TO ESTIMATE THE INCIDENCE OF POTENTIAL DRUG-DRUG INTERACTION IN STROKE PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL, TELANGANA

Objective: To determine the frequency and pattern of potential drug-drug interactions in hospitalized stroke patients. Methods: A retrospective study was carried out among patients treated for ischemic and haemorrhagic stroke at a tertiary care hospital, Hyderabad for a period of 1 y. A total of 177 prescriptions were analyzed during the study period. The potential drug-drug interactions were identified using Clinirex software. Results: Among the 177 prescriptions, 63.8% were male and 36.2% were female. Out of 177, 79 % of prescriptions had shown potential drug-drug interactions. The patients prescribed with more than 5 drugs developed higher incidence of drug-drug interactions. Based on severity scale we observed 12% major, 71% moderate and 17% minor drug-drug interactions. The incidence of pharmacodynamic interactions was 68% and the pharmacokinetic interactions were 32%. Conclusion: This study suggests that patients with stroke are frequently exposed to potential drug-drug interactions. The incidence of potential drug-drug interactions was higher in patients above 40 y. Most of the prescriptions contained polypharmacy which may lead to increased risk of hospitalization and higher health care cost. It is essential to identify potential drug-drug interactions especially in elderly patients as early as possible in order to prevent adverse drug reactions and ensure patient’s safety.&nbsp

Pulmonary placental transmogrification associated with adenocarcinoma of the lung: a case report with a comprehensive review of the literature

Pulmonary placental transmogrification (PT) is a rare entity with less than 40 cases reported in the literature. Most reported cases are associated with either bullous emphysema or with pulmonary fibrochondromatous hamartomas. We present only the second case of PT associated with adenocarcinoma of the lung. A 67-year-old female with multiple chronic medical ailments presented with shortness of breath and was found to have a 6-cm mass in the upper lobe of her right lung. A computed tomography (CT) guided core biopsy was performed that showed a well-differentiated adenocarcinoma. Interestingly the normal lung tissue showed placental villous architecture. A unique feature of our case is that the diagnosis was made on a needle core biopsy, unlike all the other cases in the literature. We also provide a comprehensive review of this rare entit

Verify and trust: A multidimensional survey of zero-trust security in the age of IoT

The zero-trust (ZT) model assumes that all users, devices, and network traffic should not considered as trusted until proven. The Zero-trust model emphasizes the importance of verifying and authenticating every user and device, and limiting access to resources based on the principle of least privilege. Under the principle of the zero-trust model, devices are granted access after they have been successfully presented with their authentication credentials and access rights based on different factors, such as user identity, device health, location, and behaviour. Access controls are then continuously evaluated and updated as user properties, locations and behaviour change. The zero-trust model can be applied in various domains (healthcare, manufacturing, financial services, government etc.) to provide a comprehensive approach to cybersecurity that helps organizations to reduce risk and protect critical assets. This paper aims to provide a comprehensive and in-depth analysis of the zero-trust model, its principles, and its applications, as well as to propose recommendations for organizations looking to adopt this approach. We explore the major components of the zero-trust framework and their integration across different practical domains. Finally, we provide insightful discussions on open research issues within the zero-trust model in terms of the security and privacy of users and devices. This paper should help researchers and practitioners understand the importance of a zero-trust framework and adopt the zero-trust model for effective security, privacy, and resilience of their networks

Pulmonary placental transmogrification associated with adenocarcinoma of the lung: a case report with a comprehensive review of the literature

Pulmonary placental transmogrification (PT) is a rare entity with less than 40 cases reported in the literature. Most reported cases are associated with either bullous emphysema or with pulmonary fibrochondromatous hamartomas. We present only the second case of PT associated with adenocarcinoma of the lung. A 67-year-old female with multiple chronic medical ailments presented with shortness of breath and was found to have a 6-cm mass in the upper lobe of her right lung. A computed tomography (CT) guided core biopsy was performed that showed a well-differentiated adenocarcinoma. Interestingly the normal lung tissue showed placental villous architecture. A unique feature of our case is that the diagnosis was made on a needle core biopsy, unlike all the other cases in the literature. We also provide a comprehensive review of this rare entit

Validation of verbal autopsy tool for ascertaining the causes of stillbirth

Objective: To assess performance of the WHO revised verbal autopsy tool for ascertaining the causes of still birth in comparison with reference standard cause of death ascertained by standardized clinical and supportive data.Methods: All stillbirths at a tertiary hospital in Karachi, Pakistan were prospectively recruited into study from August 2006- February 2008. The reference standard cause of death was established by two senior obstetricians within 48 hours using the ICD coding system. Verbal autopsy interviews using modified WHO tool were conducted by trained health workers within 2- 6 weeks of still birth and the cause of death was assigned by second panel of obstetricians. The performance was assessed in terms of sensitivity, specificity and Kappa.Results: There were 204 still births. Of these, 80.8% of antepartum and 50.5% of intrapartum deaths were correctly diagnosed by verbal autopsy. Sensitivity of verbal autopsy was highest 68.4%, (95%CI: 46-84.6) for congenital malformation followed by obstetric complication 57.6%, (95%CI: 25-84.2). The specificity for all major causes was greater than 90%. The level of agreement was high (kappa=0.72) for anomalies and moderate (k=0.4) for all major causes of still birth, except asphyxia.Conclusion: Our results suggest that verbal autopsy has reasonable validity in identifying and discriminating between causes of stillbirth in Pakistan. On the basis of these findings, we feel it has a place in resource constrained areas to inform strategic planning and mobilization of resources to attain Millennium Development Goal

Production, Partial Purification and Characterization of Protease through Response Surface Methodology by Bacillus subtilis K-5

Abstract The aim of present study was the production of protease from local Bacillus subtilis through solid state fermentation. Response Surface Methodology (RSM) was used for the optimization of all the culture conditions. Casein (1% w/v) was used as a substrate in nutrient agar medium for the screening of enzyme production potential and showed maximum zone of clearance (4.6 cm). It was identified as Bacillus subtilis K-5 by genetic identification based on 16S rRNA and blast technology of NCBI. Among culture conditions, incubation temperature, incubation time, pH of the medium and moisture level of the substrate were optimized. Maximum protease production was observed at 37oC, pH 9.0 with incubation time of 36 h and moisture to substrate ratio of 1: 0.75. Maximum protease production of 70.21 U/mL was recorded when wheat bran was used as an agro-industrial substrate. The activity of crude protease was observed 99.63 % at 60oC and pH 10.0 with protein concentration 0.63 mg/mL and specific activity of 111.56 U/mg. Protein contents of 0.57 mg/mL (specific activity of 124.72 U/mg) and protein contents of 0.44 mg/mL (specific activity of 143.65 U/mg) were observed by 70% saturation with ammonium sulphate and gel chromatography, respectively. Line Weaver Burk plot was used to find its Vmax and Km, which were 344. 83 mg/mL/min and 100.04 mg/mL, respectively. The study concluded that Bacillus subtilis K-5 is thermophilic and alkaliphilic strain which produces active protease and can be used as potential microorganism for industries

Characterization of aortic carboxypeptidase-like protein mutations that cause Ehlers-Danlos syndrome

Ehlers-Danlos Syndrome (EDS) is a hereditary connective tissue disease that can cause a wide range of symptoms throughout the body. There are currently 14 different subtypes of EDS based on the molecular genetics of the disease with many subtypes due to mutations in collagen genes. Classical-like Type 2 EDS is caused by mutations in aortic carboxypeptidase-like protein (ACLP), gene name AEBP1. ACLP plays important roles in collagen polymerization, vascular smooth muscle differentiation, and myofibroblast differentiation. There have been multiple ACLP mutations that have been implicated in EDS. Previous studies have shown an ACLP mutation Asn490_Met495delins, a mutation with intron inclusion in the protein, is intracellularly retained and causes endoplasmic reticulum (ER) stress. This study aims to characterize 5 additional human ACLP mutations that cause EDS including Leu642Pro, Asn236Ser, Trp356*, Cys581*, and Arg631* to determine how these proteins disrupt the extracellular matrix (ECM). To achieve this goal, plasmid vectors harboring the desired mutation were generated. Immunofluorescent imaging revealed all mutated proteins remained in the secretory pathway and were properly translocated to the endoplasmic reticulum (ER). Western blot of cell lysate and media sample from cells transfected with the generated plasmid revealed that Leu642Pro was intracellularly retained while Asn236Ser, Trp356*, Cys581*, and Arg631* were secreted from the cell into the extracellular environment. Additionally, ACLP knockout mouse models were generated to further study the role of ACLP in aortic dysfunction observed in some ACLP null EDS patients. These studies provide further information about the molecular mechanisms in which ACLP causes EDS that could be possible targets for intervention in the future.  2025-02-06T00:00:00

Analyzing hematological indices and clinical associations of FLT3 mutation in acute leukemia

Objective: The purpose of this research is to examine the relationship between FLT3 mutation and hematological indices and clinical correlates in patients with severe myelogenous leukemia & acute lymphoblastic leukemia. Study Design: Descriptive Study. Place and Duration: Diagnostic and research Laboratory Liaquat university of Medical and health sciences jamshoro Hyderabad. January 2021 to December 2021. Methods: Total 79 cases of acute leukemia were included in this study. Patients provided written consent for detailed demographics and for self-structure questionnaire. All the data was obtained from laboratory records. The patients' clinico-hematologic and immunophenotypic characteristics were recorded, and the FLT3 mutation was analyzed molecularly. SPSS 24.0 was used to analyze all data. Results: Majority of the patients 44 (55.7%) were males and 35 (44.3%) cases were females. The included patients had mean age 37.21±14.59 years and had mean BMI 23.6±4.18 kg/m2. We found that 48 (60.8%) cases had acute myeloid leukemia (AML) and 31 (39.2%) cases had acute lymphoblastic leukemia (ALL). Frequency of FLT 3 mutations in AML patients was 6 (12.5%) and in ALL patients was 1 (3.2%) after polymerase chain reaction. WBC was the most statistically significant hematological and clinical result connected with FLT3 mutation.&nbsp

Molecular detection of blaOXA-23gene and blaOXA-51 gene in carbapenem resistant strains of Acinetobacterbaumannii in patients with ventilator associated pneumonia at tertiary care hospital

Objective: To evaluate carbapenem resistance and to detect blaOXA-23 and blaOXA-51 genes in carbapenem-resistant acinetobacter baumanii isolates recovered from patients having pneumonia secondry to ventilation. Methods: The cross-sectional study was conducted from July 2017 to June 2018 at the Department of Microbiology, University of Health Sciences, Lahore, Pakistan, and comprised endotracheal aspirates / tracheobroncheal lavage samples from patients irrespective of age and gender who developed pneumonia after being on the ventilator for 48 hrs at the Combined Military Hospital, and Jinnah Hospital, Lahore.  The samples were inoculated on MacConkey and blood agar and aerobically incubated at a temperature of 370C for 18-24 hours. The isolated organisms were further assessed by standard morphological, cultural and biochemical profile. Antibiotic susceptibility was done by Kirby-Bauer disc diffusion method. Carbapenem-resistant acinetobacter baumannii were checked for carbapenemase production using Modified Hodge Test. Conventional polymerase chain reaction and agarose gel electrophoreses were performed to detect blaOXA-23 and blaOXA-51 genes. Data was analysed using SPSS 17. Results: Out of 157 samples, 92(58.6%) yielded growth of bacteria, and, among them, 39(42.4%) were identified as acinetobacter baumannii. All (100%) acinetobacter baumannii cases showed resistance to carbapenem, were producing carbapenemase enzyme, and were positive for blaOXA-51 gene. The blaOXA-23 gene was amplified in 38(97.4%) isolates. Conclusion: BlaOXA-23 gene appeared to be the major cause of carbapenem resistance. Continuous..