Real-world comparison of terlipressin vs. octreotide as an adjuvant treatment in the management of variceal bleeding

Variceal bleeding is a major complication and the leading cause of death in patients with cirrhosis and portal hypertension. This study aims to compare the efficacy and safety of terlipressin vs octreotide as an adjuvant to endoscopic management of patients with esophageal variceal bleeding in a real-time scenario. We reviewed the medical records of patients with esophageal variceal bleeding from January 2005 to December 2020 at our tertiary care Aga Khan University Hospital. Mortality was assessed after 6 weeks. A total of 842 patients with variceal bleed were evaluated. 624 patients (74.1%) and 218 patients (25.9%) received Terlipressin and Octreotide respectively. On multiple regression analysis, cardiac events during hospital stay (OR: 11.22), presence of Porto-systemic encephalopathy (OR: 3.79), and elevated bilirubin levels at the time of presentation were found to be independent risk factors for increased six weeks mortality. Moreover, cardiac events during hospital stay (OR: 3.26), Porto-systemic encephalopathy at presentation (OR: 3.06), and octreotide administration (OR: 1.80) were identified as independent risk factors for increased length of hospital stay. Terlipressin and Octreotide have similar outcomes in terms of control of bleeding, hospital stay, mortality, and side effects when used as adjuvant therapy for the management of variceal bleeding.

941 The Effect of COVID-19 on Orthopaedic Trauma Theatre Efficiency and Surgical Training in the North and East of Scotland Major Trauma Centres – a Year On

Aim

To determine the orthopaedic trauma theatre efficiency in two large major trauma centres (MTCs) in Scotland before and after the outbreak of Coronavirus disease (COVID-19) pandemic.

Method

All trauma patients presented to the North and East of Scotland's MTCs prior to the outbreak of COVID-19 (7th May to 7th June 2019), during the first peak of COVID-19 (7th May to 7th June 2020), after Aerosol Generating Procedures updates (7th November to 7th December 2020) and the ‘new normal’ (7th May to 7th June 2021) were retrospectively reviewed. Training opportunities and theatre time were compared. The Kruskall-Wallis test was used.

Results

There were no significant differences in the length of hospital stay (p=0.117, 0.065) and time from injuries and surgery within groups in both MTCs (p=0.508, 0.384). The pandemic has negatively affected the anaesthetic and surgical preparation time, time between end of procedure and send for next case, and turnover time, with more profound effect on the North of Scotland's MTC. The trainee's involvement as main surgeon had decreased with the outbreak of the pandemic, with the junior trainees being affected most severely in North of Scotland. The time taken for patient to arrive to theatre after sending and total downtime were twice as long in the North of Scotland.

Conclusion

The COVID-19 pandemic has negatively impacted the orthopaedic trauma theatre efficiency and training opportunities. Actions should be taken to improve the turnover time to maximise theatre efficiency while prioritizing training opportunities.

947 COVID19 and Its Impact on the North and East of Scotland Orthopaedic Trainees

Aim

We conducted a trainee survey at the first peak of the pandemic to investigate the impact of COVID-19 on the North of Scotland (NoS) and East of Scotland (EoS) orthopaedic trainees.

Method

An online survey was distributed to all NoS and EoS orthopaedic trainees. All data collection was anonymous.

Results

Across both Scottish deaneries, 28 trainees had responded: 39% from EoS and 61% from NoS. Trainees at all stages of training responded to the survey, with the most responses received from specialist trainees in third year of training (ST3) (25%). In response to the pandemic, 18% of trainees had been redeployed and they were from NoS. Since the reconfiguration of service, 18% of trainees had done >20 operations in a month and they were senior trainees. If COVID-19 outbreak is likely going to reduce operating opportunities for a long period, only 36% of trainees would be open to the idea of making standard surgical specialty training longer whereas 57% of trainees would be open to longer working hours to achieve certification in Trauma and Orthopaedic surgery within 96 months.

Conclusion

The outbreak of COVID-19 has impacted both deaneries orthopaedic training and urgent restoration of surgical training is essential for individual trainees. Changes in working practices necessitated by COVID-19 have known to impact theatre efficiency. Actions should be taken to improve the theatre efficiency while prioritizing training opportunities.

Endophytic Fusarium oxysporum GW controlling weed and an effective biostimulant for wheat growth

Wheat crop has to compete with several weeds including Avena fatua, a noxious weed that alone is responsible for 30-70% losses in the yield annually. Because of the environmental concerns associated with conventional methods, researchers are on a continuous hunt to find clean alternatives in order to manage weeds. Fungi have shown promising weedicide potential in lab studies. The current study aimed to isolate endophytic fungi from wheat plants which can promote wheat growth and inhibit the growth of common weed, A. fatua. Of several isolates, GW (grayish white) was selected for its promising features, and the strain was identified as Fusarium oxisporum through ITS sequencing technique. This fungus released a number of compounds including Isovitexin, Calycosin, quercetagetin, and dihydroxy-dimethoxyisoflavone that inhibited the growth of A. fatua but did not influence the growth of wheat seedlings. Biomass of this fungus in the soil also reduced growth parameters of the weed and promoted the growth of wheat. For instance, the vigor index of A. fatua seedlings was reduced to only 6% of the control by this endophyte. In contrast, endophyte-associated wheat seedlings showed a higher vigor index than the control. Behind this differential response of the two plants were their contrasting physiological and biochemical status. Lower growth phenotypes of A. fatua seedlings had reduced levels of IAA, GAs, and SA and higher the levels of JA and ABA. Besides, their ROS scavenging ability was also compromised as evident from relatively lower activities of catalase, peroxidase, and ascorbic acid oxidase, as well as higher accumulation of ROS in their leaves. Wheat seedlings response to GW was opposite to the A. fatua. It may be concluded that F. oxysporum GW has the ability to differentially modulate physiology and biochemistry of the two hosts leading to contrasting phenotypic responses.

Competing risks survival data under middle censoring-An application to COVID-19 pandemic

Survival data is being analysed here under the middle censoring scheme, using specifically quantile function modelling under competing risks. The use of middle censoring scheme has been shown to be very appropriate under the COVID-19 pandemic scenario. Cause-specific quantile inference under middle censoring is employed. Such quantile inferences are obtained through cumulative incidence function based on cause-specific proportional hazards model. The baseline lifetime is assumed to follow a very general parametric model namely the Weibull distribution, and is independent of the censoring mechanism. We obtain estimates of the unknown parameters and cause specific quantile functions under classical as well as a Bayesian set-up. A Monte Carlo simulation study assesses the relative performance of the different estimators. Finally, a real life data analysis is given for illustration of the proposed methods.

Dietary Catharanthus roseus modulates intestinal microarchitecture in broilers

The study evaluated the efficacy of ethanolic extracts of Catharanthus roseus (C. roseus) in altering growth performance, viscera  development and intestinal microarchitecture in broilers. Day-old broiler chicks (n = 175) were randomly divided into seven groups (n = 25/group) with 5 replicates (n = 5). The chicks in the control groups were fed a corn-soya-based basal diet, whereas groups 2 - 4 had the same basal diets supplemented with 0.05%, 0.1%, and 0.2% ethanolic leaf extracts (ELE), respectively. Chicks in groups 5 - 7 were fed the basal diet supplemented with 0.05%, 0.1%, and 0.2% ethanolic root extracts (ERE) of C. roseus, respectively. The growth performance and feed conversion ratio remained unchanged, but feed consumption of birds supplemented with 0.1% ERE increased in weeks 1 and 3. The relative length of the small intestine was lower in the 0.05% ERE group compared with the control. Villus height, width, surface area, and lamina propria thickness were higher in the 0.1% ERE group in all three segments of the small intestine than in the control. Broilers supplemented with 0.1% ERE performed better in terms of feed consumption and improved intestinal microarchitecture of the small intestine.

Burden of Drug resistant Tuberculosis in newly diagnosed Tuberculosis patients of Khyber Pakhtunkhwa, Pakistan

OBJECTIVE

To explore the burden of drug-resistant tuberculosis in Khyber Pakhtunkhwa, Pakistan.

METHODS

The cross-sectional study was conducted from March 1, 2016, to February 28, 2017, at the Khyber Pakhtunkhwa Tuberculosis Reference Laboratory, Hayatabad Medical Complex, Peshawar, Pakistan, and comprised referred suspected tuberculosis patient samples. Drug Susceptibility testing on all Mycobacterium tuberculosis complex strains was performed and data was subjected to statistical analysis.

RESULTS

Of the 8220 samples, 4230 (51.5%) were related to females and 3990 (48.5%) to males. Also, 1978 (24%) were related to patients aged 15-24 years. Of the total, 1351 (16.5%) samples were positive on culture. Drug susceptibility testing showed 525 (39%) samples to be resistant to at least one of the first- and second-line drugs. Among the culture-positive cases, 5 (0.4%) were extensively drug-resistant, 62 (4.6%) multi-drug resistant, 243 (18%) polyresistant, 215 (16%) monoresistant and 826 (61%) were pan-sensitive.

CONCLUSIONS

Drug-resistant tuberculosis in newly-diagnosed tuberculosis patients was alarmingly high in Khyber Pakhtunkhwa region.

Orthopaedic assessment unit: a service model for the delivery of orthopaedic trauma care in a major trauma centre during the global pandemic (COVID-19)

INTRODUCTION

We describe a new service model, the Orthopaedic Assessment Unit (OAU), designed to provide care for trauma patients during the COVID-19 pandemic. Patients without COVID-19 symptoms and isolated musculoskeletal injuries were redirected to the OAU.

METHODS

We prospectively reviewed patients throughput during the peak of the global pandemic (7 May 2020 to 7 June 2020) and compared with our historic service provision (7 May 2019 to 7 June 2019). The Mann-Whitney and Fisher Exact tests were used to test the statistical significance of data.

RESULTS

A total of 1,147 patients were seen, with peak attendances between 11am and 2pm; 96% of all referrals were seen within 4h. The majority of patients were seen by orthopaedic registrars (52%) and nurse practitioners (44%). The majority of patients suffered from sprains and strains (39%), followed by fractures (22%) and wounds (20%); 73% of patients were discharged on the same day, 15% given follow up, 8% underwent surgery and 3% were admitted but did not undergo surgery. Our volume of trauma admissions and theatre cases decreased by 22% and 17%, respectively (p=0.058; 0.139). There was a significant reduction of virtual fracture clinic referrals after reconfiguration of services (p<0.001).

CONCLUSIONS

Rapid implementation of a specialist OAU during a pandemic can provide early definitive trauma care while exceeding national waiting time standards. The fall in trauma attendances was lower than anticipated. The retention of orthopaedic staff in the department to staff the unit and maintain a high standard of care is imperative.

Evaluation of serum analytes in pregnant and non-pregnant dairy cows as indicators of pregnancy

This study was conducted to reveal the dynamics of haematological indicators in pregnant and non-pregnant dairy cows. Sixty multiparous healthy dairy cows were divided into four groups based on the length of time they had been pregnant, namely first, second and third trimesters, and non-pregnant (n=15 each). Blood was collected from each animal, and serum was harvested and stored at -20 °C for biochemical profiling. Concentrations of serum total oxidants (TOC), ceruloplasmin oxidase (CpO) and triiodothyronine (T3) were higher (P <0.05) during the third trimester compared with non-pregnant cows. Serum arylesterase (Ary) concentration was lower (P <0.05) during the second and the third trimesters compared with the non-pregnant cows. The concentration of serum total homocysteine (tHcy) was higher (P <0.05) the third trimester compared with the first and the second trimesters. The concentrations of serum total antioxidants (TAC), paraoxonase 1 (PON1), thyroxine (T4), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) were not different in the pregnant and the non-pregnant cows. Thus, TOC, Ary, CpO, tHcy and T3 could be taken as biological markers to assess the progression of pregnancy and to develop management tools to improve health status during late gestation in dairy cows Keywords: ceruloplasmin, hepatic enzymes, late gestation, triiodothyronine

Synthesis of CuO-NPS by simple wet chemical method using various dicarboxylic acid salts as precursors: Spectral characterization and in-vitro biological evaluation

In this study, a simple chemical reduction method was employed to synthesize CuO-NPs.  Various dicarboxylic acids were converted into Cu(II) salt of dicarboxylic acid which were used as precursors. NPs were produced by reducing precursors with NaBH4. Characteristics of synthesized NPs were investigated by using important analytical techniques including Fourier transform infrared (FTIR) spectroscopy, X-ray diffraction (XRD), thermo gravimetric analysis (TGA) and scanning electron microscopy (SEM). Developed NPs were investigated for their antibacterial activity against a range of bacterial strains by employing agar well diffusion method. CuO-NPs exhibited good to moderate activity against E-Coli, B. Subtilis and poor activity against K. pneumonia and Methicillin-resistant Staphylococcus aureus (MRSA). It was found that amongst all experienced compounds sample 2 showed good activity with minimum inhibition concentration (MIC) 10 µg/mL (zone of inhibition: 22± 0.12 mm) while sample 3 showed poor activity with MIC 40 µg/mL (zone of inhibition: 8.0 ± 0.18 mm).                     KEY WORDS: CuO-NPs, Dicarboxylic acids, Sodium borohydride, Antibacterial study   Bull. Chem. Soc. Ethiop. 2020, 34(2), 323-334 DOI: https://dx.doi.org/10.4314/bcse.v34i2.10

Spinal epidural abscesses - The role for non-operative management: A systematic review

BACKGROUND

Spinal Epidural Abscesses (SEAs) are traditionally seen as a surgical emergency. However, SEAs can be discovered in entirely asymptomatic patients. This presents a dilemma for the attending clinician as to whether to subject these patients to significant surgery. This systematic review updates the evidence surrounding the efficacy of non-operative SEA management by means of intravenous antibiotics ± radiologically-guided aspiration.

AIMS

1. To assess failure rates of medical therapy for SEA. The absolute definition of 'failure' used by the study was recorded, and comparisons made. 2. To review of risk factors for success/failure of medical treatment for SEA.

METHODS

A database search with the MESH term 'epidural abscess' and keywords ['treatment' OR 'management'] were used.

RESULTS

14 studies were included. The number of SEA patients managed non-operatively ranged from 19 to 142. There was significant heterogeneity across the studies. Pooled Failure of Medical Therapy (FMT) (defined as any poor outcome) was 29.40%. When FMT = mortality the pooled rate was 11.49%. Commonly cited risk factors for FMT included acute neurological compromise, diabetes mellitus, increasing age and Staphylococcus aureus.

CONCLUSION

SEA will always be a condition mostly managed surgically. Despite this, there is growing evidence that non-operative management can be possible in the correct patients. The key is in patient selection - patients with any of the above-mentioned risk factors have the potential to deteriorate further on medical treatment and have a worse outcome than if they had undergone emergency surgery straight away. Ongoing research will hopefully further investigate this crucial step.

Effect of maternal yeast feeding on dam performance and serum health biomarkers of Beetal goat kids

Supplementation with dietary yeast has improved digestibility and productive performance in ruminants. In this research the primary objective was to appraise the effects of dietary yeast supplementation of female goats during the transition period on milk composition and yield and on production and serum health biomarkers of their kids. Twenty-four Beetal goats (4 ± 1.2 years) were randomly assigned to three groups, which received 0, 5, and 10 grams/animal/day of live dried yeast Saccharomyces cerevisiae for 60 days (30 days pre- and post-partum). All goats were fed 500 grams of concentrate with water and green fodder ad libitum. Milk samples were collected at 7, 14, 21, and 28 days post kidding. Kids were weighed on days 0, 7, 15, 22, and 30, and blood samples were collected on days 15 and 30 for serum metabolites (glucose, urea, cholesterol, non-esterified fatty acids (NEFA), serum total proteins, albumin, globulin, albumin to globulin ratio, serum oxidant and antioxidant activity (malondialdehyde) (MDA) and catalase), and liver enzymes aspartate aminotransferase (AST) and alanine transaminase (ALT) assessment. Milk yield was significantly (P =0.02) higher during the post-partum period in yeast-fed goats. Yeast-fed goats also produced milk containing more fat (P <0.001) and protein (P <0.001) compared with control goats. Birth weight, average daily gain, and serum health biomarkers of the kids were not influenced by the treatments. In conclusion, dietary yeast supplementation resulted in increased production performance of the dams without significant impact on their offspring.Keywords: average daily gain, catalase activity, hepatic enzymes, milk production, Saccharomyces cerevisiae, transition period

Effects of endocrine disruptor furan on reproductive physiology of Sprague Dawley rats: An F1 Extended One-Generation Reproductive Toxicity Study (EOGRTS)

The present study investigated the reproductive toxicity of furan in an Extended One-Generation Reproductive Toxicity Study in rats. Sprague Dawley F0 weaning rats (30 per sex per group) were exposed to furan orally at 0, 1, 2.5, 5, and 10 mg kg^-1 for 10 weeks (males) and 2 weeks (females) and then mated. Results of F0 indicated that in the furan-treated groups (5 mg kg^-1 and 10 mg kg^-1), body weight (bw) gain decreased during prebreed and gestational period while increased during lactation periods. F0 animals prebreeding exposure resulted in head tilt and foot splay at 10 mg kg^-1. Number of live pups at birth were decreased (p < 0.001) at 10 mg kg^-1. At postnatal day (PND) 70, a significant (p = 0.03) decrease in testosterone levels of male rats and estrogen levels of female rats (p = 0.05) was observed in 10 mg kg^-1 furan-treated group in F1 generation. Luteinizing hormone, follicle-stimulating hormone, and progesterone levels were also reduced, but their reduction was not statistically significant in all groups. In higher dose furan group (10 mg kg^-1), testicular and ovarian weights were reduced in F1 generation at PND 70, with decreased daily sperm production (p = 0.01) and disturbed estrous cyclicity (p < 0.01). Some histopathological changes were also observed in testis and ovaries in groups whose parents were previously exposed to 10 mg kg^-1 bw of furan group. Based on the above results, it is suggested that exposure to food-based contaminant furan induced remarkable changes in the F0 (parental stage) and F1 (offspring, pubertal, and adult stage) generations of Sprague Dawley rats.

Supplemental chromium-loaded chitosan nanoparticles affect growth, serum metabolites and intestinal histology in broilers

The goal of the present research was to evaluate the effects of chromium-loaded chitosan nanoparticles (Cr-CNPs) on production performance, viscera development, serum metabolites and intestinal histology in broilers. Two hundred (200) day-old broilers were randomly divided into five groups with five replicates (n = 8). Birds in the first group served as control and were fed a corn soybean-based diet, while the remaining four supplemented groups were offered 200, 400, 800, and 1200 μg Cr-CNPs/kg of feed, respectively, for 35 days. Weight gain, feed intake and feed conversion ratio (FCR) remained unaffected with Cr-CNP supplementation. No changes were observed in the relative weights of viscera. The relative length of the small intestine was decreased in birds supplemented with 200 and 800 μg Cr-CNPs/kg compared with the 1200 μg Cr-CNP-supplemented group and control. Serum metabolites remained unaffected with Cr-CNP supplementation except for serum HDL, which was increased. Cr-CNPs decreased the retention of chromium in the bone at higher concentrations. Jejunal villus height, villus surface area, and villus height to crypt depth ratio were increased in the 800 μg Cr-CNP-supplemented group. In conclusion, Cr-CNPs did not affect growth performance, viscera development, and most of the serum metabolites, but enhanced jejunal morphological attributes at 800 μg Cr-CNPs/kg of feed. Keywords: blood biochemistry, health, nano-biotechnology, prebiotics, poultry, trace mineral

Molecular Heterogeneity of β-Thalassemia in the Kohat Region, Khyber Pakhtunkhwa Province, Pakistan

The present study was intended to report the incidence of the most frequently occurring β-thalassemia (β-thal) mutations in the Kohat region [Khyber Pakhtunkhwa (KP) Province, Pakistan], their inheritance pattern in patients, and consanguinity in the parents. Moreover, this study could provide valuable information regarding thalassemia diagnoses such as prenatal diagnosis (PND), genetic counseling and carrier screening for controlling the affected births in the population. During this study, 160 peripheral blood samples of affected patients, their parents and siblings were collected from 25 discrete families having at least one child needing regular blood transfusions from different areas of the Kohat region. β-Thalassemia mutations found in the population were screened via the amplification refractory mutation system-polymerase chain reaction (ARMS-PCR). A total of 320 alleles was evaluated for the presence of six β-thal mutations. Of these six β-thal mutations, the frameshift codons (FSC) 8/9 (+G) (HBB: c.27_28insG) was found to be the most frequent in the studied population, and more interestingly, followed by IVS-I-5 (G>C) (HBB: c.92+5G>C) and FSC 5 (-CT) (HBB: c.17_18delCT). The findings of the present study show differences with previous results from other regions of the Pashtun population, which demarcates the heterogeneity in mutations found in the Pashtun ethnicity. These observations may help in implementing parental meetings about disease recurrence in future, large scale mutation screening and PND for the population of the Kohat region and also the whole Pashtun ethnicity.

Cochliobolus sp. acts as a biochemical modulator to alleviate salinity stress in okra plants

Salinity stress can severely affect the growth and production of the crop plants. Cheap and reliable actions are needed to enable the crop plants to grow normal under saline conditions. Modification at the molecular level to produce resistant cultivars is one of the promising, yet highly expensive techniques, whereas application of endophytes on the other hand are very cheap. In this regard, the role of Cochliobolus sp. in alleviating NaCl-induced stress in okra has been investigated. The growth and biomass yield, relative water content, chlorophyll content and IAA were decreased, whereas malondialdehyde (MDA) and proline content were increased in okra plants treated with 100 mM NaCl. On the contrary, okra plants inoculated with C. lunatus had higher shoot length, root length, plant dry weight, chlorophyll, carotenoids, xanthophyll, phenolicss, flavonoids, IAA, total soluble sugar and relative water content, while lower MDA. LC-MS/MS analysis of the Cochliobolus sp. extract revealed the presence of pinocembrin, chlorogenic acids, wogonin, calycosin and diadzein as a salinity stress reliever. From the results, it can be concluded that colonization of Cochliobolus sp. improves the NaCl tolerance by ameliorating the physicochemical attributes of the host plants.

Molecular Characterization of β-Thalassemia Mutations Via the Amplification Refractory Mutation System-Polymerase Chain Reaction Method at the North Waziristan Agency, Pakistan

β-Thalassemia (β-thal) is a monogenic disease characterized by mutations on the HBB gene, affecting the production of globin that results in hypochromic and microcytic anemia. The aim of this study was to determine the prevalence of six common β-thal mutations, and their frequency and inheritance pattern in affected populations of North Waziristan Agency, Pakistan. In this study, 130 blood samples from 37 unrelated β-thalassemic families having a minimum of one transfusion-dependent child with β-thal major (β-TM), were retrieved either from the Thalassaemia Centre for Women and Children Hospital Bannu or their home towns situated in Noth Waziristan Agency. All samples were analyzed by the amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) using six allele-specific primers for the presence of the six β-thal mutations common in the Pakistani population. Of the six common mutations, our study demonstrated five HBB mutations comprising HBB: c.27_28insG, HBB: c.92+5G>C, HBB: c.126_129delCTTT, HBB: c.92+1G>T and HBB: c.17_18delCT from the families studied, while mutation HBB: c.47G>A [codon 15 (G>A)] was not detected in any of the studied families. Furthermore, the HBB: c.27_28insG and HBB: c.92+5G>C were noted to be the most common with frequencies of 42.85 and 31.42%, respectively. The findings of the present study may be useful in launching carrier screening and prenatal diagnosis (PND) programs by screening analyzed and other unanalyzed affected families for the possible presence of common mutations through the ARMS-PCR technique that will help to control the disease.

Effect of Moringa oleifera leaf powder supplementation on growth performance and intestinal morphology in broiler chickens

Due to public health hazards of subtherapeutic use of antibiotics in poultry feed, there is a need for alternatives. Moringa oleifera is a phytobiotic, which is reported to possess antimicrobial and immuno-modulatory properties. This study aimed to investigate effects of M. oleifera leaf powder (MOLP) supplementation on growth performance and intestinal microarchitecture of broiler chickens. Day-old broiler chicks (n = 100) were randomly divided into five groups with four replicates each having five birds. Birds were fed a corn-based basal diet or the same diet supplemented with 0.6, 0.9, 1.2 and 1.5% MOLP. Body weight and feed conversion ratio were recorded on weekly basis. On day 35, two birds per replicate were selected to collect samples of duodenum, jejunum, ileum, caecal tonsils and bursa of Fabricius. Tissue samples were stained with haematoxylin and eosin or combined alcian blue and PAS technique. Supplementation of MOLP had no effect on feed intake, feed conversion ratio, bursa weight and intra-epithelial lymphocytes (IEL) count. Birds fed with 1.2% MOLP had higher (p < 0.05) body weight, length and empty weight of small intestine, and weight of empty and filled ceca. Villus height (duodenum, jejunum, ileum), villus surface area (duodenum) and villus height:crypt depth (ileum) were higher (p < 0.05) in 1.2% MOLP group compared with non-supplemented group. In duodenum, total goblet cell count was higher (p < 0.05) in all the supplemented groups when compared with non-supplemented birds. Acidic mucin count was higher (p < 0.05) in duodenum, jejunum and ileum of 1.2% MOLP group compared with the control group. Bursal follicle count was higher (p < 0.05) in 1.2% MOLP group compared with non-supplemented group. In conclusion, dietary supplementation of 1.2% MOLP modulated intestinal microarchitecture and acidic mucin production without any apparent effect on growth.

Pressure flow pattern of varicocele veins and its correlation with testicular blood flow and semen parameters

The pressure pattern in varicocele veins of infertile patients and its correlation with semen quality and testicular blood flow was determined. Consecutive patients at andro-urology clinic of a teaching hospital undergoing microsurgical varicocelectomy were included. Their semen quality and testicular blood flow were determined. Peak systolic velocity (PSV) and resistive index (RI) of subcapsular and intraparenchymal branches of testicular artery were noted by colour Doppler ultrasonography. During surgery before ligation of varicocele veins, intravenous pressures of internal spermatic (ISV) and external spermatic (ESV) veins were determined at baseline and after Valsalva manoeuvre. Thirty patients, 20-45 years old, were evaluated. Baseline pressure for maximum dilated ISV (A), less dilated ISV (B) and ESV was 15.93 ± 6.34, 12.38 ± 4.60 and 12.92 ± 5.65 mm. Hg, respectively, which increased after Valsalva by 104.4%, 116.2% and 38.22% respectively. Correlation (r = -.71; p < .05) was appreciated between percentage increase in pressure of ISV B with PSV of intraparenchymal testicular arteries and progressive motility (r = -.759; p < .05), nonprogressive motility (r = -.738; p < .05) and morphology (r = -.653; p = .07) of spermatozoa. In conclusion, ISV develops higher pressure on Valsalva as compared to ESV and has correlation with semen quality and testicular blood flow.

Effect of wood ash application on the morphological, physiological and biochemical parameters of Brassica napus L

The present study was conducted to determine the effect of wood ash application on different parameters of Brassica napus L. including seed germination, seedling growth, fresh and dry biomass, water content in seedlings, photosynthetic pigments, soluble sugars, total protein and cell viability. In addition, the effect of wood ash on soil microflora and accumulation of trace elements in seedlings were determined. The seeds of B. napus were grown at different doses of wood ash (0, 1, 10, 25, 50 and 100 g (wood ash)/kg (soil)) and the effect on various parameters was determined. Wood ash significantly inhibited seed germination at doses above 25 g/kg and there was no germination at 100 g/kg of wood ash. At lower concentrations of wood ash, most of the growth parameters of seedlings were stimulated, but at higher concentrations of wood ash most of the studied parameters were adversely affected. Wood ash was found to be very detrimental to B. napus when applied above 25 g/kg. Wood ash application resulted in an increased bioaccumulation of trace elements in seedlings of B. napus. Almost all trace elements were significantly higher in seedlings grown in wood ash above 10 g/kg as compared to the control. An increase in total microbial count was observed with wood ash treatment which was statistically significant at 1 and 10 g/kg of wood ash. It is concluded that at very high concentration, wood ash can be detrimental to plants; however, its application at lower application rate can be recommended.

Detection of Mycobacterium tuberculosis and Mycobacterium bovis from human sputum samples through multiplex PCR

Tuberculosis (TB) has a long history and being present even before the start of recording history. It has left detrimental effects on all aspect of the life and geared the developments in the science of health. TB is caused by Mycobacterium tuberculosis complex (MTBC) including five species M. tuberculosis, M. bovis, M. africanum, M. canetti, and M. microti. M. tuberculosis and M. bovis infect both animals and humans. Therefore, differentiation of these two closely related species is very important for epidemiological and management purpose. We undertook the present study to characterize mycobacteria isolated from sputum of known TB patients by conventional methods and further, by multiplex PCR (mPCR) to detect the prevalence of Zoonotic TB (TB caused by M. bovis). Sputum samples from TB patient were collected from two tertiary care hospitals in Peshawar i.e. Lady Reading Hospital and Hayatabad Medical Complex. All the samples were subjected to Ziehl Neelsen (ZN) stain, culture on Lowenstein Jensen (LJ) and Stone Brink medium, Nitrate reduction test and multiplex PCR. A total of hundred mycobacterial strains were isolated from these samples on the basis of ZN staining, cultural and biochemical methods. Later on, these isolates were subjected to multiplex PCR by using pncATB-1.2 and pncAMT-2 primers specific to M. tuberculosis and JB21, JB22 primers specific to M. bovis. By means of conventional method, these hundred cultures isolates were differentiated into M. tuberculosis (ninety six) and M. bovis (four). Furthermore, by mPCR, it was determined that out of hundred isolates, ninety-eight were identified as M. tuberculosis and two isolates as M. bovis. This molecular method enables to differentiate M. bovis from M. tuberculosis in human sputum.

X-ray, spectroscopic and normal-mode dynamics of calexcitin: structure-function studies of a neuronal calcium-signalling protein

The protein calexcitin was originally identified in molluscan photoreceptor neurons as a 20 kDa molecule which was up-regulated and phosphorylated following a Pavlovian conditioning protocol. Subsequent studies showed that calexcitin regulates the voltage-dependent potassium channel and the calcium-dependent potassium channel as well as causing the release of calcium ions from the endoplasmic reticulum (ER) by binding to the ryanodine receptor. A crystal structure of calexcitin from the squid Loligo pealei showed that the fold is similar to that of another signalling protein, calmodulin, the N- and C-terminal domains of which are known to separate upon calcium binding, allowing interactions with the target protein. Phosphorylation of calexcitin causes it to translocate to the cell membrane, where its effects on membrane excitability are exerted and, accordingly, L. pealei calexcitin contains two protein kinase C phosphorylation sites (Thr61 and Thr188). Thr-to-Asp mutations which mimic phosphorylation of the protein were introduced and crystal structures of the corresponding single and double mutants were determined, which suggest that the C-terminal phosphorylation site (Thr188) exerts the greatest effects on the protein structure. Extensive NMR studies were also conducted, which demonstrate that the wild-type protein predominantly adopts a more open conformation in solution than the crystallographic studies have indicated and, accordingly, normal-mode dynamic simulations suggest that it has considerably greater capacity for flexible motion than the X-ray studies had suggested. Like calmodulin, calexcitin consists of four EF-hand motifs, although only the first three EF-hands of calexcitin are involved in binding calcium ions; the C-terminal EF-hand lacks the appropriate amino acids. Hence, calexcitin possesses two functional EF-hands in close proximity in its N-terminal domain and one functional calcium site in its C-terminal domain. There is evidence that the protein has two markedly different affinities for calcium ions, the weaker of which is most likely to be associated with binding of calcium ions to the protein during neuronal excitation. In the current study, site-directed mutagenesis has been used to abolish each of the three calcium-binding sites of calexcitin, and these experiments suggest that it is the single calcium-binding site in the C-terminal domain of the protein which is likely to have a sensory role in the neuron.

Effect of dietary supplementation of prebiotics and probiotics on intestinal microarchitecture in broilers reared under cyclic heat stress

This study was designed to evaluate the effect of dietary supplementation of prebiotics, mannanoligosaccharides (MOS) and/or probiotics (LBP) on intraepithelial lymphocytes (IEL) count, goblet cells (GC) count and differentiation and intestinal micro-architecture in broilers reared under cyclic heat stress. Day-old broilers (n = 250) were randomly divided into five groups. Fifty birds were reared within the thermoneutral zone (TNZ). Remaining birds were subjected to cyclic heat stress from day 21 to 42 (35° C, 75% RH, 8 h/d). The birds were fed corn-soy-based basal diet or the same diet supplemented with 0.5% MOS (HS-MOS), or 0.1% LBP (HS-LBP), or their combination (HS-SYN). The birds were slaughtered on day 42. Tissue samples were collected from mid-duodenum, jejunum and ileum, and stained with haematoxylin and eosin or combined Alcian blue and PAS technique. All differences were considered significant at p < 0.05. The IEL count increased in all intestinal segments of the HS group compared with the TNZ group and decreased in all supplemented groups compared with the HS group. Compared with the TNZ, heat stress reduced villus height, crypt depth and surface area in duodenum and ileum, and increased crypt depth in ileum. Villus width decreased in duodenum and jejunum compared with the TNZ group. Supplementation of LBP, MOS and SYN reversed all these changes in duodenum, while only increased villus height and surface area in ileum. In jejunum, the villus height and surface area increased with HS-LBP, and crypt depth increased with HS-MOS. The number of GC containing acid mucins (duodenum and ileum) and mixed mucins (ileum) were increased in the HS compared with the TNZ. Supplementation of MOS, LBP and SYN maintained the enhanced activity of goblet cells. In conclusion, dietary supplementation of MOS and/or LBP may be helpful in alleviating some of the detrimental effects of heat stress on microstructure of the broiler gut.

Transformation of membranous into anti-GBM nephritis

Membranous nephropathy is a common glomerular disease. We report a 50-year-old man with a history of membranous nephropathy in remission, who presented with acute kidney injury, proteinuria, hematuria, and hypertension. He also had a high anti-glomerular basement membrane (anti-GBM) antibody titer and crescent transformation of primary pathology. The kidney functions deteriorated rapidly despite aggressive therapy with cyclophosphamide, methylprednisolone, and plasmapheresis.

Amphiregulin stimulates liver regeneration after small-for-size mouse liver transplantation

This study investigated whether amphiregulin (AR), a ligand of the epidermal growth factor receptor (EGFR), improves liver regeneration after small-for-size liver transplantation. Livers of male C57BL/6 mice were reduced to ~50% and ~30% of original sizes and transplanted. After transplantation, AR and AR mRNA increased in 50% but not in 30% grafts. 5-Bromodeoxyuridine (BrdU) labeling, proliferating cell nuclear antigen (PCNA) expression and mitotic index increased substantially in 50% but not 30% grafts. Hyperbilirubinemia and hypoalbuminemia occurred and survival decreased after transplantation of 30% but not 50% grafts. AR neutralizing antibody blunted regeneration in 50% grafts whereas AR injection (5 μg/mouse, iv) stimulated liver regeneration, improved liver function and increased survival after transplantation of 30% grafts. Phosphorylation of EGFR and its downstream signaling molecules Akt, mTOR, p70S6K, ERK and JNK increased markedly in 50% but not 30% grafts. AR stimulated EGFR phosphorylation and its downstream signaling pathways. EGFR inhibitor PD153035 suppressed regeneration of 50% grafts and largely abrogated stimulation of regeneration of 30% grafts by AR. AR also increased cyclin D1 and cyclin E expression in 30% grafts. Together, liver regeneration is suppressed in small-for-size grafts, as least in part, due to decreased AR formation. AR supplementation could be a promising therapy to stimulate regeneration of partial liver grafts.