Nigella Sativa-Coated Hydroxyapatite Scaffolds: Synergetic Cues to Stimulate Myoblasts Differentiation and Offset Infections

BACKGROUND@#At present osteoporosis has come into view as a major health concern. Skeletal diseases typified by weak and fragile bones have imposed threats of fissure. Hydroxyapatite (HAP) is known to induce osteoblast like differentiation and provide mechanical strength, hence, used in bone tissue engineering; whereas, Nigella Sativa has also demonstrated potential to treat bone and muscle diseases. This study was aimed to develop potential orthopedic scaffold exploiting natural resources of Saudi Arabia which can be used as prospective tissue engineering implant. @*METHODS@#The bone scaffold was developed by grafting biogenic HAP with Nigella Sativa essential oil. Nigella Sativa was applied for boosting osteogenesis and to stimulate antimicrobial potential. Antimicrobial potential was investigated utilizing S. aureus bacteria. Spectroscopic and surface characters of Nigella Sativa grafted HAP scaffolds were analyzed using Fourier-transform infrared spectroscopy, X-ray crystallography and Scanning electron microscopy. To ensure biocompatibility of scaffolds; we selected C2C12 cell-lines; best model to study mechanistic pathways related to osteoblasts and myoblasts differentiation. @*RESULTS@#Grafting of HAP with Nigella Sativa did not affect typical spherical silhouette of nanoparticles. Characteristically; protein loaded polynucleated myotubes are result of in vitro myogenesis of C2C12 myoblasts in squat serum environment. @*CONCLUSION@#It is first study of unique combination of Nigella Sativa and HAP scaffold as a possible candidate of implantation for skeletal muscles regeneration. Outcome of this finding revealed Nigella Sativa grafted HAP enhance differentiation significantly over that of HAP. The proposed scaffold will be an economical natural material for hard and soft tissue engineering and will aid in curing skeletal muscle diseases. Our findings have implications for treatment of muscular/ bone diseases.

Nigella Sativa-Coated Hydroxyapatite Scaffolds: Synergetic Cues to Stimulate Myoblasts Differentiation and Offset Infections

BACKGROUND@#At present osteoporosis has come into view as a major health concern. Skeletal diseases typified by weak and fragile bones have imposed threats of fissure. Hydroxyapatite (HAP) is known to induce osteoblast like differentiation and provide mechanical strength, hence, used in bone tissue engineering; whereas, Nigella Sativa has also demonstrated potential to treat bone and muscle diseases. This study was aimed to develop potential orthopedic scaffold exploiting natural resources of Saudi Arabia which can be used as prospective tissue engineering implant. @*METHODS@#The bone scaffold was developed by grafting biogenic HAP with Nigella Sativa essential oil. Nigella Sativa was applied for boosting osteogenesis and to stimulate antimicrobial potential. Antimicrobial potential was investigated utilizing S. aureus bacteria. Spectroscopic and surface characters of Nigella Sativa grafted HAP scaffolds were analyzed using Fourier-transform infrared spectroscopy, X-ray crystallography and Scanning electron microscopy. To ensure biocompatibility of scaffolds; we selected C2C12 cell-lines; best model to study mechanistic pathways related to osteoblasts and myoblasts differentiation. @*RESULTS@#Grafting of HAP with Nigella Sativa did not affect typical spherical silhouette of nanoparticles. Characteristically; protein loaded polynucleated myotubes are result of in vitro myogenesis of C2C12 myoblasts in squat serum environment. @*CONCLUSION@#It is first study of unique combination of Nigella Sativa and HAP scaffold as a possible candidate of implantation for skeletal muscles regeneration. Outcome of this finding revealed Nigella Sativa grafted HAP enhance differentiation significantly over that of HAP. The proposed scaffold will be an economical natural material for hard and soft tissue engineering and will aid in curing skeletal muscle diseases. Our findings have implications for treatment of muscular/ bone diseases.

Comparison of effectiveness and cost of patent ductus arteriosus device occlusion versus surgical ligation of patent ductus arteriosus

Objectives: Comparison of effectiveness and cost of transcatheter occlusion of patent ductus arteriosus [DA] with surgical ligation of PDA

Methods: This retrospective comparative study was conducted in the pediatric cardiology department of Ch. Pervaiz Elahi Institute of Cardiology Multan, Pakistan. Data of 250 patients who underwent patent ductus arteriosus [PDA] closure either surgical or trans-catheter closure using SHSMA Occluder having weight >5 kg from April 2012 to October 2015 were included in this study. SPSS version 20 was used for data analysis. Quantitative variables were compared using independent sample t-test. Chi-square test and fishers exact was used for qualitative variables. P-value <0.05 was considered statistically significant

Results: There were one hundred and twenty [120] patients who underwent transcatheter occlusion of PDA using SHSMA occluder [PDA Device Group] and one hundred and thirty [130] patients who underwent surgical ligation of PDA [Surgical Group]

Incidence of residual shunting was two [1.5%] in surgical group and 0 [0.0%] in PDA Device group for one month follow up period

There were 4 [3.1%] major complications in surgical group. The rate of blood transfusions were high in surgical group [p-value 0.04]

Hospital stay time was significantly less in PDA Device group [P-value <0.001]

Total procedural cost was 110695+1054 Pakistani rupees in PDA Device group and 92414+3512 in surgical group [p-value <0.001]

The cost of PDA device closure was 16.52% higher than the surgical ligation of PDA

There was no operative mortality

Conclusion: The transcatheter closure of PDA is an effective and less invasive method as compared to the surgical ligation. There is a lower rate of complications and the cost is not much high as compared to surgical PDA ligation

A Comparative Study between Intranasal Midazolam and Intravenous Midazolam In Control Of Seizure In Children

Introduction: Seizures are one of the important reasons for children visiting the hospital. Febrile seizures are the most common type of seizures found in childhood. Earlier Diazepam was widely used for treating all types of seizures but due to short duration of action, newer drugs were tried and found better than diazepam. Aims: To compare midazolam given intranasally with midazolam given intravenously for the treatment of febrile seizures in children. Methods: This prospective study was conducted in children suffering from seizures at the Paediatric Emergency Department of Teerthanker Mahaveer Medical over a period of 12 months. 84 children between the ages of one months to fourteen years with febrile seizures lasting for at least 10 minutes were eligible for inclusion in our study.  Treatment was considered successful if the seizure ceased within one hundred twenty seconds Results: In group A out of 44 patients, 20(45.5%) patients were responded to Intranasal Midazolam, whereas   in group B 40 patients who were treated with IV Midazolam as first line treatment, 36 patients (90%) had responded to it.  Time recorded for the commencement was more in IV Midazolam group (1.598 min) than IN Midazolam group (0.379 min), but average response time was lesser in group B (1.009 min) than group A (3.001 min). Conclusion: Midazolam given intranasally is a safe and effective treatment for prolonged febrile seizures in children and may be used in general practice and, with appropriate instructions, by the parents of children with recurrent febrile seizures at home.

Recurrent mutation in CDMP1 in a family with Grebe chondrodysplasia: broadening the phenotypic manifestation of syndrome in Pakistani population

Grebe syndrome [OMIM-200700] is a very rare type of acromesomelic dysplasia with autosomal recessive inheritance. We studied a Pakistani family with two affected individuals having typical features of Grebe chondrodysplasia. Patients were observed with short and deformed limbs having a proximo-distal gradient of severity. Hind-limbs were more severely affected than fore-limbs. Digits on autopods were very short and nonfunctional. Index subject also had nearsightedness. However, symptoms in the craniofacial and axial skeleton were minimal. Genetic analysis revealed four base pair insertion mutation [c.1114insGAGT] in gene coding cartilage-derived morphogenetic protein-1 [CDMP1]. This mutation was predicted to cause premature stop codon. The clinical presentation in this study broadens the range of phenotypes associated with CDMP1 mutation in Pakistani population

Pharyngocutaneousfistula; its causes and management

Objective: to study the various causes and management of Pharyngocutaneous fistula in total laryngectomy

Material and Methods: 40 patients underwent total laryngectomy in service hospital Lahore from May 2003 to December 2014. The patients were prospectively studied regarding formation of Pharyngocutaneous fistula in the following aspects age, tumor site, and stage of disease, primary repair, infection and recurrence of tumor

Results: pharyngocutaneous fistula was diagnosed in 9 patients [22%] out of 40. Fistula developed in 2 patients [22%] on 3rd day due to rent in repair. 5 patients [55%] had fistulae due to infection on 8th day and 2 patients [23%] due to presence of residual tumor on 15th day. Pharyngocutaneous fistula is common complication which occurs after total laryngectomy. Three patients previously submitted to tracheostomy had fistula out of 5patients 6O %[ higher incidence] as compared to the 6 patients out of 35[17%] without tracheostomy. The reported incidence ofpharyngocutaneous fistula is extremely variable in literature ranging from 13% to 25% and in our series it is about 22 %

Conclusions: spontaneous closure is possible with proper wound care, good nutrition and antibiotics. 7 cases out of 9 in our series heeled with conservative treatment. Incidence of Pharyngocutaneous fistula formation is more in supraglottic, previously tracheostomised patients and also in advanced stage. In some patients surgical intervention is needed to close the fistula by flap. We used deltopectoral flapin two patients

Effect of precursors feeding and media manipulation on production of novel anticancer pro-drug camptothecin from endophytic fungus

We have established methodology for the isolation and characterization of a novel endophytic fungus from the inner bark of medicinal plant Nothapodytes foetida, which produced camptothecin in Sabouraud broth (SB) under shake flask conditions. Camptothecin and its related compounds are at present obtained by extraction from intact plants, but fungal endopytes may be an alternative source of production. In present study we have observed the effect of different nutrient combinations and precursors (tryptophan, tryptamine, geraniol, citral, mevalonic acid and leucine) on the accumulation of camptothecin by endophytic fungus Entrophospora infrequens. The precursors were fed either alone or in combinations (tryptophan and geraniol, tryptophan and citral, tryptophan and mevalonic acid, tryptophan and leucine). The highest camptothecin content was observed in the range of 503 ± 25µg/100g dry cell mass in Sabouraud medium. Camptothecin content in the medium was increased by 2.5 folds by the presence of tryptophan and leucine whereas the production with trytophan was also significantly different from other treatments. Furthermore, the effect of fungal camptothecin on the morphology of human cancer cell lines was also studied. The treated cells showed reduction in size, condensation of nucleus and the protoplasmic extensions were reduced. All these characteristics are found in apoptotic cells.

Rate and risk factors for surgical site infection at a tertiary care facility in Peshawar, Pakistan

Surgical site infections [SSI] are among the most common complications in surgical patients and have serious consequences for outcomes and costs. This study aimed to determine the rates and risk factors affecting surgical site infections and their incidence at Surgical 'C' Unit, Khyber Teaching Hospital, Peshawar, Pakistan. The study was conducted to compare with rates obtained by large international multi-centre studies. A review of all general surgical interventions involving an incision, excluding anal procedures, performed between December 2008 and March 2009 [n=269] was undertaken. Various clinical parameters were recorded. Infection rates were calculated. Data were analysed using the Fisher's exact test. The overall SSI rate was 9.294%, 4.88% in clean cases [C], 8.39% in clean contaminated cases [CC], and 20.45% in contaminated or dirty cases [D]. There were significantly higher surgical site infection rates among patients with combined American Society of Anaesthesiologists scores II and III than those with ASA score I in clean contaminated [p=0.0007], and dirty cases [p=0.0212]. There were also significantly higher surgical site infection rates among patients with combined Co-morbidity Scale score 1-6 than those with no comorbid factors in clean contaminated [p=0.0002]. Surgical site infection rate was highest in gastrointestinal system surgeries. The Surgical site infections can be minimised by adopting international protocols for surveillance

Diabetes mellitus; prevalence of high blood cholesterol, obesity, smoking and physical activity in urban population of Faisalabad

To estimate the prevalence of diabetes high total cholesterol obesity smoking and physical activity in urban population of Faisalabad. The project was limited to population based screening for above mentioned variables using WHO criteria. Study was conducted by holding numerous screening camps in different urban areas over the course of two years. People age 20 years or above were included in the study. Total 5349 people, 58% males [3102] and 42% females [2247] were screened for diabetes and high blood cholesterol. Body mass index was calculated by measuring height in meter square and weight in kilograms. People were interviewed for smoking and physical activity and relevant data was entered in the designed proforma. Within the chosen age range, total prevalence of diabetes was 16% and among them 11% were previously diagnosed and 5% were unaware of their diabetes [newly diagnosed]. Cholesterol was high [>/= 200 mg/dl] in 48% males and 34% females. 9.2% of the males were found to be obese [BMI>30] in comparison to 14.3% of females whereas 36.26% of males and 36.84% of females were overweight [BMI >/= 25 to 29.9 kg/m[2]]. The prevalence of smoking was 38.8% in males and 1.2% in females respectively. In daily routines only 6.8% of the males were doing the physical exercise [30 minutes exercise five days a week or equivalent] whereas among females it was 1.9%. Diabetes and metabolic syndrome in adults is now a global health problem, and the population of developing countries like Pakistan are facing this menace especially in the urban areas where it is on the rise with each passing day

Can fetal mortality be reduced by estimating maternal blood gas levels during intrapartum period?

The purpose of this study was to observe the affect of maternal asphyxia influencing the fetus and compare the maternal arterial blood gases [ABGs] and acid base levels of normal full term females with the full term females showing any subjective signs of fetal asphyxia during intrapartum period. In this case control study maternal ABGs and acid base levels of 40 normal term pregnant ladies were compared with 40 other term pregnant females with subjective signs of fetal asphyxia [i.e. fetal heart rate > 160bpm or< 120bpm, meconium staining of liquor, or Apgar score < 7 at one minute] during intrapartum period. Lactic acid and pH were also estimated to assess the acid base balance. There was considerable difference of lactic acid [LA] and Pco2 levels, which were significantly increased [P<0.025] in asphyxiated mothers [AM] as compared with control mothers [CM]. No significant difference was observed regarding pH values, ,bicarbonate ions [HCO[3]], base excess[BE],carbon dioxide content [CtCO[2]] andpercentage saturation of oxygen [%O[2]SAT] levels in both CM and AM groups. The levels of hemoglobin [Hb], packed cell volume [PCV], partial pressure of oxygen [PO[2]] and oxygen content [O[2]CT] in AM group were found significantly lower [P<0.0001] as compared to CM group. This study reveals a strong correlation between the fetal asphyxia and the mothers suffering from anemia, hypoxia or acidemia which may cause the fetal asphyxia during intrapartum period and need for proper investigations like blood gas and acid base analysis during intrapartum period for intervention in earlier phases of labor to prevent feto-ma-ternal mortality