Effect of Iron-fortified Wheat Flour on Hemoglobin Levels among Women of Reproductive Age Group in Mansehra, KPK, Pakistan.

Micronutrient deficiencies continue to affect approximately 25% of the World's population. Fortification of staple foods is recognized as one of the most effective interventions to combat micronutrient deficiencies such as iron deficiency. The objective of the current research was to elucidate the effect of iron-fortified wheat flour on the mean hemoglobin levels of women of the reproductive age group (15-49 years) in the Mansehra district, KPK, Pakistan. The study sample consisted of 280 women whose baseline hemoglobin levels were determined at the start of the study. They were fed with iron-fortified wheat flour for a period of 120 days after which their hemoglobin levels were measured again. A 24-hour dietary recall was also taken from the study participants to determine the amounts and frequencies of major foods consumed during the last 24 hours. The study results showed that the consumption of iron-fortified wheat flour had significantly increased the mean hemoglobin levels of women. The study concluded that the consumption of iron-fortified wheat flour could be an effective strategy to combat the problem of iron deficiency in Pakistan.

Spirulina, an FDA-Approved Functional Food: Worth the Hype?

Spirulina, a blue-green microalga is an eminent functional food due to its unique nutritional and disease-mitigating properties. The main objective of this article is to present an overview of the nutritional composition of Spirulina. Along with its therapeutic potential and applications in the food industry. Studies included in this review have suggested spirulina to be a rich source of complete proteins, essential fatty acids (EFAs), vitamins, minerals and various bioactive compounds like carotenoids, chlorophyll, and xanthophylls. This makes Spirulina a promising functional food for the treatment of ailments like diabetes, cancer, cardiovascular disorders (CVDs), COVID-19, neuroinflammatory conditions and gut dysbiosis. Additionally, data from numerous studies suggest its use in food formulations, primarily in sports supplements, bakery products, beverages, dairy products, snack sources and confectionaries. It has also been used by the National Aeronautics and Space Association (NASA) for astronauts on space missions to the Moon and Mars. Furthermore, spirulina's use as a natural food additive possesses enormous potential for further research. Owing to its high nutritional profile and disease-fighting potential, it lends itself to numerous food formulations. Therefore, based on the findings of previous studies, further progress can be made considering spirulina's application in the food additive industry.

Single maintenance and reliever therapy in treatment of asthma exacerbations.

OBJECTIVE: To evaluate the effectiveness and practicality of single maintenance and reliever therapy (SMART) in the treatment of asthma exacerbation. DATA SOURCES: PubMed, MEDLINE, Cochrane, and Clinical Trial databases using the keywords SMART therapy, maintenance and reliever therapy, and budesonide and formoterol. STUDY SELECTIONS: Articles were selected based on their relevance and applicability to this topic. RESULTS: Multiple studies have evaluated the efficacy of SMART in reducing asthma exacerbations in comparison to standard inhaled corticosteroid maintenance and short-acting beta-agonist rescue therapy. Most of the randomized trials demonstrated a reduction in asthma exacerbation with open-label studies revealing similar effectiveness in reducing asthma exacerbation. Previously, concerns have been raised regarding the administration of increased doses of long-acting beta-agonist that may potentially mask symptoms and delay appropriate medical attention. However, studies have not demonstrated an increase in morbidity or mortality. The primary concern regarding many of these trials is that they have been sponsored by pharmaceutical companies. CONCLUSION: Although not all studies demonstrated the effectiveness of SMART, most revealed a substantial reduction in asthma exacerbation frequency and severity.

A Systematic Review of Human Trials on Mycoprotein - Way towards a Sustainable Ecosystem.

Rapidly increasing global warming and world population calls for exploring untapped elements of biodiversity in a much broader sense. Though there exists much evidence on the importance of livestock and animal-derived protein, escalating challenges related to sustainability have led to finding alternatives to animal-derived proteins. Mycoprotein is an eco-friendly sustainable product.  This fungal-derived protein is high in fiber and protein content. For this particular review paper, literature was searched for human trials using PubMed, Google Scholar, and Cochrane Library. Fifteen trials, totaling 952 participants were included- 5 solely reported on cholesterol response, 3 for glycemic response and 2 for serum uric acid concentrations, while 4 studies reported the combined effect of health markers such as cholesterol, glycemic response, and uric acid concentrations and 1 study on gut health. The Jadad scale was used to assess the quality of studies. Five trails were identified to be of good quality scoring 3 or more. The results showed cholesterol lowering percentage to be ranging between 4.3 to 13%. Similarly, a significant increase of (+0.02) (P< 0.05) was observed in Lactobacillus spp from the baseline value following mycoprotein consumption. Results however were inconclusive for glucose and insulin response. Overall given the growing increase in sustainable proteins, this area should be explored further from a public health perspective.

COVID-19 Vaccination as a Potential Trigger for New-Onset Systemic Lupus Erythematosus.

Immune hyperactivation has been linked to various vaccines. We present a potential association of new-onset systemic lupus erythematosus (SLE) post-COVID-19 immunization. The patient is a 54-year-old male admitted for evaluation of flu-like symptoms two weeks after receiving the second dose of the COVID-19 vaccine. Physical examination revealed high-grade fever, diffuse bilateral non-tender cervical lymphadenopathy, and erythematous maculopapular palpable purpuric lesions on bilateral feet. Laboratory evaluation showed a significant hypocomplementemia (C3 < 11 mg/dL, C4 < 3 mg/dL, and CH50 < 10 U/mL), high titer antinuclear antibody, anti-dsDNA antibodies, anti-Sjogren's syndrome-related antigen A antibodies, anti-Sjogren's syndrome-related antigen B antibodies, anti-Smith antibodies, anti-ribonucleoprotein antibodies, anti-histone antibodies with a negative malignancy, and infection workup. The patient was treated with a high dose of steroids with a positive response. This case highlights the possibility of SLE, a rare adverse event following COVID-19 vaccination.

Effect of inulin, galacto oligosaccharides and iron fortification on iron deficiency anemia among women of reproductive age; a randomized controlled trial.

Iron supplementation and fortification are the well-known approaches to treat iron deficiency anemia (IDA) in women of reproductive age. The objective of the current randomized controlled trial (RCT) was to evaluate the cumulative effects of prebiotics and iron fortification among women of reproductive age. For this purpose, a total of 75 iron deficient women of childbearing age were recruited and randomly divided into 5 groups (4 treatment groups and 1 control group). Four different types of fortified wheat flour were prepared using two iron fortificants (NaFeEDTA and FeSO4) and two prebiotics [inulin and galacto oligosaccharides (GOS)], while control group was treated with iron fortified flour without any prebiotics. Blood samples were collected from overnight fasted women on monthly basis up to 90 days. Hematological indices such as Hemoglobin (Hb), Hematocrit, Red Blood Cell (RBC) Count and Mean Corpuscular Volume (MCV), as well as iron biomarkers including serum iron, ferritin, transferrin, and Total Iron Binding Capacity (TIBC) were evaluated for analyses. The results showed a considerable positive improvement in all iron biomarkers as well as hematological indices among the treatment groups (P-value < 0.05), as compared to the control group. A maximum Hb (11.86 ± 0.24 mg/dL) and hematocrit value (35.06 ± 1.32%), was reported in group G3 which was treated with fortified wheat flour at a dose of 963 mg/kg GOS + 15 ppm FeSO4. On the other hand, highest mean values for RBC Count (4.73 ± 0.41 mil/mm3), MCV (81.41 ± 3.21 fL), serum iron (75.62 ± 2.79 µg/dL), serum transferrin (16.82 ± 0.30 mg/dL), and TIBC (403.68 ± 7.27 µg/dL) were observed in G4 group receiving the fortified wheat flour at a dose of 963 mg/kg GOS + 30 ppm FeSO4 level. The study concluded that prebiotic fortification along with iron salts helps to enhance iron absorption among iron deficiency anemic women of reproductive age.

Frequency Of Panton Valentine Leucocidin Gene In Staphylococcus Aureus From Skin And Soft Tissue Infections.

BACKGROUND: Staphylococcus aureus harbouring Panton Valentine Leucocidin gene are emerging and spreading worldwide. PVL gene was first identified by Noel Panton and Francis Valentine in 1932 who explained its ability to lyse leucocytes and its main relationship with skin and soft tissue infections. In Pakistan only limited data is available on the frequency and molecular analysis of PVL gene positive Staph aureus. Therefore, this study was conducted to understand the clinical epidemiology of PVL positive Staph aureus in our setup. Objectives of the study was aimed to determine the frequency of PVL gene in Staph aureus obtained from pus samples from skin and soft tissue infections from various departments; indoor and outdoor of a tertiary care hospital of Lahore. METHODS: 384 Staph aureus isolates from skin and soft tissue infections were selected from both indoor and outdoor departments of hospital. After identification by phenotypic methods, they were processed by PCR using luk-F and luk-S primers for the detection of PVL gene. RESULTS: 186 out of 384 Staph aureus isolates were positive for PVL gene. Overall frequency of PVL gene was 49%. Frequency of PVL gene in Staph aureus was 44.9% in males and 53.5% in females. The highest frequency of PVL gene was detected in paediatric age group. A large majority of positive isolates were from pus samples other than swabs and from the general surgery department. They mostly belong to indoor with indoor outdoor ratio of approximately 2:1. Frequencies of PVL gene in MRSA and MSSA were 51% and 44% respectively. Frequency of PVL gene was found to be high in Ciprofloxacin sensitive, Gentamicin sensitive, Erythromycin resistant and Fusidic acid resistant isolates. CONCLUSION: Almost half of Staph aureus isolates were found PVL positive. They were mostly multidrug resistant came from indoor setup. This situation is very alarming so, there is a need to adopt strict infection control policies in the hospitals to limit the widespread and injudicious use of antibiotics. There is also a need to apply PVL positive Staph aureus treatment to the effected individuals which involve not only antibiotics but also the decolonization of effected individuals and their close contacts.

'Only systems thinking can improve family planning program in Pakistan': A descriptive qualitative study.

BACKGROUND: Family Planning (FP) program in Pakistan has been struggling to achieve the desired indicators. Despite a well-timed initiation of the program in late 50s, fertility decline has been sparingly slow. As a result, rapid population growth is impeding economic development in the country. A high population growth rate, the current fertility rate, a stagnant contraceptive prevalence rate and high unmet need remain challenging targets for population policies and FP programs. To accelerate the pace of FP programs and targets concerned, it is imperative to develop and adopt a holistic approach and strategy for plugging the gaps in various components of the health system: service delivery, information systems, drugs-supplies, technology and logistics, Human Resources (HRs), financing, and governance. Hence, World Health Organization (WHO) health systems building blocks present a practical framework for overall health system strengthening. METHODS: This descriptive qualitative study, through 23 in-depth interviews, explored the factors related to the health system, and those responsible for a disappointing FP program in Pakistan. Provincial representatives from Population Welfare and Health departments, donor agencies and non-governmental organizations involved with FP programs were included in the study to document the perspective of all stakeholders. Content analysis was done manually to generate nodes, sub-nodes and themes. RESULTS: Performance of FP programs is not satisfactory as shown by the indicators, and these programs have not been able to deliver the desired outcomes. Interviewees agreed that inadequate prioritization given to the FP program by successive governments has led to this situation. There are issues with all health system areas, including governance, strategies, funding, financial management, service delivery systems, HRs, technology and logistic systems, and Management Information System (MIS); these have encumbered the pace of success of the program. All stakeholders need to join hands to complement efforts and to capitalize on each other's strengths, plugging the gaps in all the components of FP programming. CONCLUSION: All WHO health system building blocks are interrelated and need to be strengthened, if the demographic targets are to be achieved. With this approach, the health system shall be capable of delivering fair and responsive FP services.