Ultrasound Detected Non-Alcoholic Fatty Liver Disease Prevalence and its Risk Factors in Pakistani Population

Background: Nonalcoholic fatty liver disease (NAFLD) is the most common predictor of chronic liver disease. It is an emerging health condition in Pakistan and in most cases, the disease remains undiagnosed due to a low trend of screening processes observed over the years. The purpose of this research was to assess the relationship of ultrasonography (USG) – detected NAFLD with the risk factors including obesity, diabetes, hypertension, and menopause.Methods: This cross-sectional study evaluated the data gathered from medical histories, anthropometric measurements, and diagnostic abdominal ultrasound scans of 87 patients referred to radiology department of a trust hospital in Lahore, Pakistan. Patient diagnosed with NAFLD without any other disease or complication were selected through purposive sampling for further study.Results: The results depicted a higher prevalence of NAFLD in females. Among diagnosed NAFLD patients, most (33.7%) showed signs of mild fatty liver on USG. Statistically, a significant (p value= 0.002) relationship of obesity with NAFLD was observed. NAFLD patients had higher mean BMI values (31.04 ± 4.67 Kg/m2, p value = 0.000) as compared to other patients (25.34 ± 4.71 Kg/m2), confirming that obesity is the most important risk factor for NAFLD. Other risk factors (diabetes, hypertension, and menopause) were not found to be significantly related to NAFLD.Conclusion: The major finding of this study is that higher BMI increases the likelihood of developing NAFLD. Prevention and treatment of overweight and obesity can reduce the prevalence of NAFLD.          Keywords: Non-Alcoholic Fatty Liver Disease; Obesity; Cirrhosis     

PLANKTON DYNAMIC AT EASTERN ARABIAN GULF AND SEA OF OMAN

The present study is part of the collaborative research project entitled “Comparative Analysis and Predictions of Algal Blooms in the Arabian Gulf and the Sea of Oman”, between the United Arab Emirates University and Sultan Qaboos University (Grant # G00002684- 31S321), in which simultaneous and intensive biweekly plankton and water samples were collected from two opposite coastal stations off the Strait of Hormuz with the aim to study plankton dynamics at the Arabian Gulf and the Sea of Oman and the effect of environmental parameters on their community structures during the period from May 2018 until May 2019. For the Arabian Gulf, samples were collected from Ras Al Khaimah (RAK) station, while for the Sea of Oman samples were collected from the Sohar (SOH) station Due to the differences of the morphometric as well as the bathymetric features of the two basins, plankton samples and environmental parameters measurements were collected from 6 meters depth at Ras Al Khaimah and from 20 meters depth from the Sea of Oman. However, similar methodologies have been used for sampling collection and analyses. Phytoplankton and zooplankton samples were collected by using 20 μm and 80 μm respectively. Environmental parameters were measured in situ (water temperature, Salinity, pH, and Dissolved Oxygen) by using multisensory instruments, while nutrient salts concentration (Nitrate NO3, Ammonia NH3, phosphate PO4), were determined at the designated laboratories using an auto-analyzer instrument following the approved standard methods. Chlorophyll concentrations at RAK were measured in situ, while at SOH it was extracted from remote sensing data analyses. The obtained results indicated that water temperature at SOH was cooler (maximum 28.7°C) in summer months than that of RAK (maximum 34.8°C). Strikingly, the RAK water temperature in winter was cooler than at the SOH station. Due to the Sea of Oman direct connection with the Indian Ocean, its water salinity was always close to Oceanic salinity (i.e. 36 ppt); while the semi-closed and shallow nature of the Arabian Gulf have increased its water salinity up to 41 ppt. It was clear from the nutrients analyses that the concentrations at the SOH station were higher than values resulting from the analyses of water samples collected from RAK. Phytoplankton community structure at RAK was mainly composed of Bacillariophyceae and Dinophyceae with Bacillariophyceae dominance (≥ 90%), along the study period, except in June 2018 where other groups such as cyanobacteria and Chlorophyceae were represented up to 50% of the community structure. While at SOH, Bacillariophyceae were less dominant during the study period with values ranging between \u3c 1% in August 2018 and April 2019 and between 80% in February 2019 and 10% in May 2019. Both cyanobacteria and Chlorophyceae were alternating the dominance with Bacillariophyceae. Dinophyceae were sporadically represented, with a maximum of 10% of the community structure occurring during November 2018. At both stations, zooplankton was represented by three groups i.e., Calanoids, Cyclopoids and Harpacticoids. At RAK Cyclopoids was dominating the zooplankton community along the study period, while Calanoids was dominating the SOH zooplankton community. Harpacticoids was more presented at RAK compared to SOH during the study period. The results also indicated that, although the numbers of phytoplankton communities were more diverse (1151 species) at RAK compared to SOH (192 species), the phytoplankton biomass was \u3e10 folds at SOH compared to RAK station. Indeed, the zooplankton density at SOH was 4 times more than that found at the RAK station. Based on the obtained results, the present study also analyzed the relationship between phytoplankton biomass and zooplankton densities during the study period and came to the conclusions that:1- Both phytoplankton and zooplankton communities at the studied stations are not similar in its monthly community structures, 2- The variations between the two basins in environmental parameters are also affecting the species dominance and the monthly community structures of both phytoplankton and zooplankton, 3- Wind stress and its directions over the studied period are controlling the surface water current directions through the Strait of Hormuz which control by its time the movements of planktonic organisms between the two basins, 4- At RAK the relationship between phytoplankton and zooplankton is based on grazing of zooplankton on phytoplankton; while at SOH it is mainly based on pray predator interaction, especially with the presence of high densities of fish larvae (especially Sardine and Anchovy), which controlled the zooplankton ability to limit the phytoplankton productivity. Statistical analyses (Principal component Analyses–PCA), has confirmed the negative relationship between phytoplankton and zooplankton at RAK, but it was less able to explain such a relationship at the SOH station. The present study is the first in its kind to study simultaneously the dynamics of plankton communities at the Arabian Gulf and the Sea of Oman and it could be a baseline for future research

Association of health literacy and medication adherence with health-related quality of life (HRQoL) in patients with ischemic heart disease

Abstract Background Medication Adherence (MA) and Health Related Quality of Life (HRQoL) are two inter-connected concepts, co-influenced by Health Literacy (HL), with significant impact on patient management and care. Thus, we aimed to estimate the association of HL and MA with HRQoL in IHD patients. Methods Cross-sectional study of 251 IHD patients recruited from Lahore over 6 months period. HL, MA and HRQoL was assessed using validated questionnaires; 16-items of HL, Morisky Green Levine Scale (MGLS) and SF-12, respectively. Chi-square for significance, logistic-regression for association and linear regression for predictions were used. Results IHD patients; males (p = 0.0001), having secondary—higher education (p = 0.0001), middle/upper class (p = 0.0001) and employed (p = 0.005) had adequate HL, and were more likely to be adherent (OR; 4.3, p = 0.014). Both physical (PCS-12) and mental (MCS-12) component scores of HRQoL for age, gender, education, area of residence, employment and MA were significantly higher in patients with adequate HL. In multinomial regression, improved PCS-12 scores tend to be higher in subjects having secondary—higher education (OR; 3.5, p = 0.067), employed (OR; 6.1, p = 0.002) and adherent (OR; 2.95, p = 0.218), while MCS-12 scores tend to be higher in patients &lt; 65 years (OR; 2.2, p = 0.032), employed (OR; 3, p = 0.002) and adherent (OR; 4, p = 0.004). In adjusted model, HL (β;0.383, p = 0.0001) and MA (β; − 0.133, p = 0.018) were significantly associated with PCS-12, and MCS-12 with MA (β; − 0.161, p = 0.009) only. Conclusion Data suggested that adequate HL was significantly associated with adherence and both physical and mental dimensions of HRQoL were higher in IHD patients with adequate HL. Besides, HL and MA are independent predictors of HRQoL in IHD patients. </jats:sec

Chemical pretreatments of Trapa bispinosa's peel (TBP) biosorbent to enhance adsorption capacity for Pb(ll)

In this study, Trapa bispinosa's peel (TBP) biomass is exploited as an effective, low cost and new adsorbent to remove Pb(II) from aqueous solution. TBP is pretreated and modified with HNO3, HClO4 and H2O2 to enhance the Pb(II) removal and it is perceived that chemical modifications enhance the adsorption capacity of TBP. The adsorption behavior of Pb(II) is studied under different conditions, including pH (3-6), TBP dose (0.050.8 g), stirring speed (100-200 rpm), initial Pb(II) ion concentration (25-400 mg L-1) and contact time (0-1440 min). Kinetic study reveals sorption is fast in first 15 to 30 min achieving equilibrium in 60 min with qmax (mg g-1) are 77.09, 105.40 and 123.82 for NT-TBP, NA-TBP and HCA-TBP respectively. The Langmuir model successfully defines the sorption data having higher R2 and good agreement between theoretical and experimental uptake capacity of Pb(II). The kinetic study exhibits that the pseudo-second order rate equation is better portrayed sorption process. TBP modified with HClO4 shows the highest metal uptake in comparison to HNO3, H2O2 modified TBP and native TBP

FREQUENCY AND RISK FACTORS OF OVERWEIGHT AND OBESE SCHOOL GOING ADOLESCENTS OF DISTRICT PESHAWAR, KHYBER PAKHTUNKHWA, PAKISTAN

ABSTRACT&#x0D; Objective:&#x0D; To assess the frequency and risk factors of overweight and obese school going children of district Peshawar.&#x0D; To determine association of these risk factors with obesity in school going children.&#x0D; Material and methods:&#x0D; This is a cross sectional descriptive study, performed in public and private schools of district Peshawar from 1st October 2020 till 30th March 2021. A pre validated questionnaire was used to assess the dietary habits of students. The listed schools were stratified according to the monthly fee structure of the schools into three strata, low SES status (fee &lt; 1000 PKR), middle SES (fee = 1000-2500 PKR), high socioeconomic status (SES) (fee &gt; 2500 PKR). Two schools were selected using stratified random technique from each stratum. Simple random sampling technique (balloting) was used to select students from each selected school. Data were analyzed using SPSS 23. Chi square test was used to determine association between obesity and socioeconomic status and between obesity and dietary habits. Kendal-tau was used to determine statistical correlation between obesity and socioeconomic status and between obesity and dietary habits.&#x0D; Results: The overall frequency of overweight and obesity was found to be 14.7 % and 8% respectively. After applying chi square test, it was found that obesity has a significant association with socioeconomic condition and dietary habits of children. Kendal-tau was applied to develop correlation. It was found that obesity has positive correlation with socioeconomic condition +0.312. However obesity has negative correlation with dietary habits -0.092.&#x0D; Conclusion: childhood obesity is rising significantly in district Peshawar where every 4th or 5th child is either overweight or obese. The major risk factors that were studied were socioeconomic status and dietary habits, which were statistically found to be associated with obesity.&#x0D; Keywords: BMI, school going children, obesity, overweight.</jats:p

Effect of polymeric stabilizers on the size and stability of PLGA paclitaxel nanoparticles

The aim of this study is to formulate polymeric paclitaxel nanoparticles with various stabilizers to improve solubility, enhance stability, maximize therapeutic efficacy and minimize detrimental toxicities of paclitaxel. In this study, trastuzumab-guided poly lactic-co-glycolic acid (PLGA)-loaded paclitaxel nanoparticles were formulated with pluronic F-127, polyvinyl alcohol (PVA), poloxamer 407, Tween-80, span 20, sodium dodecyl sulfate (SDS), and sodium lauryl sulfate (SLS) at different concentrations (0.5, 1, 1.5 and 2%) using the solvent evaporation method. The nanoparticles were evaluated for physicochemical characteristics and short and long-term stability. The optimum particle size (190 nm ± 12.42 to 350 nm ± 11.1), PDI (0.13 ± 0.02 to 0.2 ± 0.01), surface charge (-19.1mv ± 1.5 to −40.4mv ± 1.6), drug loading (2.43 to 9.5 %) and encapsulation efficiency (greater than 80 %) were obtained with these stabilizers while keeping the polymer concentration, temperature, probe size, amplitude and sonication time constant. The nanoformulations were stably stored at 4 °C. The nanoformulations of paclitaxel with pluronic F-127, polyvinyl alcohol (PVA), and poloxamer 407 were found to be more soluble, stable, uniform in physicochemical properties, and efficient in drug loading and encapsulation for improved therapeutic effects

High levels of Zinc-α-2-Glycoprotein among Omani AIDS patients on combined antiretroviral therapy

To investigate the levels of zinc-α-2-glycoprotein (ZAG) among Omani AIDS patients receiving combined antiretroviral therapy (cART). Methods: A total of 80 Omani AIDS patients (45 males and 35 females), average age of 36 years, who were receiving cART at the Sultan Qaboos University Hospital (SQUH), Muscat, Oman, were tested for the levels of ZAG. In addition, 80 healthy blood donors (46 males and 34 females), average age of 26 years, attending the SQUH Blood Bank, were tested in parallel as a control group. Measurement of the ZAG levels was performed using a competitive enzyme-linked immunosorbent assay and in accordance with the manufacturer's instructions. Results: The ZAG levels were found to be significantly higher among AIDS patients compared to the healthy individuals (P=0.033). A total of 56 (70%) of the AIDS patients were found to have higher levels of ZAG and 16 (20%) AIDS patients were found to have high ZAG levels, which are significantly (P>0.031) associated with weight loss. Conclusions: ZAG levels are high among Omani AIDS patients on cART and this necessitates the measurement of ZAG on routine basis, as it is associated with weight loss

TDP-43 proteinopathy in ALS is triggered by loss of ASRGL1 and associated with HML-2 expression

Abstract TAR DNA-binding protein 43 (TDP-43) proteinopathy in brain cells is the hallmark of amyotrophic lateral sclerosis (ALS) but its cause remains elusive. Asparaginase-like-1 protein (ASRGL1) cleaves isoaspartates, which alter protein folding and susceptibility to proteolysis. ASRGL 1 gene harbors a copy of the human endogenous retrovirus HML-2, whose overexpression contributes to ALS pathogenesis. Here we show that ASRGL1 expression was diminished in ALS brain samples by RNA sequencing, immunohistochemistry, and western blotting. TDP-43 and ASRGL1 colocalized in neurons but, in the absence of ASRGL1, TDP-43 aggregated in the cytoplasm. TDP-43 was found to be prone to isoaspartate formation and a substrate for ASRGL1. ASRGL1 silencing triggered accumulation of misfolded, fragmented, phosphorylated and mislocalized TDP-43 in cultured neurons and motor cortex of female mice. Overexpression of ASRGL1 restored neuronal viability. Overexpression of HML-2 led to ASRGL1 silencing. Loss of ASRGL1 leading to TDP-43 aggregation may be a critical mechanism in ALS pathophysiology

Global variation in postoperative mortality and complications after cancer surgery: a multicentre, prospective cohort study in 82 countries

© 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 licenseBackground: 80% of individuals with cancer will require a surgical procedure, yet little comparative data exist on early outcomes in low-income and middle-income countries (LMICs). We compared postoperative outcomes in breast, colorectal, and gastric cancer surgery in hospitals worldwide, focusing on the effect of disease stage and complications on postoperative mortality. Methods: This was a multicentre, international prospective cohort study of consecutive adult patients undergoing surgery for primary breast, colorectal, or gastric cancer requiring a skin incision done under general or neuraxial anaesthesia. The primary outcome was death or major complication within 30 days of surgery. Multilevel logistic regression determined relationships within three-level nested models of patients within hospitals and countries. Hospital-level infrastructure effects were explored with three-way mediation analyses. This study was registered with ClinicalTrials.gov, NCT03471494. Findings: Between April 1, 2018, and Jan 31, 2019, we enrolled 15 958 patients from 428 hospitals in 82 countries (high income 9106 patients, 31 countries; upper-middle income 2721 patients, 23 countries; or lower-middle income 4131 patients, 28 countries). Patients in LMICs presented with more advanced disease compared with patients in high-income countries. 30-day mortality was higher for gastric cancer in low-income or lower-middle-income countries (adjusted odds ratio 3·72, 95% CI 1·70–8·16) and for colorectal cancer in low-income or lower-middle-income countries (4·59, 2·39–8·80) and upper-middle-income countries (2·06, 1·11–3·83). No difference in 30-day mortality was seen in breast cancer. The proportion of patients who died after a major complication was greatest in low-income or lower-middle-income countries (6·15, 3·26–11·59) and upper-middle-income countries (3·89, 2·08–7·29). Postoperative death after complications was partly explained by patient factors (60%) and partly by hospital or country (40%). The absence of consistently available postoperative care facilities was associated with seven to 10 more deaths per 100 major complications in LMICs. Cancer stage alone explained little of the early variation in mortality or postoperative complications. Interpretation: Higher levels of mortality after cancer surgery in LMICs was not fully explained by later presentation of disease. The capacity to rescue patients from surgical complications is a tangible opportunity for meaningful intervention. Early death after cancer surgery might be reduced by policies focusing on strengthening perioperative care systems to detect and intervene in common complications. Funding: National Institute for Health Research Global Health Research Unit