Disease In Pakistan Research Articles

The Trend of Modifiable Risk Factors of Ischemic Heart Disease in Pakistan from 2000 To 2022

Ischemic Heart Disease is the leading cause of mortality in Pakistan. It is cause by myocardial ischemia. Most cases of myocardial ischemia are as a result of coronary artery atherosclerosis. There are Modifiable and nonmodifiable risk factors of atherosclerosis. Here we discuss the trend of modifiable risk factors in Pakistan from 2000 to 2022. A Secondary analysis was conducted to find the trend of Modifiable risk factors and its relation with ischemic heart disease in Pakistan from 2000 to 2022. For this purpose, Literature review was performed using google scholar and PubMed, Data on trends of these risk factors was obtained from WHO Pakistan website. The trend of modifiable factors of ischemic heart disease, namely Tobacco smoking, Obesity, Alcohol consumption and Hypertension has been increasing in Pakistan, except for Tobacco smoking. Proper preventive measures must be taken to counter this specific death rate. This may include mass Health education, Health promotion, Dietary changes, and lifestyle changes.

Renal satellite units in Pakistan: Challenges, efforts, and recommendations.

This commentary delves into the complexities surrounding chronic kidney disease management in Pakistan, specifically examining the critical role played by renal satellite units in providing accessible dialysis services. Chronic kidney disease in Pakistan accounts for 3.9% of total deaths, warranting a focused exploration of challenges and potential solutions. RSUs, smaller entities affiliated with main renal units, emerge as key players in addressing issues of geographic accessibility and diminishing travel burdens for chronic kidney disease patients. Challenges such as financial constraints, limited resources, and staff shortages, particularly in rural settings, pose significant hurdles to the effective functioning of RSUs. This commentary emphasizes the importance of clear eligibility criteria, robust vascular access support, regular physician engagement, and the strategic integration of telemedicine. It explores diverse funding models, including government allocations, community contributions, and philanthropic partnerships, as potential solutions to alleviate cost-related concerns. The commentary advocates for a holistic, cost-effective approach to chronic kidney disease care, highlighting the transformative potential of renal satellite units in improving health outcomes across varied settings.

Prevalence of nonalcoholic fatty liver disease in Pakistan: a systematic review and meta-analysis

Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver condition globally and the leading cause of liver-related death and morbidity. The goal of this study was to collect current data in order to calculate the pooled prevalence of NAFLD in Pakistan. We conducted a comprehensive literature search on four electronic databases until March 2024 to find studies on the prevalence of NAFLD in Pakistan. Pooled prevalence estimates of NAFLD were obtained using random-effects meta-analytic models. The chi-square test was used to account for study heterogeneity, whereas the I2 statistic was used to assess inconsistency. The data were stratified by the general population (average risk) and individuals with metabolic diseases (high risk). Two reviewers thoroughly and independently screened, reviewed, and assessed all studies. In total, 468 studies were reviewed, and 34 were included. The pooled NAFLD prevalence in the general population was 29.82% (95% CI 21.39–39.01%; prediction interval: 2.98–68.92%) based on 13 studies. In individuals with metabolic disorders, the prevalence of NAFLD in patients with diabetes, hypertension, and obesity, was 58.47% (95% CI 54.23–62.64%; prediction interval: 38.16–77.40%), 74.08% (95% CI 60.50–85.70%), and 47.43% (95% CI 30.49–64.66%), respectively. There was no evidence of publication bias, although a statistically significant level of heterogeneity was seen among the studies (I2 ranged from 57.5 to 98.69%). The findings of this study indicate a substantial prevalence of NAFLD in the population of Pakistan. The Pakistani government must formulate a comprehensive approach and plan aimed at augmenting awareness, control, prevention, and treatment of fatty liver disease.Prospero Registration no: CRD42022356607.

Retinopathy and their mechanism

Retinopathy is the emerging disease in Pakistan over the age of 30 in diabetic patients. In diabetic patients this disease causes blindness, visual loss, and hazy eyesight. Several suggested metabolic mechanisms that connect micro vascular problems to hyperglycemia. Activation of protein kinase C (PKC), oxidative stress, polyol buildup, and the production of advanced glycation end products (AGEs) are a few of these. The anti-VEGF drugs, laser, eye surgery is the treatment of Retinopathy. The patient HBA1C lab test below than 6.5% will be preferred for surgery. The Diabetic patient should control their blood glucose level to reduce the complexicity of the disease.

Surgery for congenital heart disease in Pakistan—the challenges and solutions

Surgery for congenital heart disease in Pakistan—the challenges and solutions

Stepping Stones In Prevention of Kidney Stone Disease In Pakistan

The prevalence and incidence of kidney stone disease (KSD) has increased in Pakistan since last 5 decades, it is not only the cause of pain, hematuria and fever but is also an important cause of chronic kidney disease, Morbidity and mortality as well if left untreated. It is recurrent disease and can be manifestation of systemic diseases, (D.M, obesity, HTN) genetic and environmental factors play a role in etiology of disease. In spite of modern methods of surgical removal available in Pakistan there is constant increase in number of patients. Economic burden of disease is quite significant, so established metaphylaxsis program is essential part of management of this surgical and medical disease. Main therapies based on history, stone analysis, 24 hour urine metabolic study constitutes the basis of prevention. Increasing fluid intake dietary modification, Pharmacotherapy is the main stay of metaphylaxsis. Compliance of the patient and establishment of specialized stone clinics should be managed jointly by urologist, nephrologist, dietitians, metabolic laboratory expert and Medical Social officers. Prevention is possible in many cases if these patients are managed jointly by multidisciplinary team.

The frequency and associated factors of typhoid carriage in patients undergoing cholecystectomy for gallbladder disease in Pakistan: A cross-sectional study.

Enteric fever is caused by Salmonella enterica serovars Typhi (S. Typhi) and Paratyphi A, B, and C. It continues to be a significant cause of morbidity and mortality worldwide. In highly endemic areas, children are disproportionately affected, and antimicrobial resistance reduces therapeutic options. It is estimated that 2-5% of enteric fever patients develop chronic asymptomatic infection. These carriers may act as reservoirs of infection; therefore, the prospective identification and treatment of carriers are critical for long-term disease control. We aimed to find the frequency of Salmonella Typhi carriers in patients undergoing cholecystectomy. We also compared the detection limit of culturing versus qPCR in detecting S. Typhi, performed a geospatial analysis of the carriers identified using this study, and evaluated the accuracy of anti-Vi and anti-YncE in identifying chronic typhoid carriage. We performed a cross-sectional study in two centers in Pakistan. Gallbladder specimens were subjected to quantitative PCR (qPCR) and serum samples were analyzed for IgG against YncE and Vi by ELISA. We also mapped the residential location of those with a positive qPCR result. Out of 988 participants, 3.4% had qPCR-positive gallbladder samples (23 S. Typhi and 11 S. Paratyphi). Gallstones were more likely to be qPCR positive than bile and gallbladder tissue. Anti-Vi and YncE were significantly correlated (r = 0.78 p<0.0001) and elevated among carriers as compared to qPCR negative controls, except for anti-Vi response in Paratyphi A. But the discriminatory values of these antigens in identifying carriers from qPCR negative controls were low. The high prevalence of typhoid carriers observed in this study suggests that further studies are required to gain information that will help in controlling future typhoid outbreaks in a superior manner than they are currently being managed.

Dominance of Cotton leaf curl Multan virus-Rajasthan strain associated with third epidemic of cotton leaf curl disease in Pakistan

Cotton (Gossypium hirsutum) is an economically potent crop in many countries including Pakistan, India, and China. For the last three decades, cotton production is under the constant stress of cotton leaf curl disease (CLCuD) caused by begomoviruses/satellites complex that is transmitted through the insect pest, whitefly (Bemisia tabaci). In 2018, we identified a highly recombinant strain; Cotton leaf curl Multan virus-Rajasthan (CLCuMuV-Raj), associated with the Cotton leaf curl Multan betasatellite-Vehari (CLCuMuBVeh). This strain is dominant in cotton-growing hub areas of central Punjab, Pakistan, causing the third epidemic of CLCuD. In the present study, we have explored the CLCuD diversity from central to southern districts of Punjab (Faisalabad, Lodhran, Bahawalpur, Rahimyar Khan) and the major cotton-growing region of Sindh (Tandojam), Pakistan for 2 years (2020–2021). Interestingly, we found same virus (CLCuMuV-Raj) and associated betasatellite (CLCuMuBVeh) strain that was previously reported with the third epidemic in the central Punjab region. Furthermore, we found minor mutations in two genes of CLCuMuV-Raj C4 and C1 in 2020 and 2021 respectively as compared to its isolates in 2018, which exhibited virus evolution. Surprisingly, we did not find these mutations in CLCuMuV-Raj isolates identified from Sindh province. The findings of the current study represent the stability of CLCuMuV-Raj and its spread toward the Sindh province where previously Cotton leaf curl Kokhran virus (CLCuKoV) and Cotton leaf curl Shahdadpur virus (CLCuShV) have been reported. The findings of the current study demand future research on CLCuD complex to explore the possible reasons for prevalence in the field and how the virus-host-vector compatible interaction can be broken to develop resistant cultivars.

Physicians' Perspective on Percutaneous Left Atrial Appendage Closure in Patients with Atrial Fibrillation and Chronic Kidney Disease in Pakistan.

This study, conducted in Pakistan, examines the perspectives of 1200 physicians across diverse specialties regarding Left Atrial Appendage Occlusion (LAAO) procedures for atrial fibrillation (AF) patients with chronic kidney disease (CKD). Using a random sampling approach, physicians participated in a survey that assessed their familiarity with LAAO, views on its effectiveness and safety, experience levels, and encountered challenges. The results unveil a spectrum of knowledge levels among physicians, reinforcing the need for tailored medical education and training programs. The majority of respondents were between 30 and 49 years old (59.8 %). A notable proportion, 33.3 %, had limited or no knowledge of LAAO, with 16.7 % having never heard of the procedure, and 16.7 % having limited knowledge but no experience. About 36.2 % of physicians believed LAAO was moderately to extremely effective in reducing stroke risk, with 23.3 % considering it very effective and 25.4 % believing it to be extremely effective. The most commonly cited clinical indications were a history of recurrent strokes despite anticoagulation (34.6 %) and a high CHA2DS2-VASc score (27.3 %). Renal considerations played a significant role, with 33.1 % considering LAAO for CKD stage 4 or 5 patients with elevated stroke risk. Patient preferences, such as a desire to avoid long-term anticoagulant use, were important for 28.7 % of physicians. Identified challenges encompass limited equipment access, training gaps, patient reluctance, and administrative complexities. Furthermore, the study underscores the pivotal role of shared decision-making in healthcare delivery. These findings lay essential groundwork for improving LAAO utilization and patient-centered care in Pakistan's healthcare system.

Tinea Corporis Medicational treatment with clinical examination in Pakistan

Fungal infection spread worldwide due to the pets, Humid areas, damp and excess sweating, it’s become more untreated disease in Pakistan by using excessive treatment, not consulting with doctors, self-medication these are the main reason. In this research we use medicational combinations to treat fungus on skin. Different lab tests were performed for the clinical diagnosis. The result shows that the lfts are the main focus in this disease. The elevation of ALT, AST, BIL, Alk. Phosphate, HCV, and HBV cause hepatic injury, terbinafine salt also raise lft’s in human blood. To minimize the terbinafin effect on liver, silymarin 200 mg tab used for this purpose. After the 1month medication the fungus disappear from skin

Food and Cardiovascular Disease: What to Eat and What Not to Eat

In 2019, the Global Burden of Disease study revealed alarming statistics regarding cardiovascular disease (CVD) in Pakistan. The estimated age-standardized incidence and death rates were 918.18 and 357.88 per 100,000 respectively, surpassing global averages.1 Notably, Pakistan faces unique challenges with a high prevalence of Rheumatic heart disease and early onset coronary artery disease.1&#x0D; The World Health Organization's 2021 factsheet underscores four pivotal modifiable behavioral risk factors for CVD and stroke: unhealthy diet, physical inactivity, tobacco use, and harmful alcohol consumption. These behaviors manifest in individuals as elevated blood pressure, glucose, lipids, and adverse body mass index, exacerbating cardiovascular risk.2 In Pakistan, the consumption of unhealthy foods and excessive calories significantly contributes to adverse cardiometabolic profiles, including obesity and dyslipidemia.2&#x0D; Recent research, such as that by Daruish Mozaffain et al. in "Food is Medicine," advocates for food-based interventions tailored to individual health conditions, ranging from medically tailored meals to nutritional and culinary education.3 However, Pakistani patients with CVD face challenges due to the lack of localized guidelines, educational resources, and accessible nutritionists. Shah et al.'s review underscores the importance of providing clear and culturally relevant dietary guidance for the local population.4&#x0D; Addressing these challenges requires the development of high-quality, culturally sensitive educational materials. These resources should be readily understandable, pictorial, and integrated into both inpatient and outpatient care. Local experts, including dietitians and researchers, can play a crucial role in creating tailored educational content. Figures 1 exemplify the efforts of these experts to provide practical guidance to the Pakistani population.4&#x0D; In conclusion, there is an urgent need for comprehensive, easy-to-understand patient education resources catering to the unique nutritional needs of Pakistani individuals with cardiovascular disease. By addressing these gaps, we can empower patients to make informed dietary choices and improve cardiovascular outcomes.&#x0D; References&#x0D; &#x0D; Samad Z, Hanif B. Cardiovascular Diseases in Pakistan: Imagining a Postpandemic, Postconflict Future. Circulation. 2023;147(17):1261-3.&#x0D; Liaquat A, Javed Q. Current trends of cardiovascular risk determinants in Pakistan. Cureus. 2018;10(10):e3409.&#x0D; Mozaffarian D, Aspry KE, Garfield K, Kris-Etherton P, Seligman H, Velarde GP, et al. “Food Is Medicine” Strategies for Nutrition Security and Cardiometabolic Health Equity: JACC State-of-the-Art Review. J Am Coll Cardiol. 2024;83(8):843-64.&#x0D; Shah SU, Waseem T, Afridi T, Shah MI. Nutritional Needs for Cardiovascular Health in Pakistani Population. Pak Heart J. 2022;55(2):101-13.&#x0D; American Heart Association. Lifestyle Changes for Heart Failure. Accessed on March 30, 2024. Available at: https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure/lifestyle-changes-for-heart-failure&#x0D; American Diabetes Association. What superstar foods are good for diabetes? Accessed on March 30, 2024. Available at: https://diabetes.org/food-nutrition/food-and-blood-sugar/diabetes-superstar-foods&#x0D; American Heart Association. The American Heart Association Diet and Lifestyle Recommendations. Accessed on March 30, 2024. Available at: https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/nutrition-basics/aha-diet-and-lifestyle-recommendations&#x0D; American Heart Association. Managing Blood Pressure with a Heart-Healthy Diet. Accessed on March 30, 2024. Available at: https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure/managing-blood-pressure-with-a-heart-healthy-diet&#x0D;

Analysis of human ABO Blood Group as a risk factor with knee osteoarthritis at tertiary care hospital in Pakistan.

To investigate the association and risk estimation of ABO blood group distribution and clinical attributes in patients with Knee Osteoarthritis. This was a hospital-based study conducted at, Liaquat University Hospital Hyderabad from December, 2019 to December, 2022 to investigate this least researched area of highly prevalent musculoskeletal disease in Pakistan. Non-Probability Convenience Sampling was used for selecting 190 cases of confirm Knee Osteoarthritis patients diagnosed by Orthopedic surgeon based on standard clinical and radiographic criteria. Data were analyzed using IBM-SPSS version 23.0. Percentages and frequencies were counted for categorical data. Pearson Chi Square test and fisher's exact test were used to check the association and Multinomial Logistic Regression was used to estimate the risk for moderate and severe kellgren grading Knee Osteoarthritis (KOA) cases with ABO blood grouping in comparison of mild Kellgren grading. A total of 190 cases of Knee Osteoarthritis (KOA) were included in the study. Females (61.6%) and patients with age 50 and above were 40.5 % were found in greater proportion. Majority (41.6%) were classified radiologically as mild cases with O group (39.5%) and positive Rh antigen (95.8%). Strong association (p = <0.01) was found between gender, age group and ABO blood group with KOA radiological Kellgren and Lawrence score. There is strong relation in between radiological grading of knee osteoarthritis severity and A blood group, gender and age.

Prevalence of Parkinson’s disease in Pakistan – A Systematic Review

Numerous epidemiological investigations pertaining to Parkinson's disease (PD) have been carried out on a global scale during the course of time. While each research documented an increase in the frequency and incidence rate of PD as individuals age, there were variations in the overall estimations seen across various nations. Objective: The purpose of this study is to provide a thorough analysis of PD incidence and prevalence rates in Pakistan. Methods: Google Scholar, Medline, and Embase were used to look for studies which reported the incidence of PD around the world. The searches were limited to English-language studies about people that happened between 1965 to 2023. Results: A total of 7 studies were conducted on Parkinson’s disease in Pakistan. Muhammad Tufail et al. in a cross-sectional study observed a heightened prevalence of Parkinson's disease, with 600 patients identified in Khyber Pakhtunkhwa (KPK). In a cross-sectional study conducted in Lahore, 85 cases of PD were identified within a hospital setting. Fifty cases in a cross-sectional study were conducted at a Hospital in Rawalpindi. Saira et al. performed an observational study at Islamabad Hospital and found the prevalence of We estimated the overall frequency of PD in Pakistan was 1016 cases in this systematic review. Males were more diagnosed with PD as compared to females. Conclusions: The data from the studies reviewed here indicate that PD increased in Pakistan during the last decade. While males were dominant in this study which is not different from across the globe.

Exploring the Effectiveness of Transpedicular Fixation for Managing Thoracic and Lumbar Tuberculous Spine Disease

Background: Tuberculous spine disease, particularly in the thoracic and lumbar regions, poses a significant health challenge in Pakistan, necessitating effective surgical interventions. Transpedicular fixation has emerged as a promising treatment option, yet there is a paucity of comprehensive studies evaluating its efficacy within this demographic. Objective: The study aimed to systematically assess the effectiveness of transpedicular fixation for treating thoracic and lumbar tuberculous spine disease in Pakistan by analyzing preoperative conditions, surgical details, and postoperative outcomes. Methods: This retrospective cohort study involved 78 patients from the Neurosurgical Ward of Khyber Teaching Hospital, Peshawar, who underwent transpedicular fixation from January 2021 to December 2022. Demographics, preoperative clinical data, radiological findings, intraoperative details, and postoperative outcomes were collected. Statistical analysis was conducted using SPSS version 26, employing Chi-square and t-tests to evaluate outcome significance. Results: The patient cohort comprised 53.85% males, with a mean age of 36.3 years. The lumbar region was the most affected (45%), followed by the thoracic (38%) and thoracolumbar (17%). Postoperative outcomes indicated an improvement in radiological stability from 48.72% preoperatively to 73.08% postoperatively (p=0.001), a non-significant increase in complications (12.82% to 19.23%, p=0.231), and a slight rise in patient satisfaction (84.62% to 88.46%, p=0.453). Conclusion: Transpedicular fixation is effective in improving radiological stability and maintaining high patient satisfaction in the treatment of thoracic and lumbar tuberculous spine disease in Pakistan. The procedure's safety profile is acceptable, though the slight increase in postoperative complications warrants attention.

Emerging Threat: First Case of West Nile Virus Encephalitis in Peshawar, Pakistan

West Nile Virus (WNV), once confined primarily to Africa, is now an emerging communicable disease in Pakistan. Clinical cases and serological evidence of WNV infection have been documented in both human and animal populations in the Punjab and Sindh provinces of Pakistan. We report the first case of WNV encephalitis in an 80-year-old hypertensive and diabetic lady from district Peshawar. Sadly, the patient did not survive. This case highlights the importance of thinking of zebras in addition to horses when confronted with the sound of hoofbeats, as ‘zebra diagnoses’ do exist. Clinicians shall consider novel infections when evaluating patients with fever and altered mental status.

Incidence and Molecular Characterization of Citrus Bacterial Canker Disease in Pakistan

The prevalence of Citrus Bacterial Canker (CBC) in the Indo-Pak subcontinent, particularly in Pakistan, poses a significant economic threat due to its quarantine implications. This research aimed to assess the current status of CBC in major citrus-growing regions of Punjab and KPK, shedding light on the incidence and severity of the disease. In Punjab, varying degrees of CBC incidence (20-81 %) were observed across different districts, with Sargodha, Toba Tek Singh, Faisalabad, Chiniot, and Mianwali showing higher rates. Conversely, Sialkot and Sahiwal were found to be free from the disease. The severity of CBC was most pronounced in Mianwali (26.2 %), highlighting the region's vulnerability. Similarly, in KPK, varying incidence rates (3-7 %) were recorded, with Haripur, Nowshera, Lower Dir, and Swat reporting minimal or no occurrences. A total number of ninety-six were confirmed as Xanthomonas citri pv. citri through PCR and pathogenicity tests. Despite these findings, further research is imperative to unravel the pathogenic diversity of X. citri in Pakistan, paving the way for more targeted and effective management strategies. This research underscores the importance of ongoing monitoring and in-depth investigations to mitigate the economic impact of CBC on the citrus industry in Pakistan. Identifying and understanding the pathogenic variations within X. citri will be crucial for devising sustainable and region-specific control measures.

Translation and validation of the Addiction Recovery Questionnaire (ARQ)

Substance abuse is a pandemic disease in Pakistan. The use of stimulants such as methamphetamine and ecstasy is common among adolescents, and it is increasing day by day. Our educational institutes are also facing this problem. So, in the present study, the Addiction Recovery Questionnaire (ARQ) was translated and validated in Pakistani culture to address the language barrier. The present study aimed to translate and validate the addiction recovery questionnaire on a sample of 140 substance users. Five independent translators who were experts in translation were selected to translate the ARQ in Urdu, which was finalized by the committee of 3 experts. Similarly, 3 English translators were contacted to translate the Urdu version back into English and shared with the Authors for their feedback. The author's recommendations were also incorporated. The alpha reliability of the ARQ was reported as α = 0.60, which shows the reliability of the measure. CFA was applied for the translated version for model fit, and to confirm the factor loading, the value of Chi-Square 63.20 with RMSEA of 0.04 indicates an adequate fit of the model. The reliability of the measure was first time established in the present study, and the CFA was also done to determine the construct-based factors of recovery. Hence, the ARQ is a reliable and brief recovery outcome that can give information about different dimensions of recovery, such as abstinence, normal living, and positive life expectancy.

Systematic review of end stage renal disease in Pakistan: Identifying implementation research outcomes.

The aim of this study was to conduct a systematic review analysis to identify and evaluate the available literature on implementation science outcomes research in relation to End Stage Renal Disease (ESRD) in Pakistan. A systematic database search of PubMed, Web of Science, EMBASE, Cochrane Library, CINAHL, and Ovid was conducted through October 22nd, 2022, without any restrictions on publication dates. A screening and data extraction tool, Covidence, was used to evaluate the literature against our inclusion and exclusion criteria. Furthermore, a Mixed Methods Appraisal Tool (MMAT) was used to evaluate the selected studies. We identified four studies that presented findings of implementation outcomes research which were related to appropriateness, feasibility, and acceptability. Appropriateness was examined using knowledge scores (p = 0.022) and medication adherence scores (p < 0.05) that showed statistical significance between the control and intervention groups. Acceptability was assessed through a cross sectional quantitative descriptive study that evaluated the reasons for refusal and acceptance of treatment in a cohort of patients suffering from ESRD. Feasibility was examined in one cross sectional, and one mixed methods study that aimed to evaluate and understand the impact of initiating dialysis treatment and the feasibility of maintaining it in low-income families that care for children or adults with ESRD. The preliminary results of this review indicate a gap in the availability of implementation research studies about ESRD in Pakistan. The burden of ESRD, and the implementation methods by which it is treated is notable in Pakistan and requires evidence-based measures to be implemented to support the critical healthcare delivery platforms that provide treatment.

Etiology and management of citrus Melanose disease in Pakistan: A review

Diaporthe species are important pathogens of many hosts, including economically important crops. They cause severe melanose disease, stem-end rot of fruits, and gummosis of perennial plants worldwide. Among the Diaporthe species, Diaporthe citri is responsible for causing melanose disease. Melanose disease harms fruit, leaves, twigs, branches, and in certain cases, the main stem of trees of any age. The melanose infection can affect practically all citrus cultivars. Citrus melanose disease is a persistent and incurable disease leading to a massive loss of output in the citrus industry. Due to the lack of resistant cultivars, the failure of chemical treatments, and the dangers to environmental health, large-scale research is being conducted to develop a long-term remedy. Recently, biological control agents (BCAs) have been used as an alternative to fungicides to manage citrus melanose disease. In this review, we highlighted some significant aspects of melanose disease (Diaporthe citri) in citrus, such as its history, morphology, disease cycle, pathogenicity symptoms, and impact on the economy of the citrus industry. The current literature assists the researchers in averting melanose disease in citrus, developing genetically resistant cultivars, and ecofriendly management against Diaporthe citri. Keywords: Diaporthe citri, Melanose, Symptoms, Transmission, Disease cycle, Control management

Dengue virus: Epidemiology, clinical aspects, diagnosis, prevention and management of disease in Pakistan: Review

Abstract Worldwide, the dengue virus (DENV) is a common cause of infections. The disease can range from a minor flu-like illness to a serious complex ailment that kills the sufferer. Both the morbidity and fatality rates associated with dengue fever (DF) are high in Pakistan and other Asian nations. Through a mosquito bite, the DENV is spread. DENV was isolated to specific regions of the tropics and subtropics until the middle of the 20th century. Global distribution of DF is influenced by a number of variables, including changing climate, rising international travel and urban population, poor vector management techniques, lack of safe and effective antiviral medications and a lack of vaccines to prevent the disease. In over 100 nations, DF poses a major threat to the lives of over 2.5 billion people. Today, DF is endemic to the Caribbean, South America, Africa and Asia. In actuality, 40% of the world’s population currently resides in nations where there is a significant risk of DF transmission. It has grown to be a significant health issue in Pakistan and is predicted to get worse over the next few years. In Pakistan, dengue cases increase in the rainfall season, especially during monsoon season. In Pakistan, the mosquito species Aedes aegypti is the main carrier of this disease. This review article summarizes the epidemiology, clinical aspects of DF and DHF, diagnosis, prevention and management of disease in Pakistan.