Pro-Calcitonin and C Reactive Protein as Marker of Infection: Evaluation of Systemic Inflammatory Response Syndrome (SIRS) in Patients with Normal and Impaired Renal Function

Background: To investigate Pro-Calcitonin (PCT) and C reactive protein (CRP) as a predictor of infectious systemic inflammatory response syndrome (SIRS) in patients with normal and impaired renal function.Methods: In this cross-sectional study >18 year old patients with features suggestive of SIRS were included.PCT and CRP were done on the first day of admission. Based on clinical features and results of cultures, patients were divided into non-infection and infection (sepsis) groups. Based on glomerular filtration rate (GFR) patients were further divided to Group A (GFR ≥60ml/min) and Group B (GFR <60ml/min).Receiver operating characteristic (ROC) curve was used for statistical analysis.Results: Out of 740 patients, 48.3% were diagnosed to be suffering from infection (sepsis). GFR of 50.8% patients was ≥ 60 ml/min/1.73m2 (Group A), and GFR of 364 (49.2%) patients was < 60 ml/min/1.73m2(Group B).For prediction of infection in SIRS patients, ROC curve based AUC for PCT in all, Group A, and Group B patients was 0.84, 0.86, and 0.71 respectively. Similarly for CRP AUC was 0.81, 0.78, and 0.83 respectively. Best cut off value of PCT predicting the infectious cause of SIRS in all, Group A, and Group B patients was 0.24, 0.13, and0.93 ng/mL respectively. Similar best cut off value of PCT for all, Group A and B patients were 13.10 and 11.10 mg/L respectively.Conclusion: Initial PCT≥ 0.24ng/mL and CRP ≥ 13.10 mg/L are predictors of sepsis in SIRS patients. PCT is a better predictor for patients with normal and CRP better predictor for patients with deranged renal function

An Investigation Of Foreign Language Classroom Anxiety And Its Relationship With Students Achievement

The present study examines anxiety in English undergraduate classes with regard to the type of situations that provoke anxiety during different stages of the learning process and the relationship of anxiety with learners’ achievement. Participants of the study include 149 undergraduates enrolled in second and sixth semester of different departments of University of Sargodha who are learning English as a foreign language. The questionnaire used in this study is the abbreviated form of Foreign Language Classroom Anxiety Scale (FLCAS). An inventory is also used to determine different situations that provoke anxiety. Finally, students’ GPA in English classes is taken to find its relationship with language anxiety. The results show that language anxiety and achievement are negatively related to each other. It is also found that female students are lessanxious in learning English as a foreign language than male students. ‘Speaking in front of others’ is rated as the biggest cause of anxiety followed by ‘worries about grammatical mistakes’, ‘pronunciation’ and ‘being unable to talk spontaneously’. It is suggested that the classroom environment should be encouraging and motivating. Moreover, teachers need to deal with anxiety-provoking situations carefully

Wheat Antioxidants, Their Role in Bakery Industry, and Health Perspective

Wheat grains and its fractions contain significant level of antioxidant activity and many phytochemicals, such as phenolic acids (ferulic and vanillic acids), carotenoids, and tocopherol are beneficial in curing many disorders. The beneficial phytochemicals are mostly present in aleurone fraction of wheat bran. The phytochemicals and antioxidants present in wheat have several health benefits, such as their ability to act as antioxidants, immunoenhancers, and inhibitors of certain lesions, which have been demonstrated for phenolic. Many wheat antioxidants are similar to the antioxidants present in wheat, but their characteristics are also unique in nature. The regular consumption of these antioxidant compounds in whole grains is associated with a reduced risk of many heart diseases and several forms of cancers and improves the regulation of blood glucose. Wheat antioxidants play a vital role in bakery industry mostly in bread industry. People are getting aware to use the bakery products that are prepared from the white flour due to proper nutrition, healthy lifestyle, improved nutritional composition, and functional properties. In nutshell, wheat antioxidants including phytochemicals synergistically improve the health status of consumers by consuming the products having complete nutrition

Studies towards the synthesis of (±)-reserpine: Photocyclization mediated a novel and efficient synthesis of 11,18-dimethoxy-(20α)-18,19-didehydro-yohimban-17-one

A short, highly efficient synthesis of advanced intermediates to reserpine 1 has been developed starting from enamide 8. The enamide underwent photocyclization reaction using high pressure mercury lamp to afford the lactam 9 in excellent yield. Then lactam was reduced to the required amine 10, which upon acidic hydrolysis gave the nonconjugate ketone product 11, followed by reaction with sodium hydroxide resulted the desired conjugate ketone 12. Epoxidation, and then ring opening of the epoxide 13 with methanol yielded the desired product 14, which is key intermediate to the total synthesis of (±)-reserpine

PHENOTYPIC AND GENOTYPIC CHARACTERISTICS OF PROGRESSIVE FAMILIAL INTRAHEPATIC CHOLESTASIS TYPE 3 IN PEDIATRIC POPULATION IN PAKISTAN

OBJECTIVE: To determine the phenotypic and genotypic characteristics of progressive familial intrahepatic cholestasis (PFIC) type 3 in Pakistani children in a hospital setting. METHODS: This cross-sectional observational study was conducted at department of Pediatrics Gastroenterology & Hepatology, The Children’s Hospital Lahore, Pakistan from October 2020 to March 2021. Patients of either sex under 16 years of age presenting with jaundice, pruritus, neonatal cholestasis or with chronic liver and gamma glutamyl transferase >100 IU/ml were included in the study after taking informed consent by parents. For Molecular genetics 2ml blood in EDTA was sent to an international laboratory free of cost on research basis. Reports were assessed and levels were noted and genetic coding was also recorded. Data was entered and analyzed in SPSS version 22. Molecular data was interpreted with the help of clinical geneticist. RESULTS: Out of 34 children, 14 (41.2%) were males and 20 (58.8%) were females. Mean age of children was 6.71±3.10 years. Consanguinity was noted in 32 (94.1%) parents having positive family history in 24 (70.6%) cases. The most common mutation was c. 1783C>T p.(Arg595*),  noted in 12 (35.3%) cases, followed by c. 2861G>T p.(Gly954 ASP) [8 (23.5%) cases], c. 153G>A p.(Trp51) [3 (8.8%) cases], c. 1714 C>T p.(Gln572*) c. 1906C>T p. (Gln636), c. 3220G>A p.(Gly1074Arg, c. 3433del p. (val1145Leufsx7)  in 2 (5.9%) cases each, c. 3859 C>T p.(1287Argext*) c. 88-91del p.(Lys30gly fsx7) and c. 1429c>T p. (Gln477) in one (2.9%) case each. CONCLUSION: Children with PFIC type 3 have variable phenotypic and genotypic presentation

Effect of In Vitro Digestion on the Antioxidant and Angiotensin-Converting Enzyme Inhibitory Potential of Buffalo Milk Processed Cheddar Cheese

The purpose of this study was to develop an in-vitro digestion protocol to evaluate the antioxidant potential of the peptides found in processed cheddar cheese using digestion enzymes. We first studied antioxidant and angiotensin-converting enzyme (ACE) inhibition and antioxidant activities of processed cheddar cheese with the addition of spices e.g., cumin, clove, and black pepper made from buffalo milk and ripened for 9 months. Then we conducted an in vitro digestion of processed cheddar cheese by gastric and duodenal enzymes. Freeze-dried water (WSE) and ethanol-soluble fractions (ESE) of processed cheddar cheese were also monitored for their ACE inhibition activity and antioxidant activities. In our preliminary experiments, different levels of spices (cumin, clove, and black pepper) were tested into a cheese matrix and only one level 0.2 g/100 g (0.2%) based on cheese weight was considered good after sensory evaluation. Findings of the present study revealed that ACE-inhibitory potential was the highest in processed cheese made from buffalo milk with the addition of 0.2% cumin, clove, and black pepper. A significant increase in ACE-inhibition (%) of processed cheddar cheese, as well as its WSE and ESE, was obtained. Lower IC50 values were found after duodenal phase digestion compared to oral phase digestion

1-Azido-N′-(phenylsulfonyl)methan­imid­amide

In the title compound, C7H7N5O2S, the aromatic ring is oriented at dihedral angles of 79.46 (2) and 89.17 (2)°, respectively, with respect to the amino­(azido)­methyl and the S(6) six-membered ring motif generated by an intra­molecular N—H⋯O inter­action [N⋯O = 2.8901 (15) Å]. Inter­molecular N—H⋯O hydrogen bonds [N⋯O = 2.9177 (15) and 2.9757 (15) Å] generate an infinite one-dimensional network along the base vector (010)

Frequency of Different Types of Focal Hepatic Lesions on Triphasic Computed Tomography Scan in Adult Patients

Out of various pathologies that affect the liver, focal liver lesion form an important group. Triphasic computed tomography is the imaging modality most often used to evaluate focal liver lesions. The purpose of this study was to evaluate the role of computed tomography in the diagnosis of liver lesions and to determine frequency of these lesions.Keywords: Liver, focal lesion, liver parenchyma, enhancement, iso-dense, hypo-dense and hyper-denseDOI: 10.7176/JHMN/77-04Publication date:July 31st 202

Post-Flood Rehabilitation of Affected Communities by NGOs in Punjab, Pakistan-Learning Lessons for Future

Flood is one of the most frequently occurring disasters in the world which causes loss of thousands of human lives and properties worth millions of dollars. Pakistan faced severe flood during the year 2010. Most of the damage occurred in Punjab, the most populous province of the country. The federal and provincial governments attempted to rescue people and to restore/provide shelter. But both could not meet public expectations due to lack of institutional capacity and financial resources. In this situation, several NGOs took part in rehabilitation of affected communities on existing as well as new sites. Two of such communities have been taken as case studies. A detailed investigation reveals that NGOs played very effective role in improving living conditions and quality of life in affected communities. Resultantly, a vast majority of residents is satisfied. Some issues pertaining to the rehabilitation process and maintenance of settlements have also surfaced. Nevertheless, the experience of NGOs in this regard demonstrates many attributes of good rehabilitation strategy which are worth considering by other countries.    &nbsp