COVID-19 leading to amputation in an eleven-year-old: A Case Report

COVID-19 is an ongoing pandemic and all age groups are affected by SARS-CoV-2. Past studies showed that children are less affected by it and symptoms are quite variable as compared to adults. Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki-like illness are observed along with COVID-19 associated multi-organ failure, acute respiratory distress syndrome (ARDS), and coagulopathy in the paediatric age group. Thrombotic complications in patients with COVID-19 have variable presentation including venous thromboembolism and ischemic complications related to thrombosis of extremity, cerebral, coronary, and distal arteries. Early recognition of acute limb ischemia and treatment can help to reduce mortality and maximize the chance of limb salvage. Here, we report a case of 11 years old child who developed gangrene of bilateral lower limbs after mild COVID-19 illness that ended in below-knee amputation

Job Satisfaction of University Teacher’s: A Study on Private University in Bangladesh

The aim of this article is to evaluate the job satisfaction of the faculty of private University in Bangladesh. Salary and fringe benefit, opportunity for scholarly pursuit, course load quality students, office and lab facilities, independency about work, professional relationship and interaction with other faculties, job security, relationship with administration, opportunity to develop new ideas, relationship with immediate superior/dept. head/Pro-VC/VC and opportunity for promotion etc significantly influence job satisfaction of faculty members in Private Universities in Bangladesh. In this study, it is found that only 8 percent are very satisfied about their job. 45, 40, 3.33 and 3.33 percent respondents are satisfied, neutral, very dissatisfied and dissatisfied respectively about their job.So, the respective University authority should take necessary steps such as a raise in the salary, opportunities given to do research, proper recognition given to the faculties, better quality of students must be taken, administration system must be improved and proper and solid criteria for promotion can be introduced and shared with all the faculties. Keywords: Job satisfaction, working environment, job security, salary and fringe benefits, teaching loa

Early Bubble Continuous Positive Airway Pressure Therapy for Premature Neonates with Respiratory Distress Syndrome

Objective: To determine the outcome of preterm neonates with the early introduction of bubble continuous positive airway pressure (CPAP). Methodology: This observational study was conducted in NICU of Shifa International Hospital, Islamabad from March 2017 to August 2017. Ninety preterm infants were enrolled with a gestational age of 28 to 37 weeks and with the clinical features of Respiratory Distress Syndrome (RDS). Infant variables that were recorded were birth weight, gestational age, and severity of RDS and Fio2 requirement. Bubble CPAP was started at 5cm of water and FiO2 adjusted to maintain SpO2 of 87 to 95%. The SPSS 26 version was used to analyze data. The Chi square test was used, with a P value of <0.05 considered significant. Results: The study included 90 neonates who were clinically diagnosed with RDS. To treat RDS, CPAP was started at the mean age of 5.27 hours of life with a standard deviation of 2.66 hours. 11 out of 90 (11.22%) babies had chest X-ray findings in favor of severe RDS; while X-rays of the remaining 79 (88.78%) showed mild to moderate RDS. Conclusion: CPAP is of valuable importance in low resource countries with a lack of ventilators and provides an adequate and conservative treatment method of mild to moderate RDS for preterm neonates. However, in cases of severe RDS, intubation and mechanical ventilation are often necessary

Dietary Calcium Intake, Vitamin D Status, and Bone Health in Postmenopausal Women in Rural Pakistan

The high prevalence of osteoporosis in Pakistan is of public-health concern. However, there is a paucity of information regarding nutrition and bone density in rural communities. The purpose of this study was to evaluate the dietary and lifestyle factors that impact bone health in Nahaqi. Data were collected from 140 postmenopausal women using an interviewer-administered 24-hour dietary recall questionnaire. Bone mineral density was estimated using the quantitative ultrasound index (QUI). Serum 25(OH)D was measured in fasting blood samples. The QUI scores revealed that 42% and 29% of the women had T-scores, indicative of osteopaenia and osteoporosis respectively. The mean calcium intake was 346 mg/d, which is less than 50% of the recommended daily intake. The QUI correlated with 25(OH)D after controlling for age (p=0.021, r=0.41, r2=0.168). Vitamin D deficiency and low intake of dietary calcium are two key factors contributing to poor bone health in this population

Impact of Nitrogen and Phosphorous Fertilizer on Growth, Yield and Yield Contributing Factors of Okra (Abelmoschus esculentus L.) Under Conditions of Mansehra, Pakistan

A field experiment was conducted at National Tea and high Value crops Research  Institute Shinkiari (Mansehra), Pakistan during 2014 to evaluate the effect of nitrogen and phosphorus on yield and yield components of Okra (Var: Sabz Pari)  The experiment was laid out in a Randomized Complete Block Design with split plot arrangement having three replicates various levels of nitrogen and phosphorus were included, namely T1(0-0), T2(100-60 ), T3(100-90), T4(100-120), T5(150-60), T6(150-90) and  T7(150-120) NP kg/ha. Urea and single superphosphate (SSP) were used as source of nitrogen and phosphorus, respectively. Significant response of various levels of nitrogen and phosphorus were observed. Results revealed that maximum days to 50 % emergence (6.66) were recorded in T1 as compared to 5 days to emergence in T7. Maximum germination percentage (89.66), days to 50% flowering (46), days to first fruits picking (49), plant height at first picking (81.66cm), No. of Pod per plant (23.33), were recorded in T7.  The lowest 84.33% germination, 43.33 days to 50% flowering, 49.33 days to first fruits picking, 61 cm plant height at first picking, 13.33 No. of pod per plant and 37.33 No. of seeds per pod were recorded in T1.  Maximum pod length (16.16 cm) and pod diameter (2.03 cm) was recorded in Treatment (T3) as compared to 12.50 cm pod length and 1.59 cm pod diameter in T1. Maximum 1000 seed weight of 59.06 g was recorded in T6 while minimum 1000 seed weight of 49.50 g was recorded in T1.  Maximum fruits yield (10.48 tons ha-1) was recorded in T6, followed by T3, T5 while T1 produced the lowest fruits yield of 6.99 tons ha-1.  It was concluded that application of N and P @ 150 kg N ha-1 + 90 kg P ha-1 in combination resulted in higher yield of Okra

TCT-613 A Prospective Randomized Multi-Center Trial to Assess the Everolimus-Eluting Stent System (Promus Element) for Coronary Revascularization in a Population of Unrestricted Patients

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Dietary Calcium Intake, Vitamin D Status, and Bone Health in Postmenopausal Women in Rural Pakistan

The high prevalence of osteoporosis in Pakistan is of public-health concern. However, there is a paucity of information regarding nutrition and bone density in rural communities. The purpose of this study was to evaluate the dietary and lifestyle factors that impact bone health in Nahaqi. Data were collected from 140 postmenopausal women using an interviewer-administered 24-hour dietary recall questionnaire. Bone mineral density was estimated using the quantitative ultrasound index (QUI). Serum 25(OH)D was measured in fasting blood samples. The QUI scores revealed that 42% and 29% of the women had T-scores, indicative of osteopaenia and osteoporosis respectively. The mean calcium intake was 346 mg/d, which is less than 50% of the recommended daily intake. The QUI correlated with 25(OH)D after controlling for age (p=0.021, r=0.41, r2=0.168). Vitamin D deficiency and low intake of dietary calcium are two key factors contributing to poor bone health in this population

Alterations in the transcriptome and antibiotic susceptibility of Staphylococcus aureus grown in the presence of diclofenac

<p>Abstract</p> <p>Background</p> <p>Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) which has been shown to increase the susceptibility of various bacteria to antimicrobials and demonstrated to have broad antimicrobial activity. This study describes transcriptome alterations in <it>S. aureus </it>strain COL grown with diclofenac and characterizes the effects of this NSAID on antibiotic susceptibility in laboratory, clinical and diclofenac reduced-susceptibility (Dc^RS) <it>S. aureus </it>strains.</p> <p>Methods</p> <p>Transcriptional alterations in response to growth with diclofenac were measured using <it>S. aureus </it>gene expression microarrays and quantitative real-time PCR. Antimicrobial susceptibility was determined by agar diffusion MICs and gradient plate analysis. Ciprofloxacin accumulation was measured by fluorescence spectrophotometry.</p> <p>Results</p> <p>Growth of <it>S. aureus </it>strain COL with 80 μg/ml (0.2 × MIC) of diclofenac resulted in the significant alteration by ≥2-fold of 458 genes. These represented genes encoding proteins for transport and binding, protein and DNA synthesis, and the cell envelope. Notable alterations included the strong down-regulation of antimicrobial efflux pumps including <it>mepRAB </it>and a putative <it>emrAB/qacA</it>-family pump. Diclofenac up-regulated <it>sigB </it>(σ^B), encoding an alternative sigma factor which has been shown to be important for antimicrobial resistance. <it>Staphylococcus aureus </it>microarray metadatabase (SAMMD) analysis further revealed that 46% of genes differentially-expressed with diclofenac are also σ^B-regulated. Diclofenac altered <it>S. aureus </it>susceptibility to multiple antibiotics in a strain-dependent manner. Susceptibility increased for ciprofloxacin, ofloxacin and norfloxacin, decreased for oxacillin and vancomycin, and did not change for tetracycline or chloramphenicol. Mutation to Dc^RSdid not affect susceptibility to the above antibiotics. Reduced ciprofloxacin MICs with diclofenac in strain BB255, were not associated with increased drug accumulation.</p> <p>Conclusions</p> <p>The results of this study suggest that diclofenac influences antibiotic susceptibility in <it>S. aureus</it>, in part, by altering the expression of regulatory and structural genes associated with cell wall biosynthesis/turnover and transport.</p

Alterations In the Transciptome and Antibiotic Susceptibility of \u3ci\u3eStaphylococcus aureus\u3c/i\u3e Grown In the Presence of Diclofenac

Background Diclofenac is a non-steroidal anti-inflammatory drug (NSAID) which has been shown to increase the susceptibility of various bacteria to antimicrobials and demonstrated to have broad antimicrobial activity. This study describes transcriptome alterations in S. aureus strain COL grown with diclofenac and characterizes the effects of this NSAID on antibiotic susceptibility in laboratory, clinical and diclofenac reduced-susceptibility (DcRS) S. aureus strains. Methods Transcriptional alterations in response to growth with diclofenac were measured using S. aureus gene expression microarrays and quantitative real-time PCR. Antimicrobial susceptibility was determined by agar diffusion MICs and gradient plate analysis. Ciprofloxacin accumulation was measured by fluorescence spectrophotometry. Results Growth of S. aureus strain COL with 80 μg/ml (0.2 × MIC) of diclofenac resulted in the significant alteration by ≥2-fold of 458 genes. These represented genes encoding proteins for transport and binding, protein and DNA synthesis, and the cell envelope. Notable alterations included the strong down-regulation of antimicrobial efflux pumps including mepRAB and a putative emrAB/qacA-family pump. Diclofenac up-regulated sigB (σB), encoding an alternative sigma factor which has been shown to be important for antimicrobial resistance. Staphylococcus aureus microarray metadatabase (SAMMD) analysis further revealed that 46% of genes differentially-expressed with diclofenac are also σB-regulated. Diclofenac altered S. aureus susceptibility to multiple antibiotics in a strain-dependent manner. Susceptibility increased for ciprofloxacin, ofloxacin and norfloxacin, decreased for oxacillin and vancomycin, and did not change for tetracycline or chloramphenicol. Mutation to DcRS did not affect susceptibility to the above antibiotics. Reduced ciprofloxacin MICs with diclofenac in strain BB255, were not associated with increased drug accumulation. Conclusions The results of this study suggest that diclofenac influences antibiotic susceptibility in S. aureus, in part, by altering the expression of regulatory and structural genes associated with cell wall biosynthesis/turnover and transport