Khyber Pakhtunkhwa Region Research Articles

Challenges Linked to Post-Polio-Paralysis in Khyber Pakhtunkhwa Region

Background: Poliomyelitis is a highly infectious viral disease often causing permanent paralysis. Post-Polio Paralysis (PPP) involves the delayed onset of new or worsening neuromuscular symptoms years after the initial attack. Polio survivors face numerous physical disabilities and significant social, financial, and human rights barriers. Aims: To identify the challenges faced by individuals with PPP in the Khyber Pakhtunkhwa region. Methods: The study employed a cross-sectional survey design with a sample size of n=200, selected through non-probability convenience sampling. Data were collected using the Post-Polio Clinic Questionnaire and analyzed with SPSS 22. Results: The gender distribution was 21.50% female and 78.50% male. New health and physical problems (neurological, arthritis, and physiological) were observed in 64.5% (n=129) of participants. Aggravated previous complications, such as pain, fatigue, and muscular atrophy, were reported by 91.5% (n=183). Difficulty performing heavy tasks was noted by 49.5% (n=99). Using public transport was a challenge for 46.5% (n=93), and driving a car was deemed impossible by 70% (n=140). Using an Indian commode as a toilet was a complication for 58% (n=116) of participants. Conclusion: The study reveals significant health and daily life challenges for polio survivors in Khyber Pakhtunkhwa, including a high prevalence of new and worsening neuromuscular symptoms, aggravated complications like pain and fatigue, and difficulties with heavy tasks, public transport, driving, and using certain toilets. These findings underscore the urgent need for targeted interventions to improve the quality of life for polio survivors by addressing their physical health and social and financial barriers.

Xanthium strumarium L., an invasive species in the subtropics: prediction of potential distribution areas and climate adaptability in Pakistan

Invasive species such as Xanthium strumarium L., can disrupt ecosystems, reduce crop yields, and degrade pastures, leading to economic losses and jeopardizing food security and biodiversity. To address the challenges posed by invasive species such as X. strumarium, this study uses species distribution modeling (SDM) to map its potential distribution in Pakistan and assess how it might respond to climate change. This addresses the urgent need for proactive conservation and management strategies amidst escalating ecological threats. SDM forecasts a species’ potential dispersion across various geographies in both space and time by correlating known species occurrences to environmental variables. SDMs have the potential to help address the challenges posed by invasive species by predicting the future habitat suitability of species distributions and identifying the environmental factors influencing these distributions. Our study shows that seasonal temperature dependence, mean temperature of wettest quarter and total nitrogen content of soil are important climatic factors influencing habitat suitability of X. strumarium. The potential habitat of this invasive species is likely to expand beyond the areas it currently colonizes, with a notable presence in the Punjab and Khyber Pakhtunkhwa regions. These areas are particularly vulnerable due to threats to agriculture and biodiversity. Under current conditions, an estimated 21% of Pakistan’s land area is infested by X. strumarium, mainly in upper Punjab, central Punjab and Khyber Pakhtunkhwa. The range is expected to expand in most regions except Sindh. The central and northeastern parts of the country are proving to be particularly suitable habitats for X. strumarium. Effective strategies are crucial to contain the spread of X. strumarium. The MaxEnt modeling approach generates invasion risk maps by identifying potential risk zones based on a species’ climate adaptability. These maps can aid in early detection, allowing authorities to prioritize surveillance and management strategies for controlling the spread of invasive species in suitable habitats. However, further research is recommended to understand the adaptability of species to unexplored environments.

“We are in a very precarious position”: Exploring the resilience of Khawaja Sara and Hijra communities during the COVID-19 pandemic in Pakistan

This paper draws upon empirical data in order to offer insights to the impact of the COVID-19 pandemic on the lives of Khawaja Sara and Hijra communities in Peshawar City, in the Khyber Pakhtunkhwa region of Pakistan. The paper also considers the resilience that the community developed during this time. Drawing on Butler’s concept of precarity and liveability, we in this article demonstrate how the precarious positionalities of Khawaja Sara and Hijra were exacerbated during the COVID-19 pandemic and thereafter in Pakistan. 10 members of Khawaja Sara and Hijra communities were engaged in face-to-face interviews, and the paper demonstrates how community is made and maintained by Khawaja Sara and Hijra, who are amongst the most vulnerable, marginalized, oppressed, and isolated people in South Asian communities. Whilst not shying away from the violence that characterises the lives of participants, who face familial rejection, community, and social pressure to conform to strict cultural gender norms, and sexual and physical violence, the paper also works to highlight the ongoing adaptability and resilience of these ancient communities through engaging with the ways in which participants supported each other through the pandemic.

Acquisition Management in the University Libraries of Pakistan: A Provincial Perspective

Acquisition management is the kind of strategy that university libraries adopt to assist the information needs of the client population. This study attempted to understand the acquisition management in the university libraries in the Khyber Pakhtunkhwa region of Pakistan. The study adopted a survey method and included all those well-established public and private sector universities that were chartered by the Government of Khyber Pakhtunkhwa and recognized by HEC until December 31, 2012, in the province (Public = 17 and Private = 9; Total = 26 universities). The population of this study was the senior library professionals working in the central libraries of the main campuses of all the universities in the province. The study’s findings show that the acquisition management in the university libraries in Khyber Pakhtunkhwa is more focused on fulfilling the curriculum requirements of the parent institutions to which they are attached.

Association of Human Leukocyte Antigen (HLA) Class II Alleles of DQB1 (DQB1*03:02) (DQB1*06:02) and DRB1 (DRB1*04:01) with Type-1 Diabetes Patients of Khyber Pakhtunkhwa, Pakistan

Type-1 diabetes (T1D), an autoimmune disease, significantly impacts global health, with varying prevalence across different geographies. This study investigates the association of specific Human Leukocyte Antigen (HLA) Class II alleles, namely DQB1*03:02, DQB1*06:02, and DRB1*04:01, with T1D in the Khyber Pakhtunkhwa (KP) population of Pakistan. Conducted as a 1:1 matched case-control study, this research involved 33 T1D patients and an equal number of age- and gender-matched healthy controls. Our findings reveal a weak association of alleles DRB1*04:01 and DQB1*03:02 with T1D (OR = 2.065 and 1.393, respectively, p > 0.05). DQB1*06:02 allele, which is considered to have a protective effect against T1D was more prevalent in control as compared to cases (93.9% vs 90.9%), however, the association was non-significant (OR 0.645, p > 0.05). These insights contribute to understanding genetic influences on T1D in the KP region and underscore the need for further research with larger, diverse cohorts to refine the genetic markers of T1D risk and protection

Assessing tobacco-related ischemic stroke in Pakistan (1990-2019): Insights from the Global Burden of Disease Study.

This study analyzes the impact of active smoking and secondhand smoke on the ischemic stroke burden of Pakistan, 1990-2019. We used data from the Global Burden of Disease (GBD) database to conduct a comprehensive evaluation of ischemic stroke-related indicators in Pakistan, including the number of deaths, mortality rates, disability-adjusted life years (DALYs), DALY rates, and the estimated annual percentage change (EAPC). Joinpoint analysis was applied to assess sex-specific temporal trends in the burden of active smoking and secondhand smoke in Pakistan and regions of Pakistan. These assessments incorporated the Socio-Demographic Index (SDI) and we have made comparative analyses of epidemiological differences between active smoking and secondhand smoke exposure. The burden of ischemic stroke related to tobacco use is presented in terms of the age-standardized mortality rate (ASMR) and the age-standardized disability-adjusted life year rate (ASDR) per 100000 population. The results (ASMR/ASDR) for Pakistan were 6.04/130.81, in the middle SDI region 7.69/176.54, and low-middle SDI region 5.64/124.22. Pakistan's ASMR is higher than the global average of 5.85, while ASDR is lower than the global average of 140.23. From 1990 to 2019, a downward trend in both ASMR and ASDR was observed, indicating progress in controlling tobacco-related stroke burdens. Individuals aged ≥70 years experienced the highest rates of stroke (ASMR: 66.31; ASDR: 1091.20). Gender disparities were evident: men were more affected by active smoking (ASMR: 3.08; ASDR: 78.47) than women (ASMR: 0.79; ASDR: 20.76), while women faced a higher burden from secondhand smoke (ASMR: 0.66; ASDR: 16.33) compared to men (ASMR: 0.79; ASDR: 9.93). Regional differences within Pakistan show fluctuating death and DALY rates. Notably, an increasing trend in female ASDR due to secondhand smoke in the Khyber Pakhtunkhwa Region (annual percentage change, APC=0.17 from 2010 to 2019) calls for focused health interventions. The study finds ASMR for tobacco-related ischemic stroke in Pakistan exceeds global averages, with significant gender and age disparities in exposure to smoke, highlighting the need for targeted health interventions.

Distribution pattern of UGT1A6 and UGT2B7 gene polymorphism and its impact on the pharmacokinetics of valproic acid and carbamazepine: Prospective genetic association study conducted in Pakistani patients with epilepsy

BackgroundEthnic variation is one of the important factors in clinical practice that may affect the pharmacokinetics of drugs. The present study aims to determine the distribution pattern of UGT1A6 and UGT2B7 gene polymorphism and its possible impact on the metabolism of valproic acid (VPA) and carbamazepine (CBZ) in patients with epilepsy from Khyber Pakhtunkhwa region of Pakistan. Methods: After the enrollment of targeted patients, blood was collected for genotype analysis through Sanger sequencing. Plasma concentrations of VPA and CBZ were determined by reversed-phase high-performance liquid chromatography (HPLC) at the follow-up visit of third month from the initiation of therapy. The drug plasma levels were correlated with different genotypes of UGT1A6 and UGT2B7 to determine the impact of genetic polymorphism on the drug metabolism. Results: Of the total 178 epileptic patients, 120 subjects were prescribed VPA monotherapy while 58 subjects were given CBZ monotherapy. The mean age of the subjects was recorded as 26.1 ± 13.5 years with a predominance of the male gender. Generalized tonic-clonic (GTC) was the most prevalent type of seizure (82%) followed by partial seizure. Genotype analysis revealed that the frequency of homozygous and heterozygous variants of the targeted UGT genes were exceptionally high in the Khyber Pakhtunkhwa population compared to the ethnic groups of other countries. In UGT1A6-A552C and UGT1A6-A541G, AC and AG were the most prevalent genotypes with respective frequencies of 43.2% and 41.1% whereas, in UGT2B7-T161C and UGT2B7-G211T, TC and GG were the most prevalent genotypes with respective frequencies of 42.7% and 99.4%. In the VPA-treated group, the homozygous and heterozygous variants of UGT1A6-A552C and UGT1A6-A541G were significantly associated with lower drug plasma concentrations (p < 0.05). However, none of the genotypes of UGT2B7-T161C revealed any significant association with VPA plasma concentration (p greater than 0.05). In the CBZ-treated group, UGT gene polymorphisms were not recognized to cause alteration in the drug plasma concentrations (p greater than 0.05). Conclusion: The genetic polymorphisms of UGT1A6, but not UGT2B7 significantly affected the plasma levels of valproic acid. The chosen SNPs did not reveal a role in determining the plasma levels of carbamazepine.

Frequency of Iron Deficiency Anemia Among Children a Multi-Center Study

Background: Anaemia, marked by abnormally low levels of haemoglobin and often caused by an absence of iron, remains a severe public health problem in Pakistan. Studies have yet to be done on the prevalence of iron deficiency anaemia in children, making it essential to research the Khyber Pakhtunkhwa region to understand better how widespread this ailment is amongst the region's pediatric populations. Objective: Determine the prevalence of iron deficiency anaemia in anaemic newborns between 6 and 66 months. Materials and Methods: This multi-center study was conducted between February 2022 and February 2023 at the Hayatabad Medical Complex pediatric department in Peshawar. The 180 enrolled children's basic demographic information, including age, gender, and weight, were collected. Operational guidelines for automated analysis of iron deficiency anaemia collected venous whole blood samples.

Assessment of cypermethrin and amitraz resistance and molecular profiling of voltage-gated sodium channel and octopamine tyramine genes of Rhipicephalus microplus.

Control of ticks and tick-borne pathogens is a priority for human and animal health. Livestock-holders extensively rely on acaricide applications for tick control. Different groups of acaricides including cypermethrin and amitraz have been consistently used in Pakistan. There has been a gap in understanding the susceptibility or resistance of Rhipicephalus microplus, the most prevalent tick in Pakistan, to acaricides. The present study aimed to molecularly characterize cypermethrin and amitraz targeted genes such as voltage-gated sodium channel (VGSC) and octopamine tyramine (OCT/Tyr) of R. microplus ticks in Khyber Pakhtunkhwa (KP), Pakistan to monitor the acaricides resistance. Tick specimens were collected from cattle and buffaloes in northern (Chitral, Shangla, Swat, Dir, and Buner), central (Peshawar, Mardan, Charsadda, Swabi, and Nowshera), and southern districts (Kohat, Karak, Lakki Marwat, Tank, and Dera Ismail Khan) of KP, Pakistan. Different concentrations of commercially available cypermethrin (10%) and amitraz (12.5%) were prepared for in vitro larval immersion tests (LIT). In LIT, the average mortality rate of immersed larvae was recorded that was increased gradually with an increase in the concentration of specific acaricide. The larvae's highest mortality rates (94.5% and 79.5%) were observed at 100-ppm of cypermethrin and amitraz, respectively. A subset of 82 R. microplus ticks was subjected to extract genomic DNA, followed by PCR to amplify partial fragments of VGSC (domain-II) and OCT/Tyr genes. The BLAST results of the consensus sequence of VGSC gene (domain-II) showed 100% identity with the acaricides susceptible tick sequence from the United States (reference sequence). Obtained identical sequences of OCT/Tyr genes showed maximum identity (94-100%) with the identical sequences reported from Australia (reference sequence), India, Brazil, Philippines, USA, South Africa, and China. Thirteen single nucleotide polymorphisms (10 synonymous and three non-synonymous) were observed at various positions of partial OCT/Tyr gene fragments. The SNP at position A-22-C (T-8-P) in OCT/Tyr gene has been linked to amitraz resistance in R. microplus ticks. Molecular analysis and LIT bioassay's findings indicate the availability of resistant R. microplus ticks in the KP region. To our understanding, this is the first preliminary study to monitor cypermethrin and amitraz resistance via molecular profiling of cypermethrin and amitraz targeted genes (VGSC and OCT/Tyr) in combination with in vitro bioassays (LIT) in R. microplus ticks from Pakistan.

Statistical analysis of the university sustainability in the higher education institution a case study from the Khyber Pakhtunkhwa province in Pakistan

Educational institutions can incorporate the idea of sustainability at the grass root level for any society. This study is part of an effort to get insight into the campus sustainability in one of the Higher Education Institution (HEI) in the Khyber Pakhtunkhwa region of Pakistan. Aim is to investigation university students' and faculty members insight regarding sustainability. Thus, questionnaire-based survey followed by statistical inference was conducted for the potential outcomes. The questionnaire is comprised of 24 questions, 05 of which are on demographics and the remaining 19 are about sustainability. The sustainability related questions focused mostly on the respondents' knowledge, understanding, and interest in sustainability. A handful of the other questions in the questionnaire were tailored to the university input to achieve sustainability. The dataset is manipulated with basic statistical and computational approaches, and the results are analyzed using mean values. The mean values are further classified into flag values of 0 and 1. Flag value 1 indicates a good marker of the received response, while flag value 0 indicates the least amount of information included in responses. The results show that respondents' knowledge, awareness, interest, and engagement in sustainability are significantly sufficient, as we obtained a flag value of 1 for all questions about sustainability. The study's findings, on the other hand, indicated that the institution is lagging in terms of supporting, disseminating, and implementing campus-wide sustainability-related activities. This study is one of the first initiatives to provide a baseline dataset and substantial information to go a step further in achieving the bottom-line target of being and acting sustainable in the HEI.

Understanding Women's Political Motivations in KP: Unveiling the Driving Forces

This study examines the reasons why women get involved in politics, concentrating on the National Assembly and provincial assembly members of Pakistan's Khyber Pakhtunkhwa region. The relevance of family connections, which facilitate women's entry into politics, is revealed via thematic analysis of interview data. Important motivators include persistence, character traits, inspirational leaders, alluring party platforms, and a need for accountability. Women can participate in politics if they are financially independent and have free time. The study expands on earlier research by illuminating the intricate interplay of institutional, cultural, and individual factors influencing women's political involvement. It places a focus on the necessity of addressing gender-related barriers and encouraging educational reforms to provide women with more leadership abilities. For societal change and democratic governance, political decision-making needs to be more gender diverse. The results provide useful information for political parties and authorities looking to create a welcoming environment for women in politics.

Financial Literacy and Credit Accessibility of Rice Farmers in Pakistan: Analysis for Central Punjab and Khyber Pakhtunkhwa Regions

This study investigates the factors that affect farmers’ access to Food Security and Agricultural Credit (FSAC) services for the farmers of Pakistan who have no access to banking but have a feasible farm business. Using multiple regressions and logistic analysis, the authors revealed the determinants of farmers’ financial literacy and analyzed the variables which affected the farmers’ accessibility to FSAC. Results indicated that the average financial literacy of respondents was at a moderate level. It was affected by the age of respondents, length of their education, distance to nearby cities, ownership of bank accounts, annual income, and financial education experience. The FSAC accessibility was also impacted by the area of cultivated land, interest rate, collateral, farms’ income, financial literacy index, credit accessibility experiences, the legal status of farmer groups, and the amount of a loan. Some of the issues that prevent farmers from having widespread access to the FSAC include the lack of loan need, lack of FSAC awareness, lack of collateral, loan usury perspective, loan rejection experience, fear of borrowing from the bank, and inactive farmer groups. The study contributes to the existing literature on the determinants of farmers’ access and choice of credit sources by using a primary data set.

Population genetic analyses inferred a limited genetic diversity across the pvama-1 DI domain among Plasmodium vivax isolates from Khyber Pakhtunkhwa regions of Pakistan

BackgroundPlasmodium vivax apical membrane antigen-1 (pvama-1) is an important vaccine candidate against Malaria. The genetic composition assessment of pvama-1 from wide-range geography is vital to plan the antigen based vaccine designing against Malaria.MethodsThe blood samples were collected from 84 P. vivax positive malaria patients from different districts of Khyber Pakhtunkhwa (KP) province of Pakistan. The highly polymorphic and immunogenic domain-I (DI) region of pvama-1 was PCR amplified and DNA sequenced. The QC based sequences raw data filtration was done using DNASTAR package. The downstream population genetic analyses were performed using MEGA4, DnaSP, Arlequin v3.5 and Network.5 resources.ResultsThe analyses unveiled total 57 haplotypes of pvama-1 (DI) in KP samples with majorly prevalent H-14 and H-5 haplotypes. Pairwise comparative population genetics analyses identified limited to moderate genetic distinctions among the samples collected from different districts of KP, Pakistan. In context of worldwide available data, the KP samples depicted major genetic differentiation against the Korean samples with Fst = 0.40915 (P-value = 0.0001), while least distinction was observed against Indian and Iranian samples. The statistically significant negative values of Fu and Li’s D* and F* tests indicate the evidence of population expansion and directional positive selection signature. The slow LD decay across the nucleotide distance in KP isolates indicates low nucleotide diversity. In context of reference pvama-1 sequence, the KP samples were identified to have 09 novel non-synonymous single nucleotide polymorphisms (nsSNPs), including several trimorphic and tetramorphic substitutions. Few of these nsSNPs are mapped within the B-cell predicted epitopic motifs of the pvama-1, and possibly modulate the immune response mechanism.ConclusionLow genetic differentiation was observed across the pvama-1 DI among the P. vivax isolates acquired from widespread regions of KP province of Pakistan. The information may implicate in future vaccine designing strategies based on antigenic features of pvama-1.

Narrating the ‘social’: the evolving stories of Pakistan’s social entrepreneurs

ABSTRACT Social enterprises are often characterized by the vision and drive of an individual founder. We challenge this by taking inspiration from Alistair R. Anderson’s arguments that social entrepreneurship is better understood as enacted within a social context. We move beyond linear conceptualizations to consider a more nuanced, contextually informed picture, where understandings of what it is to be ‘social’ in one’s entrepreneuring are created at the interaction of the individual and their situation. A narrative approach is used to analyse 25 life stories used by social entrepreneurs in the Khyber-Pakhtunkhwa region of Pakistan, an area of social transition. We access how these entrepreneurs give meaning to the ‘social’ aspects of what they do. Our findings present a multifaceted character, defined by their responses to changing social contexts. This is manifest in entrepreneurial practice, where we have a vacillation between acts of social rebellion and an enterprising organization of benevolence, evolving in a social context which changes with and, in part, because of our social entrepreneurs. We move beyond definitional characteristics and closer to a theory of practice, by considering how social entrepreneurs interact with changing social demands and adapt their activities accordingly.

Fragile X premutation carrier screening in Pakistani preconception women in primary care consultation

PurposeWomen of reproductive age who carry fragile X premutation (PM) alleles have 56 to 200 CGG repeats in the 5′-untranslated region of FMR1 gene are at increased risk for producing children with intellectual disabilities (ID) or autism spectrum disorders (ASD) due to expansion of PM alleles to full mutation alleles (> 200 repeats) during maternal transmission.MethodsIn present study fragile X PM carrier screening was performed in total 808 women who were consulting primary health care centers for preconception care in Khyber Pakhtunkhwa region of Pakistan between April, 2018 and December, 2020. Polymerase chain reaction (PCR) was performed for detection of PM carrier women and the CGG repeats number was confirmed by Southern blotting and capillary electrophoresis.ResultsThe prevalence rate for PM carriers among preconception women was found to be 0.7% that was contributed by 0.5% women in risk group (RG1) with family history of ID and 0.2% in risk group 2 (RG2) with family history of ASD. PM carrier women had at least one affected child or sibling. In addition, the preconception women with FMR1 PM alleles were found to be at increased risk for primary ovary insufficiency (RG1: P = 0.0265, RG2: P = 0.0389), postpartum depression (RG1: P = 0.0240, RG2: P = 0.0501) and neuropsychiatric disorders (RG1: P = 0.0389, RG2: P = 0.0432).ConclusionsCurrent study provides first evidence of fragile X PM carrier screening in Pakistani preconception women in primary care consultation. Findings of current study may help to improve preconception care and to reduce burden of fragile X associated disorders in our population.

Health Risk Assessment and Multivariate Statistical Analysis of Heavy Metals in Vegetables of Khyber Pakhtunkhwa Region, Pakistan.

The level of heavy metals in vegetables grown in soil irrigated with various sources of water and the health risks associated with the consumption of these vegetables were assessed in this study. Samples of water, soil, and vegetables were collected from farmer fields. After digestion in acidic solution, analytical measurements were made using an atomic absorption spectrophotometer. The mean concentration of Pb, Cr, Cd, Cu, Zn, Ni, Fe, and Mn in the soil of two sampling area were in the range from 60.00 to 84.00mgkg-1, 68.00 to 98.00mgkg-1, 1.60 to 2.60mgkg-1, 26.10 to 33.20mgkg-1, 22.60 to 30.80mgkg-1, 50.10 to 78.30mgkg-1, 420.00 to 471.00mgkg-1, and 270.20 to 340.50mgkg-1, respectively. Heavy metals in soil varied significantly at (P ≤ 0.001) among sampling area. The nine heavy metals were divided into two clusters for wastewater and soil, according to cluster analysis. The number of variables was reduced using principal component analysis, which yielded three latent factors, one for wastewater and one for soil. Pb, Cr, Cd, Cu, Zn, Ni, Fe, and Mn concentrations were significantly higher at P ≤ 0.001 in nine vegetables grown on soil irrigated with untreated wastewater than in vegetables grown on fresh-tube well-water-irrigated soil. The health risks associated with metal intake were assessed using the estimated daily intake of metals (EDIM), hazard quotients (HQs), and hazard index (HI). The rates of metal transfer to vegetables have been determined. Except for Pb and Cd, all of the elements' EDMI values were found to be lower than their RfD values. The corresponding HRI values of metals in the various vegetables were found to be below 1, implying that vegetable consumption in the studied region poses no carcinogenic risk. Constant determination of heavy metals in all fruits and vegetables is essential for the assessment of health risks associated with dietary metal exposure. The study has provided valuable information to the general public about the use of wastewater for irrigation of vegetables.

Risk of mortality due to COVID-19 and air pollution in Pakistan.

The present research aims to investigate the impact of air pollution on the number of mortalities caused by COVID-19 per Pakistani province. To do so, for each independent area of Pakistan, the observed mortality due to COVID-19 has been standardized over the entire population using standard age groups ranging from 0 to 4, 5 to 9, 10 to 14,…, 65, and above years, supported by the 2017 state people census. The impact of air pollution and COVID-19 transience among Pakistani areas, Islamabad Capital Territory (ICT), and the Federally Administered Tribal Region (FATA) was analyzed by a multiple-linear regression model, while the broad collection of attributes was observed by the resources of local spatial autocorrelation indicators, including the spatial portion of COVID-19 association. The result indicates that the observed mortality rate is much higher than predicted in certain provinces, namely, the Khyber Pakhtunkhwa and Punjab provinces, and the prevalence of PM10 was independently linked to mortality due to the corona virus. Additionally, the results of the local spatial autocorrelation indicators on the standardized mortality rate and PM10 define a collection of very higher ideologies in the broad range of KPK and the southern part of Punjab province, respectively, with a definite degree of connection between the two distributions in the Khyber Pakhtunkhwa region. In brief, this research seems to find a justification for confirming the existence of a correlation between the possibility of COVID-19 mortality and air pollution, more precisely considering air pollutants (i.e., particulate (PM10) and land take-over. To this end, the need to mediate in favor of measures aimed at eliminating emissions in the environment will be reiterated by speeding up current proposals and policies aimed at all causes of atmospheric pollution: urbanization, water and manufacturing, home heating, and transportation.

Burden of Drug resistant Tuberculosis in newly diagnosed Tuber-culosis patients of Khyber Pakhtunkhwa, Pakistan

Abstract Objective: To explore the burden of drug resistant tuberculosis in Khyber Pakhtunkhwa, Pakistan. Methods: A total of 8220 referred suspected TB patient samples were collected from 1st March 2016 to 28th February 2017 from TB laboratories across all districts of Khyber Pakhtunkhwa province and processed for the detection of drug resistant tuberculosis (DR-TB). Drug Susceptibility testing (DST) on all Mycobacterium tuberculosis complex (MTC) strains was performed at Provincial TB Reference Laboratory, Peshawar. Results: Among the 8220 suspected TB samples, 1351 samples were declared positive on culture. The DST results showed that 525 samples were resistant to at least one of the first and second line anti-TB drugs. Importantly, among these 525 TB resistance cases, XDR-TB were 0.4% (n=5), MDR-TB were 4.6% (n=62), polyresistant were 18% (n=243), monoresistant was 16% (n=215) and 61% (n=826) were reported as pan-sensitive. Gender wise ratio are slightly increased in female (n= 4230; 51.5%) as compared to male (n=3990; 48.5%), while the age group 15-24 were the main target of TB disease (n=1978; 24%). Conclusion: Our data suggests that DR-TB cases especially MDR-TB and XDR-TB in newly diagnosed TB patients are alarmingly increased in Khyber Pakhtunkhwa region. Furthermore, the timely detection of drug resistance is important to optimize treatment and management of MDR-TB as well as XDR-TB. Key words: Tuberculosis; MDR-TB; XDR-TB; Continuous....

The STAT4 and not the IFNL3 variant is associated with hepatitis B virus clearance in a population from the Khyber Pakhtunkhwa region of Pakistan

Background and study aimsHost genetic modifiers of the risk and persistence of hepatitis B virus (HBV) infection in the Pakistani population have not been clearly elucidated. Recently, two genome-wide association studies described that STAT4 and IFNL3 variants are associated with different aspects of the course of HBV infection. However, the roles of these variants in the persistence of HBV infection have not been investigated in the HBV-infected population of Pakistan. Therefore, we examined the roles of the STAT4 and IFNL3 variants in a chronic HBV-infected population from the Khyber Pakhtunkhwa (KPK) region of Pakistan. Patients and methodsSTAT4 rs7574865 and IFNL3 rs12979860 genotyping were performed in 297 subjects (240 infected with HBV and 57 controls). Statistical analyses were performed using the chi-squared test, Student’s t-test, Hardy–Weinberg equilibrium tests and logistic regression models. ResultsAmong the 297 subjects, compared with the IFNL3 rs12979860 genotype [odds ratio (OR) = 0.7, 95% confidence interval (CI) = 0.39–1.29, p = 0.2), the STAT4 rs7574865 genotype was independently associated with the risk of developing chronic HBV infection [OR = 1.9, 95% CI = 1.09–3.50, p = 0.02]. ConclusionThe STAT4 rs7574865 and not the IFNL3 rs12979860 variant is associated with persistence of HBV infection in a Pakistani population from the KPK region.

Female School Stipend Programs in Pakistan: A Case Study of Khyber Pakhtunkhwa Region

The study was conducted to assess the success of a stipend program in girls’ schools launched by Khyber Pakhtunkhwa (KP) government about three years ago. The program aims to increase the female enrolment and reduce gender parity in education. A mix methodology employed. Study show that program did not put any impact on girls’ enrolment Khyber Pakhtunkhwa region. Instead different other observations affecting the enrolment ratio were noted. To further explore the other factors causing no increase in girls’ enrolment and to test the results of the study, a primary study was done using qualitative method. Grounded theory was built and tested. Both the deductive and in-deductive approaches have been used to strengthen the study. Results of the study interestingly show that, it is not the money but culture which is the real hurdle in increase in enrolment ratio. Most of the parents do not allow girls to go to school due to cultural barriers. Awareness campaigns need to be designed for the parents. Keywords: Enrolment, Government Schools, Gender, Pakistan Social and Living Standards Measurement Survey (PSLMS), Logistic Regression, Pakistan. DOI: 10.7176/RHSS/10-9-03 Publication date: May 31 st 2020