Theileria equi (T. equi) is an obligate intra- and extra-erythrocytic parasite that causes equine theileriosis (ET) in equids. Equine theileriosis is considered a notifiable disease of global significance, a major constraint to the international movement of horses, and endemic in many countries. This disease may be difficult to diagnose, as it can produce variable and nonspecific clinical signs. A cross-sectional study was designed for the molecular characterisation of T. equi and to investigate the associated risk factors of ET accompanied by its consequences on haematological and sero-biochemical parameters. A convenience sampling of 500 blood samples were collected from ET suspect horses from January to December 2017. PCR was performed on all blood samples targeting the 18S rRNA gene of T. equi followed by sequencing; 9% animals tested positive with confirmed sequences. The isolates of this study showed high homology with Cuban, Russian and Brazilian isolates of T. equi (accession numbers KY111762.2, MG551915.1 and KY952237.1, respectively). Based on multivariate analysis, the principal risk factors consisted of absence of dogs on the premises and presence of tick infestation. The haemato-biochemical parameters showed a decrease in granulocytes and erythrocytes, and an increase in lymphocytes, monocytes, mean corpuscular volume, mean corpuscular haemoglobin, mean platelet volume, glucose, phosphorus and aspartate aminotransferase in positive horses. This is the first study which identified ET in Punjab (Pakistan) using molecular techniques and risk factors together with the haemato-biochemical variations in horses. Ticks are major external parasites of horses that affect animal welfare and transmit many infections. Little is known about the epidemiology of ticks in horses in Pakistan. Keeping in view the significance of horses and its importance, a cross-sectional study was designed to investigate species distribution, seasonal dynamics and epidemiology of ticks infesting horses in Pakistan. By convenience sampling, 500 horses in two districts (Sargodha and Lahore) of Punjab were screened for the presence of ticks from January to December 2017. Tick samples were collected from horses and identified to species level. Data of temporospatial, host and husbandry practices-related risk factors were recorded in a separate questionnaire. Ticks representing six species were collected i.e. Hyalomma impeltatum (n=52), H. impressum (n=25), H. excavatum (n=9), H. anatolicum (n=3), H. scupense (n=3) and H. dromedarii (n=3). The sex ratio of collected ticks showed 63 (66.32%) male and 32 (33.68%) female. In both districts, predominant species in horses was H. impeltatum. All infested horses had more than one tick species. The overall proportion of tick infested horses was 7% (35/500), which was high in district Lahore (8.15%) than district Sargodha (5.99%). Summer, ≤3 body condition score, satisfactory nutritional status, same breed rearing system, presence of dogs and absence of birds at farms, and activity were important risk factors associated with high equine tick infestation. This is the first report regarding the presence of H. dromedarii in the horses of Punjab.
Morality is the essence of humanity and is a basic need of every society for the development, prosperity, sincerity and brotherhood. Nobody can present good character without morality. Our beloved and last Prophet Muhammad (صلى الله عليه وسلم (settled clear rules in this regards in every dimension of life. In this paper an attempt was made to discussed the Prophetic code of ethics regarding to three basic dimensions of life, political ethics, teaching and preaching ethics and ethics in family life.
Background: Palliative care is a modality of treatment that addresses physical, psychological and spiritual symptoms. Dignity therapy, a form of psychotherapy, was developed by Professor Harvey Chochinov, MD in 2005.
Methods: This was a randomized control trial of 144 patients (72 in each arm) randomized into group 1 (intervention arm) and group 2 (control arm). Baseline ESAS scores were determined in both arms following which group 1 received Dignity therapy while Group 2 received usual care only. Data collected was presented as Legacy documents to group 1 participants. Post intervention ESAS scores were obtained in both groups after 6 weeks. Analysis was based on the intention to treat principle and descriptive statistics computed. The main outcome was symptom distress scores on the ESAS (summated out of 100 and symptom specific scores out of 10). The student T-test was used to test for difference in ESAS scores at follow up and graphs computed for common cancers and comorbidities.
Results: Of the 144 (72 patients in each arm) patients randomized, 70%were female while 30% were male with a mean age of 50 years. At 6 weeks, 11 patients were lost to follow up, seven died and 126 completed the study. The commonly encountered cancers were gastrointestinal cancers (43%, p=0.29), breast cancer (27.27% p=0.71) and gynaecologic cancers (23% p=0.35).Majority of the patients i.e. 64.3% had no comorbidities.
After adjusting for baseline scores, the mean (summated) symptom distress score was not significant (GLM p=0.78). Dignity therapy group showed a trend towards statistical improvement in anxiety (p=0.059). The largest effects seen were in improvement of appetite, lower anxiety and improved wellbeing (Cohen effect size 0.3, 0.5 and 0.31 respectively).
Conclusion: Dignity therapy showed no statistical improvement in overall quality of life. Symptom improvement was seen in anxiety and this was a trend towards statistical significance (p=0.059).