Suillus: an emerging model for the study of ectomycorrhizal ecology and evolution.

Research on mycorrhizal symbiosis has been slowed by a lack of established study systems. To address this challenge, we have been developing Suillus, a widespread ecologically and economically relevant fungal genus primarily associated with the plant family Pinaceae, into a model system for studying ectomycorrhizal (ECM) associations. Over the last decade, we have compiled extensive genomic resources, culture libraries, a phenotype database, and protocols for manipulating Suillus fungi with and without their tree partners. Our efforts have already resulted in a large number of publicly available genomes, transcriptomes, and respective annotations, as well as advances in our understanding of mycorrhizal partner specificity and host communication, fungal and plant nutrition, environmental adaptation, soil nutrient cycling, interspecific competition, and biological invasions. Here, we highlight the most significant recent findings enabled by Suillus, present a suite of protocols for working with the genus, and discuss how Suillus is emerging as an important model to elucidate the ecology and evolution of ECM interactions.

Treatment vegetable oil refinery wastewater by sequential electrocoagulation-electrooxidation process.

In the present study a sequential process composed of electrocoagulation (EC) followed by electrooxidation (EO) was utilized at the laboratory scale to remove the chemical oxygen demand (COD) from wastewater generated in Iraqi vegetable oil refinery plant.in the EC, impacts of operating variables such as current density (10-30 mA cm-2) and pH (4-10),and EC time (30-90 min) on the COD removal (RE%) were investigated using response surface methodology (RSM) based on Box- Behnken design(BBD). a mathematical correlation that relates the operating factors with RE% was developed and its regression coefficient was 99.02% confirming the significant of the model. Response surface plots showed that RE% increased with increasing current density and time while it decreased with increasing pH. The optimum removal with a lower cost for EC process were achieved at current density of 30mA/cm2, pH of 4, and electrolysis time of 90 min in which RE% of 69.19% was obtained with requirement of 0.513kWh/kg COD as specific energy consumption (SEC). The effluent exit from EC was treated by EO for a period of 240min at a current density of 30mA/cm2 and an initial pH value of 4 to obtain RE% of 96% at SEC of 1.554 kWh/kg COD. Combining EC with EO resulted in a total RE% of 98.72% and a total SEC of 2.067 kWh/kg COD. Based on the results of present study, the applicability of a sequential electrocoagulation-electrooxidation process for treatment vegetable oil wastewaters is feasible.

Prevalence and risk factors assessment of mange mites in livestock of Malakand Division, Pakistan.

Mange mites represent a serious problem in livestock farming due to their worse effect on animals health, reducing milk and meat production. The status of mange mites prevalence was unknown from the livestock present in Malakand Division, Pakistan. Hence, the present study was conducted to determine the prevalence and risk factors assessment of mange mites in livestock of Malakand Division, Pakistan. Villages and livestock herds were visited for data collection and sampling for one year from September 2017 to August 2018. The diagnosis of mange infestation was carried out from skin scrapings collected from symptomatic animals. A total of 1437 animals were screened (240 sheep, 658 cows, 340 buffalos, 199 goats) from selected localities of the Malakand Division. The overall prevalence was 2.37%, with the highest prevalence in buffalos (5.0%) and lowest (0.42%) in sheep (p < 0.05). The locality also significantly affect the prevalence of mange mites in livestock, with a higher percentage (8.14%) in the Ouch area. The prevalence was higher in winter (3.78%) than in summer (1.07%). The prevalence was high (p < 0.05) in young animals (≤1 year) (4.7%) as compared to adults (>1 year) (1.15%). Gender was also a significant risk factor for mange infestation. The infestation was higher in females (2.85%) as compared to males (0.64%) (p < 0.05). Herd size of less than ten animals had a significantly high prevalence rate (3.69%) compared to >10 animals (1.89%). Animals having an infection history >15 days infected more than animals having infection history ≤15 days. This study documented for the first-time epidemiology of mange mites in livestock of Malakand Division, Pakistan. Further studies involving molecular characterization of mange mites will increase our understanding on the spread of mange mites in Malakand Division livestock.

Heterospecific Neighbor Plants Impact Root Microbiome Diversity and Molecular Function of Root Fungi.

Within the forest community, competition and facilitation between adjacent-growing conspecific and heterospecific plants are mediated by interactions involving common mycorrhizal networks. The ability of plants to alter their neighbor's microbiome is well documented, but the molecular biology of plant-fungal interactions during competition and facilitation has not been previously examined. We used a common soil-plant bioassay experiment to study molecular plant-microbial interactions among rhizosphere communities associated with Pinus taeda (native host) and Populus trichocarpa (non-native host). Gene expression of interacting fungal and bacterial rhizosphere communities was compared among three plant-pairs: Populus growing with Populus, Populus with Pinus, and Pinus with Pinus. Our results demonstrate that heterospecific plant partners affect the assembly of root microbiomes, including the changes in the structure of host specific community. Comparative metatranscriptomics reveals that several species of ectomycorrhizal fungi (EMF) and saprotrophic fungi exhibit different patterns of functional and regulatory gene expression with these two plant hosts. Heterospecific plants affect the transcriptional expression pattern of EMF host-specialists (e.g., Pinus-associated Suillus spp.) on both plant species, mainly including the genes involved in the transportation of amino acids, carbohydrates, and inorganic ions. Alteration of root microbiome by neighboring plants may help regulate basic plant physiological processes via modulation of molecular functions in the root microbiome.

COVID-19 infection map generation and detection from chest X-ray images.

Computer-aided diagnosis has become a necessity for accurate and immediate coronavirus disease 2019 (COVID-19) detection to aid treatment and prevent the spread of the virus. Numerous studies have proposed to use Deep Learning techniques for COVID-19 diagnosis. However, they have used very limited chest X-ray (CXR) image repositories for evaluation with a small number, a few hundreds, of COVID-19 samples. Moreover, these methods can neither localize nor grade the severity of COVID-19 infection. For this purpose, recent studies proposed to explore the activation maps of deep networks. However, they remain inaccurate for localizing the actual infestation making them unreliable for clinical use. This study proposes a novel method for the joint localization, severity grading, and detection of COVID-19 from CXR images by generating the so-called infection maps. To accomplish this, we have compiled the largest dataset with 119,316 CXR images including 2951 COVID-19 samples, where the annotation of the ground-truth segmentation masks is performed on CXRs by a novel collaborative human-machine approach. Furthermore, we publicly release the first CXR dataset with the ground-truth segmentation masks of the COVID-19 infected regions. A detailed set of experiments show that state-of-the-art segmentation networks can learn to localize COVID-19 infection with an F1-score of 83.20%, which is significantly superior to the activation maps created by the previous methods. Finally, the proposed approach achieved a COVID-19 detection performance with 94.96% sensitivity and 99.88% specificity.

Advance Warning Methodologies for COVID-19 Using Chest X-Ray Images.

Coronavirus disease 2019 (COVID-19) has rapidly become a global health concern after its first known detection in December 2019. As a result, accurate and reliable advance warning system for the early diagnosis of COVID-19 has now become a priority. The detection of COVID-19 in early stages is not a straightforward task from chest X-ray images according to expert medical doctors because the traces of the infection are visible only when the disease has progressed to a moderate or severe stage. In this study, our first aim is to evaluate the ability of recent state-of-the-art Machine Learning techniques for the early detection of COVID-19 from chest X-ray images. Both compact classifiers and deep learning approaches are considered in this study. Furthermore, we propose a recent compact classifier, Convolutional Support Estimator Network (CSEN) approach for this purpose since it is well-suited for a scarce-data classification task. Finally, this study introduces a new benchmark dataset called Early-QaTa-COV19, which consists of 1065 early-stage COVID-19 pneumonia samples (very limited or no infection signs) labeled by the medical doctors and 12544 samples for control (normal) class. A detailed set of experiments shows that the CSEN achieves the top (over 97%) sensitivity with over 95.5% specificity. Moreover, DenseNet-121 network produces the leading performance among other deep networks with 95% sensitivity and 99.74% specificity.

Fungal-Bacterial Networks in the Populus Rhizobiome Are Impacted by Soil Properties and Host Genotype.

Plant root-associated microbial symbionts comprise the plant rhizobiome. These microbes function in provisioning nutrients and water to their hosts, impacting plant health and disease. The plant microbiome is shaped by plant species, plant genotype, soil and environmental conditions, but the contributions of these variables are hard to disentangle from each other in natural systems. We used bioassay common garden experiments to decouple plant genotype and soil property impacts on fungal and bacterial community structure in the Populus rhizobiome. High throughput amplification and sequencing of 16S, ITS, 28S and 18S rDNA was accomplished through 454 pyrosequencing. Co-association patterns of fungal and bacterial taxa were assessed with 16S and ITS datasets. Community bipartite fungal-bacterial networks and PERMANOVA results attribute significant difference in fungal or bacterial communities to soil origin, soil chemical properties and plant genotype. Indicator species analysis identified a common set of root bacteria as well as endophytic and ectomycorrhizal fungi associated with Populus in different soils. However, no single taxon, or consortium of microbes, was indicative of a particular Populus genotype. Fungal-bacterial networks were over-represented in arbuscular mycorrhizal, endophytic, and ectomycorrhizal fungi, as well as bacteria belonging to the orders Rhizobiales, Chitinophagales, Cytophagales, and Burkholderiales. These results demonstrate the importance of soil and plant genotype on fungal-bacterial networks in the belowground plant microbiome.

Fungal Endophytes of Populus trichocarpa Alter Host Phenotype, Gene Expression, and Rhizobiome Composition.

Mortierella and Ilyonectria genera include common species of soil fungi that are frequently detected as root endophytes in many plants, including Populus spp. However, the ecological roles of these and other endophytic fungi with respect to plant growth and function are still not well understood. The functional ecology of two key taxa from the P. trichocarpa rhizobiome, M. elongata PMI93 and I. europaea PMI82, was studied by coupling forest soil bioassays with environmental metatranscriptomics. Using soil bioassay experiments amended with fungal inoculants, M. elongata was observed to promote the growth of P. trichocarpa. This response was cultivar independent. In contrast, I. europaea had no visible effect on P. trichocarpa growth. Metatranscriptomic studies revealed that these fungi impacted rhizophytic and endophytic activities in P. trichocarpa and induced shifts in soil and root microbial communities. Differential expression of core genes in P. trichocarpa roots was observed in response to both fungal species. Expression of P. trichocarpa genes for lipid signaling and nutrient uptake were upregulated, and expression of genes associated with gibberellin signaling were altered in plants inoculated with M. elongata, but not I. europaea. Upregulation of genes for growth promotion, downregulation of genes for several leucine-rich repeat receptor kinases, and alteration of expression of genes associated with plant defense responses (e.g., jasmonic acid, salicylic acid, and ethylene signal pathways) also suggest that M. elongata manipulates plant defenses while promoting plant growth.

Correction to: Systematic Review and Meta-analysis of Short-versus Long-Acting Granulocyte Colony-Stimulating Factors for Reduction of Chemotherapy-Induced Febrile Neutropenia.

The article "Systematic Review and Meta-analysis of Short-versus Long-Acting Granulocyte Colony-Stimulating Factors for Reduction of Chemotherapy-Induced Febrile Neutropenia", written by Paul Cornes, Pere Gascon, Stephen Chan, Khalid Hameed, Catherine R. Mitchell, Polly Field, Mark Latymer, Luiz H. Arantes Jr was originally published electronically on the publisher's internet portal (currently SpringerLink) on October 8, 2018 without open access.

Systematic Review and Meta-analysis of Short- versus Long-Acting Granulocyte Colony-Stimulating Factors for Reduction of Chemotherapy-Induced Febrile Neutropenia.

INTRODUCTION: Short- and long-acting granulocyte-colony stimulating factors (G-CSFs) are approved for the reduction of febrile neutropenia. A systematic literature review was performed to identify randomized controlled trials (RCTs) and non-RCTs reporting the use of G-CSFs following chemotherapy treatment. METHODS: Medline®/Medline in-process, Embase®, and the Cochrane Library were searched for studies published between January 2003 and June 2016. A hand-search of relevant conference proceedings was conducted for meetings held between 2012 and 2016. Eligible studies were restricted to those reporting a direct, head-to-head comparison of short- versus long-acting G-CSFs for reduction of chemotherapy-induced febrile neutropenia. Risk-of-bias assessments were performed for full publications only. RESULTS: The search strategy yielded 4044 articles for electronic screening. Thirty-six publications were evaluated for the meta-analysis: 11 of 12 RCTs and 2 of 24 non-RCTs administered doses of the short-acting G-CSF filgrastim for ≥ 7 days. In RCT studies, there was no statistically significant difference in outcomes of interest between short- and long-acting G-CSFs. In non-RCTs, the overall risk was lower with long-acting G-CSF than with short-acting G-CSF for incidence of febrile neutropenia [overall relative risk (RR) = 0.67, P  = 0.023], hospitalizations (overall RR = 0.68, P  < 0.05), and chemotherapy dose delays (overall RR = 0.68, P  = 0.020). CONCLUSIONS: Overall, the weight of evidence from RCTs indicates little difference in efficacy between the short- and long-acting G-CSFs if dosed according to recommended guidelines. There is some evidence for greater efficacy for long-acting G-CSFs in non-RCTs, which may be a result of under-dosing of short-acting G-CSFs in general practice in real-world usage. FUNDING: Hospira Inc, which was acquired by Pfizer Inc in September 2015, and Pfizer Inc.

Mitochondrial Genetic Diversity and Phylogeography of Mus musculus castaneus in Northern Punjab, Pakistan.

Regions of Iran, Afghanistan, Pakistan and northwestern India have been proposed as the place of origin of Mus musculus castaneus. But despite the fact that Pakistan encompasses an important part of its range, M. m. castaneus populations in Pakistan have not been the subject of intensive genetic and biogeographic studies, except for a very small number of samples included in past studies. We studied genetic variation in M. m. castaneus (CAS) from northern Punjab Province, Pakistan, by using cytochrome b (Cytb) analysis in a sample of 98 individuals. Median-joining network revealed four well differentiated CAS sub-lineages coexisting within a small geographical region; these had previously been thought to have largely non-overlapping geographic distributions. Moreover, haplotypes from Pakistan occupied a central position in the network and all identified global haplotypes were also present in Pakistan. All identified CAS sub-lineages proved to be highly diverse on the basis of haplotype and nucleotide diversity indices. Tajima's D test and Fu's Fs tests of neutrality suggest recent population expansions in all sub-lineages. Expansion times were estimated as 21,760-134,930, 10,800-64,400 and 4950-30,665 ybp using substitution rates of 2.5%, 5% and 11%, respectively. Our results support the hypothesis that northern Punjab Province in Pakistan is the most likely source area for M. m. castaneus, and that the CAS sub-lineages in this region have undergone rapid population expansion events at different time periods, which appear to have benefitted from human-mediated transport, although one of them clearly predates the establishment of human settlements in this region.

Trichophyton verrucosum infection in livestock in the Chitral district of Pakistan.

INTRODUCTION: Trichophyton verrucosum belongs to the dermatophyte fungi, closely related organisms that cause skin infections in animals and humans. T. verrucosum infection has been reported in livestock and people in different countries from all continents. Human cases have been reported in different areas of Pakistan, but there is little information about the animal source of the fungus. METHODOLOGY: Dermatological specimens collected in the Chitral district of Pakistan for a study on mange in livestock were retrospectively analyzed for the presence of T. verrucosum. In total, 5,873 animals (1,087 cows, 2,033 goats, and 2,753 sheep) were screened for evidence of dermatological lesions during two surveys performed in the summer and winter seasons. Skin scrapings collected from animals with lesions were analyzed by direct microscopic examination after digestion in sodium hydroxide and a real-time polymerase chain reaction (PCR) targeting pathogenic Trichophyton species. RESULTS: At microscopy, samples from 18 cows (1.6%), 3 sheep (0.1%), and 4 goats (0.2%) were positive for fungal elements consistent with T. verrucosum. PCR confirmed the microscopy results. The prevalence was lower than that reported in other countries in intensive breeding farms. Results agree with the literature regarding factors affecting T. verrucosum diffusion, i.e., infection was more prevalent in cattle, especially in younger animals during the winter season. CONCLUSIONS: This study reports, for the first time, the presence of T. verrucosum in livestock in Pakistan. A better knowledge of the animal role in the spread of this fungus may allow the adoption of more efficient control measures and prophylaxis.

Atractiella rhizophila, sp. nov., an endorrhizal fungus isolated from the Populus root microbiome.

Among fungi isolated from healthy root mycobiomes of Populus, we discovered a new endorrhizal fungal species belonging to the rust lineage Pucciniomycotina, described here as Atractiella rhizophila. We characterized this species by transmission electron microscopy (TEM), phylogenetic analysis, and plant bioassay experiments. Phylogenetic sequence analysis of isolates and available environmental and reference sequences indicates that this new species, A. rhizophila, has a broad geographic and host range. Atractiella rhizophila appears to be present in North America, Australia, Asia, and Africa and is associated with trees, orchids, and other agriculturally important species, including soybean, corn, and rice. Despite the large geographic and host range of this species sampling, A. rhizophila appears to have exceptionally low sequence variation within nuclear rDNA markers examined. With inoculation studies, we demonstrate that A. rhizophila is nonpathogenic, asymptomatically colonizes plant roots, and appears to foster plant growth and elevated photosynthesis rates.

The threatening but unpredictable Sarcoptes scabiei: first deadly outbreak in the Himalayan lynx, Lynx lynx isabellinus, from Pakistan.

Although neglected, the mite Sarcoptes scabiei is an unpredictable emerging parasite, threatening human and animal health globally. In this paper we report the first fatal outbreak of sarcoptic mange in the endangered Himalayan lynx (Lynx lynx isabellinus) from Pakistan. A 10-year-old male Himalayan lynx was found in a miserable condition with severe crusted lesions in Chitral District, and immediately died. Post-mortem examination determined high S. scabiei density (1309 mites/cm(2) skin). It is most probably a genuine emergence, resulting from a new incidence due to the host-taxon derived or prey-to-predator cross-infestation hypotheses, and less probable to be apparent emergence resulting from increased infection in the Himalayan lynx population. This is an alarming situation for the conservation of this already threatened population, which demands surveillance for early detection and eventually rescue and treatment of the affected Himalayan lynx.

Clinicopathological and prognostic significance of RECQL5 helicase expression in breast cancers.

RECQL5 is a member of the RecQ family of DNA helicases and has key roles in homologous recombination, base excision repair, replication and transcription. The clinicopathological significance of RECQL5 expression in breast cancer is unknown. In this study, we have evaluated RECQL5 mRNA expression in 1977 breast cancers, and RECQL5 protein level in 1902 breast cancers [Nottingham Tenovus series (n = 1650) and ER- cohort (n = 252)]. Expression levels were correlated to aggressive phenotypes and survival outcomes. High RECQL5 mRNA expression was significantly associated with high histological grade (P = 0.007), HER2 overexpression (P = 0.032), ER+/HER2-/high proliferation genefu subtype (P < 0.0001), integrative molecular clusters (intClust 1and 9) (P < 0.0001) and poor survival (P < 0.0001). In subgroup analysis, high RECQL5 mRNA level remains significantly associated with poor BCSS in ER+ cohort (P < 0.0001) but not in ER- cohort (P = 0.116). At the protein level, in tumours with low RAD51, high RECQL5 level was significantly associated with high histological grade (P < 0.0001), higher mitotic index (P = 0.008), dedifferentiation (P = 0.025), pleomorphism (P = 0.027) and poor survival (P = 0.003). In subgroup analysis, high RECQL5/low RAD51 remains significantly associated with poor BCSS in ER+ cohort (P = 0.010), but not in ER- cohort (P = 0.628). In multivariate analysis, high RECQL5 mRNA and high RECQL5/low RAD51 nuclear protein coexpression independently influenced survival (P = 0.022) in whole cohort and in the ER+ subgroup. Preclinically, we show that exogenous expression of RECQL5 in MCF10A cells can drive proliferation supporting an oncogenic function for RECQL5 in breast cancer. We conclude that RECQL5 is a promising biomarker in breast cancer.

Caspase-cleaved cytokeratin-18 and tumour regression in gastro-oesophageal adenocarcinomas treated with neoadjuvant chemotherapy.

AIM: To examine cytokeratin-18 (CK-18) and caspase-cleaved CK-18 expression in tumours and correlate with clinicopathological outcomes including tumour regression grade (TRG) response. METHODS: Formalin-fixed human gastro-oesophageal cancers were constructed into tissue microarrays. The first set consisted of 122 gastric/gastro-oesophageal cancer cases not exposed to neoadjuvant chemotherapy and the second set consisted of 97 gastric/gastro-oesophageal cancer cases exposed to pre-operative platinum-based chemotherapy. Expression of CK-18 and caspase-cleaved CK-18 was investigated using immunohistochemistry. RESULTS: CK18 was commonly expressed in gastro-oesophageal tumours (92.6%). Fifty-six point seven percent of tumours previously exposed to neoadjuvant chemotherapy were positive for caspase-cleaved CK-18 expression compared to only 24.6% of tumours not previously exposed to neoadjuvant chemotherapy (P = 0.009). In patients who received neoadjuvant chemotherapy, caspase-cleaved cytokeratin-18 expression correlated with favourable TRG response (TRG 1, 2 or 3, P = 0.043). CONCLUSION: This is the largest study to date of CK-18 and caspase-cleaved CK-18 expression in gastro-oesophageal tumours. We provide the first evidence that caspase-cleaved CK-18 predicts tumour regression with neoadjuvant chemotherapy.

Frequency of microbial spectrum of spontaneous bacterial peritonitis in established cirrhosis liver.

BACKGROUND: Spontaneous bacterial peritonitis is one of the most frequent and serious complication in patients with liver cirrhosis and ascites associated with high mortality. Empiric antibiotic therapy should be initiated before the results of ascitic fluid cultures are available, guided by knowledge of the microbial spectrum of spontaneous bacterial peritonitis in a particular population. METHODS: This is a descriptive study which was carried out in the Department of Gastroenterology and Hepatology, Postgraduate Medical Institute Hayatabad Medical Complex, Peshawar from January 2007 to December 2007. Fifty consecutive patients of established cirrhosis liver with ascites presenting with suspicion and or risk factors for spontaneous bacterial peritonitis were included in the study after informed consent. All selected patients were subjected to ascitic fluid tap. Twenty ml of ascitic fluid was aspirated in a heparinised disposable syringe; out of it 10 ml was immediately inoculated into blood culture bottle at bedside and sent for bacterial culture along with the remaining 10 ml for routine biochemical and cytological examination. RESULTS: Out of 50 patients, 28 (56%) were diagnosed to have spontaneous bacterial peritonitis or its variants. Classic spontaneous bacterial peritonitis was present in 11 patients (39.28%), 16 (57.14%) patients were found to have culture negative neutrocytic ascites and one patient (3.57%) had bacterascites. Out of 28 cases of spontaneous bacterial peritonitis 12 samples of ascitic fluid showed positive culture reports. E. coli was the most frequently cultured organism isolated in 8 (66.66%) cases, Streptococcus pneumonae in 2 patients (16.66%), S taphylococcus aurus and Klebsiella each in 1 case (8.33%). CONCLUSION: Spontaneous bacterial peritonitis and its variants is a common complication of liver cirrhosis with ascites. E. coli is the most frequent offending organism in these cases. Knowledge of the microbial spectrum of spontaneous bacterial peritonitis in a particular population is important for the selection of the most appropriate empiric antibiotic regimen.

Gallbladder perforation: a rare complication of acute cholecystitis.

Gallbladder perforation is a rare but potentially fatal disease and therefore is a dilemma for early diagnosis. It is usually a complication of acute cholecystitis with or without gallstones. We present a case of 70-year-old female with abdominal pain and fever. Initial ultrasound revealed cholelithiasis with possible acute cholecystitis. Clinical condition of the patient worsened and suspicion of gallbladder perforation was entertained. Hence, a repeat ultrasound and CT scan was done. Following this a gallbladder perforation was confirmed intra operatively.

Superior gluteal artery aneurysm.

To report the successful coil embolization of a rare gluteal artery aneurysm and review therapeutic options for this rare condition. We report a case of pseudo-aneurysm of superior gluteal artery initially diagnosed as gluteal abscess. They can be diagnosed by Doppler ultrasound, computed tomography or magnetic resonance imaging. Mainstay of the diagnosis is by angiography and the preferred management with good clinical results is with angiographic embolization. This report reviews the literature and addresses the incidence, aetiology, and treatment of gluteal artery aneurysms.

Frequency of osteoporosis in patients with cirrhosis due to hepatitis B and hepatitis C: a study of 100 cases.

BACKGROUND: Osteoporosis is the disease of bone that affected King David of Israel 3000 years ago. This condition is no longer considered to be due to aging alone and is increasingly recognised as a major health concern and accounts for about 1.5 million fractures annually in United States. Objective of this study was to see the frequency of osteoporosis in patients with cirrhosis due to Hepatitis B and C, and any correlation between the Bone Mineral Density (BMD) and duration and stage of the liver disease. METHODS: The study was conducted in the Department of Gastroenterology, Postgraduate Medical Institute, Hayatabad Medical Complex, Peshawar, from January 2008 to December 2008. All patients from the OPD or Ward fulfilling the criteria and consenting were included. Physical examination, with special emphasis on any signs of chronic liver disease was performed. Full blood count, platelet count, prothrombin time and INR, liver function tests including serum albumin, and renal function tests were done on all patients. Viral serology was checked for those patients who were either newly diagnosed as cirrhotic or were cirrhotic but not screened for viral markers. Abdominal sonogram was recorded on all patients. The Child's score was calculated for each patient using the clinical and lab parameters. The BMD was calculated for all patients using computer based ultrasound probe. Calcaneum was used for evaluation of BMD. The information collected was entered on structured data collection sheets and was analysed using SPSS version 11. RESULTS: Osteoporosis was found in 26% of subject and osteopenia in 42%, while 32% had BMD in the normal range. The mean T score was -1.483 (+/- 1.29). The mean duration of liver disease was 3.77 (+/- 1.56) year. Majority of the patients (81%) were in Child's Class C, followed by Class B and A (16% and 3% respectively). Fifty-nine percent of the patients were males with a mean age of 37.65 years, while 41% were females with mean age of 37.76 years. CONCLUSION: Osteoporosis is a common finding in patients with cirrhosis due to Hepatitis B and C. Osteoporosis is more frequent in patients with long duration of liver disease but there is no significant correlation between the aetiology or severity of liver disease and osteoporosis.