Antimicrobial activity of Acacia nilotica (L.) Del. plant extracts against Xanthomonas malvacearum bacteria

An experiment was conducted to check antibacterial activity of leaf bark and root extracts of Acacia nilotica (L.) Del. Plant against Xanthomonas malvacearum bacteria using agar well diffusion method expressed by zone of inhibition in mm in diameter. Antimicrobial activity of leaf, bark, and root extracts were separately assessed in triplicates for aqueous extracts, ethyl alcohol extracts. The results were compared with standard concentrations of antibiotics streptomycin and tetracycline. The ethyl acetate extracts of root seems to contain antibacterial component more than pure antibiotic with the concentration of 500 ug /ml

Mini Clinical Evaluation Exercise (Mini-CEX): An overview

Over the last two decades, medical education has changed its role significantly to move from the traditional curriculum to the outcome based education. This is done after deciding the competencies to be achieved by the students more clearly1. The Institute for International Medical Education (IIME) has clearly focused the minimum essential core competencies that a medical graduate must possess including the clinical skills, communication skills, professional values, attitudes and behaviors1.&nbsp

Overcrowding in the emergency departments: challenges and opportunities for improvement

With the advent of Emergency Medicine, one can observe an increase in the number of Emergency Departments (ED) across the country. However, most EDs struggle due to an overwhelming number of patients. Overcrowding can lead to delays in patient care. For a city like Karachi which is an active disaster zone, preemptive preparedness is required in the face of terror threats and such overcrowding needs to be decreased to a bare minimum. The most frequent causes of prolonged length of stay (LOS) in the ED include non-availability of in-hospital beds, delays in response to subspecialty consultations and escalating medical expenses. All of these can negatively impact patient care by putting patient safety at risk and patient care in jeopardy. There is an increased risk of unintentional medical errors and a concomitant increase in unwanted lawsuits. A few simple interventions which may help alleviate this situation to some extent have been discussed

Faculty Development Initiatives: A prerequisite for capacity building and enhanced productivity in a medical institution

Objective: To determine the contribution of teaching, learning and assessment forum\u27s initiatives on professional development of faculty and staff.Methods: This retrospective study was conducted at the Department of Biological and Biomedical Sciences, Aga Khan University, Karachi, from July to December 2016, and comprised teaching, learning and assessment activities carried out from 2012 to 2015. The responses acquired from feedback evaluation were recorded at the end of activity on a Likert-type scale ranging from 1-5. Positive responses were presented for each variable with respective activity type across the study years. The association of the effectiveness of teaching, learning and assessment between type of event and yearly outcome was also assessed.Results: A total of 66activities were held during the study period. Of them, 49(74.24%) were workshops/human resource trainings, 5(7.57%) were courses and 12(18.18%) were seminars. Together, they involved over 500 participants. Objectives, disclosure statement, contents, level of interaction, acquired knowledge, time management, queries responded, organisational activity, course material and overall assessment showed consistent positive response across the years, but the acquisition of new knowledge differed significantly (pConclusions: Teaching, learning and assessment initiatives, play a positive role in professional development of faculty and staff

Serum anti mullerian hormone and renalase levels in predicting the risk of preeclampsia

Objective: The aim of the study was to explore the association of serum AMH and Renalase with the risk of preeclampsia thereby assessing them as screening tools, reducing the risk of gravid consequences of preeclampsia.Materials and Methods: This cross-sectional study recruited n = 95 pregnant women between 14 and 32 gestational weeks. They were categorized as a) women with gestational hypertension (n = 45); b) women with pre-eclampsia (n = 20) and c) normotensive pregnant women (n = 30) according to the ACOG criteria. Anthropometrics data and blood and urine samples were collected. AMH and Renalase levels were measured by ELISA assay.Results: The mean age of study cohort was 27.3 ± 6.2 year and weight was 65.1 ± 14.1 kg. Blood pressures were significantly higher in pre-eclamptic patients versus both the gestational hypertensive females and controls (p \u3c 0.05). AMH was found to be significantly higher in controls but no difference was observed between gestational hypertensive and pre-eclamptic patients. No difference was seen for serum Renalase among the three groups (p \u3e 0.05). AMH showed a negative weak correlation with diastolic blood pressure (r = -0.272; p = 0.008) that remained significant even after adjustment (r = -0.236; p = 0.023) whereas Renalase did not show any difference (r = -0.051; p \u3e 0.05). Females with low levels of AMH were 1.07 times at risk of developing hypertension even after adjustment for age and BMI (p \u3c 0.05).Conclusion: Low AMH levels may lead to hypertension in pregnancy suggesting a role in detecting vascular diseases as well as its effect on ovarian aging. However, further research is required to establish a causal relationship

A STUDY OF THERAPEUTIC RESPONSE AND ADVERSE EFFECTS OF INTRAVENOUS ERYTHROPOIETIN VERSUS SUBCUTANEOUS ERYTHROPOIETIN ON HEMODIALYSIS PATIENTS IN THE DEPARTMENT OF NEPHROLOGY OF OHRC

Objective: To study the efficacy of intravenous erythropoietin and subcutaneous erythropoietin in hemodialysis patients who have persistent anemia despite correction of iron therapy and to measure the outcomes in terms of raise in haemoglobin concentration and adverse events in both the groups.Methods: After ethical committee approval the current study was conducted at the Department of Hemodialysis of Owasi Hospital and Research Centre, Hyderabad a period of 6 mo duration. 60 patients undergoing hemodialysis were recruited into out study who had haemoglobin less than 10.0 despite corrected iron levels. Patients were divided into two groups for intravenous administration and subcutaneous administration of alpha erythropoietin. Patients were stratified into three sub-groups of mild, moderate and severe anaemia. Therapeutic response was recorded in the form of monthly hemoglobin and hemoatocrit. Of the 30 patients in the subcutaneous group, erythropoietin was given to 19 males and 11 females, while intravenous erythropoietin was administered to 17 males and 13 females in the other 30 patients.Results: The mean hemoglobin level in the subcutaneous group was 5.16 at the commencement of the study and in the intravenous group the mean hemoglobin was 5.0. In the subcutaneous group, the mean rise in the hemoglobin was rapidly achieved in 3 mo duration when compared to the intravenous group. Mean Systolic Blood pressure was higher in the intravenous group when compared to the subcutaneous group. Spillage of the drug was minimal in subcutaneous group when compared to the intravenous group.Conclusion: After correction of the iron deficiency, low dose of erythropoietin subcutaneously promised to maintain expected hemoglobin level above 10 g/dL with no adverse events compared to intravenous erythropoietin. Erythropoitin alpha at a dose of 4000 IU was enough to achieve the therapeutic target of Hemoglobin>10.0 by administering subcutaneously accelerated hypertension was less when compared to Intravenous erythropieitn post dialysis. Hence we recommend to use erythropoietin subcutaneously rather than intravenously

INSULIN RESISTANCE IS ASSOCIATED WITH ALL-CAUSE MORTALITY AND ACCELERATES THE RISK OF PROGRESSION TO DIABETES IN NON DIABETIC HEART FAILURE PATIENTS

Background: Heart failure is an insulin resistant state. Insulin resistance is highly prevalent in non-diabetic patients with heart failure. The impact of insulin resistance on the development of diabetes mellitus and mortality has not been fully defined. The purpose of this study was to investigate whether insulin resistance is associated with all-cause mortality in a group of non-diabetic patients with heart failure. We have also investigated the impact of insulin resistance on the conversion to diabetes mellitus in these patients. Methods: Insulin resistance, defined by fasting Insulin resistance index (FIRI≥2.7) was assessed in 121 consecutive CHF patients (69 ± 10, 22 % females, 81% ischemic, 61% insulin resistant and FIRI of 4.19 ± 3.8 at baseline) and was followed up for their most recent HbA1c/FPG measurements and mortality data using the electronic linkage system in Dundee, UK. The primary outcome for these cohorts of patients was all cause mortality and secondary outcome was the development of diabetes mellitus.). Cox proportional hazard models were used with FIRI as a continuous variable. Results: After a 6.6 years (IQR 4.7-6.9) median follow-up period, 46 (38%) patients died. A cox proportional hazard model adjusted for relevant covariates showed that the degree of insulin resistance, was significantly associated (HR 1.09, CI 95% 1.02- 1.16), p =0.008) with all-cause mortality. Of the 81 patients we followed up for the development of diabetes, 29% of Insulin resistant-heart failure patients developed diabetes, compared to 10% of non-Insulin resistant-CHF patients. Conclusion: In conclusion, higher FIRI relates to higher all-cause mortality in heart failure patients. We also found out that heart failure patients with IR are at high risk of developing diabetes

Serum Leptin Levels in Polycystic Ovary Syndrome and Its Relationship with Metabolic and Hormonal Profile in Pakistani Females

The study aimed to investigate the levels of serum leptin in PCOS females and to correlate it with metabolic and hormonal parameters. Sixty-two PCOS and ninety normal cycling (NC) females with matched age and body mass index (BMI) were recruited for this cross-sectional study. Serum leptin, FSH, LH, E2, free testosterone, progesterone, thyroid profile, and FBG levels were measured. The mean leptin levels in PCOS and NC were not significantly different (45.56 ng/mL ± 1.49 vs 41.78 ± 1.31 ng/mL, P>0.05); however, leptin levels showed a strong correlation with BMI in PCOS and NC group (r=0.77, P<0.0001; r=0.82, P<0.0001, resp.). High E2 levels in NC had a significant correlation with leptin whereas FBG correlated with leptin in PCOS (r=0.51, P=0.005). TSH had a substantial correlation (r=0.49, P<0.005; r=0.69, P<0.005) in PCOS and NC, respectively. There was no significant difference found in circulating leptin concentration between PCOS and NC subjects. Leptin levels in PCOS were related with metabolic impairments manifested by disturbance in FBG levels and impairment of reproductive functions in terms of reduced E2 secretion

Foot-and-Mouth Disease Virus (FMDV) and Its Treatment with Plant Extracts

Foot-and-mouth disease (FMD) is a contagious viral infection which is caused by foot-and-mouth disease virus (FMDV). The disease appears in cloven-footed animals. Symptoms of the disease are abrupt manifestation of sores on the mouth, nose, feet, etc. Nowadays the control and treatment of FMDVare becoming a worldwide economic problem and challenge for the society. Currently, there is no particular treatment available for FMDV, as well as the limitations and disadvantages in the use of vaccines divert the focus of researchers toward natural sources like plant extracts which possess potential antiviral activity. Various researches documented in the literature demonstrated various plant extracts with antiviral potency against FMDV. In the current chapter, we discussed about FMDV and its possible treatment with plant extracts