Aims: 1. To evaluate the prescribing patterns and duration of benzodiazepine use among psychiatric outpatients and their adherence to established guidelines.

2. To assess the prevalence of benzodiazepine dependence and the level of patient awareness regarding its associated risks.

3. To identify discrepancies between current prescribing practices and evidence-based guidelines, particularly in the treatment of Schizophrenia, Bipolar Affective Disorder, and Generalised Anxiety Disorder.

Methods: A retrospective review of online prescription records was conducted for 35 randomly selected patients from the outpatient department of the Punjab Institute of Mental Health, Lahore, during November 2024. The review adhered to the guidelines published by the Ministry of National Health Services, Regulations & Coordination, Pakistan (April 11, 2023), and the Maudsley Prescribing Guidelines in Psychiatry, 14th Edition.

The following parameters were analysed:

Demographic details and clinical diagnosis of the patients.

Benzodiazepine use, including the type of benzodiazepine prescribed and the duration of use.

Assessment of benzodiazepine dependence, using the Severity of Dependence Scale (SDS), with a score greater than 7 indicating dependence.

Evaluation of whether patients were informed about the potential risks of dependence prior to initiating benzodiazepine treatment.

Results: Demographics and diagnoses: Out of the 35 patients audited, 29 (82.9%) were male. Diagnoses included Schizophrenia (11 patients, 31.4%), Bipolar Affective Disorder (21 patients, 60%), and Generalized Anxiety Disorder (3 patients, 8.6%).

Benzodiazepine use: A total of 97.1% (34 patients) were prescribed benzodiazepines, with 85.7% (30 patients) on long-term use exceeding six months. Commonly prescribed benzodiazepines included clonazepam (2 mg), bromazepam (3 mg), and lorazepam (1 mg), often based on pharmacy stock availability rather than patient-specific indications.

Dependence and awareness: Dependence symptoms were identified in 25 patients (71.4%). 65.7% (23 patients) were not informed about the risks of dependence or proper duration of benzodiazepine use.

Guideline discrepancies: Contrary to established guidelines recommending benzodiazepines for short-term use (2–4 weeks), these medications were prescribed for prolonged periods without regular risk assessments for dependence.

Conclusion: The audit reveals an alarming trend of prolonged benzodiazepine use among psychiatric outpatients, predominantly males with schizophrenia and bipolar disorder. The prescribing practices observed starkly contrast with international guidelines, such as NICE and Maudsley, which emphasise short-term use (2–4 weeks) and the necessity of ongoing risk assessments for dependence.

The lack of patient education on the risks of benzodiazepines and the absence of consistent, evidence-based prescribing protocols further exacerbates the problem. This is particularly concerning given the high rates of dependence and the potential for severe withdrawal symptoms upon abrupt discontinuation.

To address these issues, it is critical to:

Develop and implement national and institutional guidelines for benzodiazepine prescribing in chronic psychiatric patients.

Regularly review patients on benzodiazepines to assess the need for continued use.

Educate both healthcare providers and patients on the risks of long-term benzodiazepine use, dependence, and withdrawal.

Encourage the use of alternative, non-pharmacological interventions for managing anxiety and agitation.

Monkeypox virus (MPXV) is a contagious disease that has been endemic in central and west Africa since 1970, characterized by symptoms such as fever, headache, and skin rash. While there is no approved treatment for MPXV infections, vaccination has proven effective in limiting its transmission, and previous smallpox vaccinations may also provide protection against monkeypox. However, the dependence of monkeypox on animal hosts makes eradication more complicated than with smallpox. Research should focus on assessing the safety of the vaccines, their duration of immunity, and their efficacy against the prevalent strains of monkeypox. The virus’s accelerated rate of mutation poses additional challenges, as does the fact that it can be transmitted through animals, making eradication more complex than with smallpox. A comprehensive global immunization strategy is needed to address these complexities and draw on lessons learned from past eradication efforts.

Malaria remains a major health challenge in developing countries, with climate change intensifying its impact. Pakistan is among the most vulnerable nations. This study examines the relationship between temperature and malaria cases in two highly affected districts, Bannu and Lakki Marwat, to inform climate-adaptive interventions.

We analyzed monthly malaria cases (2014–2022) from the Integrated Vector Control/Malaria Control Program in Khyber Pakhtunkhwa, combined with gridded meteorological data from Copernicus ERA5-Land. Time-series analysis using distributed lag nonlinear models and quasi-Poisson regression was applied to assess the associations.

The findings suggest that as temperatures exceed 22.4°C, malaria transmission increases by 9 to 10% for every 1°C rise in both districts. In Bannu, up to 39.8% of reported malaria cases could be attributed to heat, while in Lakki Marwat, 54.1% of cases were attributable to heat. Under high emission scenarios, heat-related malaria cases could increase by 0.8 to 3.5% by the 2060s. Relationship between temperature and malaria transmission is complex and is influenced by environmental factors such as precipitation and humidity.

Given Pakistan’s limited healthcare infrastructure, addressing climate-driven malaria risks is urgent. Recent severe floods and malaria surges highlight the need for climate adaptation measures and strengthened healthcare systems to enhance community resilience.

The colluvium and saprolite deposits in the Fran Ali area (Oued Laou, northern Morocco) constitute the main source of raw materials used in traditional pottery. These materials are becoming scarce, however, so alternative materials with the same characteristics are needed; this would ensure the sustainability of pottery activities in the area. The objective of the present study was to examine ten representative samples of clayey materials extracted from the Fran Ali area, i.e. the Ikhadimene, Dar Haddoune, Ihadounene, Aqqbat Ajjoua, and Isalahene sites. The geological materials consist mainly of grayish to brownish phyllites, thin layers of yellowish clay, thicker intervals of reddish-yellow soils ranging in depth from 1 to 4 m, and reddish colluvium soils. The physical properties of these materials were determined using semi-wet sieving and Atterberg limit tests, while chemical, mineralogical, and thermal properties were obtained from the methylene blue test (MBT), the calcimetry test, X-ray fluorescence spectrometry (XRF), X-ray diffraction (XRD), and thermogravimetric and differential thermal (TGA/DTGA) analysis. The results suggest that the soils contain 21–35% clay, 28–34% silt, and 37–52% sand. They are moderately plastic, with methylene blue adsorption capacities ranging from 3 to 7% and minimal CaCO3 carbonate contents (1–4%). Samples are dominated by SiO2 (51–57%), Al2O3 (17–21%), and Fe2O3 (8–10%). Mineralogically, they are composed of illite (19–27%), chlorite (0–22%), kaolinite (5–9%), and quartz (29–32%). Thermal analysis showed a relatively large mass loss of ~10%. The samples are deemed to be moderately plastic. The results indicate that this raw material is acceptable for pottery fabrication, given the small proportion of irregular interlayer content and its average geotechnical properties. In addition, extraction of the colluvium material is not sustainable because of the relative scarcity of the material. Given the mineralogical similarity between the weathered layers (colluvium) and their parent rock (shales), the present results suggest that the latter is a suitable alternative to the former.

Concurrent wasting and stunting (WaSt) is a serious form of malnutrition among young children, particularly vulnerable groups affected by the conflict. Understanding the prevalence and risk factors of WaSt among vulnerable children is important to develop effective intervention measures to reduce the burden of WaSt. The present study aimed to identify the prevalence of and risk factors for WaSt among marginalised children aged 6–59 months in Sana’a city, Yemen. A community-based cross-sectional design was conducted on a total sample size of 450 marginalised children aged 6–59 months who lived at home with their mothers. Multivariable logistic regression analysis was performed and the prevalence of WaSt was found to be 10⋅7 %. Children aged 24–59 months were protected from WaSt (adjusted odds ratio (AOR) 0⋅40, 95 % confidence interval (CI) 0⋅21, 0⋅75). A higher prevalence of WaSt was associated with male sex (AOR 2⋅31, 95 % CI 1⋅13, 4⋅71), no history of being breastfed (AOR 3⋅57, 95 % CI 1⋅23, 10⋅39), acute diarrhoea (AOR 2⋅12, 95 % CI 1⋅12, 4⋅02) and family income sources of assistance from others (AOR 2⋅74, 95 % CI 1⋅08, 6⋅93) or salary work (AOR 2⋅22, 95 % CI 1⋅10, 4⋅47). Continued breast- and bottle-feeding were not associated with WaSt in children aged 6–23 months. Mothers’ age, education and work status, family size and drinking water source were not associated with WaSt. Overall, we found that the prevalence of WaSt among marginalised children remained high. Interventions to improve household income, hygienic conditions and child feeding practices are necessary to promote child growth.

OBJECTIVES/GOALS: By establishing a youth-centric web-app as a central hub of information and inspiration in an attempt to engage a young demographic, this project aims to increase community awareness and reduce misconceptions surrounding clinical trials, in hopes of fairly representing marginalized communities among future clinical trial participants. METHODS/STUDY POPULATION: We designed a children’s web-app to host a collection of child-friendly educational materials (such as picture books, games, and age-appropriate articles about advances in clinical research) explaining clinical research and its process. An emphasis was put on ensuring the web-app and its contents were understandable and appealing to children. The effectiveness of this tool will be tested through a focus group study. Children ages 7-10 will be given a preliminary survey measuring their knowledge and opinions about clinical research, and then given time to explore the web-app. Afterwards, they will be given a secondary survey to gauge their acquired knowledge from the website and asked about their opinion on the design and usability of the web-app and its materials, as well as how likely they were to revisit the site. RESULTS/ANTICIPATED RESULTS: We anticipate a very positive response from the children regarding the design and usability of the web-app and its materials. By using an adolescent-focused design methodology at every step of the design process, we will ensure that all materials are attractive and engaging to our younger target audience. Exposing children to accessible information about clinical trials at a young age allows us to build their trust in the research process prior to the possible internalization and acceptance of cultural misconceptions. Over time, we hope to see a change in attitudes toward clinical research as well as increased participation, whether from under-represented groups or a younger demographic, and positively contribute to T3 and onwards in the translational continuum. DISCUSSION/SIGNIFICANCE: In a rapidly changing world, the best approach to making change is through targeting the younger demographic, the leaders of tomorrow. Our project will allow adolescents to foster a more well-rounded opinion of clinical research, increasing their participation and better paving a more positively received future for translational science as a whole.

Understanding the reasons for the yield gap between potential and actual yield can provide insights for enhancing canola production by adapting measures for ensuring food security. The canola yield gap under different management practices (e.g. water, nitrogen, N- and sowing dates) was quantified using research trials that were conducted at on-station and historical data (1980–2016) and the CROPGRO-Canola model for Punjab, Pakistan. The integrated approach revealed that low inputs of N, the amount of irrigation, sowing date and the use of seeds from home stocks were the principal causes for a low yield. The CROPGRO-Canola model was able to simulate the canola yield from research trials (R2 = >0.90) and farm survey data (R2 = 0.63). The average yield gap between potential (YP), N-limited (YNL), water-limited (YWL), N- and water-limited (YNWL), and overall farmer field yield (YOFF) was 50, 46, 62 and 72%, respectively. The yield-gap with achievable yield (YA) for YNL, YWL, YNWL and YOFF was 34, 28, 49 and 63%, respectively. Overall, the results showed that a high canola yield for farmers’ fields can be obtained by selecting appropriate varieties and sowing dates with N rate of 120 kg/ha and efficient irrigation management. However, further studies are necessary to fully comprehend the underlying causes for the low actual yield and the high yield variability of farmers’ fields.

Mycobacterium tuberculosis is the cause of tuberculosis (TB), a granulomatous illness that mostly affects the lungs. Pakistan is one of the eight nations that accounts for two-thirds of all new cases of developing TB. TB has long been an endemic disease in Pakistan. According to the World Health Organization (WHO) estimates, the nation has over 500 000 incident TB infections per year, with a rising number of drug-resistant cases. Recently, the coexistence of COVID-19 and TB in Pakistan has provided doctors with a problem. Fever or chills, cough, shortness of breath or difficulty breathing are all signs of COVID-19. After SARS-CoV-2 infection, cough might persist for weeks or months and it is frequently accompanied by persistent tiredness, cognitive impairment, dyspnoea or pain – a group of long-term consequences known as post-COVID syndrome or protracted COVID. Coughing with mucus or blood, and coughing that continues over 2 months are indications of TB. The same clinical presentation features make it difficult for healthcare personnel to effectively evaluate the illness and prevent the spread of these fatal diseases. Pakistan lacks the necessary healthcare resources to tackle two contagious diseases at the same time. To counteract the sudden increase in TB cases, appropriate management and effective policies must be implemented. Thus, in order to prevent the spread of these infectious diseases, it is critical to recognise and address the problems that the healthcare sector faces, as well as to create an atmosphere in which the healthcare sector can function at its full potential.

Ab initio microkinetic modeling was performed to study ethanol conversion to acetaldehyde on Pt-based bimetallic alloys in a non-oxidative environment. Alloying Pt with Au, Ag, Cu, Co, Ni, Zn, Cd, Al, Ga, In, Tl, Ge, Sn, Pb, As, and Sb showed an increase in product turnover by at least an order of magnitude compared with Pt at 423 K. This was correlated to the increased stabilization of CH3CHO species over these alloys. Among the alloy candidates; Pt3Cu, Pt3Zn, Pt3Ga, Pt3Ge, Pt3Sb, and Pt3Pb were found to be more active than Pt.

Nanohybrids containing graphene and bismuth ferrite have been actively employed as efficient photo-catalysts these days owing to the low rate of charge carrier's (e−–h+) recombination, moderate surface area with a suitable range of band-gaps. We have synthesized nanohybrids of graphene oxide (GO) and doped BiFeO3 using a co-precipitation method and the doping elements were lanthanum and manganese, hence called BLFMO/GO nanohybrids. The surface area of BLFMO [La = 15% increased from 6.8 m2/g (for pure) to 62.68 m2/g (in nanohybrid)]. Also, the bandgap of the BLFMO/GO nanohybrid reduced significantly up to 1.75 eV. The resulting BLFMO/GO nanohybrid represents significantly higher catalytic activity (96% in 30 min) than the pure BiFeO3 (30% in 30 min).

Aneurysm of the sinus of Valsalva is a rare congenital cardiac anomaly. It occurs as an outpouching that progresses like a windsock, and it may rupture producing aortic regurgitation, cardiac tamponade, congestive heart failure, conduction abnormalities, and stroke. We describe a case of rupture of the sinus of Valsalva into the interventricular septum producing a large dissecting aneurysm. Despite the location, it did not produce a conduction abnormality.

The use of date palm (Phoenix dactylifera L.) has been closely connected with the survival of people in arid areas given their fruits´ high concentration of energy, fibre, minerals, vitamins and 16 amino acids. The arid climate and sandy or clayey loam soils in many parts of Pakistan are ideal for the cultivation of date palm, which contributes to feeding the country's rapidly growing population. To fill knowledge gaps on the effects of cultivar diversity and cultivation sites on the nutritional properties of dates, the present project studied dates and related physical and chemical soil properties across six districts in four provinces of Pakistan: Jhang, Muzaffargarh and Bahawalpur in Punjab; Dera Ismail Khan (D. I. Khan) in Khyber Pakhtunkhwa (KPK); Khairpur in Sindh and Panjgur in Baluchistan. To this end, during 2012–2013, a total of 170 households (HHs) were selected using a snowball sampling approach. Thirty-nine different date palm cultivars with diverse nutritional properties are grown in the study area. In these total soluble solids (TSS) were highest in Muzawati and Koharba cultivars, while cultivars and site conditions significantly affected TSS, minerals (calcium and magnesium), acidity, and firmness of dates. Concentration of CaCO3 and bulk density (BD) of soils varied widely, while hydraulic conductivity (HC) was similar across sites (p = 0.128). Mean soil pH was highest in Panjgur (8.3) and lowest in Muzaffargarh (7.6), soil organic matter content was highest in Jhang (0.8%) and lowest in D. I. Khan (0.6%) and plant available phosphorous (P) was highest in Muzaffargarh (7.8 mg kg−1) and lowest in Panjgur (6.0 mg kg−1). As indicated by correlation analysis BD and cation exchange capacity of soils seemed to affect TSS, whereas concentration of CaCO3 and available P were correlated with calcium concentration of dates. HC and electrical conductivity, however, seemed to have little effect on dates´ nutritional properties.

Background: Falls and fall-related injuries rank among the most common complications after stroke, and are characterised by high rates of morbidity and mortality. This study examined the proportion, and the socio-demographic and clinical characteristics of those who fell among stroke survivors attending physiotherapy facilities in selected hospitals in Nigeria.

Methods: Socio-demographic, clinical and falls data were obtained using a researcher-designed questionnaire while the modified Rankin scale (mRS) was used to assess functional ability of the participants. Descriptive statistics of frequencies, percentages, mean and standard deviation were used to summarise all data. Pearson's Chi square statistic was used to identify significant socio-demographic and clinical characteristics of those who fell.

Results: One hundred stroke survivors participated in the study with a majority of males (67%). Mean ± SD age of the stroke survivors was 55.97 ± 9.56 years (range = 33–85 years). Thirty-three (33%) stroke survivors fell within the 3 months prior to the study and a significant proportion were older (p < .001) and had more diminished functional ability (p < .001).

Conclusion: A considerable proportion of the stroke survivors fell, especially those in the older age-group and those with diminished functional ability. These findings suggest that improving functional ability after stroke may prevent falls while older stroke survivors would also require intensive falls prevention strategies to reduce their susceptibility to falls post stroke. Longitudinal studies on the incidence and frequency of falls among stroke survivors in Nigeria, and clinical trials on appropriate falls prevention strategies are however urgently required.