IntroductionDue to normal physiological changes in various anthropometric indices during pregnancy, the routine measurements of body weight, height, waist circumference, and waist-to-hip ratio are deemed inappropriate in predicting obesity and risk of gestational diabetes mellitus in pregnancy. Neck circumference is a novel marker to determine the risk of gestational diabetes in pregnancy. We conducted this study to determine the correlation between neck circumference and gestational diabetes mellitus and its associated risk factors.MethodsThis was an observational, cross-sectional study conducted at Jinnah Allama Iqbal Institute of Diabetes and Endocrinology (JAIDE), Allama Iqbal Medical College/ Jinnah Hospital, Lahore from July 2017 to March 2018. Pregnant females at 16 weeks of gestation underwent measurement of weight, height, body mass index, neck, and waist circumference. At the 24th gestational week, an oral glucose test was conducted and fasting lipid profile, serum albumin, and uric acid were measured. Pearson’s correlation was used to see any correlation between neck circumference and gestational diabetes and its associated risk factors.ResultsThere were 90 subjects in the study with a mean age 30.8 ± 3.2 (range: 26 – 34) years. The waist and neck circumference at 16 weeks of gestation measured 104.2 ± 9.0 cm and 36.1 ± 2.8 cm, respectively. Age, weight, waist circumference, and body mass index were positively and significantly correlated with neck circumference (p-value < 0.05). After adjusting for age, the correlation between neck circumference and weight, waist circumference, and body mass index (BMI) was statistically significant with a p-value < 0.05. Analysis of the receiver operating curve revealed that the cut-off value of neck circumference for predicting gestational diabetes was 35.70 cm with a sensitivity of 51.4% and specificity of 81.2%.ConclusionNeck circumference at the 16th gestational week is a reliable and valid tool to predict gestational diabetes mellitus at 24 weeks of gestation.

Background The first case of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was diagnosed in Wuhan, China, in 2019. By the first half of 2020, coronavirus disease 2019 (COVID-19) turned into a global pandemic. Objectives The aim of this study is to describe the clinical and demographic characteristics including comorbidities and their outcomes among patients hospitalized with COVID-19 in four tertiary care hospitals across Lahore . This retrospective study was conducted at Fatima Memorial Hospital, Sir Ganga Ram Hospital, Lahore General Hospital, and Jinnah Hospital, all in Lahore, Pakistan, from May 1, 2020, to June 30, 2020. The sample size was 445, which was derived using the convenient sampling method. Clinical outcomes during hospitalization included the requirement of invasive positive pressure ventilation, need for renal replacement therapy (RRT), and death. Data regarding demographics, baseline comorbidities, important vital signs on reporting, and initial workup with results were also collected. Results A total of 445 patients’ data were studied, of whom 291 (65.4%) were male patients and 154 (34.6%) female patients. The median age was 54 years (interquartile range [IQR]: 24). The most common comorbidities were hypertension (HTN) (195; 43.8%) followed by diabetes mellitus (DM) (168; 37.8%) and cardiovascular disease (CVD) (61; 13.7%). The median length of hospital stay was eight days (IQR: 3). Of the total patients, 137 (30.7%) were treated in intensive care unit settings, 40 (9%) received invasive mechanical ventilation, 40 (9%) patients had acute kidney injury, 38 (8.5%) received RRT, and 37 (8.3%) died. It was seen that more patients who were either diabetic or hypertensive received invasive mechanical ventilation as compared to those who did not have these comorbidities. The most common radiological finding on chest X-ray was the classical ground-glass appearance of COVID-19, which was found in 318 (71.4%) patients. Conclusions Patients with one or more underlying comorbidities had poor clinical outcomes compared to those with no comorbidities, with the most vulnerable group being patients with chronic kidney disease, DM, HTN, and CVD in descending order.

Nitrate smoothly accumulates in leafy vegetables and poses serious health hazards if connected excessively in the human diet. The objective of this study was to improve the cultivation method of low nitrate lettuce grown in plant factory. A substantial decrease of nitrate content (NO3-) in three lettuce cultivars were subjected by short-term pre-harvest treatment combined with lowing nitrogen supply of nutrient solution to half concentration and high photosynthetic photon flux density (PPFD) by LED lighting. The lettuce (Lactuca sativa L. cv. Frill ice, Lvzhu, Ziwei) were hydroponically grown in full strength of nutrient solution based on Yamasaki formula up to harvest time within a controlled environment under two light sources using fluorescent lamps and LEDs. The results demonstrated that a subsequent 3-days treatment of additional PPFD from 250 µmol m-2 s-1 to 350 µmol m-2 s-1 from 18 days after transplanting and half concentrations of nitrogen (NO3--N) in nutrient solution which is composition to standard resulted in the decrease of nitrate content as compared to plants grown under initial PPFD and full concentration of NO3--Ncomposition. The gradual decrease in nitrate content was accompanied by an increased concentration of nutritionally carbohydrates. Another important indicator of nutritional quality such as vitamin C content exhibited some variation, fresh weight of cultivars in cv. Frill ice and Ziwei observed higher with fluorescent lamps and for cv. Lvzhu with LED treatment section followed by lowest nitrate content of fresh leaves, respectively. Further, presented results disclosed that to avoid high accumulation of nitrate in leafy vegetables, the strategy of lowering nitrogen supply and increasing light intensity prior to harvest benefiting growers and consumers by improving quality of the product also making it consumer friendly.

Background The first case of Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was diagnosed in Wuhan, China in 2019. In the first half of 2020, this disease has already converted into a global pandemic. This study aimed to find that treatment of patients with COVID-19 pneumonia with Tocilizumab or steroids was associated with better outcomes. Objectives: To analyze the effectiveness of Tocilizumab in moderate to severe Covid-19 patients based on predefined assessment criteria . Study Settings : Single-center, Fatima Memorial Hospital, Lahore. Study design Quasi-experimental. Duration of study From May 12, 2020 to June 12, 2020. Patients & Methods: Sample size and technique Sample size was 93; 33 patients were kept in the experimental group, given Tocilizumab, 8 mg/kg intravenously or 162 mg subcutaneously, and the rest of the 60 patients were given corticosteroids, methylprednisolone 80 mg/day. Consecutive sampling. Failure of therapy was labeled when patients were intubated or died, and the endpoints were failure-free survival which was the primary endpoint, and overall survival secondary at the time of discharge. Results A total of 93 patients were enrolled, the Tocilizumab (TCZ) group (case) and Corticosteroid (CS) group (Control). The median age was 58 years (IQR-21), 37 (39.8%) patients with diabetes mellitus, 11 (11.8%) in the TCZ group, and 26 (28%) in the CS group. On the whole, the total median hospital stay in days was 7 with IQR (4), a total of 83 (89.2%) patients recovered successfully and discharged, 27 (29%) in the TCZ group and 56 (60.2%) in the CS group. Total 10 (10.8%) patients died, out of which 6 (6.5%) belonged to the TCZ group and 4 (4.3%) belonged to the CS group The median Oxygen requirement with IQR was 8 (9) in both the groups and in total as well, p-value (0.714). Conclusions Tocilizumab is a quite effective treatment option for critically sick patients of Covid-19 by reducing their oxygen requirement drastically and so the ICU stay, median hospital stay and so the mortality as well. Clinicals trials registration UIN # NCT04730323