Infants-feeding practices and their relationship with socio-economic and health conditions in Lahore, Pakistan

Background: Pakistan, has high infant mortality rate. Among every 1000 live births 0.76% becomes the victim of death due to malnutrition and fatal infections. Therefore, feeding modes and practices may serve as important factors for assessment of an infant's growth and nutritional status. This study was designed to assess the exclusive breast feeding rate, frequency of diseases during breast feeding, status of breast feeding along with weaning, level of education, occupation and socio-economic status of parents.Methods: In the descriptive and cross-sectional study, a total of one hundred (100) infants were included. The sampling technique was non-probability convenience sampling. This study was conducted at vaccination centers and children clinics in different hospitals in city of Lahore -Pakistan.Results: The results showed that 67% of the mothers exclusively breastfed their babies. 64% of the mothers had knowledge of exclusive breast feeding. The practice of breast feeding was found as 81% while artificial feeding was practiced among 19% of the mothers. Majority of the mothers started weaning their babies at the age 4 (31%) and 6 months (32%) whereas 28% mothers started after 6 months. 54% of mothers continued breastfeeding along with weaning. 72% of the mothers were aware of the importance of colostrum.Conclusion: Maternal education and women's employment have been found major determinants for breastfeeding. The result indicates that in Pakistan, mothers receive counseling on breast feeding which is quite satisfactory and feeding practices of infants are found as better in Pakistan

Microbial profiling and risk factors assessment for Otitis Media and Otitis Externa

Background: Otitis media and otitis externa are common otological manifestations in all generations especially in children. There is lack of accurate identification of the causative agent and thus poor diagnosis for such infections. Therefore, it leads to permanent anatomical disabilities including poor speech and defects in balancing and hearing. The study was conducted to isolate, characterize and identify the microbes causing otitis media and otitis externa. Methods: A total of 250 patients having otitis media and otitis externa were enrolled in the study from March 2011 to October 2011. All patients were examined through clinical examination and detailed history was collected. Pus samples from the discharging ears were plated on MacConkey’s, Chocolate and Blood agar for 24 to 48 hours. Isolates were identified on the basis of morphology, staining reactions and various biochemical tests. Results: In this study, only 6% cases yielded no growth, 14% yielded mixed cultures while 80% cases yielded pure cultures. The presumptive diagnosis for ear swabbing was otitis media (76%) and otitis externa (24%). The most common bacterial isolates obtained were Staphylococcus aureus (43.3%) followed byPseudomonas aeruginosa (25%) in the diagnosed cases of otitis media. While for the cases of otitis externa,Pseudomonas aeruginosa was the predominant organism with 52.2%. Infection of otitis media was most common among children and the persons having low socioeconomic conditions. Conclusion: Pseudomonas aeruginosa was identified as the principal pathogen followed by Staphylococcus aureus. To circumvent the painful effects of acute and chronic ear infections, an accurate microbial profiling may play pivotal role

Last Decade of Dengue – and the Next One

AbstractBackground: Before 1970, only 9 countries had dengue. Until 1998, there were 1.2 billion dengue infected cases in 56 different countries around the globe. To date it is prevalent in all of 6 WHO regions. Mortality rate is thought to be 2.5% as it varies from country to country. These figures are not surely depicting exact situation as many cases from most parts of the underdeveloped and developing countries go unreported due to number of reasons but one thing is sure that it is on accelerating note.Methodology: In this study, total number of dengue victims around the globe from year 2000-2009 was estimated. Data were collected from World Health Organization (WHO), different health and country specific emergency dealing agenciesand hospitals. We have shown dengue statistics in annotated maps of international regions where dengue has affected in certain.  In a country specific (Pakistan) study we have determined most vulnerable population group among society, their age, gender and immunological profile against dengue virus. Moreover, most prevalent serotype of dengue virus is determined by surveying the current data.Results: It is estimated that there were 24,956 lives lost world wide during 2000-2009 as a consequence of dengue infection (DF/DHF/DSS) with an average CFR of 0.24%. These figures are approximate as we have not included the unauthentic source figures from non-reporting (to WHO) countries or not having an official database. A total of 10,178,624 clinical cases had been reported during that period with highest share of Americas of 6,586,785 cases.Conclusion: Our estimate suggests that number of dengue cases got elevated in first decade of 21st century but death rate is not that higher as 2-2.5% which is estimated. Dengue is spreading and finding novel places as temperature and travelling is getting increased

Enteric Fever as an Antecedent to Development of Miller-Fisher Syndrome and Possible Role of COVID-19 Vaccination

Summary: Guillain-Barre Syndrome is an immune-mediated demyelinating disorder. Miller-Fisher Syndrome is an uncommon subtype of GBS. It is characterized by findings of ophthalmoplegia, ataxia, and areflexia. Here we present the case of Miller-Fisher Syndrome following an episode of typhoidal diarrhea. The presentation was of rapidly progressing weakness beginning in the lower extremity with diplopia. Examination revealed diminished reflexes. CSF testing revealed albuminocytologic dissociation which was later supported by neurophysiological testing. The patient was treated with intravenous immunoglobulins (IVIG). We conclude that Miller-Fisher syndrome should be considered in the diagnostic workup of patients presenting with new sensorimotor deficits following diarrheal illnesses and/or COVID-19 mRNA vaccination. Early recognition is essential given the propensity of GBS to cause life-threatening respiratory failure and prompt IVIG administration is associated with a better prognosis. Keywords: Enteric Fever, Miller-Fisher Syndrome, COVID-19, Vaccinatio

Salt tolerance in indica rice cell cultures depends on a fine tuning of ROS signalling and homeostasis

<div><p>Among cereal crops, salinity tolerance is rare and complex. Multiple genes control numerous pathways, which constitute plant’s response to salinity. Cell cultures act as model system and are useful to investigate the salinity response which can possibly mimic a plant’s response to stress. In the present study two indica rice varieties, KS-282 and Super Basmati which exhibited contrasting sodium chloride (NaCl) stress response were used to establish cell cultures. The cell cultures showed a contrasting response to salt stress at 100 mM NaCl. High level of intracellular hydrogen peroxide (H₂O₂) and nitric oxide (NO) were observed in sensitive cell culture for prolonged period as compared to the tolerant cells in which an extracellular H₂O₂ burst along with controlled intracellular H₂O₂ and NO signal was seen. To evaluate the role of NO in inducing cell death under salt stress, cell death percentage (CDP) was measured after 2-4-carboxyphenyl-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (cPTIO) pre-treatment. CDP was reduced significantly in both tolerant and sensitive cell cultures emphasizing NO’s possible role in programmed cell death. Expression analysis of apoplastic NADPH oxidase, i.e. <i>OsRbohA</i> and recently characterised OSCA family members i.e. <i>OsOSCA 1</i>.<i>2</i> and <i>OsOSCA 3</i>.<i>1</i> was done. Intracellular H₂O₂/NO levels displayed an interplay between Ca²⁺ influx and ROS/RNS signal. Detoxifying enzyme (i.e. ascorbate peroxidase and catalase) activity was considerably higher in tolerant KS-282 while the activity of superoxide dismutase was significantly prominent in the sensitive cells triggering greater oxidative damage owing to the prolonged presence of intracellular H₂O₂. Salt stress and ROS responsive TFs i.e. <i>OsSERF1</i> and <i>OsDREB2A</i> were expressed exclusively in the tolerant cells. Similarly, the expression of genes involved in maintaining high [K⁺]/[Na⁺] ratio was considerably higher and earlier in the tolerant variety. Overall, we suggest that a control over ROS production, and an increase in the expression of genes important for potassium homeostasis play a dynamic role in salinity tolerance in rice cell cultures.</p></div

Determination of Renal Changes by Ultrasonography in Patients with Type-2 Diabetes Mellitus

Background: Diabetes Type 2 causes damage to the kidneys; leading to diabetic nephropathy and high blood pressure. The aim of this study is determination of renal changes on ultrasonography in diabetic patients. Objective: This study evaluates changes in kidneys in patients presenting with type II diabetes mellitus having normal renal function test as compared to non-diabetics. Methods: It was a cross sectional descriptive study conducted on 116 patients with type 2 diabetes mellitus by using convenient sampling technique. The study was conducted at Ultrasound Department of Gulab Devi hospital Hospital from July 2019 to September 2019. Results: Out of 116 patients there were 43(37.1%) female and 73(62.1%) were male. The mean age of the participants was 53.24 ±10.49. This study shows that the mean volume of Rt kidney was 1.229E2 ±38.39 ranging from 25ml to 218ml and mean volume of Lt kidney was 1.1691E2 ±41.96 ranging from 26ml to 231ml in patients presenting with DM Type 2 and mean parenchymal thickness of the Rt kidney 14.40 ±6 range from 0.86mm to 1.25mm and Lt kidney 13.7 ±5 range from1.2mm to 25mm.This study showed that mean volume of both kidneys and  parenchymal thickness increased in patients having diabetes mellitus. Conclusion: Ultrasound is a reliable and easily available modality to detect renal changes and complications in earlier stages of Diabetes mellitus. Keywords: Type II diabetes mellitus, Renal changes, Ultrasonography DOI: 10.7176/JHMN/68-07 Publication date: November 30th 201

Alleviative effects of pinostrobin against cadmium-induced renal toxicity in rats by reducing oxidative stress, apoptosis, inflammation, and mitochondrial dysfunction

IntroductionCadmium (Cd) is a highly toxic heavy metal that can be found everywhere in the environment and can have harmful effects on both human and animal health. Pinostrobin (PSB) is a bioactive natural flavonoid isolated from Boesenbergia rotunda with several pharmacological properties, such as antiinflammatory, anticancer, antioxidant, and antiviral. This investigation was intended to assess the therapeutic potential of PSB against Cd-induced kidney damage in rats.MethodsIn total, 48 Sprague Dawley rats were divided into four groups: a control, a Cd (5 mg/kg), a Cd + PSB group (5 mg/kg Cd and 10 mg/kg PSB), and a PSB group (10 mg/kg) that received supplementation for 30 days.ResultsExposure to Cd led to a decrease in the activities of catalase (CAT), glutathione reductase (GSR), superoxide dismutase (SOD), and glutathione peroxidase (GSH-PX), whereas levels of reactive oxygen species (ROS) and malondialdehyde (MDA) increased. Cd exposure also caused a substantial increase in urea, kidney injury molecule-1 (KIM-1), neutrophil gelatinase-associated lipocalin (NGAL), and creatinine levels. Moreover, a noticeable decline was noticed in creatinine clearance. Moreover, Cd exposure considerably increased the levels of inflammatory indices, including interleukin-1b (IL-1b), tumor necrosis factor-a (TNF-a), interleukin-6 (IL-6), nuclear factor kappa-B (NF-kB), inducible nitric oxide synthase (iNOS), and cyclooxygenase-2 (COX-2) activity. Cd treatment decreased the expression of the antiapoptotic markers (Bcl-2) while increasing the expression of apoptotic markers (Bax and Caspase-3). Furthermore, Cd treatment substantially reduced the TCA cycle enzyme activity, such as alpha-ketoglutarate dehydrogenase, succinate dehydrogenase, malate dehydrogenase, and isocitrate dehydrogenase. Moreover, mitochondrial electron transport chain enzymes, succinatedehydrogenase, NADH dehydrogenase, cytochrome c-oxidase, and coenzyme Q-cytochrome reductase activities were also decreased following Cd exposure. PSB administration substantially reduced the mitochondrial membrane potential while inducing significant histological damage. However, PSB treatment significantly reduced Cd-mediated renal damage in rats.ConclusionThus, the present investigation discovered that PSB has ameliorative potential against Cd-induced renal dysfunction in rats

The Impact of Financial, Economic and Environmental Factors on Energy Efficiency, Intensity, and Dependence: The Moderating Role of Governance and Institutional Quality

Economies are under serious pressure to sustain themselves due to globalization, focusing simply on economic growth and operational efficiency will not yield the desired sustainable financial and economic position for economies. Management of energy efficiency and reducing the energy dependence and intensity is the core objective for the economy and achievement of the above objective financial, economic, and environmental factors need to be studied. Economic wellbeing critically depends on the efficient use of energy and which type of governance mechanism is in place will also define the ways toward energy efficiency. A better understanding of the relationship will help the economies to fulfill their energy needs efficiently, realize developmental goals, and overcome environmental issues. This study examines the relationship between financial, economic, and environmental factors with energy efficiency, intensity, and dependency with moderating role of governance including institutional quality and governance index for belt and road initiative countries. The core objective of the study is to analyze which financial, economic, and environmental factors serve well in the management of energy efficiency, intensity, and dependence issues and how various dynamics of governance policies including market structure moderate the above-mentioned relationship. For this secondary data is used from world development indicators, market insiders, and Chicago Board Options Exchange (CBOE) data. This research will help the researchers and practitioners to achieve long-term economic, financial, and environmental sustainability. The proposed model predicts that 0.44% change in Total Factor Energy Productivity measure of Energy Efficiency, 0.03% changes in Energy use/Purchasing Power Parity ratio measure of Energy Intensity, and 9.63% changes in Energy Reserves/Energy Production ratio measure of Energy Dependence. Results also reveal that environmental factors including Rural population, Urbanization, Co2 emission, energy use, and energy production will contribute most to achieving sustainable economic growth

Incidence of Vancomycin Resistant Phenotype of the Methicillin Resistant Staphylococcus aureus Isolated from a Tertiary Care Hospital in Lahore

Staphylococcus aureus (S. aureus)-associated infections are one of the major threats to public health. The aim of the present study was to determine the antibiotic resistance pattern as well as the genetic characterization of methicillin and vancomycin resistant S. aureus (VRSA) isolated from a tertiary care hospital in Lahore. The S. aureus isolates were isolated from dierent clinical samples, identified by biochemical testing, and subjected to antibiotic susceptibility testing via the disc diusion method or broth microdilution method. The methicillin resistance gene (mecA) and vancomycin resistance gene (vanA) were amplified by the polymerase chain reaction. The S. aureus isolates showed high incidences of resistance against methicillin (76%) and moderate incidences of resistance to vancomycin (14%). Isolates were also resistant to several other drugs, such as cefoxitin (76%), ertapenem (83%), ampicillin (81%), tobramycin (78%), moxifloxacin (76%), and tetracycline (74%). An encouraging finding was that 98% of isolates were susceptible to tigecycline, indicating its possible role in the treatment of methicillin-resistant Staphylococcus aureus (MRSA) and VRSA, as well as the multi-drug resistant S. aureus. The mecA gene was detected in 33.3% of tested isolates (10/30), while the vanA gene was also detected in 30% (9/30) of the tested isolates. In conclusion, the frequent presence of methicillin and vancomycin resistance in S. aureus appraises the cautious use of these antibiotics in clinical practices. Furthermore, it is suggested that there should be continuous monitoring of tigecycline treatments in clinical setups in order to delay the development of resistance against it

Fetomaternal Outcome in Women with COVID-19 in a COVID Designated Hospital in Lahore, Pakistan

Background and Objective: The pandemic caused by Coronavirus disease-2019 (COVID-19) is notably becoming similar to severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome viruses (MERS) for causing poor feto-maternal outcome. There is not much data available about COVID-19 during pregnancy in Pakistan therefore the objective of this study is to determine maternal and fetal outcome in pregnant women affected with COVID-19 and to find out frequency of vertical transmission. Methods: This descriptive case series was conducted from 1st April 2020 to 10th May 2020 at Department of Obstetrics and Gynecology, COVID ward, Sir Ganga Ram Hospital, Lahore. A total of 20 women were included in the study that were found positive for viral RNA by Real-Time Reverse TranscriptionPolymerase Chain Reaction (rRT-PCR) of nasopharyngeal specimens. Demographics, duration of gestation, fetomaternal outcome and vertical transmission were noted in the respected proformas. The data was analyzed using Statistical Package for Social Sciences version 20. Results: The mean age of these gravid females was 29.3 &plusmn; 4.17 years. The mean gravidity was 2.60 &plusmn; 1.14 and mean gestational age was 29 &plusmn; 9.53 weeks. Among 20 patients, 4(20%) were primigravida, 5(25%) females were gravida 2 and remaining 11(55%) cases were gravida 3 and 4. The most common presenting complaints were fever followed by dry cough, myalgia and shortness of breath. Nine patients were delivered by lower segment cesarean section in which fetal distress was observed in 5(55.6%) newborns and 1(10%) newborn was preterm. Among all newborns, 02 developed respiratory distress syndrome and were admitted in pediatric intensive care unit. All pharyngeal swabs of newborns were negative at 12 and 24 hours of life. Conclusion: COVID-19 in pregnant females is not different than in general population. The fetomaternal outcome is usually good and there is no evidence of vertical transmission in any newborn.</p