Identification of common candidate genes and pathways for Spina Bifida and Wilm's Tumor using an integrative bioinformatics analysis

Spina Bifida (SB) and Wilm's Tumor (WT) are conditions, both associated with children. Several studies have shown that WT later develops in SB patients, which led us to elucidate common key genes and linked pathways of both conditions, aimed at their concurrent therapeutic management. For this, integrated bioinformatics analysis was employed. A comprehensive manual curation of genes identified 133 and 139 genes associated with SB and WT, respectively, which were used to construct a single protein-protein interaction (PPI) network. Topological parameters analysis of the network showed its scale-free and hierarchical nature. Centrality-based analysis of the network identified 116 hubs, of which, 6 were called the key genes attributed to being common between SB and WT besides being the hubs. Gene enrichment analysis of the 5 most essential modules, identified important biological processes and pathways possibly linking SB to WT. Additionally, miRNA-key gene-transcription factor (TF) regulatory network elucidated a few important miRNAs and TFs that regulate our key genes. In closing, we put forward TP53, DICER1, NCAM1, PAX3, PTCH1, MTHFR; hsa-mir-107, hsa-mir-137, hsa-mir-122, hsa-let-7d; and YY1, SOX4, MYC, STAT3; key genes, miRNAs and TFs, respectively, as the key regulators. Further, MD simulation studies of wild and Glu429Ala forms of MTHFR proteins showed that there is a slight change in MTHFR protein structure due to Glu429Ala polymorphism. We anticipate that the interplay of these three entities will be an interesting area of research to explore the regulatory mechanism of SB and WT and may serve as candidate target molecules to diagnose, monitor, and treat SB and WT, parallelly.Communicated by Ramaswamy H. Sarma.

Elemental composition of Talang Queenfish (Scomberoides commersonnianus Lacépède, 1801) in relation to body size and condition factor from Pakistan

Abstract Fish is thought to be the most appropriate for indication of toxicity in water. So, purpose of present study was to determine the concentrations of few metals (Na, K, Ca, Mg, Fe, Cd, Pb and Zn) in relation to the body size and condition factor in Scomberoides commersonnianus. A total of 73 samples of marine fish, S. commersonnianus with various sizes that ranged from 93.4-1180 g of body weight and total length 20.5-56.9cm were randomly collected from the Arabian Sea of Karachi Pakistan, for examination of elemental composition. The concentration of Calcium found maximum while Cadmium found minimum in S. commersonnianus. Concentrations of Zn showed highly significant (P<0.001) negative, while Na and Ca exhibited strong positive correlation with the fish size. Correlations of Pb, K and Mg were found least significant (P<0.05) with the wet weight and total length of S. commersonnianus. Whereas, Fe and Cd were remained insignificantly correlated (P>0.05) with the fish size. Condition factor showed highly significant correlation (P<0.001) with all studied metals except cadmium and lead which were found insignificantly correlated (P>0.05) with condition factor of S. commersonnianus.

Evaluation of automated monitoring calving prediction in dairy buffaloes a new tool for calving management

Abstract Buffalo is one of the leading milk-producing dairy animals. Its production and reproduction are affected due to some factors including inadequate monitoring around parturition, which cause economic losses like delayed birth process, increased risk of stillbirth, etc. The appropriate calving monitoring is essential for dairy herd management. Therefore, we designed a study its aim was, to predict the calving based on automated machine measured prepartum behaviors in buffaloes. The data were collected from n=40 pregnant buffaloes of 2nd to 5th parity, which was synchronized. The NEDAP neck and leg logger tag was attached to each buffalo at 30 days before calving and automatically collected feeding, rumination, lying, standing, no. of steps, no. of switches from standing to lying (lying bouts) and total motion activity. All behavioral data were reduced to -10 days before the calving date for statistical analysis to use mixed model procedure and ANOVA. Results showed that feeding and rumination time significantly (P<0.05) decreased from -10 to -1 days before calving indicating calving prediction. Moreover, Rumination time was at lowest (P<0.001) value at 2h before the calving such behavioral changes may be useful to predict calving in buffaloes. Similarly, lying bouts and standing time abruptly decreased (P<0.05) from -3 to -1 days before calving, while lying time abruptly increased (P<0.01) from -3 to -1 days before calving (531.57±23.65 to 665.62±18.14, respectively). No. of steps taken and total motion significantly (P<0.05) increased from -10 to -1 days before calving. Feeding time was significantly (P<0.02) lowered in 3rd parity buffaloes compared with 2nd, 4th and 5th parity buffaloes, while standing time of 5th parity buffaloes were lowered (P<0.05) as compared to 2nd to 4th parity buffalos at -1 day of prepartum. However, rumination, lying, no. of steps taken and total motion activity at -1 day of prepartum was independent (P>0.05) of parity in buffaloes. Neural network analysis for combined variables from NEDAP technology at the daily level yielded 100.0% sensitivity and 98% specificity. In conclusion NEDAP technology can be used to measured behavioral changes -10 day before calving as it can serve as a useful guide in the prediction calving date in the buffaloes.

Size at sexual maturity estimation for 36 species captured by bottom and mid-water trawls from the marine habitat of Balochistan and Sindh in the Arabian Sea, Pakistan, using maximum length (Lmax) and logistic (L50) models

Abstract The aim of this study was to estimate the size at first sexual maturity (Lm) for 36 species belonging to 24 families from the marine habitat of Balochistan and Sindh in Arabian Sea, Pakistan through maximum length based an empirical and logistic model using commercial catch during June 2020 to May 2021. Individual total length (TL) was noted up to 0.1 cm using measuring broad. The Lm was calculated using two formulae; (i) log (Lm) = - 0.1246 + 0.9924 * log (Lmax) for Elasmobranchs and (ii) log (Lm) = -0.1189 + 0.9157* log (Lmax) for ray-finned fishes. The minimum Lm was recorded as 10.27 cm TL for Caranx malabaricus and 108.38 cm TL for Isurus oxyrinchus, respectively. Around Lm with 58.33% species were ranges from 19.00 cm to 25.00 cm TL. This study was estimated 16 newly Lm which is globally absent and rest 20 Lm are absent in the Arabian Sea (Pakistan coastal habitats). Therefore, the results will be helpful for the sustainable management and conservation of these marine fishes through the establishment of mesh size of trawl nets based on the size at sexual maturity (Lm).

Pharmacological Activities of Rhododendron afghanicum; an Endemic Species of Khyber Pakhtunkhwa, Pakistan

Majority of different kinds of metabolites having therapeutic characteristics are thought to be stored in medicinal plants. So, the present study was aimed to explore the crude extract of leaves and stem of R. afghanicum for phytochemical screening and various pharmacological activities. Toxicological studies at 100 mg/kg showed 60 % mortality where its safe dose level was 90 mg/kg. Phytochemical screening revealed the presence of alkaloids, glycosides, flavonoids and tannins in both extracts. Bacterial strains were susceptible to (RLEt) and (RLM) crude extracts except Staphylococcus aureus. RSM showed maximum anti-inflammatory activity (20.16 %) followed by RSEt (20.14 %) where lowest activity was displayed by RLEt (18.46 %). Phytotoxic activity showed a substantial dose-dependent phyto-inhibition of Lemna minor. An outstanding cytotoxic potential was displayed with LD50 values of 9.46 and 13.03 μg/ml in both stem extracts. RLEt demonstrated a dose-dependent pain relief at 30, 60 and 90 mg/kg which was 31 %, 40 % and 52 % respectively. A considerable spasmolytic action was observed by the shrinkage of jejunum muscle in albino mice. RLEt at 1000 ppm showed (17 mm) and RLM at 1000 ppm showed (16 mm) zone of inhibition against Aspergillus niger. These findings support and corroborate the traditional applications of R. afghanicum for treating digestive, analgesic and inflammatory ailments.

Outcome of Neuromuscular Electrodiagnostic Testing in Children

This study aimed to describe the spectrum of the results of neuromuscular electrodiagnostic investigations performed by age and pathology in paediatric patients. This retrospective observational study took place from January 2019 to December 2021. Electrodiagnostic records of paediatric patients (birth to 15 years) were referred to the electromyography (EMG) laboratory for EMG and nerve conduction study (NCS). Electrodiagnostic and demographic data were collected. Among these, 151 (56%) were males and 118 (44%) were females. Forty-four percent tests came out to be normal and 151(56%) tests revealed electrophysiological abnormality. Peripheral nerve neuropathy (n = 39, 14.5%), polyneuropathy (n = 35, 13%) and myopathy (n = 28, 10%) were the most common electrophysiological diagnoses. The electrodiagnostic test helps in differentiating the aetiologies, thus guiding the subsequent work-up logically in the paediatric population. Key Words: Brachial plexus neuropathies, Electromyography, Duchene muscular dystrophy, Neuromuscular junction disorders, Nerve conduction studies, Acute inflammatory demyelinating polyneuropathy, Rehabilitation, Electromyography, Hereditary sensory motor polyneuropathy.

Lactobacillus probiotics restore vaginal and gut microbiota of pregnant women with vaginal candidiasis

The development of probiotics has now included the areas along the gut-vaginal axis. We thus aimed to investigate the effects of lactobacilli probiotic to modulate and restore vaginal and gut microbiota of pregnant women with vaginal candidiasis (VC). A randomised, double-blind and placebo-controlled study was performed in 78 pregnant women with VC. Patients were randomised to either the probiotic (SynForU-HerCare) or placebo which were administered at baseline and continued for 8-weeks (two capsules/day of 9.5 log cfu/capsule). Microbiota profiles were assessed at time points of weeks-0, 4 and 8 for high vaginal swab and faecal samples. Shannon diversity index showed that after 8-weeks amid VC, a shift in microbial community compositional changes occurred in the high vaginal region at both genus (P=0.025) and species (P=0.044) levels, where the administration of probiotic prevented such a shift. These changes were mainly attributed to a decreased in abundance of Lactobacillus (P=0.042) accompanied by increased abundance of Prevotella (P=0.002) and Atopobium (P=0.002) in the placebo group while the probiotic group remained unchanged over time. The administration of probiotics also prevented a reduced abundance of faecal phylum Firmicutes after 8-weeks as seen in the placebo group (P<0.0001), which also showed reduction at subsequent taxonomic levels of class, family, genera and species. VC has not only altered the microbiota of vagina regions but also gut microbiota profiles, causing lessening of gut microbiota that are crucial for gut nutrient availability, protection and immunity. The administration of lactobacilli probiotics has prevented such a shift, leading to better modulated gut and vaginal microenvironment amid VC. The study was registered at ClinicalTrials.gov: identifier number NCT03940612.

Genetic and morphological concordance and discordance within the Cyrtodactylus brevipalmatus group (Squamata: Gekkonidae)

We use data sets from the Cyrtodactylus brevipalmatus group with limited genetic and morphological sampling to demonstrate that not accounting for sampling error may adversely influence decisions regarding species delimitation and diagnosis. Lack of geographic sampling between the endpoints of a species range may recover notable interpopulational genetic differentiation consistent with species-level differentiation. Additionally, small population sample sizes may fail recover statistically different diagnostic morphological differences. Combined, these types of sampling error can produce results seemingly consistent with the recognition of cryptic speciesgenetically delimited populations lacking diagnostic morphological characters. This is the current situation within some lineages of the C. brevipalmatus group whereas in others, sampling error is less problematic and does not jeopardize their taxonomy. We note the potential negative effects for comparative biology as a whole if sampling error is not taken into consideration prior to constructing taxonomies.

AN EVALUATION OF ANTIBIOTIC PRESCRIPTION PRACTICES: PERSPECTIVES OF VETERINARY TRAINEES AND PRACTICING VETERINARIANS

Antibiotic resistance is a major worldwide problem that has an impact on the well-being of humans as well as animals. Antibiotic resistance is caused by the misuse and excessive use of antibiotics. The key to reducing this issue lies in educating veterinary medical learners on the proper and accountable utilization of antibiotics for the care of animals. Objective - using awareness-raising and instruction as the foundation, this research of Indian veterinary learners can help resolve the issue of antibiotic resistance throughout the care of animals. The questionnaire survey was taken between June and July 2022 and it was aimed at learners registered in veterinary medical studies at academic and research institutions in India. The study included 500 pupils overall. The purpose of the survey was to gather information about students' knowledge of antibiotics, including antibiotic resistance, as well as their feelings on the consequences of antibiotic resistance on the globe at large and their acquaintance with the one health ideology. According to this study's findings, 83.3 percent of respondents thought antibiotic resistance was a serious problem. 57.92 percent of respondents understood the issue's worldwide consequences and its one health ideology. The study emphasizes the significance of expanding the veterinary educational program to include thorough instruction on prudent antibiotic usage and the concepts of one health.

UNDERSTANDING THE ADAPTATION AND SENSITIVITY OF THE MICROBIOME: MICROBIAL RESILIENT AND HUMAN WELL-BEING

The term microbiome describes the assortment of microbes that dwell in and on a person's body, particularly in the gut, comprising fungi, bacteria, infectious agents and additional microbes. According to research, numerous elements of human well-being, such as digestion, immunological response and psychological well-being, have been linked to the microbiome. Preserving human wellness requires knowledge of the microbiome's stability and how it reacts to perturbations. According to preliminary research, adults' microbial ecosystems are considered stable with no signs of significant disturbances. This stability is not preserved by inertia and the system's interaction with restorative forces keeps the processes stable. Short antibiotic doses can result in quick and substantial microbiome alterations. However, there is confirmation that the taxonomic structure of the microbiome has at least recovered after such disruptions. The effect of antibiotics is individualized and can be altered by earlier exposure to a similar drug, which is a crucial aspect to remember. These results suggest that the individual's microbiome has adaptable qualities. Examining the microbiome's reactions to perturbations might be helpful in the prediction of potential instabilities and illness by revealing important features of function, microbial connections, and important species in the native microbiota. This information can benefit the management of the individual microbial community and the promotion of better health conditions.

The United Kingdom National Health Service through the lens of an overseas clinical observer: A reflective account based on personal experience

This article provides insight into an aspect of the National Health Service (NHS) of the United Kingdom (UK) through the perspective of an overseas clinical observer. The NHS is a government-funded medical and health care service in the UK and has developed over the years providing a high standard of medical care and professionalism. The Clinical Observership Programme has been designed primarily for International Medical Graduates to experience how the NHS functions and the kind of services it offers. This article explores the overseas observer's experience in a surgical unit of the NHS including the organisational structure, delivery of care and challenges of the system. This article also highlights the observer's perspective of surgical care in the NHS compared to surgical care in low-resource income countries. The Clinical Observership is useful in learning about UK medical practice and gaining experience in a different cultural and professional environment. This is a reflective first-hand account based on personal experience.

Mucoadhesive, Fluconazole-Loaded Nanogels Complexed with Sulfhydryl-β-cyclodextrin for Oral Thrush Treatment

The objective of this study was to generate fluconazole-loaded mucoadhesive nanogels to address the problem of hydrophobicity of fluconazole (FL). An inclusion complex was formulated with sulfhydryl-β-CD (SH-β-CD) followed by nanogels formation by a Schiff base reaction of carbopol 940 (CA-940) and gelatin (GE). For characterization, PXRD, FT-IR analysis, drug content, and phase solubility studies were performed. Similarly, nanogels were assessed for particle size, zeta potential, organoleptic, and spreadability studies. Moreover, drug contents, rheological, in vitro drug permeation, release kinetics, toxicity, and stability studies of nanogels were performed. Furthermore, mucoadhesive characteristics over the buccal mucosal membrane of the goat were evaluated. The nanogels formulated with a higher amount of CA-940 and subsequently loaded with the inclusion complexes of FL showed promising results. PXRD and FT-IR analysis confirmed the physical complexes by displaying a reduction in the intensity of peaks of FL. The average particle size of nanogels was in the range of 257 to 361 nm. The highest drug content of 88% was encapsulated within the FL-SH-β-CD complex. All formulations at 0.5-1% concentration displayed no toxicity to the Caco-2 cell lines. Nanogels loaded with FL-SH-β-CD complexes showed 18-fold improved mucoadhesion on the buccal mucous membrane of the goat when compared to simple nanogels. The in vitro permeation study exhibited significantly enhanced permeation and first-order concentration-dependent drug release was observed. On the bases of these findings, we can conclude that a mucoadhesive nanogel-based drug delivery system can be an ideal therapy for candidiasis.

In Silico and In Vitro Studies of 4-Hydroxycoumarin-Based Heterocyclic Enamines as Potential Anti-Tumor Agents

The present study reports the one-step synthesis of several 3-formyl-4-hydroxycouramin-derived enamines (4a-4i) in good yields (65-94%). The characterization of the synthesized compounds was carried out via advanced analytical and spectroscopic techniques, such as melting point, electron impact mass spectrometry (EI-MS), 1H-NMR, 13C-NMR, elemental analysis, FTIR, and UV-Visible spectroscopy. The reaction conditions were optimized, and the maximum yield was obtained at 3-4 h of reflux of the reactants, using 2-butanol as a solvent. The potato disc tumor assay was used to assess Agrobacterium tumefaciens-induced tumors to evaluate the anti-tumor activities of compounds (4a-4i), using Vinblastine as a standard drug. The compound 4g showed the lowest IC50 value (1.12 ± 0.2), which is even better than standard Vinblastine (IC50 7.5 ± 0.6). For further insight into their drug actions, an in silico docking of the compounds was also carried out against the CDK-8 protein. The binding energy values of compounds were found to agree with the experimental results. The compounds 4g and 4h showed the best affinities toward protein, with a binding energy value of -6.8 kcal/mol.

Impact of Some Toxic Metals on Important ABC Transporters in Soybean (Glycine max L.)

In plants, ATP-binding cassette (ABC) transporters facilitate the movement of substrates across membranes using ATP for growth, development, and defense. Soils contaminated with toxic metals such as cadmium (Cd) and mercury (Hg) might adversely affect the metabolism of plants and humans. In this study, a phylogenetic relationship among soybeans' (Glycine max) ATP binding cassette (GmABCs) and other plant ABCs was analyzed using sequence information, gene structure, chromosomal distribution, and conserved motif-domain. The ontology of GmABCs indicated their active involvement in trans-membrane transport and ATPase activity. Thirty-day-old soybean plants were exposed to 100 μM CdCl2 and 100 μM HgCl2 for 10 days. Physiological and biochemical traits were altered under stress conditions. Compared to Control, GmABC transporter genes were differentially expressed in response to Cd and Hg. The qRT-PCR data showed upregulation of seven ABC transporter genes in response to Cd stress and three were downregulated. On the other hand, Hg stress upregulated four GmABC genes and downregulated six. It could be concluded that most of the ABCB and ABCG subfamily members were actively involved in heavy metal responses. Real-time expression studies suggest the function of specific ABC transporters in Cd and Hg stress response and are helpful in future research to develop stress-tolerant varieties of soybean.

Short-Term Outcomes and Quality-of-Life Assessment Following Rives-Stoppa and Transversus Abdominis Release Procedures of Open Ventral Hernia Repair

INTRODUCTION

Ventral hernia is one of the common surgical conditions that can significantly impact a patient's quality of life (QoL). Open ventral hernia repair using the Rives-Stoppa (RS) and Transversus Abdominis Release (TAR) procedures has gained recognition for its effectiveness in achieving hernia repair and reducing the risk of further recurrence. However, limited research has been performed to explore the short-term outcomes and QoL assessment following these two surgical techniques. The aim of this study was to know the result after RS and TAR methods of hernia repair in terms of short-term recurrences, pain, postoperative complications, and QoL.

METHODS

This was a prospective, interventional study, which included 30 patients fulfilling the inclusion criteria. The study group was subjected to posterior component separation (PCS)-TAR and RS repair as per surgical indication (RS if defect size 4-10cm; PCS-TAR if defect size >10cm and

RESULTS

Not a single recurrence was observed till POD 180 in either of the repair methods. The mean operative time for RS repair was 170.47 ± 15.08 minutes while for TAR repair was 188.8 ± 22.04 (p-value= 0.013). Surgical site infection (SSI) was reported in 14.28% of RS repair cases and 11.11% of TAR repair cases. Seroma formation was observed in 9.5% of RS repair cases. RS repair has less mean CCS score than TAR. The one-way ANOVA showed f-ratio=421.43 and p-value=0.00001 for RS repair while f-ratio= 298.05 and p-value=0 .00001 for TAR repair at POD seven, POD 30, and POD 90. Both RS and TAR repair markedly reduced mean scores in all three domains on POD 90.

CONCLUSION

Both RS and TAR had no recurrence in a short period of six months. The intraoperative time taken in TAR was less than in earlier studies. QoL improved postoperatively in both the repairs with RS repair having better QoL than TAR repair.

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Key Words

• carolina comfort scale
• quality of life
• recurrence
• rives-stoppa
• tar
• ventral hernia

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Affiliation(s)

Rajiv Kumar General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, IND
Prem Prakash General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, IND
Seema R Sinha Biochemistry, Indira Gandhi Institute of Medical Sciences, Patna, IND
Nadeem Ahmad General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, IND
Kanchan S Baitha General Surgery, Indira Gandhi Institute of Medical Sciences, Patna, IND

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PEGylated Graphene Oxide as a Nanodrug Delivery Vehicle for Podophyllotoxin (GO/PEG/PTOX) and In Vitro α-Amylase/α-Glucosidase Inhibition Activities

This study aims to develop a nanodrug delivery system containing podophyllotoxin (PTOX), a known anticancer drug, loaded on graphene oxide (GO). The system's ability to inhibit α-amylase and α-glucosidase enzymes was also investigated. PTOX was isolated from Podophyllum hexandrum roots with a yield of 2.3%. GO, prepared by Hummer's method, was converted into GO-COOH and surface-mobilized using polyethylene glycol (PEG) (1:1) in an aqueous medium to obtain GO-PEG. PTOX was loaded on GO-PEG in a facile manner with a 25% loading ratio. All the samples were characterized using FT-IR spectroscopy, UV/visible spectroscopy, and scanning electron microscopy (SEM). In FT-IR spectral data, GO-PEG-PTOX exhibited a reduction in acidic functionalities and there was an appearance of the ester linkage of PTOX with GO. The UV/visible measurements suggested an increase of absorbance in 290-350 nm regions for GO-PEG, suggesting the successful drug loading on its surface (25%). GO-PEG-PTOX exhibited a rough, aggregated, and scattered type of pattern in SEM with distinct edges and binding of PTOX on its surface. GO-PEG-PTOX remained potent in inhibiting both α-amylase and α-glucosidase with IC₅₀ values of 7 and 5 mg/mL, closer to the IC₅₀ of pure PTOX (5 and 4.5 mg/mL), respectively. Owing to the 25% loading ratio and 50% release within 48 h, our results are much more promising. Additionally, the molecular docking studies confirmed four types of interactions between the active centers of enzymes and PTOX, thus supporting the experimental results. In conclusion, the PTOX-loaded GO nanocomposites are promising α-amylase- and α-glucosidase-inhibitory agents when applied in vitro and have been reported for the first time.

Single centre experience of 120 patients with non-infectious aortitis: Clinical features, treatment and complications

BACKGROUND

Aortitis is an important form of vasculitis with significant risk of complications. Very few studies have provided detailed clinical phenotyping across the whole disease spectrum. Our primary aim was to look the clinical features, management strategies and complications associated with non-infectious aortitis.

METHODS

A retrospective review was performed on patients with diagnosis of noninfectious aortitis at the Oxford University hospitals NHS Foundation Trust. Clinicopathologic features were recorded including demographics, presentation, aetiology, laboratory, imaging findings, histopathology, complications, treatment, and outcome.

RESULTS

We report the data on 120 patients (59% females). Systemic inflammatory response syndrome constituted the most common presentation (47.5%). 10.8% were diagnosed following a vascular complication (dissection or aneurysm). All patients (n = 120) had raised inflammatory markers (median ESR 70.0 mm/h and CRP 68.0 mg/L). Isolated aortitis subgroup (15%) had significantly higher likelihood of presenting with vascular complications and challenging to diagnose due to non-specific symptoms. Prednisolone (91.5%) and methotrexate (89.8%) were the most used treatment. 48.3% developed vascular complications during the disease course including ischaemic complications (25%), aortic dilatation and aneurysms (29.2%) and dissection (4.2%). Risk of dissection was higher in the isolated aortitis subgroup at 16.6% compared to all other types of aortitis at 1.96%.

CONCLUSION

Risk of vascular complications is high in non-infectious aortitis patients during disease course, hence early diagnosis and appropriate management is key. DMARDs such as Methotrexate appear to be effective, nonetheless there remain gaps in evidence for longer-term management of relapsing disease. Dissection risk seems much higher for patients with isolated aortitis.

The lipid-lowering efficacy of rosuvastatin is associated with variations in SLCO1B1: a 12-month prospective cohort study

OBJECTIVE

Statins' efficacy and safety are subject to wide inter-individual variability, partly due to genetic predisposition. Studies have shown that the genetic variations in the common solute carrier organic anion transporter family member 1B1 (SLCO1B1) gene polymorphisms affect the transport of statins' transport into hepatocytes, their plasma concentration, and circulation time. The ultimate result is variable and personalized statins response and statin-associated muscular symptoms (SAMS). Here we report an update on the differential response to rosuvastatin therapy in the Pakistani population.

PATIENTS AND METHODS

A total of 166 hyperlipidemic patients on rosuvastatin were prospectively followed for 24 weeks. Muscle symptoms were recorded after 6-8 weeks of therapy, and assessment was done according to the SAMS-clinical index tool. Patients were genotyped for SLCO1B1 c.521T>C and c.388A>G polymorphisms, for association with lipid-lowering response and statin-associated muscle symptoms. The plasma level of rosuvastatin was determined through Liquid chromatography-mass spectrometry (LCMS) for possible correlation with adverse effects and lipid-lowering efficacy.

RESULTS

Mean reduction in low-density lipoprotein cholesterol (LDL-C) was 42.34 mg/dl (p<0.001), 35.66 mg/dl (p<0.001), and 24.47 mg/dl (p=0.202) in reference, heterozygous and mutant homozygous groups of SLCO1B1 c.521T>C, respectively. A 15.70% and 42.14% diminished LDL-C reduction was observed in c.521TC and c.521CC, respectively, compared to the reference c.521TT genotype. Similarly, for SLCO1B1 c.388A>G, 20.50% and 29.40% less LDL-C lowering effect was observed in heterozygous and mutant homozygous carriers, respectively. SAMS were observed in 37% and 33% of heterozygous and minor homozygous, respectively, (p=0.059). The rosuvastatin plasma level was 1.89-fold higher in the c.521CC genotype than in the reference homozygous type.

CONCLUSIONS

Differential lipid-lowering response and muscular symptoms due to rosuvastatin are associated with the SLCO1B1 common polymorphisms. Further studies are needed to validate dose adjustment and rationalization.

Growth, physiological, biochemical and molecular changes in plants induced by magnetic fields: A review

The Earth's geomagnetic field (GMF) is an inescapable environmental factor for plants that affects all growth and yield parameters. Both strong and weak magnetic fields (MF), as compared to the GMF, have specific roles in plant growth and development. MF technology is an eco-friendly technique that does not emit waste or generate harmful radiation, nor require any external power supply, so it can be used in sustainable modern agriculture. Thus, exposure of plants to MF is a potential affordable, reusable and safe practice for enhancing crop productivity by changing physiological and biochemical processes. However, the effect of MF on plant physiological and biochemical processes is not yet well understood. This review describes the effects of altering MF conditions (higher or lower values than the GMF) on physiological and biochemical processes of plants. The current contradictory and inconsistent outcomes from studies on varying effects of MF on plants could be related to species and/or MF exposure time and intensity. The reviewed literature suggests MF have a role in changing physiological processes, such as respiration, photosynthesis, nutrient uptake, water relations and biochemical attributes, including genes involved in ROS, antioxidants, enzymes, proteins and secondary metabolites. MF application might efficiently increase growth and yield of many crops, and as such, should be the focus for future research.

National TB elimination programme - What has changed

BACKGROUND

Before the start of Coronavirus (COVID-19) pandemic, TB was the leading cause of death due to a single infectious agent, ranking well above HIV/AIDS. Almost one-fourth of the world's population is infected with M. tuberculosis. TB is curable and preventable. About 85% of people who develop TB can be successfully treated with drug regimens of 6 months. Universal health coverage (UHC) is necessary to ensure that all those with the disease can access these treatments. Research breakthroughs (e.g., newer rapid diagnostic techniques, drugs, newer vaccine) are needed to rapidly reduce the number of new cases each year (TB incidence) worldwide.

OBJECTIVE

Changes in the National TB Elimination Programme since its inception.

CONTENT

The Government of India launched the "National TB Programme" in 1962 as District TB Centre model involved with BCG vaccination and TB treatment to fight tuberculosis, a major public health problem. The tuberculosis control programme has come a long way since then and has undergone major changes over the past few years The Ministry of Health and Family Welfare has developed the "National Strategic Plan" for Tuberculosis Elimination (2017-25) which encapsulates the bold and innovative steps required to eliminate TB in India by 2025, five years ahead of the global targets. By 2020 it was clear that the NSP- 2017-25 will not be able to meet these objectives, so another new NSP India 2025 had been launched in 2020. India has been actively involved in TB control activities for more than 50 years now. TB still continues to be a severe health problem in India. The country is now better prepared to tackle TB than before. It now has advanced and effective interventions and technologies for diagnosis, treatment and care of TB cases.

Seasonal Investigation of Anaplasma marginale Infection in Pakistani Cattle Reveals Hematological and Biochemical Changes, Multiple Associated Risk Factors and msp5 Gene Conservation

Bovine anaplasmosis is a tick-borne disease caused by an obligate intercellular Gram-negative bacterium named Anaplasma (A.) marginale. In this study, we report the seasonal prevalence, potentially associated risk factors and phylogeny of A. marginale in cattle of three different breeds from Multan District, Southern Punjab, Pakistan. A total of 1020 blood samples (crossbred, n = 340; Holstein Friesian, n = 340; and Sahiwal breed, n = 340) from apparently healthy cattle were collected on a seasonal basis from March 2020 to April 2021. Based on PCR amplification of the msp5 partial sequence, overall, the A. marginale prevalence rate was estimated at 11.1% (113/1020) of the analyzed cattle samples. According to seasons, the highest prevalence rate was observed in autumn (16.5%), followed by winter (10.6%) and summer (9.8%), and the lowest was recorded in the spring (7.5%). The crossbred and Sahiwal cattle were the most susceptible to A. marginale infection, followed by Holstein Friesian cattle (7.9%). Analysis of epidemiological factors revealed that cattle reared on farms where dairy animals have tick loads, dogs coinhabit with cattle and dogs have tick loads have a higher risk of being infected with A. marginale. In addition, it was observed that white blood cell, lymphocyte (%), monocyte (%), hematocrit, mean corpuscular hemoglobin and mean corpuscular hemoglobin concentrations were significantly disturbed in A. marginale-positive cattle compared with non-infested cattle. Genetic analysis of nucleotide sequences and a phylogenetic study based on msp5 partial sequencing demonstrated that this gene appears to be highly conserved among our isolates and those infecting apparently healthy cattle from geographically diverse worldwide regions. The presented data are crucial for estimating the risk of bovine anaplasmosis in order to develop integrated control policies against bovine anaplasmosis and other tick-borne diseases infecting cattle in the country.

Recent advances in yeast genome evolution with stress tolerance for green biological manufacturing

Green biological manufacturing is a revolutionary industrial model utilizing yeast as a significant microbial cell factory to produce biofuels and other biochemicals. However, biotransformation efficiency is often limited owing to several stress factors resulting from environmental changes or metabolic imbalance, leading to the slow growth of cells, compromised yield, and enhanced energy consumption. These factors make biological manufacturing competitively less economical. In this regard, minimizing the stress impact on microbial cell factories and strong robust performance have been an interesting area of interest in the last few decades. In this review, we focused on revealing the stress factors and their associated mechanisms for yeast in biological manufacturing. To improve yeast tolerance, rational and irrational strategies were introduced, and the molecular basis of genome evolution in yeast was also summarized. Furthermore, strategies of genome-directed evolution such as homology directed repair and nonhomologous end-joining, and the synthetic chromosome recombination and modification by LoxP-mediated evolution and their association with stress tolerance was highlighted. We hope that genome evolution provides new insights for solving the limitations of the natural phenotypes of microorganisms in industrial fermentation for the production of valuable compounds.

Therapeutic Options for the SARS-CoV-2 Virus: Is There a Key in Herbal Medicine?

SARS-CoV-2 has been responsible for over 500 million cumulative cases all over the world since December 2019 and has marked the third introduction of a highly pathogenic virus after SARS-CoV and MERS-CoV. This virus is in a winning situation because scientists are still racing to explore effective therapeutics, vaccines, and event treatment regimens. In view of progress in current disease management, until now none of the preventive/treatment measures can be considered entirely effective to treat SARS-CoV-2 infection. Therefore, it is required to look up substitute ways for the management of this disease. In this context, herbal medicines could be a good choice. This article emphasizes the antiviral potential of some herbal constituents which further can be a drug of choice in SARS-CoV-2 treatment. This article may be a ready reference for discovering natural lead compounds and targets in SARS-CoV-2 associated works.

Human brucellosis: Six years retrospective study on seropositivity in Malaysia

INTRODUCTION

Human brucellosis is a zoonotic disease in Malaysia. This study analysed six-year retrospective seropositivity trends of human brucellosis cases from 2014 to 2019.

METHODS AND MATERIALS

A total of 1,281 serum samples were obtained from suspected brucellosis patients were included. The sera were tested using an enzyme-linked immunosorbent assay for IgM and IgG antibodies for Brucella spp. Samples with equivocal or positive antibody index were confirmed with an immunocapture agglutination.

RESULTS

During the study period, 5.8% (n=74) of suspected cases showed seropositivity for human brucellosis. The central region has the highest seropositivity cases of human brucellosis. Consumption of unpasteurised milk was significantly associated with human brucellosis in this study with adjusted odds ratio ((AOR) = 4.56, 95% CI = 2.6, 8.02, p-value < 0.001). The age group of less than 15 years old was more likely to contract brucellosis ((AOR) = 2.81, 95% CI = 1.01, 7.84 p-value < 0.048).

CONCLUSION

Serological tests have been widely used for the diagnosis of human brucellosis. However, diagnosis using serology is often challenging without the presence of a convalescent sample. In conclusion, even though human brucellosis has a low prevalence rate, the disease has serious public health implications. The usage of effective diagnostic tools as well as implementation of 'One Health' approach are the way forward to prevent and control of brucellosis in the country.

Multitargeted Molecular Dynamic Understanding of Butoxypheser Against SARS-CoV-2: An in Silico Study

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was initially reported in the Wuhan province of China, spread throughout the world, and caused massive destruction in the form of a global pandemic that started back in 2020. SARS-CoV-2 is an RNA virus with various proteins like main protease, spike protein, NSP15 endoribonuclease, RNA-dependent RNA polymerase, and papain-like protease targeted to screen and find the novel drug candidate that can potentially work against the virus. Previous studies have reported multiple drugs after screening and validation against a single target and reported multiple medications. Nevertheless, many drugs are being used to date but do not have enough potential to work against SARS-CoV-2 and curb the spread and death rate. In this study, with the hypothesis of 1 drug and multiple targets, we have taken 5 main target proteins and screened the Asinex's complete BioDesign library (1,70,269 compounds) and identified N-{2-[(2S)-2-Amino-3-methylbutoxy]-6-propylbenzoyl}-L-phenylalanyl-L-serine (Butoxypheser) as multitarget inhibitor against SARS-CoV-2. Also, Butoxypheser has shown excellent docking scores, hydrogen bonding, and other bonding configurations like van der Waals force and water bridges. The stability and interaction pattern of the compound was validated with structural interaction fingerprints (SIFts) and molecular dynamics (MD) simulation. The Butoxypheser has performed flawlessly throughout the study, and the same results were used to compare the compound's activity against multiple targets. After a thorough theoretical comparative analysis, Butoxypheser can be treated as a multitargeted inhibitor candidate against SARS-CoV-2. Further, this study needs to be validated experimentally before human use.

Pharmacognostic standardization of Rhododendron afghanicum through scanning electron microscopy and analytical techniques

The aim of this study was to assess and compare the pharmacognostic and microscopic features of the selected parts of Rhododendron afghanicum Aitch. & Hemsl. It is a perennial and shrub. Anatomy of stem and leaves depicted dicot structure. It will provide knowledge about standardization, authentication, and adulteration with its co-species. The macroscopic examination reveals that fresh leaves are green, pleasant odor with a bitter taste. The leaf is oblong-elliptic in shape and sub-acute at apex; rounded at the base with entire margin. Stem is irregular and the outer surface is light brown, rough with fissures and ridges. Microscopic examination indicated the presence of xylem, phloem, peltate trichome, epidermal cells, collenchymas cells, paracytic stomata, and reticulate vessels. Stem microscopy reveals epidermis, hypodermis, cortex, sclerenchymatous sheath, phloem, xylem, and pith. It will be helpful in identification and quality control. Micro-morphological features were observed through SEM. EDX spectroscopy were carried out and revealed the presence of calcium, silicon, and potassium. Phytochemical analysis revealed the presence of tannins, saponins, phenols, protein, flavonoids, glycosides, and alkaloids. Ethyl acetate for leaf and stem demonstrate the highest extractive values (18% and 13%), respectively. XRD peaks appeared at 30.21, 28.73, 205.73, 200.73, 380.07, 390.24, 490.11, and 450.33^ο . This will be helpful to identify the ownership of herbal drugs by the diffraction peaks through crystal structures and atomic spacing. These parameters are crucial for drug identification, standardization, authentication, and drug designing. These studies also provided knowledge regarding therapeutic and nutraceutical importance of this plant.

POS0958 PROGRESSIVE IMPROVEMENT IN TIME TO DIAGNOSIS IN AXIAL SPONDYLOARTHRITIS THROUGH AN INTEGRATED REFERRAL AND EDUCATION SYSTEM

Background

Despite the advances in the treatment and management of axial spondyloarthritis (axSpA), there remains a significant delay in the diagnosis of the condition. The diagnostic delay is 8-10 years in Europe and 8.5 years on average in the United Kingdom. This is contributed by the lack of awareness of axSpA, limited access to diagnostic tests and unstructured referral pathways. The delayed diagnosis leads to higher morbidity from the condition.

Objectives

To assess the delay in the diagnosis of axSpA over time in a real world axSpA cohort diagnosed over a 7 year period from 2015 and to evaluate factors associated with this delay. During this time, we evaluated the effectiveness of the interventions to reduce the delay to diagnosis.

Methods

A cohort of axSpA patients newly diagnosed between 2015 to 2021, were studied. This was a cross-sectional study on patients with axSpA who visited a specialist rheumatology clinic at a single centre. The demographic, clinical and diagnostic variables were recorded. Diagnostic delay was defined as the time interval between the year of first symptom and year of diagnosis. The mean and median diagnostic delay were calculated. An integrated educational and referral system were implemented from 20151. This included education to the main referrers in to the system including general practitioners (GPs) and community musculoskeletal (MSK) triage physiotherapists. The electronic referral systems were updated annually according to best practice guidelines2. An impact analysis was performed evaluating diagnostic delay for axSpA during this period.

Results

Of the 110 axSpA patients studied, 60 (54.4%) were male and 50 (45.5%) female. The mean (range) age was 37 (18-52) years. All patients met the ASAS classification criteria for axSpA. Radiographic axSpA (Ankylosing spondylitis) fulfilling New York criteria, was diagnosed in (62%) of the patients. There were more patients with radiographic axSpA in the earlier years of diagnosis (100% in 2015) and more of non-radiographic axSpA in the later years (83% in 2021). HLA-B*27 positivity was found in 79 (71.8%) of patients. The majority of referrals were from general practitioners 63 (57.2%), physiotherapists 19 (17.3%), orthopaedics 18 (16.4%) and other specialties 10 (9.1%). There was no significant difference in the mean (years) delay to diagnosis from the source of the clinic referral. The mean and median delay to diagnosis by year of diagnosis were 9.9, 9.5 (±3.1) years in 2015, 7.1, 7(±1) in 2016, 5.3,5 (±2.7) in 2017, 4.9, 4 (±3) in 2018, 4.4, 2.5 (±4.8) in 2019, 3.6, 2 (±3.2) in 2020, 2.2, 1 (±2.6) in 2021. The majority of the patients were diagnosed between 31-40 years (41%), 22% between 18-30 years, 31% between 41-50 years and 4% after the age of 50 years. Higher age at diagnosis was associated with a longer diagnostic delay. Diagnosis of disease at 18-30 years of age was associated with shorter mean delay to diagnosis (2.9 years), age 31-40 (4.6), age 41-50 (5.9), and age > 51 (6.5).

Conclusion

Delay in axSpA diagnosis has significantly improved in this real-world cohort during the last seven years. The mean diagnostic delay was 2 years indicating diagnostic delay may be for most patients shorter than previously reported. The factors associated with a faster diagnosis were a) more recent year of first rheumatology consult b) earlier age at presentation. Increased educational and awareness campaigns in primary care and musculoskeletal triage has led to the early recognition of axSpA. Early referral to a rheumatology service using electronic referral symptom can improve the diagnostic delay of axSpA. With continuous improvement cycles, our aim is to get reduce delays to diagnosis to under 1 year with line with the Gold Standard to Diagnosis in axSpA.

References

[1]All Party Parliamentary Group (APPG) on Axial Spondyloarthritis. 2019.

[2]https://nass.co.uk/wp-content/uploads/2020/03/APPG-on-Axial-SpA-Second-Meeting-Minutes.pdf

[3]NICE Guideline NG65. Spondyloarthritis in over 16s: diagnosis and management. 2017. https://www.nice.org.uk/guidance/ng65

Disclosure of Interests

Antoni Chan Speakers bureau: Janssen, Novartis, Amgen, Abbvie, Celgene, UCB, Consultant of: Novartis, Lilly, Abbvie, Grant/research support from: Novartis, UCB, Kathryn Rigler: None declared, Nadia Ahmad: None declared, Tanguy Lafont: None declared

Molecular study on the role of vacuolar transporters in glycyrrhetinic acid production in engineered Saccharomyces cerevisiae

Glycyrrhetinic acid (GA) is one of the major bioactive components of the leguminous plant, Glycyrrhiza spp. (Chinese licorice). Owing to GA's complicated chemical structure, its production by chemical synthesis is challenging and requires other efficient strategies such as microbial synthesis. Earlier investigations employed numerous approaches to improve GA yield by refining the synthetic pathway and improving the metabolic flux. Nevertheless, the metabolic role of transporters in GA biosynthesis in microbial cell factories has not been studied so far. In this study, we investigated the role of yeast ATP binding cassette (ABC) vacuolar transporters in GA production. Molecular docking of GA and its precursors, β-Amyrin and 11-oxo-β-amyrin, was performed with five vacuolar ABC transporters (Bpt1p, Vmr1p, Ybt1p, Ycf1p and Nft1p). Based on docking scores, two top scoring transporters were selected (Bpt1p and Vmr1p) to investigate transporters' functions on GA production via overexpression and knockout experiments in one GA-producing yeast strain (GA166). Results revealed that GA and its precursors exhibited the highest predicted binding affinity towards BPT1 (ΔG = -10.9, -10.6, -10.9 kcal/mol for GA, β-amyrin and 11-oxo-β-amyrin, respectively). Experimental results showed that the overexpression of BPT1 and VMR1 restored the intracellular as well as extracellular GA production level under limited nutritional conditions, whereas knockout of BPT1 resulted in a total loss of GA production. These results suggest that the activity of BPT1 is required for GA production in engineered Saccharomyces cerevisiae.

Measuring Readiness for Self-Directed Learning in Medical Undergraduates

PURPOSE

To measure the readiness for self-directed learning in medical students for the evaluation of self-directed learning in the study population.

MATERIALS AND METHODS

The survey was conducted in undergraduate students. The instrument used was Fisher's readiness scale comprising of self-management, desire for learning, and self-control domains. The data were analyzed by Mann-Whitney U-test and bivariate and partial correlations. The results were compared with the reported ones.

RESULTS

Total students surveyed were 300. Of these, 96 responded - 73 (76%) of preclinical and 23 (24%) of clinical classes. The mean readiness score was 124. The mean domains' scores for self-management, desire for learning, and self-control were 38, 38, and 48, respectively. The preclinical group had a mean score of 122 for readiness,  37 for self-management and desire for learning each, and 48 for self-control. The clinical group's scores were 129, 40, and 49, respectively. Preclinical and clinical groups differed significantly in self-management domain (P = 0.03). The difference was not significant in desire for learning (P = 0.08), self-control domains (P = 0.40) and readiness score (P = 0.12). The domains of self-control and desire for learning had a positive correlation if self-management was controlled, and self-control and self-management had a positive correlation if desire for learning was controlled (P < 0.05).

CONCLUSION

The measurement of readiness for self-directed learning helps in knowing the true value of self-directed learning in a particular setting. Relatively lower scores in our study mean self-directed learning alone cannot be relied upon to achieve optimum students' learning. There is also a need for implementing strategies that will help students in improving their readiness for independent learning.

Evaluation of Pakistani wheat germplasm for leaf rust resistance at various locations

341 entries comprising of 250 genotypes/lines and 91 gene differentials were tested for leaf rust (Puccinia triticina Erik) in different ecological zones of Punjab during 2016–17 and 2017–18. Each entry was planted in a single 1 m long row and Morocco was used as a spreader. Data on leaf rust severity was recorded once in 3rd week of March during both study years at all locations by following Modified Cobb Scale while the data was recorded three times on 2nd, 22nd and 29th March during 2018 at Faisalabad location to study rust development pattern. The disease severity ranged from 0-100S during 2016–17 and from 0-80S during 2017–18. The genotype HYT 60–5 and the genes Lr-19, Lr-26 and Lr 27+31 showed no disease symptoms at any location during both the study years. These genes can be used for future breeding material development. Area under disease progressive curve (AUDPC), calculated on the basis of periodical readings from Faisalabad, ranged from 0–550 and the susceptible check Morocco has AUDPC value of 600. 120 entries including HYT 60–5 have disease progression 0, which showed that there may be a major gene based resistance in these entries. Area under disease progressive curve/Day (AUDPC/DAY) was calculated for the rest of 130 genotypes to have an understanding of the disease progression pattern and out of which 43 entries have AUDPC/Day value ranging from 1–2 and 28 entries have AUDPC/Day value ranging from 2–3 which revealed that these entries are very useful for use in breeding for durable rust resistance and can be utilized as a parent in back cross and top cross breeding schemes. Material with AUDPC value less than 10 is the best source of resistance against the leaf rust. Varieties/advanced lines, Ujala-16, V-14154, and V-14124 have shown slow rust development and are very good sources of resistance. Similarly, HYT 60–5 has proven an excellent source of resistance. The advance line V-14154 has been approved as a commercial cultivar by the name “Akbar-19”.

The Effect of Layering Structures on Mechanical and Thermal Properties of Hybrid Bacterial Cellulose/Kevlar Reinforced Epoxy Composites

The effect of layering structures on mechanical and thermal hybrid bacterial cellulose (BC) sheet/Kevlar reinforced epoxy composites was investigated. The BC sheet was extracted from Nata de Coco and used as green reinforcement material hybrid with Kevlar reinforced epoxy composites. The BC/Kevlar reinforced epoxy composite was fabricated by using hand lay-up technique equipped with vacuum bagging system and the BC sheets and Kevlar layers were laminated into different layered structures. The performance of the hybrid BC/Kevlar reinforced epoxy composites was characterized through tensile test and low velocity impact according to ASTM D3039 and ASTM D7136, respectively. The thermal performance of the hybrid composites was characterized by using dynamic mechanical analysis (DMA) test. Tensile test on BC sheet composites with Kevlar and epoxy demonstrated that the addition of BC sheet in BC/Kevlar could not withstand the tensor stress by reducing the tensile stress and Young's modulus. The one layer of Kevlar which was replaced with three to six BC sheets had increased the ability to absorb impact force. The storage modulus (E′) and Tan δ were significantly dependent on the number of BC sheets and its layering structure. The highest value of E′ was observed when BC sheets were arranged alternately with the Kevlar layers. Different damage mechanisms associated with the number of BC sheets and its layered-structure suggested that the BC sheet was functioning as an impact energy absorber as well as strengthening fibers. This study will upsurge interest in BC reinforced composites and the development of new ideas in automotive, marine and bullet applications.

P-12 A case of Descemet's membrane detachment following penetrating keratoplasty for keratoconus

*Correspondence - Nadeem Ahmad: nadeem.ahmad123@doctors.org.uk OBJECTIVE: To present an uncommon case of Descemet's (DM) detachment 20 years following PK for keratoconus. The detachment spontaneously resolved with conservative management.To review the literature and published case reports for the clinical course, prognosis, and managements employed for DM detachment following PK.

METHODS AND ANALYSIS

Case presentation of a patient presenting to our department and review of the literature.

RESULTS

Our patient presented with a spontaneous DM detachment 20 years after an uncomplicated PK for keratoconus. Imaging showed recurrence of corneal ectasia inferiorly, which would give this patient a poorer prognosis and higher risk of re-detachment after surgical intervention for the detachment. We opted for conservative management, after which the DM detachment spontaneously resolved and corneal thickness improved.DM detachment is an uncommon late complication of PK and pathophysiology is thought to be mechanical due to a retrocorneal membrane, or due to recurrence of corneal ectasia. The majority of published cases underwent surgery with air, SF6, or C3F8 with postoperative supine positioning, or progression to repeat PK or DSAEK if this initial treatment fails. Topical steroids can be given for conservative management.

CONCLUSION

Conservative management of DM detachment can be an option for patients with guarded prognosis, or in small detachments with no tears. Our case provides another data point on the presentation and progression of this complication to the small number of case reports in the literature.

Acaricide resistance in Boophilus microplus ticks collected from two ecological Zones of Khyber Pakhtunkhwa, Pakistan

Boophilus microplus is a major cattle tick specie causing great economic loss to the dairy industry throughout the globe including Pakistan. Trichlorfon and Deltamethrin are used to control bovine ticks, and their sprays are also used in other pest control programs that exert pressure on ticks to gain resistance. This study is aimed to examine the resistance level of Rhipiciphalus microplus against trichlorfon and deltamethrin. The engorged ticks were collected from two ecological regions of Khyber Pakhtunkhwa, KPK Pakistan i.e., Swat & Dir (zone-1), and Charsadda & Nowshera (zone-2). Four concentrations of acaricides in two-fold and ten-fold ppm with three replicates for each were used in both bioassays. Egg hatch assay and adult immersion tests were used to assess the resistance status. The probit analysis of egg hatch assay showed the highest hatching percentage in zone 1 on both dilutions (67-76% on two-fold and 68-88% on ten-fold dilution) while lethal concentration (LC95) was found to be 2.187 ppm and discriminating dose (DD) as 4.374 ppm for trichlorfon. In zone 2, hatching percentage was 73-84 on two-fold and 72-91% on ten-fold dilution while LC95 was recorded as 0.599 ppm and DD as 1.198 ppm. The same parameters were studied for deltamethrin and in zone 1 the hatching percentage was found as 38-56% on two-fold dilution and 37-80% on ten-fold dilution while LC95 was recorded as 0.001 ppm and DD as 0.002 ppm. In zone 2, the hatchability was recorded as 42-58% on two-fold and 43-85% on ten-fold dilution. The values for LC95 was recorded as 0.001 ppm and DD as 0.002 ppm. Further, analysis of adult immersion test against trichlorfon revealed the values of LC50 as 2.85 ppm and LC95 as 4.71 ppm in zone 1 and in zone 2 as 3.14 ppm and 5.28 ppm, respectively. Similarly, LC50 and LC95 against deltamethrin was recorded as 0.79 ppm & 1.71 ppm in zone 1 and 0.45 ppm & 4.325 ppm in zone 2, respectively. Based on the findings of this study, the isolated Rhipicephalus microplus was found to be more resistant to the widely used acaricides i.e., trichlorfon than deltamethrin. In order to maintain the efficacy of acaricides at country level, the study recommends continuous monitoring of resistance.

Global Gene Expression and Docking Profiling of COVID-19 Infection

Coronavirus is an enclosed positive-sense RNA virus with club-like spikes protruding from its surface that causes acute respiratory infections in humans. Because it is considered a member of the complex pathogen group, it has been found to infect different host species and cause a variety of diseases. So far, it has been discovered that it may affect the immune, infection, and inflammatory systems, leading to the hypothesis that the immune and inflammatory systems (signaling pathways and components) fail to control infection, opening the door to look for potential targets primarily in these systems. The study’s main purpose is to identify highly overexpressed genes and their functional implications as a result of COVID-19 infection, as well as to investigate probable infections, inflammation, and immune systems to better understand the impact of coronavirus infection. We explored the genes and pathways mostly linked with infection, inflammation, and the immune systems using the datasets available for COVID-19 infection gene expression compendium. NFKBIA, FN1, FAP, KANK4, COMP, FAM101B, COL1A2, ANKRD1, TAGLN, SPARC, ADAM19, OLFM4, CXCL10/11, OASL, FOS, APOBEC3A, IFI44L, IFI27, IFIT1, RSAD2, NDUFS1, SRSF6, HECTD1, CBX3, and DDX17 are among the genes that may be impacted by infection, according to our findings. The functional changes are mainly associated with these pathways TNF, cytokine, NF—kB, TLR, TCR, BCR, Foxo, and TGF signaling pathways are among them and there are additional pathways such as hippo signaling, apoptosis, estrogen signaling, regulating pluropotency of stem cells, ErbB, Wnt, p53, cAMP, MAPK, PI3K—AKT, oxidative phosphorylation, protein processing in endoplasmic reticulum, prolactin signaling, adipocytokine, neurotrophine signaling, and longevity regulating pathways. Moreover, we have also explored the potential herbal drug (apigenin, quercetin, and resveratrol) targets for the top-rated genes based on the overall analysis where we observe that quercetin and resveratrol as most effective.

A Systematic Review of Circulatory microRNAs in Major Depressive Disorder: Potential Biomarkers for Disease Prognosis

Major depressive disorder (MDD) is a neuropsychiatric disorder, which remains challenging to diagnose and manage due to its complex endophenotype. In this aspect, circulatory microRNAs (cimiRNAs) offer great potential as biomarkers and may provide new insights for MDD diagnosis. Therefore, we systemically reviewed the literature to explore various cimiRNAs contributing to MDD diagnosis and underlying molecular pathways. A comprehensive literature survey was conducted, employing four databases from 2012 to January 2021. Out of 1004 records, 157 reports were accessed for eligibility criteria, and 32 reports meeting our inclusion criteria were considered for in-silico analysis. This study identified 99 dysregulated cimiRNAs in MDD patients, out of which 20 cimiRNAs found in multiple reports were selected for in-silico analysis. KEGG pathway analysis indicated activation of ALS, MAPK, p53, and P13K-Akt signaling pathways, while gene ontology analysis demonstrated that most protein targets were associated with transcription. In addition, chromosomal location analysis showed clustering of dysregulated cimiRNAs at proximity 3p22-p21, 9q22.32, and 17q11.2, proposing their coregulation with specific transcription factors primarily involved in MDD physiology. Further analysis of transcription factor sites revealed the existence of HIF-1, REST, and TAL1 in most cimiRNAs. These transcription factors are proposed to target genes linked with MDD, hypothesizing that first-wave cimiRNA dysregulation may trigger the second wave of transcription-wide changes, altering the protein expressions of MDD-affected cells. Overall, this systematic review presented a list of dysregulated cimiRNAs in MDD, notably miR-24-3p, let 7a-5p, miR-26a-5p, miR135a, miR-425-3p, miR-132, miR-124 and miR-16-5p as the most prominent cimiRNAs. However, various constraints did not permit us to make firm conclusions on the clinical significance of these cimiRNAs, suggesting the need for more research on single blood compartment to identify the biomarker potential of consistently dysregulated cimiRNAs in MDD, as well as the therapeutic implications of these in-silico insights.

Fenugreek seed mucilage grafted poly methacrylate pH-responsive hydrogel: A promising tool to enhance the oral bioavailability of methotrexate

This study aimed to develop the Fenugreek seed mucilage-based pH-responsive hydrogel system in order to improve the oral bioavailability of methotrexate (MTX). Fenugreek seed mucilage (FSM) was extracted from Trigonella foenum-graecum seeds. F1-F9 formulations of pH-responsive hydrogels were prepared using various FSM ratios, methacrylic acid (MAA), and methylene bis acrylamide (MBA) via free radical polymerization technique. Swelling behavior and in vitro drug release studies of prepared hydrogels were evaluated. Toxicity studies of prepared hydrogels were performed on normal cells and on Wistar rats (n = 6). Moreover, in vivo pharmacokinetics parameters were studied on albino rabbits. Hydrogels formation was confirmed by FTIR analysis, thermal analysis and SEM studies. The maximum swelling of hydrogel was found to be 384.7% at pH 7.4. MTX-loaded hydrogel showed the controlled release of MTX up to 24 h following Super Case II transport. Prepared hydrogels exhibited no toxicity in normal cells as well as in experimental subjects. MTX loaded hydrogels exhibited less inhibition compared to free MTX on Hela cells. In Vivo studies revealed 7.5-fold improved oral bioavailability of MTX with higher C_max (928 ng/mL). These results indicate that the pH-responsive hydrogel system based on FSM is a promising tool for the controlled delivery of MTX.

Effects of Se nanoparticles supplementation on growth performance, hematological parameters and nutrient digestibility of Labeo rohita fingerling fed sunflower meal based diet

The aim of the present study is to assess the effects of selenium nanoparticles on the growth, hematology and nutrients digestibility of Labeorohita fingerlings. Fingerlings were fed with seven isocaloric sunflower meal-based diet supplemented with different concentrations of nanoparticles naming T1 to T7 (0, 0.5, 1, 1.5, 2, 2.5, and 3 mg/kg), with 5% wet body weight while chromic oxide was used as an indigestible marker. After experimentation for 90 days T3 treated group (1mg/kg -1Se-nano level) showed the best result in hematological parameters (WBC's 7.97 ×103mm-3, RBC's 2.98 ×106 mm-3 and Platelet count 67), nutrient digestibility (crude protein: 74%, ether extract: 76%, gross energy: 70%) and growth performance (weight gain 13.24 g, weight gain% 198, feed conversion ratio 1.5, survival rate 100%) as compared to the other treatment groups. Specific growth rates were found significantly higher in T5 than in other groups. The present study indicated positive effect of 1 mg/kg Se-nanoparticles on growth advancement, hematological parameters, and nutrients digestibility of L. rohita fingerlings.

Efficacy of Magnesium Sulfate in Addition to Melatonin Therapy in Neonates With Hypoxic-Ischemic Encephalopathy

Background: One of the most important causes of neonatal deaths in developing nations is birth asphyxia. Though the probability of a complete recovery is very low, hypoxic-ischemic encephalopathy (HIE) associated with asphyxia can be managed with multiple treatment options. The study evaluated the efficacy of the addition of magnesium sulfate (MgSO₄) to melatonin therapy in neonates with HIE.

Methodology: A prospective, observational study was conducted in the department of neonatal intensive care, Pakistan Institute of Medical Sciences Hospital, Islamabad, Pakistan from October 2020 to March 2021. All neonates with an Appearance, Pulse, Grimace, Activity, and Respiration (APGAR) score of less than five at five minutes, umbilical blood pH of less than 7.0, and moderate neonatal encephalopathy as detected on the modified Sarnat score which is a clinical tool used for the assessment of the severity of HIE were included in the study. Neonates with congenital abnormalities, intrauterine growth retardation, neonatal sepsis, and infants born to mothers with diabetes mellitus type 2 were excluded from the study. The infants were randomly assigned to either of the groups, i.e., i) group 1 included neonates who were administered at least three doses of magnesium sulfate (MgSO₄) infusion in addition to melatonin, or ii) group 2 included neonates who were administered melatonin only. Blood samples of all neonates were evaluated and compared between the two groups.

Results: A total of 90 neonates with HIE were included in the study. There was a predominance of female neonates. The mean ages of babies in group 1 and group 2 were 37.2 ± 0.43 and 37.3 ± 0.59 weeks, respectively. The mean weight on the term was 2.88 ± 0.11 and 2.89 ± 0.10, respectively. The Apgar score at 5 mins in group 1 was 1.73 ± 0.81 while in group 2, 1.82 ± 0.94. It was found that there was a more significant improvement in pH after 3 days and after one week of treatment in group 1 as compared to group 2. The mean pH in babies after three days of intervention was 7.23 ± 0.03 in group 1 which was significantly better than group 2 (p<0.0001). After seven days, the mean normalized to 7.39 ± 0.04 in group 1 (p < 0.0001). It was found that in patients in group 1, the mortality was lower than in group 2 (p < 0.0001).

Conclusion: HIE patients who were administered melatonin in combination with magnesium sulfate yielded better patient outcomes. Thus, it was concluded that the use of magnesium sulfate as dual therapy with melatonin improved patient outcomes for HIE. However, it is recommended that similar studies are conducted with a wider range of parameters, such as duration of hospital stay and assessment of the neurological outcomes of the patients.  

Microbiological profile and their antibiogram of bloodstream infections amongst first and second surge of the COVID-19 patients in a tertiary care hospital

Introduction

The world is experiencing a pandemic of coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2. The prescription of a superfluity of unnecessary antibiotics without regard for the potential for increased antimicrobial resistances is extensive and unimpeded during the COVID-19 pandemic.

Aims

To compare the microorganisms and the pattern of antimicrobial resistance of bacteremia during the first and second waves of the COVID-19 pandemic in a tertiary care hospital.

Methods and Material

This retrospective observational study, to compared the blood culture of the COVID-19 pandemic during the first wave (April 2020 to September 2020) and the second wave (April 2021 to September 2021). All the blood culture isolates were identified and the antimicrobial susceptibility testing was done according to standard guidelines.

Results

Out of 1470 blood culture samples, 259 (17.6%) blood bacterial isolates were grown in the first wave and, out of 4200 blood culture samples, 711 (16.9%) bacterial isolated during the second wave of the COVID-19 pandemic. Coagulase-negative staphylococcus (CONS) was 32.8% followed by Staphylococcus aureus 29.7% in COVID first wave and staphylococcus aureus (48.9%) followed by Klebsiella pneumoniae (11.6%) during COVID second wave were the most prevalent isolates.

Conclusions

This study shows that coagulase-negative staphylococcus aureus and multidrug-resistant Klebsiella spp. are the leading causes of bloodstream coagulase-negative infections during both the first and second wave in the bloodstream COVID-19 pandemic.

Prevalence of cutaneous leishmaniasis in the largest populated city Karachi, Pakistan

The study was undertaken from September 2018 to April 2019 to determine the prevalence of cutaneous leishmaniasis in human beings living in six districts of Karachi. Suspected persons were screened for the disease and positive cases were identified on the basis of skin lesions and blood samples. Samples were observed by mounting their smear. A total of 207 subjects of different ages and sex groups were investigated, however, only 192 (92%) of the suspected cases were found to have the disease 64% of cases were male which were significantly high (p 0.05), than female 36%. The lesion was more frequently detected among the youth ages of 21-30 years (31%) as compared to other groups. In both sexes, legs were found to be more infected (25% male + 20% female) followed by arms (20% male + 0% female) and face (15% male +11% female). The mixed body parts had shown the lowest infections such as (4% in males + 5%) in females. In conclusion, the highest and lowest leishmaniasis infections were observed in District West (23% male + 9% female) followed by District East (15% male + 7% female), District Malir (11% male+ 4% female), District Central (7% male + 5% female), District Korangi (4% male + 7% female) and District South (4% male + 4% female) respectively.

Trend and pattern of melioidosis seropositivity among suspected patients in Malaysia 2015 - 2019

Melioidosis is a disease of public health importance associated with high case-fatality rates in animals and humans caused by Burkholderia pseudomallei (B. pseudomallei ), a gram- negative bacterium that lives in tropical soil environments. This study determined the seropositivity for melioidosis among patients admitted to healthcare centres in Malaysia, from 2015 to 2019 and identified factors related to it. A total of 26,665 serum samples of suspected melioidosis patients from Malaysia hospitals were tested for IgM against B. pseudomallei. About 16.4% of total samples were seropositive and majority of them were 55 years old and above. However, younger people aged less than 15 years old were the most susceptible to the infection (AOR 3.04, p <0.001, 95% CI: 2.73, 3.39). Melioidosis infection was the highest in Sarawak (15.1%) while Perlis was the least exposed to the infection (0.9%). Further analyses showed that patients with chronic lung disease (adjusted OR: 4.03, p < 0.001, 95% CI: 2.77, 5.86) were more susceptible to melioidosis infection. In conclusion, although serology testing is not a gold standard test in diagnosing melioidosis, it has been used as a tool in treatment monitoring and disease surveillance among patients and at-risk community in the endemic hot-spots regions.

Advances in production and structural derivatization of the promising molecule ursolic acid

Ursolic acid (UA) is a ursane-type pentacyclic triterpenoid compound, naturally produced in plants via specialized metabolism and exhibits vast range of remarkable physiological activities and pharmacological manifestations. Owing to significant safety and efficacy in different medical conditions, UA may serve as a backbone to produce its derivatives with novel therapeutic functions. This review aims to provide ideas for exploring more diverse structures to improve UA pharmacological activity and increasing its biological yield to meet the industrial requirements by systematically reviewing the current research progress of UA. We first provides an overview of the pharmacological activities, acquisition methods and structural modifications of UA. Among them, we focused on the synthetic modifications of UA to yield valuable derivatives with enhanced therapeutic potential. Furthermore, harnessing the essential advances for green synthesis of UA and its derivatives by advent of metabolic engineering and synthetic biology are of great concern. In this regard, all pivotal advances for enhancing the production of UA have been discussed. In combination with the advantages of UA biosynthesis and transformation strategy, large-scale microbial production of UA is a promising platform for further exploration.

O-glycosyltransferases from Homo sapiens contributes to the biosynthesis of and Glycyrrhizin in Saccharomyces cerevisiae

Glycyrrhizin (GL) and Glycyrrhetic Acid 3-O-mono-β-D-glucuronide (GAMG) are the typical triterpenoid glycosides found in the root of licorice, a popular medicinal plant that exhibits diverse physiological effects and pharmacological manifestations. However, only few reports are available on the glycosylation enzymes involved in the biosynthesis of these valuable compounds with low conversion yield so far. In mammals, glycosyltransferases are involved in the phase II metabolism and may provide new solutions for us to engineer microbial strains to produce high valued compounds due to the substrate promiscuity of these glycosyltransferases. In this study, we mined the genomic databases of mammals and evaluated 22 candidate genes of O-glycosyltransferases by analyzing their catalytic potential for O-glycosylation of the native substrate, glycyrrhetinic acid (GA) for its glycodiversification. Out of 22 selected glycosyltransferases, only UGT1A1 exhibited high catalytic performance for biosynthesis of the key licorice compounds GL and GAMG. Molecular docking results proposed that the enzymatic activity of UGT1A1 was likely owing to the stable hydrogen bonding interactions and favorite conformations between the amino acid residues around substrate channels (P82~R85) and substrates. Furthermore, the complete biosynthesis pathway of GL was reconstructed in Saccharomyces cerevisiae for the first time, resulting in the production of 5.98 ± 0.47 mg/L and 2.31 ± 0.21 mg/L of GL and GAMG, respectively.