Draft genome sequence of a caprolactam degrader bacterium: Pseudomonas taiwanensis strain SJ9

Abstract Pseudomonas taiwanensis strain SJ9 is a caprolactam degrader, isolated from industrial wastewater in South Korea and considered to have the potential for caprolactam bioremediation. The genome of this strain is approximately 6.2 Mb (G + C content, 61.75%) with 6,010 protein-coding sequences (CDS), of which 46% are assigned to recognized functional genes. This draft genome of strain SJ9 will provide insights into the genetic basis of its caprolactam-degradation ability.

Physiochemical and phytochemical standardisation of khulanjan [rhizome of alpinia galanga l. willd.] - an important unani drug

Khulanjan, a rhizome of Alpinia galanga [L] Willd. [family; Zingiberaceae] is an important Unani drug found throughout India and has been recognized in many Traditional Systems of Medicine due to its medicinal and cosmetic values in various ailments and beauty enhancement. Keeping in view of the authentication and quality assurance of medicinal plants the physicochemical and phytochemical studies of Khulanjan, was conducted to meet Pharmacopoeia standard and quality control of Unani drugs before using them for health care. The physicochemical analysis includes parameters like ash values, bulk density, moisture content, loss on drying at 105°C, pH values and successive extractive values and fluorescence analysis of powder and extracts of test drug whereas the phytochemical analysis consists of thin layer chromatography, qualitative determination of different phytochemicals present in its rhizome. The data can be used as markers in the identification and standardization ol'Khulanjan that should be utilized in all the pharmaceutical industries as raw material?

Efficacy of trichloro-acetic acid peel alone versus combined topical magnesium ascorbyl phosphate for epidermal melasma

Objective: To compare the efficacy in terms of reduction in melasma area and severity index [MASI] score by more than 10 of a combination of 20% trichloro-acetic acid peel plus 5% topical magnesium ascorbyl phosphate versus 20% trichloro- acetic acid peel alone in the treatment of epidermal melasma

Study Design: Randomized controlled trial

Place and Duration of Study: Department of Dermatology, Lady Reading Hospital [LRH], Peshawar, from May 2012 to May 2013

Methodology: Patients aged 18-65 years, with Fitzpatrick skin type III-V were divided into two equal groups having 74 patients each. Detailed history was taken and Wood's lamp examination done to rule out mixed and dermal melasma

Melasma area and severity index [MASI] score was calculated for every patient. Priming was done for all patients with tretinoin cream applied once daily at night for 2 weeks, and to use a broad spectrum sun block cream before sun exposure

Patients in group A were subjected to combined treatment, i.e. trichloro-acetic acid peel 20% [weekly] plus magnesium ascorbyl phosphate cream [applied once daily], while patients in group B were subjected to trichloro-acetic acid peel 20% [weekly] alone. Treatment was continued for 6 weeks. After completion of treatment, MASI score was recalculated

Proportion of patients with significant MASI score reduction was compared using chi-square test with significance at p < 0.05

Results: Male and female patients were 11 [14.9%] and 63 [85.1%], respectively in group A, whereas 13 [17.6%] and 61 [82.4%] in group B. The mean age in group A was 30.28 +/- 8.08 years, and 29.36 +/- 6.84 years in group B. Significant MASI score reduction in group A was seen in 60 [81.1%] patients and in group B 49 [66.2%, p= 0.040]

Conclusion: Combination of trichloro-acetic acid peel and topical magnesium ascorbyl phosphate cream was significantly more effective than trichloro-acetic acid peel alone in treatment of melasma

Atrial myxoma: 14 years experience

Introduction: Cardiac tumors constitute only 0.2% of all tumors. Primary cardiac tumors occur infrequently with an incidence of 0.0017% to 0.19%, estimated on autopsies performed in non-selected populations. Left atrial myxomas are the most prevalent [75% to 80%] and right atrial are less common [10% to 18%]. Surgical excision yields an excellent prognosis and recurrence rate of only 3% with a very low morbidity and mortality

Objective: We aimed to review our experiences with this rare entity and highlight the various aspects of myxoma presentation, diagnosis and outcomes

Methodology: A retrospective chart review done on patients underwent excision of myxoma with histopathological confirmation since January 1991 till December 2015. Standard surgical approach adopted was single atrial, augmented with Biatrial approach where needed

Results: A total 42 cases were identified and 28 cases with complete data were included in the analysis. Mean age was 54.4 [ +/- 17.7] years, with female predominance [58% vs. 42%]. Preoperative comorbidities included hypertension [39.2%], diabetes [28.5%], IHD, dyslipidemia, and COPD [10.7%] that were comparable among gender. The mean dimension of myxoma measured on echocardiography was 4.9x3.5x2.7 cm. Sixty four percent had left sided and 35.7% had right sided myxoma. Most common symptom was dyspnea [71%], constitutional symptoms [39.3%] and stroke in [18%]. Echo being the diagnostic modality of choice. Post-operative complications occurred in 6 patients and mortality occurred in 2 [7.2%]. Mean post-operative follow up was 8.3 months and 10 years telephonic follow up completed in [32%] cases, with 2 late non-cardiac mortalities

Conclusion: Our results showed that the prevalence of cardiac myxoma is comparable with global estimates. Female gender was predominant and age and right atrial myxoma was slightly higher in our sample compare to other published literature. Myxoma can be excised successfully with a low rate of morbidity, mortality and recurrence

Successful treatment of giant left subclavian artery pseudoaneurysm abutting the arch of the aorta and descending aorta

A 28-year-old woman presented with 3-month history of fever of unknown origin and progressively increasing cough. She was diagnosed with pulmonary tuberculosis on bronchial lavage cultures. A chest X-ray performed on follow-up showed a new opacity in the left apical area of the chest. Computed tomography scan of chest showed a large 10 cm pseudoaneurysm of the left subclavian artery 1 cm from its take off from the arch of the aorta. The pseudoaneurysm was approached through a left posterolateral thoracotomy and opened following a proximal and distal control. A 3 cm longitudinal defect was identified in the subclavian artery within its intrathoracic portion. This was debrided and repaired with an autologous pericardial patch. The patient had an uneventful recovery and remained well on follow-up

In vitro antibacterial activity of selected medicinal plants from lower Himalayas

The present studies cover antibacterial activity of the crude methanolic extracts of 11 medicinal plants viz. Adhatoda vasica, Bauhenia variegate, Bombax ceiba, Carrisa opaca, Caryopteris grata, Debregeasia salicifolia, Lantana camara, Melia azedarach, Phyllanthus emblica, Pinus roxburghii and Olea ferruginea collected from lower Himalayas against two Gram positive [Staphylococcus aureus, Micrococcus luteus] and two Gram negative [Escherichiacoli, Pseudomonas aureginosa] bacterial strains. The extracts were applied at four different concentrations [120 mg/mL, 90mg/mL, 60mg/mL and 30mg/mL] in dimethyl sulfoxide [DMSO] by using agar well diffusion method. Antibacterial activities against Staphylococcus aureus and Micrococcus luteus were observed formethanolic extracts of all the above mentioned plants. Greater antibacterial activity against Pseudomonas aeruginosa was only exhibited by Phyllanthus emblica, Pinus roxburghii, Debregeasia salicifolia and Lantana camara. Escherichia coli was highly resistant to all the plant extracts at all concentrations. It is inferred that methanolic crude extracts of the above mentioned plantsexhibitantibacterial activities against pathogenic bacteria, which proved the ethnobotanical importance of the selected plants that indigenous people use for cure against various diseases

Evaluation of knowledge attitude and practice of health care staff on biosafety and biohazards, district Pakpattan Punjab

To evaluate the knowledge, attitude and practice of health care staff on bio-safety and biohazards in District Pakpattan. Cross Sectional epidemiological Study. This study was conducted in District Pakpattan Punjab, Pakistan from 1[st] August 2013 to 30[th] August 2013. The study was carried out to evaluate the knowledge attitude and practice on bio-safety and biohazards of health care providers, who are directly involved in the patient handling e.g. doctors, lady doctor, laboratory and blood bank technicians, Nurses, Dispensers, Lady Health Visitors, Vaccinators, OT Assistants, dental technicians, dental surgeons, while others were excluded. The target population was 552, and 33% [N=184] population was included in the study as non probability sample to reduce the bias in this reference epidemiological study. A standard questioner was pretested to identify weaknesses and strengths. Respondents interviewed individually and data was analyzed by using SPSS.15.0 for Widows Evaluation Version. Keeping Ethical Consideration in view, formal consent and permission was obtained from concerned Authorities and respondents. The study results on the variables were as; 27[14.6%] had specific training on bio-safety and biohazards,157[85.3%] had no structured training. 96[52%] respondents had habit of eating at work place, laboratory, dressing or examination rooms, 83[45%] don't have this habits or practice while 6 [3.2%] do this practice sometimes. 98[53%] had habits of storing edibles in the refrigerators meant for vaccines or laboratory purpose, 84[45.6%] don't have this habits and 2[1.0%] do this practice sometimes. Among females[N91], 35[38.4%]using cosmetics at work place,42[46%] don't have this habits or practice,11[12%] do this practice sometimes. Out of 161 the 62[40%] had habits of smoking or sniffing at work place, 99[60%] don't have this habits or practice. 89[48.3%] had habits of cutting nail with teeth and putting pen in the mouth at work, rest 93[50%] don't have this habits or practice. The study results are consistent and supported by many studies already conducted. Results showing poor knowledge, attitude and poor practices. It demonstrates the serious need of trainings on bio-safety and continuous monitoring on the practices to minimize the health risk, which is a hidden public health problem

profile of 60 patients of cutaneous leishmaniasis visiting dermatology departments of Hayatabad medical complex and lady reading hospital, Peshawar

To document the profile of patients of cutaneous leishmaniasis [CL] visiting Dermatology departments of Hayatabad Medical Complex and Lady Reading Hospital, Peshawar. Irrespective of age and sex, a total of 60 patients with a clinical diagnosis of CL were enrolled for the study. A total of 38 male and 22 female patients were enrolled for this study. Age range of the patients was 15 months to 50 years. A sizeable number of patients presented with nodular presentation. CL is usually seen in males on exposed areas as noduloulcerative lesions.

Herpes zoster in children

To study the epidemiology and clinical features of childhood herpes zoster. The study was carried out from March 2008 till February 2012. Forty two cases of herpes zoster in children less than 12 years of age were enrolled from the outpatient departments of Lahore General Hospital and Jinnah Hospital Lahore. Patients were subjected to detailed history, physical examination and relevant investigations. Out of 42 patients with herpes zoster, 57.1% were males and 42.9% were females. The mean age was 8 years with an age range of 18 days to 12 years. In most patients a single dermatome was involved [69%] and thoracic dermatome was involved in the majority [40.4%]. The most common symptom was pruritus in 52%, followed by pain in 12%. A positive history of previous exposure to varicella was present in 31% patients only, and out of these 61% were exposed before the age of two years. Six patients gave history of chickenpox in mother during pregnancy. Majority of patients i.e. 83.3% showed no evidence of immunosuppression on history, examination and investigations. Three patients were anti-HCV positive [7.1%], two [4.6%] had tuberculosis, one [2.3%] patient was taking steroids and one [2.3%] was diagnosed as leukemia. Most of the children with herpes zoster had no obvious evidence of immunosuppression. History of previous exposure to varicella was found in only 31% with majority being exposed below two years of age. Herpes zoster is a relatively mild disease in children with pruritus being the main symptom in 52% and pain occurred in only 12% of cases.

Severe haemolytic anaemia due to ingestion of naphthalene [mothball] containing coconut oil

Naphthalene, a widely used industrial and household chemical, has rarely been an agent of poisoning worldwide. Severe haemolysis from naphthalene poisoning is rare and can be a challenge to clinicians. We report a 22-year-old female, who accidentally ingested naphthalene mixed coconut oil and got admitted with recurrent vomiting, headache and passage of dark urine. Severe intravascular haemolysis with hypotension and neutrophilic leukocytosis was detected. She was treated with red blood cell transfusions, intravenous saline infusion and ascorbic acid

Clinicopathological study of cutaneous chromoblastomycosis in Pakistan

To recognize commonest clinical presentations of chromoblastomycosis and isolate fungi responsible for causing chromoblastomycosis in our part of the world. The study included all patients with clinical diagnosis of chromoblastomycosis and skin histopathology and fungal culture confirming clinical diagnosis. The disease started in all our patients during their childhood. All presented with psoriasiform plaques and showed infection with Phialophora dermatitidis Psoriasiform plaques can be the clinical presentation of chromoblastomycosis. P. dermatitidis is the fungus commonly seen in our enrolled patients

Frequency of cutaneous leishmaniasis among clinically suspected cases, visiting tertiary care hospitals of Peshawar

Background: Cutaneous leishmaniasis is a parasitic disease that is endemic in many countries in the world including Pakistan

Objectives: To determine the frequency and distribution of cutaneous leishmaniasis among suspected cases visiting various tertiary care hospitals in Peshawar

Subjects and Methods: This was a descriptive study in which a total of 320 clinically suspected people of cutaneous leishmaniasis visiting Lady Reading Hospital Peshawar and Kuwait Teaching Hospital were enrolled. This study was conducted from Sep. 2008 to Feb. 2009

Results: Out of 320 enrolled patients, 223 were found positive for cutaneous leishmaniasis during the study period. Prevalence of cutaneous leishmaniasis was higher in local population [73.06%] than in Afghan refugees [58.66%] visiting tertiary care hospitals. There was an increased burden ofinfection among children of 0-9 years while lowest prevalence was recorded in adults above 50 years of age. Prevalence was significantly higher amongst males [76.47%] as compared to females [57.75%]

Conclusion: There is high prevalence of cutaneous leishmaniasis among suspected cases in Khyber Pakhtunkhwa, Pakistan and younger population is mainly affected. Prompt measures are recommended to control this disease

Frequency of mucocutaneous manifestations in HIV positive Pakistani patients

Mucocutaneous manifestations are commonly observed in HIV patients. These range from various opportunistic infections, inflammatory dermatoses to neoplasms and drug reactions. To observe the nature and frequency of mucocutaneous manifestations in patients of HIV, with or without antiretroviral therapy and their correlation with CD4 cell counts. The duration of study was one year, starting from July 2009 to July 2010. The patients were enrolled from the HIV clinic and inpatient departments of Jinnah Hospital Lahore. Patients meeting the inclusion and exclusion criteria were subjected to a detailed history and clinical examination. Investigations were carried out where required. Treatment profile was also noted. The data was recorded on a pro forma and was analyzed later. A total of sixty two patients were enrolled in the study. There were 49 [79%] males and 13 [21%] females. The age range was 4 to 58 years. Cutaneous manifestations were seen in 51 [82%] patients. The most common cutaneous findings were fungal infections seen in 33.87% patients, followed by viral infections [29.03%], xerosis [22.58%] and bacterial infections [12.9%]. Less common manifestations were photosensitivity, scabies and hyperpigmentation. CD4 cell count was found to be more than 455xl0[9]/ in 22 patients while it was less than 455xl0[9]/in 40 patients. Skin manifestations were found in 19 [86.36%] patients with a high count and in 33 [82.5%] patients with a low count. Cutaneous manifestations are commonly seen in patients of HIV infection

Frequency of sensitivity to Parthenium hysterophorus in patients with chronic extensive eczematous eruption

Eczema is a pruritic skin disorder of exogenous or endogenous nature. Allergic contact dermatitis is of exogenous nature and can be caused by many allergens including plants. In this quasi-experimental study, 50 patients presenting with extensive eczematous eruption were enrolled. They were patch tested with fresh crushed extract of flowers of Parthenium hysterophorus. Three patch test readings were taken at 48 hours, 72 hours and 120 hours. Patch test readings were read according to ICDRG criteria. Forty four [88%] out of 50 enrolled patients were male while 6 [12%] were female with male to female ratio of 7.3:1. Average age of the patients was 56.8 years with S.D +/- 12.6 years. Fifty four percent of enrolled patients showed positive patch test reactions to fresh crushed extract of flowers of P. hysterophorus with a male to female ratio of 5.7:1. P. hysterophorus is a leading cause of extensive eczematous eruption of exogenous type in a specific group of patients

Efficacy of terbinafine vs. griseofulvin in tinea capitis in the Northern areas of Pakistan

Since longtime griseofulvin has been in use to treat tinea capitis. However due to its decreasing efficacy, higher doses and side effects a search is going on to find out a better treatment. alternative. Terbinafine is one such therapeutic option. To compare the efficacy and safety of terbinafine and griseofulvin in tinea capitis in Northern Areas of Pakistan. Children 3 to 12 year-old who were clinically diagnosed for tinea capitis and confirmed by potassium hydroxide microscopy were included in the study. One group was treated with terbinafine at a dose of 62.5mg for children weighing less than 20kg and 125mg for those weighing 20-40kg and other group with griseofulvin at a dose of 15mg/kg body weight. Both groups were treated for a period of 4 weeks. Visits were scheduled at baseline and week 2, 4 and 6 for evaluation of efficacy and safety monitoring. Efficacy was evaluated on the basis of clinical improvement and mycological cure. Terbinafine showed comparatively higher clinical cure in our patients as compared to griseofulvin at week 2 [35% vs. 22%], week 4 [50% vs. 38%] and week 6 [70% vs. 55%] [p<0.05]. Similarly, mycologic cure with terbinafine was better than griseofulvin at week 2 [30% vs. 20%], week 4 [45% vs. 35%] and week 6 [60% vs. 50%] [p<0.05]. Trichophyton tonsurans was the most common organism isolated. There were no major side effects except nausea and abdominal pain in either group. Terbinafine is more effective than griseofulvin in treating tinea capitis in our part of the world

Role of systemic steroids in the outcome of Stevens-Johnson syndrome and toxic epidermal necrolysis

Stevens-Johnson syndrome [SJS] and toxic epidermal necrolysis [TEN] are cutaneous adverse reactions which usually develop as a result of drug therapy. The role of systemic steroids in the treatment of SJS and TEN is debatable. To see the clinical outcome of patients suffering from SJS or TEN, treated with or without steroids. Forty patients of SJS and TEN were enrolled from the inpatient department of Jinnah Hospital Lahore. Clinical data were recorded on a pro forma. Clinical outcome of patients treated with or without steroids was recorded and analyzed. A total of forty patients were enrolled in the study. Twenty nine patients were suffering from SJS and 11 were suffering from TEN. Twenty three patients of SJS [79.31%] were treated without steroids. Two patients died [8.7%] and twenty one [91.30%] recovered. Six patients were given steroids [20.68%], out of these 2 [33.3%] died and 4 [66.76%] recovered. There were eleven patients of TEN, four [36.37%] were managed without steroids, one expired [25%] and rest of the three [75%] patients recovered. Seven [63.63%] patients were given steroids, three [43.86%] patients expired while four [57.14%] recovered

Scleromyxedema in an HCV-positive male

Scleromyxedema is rare chronic cutaneous mucinosis usually associated with a monoclonal gammopathy and underlying systemic disease. We report a 42-year-old male who developed scleromyxedema and was also HCV positive

A study on efficacy of lamivudine therapy in decompensated cirrhosis of liver due to chronic hepatitis B virus infection.

The prognosis of decompensated cirrhosis of liver resulting from chronic Hepatitis B Virus (HBV) infection is poor and liver transplantation is the only established mode of treatment. The benefits of treatment with interferon are outweighed by serious side effects and risks of fatal exacerbation of disease activity. Lamivudine rapidly reduces hepatitis B viral DNA in serum to undetectable levels. The purpose of this study was to evaluate effectiveness and safety of Lamivudine treatment in patients with advanced and end stage liver disease caused by Hepatitis B. This was a prospective observational study in which a total of 45 patients, 39 (87.0%) male and 6 (13.0%) female who had viral activity and child pugh score e" 8 were given Lamivudine 100 mg orally once daily. Among them 30 patients completed at least 6 months of therapy, majority (27 patients) showed improvement in liver function with decrease in serum ALT from mean (+/- SD) 118.8 +/- 106.5 to 50.2 +/- 57.1 U/L (p < 0.001), decrease in serum bilirubin from 73.9 +/- 80.5 to 44.7 +/- 62.9 micromol/l (p = 0.129), increase in serum albumin from 26.2 +/- 4.2 to 33.2 +/- 3.4 g/l (p < 0.05), decrease in prothrombin time from 8.3 +/- 4.0 to 3.9 +/- 2.9 seconds prolonged (p < 0.05) and reduction in child pugh score from 11.0 +/- 1.7 to 7.0 +/- 1.3 (p < 0.001). Seroconversion was found in 5 (11.1%) patients on Intention to treat analysis. Among the seroconverted group, 1 (2.2%) patient also lost HBsAg. Six (13.0%) patient had procore mutant virus, 2 (4.4%) of them showed virological response. Therefore, total 7 (15.5%) patients showed virological response by intention to treat analysis. We conclude that inhibition of viral replication with Lamivudine results in a significant improvement of liver function in patients with decompensated cirrhosis of liver due to HBV infection.

survey of a child psychiatry clinic in a teaching hospital in Saudi Arabia-clinical profile and cross-cultural comparison

This is an epidemiologic study of 199 children and adolescents who were referred for evaluation to a child psychiatry clinic in a teaching hospital in Riyadh, Saudi Arabia during a 6 year period. [I] to clarify who utilizes the services of a child psychiatry clinic. [2] what are the psychological problems that triggers the referral, and [3] compare our results with western literature on similar clinical populations of children and adolescents. All children referred to the child psychiatry clinic were assessed using a semi-structured interview according to the +AP DSM-III system and a modified global assessment of functioning scale provided for the fourth axis of the DSM III. Significant findings which differ from literature reports include: a low representation of conduct disorder [5%], high representations of attention deficit hyperactivity disorder [12.6%], mental retardation [20Tc], conversion disorder [8%] and obsessional disorder [4%]. First referred to traditional healers were 46% and there was a low rate [0.6%] of referral from pediatricians compared to 22% in western societies. The results are discussed with emphasis on socio-cultural perspectives

Comparative study of sensitivity and specificity of beta monoclonal agglutination inhibition and sandwich immunometric assay tests in the diagnosis of pregnancy

Urine of 30 pregnant females was tested for gravidex test. Both concentration and agglutination inhibition [Beta monoclonal] tests were performed on the same urine specimens. Results showed that the sensitivity and specificity of the concentration [colour] test was much higher than that of the B monoclonal test