Fungal decomposition of chicken-feather waste in submerged and solid-state fermentation / Decomposição fúngica de resíduos de pena de frango em fermentação submersa e de estado sólido

Poultry industry is expanding rapidly and producing million tons of feather waste annually. Massive production of keratinaceous byproducts in the form of industrial wastes throughout the world necessitates its justified utilization. Chemical treatment of keratin waste is proclaimed as an eco-destructive approach by various researchers since it generates secondary pollutants. Keratinase released by a variety of microbes (bacteria and fungi) can be used for the effective treatment of keratin waste. Microbial degradation of keratin waste is an emerging and eco-friendly approach and offers dual benefits, i.e., treatment of recalcitrant pollutant (keratin) and procurement of a commercially important enzyme (keratinase). This study involves the isolation, characterization, and potential utility of fungal species for the degradation of chicken-feather waste through submerged and solid-state fermentation. The isolated fungus was identified and characterized as Aspergillus (A.) flavus. In a trial of 30 days, it was appeared that 74 and 8% feather weight was reduced through sub-merged and solid-state fermentation, respectively by A. flavus. The pH of the growth media in submerged fermentation was changed from 4.8 to 8.35. The exploited application of keratinolytic microbes is, therefore, recommended for the treatment of keratinaceous wastes to achieve dual benefits of remediation.

A indústria avícola está se expandindo rapidamente e produzindo milhões de toneladas de resíduos de penas anualmente. A produção massiva de subprodutos queratinosos na forma de resíduos agrícolas e industriais em todo o mundo exige sua utilização justificada. O tratamento químico de resíduos de queratina é proclamado como uma abordagem ecodestrutiva por vários pesquisadores, uma vez que gera poluentes secundários. A queratinase liberada por uma variedade de micróbios (bactérias e fungos) pode ser usada para o tratamento eficaz de resíduos de queratina. A degradação microbiana de resíduos de queratina é uma abordagem emergente e ecológica e oferece benefícios duplos, ou seja, tratamento de poluente recalcitrante (queratina) e obtenção de uma enzima comercialmente importante (queratinase). Este estudo envolve o isolamento, caracterização e utilidade potencial de espécies de fungos para a degradação de resíduos de penas de frango por meio da fermentação submersa e em estado sólido. O fungo isolado foi identificado e caracterizado como Aspergillus (A.) flavus. Em um ensaio de 30 dias, constatou-se que 74% e 8% do peso das penas foram reduzidos por A. flavus, respectivamente, por meio da fermentação submersa e em estado sólido. O pH do meio de crescimento em fermentação submersa foi alterado de 4,8 para 8,35. A aplicação explorada de micróbios queratinolíticos é, portanto, recomendada para o tratamento de resíduos ceratinosos para obter benefícios duplos de remediação.

Fungal decomposition of chicken-feather waste in submerged and solid-state fermentation / Decomposição fúngica de resíduos de pena de frango em fermentação submersa e de estado sólido

Abstract Poultry industry is expanding rapidly and producing million tons of feather waste annually. Massive production of keratinaceous byproducts in the form of industrial wastes throughout the world necessitates its justified utilization. Chemical treatment of keratin waste is proclaimed as an eco-destructive approach by various researchers since it generates secondary pollutants. Keratinase released by a variety of microbes (bacteria and fungi) can be used for the effective treatment of keratin waste. Microbial degradation of keratin waste is an emerging and eco-friendly approach and offers dual benefits, i.e., treatment of recalcitrant pollutant (keratin) and procurement of a commercially important enzyme (keratinase). This study involves the isolation, characterization, and potential utility of fungal species for the degradation of chicken-feather waste through submerged and solid-state fermentation. The isolated fungus was identified and characterized as Aspergillus (A.) flavus. In a trial of 30 days, it was appeared that 74 and 8% feather weight was reduced through sub-merged and solid-state fermentation, respectively by A. flavus. The pH of the growth media in submerged fermentation was changed from 4.8 to 8.35. The exploited application of keratinolytic microbes is, therefore, recommended for the treatment of keratinaceous wastes to achieve dual benefits of remediation.

Resumo A indústria avícola está se expandindo rapidamente e produzindo milhões de toneladas de resíduos de penas anualmente. A produção massiva de subprodutos queratinosos na forma de resíduos agrícolas e industriais em todo o mundo exige sua utilização justificada. O tratamento químico de resíduos de queratina é proclamado como uma abordagem ecodestrutiva por vários pesquisadores, uma vez que gera poluentes secundários. A queratinase liberada por uma variedade de micróbios (bactérias e fungos) pode ser usada para o tratamento eficaz de resíduos de queratina. A degradação microbiana de resíduos de queratina é uma abordagem emergente e ecológica e oferece benefícios duplos, ou seja, tratamento de poluente recalcitrante (queratina) e obtenção de uma enzima comercialmente importante (queratinase). Este estudo envolve o isolamento, caracterização e utilidade potencial de espécies de fungos para a degradação de resíduos de penas de frango por meio da fermentação submersa e em estado sólido. O fungo isolado foi identificado e caracterizado como Aspergillus (A.) flavus. Em um ensaio de 30 dias, constatou-se que 74% e 8% do peso das penas foram reduzidos por A. flavus, respectivamente, por meio da fermentação submersa e em estado sólido. O pH do meio de crescimento em fermentação submersa foi alterado de 4,8 para 8,35. A aplicação explorada de micróbios queratinolíticos é, portanto, recomendada para o tratamento de resíduos ceratinosos para obter benefícios duplos de remediação.

Fungal decomposition of chicken-feather waste in submerged and solid-state fermentation

Abstract Poultry industry is expanding rapidly and producing million tons of feather waste annually. Massive production of keratinaceous byproducts in the form of industrial wastes throughout the world necessitates its justified utilization. Chemical treatment of keratin waste is proclaimed as an eco-destructive approach by various researchers since it generates secondary pollutants. Keratinase released by a variety of microbes (bacteria and fungi) can be used for the effective treatment of keratin waste. Microbial degradation of keratin waste is an emerging and eco-friendly approach and offers dual benefits, i.e., treatment of recalcitrant pollutant (keratin) and procurement of a commercially important enzyme (keratinase). This study involves the isolation, characterization, and potential utility of fungal species for the degradation of chicken-feather waste through submerged and solid-state fermentation. The isolated fungus was identified and characterized as Aspergillus (A.) flavus. In a trial of 30 days, it was appeared that 74 and 8% feather weight was reduced through sub-merged and solid-state fermentation, respectively by A. flavus. The pH of the growth media in submerged fermentation was changed from 4.8 to 8.35. The exploited application of keratinolytic microbes is, therefore, recommended for the treatment of keratinaceous wastes to achieve dual benefits of remediation.

Resumo A indústria avícola está se expandindo rapidamente e produzindo milhões de toneladas de resíduos de penas anualmente. A produção massiva de subprodutos queratinosos na forma de resíduos agrícolas e industriais em todo o mundo exige sua utilização justificada. O tratamento químico de resíduos de queratina é proclamado como uma abordagem ecodestrutiva por vários pesquisadores, uma vez que gera poluentes secundários. A queratinase liberada por uma variedade de micróbios (bactérias e fungos) pode ser usada para o tratamento eficaz de resíduos de queratina. A degradação microbiana de resíduos de queratina é uma abordagem emergente e ecológica e oferece benefícios duplos, ou seja, tratamento de poluente recalcitrante (queratina) e obtenção de uma enzima comercialmente importante (queratinase). Este estudo envolve o isolamento, caracterização e utilidade potencial de espécies de fungos para a degradação de resíduos de penas de frango por meio da fermentação submersa e em estado sólido. O fungo isolado foi identificado e caracterizado como Aspergillus (A.) flavus. Em um ensaio de 30 dias, constatou-se que 74% e 8% do peso das penas foram reduzidos por A. flavus, respectivamente, por meio da fermentação submersa e em estado sólido. O pH do meio de crescimento em fermentação submersa foi alterado de 4,8 para 8,35. A aplicação explorada de micróbios queratinolíticos é, portanto, recomendada para o tratamento de resíduos ceratinosos para obter benefícios duplos de remediação.

Metabolic Effects of Carbon Dioxide Insufflation During Laparoscopic Surgery: Changes in pH, Arterial Partial Pressure of Carbon Dioxide (PaCO2) And End Tidal Carbon Dioxide (ETCO2)

Background: Laparoscopy involves inspecting the abdomen and pelvis using an endoscope. Carbon dioxide (CO2) is the gas that is commonly used to insufflate the abdomen so as to facilitate the surgical view. Aim: The present study was under taken to determine the Metabolic effects of carbon dioxide insufflation during laparoscopic surgery. Methods: An observational study on 50 patients above 18 years of age with physical status of American Society of Anaesthesiologists (ASA) Class I and II after obtaining approval from institutional ethical committee and consent of the patient was conducted in the Postgraduate Department of Anaesthesiology and Critical Care, Government Medical College Srinagar. Results: There was a progressive decrease in the pH during pneumoperitoneum in keeping with the hypercarbia. An increase towards baseline was observed during recovery but pH was still significantly lower than baseline 15 minutes into recovery (p<0.118). The Pco2 increased after 15 mins Co2 insufflation & peaked at 30 mins with mean & SD 42.82,2.775 & 46.16,2.909 respectively which was statically significant. Etco2 also increased after 15 mins of Co2 insufflation & peaked at 30 mins with mean 41.56 & 44.50 respectively which was statically significant. Similarly, Hco3 decreased over period of time with peak decrease at 30 mins of Co2 insufflation with mean 23.70, SD 1.919 & range 19-27. Conclusion: Co2 insufflation does bring metabolic changes in Ph, Pco2, Etco2 & HCO3 but with proper monitoring & management laparoscopic procedure can be safely performed.

Quality of life assessment after successful percutaneous transmitral commissurotomy and ascertain its relationship with gender / Evaluación de la calidad de vida tras comisurotomía mitral percutánea exitosa y determinación de su relación con el sexo

Abstract Background: percutaneous transmitral commissurotomy has become an ideal treatment option for mitral stenosis due to its less adverse events and more favorable outcomes. Patients improve symptomatically after percutaneous transmitral commissurotomy but we have minimal available data about the quality of life after percutaneous transmitral commissurotomy. Objective: to assess the quality of life after percutaneous transmitral commissurotomy through WHOQol scoring covering different aspects of life, to determine its correlation with a net gain in mitral valve area (MVA) and to ascertain its association with gender. Methods: it was a prospective cohort study carried out for a period of 15 months. A total of 100 patients with mitral stenosis who had successful percutaneous transmitral commissurotomy done were enrolled in the study. Among the total included, 4 patients were lost to follow up and data were collected from 96 patients. Quality of life was assessed before the procedure, at 1 month and 3 months follow up after percutaneous transmitral commissurotomy using WHOQol scoring questionnaire. Results: among 96 patients, 64 (67%) were females and 32 (33%) were males. WHOQol scoring improved significantly after percutaneous transmitral commissurotomy from 32.8±8.9 to 54.6±11.2 and 62.8± 9.7, after one month and 3 months respectively. There was a significant association between net gain of MVA and WHOQol scoring with an R value of 0.46 and p value of 0.03. There was no difference in group comparison of all the six domains between male and female patients. Conclusion: successful percutaneous transmitral commissurotomy improves the quality of life in mitral stenosis patients regardless of their gender and has a positive correlation with a net gain in mitral valve area.

Resumen Antecedentes: La comisurotomía mitral percutánea se ha convertido en una opción terapéutica ideal para la estenosis mitral, debido a efectos menos adversos y a resultados más favorables. Los pacientes mejoran sintomáticamente tras la realización de esta técnica, aunque se dispone de escasos datos acerca de la calidad de vida tras su puesta en práctica. Objetivo: Evaluar la calidad de vida tras la comisurotomía mitral percutánea mediante la puntuación WHOQol, que cubre diferentes aspectos de la vida, para determinar su correlación con la ganancia neta del área valvular mitral (AVM), y determinar su asociación con el sexo. Métodos: Estudio prospectivo de cohorte durante un periodo de 15 meses, en el que se incluyeron 100 pacientes con estenosis mitral a quienes se les practicó con éxito comisurotomía mitral percutánea. De entre el total incluido, se perdieron 4 pacientes durante el estudio, por lo que se recolectaron datos de los 96 pacientes restantes. La calidad de vida se evaluó antes del procedimiento, y transcurridos un mes y tres meses de seguimiento, utilizando el cuestionario de puntuación WHOQol. Resultados: De los 96 pacientes, 64 (67%) eran mujeres y 32 (33%) varones. La puntuación WHOQol mejoró considerablemente tras la realización de la comisurotomía mitral percutánea, con valores de 32,8±8,9 a 54,6±11,2 y 62,8± 9,7, transcurridos uno y 3 meses, respectivamente. Se produjo una asociación significativa entre la ganancia neta de AVM y la puntuación WHOQol, con un valor R de 0,46 y un valor p de 0,03. No se produjo diferencia alguna en cuanto a la comparación grupal de los seis dominios entre varones y mujeres. Conclusión: La comisurotomía mitral percutánea exitosa mejora la calidad de vida de los pacientes de estenosis mitral, independientemente del sexo, y tiene una correlación positiva con la ganancia neta del área valvular mitral.

Efficacy of Azadirachta indica (Neem) leaf extract and hypertonic saline solution as intratesticular chemical sterilizing agents in dogs / Eficácia do extrato de folha de Azadirachta indica (Neem) e solução salina hipertônica como agente químico esterilizante intratesticular em cães

Castration refers to induced sterility via physical, chemical, or hormonal methods. Chemical castration is an efficient and reliable technique in contrast to other sterilization procedures as it is less painful to physical methods and cost­effective to hormonal methods. Azadirachta indica (neem), is a charismatic plant as its leaves possess anti­inflammatory, anti­microbial, and anti­androgenic chattels. To abate the escalating human population in South Asia, neem oil and neem leaf extract have been effectively used as a contraceptive agent. The key determinant of the current study was to evaluate Neem as a chemical sterilizing agent, (either necrotic or apoptotic), in dogs injected intratesticular in comparison to a hypertonic saline solution. Pre­ and post­injection testicular width size and blood samples for serum testosterone levels were collected on alternative days. Results disclosed substantial changes in testicular width size, histopathological profile, and serum testosterone level. A non­significant (P > 0.05) pre­injection testicular width readings in contrast to a significant increase (P < 0.05) three days post­injection was noted in all the competitive groups. The mean values recorded for testicular width size at the end of the trial study via neem leaf extract, 30% HSS and, control groups were 27.7362 ± 2.3315mm, 30.9594 ± 4.6861mm, and 24.5023 ± 2.5387mm, respectively. A declining trend, regarding serum testosterone level being statistically significant (P < 0.05) was recorded in treated groups (A, B) in contrast to the control group (C) as the values were 1.5357 ± 0.7819ng, 1.2669 ± 0.9095ng, and 2.4517 ± 0.1827ng in groups A, B, and C, respectively. Histopathological findings advocated the presence of apoptotic bodies in the neem treated group whereas the presence of degenerated interstitial cells, necrosed seminiferous tubules, damaged germinal epithelium, and ceased spermatogenesis was also studied in both competitive groups. Thus, the apoptotic effect and anti­inflammatory property of neem leaf extract resulted in less painful castration and verified Azadirachta indica as a better substitute for chemical castration in contrast to hypertonic saline solution.(AU)

A castração consiste na indução da esterilidade por meio físico, químico ou hormonal. A castração química é uma técnica eficiente e confiável, em contraste com outros procedimentos de esterilização, pois é menos dolorosa para os métodos físicos e econômicos para os métodos hormonais. Azadirachta indica (neem), é uma planta carismática, pois possui folhas anti­inflamatórias, antimicrobianas e antiandrogênicas. Para diminuir a crescente população humana no sul da Ásia, o óleo de nim e o extrato de folhas de nim têm sido efetivamente usados como agente contraceptivo. O principal determinante deste estudo atual foi avaliar o Neem como um agente esterilizante químico (necrótico ou apoptótico) em cães injetados intratesticularmente em comparação com uma solução salina hipertônica. O tamanho da largura testicular pré e pós­injeção e as amostras de sangue para os níveis séricos de testosterona foram colhidas em dias alternados. Os resultados obtidos revelaram alterações substanciais no tamanho da largura testicular, perfil histopatológico e nível sérico de testosterona. Observou­se uma leitura não significativa (P> 0,05) da largura testicular da pré­injeção, em contraste com um aumento significativo (P <0,05) três dias após a injeção em todos os grupos competitivos.Os valores médios registrados para o tamanho da largura testicular no final do estudo via extrato de folhas de nim,HSS a 30% e grupos controle foram 27,7362 ± 2,3315 mm, 30,9594 ± 4,6861 mm e 24,5023 ± 2,5387 mm, respectivamente.Uma tendência decrescente, com relação ao nível sérico de testosterona sendo estatisticamente significante (P <0,05), foi registrada nos grupos tratados (A, B), em contraste com o grupo controle (C), pois os valores eram 1,5357 ± 0,7819ng, 1,2669 ± 0,9095ng e 2,4517 ± 0,1827ng nos grupos A, B e C, respectivamente. Os achados histopatológicos advogaram a presença de corpos apoptóticos no grupo tratado com nim, enquanto a presença de células intersticiais degeneradas, túbulos seminíferos necrosados, epitélio germinativo danificado e espermatogênese interrompida também foi estudada nos dois grupos competitivos. Assim, o efeito apoptótico e a propriedade anti­inflamatória do extrato de folhas de nim resultaram em uma castração menos dolorosa e confirmaram que a Azadirachta indica foi um melhor substituto para a castração química do que a solução salina hipertônica.(AU)

Evaluating Journal Impact Factor: a systematic survey of the pros and cons, and overview of alternative measures

Journal Impact Factor (JIF) has several intrinsic flaws, which highlight its inability to adequately measure citation distributions or indicate journal quality. Despite these flaws, JIF is still widely used within the academic community, resulting in the propagation of potentially misleading information. A critical review of the usefulness of JIF is needed including an overview of the literature to identify viable alternative metrics. The objectives of this study are: (1) to assess the usefulness of JIF by compiling and comparing its advantages and disadvantages; (2) to record the differential uses of JIF within research environments; and (3) to summarize and compare viable alternative measures to JIF. Methods: Three separate literature search strategies using MEDLINE and Web of Science were completed to address the three study objectives. Each search was completed in accordance with PRISMA guidelines. Results were compiled in tabular format and analyzed based on reporting frequency. Results: For objective (1), 84 studies were included in qualitative analysis. It was found that the recorded advantages of JIF were outweighed by disadvantages (18 disadvantages vs. 9 advantages). For objective (2), 653 records were included in a qualitative analysis. JIF was found to be most commonly used in journal ranking (n = 653, 100%) and calculation of scientific research productivity (n = 367, 56.2%). For objective (3), 65 works were included in qualitative analysis. These articles revealed 45 alternatives, which includes 18 alternatives that improve on highly reported disadvantages of JIF. Conclusion: JIF has many disadvantages and is applied beyond its original intent, leading to inaccurate information. Several metrics have been identified to improve on certain disadvantages of JIF. Integrated Impact Indicator (I3) shows great promise as an alternative to JIF. However, further scientometric analysis is needed to assess its properties.(AU)

Culture sensitivity and antibiotic profile in urinary tract infection in children between 1-15 years

Background: The aim was to study the antibiotic resistance in children with urinary tract infection and to observe any difference between antibiotic resistance rates.Methods: It was a prospective study carried out in SKIMS Medical College Hospital, Srinagar over a period of two years from January 2017 to January 2019. The study included 210 children between 1 year and 15 years who had presented with complaints of urinary tract infection and whose urine cultures were positive for the growth of an organism. These children were analyzed in order to find the frequency of organisms grown on culture, sensitivity of organisms isolated on culture and the rates of developed resistance to the antibiotics.Results: A total of 210 patients aged were included in the study, encompassing 66 (31.4) males and 144 (68.6%) females. Out of 144 female children 108 were under 6years of age while as out of 66 male children 48 were under 6years of age. As per the growth on urine culture,' the commonest organism that grew on culture were Escherichia coli (E. coli) was observed in 156 (74.3%), enterococcus in 18 (8.57%), Proteus mirabilis in 11 (5.2%), Acinetobacter spp. in 7 (3.3%), Pseudomonas spp. 5 (2.4%), Staphylococcus aureus in 4 (1.9%), Morganella spp. in 3 (1.4%) patients. Authors found imipenem, aminoglycosides and nitrofurantoin as the most effective antibiotics for urinary tract infections in pediatric age group.Conclusions: From this study, they concluded that parenteral antibiotics to be started empirically for the treatment of UTIs in all pediatric age groups are' aminoglycosides. In contrast for outpatient management of urinary tract infections, our results suggest that nitrofurantoin should be used for children aged beyond 1 year of age due to the low rate of resistance to nitrofurantoin in patients aged over 1 year.

Association of patent ductus arteriosus (PDA) with prematurity and low birth weight neonates

Background: Patent ductus arteriosus (PDA) is a major morbidity encountered in preterm neonates, especially in babies less than 28 weeks gestation or 1000g. It may close spontaneously in preterm neonates; however, failure to close spontaneously in preterm neonates results in significant mortality and morbidity in them.Methods: This prospective study was conducted in a tertiary care hospital in north India over a period of one year. The study cohort consisted of preterm, newborn babies admitted in the hospital with gestational age less than 37weeks and birth weight <2500g.Results: In this study total number of patients admitted during the study were 2930. Out of these preterm low birth weight neonates were 432. Among preterm low birth weight neonates admitted, 132 neonates were excluded as per exclusion criteria. Patent ductus arteriosus was detected in 56 among the 300 neonates giving an overall incidence of patent ductus arteriosus 18.6%, the incidence of patent ductus arteriosus was 56.2% for neonates weighing less than 1000gm, 24.7% for neonates weighing between 1000-1499g, 11.6% for neonates weighing between 1500-1999g and 5.6% for the neonates weighing between 2000-2499g.Conclusions: Thus, incidence of patent ductus arteriosus was inversely proportional to gestational age and birth. Data also suggest that immaturity is the major determinant of the persistent patency of ductus arteriosus.

Normal interpupillary, inner canthal distance and outer canthal distance in a normal population of Pakistan

Objective: This study was conducted to quantify the normal indices of anthropometric measures related to ophthalmology including Interpupillary distance [IPD], Inner canthal distance [ICD], Outer canthal distance [OCD] in a normal, healthy Pakistani population

Methods: This is a cross sectional study. Total 500 patients were chosen randomly but 499 were included in this study. Patients were selected randomly in an outpatient department of Jinnah Post Graduate Medical Centre Karachi, over the period of five months. IPD, ICD and OCD all measurements were taken with the help of plastic rule by only one researcher to minimize chances of error as much as possible. IPD was reconfirmed from auto refractometer while ICD and OCD readings were taken twice by occluding one eye of researcher to reduce error. Participants were divided into four categories on basis of: Age, Gender, ethnicity and geographical location. Patients were further categorized on basis of Ethnicity to Urdu Speaking, Sindhi, Punjabi, Pathan, and others. Moreover, four age groups were drawn ranging from 15-24 years, 25-44 years, 45-64 years and 65 years and greater

Results: Our study comprised a total of 499 patents of which 272[54.5%] were males, and 227[45.5%] were females. The mean age of the participants was 39.3 +/- 14.5 years. The mean values for the IPD, ICD and OCD in mm were 61.8 +/- 6.2, 30.9 +/- 2.9 and 85.2 +/- 6.6 respectively. A statistically significant difference was observed between IPD, ICD and OCD Indices among male and female study participants [p<0.001, p=0.043, p<0.001]. While comparing the IPD, ICD and OCD indices amongst the different ethnic groups, we found no statistically significant difference [p=0.09. p=0.28, p=0.06]. Overall, there was no correlation between the age and other variables i.e. IPD, ICD, OCD, [r = 0.07, p = 0.085], [r = 0.005, p = 0.906], [r = -0.08, p = 0.058]

Conclusion: This work has recommended normative values of IPD, ICD and OCD in Pakistani population on the basis different variables including gender, age, and ethnicity

Synthesis and Development of BACE 1 Inhibitor for Alzheimer’s Diseases from Medicinal Plants

Medicinal plants have shown great promise in treating Alzheimer’s disease (AD), which significantly contributes to the production of pharmaceutical and cosmetic molecules with biologically efficient moieties. Plants derived bioactive compounds have been isolated from the medicinal plants and are used in brain diseases. Accountable for brain diseases. Plant extracts have undesirable effects such as acute or chronic toxicity; this could be involved in the delay or discouraging the adoption to the brain cells for proper and effective treatment. β-secretase is the primary protease in the process of producing Amyloid β (Aβ), which is an amyloid precursor protein in brain cells. This review is focused on the numerous different bioactive compounds present in medicinal plants such as Flavonoids, Phenyl propanoids, Prenylated flavones, Naphthoquinone, Resveratrol, Phlorotannins and Glycoside derivatives. Even though medicinal plants and their functional derivatives were reported to be good source of alternative medicines for long sought diseases like AD; but clinical trials on human are yet to be beyond the preliminary stages. The useful applications of these compounds, as bio-markers are also being explored, to further enrich control of Alzheimer’s.

Evaluation of microleakage in single-rooted teeth obturated with thermoplasticized gutta-percha using various endodontic sealers: an in-vitro study

Objective: To compare apical microleakage of extracted, single-rooted teeth obturated with thermoplasticized injectable gutta-percha using two different endodontic sealers [calcium-hydroxide and resin based]. Study Design: An experimental study. Place and Duration of Study: The Aga Khan University Hospital [AKUH], Dental Clinics and Laboratory from June to September 2015

Methodology: The study was conducted using extracted teeth. After access cavities were made, cleaning and shaping of root canals was done in 70 teeth. Teeth were randomly allocated into two groups and obturated with thermoplasticized injectable gutta-percha [Obtura II] using two sealers [Sealapex vs. AH plus]. After immersing the teeth in 2.0% methylene blue, they were split longitudinally, viewed under light microscope [magnification X4] and images were taken by a camera connected to microscope. The extent of dye penetration was assessed from apex to its coronal part and recorded in millimeters. Independent sample t-test was used to compare microleakage in the two groups. Pearson correlation coefficient was used for inter-examiner reliability of dye penetration measurements. A p-value of <0.05 was taken as statistically significant

Results: Teeth obturated with Obtura II gutta-percha with AH plus sealer had a mean dye penetration of 1.20 +/-0.79 mm. This was significantly better than Obtura II with Sealapex sealer [p=0.003]

Conclusion: Obtura II-AH plus sealer was a better combination for obturation as it showed a lesser degree of microleakage. Obtura II with Sealapex group showed higher microleakage, so this combination should be avoided in single-rooted teeth

Management of club foot by ponseti method: our experience

Objective: To present our experience of treating the club foot with the Ponseti way of conservative management. Study Design: Cross-sectional prospective study. Place and Duration of Study: Study was carried out at CMH Sialkot and CMH Rawalpindi, from Jun 2012 to Jun 2015

Material and Methods: A total of 39 children were treated by the same surgeon and 35 cases were included in this study. Ponseti method involves the non-surgical management of clubfoot, involving manipulation and casting techniques. The foot is systematically stretched as per Ponseti method into the normal shape and repeated casts are applied. Equinus is later treated by percutaneous tendoachilles tenotomy if required

Results: Our aim was over correction of the deformity before advising for foot abduction brace. Thirty one [88.57%] cases showed excellent results while we faced difficulty in achieving the required aim in 4 [11.43%] cases

Conclusion: Ponseti clubfoot management technique has reduced the need for extensive soft tissue release and major clubfoot surgery. This technique has been successful in our setup too. We recommend that it may be adopted as the gold standard for clubfoot treatment throughout the country and primary health care physicians should also be trained in this technique so that maximum people may benefit from this

In vitro effect of new antibiotics against clinical isolates of salmonella paratyphi A

Objective: The objective of this study was to determine in vitro MIC patterns of various therapeutic alternatives for the treatment of Salmonella Paratyphi A. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Pathology Rawalpindi, from Jun 2012 to May 2014

Material and Methods: Clinical samples were collected from suspected cases of salmonella infections. Culture was applied on Bactec 9050 special and/or standard media. Suspected Salmonella Paratyphi colonies were tested by API 20E and confirmed by serology. The isolates were also tested for resistance to ampicillin, cotrimoxazole, ciprofloxacin, ceftriaxone, doripenem, imipenem, ertapenem, aztreonam, moxifloxacin, cefpirome, cefepime, gatifloxacin, and chloramphenicol by Kirby-Bauer disc diffusion method. MIC [Minimum Inhibitory concentration] was done on MDR and ciprofloxacin intermediate or resistant cases by E-strips

Results: One hundred and eleven isolates of Salmonella Paratyphi were recovered from 2230 specimens. Resistance by disk diffusion technique noted in Salmonella Paratyphi A was ampicillin 60%, chloramphenicol 40%, cotrimoxazole 38%, ceftriaxone 7.9%, ciprofloxacin 8%, cefpodoxime 7.9%, imipenem and ertapenem 2.6%, aztreonam 1.3%, moxifloxacin 6.6%, and gatifloxacin 1.3%. No resistance was noted for doripenem and cefepime. MIC50 was 0.094 for Cefpirome, 0.125 Aztreonam, 0.25 imipenem and tigecycline, 2 cefpodoxime and 8 for azithromycin

Conclusion: Azithromycin, Aztreonam, Imipenem, tygecycline, cefpodoxime and cefpirome are potential therapeutic agents for resistant Salmonella Paratyphi A infections

Disseminated infection with multiple cold abscesses caused by Rhizopus Arrhizus in an immunocompetent girl

Although infections with fungi, such as Rhizopus species, usually occur in diabetics or immunocompromised patients, they can also rarely affect immunocompetent individuals. We present a case of disseminated infection with multiple cold abscesses in a 13-year, otherwise healthy girl caused by Rhizopus arrhizus

Elective division of ilioinguinal nerve in inguinal hernioplasty: remedy for the morbid postoperative inguinal pain

Objective: To compare the postoperative pain in inguinal hernioplasty, by preserving versus wide elective division of ilioinguinal nerve. Study Design: Randomized controlled trial. Place and Duration of Study: Surgical Department, Civil Hospital, Karachi, from January till August 2015

Methodology: All patients of either gender above 15 years of age, undergoing mesh repair for unilateral, reducible inguinal hernia, were included. Patients with recurrent inguinal hernia, bilateral inguinal hernia, and those who will require emergency hernia surgeries like irreducible, obstructed, and strangulated hernia, were excluded. They were randomly assigned 42 into inguinal nerve preservation group [group A] and 42 in division [group B]. Postoperative pain was assessed at first day, at discharge and after one month using visual analogue scale

Results: There were a total of 84 patients. Group A patients had median [IQR] pain scores of 5 [1] and 3 [2] as compared to group B pain scores of 4 [2] and 2 [1] at 24 hours of surgery and at discharge, respectively [p<0.05]. Median [IQR] postoperative pain score one month after inguinal hernioplasty was 2.5 [1] in group A, while 0.5 [1] in group B [p<0.05]. A significant decline in the pain scores were observed in group B from the first day of surgery till one month afterwards [p<0.05]

Conclusion: Wide resection of ilioinguinal nerve has a lower frequency of postoperative pain in comparison to the ilioinguinal nerve preservation, in inguinal hernioplasty

Glanular hypospadias management with modified circumcision and firlit procedure

Objective: To document the results of using simple technique of Firlit procedure with modified circumcision for treatment of glanular hypospadias. Study Design: Descriptive case series. Place and Duration of Study: Department of Urology, Shifa International Hospital, Islamabad, from January 2011 till May 2017

Methodology: The subjects included pediatric patients who underwent repair of glanular hypospadias by using modified circumcision and Firlit procedure. Patients were analyzed for operative time, age, hospital stay, and peroperative and postoperative complications. Chart review was done for collection of data on specified proforma

Results: There were 73 patients with mean age of 1.81 +/- 0.92 years. Children were discharged on the same day. None of them needed catheterization and dressing. Temporary dressing was used for mild bleeding immediate post op in 13 [17.80%] cases only. Postoperative complication such as urinary retention, fever, severe pain, or urinary tract infection were not seen in children. Meatal stenosis was not seen on a 2-24 months' follow-up. Satisfactory urine stream and good cosmesis was noted by the parents

Conclusion: The Firlit technique for the repair of glanular hypospadias was simple and satisfactory in terms of urine stream and cosmesis with minimal complications