Cell-derived nanovesicles from mesenchymal stem cells as extracellular vesicle-mimetics in wound healing

Wound healing is a dynamic process that involves a series of molecular and cellular events aimed at replacing devitalized and missing cellular components and/or tissue layers. Recently, extracellular vesicles (EVs), naturally cell-secreted lipid membrane-bound vesicles laden with biological cargos including proteins, lipids, and nucleic acids, have drawn wide attention due to their ability to promote wound healing and tissue regeneration. However, current exploitation of EVs as therapeutic agents is limited by their low isolation yields and tedious isolation processes. To circumvent these challenges, bioinspired cell-derived nanovesicles (CDNs) that mimic EVs were obtained by shearing mesenchymal stem cells (MSCs) through membranes with different pore sizes. Physical characterisations and high-throughput proteomics confirmed that MSC-CDNs mimicked MSC-EVs. Moreover, these MSC-CDNs were efficiently uptaken by human dermal fibroblasts and demonstrated a dose-dependent activation of MAPK signalling pathway, resulting in enhancement of cell proliferation, cell migration, secretion of growth factors and extracellular matrix proteins, which all promoted tissue regeneration. Of note, MSC-CDNs enhanced angiogenesis in human dermal microvascular endothelial cells in a 3D PEG-fibrin scaffold and animal model, accelerating wound healing in vitro and in vivo. These findings suggest that MSC-CDNs could replace both whole cells and EVs in promoting wound healing and tissue regeneration.

Reliability Of Anthropometric Measurements Conducted In National Physical Fitness Standard (SEGAK) Assessments Among School-Aged Adolescents In Terengganu, Malaysia

@#School-based health programs implemented by the Malaysian Ministry of Education (MOE) through the National Physical Fitness Standard (SEGAK) assessments provided an important platform in health status monitoring among schoolchildren. However, to date, there is still no reliability study conducted on this method. Therefore, this study aimed to determine the reliability of the anthropometric data collected by physical education (PE) teachers in the SEGAK assessments. Anthropometry measurements of standard six school adolescents involved in the Health of Adolescents in Terengganu study were taken by trained researchers using a standardised protocol. The anthropometrics data were then compared with PE teachers’ measurements from the SEGAK assessments obtained from the specifically developed Health Monitoring System database. Reliability of the anthropometric measurements were analysed using Pearson’s correlation test, Intraclass Correlation Coefficients (ICC), Bland-Altman plot and Cohen’s Kappa statistics. Intraclass correlation coefficient between teacher-measured and researcher-measured values shows good correlation in weight (ICC = 0.93), height (ICC = 0.98) and BMI (ICC = 0.91). The Bland-Altman plot showed a relatively small difference in mean of weight, height, and BMI between teacher-measured and researcher-measured value. The mean difference between teacher-measured and researcher-measured value of weight, height, and BMI were 1.8kg, 0.1cm, and 0.8kg/m2 respectively. Overall, Cohen’s Kappa statistics showed substantial agreement (κ = 0.642) in BMI categorisation between the two measurements. Findings from reliability analysis conducted affirmed that anthropometrics assessments conducted by PE teachers in SEGAK assessments are reliable to be used for identification of body weight status among school children and adolescents particularly in Terengganu, Malaysia.

Breastfeeding knowledge among indigenous Temiar women: a qualitative study

@#Introduction: The benefits of breastfeeding for both mothers and infants are widely recognised. Breastfeeding confirms a woman’s unique ability to care for her infant in the best way possible and promotes optimum infant and maternal health. Methods: A qualitative research method involving five focus group discussions (n=33) was chosen in this study to compare and contrast the breastfeeding practice in two different locations: the communities of Pos Pulat and the regroupment scheme settlement at Rancangan Pengumpulan Semula (RPS) Kuala Betis in Kelantan, Malaysia which represents different lifestyle experiences of indigenous Temiar population. Results: The benefits of breastfeeding to the infants reported by some Temiar women (42.4%) were for the infant’s health and growth. Responses from urban RPS Kuala Betis women include breast milk contains antibodies (3.0%), delays in the return of regular ovulation (6.1%), thus lengthening birth intervals and bonding between maternal-baby (6.1%). In general, respondents from Pos Pulat seemed to have little knowledge regarding this issue, except for a woman who mentioned that maternal milk contains vitamins. Based on the narrative analysis, knowledge gap was observed between these two communities. Conclusion: Although all the women interviewed had the experience of breastfeeding their infants, most of them lacked the knowledge regarding the benefits of the breastfeeding either to the infants or to the mothers. The findings from this study are crucial for the preservation of breastfeeding culture among the Temiar women and can be used to improve promotion of breastfeeding to other Orang Asli groups in Malaysia.

Chemical compositions and in vitro antimicrobial activity of Cymbopogon nardus on food borne microorganisms

Aims@#Food borne infections are routinely observed and frequently reported. Cymbopogon nardus, or commonly known as citronella is a tropical plant widely used for aromatherapy and insect repellant. This study aimed to evaluate the phytochemical compositions of C. nardus ethanol extract and its antimicrobial activity on food borne microorganisms. @*Methodology and results@#The plant materials were extracted with ethanol using maceration technique. The ethanol extract obtained was analysed using GC-MS and the most abundant compounds were 6-methyloctahydrocoumarin (31.5%) and 2,4-di-tert-butylphenol (28.7%). On Kirby Bauer assay, the extract showed wide spectrum inhibitory effect on one Gram-positive bacteria (Bacillus coagulans), two Gram-negative bacteria (Proteus mirabilis and Escherichia coli), and one yeast (Candida albicans). All the test microorganisms showed different susceptibility to the extract, where the minimal inhibitory concentrations were ranged from 63 to 250 μg/mL. The inhibitory effect of the extract was bactericidal. In addition, the time kill analysis of the extract exhibited inhibitory effect on P. mirabilis which was concentration-dependent. The C. nardus extract exhibited rapid bactericidal effect on P. mirabilis and lower bacterial counts were obtained with increased extract concentration. Besides, the extract did not exert significant toxicity effect to Artemia salina on brine shrimp lethality assay. @*Conclusion, significance and impact of study@#Therefore C. nardus can be a potential source of safe and effective antimicrobial agent to combat food borne infections.

Sociodemographic Determinants Of Obesity Among 12 Years Old School Adolescents In Kuala Terengganu And Besut Districts, Malaysia

Worldwide prevalence of obesity among children and adolescents increased substantially over decades. Addressing potential risk factors of obesity among adolescents is very important for a successful intervention program in this population. The present study aimed to identify the sociodemographic determinants of obesity among school adolescents in Terengganu. A cross-sectional survey involving 3,798 school adolescents age 12 years old from 136 government primary schools in Kuala Terengganu and Besut districts were carried out from November 2014 to June 2015. For the purpose of this paper, the data for 2,842 school adolescents classified as either normal BMI (< +1SD) (n= 2,305) or obese (+2SD) (n= 537) based on WHO cut-off points were taken for analysis. Sociodemographic information on subjects and their parents were obtained from self-reported questionnaire. Anthropometric measurements were conducted by Physical Education teachers and uploaded into a specific developed database. The prevalence of obesity was relatively high in both genders in this study. Binary logistic regression analysis found gender, parental BMI, household income, household size and maternal working status were independently associated with obesity among school adolescents in this population. In the final model, being male, having working mother, and having obese parents were identified to be potential risk factors for obesity whilst having large household size lower the risk of obesity among these adolescents. Prevention programs are needed to increase awareness about the risk factors of obesity in adolescent and interventions should now focus on family member as well mainly the parents.

Sociodemographic Determinants Of Obesity Among 12 Years Old School Adolescents In Kuala Terengganu And Besut Districts, Malaysia

@#Worldwide prevalence of obesity among children and adolescents increased substantially over decades. Addressing potential risk factors of obesity among adolescents is very important for a successful intervention program in this population. The present study aimed to identify the sociodemographic determinants of obesity among school adolescents in Terengganu. A cross-sectional survey involving 3,798 school adolescents age 12 years old from 136 government primary schools in Kuala Terengganu and Besut districts were carried out from November 2014 to June 2015. For the purpose of this paper, the data for 2,842 school adolescents classified as either normal BMI (< +1SD) (n= 2,305) or obese (+2SD) (n= 537) based on WHO cut-off points were taken for analysis. Sociodemographic information on subjects and their parents were obtained from self-reported questionnaire. Anthropometric measurements were conducted by Physical Education teachers and uploaded into a specific developed database. The prevalence of obesity was relatively high in both genders in this study. Binary logistic regression analysis found gender, parental BMI, household income, household size and maternal working status were independently associated with obesity among school adolescents in this population. In the final model, being male, having working mother, and having obese parents were identified to be potential risk factors for obesity whilst having large household size lower the risk of obesity among these adolescents. Prevention programs are needed to increase awareness about the risk factors of obesity in adolescent and interventions should now focus on family member as well mainly the parents.

A “Near Miss" Congenital Eventration of the Right Hemidiaphragm in A Neonate: A Case Report

Focal eventration involving the posterior segment of the hemidiaphragm is a rare congenital anomaly. We report of a 10- day-old infant who presented with significant respiratory insufficiency and failure to show any responses to standard treatment. The diagnosis of focal eventration of the diaphragm was not anticipated until ultrasonographic examination revealed the defect. Diaphragmatic plication resulted in complete resolution of symptoms. A high level clinical awareness is crucial as a relatively simple surgical procedure could avert long term life-threatening complications.

Nutritional Assessment and Mineral Composition of Some Selected Edible Vegetables.

Aims: The present study aimed to assess the nutritional significance of some of the commonly consumed vegetables collected from Hangu, Khyber Pakhtunkhwa, Pakistan. Study Design: The study was designed in randomized block design and each analysis was performed with three replicates. Place and Duration of Study: Kohat University of Science & Technology, Kohat and the duration of the study was one year. Methodology: Present study was conducted to determine the nutritional importance of the commonly consumed vegetable viz. Amaranthus caudatus, Lathyrus aphaca, Abelmoschus esculenthus, Solanum melongena, Raphanus sativus and Brassica rapa. These vegetable species were evaluated for their nutritional values and mineral composition. By the nutritional analysis of these vegetable species, the total proteins, fats, carbohydrates, ash, and moisture contents were evaluated, whereas the macro-elements (Mg and Na) and micro-elements (Fe, Cu, Pb, Mn, Cr, and Cd) were analyzed using Atomic Absorption Spectrophotometric method. Results: The moisture content was found to be highest in R. sativus (13.59%±0.01), whereas A. caudatus was found to be highest in crude fats (2.91%±0.01), ash content (24.16% ± 0.03) and the protein value (15.65% ± 0.02). The fiber analysis indicated the highest value in A. esculenthus (30.93%±0.03), whereas B. rapa was found to be highest in the content of carbohydrates (86.65%±0.02) and thus the energy value was also calculated to be highest in B. rapa (352.52 ± 0.09). A. caudatus was also separated from the rest of the vegetables based on principal component analysis. 3-D component plot and rotated component matrix showed that this separation was due to variations in Pb and protein contents. Conclusion: The results of this study revealed that Amaranthus caudatus and Raphanus sativus are the most balanced sources with respect to nutritional values and mineral composition, as both of them were found to contain the highest content of essential nutrients and the mineral elements (macro and micro-elements).

Nutritional assessment and antioxidant analysis of 22 date palm (Phoenix dactylifera) varieties growing in Sultanate of Oman

OBJECTIVE@#To assess the nutritional values and antioxidant analysis of 22 varieties of date palm (Phoenix dactylifera) fruit collected from various regions of the Sultanate of Oman.@*METHODS@#Nutritional parameters including moisture, fats, fiber, proteins, carbohydrates, and energy value were determined using standard methods of Association of Official Analytical Chemists. The antioxidant activity was screened for their free radical scavenging properties using ascorbic acid as a standard antioxidant. Free radical scavenging activity was evaluated using 1,1-diphenyl-2-picrylhydrazyl free radical.@*RESULTS@#The results of the date fruits (dried/tamar stage) revealed significantly higher moisture (15%-21%), dry matter (78%-86%), ash content (1.0%-2.0%), fiber (1.0%-2.5%), fat (0.1%-0.7%), protein (1.8%-3.8%), nitrogen (0.25%-0.55%), carbohydrates (74.5%-82.4%), and energy values (307-345.5 kcal/100 g). The antioxidant activity ranged between 40% and 86% depending upon the type of date and location. Overall, Khalas, Fardh and Khasab have significantly higher nutritional attributes; however, other varieties such as Barshi, Qush LuLu, Handal, and Khunaizi also have comparable nutritional values. The cluster analysis further evidenced the correlation of proximate parameters in different locations. Moreover, the nutritional and antioxidant attributes of similar date varieties collected from different locations were slightly varied.@*CONCLUSIONS@#The present finding helps in understanding the nutritional significance of different date varieties in Oman while the lesser known varieties can be improved through sustainable horticultural practices as a valuable product. The study further reveals that the consumption of these dates' fruits would exert several beneficial effects by virtue of their antioxidant activity.

Nutritional assessment and antioxidant analysis of 22 date palm (Phoenix dactylifera) varieties growing in Sultanate of Oman

Objective: To assess the nutritional values and antioxidant analysis of 22 varieties of date palm (Phoenix dactylifera) fruit collected from various regions of the Sultanate of Oman. Methods: Nutritional parameters including moisture, fats, fiber, proteins, carbohydrates, and energy value were determined using standard methods of Association of Official Analytical Chemists. The antioxidant activity was screened for their free radical scavenging properties using ascorbic acid as a standard antioxidant. Free radical scavenging activity was evaluated using 1,1-diphenyl-2-picrylhydrazyl free radical. Results: The results of the date fruits (dried/tamar stage) revealed significantly higher moisture (15%-21%), dry matter (78%-86%), ash content (1.0%-2.0%), fiber (1.0%-2.5%), fat (0.1%-0.7%), protein (1.8%-3.8%), nitrogen (0.25%-0.55%), carbohydrates (74.5%-82.4%), and energy values (307-345.5 kcal/100 g). The antioxidant activity ranged between 40% and 86% depending upon the type of date and location. Overall, Khalas, Fardh and Khasab have significantly higher nutritional attributes; however, other varieties such as Barshi, Qush LuLu, Handal, and Khunaizi also have comparable nutritional values. The cluster analysis further evidenced the correlation of proximate parameters in different locations. Moreover, the nutritional and antioxidant attributes of similar date varieties collected from different locations were slightly varied. Conclusions: The present finding helps in understanding the nutritional significance of different date varieties in Oman while the lesser known varieties can be improved through sustainable horticultural practices as a valuable product. The study further reveals that the consumption of these dates' fruits would exert several beneficial effects by virtue of their antioxidant activity.

Diabetic patients; clinical profile with endstage renal disease on haemodialysis

To study the clinical profile of diabetic patients on haemodialysis with a view to identify common clinical features and the trend of compliance with treatment and follow up. Haemodialysis unit Fatima Memorial Hospital, Lahore, from January to August 2011. Method: Data collected from all patients above 14 years of age through medical history, record, examination and fundoscopy. Out of total 76 patients on haemodialysis 50[65.7%] had DM and of these 42[84%] also had hypertension. Among diabetics 28 [56%] were male and 22 [44%] female. Mean age was 56.68 +/- 9.09. Among these 15[30%] were illiterate and 27 [54%] belonged to lower social class. Ever smokers were 18[36%]. Mean duration of diabetes since diagnosis was 10.9 +/- 5.99. Mean duration of hypertension 8.28 +/- 8.07, Duration of onset of dialysis 6 months to 8 years with mean 2.16 +/- 1.47. Retinopathy was found in 29[58%], 18[36%] had diabetic and 11[22%] had hypertensive changes. Both fasting and random blood sugar levels were monitored by 28 [56%]. None had regular follow up with HbA1c levels or urine for protienuria prior to onset of haemodialysis. Compliance with dietary advice and treatment claimed by 24[48%] and 36[72%] respectively. History of intake of Hakeem and homeopathic medications was found in 16[32%] and 10[20%] respectively. 65.7% of ESRD were diabetics. Majority were in 6th decade of life. Retinopathy was present in 58%. Low trend was observed towards compliance with treatment and follow up

Comparison between on lay and sub lay methods of mesh repair of incisional hernia

To evaluate the repair of incisional hernia by two different methods onlay [Conventional method] and sublay[retromuscular preperitoneal] methods at two different tertiary care centres of Karachi-Pakistan. Patients diagnosed clinically and confirmed ultrasonographi-cally and subsequently operated upon with either methods were included in this study. The primary endpoint was hernia recurrence. Secondary endpoints were operative time, length of hospital stay and postoperative complications of the two methods. A total of 80 patients were allocated in two groups, group A [n=40] underwent incisional hernia repair by sublay method and the remaining in Group B, [n=40] by onlay method. The frequency of wound infection was found significantly higher in the Sublay method of mesh placement [p=0.019]. The frequency of seroma formation was significantly higher in the onlay method of mesh placement[p=0.076] The sublay technique was proven to be very effective, with minimal complications and low recurrence rate.

Management of obstructive jaundice: experience in a tertiary care surgical unit

To evaluate the presentation, clinical features and treatment of Obstructive Jaundice cases. Prospective observational study from Jan. 2003 to Dec. 2004. Surgical Unit IV, Civil Hospital, Karachi. All patients who were admitted and treated for Obstructive Jaundice. The patients were evaluated clinically and by investigations. After appropriate preparations surgery was carried out; the procedure depending upon the nature of the lesion. Intra and post-operative complications, and the outcome of the patient was noted and the whole data analyzed. This study comprises of 24 cases of Obstructive Jaundice. Their ages varied from 25-65 years [mean age being 41.12 years]; 10 were males and 12 females. Amongst these 13 [54.17%] patients had jaundice due to malignancy, 9 [37.5%] had stones in the common bile duct [CBD] and the remaining 2 [8.33%] patients had amoebic liver abscesses. In the malignant group five patients had Carcinoma Head of the Pancreas [two treated by pancreatoduodenectomy and three by cholecystojejunostomy], three had Cholangiocarcinoma [treated by hepatojejunostomy], three had Carcinoma Gall bladder [one treated by hepatojejunostomy, two inoperable] and two patients with malignant nodes at the porta hepatis who refused surgery and were referred for endoprostheses. All patients with stones in the CBD were treated by cholecystectomy and choledocholithotomy, whereas those with amoebic liver abscess underwent drainage/aspiration. Early diagnosis of the cause of obstruction is very important especially in malignant cases, as resection is only possible at that stage

Testicular carcinoma misdiagnosed as hydrocele: lesson to learn

About 99% of testicular tumors are malignant though they only constitute about 1-2% of malignant tumors in male. They are more readily accessible to examining fingers than a tumour of any other organ in the body, however too often they escape detection until it has metastasised. Worst error is to plunge a trocar and cannula into the enlarge testis or operating from scrotal approach in the belief that it is a hydrocele. Proper pre-operative assessment and diagnosis has the key role in the life expectancy of patient. Hydrocele and testicular tumor both have different operative approaches. For hydrocele scrotal approach and for tumor inguinal approach is recommended. For tumor, if scrotal approach has been adapted it may result in disaster. Two cases of testicular carcinoma initially diagnosed and operated as cases of hydrocele are reported

Post-operative complications in a general surgical ward of a teaching hospital

To find out post-operative complications during hospital stay of patients in a general surgical ward at a tertiary care teaching hospital of Karachi. Descriptive retrospective analysis. Surgical Unit IV, Civil Hospital Karachi. Six months, from January 1, 2004 to June 30, 2004. The records of all patients who underwent surgery between January 2004 to June 2004 were reviewed regarding postoperative complications developed during hospital stay. The following data were collected: age, sex, presentation at time of surgery [emergency or elective], surgery performed, complications during postoperative period and outcome. All data was analyzed with the help of SPSS-10. Surgery performed, post operative complications. A total of 501 patients were admitted during the study period. Total 411 surgeries were performed. 258 [62.8%] were elective and 153 [37.2%] were emergency procedures. Hernia repair was the most common surgery performed in 92 [22.4%] patients, followed by appendicectomy in 64 [15.6%] and cholecystectomy in 54 [13.2%] patients. Complications were documented in 122 [29.6%] patients. Most common complication observed was postoperative pyrexia in 75 [18.2%] patients, followed by postoperative nausea and vomiting [PONV] in 48 [11.6%], wound infection in 47 [11.4%], respiratory tract infection in 29 [7.0%] patients. During the study period 4 patients [0.9%] died in the postoperative period. This study revealed that the commonest postoperative complication was fever followed by PONV, wound infection and respiratory tract infection. It is important that the resident staff should be aware of these complications and how to manage them because these are better yardstick to measure the quality of care

Pattern of abscesses at civil hospital, Karachi

To study the pattern of abscesses at Civil Hospital, Karachi. Descriptive study from March 2003 to August 2004.Emergency Operation Theatre, Civil Hospital, Karachi.The data of all patients who presented with abscesses was collected and analyzed.Out of 537 patients who underwent drainage of abscesses, 327 were males and 210 females, with a male to female ratio of 1.56:1. Their ages ranged from 1 to 80 years with a mean age of 33.08 years. Diabetes mellitus was found in 75[13.96%] patients with a male to female ratio of 2.57:1. The most common site of abscess was the hand [17.31%] followed by breast [16.38%], anorectal region [13.96%] and foot [12.84%]. The common presenting complaints were pain, swelling and fever. All were treated by drainage with satisfactory outcome.Abscesses are the 2nd most common cause of emergency surgery at Civil Hospital, Karachi, the commonest cause being appendicitis

Facilitated blind nasotracheal intubation in paralysed patients with temporomandibular joint ankylosis

To assess the efficacy of blind nasal intubation technique, in cases of ankylosis of temporomandibular joint [TMJ] without the facility of fiber optic bronchoscope. Analytical study. Maxillofacial Surgery Department, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from August 2002 to October 2003. A total of 35 patients of ankylosis of TMJ were included in the study. Blind nasotracheal intubation technique was attempted after induction of anaesthesia and paralyzing the patients. Where blind nasotracheal intubation technique was not successful, one nasotracheal tube was passed into the esophagus and retained. Nasotracheal intubation was attempted through contralateral nares by second tube. Out of 35 patients male to female ratio was 1:1.2. The age of the patients ranged between 5 to 35 years with a mean age of 14.5 years. Blind nasotracheal intubation technique was successful in 23 cases [65.7%], whereas in 12 patients intubation was not successful. The 12 cases of failed blind nasotracheal intubation technique were successfully intubated nasotracheally by prior placement of nasotracheal tube into the esophagus through contralateral nares, which facilitated re-intubation [34.3%]. In the selected patients blind nasotracheal intubation was facilitated by prior placement of the endotracheal tube into esophagus. This technique may be helpful in reducing the psychological trauma and complications of tracheostomy in such patients. However, to-date, fiber optic intubation remains the safest and widely accepted intubation technique in such patients

Firearm injuries: a three years experience

During the last 3 years i.e. from Jan. 1994 to Dec. 1996, 1063 cases of penetrating gun-shot injuries were brought to the Emergency Department of Civil Hospital, Karachi. Of these 15 died during resuscitation, 530 patients were given treatment in the Emergency Department and discharged while 518 patients were admitted. Amongst these 78 cases were treated in Surgical Unit II and include 66.6% with abdominal injury, 10.2% with thoracic, 8.9% with thoraco-abdominal, 6.4% with head and face, and 7.6%, with limb injuries. Laparotomy was performed in 75.6%, thoracic intubation in 19.2%, wound exploration in 14.1% and tracheostomy in 1.2% cases. Average hospital stay was 8 days. Complications occurred in 7.8% cases and the mortality was 3.8%