Endophytic Bacillus amyloliquefaciens surfactin possesses anti-inflammatory potential through acetylcholinesterase and lipoxygenase inhibitory activities

Aims@#This study was aimed to investigate the anti-inflammatory and anti-rheumatoid effects of the Bacillus amyloliquefaciens derived surfactin.@*Methodology and results@#Crude and biosurfactant extracts were analyzed using thin-layer chromatography to determine the presence of biosurfactant. Both extracts were evaluated for their inhibitory effects against the acetylcholinesterase and 5-lipoxygenase enzymes. Human synovial cells were induced with TNF-α and IL-1β. The percentages of the cell viability for both normal and induced cells were determined with an MTT assay. Results showed that surfactin was detected in the biosurfactant extract and demonstrated higher inhibitory effects compared to the crude extract against both inhibitory enzymes acetylcholinesterse (IC50=30.60 μg/mL) and lipoxygenase (IC50=110.10 μg/mL). Both crudes showed no cytotoxic effects at the highest concentration used (50 μg/mL) against normal human synovial cells but showed active reactions against the induced cells. The anti-proliferative effects of biosurfactant and crude extracts were in dose-dependent manner.@*Conclusion, significance and impact of study@#Notably, surfactin obtained from B. amyloliquefaciens has shown an inhibitory effect against pro-inflammatory enzymes and cell viability of the induced rheumatoid arthritis cell line. These results highlighted the therapeutic potential of surfactin application as an anti-inflammatory agent for arthritis treatment. Further study is needed to elucidate the mechanisms underlying the anti-inflammatory effect of surfactin.

The Clinical Pattern and Prevalence of Streptococcus mutans and Streptococcus sobrinus among Adult and Children Patients with Dental Caries

Abstract Objective: To explore the clinical pattern, host factors, and presentation of Streptococcus mutans related to caries incidence among children and adults visiting Universitas Airlangga dental clinic. Material and Methods: This was an observational study with a cross-sectional approach with 50 patients in each group of carious children (6-12 years) and adults (18-35 years). Dental decay samples were taken by sterile excavator, put in a BHI's transport medium, and directly incubated overnight at 37 ºC. The next day, they were sub-cultured microbiologically in Tryptone Yeast Cystine Sucrose Bacitracin (TYCSB) selective medium. Bacterial species and serogroups were examined by PCR. All patient's data were collected from medical records and direct observation. Results: Caries were mostly media type in both children and adults. Oral hygiene (OHIS) in children was higher than in adults but not significantly different according to their DMFT. The highest scores for decay, missed and filled teeth were 16, 8 and 7, with an average of 6.82, 1.22 and 0.63, considered quite high. Conclusion: The prevalence of S. mutans was higher in children's caries than in adults, but among the adult patients the co-incidence of S. mutans and S. sobrinus was associated with higher DMFT. The mutans serotypes e, f, and d were more prevalent among children than adults.

Difference of Chemical Bonds Between UDMA Bonding Agents with Ethanol Solvent and Acetone Solvent on Dentin Collagen

ABSTRACT Objective: To investigate the difference of chemical bonds between urethane dimethacrylate (UDMA) bonding agents with ethanol solvent and acetone solvent on dentin collagen. Material and Methods: This experimental comparison study used three groups: G1 (Control): UDMA and collagen; G2: UDMA, collagen and ethanol; and G3: UDMA, collagen and acetone. The groups were then pelleted and analysed with FTIR, then the peak value of carbonyl absorption band from each study group was calculated. The result of FTIR analysis and the peak of carbonyl absorption band (P) was calculated using the formula: P = (BC / AB) X 100; AB. BC is measured in centimeters. The study of chemical bond differences between ethanol-solvent UDMA agents compared with acetone-solvent on dentin collagen resulted in a graph of peak of carbonyl absorption bands of UDMA and dentin collagen groups. To determine the chemical bonds of UDMA from the top of the carbonyl ester absorption bands with wavenumber absorption in range 1700-1750 cm-1, the decreasing peak of the carbonyl absorption bands is assumed as more chemical bonds that formed. Data were analysed using Anova one way and Tukey HSD test. Results: There were significant differences between the three study groups (p<0.05). Conclusion: UDMA bonding agents' chemical bonds with acetone solvent are much higher than the chemical bonds between UDMA bonding agents with ethanol solvent on dentin collagen.

Residual efficacy of deltamethrin applied to foliage against Malaysian Aedes aegypti (L.) and Aedes albopictus (Skuse)

@#The spraying of insecticide on foliage to provide an insecticidal barrier may serve as part of the vector control measures to combat the increasing threat of Aedes-borne diseases. The effectiveness of insecticide barrier spraying was evaluated by assessing the residual efficacy of deltamethrin sprayed on foliage against Malaysian Ae. aegypti (L.) and Ae. albopictus (Skuse). In this semi-field study, landscape plants grown within the vicinity of the Institute for Medical Research (IMR), Malaysia, were treated with deltamethrin suspension concentrate (SC) with the dosage of 30 mg/m2 and 50 mg/m2 in three rounds of spraying. Deltamethrin residual activity on treated and untreated leaves was investigated using standard WHO cone bioassays. Wild Aedes populations at both deltamethrin-treated and untreated plant clusters were monitored by ovitrap surveillance. Ovitrap monitoring revealed that the mean number of Ae. albopictus larvae at deltamethrin-treated were significantly lower than the mean number of larvae of the same species at the untreated plant cluster. Cone bioassay results showed that the insecticide remained effective for up to 4 weeks (> 80% mortality), but the insecticide residual activity was affected by rainfall. These results suggest that insecticide barrier spraying is a promising tool and may be used along with other mosquito control tools such as indoor residual spray and space spraying to reduce the dengue burden.

Evaluation of prevalence of different types of cancer and its chemotherapy in various ethnic groups of Pakistan: A retrospective study

The objective of the study was to evaluate different types of cancer and its chemotherapy in various ethnic groups of Pakistan. Ethnic groups includes, Pukhtoons, Punjabis, Sindhis, Muhajirs, Siraikis, Memoons, Hazaras, Hindkos, Baltis, Gilgitis, Kashmiris, and Afghanis. The data was collected from well reputed hospitals located in the different provinces of Pakistan. The collected data was taken from 15 hospitals where around 8500 patients visited during 2010 to 2017. From the visited patients, 8356 were analyzed for their ethnicity, age and sex while, 144 patients (male 77 and female 67) were excluded from analysis due to incomplete information or loss of follow-up. Among 8356 patients, 3762 were male (45%) whereas, 4594 were female (55%). The chemotherapy was carried out as per National Comprehensive Cancer Network guidelines (NCCN- guidelines). The most common five prevalent cancer among these ethnic groups were Head and Neck, Blood, Respiratory, Genito-urinary and Breast cancer. The most common cancer in female was breast cancer while, head and neck cancer was more prevalent in male. It can be concluded that the prevalence of cancer in Pakistan is very alarming, which may be due to lack of awareness, illiteracy, lack of national cancer control programs, and economics issues.

Prevalence of Falls and Its Characteristics among Malaysian Older Adults: A Review

@#Falls are major public health issues which highly associated with older adults worldwide. Falls can cause a negative debilitating effect on the individual and may lead to fatal injury in certain cases. Current studies on falls characteristics are limited in Malaysia. The aim of this study was to pool the current studies conducted in Malaysia regarding the fall and its characteristics. Articles were identified by using the following electronic databases; EBSCOhost, ClinicalKey, ScienceDirect, Wiley Online Library, SpringerLink and Google Scholar. Article identification was limited to English language which were published between 2013 to 2019. This study looked into older adults aged 60 years old and above; conducted either in a residential, community-dwelling or medical institute. A total of nine articles was identified and investigated. Studies indicate a huge variation in the prevalence falls among older adults in Malaysia ranging between 4-74%. A study that was conducted in the community indicated lower prevalence of falls. Majority of the falls occurred in the morning as reported by three studies which covered and ranged between 49-64.7%. Indoor accounted as the highest number of falls in term of location and ranged between 50-87% while outdoor falls were between 13-49.3%. Location in bathroom and toilet had the highest percentage of indoor falls. Fallers that sustained injury ranged between 47-82%. A variation on the fall prevalence among older adults was determined by factors such as location and existing medical conditions. Pooled information in our study indicates that there is lack of standardised measuring tools for falls characteristics in Malaysia. There is a need for large scale longitudinal prospective study to establish the prevalence and the causal-effect relationship of falls in Malaysia.

Extracts of Guiera senegalensis J.F. Gmel (Combretaceae) Galls Ameliorates Streptozotocin-Induced Diabetes Mellitus Rats Status

Background:A good number of medicinal and dietary plants are used for diabetes treatment in Burkina Faso. Aim of the Study:The present study aimed to investigate the antidiabetic activity of Guiera senegalensisgalls extracts and its potential mechanisms in streptozotocin-induced diabetic rats. Methodology:The methanol extract was administered by gavage to healthy Wistar rats for the determination of toxicity, to normal and diabetic Wistar rats forthe determination of glucose reduction level, lipid profile, insulin level and glycaemic parameters in serum. The histology and immunohistochemistry of thepancreas were also determined.Results:The acute toxicity results showed that the medium lethal dose (LD50) of the methanol galls extract of Guiera senegalensisis greater than 2000 mg/kg body weight in rats. Guiera senegalensismethanolic extract (250 mg/kg) and the tolbutamide (100 mg/kg) recorded a significantly (p < 0.05)lower level of triglyceride compared to the diabetic group. The methanol extract (250 and 500 mg/kg pc) significantly (p < 0.05)decreased the blood glucose level and increased the serum insulin level in diabetic rats. Interestingly, improved ß-cell function and antioxidant status were also observed in G. senegalensis-treated diabetic rats when compared to tolbutamide-treated diabetic rats.Conclusion:These data showed direct evidence that G. senegalensishas antidiabetic activity by decreasing blood glucose level, improving insulin secretion and β-cell functions and modulating antioxidant status

Prolonged and increased usage of a flexible ureterorenoscope: the maelor FURS protocol

We present our point of technique detailing the specific preoperative and postoperative steps used in our institution to prolong the use of a flexible ureterorenoscope, and discuss the potential cost-effectiveness of this protocol. We have used a single flexible ureterorenoscope, for 145 consecutive cases to date, using the protocol described in this article. This prolonged use has resulted in a calculated cost per case of 273.48 GBP. We have described our experience of a dedicated protocol to prolong the usage of a single flexible ureterorenoscope. We would consider recommending the technique described in this article, to prolong flexible ureterorenoscope usage in a cost-effective manner

Audit of pediatric surgical emergency: need for self evaluation

Background: The clinical or surgical audit is a systematic process in which the standard of clinical care being provided to the patients is sought through review of clinical records against specific criteria. The clinical or surgical audit is a mandatory element of the professional competence in many countries

Objective: To evaluate the yearly performance and to establish the pattern and frequency of various Pediatric Surgical emergencies encountered

Methodology: This was an observational, descriptive study covering the year 2016 with retrospective data collection was carried out in the Department of Pediatric Surgery Emergency Mayo Hospital/King Edward Medical University, Lahore

Results: A total of 3880 patients including 2350[60.6%] males and 1530[39.4%] females were admitted during the study period. The highest number of admissions were Burn Patients with the percentage of 37.8%, followed by trauma cases 23.9%, and acute appendicitis 18.6%. There had been 86 deaths which gave rise to 2.2% Mortality

Conclusion: Burn injuries and trauma are common injuries in pediatric surgery ward. It is suggested that audit must be conducted routinely and should be officially declared as a compulsory action to provide vision and feedback to the working of surgeons

Frequency of infection after immediate intramedullary nailing versus external fixator in open tibial shaft fractures

Objective: The purpose of this study was to have a comparison of frequency of infection between two procedures i.e immediate intramedullary nailing and external fixation in the treatment of type II open fracture of shaft of tibia

Study Design: The study design was a randomized controlled trial

Place and Duration of Study: The study was done at the Department of Orthopedic Surgery, Sir Ganga Ram Hospital Lahore over 1-year period from January 2017 through December 2017

Methodology: This included 40 patients of both genders aged between 19-51 years with type II [Gustilo and Anderson] open fracture of shaft of tibia. These patients were randomly divided in two groups with draw methods with AandB Groups. The patients who were put in group A were treated with External fixator with two half pins on either side of the fracture and patients with Group B allocation were treated with intramedullary nailing. The Frequency of infection was noted and compared between two groups in first 4 weeks after injury. Before including each patient in study a written informed consent was taken

Results: The age of the patients ranged from 19 years to 51 years. There were 32 [80.0%] male and 8 [20.0%] female patients in the study cohort with a male to female ratio of 4:1. Infection was observed in 3 [7.5%] patients. The frequency of infection with IM nail was lower than that of external fixator [5.0% vs. 10.0%; p=0.759]. Similar insignificant difference was observed across various age and gender groups

Conclusion: Frequency of infection was lower in intramedullary nailing group as compared to external fixation group so immediate intramedullary nailing is preferred method in type II open tibial fractures

Effect of raphanus sativus [radish] leaf extract on atorvastatin induced hepatotoxicity in rabbits

Objectives: To investigate hepato-protective effect of ethanolic leave extract of Raphanus sativus against atorvastatin induced hepatotoxicity in albino rabbits

Study design: Experimental study

Material and Method: This study conducted at department of Physiology and Pharmacology, University of Agriculture, Faisalabad. The ethanolic extract of Raphanus sativus was prepared for hepatoprotective effect against hepatotoxicity produced by atorvastatin

Results: The results were compared with normal and experimental control. Serum was tested for ALT, AST, Alkaline Phosphatase and Bilirubin along with histological studies. Ethanolic extract of Raphanus sativus with 100mg/kg. of body weight dosage developed some changes representing hepatotoxicity but higher doses showed an increase in toxicity as observed on histologic sections. A reduction in fibrosis and cholestasis was observed which needs further evaluation

Conclusion: Ethanolic extract of raphanus sativus did not show any amelioration in the increased enzymes level however a reduction in cholestasis was observed as represented by decreases in alkaline phosphatase levels also confirmed by histological studies

Analysis of toll-like receptors-9 [TLR9] gene polymorphism [rs5743836] in Pakistani patients with HCV

Toll-like receptors [TLRs] are innate immune receptors that mediate the inflammatory response during HCV infections. The goal of this study was to evaluate the association of TLR9 gene polymorphism [rs5743836] in Pakistani patients infected with genotype 3a of HCV. Total 500 subjects were recruited, 400 HCV patients and 100 healthy individuals. Genotyping of TLR9 [-1237T/C, rs5743836] was carried out in 400 HCV patients [323 interferon responders and 77 interferon nonresponder] and control group by applying High resolution melting [HRM] curve assay. No remarkable differences in distribution of genotype between HCV [p<0.0001; OR= 3.21, 95% CI= [2.514.12] and control groups [p<0.0001; OR=0.092, 95%CI= [0.0580.14] were observed. In conclusion TLR9-1237T/C gene polymorphism may not be considered as a molecular risk for patients with HCV in Pakistan

Safety of direct Trocar insertion for Laparoscopic procedures

Creation of pneumoperitoneum is first step in laparoscopic surgeries. Four basic techniques are used to create pneumoperitoneum i.e. blind veress needle [VN], direct trocar insertion [DTI], optical trocar insertion [OTI] and open method

Objective: The objective of the study is to determine the safety of direct trocar insertion for laparoscopic procedures

Setting: Department of Surgery, Allied/DHQ Hospital and Mujahid hospital Faisalabad

Duration of study: From 01-01-2013 to 31-12-2017 over a period of five years

Study design: Prospective randomized study

Methodology: A total of 1500 cases undergoing laparoscopic procedures were included in study.1470 [98 percent] patients had pneumoperitoneum established by DTI at umbilicus,25 patients by DTI at palmer's point and only 1 patient has pneumoperitoneum established by open method

Results: Out of 1500 cases, 1280 were females and 220 were males, male to female ratio was 1:5.8. The age of patients varied between 16-70 years mean age was calculated as 33.22+9.31 years. Pneumoperitoneum by DTI at umbilicus was achieved successfully in 1474[98.26 percent], while it was established by DTI at palmer's point in 25 [1.6 percent] patients. In only 1[0.06 percent] patient pneumoperitoneum was created by open method.1[0.06 percent] patient developed visceral injury,1[0.06 percent] patient developed port site hernia and 10[0.66 percent] patients developed port site infection

Conclusion: DTI is a safe and reliable technique for establishing pneumoperitoneum and should be used routinely

Falls Prevalence And Its Risk Assessment Tools Among Malaysian Community-Dwelling Older Adults: A Review

@#Falls in older adults is a major health issue globally. Falls prevalence reports vary based on the study settings. The importance of a fast, easy self-assessment tool to identify falls risk has been emphasised in numerous studies. The aim of our study was to pool information on the prevalence of falls and its risk assessment tools based on a scoping review. This information will be beneficial to inform current falls prevalence and to decide on the best falls risk assessment tool to be used among Malaysian community-dwelling older adults. Articles referred were based on the following electronic databases (MEDLINE Complete, CINAHL, Rehabilitation & Sports Medicine Source and SPORTDiscus) via EBSCOHOST, Science Direct, PubMed, Cochrane Library, Embase® and Google Scholar. Twelve studies were identified to meet the inclusion and exclusion criteria. Our review findings showed that current falls prevalence (between 4.2% and 61%) among Malaysian community dwelling older adults was consistent with the findings in Asia. Falls risk assessment tools used were similar to the ones used in other countries, taking the multiple falls risk factors in consideration.

Evaluating therapeutic potential of coriander seeds and leaves (Coriandrum sativum L.) to mitigate carbon tetrachloride-induced hepatotoxicity in rabbits

Objective: To evaluate the hepatic and renal protective potential of coriander seeds and leaves using animal feed model. Methods: Coriander seeds- and leaves-based sauces were administrated to normal (Study I) and carbon tetrachloride (2 mL/kg B.W.)-induced hepatotoxic rabbits (Study II). Hepatic and renal biomarkers like aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase, superoxide dismutase and catalase were measured. Results: Coriander leaves-based sauce exerted more decline (P<0.05) in serum aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase levels in the study II as 18.32%, 19.91% and 21.24%, respectively. While, hepatic superoxide dismutase and catalase levels were raised significantly (P<0.05) in both studies. Renal parameters also depicted positive impact by the provision of developed sauces. Conclusions: Coriander seeds and leaves based sauces are effective in alleviating the hepato/renal toxicity. The hepatoprotective effect of coriander leaves is more pronounced as compared to coriander seeds.

Validity and Reliability of Falls Screening Mobile Application (FallSA) to Inform Falls Risk among Malaysian Community Dwelling Older Adults / Jurnal Sains Kesihatan Malaysia

@#Falls is a global health concern due to its many negative consequences in older adults. Early falls screening and prevention is important among older adults. We developed Falls Screening Mobile Application (FallSA) as a self falls screening tool among older adults. FallSA was developed using data of physical performance test, demographic information and questions to inform falls risk from a larger population based longitudinal study on neuroprotective model for healthy longevity among older adults (LRGS TUA). The aim of this study was to determine validity and reliability of FallSA as a self-screening tool to inform falls risk among Malaysian older adults. This cross sectional study was conducted among 91 community dwelling older adults aged 60 years and above. FallSA was validated against Physiological Profile Assessments (PPA), a comprehensive falls risk assessment tool. Participants used FallSA to test their falls risk by repeating the test twice between an hour. Validity and test–retest reliability of FallSA was examined by using Spearman correlation, Kappa, Sensitivity and Specificity, Intra correlation coefficient (ICC), Cronbach alpha and Bland-Altman respectively. Concurrent validity test was significant with moderate correlation rs = 0.518, p < 0.001, moderate agreement K = 0.516, p < 0.001 and acceptable Sensitivity: 80.4% and Specificity: 71.1%. Reliability of FallSA was shown to be good (ICC: 0.948, CI: 0.921-0.966), good internal consistency α = 0.948, p < 0.001 and good agreement indicate by small mean differences and narrow limits of agreement (LoA). The results of this study suggest that FallSA was a valid and reliable tool to inform falls risk among Malaysian older adults. Further prospective studies are required to determine the accuracy of FallSA to correctly classify older adults into fallers and non-faller groups.

Heel pain and its associations

Objective: Heel pain is an everyday increasing problem in young people more commonly in females. It is estimated that about one million people with complaint of heel pain seek medical advice per year. Therefore, it was needed to highlight its clinical associations

Methods: One hundred and thirty-eight cases with heel pain were registered. For comparison, 134 subjects were registered as control. All subjects were segregated into gender groups. Each gender group was further subdivided into young [age < 40] and old [age > 40] groups. Three parameters were considered, i] blood pressure, ii] body mass index [BMI] and iii] serum uric acid level

Results: The overall male to female ratio was 1: 3. There was significant difference [p < .05] in the means of systolic and diastolic blood pressure of old [> 40] cases of both gender groups. The Odds ratio showed association between DBP and heel pain in female group only. There was significant difference [p < .05] in the means of BMI of cases from those of age and gender matched controls. The Odds ratios also showed strong association between increased BMI and heel pain. There was significant difference [p < .05] in the means of uric acid levels of cases from those of controls in female groups only. Similarly, the Odds ratio in this group showed association between hyperuricemia and heel pain. When above parameters were analysed for anindependentrisk factor, increased BMI and hyperuricemia were found to be associated with heel pain as isolated and independent risk factors

Conclusion: In our study, the female cases outnumbered the male cases by 1: 3.The results showing the association between heel pain and increased BMI were well consistent with the international studies. For hyperuricemia, the association with heel pain was also consistent with international studies. Similarly, the hypertension was also found in the cases with heel pain in old groups only. The obesity and hyperuricemia were found to beisolated and independent risk factors associated with the heel pain

Determination of nitrate in biological fluids by HPLC

Nitrate is the stable product of nitric oxide, which is physiologically active radical, an immunomodulator and a neuromodulator; its quantification in biological fluids is important to study the physiological and biochemical nature. Therefore, the purpose of this study was to quantify nitrate in different biological fluids like serum, cerebrospinal fluid [CSF] and ascetic fluid [ASF] using HPLC technique. A new HPLC method for the estimation of nitrate in serum, CSF and ASF was developed using the mobile phase of 1.0mM each of Na[2]CO[3] and NaHCO3 [1:1, v/v, pH 5 with H[3]PO[4]] at a flow rate of 1.0mLmin[-1]. Eluate was detected at 220nm with the retention time of nitrate 2.55 min. The LOD and LOQ values of nitrate were 0.03 micro gmL[-1] and 0.098 micro gmL[-1], respectively. Nitrate was eluted through SAX Hypersil column of 150 x 4.6mm, id, 5 micro m particle size. Run time was 10min. The method was validated according to the FDA guidelines and was found linear in the range of 0.39 to 50 micro gmL[-1] and CV was <3%, within limits of FDA guidelines. The method was used successfully for the estimation of nitrate in biological fluids like serum, CSF and ASF of 20 patients each. This is an alternate and reproducible method for the detection of nitrates in biological fluids

Formulation and in vitro evaluation of sustained release matrix tablets using cross-linked natural gum

Polysaccharide gums because of their biocompatibility, biodegradability and non-immunogenic properties are considered as the best choice for preparing sustained release tablets as compared to their synthetic counterpart. The cross linking of natural gums in matrix tablets increase the sustained release property of matrix tablets. Isoniazid is a first line therapy of tuberculosis, belongs to BCS I with half-life of 3-4 hours. These characteristics make isoniazid a good candidate for sustained release dosage form. Karaya gum crossed linked with trisodium tri metaphosphate was used as release rate retardant for preparing isoniazid cross-linked matrix tablet. Total 8 sustained release formulations were prepared. Both granules and tablets were evaluated under in vitro condition against different parameters. Dissolution studies were performed with all eight formulations for 12 hours using USP apparatus I. Four formulations designated as F1, F2, F3, F4 have drug and karaya gum while other four formulations F5, F6, F7, F8 have drug and crossed linked polymer in ratios of 1:1, 1:2, 1:3 and 1:4 respectively. Dissolution data was analyzed by using different kinetic models. Best fit model for most efficient formulation was zero order while release mechanism was super case I. Formulation 8 showed sufficiently slow release kinetics and about 83% of drug was released in 10 hours, indicating that cross-linked karaya gum proved efficient in preparing sustained release tablets