Arthrographis curvata and Rhodosporidium babjevae as New Potential Fungal Lipase Producers for Biotechnological Applications

Abstract Fungi have always attracted a lot of attention as they are able to produce a vast repertoire of enzymes that find a broad spectrum of uses in biotechnological and industrial fields. Undoubtedly, one of the most promising biocatalysts is the lipase, which has been widely used for the biotransformation of a number of commercial products due to its high stability, high catalytic efficiency, versatility and selectivity, making it one of the most attractive and best-studied enzymes. In this study we report the isolation and molecular identification of new lipase-producing fungi from different environmental samples from Morocco. The production and activity of extracellular lipases, at different parameters, was evaluated using the Rhodamine B agar, submerged fermentation and biochemical methods. Two fungal strains Arthrographis curvata and Rhodosporidium babjevae, were isolated and found to produce large amounts of lipases. The optimal activity of the extracellular lipase was detected at 40°C and pH 9.0 for A. curvata and at 40 °C and pH 8.0 for R. babjevae. This study add new information at the growing list of fungal species producing lipases with improved physicochemical proprieties which could constitute a new line of research for further studies and to be exploited for industrial or bioremediation purposes.

Spectrum of gynecological malignancies at Jamshoro

Objective: To describe the frequency and spectrum of different types of gynecological malignancies. Study Design: An observational study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Liaquat University of Medical and Health Sciences, Jamshoro, from January 2014 to December 2015

Methodology: All patients with gynecological malignancies, admitted at the study place, whether previously diagnosed or need to establish the diagnosis on the basis of EUA, biopsy, staging and for surgery during the study period were included. All patients with benign gynecologic masses were excluded. Studied variables were age, marital status, parity, education, socioeconomic status, clinical presentation, clinical diagnosis, tumor site and surgical procedure. The diagnosis and type of malignancy was confirmed on the histopathology report of the specimen taken

Results: There were a total of 65 patients [6.39%] with gynaecological malignancies. The median age was 15 years [46.26%]. Ninety-four percent were married. Seventy-one percent had a poor socioeconomic status. Cervical cancer was most common as seen in 27 [41.5%] followed by ovarian malignancy in 21 [32.3%] of cases, uterine caners in nine [13.8%], vaginal cancer in six [9.2%], and vulval cancer in three [4.6%] of cases. The common histopathological type of cervical cancer was moderately differentiated squamous cell carcinoma [n=19, 29.2%], papillary serous cyst adenocarcinoma in ovarian [n=13, 20.0%], and squamous cell carcinoma in vagina and vulva. There was no case of primary fallopian tube malignancy

Conclusion: Gynecological malignancies are common in younger age group. The need is to strengthen screening practices, making it easy and cost-effective for all the general and at risk population, so that early detection and treatment can be possible to control the female genital tract cancers

Is there any link between accreditation programs and the models of organizational excellence? / ¿Existe una relación entre los programas de acreditación y los modelos de excelencia organizacional? / Existe uma relação entre os programas de acreditação e os modelos de excelência organizacional?

Abstract OBJECTIVE To evaluate whether accredited health organizations perform better management practices than non-accredited ones. METHOD The study was developed in two stages: a literature review, and a study of multiple cases in 12 healthcare organizations in the state of São Paulo, Brazil. It surveyed articles comparing hospital accreditation with the EFQM (European Foundation for Quality Management) model of excellence in management. According to the pertinent literature, the accreditation model and the EFQM model are convergent and supplementary in some aspects. RESULTS With 99% confidence, one can say that there is evidence that accredited organizations scored better in the evaluation based on the EFQM model in comparison to non-accredited organizations. This result was also confirmed in the comparison of results between the categories Facilitators and Results in the EFQM model. CONCLUSION There is convergence between the accreditation model and the EFQM excellence model, suggesting that accreditation helps the healthcare sector to implement the best management practices already used by other business sectors.

Resumen OBJETIVO Evaluar si la organizaciones sanitarias acreditadas tienen mejores prácticas de gestión que las no acreditadas. MÉTODO La investigación fue dividida en dos etapas: revisión de la literatura y estudio de casos múltiples con 12 organizaciones sanitarias, ubicadas en el Estado de São Paulo - Brasil. Fueron investigados artículos que comparaban la acreditación hospitalaria con el modelo de excelencia en gestión de la EFQM (European Foundation for Quality Management), siendo que la literatura pertinente considera que el modelo de acreditación y el modelo de la EFQM son convergentes y, a la vez, complementarios en determinados aspectos. RESULTADOS Con el 99% de confianza, se puede afirmar que existe evidencia de que las organizaciones con acreditación obtuvieron una puntuación mayor en la evaluación basada en el modelo EFQM comparativamente con las organizaciones no acreditadas. Dicho resultado también se confirmó en la comparación de los resultados de las categorías Facilitadores y Resultados del modelo EFQM. CONCLUSIÓN Existe una convergencia entre el modelo de acreditación y el modelo de excelencia de la EFQM, sugiriendo que la acreditación contribuye a que el sector de salud implemente las mejores prácticas de gestión ya difundidas en otros sectores de negocio.

Resumo OBJETIVO Avaliar se as organizações de saúde acreditadas possuem melhores práticas de gestão do que as não acreditadas. MÉTODO A pesquisa foi dividida em duas etapas: revisão da literatura e estudo de casos múltiplos com 12 organizações de saúde, localizadas no estado de São Paulo ‒ Brasil. Foram pesquisados artigos que comparavam a acreditação hospitalar com o modelo de excelência em gestão da EFQM (European Foundation for Quality Management), sendo que a literatura pertinente considera que o modelo de acreditação e o modelo da EFQM são convergentes e, ao mesmo tempo, complementares em determinados aspectos. RESULTADOS Com 99% de confiança, pode-se afirmar que há evidência de que as organizações com acreditação obtiveram uma pontuação maior na avaliação baseada no modelo EFQM comparativamente às organizações não acreditadas. Este resultado também se confirmou na comparação dos resultados das categorias Facilitadores e Resultados do modelo EFQM. CONCLUSÃO Há uma convergência entre o modelo de acreditação e o modelo de excelência da EFQM, sugerindo que a acreditação contribui para o setor de saúde implementar as melhores práticas de gestão já difundidas em outros setores de negócio.

Cancer incidence and mortality in the kingdom of Bahrain statistics and trends

Background: The availability of baseline data for cancer incidence and trends could help policy makers in implementing evidence-based strategies for cancer prevention, early detection and management

Objective: To evaluate the epidemiology of cancer among the Bahraini population from 1998-2011

Design: A Retrospective Study

Setting: Cancer Registry, Ministry of Health, Bahrain

Method: All cancer cases in the Bahrain Cancer Registry from 1 January 1998 to 31 December 2011 were reviewed

Result: Between January 1998 to December 2011, 5,966 newly diagnosed cases of cancer were documented, an annual average of 426 cases; 2,815 [47.2%] were males, and 3,151 [52.8%] were females. The average annual crude incidence cancer rate was 86.3/100,000 Bahraini males and 97.5/100,000 Bahraini females. The average annual world ASRs were 136.4 and 135.8/100,000 Bahraini males and females, respectively. During the 14-year period, the world ASRs for the Bahraini population appear to have declined in both sexes. The decline was more marked among males, as rates dropped from 160.9 in 1998 to 111.2/100,000 in 2011. The average annual agespecific incidence rates were observed to increase dramatically with advancing age in both genders

Conclusion: During the 14-year period, the average annual world ASRs were 136.4 and 135.8 per 100,000 Bahraini males and females respectively, which is higher than GCC states and lower than Australia/New Zealand

Spatial analysis and modeling of infant mortality rate using conditional autoregressive model- a case study of Punjab, Pakistan

Background: Many Asian countries have persistently high infant mortality because of various biological and social determinants. In particular, infant mortality has increased in Asia in recent decades. The geographic distribution of people having health problems and its relationship to potential risk factors can be of great value for planning cost effective interventions

Objectives: To determine and map the spatial nature of infant mortality in Punjab, at district level and model fit spatial autocorrelation

Materials and Methods: This paper identified and mapped high risk clusters of infant mortality by mapping the infant mortality rate, as well as examines the impact of range of determinants on infant mortality by regressing 15 socio-economic covariates on dependent variable i.e. infant mortality rate by using Multiple Regression model and Conditional Autoregressive Model to quantify spatial risk of infant death

Results: The results showed that the Conditional Autoregressive model yield more reliable results as compared to the multiple regression mode] having lower value of Akaike Information Criterion i.e. 257.8 as compared to multiple regression model i.e. 283.9. The analysis showed that household size, literacy of women, houses having place of hand wash, women having comprehensive knowledge of HIV transmission, households getting benefits from government schemes of social protection and the ownership of assets etc. had low infant mortality rate while adolescent birth rate, underweight live births, unwilling pregnancy, early marriage, infant suspected pneumonia in the last two weeks, people diagnosed with Hepatitis during last one year had high infant mortality rate

Conclusion: Spatial analysis was useful in accessing the determinants of infant mortality rate

Endoscopic ultrasound-guided biliary drainage

Endoscopic ultrasound-guided biliary drainage (EUS-BD) is emerging as a safe and effective alternative for endoscopic BD. The advantage of multiple access points from stomach and duodenum allows EUS-BD in patients with altered surgical anatomy and duodenal stenosis. EUS-BD is also useful in patients with failed endoscopic retrograde cholangiopancreatography or difficult biliary cannulation. Depending on the access and exit route of the stent, a variety of EUS-BD procedures have been described. Trans-papillary as well as trans-luminal stent placements are possible with EUS-BD. Recent studies have shown a clinical success rate in excess of 90% and complication rates of < 15%. Prospective studies are needed to know the long-term results and relative efficacy of this technique.

Genetic and molecular analysis of the CLDN14 gene in Moroccan family with non-syndromic hearing loss.

BACKGROUND: Hearing loss is the most prevalent human genetic sensorineural defect. Mutations in the CLDN14 gene, encoding the tight junction claudin 14 protein expressed in the inner ear, have been shown to cause non‑syndromic recessive hearing loss DFNB29. AIM: We describe a Moroccan SF7 family with non‑syndromic hearing loss. We performed linkage analysis in this family and sequencing to identify the mutation causing deafness. MATERIALS AND METHODS: Genetic linkage analysis, suggested the involvement of CLDN14 and KCNE1 gene in deafness in this family. Mutation screening was performed using direct sequencing of the CLDN14 and KCNE1 coding exon gene. RESULTS: Our results show the presence of c.11C>T mutation in the CLDN14 gene. Transmission analysis of this mutation in the family showed that the three affected individuals are homozygous, whereas parents and three healthy individuals are heterozygous. This mutation induces a substitution of threonine to methionine at position 4. CONCLUSION: These data show that CLDN14 gene can be i mplicated in the development of hearing loss in SF7 family; however, the pathogenicity of c.11C>T mutation remains to be determined.

Breast cancer risk assessment among Bahraini women

To estimate breast cancer risk among Bahraini women aged 35 years and older attending primary healthcare centers. Primary healthcare centers. Cross sectional descriptive study. One hundred seventy-two women aged 35 years and older were assessed for the risk of invasive breast cancer risk using the modified Gail model. The study was performed from 1 February to 31 May 2005. A questionnaire was used to collect information on five years and lifetime breast cancer risks. Four percent of the women had a high risk [

Prevalence of MRSA in a peripheral hospital of Lahore

The rate of MRSA in increasing in hospitalized patients all over the world. The present study is done to find out the prevalence of MRSA in a peripheral hospital of Lahore over a period of one year from January to December 2009. Study was done by finding out percentage of MRSA among all the Staphylococcus aureus isolated from admitted patients of Ghurki Trust Teaching Hospital. Results show that 50% of all the S. aureus were MRSA

Breast cancer knowledge among Bahraini women attending primary health care centers

To evaluate breast cancer knowledge among Bahraini women aged 20 years and more attending primary health care centers. Primary health care. Cross sectional descriptive study. Three hundred Bahraini women attending the primary health care clinics were interviewed from 1st February to 31st May 2005. A multistage sample was selected with a cluster sampling technique for the selection of one health center from each region; five health centers were selected. The sample was stratified according to the percentage of females residing in each region. A semi-structured questionnaire was used for interviewing the study participants. Seventeen [5.6%] women knew more than half of the correct answers, and the mean "Percent Knowledge Index" was 32.1% +/- 12.7%. Newspapers, television, radio, were identified as the main source of knowledge of breast cancer. Highly educated women were more knowledgeable about breast cancer [p=0.002], diagnostic modalities [p=0.008], and risk factors [p<0.0001]. Women with positive family history of breast cancer knew more about treatment modalities than those without a history [p=0.017]. Moreover, no significant differences were found between the general knowledge and its subtypes among women with positive or negative personal history of breast complaints. Breast cancer knowledge was deficient among Bahraini women. Efforts to improve women's education should be encouraged. Breast cancer should be included as a subject in the high school curricula, with emphasis on modifiable risk factors. The maximum use of media should be encouraged in breast cancer campaigns

Prevalence of peripheral vascular calcifications in patients on chronic hemodialysis at a tertiary care center in Beirut a pilot study

Vascular calcifications are highly prevalent in patients maintained on chronic hemodialysis. They have been linked to numerous risk factors and have been associated with an increased risk of cardiovascular morbidity and mortality. The purpose of this pilot study is to assess the prevalence of vascular calcifications among dialysis patients in our tertiary care center and to identify the associated risk factors. In the current study, we reviewed the charts of 43 patients undergoing hemodialysis at our center. We estimated the prevalence of vascular calcifications among dialysis patients using plain X-ray of the hand as the screening tool. We compared patient's characteristics and tried to identify possible risk factors, with a special emphasis on the subgroup of patients with diabetes. Vascular calcifications were prevalent among half of the patients on hemodialysis. Duration of dialysis [p = 0.02], diabetes [p < 0.001], and hypertension [p = 0.01] were highly associated with vascular calcifications. No association was found between vascular calcifications and age, gender, calcium-based phosphate binders, vitamin D supplementation, smoking, and lipid control. In multivariate analyses, diabetes and duration of dialysis were the only independent predictors of vascular calcifications and diabetics developed vascular calcifications earlier than nondiabetics [31 months vs 69 months]. Vascular calcifications are moderately prevalent among patients undergoing hemodialysis at our center, and were found to be strongly correlated with diabetes and duration of dialysis. A larger, multicenter, prospective study should be conducted at national level, in order to confirm the findings of this study and to identify further modifiable risk factors, to decrease the incidence of vascular calcifications and the incurring cardiovascular morbidity and mortality in our population

Helicobacter pylori infection in patients with dyspeptic symptoms having normal endoscopy

To find out the frequency of Helicobacter pylori infection in the local population presenting with dyspeptic symptoms but having normal upper gastrointestinal endoscopic findings. This descriptive study was carried out in gastroenterology department of Military Hospital Rawalpindi. The study was conducted in the department of gastro intestinal of Military Hospital Rawalpindi from November 2004 to September 2005. Hundred cases of dyspepsia having normal upper gastrointestinal endoscopy were taken as study population. Although the gold standard for presence or absence of Helicobacter pylori infection is culture but in this study the diagnostic method used was histopathology of gastric antrum. The male and female ratio was 2:1. Majority of the patients were either 40 years of age or less, mean age being 40.52 [sd +/- 13.22]. The chief symptoms were pain epigastrium [46%] and upper abdominal discomfort [27%]. Helicobacter pylori gastritis was found in 51% of cases. We conclude that Helicobacter pylori infection is quite common in dyspeptic patients apparently having normal endoscopic gastric mucosal findings. Eradication therapy should be instituted in positive cases to avoid its long-term complications

Serological immune status of hepatitis-B in vaccinated healthy individuals

This study was planned to assess the Hepatitis-B serological immune response in previously vaccinated students and staff members of various faculties of Lahore Medical and, Dental College Lahore. The objective was to evaluate the effectiveness of hepatitis B vaccination in prevention of hepatitis infection, chronic liver disease and recommendation of booster dose after primary course of vaccination. The study group comprised of 276 volunteers including MBBS/BDS students and 16 staff members of different faculties. Age range among students was 17-25 years whereas staff members were 30-50 years in age. Among 276 volunteers 46% were males and 54% were females. The levels of hepatitis B surface antibodies were assessed in blood/ serum by enzyme linked immunosorbant assay [ELISA] technique. Among 276 volunteers 230 SIGMA had detectable antibodies against hepatitis B surface antigen [aHBs] while 46 [18%] showed no detectable level of antibodies against hepatitis B surface antigen [aHBs] in their serum. The titer of antibodies against hepatitis B surface antigen [aHBs] was low among staff members who were in age group of 30-50 years [n4, 0.25%] A decline in titer was observed during adolescence

Perinatal mortality and related obstetric risk factors at a tertiary care hospital of Hyderabad

Objective: To determine perinatal mortality rate and its related obstetric risk factors in our setup. Design: Observational study. Setting: Department of Obstetrics and Gynaecology [Unit-I], Liaquat University Hospital Hyderabad, from January to December 2006

Patients and Methods: All perinatal deaths including stillbirths [SBs] and early neonatal deaths [ENNDs] within 0-7 days of birth after 24 weeks of gestation were studied during the study period, while Pregnancies <24 weeks of gestation were excluded from the study. The relevant information was collected through a pre-designed proforma which contained variables including maternal demographics, obstetric risk factors and other details

Results: A total number of 2224 deliveries were analysed for perinatal mortality. Out of these, there were 224 perinatal deaths giving a PNMR of 100.7/1000 births. There were 196 SBs and 28 ENNDs. Among these, 88% women were unbooked. Commonest risk factors was antepartum haemorrhage [27.67%], followed by hypertensive disorders of pregnancy [23.21%] and mechanical factors affecting labour [14.28%]. Congenital abnormalities were found in 9.8% of PNDs while maternal medical disorders were seen in 6.25% cases. In 3.5% cases, chorioamnionitis/ neonatal septicaemia was the underlying cause and multiple pregnancies were seen in only 02 [0.89%] cases. However, in 32 [14.28%] cases, no cause was found

Conclusion: The high perinatal mortality rate in present study is comparable to the figures from other institutions. Main reason being lack of antenatal and pre-pregnancy care where from almost all obstetric risk factors can be picked up and treated / prevented

Post dural puncture headache after spinal anaesthesia for caesarean section: a comparison of 25G Quincke, 27G Quincke and 27G whitacre spinal needles

To compare the frequency and severity of post dural puncture headache in obstetric patients using 25G Quincke, 27G Quincke and 27G Whitacre spinal needles. Comparative, randomized, double-blind, interventional study. Liaquat University Hospital Hyderabad from October 2005 to December 2006. 480 ASA I-II full term pregnant women, 18 to 45 years of age, scheduled for elective Caesarean section, under spinal anaesthesia, were randomized into three groups: Group I [25G Quincke spinal needle: n=168], Group II [27G Quincke spinal needle: n=160] and Group III [27G Whitacre spinal needle: n=152]. Spinal anaesthesia was performed with 1.5-2.0 ml 0.75% hyperbaric bupivacaine using 25G Quincke spinal needle [Group I], 27G Quincke spinal needle [Group II] and 27G Whitacre spinal needle [Group III] at L3-4 inter-vertebral space. Each patient was assessed daily for four consecutive days following Caesarean section. Frequency and severity and of postdural puncture headache [PDPH] were recorded. Data were analyzed using SPSS-11. Frequency of PDPH following the use of 25G Quincke [Group I], 27G Quincke [Group II] and 27G Whitacre [Group III] spinal needles was 8.3% [14/168], 3.8% [6/160] and 2.0% [3/152] respectively. In Group I, PDPH was mild in 5 patients, moderate in 7 patients and severe in 2 patients. In Group II, it was mild in 2, moderate in 3 and severe in 1 patient. In group III, it was mild in 2 and moderate in 1 patient. Severe PDPH did not occur in Group III. Most of the patients with PDPH developed it on first and second postoperative day. When using a 27G Whitacre spinal needle, the frequency and severity of PDPH was significantly lower than when a 25G Quincke or 27G Quincke needle was used

Clinico-epidemiological study Of children Asaad Abdulah admitted to emergency department almansor teaching hospital for childreen, Baghdad

Cross-Section Descriptive study in emergency department Almasnor Teaching Hospital for Children, Baghdad. Aim of the study: Assess clinico-epidemiological character of children admitted the emergency department. The mean age of admission to emergency department was 28.8 +/- 39.01 months. Male to female ratio of 1.74: Most of patients lived in urban area. The mean age of mother or caretaker 27.22 +/- 7.72 years. Most of mother or caretaker were having primary or secondary school education level. Most of patients were admitted at night followed by afternoon time. First admission reported in [71.5] and 21[15.3%] with second admission and the other 18 [13.1%] had more than two admissions. Self-referral was the main source of admission. Half of patients were admitted because of GIT disease, while 9.9% because of respiratory system disease, followed by neurological disease in 33.9% and [4.1%] because of CVS disease. Discharged from hospital was the main outcome, three of patients had medical admission, and only two patients referred to surgical operation

audit of post-partum morbidity

The aim of this study was to identify common patterns of complications during labour and postnatal period, reduce the frequency of adverse events, modify the guidelines and for continuing education. Peurperal pyrexia is commonly defined as a temperature elevation of 38°C on two occasions after 24 hours post-partum and for six weeks. The causes include abscesses, haematoma, wound infections of abdominal or perineal wounds, urinary tract infection [UTI], pulmonary and breast pathology, uterine infections, deep vein thrombosis [DVT]. septic pelvic vein thrombophlebitis and ovarian vein thrombosis. Peurperal sepsis is an avoidable condition to a certain extent. Adequate antenatal, intra-partum and post-partum care should reduce the frequency