The role of family and culture in the disclosure of bad news: A multicentre cross-sectional study in Pakistan.

Objectives: Disclosure of bad news is distressing for patients and family members. Our aim was to assess patients' perceptions and preferences regarding bad news in the health setting. Methods: Cross-sectional, multi-centered study supported by an external grant in 15 Government and Private Hospitals across Pakistan. A sample size of 1673 patients and family members was used. Ethics permission/consent was taken from each participating hospital and participant. Responses were compared across provinces, gender, age, education and income. Results: >80% patients preferred their relatives to know the diagnosis first and they wanted the news to be disclosed to them by doctors. Significant association between education level, income and preference for wanting to know the diagnosis was found. Reasons for wanting to know the diagnosis included treatment, prognosis and prevention options whereas reasons for not wanting to know included fear of emotions and God's will. Conclusion: The majority of Pakistani patients want to be informed and want the family to know first. Preferences for disclosure vary across, age, education and income level. Innovation: First countrywide study on this topic. Identifies need for culturally sensitive guidelines that include the family's role in disclosure of bad news.

Advancing C-V2X for Level 5 Autonomous Driving from the Perspective of 3GPP Standards.

Cellular vehicle-to-everything (C-V2X) is one of the enabling vehicular communication technologies gaining momentum from the standardization bodies, industry, and researchers aiming to realize fully autonomous driving and intelligent transportation systems. The 3rd Generation Partnership Project (3GPP) standardization body has actively been developing the standards evolving from 4G-V2X to 5G-V2X providing ultra-reliable low-latency communications and higher throughput to deliver the solutions for advanced C-V2X services. In this survey, we analyze the 3GPP standard documents relevant to V2X communication to present the complete vision of 3GPP-enabled C-V2X. To better equip the readers with knowledge of the topic, we describe the underlying concepts and an overview of the evolution of 3GPP C-V2X standardization. Furthermore, we provide the details of the enabling concepts for V2X support by 3GPP. In this connection, we carry out an exhaustive study of the 3GPP standard documents and provide a logical taxonomy of C-V2X related 3GPP standard documents divided into three categories: 4G, 4G & 5G, and 5G based V2X services. We provide a detailed analysis of these categories discussing the system architecture, network support, key issues, and potential solution approaches supported by the 3GPP. We also highlight the gap and the need for intelligence in the execution of different operations to enable the use-case scenarios of Level-5 autonomous driving. We believe, the paper will equip readers to comprehend the technological standards for the delivery of different ITS services of the higher level of autonomous driving.

Bridging the Chemical Profile and Biomedical Effects of Scutellaria edelbergii Essential Oils.

The present study explored chemical constituents of Scutellaria edelbergii essential oils (SEEO) for the first time, extracted through hydro-distillation, and screened them against the microbes and free radicals scavenging effect, pain-relieving, and anti-inflammatory potential employing standard techniques. The SEEO ingredients were noticed via Gas Chromatography-Mass-Spectrometry (GC-MS) analysis and presented fifty-two bioactive compounds contributed (89.52%) with dominant volatile constituent; 3-oxomanoyl oxide (10.09%), 24-norursa-3,12-diene (8.05%), and methyl 7-abieten-18-oate (7.02%). The MTT assay via 96 well-plate and agar-well diffusion techniques against various microbes was determined for minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC), IC50, and zone of inhibitions (ZOIs). The SEEO indicated considerable antimicrobial significance against tested bacterial strains viz. Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, and Enterococcus faecalis and the fungal strains Fusarium oxysporum and Candida albicans. The free radicals scavenging potential was noticed to be significant in 1,1-Diphenyl-2-picryl-hydrazyl (DPPH) as compared to 2,2'-azino-bis-3-ethylbenzotiazolin-6-sulfonic acid (ABTS) assays with IC50 = 125.0 ± 0.19 µg/mL and IC50 = 153.0 ± 0.31 µg/mL correspondingly; similarly, the antioxidant standard in the DPPH assay was found efficient as compared to ABTS assay. The SEEO also offered an appreciable analgesic significance and presented 54.71% in comparison with standard aspirin, 64.49% reduction in writhes, and an anti-inflammatory potential of 64.13%, as compared to the standard diclofenac sodium inhibition of 71.72%. The SEEO contain bioactive volatile ingredients with antimicrobial, free radical scavenging, pain, and inflammation relieving potentials. Computational analysis validated the anti-inflammatory potential of selected hit "methyl 7-abieten-18-oate" as a COX-2 enzyme inhibitor. Docking results were very good in terms of docked score (-7.8704 kcal/mol) and binding interactions with the functional residues; furthermore, MD simulation for 100 ns has presented a correlation with docking results with minor fluctuations. In silico, ADMET characteristics supported that methyl 7-abieten-18-oate could be recommended for further investigations in clinical tests and could prove its medicinal status as an anti-inflammatory drug.

Aroma Profile and Biological Effects of Ochradenus arabicus Essential Oils: A Comparative Study of Stem, Flowers, and Leaves.

The present analysis explores the chemical constituents and determines the in vitro antimicrobial, antidiabetic, and antioxidant significance of the essential oils (EOs) of the stem, leaves, and flowers of Ochradenus arabicus for the first time. The EOs of the flowers presented seventy-four constituents contributing to 81.46% of the total EOs, with the major compounds being 24-norursa-3,12-diene (13.06%), 24-norursa-3,12-dien-11-one (6.61%), and 24-noroleana-3,12-diene (6.25%). The stem EOs with sixty-one compounds contributed 95.95% of the total oil, whose main bioactive compounds were (+)-camphene (21.50%), eremophilene (5.87%), and δ-selinene (5.03%), while a minimum of fifty-one compounds in the leaves' EOs (98.75%) were found, with the main constituents being n-hexadecanoic acid (12.32%), octacosane (8.62%), tetradecanoic acid (8.54%), and prehydro fersenyl acetone (7.27%). The antimicrobial activity of the EOs of O. arabicus stem, leaves, and flowers was assessed against two bacterial strains (Escherichia coli and Streptococcus aureus) and two fungal strains (Penicillium simplicissimum and Rhizoctonia solani) via the disc diffusion assay. However, the EOs extracted from the stem were found effective against one bacterial strain, E. coli, and one fungal strain, R. Solani, among the examined microbes in comparison to the standard and negative control. The tested EOs samples of the O. arabicus stem displayed a maximum potential to cure diabetes with an IC50 = 0.40 ± 0.10 µg/mL, followed by leaves and flowers with an IC50 = 0.71 ± 0.11 µg/mL and IC50 = 10.57 ± 0.18 µg/mL, respectively, as compared to the standard acarbose (IC50 = 377.26 ± 1.20 µg/mL). In addition, the EOs of O. arabicus flowers had the highest antioxidant activity (IC50 = 106.40 ± 0.19 µg/mL) as compared to the standard ascorbic acid (IC50 = 73.20 ± 0.17 µg/mL) using the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay. In the ABTS assay, the EOs of the same sample (flower) depicted the utmost potential to scavenge the free radicals with an IC50 = 178.0 ± 0.14 µg/mL as compared with the ascorbic acid, having an IC50 of 87.34 ± 0.10 µg/mL the using 2,2-Azino-Bis-3-Ethylbenzothiazoline-6-Sulfonic acid (ABTS) assay. The EOs of all parts of O. arabicus have useful bioactive components due to which they present antidiabetic and antioxidant significance. Furthermore, additional investigations are considered necessary to expose the responsible components of the examined biological capabilities, which would be effective in the production of innovative drugs.

Novel Bis-Schiff's base derivatives of 4-nitroacetophenone as potent α-glucosidase agents: Design, synthesis and in silico approach.

Bis-Schiff's base derivatives of 4-nitroacetophenone (1-18) were synthesized in good yields by reacting hydrazone of 4-nitroacetophenone with substituted aldehydes and ketones with catalytic amount of acetic acid. The structures of synthesized products (1-18) were deduced with the help of spectroscopic techniques like 1H NMR, 13C NMR and HR-ESIMS. The synthesized bis-Schiff's bases were assessed for their α-glucosidase inhibitory activity where compound 4 (IC50 = 2.79 ± 0.04 µM), 1 (IC50 = 9.76 ± 0.31 µM), 6 (IC50 = 11.37 ± 0.20 µM), 17 (IC50 = 14.10 ± 0.12 µM), 14 (IC50 = 17.21 ± 0.28 µM), and 8 (IC50 = 20.73 ± 0.53 µM), showed a very high potential for inhibition of α-glucosidase. Compounds 11, 15, 16, 2, 18, 7, and 5 showed significant inhibition against alpha-glucosidase with IC50 values 22.98 ± 0.34, 24.45 ± 0.53, 27.31 ± 0.29, 40.56 ± 0.60, 41.58 ± 0.47, 46.53 ± 0.76, and 47.46 ± 0.89 µM, respectively. Furthermore, compound 10 (IC50 = 52.63 ± 0.74 µM), 12 (IC50 = 70.80 ± 3.59 µM), 3 (IC50 = 82.68 ± 0.69 µM), 13 (IC50 = 88.89 ± 4.25 µM), and 9 (IC50 = 94.58 ± 0.86 µM) showed moderate activity towards the inhibition of α-glucosidase enzyme. All these compounds were compared with acarbose (IC50 = 875.75 ± 1.24 µM) as a standard α-glucosidase inhibitor. Molecular docking was used to know the molecular bases of such high activities against α-glucosidase. High docking scores were recorded implying significant interactions between the active compounds and amino acid residues of the active site of α-glucosidase.

Enzymes Inhibition and Antioxidant Potential of Medicinal Plants Growing in Oman.

The recent study was designed to explore Dodonaea viscosa, Juniperus excelsa, Helianthemum lippii, and Euryops pinifolius using methanolic (MeOH) extract. Their subfractions were examined against urease, carbonic anhydrase II (CA-II), α-glucosidase enzymes, and free radicals scavenging significance based on local practices via standard methods. Significance potential against the urease enzyme was presented by ethyl acetate fraction (EtOAc) of D. viscosa with (IC 50 = 125 ± 1.75 µg/mL), whereas the H. lippii (IC 50 = 146 ± 1.39 µg/mL) in the EtOAc was found efficient to scavenge the free radicals. Besides, that appreciable capacity was observed by the J. excelsa, D. viscosa, J. excelsa, and E. pinifolius as compared to the standard acarbose (IC50 = 377.24 ± 1.14 µg/mL). Maximum significance was noticed in methanolic (MeOH) extract of J. excelsa and presented carbonic anhydrase CA-II (IC50 = 5.1 ± 0.20 µg/mL) inhibition as compared to the standard (acetazolamide). We are reporting, for the first time, the CA-II inhibition of all the selected medicinal plants and α-glucosidase, urease, and antioxidant activities of the E. pinifolius. Thus, further screening is needed to isolate the promising bioactive ingredients which act as an alternative remedy to scavenge the free radicals, antiulcer, and act as a potential source to develop new antidiabetic drugs for controlling postprandial blood sugar as well as carbonic anhydrase inhibitors.

Phytochemical Profiling and Bio-Potentiality of Genus Scutellaria: Biomedical Approach.

Scutellaria (Lamiaceae) comprises over 360 species. Based on its morphological structure of calyx, also known as Skullcap, it is herbaceous by habit and cosmopolitan by habitat. The species of Scutellaria are widely used in local communities as a natural remedy. The genus contributed over three hundred bioactive compounds mainly represented by flavonoids and phenols, chemical ingredients which serve as potential candidates for the therapy of various biological activities. Thus, the current review is an attempt to highlight the biological significance and its correlation to various isolated bioactive ingredients including flavonoids, terpenoids, phenols, alkaloids, and steroids. However, flavonoids were the dominant group observed. The findings of the Scutellaria reveal that due to its affluent basis of numerous chemical ingredients it has a diverse range of pharmacological potentials, such as antimicrobial, antioxidant, antifeedant, enzyme inhibition, anti-inflammatory, and analgesic significance. Currently, various bioactive ingredients have been investigated for various biological activities from the genus Scutellaria in vitro and in vivo. Furthermore, these data help us to highlight its biomedical application and to isolate the responsible compounds to produce innovative medications as an alternative to synthetic drugs.

Bio-Oriented Synthesis of Novel (S)-Flurbiprofen Clubbed Hydrazone Schiff's Bases for Diabetic Management: In Vitro and In Silico Studies.

A new series of (S)-flurbiprofen derivatives 4a-4p and 5a-5n were synthesized with different aromatic or aliphatic aldehydes and ketones to produce Schiff's bases and their structures were confirmed through HR-ESI-MS, 1H, and 13C-NMR spectroscopy. The α-glucosidase inhibitory activities of the newly synthesized compounds were scrutinized, in which six compounds 5k, 4h, 5h, 4d, 4b, and 5i showed potent inhibition in the range of 0.93 to 10.26 µM, respectively, whereas fifteen compounds 4c, 4g, 4i, 4j, 4l, 4m, 4o, 4p, 5c, 5d, 5j, 5l, 5m, 5n and 1 exhibited significant inhibitory activity with IC50 in range of = 11.42 to 48.39 µM. In addition, compounds 5g, 5f, 4k, 4n, and 4f displayed moderate-to-low activities. The modes of binding of all the active compounds were determined through the molecular docking approach, which revealed that two residues, specifically Glu277 and His351 are important in the stabilization of the active compounds in the active site of α-glucosidase. Furthermore, these compounds block the active site with high binding energies (-7.51 to -3.36 kcal/mol) thereby inhibiting the function of the enzyme.

Identification of colistin resistance and its bactericidal activity against uropathogenic gram negative bacteria from Hayatabad Medical Complex Peshawar.

Objectives: Identification of colistin resistance and its bactericidal activity against gram-negative bacteria isolated from urinary tract infection (UTI) patients. Methods: This 6-month cross sectional study was conducted in Hayatabad Medical Complex Peshawar from January 2019-June2019.. A total of 2000 urine samples were collected and transported to the Health Research Institute, NIH, Research Centre, Khyber Medical College Peshawar. Samples were streaked on different media and incubated at 37C° for 24hrs. Gram negative bacteria were identified through gram staining and Analytical Profile Index (API) 10s. Gram negative bacteria were subjected under antibiotic sensitivity profile through Kirby-Bauer disc diffusion method. Colistin resistance was found through broth microdilution method. Minimum bactericidal activity was performed to find out the lowest concentration of colistin required to kill gram-negative bacteria. Results: A total of 241(12.05%) uropathogenic gram negative bacteria were isolated and identified from 2000 urine samples while excluding intrinsically resistant bacteria. After broth microdilution, colistin resistance was found in 48(19.9%) Escherichia coli, 4(1.6%) Klebsiella pneumoniae and 3(1.3%) Pseudomonas aeruginosa respectively. Colistin resistant Escherichia coli were resistant to 77% Cephalosporins, 81% to Fluoroquinolones and 70% to Penicillin combinations. Colistin resistant Klebsiella pneumoniae were 100% resistant to Cephalosporins, Penicillin combinations and Fluoroquinolones while 75% were resistant to Carbapenems and Monobactams. Pseudomonas aeruginosa isolates were sensitive to all used antibiotics. Conclusion: E.coli was the mainly responsible uropathogen causing UTIs. Colistin resistance was found in 22.8% gram negative uropathogens. Klebsiella pneumoniae isolates exhibited highest resistance to antibiotics.

Multiple health benefits of curcumin and its therapeutic potential.

Turmeric, or Curcuma longa as it is formally named, is a multifunctional plant with numerous names. It was dubbed "the golden spice" and "Indian saffron" not only for its magnificent yellow color, but also for its culinary use. Turmeric has been utilized in traditional medicine since the dawn of mankind. Curcumin, demethoxycurcumin, and bisdemethoxycurcumin, which are all curcuminoids, make up turmeric. Although there have been significant advancements in cancer treatment, cancer death and incidence rates remain high. As a result, there is an increasing interest in discovering more effective and less hazardous cancer treatments. Curcumin is being researched for its anti-inflammatory, anti-cancer, anti-metabolic syndrome, neuroprotective, and antibacterial properties. Turmeric has long been used as a home remedy for coughs, sore throats, and other respiratory problems. As a result, turmeric and its compounds have the potential to be used in modern medicine to cure a variety of diseases. In this current review, we highlighted therapeutic potential of curcumin and its multiple health benefits on various diseases.

Nanomedicine-Based Delivery Strategies for Breast Cancer Treatment and Management.

Breast cancer is one of the most common types of cancer among women globally. It is caused by mutations in the estrogen/progesterone receptors and conventional treatment methods are commonly utilized. About 70-80 percent of individuals with the early-stage non-metastatic disease may be cured. Conventional treatment is far less than the optimal ratio, as demonstrated through the high mortality rate of women with this cancer. However, conventional treatment methods like surgery, radiotherapy, and chemotherapy are not as effective as expected and lead to concerns about low bioavailability, low cellular uptake, emerging resistance, and adverse toxicities. A nanomedicine-based approach is a promising alternative for breast cancer treatment. The present era is witnessing rapid advancements in nanomedicine as a platform for investigating novel therapeutic applications and modern intelligent healthcare management strategies. This paper focuses on nanomedicine-based therapeutic interventions that are becoming more widely accepted for improving treatment effectiveness and reducing undesired side effects in breast cancer patients. By evaluating the state-of-the-art tools and taking the challenges involved into consideration, various aspects of the proposed nano-enabled therapeutic approaches have been discussed in this review.

Identification of α-Glucosidase Inhibitors from Scutellaria edelbergii: ESI-LC-MS and Computational Approach.

The recent study investigated the in vitro anti-diabetic impact of the crude extract (MeOH) and subfractions ethyl acetate (EtOAc); chloroform; n-butanol; n-hexane; and aqueous fraction of S. edelbergii and processed the active EtOAc fraction for the identification of chemical constituents for the first time via ESI-LC-MS analysis through positive ionization mode (PIM) and negative ionization mode (NIM); the identified compounds were further validated through computational analysis via standard approaches. The crude extract and subfractions presented appreciable activity against the α-glucosidase inhibitory assay. However, the EtOAc fraction with IC50 = 0.14 ± 0.06 µg/mL revealed the maximum potential among the fractions used, followed by the MeOH and n-hexane extract with IC50 = 1.47 ± 0.14 and 2.18 ± 0.30 µg/mL, respectively. Moreover, the acarbose showed an IC50 = 377.26 ± 1.20 µg/ mL whereas the least inhibition was observed for the chloroform fraction, with an IC50 = 23.97 ± 0.14 µg/mL. Due to the significance of the EtOAc fraction, when profiled for its chemical constituents, it presented 16 compounds among which the flavonoid class was dominant, and offered eight compounds, of which six were identified in NIM, and two compounds in PIM. Moreover, five terpenoids were identified-three and two in NIM and PIM, respectively-as well as two alkaloids, both of which were detected in PIM. The EtOAc fraction also contained one phenol that was noticed in PIM. The detected flavonoids, terpenoids, alkaloids, and phenols are well-known for their diverse biomedical applications. The potent EtOAc fraction was submitted to computational analysis for further validation of α-glucosidase significance to profile the responsible compounds. The pharmacokinetic estimations and protein-ligand molecular docking results with the support of molecular dynamic simulation trajectories at 100 ns suggested that two bioactive compounds-dihydrocatalpol and leucosceptoside A-from the EtOAc fraction presented excellent drug-like properties and stable conformations; hence, these bioactive compounds could be potential inhibitors of alpha-glucosidase enzyme based on intermolecular interactions with significant residues, docking score, and binding free energy estimation. The stated findings reflect that S. edelbergii is a rich source of bioactive compounds offering potential cures for diabetes mellitus; in particular, dihydrocatalpol and leucosceptoside A could be excellent therapeutic options for the progress of novel drugs to overcome diabetes mellitus.

How Do Autonomous Vehicles Decide?

The advancement in sensor technologies, mobile network technologies, and artificial intelligence has pushed the boundaries of different verticals, e.g., eHealth and autonomous driving. Statistics show that more than one million people are killed in traffic accidents yearly, where the vast majority of the accidents are caused by human negligence. Higher-level autonomous driving has great potential to enhance road safety and traffic efficiency. One of the most crucial links to building an autonomous system is the task of decision-making. The ability of a vehicle to make robust decisions on its own by anticipating and evaluating future outcomes is what makes it intelligent. Planning and decision-making technology in autonomous driving becomes even more challenging, due to the diversity of the dynamic environments the vehicle operates in, the uncertainty in the sensor information, and the complex interaction with other road participants. A significant amount of research has been carried out toward deploying autonomous vehicles to solve plenty of issues, however, how to deal with the high-level decision-making in a complex, uncertain, and urban environment is a comparatively less explored area. This paper provides an analysis of decision-making solutions approaches for autonomous driving. Various categories of approaches are analyzed with a comparison to classical decision-making approaches. Following, a crucial range of research gaps and open challenges have been highlighted that need to be addressed before higher-level autonomous vehicles hit the roads. We believe this survey will contribute to the research of decision-making methods for autonomous vehicles in the future by equipping the researchers with an overview of decision-making technology, its potential solution approaches, and challenges.

GC-MS Analysis and Biomedical Therapy of Oil from n-Hexane Fraction of Scutellaria edelbergii Rech. f.: In Vitro, In Vivo, and In Silico Approach.

The current study aimed to explore the crude oils obtained from the n-hexane fraction of Scutellaria edelbergii and further analyzed, for the first time, for their chemical composition, in vitro antibacterial, antifungal, antioxidant, antidiabetic, and in vivo anti-inflammatory, and analgesic activities. For the phytochemical composition, the oils proceeded to gas chromatography-mass spectrometry (GC-MS) analysis and from the resultant chromatogram, 42 bioactive constituents were identified. Among them, the major components were linoleic acid ethyl ester (19.67%) followed by ethyl oleate (18.45%), linolenic acid methyl ester (11.67%), and palmitic acid ethyl ester (11.01%). Tetrazolium 96-well plate MTT assay and agar-well diffusion methods were used to evaluate the isolated oil for its minimum inhibitory concentrations (MIC), minimum bactericidal concentration (MBC), half-maximal inhibitory concentrations (IC50), and zone of inhibitions that could determine the potential antimicrobial efficacy's. Substantial antibacterial activities were observed against the clinical isolates comprising of three Gram-negative bacteria, viz., Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa, and one Gram-positive bacterial strain, Enterococcus faecalis. The oils were also effective against Candida albicans and Fusarium oxysporum when evaluated for their antifungal potential. Moreover, significant antioxidant potential with IC50 values of 136.4 and 161.5 µg/mL for extracted oil was evaluated through DPPH (1,1-Diphenyl-2-picryl-hydrazyl) and ABTS assays compared with standard ascorbic acid where the IC50 values were 44.49 and 67.78 µg/mL, respectively, against the tested free radicals. The oils was also potent, inhibiting the α-glucosidase (IC50 5.45 ± 0.42 µg/mL) enzyme compared to the standard. Anti-glucosidase potential was visualized through molecular docking simulations where ten compounds of the oil were found to be the leading inhibitors of the selected enzyme based on interactions, binding energy, and binding affinity. The oil was found to be an effective anti-inflammatory (61%) agent compared with diclofenac sodium (70.92%) via the carrageenan-induced assay. An appreciable (48.28%) analgesic activity in correlation with the standard aspirin was observed through the acetic acid-induced writhing bioassay. The oil from the n-hexane fraction of S. edelbergii contained valuable bioactive constituents that can act as in vitro biological and in vivo pharmacological agents. However, further studies are needed to uncover individual responsible compounds of the observed biological potentials which would be helpful in devising novel drugs.

Mitochondrial phylogenetic and diversity analysis in Azi-Kheli buffalo.

NOVELTY STATEMENT: The present study was conducted for the first time in Pakistan to investigate Cytochrome C Oxidase Subunit 1 (CO1) gene and full-length Displacement Loop (D-loop) region of mitochondrial DNA in Azi-Kheli buffalo breed native to northern hilly areas of Khyber Pakhtunkhwa Province of Pakistan. The present study was designed to investigate phylogeny and diversity in Azi-Kheli buffalo, through two mitochondrial DNA regions, i.e., Cytochrome C Oxidase Subunit-I (CO1) and Displacement Loop (D-loop) region. Thirty (30) blood samples were taken from Azi-Kheli pure breed animals from original breeding tract, i.e., Khwazakhela, Swat. Polymerase chain reactions using gene-specific primers were carried out for amplifying 709-bp region of CO1 gene and 1159-bp region of D-Loop for identification, phylogeny, and diversity in Azi-Kheli buffalo, respectively. The sequences of CO1 gene revealed four (04) haplotypes, whereas D-loop sequences revealed five (05) haplotypes. Mean interspecific diversity with related species was 2.56%, and mean intraspecific diversity within Azi-Kheli buffalo was 0.25%, estimated via Kimura-2 parameter. Phylogenetic tree (maximum likelihood) revealed clustering of Azi-Kheli haplotypes with river buffalo and is distinct from swamp buffalo and other related species of genus Bubalus. Mean haplotype and nucleotide diversity of D-loop were Hd = 0.9601 ± SD = 0.096 and π = 0.01208 ± SD = 0.00182, respectively. Phylogenetic tree (neighbor-joining) revealed two main clades, i.e., river buffalo and swamp buffalo clade. The haplotypes of Azi-Kheli clustered with haplotypes of different river buffalo breeds at different positions. The current study suggests that Azi-Kheli has common origin with other river buffalo breeds; hence, it is river buffalo which harbors high genetic diversity.

Dengue and Chikungunya virus co-infection in major metropolitan cities of provinces of Punjab and Khyber Pakhtunkhwa: A multi-center study.

Dengue has become endemic in Pakistan with annual recurrence. A sudden increase in the dengue cases was reported from Rawalpindi in 2016, while an outbreak occurred for the first time in Peshawar in 2017. Therefore, a multi-center study was carried out to determine the circulating dengue virus (DENV) serotypes and Chikungunya virus (CHIKV) co-infection in Lahore, Rawalpindi, and Peshawar cities in 2016-18. A hospital-based cross-sectional study was carried out in Lahore and Rawalpindi in 2016-18, while a community-based study was carried out in Peshawar in 2017. The study participants were tested for dengue NS1 antigen using an immunochromatographic device while anti-dengue IgM/IgG antibodies were detected by indirect ELISA. All NS1 positive samples were used for DENV serotyping using multiplex real-time PCR assay. Additionally, dengue samples were tested for CHIKV co-infection using IgM/IgG ELISA. A total of 6291 samples were collected among which 8.11% were NS1 positive while 2.5% were PCR positive. DENV-2 was the most common serotype (75.5%) detected, followed by DENV-1 in 16.1%, DENV-3 in 3.9% and DENV-4 in 0.7% while DENV-1 and DENV-4 concurrent infections were detected in 3.9% samples. DENV-1 was the predominant serotype (62.5%) detected from Lahore and Rawalpindi, while DENV-2 was the only serotype detected from Peshawar. Comorbidities resulted in a significant increase (p-value<0.001) in the duration of hospital stay of the patients. Type 2 diabetes mellitus substantially (p-value = 0.004) contributed to the severity of the disease. Among a total of 590 dengue positive samples, 11.8% were also positive for CHIKV co-infection. Co-circulation of multiple DENV serotypes and CHIKV infection in Pakistan is a worrisome situation demanding the urgent attention of the public health experts to strengthen vector surveillance.

Choriocarcinoma After Normal Vaginal Delivery; A Rare Entity.

Choriocarcinoma is a malignant gestational trophoblastic neoplasm with rare postpartum presentation. Its manifestation after full term delivery is very rare with paucity of data reported from Pakistan. We received a patient in the postpartum period with symptoms of distant metastasis. She was diagnosed with choriocarcinoma based on our workup and was referred for chemotherapy after management. Now she is receiving follow-up care.

Pterostilbene alleviates hydrogen peroxide-induced oxidative stress via nuclear factor erythroid 2 like 2 pathway in mouse preimplantation embryos.

Pterostilbene (PTS) in blueberries is a phytoalexin with antioxidant properties. PTS exerts strong cytoprotective effects on various cells via Nuclear Factor Erythroid 2 like 2 (NFE2L2) pathway. We evaluated the antioxidant PTS treatment in mouse preimplantation embryos. In vitro culture media were supplemented with different concentrations of PTS. Treatment of zygotes with 0.25 µM PTS improved the development of day 4 blastocysts (P < 0.05). Moreover, H2O2 treatment significantly increased the reactive oxygen species level and reduced the glutathione level in mouse blastocyst, whereas PTS treatment counteracted these effects. The fluorescence intensity of apoptotic positive cell was higher in the H2O2 group than in the PTS group. Furthermore, PTS-treated embryos significantly increased the protein expression of NFE2L2 in the nucleus and decreased Kelch-like ECH-associated protein1 (KEAP1). PTS treatment significantly increased the expression of downstream target genes involved in the NFE2L2 pathway, such as catalase (CAT), heme oxygenase1 (HMOX1), glutathione peroxidase (GPX), and superoxide dismutase (SOD); these genes confer cellular protection. In addition, PTS treatment significantly increased the expression of anti-apoptotic B-cell lymphoma 2 (BCL2), with a concomitant reduction in the apoptotic Bcl-2-associated X protein (BAX) and Caspase-3 genes in the embryo. PTS treatment also increased the protein expression of BCL2 and reduced the protein expression of BAX in the mouse embryo. In conclusion, PTS activated NFE2L2 signaling pathway in the development of mouse embryos by altering downstream expression of genes involved in the antioxidant mechanisms and apoptosis.

Pterostilbene exerts a protective effect via regulating tunicamycin-induced endoplasmic reticulum stress in mouse preimplantation embryos.

Pterostilbene (PTS) mainly enriched in small fruits such as berries and grapes exerts an antioxidant effect. However, the protective effects of PTS against endoplasmic reticulum stress (ERS) have not yet been elucidated in mouse preimplantation embryo. ERS plays an important role in regulating the pathological and physiological processes, including embryonic development. We explored the protective effect of PTS on the tunicamycin (TM)-induced ERS in mouse preimplantation embryos. In vitro, culture medium was supplemented with different concentrations of TM and PTS. Our result indicated that treatment of zygotes with 0.5 µg/ml TM significantly decreased the development of day 4 blastocysts (P < 0.05), whereas 0.25 µM PTS supplementation improved the development rate of blastocysts. Moreover, TM treatment significantly increased (P < 0.05) the apoptotic index and reduced the total cell number of the blastocyst, whereas PTS treatment counteracted these effects. Additionally, TM potently increased expression levels of ERS-related proteins, such as GRP78, ATF6, PERK, p-Perk, IRE1, ATF4, and CHOP (P < 0.05). However, PTS and PTS + TM treatment decreased expression levels of ERS-related proteins (P < 0.05). Furthermore, expression level of the anti-apoptotic protein and gene BCL2 significantly decreased (P < 0.05) in TM-treated embryo but increased by PTS treatment (P < 0.05), whereas expression levels of the pro-apoptotic protein and gene BAX increased (P < 0.05) with TM but significantly decreased (P < 0.05) with co-treatment with PTS. In summary, PTS treatment significantly increased the development potential of mouse embryo by reduction of ERS.