Incidence of Radial Artery Occlusion in Patients Undergoing Percutaneous Coronary Intervention via Trans Radial Access.

Objective: To determine the incidence of radial artery occlusion (RAO) in patients undergoing percutaneous coronary intervention (PCI) via trans-radial access (TRA). Method: A descriptive study was carried out at the Department of interventional cardiology, Chaudhary Pervaiz Elahi Institute of Cardiology, Multan from 30-April 2019 to 30-October 2020. One hundred and twenty-five patients, who underwent PCI by TRA were selected for this study. The presence of Radial artery occlusion was noted 24 hours after the procedure by Doppler ultrasonography. SPSS version 23 was used for data analysis. A Chi-square test was applied. P-value < 0.05 was taken as statistically significant. Results: Gender distribution revealed 109 (87.2%) males and 16 (12.8%) females. The mean age of the patients was 65.22 ± 11.54 years. The mean BMI of the patients was 29.93±4.87 kg/m2. 84 (67.2%) patients were hypertensive, 40 (32%) patients were diabetics, 22 (17.6%) patients were smoker and 24 (19.2%) patients were having dyslipidemia. RAO after 24 hours was found in 5(4.0%) patients. Conclusion: Radial artery occlusion is a common complication of trans-radial access so radial artery patency must be checked before using it for transcatheter procedures.

Organochlorine pesticide residues in raw milk samples collected from dairy farms and urban areas of Lahore district, Pakistan.

The current study was employed to investigate the organochlorine pesticides (OCP) concentrations in milk, as the milk we consume, has residues of these notorious pesticides. The residual concentrations of OCP in milk have numerous harmful effects on health especially the children. Therefore, milk was analyzed using gas chromatography equipped with µECD for seven OCP residues, namely α-endosulfan, ß-endosulfan, Endosulfan-sulphate, DDE, γ-HCH, Dieldrin, and DDT. Three hundred and sixty raw milk samples were collected from urban areas (10 areas of Lahore N = 300) and Dairy Farms (10 farms in Lahore N = 60) from September 2012 to September 2013. Samples were collected after an interval of 2 months, for 12 months. Mean values of OCPs in milk samples from urban areas were reported as α-endosulfan, ß-endosulfan, Endosulfan-sulphate, DDE, γ-HCH, and Dieldrin with concentration of 17.44 ± 3.99, 35.74 ± 7.50, 20.28 ± 3.95, 2.51 ± 0.55, 0.93 ± 0.16 and 1.12 ± 0.18 µg kg-1, respectively, while the milk samples from dairy farms with concentration of 26.94 ± 4.63, 59.88 ± 6.76, 32.07 ± 4.51, 4.64 ± 0.48, 1.20 ± 0.17 and 1.93 ± 0.18 µg kg-1, respectively. None of the samples analyzed were found positive for the presence of DDT, just as none of the samples from area milk shops exceeded the Maximum Residual Limits (MRLs). γ-HCH and ß-endosulfan were found higher in dairy farm milk samples than the MRLs. Conclusively, these pesticide residues are present in milk available in Lahore in enough quantity (some exceeding the MRLs) to threaten human health, particularly the infant and children.

Development of grape seed extract based formulations by using non-invasive biophysical technique and its impact on skin aging.

Given the substantial benefits of grape seed extract (GSE) in reducing oxidative stress, the study aimed development, characterization and comparative analysis of GSE-based formulations. The development entailed extraction of GSE from Vitisvinifera L. HPLC confirmed catechin, epicatechin, gallic acid, epicatechingallate and procyanidin dimers. Storage of Formulations observed, Stability & rheological parameters determined. Olive oil used as a permeability enhancer. Presence of the highest oleic acid content (65-86%) in Olive oil, skin permeability within the stratum corneum was enhanced hence better transdermal skin absorption. Using two-way ANOVA, and T-test, efficacy of formulations and impact on slowing down skin aging by countering exogenous factors of oxidative stress determined. Non-invasive biophysical technique showed emulgel substantially reduced roughness, scaliness, winkles, and sebum content by 55%, 26%, 23.9% and 30.3% respectively enhancing elasticity and hydration by 50% and 32.2% respectively. Emulsion reduced roughness, scaliness, winkles and sebum content 14%, 13%, 21% and 26.13% respectively enhancing elasticity and hydration 45.3% and 29.85% respectively. The formulations significantly offset exogenous factors of aging and impact on free radicals and oxidative stress and may be safe to incorporate bio-active botanical antioxidants for evaluation of derma cosmetic benefits in management of dehydrated and aged facial skin.

Changing the paradigm of organ utilization from PHS increased-risk donors: an opportunity whose time has come?

Approximately 8-11% of all organ donors are classified by Public Health Service (PHS) as increased-risk. The proportion of PHS increased-risk donors is on the rise. At the University of Washington Medical Center, in 2014, the proportion of transplants from PHS increased-risk donors was 28% of liver transplants and 23% of kidney transplants. Nationally, transplant providers have been reluctant to use organs from PHS increased-risk donors because of concern for transmission of HIV, HCV, or HBV. There is also patient apprehension when these organs are being offered, and thus the discard rate of these otherwise good quality organs is high. Because of the organ shortage, preventing underutilization of such organs is essential. We provide data and considerations that should be used to guide the use of organs from PHS increased-risk donors.

Isolation and molecular characterization of polyvinyl chloride (PVC) plastic degrading fungal isolates.

The recalcitrant nature of polyvinyl chloride creates serious environmental concerns during manufacturing and waste disposal. The present study was aimed to isolate and screen different soil fungi having potential to biodegrade PVC films. After 10 months of soil burial experiment, it was observed that a number of fungal strains were flourishing on PVC films. On morphological as well as on 18rRNA gene sequence and phylogenetic basis they were identified as Phanerochaete chrysosporium PV1, Lentinus tigrinus PV2, Aspergillus niger PV3, and Aspergillus sydowii PV4. The biodegradation ability of these fungal isolates was further checked in shake flask experiments by taking thin films of PVC (C source) in mineral salt medium. A significant change in color and surface deterioration of PVC films was confirmed through visual observation and Scanning electron microscopy. During shake flask experiments, P. chrysosporium PV1 produced maximum biomass of about 2.57 mg ml(-1) followed by A. niger PV3. P. chrysosporium PV1 showed significant reduction (178,292 Da(-1)) in Molecular weight of the PVC film than control (200,000 Da(-1)) by gel permeation chromatography. Furthermore more Fourier transform infrared spectroscopy and nuclear magnetic resonance also revealed structural changes in the PVC. It was concluded that isolated fungal strains have significant potential for biodegradation of PVC plastics.

Production, characterization, and antimicrobial activity of a bacteriocin from newly isolated Enterococcus faecium IJ-31.

This work aimed to isolate and characterize Enterococcus spp. from indigenous dairy products in Islamabad, Pakistan. By classical microbiological techniques, one strain from a butter sample was identified to be Enterococcus faecium, and we designated it E. faecium IJ-31. The precise identity of this strain was then established by determining the sequence of its 16S and 23S rRNA genes. The sequence homology searches revealed matches with a number of previously reported strains, such as E. faecium HN-N3 and HN-N29, both isolated from swine intestines in China. The newly isolated strain was tested for hemolysis and antibiotic sensitivity; it was nonhemolytic on sheep and human blood and sensitive to vancomycin. Consistent with its vancomycin sensitivity, repeated attempts to amplify the vancomycin resistance genes vanA and vanB failed. Similar attempts to amplify the virulence genes gelE, agg, and cyl also failed, suggesting the absence of these genes. In contrast, the enterocin-P gene, entP, readily amplified with primers based on the previously reported sequences, and the deduced sequence showed near identity with a number of reported sequences from E. faecium. Further, the 71-residue enterocin-P sequence from strain IJ-31 is only the second complete sequence reported. The enterocin was partially purified and tested for antibacterial activity. It showed potent inhibitory activity against many bacteria, including Listeria monocytogenes, a routinely used test strain. Further, the enterocin showed potent activity against Bacillus subtilis and Bacillus cereus. The enterocin retained antibacterial activity even following heating to 121 degrees Celsius for 15 min. Further, it also retained activity after exposure to pH values ranging from 4 to 10. However, proteinase K treatment rendered the peptide nonfunctional.

Bacteriocinogenic potential of newly isolated strains of Enterococcus faecium and Enterococcus faecalis from dairy products of Pakistan.

Present study was carried for the isolation of bacteriocin producing Enterococci from indigenous sources. Gram positive enterococci are known for having the ability to produce enterocins with good antimicrobial potential. A total of 34 strains were isolated from processed dairy products of Pakistan and seven out of them were found to be member of genus enterococci on selective enumeration. Biochemical and molecular characterization revealed that four of these isolates (IJ-03, IJ-07, IJ-11 and IJ-12) were Enterococcus faecalis while three (IJ-06, IJ-21 and IJ-31) were Enterococcus faecium. Local processed cheese was the source of all enterococcal isolates, except E. faecium IJ-21 and IJ-31 which were isolated from indigenous yoghurt and butter samples respectively. Bacterial isolates were sensitive to commonly used antibiotics except methicillin and kanamycin. They also lack critical virulence determinants mainly cytolysin (cyl), gelatinase (gel), enterococcal surface protein (esp) and vancomycin resistance (vanA and vanB). Polymerase chain reaction amplification identified that enterocin A and P genes were present in the genome of E. faecium IJ-06 and IJ-21 while E. faecium IJ-31 genome showed only enterocin P genes. No amplification was observed for genes that corresponded with the enterocins 31, AS-48, L50A, L50B and ent 1071A and 1071 B. Also there were no signals of amplification found for E. faecalis IJ-11 indicating that the antimicrobial activity was because of an enterocin different from those checked by PCR. So the indigenous bacterial isolates have great potential for bacteriocin production and they had antibacterial activity against a variety of closely related species.

Are hepatitis C-positive allografts in simultaneous pancreas-kidney transplantation underutilized?

BACKGROUND: A recent review reported that recipient HCV infection had no significant impact on acute rejection rates or patient survival in SPKT but the utilization of HCV(+) organs was negligible. Using the UNOS database, we sought to determine utilization rates for HCV(+) allografts in Simultaneous Pancreas-Kidney Transplantation (SPKT. MATERIAL/METHODS: The Organ Procurement and Transplant Network / United Network for Organ Sharing database was employed to obtain information regarding HCV(+) and HCV-negative (HCV(-)) SPKT recipients and the disposition of donor pancreata. RESULTS: Between 2000 and January 2011, 702 of 25,904 donors (2.7%) were HCV(+) and met otherwise ideal criteria. We identified 16 patients who received HCV(+) organs for SPKT between 1995 and 2010. Four had kidney allograft losses secondary to chronic rejection. Six had pancreatic allograft losses: one due to pancreatitis, one to infection, one to chronic rejection, one to acute rejection and two to graft thrombosis. None of the sixteen patients were subsequently listed for liver transplantation. Meanwhile, 702 HCV(+) donors between the age of 14 and 40 with a BMI less than 30 were identified. During that time period, only 8 simultaneous pancreas-kidney transplants using HCV(+) donor organs occurred. Therefore, 694 HCV(+) pancreata were not utilized for SPKT in that time span. CONCLUSIONS: 16 patients have undergone SPKT with HCV(+) organs. Aggressive use of HCV(+) organs for SPKT could potentially lead to earlier transplantation for HCV(+) recipients and allow HCV(-) organs to be available more quickly for HCV(-) recipients additional research of this topic is warranted.

Metronidazole-induced encephalopathy in a patient with end-stage liver disease.

Purpose. Metronidazole-induced encephalopathy (MIE) has been rarely reported. We report a case in a patient with end-stage liver disease (ESLD). Summary. A 63-year-old male with ESLD secondary to hepatitis C virus presented with progressively worsening fatigue, slurred speech, aphasia, vomiting, and left-sided facial droop after completing a 2-week course of metronidazole for recurrent Clostridium difficile-associated diarrhea. He completed a previous course of metronidazole 3 weeks prior to presentation. He is on the liver transplant waiting list and has known hepatic encephalopathy. MRI revealed hyperintense T2 signals involving the bilateral dentate nuclei, inferior colliculi and splenium of the corpus callosum, and increased diffusion restriction at the splenium of the corpus callosum. His neurological function improved over the next several days. He underwent liver transplantation 6 days after admission. A follow-up MRI 6 weeks after presentation revealed resolution of abnormalities; however, paresthesias persisted 6 months after MIE diagnosis. Conclusion. An ESLD patient with hepatic encephalopathy developed MIE after a relatively short course of metronidazole. Metronidazole has been shown to accumulate in patients with ESLD. Increased awareness for neurotoxicity when using metronidazole in ESLD patients is warranted, especially in those with potentially confounding hepatic encephalopathy.