Evaluation of RIPASA and ALVARADO Score for Diagnosis of Acute Appendicitis

Background:To evaluate RIPASA andALVARADO scores for the diagnosis of acuteappendicitis.Methods : In this cross sectional study, patientspresenting with features suggestive of acuteappendicitis and who had undergoneappendectomy, were included. All those patientswhose follow up was not possible withhistopathology reports were excluded .Samplingtechnique was non probability random samplingtechnique.Frequencies , percentages were calculatedfor categorical variables i.e. different parameters ofRIPASA and ALVARDO scoring system. Sensitivityand specificity of both scoring system was checkedkeeping histopathology reports as gold standard .Results :Mean age was 20.2 years. MinimumRIPASA score was 5.5 , maximum 14 ,mean 10.64 andrange turned out to be 8.50 with standard deviationof 1.639. P value for RIPASA score was 0.015 . 155cases had RIPASA score of 7.5 and above . MaximumALVARADO score was 9 and minimum 2 , mean of8.13 and standard deviation of 1.48. Majority(92.5%) had ALVARADO score more than 5 . P valuefor ALVARADO score was 0.001 .The gold standardfor diagnosing acute appendicitis washistopathology report which was positive in90.6%.Sensitivity of RIPASA score 95 %ALVARADO 88 % .Specificity of RIPASA was 21 %while of ALARADO 42 %.Conclusion: RIPASA score >7 and ALVARADO >6 are significant for diagnosing appendicitis.RIPASA is more sensitive but less specific thanALVARADO score for diagnosing acuteappendicitis

Methicillin resistant staphylococcus aureus outbreak in a neonatal intensive care unit

The global and national burden of communicable and noncommunicable diseases continues to rise, thus making access to Healthcare workers (HCWs) colonized with methicillin-resistant Staphylococcus aureus (MRSA) may pose transmission risk to vulnerable patients including neonates. This study reports an MRSA outbreak in a level-II neonatal intensive care unit (NICU) of a secondary care hospital in Pakistan. Once identified, an infection control team from the parent hospital visited the facility, risk factors were listed and infection control measures taken to control the outbreak. Screening cultures of NICU staff and environmental cultures from NICU were obtained for the presence of MRSA. Five neonates were positive for MRSA; one HCW was found to be colonized with MRSA, the antibiogram pattern of which matched with that of the outbreak strain. Decolonization of colonized HCWs and re-deployment from NICU to outpatient department were taken and the outbreak was declared over once no further MRSA cases were identified. Identification of an outbreak situation is the cornerstone for its control and multiple measures taken simultaneously help in curbing the outbreak. Although an epidemiological link was established with the HCW, a molecular link could not be proven

Mechanisms of Bioinformatics

The article plans to acquaint computer researchers with the new field of bioinformatics. The article gives a 10,000 foot perspective of the essential ideas in atomic cell science diagrams the way of the current information, tranquilize revelation representation and portrays the sort of PC calculations and systems that are important to comprehend cell conduct. The points secured include: portrayals of the present programming particularly produced for scholars, PC and numerical cell models, and regions of software engineering that assume a critical part in bioinformatics

Changes in Liver Fibrosis as Determined by FIB-4 Score Following Sofosbuvir-Based Treatment Regimes Without Interferon

Objective: To determine the mean change in liver fibrosis as evaluated using the FIB-4 score following Sofosbuvir based treatment regimens without interferon. Methodology: This prospective observational study was conducted at the Department of Medicine, Federal Government Services Hospital, Islamabad, from January 09, 2019 to January 03, 2020. A total of seventy (n=70) patients of either gender between age 18-75 years who were diagnosed with cases of HCV infection were enrolled in this study. All patients were treated with Sofosbuvir-based treatment regimens and were assessed for liver fibrosis using the FIB-4 score at baseline, at end of treatment (EOT) and 12 weeks after EOT. Results: The mean FIB-4 score at baseline was 2.45±0.42, at EOT was 1.0981±0.33 and at 12 weeks after EOT was 1.51±0.32.  As compared to the baseline, the mean FIB-4 score was significantly lesser at EOT (P=0.001) and at 12 weeks after EOT (P=0.001). A similar trend was observed across all stratified groups, i.e., age, gender, and type of patients (P<0.05 across all groups). Conclusion: The sofosbuvir-based treatment regimen significantly reduced liver fibrosis at EOT and 12 weeks after EOT, as evidenced by FIB-4 scores that were significantly lower than baseline at EOT and 12 weeks after EOT

Optimization of the Real-Time Quaking-Induced Conversion Assay for Prion Disease Diagnosis

The real-time quaking-induced conversion (RT-QuIC) assay is a highly reproducible and robust methodology exhibiting an excellent pre-mortem diagnostic accuracy for prion diseases. However, the protocols might be time-consuming and improvement of the detection technology is needed. In the present study, we investigated the influence of a pre-analytical cerebrospinal fluid (CSF) treatment with proteinase K (PK) on the kinetic of the RT-QuIC signal response. For this purpose, we added PK at different concentrations in RT-QuIC reactions seeded with Creutzfeldt-Jakob disease (sCJD) CSF. We observed that a mild pre-analytical PK treatment of CSF samples resulted in an increased seeding efficiency of the RT-QuIC reaction. Quantitative seeding parameters, such as a higher area under the curve (AUC) value or a shorter lag phase indicated a higher conversion efficiency after treatment. The diagnostic accuracy resulting from 2 mu g/ml PK treatment was analyzed in a retrospective study, where we obtained a sensitivity of 89%. Additionally, we analyzed the agreement with the previously established standard RT-QuIC protocol without PK treatment in a prospective study. Here, we found an overall agreement of 94% to 96%. A Cohen's kappa of 0.9036 (95% CI: 0.8114-0.9958) indicates an almost perfect agreement between both protocols. In conclusion, the outcome of our study can be used for a further optimization of the RT-QuIC assay in particular for a reduction of the testing time

Chromium poisoning in buffaloes in the vicinity of contaminated pastureland, Punjab, Pakistan

This article focuses on the toxic element chromium (Cr) in wastewater, its incorporation into soil plant systems, and its relevant toxicity in the food chain as assessed by a health risk assessment from dietary intake. The Nili Ravi buffalo is an important cattle inhabiting Sargodha, Punjab, Pakistan, and forage crops grown on soils contaminated with Cr might cause toxicity in the food chain by local inhabitants eating meat. The soil, forage and animal blood samples were collected from five different locations in Tehsil Sahiwal (Chak Dhool, Bagabalocha, Chandia, Dhool Bala and Kakrani) twice at six-month intervals. A total of 30 samples from each ecological zone were collected from the soil and forage crops (Zea mays, Sorghum bicolor, Trifolium alexandrinum). The samples from zone-V and zone-IV showed the maximum concentration of Cr because these areas receive highly contaminated water for irrigation. The Cr was greater than the permissible limits. Environmental indices for all samples ranged below 1. The bioaccumulation and pollution load of Cr in soil and forage crops due to wastewater irrigation can contaminate the whole food chain via the soil, forages and animals. The health risk index (HRI) and a high value of enrichment factor were found for Cr in some sites. The Cr concentration was higher during the summer season than winter. Fodder crops with different concentrations and an elevated level of Cr were observed in maize. Attention should be paid when wastewater is used for fodder crop irrigation and its potential risks to human health following dairy product (milk, meat) entry into the food chain.Department of Botany, University of Sargodha, Sargodha, PakistanHigher Education Commission of Pakistan | Ref. #2484/13Princess Nourah bint Abdulrahman University | Ref. PNURSP2022R7

Frequency of Congenital Anomalies in Newborns and Its Relation to Maternal Health in a Tertiary Care Hospital in Peshawar, Pakistan

Background: Congenital anomalies are a major cause of perinatal and neonatal deaths, both in low- and high-income countries. They are relatively common worldwide, affecting 3% to 5% of live births. Methods: A cross-sectional study was conducted from January 2014 to June 2014 at the Khyber teaching hospital in Peshawar. Specific patient information was obtained from patient records at the beginning of the study. Those individuals found to have at least one birth defect were approached and their attendants (mothers) were interviewed. Information regarding various risk factors was collected. Descriptive analyses were carried out. Results: Out of 1062 deliveries, 2.9% (31) of newborns had various congenital anomalies.b Hydrocephalus (22.6%), anencephaly (12.9%), and spina bifida (9.7%) were major anomalies. The maternal age ranged from 18 years to 46 years (mean: 30 ± 8). Most of the anomalies (35.5%) were present in the 26-30 years age group. Out of 31 babies, 6.4% had multiple anomalies. The preponderance of various congenital anomalies was seen in parity 1 (35.4%); parities 2 to 4 had lower incidences (35.4%). The consanguinity rate was 67.7%; only 32.3% of patients were using folic acid. History of passive smoking was positive in 16.1% of cases. Conclusion: Anencephaly and hydrocephalus were the most prominent anomaly detected; early prenatal diagnosis may be helpful in decreasing mortality by offering early termination. Low intake of folic acid and a high consanguinity rate were the most common associated risk factors for congenital anomalies. These risk factors may be reduced by creating awareness regarding the avoidance...

Socio-demographic correlates of betel, areca and smokeless tobacco use as a high risk behavior for head and neck cancers in a squatter settlement of Karachi, Pakistan

BACKGROUND: Head and neck cancers are a major cancer burden in Pakistan. They share a common risk factor profile including regular consumption of products of betel, areca and tobacco. Use of paan, chaalia, gutka, niswar and tumbaku is acceptable in Pakistan and is considered a normal cultural practice. This cross-sectional study was carried out to understand the relation of socio-demographic factors for the consumption of paan, chaalia, gutka, niswar and tumbaku in Pakistani population. Through systematic sampling, 425 subjects from a squatter settlement in Karachi were interviewed using a structured questionnaire. High risk behavior was defined as Daily use of any of the above products. RESULTS: Daily use of all the substances except chaalia was higher among males compared to females. Chaalia use was higher among adolescents than adults while non-married consumed both chaalia and gutka more than married. Mohajir ethnicity had higher prevalence of paan, gutka and tumbaku use while Pathans had higher prevalence of niswar use. CONCLUSION: Prevalence of use of chewable products is high in Pakistan with particularly high use of certain substances related with socio-demographic profiles. Industrially prepared products, chaalia and gutka, are gaining popularity among youth. Policies and focused interventions can be developed taking into consideration the preferred use of products among different socio-demographic groups