ABSTRACT
Abstract Pakistan is an agricultural country and fisheries play a very important role in the economic development of the country. Different diseases are prevalent in Pakistani fish but information related to the causative agents is not well-known. Keeping in view the significance of bacterial pathogens as the causative agents of multiple fish diseases, the present study was conducted for identification, characterization and analysis of virulence genes of Aeromonas spp. isolated from diseased fishes. A total of fifty fish samples having multiple clinical indications were collected from different fish farms of district Kasur, Punjab Pakistan. For isolation of Aeromonas spp. samples were enriched and inoculated on Aeromonas isolation medium. Isolates were identified and characterized by different biochemical tests, Analytical Profile Index (API) 20E kit and Polymerase Chain Reaction (PCR) assays. All isolates were screened for three putative virulence genes including aerolysin (aer), haemolysin (hyl) and heat labile cytotonic enterotoxin (alt). Seven isolates of Aeromonas (A.) hydrophila were retrieved and identified based on API 20E. These isolates were further confirmed as A. hydrophila on the basis of PCR assays. Three isolates were detected positive for the presence of virulence genes (alt and hyl). Whereas aerolysin (aer) gene was not present in any of A. hydrophila isolates. The present study confirmed A. hydrophila as the causative agent of epizootic ulcerative syndrome and motile Aeromonas septicemia in fish farms of district Kasur, Punjab Pakistan. Moreover, detection of two virulence genes (alt and hyl) in A. hydrophila isolates is a threat for fish consumers of study area.
Resumo O Paquistão é um país agrícola, onde a pesca desempenha um papel muito importante para o desenvolvimento econômico. Diferentes doenças são prevalentes em peixes do Paquistão, mas as informações relacionadas aos agentes causadores não são bem conhecidas. Tendo em vista a importância dos patógenos bacterianos como agentes causadores de múltiplas doenças em peixes, o presente estudo foi conduzido para identificação, caracterização e análise de genes de virulência de isolados de Aeromonas spp. de peixes doentes. Foram coletadas 50 amostras de peixes com múltiplas indicações clínicas em diferentes fazendas do distrito de Kasur, Punjab, Paquistão. Para isolar Aeromonas spp., as amostras foram enriquecidas e inoculadas em meio de isolamento. Os isolados foram identificados e caracterizados por diferentes testes bioquímicos, kit Analytical Profile Index (API) 20E, e ensaios de reação em cadeia da polimerase (PCR). Todos os isolados foram selecionados para três genes de virulência putativos, incluindo aerolisina (aer), hemolisina (hyl) e enterotoxina citotônica termolábil (alt). Sete isolados de Aeromonas hydrophila foram recuperados e identificados com base no API 20E. Esses isolados foram posteriormente confirmados como A. hydrophila de acordo com ensaios de PCR. Três isolados indicaram a presença de genes de virulência (alt e hyl), enquanto o gene aerolisina (aer) não esteve presente em nenhum dos isolados de A. hydrophila. O presente estudo confirmou A. hydrophila como o agente causador da síndrome ulcerativa epizoótica e septicemia móvel por Aeromonas em fazendas de peixes, no distrito de Kasur, Punjab, Paquistão. Além disso, a detecção de dois genes de virulência (alt e hyl) em isolados de A. hydrophila é uma ameaça para os consumidores de peixes da área de estudo.
Subject(s)
Animals , Gram-Negative Bacterial Infections/veterinary , Gram-Negative Bacterial Infections/epidemiology , Aeromonas/genetics , Pakistan , Aeromonas hydrophila/genetics , Enterotoxins/genetics , FishesABSTRACT
Abstract Pakistan is an agricultural country and fisheries play a very important role in the economic development of the country. Different diseases are prevalent in Pakistani fish but information related to the causative agents is not well-known. Keeping in view the significance of bacterial pathogens as the causative agents of multiple fish diseases, the present study was conducted for identification, characterization and analysis of virulence genes of Aeromonas spp. isolated from diseased fishes. A total of fifty fish samples having multiple clinical indications were collected from different fish farms of district Kasur, Punjab Pakistan. For isolation of Aeromonas spp. samples were enriched and inoculated on Aeromonas isolation medium. Isolates were identified and characterized by different biochemical tests, Analytical Profile Index (API) 20E kit and Polymerase Chain Reaction (PCR) assays. All isolates were screened for three putative virulence genes including aerolysin (aer), haemolysin (hyl) and heat labile cytotonic enterotoxin (alt). Seven isolates of Aeromonas (A.) hydrophila were retrieved and identified based on API 20E. These isolates were further confirmed as A. hydrophila on the basis of PCR assays. Three isolates were detected positive for the presence of virulence genes (alt and hyl). Whereas aerolysin (aer) gene was not present in any of A. hydrophila isolates. The present study confirmed A. hydrophila as the causative agent of epizootic ulcerative syndrome and motile Aeromonas septicemia in fish farms of district Kasur, Punjab Pakistan. Moreover, detection of two virulence genes (alt and hyl) in A. hydrophila isolates is a threat for fish consumers of study area.
Resumo O Paquistão é um país agrícola, onde a pesca desempenha um papel muito importante para o desenvolvimento econômico. Diferentes doenças são prevalentes em peixes do Paquistão, mas as informações relacionadas aos agentes causadores não são bem conhecidas. Tendo em vista a importância dos patógenos bacterianos como agentes causadores de múltiplas doenças em peixes, o presente estudo foi conduzido para identificação, caracterização e análise de genes de virulência de isolados de Aeromonas spp. de peixes doentes. Foram coletadas 50 amostras de peixes com múltiplas indicações clínicas em diferentes fazendas do distrito de Kasur, Punjab, Paquistão. Para isolar Aeromonas spp., as amostras foram enriquecidas e inoculadas em meio de isolamento. Os isolados foram identificados e caracterizados por diferentes testes bioquímicos, kit Analytical Profile Index (API) 20E, e ensaios de reação em cadeia da polimerase (PCR). Todos os isolados foram selecionados para três genes de virulência putativos, incluindo aerolisina (aer), hemolisina (hyl) e enterotoxina citotônica termolábil (alt). Sete isolados de Aeromonas hydrophila foram recuperados e identificados com base no API 20E. Esses isolados foram posteriormente confirmados como A. hydrophila de acordo com ensaios de PCR. Três isolados indicaram a presença de genes de virulência (alt e hyl), enquanto o gene aerolisina (aer) não esteve presente em nenhum dos isolados de A. hydrophila. O presente estudo confirmou A. hydrophila como o agente causador da síndrome ulcerativa epizoótica e septicemia móvel por Aeromonas em fazendas de peixes, no distrito de Kasur, Punjab, Paquistão. Além disso, a detecção de dois genes de virulência (alt e hyl) em isolados de A. hydrophila é uma ameaça para os consumidores de peixes da área de estudo.
ABSTRACT
@#Introduction: The study aimed to target the current practices of the orthopaedic community in outpatient (OPD), emergency (ER) and surgical services (OT) during COVID19. Material and method: This study surveyed 303 orthopaedic surgeons from all over Pakistan. The survey had 30 questions targeting the setup of outpatient, emergency and operation services in orthopaedic departments of different hospitals in Pakistan. Result: A total of 302 surgeons were included from 53 cities all over Pakistan. Between 35-48% of the respondents reported lack of availability of standard operating procedures in OPD, ER and in OT. Majority of the respondents noted that their OPD and surgical practice had been affected to some degree and 69% of the surgeons were only doing trauma surgery. This trend was higher in younger consultants of less than 45 years of age (p<0.001). Almost two-third of the surgeons, mostly senior (p=0.03) were using surgical masks as the only protective measure during various practices of OPD, ER and OT, while most of the setups were not assessing patients even for signs and symptoms of COVID. Almost 89% of the orthopaedic community is facing definite to mild stress during this pandemic and this has significantly affected the senior surgeons (p=0.01). Conclusion: Our study highlighted that COVID-19 has resulted in marked changes to the practices of the majority of Pakistani orthopaedic surgeons. Despite a sharp upsurge in the number of cases and mortality due to COVID-19, guidelines were still lacking at most of the settings and a substantial percentage of the orthopaedic community were not following adequate safety measures while attending to patients.
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Background: Thyroid lobectomy is a common operative technique of management of benign solitary thyroid nodules in which drains are used routinely. Objective of this study to compare the outcome of thyroid lobectomies undergone with and without drains in patients of benign solitary thyroid nodules.Methods: A comparative cross-sectional research was completed on 98 patients of benign solitary thyroid nodules at surgery department of Liaquat University Hospital Jamshoro. Patients having age of 18-60 years underwent thyroid lobectomies were included and distributed in two groups A and B. Group A includes thyroid lobectomies with drain and Group B without drain. Postoperative outcomes including pain score assessed via visual analog score (VAS), hospital stay and complications including wound infection, seroma and hematoma.Results: Out of 98 cases, 49 underwent thyroid lobectomy with drain and 49 without a drain. Females patients were in majority in group A 42 (85.7%) and also in group B 47 (95.9%). No significant difference (p-value=0.674) was in mean age of group A 30.8±10.2 years and group B 31.8±12.2 years. Higher mean with significant difference (p-value=0.001) was in pain score of group A 5.61±1.25 as compared to group B 3.55±0.70. No significant difference was in complications; seroma 1 (2.04%) vs 5 (10.20%), hematoma 1 (2.04%) vs 1 (2.04%) and infection 3 (6.12%) vs 0 (0.0%) in group A and B respectively. Higher mean with significant difference (p-value=0.001) was in hospital stay of group A 2.40±1.57 days as compared to group B 1.42±0.54 days. No significant difference (p-value=0.748) was in overall rate of complications in group A 5 (10.20%) and B 6 (12.24%).Conclusions: Thyroid lobectomy with drain is not effective in lowering the postoperative complications whereas enhanced the risk of postoperative pain, wound infection and duration of hospital stay as compared to thyroid lobectomy without a drain.
ABSTRACT
The immunization process of current commercial manufacturing of anti-snake venom (ASV), uses injections of bentonite, complete Freund’s adjuvant, or incomplete Freund’s adjuvant, mixed with low doses of the snake venom in horses (but rarely in other large mammals), which frequently cause serious adverse effects in host animals. At the site of injection, horses may develop painful swelling, granuloma, abscess, scar, or systemic neurological and hematological defects, low antibody response, or death due to anaphylactic shock. We sought to investigate a novel alternate immunization strategy with oral administration of snake venom with adjuvants. We utilized M5904 mineral oil emulsion as an adjuvant that was mixed with sub-lethal doses (LD) of the snake venoms. Our preliminary experiments were initiated in March 2011 and the present data culminated in March 2018. In our initial experiments which were carried out in inbred mice, the LD100 was 10.36 ug/25 grams of mice for Naja. oxins and 10.0 ug/25 gram of Naja. karachians. We extrapolated the sub-LD dose to horses by cutting the LD100 in mice to 20%. This dose did not cause any apparent pathology in horses and therefore, we adopted that dose for the equine.
ABSTRACT
OBJECTIVE@#To assess the knowledge on Zika virus infection among healthcare providers (doctors) in Aceh province, Indonesia.@*METHODS@#A self-administered internet based survey was conducted from 3 May to 3 June 2016 among the members of doctor organizations in Aceh province. A set of validated, pre-tested questionnaire was used to measure knowledge regarding Zika infection and to collect a range of explanatory variables. A two-steps logistic regression analysis was employed to assess the association of participants' demographic, workplace characteristics and other explanatory variables with the knowledge.@*RESULTS@#A total of 442 participants included in the final analysis and 35.9% of them (159) had a good knowledge on Zika infection. Multivariate model revealed that type of occupation, type of workplace, availability of access to medical journals and experience made Zika disease as differential diagnose were associated with knowledge on Zika infection. In addition, three significant source of information regarding Zika were online media (60%), medical article or medical news (16.2%) and television (13.2%).@*CONCLUSION@#The knowledge of the doctors in Aceh regarding Zika infection is relatively low. Doctors who have a good knowledge on Zika infection are more confident to established Zika disease as differential diagnosis in their clinical setting. Therefore, such program to increase healthcare providers' knowledge regarding Zika infection is needed to screen potential carriers of Zika infection.
ABSTRACT
Objective To assess the knowledge on Zika virus infection among healthcare providers (doctors) in Aceh province, Indonesia. Methods A self-administered internet based survey was conducted from 3 May to 3 June 2016 among the members of doctor organizations in Aceh province. A set of validated, pre-tested questionnaire was used to measure knowledge regarding Zika infection and to collect a range of explanatory variables. A two-steps logistic regression analysis was employed to assess the association of participants' demographic, workplace characteristics and other explanatory variables with the knowledge. Results A total of 442 participants included in the final analysis and 35.9% of them (159) had a good knowledge on Zika infection. Multivariate model revealed that type of occupation, type of workplace, availability of access to medical journals and experience made Zika disease as differential diagnose were associated with knowledge on Zika infection. In addition, three significant source of information regarding Zika were online media (60%), medical article or medical news (16.2%) and television (13.2%). Conclusion The knowledge of the doctors in Aceh regarding Zika infection is relatively low. Doctors who have a good knowledge on Zika infection are more confident to established Zika disease as differential diagnosis in their clinical setting. Therefore, such program to increase healthcare providers' knowledge regarding Zika infection is needed to screen potential carriers of Zika infection.
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An accurate gas chromatography coupled to a flame ionization detector (GC-FID) method was validated for the simultaneous analysis of light hydrocarbons (C2-C4) in their gas mixture. The validation parameters were evaluated based on the ISO/TEC 17025 definition including method selectivity, repeatability, accuracy, linearity, limit of detection (LOD), limit of quantitation (LOQ), and ruggedness. Under the optimum analytical conditions, the analysis of a gas mixture revealed that each target component was well-separated with high selectivity property. The method was also found to be precise and accurate. The method linearity was found to be high with good correlation coefficient values (R² ≥ 0.999) for all target components. It can be concluded that the GC-FID developed method is reliable and suitable for determination of light C2-C4 hydrocarbons in their gas mixture. The validated method was successfully applied to the estimation of light C2-C4 hydrocarbons in natural gas samples, showing high performance repeatability with relative standard deviation (RSD) less than 1.0% and good selectivity with no interference from other possible components.
Se validó una cromatrografía de gases precisa, acoplada con un detector de ionización de llama (GC-FID) para el análisis simultáneo de hidrocarburos ligeros (C2-C4) en su mezcla gaseosa. Los parámetros de validación se evaluaron con base en la definición de la ISO/ IEC 17025, que incluye selectividad del método, precisión y repetibilidad, exactitud, linealidad, limite de detección (LOD), limite de cuantificación (LOQ) y robustez. Bajo las condiciones analiticas óptimas, el análisis de la mezcla gaseosa mostró que cada analito de interés fue separado adecuadamente con alta selectividad. Se encontró también que el método fue preciso y exacto; la linealidad fue alta y con buen coeficiente de correlación lineal (R² ≥ 0.999) para todos los analitos. Se puede concluir que el método GC-FID es confiable y apropiado para la determinación de hidrocarburos ligeros C2-C 4 en una mezcla gaseosa. El método validado ha sido exitosamente aplicado a la valoración de hidrocarburos ligeros C2-C4 en muestras de gas natural, mostrando alta repetibilidad con desviación estándar relativa (RDS) menor al 1% y buena selectividad sin interferencias de otros posibles componentes.
Foi avaliada uma cromatografia gasosa precisa, equipada com um detector de ionização de chama (CG-FID) para a análise simultâneo de hidrocarbonetos ligeiros (C2-C4) em uma mistura gasosa. Os parâmetros de validação foram avaliados baseados na definição da ISO/IEC 17025, que inclui seletividade do método, precisão e repetibilidade, exatidão, linearidade, limite de detecção (LOD), limite de quantificação (LOQ) e robustez. Baixo as condições analiticas ótimas, a análise da mistura gasosa mostrou que cada analito foi separado adequadamente com alta seletividade. Também foi encontrado que o método foi preciso e exato; a linearidade foi alta e com bom coeficiente de correlação linear (R² ≥0.999) para todos os analitos. Pode-se concluir que o método GC-FID é confiável e apropriado para a determinação de hidrocarbonetos ligeiros C2-C4 em uma mistura gasosa. O método avaliado têm sido exitosamente aplicado à valoração de hidrocarbonetos ligeiros C2-C4 em amostras de gás natural mostrando alta repetibilidade com desvio-padrão relativo menor funcionais. ao 1% e boa seletividade sem interferências de outros possiveis componentes.
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Objectives: There are a number of validated questionnaires available for the screening of Post-Traumatic Stress Disorder (PTSD), and the PTSD Checklist for Civilians is one of them. However, none was translated into the Malay Language and validated for use in the Malaysian population. The aim of this study is to translate and validate the Malay PTSD Checklist for Civilians (MPCL-C). Methods: The PCL-C was translated into the Malay Language and back-translated. The reliability and validity of the MPCL-C were then determined by administering them to those who presented at the emergency department for motor vehicle accident at least one month before. Results: The MPCL-C has good face and content validity. In terms of reliability, it is also good, with Chronbach’s alpha values of 0.90, 0.77, 0.75 and 0.74 for the full scale, re-experiencing, avoidance and arousal domains respectively. Conclusions: The MPCL-C is a valid and reliable instrument to screen for PTSD in motor vehicle accident victims for the studied population.
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The purpose was to estimate the prevalence of blindness due to cataract, assess visual outcomes of cataract surgery, and determine the cataract surgical coverage rate and barriers to uptake of services among individuals aged 50 years or older in Plateau State, Nigeria. A population-based, cross-sectional survey of 4200 adults 50 years or older was performed. Multistage stratified random sampling, with probability proportional to size was used to select a representative sample. The Rapid Assessment of Cataract Surgical Services protocol was used. Statistical significance was indicated by [P < 0.05]. The cohort comprised 4115 subjects [coverage: 98%]. The prevalence of bilateral blindness due to cataract was 2.1%, [95% confidence intervals [CI]: 1.7-2.5%] in the entire cohort, 2.4% in females [95% CI: 1.8-3.8%]; and 1.8% in males [95% CI: 1.2-2.4%] [chi[2] = 0.85, P > 0.05]. The prevalence of monocular blindness due to cataract was 5.9% [95% CI: 5.2-6.6%]. The cataract surgical coverage for subjects with visual acuity [VA] less 3/60 was 53.8% in the entire cohort; 60.5% for males and 48% for females [chi[2] = 2.49, P > 0.05]. The couching coverage for subjects who were blind was 12%. A total of 180 eyes underwent surgical intervention [surgery or couching] for cataract, of which, 48 [26.7%] eyes underwent couching. The prevalence of bilateral [pseudo] aphakia was 1.5%, [95% CI: 1.2-1.9%] and 2.7% [95% CI: 2.2-3.2%] for unilateral [pseudo] aphakia. Visual outcomes of the 180 eyes that underwent surgical intervention were good [VA >/= 6/18] in 46 [25.6%] eyes and poor [VA < 6/60] in 105 [58.3%] eyes. Uncorrected aphakia was the most common cause of poor outcome [65.1%]. Most subjects who underwent cataract surgery were not using spectacles 74 [71.2%]. Cost and lack of awareness were the main barriers to uptake of cataract surgery services. Couching remains a significant challenge in Nigeria. The outcomes of cataract surgery are poor with the lack of aphakic correction being the main cause of the poor outcomes
ABSTRACT
Leiomyoma of the uterus is a common tumor during the reproductive age of females. It is classified as intrauterine and extrauterine. Extrauterine leiomyomas may occur without a concurrent uterine pathology. Different growth patterns have been described, like retroperitoneal and parasitic growth. We report a case of a 28-year-old female who was found to have inguinal mass, and it was finally diagnosed as parasitic leiomyoma. The mass was coming through the posterior inguinal wall into the subcutaneous region, like a direct inguinal hernia. She underwent excision of the mass, and repair of posterior inguinal wall. Parasitic leiomyoma can be a rare cause of inguinal swelling. When diagnosed, surgical excision is the treatment of choice
Subject(s)
Humans , Female , Uterine Neoplasms , Hernia, Inguinal , Parasitic Diseases , GroinSubject(s)
Humans , Male , Female , Islam , Blood Glucose , Lipids/blood , Diabetes Mellitus, Type 2 , Blood Pressure , Cholesterol , Triglycerides , Lipoproteins, HDL , Lipoproteins, LDLABSTRACT
The role of laparoscopic appendectomy is still not well defined in the literature. This study was conducted to evaluate the feasibility of laparoscopic appendectomy at a university hospital in a developing country. Patients undergoing laparoscopic appendectomy [LA] from August 2002 to August 2006 were identified. For each case, a control was selected from patients undergoing open appendectomy [OA] during the same year by systematic sampling. The groups were compared in terms of duration of surgery, requirement of narcotic analgesia, length of hospital stay, postoperative complications and the overall cost for each patient. A total of 68 patients underwent laparoscopic appendectomy during the study period. Median duration of surgery was 82 minutes in LA group and 70 minutes in OA group [P < 0.001]. Forty-five patients in LA group and 64 in OA group required narcotic analgesia [P < 0.001]. Median length of hospital stay [P = 0.672] and postoperative complications [P = 0.779] were comparable in both groups. Median cost of hospital stay was Pakistani Rupees [PKR] 47121/in LA group and PKR 39318/in OA group, the difference being significant [P = 0.001]. Laparoscopic appendectomy is feasible in developing countries with similar postoperative outcome and less requirement of narcotic analgesia. The duration of surgery and overall cost were significantly higher and efforts should be made to develop expertise and reduce operative time with resultant decrease in cost. Development of standardized protocols for discharge of patients from the hospital after LA may further reduce the cost and benefit patients in developing countries
Subject(s)
Humans , Female , Male , Adult , Appendicitis/surgery , Laparoscopy , Developing Countries , Treatment OutcomeABSTRACT
To study the incidence of abdominal wall endometriosis after cesarean section and its presentation to the general surgeon. Fourteen patients were treated for abdominal wall endometriosis during the period June 1997 to May 2002 at Princess Basma Teaching Hospital and King Abdulla University Hospital, Irbid, Jordan. The patient's files were reviewed to see their way and time of presentation after cesarean section, provisional diagnosis made and operative procedures performed. Symptoms suggestive of and investigations carried out to detect pelvic endometriosis were also looked for and recorded. Fourteen patients were treated within 5 years; all had painful scar-related mass. The pain was exacerbating during menstruation in 5. The clinical diagnosis was stitch granuloma in 3; incisional hernia in 3, abdominal wall tumor in 3 and abdominal wall endometrioma in 5 patients. The mean time for the mass to be noticed by the patient was 2 years. They were treated with wide local excision. Histopathological examination proved the diagnosis of abdominal wall endometriosis. None had evidence of pelvic endometriosis and none of them had recurrence. The incidence of the disease is around 0.2% of the cesarean sections performed during the same period. The treating physician should keep in mind abdominal wall endometriosis as a possible cause of post cesarean section scar-related masses
Subject(s)
Humans , Female , Endometriosis/etiology , Abdominal Muscles , Cesarean Section/adverse effectsABSTRACT
To compare the results of 20% silver nitrate and galvanic cautry for the treatment of allergic rhinitis. SETTING: ENT department Mayo Hospital, Lahore: DESIGN: Retrospective study. PATIENTS AND METHODS: This study was conducted on 100 patients of allergic rhinitis with age range of 16 years to 50 years from Oct 1992 to Oct 1995. Taking into consideration the morbidity and beneficial effects of using 20% silver nitrate cautry and galvanic cautry for the treatment of allergic rhinitis detailed results are studied. 20% silver nitrate cautry is far superior than galvanic cautry for the treatment of allergic rhinitis
Subject(s)
Humans , Rhinitis, Allergic, Seasonal/drug therapy , Silver Nitrate , Silver Nitrate/administration & dosage , ElectrocoagulationABSTRACT
Cirhotic patients with ascites presenting at Chandka Medical College Hospital, Larkana, from May 1997 to June 1998 were included in the study to see the frequency, bacterial spectrum, clinical and biochemical features of spontaneous bacterial peritonitis [SBP]. Ninety cases [63 males and 27 females] of liver cirrhosis with ascites were selected for analysis. SBP was found in 29 [32.2 percent] of cases. The breakup of SBP into its subtypes was, classic SBP found in 10 [34.5 percent] of cases, the bacterascites [BA] was found in 1 [3.4 percent] and that of culture negative neutrocyte ascites [CNNA] was found among 18 [62.1 percent] of cases. The frequency of organisms found in culture of ascitic fluid was; E. coLi was found in 7 [63.64 percent] cases, pneumococcus in 2 [18.18 percent] cases, Kiebsiella in 1 [9.09 percent] and Staphylococcus in 1 [9.09 percent]. Mortality rate in patients with SBP was 31.03 percent