Biochemical Markers of Liver Toxicity among Coal Mine Workers of Punjab, Pakistan Suffering from HCV

Hepatitis C is among the leading hepatic disorders in current period through which about 3 % world population has been anguish among them 170 million were diagnosed as persistent carriers. A great range of alteration in liver biochemical parameters were found to be allied with HCV infestation. Current study was designed to evaluate the extent of HCV mediated abnormalities in liver biochemical markers which includes ALT (alanine aminotransferase), AST (Aspartate transaminase), ALP (Alkaline Phosphatase) and serum bilirubin. The study was conducted on coal miners of Punjab province, Pakistan. HCV was primarily diagnosed through one step rapid test device after which positive samples were confirmed through ELISA. Biochemical markers were determined through Autoanalyzer by using standard procedure provided with spinreact kits. Simple linear regression analysis significantly explained 24 %, 56.2 %, 68.8 % and 56 % variance in ALT (alanine aminotransferase), AST (Aspartate transaminase), ALP (Alkaline Phosphatase) and serum bilirubin level among HCV positive coal mine workers respectively. Results have clearly indicated significant correlation between HCV seropositivity and liver biochemical markers. Findings of present study conclude monitoring of liver biochemical markers is crucial during HCV infectivity as it represents the degree of impairment in liver functioning. In addition to this elevation in these diagnostic markers could points toward the presence of HCV in respective individual

Some new lichen records from Pakistan

During a survey of the lichens in the state of Azad Jammu and Kashmir, many specimens were collected from the Jhelum and Neelum valley and characterized using morpho-anatomical, molecular and chemical test methods. Two taxa new for Pakistan, i.e., Physciella chloanta and Xanthoparmelia protomatrae s. l., were found in the collection while Physconia enteroxantha represent range extensions within Pakistan. Morpho-anatomical descriptions, ecology and distribution are provided

A new species of Circinaria (Pertusariales, Megasporaceae) from Pakistan

Circinaria pakistanica sp. nov. is described from the Himalayan moist temperate forests in Pakistan. The morphology, chemistry and ITS sequence support its distinction from other species of this genus. The taxon is characterised by a whitish to blackish grey thallus, greyish white epruinose apothecia, flat to slightly concave areoles, a hymenium 110–200 μm high, large ascospores (22–38 × 18–32 μm) and the absence of pycnidia; it also differs from related species in the ITS region

Effectiveness of Natural Antioxidants against SARS-CoV-2? Insights from the In-Silico World

The SARS CoV-2 pandemic has affected millions of people around the globe. Despite many efforts to find some effective medicines against SARS CoV-2, no established therapeutics are available yet. The use of phytochemicals as antiviral agents provides hope against the proliferation of SARS-CoV-2. Several natural compounds were analyzed by virtual screening against six SARS CoV-2 protein targets using molecular docking simulations in the present study. More than a hundred plant-derived secondary metabolites have been docked, including alkaloids, flavonoids, coumarins, and steroids. SARS CoV-2 protein targets include Main protease (M(Pro)), Papain-like protease (PL(pro)), RNA-dependent RNA polymerase (RdRp), Spike glycoprotein (S), Helicase (Nsp13), and E-Channel protein. Phytochemicals were evaluated by molecular docking, and MD simulations were performed using the YASARA structure using a modified genetic algorithm and AMBER03 force field. Binding energies and dissociation constants allowed the identification of potentially active compounds. Ligand-protein interactions provide an insight into the mechanism and potential of identified compounds. Glycyrrhizin and its metabolite 18-β-glycyrrhetinic acid have shown a strong binding affinity for M(Pro), helicase, RdRp, spike, and E-channel proteins, while a flavonoid Baicalin also strongly binds against PL(pro) and RdRp. The use of identified phytochemicals may help to speed up the drug development and provide natural protection against SARS-CoV-2

Pattern of fall injuries in Pakistan: the Pakistan National Emergency Department Surveillance (Pak-NEDS) study.

Background: We aimed to analyse the frequency and patterns of fall-related injuries presenting to the emergency departments (EDs) across Pakistan.Methods: Pakistan National Emergency Departments surveillance system collected data from November 2010 to March 2011 on a 24/7 basis using a standardized tool in seven major EDs (five public and two private hospitals) in six major cities of Pakistan. For all patients presenting with fall-related injuries, we analysed data by intent with focus on unintentional falls. Simple frequencies were run for basic patient demographics, mechanism of falls, outcomes of fall injuries, mode of arrival to ED, investigations, and procedures with outcomes.Results: There were 3335 fall-related injuries. In cases where intent was available, two-thirds (n = 1186, 65.3%) of fall injuries were unintentional. Among unintentional fall patients presenting to EDs, the majority (76.9%) were males and between 15-44 years of age (69%). The majority of the unintentional falls (n = 671, 56.6%) were due to slipping, followed by fall from height (n = 338, 28.5%). About two-thirds (n = 675, 66.6%) of fall injuries involved extremities, followed by head/neck (n = 257, 25.4%) and face (n = 99, 9.8%). Most of the patients were discharged from the hospital (n = 1059, 89.3%). There were 17 (1.3%) deaths among unintentional fall cases.Conclusion: Falls are an important cause of injury-related visits to EDs in Pakistan. Most of the fall injury patients were men and in a productive age group. Fall injuries pose a burden on the healthcare system, especially emergency services, and future studies should therefore focus on safety measures at home and in workplaces to reduce this burden

Survey of Fasting Blood Glucose levels in New Medical College Entrants of CMH LMC and IOD

Background & Objectives: Our objective was to measure the fasting blood sugar level (BSL) in new college entrants of CMH Lahore Medical College and Institute of Dentistry (CMHLMC&IOD), and to compare if fasting BSL is affected by positive family history of Diabetes Mellitus (DM). Study Design: Observational cross-sectional study. Place & Duration of Study: This study was carried out in CMHLMC&IOD from January,2018 to August, 2018. Methods: Non-probability convenient sampling was used to collect data from 67 medical students (MBBS and BDS) after informed consent. The data was enteredand analyzed using SPSS 20. Results: A total of 67 students were included in the study with mean age of 20.13 + 1.22 years with 44 females and 23 males. The mean fasting BSL was 92.56 10.24 mg/dl. For students with positive family history of DM, mean fasting BSL was 94.10=9.11 and for those with no family history of DM, mean fasting BSL was 90.55 +11.40 mg/dl. Conclusion: Our study concluded that the mean fasting BSL of students with family history of DM was slightlyhigher as compared to those with no family history of DM but remained statistically insignificant at this sample size

Psychosocial problems faced By thalassemia major patients of district Multan, Pakistan

Objective: To identify the psychosocial problems faced by thalassemia major patients in District Multan, Pakistan. Study design: A Cross sectional study Place & duration: The study was carried out at the four thalassemia Centers (i) Amina Blood Foundation (ii) Fatimid blood foundation (iii) Minhaj ul Quran (iv) Thalassemia Centre, CH&ICH Multan, Pakistan from 1st January 2017 to 30st May 2017. Methodology: Two hundred thalassemia major patients were selected through convenient sampling. Young people (age 12-18) suffering from thalassemia major and regularly attending the thalassemia centers were included. Other forms of thalassemia and refusal to participate in the study were excluded. Data was collected through structured interview and analyzed by using SPSS (Statistical Package for Social Sciences) version 21 and Chi square test was used to check the association. The questions related to psychosocial burden of thalassemia e.g. disease burden on their education, time off school, outdoor-indoor games, social activities, government support, hindrance to get blood, people’s attitude, fear of life were asked. Results: Two hundred Thalassemia major patients from four Thalassemia Centres participated in the study. Majority 123 (61.5%) were from Fatimid Foundation Multan whereas 46 (23.0%) patients belonged to Thalassemia Centre of CH&ICH Multan, 19 (9.5%) were from Amina blood foundation and 12 (6.0%) patients belonged to Minhajul Quran Multan. Significant proportion of the respondents consisted of males 114 (57%) while 86 (43%) were females. Majority 106 (53%) of the respondents family monthly income was PKR <20000 per month. Results indicated the significant association between the education level of thalassemia major patients and gender (X2=17.905a), (P=.000). Moreover there was the significant association between the male and female thalassemia patients participation in extracurricular activities (X2 =6.627a ), (P=.007). Conclusions: The study concluded that thalassemia major patients faced psychosocial burden in their life. The finding suggested that psychosocial support as well as medical help should be provided to the thalassemia major patients to minimize their burden. Social worker, doctors, nurses, volunteers must provide the psychosocial support to thalassemia major children and motivate their families

Patients understanding of discharge instructions in the emergency department of a tertiary care hospital in Karachi, Pakistan

Background & Objectives: Good understanding of discharge instructions is an important part of patient care. It includes working diagnosis, treatment plan, self-care, follow up referrals and addressing any concerns. The objective of this study was to assess patients understanding of discharge instructions. Methodology: A prospective, observational study conducted by telephonic interviews of randomly selected patients discharged from the emergency department of Aga Khan University Hospital from January 2013 to June 2013. Four independent emergency physicians listened to those recordings and scored patient understanding as no understanding, partial understanding or complete understanding. Results: A total of 202 patients were interviewed out of which 179 (90.9 %) think they completely understand the discharge instructions. 101 patients (88.6 %) said that the verbal instructions were difficult to understand and only 59.6 % have read the discharge summary. Ninety patients (70.3 %) had complete understanding of their diagnosis however only one fourth knew the expected disease course. For medications instructions it was found that 89 patients (81.7 %) knew the dose, 84 (79.2 %) the duration and 76 (68.5 %) the purpose; however 84 patients (80.0 %) were unaware of side effects. Around half of the patients (47.9 %) were unaware of any self-care required and 44 patients (35.5 %) had no understanding regarding their follow up referral. Only 27 patients (21.6 %) knew return to emergency instructions. Conclusion. Patients appear to be unaware of their lack of knowledge about discharge instructions. Deficits were more with medications side effects and return to emergency instructions. Keywords: Discharge, Instructions, Karachi, Pakista

Disease severity and presentation in children with recent measles epidemic: Karachi, Pakistan

Introduction: Measles is an important vaccine preventable infection. Despite immunization the reported measles related deaths are increased globally. An estimated 164 000 people died from measles in 2008 mostly children under the age of five. Objective: To determine the clinical features and disease severity of measles in children during recent epidemic, presenting to emergency department. Material and Method: The study was conducted at Emergency department (ED) of Aga Khan University from February 2012 to August 2012.The charts of the patients with the diagnosis of “measles” or “suspected measles” were reviewed retrospectively. Data was collected on variables like age, gender, duration of illness, vaccination status and history of contact with index measles case. All the signs and symptoms like fever, rash, vomiting, irritability, drowsiness, and decrease intake were recorded. The duration of hospital stay and disease complications were recorded. Data would be entered and analyzed using SPSS version 19.0. Results: Total 170 children presented to emergency department with suspected measles. The mean age was 22 months, with mostly children (76%) more than 9 month of age. Males were 53.5%. More than half were unvaccinated (53%). History of contact with measles was positive in 9.4%. Fever (67%) and cough (22.4%) were the most common presenting complaints. From ED 77% got admitted. Complications observed were acute gastroenteritis (48%), pneumonia (31.6%), otitis media (3%) and encephalitis(2.2%) respectively Conclusion: Measles is still a common reason for Emergency department visits in children. Improving vaccination in children can prevent morbidity and mortality related to this communicable disease. Keywords: Vaccination, Disease, Children, Emergenc

Taxonomic and phylogenetic study of the genus Diploschistes (Ostropales, Thelotremataceae) reveals one new species from Pakistan

ABSTRACT Diploschistes pakistanicus sp. nov. is described from the Himalayan moist temperate forest, Pakistan. ITS sequences confirm its position within the genus Diploschistes and, together with its morphology and chemistry, suggest that it is separate from other species of this genus. The taxon is characterized by grey to greyish white pruinose thallus, perithecioid-type ascomata, small apothecia 0.1‒0.4 mm wide, hypothecium 20‒25µm thick, ascus of 85‒110 × 9‒17 µm in size, 3‒5 transverse and 2‒4 longitudinal septa in large ascospores 42‒55 × 18‒30; also differing from related species in ITS region