Probiotic Characterization of Enterococcus spp. Isolated from Raw Goat Milk

Abstract: The aim of this research was to determine the probiotic potential and safety of lactic acid bacteria (LAB) isolated from raw goat milk. Gram positive and catalase negative bacteria were isolated from raw goat milk (n = 61) and identified as LAB. LAB isolates were screened for antimicrobial, probiotic and technological characteristics. LAB isolates showed antimicrobial activity against foodborne pathogens (Staphylococcus aureus, Escherichia coli and Salmonella Typhimurium) and high survival rate at pH 2 (93.54-100.38% after 4h), in the presence of 0.3% bile salts (100.85-108.96% after 4h) and simulated gastric fluid (74.16-80.13% after 3h). Three LAB isolates (1, 3 and 13) with high antimicrobial activity against all foodborne pathogens and probiotics characteristics were subjected to 16S rRNA sequencing and identified as Enterococcus faecium strains. Enterococcus spp. exhibited milk coagulation potential, amylolytic activity, susceptibility to antibiotics and no evidence of hemolysis. Enterococcus spp. isolated from goat milk showed probiotic and technological characteristics and can be used as a starter culture after further safety evaluation.

Antibacterial Effects of Cinnamon Extract, Clove Oil and Antibiotics against Helicobacter pylori Isolated from Stomach Biopsies

Abstract Helicobacter pylori is a pathogenic bacterium causing gastric problems such as, peptic ulcers and stomach cancer. H. pylori were isolated from the stomach biopsy specimens (n = 100) of gastric patients by performing polymerase chain reaction (PCR) against cagA (cytotoxin associated gene A) and ureC (Urease subunit alpha) genes. Furthermore, antibiogram studies of the H. pylori isolates were evaluated against the common antibiotics. The overall detection rate of H. pylori was 71% in biopsy specimens of gastric patients. The antimicrobial susceptibility test revealed the resistance rate of H. pylori isolates against metronidazole (50%), clarithromycin (28.33%), tetracycline (21.66%), amoxicillin (18.33%), and ciprofloxacin (11.66%). However, the H. pylori isolates were completely resistant to vancomycin, erythromycin and nalidixic acid antibiotics. Clove oil showed a remarkable antimicrobial effect against H. pylori whereas, mild inhibition (10 mm) was observed in case of curcumin extract. Due to increase incident of resistance and high prevalence of H. pylori in gastric patients, natural antimicrobial like clove oil can be explored as an alternative treatment.

Anti-diabetic properties and bioactive compounds of Teucrium polium L

Diabetes mellitus is a common metabolic disease with considerable morbidity and mortality. Untreated or improperly-treated diabetes can be associated with several long-term complications that necessitate an effective way to manage diabetes. Due to the side effects of synthetic glucose-lowering agents, alternative therapeutic modalities such as medicinal plants have attracted notable attention. Teucrium polium L. is a medicinal herb with antioxidant, antinociceptive, anti-inflammatory, hypolipidemic, hepatoprotective, and hypoglycemic properties. In vitro and in vivo studies have been conducted to characterize the anti-diabetic properties of Teucrium polium L. and its bioactive compounds. We conducted a literature study using Scopus, PubMed, and Google Scholar including the keywords "diabetes" and "Teucrium polium". We also scanned all the references cited by the retrieved articles. According to this review, Teucrium polium administration displayed anti-diabetic effects by targeting different mechanisms and pathways, such as enhancement of insulin secretion and insulin level, improvement of oxidative damage, regeneration of pancreatic β-cells, and promotion of glucose uptake in muscle tissues by increasing GLUT-4 translocation as well as inhibiting α-amylase activity. Although Teucrium polium has been widely regarded as a traditional method, the pharmacological studies on anti-diabetic effects are not sufficient, most studies are either in-vivo or in-vitro. The preclinical and clinical studies are further required to confirm the efficacy of Teucrium polium.

Association between neck circumferences and cardiometabolic risk factors

Background: Anthropometric measures have been used for screening patients for cardiovascular abnormalities and metabolic syndrome since many years. There are numerous methods to assessing overweight and obesity, such as measurements of weight, height, waist circumference, hip circumference and calculation of waist hip ratio and BMI. Due to cultural inhibitions measurement of hip, thigh or waist circumference is cumbersome in females, neck circumference could be an acceptable option for such patients.Methods: A cross-sectional study was conducted on patients attending the outpatient department in Yenepoya medical college Hospital between the period of May 2017 to May 2018. Total 201 patients chosen randomly in which 145 males and 56 females, fulfilling criteria of age >20 years were included. Pregnant females, patients with thyroid disorders, history of previous neck surgery were excluded.Results: Out of the 201 population studied, Cardio metabolic syndrome was present in 94 participants according to criteria of NCEP ATP III. In our study there is a significant correlation between neck circumference and metabolic syndrome (p value <0.001).Conclusions: Patients with Neck Circumference (NC) >37 cm in males and >34 cm in females are more prone for having cardio metabolic risk factors than patients with NC <37 cm in males and <34 cm in females. NC may be used as a simple and time saving screening measure to identify cardio metabolic risk factors in patients.

Differentiation analysis on the health education needs for clinical medical students and clinicians / 中华健康管理学杂志

Objective To understand the current situation of health education contents as well as the differences in their requirements between clinical medical students and clinicians,and to provide reference for the optimization of health education curricula for medical students.Methods A stratified sampling method was adopted to select 511 medical students (303 females and 208 males) from a medical university,and the survey results of 436 clinicians (144 females and 292 males) were taken as reference.Differences in the degrees of need between clinical medical students and clinicians were compared by chi-square tests.Results There were statistical differences in needs between clinical medical students and clinicians regarding drug compliance,smoking cessation intervention,balanced diet,application of Chinese traditional rehabilitation medicine,mobile health technology education,exercise rehabilitation guidance,and theory of health promotion (P＜0.01).With regard to drug compliance,smoking cessation intervention,and exercise rehabilitation guidance,the proportions of clinical medical students' needs were just 87.1％,82.2％,and 81.2％,respectively,but for clinicians the proportions reached up to 96.3％,93.8％,and 92.8％,respectively.Whereas,there were no statistical differences for mental stress management,chronic infectious disease health education,and acute infectious disease health education (P＞0.05).Conclusion There is still a big gap between medical students and clinical doctors when it comes to the knowledge of chronic disease management and healthy lifestyles;clinical medical students have not yet realized the importance of such knowledge and skills.Therefore,the strengthening of course construction for clinical medical students is suggested.

capability approach: a guiding framework to improve population health and the attainment of the Sustainable Developmental Goals

The world is progressing in terms of communication, innovative technology and cure of various diseases through advanced pharmacological preparations. Unfortunately, populations are still struggling with ill-health, disabilities, poverty, hunger, inequality, gender disparities and conflicts. Several questions come to mind in this regard: why are prosperity, health, peace and progress not evenly distributed and what is the best approach to address the issues associated with population health? The capability approach may offer a possible model. This approach is a blend of 5 key concepts: capabilities, functioning, agency, endowment, and conversion factors. It proposes an innovative approach to examine and enhance the quality of life and well-being of individuals. This reflective paper provides an overview of the capability approach, critically analyses population health from the theoretical lens of the capability approach and highlights the relevance of this approach to achieving the Sustainable Developmental Goals

Significance of herbal medicine in removing excessive iron content in human

Heavy metals in cigarette tobacco such as iron may cause a serious damage on human health. Surveys showed that the accumulation of certain toxic heavy metals like cadmium, mercury, iron is very often due to the effect of smoking. This work involved 15 volunteers in two randomly divided groups having the habit of cigarette smoking over 15 cigarettes / day. Concentration level of iron in blood and urine before and after treatment using the herbal medicine, widely used in Europe, is analyzed. Determination of Iron concentration in blood and urine was calculated by Inductively Coupled Plasma-Atomic Emission Spectrometry [ICP-AES] according to the procedure DIN EN ISO 11885 ["E22" from April 1998]. The analysis shows that the concentration of iron in blood and urine samples in both groups increased in some volunteers instead of decrease. The independent T-test shows that the mean of iron concentration in the group A and group B had no significant difference [p>0.05]. The results suggested that the herbal medicine under test does not have significant influence on reduction of iron concentration levels

Primary neuroendocrine tumors

To evaluate clinical presentation and surgical out come of primary neuroendocrine tumors of Kidney, U. bladder and Prostate gland. A Retrospective study. Urology Department, SMBBMU Larkana. 2001-2011. Series of 6 patients of primary neuroendocrine tumors of Kidney, U. bladder and Prostate gland were identified from 1890 cases of urinary tract tumors. Two cases of renal carcinoid, two cases of small cell carcinoma of urinary bladder and two cases of small cell carcinoma of prostate glands. Renal carcinoid tumors presenting with lumbar pain and microscopic haematuria and identified on the ultrasound. Small cell carcinoma of urinary bladder presenting with dysuria, gross haematuria and on ultrasound while small cell carcinoma of prostate gland presenting with irritatory and obstructive symptoms and confirmed on DRE. 6 patients [5 male and 1 female],Mean age of patients were 45years and range was 35-55 years. All patients treated primarily by definitive surgery like Radical Nephrectomy, TURBT and Pallitive TURP and all tumors confirmed on histopathological examination and referred to LINAR Larkana for proper managements. primary neuroendocrine tumors of Kidney, U.bladder and Prostate gland are rare tumors. Carcinoid tumors have good prognosis but small cell carcinoma have poor prognosis so require prompt treatment

DNA Repair Genes XRCC1, XRCC3, XPD, and OGG1 Polymorphisms among the Central Region Population of Saudi Arabia

DNA repair is one of the central defense mechanisms against mutagenic exposures. Inherited SNPs of DNA repair genes may contribute to variations in DNA repair capacity and susceptibility to cancer. Due to the presence of these variants, inter-individual and ethnic differences in DNA repair capacity have been established in various populations. Saudi Arabia harbors enormous genetic and cultural diversity. In the present study we aimed to determine the genotype and allele frequencies of XRCC1 Arg399Gln (rs25487), XRCC3 Thr241Met (rs861539), XPD Lys751Gln (rs13181), and OGG1 Ser326Cys (rs1052133) gene polymorphisms in 386 healthy individuals residing in the central region of Saudi Arabia and compare them with HapMap and other populations. The genotype and allele frequencies of the four DNA repair gene loci in central Saudi population showed a distinctive pattern. Furthermore, comparison of polymorphisms in these genes with other populations also showed a unique pattern for the central Saudi population. To the best of our knowledge, this is the first report that deals with these DNA repair gene polymorphisms among the central Saudi population.

Prevalence and antibiogram study of Salmonella and Staphylococcus aureus in poultry meat

Objective:To evaluate the presence and antibiogram pattern of Salmonella and Staphylococcus aureus (S. aureus) in retail poultry meat products. Methods: Foodborne pathogens (Salmonella and S. aureus) were isolated from poultry meat and confirmed with the help of biochemical and immunological test. Antibiogram of the isolates were examined by following CLSI methods. Results: A total number of 209 poultry meat samples were collected and studied in this study. Out of which, 5.26%were found contaminated with Salmonella while 18.18%were found contaminated with S. aureus. All the Salmonella and S. aureus isolates were found resistant to at least one antibiotic. About 72.72%of the Salmonella isolates showed resistance to tetracycline, while S. aureus isolates were also found highly resistant to tetracycline equal to 44.73%. One of the Salmonella isolates showed multi-drug resistance to almost six antibiotics out of nine antibiotics used in the study. Multidrug resistant S. aureus isolates were also found in the study. Conclusions: The study confirmed the presence of Salmonella and S. aureus in retail poultry meat. It is a potential threat to consumer health. To reduce the risk of contamination, good hygiene practices are necessary from processing to storage.

Consensus recommendations for preventing and managing bleeding complications associated with novel oral anticoagulants in singapore

<p><b>INTRODUCTION</b>Novel oral anticoagulants (NOACs) have at least equivalent efficacy compared to standard anticoagulants with similar bleeding risk. Optimal management strategies for bleeding complications associated with NOACs are currently unestablished.</p><p><b>MATERIALS AND METHODS</b>A working group comprising haematologists and vascular medicine specialists representing the major institutions in Singapore was convened to produce this consensus recommendation. A Medline and EMBASE search was conducted for articles related to the 3 available NOACs (dabigatran, rivaroxaban, apixaban), bleeding and its management. Additional information was obtained from the product monographs and bibliographic search of articles identified.</p><p><b>RESULTS</b>The NOACs still has substantial interactions with a number of drugs for which concomitant administration should best be avoided. As they are renally excreted, albeit to different degrees, NOACs should not be prescribed to patients with creatinine clearance of <30 mLs/min. Meticulous consideration of risk versus benefits should be exercised before starting a patient on a NOAC. In patients presenting with bleeding, risk stratification of the severity of bleeding as well as identification of the source of bleeding should be performed. In life-threatening bleeds, recombinant activated factor VIIa and prothrombin complex may be considered although their effectiveness is currently unsupported by firm clinical evidence. The NOACs have varying effect on the prothrombin time and activated partial thromboplastin time which has to be interpreted with caution. Routine monitoring of drug level is not usually required.</p><p><b>CONCLUSION</b>NOACs are an important advancement in antithrombotic management and careful patient selection and monitoring will permit optimisation of their potential and limit bleeding events.</p>

HDV infection in HBV infected individuals

To determine the status of HDV infection in HBV infected individuals at Larkana. This is a laboratory based retrospective study conducted at Molecular Laboratory PHCP-CMI Central laboratory CMC Hospital City block Larkana from October 2010 to September 2011. During the study period all the serum samples in which the HBV DNA was qualitatively detected were further processed for HDV RNA detection by the method of Real time PCR. During the study period a total of 1564 HBV DNA detected serum samples were processed for HDV RNA detection. The males were 1078 [69.0%] and females 486 [31.0%]. The age were ranged between 15 to 73 years. Out of the 1564 HBV DNA detected serum samples, the HDV RNA was detected in 865 [55.31%] and not detected in 699 [44.69%] individuals. This study showed 55.3% HDV infection in the HBV infected patient. Hence, to formulate the treatment option and to predict the response of treatment it is necessary that every HBV infected case should be processed for HDV RNA detection

Malnutrition in young Pakistani children

Pakistan is a developing country with the second highest infant and child mortality rate in South Asia. In this region, malnutrition underlies much of the high infant and under five child morbidity and mortality rates. Although struggle to tackle the issue of malnutrition among young Pakistani children has been going on since many decades, till yet a realistic solution for this growing problem has not been found. This paper aims at reviewing literature to analyse the biological, maternal, socio-cultural, environmental, and politico-economical determinants of malnutrition among young children in Pakistan so that need based interventions can be recommended to prevent and overcome this growing issue. A systematic search of national, regional, and international literature was undertaken from peer-reviewed databases for 1991-2011 including MEDLINE, CINAHL, and PubMed. The search was augmented by reviewing the literature from WHO and UNICEF websites, books, local newspapers, and reference lists of articles thought to be relevant. Determinants of malnutrition among Pakistani children are multiple and are prevalent at the level of individual, family, and community. An analysis of biological, maternal, socio-cultural, environmental, and politico-economical factors indicate that most of these factors are interrelated; therefore, to tackle this issue, there is a need to plan composite interventions at the level of malnourished children, their families, and the Pakistani community.

In vitro scolicidal effect of Satureja khuzistanica (Jamzad) essential oil

Objective: To investigate the scolicidal effect of the Satureja khuzistanica (S. khuzistanica) essential oil from aerial parts of this herbal plant. Methods: The essential oil was obtained by hydrodistillation method. Gas chromatography (GC) and gas chromatography mass spectrometry (GC-MS) were employed to determine the chemical composition of the essential oil. Protoscolices were collected aseptically from sheep livers containing hydatid cyst. Protoscolices were exposed to various concentrations of the oil (3, 5 and 10 mg/mL) for 10, 20, 30, and 60 min. Viability of protoscolices was confirmed by 0.1% eosin staining. Results: A total of 19 compounds representing 97.6% of the total oil, were identified. Carvacrol (94.9%) was found to be the major essential oil constituent. Scolicidal activity of S. khuzistanica essential oil at concentration of 3 mg/mL was 28.58, 32.71, 37.20 and 42.02%, respectively. This essential oil at concentration of 5 mg/mL killed 51.33, 66.68, 81.12, and 100% of protoscolices after 10, 20, 30 and 60 min, respectively. One hundred scolicidal effect was observed with S. khuzistanica essential oil at the concentration of 10 mg/mL after 10 min (comparing with 7.19% for control group). Conclusions: The essential oil of S. khuzistanica is rich in carvacrol and may be used as a natural scolicidal agent.

Effect of cinnamon supplementation on blood glucose and lipid levels in type2 diabetic patients

This study was planned to investigate the effects of supplementation of cinnamon on fasting blood glucose levels and lipid profiles among type2 diabetic patients. 60 subjects with type 2 diabetes from both sexes [30 males and 30 females] were allocated to the intervention and control groups [30 individuals per group]. The doses of 1.5 g of cinnamon were equally administered orally in the form of cinnamon powder into 500 mg per capsule with breakfast, lunch, and dinner for 60 days. Control group received capsules of containing placebo. Blood samples were obtained on the beginning day of the experiment and at the end of 60 days. The fasting blood glucose levels and lipid profiles including total cholesterol, LDL-C, HDL-C and triglycerides of types 2 subjects were measured. Fasting blood glucose levels and lipid profiles in intervention group were significantly lower than control group [p<0.05]. The average of fasting blood glucose levels, total cholesterol, cholesterol LDL and triglyceride levels were decreased after consumption of cinnamon powder, significantly[p<0.05]. We observed no significant changes in fasting blood glucose levels and lipid profiles after consumption of placebo in control group. Conclusion: This study showed that consumption of cinnamon supplementation may be useful in control and decreasing of fasting blood glucose levels and lipid profiles among type 2 diabetes individuals

comparative study of efficacy of intensive insulin therapy versus conventional method on mortality and morbidity of critically ill patients

Hyperglycemia is associated with increased mortality and morbidity. Current evidence has controversies about Intensive Insulin Therapy [NT] and its effect on reducing mortality in critically ill patients. In this trial we evaluated the effect of intensive insulin therapy with a simple protocol versus traditional method on morbidity and mortality of critically ill patients who were admitted to surgical intensive care unit. Sixty adult patients admitted to surgical intensive care unit between Feb 2009 to Feb 2010 in Shohada Hospital, were enrolled in this study. Patients were randomly allocated to intensive insulin therapy group [with a target blood sugar of 80-120 mg/dl] and conventional group [received insulin if blood glucose was more than 200 mg/dl]. Study was continued through the ICU stay of all patients. Acute Kidney Injury, Renal Replacement Therapy, Bactremia and transfusion were less in intensive insulin therapy without significant difference compared to control group. Mortality also was not significant between two groups. Because of the consequences of hyperglycemia, NT might be considered in critically ill patients, but intermediate levels may be more safe and effective and remains the best practice in Intensive Care Units. Defining ICU capability is critical for implementing tight glycemic control and future multi center studies are needed to consider the effect of NT on mortality as an essential outcome

Experience of upper urinary tract stones with dornier mpl 9000 lithotripter

To report our experience with Dornier MPL9000X Lithotripter in terms of safety, efficacy and complications in the management of upper urinary tract stones. Retrospective study. From 19[th] April 1998 to 15 August 2007 in the department of Nephrology, Chandka Medical College, Larkana. All patients who had renal calculi up to 2.5cm in size were selected for extra corporeal shock wave lithotripsy with Dornier MPL 9000 on the basis of clinical examination, laboratory investigations, X-Ray, intravenous urography and ultrasonography. Simple analgesics /sedation were used before the procedure, except in children where general anesthesia was used. A total of 1965 patients were treated with 3930 sessions [Average 4.1 sessions per patients]. Male to female ratio was 1.8:1. Average age of the patients was 35.3 years. The average stone burden was 1.8cm in diameter. Stone did not break in 3.3% cases, where as in 53 [2.69%] cases partial fragmentation had occurred. Over all success rate was 84%. About 10.2% cases were lost to follow up. Complications like colic pain, transient haematuria and stein Strasse was observed in 33%, 17% and 2.5% respectively. Extra corporeal shock wave lithotripsy for renal calculi was simple, safe and effective in selected group of patients

Aluminium phosphide poisoning: a case report

This paper reports the case of a family in which three children were presented at Emergency Room [ER] with poisoning after the use of a pesticide at home. Initially, the cases were managed as routine cases of organophosphorus poisoning; however, the death of two children made the health team members realise that the poison's effects were delayed and devastating. Later, the compound was identified as Aluminium Phosphide [ALP], and the life of the last surviving child in the family was saved

giant polypoid basal cell carcinoma of the lower extremity

Less than 1% of basal cell carcinomas are giant basal cell carcinomas. Giant basal cell carcinomas are rare. They preferentially involve the trunk and are commonly associated with neglect. Giant basal cell carcinomas of 10 cm or greater are associated with a high rate of metastasis. We report a case of giant basal cell carcinoma of the leg which is not associated with neglect and no signs of metastasis, despite being more than 10 cm in diameter. The present paper includes a brief review of the literature