MicroRNAs: a new paradigm towards mechanistic insight of diseases

In 1993 miRNAs were discovered during a research on Caenorhabditis elegans conducted by Victor Ambros and Gary Ruvkun. The gene lin-4 that played important role in development in C. elgans was observed not encoding any protein but a very small RNA molecule of just 22 nucleotides. Main objective of this review is to highlight the significance of miRNAs in regulating the expression of many genes, which are either directly or indirectly involved in many diseases. One of the major causes of illness and death in developed countries of the world is cardiovascular disease. Some of the miRNAs have certain role to play in heart that are not specified for heart. So miRNAs have been found to be in other tissues like fibroblasts, endothelial cells and smooth muscle cells that are part of physiological study of cardiovascular system. Adult heart has limited capacity of regeneration therefore lost cardiomyocytes due to myocardial ischemia or infarction can result in low performance of heart. miRNAs have been shown to play a role in apoptotic regulation of cardiomyocytes in vivo. Many studies have shown that miR146a and 155 are up regulated in peripheral blood mononuclear cells, synovial fibroblasts, synovial fluid and Th-17 cells from rheumatoid arthritis patients as compared to healthy persons. Several types of miRNAs are playing important roles in type 1 diabetes mellitus including miR-375 and miR-375 with intolerance to glucose and decreased beta cells account due to impaired proliferation. Up regulation of miR-125a in WAT of type 2 Diabetes mellitus have been observed. miRNAs have proved to be the important regulators of cytokines and growth factor expression. Thus, suggested as a good biomarker and target of therapy. miRNA profiling techniques have revealed the role of miRNAs in Multiple sclerosis

Accuracy of anti-tissue transglutaminase IgA antibody in the diagnosis of paediatric celiac disease

Objective: to determine the accuracy of anti-tissue transglutaminase IgA [TTG] antibody titer in the diagnosis of celiac disease, taking small intestine histopathology as the gold standard

Study Design: cross-sectional analytical study

Place and Duration of Study: department of Paediatrics, Benazir Bhutto Hospital, Rawalpindi, from February to July 2013

Methodology: sixty patients aged 2 - 13 years, admitted in the Paediatric Department of Benazir Bhutto Hospital, Rawalpindi, having at least 3 features from chronic diarrhea, malnutrition, short stature, anemia, abdominal distension and clubbing, were included. Age, gender, weight and height were recorded. Abdominal distension and clubbing were clinically noted. For hemoglobin, blood complete picture was done. For determination of nutritional status and short stature, standard centile charts were used. TTG titer upper GI endoscopy, duodenal biopsy, and histopathology were done in all cases

Results: there were 60 patients; 32 males, 28 females with mean age of 5.85 +/- 3.36 years. Frequency of CD was 63.33% in study population. Sensitivity of TTG was 86.84%, with 81.82% specificity, 89.19% positive predictive value, and 78.26% negative predictive value for diagnosing CD. TTG titre more than 50 iu/ml had a 100% positive predictive value

Conclusion: TTG is an excellent screening test for the diagnosis of paediatric CD. TTG value > 50 IU/ml has 100% positive predictive value

Diarrheal versus non-diarrheal presentations of paediatric celiac disease

Objective: to compare the frequencies and clinical features of diarrheal versus non-diarrheal presentation of celiac disease [CD]

Study Design: cross-sectional study

Place and Duration of Study: paediatric Department, Benazir Bhutto Hospital, Rawalpindi, from January to December 2013

Methodology: children with celiac disease, newly diagnosed on the basis of tissue transglutaminasel [TTG] and intestinal histopathology, were included in the study by consecutive non-probability sampling. Patients were divided into diarrheal and non-diarrheal groups on the basis of presence or absence of chronic or recurrent diarrhea. Comparison between two groups was done and a p-value < 0.05 was considered significant

Results: total patients were 54 [26 males, 28 females] with mean age of 6.67 +/-3.35 years. Chronic diarrhea was present in 31 [57.4%] and absent in 23 [42.6%]. Patients in non-diarrheal group were diagnosed at a significantly later age [p=0.038] and had a greater frequency of severe malnutrition [p=0.02]. Short stature, anemia, rickets, clubbing and abdominal distension were equally prevalent. There was no significant difference in TTG value and intestinal histopathology among two groups

Conclusion: children with atypical presentation of CD had significant severe malnutrition and higher age at diagnosis than at diarrheal presentation

Isolation identification and control of vancomycin resistant Staphylococcus aureus

PakisVancomycin resistant Staphylococcus aureus [VRSA] has been reported from many parts of the world including Asian countries. Hence, main objective of study was to evaluate the possible occurrence of VRSA in hospitals of Lahore city and to ensure the effectiveness of various substitute therapeutic options. A total of 150 samples of pus/wounds were collected from three hospitals of the city and VRSA were isolated and confirmed through recommended method of Clinical and Laboratory St and ards Institute. Out of 51 [49.04%] methicillin resistant S.aureus [MRSA] isolates, 5 [9.8%] were found resistant to vancomycin. Minimum inhibitory concentration [MIC] of Linezolid [LZD], Moxifloxacin [MFX] and Clindamycin [CD] were calculated against VRSA isolates by broth microdilution test. All 5 [100%] isolates were susceptible to Linezolid and Clindamycin, while 4 [80%] were susceptible to Moxifloxacin. Ethanolic extracts of Turmeric, Mint, Cori and er, Garlic, Kalonji, Cinnamon and Cloves illustrate average MIC values of 140.8µg/ml, 563.2µg/ml, 486.4µg/ml, 614.4µg/ml, 409.6µg/ml, 281.6µg/ml and 64µg/ml, respectively against 5 VRSA strains. Concentration dependent increase in growth inhibition zones of ethanolic plant extract was recorded by agar well diffusion test. This study was helpful to find out the effective antibiotic against VRSA. Plant extracts encompass anti-staphylococcal activity and this finding dem and s necessity of further exploration of potential found in these natural herb.

Preparation, biodistribution and scintigraphic evaluation of [99m]Tc-lincomycin

A complex of lincomycin was synthesized with technetium-99m. The synthesis was carried out by using SnCl[2].2H[2]O as reducing agent and ascorbic acid as stabilizer. The effect of various parameters such as amount of ligand/reducing agent, pH value and reaction time on radio labeling process was studied. The characterization of the [99m]Tc-Lincomycin was performed by HPLC and electrophoresis Biodistribution studies were carried out by analyzing the model of bacterial infectious rats [Sprague-Dawley]. The uptake of infectious lesions at different time interval was also studied by using scintigraphic technique. The complex showed effective target to non-target ratio for various inflammatory or infectious lesions. The [99m]Tc-Lincomycin effective binding to living bacteria and could be used successfully as an infection imaging agent

Prevalence and patterns of impacted maxillary canine in a Peshawar sample

Maxillary canines are important aesthetically and functionally, but impacted canines are more difficult and time consuming to treat. Permanent maxillary canine impaction has been reported in about 1% to 5% of the population. The objective of this study was to determine the prevalence of impacted maxillary canine in patients visiting to Khyber college of dentistry, Peshawar. A total of 500 patients of 15 years and above were examined clinically. Those having maxillary canine impaction were advised Anterior Occlusal View and panoramic radiograph to determine the patterns of impaction by vertical parallaxing technique. Data were processed in SPSS version 16.0. The chi-squared test was used to reveal any differences in the distribution of impacted maxillary canines when stratified by gender and location [left or right]. A p-value of <0.05 was accepted as statistically significant. Out of 500 patients examined 20[4%] had maxillary canine impaction. The mean age was 19.05 +/- 3.15 years. Age was ranged from 15 to 25 years. Female to male ratio was1.85:1. Females had more impaction of maxillary canine than males[p=0.000]. Palatal were the most common in males while buccal were in females. Left side was commonly involved in impaction in both genders

Ethnobotanical survey; common medicinal plants used by people of Cholistan desert

Medicinal plants are used for the production of different medicines and also for the treatment of different diseases

Study Design: Study is based on a survey

Setting: Traditional medicinal uses of common medicinal plants of Cholistan desert

Objectives: The present investigation is aimed to conserve and create awareness about the ethno medicinal value of the plants and their uses to draw the attention of pharmacologists, phytochemists and pharmaceuticals

Methods: In the study area a total of 33 plant genuses belonging to 21 families are reported. In current study the medicinal plants and their indigenous medicinal uses are only presented by interviewing the local informants and Hakims. The information gained by these sources is presented here. For every plant basic information like family of plant genus, botanical name, local name, plant origin, abundance, status, plant form, part used and medicinal importance are given

Results: Field observations showed that deforestation, over grazing, agricultural expansion and unscientific collection, processing and preservation of natural vegetation are the major threats in the investigated area

Conclusion: There is dire need to conserve plant resources of Cholistan desert

Subclinical rickets

The study on sub clinical rickets is unique in the sense that it has not been preplanned conducted anywhere especially in Pakistan. The objective of present study was to explore the prevalence, gender and geographical distribution of sub clinical rickets and their related factors among school students. Out of total participants, 189[90%] students were finally included in the study from rural, urban and suburban high schools of Hazara Division, KPK. The age of boys and girls students was 11 years to 16 years. Anthropometrics data along with daily intakes of meal and availability of sun shine was noted on record form. Sub clinical cases were diagnosed with abnormal biochemical findings without physical indications of rickets. Sub clinical rickets was found in 51[27%] students, out of which 15[8%] were boys and 36[19%] girls. Geographically, 26 cases of sub clinical rickets were from rural schools, 16 of urban and 09 found in suburban school. All sub clinical cases had serum level of sunshine vitamin D in between >/= 18nmol/l to

Subclinical nutritional rickets among adolescents in kaghan valley

To determine the occurrence of subclinical rickets and its causing factors among adolescent students of schools in Kaghan Valley, Pakistan. Observation cross-sectional study. Department of Biochemistry and Health Sciences, Hazara University, Mansehra, Ayub Medical College and Teaching Hospital, Abbottabad, from March to April 2012. Sixty seven students [34 boys and 33 girls] age between 11 - 16 years included in the study from different schools of Kaghan Valley, Pakistan. Characteristic, serum biochemical and nutritional status were measured for all the participants. On the basis of biochemical finding the boys and girls students were divided in to two groups, normal subjects and subclinical rickets [absent symptoms with altered biochemistry]. Twenty six participants, 19 [73%] girls and 07 [27%] boys had biochemical abnormality but no clinical signs and symptoms of rickets. Low vitamin D and high alkaline phosphatase level were observed in 26 [100%], 21 [81%], low calcium in 17 [65%] and low phosphorus 7 [27%] subjects with subclinical rickets. None had high parathormone level above normal range. Nutritional intake of calcium, phosphorus and vitamin D was found less than the recommended daily intake in all the participants. Subclinical rickets is common problem among adolescent students especially in girls which is due to low nutritional intakes and avoidance of sunshine due to environmental and traditional impacts

Evaluation of carrier added and no carrier added [90]Y-EDTMP as bone seeking therapeutic radiopharmaceutical

The optimum conditions to label ethylenediaminetetramethylene phosphonate [EDTMP] compound with [90]y as a potential candidate for bone metastases therapy were investigated. Yttrium-90 is a pure beta-emitter and can be obtained by 89y [n,gamma] [90]y nuclear reaction in a reactor or from an in-house generator system [[90]sr[rightwards arrow][90]y]. The preparation of [90]y-EDTMPis described using [90]y, which was obtained from neutron irradiation of y2o3 as well as from a laboratory scale organic resin-based [90]sr[rightwards arrow][90]y generator. Because of the radiolabeling yield of [90]y-EDTMP on ligand/metal molar ratio, incubation time and ph was evaluated. Under optimum parameters, the radiolabeling yields of [90]y-EDTMPwere <95% for no-carrier-added as well as carrier-added [90]y. The biodistribution of no-carrier-added and carrier-added [90]yEDTMPcomplexes in rats was identical. The results indicate that [90]y [carrier-added]-edtmp is also an effective bone pain palliation agent because of its rapid blood clearance, greater uptake in bones and little absorption in soft tissues

Frequency of demyelinating pattern on electrophysiological study in patients with diabetic peripheral polyneuropathy

To determine the frequency of demyelinating pattern on electrophysiological study in patients with diabetic peripheral polyneuropathy. Cross sectional study. This study was performed at Department of Neurology, Mayo Hospital, Lahore and Medical Unit II, Allied Hospital, Faisalabad from 01-Jan-2012 to 30-Sep-2012. In this study non-probability purposive sampling technique was used. The calculated sample size was 100 cases. All patients with diabetic peripheral neuropathy and of both gender and age between 15-65 y were included in the study. Whereas Diabetic patients in whom history, clinical examination or medical record showing renal failure, hereditary neuropathies, thyroid disease, alcohol intake and toxic drug intake like anti tuberculous treatment, anti-cancer medicine etc were excluded from the study. Nerve conduction studies and electromyography were performed. Patients were labeled as having demyelinating, axonal or mixed pattern. The collected information was entered into SPSS version 15. Among the enrolled 100 patients, 56 [56%] patients were male and 44 [44%] patients were female. On electrophysiological examination, demyelinating pattern was found in 18[18%] patients, axonal pattern in 54[54%] patients and mixed pattern in 28[28%] patients. Mean duration of diabetes mellitus was 82 months + 56 S.D. The duration of diabetes ranged from 8-264 months. Our study indicates that there is high frequency of demyelinating neuropathy in patients of diabetic peripheral polyneuropathy in our local population

Chronic viral hepatitis c infection; frequency of impaired glucose tolerance in patients

Objective: The objective of the study was to measure the frequency of impaired glucose tolerance [IGT] in patients having chronic hepatitis C at medical outpatient department [OPD] of Allied hospital Faisalabad

Sample technique: Non probability consecutive sampling

Duration of study: Duration of study was 6 months with first patient enrolled on 3.02.2010 and last patient enrolled on 07-08-2010

Setting: Medical [OPD] Outpatient Department of Allied Hospital, Faisalabad

Subjects: 375 patients with chronic hepatitis C, coming in Medical OPD of Allied hospital Faisalabad were enrolled

Methods: 375 patients diagnosed as having chronic hepatitis C coming in Medical OPD of Allied hospital Faisalabad, were included in the study. Fasting and two hours after glucose load blood sample were collected in sterilized syringes and was tested for fasting blood glucose [FBS] and random blood glucose level [RBS]

Results: In this study 375 patients having HCV positive on Elisa were enrolled. Out of 375 patients with chronic hepatitis C, 143 [38.1%] were found to have IGT while 232 [61.9%] were having no IGT. There was significant association between chronic hepatitis C and development of IGT

Conclusions: It is concluded that there is close association in the development of IGT in patients with chronic hepatitis C

Contribution of different global varieties of cotton towards water hardness in textile wet processing

Specimens of nineteen different global varieties of cotton were studied to determine their contribution to water hardness through calcium and magnesium impurities, resulting in various problems during textile pretreatment, colouration and finishing. Pakistani cotton was found to be the second most contaminated cotton in terms of calcium and magnesium impurities, whereas Elisa variety from Uzbekistan was the cleanest

End treatment response with pegylated interferon among chronic Hepatitis C non-responders

To determine the frequency of end treatment virologic response [ETR] with pegylated interferon alpha and ribavirin in treatment of chronic hepatitis C patients who failed to respond to interferon plus ribavirin therapy given for at least 24 weeks. Descriptive study. Medical Unit-II, Benazir Bhutto Hospital, Shafi clinic Rawalpindi and PAEC Hospital Islamabad, Pakistan, from July 2208 to June 2009. Patients with hepatitis C who were non-responders to previous treatment with standard interferon and ribavirin, were given Pegylated Interferon alpha plus ribavirin. Total duration of treatment was 24 weeks for genotypes 2 and 3 and 48 weeks for genotypes 1 and 4. The primary end point was undetectable HCV RNA by polymerase chain reaction assay at the completion of therapy. Out of the 44 enrolled patients, 24 [54.5%] were males and 20 [45.5%] were females. Mean age of patients was 45.25 +/- 7.14 years. HCV genotypes were 3 in 64%, 2 in 30% and 7% each had genotypes 1 and 4. Both the early virological response and end of treatment response was seen in 75% patients. There was a high ETR rate of 75 in previous non-responders to conventional combination therapy. This high ETR as compared to international data is because of existence of favourable genotypes in our country which is encouraging in the treatment of non-responders

Postoperative vomiting after single dose of injection dexamethasone at the time of induction of general anesthesia

To describe the effect of single dose of injection dexamethasone at the time of induction of general anesthesia on post operative vomiting within first 24 hour in Allied hospital Faislabad. This is hospital based prospective comparative study conducted from November 2007 to November 2008 at surgical unit III, Allied /DHQ Hospital Faisalabad. Two groups, cases and controls, were made. Injection dexamethasone was given to the cases group and injection normal saline was given to the controls group at the time of induction of general anaesthesia. The data was entered into a structured proforma separately. Number of episodes of vomiting was recorded within 24 hour postoperatively in each group. Both groups were compared. A total of 90 patients were included in this study. Equal number of cases and control were taken [45 patients in each group]. During the 24-Hour Postoperative observation period, 34% of patients in the dexamethasone group, compared with 63% of patients in the saline group, reported nausea and vomiting [p<0.001]. Injection dexamethasone given at the time of induction of general anesthesia significantly reduces the frequency of post operative vomiting

Blood lead levels and Occupational Hazards in child labour in Peshawar

To determine blood lead level, calcium and haemoglobin in children involved in auto labour at Peshawar. A total of 150 children; 30 control and 120 working in auto-mobile workshops for 8-10 hours daily without any safety measures, were investigated. We observed that low-income families generally encouraged their children to learn some professional skills at early age. Besides, the nature of work in automobile workshops was hazardous and the long working hours were stressful for the children. Eighty Seven percent of the children were not willing to do the job and 100% were un-aware of the safety measure. As compared to controls, the subject group have had high blood lead levels with a mean +/- 42.4 g/dl [p<0.001]; low haemoglobin +/- 11.2 g/dl [p<0.01] and decreased calcium +/- 8.6 mg/dl [P<0.01] concentration. Furthermore, the younger age group had comparatively raised lead level than old age group. Sixty eight percent children of the study group have had abnormalities like headaches, raised hearing threshold, memory loss and generalized body pain. It is concluded that the high level of blood lead affects the health of children; and poor children specially are at more risk because of inadequate nutrition. Besides, the present study suggests the need of awareness, implementation of laws for child's rights, effective family planning facilities and finally various organizations should play an effective role in child labour prevention programmes