Radiolological predictors of recurrence of chronic subdural hematoma

Objective: Chronic subdural hematoma is one of the most common clinical entities encountered in daily neurosurgical practice. Considerable recurrence rates have been reported for chronic subdural hematoma following surgical evacuation. Many studies have suggested various radiological factors that may be associated with the recurrence of CSDH. However, the results are inconsistent. This study focuses on determining the radiological factors predictive of chronic subdural hematoma recurrence

Methods: A retrospective analysis of 113 patients diagnosed with chronic subdural hematoma who were surgically treated between August 2013 and December 2014 was performed. The radiological features were analyzed to clarify the correlation between these radiological factors and postoperative recurrence of chronic subdural hematoma

Results: Twenty patients [17.7%] experienced recurrence. Chronic subdural hematoma recurrence was found to be significantly associated [p<0.05] with preoperative hematoma thickness >/= 20 mm. Midline shift, hematoma density and bilaterality were not significantly associated with recurrence. Post operative drainage also significantly [p<0.05] reduced chronic subdural hematoma recurrence

Conclusion: Preoperative hematoma thickness >/= 20 mm is an independent predictor of recurrence of chronic subdural hematoma. Postoperative drainage also significantly reduces chronic subdural hematoma recurrence

Evaluation of cytotoxic and antiviral activities of aqueous leaves extracts of different plants against foot and mouth disease virus infection in farming animals

Cytotoxic and antiviral activity of aqueous leaves extracts of three plants: Azadirachta indica, Moringa oleifera and Moms alba against Foot and Mouth disease virus [FMDV] were determined using MTT assay [3-[4, 5-Dimethylthiazol-2-yl]-2, 5-diphenyltetrazolium bromide]. Eight different concentrations of each plant were evaluated. Cytotoxic and antiviral activity of each extract was evaluated as cell survival percentage and results were expressed as Means +/- S.D. From the tested plant extracts, Azadirachta indica and Moringa oleifera exhibited cytotoxicity at 200 and 100 microg/ml respectively. In case of antiviral assay, Moringa oleifera showed potent antiviral activity [p<0.05] while Azadirachta indica showed significant antiviral activity in the range of 12.5-50 microg/ml and 50-100 microg/ml respectively. In contrast no anti-FMDV activity in the present study was observed with Morus alba, although all the tested concentrations were found to be safe

Outer membrane proteins and lipopolysaccharides mediated antibody response against bovine Pasteurella multocida type B-2

Aims: The activation of cellular and humoral immunity depends upon nature of antigens. Complex proteins like bacterial outer membrane proteins (OMP) usually successfully activate both humoral and cellular immunity. Whereas antigens like bacterial lipopolysaccharides (LPS) usually elicit T-independent immunity i.e. humoral immunity without the activation of cellular immune wing. The present study was under taken to evaluate the comparative immunologic behavior of both the important molecules (bacterial lipopolysaccharide and outer membrane proteins) of Pasteurella multocida alone and in combination in bovine calves in field conditions. Methodology and results: Pasteurella multocida was isolated, purified and identified from an outbreak by mean of culture and biochemical methods. The pathogenicity of the confirmed isolates was done in rabbits (Oryctolagus cuniculus) on the principles of Koch’s postulates. Alum based vaccine against P. multocida was prepared and antibody titer against Outer membrane protein (OMP) and lipopolysaccharides (LPS) were determined by complement fixation test (CFT). The results showed that the antibody titer against OMP and LPS in whole culture vaccine is significantly higher than the respective tested vaccines. These results concluded that OMP no doubt is an active T-dependent immunogenic molecule but its immunogenicity increases many times when combined with LPS in whole culture vaccine. Conclusion, significance and impact of study: Lipopolysaccharides (LPS) in combination with outer membrane proteins (OMP) synergistically boost the humoral immune response in vaccinated animal.

Optimization of PCR for rapid detection of CTX-M gene in ESBL producing Klebsiella pneumoniae clinical isolates from Punjab, Pakistan

Aims: The study was carried out firstly, to evaluate the prevalence of extended spectrum beta lactamase (ESBL), multidrug resistant Klebsiella pneumoniae isolates from Punjab, Pakistan and secondly, to characterize the genotypes of their beta lactamase producing enzymes and optimization of PCR based method for rapid and authentic detection of antibiotic resistant gene. Methodology and results: Two hundred of K. pneumonia strains were isolated from different clinical samples. Blood and MacConkey Agar were used to isolate and identify bacterial microorganisms while Muller Hinton Agar was used to evaluate the antimicrobial susceptibility against different antibiotics as per CLSI 2012 guidelines. ESBL producing bacteria were screened by double disk synergy /combination disk test. PCR was optimized and performed for resistant gene (CTX-M). The results showed that most of the isolates were resistant to multiple antibiotic including cephalosporin, aztreonam, sulphamethoxazole/trimethoprim, ciprofloxacin, doxycyclin and were sensitive to imipenam and amikacin. Frequency of CTX-M gene in ESBL producing K. pneumoniae was 94%. Conclusion, significance and impact of study: Based on the finding of this study it is suggested that prevalence of CTX-M gene (95%) is very high among ESBL producing isolates. Therefore, PCR based method may help clinicians for rapid detection and treatment of patients by choosing right medication against the resistant bacteria as early as possible.

Microbiological load of ethylene oxide sterilized medical devices and its elimination by cobalt 60 source

Objective: To determine the residing microbial flora of ethylene oxide [EtO] sterilized medical devices and optimization of safe dose of gamma radiation [Cobalt 60 source] for the complete elimination of microbial load

Study Design: Experimental study

Place and Duration of Study: Department of Biotechnology, Lahore College for Women University, Lahore, Pakistan from September 2014 to June 2015

Methodology: Thirty-six samples of EtO sterilized medical devices of same batch of three different companies were collected for this study. Isolation and enumeration of microbes were done by using different selective and differential media. Gram staining and biochemically characterization by API 20 [Bio Merieux, France] kit was done for identification of the microorganisms. The medical devices having high microbial load were sent to Pakistan Radiation Services [PARAS] for gamma irradiations at 3 different selected doses [20 KGy, 25 KGy, and 30 KGy]

Results: Different types of Gram positive bacteria [Staphylococcus epidermidis, Staphylococcus aureus and Bacillus subtilis] were isolated from the EtO sterilized samples. Gram negative bacteria and fungi were not detected on these medical devices. Gamma irradiations results showed that 30 KGy was optimized dose for complete elimination of microbial flora on endotracheal, Nelaton, and tracheostomy tubes

Conclusion: Gamma radiations [Co 60 source] effectively decontaminate the microbial flora on the equipment previously sterilized by the ethylene oxide gas; and 30 KGy is the optimized dose for all these medical devices

Effect of calcium hypochlorite and chloramine on blood biochemistry and sodium pentobarbital induced sleeping time in mice

Disinfectants are chemical agents used to eradicate, deactivate or kill microorganisms. Chemical disinfectants especially chlorine compound are extensively used for water sanitization. Among these calcium hypochlorite and chloramines are commonly used now a day. Large number of chemical compounds, drugs and endogenous substances are metabolized by hepatic enzymes known as cytochrome P450 enzyme system. Many chemicals are capable of enzyme induction. Enzyme induction may change the metabolism of other drugs and endogenous substances which may alter the plasma concentration of these chemicals. To evaluate the enzyme inducing ability of calcium hypochlorite and chloramine, sleeping time induced by sodium pentobarbital was noted in mice. Normal saline was taken as negative control. Rifampicin, chloramphenicol and grapefruit juice were taken as positive control group. On completion of dosing after 4 weeks, alteration in sleep induction and recovery times was noted and compared. Histological evaluation of liver was observed. Asignificant decrease in sleeping time was observed in calcium hypochlorite and chloramine treated groups. Both calcium hypochlorite and chloramine caused a significant change in liver enzymes and in the values of complete blood count.In histological evaluation both caused fat deposition in the hepatocytes. It was concluded from the study that both calcium hypochlorite and chloramine were hepatic microsomal enzyme inducer

Management of cerebrospinal fluid leak following posterior cranial fossa surgery

Objective: Cerebrospinal fluid leakage remains a significant cause of morbidity following posterior fossa surgery, and its treatment remains a difficult problem. The aim of the study was to propose a treatment algorithm for its management

Methods: A retrospective, single-center study was conducted on 147 patients who underwent elective posterior fossa surgery for a variety of diseases. Patients with post operative CSF leakage had either been treated initially with conservative measures including re-suturing of the wound, with CSF lumbar drainage to be employed in case the CSF leakage didn't stop, or the initial intervention was the institution of CSF lumbar drainage simultaneously with conservative measures. VP [ventriculo-peritoneal] shunt was done in patients with gross hydrocephalus on postoperative CT brain

Results: There were 25 [17%] cases of CSF leakage, including 24 incisional CSF leaks and one case of CSF otorrhea. In eight patients with incisional CSF leakage treated initially with conservative measures including re-suturing of the wound, CSF leakage stopped in only two cases. CSF lumbar drainage instituted later on in six cases with persistent leakage stopped the CSF leakage. In fourteen patients managed initially with re-suturing of the wound and concomitant CSF lumbar drainage, CSF leakage settled in all the cases. Two patients with gross hydrocephalus on post operative CT were managed successfully with VP shunt. Re-suturing of the wound with concomitant CSF lumbar drainage was found to be significantly associated [p=0.003] with the stoppage of CSF leakage, and the settlement of meningitis [p= 0.014]

Conclusion: Incisional CSF leaks after posterior fossa surgery should be managed with re-suturing of the wound and concomitant CSF lumbar drainage, instead of an initial trial of conservative therapy alone

Evaluation of antifungal and antioxidant potential of two medicinal plants:Aconitum heterophyllum and Polygonum bistorta

Objective:To focus on the evaluation of antimicrobial and antioxidant activity of two endangered medicinal plants Aconitum heterophyllum (A. heterophyllum) and Polygonum bistorta (P. bistorta). Materials: Plant extracts were obtained by using microwave assisted extraction method. The in vitro antifungal activity of A. heterophyllum and P. bistorta extracts were determined by measuring diameters of inhibitory zones of these extracts against Aspergillus niger and Alternalia solani. Results:Methanolic extract of A. heterophyllum showed significant (P≤0.05) antifungal activity against both the tested organisms. It was also observed that ethanolic extracts of P. bistorta also had good antifungal activity against the tested fungal strains as compared to the methanolic extracts. It showed significant antifungal activity (P≤0.05) against both the tested strains. Antioxidant activity of methanolic and ethanolic extracts of A. heterophyllum and P. bistorta were also measured using a radical scavenging method. Ascorbic acid was used as a standard. Conclusions:It was observed that A. heterophyllum and P. bistorta have significant antioxidant activity. Higher antioxidant activity was recorded in methanolic extract of A. heterophyllum as compared to its ethanolic extract. However, in case of P. bistorta ethanolic extract of the plant exhibited higher antioxidant potential than methanolic extracts. Hence both of these plants have significant antimicrobial as well as antioxidant potential.

Contribution of GLC3A locus to primary congenital glaucoma in Pakistani population

To check the contribution of GLC3A locus to primary congenital glaucoma in the Pakistani population. We enrolled twenty-nine sporadic cases and three families with multiple individuals affected with recessive primary congenital glaucoma in the year 2013. It was a genetic linkage study accomplished jointly in Department of Biotechnology of Lahore College for Women University and School of Biological Sciences, University of the Punjab, Lahore. Samples from all affected individuals were checked for homozygosity for alleles of microsatellite markers spanning CYP1B1 at GLC3A locus. Genotyping was performed with fluorescently labeled primers by capillary electrophoresis. For familial cases, linkage was evaluated by checking the co-segregation of the phenotype with the genotypes. Two-point LOD score was calculated for each microsatellite marker with MLINK. Our study revealed that GLCA3 may contribute to glaucoma in 17% of the sporadic cases and patients in 2 of the 3 families. This data suggests that the GLC3A may make an important contribution to autosomal recessive primary congenital glaucoma in the Pakistani population. Genotyping and Sequencing of more families will be helpful to identify the common mutations in CYP1B1 in future

vitro evaluation of mutagenicity of metformin and aspartame alone and in combination

To assess the Mutagenicity of Metformin and Aspartame in vitro. Observational/Analytical study This study was carried out at Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences Lahore from 1[st] Jan 2011 to Dec 2011. Ames Salmonella/ Microsome Mutagenicity Assay was used to check the mutagenic potential of test chemicals and control. The data was analyzed by using Statistical Package of Social Sciences. Metformin was found to be highly mutagenic against TA 100 and TA98 both in the presence and absence of metabolic activation system. The results were significant because there was 2 fold rise in number of revertants as compared to the negative control. Overall metformin exhibited more mutagenicity against TA 100 as compared to TA 98 strain of Salmonella Typhimurium. Aspartame showed significant rise in mutagenicity at l00microg/plate and 250microg/plate in dose dependant manner against TA 100 in presence of metabolic activation system. When combination doses of aspartame and metformin were studied, even those doses became mutagenic which were not mutagenic alone. The data advocates that combination doses showed significant additive effect [p < 0.05] in the intensity of mutagenic index as compared to the mutagenic index of metformin and aspartame alone. Both of these products alone and together may cause significant damage to the cells of body as well. Combination therapy of these products should be monitored closely

To assess the in vitro genotoxicity of metformin and aspartame alone and in combination

Metformin is a known oral antidiabetic agent belonging to the class of biguanides, widely prescribed for the treatment of type 2 Diabetes Mellitus [DM]. In this study the genotoxic potential of metformin was studied alone and in combination with an artificial sweetener aspartame as most of the diabetic patients utilized this low calorie sweetener to reduce their sugar consumption per day. Many complaints regarding its potential to cause DNA damage have been submitted to PDA. Experimental study. This study was carried out at the Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences Lahore from 1[st] Jan 2011 to Dec 2011. Peripheral Blood Lymphocytes were exposed to various concentrations of metformin, aspartame and their combination. DNA damage was checked by comet assay. The data was analyzed by using Analysis of Variance [ANOVA] by Statistical Package of Social Sciences SPSS Exhibited dose dependant rise in comet tail lengths. Moreover the data advocates that tail lengths of lymphocytes after exposure to aspartame were high as compared to metformin. When lymphocytes were exposed to combination of aspartame and metformin and DNA damage was checked by comet assay, the results were significantly different [p<0.05] as compared to metformin and aspartame alone. It can be concluded from the present study that aspartame is posing great genotoxic threat to the cells as compared to metformin and the combination is even more toxic to DNA, so the drug regime of diabetic patient must be closely monitored. There is further need of more studies in this regard