ROLE OF CIRCULATING MIR-21 EXPRESSION PROFILES AND THEIR EMERGENCE AS POTENTIAL BIOMARKERS IN ORAL SQUAMOUS CELL CARCINOMA

Among the widest range of prevalent forms of cancer is oral carcinoma, which can develop anywhere in the mouth or even on the lips. Although there have been many advances in cancer treatment, the expected lifespan for OSCCs have indeed increased marginally. The load of OSCC is anticipated to increase in the near future, yet there is no sign of relief in view. Tumorigenesis is just one of the many physiological processes that can be controlled by microRNAs, a class noncoding endogenous RNAs. Several fibrosis disorders have been linked to miR- 21, and it has been utilised to distinguish oral and tongue cancer from healthy individuals. Studies empirically highlighted the significance of these transcripts as a predictor for prediction and diagnosis in OSCCs. Therefore, the present review summarizes the expression levels of miRNAs in OSCCs and evaluates their functioning in the progression or suppression of cancer. miR-21 can be considered as a prospective candidate for their translational use in OSCCs for early diagnosis prognosis surveillance and tailored treatment which should undergo further validation.

Impact of alien fishes on the distribution pattern of indigenous freshwater fishes of Punjab, Pakistan / Impacto de peixes invasores no padrão de distribuição de peixes de água doce em Punjab, Paquistão

Pakistan is the country with mega freshwater fish diversity of native and alien species. In the presence of enormous native fishes varies species of exotic fishes have been introduced into the freshwater bodies of Pakistan which are competing with native freshwater fish fauna and making them deprive of food and habitat as well. Intentional or accidental introductions of animals, plants and pathogens away from their native niche is considered as major leading problem for biodiversity of invaded habitat. Three years study (from January 2017 to December 2019) was conducted in freshwater bodies of Province Punjab, Pakistan. Study was designed to know exotic species impacts on the distribution of native species of fishes. During current survey a total of 68 (indigenous and exotic) fish species belonging to 14 families were recorded from head Qadirabad, head Baloki, Islam headworks and Rasul barrage. Statistical analysis showed that Shannon-Wiener diversity index was the highest (1.41) at both Rasul barrage and Islam headworks but, invasive species were present in very less number in these study sites i.e. Oreochromis mozambicus, O. niloticus, Hypophthalmichthys nobilis, Carassius auratus, Ctenophryngdon idella, Cyprinus carpio and H. molitrix. The diversity index showed that comparatively low diversity was present in both area head Qadirabad (1.30) and head Baloki (1.4) due to high pressure of invasive species. Direct observation of species and statistical analysis showed that aliens' species produced negative impact on the local fish fauna diversity, evenness, and numbers. It is concluded that many factors are impacts on the diversity of native fishes, but alien (invasive) species also play a major role to reduction of native species, because aliens' species produce competition for native species. So it is urgent need to analysis the aliens and native food web and roosting sites in Pakistan, in future.

O Paquistão é um país com ampla diversidade de espécies nativas e exóticas de peixes de água doce. Contudo, diversas espécies de peixes exóticos estão sendo introduzidas nos corpos de água doce paquistanês, as quais estão competindo com a fauna nativa de peixes, tornando-os privados de alimento e habitat. A introdução intencional ou acidental de animais, plantas e patógenos fora de seu nicho nativo é considerada o principal problema da biodiversidade do habitat recém-invadido. Assim, foi realizado um estudo de três anos, de janeiro de 2017 a dezembro de 2019, em corpos de água doce na província de Punjab, Paquistão. A pesquisa foi desenvolvida para conhecer os impactos de espécies exóticas na distribuição de espécies nativas de peixes. Durante a pesquisa, foi registrado um total de 68 espécies de peixes (nativas e exóticas), pertencentes a 14 famílias, nas nascentes dos rios Qadirabad, Baloki e Islam e na barragem de Rasul. A análise estatística mostrou que o índice de diversidade de Shannon-Wiener foi mais alto (1,41) na barragem Rasul (RB) e na nascente do rio Islam (IH); e que a maioria das espécies introduzidas estava presente em um número muito menor, isto é, Oreochromis mossambicus, Oreochromis niloticus, Hypophthalmichthys nobilis, Carassius auratus, Ctenopharyngodon idella, Cyprinus carpio e Hypophthalmichthy smolitrix nessa área de estudo. Por outro lado, o índice Shannon-Wiener mostrou que a diversidade estava baixa nas nascentes dos rios Qadirabad (1,30) e Baloki (1,4) em razão da alta pressão de espécies invasoras. A observação direta das espécies e a análise estatística indicaram que as espécies invasoras produziram impacto negativo na diversidade, uniformidade e números de peixes da fauna local. Conclui-se que muitos fatores impactam na diversidade de peixes nativos, mas as espécies exóticas (invasoras) também desempenham um papel importante na redução das espécies nativas, em razão da competição existente entre elas. Portanto, é urgente uma análise futura das espécies invasoras e da teia alimentar nativa no Paquistão.

Impact of alien fishes on the distribution pattern of indigenous freshwater fishes of Punjab, Pakistan / Impacto de peixes invasores no padrão de distribuição de peixes de água doce em Punjab, Paquistão

Pakistan is the country with mega freshwater fish diversity of native and alien species. In the presence of enormous native fishes varies species of exotic fishes have been introduced into the freshwater bodies of Pakistan which are competing with native freshwater fish fauna and making them deprive of food and habitat as well. Intentional or accidental introductions of animals, plants and pathogens away from their native niche is considered as major leading problem for biodiversity of invaded habitat. Three years study (from January 2017 to December 2019) was conducted in freshwater bodies of Province Punjab, Pakistan. Study was designed to know exotic species impacts on the distribution of native species of fishes. During current survey a total of 68 (indigenous and exotic) fish species belonging to 14 families were recorded from head Qadirabad, head Baloki, Islam headworks and Rasul barrage. Statistical analysis showed that Shannon-Wiener diversity index was the highest (1.41) at both Rasul barrage and Islam headworks but, invasive species were present in very less number in these study sites i.e. Oreochromis mozambicus, O. niloticus, Hypophthalmichthys nobilis, Carassius auratus, Ctenophryngdon idella, Cyprinus carpio and H. molitrix. The diversity index showed that comparatively low diversity was present in both area head Qadirabad (1.30) and head Baloki (1.4) due to high pressure of invasive species. Direct observation of species and statistical analysis showed that aliens’ species produced negative impact on the local fish fauna diversity, evenness, and numbers. It is concluded that many factors are impacts on the diversity of native fishes, but alien (invasive) species also play a major role to reduction of native species, because aliens’ species produce competition for native species. So it is urgent need to analysis the aliens and native food web and roosting sites in Pakistan, in future.

O Paquistão é um país com ampla diversidade de espécies nativas e exóticas de peixes de água doce. Contudo, diversas espécies de peixes exóticos estão sendo introduzidas nos corpos de água doce paquistanês, as quais estão competindo com a fauna nativa de peixes, tornando-os privados de alimento e habitat. A introdução intencional ou acidental de animais, plantas e patógenos fora de seu nicho nativo é considerada o principal problema da biodiversidade do habitat recém-invadido. Assim, foi realizado um estudo de três anos, de janeiro de 2017 a dezembro de 2019, em corpos de água doce na província de Punjab, Paquistão. A pesquisa foi desenvolvida para conhecer os impactos de espécies exóticas na distribuição de espécies nativas de peixes. Durante a pesquisa, foi registrado um total de 68 espécies de peixes (nativas e exóticas), pertencentes a 14 famílias, nas nascentes dos rios Qadirabad, Baloki e Islam e na barragem de Rasul. A análise estatística mostrou que o índice de diversidade de Shannon-Wiener foi mais alto (1,41) na barragem Rasul (RB) e na nascente do rio Islam (IH); e que a maioria das espécies introduzidas estava presente em um número muito menor, isto é, Oreochromis mossambicus, Oreochromis niloticus, Hypophthalmichthys nobilis, Carassius auratus, Ctenopharyngodon idella, Cyprinus carpio e Hypophthalmichthy smolitrix nessa área de estudo. Por outro lado, o índice Shannon-Wiener mostrou que a diversidade estava baixa nas nascentes dos rios Qadirabad (1,30) e Baloki (1,4) em razão da alta pressão de espécies invasoras. A observação direta das espécies e a análise estatística indicaram que as espécies invasoras produziram impacto negativo na diversidade, uniformidade e números de peixes da fauna local. Conclui-se que muitos fatores impactam na diversidade de peixes nativos, mas as espécies exóticas (invasoras) também desempenham um papel importante na redução das espécies nativas, em razão da competição existente entre elas. Portanto, é [...].

Impact of alien fishes on the distribution pattern of indigenous freshwater fishes of Punjab, Pakistan

Abstract Pakistan is the country with mega freshwater fish diversity of native and alien species. In the presence of enormous native fishes varies species of exotic fishes have been introduced into the freshwater bodies of Pakistan which are competing with native freshwater fish fauna and making them deprive of food and habitat as well. Intentional or accidental introductions of animals, plants and pathogens away from their native niche is considered as major leading problem for biodiversity of invaded habitat. Three years study (from January 2017 to December 2019) was conducted in freshwater bodies of Province Punjab, Pakistan. Study was designed to know exotic species impacts on the distribution of native species of fishes. During current survey a total of 68 (indigenous and exotic) fish species belonging to 14 families were recorded from head Qadirabad, head Baloki, Islam headworks and Rasul barrage. Statistical analysis showed that Shannon-Wiener diversity index was the highest (1.41) at both Rasul barrage and Islam headworks but, invasive species were present in very less number in these study sites i.e. Oreochromis mozambicus, O. niloticus, Hypophthalmichthys nobilis, Carassius auratus, Ctenophryngdon idella, Cyprinus carpio and H. molitrix. The diversity index showed that comparatively low diversity was present in both area head Qadirabad (1.30) and head Baloki (1.4) due to high pressure of invasive species. Direct observation of species and statistical analysis showed that aliens species produced negative impact on the local fish fauna diversity, evenness, and numbers. It is concluded that many factors are impacts on the diversity of native fishes, but alien (invasive) species also play a major role to reduction of native species, because aliens species produce competition for native species. So it is urgent need to analysis the aliens and native food web and roosting sites in Pakistan, in future.

Resumo O Paquistão é um país com ampla diversidade de espécies nativas e exóticas de peixes de água doce. Contudo, diversas espécies de peixes exóticos estão sendo introduzidas nos corpos de água doce paquistanês, as quais estão competindo com a fauna nativa de peixes, tornando-os privados de alimento e habitat. A introdução intencional ou acidental de animais, plantas e patógenos fora de seu nicho nativo é considerada o principal problema da biodiversidade do habitat recém-invadido. Assim, foi realizado um estudo de três anos, de janeiro de 2017 a dezembro de 2019, em corpos de água doce na província de Punjab, Paquistão. A pesquisa foi desenvolvida para conhecer os impactos de espécies exóticas na distribuição de espécies nativas de peixes. Durante a pesquisa, foi registrado um total de 68 espécies de peixes (nativas e exóticas), pertencentes a 14 famílias, nas nascentes dos rios Qadirabad, Baloki e Islam e na barragem de Rasul. A análise estatística mostrou que o índice de diversidade de Shannon-Wiener foi mais alto (1,41) na barragem Rasul (RB) e na nascente do rio Islam (IH); e que a maioria das espécies introduzidas estava presente em um número muito menor, isto é, Oreochromis mossambicus, Oreochromis niloticus, Hypophthalmichthys nobilis, Carassius auratus, Ctenopharyngodon idella, Cyprinus carpio e Hypophthalmichthy smolitrix nessa área de estudo. Por outro lado, o índice Shannon-Wiener mostrou que a diversidade estava baixa nas nascentes dos rios Qadirabad (1,30) e Baloki (1,4) em razão da alta pressão de espécies invasoras. A observação direta das espécies e a análise estatística indicaram que as espécies invasoras produziram impacto negativo na diversidade, uniformidade e números de peixes da fauna local. Conclui-se que muitos fatores impactam na diversidade de peixes nativos, mas as espécies exóticas (invasoras) também desempenham um papel importante na redução das espécies nativas, em razão da competição existente entre elas. Portanto, é urgente uma análise futura das espécies invasoras e da teia alimentar nativa no Paquistão..

Manifestaciones orales y disfunción olfativa y gustativa en el síndrome respiratorio agudo severo por corona virus 2 (VIRUS SARS-COV-2): una revisión sistemáticaA / Oral Manifestations and Olfactory and Gustatory Dysfunction in Severe Acute Respiratory Syndrome Corona Virus 2 (SARSCov-2 Virus) Disease: A Systematic Review

La enfermedad del corona virus 2 del síndrome respiratorio agudo severo (virus SARS-CoV-2) apareció por primera vez en diciembre de 2019 en Wuhan, China, y desde entonces se ha extendido rápidamente por todo el mundo. Desde entonces, el brote de esta grave enfermedad viral se ha convertido en una amenaza global para la humanidad. El diagnóstico precoz y el aislamiento son las medidas más importantes necesarias para prevenir su propagación. La evidencia anecdótica reciente ha sugerido manifestaciones orales con o sin deterioro olfativo y gustativo en asociación con la enfermedad por coronavirus (COVID-19). La enzima convertidora de angiotensina-2 (ECA-2) se expresa en la mucosa oral en grandes cantidades y, por tanto, puede contribuir a las primeras manifestaciones de esta enfermedad viral mortal. Las manifestaciones bucales de la enfermedad por coronavirus pueden presentarse en forma de lesiones ulcerativas irregulares en relación con diferentes partes de la cavidad oral y, en particular, en relación con la mucosa adherida en la región del paladar duro, así como inflamación y posterior atrofia de las diversas papilas de la lengua. La disfunción olfativa y gustativa asociada también puede conducir a una pérdida parcial y / o incluso completa de la capacidad para oler y saborear en las primeras etapas del inicio de la enfermedad. La evidencia también ha sugerido la presencia de ácido nucleico del SARS-CoV-2 en la saliva humana, lo que la convierte en portadora de la enfermedad viral infecciosa y ayuda en su diagnóstico. Hemos buscado sistemáticamente la base de datos médica para el mismo y hemos revisado toda la literatura disponible hasta el 29 de junio de 2020

Severe acute respiratory syndrome corona virus 2 (SARS-CoV-2 virus) disease had first appeared in December 2019 in Wuhan, China and has been spreading quickly throughout the world since then. Since then, the outbreak of this severe viral disease has become a global threat to humanity. An early diagnosis and isolation are the most significant measures required to prevent its spread. Recent anecdotal evidence has suggested oral manifestations with or, without olfactory and gustatory impairment in association with corona virus disease (COVID-19). Angiotensin converting enzyme-2 (ACE-2) is expressed in oral mucosa in large amounts and can, thus, contribute in the early manifestations of this deadly viral disease. The oral manifestations of corona virus disease can occur in the form of irregular ulcerative lesions in relation to different parts of the oral cavity and particularly, in relation to the attached mucosa in the hard palate region as well as inflammation and subsequent, atrophy of the various tongue papilla. The associated olfactory and gustatory dysfunction can, also, lead to partial and/or, even a complete loss of the ability to smell and taste in the early stages of the disease onset. Evidence has, also, suggested the presence of SARS-CoV-2 nucleic acid in human saliva making it the carrier of the infectious viral disease as well as aiding in its diagnosis. We have systemically searched medical database for the same and have reviewed all the literature available up to 29th of June 2020.

Chronic progressive external ophthalmoplegia in a Saudi patient with a mutation in the POLG gene successfully managed with bilateral frontalis sling

Chronic progressive external ophthalmoplegia (CPEO) is a complex slowly progressive mitochondrial disorder characterized by extraocular muscle weakness with or without multisystem involvement. The mainstay of therapy in a patient with CPEO is supportive. However, in moderate cases, surgery might be indicated including surgeries for ptosis and strabismus. In this article, we report a Saudi patient with CPEO due to compound heterozygous variants in the DNA polymerase gamma (POLG) gene c.2246T>C p.(Phe749Ser) and c.1735C>T p.(Arg579Trp), which are classified as pathogenic. Proper diagnosis with genetic testing confirmation is important to guide the management and counsel the patient about the prognosis and the management options. The patient was successfully managed with bilateral frontalis sling and illustrates the importance of surgical intervention to improve vision and cosmetic appearance in patients with CPEO. We emphasize the importance of multidisciplinary care in the management of cases of mitochondriopathy, especially CPEO.

Clinicopathological correlation of cancer stem cell markers Oct-4 and CD133 expression as prognostic factor in malignant lesions of gallbladder: An immunohistochemical study

Background: Gallbladder cancer (GBC) is the most frequent biliary tract cancer, with high morbidity and poor prognosis, and shows early metastasis and invasiveness. No reliable biomarkers are available for detection of GBC progression. Aim: To investigate the immunohistochemical expression of Oct-4 and CD133 in malignant and nonneoplastic lesions of gallbladder and to analyze the clinical significance of the expressions related to clinicopathological parameters. Settings and Design: This is a prospective case control study, conducted in medical college background. Materials and Methods: A total of 103 cases of gallbladder were grouped into malignant lesions (n = 48) and nonneoplastic lesions (simple epithelial hyperplasia; n = 35 and chronic cholecystitis; n = 20). All tissue samples were evaluated for expression of Oct-4 and CD133 using immunohistochemistry in an effort to elucidate the correlation between their expressions with clinicopathological parameters. Statistical Analysis: The final score was calculated by multiplying the intensity to the percentage of positive cells. The scores ?2 were considered as positive. Results: Significant positive correlation of higher expression levels of Oct-4 and CD133 were observed in malignant as compared to nonneoplastic lesions of gallbladder (P < 0.0001). High expression of Oct-4 and CD133 were significantly associated with tumor grading (Oct-4, P = 0.04; CD133, P = 0.02), staging (Oct-4, P = 0.03; CD133, P = 0.02), and liver metastasis (Oct-4, P = 0.01; CD133, P = 0.007). Significantly reduced survival was observed with high expression of Oct-4 (P = 0.002). No significant correction was observed between CD 133 and survival. Conclusion: This study revealed that high expression level of Oct-4 may provide a new insight for the prognosis of the disease in terms of clinical staging and grade.

Developing a hybrid antimicrobial resistance surveillance system in India: Needs & challenges

Growing resistance to antimicrobials has become one of the most important problems of the 21st century. The development of new antibiotics is a time-consuming process involving huge financial resources. An alternate approach is proper utilization of the existing antibiotics through the surveillance of resistance. An important component of surveillance is the informatics tool for collection, management and analysis of antimicrobial resistance susceptibility testing data. Based on the scope, antimicrobial resistance surveillance resistance tools can be broadly classified as collectors and integrators. Individually, both the integrators and collectors have limitations which restrict their use in India. There is a strong requirement to develop a hybrid AMR surveillance tool that captures standardized data from small laboratories and integrates data from multiple sources to present a complete picture of the country. Here we describe a tooli-AMRSS developed by the Indian Council of Medical Research for collection, storage and management of AMR data from collaborating institutes/laboratories and to generate real-time analytics and reports.

Bioactive sesquiterpene lactone from Artemisia santolina / Lactona sesquiterpénica bioactiva de Artemisia santolina

Most species of genus Artemisia L. (Compositae) are medicinal herbswith several uses in the folk medicine worldwide. In the present study, methanol extract of Artemisia santolina has been subjected for isolation of its metabolites along with evaluation of cytotoxic activity against Artemia salina larvae. The structures of the compounds determined by 1H-and 13C-NMR, HMQC, HMBC, 1H-1H COSY and Mass spectral analysis. Two sesquiterpenes, 1,5-dihydroxy- 4(15)eudesman-12,6-olid (artemin) (1), 2-hidroxy-2,6,10-trimethyl-7,10- oxide-3,11-dodecadien-5-one (2) and one flavonoid, 5,7,4'-trihydroxy-6,3'-dimethoxyflavone (jaceosidin) (3) have been successfully characterized. Cytotoxicity of the sesquiterpene lactone (1), was assessed on Artemia salina larvae and resulted in IC50 value of 6.44 µg/mL, which was more potent compared to the positive standard berberine hydrochloride (IC50 = 26 µg/mL). In this study, the separation and identification of two sesquiterpenes and one flavone from the aerial parts of A. santolina is described. Among them the compound artemin (1) showed a toxicity effect against A. salina nauplii.

La mayoría de las especies del género Artemisia L. (Compositae) son hierbas medicinales con varios usos en la medicina popular en todo el mundo. En el presente estudio, el extracto metanólico de Artemisia santolina ha sido sometido al aislamiento de sus metabolitos junto con la evaluación de la actividad citotóxica contra las larvas de Artemia salina. Las estructuras de los compuestos se determinaron mediante RMN 1H y 13C, HMQC, HMBC, 1H-1H COZY y análisis espectral de masas. Dos sesquiterpenos, 1,5-dihidroxi-4 (15) eudesman- 12,6-olid (artemin) (1), 2-hidroxi-2,6,10-trimetil-7,10-óxido-3,11-dodecadien-5-ona (2) y un flavonoide, 5,7,4'-trihidroxi-6,3'- dimetoxiflavona (jaceosidina) (3). Se evaluó la citotoxicidad de la lactona sesquiterpénica (1) en larvas de Artemia salina y resultó en un valor de CI50 de 6,44 µg/ml, que era más potente en comparación con el clorhidrato de berberina estándar positivo (CI50 = 26 µg/ml). En este estudio se describe la separación e identificación de dos sesquiterpenos y una flavona de las partes aéreas de A. santolina. Entre ellos, el compuesto artemin (1) mostró un efecto de toxicidad contra los nauplios de A. salina.

Spontaneous closure of isolated ventricular septal defects in the first year of life

Objective: Ventricular septal defect [VSD] is the most common heart defect that's present at birth [congenital]. The defect involves an opening [hole] in the heart forming between the hearts lower chambers, allowing oxygen-rich and oxygen-poor blood to mix. The aim of this study was to correlate the size and location of isolated ventricular septal defect [VSD] with spontaneous closure rate in the first year of life

Methods: A retrospective study of 50 patients [27 males, and 23 females] age range between 1 day to 4 months [mean age 35.9 +/- 26.4 days] with isolated ventricular septal defect [VSD] and no other cardiac lesion was performed in whom the condition was observed during the period from 1st of June 2013 to the 1[st] of June 2014 in the Pediatric Echocardiography Unit/Babylon maternity and children teaching hospital

Results: A total of 50 infants were followed, spontaneous closure occurred in 21 [42%] cases. Fourteen [63.6%] cases of small, 7 [30.4%] cases of moderate and none of the patients with large VSDs had spontaneous closure. Spontaneous closure was noted in 15 [41.7%] of 36 cases of peri membranous defects and in 6 [60%] of 10 patients with muscular VSD

Conclusions: About two thirds of the small [66.7%] and one third [33.3%] of moderate size ventricular septal defect [VSD] had spontaneous closure by first year of age. Muscular VSDs close spontaneously at a rate higher than peri membranous VSDs in first year of age

The Story of Beta-sitosterol- A Review.

Aims: Phytosterols are a subgroup of the steroids, as an important class of bioorganic molecules, widespread in plants, animals, marines as well as fungi and have similarity to cholesterol in structure. These compounds have a long history of consumption as food or pharmaceutical products, and generally recognized as safe without undesirable side effects. Place and Duration of Study: Medicinal plants Research Center and Pharmaceutical Sciences Research Center, between March 2013 and May 2013. Results: Amongphytosterols, β-sitosterol is usually used for heart disease, hypercholesterolemia, modulating the immune system, prevention of cancer, as well as for rheumatoid arthritis, tuberculosis, cervical cancer, hair loss and benign prostatic hyperplasia. Furthermore, diverse biological activities whereby natural compounds or the extracts were considered including trypanocidal and mosquito larvicidal, even neutralization of viper and cobra venom characteristics was recorded. Conclusion: Some of the above indications are evidence based, but others are still in doubt and need more investigations to confirm its efficacy and safety. Regarding to the importance of these natural sterols and β-sitosterol as the most abundant of them, the main pharmacological and biological activities together with their clinical trials is reviewed here.

Association of unhealthy exercise patterns with overweight and obesity in Kuwaiti adults

Our aim was to investigate the frequency of the behaviors that are most often associated with excess weight gain in Kuwaitis and to determine which gender and age groups are at highest risk for each behavior. A questionnaire developed to identify barriers to exercise in western populations was modified for use with Kuwaitis and posted online during September through December 2012. Data from 1370 adults 18 to 59 years old with BMIs ranging from 15.1-70.8 was collected. The prevalence of seven behavior patterns was examined for age, BMI, and gender groups as well as the odds ratio of each behavior for each BMI group. Both individual unhealthy exercise behaviors and the sum of all such behaviors were more frequent in overweight and obese individuals. For all behaviors the odds ratio was significantly greater for those with BMIs of 30-39 than for those with BMIs below 25 [P< 0.05]. Some exercise avoidance behaviors were more frequent in older age groups and in overweight females. Unhealthy exercise behavior patterns were highly prevalent in obese individuals. Tailoring programs and counseling to the most common of these patterns in Kuwaiti obese should facilitate greater success in weight management

The ‘widow maker’: Electrocardiogram features that should not be missed

Patients with Wellen’s syndrome often present with chest pain and found to have specific precordial T-wave changes on the electrocardiogram (ECG). They subsequently develop a large anterior wall myocardial infarction. These specific electrocardiographic abnormalities are associated with critical stenosis of the proximal left anterior descending coronary artery (LAD). This syndrome is often under-recognised and has fatal consequences; it is, therefore, also known as the widow maker. We highlight a case of a 39-year old gentleman who had a history of coronary artery disease and typical ECG characteristics of Wellen’s syndrome.

relationship between cytokine gene polymorphism and unexplained recurrent spontaneous abortion in Saudi females

To investigate the relationships between unexplained recurrent spontaneous abortion [RSA] and single nucleotide polymorphisms tumor necrosis factor-alpha [TNF-alpha] [-238 G/A, -308 G/A], interleukin [IL]-6 [-634 G/C] and IL-10 [-592 C/A] in the promoter region of 3 different interleukin [TNF- alpha, IL-6, and IL-10] genes. The study group comprised 65 women [mean age: 34.1 +/- 6. 2; range: 15-45 years] with unexplained RSA, consecutively referred to the Recurrent Abortion Clinic, King Khaled University Hospital, Riyadh, Kingdom of Saudi Arabia from January 2010 to January 2011. The control group consisted of 65 females with at least 2 successful pregnancies and no history of abortion. Blood samples were drawn and deoxyribonucleic acid [DNA] was extracted using Puregene DNA purification kit. Utilizing polymerase chain reaction, the promoter region was amplified and sequenced on an Applied Biosystems Integrated sequencer to study the polymorphic sites of interest. All polymorphisms were identified in the case and control samples. A significant association was identified only between the -308 G/A polymorphism in the TNF- alpha gene promoter and the occurrence of unexplained RSA, and there was no significant association with other positions. The TNF- alpha gene polymorphism at position -308 could be a genetic predisposing factor for unexplained RSA

Molecular profile of colorectal cancer in Indonesia: is there another pathway?

Colorectal cancer is an emerging public health problem in Indonesia and currently ranks among the three highest cancers. Lack of a colonoscopy screening and lifestyle changes might contribute to it. In the last few decades, there is an increasing interest towards the contribution of genetic-environment interaction in colorectal carcinogenesis. Some studies have indicated that CRC might develop through several different pathways; the three major routes are chromosomal instability [CIN], microsatellite instability [MSI], and inflammatory pathways. An earlier study on clinical epidemiology of CRC in Indonesia showed that the majority of patients were diagnosed between 45 and 50 years old, with a mean age around 47 years old. Further studies showed that most young Indonesian cases of CRC do not have hereditary characteristics; however, the CRC did not follow the conventional pathways of sporadic CRC [the CIN] pathway. Rather, it is a mixed of MSI and inflammatory pathways. Immunohistochemical studies showed that the proportion of patients with negative mismatch repair proteins was 43.5% for MSH2 and 83.5% for MLH1. Along the sporadic colorectal carcinogenesis pathway, there was a specific role of cyclooxygenase-2 [COX-2] enzyme during the polyp formation. COX-2 expression was reported in about 80% CRC cases worldwide. However, our study found only 49% of COX-2 expression among the CRC patients. Interestingly, an inflammatory marker, the nucleus factor [k]B [NF-[k]B], was expressed in about 73.5% cases, in line with a previous study. More recently, KRAS has been used as a potential tumor marker to select treatment and its expression was reported to be as high as 30%-40% worldwide. However, we found that KRAS gene expression was only 16.3%. Our findings support that CRC patients in Indonesian might follow a distinct pathway, a hypothesis that deserves further exploration

Extracellular production of silver nanoparticles by using three common species of dermatophytes: trichophyton rubrum, trichophyton mentagrophytes and microsporum canis

To develop a new green approach for biosynthesis of silver nanoparticles, myconanotechnology has been represented as a novel field of study in nanotechnology. In this study, we have reported the extracellular synthesis of highly stable silver nanoparticles using three species of dermatophytes: Trichophyton rubrum, Trichophyton mentagrophytes and Microsporum canis. Clinical strains of these species were grown in a liquid medium containing mineral salt and incubated at 25[degree sign]C for 5-7 days. The cell-free filtrate of each culture was obtained and subjected to synthesize silver nanoparticles in the presence of 1 mM AgNO[3]. The reduction of Ag+ ions in metal nanoparticles was investigated virtually by tracing the solution color which was switched into reddish-light brown after 72 h. For T. mentagrophytes, a UV-visible spectra demonstrating a strong, quite narrow peak located between 422 and 425 nm was obtained. For M. canis, a fairly wide peak centering at 441 nm and for T. rubrum, a weak spectrum to decipher were observed. According to transmission electron microscopy [TEM] results, fairly uniform, spherical, and small in size with almost less than 50 nm particles were forms in case of T. mentagrophytes. For the other two species, TEM images showed existence of small spherical nanosilvers but not as small as nanoparticles synthesized by T. mentagrophytes. We observed that species belong to a single genus of the fungi have variable ability to synthesize silver nanoparticles extracellulary with different efficiency. Furthermore, the extracellular synthesis may make the process simpler and easier for following processes

Diabetes awareness - knowledge attitude and practice of diabetic patients in a tertiary Care Setting

Objective: to assess the awareness of people regarding diabetes and their practices about the disease so that a comprehensive education program may be designed to give awareness to the diabetic patients and contribute towards reduction of the complications of the disease

Material and Methods: a cross sectional study which included 714 patients with known type 2 diabetes conducted in Shalimar Hospital, Lahore. The technique used was non probability purposive sampling. A simple questionnaire was distributed in the diabetic clinic and a diabetic nurse filled the questionnaire by asking questions from the patients

Results: mean age was 50.5+/-24.11 years. There were 25.5% males and 7 4.5% females. A large number [37 .2%] were uneducated and only 16.1 % had education above grade 10. Regarding the economic status, 62.9% fell into grade 1 economic status and 12.9% in grade 4. In the study 64.1 % of the patients thought that the disease had no cure. 84.8% of the patients were of the opinion that the disease and the medication would decrease with time. Only 35% patients knew that it may affect different organs of the body irreversibly. 69% of the patients did not walk at all

Conclusion: in a tertiary setup in Lahore, one of the most prosperous cities of Pakistan, the awareness level is quite poor even amongst the people who are suffering from diabetes. The overall education level in our patient group is also very poor. If the awareness level of diabetic patient's remains as it is today, many new faces of diabetic complications will unveil each year. There is a need for an effective disease management program in the country

Diabetes awareness· knowledge attitude and practice of diabetic patients in a tertiary gare setting

Objective: to assess the awareness of people regarding diabetes and their practices about the disease so that a comprehensive education program may be designed to give awareness to the diabetic patients and contribute towards reduction of the complications of the disease

Material and Methods: a cross sectional study which included 714 patients with known type 2 diabetes conducted in Shalimar Hospital, Lahore. The technique used was non probability purposive sampling. A simple questionnaire was distributed in the diabetic clinic and a diabetic nurse filled the questionnaire by asking questions from the patients

Results: mean age was 50.5.+/-24.11 years. There were 25.5% males and 7 4.5% females. A large number [37.2%] were uneducated and only 16.1 % had education above grade 10. Regarding the economic status, 62.9% fell into grade 1 economic status and 12.9% in grade 4. In the study 64.1 % of the patients thought that the disease had no cure. 84.8% of the patients were of the opinion that the disease and the medication would decrease with time. Only 35% patients knew that it may affect different organs of the body irreversibly. 69% of the patients did not walk at all

Conclusion: in a tertiary setup in Lahore, one of the most prosperous cities of Pakistan, the awareness level is quite poor even amongst the people who are suffering from diabetes. The overall education level in our patient group is also very poor. If the awareness level of diabetic patient's remains as it is today, many new faces of diabetic complications will unveil each year. There is a need for an effective disease management program in the country

Subclinical cardiac involvement in systemic lupus erythematosus

Cardiovascular lesions are commonly found in children and adolescents with systemic lupus erythematosus [SLE] with relevant implication in mortality and morbidity. The purpose of the study was to verify whether there is any sign of cardiovascular involvement in childhood SLE without clinical manifestations using electrocardiography [ECG] and echocardiography [ECHO]. The study was carried out on 40 children with SLE who attended the outpatient clinics of Rheumatology, Pediatrics, Cardiology and Internal Medicine departments of Assiut and AI-Azhar universities. They were free of any clinically evident cardiac manifestations such as dyspnea, orthopnea and edema of the lower limbs. In addition, twenty apparently healthy children were taken as a control group. All subjects underwent complete history and physical examinations, x ray chest, ECG and two dimensional,M mode, continuous wave [CW], pulse wave [PW] and color flow Doppler examinations .The following investigations were done: complete blood count [CBc], erythrocyte sedimentation rate[ESR], antistreptolysin O titre [A SOT], C reactive protein[CRP], C[3] complement, rheumatoid factor[RF],anfinuclear antibodies[ANA] and anti double strand DNA[anti ds DNA]. Minor ECG changes were detected in 15% of patients. ECHO showed pericarditis with effusion, aortic insufficiency, mitral regurgitation, mild tricuspid regurgitation and mild pulmonary hypertension in 15%, 20%, 25%, 15% and 20% of patients with SLE respectively. A significant reduction of ejection fraction [EF] and fraction shortening [FS] was found in our patients .Significant diastolic dys functions were manifested by decreased early diastolic flow velocity [E], early diastolic flow velocity/late diastolic flow velocity [E/A] ratio and increased E deceleration time [Edt], left ventricular posterior wall diameter in diastole [LVPWd], interventricular septum in diastole[.lVSd] and pulmonary artery systolic pressure [PASP]. Cardiovascular involvement in childhood SLE is Regular cardiac evaluation using [ECG] and [ECHO] is recommended to detect subclinical cardiac involvement