Asymmetric Opening of Mitochondrial Permeability Transition Pore in Mouse Brain Hemispheres: A Link to the Mitochondrial Calcium Uniporter Complex

Abstract The prolonged entry of large amounts of calcium into the mitochondria through the mitochondrial calcium uniporter complex (MCUC) may cause the permeability transition pore (mPTP) to open, which contributes to the pathogenesis of several diseases. Tissue-specific differences in mPTP opening due to variable expression of MCUC components may contribute to disease outcomes. We designed this study to determine differential mPTP opening in mitochondria isolated from different regions of mouse brain and kidney and to compare it with the expression of MCUC components. mPTP opening was measured using mitochondria isolated from the left/right brain hemispheres (LH/RH, respectively) and from kidney cortex/medulla, while the expression level of MCUC components was assessed from total cellular RNA. Interestingly, LH mitochondria showed less calcium-induced mPTP opening as compared to RH mitochondria at two different calcium concentrations. Conversely, mPTP opening was similar in the renal cortex and renal medulla mitochondria. However, the kidney mitochondria demonstrated bigger and faster mPTP opening as compared to the brain mitochondria. Furthermore, asymmetric mPTP opening in the LH and RH mitochondria was not associated with the expression of MCUC components. In brief, this study demonstrates thus far unreported asymmetric mPTP opening in mouse brain hemispheres that is not associated with the mRNA levels of MCUC components.

Impact of multi-professional simulation-based training on perceptions of safety and preparedness among health workers caring for coronavirus disease 2019 patients in Pakistan / 보건의료교육평가

This study aimed to evaluate perceptions of safety and preparedness among health workers caring for coronavirus disease 2019 (COVID-19) patients before and after a multi-professional simulation-based course in Pakistan. Health workers’ perceptions of preparedness, safety, and their willingness to care for COVID-19 patients were measured before and after they attended a simulation-based training course to prepare them to care for COVID-19 patients at Combined Military Hospital Landi Kotal Cantt, from March 1 to April 30, 2020. The participants’ perceived level of safety and preparedness to care for COVID-19 patients before the simulation-based course was low, but increased after completing it (P<0.05). They felt confident and were significantly more willing to care for patients with COVID-19 or other infections requiring strict isolation. Simulation-based training is an effective tool to improve perceptions of risk and readiness to deal with COVID-19 among medical and non-medical health workers in Pakistan.

Impact of multi-professional simulation-based training on perceptions of safety and preparedness among health workers caring for coronavirus disease 2019 patients in Pakistan / 보건의료교육평가

This study aimed to evaluate perceptions of safety and preparedness among health workers caring for coronavirus disease 2019 (COVID-19) patients before and after a multi-professional simulation-based course in Pakistan. Health workers’ perceptions of preparedness, safety, and their willingness to care for COVID-19 patients were measured before and after they attended a simulation-based training course to prepare them to care for COVID-19 patients at Combined Military Hospital Landi Kotal Cantt, from March 1 to April 30, 2020. The participants’ perceived level of safety and preparedness to care for COVID-19 patients before the simulation-based course was low, but increased after completing it (P<0.05). They felt confident and were significantly more willing to care for patients with COVID-19 or other infections requiring strict isolation. Simulation-based training is an effective tool to improve perceptions of risk and readiness to deal with COVID-19 among medical and non-medical health workers in Pakistan.

Efficacy of oK-432 therapy for the incisionless treatment of head and neck cystic masses: case series

Head and neck masses can present in different pathologies that usually vary according to the age of the patient. We report five cases of benign head or neck masses occurring among patients of different ages who were managed at the Bahrain Defence Force Royal Medical Services Hospital, Ar-Rifaa, Bahrain, between 2005-2014. All of the patients were treated using the sclerotherapeutic agent OK-432. Although surgical removal is usually considered optimal treatment in the management of such cases, OK-432 appears to be a promising alternative

Prevalence of metabolic risk factors in non-alcoholic fatty liver disease

Objective: To determine the frequency of factors leading to metabolic syndrome among non-alcoholic fatty liver disease [NAFLD] patients at a tertiary care hospital

Study Design: Descriptive cross sectional study

Place and Duration of Study: Department of Medicine, Combined Military Hospital, Kharian. Study was carried out over a period of six months from Jan 2015 to Jun 2015

Material and Methods: A total of 110 patients were included in this study. Past history was taken to rule out alcohol intake, viral and drug induced etiology, to determine the presence of co-morbidities like obesity, type 2 diabetes mellitus, arterial hypertension and dyslipidemia. Physical examination was carried to determine the arterial blood pressure and to determine anthropometric data that is weight, height, body mass index [BMI] and abdominal obesity by measuring waist circumference

Results: Mean age of the patients was 49.95 +/- 8.86 years. There were 72 male patients [65.5%] while 38 [34.5%] patients were female. Different metabolic factors were central obesity in 82 patients [74.5%], raised high density lipoprotein [HDL] in 19 patients [17.3%], raised cholesterol in 87 patients [79.1%], raised blood pressure in 65 patients [59.1%] and raised fasting plasma glucose in 82 patients [74.5%]. Mean BMI was 26.31 kg/m2 +/- 2.68, mean waist circumference was 109.82 cm +/- 18.41, mean cholesterol was 237.50 +/- 48.47mg/dl, mean systolic blood pressure was 148.88mmHg +/- 22.10, mean diastolic blood pressure was 90.41mmHg +/- 12.25 and mean fasting plasma glucose was 113.28mg/dl +/- 22.80. Stratification with regard to age was carried out

Conclusion: A considerable number of patients with NAFLD had metabolic syndrome. There was a close correlation between NAFLD and metabolic syndrome

Radiological presentation of post primary tuberculosis in adult sputum smear positive patients

Background: Pulmonary Tuberculosis [TB] is traditionally classified into primary and post primary tuberculosis; both have distinct characteristics on radiology. Adetailed knowledge of different radiological patterns is helpful in diagnosis of TB

Objective: To determine the frequency of various radiological presentation of post primary tuberculosis in adult sputum smear positive patients

Methodology: This cross sectional study was carried out at Department of Pulmonology, Sheikh Zayed Medical College / Hospital, Rahim Yar Khan on adult sputum smear positive pulmonary TB patients. A total of 250 new cases of pulmonary TB with no previous history of Anti-Tuberculosis treatment were included in this study. Socio demographic data and findings of X -ray Chest from each sputum smear positive patient were collected and recorded on a predesigned performa. The data was entered and analyzed by using SPSS version 17

Result: Out of 250 patients, 146 were male and 104 were female with mean age of 35.76 +/- 16.25 years. Left lung was most affected in 40.4% cases, right lung in 35.6%, while 24% has bilateral involvement. Duration of illness prior to diagnosis was 3 +/- 1.66 months. Among the radiological presentation, cavitation was seen in 49.2% cases, alveolar consolidation in 42.4%, nodular pattern in 3.2%, reticulonodular pattern in 3.2% and reticular pattern in 2% cases. There was significant association of alveolar consolidation with male gender [0.03] while reticulonodular pattern was significantly seen in female gender [0.007]. Majority of the patients were young; 42.8% were below the age of 30 years and 82% patients were below the age of 50 years and there was a delay of > 03 months in the diagnosis

Conclusion: According to this study, cavitations and alveolar consolidation were the commonest radiological presentations of post primary TB. Majority of patients were young and there was a considerable delay in diagnosis

Prolonged Systole in a Patient with Hypothermia

No abstract available.

Relationship of cardiac disease with oral health

Objective: To observe relationship of chronic dental and oral morbidity with cardiovascular disease in Pakistani population

Materials and Methods: All indoor cardiac patients aged 40 and above, clinically and angiographically diagnosed with CHD at Islam Central Hospital, Sialkot, were included in the study. Demographic and clinical data [Age, Gender, Smoking, and Diabetes] were noted from patients' hospital record files. Missing teeth were examined and number of teeth missing was estimated from the number of teeth remaining in the mouth upon clinical examination. Attendants without a history of cardiac disease, of the cardiac patients who agreed to be included in the study, were examined for comparison of tooth loss

Results: Nine hundred and thirty six cardiac patients and 595 healthy attendants with mean age of 51.9 +/- 8.4 years were examined. Chronic periodontal disease and mean [+/-SD] tooth loss was significantly [P < 0.001] higher in cardiac patients. Odds ratio [OR] = 1.543 was found in cardiac patients when compared with healthy controls [95%CI = 1.985-2.851]. Tooth loss was significantly [P < 0.001] associated with both males and female cardiac patients especially along with diabetes and smoking

Conclusion: Chronic periodontal disease and tooth loss were found to be significantly higher in cardiac disease patients in comparison to healthy controls. Other risk factors found were age, gender, smoking and diabetes

Comparison of adhesion and bond strength of gutta percha and polyurethane materials with root dentin in phosphate buffer saline solution

Objective:To find out the adhesion and bond strength of composites of guttapercha with 10% hydroxyapatite [HA] and polyurethane [10% and 20% HA] immersed in phosphate buffer saline [PBS] solution with root dentin

Materials and Methods:This descriptive cross-sectional study was carried out from June 2010 – August 2010 at the Department of Material Sciences, Queen Mary College of Engineering London, UK. Extracted human teeth were used for this study and in vitro root canal obturation was done. After filling the samples were immersed in Phosphate Buffer Saline [PBS] solution.Push out test and scanning electron microscopy [SEM] was done to find out the adhesion and bond strength of these materials

Results: Guttapercha had maximum bond strength,where as guttapercha with 10% hydroxyapatite had minimum bond strength compared to other bioactive materials used. Polyurethane composite with 20% HA was next to guttapercha in terms of its bond strength followed by polyurethane with 10% HA

Conclusion:Guttapercha obturating material proved to be the best obturating material but polyurethane [with 10% and 20% HA] also looked promising and it should be further tested and investigated for future use as choice of obturating material with enhanced properties

In vitro activity of antimicrobial agents against streptococcus pyogenes isolated from different regions of Khyber Pakhtun Khwa Pakistan

The present study investigates the antibiotic resistance of S. pyogenes of 600 isolates collected from different body parts including throat and sputum were analyzed for their antimicrobial susceptibility to 5 antibiotics using the Kirby Bauer disc diffusion method. Based on different identification tests including, gram staining, beta hemolysis, catalase test and bacitracin sensitivity test, a total of 138 isolates were confirmed as S. pyogenes. The prevalence of S. pyogenes was 80% in sore throat and 29% in sputum samples. These isolates were further tested for antibiotics resistance using disk diffusion method. Out of 138 isolates, 49.27% isolates showed resistance towards cefixime, 28.98% towards cefotaxime and 17.39% towards ciprofloxacin, 17.39% towards ampicillin, 17.39% towards erythromycin, 15.94% towards streptomycin, 0.724% isolates towards chloromphenicol and 0% towards penicillin. Among the resistant isolates of S. pyogenes, 60.71% showed resistance towards cefixime, 57.14% towards ciprofloxacin, 57.14% towards streptomycin, 50% towards erythromycin and 25% towards cefotaxime

Prevalence of resistance to 1[st] line anti tuberculosis drugs at Rahim Yar Khan

Background: tuberculosis is an important infectious health issue and its control strongly rely upon effective treatment. The drug resistance and its pattern are important determinant of the treatment regimen, its duration and outcome

Objective: to determine the frequency and pattern of drug resistance among 1[st] line anti tuberculosis treatment

Methodology: it was a cross sectional study carried on 100 cases of smear positive TB. This study was conducted from 1[st] January 2010 to 30 June 2011. Detailed demographic data and history of ATT was taken and their sputa were sent for drug susceptibility testing on LJ media. The cases with drug resistance and no previous history of ATT were labeled as primary while those with previous history of ATT were labeled as secondary resistant cases. The data was entered and analyzed by using SPSS version 15

Results: out of 100 patients enrolled, drug susceptibility report was available for 87 isolates as sputum failed to grow any organism in 13 patients. Out of these 87 cases, 48 [55.17%] were males and 39 [44.83%] females with age range of 9-91 years. Seventeen out of 87 patients [19.5%] had previous history of ATT. Out of 87 isolate, 62 [71.26%] were sensitive to all 1[st] line drugs [R, H, E, Z, S] while 25 [28.74%] were resistant to one or more drugs. Primary resistance was seen in 17 [24%] out of 70 cases in contrast to secondary in 8 [47%] out 17. The difference between primary and secondary resistance among various drugs was statistically significant for isoniazid [p value 0.003] and pyrazinamide [p value 0.036] while the difference to streptomycin, ethambutol and rifampicin was insignificant with p values of 0.20, 0.35 and 0.09 respectively. There was no case of primary MDR-TB and 5.9% of secondary MDR-TB. None of the sociodemographic parameter was significantly associated with drug resistance

Conclusion: resistance to 1[st] line anti-tuberculosis drugs at Rahim Yar Khan is still common. There are good number of patients in which this resistance pattern compromise the currently recommended regimens. However, larger surveillance studies are needed to strengthen this evidence

Susceptibility pattern of 2[nd] line anti tuberculosis drugs at Rahim Yar Khan

Background: Pakistan has a high burden of drug resistant TB. Effective management of these cases needs the inclusion of 2[nd] line anti-tuberculosis drugs. A comprehensive knowledge of susceptibility pattern to these drugs is mandatory to formulate the best possible regimen

Objective: to determine the susceptibility pattern of 2[nd] line anti tuberculosis drugs

Methodology: this cross sectional study was carried out at Department of Pulmonology, Sheikh Zayed Medical College / Hospital, Rahim Yar Khan on smear positive cases of PTB. This study was conducted from 1[st] March 2010 to 30[th] April 2011. A total of 64 smear positive tuberculosis patients of any age and sex regardless of previous treatment with 1[st] line ATT and no history of prior exposure to 2[nd] line ATT were included. Sociodemographic data like age, sex, marital status and income were recorded. Early morning sputum samples were cultured on LJ medium at a reference lab. Drug susceptibility testing [DST] was done for ethionamide, amikacin, kanamycin, capreomycin and ofloxacin to determine the presence of resistance. The data was analyzed on SPSS version 15

Results: in this study, out of total 64 cases, 36 [56.25%] were males and 28 [43.75%] females with age range of 9 to 76 years. Thirteen cases [20.31%] had previous exposure to 1[st] line ATT. Twelve [18.8%] were resistant to one or more drugs. Resistance was highest for ofloxacin [14.1%] followed by ethionamide [6.3%], capreomycin [3.1%], amikacin [1.6%] and kanamycin [1.6%]. Sociodemographic characteristics also did not show any statistically significant association with drug resistance

Conclusion: there is high frequency of resistance to ofloxacin and ethionamide. To avoid addition of further resistance, DST should be available as early as possible by conventional methods or by rapid genotypic methods at the start of treatment

paradigm shift: the new novel oral anticoagulation agents

Atrial fibrillation [AF] is the most common arrhythmia and represents one-third of the arrhythmia-related hospital admissions in the developed countries

Embolic strokes associated with AF are more severe and disabling

Thrombo-embolic stroke prevention is a major goal in treatment of AF and Warfarin has successfully served this purpose for many years

Drug-drug interaction and regular monitoring with Warfarin pose a significant challenge where health care system has limited resources; and lack of a well-structured health system, hinders regular International Normalized Ratio [INR] monitoring. Novel oral anticoagulants [NOACs] have opened up a new exciting chapter in the field of anticoagulation in non-valvular atrial fibrillation [NVAF]. This review discussed the landmark trials that led to the development of NOACs and explored the potentials of these new agents with simultaneous comparison of Warfarin

Prevalence of dental caries among the patients visiting islam dental college hospital sialkot

Objectives: This study was designed to find out the occurrence of dental caries among the patients visiting Islam Dental College Hospital Sialkot

Study Design: Observational / descriptive / cross sectional study

Place and Duration of study: This study was carried out at Islam Dental College Hospital, Sialkot from 1[st] September 2015 to 30[th] December 2015

Materials and Methods: The study consisted of Oral Examination of 1008 Patients [526 males and 482 females] in the diagnostic department. Dentition status and treatment need [WHO 1997] method was used to assess the caries of patients. Mouth mirror and probes were used to examine the patients

Results: The results showed that there were 52% male and 48% females. Of the total patients seen, 44.4 % patients showed presence of dental caries which was higher in males [p<0.05], in the mandibular arch in both sexes and in posterior teeth compared to anterior teeth. In both the sexes, second molar teeth were affected more

Conclusion: Present study shows that the dental caries a common disease affecting both male and female and more prevalent in posterior teeth compared to other teeth. Health professionals and dentists need to educate communities regarding the risk factors of dental caries and also give proper hygiene instructions

comparative analysis of adhesion and bond strength of bioactive obturating materials with root dentin

Obturation of root canal is an important step in root canal therapy. Gutta percha is the most commonly used material to fill the root canal for obturation. In this study composites ofgutta percha with 10% hydroxyapatite [HA] and polyurethane [10% and 20%] were investigated to find out their adhesion and bond strength with root dentin after 7 days. Extracted human teeth were used for this study and in vitro root canal obturation was done. After filling the samples were immersed separately in deionised water solution. Push out test and scanning electron microscopy [SEM] was done to find out the adhesion and bond strength of these materials. Push out test and SEM evaluation of these obturating materials showed that gutta percha had maximum bond strength, where as gutta percha with 10% hydroxy apatite had minimum bond strength as compared to other bioactive materials used in this study. Polyurethane composite with 20% HA was next to gutta percha in terms of its bond strength followed by polyurethane with 10% HA. Gutta percha obturating material proved to be the best regarding adhesion and bonding with the root dentin but polyurethane [with 10% and 20% HA] also looked promising.

Pattern of maxilofacial trauma in patients reporting at Liaquat University Hospital Hyderabad

Objective: The aim of present study was to evaluate the pattern of maxillofacial trauma in patients reporting at Liaquat University Hospital Hyderabad

Study Design: Observational / descriptive / cross sectional study

Place and Duration of Study: This study was conducted at the Oral and Maxillofacial Surgery Outpatient Department of Liaquat University Hospital from 01-01-2014 to 31-12-2015

Materials and Methods: This study was to analyze the age, gender and site of facial fracture of patients due to road traffic accidents, assault, falls, gunshot and sports injuries. Data relating to 136 patients was collected. The diagnosis of the maxillofacial trauma was done on the basis of history, clinical features and appropriate radiographs. All the relevant information was recorded on proforma

Results: Most prevalent age of trauma was 21-30 years teenagers, male 104 [76%] outnumbered the female 32 [24%] with ratio of 4:1. The most common fractured bone of midface was zygomatic bone n=52 [38.3%] and the most common region of mandibular fracture was parasymphysis n=34[25.0%]

Conclusion: Trauma is a main cause of fracture of facial bones especially in the young male population of Pakistan. Zygomatic bone fracture and parasymphseal regions are most common fracture site

General complications in patients wearing polymethylmethacrylate heat cure acrylic resin partial removable dental prostheses

Objectives of this study was to determine the frequency of general complications in patients wearing polymethylmethacrylate heat cure acrylic resin partial removable dental prostheses. This descriptive study was conducted during July 2013 to June 2014 at dental outpatient department of Liaquat Uni-versity of Medical and Health Sciences Pakistan. Data relating to 110 patients were collected using a structured proforma, by methods of patient's interview, clinical and radiographic examination. Data related to age, gender, location of prosthesis in the dental arch and various complications were recorded. Majority of patients were male with age from 21 to 60 years. Most of complications occurred in maxillary arch especially on right site of the arch. The most prevailing complications in general in this study were loss of retention [56%] mucosal changes [35%], loss of support [31%], discomfort/pain [29%] and loss of stability [26%]. On the other hand the least prevalent complications were speech problem [16%], appearance problems [8%] and only 4% of patients were not satisfied with design of prosthesis. Majority of complications were related to retention, support and loss of stability after wearing prosthesis, therefore correct techniques and material in terms of raising and framing the prosthesis must be implied as it will prevent the patient from many complications

Cardiovascular impact of eating disorders in adults: a single center experience and literature review

Eating disorders have multiple medical sequelae, including potentially life-threatening cardiovascular complications. This article describes our cardiology practice experience of treating adults with eating disorders in the outpatient setting and documents baseline cardiac findings in this complex patient population. We describe our findings in patients across the spectrum of eating disorders; past studies have generally focused on anorexia only. This article also includes a review of the current literature on cardiovascular complications associated with disordered eating

Assessment of patients wearing auto polymerized acrylic resin fixed partial dentures

This descriptive study was carried out at dental out-patient department of Liaquat medical University Hospital Hyderabad from January 2013 to December 2013. Thirty-five patients wearing auto polymerized [self-cured] fixed partial dentures provided by unqualified and qualified dental practitioners were assessed. Condition of oral health was evaluated on the basis of proper history and clinical examination. Prosthesis condition was also assessed. Oral health of underlying soft and hard tissues was carefully evaluated after removing the prosthesis with the help of slow speed hand piece without jeopardizing oral tissues. It was evident in this study that fixed partial dentures made from auto polymerized [self cure] acrylic resins had adversely affected the oral tissues compelling the patients to visit the qualified dentist for proper treatment of their problems

Effect of tocotrienol on aortic atherosclerosis in diabetic mice

To study the hstomorphological effect of tocotrienol on aortic atherosclerosis in diabetic mice having high fat diet. Lab based randomized controlled trial. Army Medical College, Rawalpindi and National Institute of Health, Islamabad from November 2009 to June 2010. Forty five female BALB/c mice were randomly divided into three groups. The diabetic mice model was established by intraperitoneal injection of streptozotocin [STZ] 40 mg/kg body weight. Group A was given normal laboratory diet, group B high fat diet and group C was given tocotrienol along with hgh fat diet for 32 weeks. At the end of experiment the mice were sacrificed. The hearts of animals were dissected out and ascending aortae were taken out. The specimen was fixed in 10% form01 calcium and processed for paraffin embedding. Five micrometer thick sections were made for haematoxylin and eosin, and Verhoeff's staining. After staining, hstomorphologic changes in slides were noted. In contrast to group A, atheroscelrosis developed in groups B and C. Statistically significant atherosclerotic changes were found in the aortae of diabetic mice in group B when compared to group A. On comparison of group A to C, atherosclerotic changes were statistically insigmficant. However when group B was compared with group C, the aortic atherosclerotic changes decreased sigruficantly in group C. In diabetics with high fat diet intake, there is an increase in development of atherosclerosis in aorta which can be reduced by tocotrienol