The impact of pristine and modified rice straw biochar on the emission of greenhouse gases from a red acidic soil.

With the growing awareness of environmental impacts of land degradation, pressure is mounting to improve the health and productivity of degrading soils, which could be achieved through the use of raw and modified biochar materials. The primary objective of the current study was to investigate the efficiency of pristine and Mg-modified rice-straw biochar (RBC and MRBC) for the reduction of greenhouse gases (GHG) emissions and improvement of soil properties. A 90 days' incubation experiment was conducted using treatments which included control (CK), two RBC dosages (1% and 2.5%), and two MRBC doses (1% and 2.5%). Soil physico-chemical and biological properties were monitored to assess the effects due to the treatments. Results showed that both biochars improved soil physicochemical properties as the rate of biochar increased. The higher rates of biochar (RBC2.5 and MRBC2.5) particularly increased enzymatic activities (Catalase, Invertase and Urease) in comparison to the control. Data obtained for phospholipid fatty acid (PLFA) concentration indicated an increase in the Gram-negative bacteria (G-), actinomycetes and total PLFA with the increased biochar rate, while Gram-positive bacteria (G+) showed no changes to either level of biochar. As regards fungi concentration, it decreased with the biochar addition, whereas arbuscular mycorrhizal fungi (AMF) showed non-significant changes. The release of CO2, CH4 and N2O showed a decreasing trend over the time. CO2 cumulative emission decreased for MRBC1 (5%) and MRBC2.5 (9%) over the pristine biochar treatments. The cumulative N2O emission decreased by 15-32% for RBC1 and RBC2.5 and by 22-33% for MRBC1 and MRBC2.5 as compared to the control, whereas CH4 emission showed non-significant changes. Overall, the present study provides for the first-time data that could facilitate the correct use of Mg-modified rice biochar as a soil additive for the mitigation of greenhouse gas emission and improvement of soil properties.

Targeting Cd coping mechanisms for stress tolerance in Brassica napus under spiked-substrate system: from physiology to remediation perspective.

Cadmium (Cd) is a prevalent, non-essential, carcinogenic, and hazardous heavy metal that reduces plant productivity and capacity of arable land area around the globe. In the present substrate-based pot study, seedlings of Brassica napus 180015 were grown equidistantly in the spiked-substrate medium for 60 days under increasing concentrations of Cd (0, 10, 20, 30, 40, 50 mg kg-1). Following harvest, the morpho-physio-biochemical, antioxidative, and Cd-induced tolerance responses were evaluated in B. napus under an increasing Cd stress regime. Additionally, these parameters were also investigated to select the plant's threshold tolerance limit for Cd under the spiked-substrate system. B. napus showed dynamic behavior regarding morpho-physio-biochemical attributes, including agronomic features, biomass, photosynthetic pigments, relative water content under increased Cd toxicity. Cd stress-induced hydrogen peroxide (H2O2) production with high MDA contents and passive EL, followed by the orchestration of both enzymatic (SOD, POD, APX, CAT, and GR) and non-enzymatic antioxidants (flavonoids, TPC, TPA, proline, and total soluble protein) up to a certain limit. In addition, Cd-induced stress upregulated transcriptional levels of antioxidative enzyme SOD, POD, APX, GR, and MT encoded genes in B. napus. The increasing trend of Cd accumulation in different tissues at the highest Cd concentration was as follows: root > leaf > stem. In spiked substrate system, B. napus demonstrated improved metal extractability performance and a high potential for phyto-management of low to moderate Cd contamination, implying that this study could be used for integrative breeding programs and decontaminating heavy metals in real contaminated scenarios.Novelty statementThis study provides an insight into Cd-coping mechanisms of oilseed rape involved in alleviating toxicity and simultaneous phyto-management of increasing Cd concentration under spiked substrate system. The current study is the first scientific evidence of using a Cd-spiked soilless substrate medium. The present study will further strengthen our understanding of Cd-instigated positive responses in B. napus. Furthermore, it will provide a useful basis for integrative breeding programs and decontaminating heavy metals in real contaminated scenarios.

Application of garlic allelochemicals improves growth and induces defense responses in eggplant (Solanum melongena) against Verticillium dahliae.

Aqueous garlic extracts (AGE) and garlic allelochemical diallyl disulfide (DADS) have been recently reported to bear bioactive properties to stimulate plant growth and development and alter defense-related physiology. We, therefore, performed a bioassay to study these chemicals as possible biostimulants for defense against Verticillium dahliae in eggplant seedlings. AGE and DADS were applied as a foliar application to the eggplants and samples were collected before and after pathogen inoculation at various intervals to analyze the defense mechanism. The obtained data revealed that with the application of AGE and DADS, the seedlings showed responses including activation of antioxidant enzymes, an abundance of chlorophyll contents, alteration of photosynthesis system, and accumulation of plant hormones compared to the control plants. Furthermore, the microscopic analysis of the AGE or DADS treated plants showed high variability in pathogen density within the root crown at 28 days post-inoculation. The low abundance of reactive oxygen species was noticed in AGE or DADS treated plants, which indicates that the plants were able to successfully encounter pathogen attacks. The AGE and DADS treated plants exhibited a lower disease severity index (32.4% and 24.8% vs 87.1% in controls), indicating successful defense against Verticillium infection. Our results were therefore among the first to address the biostimulatory effects of AGE or DADS to induce resistance in eggplant seedlings against V. dahliae and may be used to establish preparation for garlic-derived bioactive compounds to improve growth and defense responses of eggplants under-protected horticultural situations such as glasshouse or plastic tunnels system.

Improvement in knowledge of healthcare professionals attending Neonatal Life Support (NeoLiS) training workshop.

OBJECTIVE: To assess the improvement in knowledge of healthcare professionals after attending Neonatal Life Support training workshop. METHODS: The interventional study with secondary data was conducted in the Neonatology Department of the Children's Hospital and the Institute of Child Health, Lahore, Pakistan, using 2-year data of all the training workshops from 2017 to 2018. The participants were consultants, post-graduate residents, nurses, lady health visitors, lady health workers and rescue workers. Knowledge was tested through a true/false questionnaire regarding resuscitation skills both before and after the hands-on workshop. The score of each candidate was recorded on a results sheet. Baselines scores were compared with respective post-workshop test. Data was analysed using SPSS 20. RESULTS: Of the 52 workshops, 35(%) were conducted in 2017 and 17(%)in 2018, and of the 1350 particpants, 1080(81%) were doctors, 257(18%) were nurses and 13(1%) were paramedics and rescue workers. Mean overall baseline score was 71.96±8.38 compared to 86.60+/-5.48 post-intervention (p<0.001). CONCLUSIONS: The Neonatal Life Support training workshop resulted in significant gain in knowledge about neonatal resuscitation by healthcare professionals.

Optimization of NPK fertilization combined with phytoremediation of cadmium contaminated soil by orthogonal experiment.

In the current experiment, influence of NPK composition on the Cd contaminated soil-plant (Solanum nigrum L.) system as well as the phytoremediation efficiency were comprehensively studied. The composition of NPK was optimized for a sustainable phytoremediation and simultaneous agronomic technique in Cd-contaminated soil by orthogonal (L14) experiment, aimed to achieve plant productivity and maximum phytoremediation potential enhancement. Results showed that different treatments of NPK composition enhanced soil properties including saccharase, urease, catalase and acid phosphatase activities as compared to the control treatment, however, soil pH was slightly decreased by 3.64%~6.67% with different composition of NPK treatments. Plant biomass and Cd concentration in the aboveground part (stem and leaves) of S. nigrum were significantly (P < 0.05) enhanced by 14.19%~48.97% and 38.50%~127.15% as compared to control plants with the addition of NPK fertilizers having different composition. Meanwhile, with the application of NPK fertilizer root/shoot Cd ratio and translocation factor (TF) was significantly decreased, however, bioconcentration factor (BCF) was increased as compared to control. Additionally, different composition of NPK fertilizers significantly increased photosynthetic pigments (chlorophyll a, chlorophyll b, total chlorophyll, and carotenoids) and soluble protein in comparison to control. The activities of antioxidant enzymes in S. nigrum including ascorbate peroxidase (APX), catalase (CAT), peroxidase (POD), superoxide dismutase (SOD) and glutathione reductase (GR) were increased, while malonaldehyde (MDA) and proline contents were decreased. Principal component analysis (PCA) showed that N3P2K2 treatment had the highest comprehensive score amongst other studied treatments of NPK composition, owing to its optimal composition for the investigated soil-S. nigrum system. Moreover, it was found that optimal composition (N3P2K2) of fertilizer resulted in increase of the plant resistance to Cd and the efficiency of phytoextraction. Therefore, it is suggested to all the small-holder famers and scientific community that precise composition of NPK fertilizer should be utilized according to soil properties, environmental conditions and plant requirements under Cd-stress condition in order to achieve maximum biomass, Cd uptake efficiency as well phytoremediation potential in moderately Cd contaminated soil.

Plant growth promotion and enhanced uptake of Cd by combinatorial application of Bacillus pumilus and EDTA on Zea mays L.

In developing countries, Cd contamination is ubiquitous which limits agriculture productivity. The current study was designed to investigate the efficacy of plant-Bacillus pumilus-ethylene diamine tetraacetic acid (EDTA) and plant-microbe-chelator (PMC) synergy for enhanced plant growth and Cd-uptake potential of Zea mays in industrially contaminated and cadmium (Cd) spiked soil. A pot experiment was conducted by growing Z. mays seedlings either inoculated with B. pumilus or un-inoculated along with the application of 5 mM EDTA. Plants were exposed to two levels of Cd contamination for 45 days. An increase in Cd uptake was observed in Z. mays inoculated with B. pumilus followed by EDTA treatment as compared to non-inoculated and un-treated ones. Zea mays showed improved values with PMC approach for different growth parameters including root length (41%), shoot length (40%), fresh weight (59%), dry weight (49%), chlorophyll contents (49%), and relative water contents (30%). Higher tolerance index (117%) was observed for plants grown in soil spiked with 300 mg kg-1 Cd (S2). PMC application markedly enhanced Cd uptake potential of Z. mays up to 12% and 68.8%, respectively, in S1 and S2 soil. While the PMC application increased Cd accumulation capacity of Z. mays by 71.2% and 52.5% in S1 and S2 soil. The calculated bioaccumulation and translocation factor revealed that Z. mays possess Cd uptake potential, and this ability can be significantly enhanced with PMC application.

Impact of intermittent kangaroo mother care on weight gain of neonate in nicu: Randomized control trial.

OBJECTIVE: To measure the impact of intermittent kangaroo mother care on weight-gain of neonates in a neonatal intensive care unit. METHODS: The randomised controlled trial was conducted at the Department of Neonatology, the Children Hospital and the Institute of Child Health, Lahore, Pakistan, from March to October, 2018, and recruited newborns admitted to the neonatal intensive care unit. The subjects were randomised into case and control groups. Intermittent kangaroo mother care was given in the case group for seven days. Data was collected and analysed using SPSS 23. RESULTS: Of the 153 neonates, 140(91.5%) were included; 70(50%) in each group. The most common reason for admission was bronchopneumonia 49(35%). In the case group, average weight gain was 10.22±1.65 grams/kg/day compared to 7.87±1.71 in the control group (p=0.0001). The average length of stay in the case group was significantly low compared to the control group (p=0.003). Multivariate analysis determined the effect of kangaroo mother care therapy as effective (p<0.0001). CONCLUSIONS: Intermittent kangaroo mother care was found to be effective for improving weight-gain in neonates in addition to the conventional treatment.

RESUSCITATION OF NEWBORNS IN HIGH RISK DELIVERIES.

BACKGROUND: High risk deliveries are usually associated with increased neonatal mortality and morbidity. Neonatal resuscitation can appreciably affect the outcome in these types of deliveries. Presence of personnel trained in basic neonatal resuscitation at the time of delivery can play an important role in reducing perinatal complications in neonates at risk. The study was carried out to evaluate the effects of newborn resuscitation on neonatal outcome in high risk deliveries. METHODS: This descriptive case series was carried out at the Department of Obstetrics and Gynecology, Jinnah Hospital, Lahore. Ninety consecutive high risk deliveries were included and attended by paediatricians trained in newborn resuscitation. Babies delivered by elective Caesarean section, normal spontaneous vaginal deliveries and still births were excluded. Neonatal resuscitation was performed in babies who failed to initiate breathing in the first minute after birth. Data was analyzed using SPSS-16.0. RESULTS: A total of 90 high risk deliveries were included in the study. Emergency. caesarean section was the mode of delivery in 94.4% (n=85) cases and spontaneous vaginal delivery in 5.6% (n=5). Preterm pregnancy was the major high risk factor. Newborn resuscitation was required in 37.8% (n=34) of all high risk deliveries (p=0.013). All the new-borns who required resuscitation survived. CONCLUSION: New-born resuscitation is required in high risk pregnancies and personnel trained in newborn resuscitation should be available at the time of delivery.

Identification and in silico analysis of noval alteration Arg420Gly in KIT proto oncogene among acute myeloid leukemia patients.

A number of studies have reported frequent incidence of c-kit gene mutations in association with core binding factor acute myeloid leukemia (CBF-AML). These genetic changes have become important prognostic predictors in patients with abnormal karyotype. Aim of this study was the detection of nucleotide alterations in newly diagnosed acute myeloid leukemia patients for three exons of c-kit gene, including cytogenetically normal patients. Thirty-one de novo AML patients were screened for any possible variations in exon 8, 11 and 17 sequences of c-kit proto-oncogene leading to amino acid substitutions or frame shift. Sanger sequencing method was employed followed by sequence analysis. Mutation data was then correlated with clinical and hematological parameters of patients and prognostic significance of genetic changes was assessed as well. The computational tools were then used to further understand the extent of damage caused by these mutations to c-kit protein. Fifteen (48.4%) mutant patients were observed with single, double or multiple mutations in one, two or all three exons studied. The analysis revealed eight new alterations which were not reported previously. Significant variation among mutant and non-mutant group of patients was observed with respect to FAB subtypes (x2 = 12.524, p = 0.029), Spleen size (x2 = 4.288, p = 0.038) and Red blood cell count (x2 = 8.447, p = 0.007). The survival analysis indicates poor overall and event free survival outcomes in mutant individuals. Furthermore, the in silico analysis suggests that changes in nucleotide sequences can possibly damage the protein structure and effect it's function. This study emphasizes the need to consider screening of c-kit gene alterations not only in CBF-AML but in cytogenetically normal AML patients as well. In current investigation the effect of mutation Arg420Gly on structure and function of c-kit protein was investigated, as this was the most observed substitution in present cohort. Various bioinformatics tools and techniques were employed, which determined that Arg420Gly is possibly non-pathogenic mutation.

Melatonin enhanced oilseed rape growth and mitigated Cd stress risk: A novel trial for reducing Cd accumulation by bioenergy crops.

Melatonin (M) is a pleiotropic molecule that improves plant growth and increases heavy metal tolerance. The role of M for improving plant growth and tolerance under cadmium (Cd) stress, and mitigation of Cd-induced toxicity has not yet been sufficiently examined. Therefore, here we conducted a glasshouse experiment to explore the influence of various M dosages on Cd detoxification and stress-tolerance responses of Brassica napus under high Cd content (30 mg kg-1). The effects of M on the modulation of Cd tolerance in B. napus plants have been investigated using various growth attributes, Cd accumulation and tolerance indices, and secondary metabolic parameters. We found that Cd stress inhibited root growth (by 11.9%) as well as triggered reactive oxygen species accumulation (by 31.2%) and MDA levels (by 18.7%); however, exogenous M substantially alleviated the adverse effect of oxidative stress by decreasing levels of H2O2 (by 38.7%), MDA (by 13.8%) and EL (by 1.8%) in the Cd-stressed plants, as compared to the M-untreated plants (control). Interestingly, exogenous M reduced Cd accumulation in roots (∼48.2-58.3-fold), stem (∼2.9-5.0-fold) and leaves (∼4.7-6.6-fold) compared to control plants, which might be due to an M-induced defense and/or detoxification response involving a battery of antioxidants. Overall, addition of the exogenous M to the Cd-stressed plants profoundly enhanced Cd tolerance in B. napus relative to control plants. These results suggested the biostimulatory role (at the physiological and molecular level) of M in improving growth, Cd tolerance, and Cd detoxification in B. napus, which indicate the potentiality of M for green remediation of Cd contaminated soils. This green trial would provide a reference for producing renewable bioenergy crops under Cd stress in contaminated soils. However, these recommendations should be verified under field conditions and the potential mechanisms for the interaction between Cd and M should be explicitly explored.

Outcome of anastomotic urethroplasty in traumatic stricture (distraction defect) of posterior urethra in boys.

OBJECTIVE: To report the outcomes of operative management of traumatic posterior urethral distraction defect in boys at our Centre, as traumatic posterior urethral stricture in children is a rare condition that presents a major surgical challenge to the paediatric urologist and consensus on the optimal treatment of these strictures in children has not been reached. PATIENTS AND METHODS: We retrospectively analysed our data from July 2013 to June 2018. All boys aged ≤16 years with traumatic posterior bulbo-prostatic obliteration (distraction defect) were included. Initial suprapubic cystostomy and delayed definite anastomotic urethroplasty was done in all the boys. The boys were evaluated preoperatively with a retrograde urethrogram and simultaneous voiding cystourethrogram, as well as cystourethroscopy. RESULTS: A total of 38 boys, with posterior urethral distraction defect, were divided into primary and redo surgery groups. The primary group comprised 34 boys who were operated upon for the first time. A perineal approach with development of an inter-crural space was done in 12 boys and along with an inferior pubectomy in 19 boys. Three boys in the primary group needed a transpubic approach due to a longer defect. In the redo group, there were six boys, of which four were operated initially outside our hospital, while two were our own unsuccessful urethroplasties. In the redo group, a perineal approach with inferior pubectomy was done in two boys and a transpubic urethroplasty in the remaining four boys. The success rate of anastomotic urethroplasty without any ancillary procedures was 81.5% (strict criterion), while the overall success rate was 94.7% (permissible criterion, which included boys who were managed later with direct vision internal urethrotomy and dilatation). CONCLUSION: The ideal treatment of post-traumatic posterior urethral defect/strictures in boys is tension-free bulbo-prostatic anastomosis. This was done using a transperineal approach in most of the boys, but a few required a transpubic approach, with good results. ABBREVIATIONS: DVIU: direct vision internal urethrotomy; SPC: suprapubic cystostomy; SUI: stress urinary incontinence.

Correlation Of Severity Of Metabolic Acidosis At Admission And Outcome In Asphyxiated Neonates.

BACKGROUND: Blood gases can provide information about the perinatal, natal and postnatal condition of newborn. Severity of metabolic acidosis has deleterious effect on the outcome of babies. When the cord blood gases are not available the arterial blood gases are used for interpreting the status of newborn. The purpose of study was to determine the relationship between severity of metabolic acidosis at admission with the stage of hypoxic ischemic encephalopathy, and its outcome in asphyxiated neonates. METHODS: This was descriptive cross-sectional study of 384 neonates born at ≥35 weeks to <42 weeks from June to December 2018, admitted in Neonatology department of the Children's hospital & the Institute of Child Health, Lahore within first 6 hours of birth. The neonates with history of delayed cry at birth and arterial pH ≤7.30 and base deficit ≥10 were included in the study. The pH and base deficit of babies was analyzed in relation to the stage of HIE, duration of stay and death or discharge of the babies using SPSS-20. The p-value was calculated using chi-square test. RESULTS: Total of 470 neonates were eligible. Eighty-four neonates were excluded. Finally, 384 neonates were included and analyzed for the outcome variables. With severe metabolic acidosis pH <7.01, all the babies developed HIEII/III. Majority (82.1%) of the babies expired and 27.9% had prolonged hospital stay. CONCLUSIONS: Increasing severity of metabolic acidosis at admission increases the likelihood of adverse outcome in asphyxiated neonates.

Pennisetum giganteum: An emerging salt accumulating/tolerant non-conventional crop for sustainable saline agriculture and simultaneous phytoremediation.

Soil salinity is a global threat to the environmental sustainability, in particular to the developing countries due to their limited resources for soil reclamation. In a greenhouse pot experiment, Pennisetum giganteum, was investigated for its tolerance to salt stress and simultaneous phytoremediation capability. 4 weeks post-germination, NaCl (10, 50, 150, 250, 350, 450 and 550 mM) and tap water (control) was applied after every 2 consecutive days for two weeks in a completely randomized design and their effects were established in the growth and physico-chemical aspects of these plants. Our results indicated that P. giganteum withstood high salt stress (with 550 mM NaCl tolerance threshold level). Interestingly, the plants grown under saline conditions had higher biomass yield when compared to the control. Furthermore, the antioxidant activity and proline content of plants under saline conditions were significantly (p < 0.05) higher than those of control plants, indicating their adaptability to high salt stress. Biochemical analysis such as chlorophyll contents, total soluble sugar, total phenol and protein contents revealed considerable differences between plants grown under higher NaCl stress compared to the control conditions. Additionally, significantly different ionic flux along with high K+/Na+ ratio was observed in plants grown under a range of saline conditions. The results obtained are therefore of value to indicate P. giganteum an eco-friendly alternate source for the phytoremediation of saline soils and may be used as base for future research on this plant. Effective strategies need to be adopted with this plant to reclaim saline-degraded as well as marginal soils.

Some Physiological and Biochemical Mechanisms during Seed-to-Seedling Transition in Tomato as Influenced by Garlic Allelochemicals.

The effects of aqueous garlic extracts (AGEs), diallyl disulfide (DADS), and allicin (AAS) were investigated during seed-to-seedling transition of tomato. Independent bioassays were performed including seed priming with AGE (0, 100, and 200 µg∙mL-1), germination under the allelochemical influence of AGE, DADS, and AAS, and germination under volatile application of AGE. Noticeable differences in germination indices and seedling growth (particularly root growth and fresh weights) were observed in a dose-dependent manner. When germinated under 50 mM NaCl, seeds primed with AGE exhibited induced defense via antioxidant enzyme activities (superoxide dismutase (SOD), peroxidase (POD), and catalase (CAT)), lipid peroxidation (malondialdehyde content (MDA)), and H2O2 scavenging. Enzyme-linked immunosorbent analysis (ELISA) of the endogenous phytohormones auxin (IAA), abscisic acid (ABA), cytokinin (ZR), and gibberellic acid (GA3) in the roots and shoots of the obtained seedlings and the relative expression levels of auxin-responsive protein (IAA2), like-auxin (LAX5), mitogen-activated protein kinase (MAPK7 and MPK2), respiratory burst oxidase homolog (RBOH1), CHI3 and SODCC1 suggested allelopathic functions in stimulating growth responses. Our findings suggest that garlic allelochemicals act as plant biostimulants to enhance auxin biosynthesis and transportation, resulting in root growth promotion. Additionally, the relative expressions of defense-related genes, antioxidant enzymes activities and phytohormonal regulations indicate activation of the defense responses in tomato seedlings resulting in better growth and development. These results, thus, provide a basis to understand the biological functions of garlic allelochemicals from the induced resistance perspective in plants.

The Protective Role of 28-Homobrassinolide and Glomus versiforme in Cucumber to Withstand Saline Stress.

The strategic role of phytohormones and arbuscular mycorrhizal fungi (AMF) to overcome various stress conditions is gaining popularity in sustainable agricultural practices. This current study aims to investigate and identify the protective roles of 28-homobrassinolide (HBL) and Glomus versiforme on two cucumber cultivars (salt sensitive Jinyou 1# and tolerant Chanchun mici (CCMC)) grown under saline conditions (100 mM NaCl). HBL and AMF were applied as individual and combined treatments on two cucumber cultivars and their effects were observed on the morphological growth and physiology under control and saline conditions. Findings revealed that the treated plants showed better performance under saline conditions through improved photosynthesis, leaf relative water content, and decreased electrolyte leakage in tolerant cultivar (CCMC) and to a lesser extent in sensitive (Jinyou 1#) cultivar. Comparable differences were noticed in the antioxidant enzymes activity such as superoxide dismutase, catalase, and peroxidase after every 10 days in both cultivars. Treating the plants with HBL and AMF also improved the mineral uptake regulation and lowered sodium concentration in roots compared to that in the non-treated plants. Current findings suggest that the protective role of HBL and AMF involves the regulation of antioxidants and lowers the risk of ion toxicity in the cucumber and hence enhance tolerance to salinity. These results are promising, but further studies are needed to verify the crop tolerance to stress and help in sustainable agricultural production, particularly vegetables that are prone to salinity.

Developmental Dysplasia Of The Hip In Older Children; Prospects Of Functional And Radiological Outcome Following A Single Stage Triple Procedure.

BACKGROUND: Developmental dysplasia of the hip (DDH) is a diverse entity, which range from mild acetabular dysplasia to frank irreducible hip dislocation. Data regarding the safety and efficacy of one stage triple procedure is limited. Our aim was to analyse the mid-term functional and radiological outcome of single stage triple procedure for children with DDH after walking age. METHODS: This is a prospective case series of 23 patients (26 hips) who were diagnosed as cases of DDH between July 2014 and June 2017. We included patients with age 20 months and above from both genders who underwent the single stage triple procedure of open reduction, femoral and pelvic osteotomy during the three years. Functional and radiological outcome were assessed according to McKay's and Severin's grading systems respectively.. RESULTS: Sixteen (69.6%) girls and 7 (30.4%) boys with a mean age of 4.4±1.9 years. The mean follow-up duration was 8.9±3.2 months. The mean preoperative acetabular index (AI) was 40.3º±2.7º which reduced to an average of 23.4º±3.8º at the end of follow-up. Eight (34.8%) of patients achieved grade I (excellent) of McKay's classification and 9 (39.1%) grade II (good). Postoperatively, 22 (95.7%) patients were below grade III and only one (4.3%) patient was in grade IVa. One case of avascular necrosis of femoral head was observed. CONCLUSIONS: The single stage triple procedure involving femoral and pelvic osteotomies have excellent functional and radiological outcomes, however, avascular necrosis of the femoral head, redislocation and osteoarthritis in long-term are the adverse events associated with the condition.

Comparative analysis of serum lipid profiles in patients with and without gallstones: A prospective cross-sectional study.

OBJECTIVES: Gallbladder disease is one of the most common diseases of the gastrointestinal tract. Various studies have shown an association between gallstones and an alteration in the serum lipids. The objective of this study was to compare serum lipid profile of gallstone patients with the controls. METHODS: This prospective cross-sectional study was conducted in the Surgical Department of the Services Institute of Medical Sciences from August 2017 to August 2018. A total of 50 patients were included in the study after screening through the inclusion criteria. A control group of 50 inpatients with no personal or family history of gallstones were also recruited for comparison. Results were expressed as mean with standard deviation. Students t-test was used to compare the data between the patients and the control groups (p < 0.05 was considered statistically significant). SPSS software, version 20 was used for statistical analysis. RESULTS: The mean age of the patients was 40.90 years and that of controls was 34.74 years. 46 patients were females and 44 controls were females. The serum cholesterol levels were high in the patients as compared to the controls but the comparison was not statistically significant. Serum triglycerides levels were high in the patients as compared to the controls and the analysis was statistically significant. Furthermore, the serum HDL levels were low in the patients as compared to the controls with a statistically significant p-value. However, the serum LDL levels were low in the patients as compared to the control group. CONCLUSION: It was concluded that serum triglyceride levels and serum HDL levels were statistically significant in gallstone patients and there was a positive correlation between these parameters and gallstone disease.

The garlic allelochemical DADS influences cucumber root growth involved in regulating hormone levels and modulating cell cycling.

Most allelochemicals are phytotoxic to the receiver plants and may influence the cell micro- and ultrastructure, cell division, phytohormone levels, and ultimately growth. In order to understand the allelopathic potential of garlic, the effects of its main bioactive allelochemical diallyl disulfide (DADS), experiments were carried out to observe the seed germination, root growth, and developmental responses in cucumber seedlings treated with various concentrations of DADS. The obtained data suggested active influence of DADS on cucumber root growth and development. Significant responses were observed in early root growth and elongation, mitotic cell division and elongation, and root architecture modulation. The effect, however, was dose dependent, and lower concentrations of DADS proved to be promotional whereas higher concentrations of DADS inhibited cucumber root growth and development. Relative root elongation (RRE) revealed that DADS could increase growth of cucumber roots in the early developmental days. Moreover, DADS application significantly influenced mitosis-related gene expression. Observed genes CYCA and CDKB were initially downregulated in the first 24 h but significantly upregulated after 48 h, while gene CDKA was upregulated in the first 24 h. Similarly, DADS application significantly altered primary plant hormones, such as IAA, ABA, GA3, and ZR, in the cucumber roots. Taken together, low concentrations of DADS treatment could promote cucumber root growth and induce main root elongation by upregulating CDKA and CDKB gene expression and regulating hormone balance in root. The current findings offer insight into the allelopathic potential of garlic allelochemical DADS and can be considered vital for establishing plant allelopathic studies.

The combination of arbuscular mycorrhizal fungi inoculation (Glomus versiforme) and 28-homobrassinolide spraying intervals improves growth by enhancing photosynthesis, nutrient absorption, and antioxidant system in cucumber (Cucumis sativus L.) under salinity.

Salinity is one of the major obstacles in the agriculture industry causing huge losses in productivity. Several strategies such as plant growth regulators with arbuscular mycorrhizal fungi (AMF) have been used to decrease the negative effects of salt stress. In our experiment, 28-homobrassinolide (HBL) with spraying intervals was combined with AMF (Glomus versiforme) in cucumber cultivars Jinyou 1# (salt sensitive) and (Changchun mici, in short, CCMC, salt tolerant) under NaCl (100 mmol/L). Studies have documented that the foliar application of HBL and AMF colonization can enhance tolerance to plants under stress conditions. However, the mechanism of the HBL spraying intervals after 15 and 30 days in combination with AMF in cucumber under salt stress is still unknown. Our results revealed that the HBL spraying interval after 15 days in combination with AMF resulted in improved growth, photosynthesis, and decreased sodium toxicity under NaCl. Moreover, the antioxidant enzymes SOD (superoxide dismutase; EC 1.15.1.1) and POD activity (peroxidase; EC 1.11.1.7) showed a gradual increase after every 10 days, while the CAT (catalase; EC 1.11.1.6) increased after 30 days of salt treatments in both cultivars. This research suggests that the enhanced tolerance to salinity was mainly related to elevated levels of antioxidant enzymes and lower uptake of Na+, which lowers the risk of ion toxicity and decreases cell membrane damage.

Reasons Of Self-Discharge From Nursery Of A Tertiary Care Hospital.

BACKGROUND: Patients who leave against medical advice (LAMA) from a health facility is a recognized problem. In neonatology practice this issue is particularly sensitive as repercussions can be severe. The purpose of this study was to evaluate the factors influencing the decision of parents to self-discharge their babies against medical advice. METHODS: This descriptive case series was conducted in the Department of Neonatology, of the Children's Hospital and the Institute of Child Health, Lahore from January to June 2015. A total of 240 patients who self-discharged/were included. RESULTS: There were (59.6%) males and (40.4%) females with a male to female ratio of 2:1.5. Term babies constituted (67.9%), spontaneous vaginal deliveries (59.1%) and (55.8%) were delivered at hospitals. Seventy seven new-borns (32.2%) had birth asphyxia followed by neonatal sepsis (27.9%). Sixty four (64.5%) self-discharged within first week of admission. More babies were signed LAMA at week end (32.1%). Likewise (53.1%) babies were self- discharged during the night shift. Highest rate of LAMA was seen in parents belonging to low socioeconomic class (72.1%). Ninety eight parents (40.8%) had no formal education while well-educated parents were found to be 35 (14.6%). The commonest reason for selfdischarge was "perceived poor clinical outcome" (36.7%) by parents. CONCLUSIONS: Multiple factors were implicated in self-discharges from neonatology unit. Commonest reasons cited by parents were perception of poor clinical outcome and family pressures. Other contributory factors were male gender; those delivered vaginally, diagnosis of birth asphyxia, first week of life, at weekends and night hours. Low socioeconomic class and education of parents was also a major causative factor.