Screening, biochemical characterization and antibiotics resistance/susceptibility of bacteria isolated from native soil and water samples / Triagem, caracterização bioquímica e resistência/suscetibilidade a antibióticos de bactérias isoladas de amostras nativas de solo e água

The present study was conducted to isolate and characterize bacteria from water and soil sample taken from the Lahore Canal at different sites i.e. Mall Road, Mohlanwal and Khera site. Isolated bacterial strains were identified on the basis of morphological and biochemical tests. Identification was confirmed by culturing bacteria on selective media. Antibiotic resistance test was also performed to observe the resistance of bacteria against different antibiotics. Blood agar test was performed for identification of different pathogenic bacteria. The result revealed that water and soil samples of Lahore Canal Lahore from different sites were contaminated with Escherichia coli, Salmonella sp., Vibrio sp., Bacillus spp., Enterococcus sp. and Staphylococcus spp. Due to presence of these pathogens, this water is not suitable for any domestic and irrigation use. Study also revealed that water of the Lahore Canal is harmful for human health as it is contaminated with bacteria that can cause severe disease e.g., Escherichia coli can cause gastroenteritis, Bacillus spp. can cause nausea and vomiting, Enterococcus may infect urinary tract, Salmonella sp. is responsible for Bacteremia, Staphylococcus spp. can cause mild fever and Vibrio sp. can be the reason of cholera. Thus it is rendered unfit for any kind of human use even other than drinking like swimming, bathing, washing etc., until and unless some remedial measures are employed to eradicate pathogenic microorganisms by WASA and LWMS according to standards of WHO. Similarly, it is quite harmful, when and where ever it is used for irrigation without proper treatment.

O presente estudo foi realizado para isolar e caracterizar bactérias de amostras de água e solo retiradas do Canal Lahore, em Lahore, em diferentes locais, ou seja, Mall Road, Mohlanwal e Khera. As cepas bacterianas isoladas foram identificadas com base em testes morfológicos e bioquímicos. A identificação foi confirmada por cultura de bactérias em testes de meios seletivos. O teste de resistência aos antibióticos também foi realizado para observar a resistência das bactérias a diferentes antibióticos. Foi realizado o teste de ágar sangue para identificar diferentes bactérias patogênicas. O resultado revelou que amostras de água e solo do Canal Lahore, Lahore, de diferentes localidades estavam contaminadas com Escherichia coli, Salmonella sp., Vibrio sp., Bacillus spp., Enterococcus sp. e Staphylococcus spp. Por causa da presença desses patógenos, essa água não é adequada para qualquer uso doméstico e de irrigação. O estudo revelou que a água do Canal Lahore é prejudicial à saúde humana, pois está contaminada com bactérias que podem causar doenças graves, por exemplo: Escherichia coli pode ocasionar gastroenterite; Bacillus spp. pode causar náuseas e vômitos; Enterococcus sp. pode infectar o trato urinário; Salmonella sp. é responsável pela bacteremia; Staphylococcus spp. pode causar febre leve; e Vibrio sp. pode ser a razão da cólera. Assim, torna-se imprópria para uso humano, como natação, banho, lavagem etc., até que algumas medidas corretivas sejam empregadas para erradicar microrganismos patogênicos por WASA e LWMS de acordo com os padrões da OMS. Da mesma forma, é bastante prejudicial, quando usada para irrigação sem tratamento adequado.

Identification of locally isolated entomopathogenic Fusarium species from the soil of Changa Manga Forest, Pakistan and evaluation of their larvicidal efficacy against Aedes aegypti / Identificação de espécies de Fusarium entomopatogênicas localmente isoladas do solo da Floresta de Changa Manga, Paquistão e avaliação de sua eficácia larvicida contra Aedes aegypti

Abstract Dengue fever vectored by the mosquito Aedes aegypti is one of the most rapidly spreading insect-borne diseases. Current reliance of dengue vector control is mostly on chemical insecticides. Growing insecticide resistance in the primary mosquito vector, Aedes aegypti, limits the effectiveness of vector control through chemical insecticides. These chemical insecticides also have negative environmental impacts on animals, plants and human health. Myco-biocontrol agents are naturally occurring organisms and are found to be less damaging to the environment as compared to chemical insecticides. In the present study, entomopathogenic potential of local strains of fungi isolated from soil was assessed for the control of dengue vector. Local fungal isolates presents better alternative to introducing a foreign biocontrol strain, as they may be better adapted to environmental conditions of the area to survive and may have more entomopathogenic efficacy against target organism. Larvicidal efficacy of Fusarium equiseti and Fusarium proliferatum was evaluated against Aedes aegypti. Local strains of F. equiseti (MK371718) and F. proliferatum (MK371715) were isolated from the soil of Changa Manga Forest, Pakistan by using insect bait method. Larvicidal activity of two Fusarium spp. was tested against forth instar larvae of A. aegypti in the laboratory, using concentrations 105, 106, 107 and 108 conidia /ml. LC50 values for F. equiseti after 24h, 48h, 72h and 96h of exposure were recorded as 3.8x 108, 2.9x107, 2.0x107, and 7.1x106 conidia /ml respectively while LC50 values for F. proliferatum were recorded as 1.21x108, 9.6x107, 4.2x107, 2.6x107 conidia /ml respectively after 24h, 48h, 72h and 96h of exposure. The results indicate that among two fungal strains F. equiseti was found to be more effective in terms of its larvicidal activity than F. proliferatum against larvae of A. aegypti.

Resumo A dengue transmitida pelo mosquito Aedes aegypti é uma das doenças transmitidas por insetos de propagação mais rápida. A dependência atual do controle do vetor da dengue é principalmente de inseticidas químicos. O aumento da resistência a inseticidas no principal vetor do mosquito, Aedes aegypti, limita a eficácia do controle do vetor por meio de inseticidas químicos. Esses inseticidas químicos também têm impactos ambientais negativos sobre os animais, plantas e saúde humana. Os agentes de micobiocontrole são organismos que ocorrem naturalmente e são menos prejudiciais ao meio ambiente em comparação com os inseticidas químicos. No presente estudo, avaliou-se o potencial entomopatogênico de cepas locais de fungos isolados do solo para o controle do vetor da dengue. Isolados de fungos locais apresentam melhor alternativa para a introdução de uma cepa de biocontrole estrangeira, pois podem ser mais bem adaptados às condições ambientais da área para sobreviver e podem ter maior eficácia entomopatogênica contra o organismo-alvo. A eficácia larvicida de Fusarium equiseti e Fusarium proliferatum foi avaliada contra Aedes aegypti. Cepas locais de F. equiseti (MK371718) e F. proliferatum (MK371715) foram isoladas do solo de Changa Manga Forest, Paquistão, usando o método de isca para insetos. Atividade larvicida de dois Fusarium spp. foi testado contra larvas de quarto ínstar de A. aegypti em laboratório, nas concentrações 105, 106, 107 e 108 conídios / ml. Os valores de LC50 para F. equiseti após 24 h, 48 h, 72 h e 96 h de exposição foram registrados como 3,8x 108, 2,9x107, 2,0x107 e 7,1x106 conídios / ml, respectivamente, enquanto os valores de LC50 para F. proliferatum foram registrados como 1,21x108, 9,6 x107, 4,2x107, 2,6x107 conídios / ml, respectivamente, após 24 h, 48 h, 72 h e 96 h de exposição. Os resultados indicam que entre duas cepas de fungos F. equiseti se mostrou mais eficaz em termos de atividade larvicida do que F. proliferatum contra larvas de A. aegypti.

Identification of locally isolated entomopathogenic Fusarium species from the soil of Changa Manga Forest, Pakistan and evaluation of their larvicidal efficacy against Aedes aegypti / Identificação de espécies de Fusarium entomopatogênicas localmente isoladas do solo da Floresta de Changa Manga, Paquistão e avaliação de sua eficácia larvicida contra Aedes aegypti

Dengue fever vectored by the mosquito Aedes aegypti is one of the most rapidly spreading insect-borne diseases. Current reliance of dengue vector control is mostly on chemical insecticides. Growing insecticide resistance in the primary mosquito vector, Aedes aegypti, limits the effectiveness of vector control through chemical insecticides. These chemical insecticides also have negative environmental impacts on animals, plants and human health. Myco-biocontrol agents are naturally occurring organisms and are found to be less damaging to the environment as compared to chemical insecticides. In the present study, entomopathogenic potential of local strains of fungi isolated from soil was assessed for the control of dengue vector. Local fungal isolates presents better alternative to introducing a foreign biocontrol strain, as they may be better adapted to environmental conditions of the area to survive and may have more entomopathogenic efficacy against target organism. Larvicidal efficacy of Fusarium equiseti and Fusarium proliferatum was evaluated against Aedes aegypti. Local strains of F. equiseti (MK371718) and F. proliferatum (MK371715) were isolated from the soil of Changa Manga Forest, Pakistan by using insect bait method. Larvicidal activity of two Fusarium spp. was tested against forth instar larvae of A. aegypti in the laboratory, using concentrations 105, 106, 107 and 108 conidia /ml. LC50 values for F. equiseti after 24h, 48h, 72h and 96h of exposure were recorded as 3.8x108, 2.9x107, 2.0x107, and 7.1x106 conidia /ml respectively while LC50 values for F. proliferatum were recorded as 1.21x108, 9.6x107, 4.2x107, 2.6x107 conidia /ml respectively after 24h, 48h, 72h and 96h of exposure. The results indicate that among two fungal strains F. equiseti was found to be more effective in terms of its larvicidal activity than F. proliferatum against larvae of A. aegypti.

A dengue transmitida pelo mosquito Aedes aegypti é uma das doenças transmitidas por insetos de propagação mais rápida. A dependência atual do controle do vetor da dengue é principalmente de inseticidas químicos. O aumento da resistência a inseticidas no principal vetor do mosquito, Aedes aegypti, limita a eficácia do controle do vetor por meio de inseticidas químicos. Esses inseticidas químicos também têm impactos ambientais negativos sobre os animais, plantas e saúde humana. Os agentes de micobiocontrole são organismos que ocorrem naturalmente e são menos prejudiciais ao meio ambiente em comparação com os inseticidas químicos. No presente estudo, avaliou se o potencial entomopatogênico de cepas locais de fungos isolados do solo para o controle do vetor da dengue. Isolados de fungos locais apresentam melhor alternativa para a introdução de uma cepa de biocontrole estrangeira, pois podem ser mais bem adaptados às condições ambientais da área para sobreviver e podem ter maior eficácia entomopatogênica contra o organismo-alvo. A eficácia larvicida de Fusarium equiseti e Fusarium proliferatum foi avaliada contra Aedes aegypti. Cepas locais de F. equiseti (MK371718) e F. proliferatum (MK371715) foram isoladas do solo de Changa Manga Forest, Paquistão, usando o método de isca para insetos. Atividade larvicida de dois Fusarium spp. foi testado contra larvas de quarto ínstar de A. aegypti em laboratório, nas concentrações 105, 106, 107 e 108 conídios / ml. Os valores de LC50 para F. equiseti após 24 h, 48 h, 72 h e 96 h de exposição foram registrados como 3,8x 108, 2,9x107, 2,0x107 e 7,1x106 conídios / ml, respectivamente, enquanto os valores de LC50 para F. proliferatum foram registrados como 1,21x108, 9,6 x107, 4,2x107, 2,6x107 conídios / ml, respectivamente, após 24 h, 48 h, 72 h e 96 h de exposição. Os resultados indicam que entre duas cepas de fungos F. equiseti se mostrou mais eficaz em termos de atividade [...].

Identification of locally isolated entomopathogenic Fusarium species from the soil of Changa Manga Forest, Pakistan and evaluation of their larvicidal efficacy against Aedes aegypti

Abstract Dengue fever vectored by the mosquito Aedes aegypti is one of the most rapidly spreading insect-borne diseases. Current reliance of dengue vector control is mostly on chemical insecticides. Growing insecticide resistance in the primary mosquito vector, Aedes aegypti, limits the effectiveness of vector control through chemical insecticides. These chemical insecticides also have negative environmental impacts on animals, plants and human health. Myco-biocontrol agents are naturally occurring organisms and are found to be less damaging to the environment as compared to chemical insecticides. In the present study, entomopathogenic potential of local strains of fungi isolated from soil was assessed for the control of dengue vector. Local fungal isolates presents better alternative to introducing a foreign biocontrol strain, as they may be better adapted to environmental conditions of the area to survive and may have more entomopathogenic efficacy against target organism. Larvicidal efficacy of Fusarium equiseti and Fusarium proliferatum was evaluated against Aedes aegypti. Local strains of F. equiseti (MK371718) and F. proliferatum (MK371715) were isolated from the soil of Changa Manga Forest, Pakistan by using insect bait method. Larvicidal activity of two Fusarium spp. was tested against forth instar larvae of A. aegypti in the laboratory, using concentrations 105, 106, 107 and 108 conidia /ml. LC50 values for F. equiseti after 24h, 48h, 72h and 96h of exposure were recorded as 3.8x 108, 2.9x107, 2.0x107, and 7.1x106 conidia /ml respectively while LC50 values for F. proliferatum were recorded as 1.21x108, 9.6x107, 4.2x107, 2.6x107 conidia /ml respectively after 24h, 48h, 72h and 96h of exposure. The results indicate that among two fungal strains F. equiseti was found to be more effective in terms of its larvicidal activity than F. proliferatum against larvae of A. aegypti.

Resumo A dengue transmitida pelo mosquito Aedes aegypti é uma das doenças transmitidas por insetos de propagação mais rápida. A dependência atual do controle do vetor da dengue é principalmente de inseticidas químicos. O aumento da resistência a inseticidas no principal vetor do mosquito, Aedes aegypti, limita a eficácia do controle do vetor por meio de inseticidas químicos. Esses inseticidas químicos também têm impactos ambientais negativos sobre os animais, plantas e saúde humana. Os agentes de micobiocontrole são organismos que ocorrem naturalmente e são menos prejudiciais ao meio ambiente em comparação com os inseticidas químicos. No presente estudo, avaliou-se o potencial entomopatogênico de cepas locais de fungos isolados do solo para o controle do vetor da dengue. Isolados de fungos locais apresentam melhor alternativa para a introdução de uma cepa de biocontrole estrangeira, pois podem ser mais bem adaptados às condições ambientais da área para sobreviver e podem ter maior eficácia entomopatogênica contra o organismo-alvo. A eficácia larvicida de Fusarium equiseti e Fusarium proliferatum foi avaliada contra Aedes aegypti. Cepas locais de F. equiseti (MK371718) e F. proliferatum (MK371715) foram isoladas do solo de Changa Manga Forest, Paquistão, usando o método de isca para insetos. Atividade larvicida de dois Fusarium spp. foi testado contra larvas de quarto ínstar de A. aegypti em laboratório, nas concentrações 105, 106, 107 e 108 conídios / ml. Os valores de LC50 para F. equiseti após 24 h, 48 h, 72 h e 96 h de exposição foram registrados como 3,8x 108, 2,9x107, 2,0x107 e 7,1x106 conídios / ml, respectivamente, enquanto os valores de LC50 para F. proliferatum foram registrados como 1,21x108, 9,6 x107, 4,2x107, 2,6x107 conídios / ml, respectivamente, após 24 h, 48 h, 72 h e 96 h de exposição. Os resultados indicam que entre duas cepas de fungos F. equiseti se mostrou mais eficaz em termos de atividade larvicida do que F. proliferatum contra larvas de A. aegypti.

Hemofilia adquirida como manifestación inicial de recidiva de adenocarcinoma colorrectal / Acquired hemophilia as the initial manifestation of colorectal cancer's recurrence

Resumen Presentamos el caso de un varón de 86 años con un hematoma espontáneo en el músculo ilíaco izquierdo y diagnóstico previo de cáncer de colon en 1998 (estadio pT3N0M0), tratado quirúrgicamente mediante colectomía transversal, considerado en remisión completa. Tras realización de estudios complementarios se demostró la presencia de autoanticuerpos inhibidores del Factor VIII que confirmaron el diagnóstico de hemofilia adquirida. Durante el ingreso el paciente presentó un sangrado digestivo bajo que conllevó al descubrimiento de recidiva del adenocarcinoma colorrectal tratado previamente. Respondió de forma favorable a la terapia inicial con corticoides sistémicos y el complejo coagulante anti inhibidor que incluye el Factor VII activado [FEIBA].

Abstract We report the case of an 86-year-old man presenting with a spontaneous hematoma in the left iliac muscle and previous diagnosis of colon cancer in 1998 (stage pT3N0M0) treated with transverse colectomy and considered in complete remission. After a complete study, it was possible to identify the presence of Factor VIII inhibitors antibodies that confirmed the presence of acquired hemophilia. During hospitalization the patient presented a lower gastrointestinal bleeding leading to the diagnosis of recurrence of a previously treated colorectal adenocarcinoma. He responded to initial therapy with systemic corticoids and anti-inhibitory coagulant complex which includes activated VII Factor [FEIBA].

Delivering a modified continuous objective structured clinical examination for ophthalmology residents through a hybrid online method / 한국의학교육

Since coronavirus disease 2019 was declared a global pandemic by the World Health Organization, it has become a challenging situation to continue medical education, including in Indonesia. The situation prohibited face-to-face (direct) educational activities in clinical settings, therefore also postponing examinations involving especially procedural skills. Adaptations were urgently needed to maintain the delivery of high-stake examinations to sustain the number of ophthalmology graduates and the continuation of eye health service. Objective structured clinical examination (OSCE) has been one of our widely used method to assess clinical competencies for ophthalmology residents, and is the one method that involves gatherings, close contact of examiners, examinees and patients, therefore the most difficult to adjust. Pandemic challenges brought technical changes in our delivering the OSCE to online, maximizing digital platforms of meetings, while still concerned to guarding the safety of candidates, patients and staffs. OSCE scenarios were also made as timely efficient as possible by changing continuous station models to a cascade one. The purpose of this article is to document our experience in conducting a feasible and reproducible OSCE in this pandemic era filled with limitations.

A Point Prevalence Survey of Antimicrobial Usage for Surgical Site Infections- A Pilot Perspective from Holy Makkah, Saudi Arabia

Introduction:This study aimed to assess the incidence, microbiological features and management of surgical site infections (SSIs). Methodology:All patients in the surgical ward were followed from admissions until discharge during the study period. Only hospitalized patients with certain SSIs within 30 days of surgeries were included in the study. Results:A total of 457 patients were followed during the study period. Interestingly, only 9 (1.9 %) of the patients developed SSIs. Most of the patients were males 6 (66.7%) and Saudi nationals 7 (77.8 %). The most common surgical procedures were laparoscopic and orthopedic surgeries with a similar rate of 3 (3.3 %).Conclusion:This study revealed that the incidence of SSIswas quite lower atthe hospital where the study was conducted and different types of antibiotics were used and recommended for prophylaxis

Effect of antibiotic prescribing in primary care on antimicrobial resistance: a literature review 2020

Our aim is to review the literature and, where appropriate, investigating subsequent antibiotic resistance in individuals prescribed antibiotics in primary care. Data sources are observational and experimental studies identified through Medline, Embase, and Cochrane searches. Review methods Electronic searches using MeSH terms and text words identified 4373 papers. Results The review included 24 studies, 22 involved patients with symptomatic infection and two involved healthy volunteers, 19 were observational studies (of which two were prospective) and five were randomised trials. The observations concluded that individuals prescribed an antibiotic in primary care for a respiratory or urinary infection develop bacterial resistance to that antibiotic.

Saudi Patients' Knowledge, Behavior, Beliefs, Self-Efficacy and Barriers Regarding Colorectal Cancer Screening

Background: Colorectal cancer is a common type of cancer in Saudi Arabia and globally. Timely screening isneeded to improved treatment outcomes. The success of colorectal cancer (CRC) depends on the compliance bythe targeted population. The aim of this study is to determine how patients’ knowledge, beliefs, behavior, selfefficacy, and barriers affect CRC screening. Materials and Methods: A cross-sectional study design was used. Atotal of 925 patients were recruited as participants from 38 hospitals in Riyadh, Jeddah, Makkah, Dammam, AlAhsa, and Albaha. Data was collected using questionnaire delivered to the participants. Results: Most of theparticipants (over 95%) were aware of CRC. More than half knew about CRC screening. However, response toscreening programs was low due to the lack of knowledge, fear, and insufficient patient awareness programs.Conclusion: Majority of the patients are willing to get regular CRC screening. However, there are low rates ofactual screening due to fear and embarrassment, lack of knowledge, and other barriers. Healthcare workers needto intervene by creating enough public awareness.

Relation between DMFT and Socioeconomic Status in Females Attending Taibah University Clinics

Aim:To assess the decayed, missing and filled tooth (DMFT) index of adult female patients attending dental clinics in the College of Dentistry TaibahUniversity. And to link the socioeconomic factors that may influence the DMFT.Study Design:A Cross-sectional analytical study.Place and Duration of Study: Conducted in Taibah University Dental Clinics, Female campus between January 2016 and May 2016.Methodology:The sample included 110 newly registered adult female patients (>18 years) attended dental clinics for screening. Dental examination for the patient using an explorer and dental mirror was done. Decayed, missing and filled tooth (DMFT) index used by the World Health Organization for the evaluation of dental caries was used. The SPSS software was used for data analysis. Results:Low DMFT presented in 49.0% of educated and 50.0% of not educated subjects. The highest percent of subjects with moderate-income ranging from 4000 to 5999 S.R/month have moderate DMFT (58.8%). The highest percent (47.4%-61.5%) of the other groups have low DMFT. Statistically, the difference is not significant.Conclusion: The study demonstrates that DMFT is independent ofsocioeconomic status

Hipervitaminosis B12: Nuestra experiencia y una revisión / Hypervitaminosis B12. Our experience and a review

Los altos niveles de vitamina B12 o cobalamina, también denominado hipervitaminosis B12 es una anormalidad analítica frecuentemente subestimada. De acuerdo con la literatura algunas de las entidades relacionadas con este hallazgo son las neoplasias sólidas (primarias o metastásicas) y las enfermedades hematológicas agudas o crónicas. Otras causas incluyen la afección hepática, la gammapatía monoclonal de significación indeterminada, la insuficiencia renal y, con menor frecuencia, un exceso de consumo de vitamina B12, enfermedades inflamatorias o autoinmunes y los trastornos hematológicos transitorios (neutrofilia y eosinofilia secundaria). Este artículo informa sobre causas de hipervitaminosis B12, nuestra experiencia y hace una revisión de la literatura.

High serum levels of vitamin B12 or cobalamin, also called hypervitaminemia B12, is a frequently underestimated biological abnormality. According to the literature, some of the entities related to this finding are solid neoplasia (primary or metastatic) and acute or chronic hematological diseases. Other causes include liver disorders, monoclonal gammapathy of undetermined significance, renal failure and, less frequently, excess of vitamin B12 intake, inflammatory or autoimmune diseases, and transient hematological disorders (neutrophilia and secondary eosinophilia). This article reports on causes of hypervitaminosis B12, our experience and a review of the literature.

Association between serum concentration of vitamin D and development of pneumonia

Background: Pneumonia is a common disease with significant morbidity and mortality. There is evidence that vitamin D deficiency can be associated with an increased incidence of lower respiratory illness requiring hospitalization. The objective of this study investigated the impact of vitamin D status on the susceptibility of pneumonia in children the design is Case - Control study, Duration of this study is One year (October 2016 -November 2017) and Setting is Niloufer Hospital, Hyderabad, India. In this study participants are 50 children aged 5 months to 5 years with pneumonia and 50 healthy children of the same age were studied.Methods: In this case-control study, children aged 5 months to 5 years with pneumonia were compared with healthy children of the same age as the control group. Serum levels of vitamin D in both groups were measured by chemiluminescence method. Mean serum levels of vitamin D in patients with pneumonia and control groups were compared using t test.Results: The mean serum levels of vitamin D in the group with pneumonia and the control group were 25.98'14.8 ng/mL and 31.18'15.81 ng/mL, respectively. The difference between the two groups was significant. However, this difference was more significant in the age group of 24 to 60 months.Conclusions: According to findings, a low level of Vitamin D is associated with a higher incidence of pneumonia and more severe disease. It is recommended to pay more attention to vitamin D deficiency in infectious diseases, particularly in pneumonia patients.

Cardiovascular Response during Induction, Laryngoscopy, Intubation and Surgery in Normotensive and Controlled Hypertensive Patients Undergoing Abdominal Surgeries under General Anaesthesia

Introduction: Hypertension is very common conditionamong adult and elderly patients. Ii is one of the importantrisk factor of atherosclerosis of vessels. Anesthetist’s morecommonly tackle the management of treated and untreatedhypertensive patients. The considerable concern of anaesthtistnot only strong association with coronary artery disease butpotential target organ damage. This study was conducted toassess cardiovascular response in different stages of generalanesthesia in abdominal surgeries.Material and methods: Sixty adult patients undergoingdifferent elective abdominal operations under generalanesthesia were included. Patients were divided into A andB group. A group consists of normotensive patients while Bgroup consists of controlled hypertensive patients. Their bloodpressure were controlled on single antihypertensive drug.B group further divided into B1 and B2. B1 group patientswere on beta blockers (BB) while B2 group patients were onangiotensin converting enzyme inhibitors(ACEI).Results: There was decrease in SAP, DP and HR in all groupsafter induction while there was increase in SAP, DP and HRin all groups after laryngoscopy and intubation. There wasminimal rise in SAP, DP and HR in all groups during surgery.The rise of HR was comparatively less in BB group thanACEI group during laryngoscopy and intubation while rise inSAP was comparatively more in ACEI than BB group duringsurgery.Conclusion: On the basis of the present observation it canbe concluded that pressure response and cardiac response(cardiovascular response) to laryngoscopy and intubationappears to be unaffected with these antihypertensive drugs.

Correlation Of Serum Mg2+ Levels With Duration Of T2dm

INTRODUCTION: Diabetes is the most common serious metabolic disease. The hallmark of Diabetes is elevated blood glucose concentration, just one of many biochemical & physiological alterations that occur in the disease. In Diabetics there is a association between serum magnesium levels & cellular glucose disposal independent of insulin secretion. DIRECT etion. This change in glucose disposal is found to be associated with INCREASED SENSITIVITY of the tissues to insulin in the presence of sufficient magnesium levels. Magnesium deficiency has been found to be related with DIABETIC MICROVASCULAR DISEASE. Hypomagnesaemia has been reported to occur in 25-38% patients with T2DM without metabolic control. Hence the present study is conducted to find any 1 correlation with DURATION of T2DM & Serum Magnesium.

Neuroprotective potential of polydatin against motor abnormalities and dopaminergic neuronal loss in rotenone induced Parkinson model / Potencial neuroprotector de la polidatina contra las anomalías motoras y la pérdida neuronal dopaminérgica en un modelo de Parkinson inducido por la rotenona

Among the neurodegenerative disorders, Parkinson disease (PD) is ranked as second most common. The pathological hallmark is selective degeneration of the dopaminergic neurons in the nigro-striatal regions of brain with appearance of the Lewy bodies. Present study explores the neuro-protective potential of polydatin in terms of amelioration of degeneration of dopaminergic neurons in nigro-striatal regions of brain and distorted neuromotor behavior in the rotenone model of Parkinson's disease. Thirty-six male Sprague Dawley rats were divided into three groups. Group A (control), Group B (rotenone treated) and Group C (rotenone+polydatin treated). Rotenone was administrated intraperitoneally (i.p) at a dose of 3 mg/kg/body weight while polydatin was given i.p. at a dose of 50 mg/ kg/body weight for four weeks. Then, animals were sacrificed; substantia nigra (SN) & striatum isolated from brain and five micron thick sections were prepared. Cresyl violet (CV), H&E and Immuno-histochemical staining using anti-TH antibody was done. Motor behavior was assessed weekly throughout the experiment using five different methods. Rotenone treated parkinsonian animals showed deterioration of motor behavior, weight loss, loss of dopaminergic neurons and diminished immune-reactivity in the sections from the nigrostriatal regions of these animals Polydatin+rotenone treatment showed contradicting effects to parkinsonism, with amelioration in weight loss, neuro-motor behavior, dopaminergic loss and immune-reactivity against dopaminergic neurons. Present study revealed a neuro-protective potential of polydatin in animal model of PD by ameliorating the neuro-motor abnormalities and degeneration of dopaminergic neurons in nigrostriatal regions.

Entre los trastornos neurodegenerativos, la enfermedad de Parkinson (EP) se clasifica como la segunda más común. El sello patológico es la degeneración selectiva de las neuronas dopaminérgicas en las regiones nigro-estriatales del cerebro, con la aparición de los cuerpos de Lewy. El presente estudio explora el potencial de protección neuronal de la polidatina en términos de la mejora de la degeneración de las neuronas dopaminérgicas en las regiones nigro-estriatales del cerebro y el comportamiento neuromotor distorsionado en el modelo de rotenona de la enfermedad de Parkinson. Treinta y seis ratas macho Sprague Dawley se dividieron en tres grupos: Grupo A (control), Grupo B (tratado con rotenona) y Grupo C (tratamiento con rotenona + polidatina). La rotenona se administró por vía intraperitoneal (i.p.) a una dosis de 3 mg/kg/peso corporal, mientras que la polidatina se administró i.p. a una dosis de 50 mg/kg/ peso corporal durante cuatro semanas. Posteriormente, los animales fueron sacrificados. Se aislaron la substantia nigra (SN) y cuerpo estriado de los cerebros y se realizaron secciones de cinco micras de espesor. Se realizó una tinción de violeta de cresilo (CV), H&E y tinción inmunohistoquímica usando anticuerpo anti-TH. El comportamiento motriz se evaluó semanalmente durante todo el experimento utilizando cinco métodos diferentes. Los animales parkinsonianos tratados con rotenona mostraron deterioro del comportamiento motriz, pérdida de peso, pérdida de neuronas dopaminérgicas y disminución de la reactividad inmune en las secciones de las regiones nigroestriadas. El tratamiento con polidatina + rotenona mostró efectos contrarios al parkinsonismo, con mejoría en la pérdida de peso, en el comportamiento motor, en la pérdida dopaminérgica y en la reactividad inmune contra las neuronas dopaminérgicas. El presente estudio reveló un potencial de protección neuronal de la polidatina en el modelo animal de la EP al mejorar las anomalías neuro-motoras y la degeneración de las neuronas dopaminérgicas en las regiones nigroestriatales.

Impact of Fibromyalgia on Das-28 score in Rheumatoid Arthritis

Objective: To determine the frequency of fibromyalgia American college of rheumatology [ACR] 2010/2011 criteria] in patients with rheumatoid arthritis and its impact on disease activity score [DAS-28]

Study Design: Cross-sectional study

Place and Duration of study: Department of Rheumatology and Immunology, Sheikh Zayed Hospital Lahore from Jun 2016 to Feb 2017

Patients and Methods: Total 140 diagnosed patients of rheumatoid arthritis by criteria ACR 2010 were included in this study. ACR modified 2010/2011 criterion of fibromyalgia was used to diagnose co existing fibromyalgia in these patients. Clinically disease activity status was assessed by standardized and validated DAS-28 calculator; 2ml of blood was drawn and sent to laboratory for estimation of erythrocyte sedimentation rate for all study participants

Results: The mean age, duration of disease, DAS-28 of sampled population was 49.12 +/- 8.5 years, 7.36 +/- 3.8 years, 4.08 +/- 1.1 respectively. Out of 140 patients, 127 patients [90.7percent] were females. Fibromyalgia was diagnosed in 41 patients [29.1percent]. The mean DAS-28 score in patients of rheumatoid arthritis with fibromyalgia was 5.39 +/- .58 while for patients of without fibromyalgia it was 3.54 +/- 0.69 [p-value<0.001]

Conclusion: Secondary fibromyalgia is common in patients with rheumatoid arthritis and needs to be screened out in all patients diagnosed as rheumatoid arthritis and on subsequent follow up visits, coexisting fibromyalgia affects the disease activity status and this may result into inappropriate and unnecessary changes in treatment plans

Iron deficiency Anemia: a risk factor for Febrile seizures in children

Objective: To find out the association between iron deficiency anemia and febrile seizures in children

Study Design: Analytical: case-control study

Place and Duration of Study: The study was conducted at Paediatrics department, Pak Emirates Military Hospital Rawalpindi, from May 2013 till Oct 2013

Material and Methods: Two Hundred patients were selected through non probability consecutive sampling, one hundred in each group i.e. patients with febrile seizures and patients without febrile seizures. The blood sample of cases and controls were taken at the time of admission and was sent for assessment of hemoglobin [Hb], serum ferritin level, mean corpuscular hemoglobin concentration [MCHC] and mean corpuscular volume [MCV]. The samples were analyzed for iron deficiency anemia and compared in both groups [patients with febrile seizures and those without febrile seizures]

Results: In the febrile seizures group 58 [58 percent] were anemic with a hemoglobin level less than 10gm/dL and 59 [59 percent] had a low plasma ferritin of less than 10ng/dL. In the control group 39 [39 percent] were anemic with a hemoglobin level less than 10gm/dL and 26 [26 percent] had a plasma ferritin of less than 10ng/dL. The frequency of anemia with low MCV, MCHC and serum ferritin was more in the febrile seizure group 38 percent as compared to 20 percent in controls [p-value = 0.002]

Conclusion: The children with febrile seizures have lower hemoglobin, MCV, MCHC and serum ferritin level as compared to the control groups suggesting that iron deficiency anemia has a positive role in the pathogenesis of febrile seizures

Nonalcoholic Fatty Liver Disease [NAFLD]

Background: Nonalcoholic fatty liver disease is the most frequent cause of liver disease across the world. Its pathophysiology is considered multifaceted and is controlled by numerous mechanisms comprising environmental, metabolic, genetic, and gut microbial factors. Diagnosis of nonalcoholic fatty liver disease poses a challenge owing to its subtle and non-specific presentation

Methodology: we conducted this review using a comprehensive search of MEDLINE, PubMed, and EMBASE from January 1987 to March 2017. The following search terms were used: fatty liver disease, nonalcoholic liver disease, chronic liver disease, diagnosis and management of liver pathology

Aim of the work: In this study we aimed to understand about the pathophysiology, diagnosis, management and prognosis of nonalcoholic fatty liver disease

Conclusion: More studies must be done to formulate a more definite and reliable diagnostic method. General practitioners and specialists must be informed of the possible manifestation sings to keep higher degree of suspicion. Once NAFLD is established, frequent follow-up and proper management can reduce complications and improve prognosis

use of butyl bromide medication amid colonoscopy

Objective: the hyoscine-n-butylbromide [Buscopan] is ought to be avoided during colonoscopy in patients with a history of angle-closure glaucoma. Angle-closure glaucoma, nonetheless, is not very common, is asymptomatic before onset and is treated definitively by a single laser treatment [if spotted early]. Openangle glaucoma is not affected by hyoscine

Purpose: the purpose of this study was to evaluate the use of hyoscine amid colonoscopists, with certain reference to glaucoma

Materials and Methods: a short questionnaire was electronically managed to members of the Saudi Society of Gastroenterology and the Association of Coloproctology of KSA. The use of Hyoscine among colonoscopists and the effect of glaucoma history upon the prescribing practice

Results: sixty-three colonoscopists responded to some or all of the questions. 41/61 [67.2%] of respondents claimed they were aware of the guidelines. 53/62 [85.5%] sometimes or always use hyoscine, while 9/62 [14.5%] never do. 45/59 [76.3%] always enquire about glaucoma history prior to administration, even though 48/58 [82.8%] make no differentiation between open-angle or angle-closure forms. 42/59 [71.2%] would [incorrectly] withhold hyoscine if the patient declares a history of any form of glaucoma. 46/59 [78.2%] do not substitute glucagon as an antispasmodic. 2/60 [3.3%] had encountered ophthalmic complications postadministration

Conclusions: current guidelines pertaining to hyoscine use and glaucoma are inappropriate. Patients undergoing colonoscopy who have received hyoscine should, instead, be advised to seek urgent medical advice if they develop ophthalmic symptoms

Helicobacter pylori infection: independent risk indicator of gastric adenocarcinoma and the role of surgery

Background: Helicobacter pylori is a ubiquitous organism that is current in about half of the global population. Chronic infection with helicobacter pylori causes atrophic and even metaplastic changes in the stomach, and it has a known association with peptic ulcer disease. This bacterial species colonizes the stomach of the greater part of the total populace; notwithstanding, only a very small proportion of infected subjects improve adenocarcinoma. helicobacter pylori causes a chronic gastritis that might last periods, and a multistep precancerous process is documented for the most common histologic type of gastric adenocarcinoma: the intestinal type

Objectives: Distinguishing of individuals at high risk for gastric cancer

Conclusion: This article briefly summarizes the main aspects concerning gastric adenocarcinomas and the carcinogenic effects of HELICOBACTER pylori infection