Antibacterial activity of Ricinus communis plant extract against antibiotic resistant Helicobacter pylori and Gluconobacter oxydans isolated from fresh apple juices samples

Abstract Bacteria were isolated from samples of Fresh Apple juices from shops of three different localities of Lahore. Analysis of samples from Liberty, Anarkali and Yateem khana Markets show different levels of contamination. There were pathogenic and non-pathogenic bacteria in all samples and were identified by the morphological and biochemical tests. Most of the plasmids of pathogenic bacteria were 4kb in their molecular size. Ribotyping of 16S ribosomal RNA gene sequencing was done to confirm Helicobacter pylori strain and Gluconobacter oxydans. The highest sensitivity of 210mm was shown by Enterobacter sp. against Aztheromysine disk (15µg) while Micrococcus sp. was highly resistant against all of the Antibiotics applied. The antibiotic resistance of pathogenic bacteria was also checked against Ricinus communis plant's extracts, all isolated bacterial pathogens were resistant but only, E.coli was inhibited at 300µl of the extracts. Presence of pathogenic bacteria in Apple juice samples was due to contamination of sewage water in drinking water while some of these pathogenic bacteria came from Apple's tree and other from store houses of fruits.

Resumo As bactérias foram isoladas de amostras de suco de maçã fresco de lojas de três diferentes localidades de Lahore. A análise de amostras dos mercados Liberty, Anarkali e Yateem khana mostram diferentes níveis de contaminação. Havia bactérias patogênicas e não patogênicas em todas as amostras e foram identificadas pelos testes morfológicos e bioquímicos. A maioria dos plasmídeos de bactérias patogênicas tinha 4 kb em seu tamanho molecular. A ribotipagem do sequenciamento do gene do RNA ribossômico 16S foi realizada para confirmar a cepa de Helicobacter pylori e Gluconobacter oxydans. A maior sensibilidade de 210 mm foi mostrada por Enterobacter sp. contra disco de azteromisina (15µg) enquanto Micrococcus sp. foi altamente resistente a todos os antibióticos aplicados. A resistência a antibióticos de bactérias patogênicas também foi verificada contra extratos de plantas de Ricinus communis, todos os patógenos bacterianos isolados foram resistentes, mas apenas E. coli foi inibida em 300µl dos extratos. A presença de bactérias patogênicas nas amostras de suco de maçã deveu-se à contaminação da água de esgoto na água potável, enquanto algumas dessas bactérias patogênicas vieram da árvore da maçã e outras de armazéns de frutas.

Burnout among Dental Students of Private and Public Dental Colleges in Pakistan - A Cross-Sectional Study

ABSTRACT Objective: To assess the prevalence of burnout among dental students of public and private institutions in Khyber Pakhtunkhwa and Punjab, Pakistan. Material and Methods: A cross-sectional descriptive survey was conducted at five public and private dental institutions from June 2021 to May 2022. A validated twelve-item closed-ended Burnout Clinical Subtype Questionnaire was distributed among the dental students of two private and two public institutes in Pakistan. The research questions focused on demographic information and students' academic experiences. Data analysis is presented through tables and descriptive methods. Results: A total of 274 dental undergraduate students - second (42.3%), third (35.4%), and final (22.3%) academic year participated in this study. The mean age of the respondents was 21.9, with the range of 20-26 years. Most participants were females (74.1%) compared to the males (25.9%). The findings for burnout syndrome among dentistry students and students in the private and public sectors were not significant. Conclusion: In the current study, burnout levels among dental undergraduates, both private and public, were low.

Outcomes of preloaded toric intraocular lens implantation in eyes undergoing phacoemulsification

Purpose: To evaluate the clinical outcomes of preloaded toric intraocular lens (IOLs) implantation in eyes undergoing phacoemulsification. Methods: This prospective study included 51 eyes of 51 patients with visually significant cataracts and corneal astigmatism ranging between 0.75 and 5.50 D. All patients underwent phacoemulsification with SupraPhob toric intraocular lens implantation under topical anesthesia. The main outcome measures were uncorrected distance visual acuity (UDVA), residual refractive cylinder, spherical equivalent, and IOL stability at 3 months follow?up. Results: At 3 months, 49% (25/51) of patients had UDVA equal to or better than 20/25 with 100% of eyes achieving better than 20/40. Mean logMAR UDVA improved from 1.02 ± 0.39, preoperatively to 0.11 ± 0.10 at 3 months follow?up (P < 0.001, Wilcoxon signed?rank test). The mean refractive cylinder improved from ? 1.56 ± 1.25 D preoperatively to ? 0.12 ± 0.31 D at 3 months follow?up (P < 0.001) while the mean spherical equivalent value changed from ? 1.93 ± 3.71D preoperatively to ? 0.16 ± 0.27D (P = 0.0013). The mean root mean square value for higher order aberrations was 0.30 ± 0.18 ?m while the average contrast sensitivity value (Pelli?Robson chart) was 1.56 ± 0.10 log unit, at the final follow?up. The mean IOL rotation at 3 weeks was 1.7 ± 1.61 degrees, which did not change significantly at 3 months (P = 0.988) follow?up. There were no intraoperative or postoperative complications. Conclusion: SupraPhob toric IOL implantation is an effective method for addressing preexisting corneal astigmatism in eyes undergoing phacoemulsification with good rotational stability

The Clinical Outcome of Brolucizumab in the Treatment of Neovascular Age-Related Macular Degeneration – A Prospective Observational Study

Background: Neovascular age-related macular degeneration (nAMD), also known as wet AMD, is a chronic eye disease that affects the macula, which is the central part of the retina responsible for sharp, central vision. Brolucizumab is a type of anti-vascular endothelial growth factor (VEGF) drug, which works by blocking the activity of a protein called VEGF that promotes the growth of abnormal blood vessels under the macula in neovascular AMD. The aim of this study was to evaluate the clinical outcome of brolucizumab in the treatment of neovascular age-related macular degeneration. Material & Methods: This prospective observational study was conducted in Department of Ophthalmology, Bangladesh Eye Hospital & Institute Ltd, Dhaka, Bangladesh, during the period from February 2022 to February 2023. Total 60 patients with neovascular AMD were included in this study who were treated with brolucizumab. Results: The mean age of the patients was 74.3 (SD±9.8) years. Majority of the study subjects were (51.7%) female patients in the study. In our study, majority (38.3%) of the patients had only their right eye affected. In optical coherence tomography (OCT) findings, we found that a high percentage of patients had subretinal fluid (85%), intraretinal fluid (61.7%), and sub-RPE fluid (83.3%). The BCVA showed a significant change after 12 weeks of treatment, as indicated by the P-value of 0.0007. Here improvement of vision was seen in patients with AMD with active Choroidal neovascularization (CNV). But in case of AMD with macular scar, no improvement of vision was seen. In addition, the SRT, FCP, and CMT parameters also showed a statistically significant (P<0.001) improvement after brolucizumab treatment. In our study, 4 patients (6.7%) experienced intraocular inflammation, which is inflammation within the eye, 2 patients (3.3%) reported cloudy vision, and 3 patients (5%) experienced eye redness as a complication of the treatment. The majority of the patients, 51 (85%) did not experience any complications from the treatment. After treatment, improved vision was seen in most of the study patients (70%) and 30% had no improvement. Conclusion: From the findings of our study, it can be concluded that brolucizumab may be an effective treatment for neovascular AMD, as it can improve the best-corrected visual acuity and structural outcomes of the retina such as subfoveal retinal thickness, foveal center point, and central macular thickness. There was also a tolerable complication rate after treatment.

Outcome of Laparoscopic Cholecystectomy in a District Level Hospital

Background: Laparoscopic cholecystectomy is a type of surgery that uses smaller incision than open cholecystectomy. LC has been performed as outpatient procedure for many years. Few studies have been conducted with primary focus on patient acceptance and preferences in terms of safety and satisfaction. We tried to explore its feasibility in otherwise healthy individuals undergoing laparoscopic cholecystectomy. The aim of the study of laparoscopic cholecystectomy is significantly affected by acute cholecystitis. Mechanical, biochemical, and bacteriological factors which are believed to participate in this inflammatory process are responsible for the different pathological processes observed in acute cholecystitis and in symptomatic cholelithiasis. Material & Methods: Data from 57 patients between the age group 20 to 70 years with cholelithiasis who underwent laparoscopic cholecystectomy in a private Hospital, Madaripur, Bangladesh from April 2018 to June 2020 as ambulatory surgery (hospital stay 23 Hours) with or without overnight stay were analyzed. Complications, admissions and readmissions, patient satisfaction and treatment expenditure were assessed. Results: There were 48 (84.2%) female and 9 (15.8%) male with a median age of 42 years. Only 2.4% patients required readmission while 9.2% patients had unplanned admission. 76.4% percent patients were highly satisfied with the procedure. Treatment cost was about 15% lower than routine inpatient operation. Conclusion: Laparoscopic cholecystectomy is safe and feasible. LC can be performed as an outpatient procedure with a low rate of complications and admissions/readmissions. Patient acceptance in terms of satisfaction is high.

Impact of Hearing Aid Usage on Emotional and Social Skills in Persons With Severe to Profound Hearing Loss

Background and Objectives@#Severe to profound hearing loss impacts the capacity for verbal communication as well as the social, emotional, and overall quality of life; however, the association between socio-emotional rehabilitation and post-hearing aid use is not widely explored. This study aimed to investigate the socio-emotional change in post-hearing aid fitted individuals with severe to profound hearing loss. @*Materials and Methods@#A total of 60 individuals comprised of 15 females and 45 males with severe to profound hearing loss within the age range of 40-60 years (mean age and standard deviation of 53.4±6.1), participated in this study. Participants were divided into two categories with a 10-year age interval i.e., 40–50 and 51-60 years. These participants were equally divided into hearing aid user (HAU) and non-hearing aid user (NHAU) groups. The hearing handicapped inventory for the adults-short version (HHIA-S) adapted from Weinstein & Ventry (1983) was used in this study. @*Results@#The mean social score of all the participants was significantly higher than the mean emotional score. However, no such advantage was observed between the HAU and NHAU groups. The mean social score of females in the HAU category was significantly higher than males. The mean social and emotional scores were also compared across two age categories in the age range of 40-50 and 51-60 years and revealed no significant difference between mean social and emotional score across the age categories (p=0.026). @*Conclusions@#In individuals with severe to profound hearing loss, social rehabilitation occurs quicker than emotional. In the HAU group, socialization occurred faster in females than males. These findings suggest that a customized counselling should be developed for the social and emotional wellbeing as these two parameters improve distinctly.

Therapeutic Application, Phytoactives and Pharmacology of Tinospora cordifolia: An Evocative Review / 中国结合医学杂志

Tinospora cordifolia (Guduchi or Gurjo), a herbaceous vine or climbing deciduous shrub, is consider as an important medicine in the Ayurvedic system of medication, which is available in India, China, Myanmar, Bangladesh and Srilanka. Menispermaceae is the family of this compound. T. cordifolia have a variety of properties to treat various ailments such as fevers, jaundice, diabetes, dysentery, urinary infections, and skin diseases. This compound has been subjected to many chemicals, pharmacological, pre-clinical, or clinical investigations and some new therapeutic potential effects have been indicated. This review aims to summarize the critical information concerning in areas of chemical constituents, chemical structure, and pharmacokinetic activities such as anti-diabetic, anticancer, immune-modulatory, antivirus (especially in silico study about COVID-19), antioxidant, antimicrobial, hepatoprotective and its effect on cardiovascular and neurological disorders as well as rheumatoid arthritis. This traditional herb needs more experimental study on the clinical, pre-clinical study, and clinical efficacy of these compounds for the prevention and treatment of COVID-19 and needs large-scale clinical studies to prove the clinical efficacy of this compound, especially in stress-related diseases and other neuronal disorders.

Characterization of Three Fusarium spp. Causing Wilt Disease of Cannabis sativa L. in Korea

In July 2021, wilting symptoms were observed in adult and seedling hemp (Cannabis sativa L. cv. Cherry Blossom) plants grown in a greenhouse. As the disease progressed, yellowing and wilting symptoms on the leaves developed, resulting in whole plant death. In seedling plants, typical damping-off symptoms were observed. To identify the pathogen, the roots of diseased plants were sampled, surface sterilized, and cultured on potato dextrose agar (PDA) media. From the culture, 4 different fungal isolates were recovered and purely cultured. Each fungal isolate showed distinct growth shapes and color development on malt extract agar, oatmeal agar, sabouraud dextrose agar, and PDA media. Microscopic observation and molecular identification using ribosomal DNA internal transcribed spacer sequencing identified them as 3 Fusarium spp. and 1 Thielaviopsis paradoxa. Additional sequencing of elongation factor 1-alpha and b-tubulin regions of 3 Fusarium spp. revealed that 2 of them are Fusarium solani, and the other one is Fusarium proliferatum. To examine which isolate can act as a causal agent of wilt disease of hemp, each isolate was tested for their pathogenicity. In the pathogenicity test, F. solani AMCF1 and AMCF2, and F. proliferatum AMCF3, but not T.paradoxa AMCF4, were able to cause wilting disease in hemp seedlings. Therefore, we report that F. solani AMCF1 and AMCF2, and F. proliferatum AMCF3 as causal agents of Fusarium wilt of hemp plants. To our knowledge, this is the first report of the wilt disease of C. sativa L. caused by Fusarium spp. in Korea.

Gastroprotective potential and mechanisms of action of Hedera nepalensis

Abstract Hedera nepalensis (H. nepalensis) , belonging to the family Araliaceae, is a medicinal plant traditionally used to treat stomach problems. The current study investigated the gastroprotective potential and the mechanism of action of H. nepalensis in diclofenac-and ethanol-induced ulcer models. Anti-oxidant and lipid peroxidation inhibitory prospects of H. nepalensis were checked out by free radical scavenging assay and UV spectrophotometer respectively. Effect of H. nepalensis on the pH, gastric total acidity of gastric juice and protective effects of H. nepalensis against ulcer models have been examined. Histopathological studies have been carried out. The aqueous methanol extract of H. nepalensis (100 µg/mL) showed anti-oxidant (83.55%) and lipid peroxidation inhibitory (70.88%) potential at 1000 µg/mL; the extract had no buffer potential. The extract (400 mg/kg) significantly (81.12% and 63.46%) showed gastroprotective effect in diclofenac and ethanol-induced rat ulcer models respectively. Histopathological studies confirmed the biochemical findings. FTIR analysis showed the presence of carboxylic acid, alkanes, conjugated alkanes, aldehydes and alkyl-aryl ethers. Gallic acid, M-coumaric acid and quercetin were found by HPLC analysis. H. nepalensis exhibited significant protection against diclofenac and ethanol induced gastric damage by anti-oxidant and lipid peroxidation suppression effects suggesting potential broad utility in treatment of diseases characterized with gastric damage.

Genetic diversity and molecular characterization of Cucumber mosaic cucumovirus (CMV) subgroup II infecting Spinach (Spinacia oleracea) and Pea (Pisum sativum) in Pothwar region of Pakistan / Diversidade genética e caracterização molecular do Cucumber mosaic cucumovirus (CMV) subgrupo II infectando espinafre (Spinacia oleracea) e ervilha (Pisum sativum) na região de Pothwar, Paquistão

Abstract Cucumber mosaic virus (CMV) is a tremendous threat to vegetables across the globe, including in Pakistan. The present work was conducted to investigate the genetic variability of CMV isolates infecting pea and spinach vegetables in the Pothwar region of Pakistan. Serological-based surveys during 2016-2017 revealed 31.70% overall CMV disease incidence from pea and spinach crops. Triple-antibody sandwich enzyme-linked immunosorbent assay (TAS-ELISA) revealed that all the positive isolates belong to CMV subgroup II. Two selected cDNA from ELISA-positive samples representing each pea and spinach crops were PCR-amplified (ca.1100 bp) and sequenced corresponding to the CMV CP gene which shared 93.7% nucleotide identity with each other. Both the sequences of CMV pea (AAHAP) and spinach (AARS) isolates from Pakistan were submitted to GenBank as accession nos. MH119071 and MH119073, respectively. BLAST analysis revealed 93.4% sequence identity of AAHAP isolate with SpK (KC763473) from Iran while AARS isolate shared maximum identity (94.5%) with the strain 241 (AJ585519) from Australia and clustered with some reference isolates of CMV subgroup II from UK (Z12818) and USA (AF127976) in a Neighbour-joining phylogenetic reconstruction. A total of 59 polymorphic (segregating) sites (S) with nucleotide diversity (π) of 0.06218 was evident while no INDEL event was observed in Pakistani isolates. The evolutionary distance of Pakistani CMV isolates was recorded as 0.0657 with each other and 0.0574-0.2964 with other CMV isolates reported elsewhere in the world. A frequent gene flow (Fst = 0.30478 <0.33) was observed between Pakistani and earlier reported CMV isolates. In genetic differentiation analysis, the value of three permutation-based statistical tests viz; Z (84.3011), Snn (0.82456), and Ks* (4.04042) were non-significant. The statistical analysis revealed the values 2.02535, 0.01468, and 0.71862 of Tajima's D, Fu, & Li's F* and D* respectively, demonstrating that the CMV population is under balancing selection.

Resumo Cucumber mosaic cucumovirus (CMV) é uma tremenda ameaça aos vegetais em todo o mundo, inclusive no Paquistão. O presente trabalho foi conduzido para investigar a variabilidade genética de isolados de CMV infectando vegetais de ervilha e espinafre na região de Pothwar, Paquistão. Pesquisas com base em sorologia durante 2016-2017 revelaram 31,70% da incidência geral da doença por CMV em safras de ervilha e espinafre. O ensaio de imunoabsorção enzimática em sanduíche de anticorpo triplo (TAS-ELISA) revelou que todos os isolados positivos pertencem ao subgrupo II do CMV. Dois cDNA selecionados de amostras positivas para ELISA representando cada safra de ervilha e espinafre foram amplificados por PCR (ca.1100 pb) e sequenciados correspondendo ao gene CMV CP que compartilhou 93,7% de identidade de nucleotídeo um com o outro. Ambas as sequências de isolados de ervilha CMV (AAHAP) e espinafre (AARS) do Paquistão foram submetidas ao GenBank como nos de acesso. MH119071 e MH119073, respectivamente. A análise BLAST revelou 93,4% de identidade de sequência do isolado AAHAP com SpK (KC763473) do Irã, enquanto o isolado AARS compartilhou a identidade máxima (94,5%) com a cepa 241 (AJ585519) da Austrália e agrupada com alguns isolados de referência do subgrupo II de CMV do Reino Unido (Z12818) e EUA (AF127976) em uma reconstrução filogenética vizinha. Um total de 59 sítios polimórficos (segregantes) (S) com diversidade de nucleotídeos (π) de 0,06218 foi evidente, enquanto nenhum evento INDEL foi observado em isolados do Paquistão. A distância evolutiva de isolados de CMV do Paquistão foi registrada como 0,0657 entre si e 0,0574-0,2964 com outros isolados de CMV relatados em outras partes do mundo. Um fluxo gênico frequente (Fst = 0,30478 < 0,33) foi observado entre os isolados de CMV do Paquistão e relatados anteriormente. Na análise de diferenciação genética, os valores de três testes estatísticos baseados em permutação viz, Z (84,3011), Snn (0,82456) e Ks * (4,04042) não foram significativos. A análise estatística revelou os valores 2,02535, 0,01468 e 0,71862 de Tajima's D, Fu, & Li's F * e D * respectivamente, demonstrando que a população de CMV está sob seleção de balanceamento.

Genetic diversity and molecular characterization of Cucumber mosaic cucumovirus (CMV) subgroup II infecting Spinach (Spinacia oleracea) and Pea (Pisum sativum) in Pothwar region of Pakistan / Diversidade genética e caracterização molecular do Cucumber mosaic cucumovirus (CMV) subgrupo II infectando espinafre (Spinacia oleracea) e ervilha (Pisum sativum) na região de Pothwar, Paquistão

Cucumber mosaic virus (CMV) is a tremendous threat to vegetables across the globe, including in Pakistan. The present work was conducted to investigate the genetic variability of CMV isolates infecting pea and spinach vegetables in the Pothwar region of Pakistan. Serological-based surveys during 2016-2017 revealed 31.70% overall CMV disease incidence from pea and spinach crops. Triple-antibody sandwich enzyme-linked immunosorbent assay (TAS-ELISA) revealed that all the positive isolates belong to CMV subgroup II. Two selected cDNA from ELISA-positive samples representing each pea and spinach crops were PCR-amplified (ca.1100 bp) and sequenced corresponding to the CMV CP gene which shared 93.7% nucleotide identity with each other. Both the sequences of CMV pea (AAHAP) and spinach (AARS) isolates from Pakistan were submitted to GenBank as accession nos. MH119071 and MH119073, respectively. BLAST analysis revealed 93.4% sequence identity of AAHAP isolate with SpK (KC763473) from Iran while AARS isolate shared maximum identity (94.5%) with the strain 241 (AJ585519) from Australia and clustered with some reference isolates of CMV subgroup II from UK (Z12818) and USA (AF127976) in a Neighbour joining phylogenetic reconstruction. A total of 59 polymorphic (segregating) sites (S) with nucleotide diversity (π) of 0.06218 was evident while no INDEL event was observed in Pakistani isolates. The evolutionary distance of Pakistani CMV isolates was recorded as 0.0657 with each other and 0.0574-0.2964 with other CMV isolates reported elsewhere in the world. A frequent gene flow (Fst = 0.30478 <0.33) was observed between Pakistani and earlier reported CMV isolates. In genetic differentiation analysis, the value of three permutation-based statistical tests viz; Z (84.3011), Snn (0.82456), and Ks* (4.04042) were non-significant. The statistical analysis revealed the [...].

Cucumber mosaic cucumovirus (CMV) é uma tremenda ameaça aos vegetais em todo o mundo, inclusive no Paquistão. O presente trabalho foi conduzido para investigar a variabilidade genética de isolados de CMV infectando vegetais de ervilha e espinafre na região de Pothwar, Paquistão. Pesquisas com base em sorologia durante 2016-2017 revelaram 31,70% da incidência geral da doença por CMV em safras de ervilha e espinafre. O ensaio de imunoabsorção enzimática em sanduíche de anticorpo triplo (TAS-ELISA) revelou que todos os isolados positivos pertencem ao subgrupo II do CMV. Dois cDNA selecionados de amostras positivas para ELISA representando cada safra de ervilha e espinafre foram amplificados por PCR (ca.1100 pb) e sequenciados correspondendo ao gene CMV CP que compartilhou 93,7% de identidade de nucleotídeo um com o outro. Ambas as sequências de isolados de ervilha CMV (AAHAP) e espinafre (AARS) do Paquistão foram submetidas ao GenBank como nos de acesso. MH119071 e MH119073, respectivamente. A análise BLAST revelou 93,4% de identidade de sequência do isolado AAHAP com SpK (KC763473) do Irã, enquanto o isolado AARS compartilhou a identidade máxima (94,5%) com a cepa 241 (AJ585519) da Austrália e agrupada com alguns isolados de referência do subgrupo II de CMV do Reino Unido (Z12818) e EUA (AF127976) em uma reconstrução filogenética vizinha. Um total de 59 sítios polimórficos (segregantes) (S) com diversidade de nucleotídeos (π) de 0,06218 foi evidente, enquanto nenhum evento INDEL foi observado em isolados do Paquistão. A distância evolutiva de isolados de CMV do Paquistão foi registrada como 0,0657 entre si e 0,0574-0,2964 com outros isolados de CMV relatados em outras partes do mundo. Um fluxo gênico frequente (Fst = 0,30478 < 0,33) foi observado entre os isolados de CMV do Paquistão e relatados anteriormente. Na análise de diferenciação genética, os valores de três testes estatísticos baseados em [...].

Genetic diversity and molecular characterization of Cucumber mosaic cucumovirus (CMV) subgroup II infecting Spinach (Spinacia oleracea) and Pea (Pisum sativum) in Pothwar region of Pakistan

Abstract Cucumber mosaic virus (CMV) is a tremendous threat to vegetables across the globe, including in Pakistan. The present work was conducted to investigate the genetic variability of CMV isolates infecting pea and spinach vegetables in the Pothwar region of Pakistan. Serological-based surveys during 2016-2017 revealed 31.70% overall CMV disease incidence from pea and spinach crops. Triple-antibody sandwich enzyme-linked immunosorbent assay (TAS-ELISA) revealed that all the positive isolates belong to CMV subgroup II. Two selected cDNA from ELISA-positive samples representing each pea and spinach crops were PCR-amplified (ca.1100 bp) and sequenced corresponding to the CMV CP gene which shared 93.7% nucleotide identity with each other. Both the sequences of CMV pea (AAHAP) and spinach (AARS) isolates from Pakistan were submitted to GenBank as accession nos. MH119071 and MH119073, respectively. BLAST analysis revealed 93.4% sequence identity of AAHAP isolate with SpK (KC763473) from Iran while AARS isolate shared maximum identity (94.5%) with the strain 241 (AJ585519) from Australia and clustered with some reference isolates of CMV subgroup II from UK (Z12818) and USA (AF127976) in a Neighbour-joining phylogenetic reconstruction. A total of 59 polymorphic (segregating) sites (S) with nucleotide diversity () of 0.06218 was evident while no INDEL event was observed in Pakistani isolates. The evolutionary distance of Pakistani CMV isolates was recorded as 0.0657 with each other and 0.0574-0.2964 with other CMV isolates reported elsewhere in the world. A frequent gene flow (Fst = 0.30478 0.33) was observed between Pakistani and earlier reported CMV isolates. In genetic differentiation analysis, the value of three permutation-based statistical tests viz; Z (84.3011), Snn (0.82456), and Ks* (4.04042) were non-significant. The statistical analysis revealed the values 2.02535, 0.01468, and 0.71862 of Tajima's D, Fu, & Lis F* and D* respectively, demonstrating that the CMV population is under balancing selection.

Resumo Cucumber mosaic cucumovirus (CMV) é uma tremenda ameaça aos vegetais em todo o mundo, inclusive no Paquistão. O presente trabalho foi conduzido para investigar a variabilidade genética de isolados de CMV infectando vegetais de ervilha e espinafre na região de Pothwar, Paquistão. Pesquisas com base em sorologia durante 2016-2017 revelaram 31,70% da incidência geral da doença por CMV em safras de ervilha e espinafre. O ensaio de imunoabsorção enzimática em sanduíche de anticorpo triplo (TAS-ELISA) revelou que todos os isolados positivos pertencem ao subgrupo II do CMV. Dois cDNA selecionados de amostras positivas para ELISA representando cada safra de ervilha e espinafre foram amplificados por PCR (ca.1100 pb) e sequenciados correspondendo ao gene CMV CP que compartilhou 93,7% de identidade de nucleotídeo um com o outro. Ambas as sequências de isolados de ervilha CMV (AAHAP) e espinafre (AARS) do Paquistão foram submetidas ao GenBank como nos de acesso. MH119071 e MH119073, respectivamente. A análise BLAST revelou 93,4% de identidade de sequência do isolado AAHAP com SpK (KC763473) do Irã, enquanto o isolado AARS compartilhou a identidade máxima (94,5%) com a cepa 241 (AJ585519) da Austrália e agrupada com alguns isolados de referência do subgrupo II de CMV do Reino Unido (Z12818) e EUA (AF127976) em uma reconstrução filogenética vizinha. Um total de 59 sítios polimórficos (segregantes) (S) com diversidade de nucleotídeos () de 0,06218 foi evidente, enquanto nenhum evento INDEL foi observado em isolados do Paquistão. A distância evolutiva de isolados de CMV do Paquistão foi registrada como 0,0657 entre si e 0,0574-0,2964 com outros isolados de CMV relatados em outras partes do mundo. Um fluxo gênico frequente (Fst = 0,30478 0,33) foi observado entre os isolados de CMV do Paquistão e relatados anteriormente. Na análise de diferenciação genética, os valores de três testes estatísticos baseados em permutação viz, Z (84,3011), Snn (0,82456) e Ks * (4,04042) não foram significativos. A análise estatística revelou os valores 2,02535, 0,01468 e 0,71862 de Tajimas D, Fu, & Lis F * e D * respectivamente, demonstrando que a população de CMV está sob seleção de balanceamento.

Antibiotic Prophylaxis Before Invasive Dental Procedures for Patients atHigh Risk of Infective Endocarditis - A Systematic Review

Background: Clinical use of antibiotics prophylaxis (AP) for preventing infective endocarditis (IE) after invasive dental procedures is controversial. Expert consensus guidelines are inconsistent, either restricting its use to high?risk individuals or advising its use again. Objectives: To determine whether there is a genuine need for AP to prevent IE in high?risk patients undergoing invasive dental procedures. Methods: Online search was performed on PubMed, Science Direct, British Dental Journal and Cochrane Register of Controlled Trials. The methodological quality of each study was assessed using the Cochrane Handbook for Systematic Reviews of Interventions. Results: Seventeen (17) clinical trials were included in the final analysis recruiting 2,410 patients (AP = 1,366; placebo = 1,044). Bacteraemia was detected in 302 AP patients (22.1%) and 362 placebo patients (34.7%). AP reduced the risk of bacteraemia by 49% (risk ratio: 0.51; 95% CI; 0.45 to 0.58; P = 0.0001). Conclusion: Although using AP for IE may be pragmatic and justified for high?risk patients undergoing invasive dental procedures, the evidence is inconclusive because post?procedural bacteraemia may not be a good surrogate marker for IE. Moreover, trials investigating the direct association between AP and IE are lacking due to low disease prevalence and high?cost challenges

Evaluation of Trifarotene 50 ?g/g Cream in the Treatment of Facial and Truncal Acne Vulgaris: A Single Centre Study

Background: Acne vulgaris is a frequent skin condition of the face and trunk that negatively influences the quality of life. It frequently impacts the face, shoulders, chest, and back, however, the cure for nonfacial acne has no longer been fastidiously studied. Trifarotene is a new first-in-class fourth-generation topical retinoid that has been uniquely studied in the treatment of each facial and truncal acne. Through selective agonism of the retinoic acid receptor (RAR)-?, the most predominant RAR-? isotype in the epidermis, trifarotene exerts extra targeted, skin-specific outcomes than earlier-generation retinoids. The aim of the study to assess the safety and efficacy of trifarotene 50 ?g/g cream, a novel topical retinoid, in moderate facial and truncal acne.Material & Methods:Clinical samples were analyzed between 36 weeks in Shahid Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh. The patient informations and sources were retrospectively collected. 120 patients were detected in the department of Skin & venereal disease, at Shahid Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh. This cross-sectional study was done among patients to the evaluation of trifarotene 50 ?g/g cream in the treatment of facial and truncal acne vulgaris.Results:Out of 120 patients, the study population of patients according to age, where 46(38.33%) were 12 to 20 years and 74(61.67%) were 21 to 30 years. And according to sex, where 60% were female and 40% were male. Most of the patients belong to the female.Conclusion:We focus on efficacy, safety, and tolerability records and highlight exceptional life outcomes and patient-reported satisfaction. Future medical trials and the clinical applicability of this novel medication in the treatment of acne are additionally discussed.

Comparison of Serum Homocysteine and Highly Sensitive C- reactive protein Levels in Patients of Acute Coronary Syndrome with and without Type-2 Diabetes

Background: The association of high serum homocysteine concentration and C- reactive protein as a risk factor for the acute coronary syndrome. The aim of study was to evaluate serum homocysteine and hs-CRP level in newly diagnosed ACS patients together with comparison of homocysteine and hs-CRP level in ACS patients with & without type 2 diabetes and also to find out the correlation between serum homocysteine and hs- CRP level among the ACS patient with and without type 2 DM.Material & Methods:This was a cross sectional study and total of 260 patients with new onset of ACS admitted in the CCU, Department of Cardiology, DMCH were included in the study during Jan, 2011 to Feb, 2012. Among them 72 ACS patients with type 2 diabetes was considered as group I and 188 ACS patients without diabetes was considered as group II. Serum total homocysteine level, hs-CRP level and traditional risk factors for ACS were documented from all the study population.Results:Most of the patients were found in 4th decade in both groups. Acute STEMI was more common clinical feature in both groups. The mean serum homocysteine level in all groups of ACS patients were significantly higher in patients without DM in comparison to type 2 DM. Similarly, the mean hs-CRP level in all groups of ACS patients were significantly higher in patients without type 2 DM. The mean serum homocysteine and hs-CRP level were significantly higher in nondiabetic ACS patients. However, dyslipidaemia was significantly higher in patients with type 2 DM. Hypertension, obesity and family history of ACS were not significant between two groups. There was no correlation found between serum homocysteine with serum hs-CRP in ACS patients with type 2 DM and ACS patients without DM respectively.Conclusion: So, both serum homocysteine and hs-CRP level in ACS patients were significantly higher in patients without DM. In ACS, C-reactive protein elevation was a better marker of extension of myocardial damage than homocyesteine. No correlation was found between serum homocysteine with hs-CRP level in ACS patients with and without type 2 DM respectively.

An Observational Study Comparing the Adverse Effect Profiles of Sputnik V and Covaxin COVID-19 Vaccines in Adult General Population of Eastern India

Aim : Currently no data is available on the safety profile of COVID-19 Vaccines like Covaxin and Sputnik V from Eastern India. Our aim was to evaluate the safety profiles of Covaxin and Sputnik V Vaccine in Eastern India. Methods : 0.5 ml of Covaxin and Sputnik V given to 701 adults in a two-dose regimen at a private tertiary care Hospital, Kolkata, with the doses separated by 4-7 weeks in Covaxin and 3 weeks in Sputnik V. Data regarding local and systemic Adverse Event Following Immunizations (AEFIs) was collected 30 minutes after vaccination and also on the first- and seventh-day following vaccination after each dosage. Results : Incidence of AEFI was 65% and 59% following the first dose of vaccination in Covaxin and Sputnik V groups, respectively. Incidence of AEFI was 83% and 70% after the second dose in Covaxin and Sputnik V groups. Pain in the injection site was the most common adverse effect. Body-ache, fever and tiredness were other systemic side effects. Adverse effects were noticeably more after the second dose. Over half of the reactions were mild in nature. Covaxin had a higher number of moderate adverse reactions after both doses. Adults with age >40 years, Comorbidities, Hypertension and Diabetes had a smaller number of side effects following the first dose of vaccination. People with previous COVID-19 infections had noticeably fewer adverse effects after the second dose. Allergic adults were associated with more systemic side effects, whereas Hypertensive adults had less total AEFI. Conclusion : Both Covaxin and Sputnik V had favorable safety profiles. Sputnik V vaccine had significantly fewer AEFIs compared to Covaxin. Age, co-morbidities, specifically hypertension, Diabetes, Allergy and previous history of COVID-19 infection, were important variables observed in the prevalence of side effects.

Periprosthetic Femur Fracture in a 73-Year-Old Female: A Case Report

Increasing use of joint replacement for various conditions has led to a new group of fractures- the periprosthetic fractures. Periprosthetic fractures are considered which are associated with an orthopaedic implant. Worldwide incidence of Periprosthetic fractures is increasing due to increased number of primary joint arthroplasties and other revision surgeries. Periprosthetic femoral fracture can be classified as intraoperative & post-operative. The intraoperative periprosthetic fractures usually occur during the insertion of the femoral stem, often preceded by an area of increased cortical thickness. The management of these fractures are complex and usually needs application of basic principles to fit an individual situation rather than having a fixed set of rules. Standard treatment protocol includes use of locking plate with encirclage wires. In this study, we provide a case of periprosthetic femur fracture pain. A 75-year-old woman presented to us with pain in her right hip and thigh. The patient was a homemaker who had cemented total hip replacement surgery due to a femoral neck fracture 27 days back. After the primary replacement surgery, the patient appeared to be doing well and adhering to the hip precautions. While getting out of bed, she tripped and fell carelessly in the morning & complained of severe pain in her right hip. After assessment of all her medical conditions and physical examination, she was advised for revision surgery. An open reduction and internal fixation of the fracture with revision of the femoral component was planned. Risks, benefits, and alternatives were discussed at length with her and her family. The patient and her family agreed to the operative plan.

Outcome of Longitudinal Pancreatico-Jejunostomy on Pain Control and Pancreatic Function in Chronic Pancreatitis

Background: Outcome of drainage operation for chronic pancreatitis are variable. The present study is taken to observe effect of longitudinal pancreatico-jejunostomy (LPJ) on pain control and pancreatic function in chronic pancreatitis in our setting.Material & Methods:Thirty-three patients who underwent LPJ for symptomatic chronic pancreatitis for one year period presented with abdominal pain (100%), steatorrhoea (30.3%), diabetes (66.7%) and weight loss (78.8%). Definitive diagnosis was made on the basis of ultrasonography and MRCP findings. LPJ (Partingtong-Rochelle) operation was done in all patients. Pain (using visual analoge scale), glycemic status (using FBS, 2hABF, HbA1c), body weight, serum zinc levels (as a marker of exocrine function), and serum insulin level (as a marker of endocrine function) were measured immediately after admission and 3 months after operation.Results:Three months after operation pain was completely disappeared in 23 (69.7%) patients, it persisted in different grade in 10 (30.3%) patients and the pain reduction rate was significant. Twenty two patients who had diabetes prior to surgery, their glycemic status significantly decreased and serum insulin level significantly increased (preoperative; 7.1�1 礥/L, postoperative; 14.3�礥/L) in 22 patients with DM after surgery. Serum zinc level increased (preoperative; 80.8�.5 礸/dl, postoperative; 85.3�.7 礸/dl) 3 months after surgery but the difference was not significant (p=0.571). However the body weight of all patients were significantly increased after operation.Conclusions:LPJ reduces abdominal pain and improves both exocrine and endocrine function in patient with chronic pancreatitis. Serum zinc levels can be considered as a tool of exocrine function.

Anterior Segment Optical Coherence Tomography In Scleral Lens Fitting

Background: AS-OCT is a noncontact imaging device that provides the detailed structure of the anterior part of the eyes. The Objectives In this review, the author will discuss the clinical applications of AS-OCT in the scleral contact lens fittings.Material & Methods:Pre-Scleral lens fit and post fit ASOCT done on 30 patients to assess the normal fitting and compare it with the slit lamp evaluation.Results:ASOCT gives a Quantitative measurement of the fit.Conclusions:ASOCT comes out as a helpful tool for beginners particularly for a good assessment of a contact lens fit. The author also presents some interesting cases demonstrated via AS-OCT.

Ocular Prosthesis � For Beginners

Background: The Ocular Prosthesis device is very important toprovide the best possible functional & cosmetic results. It is important to have a firm understanding of management of the anophthalmic socket & when to make appropriate referrals to the Ophtahlmic Surgeon. The Objectives In this review, the author will discuss about one of the component of Ocular Prosthesis ie. Orbital implants.Material & Methods:The patients who requires ocular prosthesis are selected as per the need & requirement, also on the basis of types of available implants.Results:One should follow the components& scenario for optimal outcome.Conclusions:An eye care professional should be aware of the entire structure & all the recent development involved in it. They also have to be empathetic and have a creative oulook in management of such conditions by using all the available resources.