Group A rotavirus (RVA) is the leading cause of diarrhea in children <5 years in many countries. The objectives of this pre-vaccination era study were to explore the prevalence and the genetic diversity of RVA strains in <5 years children, hospitalized due to gastroenteritis during 2014 – 2016. Two tertiary care hospitals Benazir Bhutto Hospital (BBH) located in Rawalpindi and Kharadar General Hospital (KGH) in Karachi were the study sites. A total of 1227 children were tested through ELISA for the presence of RVA and 28.5% (n=350) were found positive. From the 956 children enrolled in BBH (n=502 in 2014 and n=454 in 2015), 29.1% (n=279) were RVA positive. Among the 271 children enrolled in KGH during 2016, 26% (n=71) were found to be infected with RVA. A majority (78%; n=272) of RVA gastroenteritis cases were found in children <1 year of age and the virus was detected throughout the study period. Genotyping of ELISA positive samples through RT-PCR showed G12P[6] (21%) as the most dominant genotype followed by G3P[8] (16%), G2P[4] (12%), G1P[8] (9%), G9P[6] (8%) and G3P[6] (6%). A high proportion (10%) of mixed infection was also observed. Phylogenetic analysis clustered Pakistani G1 strains into two lineages, G1 lineage 1 & 2 along with strains from Russia, Australia, Thailand, India, Bhutan, Belgium Turkey, and the USA. The G2 strains clustered into G2 lineage IV, sub lineage IVa-3 along with strains reported worldwide. Pakistani G2 strains showed the D96N and S242N substitutions which are characteristic of sub-lineage IVa-3 and have been linked to the reemergence of these strains in many countries. Pakistan G3 viruses clustered into G3 lineage 3, sub-lineage 3d and were closely related to strains from China, Russia, Japan, and the USA. High amino acid similarities existed among indigenous G3 and the new variant G3 viruses that were first reported from Japan in 2003-2004. We hereby report the first finding of these variant G3 viruses from our country. The G9 strains grouped into two lineages G9 lineage 3 & 4 with the majority of strains belonging to lineage 3. Pakistani G12 strains belonged to the G12 lineage 3 together with G12 from different countries. The P[4], P[6] and P[8] Pakistani strains were linked to VP4 genotypes found globally. Comparative analysis of wild-type rotaviruses with RotarixTM and RotaTeqTM revealed several amino acid differences in the VP7 and VP8* antigenic epitopes. Notably, Pakistani G3 isolates contained a K238N amino acid change that generates an extra N linked glycosylation site which could have an effect on the antigenicity of these strains. This is the first report on the predominance of G12P[6] and the emergence of G3P[8] from Pakistan. Our findings provide important information pertinent to the genetic diversity of RVA strains circulating in the two cities of Pakistan (Rawalpindi and Karachi) and emphasize the need for large-scale epidemiological studies across the country.
Introduction: A total of 144 medical colleges are contributing to the country’s progress. Excessive usage of social media is a cause of not only the deterioration of physical and psychological health of medical students, but has also become a defining reason of procrastination and attaining less than ideal grades. Where most western institutes implement strict social media policies in medical schools, those in Pakistan are gravely lacking. Objective: The objective of this research implementation of social media in medical schools of Pakistan and then identify the need to develop such policies. Methods: We conducted qualitative research in which method of data collection was primarily focus group discussions (FGD) of a total of 40 participants from five different medical colleges of Pakistan. The participants included medical practitioners and medical students(n=20) who were further divided into four groups of five participants each. FGD was conducted online. Results: Content analysis revealed seven core themes as point of discussions to be highlighted. Almost all participants were grossly unaware of the importance of social media usage regulation and its implementation in medical schools. Conclusion: At the end of the FGD it was unanimously agreed upon that there must be a uniform and standard social media policy defined by the regulating bodies of medical schools. This research may further be conducted by including policymakers in the sample. KEYWORDS: Social media, policy, medical colleges.
With the advancement in technology and decrease in prices of electronic items, Personal Computers (PCs) are becoming common. This has resulted in PCs replacing many other electronic gadgets (televisions, play stations, etc.), as people are inclined to use televisions and play stations in their PCs through software. Games are not an exception from this electronic advancement. All this has increased the number of choices in computer games for the users. At the same time the quality of entertainment provided by these games has also decreased due to abundance of games in the market for PCs. On the other hand the task of game development for the developers is becoming tiresome, which requires scripting the game, modeling its contents and other such activities. Still it cannot be known how much the developed game is entertaining for the end users, as entertainment is a subjective term. Another issue from the point of view of game developers is the constant need of writing new games, requiring investment both in terms of time and resources. In order to address afore mentioned challenges (measuring of entertainment and automated generation of games). First task is to devise some metrics that can quantify the entertainment value of a game. Although creating a single quantitative measure for all genres of games is not trivial, but a separate metrics for each can be devised. Based upon the entertainment metrics some computational intelligence techniques can be used to create new and entertaining games. In this work we create a set of metrics for measuring entertainment in computer games. The genres we address are board based games and video games (predator/prey and platform games). The metrics are based theories of entertainment in computer games, taken from literature. Further we use Evolutionary Algorithm (EA) to generate new and entertaining games using the proposed entertainment metrics as the fitness function. The EA starts with a randomly initialized set of population and using genetic operators (guided by the proposed entertainment metrics) we reach a final set of population that is optimized against entertainment. For the purpose of verifying the entertainment value of the evolved games with that of the human we conduct a human user survey and experiment using the controller learning ability.