Acute mesenteric, portal and inferior vena cava, venous thrombosis, anticoagulation

The prevalence and clinical spectrum of acute mesenteric venous thrombosis (AMVT) in Pakistan is largely unknown. The authors report two patients with acute mesenteric, portal and inferior vena cava venous thrombosis confirmed on CT imaging. The diagnoses were established within 24 hours of presentation and both patients were successfully treated with therapeutic heparin during hospital admission and continued on oral warfarin because of hypercoagulable state. The protocol that we currently use is evidence based and is leading to optimal outcome

Acute mesenteric, portal and inferior vena cava (IVC) venous thrombosis: optimal outcome achieved with anticoagulation

The prevalence and clinical spectrum of acute mesenteric venous thrombosis (AMVT) in Pakistan is largely unknown. The authors report two patients with acute mesenteric, portal and inferior vena cava venous thrombosis confirmed on CT imaging. The diagnoses were established within 24 hours of presentation and both patients were successfully treated with therapeutic heparin during hospital admission and continued on oral warfarin because of hypercoagulable state. The protocol that we currently use is evidence based and is leading to optimal outcome

New Ectomycorrhizas in association with Poplar from Himalayan moist forests of Pakistan

Populinirrhiza pinnata and populinirrhiza khanspurensis are described and illustrated as new ectomycorrhizas from Himalayan moist temperate forests of Pakistan in association with the root system of Populus ciliata. Populinirrhiza pinnata has monopodial pinnate type of ramification. The young mycorrhizas are dark brown while the older ones are black. White sugary crystals are present on mycorrhizal system. Emanating hyphae surround mycorrhizas. Rhizomorphs are thick and branched. Populinirrhiza khanspurensis has a simple to monopodial type of ramification. The color of the young mycorrhiza is brown; some times with dark tips while the older ones are dark brown. Rhizomorph and emanating hyphae are absent. As so far no fungal partner of these mycorrhizas has been identified, these fall under the category of ‘unknown’ and ‘unidentified’ mycorrhizas.&nbsp

Domestication and element analysis of the giant edible Macrocybe gigantea from Pakistan

During a survey of mushrooms of Pakistan, Macrocybe gigantea was collected from University of the Punjab, Lahore, Pakistan under the Morus species. For the domestication of this wild species, its culturability and cultivation potential was assessed by using different synthetic culture media and substrates. Among these different media used, maximum cultural growth was observed on Potato Dextrose Agar (PDA) medium at 30 °C followed by Malt Extract Agar (MEA), Compost Extract Agar (CEA), Glucose Peptone Agar (GPA), and Saboraud Dextrose Agar (SDA). Strains on PDA medium were used for production of spawning material on wheat, sorghum and barleyngrains. Sorghum grains at 30 °C were the best combination for spawn production. A mixed substrate of wheat straw and Tea waste at 30 °C produced the highest yield. Mineral analysis of the wild and cultivated strain revealed that both forms enrich Potassium and Calcium. These findings show that this giant edible mushroom species could be domesticated on the number of media and substrates. Its domestication can provide nutritional, economical, medicinal and tasty food to the growing population that would otherwise be restricted to natural production at a specific time of the year

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

Comparison of Outcome of two different Methods for the treatment of Intra-articular fracture of Distal Radius

Objective: It is to compare the radiological and functional outcome of two different fixation methods for displaced intra articular distal radius fracture (DRF): open reduction and internal fixation with anatomical plate and closed reduction with percutaneous K-wires. Methodology: A randomized controlled trial was conducted in Orthopaedics department, Shaikh Zayed Hospital, Lahore for one year; from April 2017 to March, 2018. Total 90 patients were selected in the study by ‘non-probability, consecutive sampling technique’ with 45 patients in each group of the study; Group-A (fixation method: Open reduction with internal fixation with volar plate) and Group-B (Fixation method: Kirschner-wire known as K-wire). Results: The mean age in the group A and group B was 53.7 ± 11.8 years and 55.2 ± 12.3 years respectively. There were 58 male and 32 females in the study. The differences in volar tilt, radial inclination, radial length and modified Mayo score were significantly better in group A than group B (p-value < 0.05). The differences were not significantly different for articular step off in the two study groups (p-value > 0.05). Conclusion: Open reduction with internal fixation using volar locking plates yielded significantly better radiological and functional outcomes than percutaneous fixation using K-wire in the 6 months’ postoperative period

Comparison of casting versus elastic nail for the treatment of pediatric tibial diaphyseal fractures

Objective: To assess outcomes of Titanium elastic nail (regarding radiologic union, a discrepancy of limb length, malalignment, pain and complications) in treating pediatric tibial fractures in comparison with the traditional Casting method.Methodology: This randomized controlled trial study was conducted in Department of Orthopaedics, Shaikh Zayed Hospital, Lahore through emergency /Outdoor patient department from May 2018 to Feb 2019. The total number of patients were categorized into two groups, 14 each group. In Group A, patients underwent treatment by elastic nails and patients in group B, underwent treatment with cast method. Post op X-Rays (serial) were done and Leg length inequality, Malalignment, pain and radiological union were assessed radiologically. Follow up of the patients was done in the outpatient department of Orthopaedic department after 1,3 and 6 months. The comparison for this among both groups was done by using Chi-square test. P value ≤ 0.05 was considered significant.Results: The mechanism of injury was statistically same in both groups, p-value > 0.05. In group-A, 7(50.0%) cases had Transverse, 4(28.6%) had Oblique and 3(21.4%) cases had comminuted fracture while in group-B there were 5(35.7%) cases who had Transverse, 2(14.3%) had Spiral, 4(28.6%) cases had Oblique and 3(21.4%) cases had Comminuted fracture, p-value > 0.05. In both groups, the leg length inequality, frequency of malalignment, pain severity and complications were statistically same, p-value was > 0.05.Conclusion: Similar outcomes of Titanium elastic intramedullary nailing as compared to cast application in terms of bone union, alignment and infection rates

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Fungal systematics and evolution : FUSE 6

Fungal Systematics and Evolution (FUSE) is one of the journal series to address the “fusion” between morphological data and molecular phylogenetic data and to describe new fungal taxa and interesting observations. This paper is the 6th contribution in the FUSE series—presenting one new genus, twelve new species, twelve new country records, and three new combinations. The new genus is: Pseudozeugandromyces (Laboulbeniomycetes, Laboulbeniales). The new species are: Albatrellopsis flettioides from Pakistan, Aureoboletus garciae from Mexico, Entomophila canadense from Canada, E. frigidum from Sweden, E. porphyroleucum from Vietnam, Erythrophylloporus flammans from Vietnam, Marasmiellus boreoorientalis from Kamchatka Peninsula in the Russian Far East, Marasmiellus longistipes from Pakistan, Pseudozeugandromyces tachypori on Tachyporus pusillus (Coleoptera, Staphylinidae) from Belgium, Robillarda sohagensis from Egypt, Trechispora hondurensis from Honduras, and Tricholoma kenanii from Turkey. The new records are: Arthrorhynchus eucampsipodae on Eucampsipoda africanum (Diptera, Nycteribiidae) from Rwanda and South Africa, and on Nycteribia vexata (Diptera, Nycteribiidae) from Bulgaria; A. nycteribiae on Eucampsipoda africanum from South Africa, on Penicillidia conspicua (Diptera, Nycteribiidae) from Bulgaria (the first undoubtful country record), and on Penicillidia pachymela from Tanzania; Calvatia lilacina from Pakistan; Entoloma shangdongense from Pakistan; Erysiphe quercicola on Ziziphus jujuba (Rosales, Rhamnaceae) and E. urticae on Urtica dioica (Rosales, Urticaceae) from Pakistan; Fanniomyces ceratophorus on Fannia canicularis (Diptera, Faniidae) from the Netherlands; Marasmiellus biformis and M. subnuda from Pakistan; Morchella anatolica from Turkey; Ophiocordyceps ditmarii on Vespula vulgaris (Hymenoptera, Vespidae) from Austria; and Parvacoccum pini on Pinus cembra (Pinales, Pinaceae) from Austria. The new combinations are: Appendiculina gregaria, A. scaptomyzae, and Marasmiellus rodhallii. Analysis of an LSU dataset of Arthrorhynchus including isolates of A. eucampsipodae from Eucampsipoda africanum and Nycteribia spp. hosts, revealed that this taxon is a complex of multiple species segregated by host genus. Analysis of an SSU–LSU dataset of Laboulbeniomycetes sequences revealed support for the recognition of four monophyletic genera within Stigmatomyces sensu lato: Appendiculina, Fanniomyces, Gloeandromyces, and Stigmatomyces sensu stricto. Finally, phylogenetic analyses of Rhytismataceae based on ITS–LSU ribosomal DNA resulted in a close relationship of Parvacoccum pini with Coccomyces strobi.http://www.sydowia.at/index.htmpm2021Medical Virolog