Serum Uric Acid and Serum Lipid Levels in Patients with Acute Ischemic Stroke Admitted in Mymensingh Medical College Hospital

Stroke is the second-leading cause of death and also a leading cause of combined death and disability. In Bangladesh, stroke prevalence is 11.39 per 1000 population, but highest prevalence of stroke is 14.71 per 1000 population in the Mymensingh division. Hyperuricemia has been reported as an independent risk factor for stroke in different studies and a significant association between serum uric acid and dyslipidemia has also been stated. On the contrary, some studies suggest that uric acid has a neuroprotective role. This cross-sectional study was completed in the Medicine Department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh from March 2021 to January 2023. In this cross-sectional study, 352 adult acute ischemic stroke patients were included from the Medicine Department of Mymensingh Medical College Hospital. Serum uric acid and fasting serum lipid levels were measured within 48 hours of admission. The mean age ±SD of the respondents was 61.9±12.8 years. Hyperuricemia was found among 18.2% of respondents, whose mean ±SD serum uric acid was 5.7±1.9 mg/dl. Dyslipidemia was present in 88.4% of patients. The mean ±SD of the National Institutes of Health Stroke Scale (NIHSS) score was 12.0±5.9. Most of the patients (65.6%) were suffering from moderate stroke, followed by moderate to severe stroke (15.1%), severe stroke (10.8%) and minor stroke (8.5%). After multiple linear regressions, the independent variables age, gender, serum uric acid and total cholesterol were found to be significant predictors of the NIHSS score of the respondents. In conclusion, the majority of acute ischemic stroke patients have an association with dyslipidemia, but only around one-fifth of patients have hyperuricemia. There is a significant association of high serum uric acid and high serum total cholesterol with stroke severity (NIHSS score). But low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and, triglycerides have no association with stroke severity.

Parenthood desire, perceived parenthood stigma, and barriers to achieving parenthood in childless sexual minority men

PURPOSE

To examine the parenthood desire, perceived parenthood stigma, and barriers to achieving parenthood among sexual minority men (SMM) in Canada, and to investigate factors influencing their fertility and assisted reproductive knowledge.

METHODS

Data were collected from March to mid-June 2023 using a 78-item anonymous online survey. Childless cisgender SMM (age 18+) living in Canada were recruited from the LGBTQIA+ community outside the fertility care networks. Chi-square, t-tests, ANOVA, reliability tests, Spearman's correlation, and hierarchical regression model were used for analysis.

RESULTS

Over 160 people clicked the survey hyperlink during the study period and 112 completed surveys were analyzed. The mean age of participants was 33.2±8.5 (range: 19.7-60.0). Having a child by any means was "quite"/"very" important to 35.7% (n=40), yet 56.0% (n=61) thought it was "unlikely" to achieve parenthood. Financial readiness (n=90, 85.7%) and relationship stability (n=86, 81.9%) were the two most "important" parenthood considerations. Participants who were non-white (p=0.017), under age 30 (p=0.008), and had no siblings (p=0.024) had significantly higher means of parenthood desire compared to others. The final hierarchical regression model explained 43% of the variance in the knowledge scores (R2adj =0.353), predicted by the levels of (i) education (β=0.37, p<0.001), (ii) family acceptance of sexual orientation (β=0.39, p=0.004), and (iii) parenthood desire (β=0.27, p=0.002).

CONCLUSIONS

With an increasing number of SMM desiring children, it is pivotal to advance family-building equality through improving their fertility and assisted reproductive knowledge, removing disparities in accessing adoption and assisted reproductive services, and decreasing social stigma against SMM having children.

Multifunctional analysis and antimicrobial activity of Adhatoda vasica: a traditional medicinal plant

OBJECTIVES

Antibiotic resistance is rising, prompting innovative strategies for eradicating the epidemic. This study investigated the antibacterial properties of the leaves of a widely used medicinal plant, Adhatoda vasica.

METHODS

The plant's polar (water, methanol) and non-polar (hexane) extracts were tested against several different bacterial strains using the disc diffusion technique.

RESULTS

In a study, it was found that the water extract had the greatest inhibitory effect on Staphylococcus simulans and Staphylococcus aureus, with minimum inhibitory concentrations of 16.444 and 19.315 g/mL, respectively. Gram-negative strains were more susceptible to plant extracts than Gram-positive strains. The phytochemical analysis indicated the presence of secondary metabolites such as alkaloids, saponins, flavonoids, tannins, and steroids, where absorbance was recorded at 415 nm. The water extract had the highest amount of phenolics, with a total phenolic content of 53.92 0.47 mg and a total flavonoid content of 7.25 0.08 mg. Results suggest that the extract may have potential therapeutic applications for antimicrobial properties.

CONCLUSIONS

The study concluded that the extract's phenolic group of secondary metabolites were responsible for its antibacterial activity. The study highlights A. vasica as a promising source for discovering new and effective antibacterial compounds.

Effect Of Sglt2 Inhibitor Dapagliflozin On Sodium, Potassium And Creatinine Levels In Patients With Acute Heart Failure

Background

Sodium-glucose co-transporter 2 inhibitors (SGLT2i) is a new class of medication for the treatment of type 2 diabetes mellitus. Additionally, they have been found to have beneficial effects on heart failure outcomes, convincingly reducing the morbidity and mortality in heart failure. Although the medical data indicates SGLT2i to be safe and cardio-protective, very little attention has been given to the impact of these agents on electrolyte balance particularly in acute heart failure (AHF). We aimed to evaluate the effect of SGLT2i, and dapagliflozin on serum sodium, potassium and creatinine in AHF.

Methods

Overall, 160 adult patients of either gender, admitted with AHF were selected for the study. Selected individuals were randomly assigned to receive dapagliflozin 10 mg orally added to standard medical treatment (n=80) or were in reception of standard medical therapy only (n=80). Serum electrolytes and serum creatinine were collected on admission and day 7 or on discharge whichever happened earlier.

Results

The mean level of serum electrolytes displayed insignificant differences among both groups on admission. The mean level of serum potassium was higher in the dapagliflozin group compared with the control group (p<0.001) on day 7/discharge. Mean serum sodium level was comparable and showed significant differences between the two groups following treatment (p-value=0.021). Significant higher levels of serum creatinine were observed following treatment in both groups. However, on intergroup comparison, they were statistically insignificant.

Conclusion

Dapagliflozin is an effective treatment of heart failure and is not associated with deterioration of serum electrolyte levels and renal functioning when used as add-on therapy in AHF.

Evaluation Of Anti-Inflammatory Efficacy Of Ascorbic Acid After Third Molar Surgery

BACKGROUND

Abstraction of wisdom teeth or impacted third molar under local anaesthesia is one of the most frequent interventions by an oral and maxillofacial surgeon. The abstraction of the third molar is usually followed by the release of liberation and consequent trismus, pain, and swelling due to the area of the third molar being highly vascularized and rich in loose connective tissue. Objective of the study was to evaluate the anti-inflammatory effect of ascorbic acid following surgical extraction of the third molar.

METHODS

The current study was carried out Armed Forces Institute of Dentistry, Rawalpindi, from October to December 2022. This was a cross-sectional observational study. Fifty participants who required surgical extraction of the impacted third molar were included in the study via non-probability purposive sampling and were segregated equally into two groups, i.e., Group A and Group B, comprising twenty-five participants in each group. Group A received amoxicillin with clavulanic acid (625 mg) thrice a day and metronidazole (400 mg) twice daily. In comparison, Group B received amoxicillin with clavulanic acid (625 mg) thrice daily, ascorbic acid (500 mg) twice daily, and metronidazole (400 mg) twice daily. Both groups received naproxen sodium as per requirement (550 mg). Pain, facial swelling, and C reactive protein concentration were evaluated until the 7th postoperative day.

RESULTS

There was a reduction in pain and facial swelling in both groups, but in the ascorbic acid group, there was more reduction in pain and facial swelling compared to the control group. However, the difference between the two groups in reducing pain and facial swelling was statistically significant (p<0.01). There was a reduction in CRP in both groups, but in the ascorbic acid group, there was more reduction in CRP 2.35 (1.60-5.30) compared to the control group 2.6 (0.86-5.03). However, the difference between the two groups in reducing C reactive protein concentration was statistically insignificant (p>0.05).

CONCLUSIONS

Our study concluded that ascorbic acid significantly reduced inflammation and C reactive protein, so ascorbic acid should be used as an adjuvant supplement with other conventional drugs.

Case Series on DRESS: An Unpredictable Adverse Drug Reaction

Drug rash with eosinophilia and systemic symptoms syndrome (DRESS) is a potentially life-threatening, drug-induced, multi-organ system reaction. The most frequently involved organ is the liver, followed by the kidneys and lungs. Early detection and diagnosis followed by withdrawal of the offending agent is vital to minimise the associated morbidity and mortality, and a detailed drug history is vital to identify the causative drugs. Although Spanish guidelines were developed by a panel of allergy specialists from the Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC) and are available in literature from 2020, many clinicians are still unaware about the management of this syndrome. Framing National guidelines for the early diagnosis and pharmaco-therapeutic management of DRESS will help healthcare professionals to save the patients from unintended vulnerability. We hereby present a case series on DRESS.

Genome-wide gene expression responses to experimental manipulation of Saccharomyces cerevisiae repressor activator protein 1 (Rap1) expression level

Precise regulation of transcription in gene expression is critical for all aspects of normal organism form, fitness, and function and even minor alterations in the level, location, and timing of gene expression can result in phenotypic variation within and between species including evolutionary innovations and human disease states. Eukaryotic transcription is regulated by a complex interplay of multiple factors working both at a physical and molecular levels influencing this process. In Saccharomyces cerevisiae, the TF with the greatest number of putative regulatory targets is the essential gene Repressor Activator Protein 1 (RAP1). While much is known about the roles of Rap1 in gene regulation and numerous cellular processes, the response of Rap1 target genes to systematic titration of RAP1 expression level remains unknown. To fill this knowledge gap, we used a strain with a tetracycline-titratable promoter replacing wild-type regulatory sequences of RAP1 to systematically reduce the expression level of RAP1 and followed this with RNA sequencing (RNA-seq) to measure genome-wide gene expression responses. Previous research indicated that Rap1 plays a significant regulatory role in particular groups of genes including telomere-proximal genes, homothallic mating (HM) loci, glycolytic genes, DNA repair genes, and ribosomal protein genes; therefore, we focused our analyses on these groups and downstream targets to determine how they respond to reductions in RAP1 expression level. Overall, despite being known as both an activator and as a repressor of its target genes, we found that Rap1 acts as an activator for more target genes than as a repressor. Additionally, we found that Rap1 functions as an activator of ribosomal protein genes and a repressor of the silent mating locus genes consistent with predictions from the literature. Unexpectedly, we found that Rap1 functions as a repressor of glycolytic enzyme genes contrary to prior reports of it having the opposite effect. We also compared the expression of RAP1 to five different genes related to DNA repair pathway and found that decreasing RAP1 downregulated four of those five genes. Finally, we found no effect of RAP1 depletion on telomere-proximal genes despite its functioning to silence telomeric repeat-containing RNAs. Together our results enrich our understanding of this important transcriptional regulator. The graphical abstract is provided as a supplementary fig. (S-Fig 1).

Frequency of impaired glucose tolerance and its correlates in females of reproductive age in urban slums of Lahore, 2019

BACKGROUND

The prevalence of diabetes mellitus has almost reached global epidemic proportions. Fortunately, the progress of the disease can be stemmed at the prediabetic level. The objective of the present study was to determine the frequency of impaired glucose tolerance (IGT) and its predictors in females of reproductive age in the urban slums of Lahore.

MATERIALS AND METHODS

A cross-sectional study was conducted among females of reproductive age in the slums of metropolitan Lahore. The calculated sample size was 384. Data were collected using a structured questionnaire covering demographic variables, lifestyle, medical, and dietary history. The oral GT test was carried out on the study participants after a 10 hour overnight fasting. Data were entered and analyzed using Statistical Package for the Social Sciences (SPSS version 23). Frequency distributions and percentages were calculated for categorical variables, and the mean and standard deviation were calculated for continuous variables. The Chi-square test or Fisher's exact test, as appropriate, was used to determine the association between IGT and various categorical variables. Logistic regression analysis was performed to determine the correlates of IGT after adjusting for confounders.

RESULTS

The final sample size was 394 women; 17% of whom had IGT, and 8.6% had newly diagnosed diabetics. Results of logistic regression showed increased waist/hip ratio, lower literacy of father or husband, age, and low intake of pulses as significant predictors of IGT (P < 0.05).

CONCLUSION

The frequency of IGT is high in females of reproductive age living in the urban slums of Lahore. There is a need for targeted health promotion and educational activities to improve the health and social conditions of slum dwellers.

In utero acetaminophen exposure and child neurodevelopmental outcomes: Systematic review and meta-analysis

BACKGROUND

Acetaminophen is a frequently used analgesic for pain and fever. There have been reports of adverse neurodevelopmental outcomes associated with in utero acetaminophen exposure. However, it is unclear whether this association is related directly to acetaminophen use, or the reasons for use.

OBJECTIVES

To summarise the literature on the association between in utero acetaminophen exposure and child neurodevelopmental outcomes, and assess the extent to which the association is due to confounding by indication.

DATA SOURCES

OVID for Medline, Embase, and PsycINFO, and EBSCO for CINAHL, from inception to August 18, 2022.

STUDY SELECTION AND DATA EXTRACTION

We searched for peer-reviewed, English-language studies on in utero acetaminophen exposure and child neurodevelopmental outcomes. Data were extracted using a standardised form created a priori, and quality was assessed using the Systematic Assessment of Quality in Observational Research.

SYNTHESIS

We generated pooled risk ratios (RR) for outcomes examined by ≥3 studies using random-effects models; outcomes that could not be meta-analysed were narratively summarised following Synthesis Without Meta-Analysis guidelines.

RESULTS

Twenty-two studies including 23 cohorts were eligible (n = 367,775 total participants; median: 51.7% with acetaminophen exposure). Studies were primarily prospective cohort studies from Europe and the US, with attention deficit/hyperactivity disorder (ADHD) being the most common outcome. Quality assessments resulted in 13.6% of studies being classified as high, 59.1% as medium, 22.7% as low, and 4.5% as very low quality. In utero acetaminophen exposure was associated with an elevated risk of ADHD (unadjusted pooled RR 1.32, 95% confidence interval [CI] 1.20, 1.44; I²  = 47%, n = 7 studies), with little difference after adjusting for confounders, including indications for acetaminophen use (adjusted pooled RR 1.34, 95% CI 1.15, 1.55; I²  = 50%, n = 4 studies).

CONCLUSIONS

Confounding by indication did not explain the association between in utero acetaminophen exposure and child ADHD. Further, high-quality research is needed on this and other neurodevelopmental outcomes.

Leflunomide Induced Atypical DRESS: A Case Report and Literature Review

Drug rash with eosinophilia and systemic symptoms syndrome (DRESS syndrome) is a potentially life-threatening, drug-induced, multi-organ system reaction, the most frequently involved organ is liver, followed by the kidneys and lungs.¹ Early detection and diagnosis followed by withdrawal of the offending agent is vital to minimise the associated morbidity and mortality. A detailed drug history is vital to identify the causative drugs. Although Spanish guidelines were developed by a panel of allergy specialists from the Drug Allergy Committee of the Spanish Society of Allergy and Clinical Immunology (SEAIC) and are available in literature from 2020, many clinicians are still unaware about the management of this syndrome. Framing national guidelines for the early diagnosis and Pharmaco-therapeutic management of DRESS will help the healthcare professionals to save the patients from unintended vulnerability. Leflunomide, a drug widely used in rheumatology and orthopaedics must be used with caution since it has the potential to cause DRESS syndrome. We report a case of a lady aged 32 years, presented to our hospital with a history of leflunomide intake and symptoms of DRESS.

Effect of Vegetable Waste on Growth Performance and Hematology of Broiler Chicks

Vegetable waste (spinach, potato, and cauliflower) is a rich and natural source of nutrients, potentially good for supplying minerals, essential amino acids, and antioxidants to the birds. Relatively, its cost very low, easily to accessible, easily process & pose little risk of illness. The aim of present study was to evaluate the effect of vegetable waste (VW) as feed supplement on growth performance and hematology of broiler chicks. For this purpose, a total of 200 (4 days old) vaccinated chicks were acquired from a commercial hatchery Multan which was acclimated for three weeks (21 days) on basal starter feed after that 25-day-old chicks with uniform body weight were allocated according to a CRD (completely randomized design) into four dietary treatments with three replicates of each contained 15 chicks in 12 pens. In dietary treatments, chicks were feed with basal feed (BF) and supplemented feed with vegetable waste (VW) of spinach, potato, and cauliflower. For this purpose, the dietary treatments included control treatment (T 1) (100% BF+0% VW) and other dietary treatments (T 2) (75% BF+25% VW), (T 3) (50% BF+50% VW), and (T 4) (25% BF+75% VW). The body weight, feed intake, food conversion ratio (FCR), and mortality were checked on weekly and daily basis. For hematology analysis, after the 1st experimental week (25-day-old chicks) and the last 5th experimental week (56-day-old chicks), the samples of blood were gathered from the wing's veins of two birds from each treatment in random way. At the end of five weeks (35 days), birds with uniform average body weight were selected per treatment with three replicates (2 bird/replicate) and then were manually slaughtered according to the Halal method to analyze the weight of internal body organs of broilers by physical and statistical analysis (ANOVA). There was no significant effect (P > 0.05) on feed intake and FCR among all the dietary treatments. But in average, body weight and BWG were higher in treatment (T 2) (P < 0.01) than all other dietary treatments (T 3) and (T 4) and control treatment (T 1). The blood constituents in this study showed that broilers in control treatment (T 1) and other dietary treatments (T 2), (T 3), and (T 4) fed on different doses were significantly (P < 0.01) different from each other. The week 5 (W 5) shows higher values of blood constituents (P < 0.01) than week 1 (W 1). The carcass yield of the chicks fed on different doses showed that they were significantly different (P < 0.01) among the dietary treatments. The VW inclusion 0%, 25%, 50%, and 75% had positive effect on blood constituents and carcass yield of the broiler chicks; they were significantly (P < 0.01) different among the treatments.

Perceived Stress Among Students of Private and Public Sector Medical Colleges of Pakistan: A Cross Sectional Study

Introduction

Medical-education is associated with high overall stress and it is important to identify relevant factors.

Objectives

The study was aimed to discern the differences in perceived stress among the students of public and private medical colleges of Pakistan and to identify factors subservient to any hypothesized difference.

Methods

This cross-sectional study was conducted at different private and public medical colleges of Pakistan using validated tools: PSS-14 (Perceived Stress Scale) to find out the levels of stress faced by each sector and MSSQ (Medical Student Stressor Questionnaire) to determine the factors associated with increased stress.

Results

Total of 424 medical students from various public and private medical colleges of Pakistan (212 each) filled the questionnaires. The mean score +/- SD of PSS-14 was 36.17 ± 6.096 for the public sector and 36.29 ±5.732 for the private sector. Hence, there was no difference between the two comparative means of PSS score, t(422)=-0.213,p=0.831.The results for both sectors were classified as high perceived stress (27-40 score is high perceived stress). Out of 40 individual stress-causing factors in MSSQ, the students from private-sector scored higher as compared to public-sector: Quota System in examination t(422)=-3.951,p=0.000, stress caused by lack of time for friends and family t(422)=-3.225,p=0.001, stress caused by Tests/Examination t(422)=-2.131,p=0.034, stress caused by the parental wish for them to study medicine t(422)=-2.346,p=0.019 and stress caused by fear of getting poor marks t(422)=-2.183,p=0.030.

Conclusions

There exists no overall difference in the perceived-stress among the medical students of public and private medical colleges despite private-sectors having significantly more operational financial resources.

Disclosure

No significant relationships.

Boswellic Acids, Pentacyclic Triterpenes, Attenuate Oxidative Stress, and Bladder Tissue Damage in Cyclophosphamide-Induced Cystitis

Boswellic acids, derived from the Boswellia serrata plant, have been demonstrated to have anti-inflammatory properties in experimental animal models. The present study was aimed to evaluate the uro-protective effect of boswellic acids in rats with cyclophosphamide-induced cystitis. Interstitial cystitis was induced by cyclophosphamide (CYP). In order to analyze the reduction of the urothelial damage, the bladder weight, the nociception response, and the Evans blue dye extravasation from the bladder were evaluated. To investigate the involvement of lipid peroxidation and enzymatic antioxidants CAT, SOD, and GPX and MPO and NO were evaluated. IL-6 and TNF-α were measured by the ELISA immunoassay technique. The results showed that pretreatment with boswellic acids significantly reduced urothelial damage which was accompanied by a decrease in the activity of MDA, CPO, and NO levels and prevention of the depletion of CAT, SOD, and GPX. The levels of IL-6 and TNF-α were dramatically reduced by boswellic acids. Histopathological findings revealed a considerable reduction in cellular infiltration, edema, epithelial denudation, and bleeding. Our findings showed that boswellic acids, by their antioxidant and anti-inflammatory properties, negate the detrimental effects of cyclophosphamide on the bladder, suggesting boswellic acids as promising therapeutic alternatives for cystitis.

Performance evaluation of the commercial aquafeeds available in the market of Pakistan on Channa marulius (Sole)

The present study aimed to determine the effect of different levels of protein on the growth, body composition, amino acid profile and serology of Channa marulius fingerlings. The experiment was conducted in ten happas installed in earthen ponds, each stocked with 10 fishes for 90 days. Four commercial fish feeds having 25%, 30%, 32% and 40% crude protein (CP) levels were fed to fish at 3% of their wet body weight three times a day. The results of the study revealed that highest weight gain, feed conversion ratio and survival rate were observed in 30% protein feed. Meanwhile, moisture content was higher in fish fed with 30% CP feed while highest crude protein was recorded in 40% CP fed fish. Lowest fat content was observed in 32% CP feed. Amino acid profile of fish revealed better results in 30% CP feed. Total protein, glucose and globulin were also highest in fish feeding 30% CP feed, while albumin was highest in 40% CP feed. It is concluded that 30% CP feed showed better results in terms of growth, amino acid profile and serological parameters without effecting fish body composition.

A Prospective Study on the Degree of Hyponatremia in Transurethral Resection of Prostate

Background: Systemic uptake of hypotonic fluid during irrigation performed at the time of Transurethral Resection of the Prostate (TURP) may cause electrolyte changes including sodium, potassium and calcium. The present study was aimed to assess the degree of sodium changes during Transurethral Resection of Prostate (TURP). Methods: 50 males aged 54 to 86 years, presented for TURP, were enrolled in the study with ASA classification of I to IV grades. Glycine 1.5% was used with height of irrigation kept at 60 cm. One day preoperatively and one hour postoperative, levels of serum sodium were measured for all the patients. Results: Spinal anaesthesia was given in 31 patients, whereas 19 patients were managed under general anaesthesia, with mean duration time being 72.42 ± 24.77min. The mean size of the resected prostate was 54.82 ± 25.04g. 58% patients developed mild hyponatremia, 4% had asymptomatic moderate hyponatremia and no patient developed severe hyponatremia or TURP Syndrome. The systemic diseases like hypertension, DM, or IHD found to be insignificant. Conclusion: TURP was associated with a high incidence of asymptomatic mild hyponatremia. Duration of operation was one of the most important factors.

Prevalence of Type 2 Diabetes Mellitus and Pre-Diabetes Using HbA1c

Introduction: Type 2 diabetes mellitus (T2DM) is a group of metabolic diseases depicted by crippled insulin release by the pancreas and insulin resistance of body tissues.  Objectives: The main objective of the study is to analyse the prevalence of type 2 diabetes mellitus and pre-diabetes using HbA1c. Material and Methods: This cross sectional study was conducted in Islam Medical College Sialkot during 2020 to 2021. A special questionnaire concerning family history and health-related information was filled for all participants by direct interviews with the researchers. People previously diagnosed with diabetes or hemoglobinopathies were ruled out from the study. Blood samples were collected from all subjects using EDTA tubes and centrally analyzed for HbA1c. Results: The data was collected from 200 patients of both genders. In all, 200 participants were found to be currently diabetic, giving an overall prevalence of current condition to be 24.6% (95% CI 21.90 - 27.49) in the study population. History of disease was reported by 31.5% participants (P < 0.001). Conclusion: It is concluded that adjustments in platelet files are believed to be measurably connected with diabetes and its intricacies. The prevalence of type 2 diabetes and pre-diabetes is much higher than previously thought in Pakistan.

Knowledge of Autism Spectrum Disorder Among 2nd to 4th Phase MBBS Students of Bangladesh

Autism spectrum disorder (ASD), being one of the fastest-growing disabilities in children, is an omnipresent, immutable neurodevelopmental disorder characterized by impaired socialization, impaired verbal and non-verbal communication, restricted interests, and repetitive behaviour patterns. A descriptive cross-sectional study was conducted from 30 October to 30 November 2019 among the MBBS students of 21 medical colleges in Bangladesh to assess their knowledge of autism. The 'Knowledge about Childhood Autism among Health Workers (KCAHW)' questionnaire containing 19 item questions divided into four domains was used. The total median score in the KCAHW questionnaire is 13 out of 19. The final total of respondents numbered 483. There were 215 (44.51%) male and 268 (55.49%) female students. Among 21 medical colleges, 10 are situated in the Dhaka district and 11 outside Dhaka; 14 medical colleges were public, and seven were private. The study shows that students' knowledge of autism spectrum disorder (ASD) is not up to the mark. While assessing the knowledge in each domain, Domain 4 (knowledge regarding nature, comorbidities, and onset) shows that only 32.6% of students of 4th phase and 21.5% of other phases have scored more than the median value, revealing that medical students were not familiar with nature, comorbidities, and the onset of ASD. It can be reliably diagnosed before two years of age, but the practical scenario is a different picturesque. Thus, medical students should have bona fide knowledge to diagnose this progressively prevailing disorder at the earliest possible time. We hope this study's aftermath will significantly impact the integrity and diversity of autism spectrum disorder.

Limiting amino acids supplementation in low crude protein diets and their impacts on growth performance and carcass composition in Labeo rohita (rohu) adult fish

Ninety days study was conducted in hapas installed in earthen ponds. Fish of an average initial weight (220g) were evenly distributed in triplicate groups within fifteen hapas. Five experimental diets labeled as T1 (25% CP and NRC recommended amino acid level) as control diet, T2 (with 2% low protein and 5% amino acid supplementation), T3 (with 2% low protein and 10% amino acid supplementation), T4 (with 4% low protein and 10% amino acid supplementation) and T5 (with 4% low protein and 20% amino acid supplementation) were prepared. Fish were fed with @3% of their body weight twice a day at 10.00 & 16:00 hour. Significantly higher percent weight gain (420.18 ± 66.84a) and specific growth rate (13499.33±1273.54a) along with improved feed conversion ratio (1.29 ± 0.09b) and hundred percent survivals were recorded during the trial. Furthermore proximate analysis of meat showed significant improvement in the crude protein level (81.77 ± 0.19a) served with diet containing 20% limiting amino acids mixture. Therefore, limiting amino acids can be a source of cost effective feed and use safely in L. rohita diet.

Green synthesis of gold nanoparticles from Manilkara zapota L. extract and the evaluation of its intrinsic in vivo antiarthritic potential

The aim of this study is to evaluate the in vivo acute and sub-acute antiarthritic activity of aqueous extract of M. zapota and its biosynthesized gold nanoparticles (AuNPs).

Trapezius or facial muscles: Which one is more suitable for the measurement of stress using sEMG signals?

A number of techniques have been reported to detect mental stress. Surface Electromyography (sEMG) has also been used to measure stress by acquiring the signals from various sites of the human body, however, consensus need to be established to determine the best possible site to harvest stress related information. In this study, work related mental stress using sEMG signals acquired from trapezius muscle and facial muscles were compared. BIOPAC signal acquisition system was used to acquire sEMG signals simultaneously from both trapezius and facial muscles from forty five (45) healthy volunteers. Stress was induced using different standard methods in a controlled environment. Statistical significant difference was found between the stress and rest levels of sEMG signals. The statistical test also showed that the upper trapezius muscle was a better stress detection site as compared to facial muscles.Clinical Relevance- Optimized stress detection can help in the prevention of the possible stress related physical disorders.

Occupational Hand-Related Injuries at a Major Tertiary Care Burn and Reconstructive Center in Pakistan

Introduction

Work-related hand injuries are usually a consequence of mechanical force on hand. This study retrospectively investigated the occurrence of work-related hand injuries in patients belonging to different age groups, gender, educational status, occupation, etc. 

Methodology

This cross-sectional study was conducted from October 2018 to December 2019 at the Department of Burn and Plastic Surgery, Holy Family Hospital, Rawalpindi, Pakistan. Demographic and clinical characteristics were gathered through a structured questionnaire based on relevant literature. Patients were assessed using the purposive sampling technique and written informed consent was taken from each participant. A p-value of <0.05 was considered statistically significant. Statistical tests were performed using the Statistical Package for the Social Sciences (SPSS).

Results

One hundred and twenty participants were interviewed, and 87.5% of patients did not have a vascular injury, and 62.5% of patients had an associated fracture. Over half of them (57.5%) had injuries of their dominant hands. Most of the injuries (67.5%) involved fingers while the rest of the injuries were found either in the palm or the dorsum of the hand. Among the causes of accidents, the majority didn't wear or wore unfitted gloves (76.6%) and the main causes of the hand injuries were related to defects in the workplace (53.3%). Lack of concentration (11.7%), wearing loose or unfitted clothes or jewelry (19.2%), lack of machine maintenance (29.2%), and a patient’s chronic disease (1.66%) were among the less frequent causes. 

Conclusion

It is important to understand the relationship between occupational and hand injuries. It provides an insight into the lack of protection and guidance of workers.

Structures and internal dynamics of diphenylether and its aggregates with water

We report on a detailed multi-spectroscopic analysis of the structures and internal dynamics of diphenylether and its aggregates with up to three water molecules by employing molecular beam experiments.

Bentonite and Biochar Mitigate Pb Toxicity in Pisum sativum by Reducing Plant Oxidative Stress and Pb Translocation

Lead (Pb)-polluted soils pose a serious threat to human health, particularly by transmitting this heavy metal to the food chain via the crops grown on them. The application of novel amendments in Pb-polluted soils can significantly reduce this problem. In this research, we report the effects of various organic and inorganic amendments i.e., bentonite (BN), biochar (BR), lignin (LN), magnesium potassium phosphate cement (CM) and iron hydroxyl phosphate (FeHP), on the Pb bioavailability in Pb-polluted soil, upon Pb distribution in shoots, roots, grain, the translocation factor (TF) and the bioconcentration factor (BCF) of Pb in pea (Pisum sativum L.) grain. Furthermore, effects of the said amendments on the plant parameters, as well as grain biochemistry and nutritional quality, were also assessed. Lead pollution significantly elevated Pb concentrations in roots, shoots and grain, as well as the grain TF and BCF of Pb, while reducing the nutritional quality and biochemistry of grain, plant height, relative water content (RWC), chlorophyll contents (chl a and chl b) and the dry weight (DW) of shoot, root and grain. The lowest Pb distribution in shoots, roots and grain were found with BN, FeHP and CM, compared to our control. Likewise, the BN, FeHP and CM significantly lowered the TF and BCF values of Pb in the order FeHP > CM > BN. Similarly, the highest increase in plant height, shoot, root and grain DW, RWC, chl a and chl b contents, grain biochemistry and the micronutrient concentrations, were recorded with BR amendment. Biochar also reduced grain polyphenols as well as plant oxidative stress. Given that the BR and BN amendments gave the best results, we propose to explore their potential synergistic effect to reduce Pb toxicity by using them together in future research.

Bentonite and Biochar Mitigate Pb Toxicity in Pisum sativum by Reducing Plant Oxidative Stress and Pb Translocation

Lead (Pb)-polluted soils pose a serious threat to human health, particularly by transmitting this heavy metal to the food chain via the crops grown on them. The application of novel amendments in Pb-polluted soils can significantly reduce this problem. In this research, we report the effects of various organic and inorganic amendments i.e., bentonite (BN), biochar (BR), lignin (LN), magnesium potassium phosphate cement (CM) and iron hydroxyl phosphate (FeHP), on the Pb bioavailability in Pb-polluted soil, upon Pb distribution in shoots, roots, grain, the translocation factor (TF) and the bioconcentration factor (BCF) of Pb in pea (Pisum sativum L.) grain. Furthermore, effects of the said amendments on the plant parameters, as well as grain biochemistry and nutritional quality, were also assessed. Lead pollution significantly elevated Pb concentrations in roots, shoots and grain, as well as the grain TF and BCF of Pb, while reducing the nutritional quality and biochemistry of grain, plant height, relative water content (RWC), chlorophyll contents (chl a and chl b) and the dry weight (DW) of shoot, root and grain. The lowest Pb distribution in shoots, roots and grain were found with BN, FeHP and CM, compared to our control. Likewise, the BN, FeHP and CM significantly lowered the TF and BCF values of Pb in the order FeHP > CM > BN. Similarly, the highest increase in plant height, shoot, root and grain DW, RWC, chl a and chl b contents, grain biochemistry and the micronutrient concentrations, were recorded with BR amendment. Biochar also reduced grain polyphenols as well as plant oxidative stress. Given that the BR and BN amendments gave the best results, we propose to explore their potential synergistic effect to reduce Pb toxicity by using them together in future research.

Transgenerational effect of parental obesity and chronic parental bisphenol A exposure on hormonal profile and reproductive organs of preadolescent Wistar rats of F1 generation: A one-generation study

There is a global concern about adverse health effects of endocrine-disrupting chemicals (EDCs). Bisphenol A (BPA), an estrogenic and obesogenic compound, used in the plastic and medical industry has a dominant position among EDCs as far as human health and regulatory scenario are concerned. Due to its omnipresence across the biosphere, population of all age groups and health status is unavoidably exposed to BPA. Transgenerational exposure to BPA and its effects have also been recognized. However, there is no report on the transgenerational effect of BPA on metabolically disordered parents, such as obese ones. We studied effect of BPA exposure in F0 generation and its impact on F1 generation and factored parental obesity in transgenerational effect of concurrent exposure to low dose BPA (10 ppm × 180 days) in Wistar rats in a one-generation study protocol. The exposed F0 generation animals were crossed and F1 generation was analyzed 35 days after birth for indications of reproductive toxicity. We observed changes in hormone levels and disturbance in glucose and lipid homeostasis. Animals showed increased serum cholesterol and triglycerides along with higher birth weight and rapid weight gain. Histopathological evidence confirmed the presence of regressive and inflammatory changes in the ovary and testis. The test group showed metabolic disturbances in comparison to control group. Our study showed the additive effect of parental obesity in transgenerational reproductive toxicity of BPA. Female animals of F1 generation of BPA-treated obese parents showed more insulin resistance than males with similar exposure scenario. Our study highlights the confounding role of metabolic disorders such as obesity in the transgenerational toxicity of BPA, which otherwise itself is implicated in the aetiology of such metabolic disorders, directly or indirectly.

Effects of biochar and zeolite soil amendments with foliar proline spray on nickel immobilization, nutritional quality and nickel concentrations in wheat

Since Ni-rich soils are a threat to the environment, growing edible crops on Ni-rich soils can pose a serious risk to human, animal, plant and ecosystem health and, hence, is considered as a challenging task for the researchers. Contrarily, limiting the bioavailability of Ni in such soils upon the addition of suitable amendments cum foliar spray of proteinogenic amino acids having an objective to alleviate stress to crop plants can considerably reduce the environmental risk. In this pot trail, we substantiate the effects of biochar (BR) and zeolite (ZL) addition in the soil along with proline (PN) spray on the resistance, and stress responses of wheat against Ni as well as on Ni translocation and accumulation in wheat plants grown on a Ni-rich soil contaminated by electroplating effluent. The treatments, applied with and without PN spray, involved: no amendment; BR; ZL; and a concoction of both amendments (BR50%+ZL50%). We found that BR50%+ZL50% treatment significantly immobilized Ni in the soil, reduced its accumulation in the shoot, root, and grain, blocked membrane lipid peroxidation and showed an improvement in photosynthetic parameters, the status of antioxidant activities, grain biochemistry and grain yield, compared to the control. Interestingly, exogenous PN spray caused a significant additive effect on the aforementioned parameters in the wheat plants grown on BR50%+ZL50% treated soil. Our results involved a reduced Ni bioavailability in wheat rhizosphere due to BR50%+ZL50% in soil and, furthermore, the additive effect of PN spray to scavenging ROS, obstructing peroxidation of lipid membrane and, thus providing resilience to wheat plant against Ni stress. The suggested technique can make Ni-rich soils suitable for cultivation and production of high-quality food by minimizing Ni bioavailability and toxicity to plants.

Anti-inflammatory role of tempol (4-hydroxy-2,2,6,6-tetramethylpiperidin-1-oxyl) in nephroprotection

Inflammation is one of the mechanisms involved in the acute kidney injury (AKI) caused by cisplatin (CP)-induced nephrotoxicity. Tempol (4-hydroxy-2,2,6,6-tetramethylpiperidin-1-oxyl) has powerful antioxidant activity. We investigated its potential nephroprotective effects and the underlying mechanisms that may add further benefits to its clinical usefulness in a CP-induced AKI model. Male Swiss albino mice were divided randomly into four groups: control, CP (20 mg/kg intraperitoneally), tempol (100 mg/kg/day, per os) + CP, and tempol only treatments. Blood samples were collected to analyze renal function parameters. Immunoblotting and immunohistochemical analysis were used to assess the level and localization of inflammatory markers. Tempol afforded protection to animals from CP-induced elevation of inflammatory markers as indicated by reduced expression of nuclear factor-kappa B, cyclooxygenase-2, and tumor necrosis factor-α in kidney tissue. Histological findings and analysis of kidney function markers corroborated with these findings confirming a nephroprotective role for tempol. In conclusion, this study provides important evidence for the promising anti-inflammatory effects of tempol which appears to contribute significantly to its nephroprotective action.

Dispersion-controlled docking preference: multi-spectroscopic study on complexes of dibenzofuran with alcohols and water

The planarity and rigidity of dibenzofuran inverts the docking preference for increasingly bulky R-OH solvent molecules, compared to the closely related diphenyl ether. Now, London dispersion favors OH⋯π hydrogen bonding.

Promoting the productivity and quality of brinjal aligned with heavy metals immobilization in a wastewater irrigated heavy metal polluted soil with biochar and chitosan

Depleting aquifers, lack of planning and low socioeconomic status of Pakistani farmers have led them to use wastewater (WW) for irrigating their crops causing food contamination with heavy metals and ultimately negative effects on human health. This study evaluates the effects of chitosan (CH) and biochar (BC) on growth and nutritional quality of brinjal plant together with in situ immobilization of heavy metals in a soil polluted with heavy metals due to irrigation with wastewater (SPHIW) and further irrigated with the same WW. Both CH and BC were applied at three different rates i.e. low rate [(LR), BC0.5%, CH0.5% and BC0.25%+CH0.25%], medium rate [(MR), BC1%, CH1% and BC0.5%+CH0.5%] and high rate [(HR), BC1.5%, CH1.5% and BC0.75%+CH0.75%]. Result revealed that brinjal growth, antioxidant enzymes, and fruit nutritional quality significantly improved from LR to HR for each amendment, relative to control. However, these results were more prominent with BC alone and BC+CH, compared with CH alone at each rate. Similarly, with few exceptions, significant reduction in Ni, Cd, Co, Cr and Pb concentrations in the root, shoot and fruit were found in sole CH treatment both at LR and MR but in both CH and BC+CH treatments at HR, relative to control. Interestingly, the concentrations of Fe in the roots, shoots and fruit were more pronounced at BC treatments relative to CH and BC+CH treatments at each rate, compared to control. Overall, the BC+CH treatment at HR was the most effective treatment for in situ immobilization of heavy metals in SPHIW and further irrigated with the same WW, compared to rest of the treatments. This study indicates that BC0.75%+CH0.75% treatment can be used to reduce mobility and bioavailability of heavy metals in SPHIW and facilitates plant growth by improving the antioxidant system. However, the feasibility of BC0.75%+CH0.75% treatment should also be tested at the field scale.

Preparation and Antibacterial Properties of Silver-Doped Nanoscale Hydroxyapatite Pastes for Bone Repair and Augmentation

The treatment of deep bone infections remains a significant challenge in orthopaedic and dental surgery. The relatively recent commercial manufacture of nanoscale hydroxyapatite has provided surgeons with an injectable biomaterial that promotes bone tissue regeneration, and with further modification it may be possible to incorporate antimicrobial properties into these devices. Silver-doped nanoscale hydroxyapatite pastes (0, 2, 5 and 10 mol.% silver) were prepared using a rapid mixing method. When the process was modified to prepare a 10 mol.% silver-doped material, silver phosphate was detected in addition to nanoscale hydroxyapatite. Thermal decomposition occurred more readily with greater silver content following calcination at 1000 °C for 2 h. Silver-doped nanoscale hydroxyapatite pastes showed antibacterial activity against Staphylococcus aureus and Pseudomonas aeruginosa in a dose dependent manner using both agar diffusion assays and suspension cultures. It was concluded that the enhanced antibacterial activity of the silver-doped pastes was due to the action of diffusible silver ions. Based on these results, silver-doped nanoscale hydroxyapatite pastes represent a highly promising new biomaterial system for the prevention and treatment of deep infections in bone tissue.

PCR based detection of Theileria lestoquardi in apparently healthy sheep and goats from two districts in Khyber Pukhtoon Khwa (Pakistan)

The present study was carried out to determine the prevalence of Theileria lestoquardi from two districts of Khyber Pukhtoon Khwa (Kohat and Peshawar) in Pakistan and also to report the risk factors associated with the spread of ovine theileriosis. A total of 165 blood samples were collected from sheep (N = 44) and goats (N = 121) from randomly selected herds. Data on the characteristics of animals and the herds were collected through questionnaires. Five (3%) out of total 165 samples produced 730 base pairs DNA fragment, through PCR amplification of 18S SSU rRNA gene, specific for T. lestoquardi. All positive samples were from district Kohat while samples from Peshawar were found negative for this parasite. Statistical analysis indicated a significant association (P = 0.005) between sampling site and prevalence of T. lestoquardi. It was observed that presence of tick on the ruminant (P = 0.0007) and the dogs associated with the herd (P = 0.001) were highly significant risk factor for the spread of ovine theileriosis. It was also observed that mixed herds (containing both sheep and goats) were more prone to the parasite. We have concluded that PCR is a sensitive and reliable diagnostic tool for detection of T. lestoquardi in blood samples of small ruminants and can be used for the prophylactic screening and treatment of this blood parasite in order to increase the live stock production in Pakistan.

Can tibial coverage in total knee replacement be reliably evaluated with three-dimensional image-based digital templating?

Objectives

There remains a lack of data on the reliability of methods to estimate tibial coverage achieved during total knee replacement. In order to address this gap, the intra- and interobserver reliability of a three-dimensional (3D) digital templating method was assessed with one symmetric and one asymmetric prosthesis design.

Methods

A total of 120 template procedures were performed according to specific rotational and over-hang criteria by three observers at time zero and again two weeks later. Total and sub-region coverage were calculated and the reliability of the templating and measurement method was evaluated.

Results

Excellent intra- and interobserver reliability was observed for total coverage, when minimal component overhang (intraclass correlation coefficient (ICC) = 0.87) or no component overhang (ICC = 0.92) was permitted, regardless of rotational restrictions.

Conclusions

Measurement of tibial coverage can be reliable using the templating method described even if the rotational axis selected still has a minor influence.

A study on the determination of risk factors associated with babesiosis and prevalence of Babesia sp., by PCR amplification, in small ruminants from Southern Punjab (Pakistan)

Babesiosis is a parasitic infection due to the multiplication of tick borne parasite, Babesia sp., in erythrocytes of host, which includes a wide variety of vertebrates including small ruminants causing decreased livestock output and hence economic losses. The objective of the present study was to establish a PCR based method for the detection of Babesia sp. in small ruminant population in Southern Punjab and to determine the risk factors involve in the spread of babesiosis. A total of 107 blood samples were collected from 40 sheep and 67 goats in seven districts of Southern Punjab from randomly selected herds. Data on the characteristics of the animals and the herd were collected through questionnaires. 36 blood samples (34% of total) produced the DNA fragment specific for 18S rRNA gene of Babesia sp., by PCR amplification, of which 20 were sheep and 16 were goats. Samples from all seven district contained Babesia positive samples and prevalence varied between 18 to 68%. It was observed that male animals (P = 0.009) and young animals under one year of age (P = 0.01) were more prone to the parasite. It was observed that herds consist of more than 15 animals (P = 0.007), composed of mixed species of small ruminants (P = 0.022), associated with dogs (P = 0.003) and dogs having ticks on their bodies (P = 0.011) were among the major risk factors for the spread of babesiosis in small ruminants.

Determining the risk factors and prevalence of osteoporosis using quantitative ultrasonography in Pakistani adult women

INTRODUCTION

Osteoporosis-related bone fractures are a significant public health problem. The aim of this study was to determine the prevalence of osteoporosis among Pakistani women and identify modifiable risk factors.

METHODS

A cross-sectional study was conducted in an obstetrics / gynaecology setting during March-April 2007 in Quetta, Pakistan. A total of 334 women older than 20 years of age underwent quantitative ultrasonography and were interviewed to find out the risk factors for osteoporosis. Bone mineral density was assessed by the speed of sound using a quantitative ultrasound device. The sociodemographic characteristics of normal, osteopenic and osteoporotic women were compared using the chi-square test for categorical variables and ANOVA for continuous variables. Binary logistic regression was used to determine the independent predictors of being osteopenic or osteoporotic.

RESULTS

146 (43.7 percent) women were reported to be normal, 145 (43.4 percent) were osteopenic and 43 (12.9 percent) were osteoporotic. The mean age and standard deviation of the participants were 36.7 years +/- 13.0 years, with a body mass index (BMI) of 25.81 (standard deviation 5.10) kg per square metre. In the univariate analysis, factors that were associated with osteoporosis / osteopenia included age, parity, BMI, smoking (pack years), consumption of calcium-rich food/week, personal and family history of osteoporosis, education and socioeconomic status (p-value is less than 0.05). Using binary logistic regression with osteoporosis / osteopenia as an outcome compared to normal individuals, BMI, smoking pack years, a family history of osteoporosis / fracture and house ownership were found to be independent predictors of the outcome.

CONCLUSION

The prevalence of osteoporosis and osteopenia is high, especially among young Pakistani women, and is associated with modifiable risk factors.

Combined effects of herbicides on biomarkers reflecting immune-endocrine interactions in goldfish. Immune and antioxidant effects

Goldfish (Carassius auratus) were exposed to a mixture of herbicides, namely atrazine, simazine, diuron, and isoproturon (ASDI) at a cumulative concentration of 50microg/l for 12 weeks. Control fish and exposed fish were sampled at 4, 8 and 12 weeks of exposure to observe the combined impact of herbicides on non-specific and specific mechanisms of immunity and antioxidant defenses. The antioxidant defenses were evaluated in haemopoietic organs and liver. ASDI-induced stress was reflected as a significant induction of superoxide (O(2)(-)) production in phagocytic cells of head kidney and spleen. In addition, plasma lysozyme activity was consistently high in the treatment group. Specific immunity was assessed by antibody titre responses following immunization of the fish with sheep red blood cells (SRBCs). Antibody titre was reduced throughout the period of observation in ASDI-treated fish. This reduction was found to be significant at week 4 (p<0.05). Herbicide-exposed fish showed reduced resistance against pathogen invasion but remarkable enhancement in lysozyme activity. The ASDI-induced oxidative stress in spleen, kidney and liver was reflected as a change in the antioxidant enzyme activities in these vital organs of fish. Our data indicate that herbicides at concentrations present in water bodies in Europe cause immune suppression in goldfish.

Detection of Infectious Bronchitis Virus and Specific Anti- Viral Antibodies Using a Concanavalin A–Sandwich–ELISA

Concanavalin A-Sandwich ELISA (Con A-S-ELISA) was developed for the detection of infectious bronchitis virus (IBV) or chicken specific anti-viral antibodies. The antigen detection limit for the Con A-S-ELISA was 10(5,1) EID(50)/mL. Three homologous and four heterologous IBV strains were similarly detected. This assay was highly effective in detecting the virus after infected tissue homogenates were passed once in embryonated chicken eggs, showing a good agreement with virus isolation technique. The Con A-S-ELISA was also used to measure anti-IBV chicken antibodies and showed a high coefficient of correlation (r = 0.85) and an agreement of k = 0.80 with the commercially available Indirect-ELISA. The relative sensitivity and specificity between these two tests were, respectively, 92.86% and 95.65% with an accuracy of 93.39%. Thus, the Con A-S-ELISA proved to be able to detect alternatively homologous and heterologous IBV strains or specific chicken anti- IBV antibodies, using the Con A as capture reagent of this assay.

Paper and pulp mill effluent-induced immunotoxicity in freshwater fish Channa punctatus (Bloch)

The influence of temperature variation on the humoral immune response using the plaque-forming cell (PFC) assay in freshwater fish Channa punctatus (Bloch) was investigated. The fish was exposed to 1% concentration (v/v in water) of paper and pulp mill effluent under standard laboratory conditions in glass aquaria. Effect of effluent exposure on the organ weight and organ cellularity was also evaluated. In general, lower temperature in winter produced a subdued response in control as well as experimental group. At higher temperature of summer and rainy seasons, an elevated response was observed. It was revealed that though suppressive effect of effluent was evident during all the seasons, in summer, extent of suppression was greater as compared to winter. Paper and pulp mill effluent exposure resulted in a decrease in the splenic and pronephric (head kidney) cellularity, with more pronounced effect in the summer season. We also studied the effects of the length of exposure on various parameters. Fish were exposed for 15, 30, 60, and 90 days to effluent. Short-term exposure for 15 days induced an elevated PFC response, but change was not statistically significant. Conversely, the exposure for 30, 60, and 90 days significantly reduced (p < 0.05-0.001) the PFC response. Long-term exposure also caused significant reduction (p < 0.05-0.01) in the weights of lymphoid organs (spleen, head kidney, and total kidney). These results show a suppressive effect of chemical constituents of paper and pulp mill effluent on the immune functions. Furthermore, results demonstrated that though modulatory effect of the temperature on immune functions is recognized, it was not a major contributory factor to the elevated immunotoxicity of paper and pulp mill effluent in the seasons of high temperature.

Induction of hepatic antioxidants in freshwater catfish (Channa punctatus Bloch) is a biomarker of paper mill effluent exposure

Enzymatic and non-enzymatic antioxidants serve as an important biological defense against environmental oxidative stress. Information on antioxidant defense in fish is meager despite that fish are constantly exposed to a myriad of environmental stress including the oxidants. This study, therefore, assesses the activities of antioxidant enzymes viz., glutathione peroxidase, catalase and glutathione S-transferase and the non-enzymatic antioxidants viz., glutathione and metallothionein in various tissues of freshwater fish Channa punctatus (Bloch), in response to short-term and long-term exposures to paper mill effluent. The fish were exposed to the effluent at a concentration of 1.0% (v/v) for 15, 30, 60 and 90 days. The exposure caused a time-dependent increase in glutathione level (P < 0.001), activities of glutathione peroxidase (P < 0.05 to P < 0.001), glutathione S-transferase (P < 0.001) and a marginal initial decrease in catalase activity in the liver (P < 0.01 to P < 0.001). Metallothionein was induced in liver after 60 days of exposure. Two isoforms of metallothionein were detected. Catalase activity also increased 60 days afterwards. Antioxidant pattern was different in gill and kidney showing that liver was more resistant to oxidative damage as compared to gills and kidney. Our results demonstrate a pollutant-induced adaptive response in fish. In addition, levels of enzymatic and non-enzymatic tissue antioxidants may serve as surrogate markers of exposure to oxidant pollutants in fish.

Pollutant-induced over-activation of phagocytes is concomitantly associated with peroxidative damage in fish tissues

Pollutant-induced abnormal functioning of phagocytes and associated consequences were studied in freshwater catfish Heteropneustes fossilis (Bloch). Fish were exposed to effluent collected from bleached kraft type of paper mill at the concentration levels of 0.5, 1 and 2% for 15, 30, 60 and 90 days. Respiratory burst activity of peritoneal and head kidney phagocytes of exposed fish was measured by nitroblue tetrazolium reduction assay. Lipid peroxidation (LPO) was estimated in liver, gill and kidney of fish by measuring thiobarbituric acid reaction substances. It was observed that the phagocyte-activating xenobiotics of effluent induced an increase in the respiratory burst activity in phagocytes. The induction of respiratory burst activity was concomitantly associated with an increase in the peroxidative damage of tissues. The tissues most affected were kidney and gills. The change in LPO values in the gills of exposed fish was concentration- and time-dependent, showing significant increases (P<0.05 to <0.001) in all the exposed groups as compared with control fish. An almost similar pattern of LPO was observed in head kidney tissue (P<0.05 to <0.001). As regards liver, increase in LPO was not widespread, except at 0.5% for 90 days (P<0.05). In fact, reduced rates of LPO were observed in the livers of some groups. The results of respiratory burst corroborate with the phagocytic activation as well as with the extent of lipid peroxidation in the tissues, showing high population of circulatory phagocytes. Our results demonstrate that fish of polluted water are subjected to oxidative stress of multifarious dimensions.

Awareness of sexually transmitted diseases in a selected sample in Karachi

INTRODUCTION

Sexually Transmitted Diseases (STDs) are a major public health problem in developing countries (Adler, 1996). The purpose of this study was to asses women's knowledge level about STDs.

METHODOLOGY

A cross sectional survey was done and data collected through a semi-structured interview. A convenient sample of 30 sexually active females between the ages of 15-45 years from an urban community in Karachi was selected for the study.

RESULTS

The survey findings showed that 30% of the women reported that they had adequate knowledge and 20% partial knowledge. Thus almost three-quarters of the respondents indicated either inadequacy or lack of knowledge about STDs.

CONCLUSION

Our results establish a need for STD clinics at Community-based Primary Health Care (PHC) Centers. These clinics need to address screening, treatment and health education issues in relation to STDs for the target population.

Immunomodulatory activity of a Unani gold preparation used in Indian system of medicine

Kushta Tila Kalan (KTK), a gold preparation used in Unani-Tibb is claimed to possess general tonic, anti-infective and rejuvenating properties. We evaluated immunomodulatory activity of KTK in male mice. KTK was orally administered to animals at dosage of 6.25, 12.5, 25 and 50 mg/kg b.w. for 10 days. Beside general immunopathological parameters, cell-mediated immunity was evaluated by measuring delayed type of hypersensitivity response (DTH) while humoral immunity was assessed using plaque forming cell (PFC) assay. KTK augmented both the immune responses at dose levels of 6.25, 12.5 and 25 mg/kg. The optimum activities were recorded at 25 mg/kg. High dose of 50 mg/kg showed suppressive effects on immune functions. The modulatory effects may be attributed to the interactions of gold with herbomineral adjuncts incorporated during the specialized ashing techniques used in the preparation. The results are interesting in view of reported suppressive effects of other gold preparations.

Role of human decay-accelerating factor in the evasion of Schistosoma mansoni from the complement-mediated killing in vitro

Decay-accelerating factor (DAF) is a 70-kD membrane glycoprotein that prevents complement (C)-mediated hemolysis by blocking the assembly or accelerating the decay of C3 convertase. Purified DAF is known to incorporate into the membrane of DAF-deficient cells, inhibiting lysis. Since Schistosoma mansoni is a blood-dwelling parasite, we investigated whether DAF can be transferred from human erythrocytes to the worm and protect it against C-mediated killing in vitro. We have found that schistosomula (schla) incubated with normal human erythrocytes (N-HuE), but not with DAF-deficient erythrocytes, become resistant to C damage in vitro. Protected parasites acquire a 70-kD surface protein which can be immunoprecipitated by anti-DAF antibodies. The acquired resistance is abrogated by treatment of N-HuE-incubated parasites with anti-DAF antibody. These results indicate that, in vitro, N-HuE DAF can be transferred to schla, and suggest its participation in preventing their C-mediated killing. This could represent an important strategy of parasites to evade the host's immune response in vivo.