Efficacy of genotype-matched Newcastle disease virus vaccine formulated in carboxymethyl sago starch acid hydrogel in chickens vaccinated via different routes

Background@#The commercially available Newcastle disease (ND) vaccines were developed based on Newcastle disease virus (NDV) isolates genetically divergent from field strains that can only prevent clinical disease, not shedding of virulent heterologous virus, highlighting the need to develop genotype-matched vaccines Objectives: This study examined the efficacy of the NDV genotype-matched vaccine, mIBS025 strain formulated in standard vaccine stabilizer, and in carboxymethyl sago starch-acid hydrogel (CMSS-AH) following vaccination via an eye drop (ED) and drinking water (DW). @*Methods@#A challenge virus was prepared from a recent NDV isolated from ND vaccinated flock. Groups of specific-pathogen-free chickens were vaccinated with mIBS025 vaccine strain prepared in a standard vaccine stabilizer and CMSS-AH via ED and DW and then challenged with the UPM/NDV/IBS362/2016 strain. @*Results@#Chickens vaccinated with CMSS-AH mIBS025 ED (group 2) developed the earliest and highest Hemagglutination Inhibition (HI) NDV antibody titer (8log 2 ) followed by standard mIBS025 ED (group 3) (7log 2 ) both conferred complete protection and drastically reduced virus shedding. By contrast, chickens vaccinated with standard mIBS025 DW (group 5) and CMSS-AH mIBS025 DW (group 4) developed low HI NDV antibody titers of 4log 2and 3log 2 , respectively, which correspondingly conferred only 50% and 60% protection and continuously shed the virulent virus via the oropharyngeal and cloacal routes until the end of the study at 14 dpc. @*Conclusions@#The efficacy of mIBS025 vaccines prepared in a standard vaccine stabilizer or CMSS-AH was affected by the vaccination routes. The groups vaccinated via ED had better protective immunity than those vaccinated via DW.

Determination of specificity and pattern of antinuclear antibodies [ANA] in systemic rheumatic disease patients positive for ANA testing

Objective: To determine probability of finding antinuclear antibodies [ANA] and anti extractable nuclear antigens [ENA] positive samples and associating ANA patterns with anti-ENA reactivities among a consecutive cohort of samples of systemic rheumatic disease patients referred for ANA testing. Study Design: Prospective cohort study. Place and Duration of Study: Immunology Department, Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from January to June 2016

Methodology: All the samples referred for ANA testing with clinical suspicion of systemic rheumatic disease were included. After screening, ANA positive samples were subjected to anti-ENA antibodies testing [including anti-SSA, antiSSB, anti-Sm, anti-RNP, anti-SCL-70 and anti-Jo-1 antibodies] and ANA pattern and titer determination

Results: Of 4,347 samples received, 397 were positive for ANA [9%]. Of 397, 96 [24%] samples positive on ENA screen were tested for anti-ENA reactivity. Anti-SSA antibodies were found in 59 samples. Commonest ANA patterns were coarse and fine speckled [43 and 22 samples of 81 tested], while majority of samples carried ANA in titers of 1:40 and 1:80 [22 and 18 samples of 81 tested]. No specific ANA pattern was associated with any particular anti-ENA reactivity

Conclusion: Among samples/patients referred for investigations of autoimmune disorders, probability of finding positive ANA is approximately 9%. Of these 9%, about 24% also show reactivity against ENA. Commonest ANA pattern is coarse speckled and majority of such patients carry ANA in titers ranging from 1:40 to 1:80. Commonest ENA reactivity was against SSA

Leukocyte adhesion deficiency type 1 with low expression of CD 11b

Leukocyte adhesion deficiency type 1 [LAD-1] is a rare autosomal recessive disorder caused by mutations in the gene that codes for CD18, the beta chain of beta-2 integrins, located on the long arm of chromosome 21. This defect results in failure of leukocyte migration to the site of infection due to the absence of surface integrins. Leukocyte adhesion deficiency should be suspected in any patient with recurrent infections, impaired wound healing, history of delayed umbilical cord separation, periodontitis, leukocytosis, recurrent soft tissue and oral infections. Diagnosis is based on the analysis of neutrophils for the surface expression of CD18, CD11a, CD11b and CD11c by flow cytometry. Here, we present a 55-day male infant with umbilical cord separation on the 10th day of life and no history of infection, who was identified with LAD-1 with low expression of CD11b. The purpose of performing LAD flow cytometric analysis in this patient was to screen him for LAD-1 as his elder brother had LAD-1 and one elder sister died undiagnosed with recurrent skin and chest infections at 8 months of age

unusual case of inflammatory myofibroblastic tumor of the appendix masquerading as acute appendicitis

Inflammatory myofibroblastic tumor [IMT] is reported virtually in every anatomic location of the body, but most cases are commonly identified in the mesentery and omentum. The etiology of this tumor is unclear with many suggestions of viral, inflammatory, or oncogenic mutational factors that establish it as a clonal neoplasm. Clinical and laboratory workup, including roentgenography, is not usually helpful to reach a pre- or intraoperative diagnosis. Histopathology and immunohistochemistry of the resected specimen provides a definitive answer by the exclusion of a close clinical differential diagnosis of gastrointestinal stromal tumor and many lookalikes. Complete surgical excision with clear margins is the mainstay of treatment. Rare cases have been seen involving the appendix. To the best of our knowledge, only 11 confirmed cases of purely appendiceal IMT have been published in the literature to date

Spectrum of acute leukemias and aberrant markers expression based on flowcytometry in a tertiary care centre

Objective: To determine frequency of different types of leukemias and aberrant CD markers expression on these types. Study Design: Descriptive study. Place and Duration of Study: Department of Immunology, Armed Forces Institute of Pathology, Rawalpindi from Jul 2015 to Dec 2015

Material and Methods: All peripheral blood and bone marrow samples to confirm the suspicion of acute leukemia with flow cytometric immunephenoltyping were included in the study. Cells were stained with lineage specific monoclonal antibodies against cell specific CD markers through lyse wash procedure. Cell acquisition and analysis was done on Cell Quest software in multi parameter flow cytometer. Data was entered in SPSS v 20.0 to determine the frequencies of different types of leukemias and aberrant CD markers expression

Results: Over 6 months, 102 males and 49 females were tested with mean age 26 +/- 21 years. Commonest leukemia was AML M2. Among 69 pediatric cases with mean age 7.4 +/- 5.8 years, precursor B ALL was commonest. Among 82 adults with mean age 41.5 +/- 15.7 years, AML M2 was commonest leukemia. Total 32 cases [18 children and 12 adults] expressed cross lineage aberrant markers, CD13, CD33 and CD7

Conclusion: Aberrant CD markers expression must be kept in mind during lineage assignment of acute leukemias while performing flow cytometric immunophenotyping

Frequency of self-monitoring of blood glucose among cases of type two diabetes mellitus

Background: Diabetes mellitus [DM] is a common and a high burden health issue. It can lead to various organ damages due to wide range of pathophysiological mechanisms. Good glycemic control is the best choice and self-monitoring of blood glucose [SMBG] seems an important step

Objective: To determine the frequency of patients doing self monitoring of blood glucose [SMBG] in cases with type II diabetes mellitus

Methodology: This cross sectional study was conducted from 1[st] June to 31[st] December 2016. There were total 100 cases of type II DM enrolled in this study. The SMBG was labeled on basis of documentation of fasting and postprandial blood glucose values with date and time of blood glucose testing and any action taken if needed [e.g. increase in dose of oral hypoglycemic agents, change in oral hypoglycemic agents], after seeing the blood glucose values, for at least once per day over the last 6 weeks. The data was entered and analyzed by using SPSS version 20

Results: In this study there were total 100 cases out of which 55 [55%] were females and 45 [45%] males. The mean age of study subjects and duration of type II DM were 45.31+/-7.13 year and 6.14+/-3 years respectively. The SMBG was done by 68 [68%] of cases. In this study, 29 [64.44%] out of 45 and 39 [70.91%] out of 55 females did SMBG with p= 0.74. There was significant association in terms of both residential status and education level with SMBG with p values of 0.01 and 0.001 respectively

Conclusion: Self monitoring of blood glucose was carried out in almost every 2/3[rd] of patients with type II diabetes mellitus and it is significantly higher in cases from that are urban area and having education level more than graduation

Metabolic syndrome in cases with hepatitis C virus infection

Background: Hepatitis C virus [HCV] infection is one of the leading causes of morbidity and mortality in the developing world and metabolic syndrome can further worsen the condition

Objective: To determine the frequency of metabolic syndrome in cases with hepatitis C virus infection

Methodology: A total of 90 patients diagnosed as cases of HCV infection either by PCR or ELISA were selected in this cross sectional study, from 1[st] July to 31[st] December 2016. Detailed sociodemographic data like age, gender, weight, height, BMI and clinical data like duration of HCV, and other data like waist circumference, lipid profile [fasting], blood sugar, blood pressure were also recorded. Metabolic syndrome was labelled as yes according to National Cholesterol Education Program Adult Treatment Panel III criteria for Asian-Americans. The data was analyzed by using SPSS version 21

Results: In this study there were 90 cases out of which were 60 [66.67%] were males and 30 [33.33%] females. The mean age was 41.23 +/- 7.16 years and mean duration of HCV was 7.41 +/- 3.24 years. Metabolic syndrome was seen in 16 [17.78%] of the cases. It was seen in 11 [18.33%] out of 60 males and 5 [16.67%] out of 30 females with p value of 1.12. On stratification of age groups, it was seen in 10 [19.23%] out of 42 cases in age group of 15 to 39 years [p= 0.89]. The results were significantly associated with metabolic syndrome and HCV where was maximum cases were seen in cases that had the duration of HCV more than 3 year where its was seen in 12 [27.27%] out of 32 cases with p value of 0.01

Conclusion: The prevalence of metabolic syndrome in cases with HCV infection is not uncommon and the duration of HCV infection more than 3 years is significantly associated with metabolic syndrome

Immunophenotyping pattern in mixed phenotype acute leukaemias

Objective: To evaluate Immunophenotyping patterns in Mixed-Phenotype Acute Leukemias [MPAL]

Study Design: Descriptive study

Place and Duration of Study: This study was carried out in the department of Hematology, Armed Forces Institute of Pathology Rawalpindi, from 1st Jan 2013 to 31st Jan 2017

Material and Methods: After taking informed consent from the patients fulfilling the inclusion criteria, detailed history was taken and blood samples were drawn for blood complete picture. The patients suspected to have acute leukemia were subjected to bone marrow examination [aspiration and trephine biopsy] for further cytochemical staining [SBB] and Immunophenotyping

Results: Total 680 new cases of acute leukemias on initial workup of either gender age were included. Patients of other haematological disorders were excluded from the study. Among 680 new cases of acute leukaemia, 23[3.4%] cases were of MPAL immunophenotyping using scoring system proposed by EGIL [European Group for the Immunological Characterization of Leukemias] classification. Among MPAL, 19[83%] cases were Biphenotypic [13[57%] cases of My/B-ALL, 5[22%] cases of My/T-ALL, and 1[4%] case of T/B-ALL]. 4[17%] cases were Bilineage [My/B-ALL]. Most of the cases were diagnosed at less than 10 years of age

Conclusion: My/B-ALL is the most common immunophenotype followed by My/T-ALL. Therefore immunophenotyping is indispensable for diagnosis and for therapy decisions of MPAL]

Prevalence of human leukocyte antigen [HLA] B27 among patients of spondyloarthropathies referred to a tertiary care center

Objective: To determine prevalence of HLA-B27 among patients of spondyloarthropathies

Study Design: Cross sectional study

Place and Duration of Study: Department of Immunology, Armed Forces Institute of Pathology Rawalpindi Jan 2015 to Aug 2016

Material and Methods: All peripheral blood samples of spondyloarthropathy patients received for HLA-B27 typing were included in the study. Cells were stained with monoclonal antibodies against HLA-B27 and CD3 using lyse wash procedure. Cell acquisition and analysis was done on Cell Quest software in multi parameter flow cytometer. Data was entered in SPSS 20.0 to determine the frequency of HLA-B27 positive individuals

Results: Over 20 months, 252 males and 77 females [total 329] were tested with age ranging from 5 to 80 years. Total 77 patients [23.4%] including 66 males [26.2%] and 11 females [14.3%] were positive for HLA-B27

Conclusion: Nearly 23% patients of spondyloarthropathies carry HLA-B27 antigen, with male's predominance [26% vs 16%]

Outcome of shish kabab osteotomies fixed with SIGN NAILI in osteogenesis imperfecta. our experience at Ghurki Trust Teaching Hospital, Lahore, Pakistan

Objective: To evaluate the results of shish kabab osteotomies fixed with SIGN NAIL in long bone deformities of patients suffering from osteogenesis imperfect

Methods: This study was carried out on 12 patients who presented in OPD or Emergency Department with deformities of long bones. Detailed history, examination and investigations including X-ray AP and Lateral view of involved bone were done. All these cases were treated with Shish Kabab Osteotomies and SIGN NAILunder spinal or general anaesthesia. These cases were followed up for up to average of 20 months [range 06 months -6 years ] and results of the nail were observed in terms of union, rehabilitation and complications

Results: It was found that 8 [66.7%] were male and 4 [33.3%] were females with a mean age of 14.83 +/- 5.24. 5 [41.7%] patients having age 10-15 years and 7 [58.3%] were between 16-20 years. Total 21 surgeries performed. 3[25.0%] had surgery on unilateral femur,2 [16.7%] on unilateral tibia, 3[25.0%] on both unilateral tibia and femur,3 [25.0%] had surgery on bilateral tibia and 1[13.3%] with bilateral tibia and femur. The parents of all patients had a first degree consanguineous marriage. The mean hospital stay were 4.17 +/- 1.75 days. All osteotomies sites heal within 06 months, better bone densities, 1 Having recurrence of deformity and no fracture were found. Only two patients using walkers while remaining need no support for walking

Conclusion: Sign Nail along with shish kabab osteotomies in deformities of osteogenesis imperfecta is the treatment of choice. Patient rehabilitation is early, hospitalization is short, and osteotomies site healing response is good as well as decrease risk of fracture

Serum zinc and immunoglobulin G levels in lower and upper/ upper middle socioeconomic groups

Objective: to assess the serum zinc and serum immunoglobulin G levels in different socioeconomic groups

Methods: hundred subjects in total were investigated. Out of these, 50 [25 males and 25 females] belonged to the lower socioeconomic [LSEC] group and 50 [25 males and 25 females] belonged to the upper/ upper middle socioeconomic [USEC] group. Estimation of serum zinc was made by colorimetric method whereas serum immunoglobulin G [lgG] was determined by the immunoturbidimetric assay. A comparison of both parameters was made between the two socioeconomic [SEC] groups

Results: results revealed significantly low serum zinc in the LSEC group as compared to the USEC group. Similarly serum lgG levels were also significantly low in the LSEC group. Serum lgG levels did not show significant gender difference in the ·LSEC group however it was significantly higher in females than in males in the USEC. Generally a significantly positive correlation was found between serum zinc and serum lgG levels

Conclusion: the LSEC class has low serum zinc levels and low serum lgG levels and hence is at greater risk of developing infections

Impairment of renal function in non-proteinuric diabetic patients

Objective: to evaluate renal function in non-proteinuric diabetic patients

Material and Methods: it was a descriptive analytical study, conducted in University of Health Science Lahore, from February 2010 to January 2011, with a sample size of 195 diabetic subjects. They were divided equally among normoalbuminuric, microalbuminuric and macroalbuminuric groups, according to their daily urinary albumin excretion rate [AER], with 65 patients in each group. Their renal function status and GFR was evaluated by conducting tests on serum and urine samples. Kruskal-Wallis test and Mann-Whitney U test were used to observe differences of medians in different groups. p value less than 0.05 was taken statistically significant

Results: there was predominance of males in microalbuminuric and macroalbuminuric groups while females were more in number in normoalbuminuric group. Majority of normoalbuminuric individuals were unmarried, while married individuals were prevalent in microalbuminuric and macroalbuminuric group. Significant differences were found in serum urea concentration, serum creatinine concentration, serum uric acid concentration, glomerular filtration rate, urinary creatinine concentration, urine flow rate, daily albumin excretion rate and urinary albumin concentration among the three groups. Urinary creatinine concentration and glomerular filtration rate were in the highest ranges in normoalbuminuric group and in the lowest ranges in macroalbuminuric group. While rest of the parameters [ie. age, duration of diabetes, serum urea concentration, serum creatinine concentration, urine flow rate, daily AER , urinary albumin concentration and serum uric acid concentration] were in the lowest ranges in normoalbuminuric group and in the highest ranges in macroalbuminuric group. There was significant renal function impairment in microalburoinuric stage of diabetic nephropathy. p <0.05 was taken statistically significant

Conclusion: it is concluded that impairment in renal function occurs even in microalbuminuric stages of diabetic nephropathy. Renal functions are impaired even in the diabetic patients who have not yet developed frank proteinuria

Antimicrobial and toxicological studies of Ochthochloa compressa plant

The present study demonstrates the biological activity of Ochthochloa compressa, since extensive literature survey has shown no documented biological activity of this plant. Ethanolic extract of whole plant was prepared and evaporated under reduced pressure by rota vapor

The crude extract was further fractionated into n- hexane, dichloromethane, ethyl acetate and n-butanol soluble fractions

These fractions were screened for antifungal, phytotoxic, cytotoxic and antibacterial activities

Dichloromethane soluble fraction showed significant phytotoxicity whereas n-hexane, ethyl acetate, and n-butanol soluble fractions showed non-significant phytotoxicity

Similarly, ethyl acetate soluble fraction was the only fraction, which showed significant cytotoxic activity

There was no antibacterial but moderate antifungal activity was shown by these fractions against selected strains of bacteria and fungi. This is the first report on the biological activity of O. compressa

outcome of microvascular free flap surgery with or without the use of postoperative heparin

Objective: To determine the outcome of microvascular free tissue transfer with or without use of postoperative heparin in terms of flap viability and postoperative complications. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Plastic Surgery, King Edward Medical University, Lahore, from July 2010 to July 2012

Methodology: Thirty eight patients requiring elective or emergency microvascular free tissue transfer were selected. Those with poly-trauma, previous failed free flap and re-anastomosis of vessels were excluded from the study. All anastomoses were performed by trained microvascular surgeons. Per operatively, Aucland test was performed to ensure anastomotic patency. Thereafter, patients were divided into two groups: in group A, heparin was not given postoperatively and in group B, heparin was given postoperatively. The flaps were monitored for signs of vascular compromise, viability or non-viability and complications of the procedure. Chi-square test was used to compare the distribution of qualitative variable in two groups. P-value less than 0.05 was considered significant

Results: In group A, the number of viable flaps was 13 [81%] and non-viable flaps were 3 [19%]. In group B the number of viable flaps was 11 [73%] and non-viable flaps were 04 [23%] [p = 0.68]. There was no significant difference regarding postoperative complications between the two groups [p > 0.05]

Conclusion: Postoperative heparin does not appear to have an influence on the viability or complications of free flaps

Calcium status of female and male medical students

Objective: to assess the calcium status of healthy female and male medical students

Material and Methods: this cross sectional study was carried out in 30 female and 30 male healthy medical students in Department of Physiology, Services Institute of Medical Sciences, Lahore. Subjects were selected according to the inclusion criteria. Height and weight of each subject was determined and BMI was calculated. Serum calcium was determined by colorimetric method. Serum parathyroid and calcitonin were estimated by the ELISA

Results: the height and weight of female students were significantly less than those of male students. BMI of female students was non-significantly lower than those of male students. In female students, serum calcium and calcitonin levels were significantly lower while serum parathyroid hormone was non significantly lower than in male students. A significant positive correlation between serum calcium and serum calcitonin levels and significant negative correlation between serum calcium and parathyroid hormone levels were found in total study population. Significant correlations of serum calcitonin with weight and height were also present

Conclusion: the female medical students have low calcium status and are more prone to have bone loss