We report the initial characterization of the gastrointestinal tract (gut) and oral microbiota (bacteria) in 32 urban Pakistani adults. Study participants were between ages 18 and 40, had body mass index between 18 and 25 Kg/m 2 , and were students or early-career professionals. These individuals donated a total of 61 samples (32 gut and 29 oral) that were subjected to 16S ribosomal RNA (rRNA) gene sequencing. Microbiome composition of Pakistani individuals was compared against the uBiome database of selected individuals who self-reported to be in excellent health. We observed strong gender-based differences in the gut microbiome of Pakistani individuals, a skewness toward Firmicutes, and unusually high levels of Proteobacteria in the Pakistani men. These observations may indicate microbiota dysbiosis, though 16S data alone can neither establish cause nor effect to human health. Albeit conducted on a smaller scale, our report provides a first snapshot about the composition and diversity of gut and oral microbiota communities in Pakistani individuals.

Background: Health Care Systems face an unprecedented pressure in the 21stcentury. Building and sustaining good health care services and systems remains a challenge throughout the world generally and for developing economies particularly and is known to have a massive impact on the society and ultimately the economic well-being of a nation. This study addresses how Ethical Leadership and its factors of interpersonal justice and informational justice can play a role in fostering the climate of innovation; continuous development and consistency in the healthcare sector. Methods: The data was collected by administering standard questionnaires for each of the involved variable. The health care industry particularly public and private Hospitals in Pakistan were targeted to collect relevant data. The data analysis was performed through the software for Statistical Package for Social Sciences (SPSS). The analysis included the descriptive analysis, frequencies, reliability analysis, correlation analysis and Regression analysis. Results: The results state a significant and positive relationship between ethical leadership and climate of innovation in the Health care sector of Pakistan with a significance level <0.05. Conclusion: Given the need for innovation as a solution to the complex challenges faced by health care organizations, ethical leadership plays an important role in promoting climate of innovation in the Health Care sector of Pakistan, which may benefit both the Health care service providers and those who avail the services.

Systemic sclerosis is an autoimmune condition that frequently affects women. It is a progressive, debilitating disease that has widespread manifestations, targeting different organs of the body with potentially fatal consequences due to lung and kidney involvement. Women with this disease mostly present with Raynaud’s phenomenon along with symptoms of gastro-esophageal reflux disease (GERD). Just like any chronic debilitating condition, patients with systemic sclerosis often suffer from mental health issues that can further worsen their condition, significantly affecting their quality of life. Further research regarding the effects and severity of the disease should be encouraged for a better understanding of the illness, its diagnosis, and treatment. We present a rare case of a 55-year-old woman who presented with complaints of a major depressive episode. She was diagnosed with systemic sclerosis last year and has a history of generalized anxiety disorder. She was prescribed Mirtazapine, an antidepressant. On her follow-up after one month, she started complaining of obsessive ruminations that were causing her significant distress. She was prescribed an add-on therapy with a selective serotonin reuptake inhibitor (SSRI) antidepressant with the emphasis being placed on cognitive behavioral therapy (CBT). She reported an improvement in her obsessive symptoms as well as depression after two months.