Maintenance of dental records and awareness of forensic odontology among pakistani dentists: a mixed-method study with implications for dental data repository.

OBJECTIVE: Dental records and forensic odontology play an important role in both healthcare and the legal system, aiding in personalized patient care, human identification, and legal proceedings. This study aims to investigate dental record-keeping practices and assess the awareness of forensic odontology among Pakistani dentists over 12 months. This study aims to collect data from 500 dentists, identify areas for enhancement, and develop a strategic action plan to improve record-keeping quality and forensic odontology application, culminating in a comprehensive dental data repository to support legal and criminal investigations in Pakistan. METHODOLOGY: This study employed a mixed-method approach conducted at Hamdard Dental College from January to March 2023. The quantitative phase involved distributing questionnaires to 463 dentists, chosen through stratified random sampling. Out of these, 413 responded, yielding an 86% response rate. These questionnaires focused on dental record-keeping practices and dentists' awareness of forensic odontology. Subsequently, based on the questionnaire results, face-to-face interviews were conducted with 20 purposively selected dentists to gain deeper insight into the challenges and potential solutions. Data from both phases were integrated and analyzed accordingly. RESULTS: The study included 413 participants, mainly females (79%), with ages ranging from 27 to 65 years and an average age of 46.4 years. Most dentists had 5-20 years of work experience (53%), and most (87.4%) were practicing in private clinical settings. All the dentists generated medical and dental records, but the duration of their record-keeping varied, with some maintaining them for up to a year and others for two years or longer. Five themes were generated from the qualitative content analysis. These themes were dentists' perceptions, barriers and challenges, knowledge and awareness, and improvement strategies. CONCLUSION: Our study revealed that local practitioners in Pakistan exhibit subpar practices in dental record-keeping and maintenance of patient history, irrespective of whether they use a digital or traditional file-based system. Even though dentists are cognizant of the importance of record-keeping, they do not actively maintain comprehensive records. This suggests the need for improved training and system improvements to address the gaps in record-keeping practices.

Interactions between diabetic and hypertensive drugs: a pharmacogenetics approach.

Diabetes is known to increase susceptibility to hypertension due to increase in inflammation, oxidative stress, and endothelial dysfunction, leading to vascular stiffness. The polytherapy might lead to several drug-drug interactions (DDIs), which cause certain life-threatening complications such as diabetic nephropathy and hypoglycaemia. So, in this review we focused on drug-drug interactions and impact of genetic factors on drug responses for better disease management. Drug-drug interactions (DDIs) may act either synergistically or antagonistically. For instance, a combination of metformin with angiotensin II receptor antagonist or angiotensin-converting enzyme inhibitors (ACEIs) synergistically improves glucose absorption, whereas the same hypertensive drug combination with sulphonylurea might cause severe hypoglycaemia sometimes. Thiazolidinediones (TDZs) can cause fluid retention and heart failure when taken alone, but a combination of angiotensin II receptor antagonist with TZDs prevents these side effects. Interindividual genetic variation affects the DDI response. We found two prominent genes, GLUT4 and PPAR-γ, which are common targets for most of the drug. So, all of these findings established a connection between drug-drug interaction and genetics, which might be used for effective disease management.

Insights of OPs and PYR cytotoxic potential Invitro and genotoxic impact on PON1 genetic variant among exposed workers in Pakistan.

Different pesticide chemicals are used to enhance crop yield by protecting from pests. Organophosphate (OPs) and Pyrethroid (PYR) are used in fields of Sanghar, Sindh Pakistan. PON1 an antioxidant enzyme implicated in OPs detoxification may predispose by OPs chronic exposure. This study was conducted to evaluate the toxic potential of active pesticide chemicals at cellular and genetic levels. To examine toxic potential, locally consumed pesticide n = 2 and reference pesticide compounds organophosphate (OPs): Chloropyrifos, Malathion and Pyrethroid (PYR): Cyprmethrin, Cyhalothrin n = 4 were tested against NIH 3T3 cells using MTS assay. Local consumer pesticides demonstrated relevance for half-maximum inhibitory concentration (IC50) 0.00035 mg/mL with selected compound. Malathion IC50 exhibited the highest cytotoxicity among four compounds at 0.0005 mg/mL. On genotoxicity analysis in exposed subjects n = 100 genotypes and alleles n = 200 exhibited significant differences in genotypic and allelic frequencies of pesticide exposed subjects and controls n = 150 (X2 = 22.9, p = 0.001). Screening of genotypes were performed by PCR- RFLP. Statistical assessment carried out using online software and tools. Results suggested that higher heterozygous genotype A/G (74%) may confer low PON1 metabolic activity towards pesticides in exposed subjects. Findings could be helpful to establish health plans by avoiding toxic chemicals that harming exposed population.

Video based learning vs instructor led training for optimizing personal protective equipment use to prevent Covid-19 infection - a comparative study.

Objectives: To evaluate two different types of education and training aids to improve compliance with guidelines related to personal protective equipment in healthcare workers. METHODS: The quasi-experimental study was conducted at the Department of Gynaecology and Obstetrics, Combined Military Hospital, Rawalpindi, from July 1 to December 31, 2020, and comprised healthcare personnel who were divided into two equal groups. Group A received weekly instructor-led training session of donning and doffing for two hours. Group B was assigned to watch 30-min training videos weekly. After one month, an independent instructor evaluated both the groups using validated checklists, with maximum score 8 for donning and 14 for doffing. Data was analysed using SPSS 22. RESULTS: Of the 60 subjects, 34(56.6%) were females and 26(43.3%) were males. There were 30(50%) subjects in group A with a mean age of 35.35±5.67years, and the remaining 30(50%) were n group B with a mean age of 33.12±4.13 years. There was no significant difference in donning and doffing scores between the groups (p>0.05). CONCLUSIONS: Both types of education and training aids could be used to improve compliance with guidelines related to personal protective equipment in healthcare workers.

Synergistic evaluation of Moringa oleifera extract and ß-lactam antibiotic to restore the susceptibility of methicillin-resistant Staphylococcus aureus.

INTRODUCTION: The antibiotic resistance has become a major threat to global health. The combinatorial use of two or more compounds to develop a new formulation may overcome the emerging cases of drug resistance. Moringa oleifera has been utilized as a strong nutritional, immunomodulator and therapeutic agent for decades. In this study, different parts of Moringa oleifera were screened for bioactive compounds that can act as a resistance modifying agent for multi-drug resistant organisms (MDROs). METHODOLOGY: Initially, the combined effect of stem bark extracts and ampicillin was calculated by checkerboard assay. Active compounds of effective extract were assessed by High Performance Liquid Chromatography (HPLC). Minimal Inhibitory Concentration (MIC) and Fractional Inhibitory Concentration Index (FICI) were calculated to evaluate the synergistic behavior of stem bark extract with ampicillin. To study the blocking of resistance pathways of Methicillin-Resistant Staphylococcus aureus (MRSA) western blot was performed. RESULTS: The results revealed that stem bark has significant anti-MRSA activity. The methanolic extract of stem bark in combination with ampicillin showed the highest synergistic effect (FICI value ≤ 0.237) against MRSA. Killing kinetics and membrane potential of ampicillin alone and in combination revealed an increase in the inhibitory potential of ampicillin against MRSA. Decolourization in iodometric assay confirmed the inhibition of ß-lactamase, western blot results confirmed the blocking of penicillin-binding protein (PBP2a) expression with the restoration of MRSA sensitivity against ß-lactams. CONCLUSION: It can be concluded that methanolic extract of Moringa oleifera stem bark has bioactive compounds and can be used as an adjuvant with antibiotics to modify the resistance of MDROs.

Production of multienzyme by Bacillus aestuarii UE25 using ionic liquid pretreated sugarcane bagasse.

The utilization of sugarcane bagasse (SB) in fermentation requires pretreatment processes to render fermentable components available to microorganisms. Pretreatment by using ionic liquids (ILs) is considered promising but the high cost is an impediment in its adoption, therefore, a mixture of IL pretreated and untreated SB was utilized to obtain bacterial multienzyme under solid-state fermentation (SSF). Bacillus aestuarii UE25, a thermophilic strain was utilized for that purpose. Fermentation conditions were optimized by adopting a central composite design. The model showed a good correlation between the predicted and the experimental values for amylase, xylanase, endoglucanase, and ß-glucosidase. Volumetric and specific productivity of xylanase (4580 IU ml-1 h-1 , 244.25 IU mg-1 substrate, and 50 IU mg-1 protein) were higher than the other enzymes. Changes in lignin content and reduced cellulose crystallinity due to IL pretreatment, followed by fermentation, were visualized by scanning electron microscopy, Fourier transform infrared spectroscopy, and Nuclear magnetic resonance. The strategy adopted by utilizing a mixture of IL pretreated and untreated SB under SSF proved promising to obtain high titers of different enzymes simultaneously. Since the bacterial strain used is thermophilic, therefore, the multienzyme can find its application in commercial processes which are carried out at high temperatures.

Biosynthesis of silver nanoparticles for the fabrication of non cytotoxic and antibacterial metallic polymer based nanocomposite system.

Nanomaterials have significantly contributed in the field of nanomedicine as this subject matter has combined the usefulness of natural macromolecules with organic and inorganic nanomaterials. In this respect, various types of nanocomposites are increasingly being explored in order to discover an effective approach in controlling high morbidity and mortality rate that had triggered by the evolution and emergence of multidrug resistant microorganisms. Current research is focused towards the production of biogenic silver nanoparticles for the fabrication of antimicrobial metallic-polymer-based non-cytotoxic nanocomposite system. An ecofriendly approach was adapted for the production of silver nanoparticles using fungal biomass (Aspergillus fumigatus KIBGE-IB33). The biologically synthesized nanoparticles were further layered with a biodegradable macromolecule (chitosan) to improve and augment the properties of the developed nanocomposite system. Both nanostructures were characterized using different spectrographic analyses including UV-visible and scanning electron microscopy, energy dispersive X-ray analysis, dynamic light scattering, and Fourier transform infrared spectroscopic technique. The biologically mediated approach adapted in this study resulted in the formation of highly dispersed silver nanoparticles that exhibited an average nano size and zeta potential value of 05 nm (77.0%) and - 22.1 mV, respectively with a polydispersity index of 0.4. Correspondingly, fabricated silver-chitosan nanocomposites revealed a size of 941 nm with a zeta potential and polydispersity index of + 63.2 mV and 0.57, respectively. The successful capping of chitosan on silver nanoparticles prevented the agglomeration of nanomaterial and also facilitated the stabilization of the nano system. Both nanoscopic entities exhibited antimicrobial potential against some pathogenic bacterial species but did not displayed any antifungal activity. The lowest minimal inhibitory concentration of nanocomposite system (1.56 µg ml-1) was noticed against Enterococcus faecalis ATCC 29212. Fractional inhibitory concentration index of the developed nanocomposite system confirmed its improved synergistic behavior against various bacterial species with no cytotoxic effect on NIH/3T3 cell lines. Both nanostructures, developed in the present study, could be utilized in the form of nanomedicines or nanocarrier system after some quantifiable trials as both of them are nonhazardous and have substantial antibacterial properties.

Structural elucidation and cytotoxic analysis of a fructan based biopolymer produced extracellularly by Zymomonas mobilis KIBGE-IB14.

Fructan based biopolymers have been extensively characterized and explored for their potential applications. Linear chained biopolymers, like levan-type fructan, have gained attention because they have exhibited unconventional stretchable and unbendable properties along with biodegradable and biocompatible nature. Current study deals with the chemical characterization and cytotoxic analysis of fructose based exopolysaccharide that was extracellularly produced by an indigenously isolated bacterial species (Zymomonas mobilis KIBGE-IB14). Maximum yield of exopolysaccharide (44.7 gL-1) was attained after 72 h of incubation at 30 °C under shaking conditions (180 rpm) when the culture medium was supplemented with 150.0 gL-1 of sucrose as a sole carbon source. This exopolysaccharide displayed high water solubility index (96.0%) with low water holding capacity (17.0%) and an intrinsic viscosity of about 0.447 dL g-1. This biopolymer exhibited a characteristic linear homopolysaccharide structure of levan when characterized using Fourier Transform Infrared (FTIR), Nuclear Magnetic Resonance (NMR) spectroscopy (1H, 13C, TOCSY and NOESY) while, Atomic Force Microscopy (AFM) revealed its pointed and thorny structure. The decomposition temperature of levan was approximately 245 °C as revealed by Thermal Gravimetric Analysis (TGA). X-Ray Diffraction (XRD) results revealed its amorphous nature with crystalline phase. Cytotoxicity of different concentrations of levan was investigated against mouse fibroblast cell lines by measuring their cellular metabolic activity and it was noticed that a higher concentration of levan (2.0 mg ml-1) permitted the normal cell growth of NIH/3T3 cell lines. This non-cytotoxic and biocompatible nature suggests that this levan has the capability to be utilized in food and drug-based formulations as it exhibited biomedical potential.

Using World Health Organisation near miss approach to assess preventable maternal morbidity and mortality at a tertiary care hospital.

OBJECTIVE: To determine frequency of severe maternal complications, maternal near-miss cases and maternal deaths in obstetric patients in a tertiary care setting. METHODS: The prospective cross-sectional analytical study was conducted at the Obstetrics Unit of Combined Military Hospital, Kharian, Pakistan, from January to June 2019, and comprised cases of severe maternal complications, critical interventions and life-threatening situations. A conditions as defined by the World Health Organisation guidelines. Severe maternal outcome ratio, maternal near-miss, maternal mortality ratio, near-miss-to-mortality ratio and the mortality index were calculated. Data was analysed using SPSS 20. RESULTS: Of the 1054 live births during the study period, there were 42(3.9%) near-miss cases and 4(0.3%) maternal deaths. Management-based criteria identified 34(80%) cases, followed by clinical 14(33%) and laboratory criteria 2(4.7%). Maternal mortality ratio was 379/100,000 and near-miss-to-mortality ratio was 39/1000 live births. Severe maternal outcome ratio was 4.36 (42+4/1054). For near-miss cases, the mortality index was 8.6, and the maternal near-miss-to-maternal death ratio was 10.5:1. CONCLUSION: The use of a standardised near-miss criterion makes audit and comparison of results between hospitals and even countries having the same resources possible and reproducible.

Inhibitory mechanism of BAC-IB17 against ß-lactamase mediated resistance in methicillin-resistant Staphylococcus aureus and application as an oncolytic agent.

Cancer remains a foremost cause of deaths worldwide, despite several advances in the medical science. The conventional chemotherapeutic methods are not only harmful for normal body cells but also become inactive due to the development of resistance by cancer cells. Therefore, the demand of safe anticancer agents is increasing and enforced the bottomless research on the bacteriocins. Several studies have reported the selective anticancer property of bacteriocins. Current research is the contribution to explore the exact mechanism of action and in vitro application of bacteriocin (BAC-IB17) as an oncolytic agent. In this study, ß-lactamase mediated resistance of methicillin resistant Staphylococcus aureus (MRSA) was studied and inhibitory mechanism of MRSA by BAC-IB17 was investigated. Cytotoxic studies were conducted to analyze the anticancerous potential of BAC-IB17. Results revealed that BAC-IB17 inhibited the ß-lactamase and produced profound effect on the membrane integrity of MRSA confirmed by scanning electron microscope (SEM). FTIR spectroscopic analysis revealed the changes in the functional groups of bacterial cells before and after treatment with BAC-IB17. BAC-IB17 also found anticancer in nature as it kills HeLa cell lines with the IC50 value of 12.5 µg mL-1 with no cytotoxic effect on normal cells at this concentration. This specific anticancer property of BAC-IB17 will make it a promising candidate for the treatment of cancer after further clinical trials. Moreover, BAC-IB17 may control MDR bacteria responsible for the secondary complications in cancer patients.

Production of commercially important enzymes from Bacillus licheniformis KIBGE-IB3 using date fruit wastes as substrate.

BACKGROUND: Pakistan is one of the top five date fruit-producing countries and produced more than 30% wastes in picking, packing, storage, and commercialization stages. The date fruit wastes are usually considered inedible for humans and only used for livestock feed. In current research, Bacillus licheniformis KIBGE-IB3 was screened for pectinase, xylanase, cellulase, and amylase production using date fruit wastes as substrate through solid state fermentation. RESULTS: The B. licheniformis KIBGE-IB3 produced higher concentration of pectinase using date fruit wastes as substrate as compared to amylase, cellulase, and xylanase. B. licheniformis KIBGE-IB3 produced maximum pectinase using 5.0 g/dl date fruit wastes and 0.5 g/dl yeast extract. B. licheniformis KIBGE-IB3 required pH 7.0, 37 °C incubation temperature, and 72 h incubation period for maximum production of pectinase. CONCLUSION: It has been concluded that date fruit waste is a good source of biomass and can be utilized for the commercial production of pectinase.

Expectations, Fears and Perceptions of doctors during Covid-19 Pandemic.

OBJECTIVES: The aim of this study was to explore the expectations and fears faced by doctors during Covid-19 Pandemic. METHODS: This is a mixed method exploratory survey. A questionnaire exploring expectations of doctors from administration and seniors as well as their fears while working during pandemic, was developed on Google survey Forms. It included eight closed ended questions and four open ended questions. Data was collected through online Google survey Forms during month of March and April 2020. Doctors were approached through email and WhatsApp group. RESULTS: The mean age of participants was 33.58±4.21 years. Female 150(67.5%) and Male 72(32.4%) participated. 29(13.1%) Associate Professor, 34(15.3%) Assistant Professor, 56(25.2%) Senior Residents and 103(46.3%) residents, medical officers and house officers responded to the survey. 134(60.3%) doctors were working in hospitals which were not dealing with Covid-19. Fear included, infecting family members 177(79.7%), rapid spread of disease 140(63%), complications of disease 134(60.3%), becoming a carrier in 64(28.8%) and 62(27.9%) feared missing the diagnosis. More than 80% expected from seniors and administration, of providing PPE, facilitation, continue chain of supply of essential items, ensuring doctor safety, avoiding exposure of all doctors and keeping reserve workforce, limiting routine checkups, avoid panic and 20% had no expectations. CONCLUSION: It was concluded that doctors had their fears and perceptions regarding pandemic which need to be addressed while policy making. They fear wellbeing of their families and contacting Covid-19, if not provided proper PPE. Our study provides insight of expectations, fears and perceptions of our frontline which invariably gives insight of the views of healthcare workers.

Study of causes behind abnormal uterine bleeding according to PALM- COEIN classification at a tertiary care hospital.

This descriptive observational study was carried out to determine the frequency of causes behind Abnormal Uterine Bleeding (AUB) amongst patients of reproductive age presenting to gynaecology OPD from January to June 2018 at the Combined Military Hospital Kharian, a tertiary care hospital. All women presenting with complaints of AUB were enrolled for the study, except for those who were pregnant, adolescent and postmenopausal. Detailed history, physical examination and relevant investigations were done and patients were categorised according to FIGO PALM-COEIN classification system and placed in nine main categories. A total of 238 patients were enrolled and the incidence of AUB among them was found to be 11% according to PALM-COEIN classification system. The frequency and percentage of all etiologies was calculated. Frequency of structural causes was Polyp 10 (6.7%), Adenomyosis 35 (23.5%), Leiomyomata 80 (53.7) and Malignancy 24 (16.1%). Nonstructural causes were Coagulation Disorders 5 (5.6%), Ovulatory 56 (37.6%), Endometrial Dysfunction 3 (3.4%), Iatrogenic 14 (15.7%) and Not-yet-classified 11 (12.4%). Development of a universally accepted classification system is a step towards facilitating clinicians, patients and researchers to communicate with each other and make objective management plans.

A comparative study on degradation of complex malathion organophosphate using of Escherichia coli IES-02 and a novel carboxylesterase.

Malathion organophosphates considered as the major constituent of herbicides, pesticides and insecticides. Extensively used in agricultural, horticultures and for numerous household applications contributes to precedence organic pollutants leading antagonistic effects on human health and environment. Therefore detoxification of malathion from contaminated site is of general interest. Simultaneously it is very emerging to isolated novel indigenous microbial strains from contaminated site with a record of pesticide application. In this study Escherichia coli IES-02 isolated from malathion contaminant effluent and the strain showed maximum efficiency in malathion degradation that utilized it as the sole source of carbon. Carboxylesterase (33.0, 30.0, 28.0 kDa) were purified (1685.71 U/mg) from Escherichia coli IES-02 showed significant results in malathion degradation approximately 81% within 20 min as compared with Escherichia coli IES-02 cells within 4 h (99.0 to 95.0%) into monocarboxylic acid and diacid derivatives. The generation time of Escherichia coli was also observed at 60 min with 0.1 ppm, 68 min with 0.5 ppm, 74.5 min with 2.0 ppm and 91.37 min with 50 ppm of malathion. The degradation rate and transformation metabolites were estimated by Gas Chromatography-Mass Spectrometry respectively. Malathion metabolites pathway proposed in this study which revealed the potential application against lethal environmental pollution.

An Audit of Caesarean Section Rate Using Modified Robson Criteria at a Tertiary Care Hospital.

OBJECTIVE: To evaluate the rising rate of caesarean section (CS) and its contributing factors at a tertiary care hospital. STUDY DESIGN: Clinical audit. PLACE AND DURATION OF STUDY: Obstetrics and Gynecology Department, Pak Emirates Military Hospital (PEMH), Rawalpindi, from January to December 2017. METHODOLOGY: All caesarean sections were classified according to modified Robson criteria into twelve groups, after modification. The size of each group, rate of caesarean section and contribution of each group was calculated. A re-audit was carried out after 6 months under the same protocol thus completing the audit cycle. RESULTS: CS rate was 54% (n=3878). The maximum contribution 27.42% (n=1976) to total CS rate was made by Group 5, 12.07% (n=870) by group 12 and 7.34% (n=531) by group 2. Re-audit showed a reduced CS rate of 38.2% (n=1342) with contribution by Group 5 reduced to 16.05% (n=563), Group 12 to 7.47% (n=262) and Group 2 reduced to 5.7% (n=202), respectively. CONCLUSION: Modified Robson Criteria is an effective auditing tool which identifies the exact areas where efforts and strategies are required to reduce the overall CS rate.

Morphological Analysis Of Cementoenamel Junction Types In Premolars And Molars Of A Sample Of Pakistani Population.

BACKGROUND: Cementoenamel junction represents the demarcation between enamel covered crown and cementum covered root surface. There is paucity of population specific data of the morphological variability of cementoenamel junctions of permanent and primary teeth. The objective of this study was to investigate the morphological diversity and interrelationship of cementoenamel junction of premolar and molar teeth in permanent dentition of a sample of Pakistani population with potential forensic and anthropological implications. METHODS: This cross-sectional study was conducted at Oral Biology department of Dr Ishrat ul Ebad khan institute of oral health science, Dow University from March till September 2016. Seventy-five maxillary and mandibular permanent premolar and molars from adult patients of both sexes were selected and sectioned. Longitudinal ground sections were prepared to study the morphological interrelationship between Cementum and Enamel in each specimen to be viewed under light microscope. A chi-square test was applied between the categorical variables. RESULTS: Results showed 57.3% of sections had cementum overlapping enamel interrelation, 32% showed edge to edge cementum and enamel relation and 9.3% showed that cementum and enamel failed to meet resulting in exposed dentine, while 1.3% sample showed enamel over cementum relation. No significant correlation was found between gender, type of tooth, maxillary, mandibular arches and the morphological variation of CEJ (p>0.05). CONCLUSIONS: It can be concluded that there are considerable morphological variations in CEJ of premolars and molars with preponderance of cementum overlapping enamel in these teeth. Based on these findings, dentists are advised to be mindful of dental procedures involving the CEJ and that these interventions should be performed meticulously avoiding any detachment of cementum and subsequent exposure of dentin resulting in dentin hypersensitivity.

Screening, purification and characterization of thermostable, protease resistant Bacteriocin active against methicillin resistant Staphylococcus aureus (MRSA).

BACKGROUND: The emergence of serious issues of multidrug resistance in the past few years have enforced the use of bacteriocins for combating infections. Threat posed to public health by various multidrug resistant (MDR) organisms can be resolved by discovering new antimicrobial proteins with broad spectrum of inhibition. RESULTS: In the current study, Bacteriocin (BAC-IB17) produced by Bacillus subtilis KIBGE-IB17 is found to be effective against different strains of methicillin resistant Staphylococcus aureus (MRSA). The approximate molecular mass of BAC-IB17 is 10.7 kDa. This unique bacteriocin is found to be highly thermostable and pH stable in nature. It also showed its stability against various heavy metals, organic solvents, surfactants and proteolytic enzymes. Amino acid profile of BAC-IB17 clearly showed that this protein mainly consists of non-polar and basic amino acids whereas; some acidic amino acids were also detected. Sequence of first 15 amino acid residues obtained from N-terminal sequencing of BAC-IB17 were NKPEALVDYTGVXNS. CONCLUSIONS: The anti-MRSA property of purified bacteriocin may be used to prevent the spread of MRSA infections. Remarkable features of BAC-IB17 suggests its applications in various pharmaceutical and food industries as it can function under a variety of harsh environmental conditions.

Characterization and interplay of bacteriocin and exopolysaccharide-mediated silver nanoparticles as an antibacterial agent.

Metallic nanoparticles have a substantial scientific interest because of their distinctive physicochemical and antimicrobial properties and the emergence of multidrug resistant pathogens could unlock the potential of nanoparticles to combat infectious diseases. The aim of the current study is to enhance the antibacterial potential of purified bacteriocin by combining bacteriocin and antibacterial silver nanoparticles (AgNPs). Hence, the interaction of natural antimicrobial compounds and antibacterial nanoparticles can be used as a potential tool for combating infectious diseases. In this study, a green, simple and effective approach is used to synthesize antibacterial AgNPs using fungal exopolysaccharide as both a reducing and stabilizing agent. The AgNPs were characterized by spectroscopic analysis, Scanning Electron Microscopy (SEM), Energy Dispersive X-ray spectroscopy (EDX) and Dynamic Light Scattering (DLS). Furthermore, the synergistic effect of bacteriocin-AgNPs was determined against pathogenic strains. The histogram of AgNPs indicated well-dispersed, stabilized and negatively charged particles with variable size distribution. The combination of bacteriocin with nanoparticles found to be more effective due to broad antibacterial potential with possibly lower doses. The current study is imperative to provide an alternative for the chemical synthesis of silver nanoparticles. It showed environmental friendly and cost effective green synthesis of antibacterial nanoparticles.

Manual Vacuum Aspiration (MVA) - A safe option for evacuation of first trimester miscarriage in cardiac patients.

This case series was done at Armed Forces Institute of Cardiology, National Institute of Heart Disease, Rawalpindi, to observe safety and efficacy of manual vacuum aspiration and frequency of complications in cardiac patients with missed abortion. All cardiac patients presenting in first trimester with diagnosed early foetal demise (missed miscarriage) or incomplete miscarriage were included. Manual vacuum aspiration was done as an outpatient procedure. Cardiac and procedure related complications including arrhythmias, thromboembolism, heart failure and ischaemia were noted. A total of 34 patients were enrolled. Mean age and parity was 25.9±2.25 years and 1.18±1.02. Mitral valve was the dominant valve involved in 20(58.8%) followed by double valve replacement in 5(14.7%), dilated cardiomyopathy 4(11.76%), aortic valve involvement in 3(8.8%) and supra ventricular tachycardia in 2(5.9%) patients. Complete evacuation was achieved in 100% patients and there were no major cardiac or gynaecological complications except arrhythmia in 1(2.9%) patient. MVA seems to be a safe and cost effective intervention compared to other modalities of miscarriage management even in high risk cardiac patients.