Consanguinity in northwest Pakistan: evidence of temporal decline

Pakistan has a high burden of hereditary and congenital anomalies and their incidence rate almost doubles against the background of parental consanguinity. Consanguineous unions (CU) are customary in Pakistan and deeply rooted socio-cultural norms favour CU. This study aimed to elucidate the determinants and temporal change in CU in four northwestern populations of Pakistan. In a cross-sectional study, data on marital union types, bio-demographic factors, and paternal consanguinity were collected from 6,323 ever-married individuals in four districts of northwest Pakistan: Haripur, Muzaffarabad, Mansehra, and Shangla. We used descriptive statistics and multivariable logistic regression analysis. The CU were calculated to be 55%, and inbreeding coefficient F (ICF) was estimated to be 0.029. Eight factors, including district, rural origin, age of husband, occupational group of husband, literacy of husband, parental consanguinity, exchange marriage, and extended family type, were found to be significant predictors of consanguinity in the multivariable logistic regression analysis. The rate of consanguinity decreased significantly in the younger age categories of individuals. The rate of CU was seen to be declining over time and in marriages that started 'before 1980' and 'after 2010', respectively, and there was a decline in ICF from 0.030 to 0.027. These analyses also showed that the literacy rate improved, the average age at marriage increased, and the frequency of exchange marriages decreased over time. This study employs a sizable first-hand dataset to demonstrate a lowering CU rate in northwest Pakistan. It is anticipated that the burden of inherited and congenital anomalies may likely to diminish in the study populations along with the fall in ICF.

Formulation development of pharmaceutical nanoemulgel for transdermal delivery of feboxostat: Physical characterization and in vivo evaluation

This study aimed to fabricate and characterize feboxostat (FXT) loaded nanoemulgel (NEG) for transdermal delivery. NEG was prepared by high sheared homogenization technique and characterized for thermodynamic stability, pH analysis, drug content, zeta analysis, viscosity, spreadability, FTIR, in-vitro drug release and ex-vivo permeation. In vivo anti-inflammatory activity was evaluated in albino rats by inducing edema in hind paws using carrageenan. The formulations showed optimum thermodynamic stability, having no phase separation and color change. The pH was in the range of human skin range i.e. 5.5-6.5. The drug content of F3 and F4 formulations were 97.56 ± 3.45 % and 83.88 ± 3.12 % respectively which were in official limit of USP i.e. 90 ± 10 %. No interaction was found between the FXT and various components after FTIR analysis. The viscosity of NEG was 4587 cp at 6 rpm and 2681 cp at 12 rpm. The droplet sizes of F1 (Blank NE), F2 (Blank NEG), F3 (Drug loaded NE) and F4 (Drug loaded NEG) were 148.6 nm, 153.4 nm, 402.1 nm and 498.3 nm respectively. The percent drug release of F3 was 82 ± 0.97 %, while F4 released 78 ± 0.91 % after 24 h. The drug permeation was 77 ± 1.28 % and 74 ± 1.10 % for F3 and F4 respectively. The optimized formulation significantly (p < 0.05; ANOVA) inhibited the paw edema in albino rats as compared to the control and standard group. It has been concluded that FXT loaded NEG can be a safe and effective alternative to the oral therapy of FXT.

Enhancement in the dielectric and magnetic properties of Ni2+-Cu2+ co-doped BaFe11Cu1-xNixO19 hexaferrites (0.0 ≤ x ≤ 1.0)

Herein, Ni2+-Cu2+ co-doped barium hexaferrites (BaFe11Cu1-xNixO19, 0.0 ≤ x≤ 1.0 with an interval of 0.25) were successfully synthesized using a co-precipitation method. The formation of a magnetoplumbite structure with the P63/mmc space group was confirmed by Rietveld refinement of the obtained X-ray diffraction patterns. Microstructural investigations revealed grains in the shape of hexagonal plates, while co-doping resulted in a variation in the grain sizes of the prepared samples. X-ray photoelectron spectroscopy was performed to determine the valence state of iron in the prepared hexaferrites. Impedance spectroscopy analysis revealed that dielectric permittivity initially decreased with an increase in the co-dopant content up to x = 0.5 and then increased by two orders of magnitude for x = 1.0. Alternatively, resistive properties showed microstructural resistance values in the range 105-108 Ω, with the highest value obtained for the sample with x = 0.5. Furthermore, magnetic measurements indicated that all the prepared samples exhibited ferrimagnetic behaviour. Saturation magnetization and magnetic anisotropy values were found to be the highest for the sample with x = 1.0, which also had the lowest coercivity among the prepared samples. Herein, the observed variations in the obtained results can be explained by the variations in grain sizes and the Fe2+/Fe3+ ratio associated with the preferential occupation of co-dopants at octahedral sites. Based on our findings, the BaFe11Ni1O19 (x = 1.0) composition appears to be the most promising choice as a microwave absorption material among the prepared samples owing to the coexistence of high dielectric permittivity (>103 at 107 Hz) and saturation magnetization (73 emu g-1).

A systematic review of inherited retinal dystrophies in Pakistan: updates from 1999 to April 2023

BACKGROUND

Inherited retinal degenerations (IRDs) are a group of rare genetic conditions affecting retina of the eye that range in prevalence from 1 in 2000 to 1 in 4000 people globally. This review is based on a retrospective analysis of research articles reporting IRDs associated genetic findings in Pakistani families between 1999 and April 2023.

METHODS

Articles were retrieved through survey of online sources, notably, PubMed, Google Scholar, and Web of Science. Following a stringent selection criterion, a total of 126 research articles and conference abstracts were considered. All reported variants were cross-checked and validated for their correct genomic nomenclature using different online resources/databases, and their pathogenicity scores were explained as per ACMG guidelines.

RESULTS

A total of 277 unique sequence variants in 87 distinct genes, previously known to cause IRDs, were uncovered. In around 70% cases, parents of the index patient were consanguineously married, and approximately 88.81% of the detected variants were found in a homozygous state. Overall, more than 95% of the IRDs cases were recessively inherited. Missense variants were predominant (41.88%), followed by Indels/frameshift (26.35%), nonsense (19.13%), splice site (12.27%) and synonymous change (0.36%). Non-syndromic IRDs were significantly higher than syndromic IRDs (77.32% vs. 22.68%). Retinitis pigmentosa (RP) was the most frequently observed IRD followed by Leber's congenital amaurosis (LCA). Altogether, mutations in PDE6A gene was the leading cause of IRDs in Pakistani families followed by mutations in TULP1 gene.

CONCLUSION

In summary, Pakistani families are notable in expressing recessively inherited monogenic disorders including IRDs likely due to the highest prevalence of consanguinity in the country that leads to expression of rare pathogenic variants in homozygous state.

Graphene nanoplatelets (GNPs): a source to bring change in the properties of Co-Ni-Gd-ferrite/GNP nanocomposites

The nanocomposites of Co0.5Ni0.5Gd0.03Fe1.97O4/graphene nanoplatelets (CNGF/GNPs) were synthesized by a cost-effective sol-gel auto combustion (SGAC) route. The X-ray diffraction analysis confirmed the cubic structure of the as-prepared nanocomposites, and a crystallite size of 32.28 nm was observed for the 7.5 wt% GNPs. Irregular and unique nanoparticles consisting of short stacks of graphene sheets having a platelet shape were confirmed by the morphological analysis of the as-prepared nanocomposites. Raman analysis revealed a spinel crystal structure along with a new vibrational mode due to the GNPs. The energy bandgap was 3.98 eV for the composite with 7.5 wt% GNP concentration. It was observed that the percentage temperature coefficient of resistance (TCR%) rapidly decreased with an increase in temperature both in low- and high-temperature ranges. Dielectric studies carried out in the frequency range 104-107 Hz confirmed that the graphene-added composites had high values for both the real and imaginary parts of permittivity at low frequencies. A decrease in saturation magnetization with an increase in GNP concentration was observed compared with the pure CNGF samples. Hence, the as-prepared composites are useful for application in high-frequency devices as well as spintronics.

Photocatalytic degradation of different types of microplastics by TiOx/ZnO tetrapod photocatalysts

We investigated the use of titania coated ZnO tetrapods for photocatalytic degradation of two common types of microplastics, namely polyethylene (PE) microparticles and polyester (PES) microfibers. We found that the plastics morphology affects the rate of degradation, and that the use of electron scavengers is needed to maintain the reactivity of the photocatalysts over a prolonged period of time. Complete mass loss of PE and PES is achieved under UV illumination for 480 h and 624 h, respectively. In addition to pristine microplastics, the degradation of environmental microplastics sample (consisting primarily of polypropylene) was also demonstrated, though in this case longer degradation time (∼816 h) was needed to achieve complete mass loss of the samples.

A Rare Case of Nutcracker Phenomenon Associated With Midgut Malrotation and Congenital Solitary Kidney

Medical conditions such as the nutcracker phenomenon, midgut malrotation, and congenital solitary kidney are rare. Hereby, we present a 21-year-old South Asian male referred to the nephrology clinic for hypertension and increased serum creatinine and was diagnosed with all three conditions. We briefly reviewed the literature on this subject. We present this case report to highlight the complex interplay of multiple renal and gastrointestinal anomalies and to emphasize the importance of a multidisciplinary approach in patient care to optimize outcomes and quality of life.

Molecular identification and cross-immunogenic study on two field isolates of Mycoplasma synoviae isolated from broilers in five districts of Khyber Pakhtunkhwa

Background

Mycoplasma synoviae (MS) is an important poultry pathogen causing heavy economic losses Worldwide. Subclinical persistence of this pathogen is the major issue to control its prevalence.

Aim

This study aimed to determine the molecular and cross-immunogenicity of MS among broilers in five Districts of Khyber Pakhtunkhwa (KP).

Methods

This study was conducted by collecting 434 specimen samples from 40 broiler farms and desi poultry in five districts of KP. Specimen samples from the broiler birds (n = 150), broiler farm environment (n = 264), and desi poultry birds (n = 20) were aseptically collected and serially passaged in Modified Frey's broth. The homologous and heterologous antibody reactions were studied in rabbits. Before inoculation into rabbits, the MS isolates were inactivated by formalin and adjuvanted with Montanide.

Results

The overall turbidity prevalence in Frey's broth was observed as 109/434 (25.11%) samples, and these turbidity-positive samples were shifted on Frey's agar. After the appearance of classic fried egg colonies, the Biochemical confirmation was supported by the production of catalase and phosphatase, reduction of tetrazolium, film and spot assay, and fermentation of glucose for species differentiation in avian mycoplasma. The MS prevalence percentage was recorded as 2% (9/434) through biochemical tests. The PCR results showed 0.5% MS prevalence with two field isolates (named MS-1 and MS-2). Both MS-1 and MS-2 field isolates showed similar values (42.2) of homologous geometric mean titer (GMT). While the heterologous GMT for MS-1 serum against MS-2 isolate was lower (27.9) as compared to MS-2 serum against MS1 isolate (38.9). No titer was detected in the control group (Group-III).

Conclusion

In conclusion, the results indicated the existence of MS in broiler birds and high homologous titers recorded between field isolates, which is a perpetual menace to poultry.

3D Printable Geopolymer Composites Reinforced with Carbon-Based Nanomaterials - A Review

Three-dimensional (3D) geopolymer printing (3DGP) technology is a rapidly evolving digital fabrication method used in the construction industry. This technology offers significant benefits over 3D concrete printing in terms of energy saving and reduced carbon emissions, thus promoting sustainability. 3DGP technology is still evolving, and researchers are striving to develop high-performance printable materials and different methods to improve its robustness and efficiency. Carbon-based nanomaterials (CBNs) with beneficial properties have a wide range of applications in various fields, including as concrete/geopolymer systems in construction. This paper comprehensively reviews the research progress on carbon-based nanomaterials (CBNs) used to develop extrusion-based 3D geopolymer printing (3DGP) technology, including dispersion techniques, mixing methods, and the materials' performance. The rheological, mechanical, durability, and other characteristics of these materials are also examined. Furthermore, the existing research limitations and the prospects of using 3DGP technology to produce high-quality composite mixtures are critically evaluated.

A Novel Intronic Deletion in PDE6B Causes Autosomal Recessive Retinitis Pigmentosa by Interfering with RNA Splicing

INTRODUCTION

Retinitis pigmentosa (RP) is a rare degenerative retinal disease caused by mutations in approximately seventy genes. Currently, despite the availability of large-scale DNA sequencing technologies, ∼30-40% of patients still cannot be diagnosed at the molecular level. In this study, we investigated a novel intronic deletion of PDE6B, encoding the beta subunit of phosphodiesterase 6 in association with recessive RP.

METHODS

Three unrelated consanguineous families were recruited from the northwestern part of Pakistan. Whole exome sequencing was performed for the proband of each family, and the data were analyzed according to an in-house computer pipeline. Relevant DNA variants in all available members of these families were assessed through Sanger sequencing. A minigene-based splicing assay was also performed.

RESULTS

The clinical phenotype for all patients was compatible with rod cone degeneration, with the onset during childhood. Whole exome sequencing revealed a homozygous 18 bp intronic deletion (NM_000283.3:c.1921-20_1921-3del) in PDE6B, which co-segregated with disease in 10 affected individuals. In vitro splicing tests showed that this deletion causes aberrant RNA splicing of the gene, leading to the in-frame deletion of 6 codons and, likely, to disease.

CONCLUSION

Our findings further expand the mutational spectrum of the PDE6B gene.

A novel homozygous missense substitution p.Thr313Ile in the PDE6B gene underlies autosomal recessive retinitis pigmentosa in a consanguineous Pakistani family

BACKGROUND

Retinitis pigmentosa (RP) is one of the most frequent hereditary retinal diseases that often starts with night blindness and eventually leads to legal blindness. Our study aimed to identify the underlying genetic cause of autosomal recessive retinitis pigmentosa (arRP) in a consanguineous Pakistani family.

METHODS

Following a detailed ophthalmological examination of the patients by an ophthalmologist, whole-exome sequencing was performed on the proband's DNA to delineate the genetic cause of RP in the family. In-depth computational methods, in-silico analysis, and familial co-segregation study were performed for variant detection and validation.

RESULTS

We studied an inbred Pakistani family with two siblings affected by retinitis pigmentosa. The proband, a 32 years old female, was clinically diagnosed with RP at the age of 6 years. A classical night blindness symptom was reported in the proband since her early childhood. OCT report showed a major reduction in the outer nuclear layer and the ellipsoid zone width, leading to the progression of the disease. Exome sequencing revealed a novel homozygous missense mutation (c.938C > T;p.Thr313Ile) in exon 12 of the PDE6B gene. The mutation p.Thr313Ile co-segregated with RP phenotype in the family. The altered residue (p.Thr313) was super conserved evolutionarily across different vertebrate species, and all available in silico tools classified the mutation as highly pathogenic.

CONCLUSION

We present a novel homozygous pathogenic mutation in the PDE6B gene as the underlying cause of arRP in a consanguineous Pakistani family. Our findings highlight the importance of missense mutations in the PDE6B gene and expand the known mutational repertoire of PDE6B-related RP.

Cement Composites with Carbon-based Nanomaterials for 3D Concrete Printing Applications - A Review

3D concrete printing (3DCP) is an emerging additive manufacturing technology in the construction industry. Its challenges lie in the development of high-performance printable materials and printing processes. Recently developed carbon-based nanomaterials (CBNs) such as graphene, graphene oxide, graphene nanoplatelets, and carbon nanotubes, have various applications due to their exceptional mechanical, chemical, thermal, and electrical characteristics. CBNs also have found potential applications as a concrete ingredient as they enhance the microstructure and modify concrete properties at the molecular level. This paper focuses on state-of-the-art studies on CBNs, 3DCP technology, and CBNs in conventional and 3D printable cement-based composites including CBN dispersion techniques, concrete mixing methods, and fresh and hardened properties of concrete. Furthermore, the current limitations and future perspectives of 3DCP using CBNs to produce high-quality composite mixtures are discussed.

Patients’ perception of the pharmacovigilance system: A pre-diagnostic and post-interventional cross-sectional survey

Background and objective: The risk of adverse reactions necessitated the pharmacovigilance system for patient safety. A literature search documented better health literacy of patients through intervention. This investigation aims to assess the perception and the effect of an intervention on patients regarding adverse reactions caused by drugs.

Methods: A pre-diagnostic and post-interventional cross-sectional investigation was designed with a sample size of 423 patients in hospitals of Islamabad. The proportion of patients was selected based on a stratified probability technique. A prevalidated tool was used to collect the response twice through a health promotion brochure with counseling, which was applied as an intervention.

Results: The outcome of the investigation revealed that the prerequisite of the pharmacovigilance center in the hospital among respondents was improved significantly by 41.2% after intervention. Knowledge, communication, and practice were significantly different with respect to gender. There was a moderate Pearson correlation between diagnostic and interventional responses of patient’s knowledge of adverse reactions by drugs (r = 0.66, p &lt; 0.01) and patient’s communication in pharmacovigilance (r = 0.62, p &lt; 0.01) and a strong correlation between diagnostic and interventional responses of patient’s practice in the pharmacovigilance system (r = 0.72, p &lt; 0.01).

Conclusion: The finding of the investigation provided evidence that patient awareness was significantly improved by the health promotion model. Patient participation in the reporting of adverse reactions of drugs will complement the hospital staff reporting. These reports will construct an authentic, cross-checked database for rational drug safety practices in Pakistan.

The Development of Eletriptan Hydrobromide Immediate Release Buccal Films Using Central Composite Rotatable Design: An In Vivo and In Vitro Approach

The objective is to develop immediate release buccal films of Eletriptan Hydrobromide (EHBR) using hydroxypropyl methylcellulose (HPMC) E5. The buccal films have the ability to disintegrate rapidly and provide both systemic and local effects. The solvent casting method was employed to prepare the films and the central composite rotatable design (CCRD) model was used for film optimization. All the formulated films were characterized for physicochemical evaluation (Fourier transform infrared spectroscopy (FTIR), X-ray Diffraction (XRD), differential scanning calorimetry (DSC), and Scanning electron microscopy (SEM), in in-vitro, ex-vivo, and in-vivo drug release. The fabricated films were transparent, colorless, and evenly distributed. The FTIR spectra showed no chemical interaction between the drug and excipients. In in-vitro analysis, the film has the highest% drug release (102.61 ± 1.13), while a maximum of 92.87 ± 0.87% drug was diffused across the cellulose membrane having a pore size of 0.45 µm. In the ex-vivo study, drug diffusion across the goat mucosa was performed and 80.9% of the drug was released in 30 min. In-vivo results depict a mean half-life (t½) of 4.54 ± 0.18 h and a Cmax of 128 ± 0.87 (ng/mL); Tmax was achieved in 1 h. Furthermore, instability and histopathological studies buccal films were proven to be safe and act as an effective dosage form. In a nutshell, optimized and safe instant release EHBR buccal films were prepared that have the tendency to provide effect effectively.

Grevillea robusta Delayed the Progression of Experimentally Induced Hepatic Fibrosis and Cirrhosis in Wistar Rats by Attenuating the Expression of Smooth Muscle Actin, Collagen, and TGF-β

The chronic damage to the liver causes fibrosis, especially when different proteins are accumulated in the liver, which is the basic characteristic of chronic liver damage. The excessive accumulation of the matrix protein such as collagen causes liver fibrosis. Liver fibrosis leads to cirrhosis, liver failure, and portal vein hypertension. Plants having antioxidants, free radical scavenging activities, and anti-inflammatory constituents are believed to be hepatoprotective in nature. Grevillea robusta (GR) is native to the subtropical environment. Its in vitro antioxidant, cytotoxic, and free radical scavenging activities are known, while the effect on liver fibrosis and cirrhosis remains elusive. The aim of this study was to evaluate the hepatoprotective and antifibrotic effects of Grevillea robusta plant. GR leaf extract (GREE) was prepared from the hydroethanolic extract (70%). Polyphenol and flavonoid contents and the in vitro antioxidant activity of the extract were determined. In vivo hepatitis was induced in Wistar rats by continual IP injections of CCl₄. GREE was administered by oral gavage at a dose of 100, 300, and 500 mg/kg of body weight once daily for 4 weeks. Variations in rat’s body weight, liver-to-body weight ratio, serum alanine aminotransferases, gamma-glutamyltransferase, liver histology, and cellular markers of liver fibrosis were evaluated. Serum levels of alanine aminotransferase (ALT) (p < 0.05) and gamma-glutamyltransferase (γ-GT) (p < 0.001) were decreased in the treatment group compared with the disease control group. RBC count was increased (p < 0.001) in the treatment group compared with the disease control group. The expression of alpha-SMA was downregulated to 40% (p < 0.05) and that of collagen was decreased by 9% (p < 0.05) compared with the disease control group. Extracellular matrix deposition and necrotic areas were also decreased as compared to the disease control group. It can be concluded that GR possesses hepatoprotective action by virtue of antioxidant constituents and delays the progression of liver cirrhosis by suppressing the activation of extracellular matrix–producing cells in the liver.

Enhanced Antifungal and Wound Healing Efficacy of Statistically Optimized, Physicochemically Evaluated Econazole-Triamcinolone Loaded Silica Nanoparticles

Co-encapsulated econazole nitrate-triamcinolone acetonide loaded biocompatible, physically stable, and non-irritating mesoporous silica nanoparticles (EN-TA–loaded MSNs) were prepared and optimized by using a central composite rotatable design (CCRD) for providing better therapeutic efficacy against commonly prevailed resistant fungal infections. These drugs loaded MSNs can significantly overcome the deficiencies and problems like short duration of action, requirement of frequent administration, erythema, and burning sensation and irritation associated with conventional drug delivery systems. The stability of optimized drugs loaded MSNs prepared with 100 gm of oil at pH 5.6 with a stirring time of 2 h was confirmed from a zeta potential value of −25 mV. The remarkable compatibility of formulation ingredients was depicted by X-ray diffraction (XRD), differential scanning calorimetry (DSC), and Fourier transform infrared spectroscopy (FTIR) spectra while scanning electron microscopy (SEM) and size analysis represented a very fine size distribution of nanoparticles ranging from 450–600 nm. The CCRD clearly predicted that the optimized parameters of drugs loaded MSNs have better values of percentage yield (85%), EN release (68%), and TA release (70%). Compared to pure drugs, the decreased cytotoxicity of EN-TA–loaded MSNs was quite evident because they showed a cell survival rate of 90%, while in the case of pure drugs, the survival rate was 85%. During in vivo antifungal testing against Candida albicans performed on three different groups, each consisting of six rabbits, the EN-TA–loaded MSNs were relatively superior in eradicating the fungal infection as a single animal exhibited a positive culture test. Rapid recovery of fungal infection and a better therapeutic effect of EN-TA–loaded MSN were quite evident in wound healing and histopathology studies. Likewise, on the 14th day, a larger inhibitory zone was measured for optimized nanoparticles (15.90 mm) compared to the suspension of pure drugs (13.90 mm). In skin irritation studies, MSNs did not show a grade of erythema compared to pure drugs, which showed a four-fold grade of erythema. As a result, MSNs loaded with combination therapy seem to have the potential of improving patient compliance and tolerability by providing enhanced synergistic antifungal effectiveness at a reduced dose with accelerated wound healing and reduced toxicity of therapeutics.

Unusual semiconductor-metal-semiconductor transitions in magnetite Fe3O4 nanoparticles

Magnetite (Fe₃O₄) nanoparticles were successfully prepared by a co-precipitation method. Rietveld refinement on the X-ray diffraction pattern confirmed the development of a single-phase cubic spinel structure with space group Fd3̄m. However, ⁵⁷Fe Mössbauer spectroscopy suggested the presence of Fe³⁺ and Fe^2.5+ (mixed Fe³⁺ and Fe²⁺) ions at the tetrahedral and octahedral sites of the inverse spinel structure, respectively. Impedance spectroscopy measurements showed a discontinues variation in the temperature dependence of the sample's resistive behavior, indicating the appearance of semiconductor–metal–semiconductor like transitions between the temperature range of 293 and 373 K. A similar dual transition was also observed from the dielectric and conductivity measurements around the same temperature regions. The observed unusual transition is explained in term of the competitive effects among the hopping of localized/delocalized and short-range/long-range charge carriers present in the sample. Moreover, the prepared sample exhibits colossal dielectric permittivity (∼10⁶), reduced tangent loss (∼0.2) and moderate conductivity (>10⁻⁶ S cm⁻¹) values, making Fe₃O₄ nanoparticles a potential candidate for electromagnetic absorbing materials.

Herein, we report the existence of a novel semiconductor–metal–semiconductor type transition in Fe₃O₄ nanoparticles by employing impedance spectroscopy techniques.

Pharmacist Role in Telehealth Practice in Pakistan During 2019 Novel Coronavirus Pandemic: The Neglected Link for Patient Safety

Telehealth services have been working for decades to offer health advice at the point of treatment care. The usage of this innovative modern communication technology for the general public is still in its infancy in developing countries including Pakistan. The communities are advised to practice social distancing for safe survival during the corona pandemic. The role of a pharmacist is well recognized Worldwide in the practicing telemedicine models of drug information centers and poison control centers. Telemedicine centers were established by different hospitals and medical universities to provide telephonic consultation regarding any ailment during the 2019 Novel Coronavirus pandemic in Pakistan. The pharmacist’s potential and professional expertise are neglected and unexplored as drug information experts in hospitals and community pharmacies, antidote specialists in poison control centers, patient counselor for treatment compliance in Pakistan. The telemedicine practice in the institutions ensures the inclusion of trained pharmacists for better patient care. Telepharmacy initiation at the community level by the government will also reduce the burden on the hospital level.

Preparation, characterization and biological evaluation of silver nanoparticles and drug loaded composites for wound dressings formed from Lallemantia royleana seeds' mucilage

After an injury, the wounds need to be covered with a dressing. Lack of absorptive potential and sticking of dressing with the wound causes pain and slows the healing process. The aim of this study was to develop wound dressings having more absorptive potential and less sticking with the wound. The hemicelluloses from Lallemantia royleana seeds possess desirable properties for a wound dressing. The hemicellulose was blended with chitosan/chitin and glutaraldehyde to enhance the absorptive properties of the hemicellulose through cross-linking. Two types of formulations incorporating silver nanoparticles and ciprofloxacin were prepared. The composites were characterized by elemental analysis, Fourier-transform infrared spectroscopy and scanning electron microscopy, and evaluated for their antibacterial activity against Escherichia coli (Gram-negative) and Staphylococcus aureus (Gram-positive). The dressings were subjected to in vivo studies on Albino rats. The dressings were found to be porous and the silver nanoparticles and drug particles were found to be uniformly distributed in the polymeric matrix. The composite containing ciprofloxacin released the drug in a sustained manner for 14-16 days. From extrapolation of the data, it was discovered that the formulation would release around 80% of ciprofloxacin in about two weeks. Silver-ciprofloxacin nano-composites exhibited comparable activity (zone of inhibition 19-30 mm) against E. coli to that of ciprofloxacin (standard, 21-35 mm) and relatively lower activity in case of S. aureus (zone of inhabitation 11-17 mm). The dressings did not stick to the wound site and the site remained wet during the healing process. Thus the use of hemicellulose from L. royleana seeds proved to be beneficial for preparing wound dressings with improved properties because of having high swelling index, porosity and spongy texture.

A novel homozygous missense variant p.D339N in the PKLR gene correlates with pyruvate kinase deficiency in a Pakistani family: a case report

Background

Pyruvate kinase deficiency is an exceptionally rare autosomal recessive Mendelian disorder caused by bi-allelic pathogenic variants in the PKLR gene. It is mainly characterized by chronic nonspherocytic hemolytic anemia though other symptoms such as splenomegaly, hepatomegaly, pallor, fatigue, iron overload, shortness of breath, hyperbilirubinemia, and gallstones might also prevail.

Case presentation

We present here a novel genetic defect in the PKLR gene that correlates with pyruvate kinase deficiency phenotype in a consanguineous family from North-Western Pakistan. The family included three affected individuals who were all born to consanguineous parents. The proband, a 13-year-old female of Pashtun ethnicity, showed chronic nonautoimmune hemolytic anemia since birth, extremely low hemoglobin (7.6 g/dL) and pyruvate kinase (12.4 U/g Hb) levels, splenomegaly, and hepatomegaly. Bone marrow aspirate showed a markedly decreased myeloid to erythroid ratio and hypercellular marrow particles due to hyperplasia of the erythroid elements. Molecular characterization of the proband’s genomic DNA uncovered a likely pathogenic homozygous missense variant p.[D339N] in exon 7 of the PKLR gene. In-depth in silico analysis and familial cosegregation implies p.[D339N] as the likely cause of pyruvate kinase deficiency in this family. Further in vitro or in vivo studies are required to validate the impact of p.[D339N] on protein structure and/or stability, and to determine its role in the disease pathophysiology.

Conclusions

In summary, these findings suggest a novel genetic defect in the PKLR gene as a likely cause of pyruvate kinase deficiency, thus further expanding the mutational landscape of this rare Mendelian disorder.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13256-022-03292-z.

Geoeconomic variations in epidemiology, ventilation management, and outcomes in invasively ventilated intensive care unit patients without acute respiratory distress syndrome: a pooled analysis of four observational studies

Background

Geoeconomic variations in epidemiology, the practice of ventilation, and outcome in invasively ventilated intensive care unit (ICU) patients without acute respiratory distress syndrome (ARDS) remain unexplored. In this analysis we aim to address these gaps using individual patient data of four large observational studies.

Methods

In this pooled analysis we harmonised individual patient data from the ERICC, LUNG SAFE, PRoVENT, and PRoVENT-iMiC prospective observational studies, which were conducted from June, 2011, to December, 2018, in 534 ICUs in 54 countries. We used the 2016 World Bank classification to define two geoeconomic regions: middle-income countries (MICs) and high-income countries (HICs). ARDS was defined according to the Berlin criteria. Descriptive statistics were used to compare patients in MICs versus HICs. The primary outcome was the use of low tidal volume ventilation (LTVV) for the first 3 days of mechanical ventilation. Secondary outcomes were key ventilation parameters (tidal volume size, positive end-expiratory pressure, fraction of inspired oxygen, peak pressure, plateau pressure, driving pressure, and respiratory rate), patient characteristics, the risk for and actual development of acute respiratory distress syndrome after the first day of ventilation, duration of ventilation, ICU length of stay, and ICU mortality.

Findings

Of the 7608 patients included in the original studies, this analysis included 3852 patients without ARDS, of whom 2345 were from MICs and 1507 were from HICs. Patients in MICs were younger, shorter and with a slightly lower body-mass index, more often had diabetes and active cancer, but less often chronic obstructive pulmonary disease and heart failure than patients from HICs. Sequential organ failure assessment scores were similar in MICs and HICs. Use of LTVV in MICs and HICs was comparable (42·4% vs 44·2%; absolute difference –1·69 [–9·58 to 6·11] p=0·67; data available in 3174 [82%] of 3852 patients). The median applied positive end expiratory pressure was lower in MICs than in HICs (5 [IQR 5–8] vs 6 [5–8] cm H₂O; p=0·0011). ICU mortality was higher in MICs than in HICs (30·5% vs 19·9%; p=0·0004; adjusted effect 16·41% [95% CI 9·52–23·52]; p<0·0001) and was inversely associated with gross domestic product (adjusted odds ratio for a US$10 000 increase per capita 0·80 [95% CI 0·75–0·86]; p<0·0001).

Interpretation

Despite similar disease severity and ventilation management, ICU mortality in patients without ARDS is higher in MICs than in HICs, with a strong association with country-level economic status.

Funding

No funding.

EFFICACY OF DOXAZOSIN VERSUS TAMSULOSIN IN LOWER URETERIC STONE EXPULSION IN ADULT POPULATION OF DISTRICT DERA ISMAIL KHAN, PAKISTAN

Background: Urolithiasis is the third common disease of the urinary tract after UTIs and pathological diseases of the prostate. The objective of this study was to compare the efficacy of doxazosin versus tamsulosin in lower ureteric stone expulsion in adult population of District Dera Ismail Khan, Pakistan.Materials Methods: This non-randomized control trial was conducted in the Department of Urology, Gomal Medical College, Dera Ismail Khan, Pakistan from February 2020 to December 2020. The 252 patients included in our study were divided in to two groups. The patients in experimental group received Tab. doxazosin 4 mg daily for 4 weeks and Tab. diclofenac sodium 50 mg B.D for 5 days and then on need basis. The patients in control group received Cap. tamsulosin 0.4 mg daily for 4 weeks and similarly Tab. diclofenac sodium 50 mg as in experimental group. All the patients were followed regularly for expulsion of ureteric stones for four weeks. Sex, age and stone size were matching, while stone expulsion was a research variable. Hypothesis was verified by McNemar chi-square test.Results: Out of 252 patients, 113 (89.68%) patients in experimental group, while 77 (61.11%) patients in control group passed the stones. There was statistically significant difference in efficacy in doxazosin group as compared to tamsulosin group (p-value=.0001).Conclusion: The use of doxazosin as the medical expulsion therapy for the lower ureteric stone proved to be more effective as compared to tamsulosin as demonstrated by our results.

Role of the Media in Health-Related Awareness Campaigns on Perception of COVID-19: A Pre-post Study in the General Population of Pakistan

Medical preparedness and community education are the most valuable preventive tools for combatting the COVID-19 pandemic. This study aims to assess the role of media public health awareness campaigns on the knowledge of the general population about COVID-19 in Rawalpindi, Pakistan. A quantitative study using a pre-post design among 384 respondents was conducted. A structured questionnaire was administered to the participants twice: The first response (t₁) from participants was filled in during the 1st week in February 2020 before any confirmed cases were reported in the country, and the second response (t₂) was completed 1 month after the first case detection in Pakistan (March 2020). Media health awareness campaigns were launched just after the detection of the first case in Pakistan. Exposure to the media and knowledge relating to COVID-19 increased over time. Whereas, only a quarter of respondents judged the isolation of suspected cases in quarantine to be important to prevent the spread of infection in society at t₁, more than half did so at t₂. Socio-demographic characteristics were not significantly associated with knowledge (gains). However, more frequent use of electronic media is associated with greater knowledge gains from t₁ to t₂. The findings of this study provide evidence that awareness and knowledge related to COVID-19 symptoms and preventive measures increased significantly over time. The increased frequency of following the media indicates that health awareness campaigns are important for enhancing the knowledge of the general public regarding COVID-19.

Deep eutectic solvent mediated synthesis of 3,4-dihydropyrimidin-2(1H)-ones and evaluation of biological activities targeting neurodegenerative disorders

Substitution of hazardous and often harmful organic solvents with "green" and "sustainable" alternative reaction media is always desirous. Ionic liquids (IL) have emerged as valuable and versatile liquids that can replace most organic solvents in a variety of syntheses. However, recently new types of low melting mixtures termed as Deep Eutectic Solvents (DES) have been utilized in organic syntheses. DES are non-volatile in nature, have sufficient thermal stability, and also have the ability to be recycled and reused. Hence DES have been used as alternative reaction media to perform different organic reactions. The availability of green, inexpensive and easy to handle alternative solvents for organic synthesis is still scarce, hence our interest in DES mediated syntheses. Herein we have investigated Biginelli reaction in different DES for the synthesis of 3,4-dihydropyrimidin-2(1H)-ones. Monoamine oxidases and cholinesterases are important drug targets for the treatment of various neurological disorders such as Alzheimer's disease, Parkinson's disease, depression and anxiety. The compounds synthesized herein were evaluated for their inhibitory potential against these enzymes. Some of the compounds were found to be highly potent and selective inhibitors. Compounds 1 h and 1c were the most active monoamine oxidase A (MAO A) (IC₅₀ = 0.31 ± 0.11 µM) and monoamine oxidase B (MAO B) (IC₅₀ = 0.34 ± 0.04 µM) inhibitors respectively. All compounds were selective AChE inhibitors and did not inhibit BChE (<29% inhibition). Compound 1 k (IC₅₀ = 0.13 ± 0.09 µM) was the most active AChE inhibitor.

Whole exome sequencing in 17 consanguineous Iranian pedigrees expands the mutational spectrum of inherited retinal dystrophies

Inherited retinal dystrophies (IRDs) constitute one of the most heterogeneous groups of Mendelian human disorders. Using autozygome-guided next-generation sequencing methods in 17 consanguineous pedigrees of Iranian descent with isolated or syndromic IRD, we identified 17 distinct genomic variants in 11 previously-reported disease genes. Consistent with a recessive inheritance pattern, as suggested by pedigrees, variants discovered in our study were exclusively bi-allelic and mostly in a homozygous state (in 15 families out of 17, or 88%). Out of the 17 variants identified, 5 (29%) were never reported before. Interestingly, two mutations (GUCY2D:c.564dup, p.Ala189ArgfsTer130 and TULP1:c.1199G > A, p.Arg400Gln) were also identified in four separate pedigrees (two pedigrees each). In addition to expanding the mutational spectrum of IRDs, our findings confirm that the traditional practice of endogamy in the Iranian population is a prime cause for the appearance of IRDs.

Sero-epidemiology and risk factor analysis of human brucellosis in Punjab, Pakistan: a cross sectional study

Human brucellosis is a neglected zoonotic problem worldwide with a high degree of morbidity in humans and is mostly overlooked due to other febrile conditions. The aim of this study was to evaluate the sero-prevalence and risk factors of human brucellosis among subjects living in Punjab, Pakistan. In this cross-sectional study, human blood samples were collected from seven districts of Punjab, Pakistan. Information regarding personal data, demographic data and potential risk factors was collected through a structured questionnaire. Detection of anti-Brucella antibodies was done through Rose Bengal Plate Test (RBPT) and Enzyme Linked Immunosorbent Assay (ELISA). Descriptive analysis, Chi square test and Odds ratio was applied using STATA software version 12. The sero-prevalence of human brucellosis was 13.13% with significantly higher percentage in males 17.23% and age group 25-40 years 16.50% (P=< 0.001). The demographic factors positively associated with human brucellosis were lack of education (P = 0.003; OR = 1.85) and farming as an occupation (P =<0.001; OR = 2.50) Similarly, among the risk factors studied, keeping animals at home (P =<0.001; OR = 2.03), slaughtering of animals (P =<0.001; OR = 15.87) and consuming raw milk (P =<0.001; OR = 5.42) were the factors strongly connected with human brucellosis. A massive awareness should be given to livestock farmers and individuals directly linked to animals regarding risk factors and transmission of brucellosis. Consumption of unpasteurized milk and its products should be condemned to curtail this neglected disease.

3D Concrete Printing: A Systematic Review of Rheology, Mix Designs, Mechanical, Microstructural, and Durability Characteristics

This paper provides a state-of-the-art report on the up-to-date research on the emerging 3D concrete printing technology from the concrete materials perspective. It reviews the recent research focused on understanding and characterizing the rheological necessities of the concrete printing process and discusses how the researchers are tailoring compatible mix proportions for the 3D concrete printing process by using eco-friendly binders, waste aggregates, chemical admixtures, and nano-additives. This paper systematically evaluates anisotropic behavior in the mechanical properties of printed concrete and establishes an order for anisotropic behavior in the compressive, flexural, and tensile strengths along three different axes (X, Y, and Z axes) of printed concrete. It evaluates the ratio of flexural strength to the compressive strength of printed concrete along the above three axes. This article explains the influence of variation of printing process parameters on the mechanical properties and discusses reinforcement approaches used for increasing structural performance. The microstructure at the interface of adjacent layers and also at the interface of the reinforcement-cement matrix is discussed. The recent research on the durability performance of printed concrete is critically discussed and future research needs for 3D concrete printing are identified in this paper.

Synthesis of Thiol-Modified Hemicellulose, Its Biocompatibility, Studies, and Appraisal as a Sustained Release Carrier of Ticagrelor

Background: Nature has always been considered as the primary source of pharmaceutical ingredients. A variety of hemicelluloses, as well as their modified forms, have been under investigation. Herein, a study was designed to explore the biocompatibility of hemicellulose and its modified form (thiolated hemicellulose) as well as its potential as a pharmaceutical excipient. Method: For thiol modification thiourea was used as the thiol donor, HCl as the catalytic reagent, and methanol was used for washing purposes. Modified polymers were characterized for physicochemical characteristics, including surface morphology, the amorphous or crystalline nature of the particles, modification of polymer by FTIR, and biocompatibilities. For acute oral toxicity study, a single dose of 2 g/kg was administered to albino rats of 200 g average weight (n = 3). Polymers were evaluated as pharmaceutical excipients by preparing compressed tablets of antiplatelet drug (Ticagrelor), followed by various quality control tests, such as swelling index, thickness and diameter, disintegration, and in-vitro drug release. Results: From the results, it was observed that thiol modification has been successfully accomplished as characteristic peaks belonging to -SH group appeared at 2667.7691 cm-1 in FTIR scan. The modified polymer was found safe in the use concentration range, confirming their safe use for in vivo analysis. No significant effect has been observed in the behavior, biological fluid (blood), or on vital organs. Thiolated hemicellulose was found to be an excellent drug retarding polymer as 8 h of dissolution studies showed that 67.08% of the drug has been released. Conclusion: Conclusively, incorporation of thiol moiety made the polymer more mucoadhesive with, and a worthy carrier of, the drug with good biocompatibilities.

New variants and in silico analyses in GRK1 associated Oguchi disease

Biallelic mutations in G-Protein coupled receptor kinase 1 (GRK1) cause Oguchi disease, a rare subtype of congenital stationary night blindness (CSNB). The purpose of this study was to identify disease causing GRK1 variants and use in-depth bioinformatic analyses to evaluate how their impact on protein structure could lead to pathogenicity. Patients' genomic DNA was sequenced by whole genome, whole exome or focused exome sequencing. Disease associated variants, published and novel, were compared to nondisease associated missense variants. The impact of GRK1 missense variants at the protein level were then predicted using a series of computational tools. We identified twelve previously unpublished cases with biallelic disease associated GRK1 variants, including eight novel variants, and reviewed all GRK1 disease associated variants. Further structure-based scoring revealed a hotspot for missense variants in the kinase domain. In addition, to aid future clinical interpretation, we identified the bioinformatics tools best able to differentiate disease associated from nondisease associated variants. We identified GRK1 variants in Oguchi disease patients and investigated how disease-causing variants may impede protein function in-silico.

Epidemiological Characteristics, Ventilator Management, and Clinical Outcome in Patients Receiving Invasive Ventilation in Intensive Care Units from 10 Asian Middle-Income Countries (PRoVENT-iMiC): An International, Multicenter, Prospective Study

Epidemiology, ventilator management, and outcome in patients receiving invasive ventilation in intensive care units (ICUs) in middle-income countries are largely unknown. PRactice of VENTilation in Middle-income Countries is an international multicenter 4-week observational study of invasively ventilated adult patients in 54 ICUs from 10 Asian countries conducted in 2017/18. Study outcomes included major ventilator settings (including tidal volume [V _T] and positive end-expiratory pressure [PEEP]); the proportion of patients at risk for acute respiratory distress syndrome (ARDS), according to the lung injury prediction score (LIPS), or with ARDS; the incidence of pulmonary complications; and ICU mortality. In 1,315 patients included, median V _T was similar in patients with LIPS < 4 and patients with LIPS ≥ 4, but lower in patients with ARDS (7.90 [6.8-8.9], 8.0 [6.8-9.2], and 7.0 [5.8-8.4] mL/kg Predicted body weight; P = 0.0001). Median PEEP was similar in patients with LIPS < 4 and LIPS ≥ 4, but higher in patients with ARDS (five [5-7], five [5-8], and 10 [5-12] cmH₂O; P < 0.0001). The proportions of patients with LIPS ≥ 4 or with ARDS were 68% (95% CI: 66-71) and 7% (95% CI: 6-8), respectively. Pulmonary complications increased stepwise from patients with LIPS < 4 to patients with LIPS ≥ 4 and patients with ARDS (19%, 21%, and 38% respectively; P = 0.0002), with a similar trend in ICU mortality (17%, 34%, and 45% respectively; P < 0.0001). The capacity of the LIPS to predict development of ARDS was poor (ROC AUC of 0.62, 95% CI: 0.54-0.70). In Asian middle-income countries, where two-thirds of ventilated patients are at risk for ARDS according to the LIPS and pulmonary complications are frequent, setting of V _T is globally in line with current recommendations.

Microsponge carrier for the safe and effective delivery of mycophenolate mofetil

The current study was designed for the delivery of mycophenolate mofetil using microsponges. Quasi-emulsification and double-emulsification techniques were used to develop ethyl cellulose (EC)- and xanthan gum-facilitated EC microsponges. The microsponges were characterized using micromeritics, Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD) and surface morphology, particle size and zeta potential analyses; in vitro drug release and release kinetics were assessed by using various kinetic models. The studies revealed that the prepared microsponges offer free-flow properties with an adequate release profile and spherical porous surface morphology. The FTIR study did not reveal any interaction among the ingredients. XRD analysis confirmed the amorphous nature of mycophenolate mofetil. In vitro release studies showed that the sustained effect was maintained successfully up to 8 h. It can be concluded from the results that both EC and xanthan gum played an important role in the formulation of controlled-release microsponges of mycophenolate mofetil.

Management of Full-Thickness Macular Hole in A Genetically Confirmed Case with Usher Syndrome

INTRODUCTION

Full-thickness macular hole (FTMH) formation is rarely seen in patients with retinitis pigmentosa (RP) and can have an adverse impact on their residual visual function. The underlying mechanisms are unknown, and clinical experience is limited regarding surgical outcomes. Here, we describe the surgical management of FTMH in a young patient with genetically confirmed Usher syndrome, the most common form of syndromic RP.

CASE REPORT

A 28-year-old woman presented with blurred vision in her right eye (RE). She had a history of RP and bilateral hearing impairment since childhood. Fundoscopy and spectral-domain optical coherence tomography revealed a FTMH in the RE along with typical RP features bilaterally. After pars plana vitrectomy (PPV) with internal limiting membrane peel and gas tamponade, the FTMH closed. Six months after PPV the patient underwent cataract surgery in the affected eye, and the visual acuity remained stable compared to baseline. The clinical diagnosis of Usher syndrome was genetically confirmed by whole exome sequencing (WES), which revealed the presence of two pathogenic nucleotide variants in trans (compound heterozygosity) in the gene USH2A.

CONCLUSION

We report a rare case of successful closure of a FTMH in a patient with Usher syndrome. Surgical treatment of FTMH can help preserve the central vision in RP patients, whose peripheral vision is severely affected.

In Silico Study and Pharmacological Evaluation of Eplerinone as an Anti-Alzheimer's Drug in STZ-Induced Alzheimer's Disease Model

Alzheimer's disease (AD) is the neurodegenerative disorder characterized by impairment of higher intellectual dysfunctions associated with changes in the cognitive, behavioral, and social activities.

AIM OF THE STUDY

The current study was designed to evaluate the potential of aldosterone antagonist in the treatment of AD.

METHODOLOGY

The study was conducted on albino mice of either sex (n = 60). Mice were subcategorized into six groups, each group having 10 mice. Group I-normal control (CMC 1 mL/kg), group II-diseased [streptozotocin (STZ), 3 mg/kg, intracerebroventricular (i.c.v.)], group III-standard (piracetam, 200 mg/kg, i.p.), and groups IV-VI designated as the treatment group (eplerinone at dose levels of 4, 8, and 16 mg/kg, orally), respectively. The study was carried out for 14 consecutive days. STZ was administered through the i.c.v. route on first and third days of the study for memory impairment. The molecular docking was performed to investigate the chemical behavior of compounds to inhibit the AChE. Anti-Alzheimer's effect was assessed by using the behavioral paradigms such as passive avoidance, elevated plus maze, Morris water maze, open field, and balance beam. Various endogenous antioxidants such as SOD, GSH, nitrite, MDA, CAT, and AChE were identified in brain tissues of treated mice to assess the oxidative stress index. Biochemical markers for AD such as norepinephrine, dopamine, and serotonin, Aβ 1-40, Aβ 1-42, NF-κB, and tumor necrosis factor alpha were analyzed in brain tissues of mice. Expression of beta amyloid was observed by PCR.

RESULTS

The in silico study indicated the distinct mechanism of eplerinone to inhibit the AChE. The outcomes of the in vivo study manifested that eplerinone at the highest dose was found to be more effective in the treatment of AD.

CONCLUSION

It may be concluded from the research work that eplerinone can be effective for cognitive improvement which proposes its therapeutic effect in many neurodegenerative disorders such as AD.

A frequent variant in the Japanese population determines quasi-Mendelian inheritance of rare retinal ciliopathy

Hereditary retinal degenerations (HRDs) are Mendelian diseases characterized by progressive blindness and caused by ultra-rare mutations. In a genomic screen of 331 unrelated Japanese patients, we identify a disruptive Alu insertion and a nonsense variant (p.Arg1933*) in the ciliary gene RP1, neither of which are rare alleles in Japan. p.Arg1933* is almost polymorphic (frequency = 0.6%, amongst 12,000 individuals), does not cause disease in homozygosis or heterozygosis, and yet is significantly enriched in HRD patients (frequency = 2.1%, i.e., a 3.5-fold enrichment; p-value = 9.2 × 10-5). Familial co-segregation and association analyses show that p.Arg1933* can act as a Mendelian mutation in trans with the Alu insertion, but might also associate with disease in combination with two alleles in the EYS gene in a non-Mendelian pattern of heredity. Our results suggest that rare conditions such as HRDs can be paradoxically determined by relatively common variants, following a quasi-Mendelian model linking monogenic and complex inheritance.

The Coat Protein of Citrus Yellow Vein Clearing Virus Interacts with Viral Movement Proteins and Serves as an RNA Silencing Suppressor

Citrus yellow vein clearing virus is a newly accepted member of the genus Mandarivirus in the family Alphaflexiviridae. The triple gene block proteins (TGBp1, TGBp2 and TGBp3) encoded by plant viruses in this family function on facilitating virus movement. However, the protein function of citrus yellow vein clearing virus (CYVCV) have never been explored. Here, we showed in both yeast two-hybrid (Y2H) and bimolecular fluorescence (BiFC) assays that the coat protein (CP), TGBp1 and TGBp2 of CYVCV are self-interacting. Its CP also interacts with all three TGB proteins, and TGBp1 and TGBp2 interact with each other but not with TGBp3. Furthermore, the viral CP colocalizes with TGBp1 and TGBp3 at the plasmodesmata (PD) of epidermal cells of Nicotiana benthamiana leaves, and TGBp1 can translocate TGBp2 from granular-like structures embedded within ER networks to the PD. The results suggest that these proteins could coexist at the PD of epidermal cells of N. benthamiana. Using Agrobacterium infiltration-mediated RNA silencing assays, we show that CYVCV CP is a strong RNA silencing suppressor (RSS) triggered by positive-sense green fluorescent protein (GFP) RNA. The presented results provide insights for further revealing the mechanism of the viral movement and suppression of RNA silencing.

Anti-fibrotic effects of polygonum plebeium r.br. in CCl4-induced hepatic damage and fibrosis in rats

Introduction: Asian countries have the highest burden of liver diseases. Polygonum plebeium (P. plebeium), a.k.a. the common knotweed, is a species of plant in the knotwood family that can act as a blood purifier and has been widely used in Pakistan to cure liver disorders like jaundice and hepatitis. The plant is also used in the treatment of pneumonia, bowel complaints, diarrhea, dysentery, eczema and ring worms. Tannins, flavonoids, saponins and alkaloids are the major components of P. plebeium. Since its use in folk medicine in Pakistan, there has been little scientific evidence or information on it. Therefore, this study was aimed at investigating the anti-fibrotic effects of P. plebeium in carbon tetrachloride (CCl4)-induced hepatic toxicity and fibrosis. Methods: The extracts of whole plant of P. plebeium were prepared and administered by oral gavage in rats. Liver fibrosis was induced by intraperitoneal (i.p.) administration of CCl4. To evaluate the hepatoprotective activity of P. plebeium, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transpeptidase (γGT) levels were quantified. Histological evaluation of liver tissue revealed tissue necrosis and extracellular matrix deposition. Real-time PCR was done to evaluate mRNA expression of genes related to liver fibrosis. Results: The groups treated with P. plebeium extract showed an ablation in liver damage; the elevated enzyme levels of ALT, AST and γGT were decreased. Treatment with P. plebeium extract treatment restored the CCl4-induced tissue fibrosis by significantly suppressing alpha-smooth muscle actin (α-SMA), tumor growth factor beta (TGF-β) and collagen mRNA expression levels. Histology of liver sections also showed that the CCl4-induced fibrosis was improved in the treatment groups. Conclusion: Polygonum plebeium has therapeutic potential and can be used for preventing fibrosis in inflammatory liver disease.

Determinants of consanguinity and inbreeding coefficient in the multiethnic population of Mardan, Khyber Pakhtunkhwa, Pakistan

Background

Despite the high sociocultural preferences in contracting marriages among close relatives in Pakistan, marked regional differences exist in the prevalence of consanguinity. There is great interest to elucidate the sociodemographic variables underlying the heterogeneity in consanguinity prevalence in the various populations. The present study was conducted in the Mardan district of Pakistan, the second largest multiethnic Pashtun metropolis.

Objective

To find determinants of consanguineous unions.

Methods

In a cross-sectional study design, a convenience sample of 1,202 ever-married men from 3 tehsils of Mardan district was recruited in an unselected manner and data regarding their marital union types and sociodemographic variables were obtained by a structured interview. Descriptive statistics and multivariable logistic regression analyses were used.

Results

Consanguineous unions accounted for 44% of all marriages, and the inbreeding coefficient was calculated as 0.0258. Regression analyses revealed that 6 variables were significant predictors of consanguinity, namely, tehsil, age, year of marriage, caste (zaat/biradari) system, area of house, and marriage arrangement of the respondent, while 6 other variables, namely, rural/urban origin, literacy, occupation, monthly income, household type, and number of family members, were not found to be significant. Regression analyses showed that there were different combinations of variables predictive of consanguinity among the various tehsils.

Conclusions

The prevalence of consanguinity in the Mardan district was found to be lower than that in many other districts of Pakistan. National regional differences exist in consanguinity, and the combination of predictive factors varies greatly.

Evaluation of methanolic extract of Phragmites karka on carbon tetrachloride-induced liver fibrosis in rat

<p class="Abstract"><em>Phragmites karka</em> has been reported for its anti-inflammatory and analgesic activities. Here, extracts of leaf and rhizome of the plant were individually investigated in CCl₄-induced hepatofibrosis in male Wistar rats by administering CCl₄ intraperitoneally biweekly for 6 weeks.  Afterwards the animals were investigated for liver fibrosis at biochemical, molecular and histological levels, and it showed a profound increase (p&lt;0.001) in elevation of serum levels of transaminases, γ-glutamyl transpeptidase, mRNA expression of α smooth muscle actin, collagen and transforming growth factor beta (TGFβ), and extracellular matrix deposition and perilobular necrosis. Both extracts markedly (p&lt;0.001) decreased the elevated levels of these markers. Histopathological investigations also substantiated the above results by exhibiting a decreased in extracellular matrix deposition in post-treatment animals. In conclusion, both extracts had substantially modified the biochemical and molecular markers of liver fibrosis, in addition to histological improvement in architecture of liver.</p>

Unresolved questions regarding human hereditary deafness

Human hearing loss is a common neurosensory disorder about which many basic research and clinically relevant questions are unresolved. This review on hereditary deafness focuses on three examples considered at first glance to be uncomplicated, however, upon inspection, are enigmatic and ripe for future research efforts. The three examples of clinical and genetic complexities are drawn from studies of (i) Pendred syndrome/DFNB4 (PDS, OMIM 274600), (ii) Perrault syndrome (deafness and infertility) due to mutations of CLPP (PRTLS3, OMIM 614129), and (iii) the unexplained extensive clinical variability associated with TBC1D24 mutations. At present, it is unknown how different mutations of TBC1D24 cause non-syndromic deafness (DFNB86, OMIM 614617), epilepsy (OMIM 605021), epilepsy with deafness, or DOORS syndrome (OMIM 220500) that is characterized by deafness, onychodystrophy (alteration of toenail or fingernail morphology), osteodystrophy (defective development of bone), mental retardation, and seizures. A comprehensive understanding of the multifaceted roles of each gene associated with human deafness is expected to provide future opportunities for restoration as well as preservation of normal hearing.

Bottom-up fabrication of graphene on Ru(0001) via molecular self-assembly

A bottom-up fabrication of graphene via molecular self-assembly of p-Terphenyl on Ru(0001) has been investigated by scanning tunneling microcopy and density functional theory. Upon annealing of the sample at 450 °C, the intermediate stage is observed, in which the adsorbed p-Terphenyl molecules and graphitized flakes converted from the molecules coexist, implying the onset of dehydrogenation of p-Terphenyl. At the annealing temperature of 480 °C, the graphitized flakes start to convert into graphene. An adsoption energy of 5.99 eV is calculated for an individual p-Terphenyl molecule on Ru(0001), denoting a strong interaction between the adsorbate and substrate. The intermolecular interaction brings an extra adsorption energy of 0.28 eV for each molecule in the di-molecule adsorption system. During the conversion process from adsorbed molecule into graphene, the intermolecular interaction leads to the increase of the dehydrogenation barrier from 1.52 to 1.64 eV.

Glutathione and antioxidant enzymes serve complementary roles in protecting activated hepatic stellate cells against hydrogen peroxide-induced cell death

BACKGROUND

In chronic liver disease, hepatic stellate cells (HSCs) are activated, highly proliferative and produce excessive amounts of extracellular matrix, leading to liver fibrosis. Elevated levels of toxic reactive oxygen species (ROS) produced during chronic liver injury have been implicated in this activation process. Therefore, activated hepatic stellate cells need to harbor highly effective anti-oxidants to protect against the toxic effects of ROS.

AIM

To investigate the protective mechanisms of activated HSCs against ROS-induced toxicity.

METHODS

Culture-activated rat HSCs were exposed to hydrogen peroxide. Necrosis and apoptosis were determined by Sytox Green or acridine orange staining, respectively. The hydrogen peroxide detoxifying enzymes catalase and glutathione-peroxidase (GPx) were inhibited using 3-amino-1,2,4-triazole and mercaptosuccinic acid, respectively. The anti-oxidant glutathione was depleted by L-buthionine-sulfoximine and repleted with the GSH-analogue GSH-monoethylester (GSH-MEE).

RESULTS

Upon activation, HSCs increase their cellular glutathione content and GPx expression, while MnSOD (both at mRNA and protein level) and catalase (at the protein level, but not at the mRNA level) decreased. Hydrogen peroxide did not induce cell death in activated HSCs. Glutathione depletion increased the sensitivity of HSCs to hydrogen peroxide, resulting in 35% and 75% necrotic cells at 0.2 and 1mmol/L hydrogen peroxide, respectively. The sensitizing effect was abolished by GSH-MEE. Inhibition of catalase or GPx significantly increased hydrogen peroxide-induced apoptosis, which was not reversed by GSH-MEE.

CONCLUSION

Activated HSCs have increased ROS-detoxifying capacity compared to quiescent HSCs. Glutathione levels increase during HSC activation and protect against ROS-induced necrosis, whereas hydrogen peroxide-detoxifying enzymes protect against apoptotic cell death.