Molecular characterization and spoligotyping analysis of multi drug resistant mycobacterium tuberculosis from a high TB endemic area of Pakistan

Background: Multidrug resistant tuberculosis caused by Mycobacterium tuberculosis is an infection that is resistant to rifampicin and isoniazid. Management of Multidrug resistant tuberculosis is a serious challenge worldwide

Objectives: To investigate hotspot mutations in rpoB, katG and inhA genes and its possible co-relation with predominant genotypes in Khyber Pakhtunkhwa, Pakistan

Study design, settings and duration: This cross sectional study was conducted after approval from research and ethics committee of Provincial TB Control Program, Khyber Pakhtunkhwa in March 2015

Materials and Methods: A total of 166 clinical isolates were analysed which were collected from programmatic management of drug-resistant tuberculosis units. All samples were characterized by phonotypical drug susceptibility test, genotypic drug resistant test [line probe assay] and spoligotyping analysis using ''TB-SPRINT' micro bead assay

Results: Out of the total 166 samples, 97 strains were resistant to rifampicin [RIF] and 106 strains were resistant to isoniazid [INH]. Most common mutation in rpoB was S531L in 75 [77%] isolates followed by D516V in 10 [10%] and H526Y in 6 [6%] samples respectively. A rare mutation in rpoB gene at codon 522 and deletion of codon 518 was also reported. In 106 INH resistant strains, 97[91%] were associated with mutation in katG gene while resistance in 9 [8.4%] strain was due to mutation in the inhA promoter region. Spoligotyping analysis revealed 55 distinct types of different patterns. Spoligotyping patterns of 146 samples matched with 15 different linage of M.tuberculosis in which 101 [60%] were identified as the predominant CAS1-Delhi linage. The pattern of 20 strains [12%] did not matched to any other pattern in the SITVIT database and were named orphan KP

Conclusion: Molecular characterization of M.tuberculosis is very helpful in the early identification of MDR-TB. As CAS1-Delhi is the predominant type in this region, its association with drug resistance, treatment failure and patient demographic profiles should be investigated

Post traumatic stress disorder among school children of Army Public School Peshawar after six month of terrorists attack

Background and Objectives: Terrorist attack in Army Public School Peshawar, Pakistan left behind more than hundred children dead. It was the highest death toll of children in the world in a single terrorists attack. The attack dominated national and international news, high level security measures have been adopted in all school throughout Pakistan, which created fear and stress in children. The objective of the study was to determine post-traumatic stress disorder among children after six month of terrorist attack inspite of rigorous psychosocial support and rehabilitation

Methods: We wanted to determine Post Traumatic Stress Disorder [PTSD] among children of Army Public School of age range 10 to 18 years after 5 months of intervention and rehabilitation following terrorists attack. For this a self-report questionnaire, Child PTSD Symptom Scale [CPSS], which assess and identify symptoms matching DSM [Diagnostic and Statistical Manual of Mental Disorders] IV criteria for post-traumatic stress disorder of children, was filled. Informed consent was taken from school Principal and responders

Results: A total 205 students of age range 10 to 18 years participated in the study. The most frequent age group of the study were 16 years and 14 years students with frequency 58 [28.3%] and 46 [22.4%] respectively. Among 205 participated school children PTSD were found in 154 [75.2%] children while only 24.8% students had no PTSD symptoms. In more than 50% PTSD positive school children had functional impairment for each category of fun and hobbies, friendship, school work, family relation, doing chores, general happiness and saying prayers

Conclusion: Study found a very high prevalence of PTSD among 10 to 18 years age group students of Army Public School inspite of five months continuous intervention and rehabilitation services. Study showed that this age group needs long term psychosocial treatment in case of trauma

Reactive oxygen species-mediated unfolded protein response pathways in preimplantation embryos

Excessive production of reactive oxygen species (ROS) and endoplasmic reticulum (ER) stress-mediated responses are critical to embryonic development in the challenging in vitro environment. ROS production increases during early embryonic development with the increase in protein requirements for cell survival and growth. The ER is a multifunctional cellular organelle responsible for protein folding, modification, and cellular homeostasis. ER stress is activated by a variety of factors including ROS. Such stress leads to activation of the adaptive unfolded protein response (UPR), which restores homeostasis. However, chronic stress can exceed the toleration level of the ER, resulting in cellular apoptosis. In this review, we briefly describe the generation and impact of ROS in preimplantation embryo development, the ROS-mediated activation mechanism of the UPR via the ER, and the subsequent activation of signaling pathways following ER stress in preimplantation embryos.

Impact assessment of educational intervention among private dental practitioners about infection control practices in district Peshawar

Cross infections occur frequently in dental health care personnel therefore, to protect themselves and their patients; they have to strictly follow infection control practices. To assess the impact of educational interventions on knowledge and practices of private dental practitioners. Interventional study, done from March 2012 to June 2013 in private practitioners of Peshawar using convenient sampling technique. After acquiring base line data on the practices, pertaining to prevention of cross infection in dental practitioners, educational knowledge intervention was applied to them on same day and repeated after two months. Post intervention data was collected using same questionnaire. The data was analyzed using Statistical Package for Social Sciences [SPSS] version 16.0. A total of 90 dental practitioners were included, of whom 49 [54.4%] were qualified and 41 [45.6%] unqualified. Their overall mean age was 33.77 +/- 8.97 years. The mean age of qualified practitioners was 36.24 +/- 10.40 years. Their pre and post intervention practices showed significant improvement in various practices like; screening of patients prior to procedure [p <0.043], hepatitis B vaccination [p < 0.000], type of gloves used [p < 0.031], hand washing [P < 0.004] separate instrument processing area [p < 0.004], floor cleansing with disinfectant [p < 0.000] and proper ventilation [p <0.021]. The mean age of unqualified practitioners was 30.80 +/- 5.73 years. Their pre and post intervention change in knowledge and practices showed poor compliance to most interventions. Qualified dental practitioners had a positive attitude towards educational infection as compared to unqualified practitioners. Yearly health education certification should be implemented for all health care professional [qualified and unqualified] to keep them abreast with the infection control practices

Differential inhibitory potencies of alcoholic extract of different parts of Dryopteris chrysocoma on inflammation in mice and rats

Phytomedicinal therapy for inflammation is not new and it is highly effective for the treatment of various inflammatory disorders. The inflammation is one of the initial parameter for most of the disorders occurring in the body. The anti-inflammatory potential can be determined by using various techniques. Dryopteris chrysocoma is a male fern commonly found in damp and moist areas of Pakistan. The study was conducted on mice and rats by inducing inflammation with subcutaneous administration of formalin and Carrageenan in hind paw. The results were compared with standard drug Aspirin administered orally in the dose of 300 mg/kg and a decrease in hind paw volume was observed. The intensity of edema was observed in mice after formalin injection and the time of disappearance of edema was observed. In rats the inhibition of inflammation by root, leaves and stem extract was 51.19%, 41.66% and 30.95% respectively after administration of formalin. Similar inhibition of inflammation produced by root, leaves and stem extracts i.e. 57%, 42% and 35% respectively in Carrageenan treated rats. Root extract showed the highly significant results at p

Solitary thyroid nodule, frequency of malignancy at combined military hospital Rawalpindi

To determine frequency of malignancy in solitary thyroid nodule. Case-series study. The study was conducted at Department of Surgery, Combined Military Hospital Rawalpindi, from April 2002 till April 2003. Sixty patients with clinical solitary thyroid nodule fulfilled the selection criteria and were included in the study. Thyroid function tests, ultrasonography and thyroid scanning was done. Finally FNAC and histopathology were done in all the operated cases and record was evaluated. Out of 60 cases studied, 8 [13.33%] were found to have malignant lesions. The remaining 52 [86.67%] cases had benign pathology. Male patients with solitary thyroid nodule showed a higher incidence of malignancy 17.65% as compared to females 11.63%, Maximum malignant cases [50%] were found between the ages of 31 to 40 years. Papillary carcinoma was the most common malignancy [50%] found in our study. The incidence of malignancy in solitary thyroid nodule is quite high [13.33%]. So people should be educated to attend thyroid clinics for early diagnosis and adequate treatment

Development of 19-plex Y STR system and polymorphism studies in Pakistani population / 药物分析学报

For the development of 19-plex Y STR system and polymorphism studies in locl ethnic populations sixteen markers of non-recombining regions (NRY) of Y chromosome, which show high power of discrimination among individuals, were selected in this study. Blood samples (600) were e.ollected from the males of three most common castes of Pakistani population (Arnin, Awan and Rajput) with different parent lineages. Three markers (DYS385a/b, DYS389Ⅰ/Ⅱ and YCAⅡa/b) among 16 Y STRs are double-targeted regions of the Y chromosome and thus provide two polymorphie peaks for each respective primer set. These 16 Y-STRs were developed into Megaplex system for simultaneous amplification of all markers within the population. The overall power of discrimination observed in focused populations was 60.5%, 66.5% and 55% in Rajput, Awan and Arain casts respectively. This discrimination power will be helpful in haman identification for forensic casework studies including sexual assaults and paternity testing.