ASSESSMENT PRACTICES OF SPEECH AND LANGUAGE PATHOLOGISTS FOR COGNITIVE COMMUNICATION IMPAIRMENT AFTER TRAUMATIC BRAIN INJURY

Background of the Study: The aim of the present research was to examine the assessment practices of Speech-Language Pathologists for Cognitive Communication Disorders after Traumatic Brain Injury. Methodology: It was a cross-sectional survey method, a convenient sampling technique. Research was carried out from January 2021 to June 2021. The sample size was n=21, out of which n= 9 (42.8%) participants, each from Rawalpindi and Islamabad n= 3 (14.4%) participants from Lahore filled in their responses. Medium; being Online, the questionnaire was distributed either through email, WhatsApp or Facebook MessengerApp. SLPs who were undergraduates or who had no experience working with TBI clients were excluded. Questionnaire included 12 items. Responses of research participants were recorded using Google Forms and presented in the form of n (%). The data were analyzed using descriptive analysis, and chi-square analysis was performed to confirm the association between settings, city of practice and years of experience through Statistical Package of Social Sciences (SPSS) Version 22.0. Results: Speech-Language Pathologists reported that they routinely assessed (62% each) Receptive and Expressive communication. However; less than half of the participants routinely evaluated domains like verbal pragmatic skills (43.3%), functional communication (33.3%) and phonemic awareness (33.3%). SLPs assessed their clients by employing tests like MoCA (55.62%), Quick Aphasia Battery (18.75%), Cognitive Assessment (LOTCA Protocol) (14.35%) and a combination of Formal (48%) and Informal (52%) clinical interviews. Conclusion: Informal discourse assessment is incorporated more frequently as compared to informal discourse evaluation in assessment practices of Speech-Language pathologists of Pakistan for cognitive communication impairment followed by traumatic brain injury.

Seroprevalence of Toxoplasmosis, Hematological and Serum Biochemical Profile in Sheep in Multan and Khanewal Districts, Punjab Pakistan .

The present study was conducted to determine the seroprevalence of toxoplasmosis, hematological and serum biochemical changes in sheep naturally infected with Toxoplasma gondii and compared between T. gondii positive and negative sheep in Multan and Khanewal districts, Punjab (Pakistan).Blood samples were collected from 500 sheep and T. gondii antibodies were tested by latex agglutination test (LAT) and Enzyme Linked Immunosorbent Assay (ELISA).Information related to hosts and herds were recorded on questionnaire basis such as gender, age of animals, aborted or non-aborted sheep, cats association with herd, method of disposing aborted fetuses and herd size.The overall prevalence of toxoplasmosis in sheep was 33.6% by latex agglutination test (LAT) and 27.4% by ELISA (P-value = 0.033, OR = 1.341, 95 % CI = 1.023, 1.757).The area wise prevalence of toxoplasmosis was 34.02% and 33. 01 % by LAT (P-value = 0.813, OR = 1.031, 95 % CI = 0.802, 1.324) in Multan and Khanewal and 28.12 % and 26.41 % by ELISA (P-value = 0.672, OR = 1.065, 95 % CI = 0.796, 1.424) in Multan and Khanewal respectively.Difference was statistically non-significant (P>0.05).The seroprevalence of toxoplasmosis was compared between aborted and non-aborted sheep and according to these results infection rate was 51.66% and 31.10% in aborted and non-aborted sheep by LAT (P-value = 0.002, OR = 1.661, 95 % CI = 1.248, 2.211) and 41.66 % and 26.22% in aborted and non-aborted sheep by ELISA (P-value = 0.013, OR = 1.589, 95 % CI = 1.128, 2.238) respectively.Difference was statistically significant (P<0.05) by both techniques.The relationship between sex of sheep and toxoplasmosis showed that infection was 31.37% and 33.85 % by LAT (P-value = 0.722, OR = 0.927, 95 % CI = 0.605, 1.419) in males and females respectively.Similarly prevalence was 19.6 % and 28.28% by ELISA (P-value = 0.188, OR = 0.693, 95 % CI = 0.390, 1.232) in males and females respectively.The prevalence was higher in females than males and difference was statistically non-significant (P>0.05) by both techniques.The prevalence of T. gondii was compared between different age groups and according to these findings infection rate was higher in age group 60-73 months (64.5% and 38.7%) and lowest in age group 4-17 months (26.4% and 22.4%) by LAT (P-value = 0.001) and ELISA (P-value = 0.404).Difference was statistically significant (P<0.05) by LAT and non-significant (P>0.05) by ELISA.Risk factors associated with prevalence of toxoplasmosis in sheep were also studied and according to these results a large flock size, presence of cats, and the aborted fetuses openly left on ground were all statistically significant (P≤0.05) risk factors that were positively associated with prevalence of toxoplasmosis in sheep flocks.Hematological and serum biochemical parameters were studied between T. gondii positive and negative sheep andaccording to these results mean values of haemoglobin, glucose, cholesterol, AST, ALT and LDH were 9.5 ± 2.6 g/dL, 50.6 ± 11.3 mg/dL, 211.6 ± 79.6 mg/dL, 216.4 ± 144.4 U/L, 79.0 ± 64.1 U/L, 613.9 ± 297.2 U/L in T. gondii positive sheep by LAT and 9.9 ± 3.1 g/dL, 52.3 ± 11.3 mg/dL, 198.5 ± 73.6 mg/dL, 209.44 ± 629.3 U/L, 98.7 ± 228.7 U/L, 578.3 ± 292.9 U/L in T. gondii negative sheep respectively.Similarly mean values of haemoglobin, glucose, cholesterol, AST, ALT and LDH were 9.5 ± 2.5 g/dL, 50.6 ± 11.3 mg/dL, 214.6 ± 79.9 mg/dL, 217.3 ± 140.7 U/L, 77.8 ± 66.4 U/L, 606.8± 291.5 U/L in T. gondii positive sheep by ELISA and 9.9 ± 3.1 g/dL, 52.3 ± 11.2 mg/dL, 198.4± 73.8 mg/dL, 209.6 ± 605.1 U/L, 97.6 ± 219.8 U/L, 583.8 ± 295.7 U/L in T. gondii negative sheep respectively.Hemoglobin, glucose and ALT concentration was lower in T. gondii positive sheep as compared to T. gondii negative sheep.Cholesterol, AST and LDH concentration was higher in T. gondii positive sheep than T. gondii negative sheep.Haemoglobin, Glucose, AST, ALT and LDH values varied statistically non-significantly (P>0.05) between T. gondii positive and negative sheep whereas cholesterol level varied statistically significantly (P<0.05) between T. gondii positive and negative sheep. In conclusion, cholesterol level was found higher in sheep infected with toxoplasmosis which may lead to certain complications including coronary artery diseases, myocardial infarction, atherosclerosis, hypertension, hemorrhage and vascular thrombosis in infected sheep.T. gondii is a blood parasite which can cause abortion, fetal death, stillbirth, neonatal death in sheep which can lead toward economic losses such as reduction in fur, wool, meat, milk and other dairy products etc. The results indicated the overall high rates of seroprevalence of T. gondii in sheep that warranted the threat to public health especially farmers and abattoir workers via zoonotic transmission of toxoplasmosis.Keeping in view, the medical and veterinary importance of T. gondii it is recommended that human population (especially farmers and abattoir workers), other livestock species and stray cats present in study area must also be screened for the Toxoplasma infection in the public interest.