review on requirements for vitamin D fortification in Pakistan

Despite the fact that Pakistan is a country situated near equator and has plenty of sunshine, it still has major population deficient in vitamin D3. The majority of food opted by general public is not sufficient source of vitamin D. For the reason vitamin D fortification is a compulsory requirement for healthy living. Developed countries like United Kingdom and Canada have overall improved their population vitamin D status by fortifying foods with vitamin D. For applying a well maintained vitamin D food fortification strategy in Pakistan , it is necessary to review various methods , type of food and their fortification results implemented all over the world. This review investigates all such prospective approaches which could be used for the fortification of foods in Pakistan. Looking at the socio economic status the majority of Pakistani residents, vitamin D fortification of staple foods such as whole grains, flour and rice by spray methods might serve as viable approaches in targeting majority of Pakistani population to ingest and improve their vitamin D status

Optimization of PCR for rapid detection of CTX-M gene in ESBL producing Klebsiella pneumoniae clinical isolates from Punjab, Pakistan

Aims: The study was carried out firstly, to evaluate the prevalence of extended spectrum beta lactamase (ESBL), multidrug resistant Klebsiella pneumoniae isolates from Punjab, Pakistan and secondly, to characterize the genotypes of their beta lactamase producing enzymes and optimization of PCR based method for rapid and authentic detection of antibiotic resistant gene. Methodology and results: Two hundred of K. pneumonia strains were isolated from different clinical samples. Blood and MacConkey Agar were used to isolate and identify bacterial microorganisms while Muller Hinton Agar was used to evaluate the antimicrobial susceptibility against different antibiotics as per CLSI 2012 guidelines. ESBL producing bacteria were screened by double disk synergy /combination disk test. PCR was optimized and performed for resistant gene (CTX-M). The results showed that most of the isolates were resistant to multiple antibiotic including cephalosporin, aztreonam, sulphamethoxazole/trimethoprim, ciprofloxacin, doxycyclin and were sensitive to imipenam and amikacin. Frequency of CTX-M gene in ESBL producing K. pneumoniae was 94%. Conclusion, significance and impact of study: Based on the finding of this study it is suggested that prevalence of CTX-M gene (95%) is very high among ESBL producing isolates. Therefore, PCR based method may help clinicians for rapid detection and treatment of patients by choosing right medication against the resistant bacteria as early as possible.

Microbiological load of ethylene oxide sterilized medical devices and its elimination by cobalt 60 source

Objective: To determine the residing microbial flora of ethylene oxide [EtO] sterilized medical devices and optimization of safe dose of gamma radiation [Cobalt 60 source] for the complete elimination of microbial load

Study Design: Experimental study

Place and Duration of Study: Department of Biotechnology, Lahore College for Women University, Lahore, Pakistan from September 2014 to June 2015

Methodology: Thirty-six samples of EtO sterilized medical devices of same batch of three different companies were collected for this study. Isolation and enumeration of microbes were done by using different selective and differential media. Gram staining and biochemically characterization by API 20 [Bio Merieux, France] kit was done for identification of the microorganisms. The medical devices having high microbial load were sent to Pakistan Radiation Services [PARAS] for gamma irradiations at 3 different selected doses [20 KGy, 25 KGy, and 30 KGy]

Results: Different types of Gram positive bacteria [Staphylococcus epidermidis, Staphylococcus aureus and Bacillus subtilis] were isolated from the EtO sterilized samples. Gram negative bacteria and fungi were not detected on these medical devices. Gamma irradiations results showed that 30 KGy was optimized dose for complete elimination of microbial flora on endotracheal, Nelaton, and tracheostomy tubes

Conclusion: Gamma radiations [Co 60 source] effectively decontaminate the microbial flora on the equipment previously sterilized by the ethylene oxide gas; and 30 KGy is the optimized dose for all these medical devices

Contribution of GLC3A locus to primary congenital glaucoma in Pakistani population

To check the contribution of GLC3A locus to primary congenital glaucoma in the Pakistani population. We enrolled twenty-nine sporadic cases and three families with multiple individuals affected with recessive primary congenital glaucoma in the year 2013. It was a genetic linkage study accomplished jointly in Department of Biotechnology of Lahore College for Women University and School of Biological Sciences, University of the Punjab, Lahore. Samples from all affected individuals were checked for homozygosity for alleles of microsatellite markers spanning CYP1B1 at GLC3A locus. Genotyping was performed with fluorescently labeled primers by capillary electrophoresis. For familial cases, linkage was evaluated by checking the co-segregation of the phenotype with the genotypes. Two-point LOD score was calculated for each microsatellite marker with MLINK. Our study revealed that GLCA3 may contribute to glaucoma in 17% of the sporadic cases and patients in 2 of the 3 families. This data suggests that the GLC3A may make an important contribution to autosomal recessive primary congenital glaucoma in the Pakistani population. Genotyping and Sequencing of more families will be helpful to identify the common mutations in CYP1B1 in future

Practice of written feedback in nursing degree programmes in Karachi: the students' perspective

To identify students' perceptions about the practices of provision and utilization of written feedback in the nursing degree programmes in Karachi. Cross-sectional descriptive study. Nine Nursing Institutions in Karachi, Pakistan were selected for the study, from February to October 2011. The sample consisted of 379 second year nursing students from nine institutions in Karachi. The data was collected through a modified Assessment Experience Questionnaire [AEQ] developed by Gibbs and Simpson. The data obtained through AEQ was analyzed in the SPPS. Students reported wide variations in the practices related to written assignments, and the provision of written feedback. Although 80% of the students, reported receiving written feedback with or without oral feedback, 20% of them, received only verbal feedback on their assignments. For 44 - 46% of the students, the quality, quantity, timing, and utilization of feedback was below the reference scores, which is indicative of negative perceptions. Only 40% reported receiving feedback on regular basis. Assignment guidelines were not always provided in a written form. In most cases, the guidelines were ambiguous as well as the feedback was not always reflective of the guidelines. The findings have implications for teachers, students, and institutions similar to the context of this study. Teachers need to be aware of the role and the impact of written feedback on students' learning and develop competence for giving effective feedback. Finally, institutional commitment and policies are needed to promote the practices of written feedback.

Safety of caesarean myomectomy

Uterine fibroids are the most common type of tumours in women arising from uterine myometrium and less commonly from cervix. Objective of the study was to check the safety of caesarean myomectomy. Patients attending Gynaecology-B Unit of Ayub Teaching Hospital having pregnancy with fibroid and undergoing myomectomy along with caesarean section [CS] were included in this prospective study during Jan 2010-Dec 2011. Intra-operative and postoperative maternal morbidity in terms of blood loss, operative time and length of hospital stay was compared to matched pregnant woman with caesarean section alone. Out of 6,000 antenatal mothers registered during the study period myoma was detected in 96 [1.6%] cases. Mean age of mother having myoma was 28 years, 70% were primigravida, and mean haemoglobin was 10.56 gm%. Size of myoma was 12 Cm in 30% cases 5 Cm in 23% and more than 1 myoma in 60% cases. There was no significant difference in intra-operative haemorrhage and length of hospital state in comparison matched women with CS although operating time was double than later. None required caesarean hysterectomy. Myomectomy can be safely performed in majority of carefully selected patients with myomas without any serious life threatening complications.