Mannich bases derivatives of 2-Phenyl-5-Benzimidazole sulfonic acid; Synthesis, Characterization, Computational studies and Biological evaluation

Abstract A new series of N-Mannich bases of 2-Phenyl-5-benzimidazole sulfonic acid have been synthesized through amino methylation reaction with secondary amines. The two moieties were held together through a methylene bridge, which comes from formaldehyde (Formalin Solution 37%) used in the reaction. Chemical structures of the newly synthesized compounds have been confirmed using FT-IR, 1HNMR and 13CNMR. Different in vitro assays including Anti-oxidant, Enzyme inhibition, Anti-microbial and Cytotoxicity assay were performed to evaluate the biological potential with reference to the standard drug. Among the synthesized library, compound 3a shows maximum alpha-glucosidase inhibition with an IC50 value of 66.66 µg/ml, compound 3d was found most toxic with LC50 value of 10.17 µg/ml. ADME evaluation studies were performed with the help of Molinspiration online software. Docking calculations were also performed. Given the importance of the nucleus involved, the synthesized compound might find extensive medicinal applications as reported in the literature.

Current pandemic COVID-19 vaccine strategies and development: a comprehensive review

The coronavirus disease-19 pandemic with the characteristics of asymptomatic condition, long incubation period and poor treatment has influenced the entire globe. Coronaviruses are important emergent pathogens, specifically, the recently emerged sever acute respiratory syndrome coronavirus 2, the causative virus of the current COVID-19 pandemic. To mitigate the virus and curtail the infection risk, vaccines are the most hopeful solution. The protein structure and genome sequence of SARS-CoV-2 were processed and provided in record time; providing feasibility to the development of COVID-19 vaccines. In an unprecedented scientific and technological effort, vaccines against SARS-CoV-2 have been developed in less than one year. This review addresses the approaches adopted for SARS-CoV-2 vaccine development and the effectiveness of the currently approved vaccines(AU)

La pandemia de COVID-19, con sus características de condición asintomática, largo periodo de incubación y escaso tratamiento, ha tenido un impacto global. Los coronavirus son importantes patógenos emergentes, específicamente, el coronavirus del síndrome respiratorio agudo severo 2 descubierto recientemente, virus causal de la actual pandemia de COVID-19. Para mitigar el virus y reducir el riesgo de infección, las vacunas son la solución más esperanzadora. La estructura de la proteína y la secuencia del genoma del SARS-CoV-2 se procesaron y proporcionaron en un tiempo récord, lo que ha permitido el desarrollo de las vacunas contra el COVID-19. En un esfuerzo científico y tecnológico sin precedentes, se han desarrollado vacunas contra el SARS-CoV-2 en menos de un año. Esta revisión aborda los enfoques adoptados para el desarrollo de la vacuna contra el SARS-CoV-2 y la eficacia de las vacunas actualmente aprobadas(AU)

Delay in Diagnosis of Stomach Cancer Patients Attending a Tertiary CareHospital in Kashmir: A Hospital Based Cross Sectional Study

Introduction: cancers is associated with a favourable outcome. Stomach cancer is one of the most common cancers of gastrointestinal tract. Majority patients visit physicians in developed stages. To evaluate theObjective: reporting pattern of stomach cancer patients living in Kashmir valley in order to determine the median time of delay from the beginning of symptoms to diagnosis. Total 116 proven stomach cancer patientsMethod: were evaluated for the pattern of presentation at endoscopy laboratory of Super Speciality Hospital, Shireen Bagh Kashmir from April 2019 to September 2020. In this study, the mean age (SD) of participantsResults: was 60.22 ± (11.90) years. Majority of the participants (69.8%) were males. Cases were predominantly from the rural area (58%).Only 15.5 % of the cases were diagnosed within one month of their symptoms while as 3.4% of the cases had a total delay of more than 12 months. The study found a considerable total delay in the diagnosis of stomach cancer. The mean of the patient delay was 45.6 days. The median total delay was 20 weeks. Since stomach cancer has high mortality and morbidity rates associated, creatingConclusion: awareness among the population and training of physicians regarding timely referral of patients seems important

Determination of Serum Thyroglobulin Concentration in Simple Diffuse Goiter Patients with Known Iodine Status

Background: Thyroglobulin (TG) seems to be a valuable indicator of thyroid function and iodine nutrition status. Aim of the study: The aim of the study was to observe the relationship between serum thyroglobulin and urinary iodine (UI) in simple diffuse goiter patients.Methods:This cross-sectional observational study was conducted at the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. The study duration was 2 years, starting from May 2014 to March 2016. Total 87 patients with simple diffuse goiter attending the OPD Department of Endocrinology of BSMMU had been recruited as study population. A purposive sampling technique was followed for sample selection.Results:Serum thyroglobulin (ng/mL, mean盨D and median) was lowest in the age group 12-16 years (6.0�5, 5.16 ng/mL) followed by age>31 years (8.8�1, 6.16 ng/mL), whereas other age groups showed level around 13.0 and 10.0 ng/mL (p= 0.520). Mean (盨D) Urinary Iodine was not statistically different among age groups (347.4� 226.5 vs. 337.08�8.9 vs. 300.5� 95.37 vs. 337.7� 225.42 vs. 278.3� 105.7, 礸/L; F 0.451, p=0.771) while median values were 325.26 vs. 355.68 vs. 325.80 vs. 338.86 and 300.90 礸/L respectively. Neither thyroglobulin (5.76�72 vs. 11.60� 13.50; 3.47 vs. 8.9 ng/mL, m盨D and median; p=0.294) nor Urinary Iodine (373.5� 44.5 vs. 317.2� 180.32; 378.1 vs. 308.9 礸/L, m盨D and median; p=0.450) were statistically different between the gender groups. Similarly, thyroglobulin and Urinary Iodine were also statistically similar for grade-1 and grade-2 goiter (thyroglobulin: 6.79�33 vs. 11.67�.69 and 6.74 vs. 8.02 ng/mL, m盨D and median, p=0.319; Urinary Iodine: 361.33� 51.60 vs. 317.09� 182.44, 362.69 vs. 305.35 礸/L, m盨D and median, p=0.498).Conclusion:Thyroglobulin seems to have an inverse association in iodine deficiency state and positive association in over sufficient state with UI. There was no statistically significant difference of TG concentration between males and females nor between Grade-1 and Grade-2 goiter.

Seasonal Fluctuations of N, P and K in Leaves Influenced Nutrient Requirement During Fruit Development Stages in Different Olive Genotypes

Abstract: Olive is grown in semi-arid climatic conditions; however, little is known about mineral changes in olive plant and nutrient requirements during the production period. Hence, the current study was conducted under Pothwar agro-climatic conditions in order to select appropriate stage of macronutrients (N, P, K) application in relation to soil and leaf nutritional status during 2017 and 2018 growing seasons. Soil and leaf analysis were performed at four different phenological stages (i.e. flowering, fruit setting, fruit enlargement and fruit maturity stages). The results revealed that the assessed macronutrient in leaf and soil varied significantly among varieties, phenological stages and growing year. The results revealed also that nitrogen level was found to decrease from fruit set (1.56%) to fruit enlargement stage (1.47%). Leaf and soil N, P and K contents were found higher before the flowering (stage 1) and depleted after fruit harvesting (stage 4), regardless of olive varieties. However, high yielding varieties showed lower nutrients after fruit harvesting (stage 4). Therefore, N content in leaf and soil gradually decreased during fruit growth and development. Whereas, K content in leaf and soil sharply declined from fruit maturity to fruit ripening stage. Overall, the trend of nutrient depletion showed that plants need phosphorus for fruit setting, nitrogen before and after fruit setting, and potash after pit hardening or at oil accumulation stages.

Effectiveness of agricultural extension's farmer field schools (FFS) in Pakistan: the case of citrus growers of Punjab province / Eficácia das escolas de extensão agrícola de campo (FFS) no Paquistão: o caso dos produtores de frutas cítricas da província de Punjab

ABSTRACT: Citrus is one of the major exported fruits of Pakistan. Especially Kinnow cultivar is famous across the globe because of its aroma and taste. The overall production of citrus is reported as half of the potential because of the non-adoption of research-based practices and lack of agricultural extension services and training of the citrus growers. In the last few years, the department of agricultural extension has started training programs called Farmer Field Schools (FFS) for citrus growers in the major citrus growing zone of the Punjab province, i.e., Sargodha region. This research was conducted in the Sargodha district to evaluate the knowledge and skills gained by the farmers from the FFS. The interview schedule was designed for the purpose of data collection. The data was collected from 120 farmers randomly selected from 15 FFS in the study area. All the respondents were participants of the FFS. The data was analyzed using Statistical Package for Social Sciences (SPSS). The Results of the study showed that 40% of the farmers learned about citrus verities, one-third of respondents learned about the management of new plants/orchards, 28% of the respondents got knowledge about the cultivation of fruits, and one-fourth of respondents acquired knowledge and skills about layout and management of citrus orchards. These findings conclude that training course has a positive influence on farmers' farm management skills; hence emphasize on its persistence and further improvement by the concerned authorities.

RESUMO: Os citros são as principais frutas exportadas do Paquistão, especialmente, a cultivar Kinnow é famosa em todo o mundo por causa de seu aroma e sabor. A produção geral de citros é relatada como a metade do potencial devido a não adoção de práticas baseadas em pesquisas e a falta de serviços de extensão agrícola e treinamento dos citricultores. Nos últimos anos o departamento de extensão agrícola iniciou programas de treinamento chamados Farmer Field Schools (FFS) para citricultores na maior zona de cultivo de citros da província de Punjab, no distrito de Sargodha. Esta pesquisa é conduzida no distrito de Sargodha para avaliar o conhecimento e as habilidades adquiridas pelos agricultores da FFS. O cronograma de entrevistas foi elaborado para fins de coleta de dados. Os dados foram coletados de 120 agricultores aleatoriamente de 15 FFS na área de estudo. Todos os entrevistados eram participantes da FFS. Os dados foram analisados ​​por meio do programa estatístico "Statistical Package for the Social Sciences (SPSS"). Os resultados do estudo mostraram que 40% dos agricultores aprenderam informações importantes sobre citros, um terço dos entrevistados aprenderam sobre o manejo de novas plantas / pomares, 28% dos entrevistados aprenderam sobre o cultivo de frutas e um quarto dos entrevistados adquiriu os conhecimentos e habilidades sobre layout e manejo de pomares de citros. Essas descobertas concluem que o curso de treinamento tem uma influência positiva nas habilidades de gestão das propriedades; portanto, suporta a necessidade de sua persistência e melhorias adicionais pelas autoridades para alavancar ainda a produtividade essa atividade no futuro.

Therapeutic potential of medicinal plants against Leishmaniasis: a public healh concern / Potencial terapeútico de plantas medicinales contra la Leishmaniasis: un problema de salud pública

Leishmaniasis is an important disease affecting global public health which is spread by sand fly having different species. Various chemical drugs are used to treat and control Leishmaniasis including pentavalent antimonials, antimicrobial and antibiotics. Due to emergence of drug resistance, these therapeutic options are losing effectiveness in attaining success. Furthermore, these drugs are expensive and have toxic effects on liver and kidneys. There has been an emerging interest and excellent response by using plant based drugs and extracts to control Leishmaniasis. Different medicinal plants including Glycyrrhiza glabra, Allium sativum, Peganum harmala and Nigella sativa have shown excellent anti-leishmanial activity. Therefore, medicinal plants can help in effective drug development against Leishmaniasis diseases in both animals and humans which will be safer and health protective.

La Leishmaniasis es una enfermedad importante que afecta la salud pública mundial y que es transmitida por las moscas de la arena, que tienen diferentes especies. Se utilizan varios medicamentos químicos para tratar y controlar la Leishmaniasis, incluidos los antimoniales pentavalentes, antimicrobianos y antibióticos. Debido a la aparición de resistencia a los medicamentos, estas opciones terapéuticas están perdiendo eficacia para lograr el éxito. Además, estos medicamentos son costosos y tienen efectos tóxicos en hígado y riñones. Ha habido un interés emergente y una excelente respuesta mediante el uso de extractos y medicamentos a base de plantas para controlar la Leishmaniasis. Diferentes plantas medicinales como Glycyrrhiza glabra, Allium sativum, Peganum harmalay Nigella sativahan mostrado una excelente actividad anti-leishmanial. Por lo tanto, las plantas medicinales pueden ayudar en el desarrollo de fármacos eficaces contra las enfermedades de la leishmaniasis tanto en animales como en seres humanos, lo que será más seguro y proteja la salud.

Comparative anthelmintic efficacy of Arundo donax, Areca catechu, and Ferula assa-foetida against Haemonchus contortus / Eficácia anthelmíntica comparativa de Arundo donax, Areca catechu e Ferula assa-foetida contra Haemonchus contortus

Abstract In the present study, anthelmintic activities of Arundo (A.) donax L., Areca (Ar.) catechu L., and Ferula (F.) assa-foetida L. were determined. Leaves of A. donax L., latex of F. assa-foetida L. and seeds of Ar. catechu L. in different solvent fractions were subjected to in vitro (egg hatch assay; EHA, and adult motility assay; AMA) and in vivo (faecal egg count reduction test; FECRT) tests of anthelmintic activity using Haemonchus contortus model. In the AMA, crude aqueous methanol extracts (CAME) and ethyl acetate fractions of F. assa-foetida at 10 hr post-treatment showed maximum mortality of H. contortus at 12.5-50 mg mL-1. In the EHA, CAME of F. assa-foetida was identified as a potent ovicide based on its low LC50 (16.9 µg mL-1), followed in order by Ar. catechu and A. donax. Results from the FECRT also showed the extract of F. assa-foetida L. to be more effective than those of Ar. catechu L. and A. donax L., against the gastrointestinal parasitic nematodes. Chloroform and ethyl acetate fractions showed better anthelmintic activities against the adult worms in vitro, while CAME of these plants were better than their crude powders in vivo. It is recommended to document and investigate indigenous knowledge of possible medicinal plants to plan scientific trials that may justify their endorsement.

Resumo No presente estudo, as atividades anti-helmínticas de Arundo (A.) donax L., Areca (Ar.) Catechu L. e Ferula (F.) assa-foetida L. foram determinadas. Folhas de A. donax L., látex de F. assa-foetida L. e sementes de Ar. catechu L. em diferentes frações de solvente foram submetidos a testes in vitro (teste de eclosão de ovos, EHA e ensaio de motilidade em adultos, AMA); e in vivo (teste de redução da contagem de ovos fecais, FECRT) de atividade anti-helmíntica, usando-se Haemonchus contortus. Na AMA, extratos aquosos brutos de metanol (CAME) e frações de acetato de etila de F. assa-foetida. Dez horas pós-tratamento, apresentaram mortalidade máxima de H. contortus em 12,5-50 mg mL-1. No EHA, CAME de F. assa-foetida foi identificado como um ovicida potente baseado em seu baixo LC50 (16,9 µg mL-1), seguido em ordem por Ar. catechu e A. donax. Os resultados do FECRT também mostraram que o extrato de F. assa-foetida L. é mais eficaz do que o de Ar. catechu L. e A. donax L., contra nematoides parasitas gastrointestinais. As frações clorofórmio e acetato de etila mostraram melhores atividades anti-helmínticas contra vermes adultos in vitro, enquanto o CAME dessas plantas foi melhor do que o pó bruto in vivo. Recomenda-se documentar e investigar o conhecimento indígena de possíveis plantas medicinais para planejar ensaios científicos que possam justificar seu endosso.

Impact of diabetes mellitus on nerves

Background: Involvement of the peripheral and autonomic nervous systems is probably the most common complication of diabetes. The main symptoms of diabetic polyneuropathy include negative symptoms (those related to nerve fiber loss or dysfunction) such as numbness and weakness, and positive symptoms (those related to abnormal function of surviving nerve fibers) such as tingling and pain.Methods: This was a cross-sectional study held in diabetic clinic of Nishter hospital, Multan, Pakistan. The study included any diabetic patients showing symptoms of neuropathy.Results: There were total of 140 in this study. This study included 85% of male and 15% of female. Most common symptoms of diabetic neuropathy were pain (70%) and tingling (70%) followed by numbness in 65% of patients. There were 28 patients in 5 years duration of diabetes, 35 people in 6-10 years duration, 21 patients in 11-15 years duration, and 14 patients in 20+ years duration.Conclusions: Neuropathy due to diabetes is crippling especially when pain is the prominent symptoms. Autonomic symptoms like constipation and lightheadedness are discomforting for the patients. The most commonly used screening test is vibrating tuning fork test which is east to perform is clinical setting and is not time consuming. Diabetic patients need to take special care of.

The spectrum of Evans syndrome: a literature review

Evans syndrome (ES) is an autoimmune disorder characterized by the simultaneous or sequential development of autoimmune hemolytic anemia (AIHA) and immune thrombocytopenia (ITP) and/or immune neutropenia in the absence of any underlying cause. Evans syndrome is a rare disorder although the exact frequency is unknown. No sex predilection is known and Evans syndrome has been described in all ethnic groups and at all ages. Classification of ES includes primary, with this being an exclusion diagnosis with no underlying condition, and secondary in the presence of an underlying disease. Clinical features are associated with anemia and thrombocytopenia including pallor, weakness, fatigue, jaundice, petechiae, ecchymosis, gingivorrhagia and epistaxis. First, a detailed history must be taken from the patient to determine the risk factors for developing ES then a family history of immune disorders along with a thorough physical examination. The management of Evans syndrome remains a challenge. Steroids with and without IVIG are recommended as front-line therapy. Red blood cell/platelet transfusion is indicated only in severe symptomatic patients due to the risk of exacerbations. Splenectomy may also be considered a second-line treatment.

Types and clinical presentation of stroke

Background: Stroke is one of the leading causes of mortality and morbidity worldwide. In this study, authors worked on clinical presentation and types of stroke. The two main types of strokes are ischemic and haemorrhagic. Brain infarction is caused by decrease blood flow due to either narrowing of artery or complete obstruction to blood flow owing to embolism. While haemorrhage is caused by rupture of artery or aneurysms leading to accumulation of blood in the brain parenchyma.Methods: Cross sectional study of group of patients in Nishtar hospital Multan, Pakistan who presented with variety of neurological symptoms who were subsequently diagnosed as non-traumatic stroke. All patients were subjected to a detailed history and thorough clinical examination and investigations after obtaining informed consent.Results: Of 122 patient, 66 patients were male and 56 were female. Ischemic stroke was more common: present in 76 patients as compared to 46 patients with hemorrhagic stroke. Hypertension was present in 40.9% of ischemic stroke and 27.8% of hemorrhagic strokes. Most of the patients (67.2%) had altered sensorium at presentation followed by hemiplegia in 39.3 % of patients.Conclusions: Prevalence of ischemic strokes is higher than that of haemorrhagic stroke. Hypertension is associated with both types of these strokes. Moreover, hyperglycaemia and high blood pressure are common in early phase of stroke. Vomiting in stroke favors haemorrhagic stroke.

Pregnancy and Maternity at Workplace, a Qualitative Study to Know the Employers Perspective.

The twentieth century witnessed women expanding the range of possibilities for their gender; by participating as professionals in different fields and by actively dissolving the boundaries of the traditionally held gender roles and they continue to work even during the most crucial phase of their life, that is pregnancy. Discussing the factors related with women's career progress, the negative aspects were found to be domination of men in senior executive positions, discrimination against women, and gender stereotyping. The main objective of this study was to take point of view of employers regarding pregnancy at workplace, their concerns and challenges and how they place themselves in the whole scenario of changing environment for a worker.METHODSA qualitative study design was adopted by conducting semi-structured interviews for which a guideline was developed beforehand. In depth interviews were conducted with the employers at different levels in different organizations of Lahore.RESULTSClassical content analysis of interviews revealed that employers display unfavourable attitude towards the employment of childbearing age group women in the first place and pregnancy at workplace is not a welcoming event at all. All this negative attitude is due to the cost and HR issues raised by the absences and maternity leave of a pregnant worker. There is a great chaos regarding workload shared by the colleagues in pregnant women’s absence. For maternity leave, cost of hiring a new person and training are the issues raised by the employers especially in small organizations.CONCLUSIONSThere is a great need to give awareness to workers as well as management regarding laws and regulations about maternity at workplace.

Cytotoxicity, Morphology and Chemical Composition of Two Luting Cements: An in Vitro Study

Abstract Objective: To assess the cytotoxicity, surface morphology, elemental compositions and chemical characterization of two commonly used luting cement. Material and Methods: The two luting types of cement used were Elite Cement® and Hy-Bond Resiglass®. Freshly mixed (n=6) and set form (n=6) of each cement was placed in medium to obtain extracts. The extract from each sample was exposed to L929 mouse fibroblasts (1x104cells/well). Alamar Blue Assay assessed cell viability. Surface morphology and elemental composition were evaluated using scanning electron microscopy and energy dispersive spectroscopy. The chemical characterization was performed by Fourier Transform Infrared Spectroscopy. One-way ANOVA and post-hoc Tukey analysis were conducted to assess results. Results: Hy-Bond Resiglass® was the more cytotoxic of the two types of cement in both freshly mixed (68.10 +5.16; p<0.05) and set state (87.58 +4.86; p<0.05), compared to Elite Cement® both freshly mixed (77.01 +5.45; p<0.05) and set state (89.39 +5.66; p<0.05). Scanning electron microscopy revealed a more irregular and porous structure in Hy-Bond Resiglass® compared to Elite Cement®. Similarly, intense peaks of aluminium, tungsten and fluorine were observed in energy dispersive spectroscopy in Hy-Bond Resiglass. Conclusion: All these three elements (aluminium, tungsten and fluorine) have cytotoxic potential. The Fourier transform infrared spectroscopy revealed the presence of hydroxyethyl methacrylate in Hy-Bond Resiglass®, which has a cytotoxic potential.

Observation of Adverse Effect of Topiramate & Propranolol in Migraine Prophylaxis

Background: Migraine headache is a common neurologicalepisodic condition originating from the central nervous systemthat can significantly impair the lives of otherwise normallyfunctioning people. Pharmacologic options for migraineprophylaxis include beta blockers, calcium channel blockers,antidepressants and anticonvulsants; all of which have varyingdegrees of adverse effects that may significantly limit their usein this disease.Objectives: To observe whether low dose Topiramate is moreeffective compared to Propranolol in migraine prophylaxis.Methods: This clinical trial was carried out in the Out PatientDepartment (OPD) & Headache Clinic, Department ofNeurology, Bangabandhu Sheikh Mujib Medical University,Dhaka. A total of 120 patients around the age range of 18 to 50years diagnosed as migraine (with aura or without aura)according to ICHD-3 criteria, were recruited as the studypopulation. By simple random sampling procedure, using odd& even number, 60 patients were administered by Tab.Topiramate 50 mg/ day named as group-I and rest 60 patientswere administered by Tab. Propranolol 80 mg /day named asgroup-II. Out of them in total 96 patients had completed thestudy due to drop out of 13 patients in group-I & 11 patients ingroup-II in different steps of follow up. Finally 47 patientsremain in group-I and 49 patients in group-II. During trial, threefollow up visits were taken for both group, 1st follow up after 4weeks of baseline information (Before starting prophylacticmedication), 2nd follow up after 4 weeks of treatment, 3rdfollow up after 8 weeks of treatment. Efficacy of treatment wasmeasured by headache frequency, duration and Severity ofheadache as measured by the VAS.Results: The mean (SD) age of group-I (topiramate) andgroup-II (propranolol) group were found 29.72 (9.58) yearsand 30.96 (10.11) years respectively. Female sex was foundpredominant in both groups. At final follow up, there wasstatistically significant difference in mean (SD) value offrequency of migraine attack between topiramate andpropranolol group [4.72 (2.80) vs. 3.48 (2.20); p=0.024].Propranolol appeared statistically significant than topiramate[TPM 5.53 (2.98) vs. PRO 4.36 (1.55); p=0.047]. RegardingSeverity of headache, better results also were observed in thepropranolol group than topiramate (p < 0.05). Both drugsappeared significant in efficacy measurement (p < 0.001).Patient drop out was more in the topiramate group than thepropranolol group (21.68 % vs. 18.34%). Furthermore, in thetopiramate group, patients complained of more adverse effectsthan propranolol group (23.4% vs. 14.3%), which wasstatistically significant.Conclusion: The present study suggests that low doseTopiramate and Propranolol are effective for migraineprophylaxis in reduction of frequency, Severity and duration ofmigraine headache individually and propranolol appears moreeffective compared to that of topiramate.

Potential of botanical driven essential oils against Haemonchus contortus in small ruminants / Potencial de aceites esenciales botánicos contra Haemonchus contortus en pequeños rumiantes

The livestock sector is continuously facing problems in controlling parasitic diseases especially Haemonchosis due to emergence of anthelminthic resistance and failure in vaccination control programmes. Therefore, to increase milk and meat production and emerging demand of meat free from drug residues development of new alternative approaches are appealing for prevention and control of Haemonchosis in small ruminants. Among alternatives, plants driven essentials oils have shown promising results in control of Haemonchus contortus infection at various concentrations by different assays including egg hatch assay, larval development assay, larval exsheathment assay and adult motility assay. Essential oils are complex mixtures of various impulsive or volatile compounds which have potential to control Haemonchosis. The current study reviews the therapeutic effects of essential oils of plants against Haemonchus contortus and to be used them against Haemonchus contortus for future perspectives.

El sector ganadero enfrenta continuamente problemas para controlar las enfermedades parasitarias, especialmente la hemoncosis, debido a la aparición de resistencia antihelmíntica y al fracaso en los programas de control de vacunación. Por lo tanto, para aumentar la producción de leche y carne, y la demanda emergente de carne libre de residuos de medicamentos, el desarrollo de nuevos enfoques alternativos es atractivo para la prevención y el control de la hemoncosis en pequeños rumiantes. Entre las alternativas, los aceites esenciales producidos por las plantas han mostrado resultados prometedores en el control de la infección por Haemonchus contortus a diversas concentraciones mediante diferentes ensayos, incluido el análisis de eclosión de huevos, el desarrollo de larvas, el análisis de vaciado de larvas y el ensayo de motilidad en adultos. Los aceites esenciales son mezclas complejas de varios compuestos impulsivos o volátiles que tienen potencial para controlar la hemonchosis. Este estudio revisa los efectos terapéuticos de los aceites esenciales de las plantas contra Haemonchus contortus y evalúa sus perspectivas futuras como agentes para combatir las enfermedades causadas por este parásito.

Three point fixation is superior to two point fixation technique for zygomatic complex fracture

Background:Isolated zygomatic or malar bone fractures are second most common fracture among facial skeletal injuries. It has been reported that three point fixation is appropriate for isolated zygomaticbone fracture. The objective of current study was to compare the mean difference in terms of malar height outcome by using different fixation techniques (two point and three point)in patients with zygomatic complex fracture.Methods:This randomized controlled trial was conducted at Department of Oral and Maxillofacial Surgery, MMDC, Multan, during a period of six months from 1st June 2017 to 30th November 2017. A total 182 patients of both genders were included in this study. Two point fixation techniques were used in Group-A patients. While 3 point fixation was used in Group-B patients. After 6 weeks follow-up, patients were assessed for malar height. Outcome was measured by comparing the mean difference of pre and postoperative malar height of both techniques. Data were analyzed using computer program SPSS-21. P≤0.05 was taken as significant in all analysis.Results:Among patients in two pointfixation group, the mean malar height was 67.55±2.98 mm and in three pointfixation group, meansmalar height was 71.55±2.36 mm. The difference of malar height among two treatments was highly significant with p<0.01. Conclusions: Using three point fixation results better as compared to two point fixations in terms of malar height outcome

Correlation of Obesity and Other Factors with Presence of Extra Hepatic Disease among the Patients Presenting with Fatty Liver

Purpose: To assess the Correlation of obesity and other factors with presence of extrahepatic disease among the patients presenting with fatty liver at CMH Rawalakot, Azad Kashmir. Study design: Correlational Study. Setting: Gastroenterology department CMH//Sheikh Khalifa Bin Zayad Al Nahyan Hospital Rawalakot. Duration of study: Six months, from 01-09-2018 to 01-03-2019. Patients and methods: A prospective study was conducted on 51 patients of fatty liver diagnosed on ultrasound by consultant radiologist of own hospital. The demographic profile included age, gender, presence of obesity, triglyceride levels and total cholesterol levels. Common extra-hepatic conditions which were looked for in this study included Diabetes mellitus (DM), Hypertension (HTN), Ischemic heart disease (IHD) and Osteoarthritis (OA) which were diagnosed with the help of detailed history taking, relevant physical examination and laboratory investigations. Results: Out of 51 patients included in the final analysis 31 were male and 20 were female. Twenty-seven participants had one or more co-morbid illnesses while 24 had no such diseases at the time of study. DM was the commonest comorbid illness while OA was least reported. Twenty four patients were obese while 27 had BMI less than 30. The presence of obesity and raised total cholesterol levels had a significant relationship with presence of extra-hepatic illness among the patients presenting with fatty liver. Conclusion: Patients presenting with fatty liver have high prevalence of extrahepatic diseases. Routine screening of common illnesses should be done on all the patients who have been diagnosed as having a fatty liver. Special attention should be given to the patients who had BMI more than 30 or raised total cholesterol levels.

A Comparison of Sensitivity and Specificity of AST to Platelet Index (APRI) and FIB-4 with Transient Elastography i.e. Fibro Scan in Chronic HCV Infected Patients

Background: Hepatitis C is a leading cause of liver fibrosis, cirrhosis, and cirrhosis associated complications. In this study, we compared readily available non-invasive fibrosis indexes with fibro scans for fibrosis staging and predicting its progression in Pakistani population. Methods: The retro prospective cross-sectional study was conducted in medicine unit 1 and 2 and hepatitis clinic of Lahore General Hospital, Lahore starting from February 12, 2018 to January 8, 2019. We studied 1464 HCV infected patients which were got CBC, LFTs, ELISA, PCR and fibro scan was done to perfectly diagnose ongoing hepatitis C infection. In order to differentiate HCV fibrosis progression, we compared the effectiveness of readily available AST to Platelet Index (APRI), and FIB-4 with fibro scan. Results: Readily available serum indexes AST to Platelet Index (APRI) and FIB-4 were able to stage liver fibrosis in advanced stages of fibrosis (F4 especially) with correlation coefficient indexes 0.462, and 0.131 with considerable specificities and sensitivities. For APRI >1.5, it did predict F4 stage with sensitivity of 87.6% and specificity of 74.8%. For Fib-4> 3.25, it did predict F4 stage with sensitivity of 72.3% and specificity of 53.2%. Conclusion: Readily available and cheap serum indexes, AST to Platelet Index (APRI) and FIB-4 accurately predicted distinguished between cirrhotic and non- cirrhotic stages in HCV infected patients in comparison to the costly and rarely available Fibro scan score.

Effectiveness of Endoscopist-Directed Nurse-Administered Propofol Sedation (EDNAPS) for EGD, Colonoscopy and MRCP: A Prospective Study in 929 Patients

Background/objectives: The aim of our study was to review the safety and effectiveness of Endoscopist-directed nurse-administered propofol sedation (EDNAPS) during GIT endoscopic procedures, occurrence of major and minor adverse events followed by propofol sedation, level of patient satisfaction and possible choice of propofol as sedative agent in their future endoscopic procedures in Pakistani population. Materials and methods: Prospective data were collected from patients receiving diagnostic AGD, colonoscopy or ERCP. Subjects who stopped the emergency procedure or both EGD and colonoscopy were excluded on the same date. Other exclusions include over 20 years of age, pregnancy, the American society of associate psychologists (ASA) Class III or IV, overweight (body weight>100kg), or drugs or its components or components (Soybean or egg) allergies included. Result: In our study a total of 929 patients comprising 520 males (56%) and 409 females (44%) with mean age of 46.19 ± 15.3years, mean MBI 24.27 ± 2.7. Age-specific propofol dosage was similar across gender except for age group 60 years and above where higher mean propofol dosage was required for females as compared to males for EGD and Colonoscopy (82.8 ± 32.2 vs. 63.5 ± 29.8; p-value 0.005; 81.1 ± 26.1 vs. 75.3 ± 25.0; p-value 0.03). The required examination was completed in all cases. There was no major adverse event. Majority of the patients rated the procedure satisfactory and agreed to undergo same sedative for next time. Conclusion: Endoscopist-directed nurse-administered propofol sedation (EDNAPS) during GIT endoscopic procedures is safe and effective in selected patients.