Parental consanguinity increases the risk of congenital malformations

Introduction: Congenital malformation is a physical or structural abnormality present either prenatally or after birth. These anomalies are either primary or secondary malformation. Primary malformations adversely affect body functions, however, the secondary malformations are the structural defects which may have less or no effect on body functions. Primary congenital anomalies show marked variations globally with respect to prevalence. The aim of the current study was to further add to the scientific evidences on the pattern and prevalence of congenital anomalies in cousins and non-cousins’ marriages in Khyber Pakhtunkhwa. Material and Methods: Data of 200 patients (divided into two groups) was collected by convenience sampling through cross-sectional survey. Group-I consisted of 100 gravidas who were diagnosed with anomalous foetus either hydrocephalous, anencephaly or cleft lip/palate and Group-II comprised of infants with inborn heart defects were selected. Results: The study shows 68% consanguineous and 32% non-consanguineous marriages. Hydrocephalous shows the highest rate of incidence (55%) followed by anencephaly (40%) cleft lip/palate (5%), Ventricular Septal Defect (43%), Atrial Septal Defect (29%), Patent Ductus Arteriosus (16%) and Tetralogy of Fallot (12%). The relative risk of hydrocephalus and anencephaly in consanguineous and non-consanguineous marriage was 0.98 while the relative risk of Ventricular Septal Defect and Patent Ductus Arteriosus was 1.1. Rate of miscarriages was comparatively high in cousin marriages. Frequency of CM was higher in multigravida compared to primigravida. Detection rate of hydrocephalus was highest in second trimester, cleft lip/palate in third trimester and anencephaly in first trimester. Conclusion: Parental consanguinity is one of the major risk factors for structural, neurological and cardiac anomalies

STAPHYLOCOCCUS CASSETTE CHROMOSOME MEC TYPING OF METHICILLIN RESISTANT STAPHYLOCOCCUS AUREUS STRAINS PREVAILING IN HAYATABAD MEDICAL COMPLEX, PESHAWAR

Introduction: Methicillin resistance Staphylococcus aureus is a very potential human pathogen, and its significant antibiotic resistance further complicates the management of this pathogen. Methicillin resistance in S. aureus is conferred by the presence of SCCmec elements but there are different types of SCCmec in MRSA which results in the need of typing of SCCmec elements. Material & Methods: This cross-sectional study was conducted to determine the current antibiotic resistance pattern and prevalence of different types of SCCmec elements in the circulating MRSA at Hayatabad Medical Complex, Peshawar. A total of 60 non repetitive MRSA isolates collected from pus aspirate and wound swab were enrolled in the study. All the MRSA isolates were tested by disc diffusion method against the ten antibiotics and further subjected to the SCCmec typing through two multiplex PCR reactions. Results: Out of the total tested MRSA isolates 80% were resistant to Ciprofloxacin, 63.4% to Erythromycin, 58.4% to Gentamicin, 55.0% to Cotrimoxazole, 51.6% to Tetracycline, 48.4% Fusidic acid, 46.6% to Clindamycin, 35.0% to Doxycycline, while Quinupristin/Dalfopristin and Linezolid kill 100% strains of the MRSA included in the study. SCCmec typing of MRSA isolates showed that prevalence of SCCmec type-III was 3.3% (3/60), types-IV was 58.3% (35/60), and type-V was 38.3% (23/60). Conclusion: The studied MRSA showed worrisome resistance, but Quinupristin/Dalfopristin and Linezolid kill all the strains of MRSA. The prevalence of SCCmec types IV and V is very high which indicates that the circulating MRSA clone are community associated, because they harbour SCCmec type IV and V

Salivary oxidative stress and antioxidant capacity in smokeless tobacco (Naswar) users

Naswar, a smokeless tobacco product, commonly consumed in Pakistan, is associated with a 10-fold increase in the risk of oral cancer. However, little is known about Naswar's underlying toxicity mechanisms. The current study aimed to investigate the effects of Naswar use on oral health and salivary parameters. A case-control study was conducted among Naswar users ( =42) and age-matched healthy controls ( =42) in Pakistan in 2019. Participant data were collected using questionnaires. Decayed, missing, and filled teeth (DMFT) scores were computed during clinical examinations. Unstimulated whole saliva was collected to assess salivary flow rate, pH, and salivary total oxidative stress (TOS)/total antioxidant capacity (TAC) using commercially available kits. Participants' oral health parameters were compared between cases and controls using ANOVA. No significant differences were observed between the two groups in terms of age, oral health, and hygiene practices and mean DMFT score. Mean salivary pH and the salivary flow rate was significantly ( <0.001) higher in Naswar users (7.7 and 0.71 mL/minute, respectively) than in non-users (6.95 and 0.52 mL/minute, respectively). Although TOS and TAC were not significantly different between the groups, Naswar users generally had a higher TOS (51.6±42 µmol/L) and lower TAC (0.55±0.18 mmol/L) than non-users (TOS 45.5±38.2 µmol/L and TAC 0.57±0.17 mmol/L). Correlational analysis also revealed a significant positive correlation between DMFT score and Naswar use duration ( =0.796, <0.001) and the number of dips/units consumed each day ( =0.515; <0.001). Habitual Naswar use is associated with increased salivary flow rate, pH, and TOS, and reduced TAC levels in Pakistani adults compared to non-users. The pro-oxidant changes may contribute toward deleterious effects of Naswar use including oral cancer