Few studies have assessed the burden of human papillomavirus (HPV) infection in Pakistan. We aim to provide specific information on HPV-type distribution in invasive cervical cancer (ICC) in the country. A total of 280 formalin-fixed paraffin-embedded tissue blocks were consecutively selected from Shaukat Khanum Memorial Cancer Hospital and Research Centre (Lahore, Pakistan). HPV-DNA was detected by SPF10 broad-spectrum PCR followed by DNA enzyme immunoassay and genotyping by LiPA25. HPV-DNA prevalence was 87.5% (95%CI: 83.0–91.1), with 96.1% of cases histologically classified as squamous cell carcinoma. Most of the HPV-DNA positive cases presented single infections (95.9%). HPV16 was the most common type followed by HPV18 and 45. Among HPV-DNA positive, a significantly higher contribution of HPV16/18 was detected in Pakistan (78.4%; 72.7–83.3), compared to Asia (71.6%; 69.9–73.4) and worldwide (70.8%; 69.9–71.8) and a lower contribution of HPVs31/33/45/52/58 (11.1%; 7.9–15.7 vs. 19.8%; 18.3–21.3 and 18.5%; 17.7–19.3). HPV18 or HPV45 positive ICC cases were significantly younger than cases infected by HPV16 (mean age: 43.3, 44.4, 50.5 years, respectively). A routine cervical cancer screening and HPV vaccination program does not yet exist in Pakistan; however, the country could benefit from national integrated efforts for cervical cancer prevention and control. Calculated estimations based on our results show that current HPV vaccine could potentially prevent new ICC cases.

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Objective: Observing antimicrobial resistance (AMR) trends is critical to identify emerging pathogens and potential disease outbreaks. Determining these trends also allows for policy evaluations and development of interventions. We performed a retrospective analysis of microbiological testing results from a hospital and diagnostic facility in Lahore, Pakistan that represents country-wide sampling. Within this analysis, data was disaggregated by nationality, as it has been suggested that migration increases the burden of AMR. We sought to determine any trends in AMR among populations, which are often at-risk, while contributing to AMR surveillance in Pakistan, which currently does not have a national surveillance network. Methods: Retrospective analysis of antimicrobial susceptibility records from 2014 to 2018 from Shaukat Khanum Memorial Cancer Hospital & Research Centre (SKMCH&RC) in Lahore, Pakistan was performed. All positive microbiological cultures from patients was analyzed to assess antibiotic resistance rates of the most common bacterial isolates and incidence of ESKAPE pathogens and emerging outbreaks among adults and children. Results: For all years, data for a total of 12,702 and 78,130 bacterial and fungal isolates from children and adults, respectively, with Pakistani nationality were analyzed. For all years, data for 597 and 2470 bacterial and fungal isolates for children and adults, respectively, with Afghan nationality were analyzed. AMR rates largely did not vary between populations, but rather followed similar trends. AMR rates also largely agreed with the World Health Organization Global Antimicrobial Surveillance System results for Pakistan. Conclusion: Pakistan requires increased AMR surveillance to identify emerging resistance infections and outbreaks.

To the editor About 80% of breast and ovarian cancer families and about 50% of site-specific breast cancer families are due to germ line mutations in either BRCA1 (MIM 113705) or BRCA2 (MIM 600185) [1][2][3]. Women carrying a pathogenic mutation in BRCA1 or BRCA2 face average lifetime risks of 65% and 45%, respectively, of developing breast cancer, and corresponding ovarian cancer risks of 39% and 11% [4]. In humans, almost all BRCA carriers have been found to be heterozygous [5,6]. The lack of viable homozygous BRCA mutation carriers in humans suggests that homozygous fetuses may be more susceptible to spontaneous abortions. Further evidence for this hypothesis comes from in vivo animal studies showing that mice homozygous for mutations in the BRCA1 or BRCA2 gene die early in embryogenesis [7, 8].Two recent studies have explored the impact of BRCA mutation status on the occurrence of miscarriages. One study included BRCA carriers of Ashkenazi Jewish descent [9], and the other included mutation carriers from United States and Canada [10]. Neither study found a significant difference in the rate of miscarriage between BRCA carriers and non-carriers. We conjectured that miscarriages may occur more frequently in BRCA carriers from consanguineous parents since their offspring are more often homozygous by descent compared to those of unrelated parents, and living homozygous BRCA mutation carriers have not been observed. To explore this question, we studied the rates of miscarriages in Pakistani BRCA mutation carriers and non-carriers with a history of parental consanguinity. Pakistan has one of the highest rates of consanguinity in the world (range 60-70%) [11, 12].Breast and/or ovarian cancer families were recruited at the Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, between June 2001 and November 2004. Of the 165 female index patients, 30 carried a deleterious BRCA mutation, and 135 were without any identifiable mutation. All families, screening methods and mutations have been described previously [13]. Four additional families carrying a deleterious BRCA mutation identified recently were also included in this study. Relevant information regarding potential breast cancer risk factors including family history of cancer, hormone use, reproductive history, medical history and life style factors was collected by interview-administered questionnaires. Detailed information on the outcome of each pregnancy (year of each pregnancy, number of miscarriages including spontaneous and therapeutic abortions, number of still and live born), and parental consanguinity was collected.

Burning of crop residues in semi-arid region with hot climate and less than 1 % soil organic matter not only pose severe threat to global climate but also become the reason of ever decreasing organic matter status. Keeping in view the objective to monitor the impacts of crop resides, burning and incorporation into the soil on crop yield, nutrients uptake and soil physico-chemical properties, this long-term study was planned and conducted at Soil Chemistry Section, Ayub Agricultural Research Institute, Faisalabad. Four treatments (sub plots) viz; 0 fertilizer, 50% of recommended fertilizer, 75% of recommended fertilizer and 100% of recommended fertilizer were applied under split plot design repeated thrice with 3 major plots (methods of residues management) i. traditional practice by complete removing (C) whole crop biomass from field, ii. burnt (B) practice by burning the crop biomass in field after threshing and iii. Residue's (R) incorporation practice by rotavating the crop biomass into the soil. The selected field was sufficient in exchangeable K and available P but was deficient in organic matter contents. The results showed that in first year the wheat yield was maximum in T 4 (5.04 t ha -1 ) in complete removal plot followed by residues incorporated (4.43 t ha -1 ) and burnt plots (3.72 t ha -1 ) respectively. It was observed that yield in residues incorporated plots was declined in next year after that, an increasing trend was witnessed. Burning of residues caused decrease in yield up to 11 % as compared to complete removal and up to 17% than residues incorporation. Organic matter status of soil before start of experiment was 0.69 %. Mean organic matter contents in residues incorporated plots was increased up to 27% than complete removal and up to 32% than burnt plots. Nitrogen and phosphorus uptake were maximum in residues incorporated plots followed by complete removal and burnt plots, however potassium uptake was maximum in complete removal followed by residues incorporated and burnt plots. ECe of burnt plots was increased by 100 dS m -1 than complete removal and 200 dS m -1 than residues incorporated plots. Other physicochemical properties were not affected significantly.