Frequency of Thyroid Dysfunction and Congenital Heart Defects in Subjects with Down Syndrome

ABSTRACT: Background: Down syndrome (DS) is the most common chromosomal abnormality with prevalence of 1 in 700-1500 live births. Its manifestations may include congenital heart defects(CHD), thyroid dysfunctions, hematopoietic disorders, early-onset Alzheimer disease, gastrointestinal disorders, neuromuscular weakness, hearing and visual problems, characteristic facial and physical features. The prevalence of thyroid disorders and congenital heart diseases are higher in DS patients than in general population. Objective:To explore the frequency, and types of congenital heart defects (CHD) and Thyroid disorders in children with Down syndrome (DS) in the children hospital and the institute of child health (CHICH) Multan. Study design:  Descriptive cross sectional Setting: Outpatient department (OPD) of CHICH Multan Method:A total of 158 down syndrome (DS) patients of 0 to 15 years of age, of both genders were included in this study from October 2019 to October 2020. DS was diagnosed by specific clinical features and karyotyping. Age, sex and mother’s age was noted. Blood samples of all the patients were sent for karyotyping and serum T4 and Thyroid stimulation hormone (TSH). For patients more than 36 months, blood samples were also sent for Antithyroglobulin and antithyroid peroxidase antibodies. Echocardiography of all the patients was done. Data was collected and analyzed by using SPSS version 16.0. Results:Out of 158 DS children most presented below 6months of age, with male to female ratio of 1:1.4. Mostly mothers were between 20 to 40 years of age. Karyotyping revealed non disjunction in 97% of cases. Cardiac abnormalities were found in 48% of DS children. Most common Type was VSD (10.9%), Thyroid abnormalities were detected in 24% of DS patients, subclinical hypothyroidism (13.9%) was most common. Conclusion: CHD and Thyroid disorders must be ruled out in all DS patients,to start early management.  Keywords: Down syndrome, Congenital heart disease, hypothyroidism

Frequency of hepatitis E and Hepatitis A virus in water sample collected from Faisalabad, Pakistan

Hepatitis E and Hepatitis A virus both are highly prevalent in Pakistan mainly present as a sporadic disease. The aim of the current study is to isolate and characterized the specific genotype of Hepatitis E virus from water bodies of Faisalabad, Pakistan. Drinking and sewage samples were qualitatively analyzed by using RT-PCR. HEV Genotype 1 strain was recovered from sewage water of Faisalabad. Prevalence of HEV and HAV in sewage water propose the possibility of gradual decline in the protection level of the circulated vaccine in the Pakistani population

Erectile dysfunction: prevalence, risk factors and involvement of antihypertensive drugs intervention

Purpose: To explore the literature regarding prevalance, risk factors and the involvement of antihypertensive drugs in erectile dysfunction (ED).Methods: Original research articles, reviews, editorials and case reports published in English language on the prevalence of sexual/erectile dysfunction in hypertensive men taking antihypertensive drugs and risk factors were identified through a search of four bibliographic databases, namely, PubMed, EMBASE, CINAHL and EBSCO Health.Results: Recent analyses suggest that hypertensive men of almost all age groups suffer from ED but it is more prevalent in elderly male patients. The involvement of β-blockers was found to be controversial. Nevertheless, some evidence had been found regarding the use of propranolol in high doses.Conclusion: The present review indicates the need for research to unravel the role of β-blockers in the manifestation of ED in hypertensive males, whom there are no contributory factors such as sedentary lifestyle, aging, stress and anxiety, etc.Keywords: Hypertension, Antihypertensive drugs, β-Blockers, Propranolol, Erectile dysfunction, Life style, Risk factor

Hydrocarbon degradation, plant colonization and gene expression of alkane degradation genes by endophytic Enterobacter ludwigii strains

The genus Enterobacter comprises a range of beneficial plant-associated bacteria 2 showing plant growth-promotion. Enterobacter ludwigii belongs to the Enterobacter 3 cloacae complex and has been reported to include human pathogens but also plant-4 associated strains with plant beneficial capacities. To assess the role of Enterobacter 5 endophytes in hydrocarbon degradation, plant colonization, abundance and expression of 6 CYP153 genes in different plant compartments, three plant species (Italian ryegrass, 7 birdsfoot trefoil and alfalfa) were grown in sterile soil spiked with 1% diesel and 8 inoculated with three endophytic Enterobacter ludwigii strains. Results showed that all 9 strains were capable of hydrocarbon degradation and efficiently colonized the 10 rhizosphere and plant interior. Two strains, ISI10-3 and BRI10-9, showed highest 11 degradation rates of diesel fuel up to 68% and performed best in combination with Italian 12 ryegrass and alfalfa. All strains expressed the CYP153 gene in all plant compartments, 13 indicating an active role in degradation of diesel in association with plants.Higher Education Commission of Pakistanhttp://www.sciencedirect.com/science/journal/0269749

Do Anti-Epilepsy Drugs Increase Suicide Ideation Risk In Epilepsy Patients?

Objective: To determine the frequency of suicide risk within first six months after starting anti-epilepsy treatment. Methodology: This Descriptive cross-sectional study conducted at department of Medicine, Jinnah Hospital Allama Iqbal Medical College Lahore Pakistan from January 2019 to January 2020.The Scale of Suicidal Ideation (SCI)consists of 19 items which were used to evaluate patients’ suicidal intentions and to monitor patients’ response tointerventions over time. Patients with diagnosed psychiatric illness such as depression and schizophrenia, past historyof suicidal attempts and patients with poor drug compliance were excluded. After informed consent, 140 epilepticpatients, who had been recently started on anti-epilepsy medicines, aged 20 to 55 years of both gender were enrolled using non-probability consecutive sampling technique. Demographic information and detailed medical history were noted and patients were assessed for suicide risk using the Scale of Suicidal Ideation (SCI). All data was recorded and analyzed using SPSS version 23.0. Results: Mean age was 28.9±6.3 years with 104 (74.3%) males and 36 (25.7%) females. Sixty-eight (48.6%) patients belonged to low socio-economic status whereas 29 (20.7%) and 43 (30.7%) patients were from middle and high Socio-economic Status respectively. Sixty-eight (48.6%) patients were illiterate while 42 (30.0%) and 30 (21.4%) patients had educational status of up to matriculation and graduate or above respectively. In the present study, 46 (32.8%) patients had suicidal ideation with low socio-economic status  (p-value 0.013)  and illiterate educational status (p-value 0.002) having statistically significant association with suicidal ideation. Conclusion: Suicidal ideation was seen in almost one-third epilepsy patients on anti-epileptic drugs with low socioeconomic status and illiterate educational status being significant risk factor

Development of Paracetamol-Caffeine co-crystals to improve compressional, formulation and in-vivo performance

Paracetamol, a frequently used antipyretic and analgesic drug, has poor compression moldability owing to its low plasticity. In this study, new co-crystals of paracetamol (PCM) with caffeine (as a co-former) were prepared and delineated. Co-crystals exhibited improved compaction and mechanical behavior. A screening study was performed by utilizing a number of methods namely dry grinding, liquid assisted grinding (LAG), solvent evaporation (SE) and anti-solvent addition using various weight ratios of starting materials. LAG and SE were found successful in the screening study. Powders at 1:1 and 2:1 weight ratio of PCM/CAF by LAG and SE respectively resulted in the formation of co-crystals. Samples were characterized by PXRD, DSC and ATR-FTIR techniques. Compressional properties of PCM and developed co-crystals were analyzed by in-die heckle model. Mean yield pressure (Py), an inverse measure of plasticity, obtained from the heckle plots decreased significantly (p<0.05) for co-crystals than pure drug. Intrinsic dissolution profile of co-crystals showed up to 2.84 fold faster dissolution than PCM and physical mixtures in phosphate buffer pH 6.8 at 37 oC. In addition co-crystals formulated into tablets by direct compression method showed better mechanical properties like hardness and tensile strength. In vitro dissolution studies on tablets also showed enhanced dissolution profiles (~90- 97%) in comparison to the tablets of PCM prepared by direct compression (~55%) and wet granulation (~85%) methods. In a single dose sheep model study co-crystals showed up to two fold increase in AUC and Cmax. A significant (p < 0.05) decrease in clearance as compared to pure drug was also recorded. In conclusion new co-crystals of PCM were successfully prepared with improved tabletability in-vitro and in-vivo profile. Enhancement in AUC and Cmax of PCM by co-crystallisation might suggest the dose reduction and avoidance of side effects

Prevalence of different tick species on livestock and associated equines and canine from different agro-ecological zones of Pakistan

Ticks are ectoparasites that act as vectors for transmission of various pathogens to wild and domesticated animals and pose a serious threat to human health. Because of the hot and humid conditions in different agro-ecological zones of Pakistan, ticks are abundant and parasitize a variety of animals. The aim of this study was to identify different tick species and distribution on different hosts especially livestock, such as sheep, goat, cattle, buffalo, and camel, and livestock associated canines and equines, such as horse, donkey, and dog, across different agro-ecological zones of Pakistan. The ticks samples were collected and morphologically identified at genus and species level using morphological keys under stereomicroscope. A total of 2,846 animals were examined for the tick infestation, and 408 animals were tick-infested. Eleven tick species belonging to 4 genera were identified: Hyalomma anatolicum, Hyalomma scupense, Hyalomma dromedarii, Hyalomma isaaci, Rhipicephalus microplus, Rhipicephalus haemaphysaloides, Rhipicephalus turanicus, Haemaphysalis cornupunctata, Haemaphysalis montgomeryi, Haemaphysalis bispinosa, and Ixodes kashmiricus. The overall tick prevalence was 14.3%; host-wise infestation rate was 12.2% in sheep; 12.6%, goat; 11.7%, buffalo; 11.7%, cattle; 19.6%, camel; 27.4%, donkey; 23.5%, horse; and 24.3%, dog. Tick infestation of different animals differed on the basis of the zones. Camels showed the highest tick infestation rate in zones 1 and 2 (21.4 and 26.7%, respectively), whereas donkeys showed the highest infestation rate in zones 3, 4, 6, and 7 (25, 39.3, 3.3, and 21.4%, respectively). The infestation rates of Hyalomma and Rhipicephalus were the highest in zone 2 (71.4 and 52.9%, respectively). The infestation rate of Hyalomma was the highest (47.4%) in sheep; Haemaphysalis (46.9%), goat; Rhipicephalus (69.7%), buffalo; Rhipicephalus (62.3%), cattle; Hyalomma (70%), camel; Ixodes (60.9%), donkey; Ixodes (75%), horse; and Rhipicephalus (61.1%), dog. This study showed the diversity and infestation rate of different ticks with respect to their hosts and agro-ecological zones of Pakistan. High tick burdens and infestation rates are responsible for the spread of different tick-borne infections, resulting in loss of animal productivity and posing a threat to animal and human health. Understanding different tick species and their distribution across different zones will be helpful for developing efficient control strategies against different tick born infections

Community Based Assessment of Behavior and Awareness of Risk Factors of Cystic Echinococcosis in Major Cities of Pakistan: A One Health Perspective.

Background: The parasitic disease, cystic echinococcosis (CE), is a serious health problem in Pakistan. Risk of disease transmission is increased by economic and political instability, poor living conditions, and limited awareness of hygienic practices. The current study aimed to investigate the community perception and awareness regarding the risk factors of CE in Pakistan, from a One Health perspective. Methods: We conducted a community-based survey involving 454 participants in the major cities of Pakistan. Quantitative data based on knowledge, attitude, and practices (KAP), the One Health concept, risk factors, and community perception of CE among the general population of the major cities of Pakistan were collected. The questions included those related to knowledge, attitude, practices, One Health concept, risk factors, and community perception. The Chi-squared test was applied to determine the associations regarding KAPs across socio-demographic parameters. Results: KAPs had no significant associations with sociodemographic aspects such as age, sex, religion, ethnicity, education, marital status, occupation, or financial status of the participants. The findings indicated a lack of awareness about CE among the participants. Respondents were unaware of the risk factors and the One Health concept of CE. However, the community attitude and perception were positive toward the control of CE. Conclusion: Illiteracy, deficient sanitation systems and lack of awareness are the contributing factors to CE in Pakistan. It is necessary to make the community aware regarding CE and its importance. Increasing this awareness represents an important step toward the eradication and control of CE

Cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life years for 29 cancer groups from 2010 to 2019 a systematic analysis for the global burden of disease study 2019

IMPORTANCE The Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) provided systematic estimates of incidence, morbidity, and mortality to inform local and international efforts toward reducing cancer burden. OBJECTIVE To estimate cancer burden and trends globally for 204 countries and territories and by Sociodemographic Index (SDI) quintiles from 2010 to 2019. EVIDENCE REVIEW The GBD 2019 estimation methods were used to describe cancer incidence, mortality, years lived with disability, years of life lost, and disability-adjusted life years (DALYs) in 2019 and over the past decade. Estimates are also provided by quintiles of the SDI, a composite measure of educational attainment, income per capita, and total fertility rate for those younger than 25 years. Estimates include 95% uncertainty intervals (UIs). FINDINGS In 2019, there were an estimated 23.6 million (95% UI, 22.2-24.9 million) new cancer cases (17.2 million when excluding nonmelanoma skin cancer) and 10.0 million (95% UI, 9.36-10.6 million) cancer deaths globally, with an estimated 250 million (235-264 million) DALYs due to cancer. Since 2010, these represented a 26.3% (95% UI, 20.3%-32.3%) increase in new cases, a 20.9% (95% UI, 14.2%-27.6%) increase in deaths, and a 16.0% (95% UI, 9.3%-22.8%) increase in DALYs. Among 22 groups of diseases and injuries in the GBD 2019 study, cancer was second only to cardiovascular diseases for the number of deaths, years of life lost, and DALYs globally in 2019. Cancer burden differed across SDI quintiles. The proportion of years lived with disability that contributed to DALYs increased with SDI, ranging from 1.4% (1.1%-1.8%) in the low SDI quintile to 5.7% (4.2%-7.1%) in the high SDI quintile. While the high SDI quintile had the highest number of new cases in 2019, the middle SDI quintile had the highest number of cancer deaths and DALYs. From 2010 to 2019, the largest percentage increase in the numbers of cases and deaths occurred in the low and low-middle SDI quintiles. CONCLUSIONS AND RELEVANCE The results of this systematic analysis suggest that the global burden of cancer is substantial and growing, with burden differing by SDI. These results provide comprehensive and comparable estimates that can potentially inform efforts toward equitable cancer control around the world. © 2022 American Medical Association. All rights reserved. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliate “Muhammad Aziz Rahman" is provided in this record*