Outcome of Acute Peritonitis Related To Cause and Duration Of Presentation

Objective: To determine the outcome of acute cause-related peritonitis correlated with the duration of inflammation within 24, 24-48, and after 48 hours of hospital admission. Methodology: This quasi experimental study was conducted at Surgical Ward #3, Jinnah Postgraduate Medical Centre from September 2019 to March 2021. Patients over 12 years old were included in this study. The duration, cause, and outcomes of peritonitis were noted. All complications were recorded and treated accordingly. Results: 136 patients between the ages of 13 to 80 years old were included, 104 were males (76.8%) and 32 females (23.18%). 37 patients (28.2%) were aged 13–20 years, 61 (44.2%) were aged 21–40, 33 (23.91%) were aged 41–60, and 5 (3.6%) were aged over 60 years. Mortality showed 2 patients (1.47%) expired in 24–48 hours, and 6 (4.4%) in 48 hours.  The cause of peritonitis included typhoid ileal perforation (41%), duodenal perforation (33%), ruptured appendix (28%), intestinal tuberculous (14%), gangrenous gut (7%), tumour perforation (6%), liver abscess (3%), and gastric perforation and rectal tear (1%). Notably, 2.4% of patients with typhoid peritonitis, 3.0% with duodenal perforation, 3.5% with ruptured appendix, 14.2% with tuberculous intestine, 33.3% with tumour perforation, and 100% with liver abscess perforation passed. Paralytic ileus (8%) and burst abdomen (8%), were the most common complications. Conclusion: Typhoid ileal perforation was the major cause of peritonitis, and paralytic ileus and burst abdomen were the most common complications contributing to the mortality rate

Novel ZnO:Ag nanocomposites induce significant oxidative stress in human fibroblast malignant melanoma (Ht144) cells

The use of photoactive nanoparticles (NPs) such as zinc oxide (ZnO) and its nanocomposites has become a promising anticancer strategy. However, ZnO has a low photocatalytic decomposition rate and the incorporation of metal ions such as silver (Ag) improves their activity. Here different formulations of ZnO:Ag (1, 3, 5, 10, 20 and 30% Ag) were synthesized by a simple co-precipitation method and characterized by powder X-ray diffraction, scanning electron microscopy, Rutherford back scattering and diffuse reflectance spectroscopy for their structure, morphology, composition and optical band gap. The NPs were investigated with regard to their different photocatalytic cytotoxic effects in human malignant melanoma (HT144) and normal (HCEC) cells. The ZnO:Ag nanocomposites killed cancer cells more efficiently than normal cells under daylight exposure. Nanocomposites having higher Ag content (10, 20 and 30%) were more toxic compared to low Ag content (1, 3 and 5%). For HT144, under daylight exposure, the IC50 values were ZnO:Ag (10%): 23.37 μg/mL, ZnO:Ag (20%): 19.95 μg/mL, and ZnO:Ag (30%): 15.78 μg/mL. ZnO:Ag (30%) was toxic to HT144 (IC50: 23.34 μg/mL) in dark as well. The three nanocomposites were further analyzed with regard to their ability to generate reactive oxygen species (ROS) and induce lipid peroxidation. The particles led to an increase in levels of ROS at cytotoxic concentrations, but only HT144 showed strongly induced MDA level. Finally, NPs were investigated for the ROS species they generated in vitro. A highly significant increase of 1O2 in the samples exposed to daylight was observed. Hydroxyl radical species, HO•, were also generated to a lesser extent. Thus, the incorporation of Ag into ZnO NPs significantly improves their photo-oxidation capabilities. ZnO:Ag nanocomposites could provide a new therapeutic option to selectively target cancer cells

Association analysis of GWAS and candidate gene loci in a Pakistani population with psoriasis.

Psoriasis is a common inflammatory and hyper proliferative condition of the skin and a serious chronic systemic autoimmune disease. We undertook an association study to investigate the genetic etiology of psoriasis in a Pakistani population by genotyping single-nucleotide polymorphisms (SNPs) previously reported to be associated in genome-wide association (GWAS) or in candidate gene studies of psoriasis. Fifty seven single-nucleotide polymorphisms (SNPs) from 42 loci were genotyped in 533 psoriasis patients and 373 controls. Our results showed genome wide significant association of the MHC region (rs1265181 being the most significant from five SNPs used with overall OR=3.38; p=2.97E-18), as well as nominally significant associations at ten other loci (

Molecular Diagnosis of Fragile X Syndrome in Subjects with Intellectual Disability of Unknown Origin: Implications of Its Prevalence in Regional Pakistan

<div><p>Fragile-X syndrome (FXS) is the most common form of inherited intellectual disability (ID) and affects 0.7–3.0% of intellectually compromised population of unknown etiology worldwide. It is mostly caused by repeat expansion mutations in the <i>FMR1</i> at chromosome Xq27.3. The present study aimed to develop molecular diagnostic tools for a better detection of FXS, to assess implementation of diagnostic protocols in a developing country and to estimate the prevalence of FXS in a cohort of intellectually disabled subjects from Pakistan. From a large pool of individuals with below normal IQ range, 395 subjects with intellectual disability of unknown etiology belonging to different regions of the country were recruited. Conventional-PCR, modified-PCR and Southern blot analysis methods were employed for the detection of CGG repeat polymorphisms in the <i>FMR1</i> gene. Initial screening with conventional-PCR identified 13 suspected patients. Subsequent investigations through modified PCR and Southern blot analyses confirmed the presence of the <i>FMR1</i> mutation, suggesting a prevalence of 3.5% and 2.8% (mean 3.3%) among the male and female ID patients, respectively. These diagnostic methods were further customized with the in-house conditions to offer robust screening of referral patients/families for diagnostics and genetic counseling. Prescreening and early diagnosis are crucial for designing a prudent strategy for the management of subjects with ID. Outcome of the study recommends health practitioners for implementation of molecular based FXS diagnosis in routine clinical practice to give a better care for patients similar to the ones included in the study.</p></div