With recent advances in data collection practices, empirical evidence about the efficacy of highly localized containment and intervention activities, which can lead to optimal deployment of resources, is possible. However, there are several challenges in analyzing data from such real-world observational settings.

Transvenous Lead Extraction in Patients With Arrhythmogenic Right Ventricular Cardiomyopathy.

Objectives: This study aimed to evaluate the effectiveness and safety of transvenous lead extraction (TLE) in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC).

Background: ARVC is an increasingly diagnosed cardiomyopathy that often requires device implantation to prevent sudden death. Little is known about TLE in this setting, which has potential challenges and risks, primarily due to right ventricular (RV) wall thinning and fragility.

Life-Threatening Complications of Atrial Fibrillation Ablation: 16-Year Experience in a Large Prospective Tertiary Care Cohort.

Objectives: This study sought to assess the incidence and outcomes of life-threatening complications from atrial fibrillation ablations in a high volume center.

Background: With increasing rates of atrial fibrillation ablation procedures, an increase in life-threatening procedure-related complications has been reported despite improvements in technology and ablation strategies.

Methods: Between 2000 and 2015, 10,378 patients underwent atrial fibrillation ablation at our institution and were enrolled in a prospectively maintained data registry.

Recurrent Atrial Fibrillation After Initial Long-Term Ablation Success: Electrophysiological Findings and Outcomes of Repeat Ablation Procedures.

Background: Atrial fibrillation recurrence after initial long-term success of catheter ablation has been described, yet not well studied. We assessed the electrophysiological findings and outcomes of repeat ablation procedures in this setting.

Methods And Results: Between 2000 and 2015, 10 378 patients underwent atrial fibrillation ablation and were enrolled in a prospectively maintained data registry.

Repeat ablation or medical management alone for recurrent arrhythmias after ablation of persistent atrial fibrillation.

Introduction: Management of persistent atrial fibrillation (PersAF) remains challenging, and many patients are left on medical therapy after a failed first ablation. In patients with recurrent symptomatic arrhythmias after PersAF ablation, we aimed to compare outcomes of repeat ablation and medical therapy versus medical therapy alone.

Methods And Results: All 682 consecutive patients with recurrent symptomatic arrhythmia after a first ablation for PersAF at our institution (2005-2012) were included.

Transvenous Lead Extraction in Chronic Kidney Disease and Dialysis Patients With Infected Cardiac Devices.

Background: Cardiac implantable electronic device infections have been on the rise. A high-risk population is that with renal disease, especially dialysis. We aimed to assess procedural profiles and clinical outcomes of transvenous lead extraction for cardiac implantable electronic device infection based on renal disease status.

Long-term mortality in patients with severe secondary mitral regurgitation and normal left ventricular ejection fraction: interventional perspective.

Aims: Patients with severe secondary mitral regurgitation (MR) and normal ejection fraction are being excluded from clinical trials evaluating transcatheter mitral devices. We sought to evaluate the long-term mortality with medical management alone in this patient population.

Methods And Results: We retrospectively evaluated patients diagnosed with ≥3+ MR at our institution over 15 years.

Computed tomography measurement of the left atrial appendage for optimal sizing of the Watchman device.

Introduction: Percutaneous left atrial appendage (LAA) occlusion is an emerging treatment option for patients with non-valvular atrial fibrillation who cannot tolerate oral anticoagulation. The Watchman device (Boston Scientific Corporation, Natick, MA, USA) is deployed at the ostium of the LAA, and an appropriately sized device is critical for successful occlusion. However, standardized imaging protocols for device sizing have not been established.

Tracing biomarker of PAH-exposure and susceptibility factor (GSTM-polymorphism) among cancer patients in Pakistan.

We studied cancer patients for possible PAH exposure, using urinary concentration of 1-hydroxypyrene (1-OHP) as a biomarker of internal dose of polycyclic aromatic hydrocarbons (PAHs). The subjects included in this study belonged to various socio-demographic backgrounds, and were diagnosed with cancer (i.e.

Fine-grained dengue forecasting using telephone triage services.

Thousands of lives are lost every year in developing countries for failing to detect epidemics early because of the lack of real-time disease surveillance data. We present results from a large-scale deployment of a telephone triage service as a basis for dengue forecasting in Pakistan. Our system uses statistical analysis of dengue-related phone calls to accurately forecast suspected dengue cases 2 to 3 weeks ahead of time at a subcity level (correlation of up to 0.

Green biocides, a promising technology: current and future applications to industry and industrial processes.

The study of biofilms has skyrocketed in recent years due to increased awareness of the pervasiveness and impact of biofilms. It costs the USA literally billions of dollars every year in energy losses, equipment damage, product contamination and medical infections. But biofilms also offer huge potential for cleaning up hazardous waste sites, filtering municipal and industrial water and wastewater, and forming biobarriers to protect soil and groundwater from contamination.

FluBreaks: early epidemic detection from Google flu trends.

Background: The Google Flu Trends service was launched in 2008 to track changes in the volume of online search queries related to flu-like symptoms. Over the last few years, the trend data produced by this service has shown a consistent relationship with the actual number of flu reports collected by the US Centers for Disease Control and Prevention (CDC), often identifying increases in flu cases weeks in advance of CDC records. However, contrary to popular belief, Google Flu Trends is not an early epidemic detection system.