Overviewing the Application of ß-Galactosidase "Immobilized on Nanoparticles" in Dairy Industries

Abstract Owing to the excellent catalytic potential, β-galactosidase (EC: 3.2.1.23) has been exploited as an important industrial enzyme for obtaining galactooligosaccharides (GOS) and lactose-free products in dairy industries. Moreover, novel technologies have been implemented in the recent past for preparing and modifying nanoparticles (NPs) for immobilizing therapeutically and industrially important enzymes. Nanoparticles based enzyme immobilization (NBEI) offered more stability and robustness to the enzymes due to their fixed conformation and hence extend their applications in broader areas. A quick overview of the results exhibited greater activity for the enzymes immobilized on NPs as compared to enzyme immobilized on 2-D matrices. Based on these findings, this review was aimed to emphasize the recent development achieved for immobilizing β-galactosidase on NPs with their specific utilization in obtaining dairy products. These studies includes β-galactosidases from various sources that were immobilized on various NPs for hydrolyzing lactose in batch and continuous reactors, and for the production of GOS in biotechnology industries. NBEI of β-galactosidase offered profound stability for transporting substrate and product for enzymatic reactions, apart from cost effective advantage due to reusable nature of immobilized enzyme.

Percutaneous pulmonary valve implantation as an alternative to repeat open-heart surgery for patients with pulmonary outflow obstruction: a reality in Singapore

Right ventricle to pulmonary artery (RV-PA) conduits have been used for the surgical repair of congenital heart defects. These conduits frequently become stenosed or develop insufficiency with time, necessitating reoperations. Percutanous pulmonary valve implantation (PPVI) can delay the need for repeated surgeries in patients with congenital heart defects and degenerated RV-PA conduits. We presented our first experience with PPVI and described in detail the procedural methods and the considerations that are needed for this intervention to be successful. Immediate and short-term clinical outcomes of our patients were reported. Good haemodynamic results were obtained, both angiographically and on echocardiography. PPVI provides an excellent alternative to repeat open-heart surgery for patients with congenital heart defects and degenerated RV-PA conduits. This represents a paradigm shift in the management of congenital heart disease, which is traditionally managed by open-heart surgery.

Childhood-onset systemic lupus erythematosus: a cohort study

Objective: To determine the clinical and immunological characteristics and short-term outcome of children with systemic lupus erythematosus [SLE]. Study Design: A descriptive cohort study. Place and Duration of Study: Paediatric Rheumatology Clinic, The Aga Khan University Hospital, Karachi, from January 2011 to December 2015

Methodology: Clinical and immunological profile and short-term outcome of children less than 16 years of age admitted in the paediatric ward, with the diagnosis of SLE was studied. Demographic data, clinical presentation, laboratory findings, immunological profile and treatment regimens of these children were evaluated

Results: Thirty-two children, satisfying the criteria of American College of Rheumatology [ACR] for SLE, were enrolled during the study period of five consecutive years. A female predominance was observed with 28 [87.5%] patients being female [F:M 7:1]. Mean age at symptom onset was 10.5 +2.7 years; and 8.8 +2.1 years in females and males, respectively. The mean age at diagnosis was 11.3 +2.8 years in females and 9.4 +1.9 years in males. Prolonged fever was the most common non-specific symptom found in 27 [84%], followed by pallor in 13 [41%] patients. Twenty-two [69%] children were found to be anemic and 18 patients [56%] having signs of arthritis at presentation. Renal involvement was observed in 15 [47%] patients. The most common laboratory finding was anemia, found in 22 [69%] of cases. The most common immunological markers were serum anti-neutrophil antibodies [ANA], positive in 28 [88%] patients, followed by anti double-stranded DNA antibodies, raised in 26 [81%] of cases. Out of 32, 12 patients were lost to follow-up. Of the remaining 20 children who were followed for four years, ten [50%] went into remission

Conclusion: Childhood-onset SLE encompasses a wide variety of manifestations with a female preponderance. Fever, arthralgia and pallor are the most frequent clinical manifestations among the children. Hemolytic anemia [HA] is the most common laboratory abnormality, with ANA and anti ds-DNA antibodies positivity in the majority of padiatric patients

Knowledge, attitude and practices of pregnant women regarding benefits of breast feeding and immunization in newborns

Objectives: To study the knowledge attitude and practices of pregnant women regarding benefits of breastfeeding and immunization. Study design: Descriptive cross-sectional study

Material and Method: This study was conducted at Department of Obstetrics of P.N.S. Shifa Hospital Karachi over a period of six months. All pregnant women admitted in the obstetric ward were included. After obtaining informed consent participants were administered questionnaire, which was filled in by the researcher. The questions were in the native language. Performa includes questions pertinent to knowledge, attitude and practices regarding benefits of breast feeding and immunization to achieve the millennium development goal 4

Results: Despite of the level of education out of 235 participants at most of them [97%] were aware of role of immunization and breast feeding. But 14.5% lack knowledge of frequency of breast feeding. 42.11% participants said doctor advise her to breast feed while 52.2% counseled by the family lady, midwife and friends. 45.96% participants never got advice by the doctors against use of un-prescribed drugs during pregnancy

Conclusion: The knowledge attitude and practices of pregnant women regarding benefits of breastfeeding and immunization are not up to the mark. There is a need to increase the education of the mothers to ensure better understanding regarding breastfeeding and immunization to achieve the Millennium Development Goal 4

Maternal predictors of intrauterine growth retardation

Objective: To identify maternal factors associated with intrauterine growth restriction [IUGR]

Study Design: A case-control study

Place and Duration of Study: Neonatal Unit of The Aga Khan Hospital for Women [AKHW], Karimabad, from January 2014 to December 2015

Methodology: Cases were IUGR live born babies [n=90], while control were appropriate-for-gestational age [AGA] babies [n=180]. Information recorded in pre-designed proforma included gestational age and birth weight of baby, demographics of mothers, pregnancy related medical and obstetric complications. Data were analysed through SPSS-19. Multivariable logistic regression was used to determine the maternal factors associated with the intrauterine growth restriction

Results: Maternal factors associated with IUGR after adjusting for confounders in the multivariable model included younger age [OR=0.9, CI=0.8-0.9], poor gestational weight gain [OR=3.0, CI=1.6-6.1] and history of previous abortion [OR=3.06, CI=1.1-8.0]. Significant interaction was found between pregnancy-induced hypertension [PIH] and parity of mother, primary-para mother with PIH having an increased risk for IUGR babies [OR=10.1, CI=1.0-23.2]

Conclusion: Young age, primigravida status, low gestational weight gain, previous history of abortion, PIH and GDM have strong association with IUGR; hence, special consideration is essential to overcome these issues in order to improve maternal and neonatal health

Perinatal arterial ischaemic stroke in neonate

Arterial ischemic stroke [AIS] is not uncommon in neonates, but in large part of developing world it has been missed and remains undiagnosed because of lack of resources and insufficient engagement by health care providers. The incidence of ischemic perinatal stroke ranges between 1 in 200 No, to 1 in 5000 births and is reported to be responsible for 30% to 50% of congenital hemiplegic cerebral palsy [CP] who were born at term or late preterm gestations. The true incidence of AIS from the developing world is not known as neuroimaging facilities are available in few centers; most of these cases remain undiagnosed. Over the past decades, ischemic perinatal stroke has emerged as an important cause of brain injury in the perinatal period and remains a leading cause of cerebral palsy. We are reporting a 3 days old male baby who presented with refractory seizures, subsequently diagnosed as arterial ischemic stroke

Moyamoya: an uncommon variant of stroke in children

Moyamoya is a rare cause of stroke in children. It is an infrequent cerebrovascular disorder of unknown etiology. We are reporting a case of a 7-year-old girl who presented with an acute history of left-sided weakness. On imaging she was diagnosed with Moyamoya disease. CT Angiogram revealed an occlusion of the right middle cerebral artery typical of Moyamoya disease. The child improved with conservative therapy

Role of Glutaraldehyde in Imparting Stability to Immobilized β-Galactosidase Systems

ABSTRACT This review article highlights the role of glutaraldehyde as a matrix activator/stabilizer in imparting higher operational and thermal stability to β-galactosidase (βG) for biotechnological applications. Glutaraldehyde has been used extensively as a crosslinking agent as well as for functionalization of matrices to immobilize β-galactosidase. Immobilized β-galactosidase systems (IβGS) obtained as a result of glutaraldehyde treatment has been employed to hydrolyze whey and milk lactose in batch reactors, continuous packed-bed and fluidized bed reactors under various operational conditions. Moreover, these IβGS have also been utilized for the production of galactooligosaccharides in food, dairy and fermentation industries. It was observed that glutaraldehyde provided remarkable stability to immobilize βG against various physical/chemical denaturants, thus enhancing thermal/operational stability and rendering it more suitable for repeated utilization in industrial scale operations.

Burr hole aspiration of brain abscess in children with cyanotic heart disease

Objective: To determine the efficacy of burr hole aspiration of brain abscess in children with cyanotic heart disease in terms of number of aspirations and residual abscess

Study Design: Experimental study

Place and Duration of Study: Department of Pediatric Neurosurgery at The Children's Hospital and The Institute of Child Health, Multan, from July 2010 to June 2014

Methodology: Pediatric patients of cyanotic heart disease with brain abscess were admitted. After taking history, clinical examination and necessary investigation, aspiration of abscess through a burr hole was performed. Data was collected through pre-designed proforma. Analysis of results was performed and comparison was made through statistical package for social sciences [SPSS-20]

Results: Total number of patients were 50 with 31 [62%] male and 19 [38%] female children. Patients' age ranged from 5-10 years with mean age of 7.44 +/-1.11 years. Single abscess in supra tentorial was commonly found in 44 [88%] patients. Multiple abscesses were present in 4 [8%] patients. Cerebellum was involved in 2 [4%] patients. Abscess was completely aspirated in single attempt in 37 [74%] patients, two attempts in 9 [18%] patients, and three attempts in 4 [8%] patients. No bacterial growth on culture was reported in 32 [64%] patients. Culture was positive in 18 [36%] patients. Postoperative hematoma developed in 2 [4%] patients. No mortality was reported in early postoperative period

Conclusion: Aspiration of brain abscess in children with cyanotic heart disease through a burr hole is safe and successful

Functional outcome of external fixator in grade 11 and 111 open fractures of tibia in children

Objective: To assess the functional outcome of external fixator in children with open tibial fracture in the department of Orthopaedics Surgery of LUH Hyderabad/ Jamshoro

Study Design: Observational / descriptive study

Place and Duration of Study: This study was conducted at the Orthopaedic Department of LUMHS from June 2014 to March 2015

Materials and methods: In this study, 60 children [younger than 12 years] suffering from Gustilo grade II and III open fracture of tibia were admitted at the emergency department of the center and evaluated. All the cases were treated with external fixation, after complete counseling their parents or their attendants. While the children were admitted at the emergency department of the hospital, they underwent prophylaxis using antibiotic. All patients underwent washing and primary debridement operation at the emergency department. According to the attending surgeon, the patients were treated either using external fixator after hospitalization. After management union of the fracture was assessed through clinical examinations such as lack of pain, tenderness, and radiography of both lateral and anteroposterior [AP] views during the follow-up period

Results: In this study mean age was found 10.3 +/- 3.6 years, male were found in majority 42[80.67%]. Road traffic accident was the most common cause of mechanisms of injury was in 35[67.31%]. Cases with grade III type of fracture found in majority 57.69%. union after management was achieved 98.8% of the cases, superficial infection was found in 06[11.53%] cases, while deep infection, Malunion and delayed union were found 03[5.76%], 07[13.46%] and 05[9.61%] respectively. While non-union was found only in one case

Conclusion: External fixator is very safe, insignificant intrusive, get short surgical time, following by short hospital duration as well as can be applicable as unequivocal and effective administration of open fractures of tibia among children

Functional outcome of frozen shoulder treated with physiotherapy vs. intrarticular injection of corticosteroid

Objective: To assess the functional outcome of frozen shoulder when treated with physiotherapy vs intrarticular injection of corticosteroid the department of Orthopaedics Surgery of LUH Hyderabad/ Jamshoro

Study Design: Observational / comparative study

Place and Duration of Study: This study was carried out in the Orthopaedic Department of LUMHS, Hyderabad/ Jamshoro from August 2013 to March 2014

Materials and Methods: In this study, 100 cases between age of 40-70 years selected after diagnosis of frozen shoulder or adhesive capsulitis. All the cases having pain into shoulder moving function for minimum 3 months of period, both gender and detected adhesive capsulitis or frozen shoulder were included in the study. Later on, subjects were isolated at random into groups, 48 cases of group A were underwent intrarticular injection of corticosteroid and the 52 cases of group B were underwent physiotherapy management. Result assessed at 4 and 8 weeks follow up continue at 16 weeks

Results: In this study mean age was found 55.23 +/- 9.8 years. In this forth week follow up visit we found more improved patients 29/69% in Interarticular Injections group out of 42 cases, and in 23/50.5% cases found improvement in physiotherapy group out of 45 cases. Similarly 4[th] and 8[th] week follow-up on 16[th] week also some cases were missed, but on this follow up visit we found physiotherapy is the superior than Interarticular Injections group. As well as in this 16[th] week follow up visit we found improvement in the majority of patients 30/81.0% in physiotherapy group out of remaining total 37 cases, and in 17/58.6% cases found improvement in Interarticular Injections group out of remaining 29 cases

Conclusion: Physiotherapy has better result in reduce pain and range of movement [ROM] exercise than Interarticular injections of cortisone plus home exercise in the long time

Right-sided congenital diaphragmatic hernia and myelomeningocele: a rare association

Congenital diaphragmatic hernia [CDH] is a rare birth defect with a prevalence of < 0.5 per 1,000 live births. Majority of these defects are left-sided as most studies suggest that frequency of right-sided CDH was 10% of the total. The association of CDH with myelomeningocele [MMC] is extremely rare; as in Sweed's study of 116 consecutive cases of CDH, the incidence of associated MMC with CDH was stated as 4.3%. There has been one previous case report of leftsided CDH, MMC and hydrocephalus prenatally diagnosed; but to the best of authors' knowledge, this is the first reported case of the above constellation with a right-sided CDH diagnosed prenatally

Dynamic hip screw [DHS] evaluation of stable and unstable intertrochanteric fracture of femur fixed

Objectives: To analyze the comparative results of dynamic DHS fixation in stable and the unstable intertrochanteric fractures at LUH. Study Design: Comparative study. Setting: Orthopedic unit I of LUH Jamshoro. Period: 26[th] May 2010 - 25[th] August 2011

Methodology: All 40 patients with femur intertrochanteric fracture were enlisted. All cases isolated in 2 groups every having 20 patients, group A stable fracture and group B unstable fractures. After complete physical examination, examinations and fracture arrangement evaluation, patients were readied for operation. Fracture table was used in each operation. Fracture reduction was initially attempted by close manipulation and was successful in 30 [75%] cases. Lateral approach for proximal femur was used in every case. All fractures, whether stable or unstable, were reduced anatomically without any type of osteotomy and then fixed with 135o dynamic hip screw

Results: Mean age was 62.8.2 years of the cases. Gender ratio was 3:1. According to mode of injury were found RTA in 21 [70%] patients. Postoperative complications were recorded as; superficial infection noted in 2 [5%] patients and there was no case of deep infection. Average stay of hospital found 16.5 days in 17 [42.5%] patients belongs to stable group and 06 [15%] patients belong to unstable group. All [n=40] patients were pain free on their discharge from hospital. In all [n=40] patients we achieved union and there was no case of delayed union or non-union. We assessed functional outcome of our patients on the base of Stinchfield Hip Assessment system. According to SHAS 28 [70%] patients were excellent, 05 [12.5%] patients were good, 04 [10%] were fair and 03 [7.5] were poor. We had not found mortality in our patients

Conclusions: According to our conclusion DHS is the best implant for intertrochanteric fracture fixation. No matter; whether fracture is stable, unstable and fresh or old

Patriarchy in family care-giving: experiences of families of children with intellectual disability in Pakistan

Objective: To know the effects of children with intellectual disability [ID] on families in Pakistan with special focus on the experiences of mothers living in nuclear and joint families

Methodology: This was qualitative study in which qualitative methods were employed for this study. Data was collected from parents and family members of children with intellectually disability. Participants from the diverse socio-economic features were selected from the three rehabilitation centres for children with intellectual and physical disability in Peshawar and Haripur districts of Khyber Pakhtunkhwa province. A total of 58 respondents were interviewed including 30 in-depth individual interviews [IDIs] with parents having children with ID and 4 Focus Group Discussions [FGDs] with a total of 28 parents [7 participants in each FGD]. Both mothers and fathers participated in this study for ensuring equal gender ratio

Results: Women in the families were suffering more as compare to men due to socially assigned role of primary care of the children. Women were facing social exclusion, stress/ fatigue due to role strain, rejection in the form of family breakdown and work-family conflict due to gender imbalance in role performances. Moreover, families were also prone to displacements and social hazards like beggary, child labour and drop out of normal female children from schools due poor institutional role in child support and rehabilitation

Conclusion: Patriarchy promotes uneven distribution of roles for men and women in the families having children with ID which causes more agonies for mothers and other female members of the house as compared to male members of the family

Phytochemical, antioxidant and antimicrobial activities of flowers of phlox drummondii

The extracts and fractions of flowers of Phloxdrum mondii were evaluated for antimicrobial and antioxidant activities. Their purification resulted in the isolation of four known constituents of which uracil and 2-methyl-1,2,3,4- butantetrol have not been obtained previously from any specie of the genus Phlox, while isolation of the flavonoid glycosides [1] and [2] have been reported from the flowers of the plant. Among all the samples PhFC and its fraction PhFCM showed significant activity against both bacteria and fungi. Flavonoid glycoside O-rhamnosyl-6-C-xylosylapigenin 1 and O-rhamnosyl- 6- C-xylosylluteolin 2 demonstrated antioxidant activity which were of same magnitude [IC50 42.67 +/- 4.99 micro g/ml and 46.33 +/- 6.65 micro g/ml, respectively]. Thereby, suggesting that the presence or absence of hydroxyl group at position C-3' does not play a significant role in said activity in this case. Interestingly, the mixture of 1 and 2 apparently showed synergism as reflected by 45% improvement in antioxidant activity as compared to the individual values obtained for either 1 or 2

Reno-protective effect of garlic extract against immobilization stress induced changes in rats

OBJECTIVE: To examine immobilization stress-induced antioxidant defense alterations in rat kidney and the antioxidant effects of aqueous garlic extract in pre and post stress extract treatments. METHODS: Albino rats were treated with aqueous extract of garlic both before and 6 h of immobilization stress. Pro-oxidant eminence of rat kidney was assessed by determining the levels of glutathione, thiobarbituric acid reactive substances, aspartate aminotransferase, alanine aminotransferase, glucose, uric acid, alkaline phosphatase and antioxidant enzymes activities. RESULTS: In response to 6 h of immobilization stress, a significant rise in the level of kidney enzymes was recorded. However, antioxidant enzyme activities showed a sharp decline. CONCLUSIONS: The extract treatment before and after the stress reverted the activities of above mentioned enzymes towards their control values. Hence, garlic extract can be given as nutritional supplement for scavenging the free radicals generated in rat kidney.

Natal and neonatal teeth- an uncommon oral finding: a cross sectional study in Pakistani subjects

The objective of this study was to determine the frequency, types of teeth present at the time of birth and reasons for extraction of natal and neonatal teeth in Pakistani neonates. This cross sectional hospital based study was carried out during the period February 2011 to May 2013 at different dental colleges of Karachi and Hyderabad. All neonates with natal and neonatal teeth referred from different dental sections of Karachi and Hyderabad were included in the study. Their characteristics, common sites of eruptions, complications and reasons for extractions were observed and analyzed. A total of 22 patients were selected for data analysis out of which 8 [36.4%] were males and 14 [63.6%] were females and standard deviation was SD +/- 9.74. Out of 22 subjects studied, 17[77.3%] had natal and 05[22.7%] neonatal teeth which were uncomfortable both for the mother and the neonate. The most common teeth present at the time of birth were mandibular central incisors. It was concluded that it was a benign but rare condition of oral cavity among Pakistani neonates which requires special attention when causing feeding problems for mothers and children

Frequency of undiagnosed hypothyroidism in obese females

To determine the frecuancy of undiagnosed hypothyroidism in obese females. Cross sectional. Department of general Medicine, Combined Millitary Hopital, Multan [a tertiay care hospital]. six months All individuals fulfilling the inclusion criteria were enrolled in the study after their consent. Based upon their height and weight, the body mass index was calculated and their blood drawn for thyroid profile. Total 133 participants were included in the study and all were females, and their mean age [ +/- SD] waz 47.68 +/- 11.382 years. The overall frequencv of undiagnosed hypothyroidism was 4.5% [6 out of the 133 subjects] The determined frequency of undiagnosed hypothyroidism in obese females is not hgh enough tc recommend mass screening in all obese females

Diaphyseal femoral fractures; treatment by close v/s open intramedullary interlocking nail

To assess the best results of diaphyseal femoral fractures treated by closed intramedullary interlocking nail and open intramedullary interlocking nail. Cross sectional. Jan 2009 to Jan 2011. LUH Jamshoro / Hyderabad. Total 40 fractures of shaft of femur in 40 patients were treated with IMILN. All patients have same post operative follow up. Early range of motion exercises of hip and knee joint was started, pain management and 3rd generation cephalosporin intravenous antibiotics given for 5 days followed by oral antibiotics. Patients discharged as early as possible when patient's condition allowed and removal of stitches after two weeks. Patient's assessment regarding wound condition, range of movement of proximal and distal joints and fractures assessment radiologically and clinically was done every month. Majority of the cases were with the age groups of 37.5% between 21-30 years. RTA was found most common 70% of the cases. According to the AO classification oblique fractures were found most common 45%. On the assessment of final results in both close and open methods, 5% infection found in close method and 7.5% infection were in open method, less union time was found in closed group, deformity was equally found in both groups and heeling time was also less found in closed group. It is concluded that closed intramedullary interlocking nailing method is the best procedure with excellent union for the femoral fracture