Effect of Implementation of COVID-19 Guidelines on the Lives of Haemophilia Patients Registered with the Haemophilia Treatment Centre, Rawalpindi

Introduction: The development of isolation strategies to prevent spread of COVID -19 could affect the lives of Haemophilia patients beyond the risk of infection. In order to prevent this, the Haemophilia Treatment Centre, Rawalpindi, adopted additional combat strategies including the use of telephonic and video consultations, dispensing medicine at home and single day treatments.Objective: To assess the impact of COVID -19 pandemic and associated lockdown and changes in Standard Operating Procedures (SOPs) on the working of Haemophilia Treatment Centre, Rawalpindi and on the lives of its registered patients.Methods: An observational study was carried out at the Haemophilia Treatment Centre, Rawalpindi, between September, 2019 and August, 2020. Written records of frequency of virtual/physical visits to the Centre, treatment compliance, bleeding episodes, musculoskeletal health, psychosocial health, pain, disability and inhibitor status were obtained from six months pre pandemic and followed prospectively six months into the pandemic.Results: The Haemophilia Treatment remained open and functional throughout the study period. All staff members followed specially developed Haemophilia Treatment Centre guidelines vigilantly. Since telemedicine was encouraged , a rise in telephonic consultations was observed and therefore, no difference in overall visits was observed among the Pre- and Intra- Pandemic eras. The option of at-home dispensing of medicine via courier was available, and therefore, all patients remained treatment compliant. Among patients on Low Dose Prophylaxis (LDP) regimen, no difference in musculoskeletal health, bleeding episodes, inhibitor status, psychosocial health and nutritional status was observed among the two time periods. None of the staff members or patients were affected by the Covid-19.Conclusion: Our study shows that timely anticipation of potential impact of a pandemic and prompt development of modified mechanisms can indeed make the working of a Health Care Centre successful and prevent side effects on the lives of its patients

Isolation of thymoquinone from Nigella sativa L. and Thymus vulgaris L., and its anti-proliferative effect on HeLa cancer cell lines

Purpose: To isolate thymoquinone (TQ) from Nigella sativa L. and Thymus vulgaris L., and investigate its anti-proliferative effect on HeLa cancer cells.Method: Pulverized dried samples of N. sativa seed (100 g) and aerial parts of T. vulgaris (1000 g) were subjected to Soxhlet extraction using methanol and n-hexane combined in different proportions. Thymoquinone (TQ) was then isolated from the extracts using high performance liquid chromatography (HPLC). The isolated TQ was further subjected to Fourier Transform Infrared (FTIR) spectroscopy to identify its functional groups. The anti-proliferative effect of TQ on HeLa cancer cells was evaluated using 3-[4, 5-dimethylthiazol-2-yl]-2,5 diphenyl tetrazolium bromide (MTT) assay.Results: Extract yield from N. sativa was significantly higher than from T. vulgaris, and also increased with increase in the proportion of methanol in the extraction solvent (p < 0.05). Methanol and n-hexane (4:1, v:v) yielded the highest amount of oil, with yields of 15.8 and 9.7 ml/25 g dry weight (d.wt.) from N. sativa and T. vulgaris, respectively. The results obtained from HPLC showed that the concentration of TQ isolated from N. sativa (388.61 μg/ml) was significantly higher than that from T. vulgaris (357.03 μg/ml, p < 0.05). The anti-proliferative effects of TQ standard and TQ isolated from N. sativa on HeLa cancer cells were dose-dependent, and was highest at the lowest concentration. The number of viable cells significantly decreased with increase in TQ concentration (p < 0.01). TQ from N. sativa significantly reduced the number of viable cells even at the lowest concentration when compared to TQ standard (p < 0.05). Cell death was significantly higher in TQ-treated groups than in untreated cancer cells.Conclusion: The results obtained in this study show that N. sativa is a potential source of TQ, with the yield enhanced by modifying the extraction procedure or solvent used. Furthermore, TQ isolated from N. sativa exerts a dose-dependent anti-proliferative effect on HeLa cancer cells.Keywords: Thymoquinone, Nigella sativa, Thymus vulgaris, Anti-proliferative effec

Utilization of malted barley flour as replacement of wheat flour to improve technological, rheological, physicochemical, and organoleptic parameters of fortified breads

Introduction: Flours from cereal grains have the potential to be used in the production of bakery products, especially breads, and the addition of other non–wheat plant materials in the form of flours, extracts and malts has always been the area of interest for food producers. Methods: In this research work, barley grains were converted into barley malt flour (BMF), by adopting a series of processes, including steeping, germination, kilning, drying and milling. With the aim of compensating the role of commercial bread improvers, wheat flour was replaced at 0, 2.5, 5, 7.5, and 10% levels with BMF, to study the effect of BMF on physicochemical and sensory characteristics of bread. Results and discussion: Chemical analysis of flours revealed that ash, fat, moisture, protein and fibers were found greater in BMF and BMF–incorporated composite flours, as compared to wheat flour. Significant increases in water absorption and decrease in dough stability, dough development time and falling number were noticed, as a result of an increase in the replacement level of BMF. Water absorption of control dough was 58.03%, which increased to 58.77% in composite flour having 10% BMF, whereas dough development time, dough stability and α–amylase activity of control, were 6.97 min, 12 min, and 736 s, respectively, which were decreased to 3.83 min, 4.73 min, and 360 s, respectively in composite flour having 10% BMF. The internal and external characteristics of breads obtained the best sensorial score at 5% replacement level of BMF, and deterioration in the quality of breads was noticed, as the level of BMF was further increased to 7.5 and 10%. Hence, breads developed with 5% BMF and 95% wheat flour, were not only nutritionally rich, but were also with optimum physical and sensory features. BMF could prove a useful alternate ingredient of wheat flour, and a cost-effective replacement of commercially available bread improvers, in the breads manufacturing process in replacement of synthetic bread improvers

Intracranial Haemorrhage in Patients with Congenital Bleeding Disorders

Background To study patients with congenital bleeding disorders presenting with intracranial haemorrhage in relation to the severity of bleeding disorder, presenting features, diagnosis, management and complications.Methods: This descriptive study included all the patients who presented with intracranial bleed. Age, gender, type and severity of bleeding disorder, presence of inhibitor, history of trauma, presenting symptoms and signs, diagnosis, management and complications were documented.Results: Out of 659 registered patients, twenty one presented with twenty three episodes of intracranial haemorrhage. Majority of the patients, presenting with intracranial bleed were of Haemophilia A (61.9%). Intracranial haemorrhage was confirmed by computed tomography except in one case that died immediately after arrival at the centre. Headache(85.7%), vomiting (71.4%) and seizures ( 38.1%) were common presentations.Conclusion: Intracranial haemorrhage needs an index of suspicion in patients with bleeding disorders who present with headaches. As adequate treatment prevents morbidity and mortality, efforts should be made for provision of factor concentrates to ensure adequate management

Integrated Nutrient Management Enhances Soil Quality and Crop Productivity in Maize-Based Cropping System

Soil quality deterioration, especially in intensive cropping systems, has become a serious problem for crop productivity; consequently, strategies for sustainable crop production and soil health are urgently required. Experiments on fields were organized to investigate the impact of organic manures on crop productivity, soil physiochemical properties and soil water availability in a maize-based cropping system. The experiment consisted of five treatments, including organic manures (OM) and inorganic nitrogen, phosphorus and potassium (NPK) fertilizers applied separately and in combinations: NPK = 250-150-125 Kg/ha (recommended rate), farmyard manure (FYM) = 16 t/ha, poultry manure (PM) = 13 t/ha, NPK + FYM = 150-85-50 Kg/ha + 8.5 t/ha and NPK + PM = 150-85-50 Kg/ha + 7.0 t/ha. The results showed that the combination of OM with mineral fertilizers increased crop productivity, fertilizer use efficiency and yield sustainability indices over the treatments amended with sole application of mineral fertilizers and OM. The analysis of undisturbed soil samples during different crop growth stages revealed that the addition of OM decreased the bulk density and increased the pore volume of soil at the beds of 0–20 and 20–40 cm. The application of OM to the soil not only increased saturated hydraulic conductivity of the soil but also improved total available and readily available water contents to the plants, especially when FYM was included at 16 t ha−1. Soil-water retention properties recorded over the entire seven-day monitoring period following irrigation in the OM-amended treatments were consistently higher than the sole mineral NPK application treatments. When testing the soil nutrient status during different crop growth stages, it was noted that by adding OM into the soil not only the status of the organic carbon of soil, extractable N and K and available P contents is increased, but the duration of their availability to the plants are also enhanced. The results of the study show that organic manures addition is of major significance for maintaining soil quality and crop production sustainably, and should be advocated in the nutrient management strategies of intensive water- and nutrient-demanding cropping systems