ANTICANCER ACTIVITY OF PHLORETIN COMPOUND PURIFIED FROM IRAQI MALUS DOMESTICA L. (APPLE) LEAVES.

The present study was dealing with a Polyphenolic compound known as Phloretin. Phloretin (Ph), a dihydrochalcone, was determined qualitatively and quantitatively in different aerial parts for Iraqi Malus domestica (apple), cv." Ibrahimi" included leaves, petioles, stems, fruit pulp, and peels extracts. Leaves represented a rich source of Ph, which was separated and purified by preparative HPLC. The chemical structure of the isolated Phloretin (Ph2) was confirmed using various analytical characterization techniques: TLC, HPLC, FTIR, Melting point, CHN elemental analyses, 1H-NMR, and 13C-NMR). The scavenging efficacy of Ph2 by DPPH assay was employed. Cytotoxic effect was assessed by MTT assay against cancer cell lines including (Hep G2/ human hepatocyte carcinoma, A549/ human lung adenocarcinoma, SW480 / human colon cancer cell, and AGS /adenocarcinoma of the stomach), beside the non-cancerous cell line (HEK 293). About 1.404 g Ph2 was obtained from 18.146 g apple leaves (7.7%). The DPPH and MTT assay results demonstrated that the purified Ph2 possessed potent antioxidant activity with significant anticancer effects on all cancer cell lines. Data suggested that purified Ph2 from Iraqi apple leaves has potential antioxidant, cytotoxicity, which may benefit in human health.

Predictors of citation rates for research publications in Neurosciences.

OBJECTIVES: To identify the predictors of citation rates for research publication in Neurosciences. METHODS: All original articles including meta-analyses (MAs) and systematic reviews (SRs) that were published in Neurosciences during 2011 to 2019 were reviewed. The impact of several predictors on citation rates was assessed using correlation coefficient and mean difference tests. RESULTS: This study examined 231 articles. The mean article citation number was 11.6. The correlation analysis showed a significant association between citation rates and duration from publication in years (p<0.0001), sample size (p<0.0001), study design (p=0.0353), and level of evidence (LOE) (p=0.03). The comparative analysis showed significantly more citations for articles that were published 6-10 years ago (p<0.0001), had a sample size >91 (p=0.0359), were randomized controlled trials (p=0.0353), MAs and SRs (p<0.0001), and level of evidence (LOE)-I (p=0.0004). Retrospective case series had significantly lower citations. The higher and lower citation numbers for publications from Iran and rehabilitation, respectively, may have been influenced by the duration from publication. CONCLUSION: The most significant predictors of citation rates for Neurosciences publications were the age of articles, population size, study design, and LOE. Awareness of the predictors of citation rates may help researchers enhance the academic impact of their work.

Biocontrol efficacy of Trichoderma asperellum-enriched coconut fibre against Fusarium wilts of cherry tomato.

AIMS: Agro-based wastes were evaluated as a medium for mass micropropagule production and optimal efficacy of Trichoderma asperellum B1092 in controlling Fusarium oxysporum f. sp. lycopersici and promoting tomato growth. This study focused on biological control because pathogen persistence in the soil makes the disease difficult to control. METHODS AND RESULTS: Rice bran, biochar, empty fruit bunches, coconut fibres, compost, top soil and mixed soil were evaluated as media for mass multiplication of T. asperellum, which is effective in controlling plant pathogens. Yielding the most colony forming units (CFU) among the media, coconut fibre was deemed most suitable for promoting sporulation. After 120 days on the medium, T. asperellum B1902 produced 9·053 × 105  CFU per gram coconut fibre; oil palm empty fruit bunches was second highest (7·406 × 105  CFU per gram). In field tests of T. asperellum B1092 against F. oxysporum f. sp lycopersici (causing Fusarium wilt of cherry tomato), B1092 significantly promoted plant growth compared to the control. The efficacy of this formulation resulted in increased growth of roots and shoots tomato plants and total lycopene, sugar, K, N, Ca, P and Mg content after 120 days. CONCLUSIONS: Trichoderma asperellum B1092 showed great field potential for improving productivity and quality of tomatoes and in controlling Fusarium wilt of cherry tomato. SIGNIFICANCE AND IMPACT OF THE STUDY: This innovative approach using a cheap agro-waste to control the persistent soil-borne Fusarium pathogen of cherry tomato should increase soil survival rate of Trichoderma and has potential for upscaling in the field for other crops.

Patient preferences for topical treatment of actinic keratoses: a discrete-choice experiment.

BACKGROUND: The treatment of actinic keratosis (AK) is a potentially effective strategy for the prevention of cutaneous squamous cell carcinoma (cSCC). However, the patient perspective on potential benefits of AK treatment in terms of skin cancer reduction has received little attention to date. OBJECTIVES: (i) To investigate patient preferences for topical treatments for AK using a discrete-choice experiment (DCE); (ii) to evaluate patient willingness to trade between clinical benefit and medical burden. METHODS: The DCE was conducted as part of a study to establish the feasibility of a phase III randomized controlled trial evaluating the prevention of cSCC using currently available topical interventions. Preferences were elicited by asking patients to make a series of choices between treatment alternatives with different hypothetical combinations of attribute levels. Willingness to trade between treatment attributes was estimated using a flexible-choice model that allows for the heterogeneity of patient preferences. RESULTS: A total of 109 patients with AK completed the DCE. The majority of patients who expressed valid preferences were willing to accept some reduction in both prophylactic and cosmetic efficacy to reduce the burden of the treatment regimen, the severity of skin reaction and other adverse effects. Patients may reject treatment if the perceived therapeutic benefit is outweighed by the subjective burden of treatment. CONCLUSIONS: Evidence of significant variation in the perceived utility of treatments across patients highlights the importance of taking individual patient preferences into account to improve AK treatment acceptability and adherence.

Randomized Controlled Trial of Slow Versus Rapid Enteral Feeding Advancements on the Clinical Outcomes in Very Low Birth Weight Neonates.

Starting and advancement of feeding in very low birth weight (VLBW) infants are big challenges for the neonatal practitioners. Wide variations in volume of feed advancement have observed in earlier trials both in slow and rapid advancement groups. Volume advancement in slow advancement groups have ranged from 10ml/kg/day to 23ml/kg/day and in rapid advancement groups have ranged from 15ml/kg/day to 45ml/kg/day in earlier different studies. This randomized controlled trial was conducted in neonatal intensive care unit (NICU) of Bangabandhu Sheikh Mujib Medical University (BSMMU) from April 2013 to July 2014 to evaluate the effects of slow versus rapid rates of feeding advancements on the clinical outcomes in very low birth weight infants. A total 95 infants were enrolled into two strata according to their birth weight. Infants of each stratum were randomly allocated to either slow or rapid advancement group during initiation of feeding. After gut priming over five days, feeding was advanced daily 10ml/kg in slow and 15ml/kg in rapid advancement group for 1000 - <1250gm weighing infants. For 1250 - <1500gm weighing infants, feeding was advanced daily 15ml/kg in slow and 20ml/kg in rapid advancement group. The primary outcome variable was time taken to achieve full enteral feed. Total 82 infants completed the trial. Demographically both groups were same. Infants in the rapid feeding advancement group achieved full enteral feedings before the slow advancement group, had significantly fewer days of parenteral nutrition and regained birth weight earlier. There were no statistical differences in episodes of feed interruption, number of infants with apnea, feed intolerance or diagnosis of sepsis. Rapid enteral feeding advancements were well tolerated by very low birth weight infants.

Osteopenia of Prematurity: Are We at Risk?

The continuous advances in intensive care have led to increased survival of premature infants. As a consequence, the problem of less imminent, slowly progressing disorders such as osteopenia of prematurity has been emerging. Osteopenia of prematurity (OOP) also called metabolic bone disease of prematurity (MBD) or rickets of prematurity is characterized by a reduction in bone mineral content usually manifest between 6th to 12th weeks of corrected gestational age. It occurs in up to 55% of infants born with weight <1000gm and 23% of infants weighing <1500gm. Clinical features of osteopenia of prematurity are mostly non-specific often appears as a late symptoms. Several biochemical markers have frequently been used as screening tools and diagnostic markers, but timing of measurements and the levels at which treatment should be initiated vary widely. Dual energy X-ray absorptiometry (DEXA) and Quantitative ultrasnogram are important diagnostic tool. Standard X-ray, a widely accepted but cannot detect osteopenia unless 20% loss of bone mineralization. The treatment of osteopenia includes provision of adequate mineral supplementation. Monitoring of serum and urinary markers are mandatory. The focus on prevention has largely centered on providing adequate intake of phosphorus and calcium but more research is needed. Till date there are neither enough data regarding clinical risk factors, valid biochemical markers which can detect premature babies at risk of osteopenia nor supplementation as well as appropriate timely management protocol is practicing in Bangladesh.

Clinico-pathological profile of dengue syndrome: an experience in a tertiary care hospital, Dhaka, Bangladesh.

Dengue is the fastest emerging arboviral infection and became a major public health concern in tropical and subtropical countries. Dengue infections can result in a wide spectrum of disease severities ranging between dengue fever (DF) to the life-threatening dengue hemorrhagic fever (DHF) and dengue shock syndrome (DSS). This study was performed to find out the varied presentations and laboratory findings to put forward an overview about dengue syndrome in Bangladesh, in order to create better awareness and diagnostic skills among the health care providers. This hospital based observational study was conducted in the department of Medicine, Square Hospitals Ltd. during January, 2008 to December, 2010. A total of 262 adult subjects of both sexes having dengue syndrome were included in this study. Dengue syndrome was common in younger age group and the majority (72%) was below 45 years of age. All the patients had fever and the majority had malaise (96%), severe headache (72%) and musculoskeletal pain (65%). Skin rash (47%) was the commonest hemorrhagic manifestation while tourniquet test (49%) and low pulse pressure (37%) were the commonest clinical signs. All had thrombocytopenia (100%) and the majority had leukopenia (84%) and elevated liver transaminase (ALT-74%, AST-88%). Most of the subjects developed anti dengue antibody (IgM-92%, IgG -72%). All subjects survived.

Cardiovascular Morbidity in Systemic Lupus Erythematosus: A Single-Center Retrospective Study.

BACKGROUND: Systemic Lupus Erythematosus (SLE) is an autoimmune inflammatory condition affecting multiple systems. Cardiovascular morbidity is a significant concern, with around 25% of SLE patients experiencing cardiac complications. OBJECTIVE: This study aims to determine the prevalence of cardiovascular morbidity in SLE patients in King Fahad Medical City (KFMC) in Riyadh, Saudi Arabia. METHODOLOGY: This retrospective record-based research was conducted at KFMC from January 2015 to October 2023. A review of the medical files of all SLE patients was accomplished. RESULTS: The vast majority of the patients (90.9%) were females. The mean age for the patients was 36.5 years. The most common comorbidities were lupus nephritis (34.6%), hypothyroidism (18.4%), and anti-phospholipid syndrome (9.2%). The most commonly used medications were hydroxychloroquine (81.8%), corticosteroids (prednisolone) (43.0%), and mycophenolate mofetil (27.9%). Around 45.2% (n= 176) of the patients with SLE developed cardiovascular complications. The most commonly reported cardiovascular diseases that developed after diagnosing patients with SLE were hypertension (22.4%), valvular heart diseases (13.2%), and dyslipidemia (9.2%). The study also found that anti-dsDNA antibodies can reduce the likelihood of developing hypertension by 40%. This research contributes to the medical literature on SLE and sets the stage for future research on personalized healthcare strategies for managing SLE and its complications. CONCLUSION: This study highlights that a considerable proportion of SLE patients(~50%) develop cardiovascular complications, with hypertension, valvular heart diseases, and dyslipidemia being the most common. We also discovered that anti-double-stranded deoxyribonucleic acid antibodies (Anti-dsDNA) reduce the likelihood of developing hypertension.

Knowledge and Attitudes Regarding Do-Not-Resuscitate Decisions Among Clinical-Year Medical Students and Interns in the Western Region of Saudi Arabia.

Background The directive to withhold emergent interventions in the case of cardiac and/or respiratory arrest with the continuation of standard care and therapy is known as do-not-resuscitate (DNR). The diversity of DNR guidelines depends on moral and religious factors. In Saudi Arabia, a DNR policy was published in 2017 which corresponds to the religious and ethical aspects of Islamic law. To augment future awareness regarding DNR decisions, as they are an essential element in critical care medicine, the foundational principles of DNR must be provided during the clinical years of medical school. Objectives The current study aims to assess and evaluate the knowledge and attitudes regarding DNR decisions among clinical-year medical students and interns in the Western Region of Saudi Arabia. Methods A cross-sectional study was carried out from October to December 2023, utilizing a self-administered online survey distributed via social media platforms. After receiving ethical approval from the institutional review board, data were collected from clinical-year medical students and interns in the Western Region of Saudi Arabia, and an appropriate statistical analysis was performed. Results A total of 397 participants were enrolled in this study. More than half (n = 251, 63.2%) were from Umm Al-Qura University, while the remaining (n=79, 19.9%) were from Taibah University. Of the total, 258 (65%) were male participants, and 139 (35%) were female. A total of 152 (38.3%) were fifth-year medical students, and 102 (25.7%) were interns. The vast majority (n = 364, 91.7%) had heard the term DNR, with the most reported source of information being from healthcare providers (n = 306, 83.2%), while a minority (n = 33, 8.3%) had not. Of the respondents, 226 (56.9%) identified the presence of a clear DNR policy in Saudi Arabia, and 77 (19.4%) had previously had experience with DNR. Most of the studied population (n = 333, 83.9%) expressed a willingness to take a lecture/session regarding DNR. Most of our participants, 347 (87.4%), believe it is essential to consider legal concerns when making a DNR decision. Interestingly, 152 (38.5%) of the participants think it is acceptable to be conservative in investigations and treatments with patients who are labeled as DNR, and 223 (56.2%) agree that patients should be aware of their DNR status. Approximately three-quarters of the study population (n = 290, 73%) agreed that it is stressful to discuss the possibility of a DNR order. In the association of who heard about DNR more, 101 (99%) of the interns had heard about the term DNR, while only 53 (75.7%) of the fourth-year medical students had. At the same time, 74 (72.5%) of the interns showed a positive attitude regarding the DNR definition, compared to 33 (47.1%) of the fourth-year medical students. Conclusion This study highlights the necessity of integrating educational interventions into DNR decisions in addition to clinical placement in the intensive care unit as part of the medical school curriculum.

Rho kinase regulates induction of T-cell immune dysfunction in abdominal sepsis.

T-cell dysfunction increases susceptibility to infections in patients with sepsis. In the present study, we hypothesized that Rho kinase signaling might regulate induction of T-cell dysfunction in abdominal sepsis. Male C57BL/6 mice were treated with the specific Rho kinase inhibitor Y-27632 (5 mg/kg of body weight) prior to cecal ligation and puncture (CLP). Spleen CD4 T-cell apoptosis, proliferation, and percentage of regulatory T cells (CD4(+) CD25(+) Foxp3(+)) were determined by flow cytometry. Formation of gamma interferon (IFN-γ) and interleukin 4 (IL-4) in the spleen and plasma levels of HMBG1, IL-17, and IL-6 were quantified by use of enzyme-linked immunosorbent assay (ELISA). It was found that CLP evoked apoptosis and decreased proliferation in splenic CD4 T cells. Inhibition of Rho kinase activity decreased apoptosis and enhanced proliferation of CD4 T cells in septic animals. In addition, CLP-evoked induction of regulatory T cells in the spleen was abolished by Rho kinase inhibition. CLP reduced the levels of IFN-γ and IL-4 in the spleen. Pretreatment with Y-27632 inhibited the sepsis-induced decrease in IFN-γ but not IL-4 formation in the spleen. CLP increased plasma levels of high-mobility group box 1 (HMGB1) by 20-fold and IL-6 by 19-fold. Inhibition of Rho kinase decreased this CLP-evoked increase of HMGB1, IL-6, and IL-17 levels in the plasma by more than 60%, suggesting that Rho kinase regulates systemic inflammation in sepsis. Moreover, we observed that pretreatment with Y-27632 abolished CLP-induced bacteremia. Together, our novel findings indicate that Rho kinase is a powerful regulator of T-cell immune dysfunction in abdominal sepsis. Thus, targeting Rho kinase signaling might be a useful strategy to improve T-cell immunity in patients with abdominal sepsis.

Mycobacterium tuberculosis Sonicate-Induced IFNγ, CXCL10 and IL10 can Differentiate Severity in Tuberculosis.

Improved tools are required to study immunopathogenesis of tuberculosis (TB). Mycobacterium tuberculosis antigen-stimulated T cell-based assays can detect TB but are less effective when responses are compromised such as in severe disease. We investigated immune responses to M. tuberculosis whole sonicate (MTBs), recombinant antigens ESAT6 and CFP10 in whole blood cells of healthy endemic controls (EC, n = 42) and patients with pulmonary (PTB, n = 36) or extrapulmonary (ETB, n = 41) disease. Biomarkers of T cell activation (IFNγ) or modulation (IL10) and chemokines, CXCL9, CXCL10 and CCL2, secretion were measured. MTBs, ESAT6 and CFP10 all induced IFNγ responses in TB. ESAT6-induced IFNγ was elevated in TB as compared with EC. MTBs stimulated the highest IFNγ levels but did not differentiate between TB and EC. However, MTBs-induced CXCL10 (P = 0.004) was reduced, while IL10 (P < 0.001) was raised in TB as compared with EC. Between sites, MTBs-induced CCL2 (P = 0.001) and IL10 secretion was higher in PTB than ETB (P < 0.001). In comparison of disease severity, MTBs-induced IFNγ (P = 0.014) and CXCL10 (P = 0.022) levels were raised in moderate as compared with far advanced PTB. In ETB, MTBs-induced IL10 levels were greater in less-severe (L-ETB) than in severe disseminated (D-ETB) cases, P = 0.035. Within the L-ETB group, MTBs-induced IFNγ was greater in patients with tuberculous lymphadenitis than those with pleural TB (P = 0.002). As immune responses to MTBs were differentially activated in TB of different sites and severity, we propose the utility of MTBs-induced IFNγ, CXCL10 and IL10 as biomarkers in TB.

SOCS1 gene expression is increased in severe pulmonary tuberculosis.

Suppressors of cytokine signalling (SOCS) molecules inhibit cytokine signalling and may regulate protective immunity in tuberculosis (TB). We investigated the association of SOCS with disease progression in patients with pulmonary TB. For this purpose, we studied peripheral blood mononuclear cells (PBMCs) and T cells from patients with pulmonary TB (TB, n=33) and healthy endemic controls (EC, n=15). Cases were stratified into those with moderately advanced (Mod-PTB) or far advanced disease (Adv-PTB). Interferon-gamma (IFN-γ), SOCS1 and SOCS3 gene expression was determined by RT-PCR. Statistical analysis was performed using the Mann-Whitney test. Levels of IL6 (P=0.018) and IL10 (P=0.013) were found to be elevated in PBMC supernatants from patients with TB as compared with EC. SOCS1 mRNA gene expression in T cells from patients with TB was increased as compared with that of EC (P=0.02). In addition, levels of SOCS1 mRNA transcripts were found to be elevated in PBMCs of Adv-PTB as compared with Mod-PTB (P=0.008) cases. Our data show that raised SOCS1 levels are associated with increased disease severity in TB. As SOCS1 regulates IFN-γ-driven immunity and SOCS1 can be further upregulated by IL6 levels, the increase in SOCS1 in severe disease indicates a mechanism by which mycobacteria impede disease control in TB.

Cervical spinal cord injury due to fall while carrying heavy load on head: a problem in Bangladesh.

STUDY DESIGN: Observational study. SETTING: Centre for the Rehabilitation of the Paralysed (CRP), Dhaka, Bangladesh. METHODS: This observational study was conducted on 84 patients of Cervical spinal cord injury (CSCI) due to fall while carrying heavy load on head. They were admitted at the CRP, Dhaka, Bangladesh between January 1999 and December 2001. Relevant personal information, neurological status, types of bony injuries and x-ray findings were noted down in pre-structured questionnaire. In addition, each subject was interviewed to find out the cause of accidental fall while carrying heavy load on head. RESULTS: Age of the studied subjects ranged between 10 to 50 years. All were male of whom 79 (94%) subjects were farmers and/or low cost daily laborers. In all, 72% percent of the subjects were carrying 60-80 kg weight on their head when fall occurred. A total of 48 (57%) subjects had complete neurological lesion. The most common vertebral levels were C5 and C6. So far the mechanism of injury is concerned hyper flexion of the cervical spine predominated (61%) over hyperextension (36%). CONCLUSION: Fall while carrying heavy load on head is a common cause of CSCI in Bangladesh. The victims are mostly young farmers or unskilled day laborers who were not habituated to carry heavy load on head.

Pattern of congenital heart diseases.

This prospective observational study was done to find out the frequency of various forms of congenital heart disease (CHD) diagnosed by echocardiography. During the study period (January 2002 to December 2005) 2050 patients were screened by echocardiography. All patients were evaluated by cardiologists and had chest radiograph, electrocardiogram and echocardiography. Total 2050 patients were studied and among them 1071 had congenital heart disease. Male was 561(52.38%) and female was 510(47.62%). Atrial septal defect (ASD) was 374(34.92%), ventricular septal defect (VSD) was 318(29.69%), patent ductus arteriosus (PDA) 83(7.75%), pulmonary stenosis (PS) 58(5.42%), tetralogy of Fallot 162(15.13%), transposition of great vessels (TGA) 16(1.49%), Ebstein anomaly 5(0.4%), coarctation of aorta 1(0.09%) and single ventricle 2(0.19%). This distribution is more or less similar to that reported in studies at home and abroad. In this study atrial septal defect (ASD) was the commonest in acyanotic CHD and tetralogy of Fallot was the commonest cyanotic CHD.

Monitoring pond water quality to improve the production of Labeo rohita (Hamilton, 1822) in Bannu Fish Hatchery of Bannu district, Khyber Pakhtunkhwa province; An Implications for artificial fish culture.

The water quality parameters of a fish pond are essential to be managing properly under control for successful operations of fish culture. Improper management of pond water quality during the juvenile stages can create stressful conditions to produce various harmful diseases, which may decrease the fish quality and results in low profits. The present study was aimed to monitored important water quality parameters of nursery ponds of Labeo rohita culturing in Bannu fish hatchery. The study duration was 75 days extends from 10th June to 24th August 2019 for the successful culture of this specie which can play a significant role in breeding season. Furthermore, the concentration of some heavy metals like copper (Cu), nickel (Ni), manganese (Mn), iron (Fe), cadmium (Cd), and zinc (Zn) in pond water and fry stages of this species was also determined. The data obtained from all water quality parameters were analyzed expressed as range, mean and standard deviation using MS Excel 2013. The obtained results of 75 days study revealed that the water pH & temperature, electric conductivity, total dissolved solids (TDS), and total dissolved oxygen (DO) of pond water samples were found within a tolerable limit except salinity and dissolved ammonia concentration were not permissible for fish growth. The average concentration of heavy metals in pond water exhibited descending order Fe>Ni>Mn>Zn>Cd>Ni, which was found in acceptable ranges. Whereas, the average values of heavy metals in fry stages were in the order of Zn>Fe>Ni>Cu>Cd>Mn, and found within the recommended values of WHO/FAO. Thus, it was concluded from this study that good water quality is a precondition, maintaining balanced levels of water quality parameters is fundamental for both the health and growth of fish culture which is quite necessary for assuring increased fish productivity. It is recommended to monitor and assess water quality parameters on a routine basis for promoting healthy fish culture.

Local spectroscopic evidence for a nodeless magnetic kagome superconductor CeRu2.

We report muon spin rotation (µSR) experiments on the microscopic properties of superconductivity and magnetism in the kagome superconductor CeRu2withTc≃5 K. From the measurements of the temperature-dependent magnetic penetration depthλ, the superconducting order parameter exhibits nodeless pairing, which fits best to an anisotropics-wave gap symmetry. We further show that theTc/λ-2ratio is comparable to that of unconventional superconductors. Furthermore, the powerful combination of zero-field (ZF)-µSR and high-fieldµSR has been used to uncover magnetic responses across three characteristic temperatures, identified asT1∗≃110 K,T2∗≃65 K, andT3∗≃40 K. Our experiments classify CeRu2as an exceedingly rare nodeless magnetic kagome superconductor.

Serum measurement of interleukin-31 (IL-31) in paediatric atopic dermatitis: elevated levels correlate with severity scoring.

BACKGROUND: Interleukin-31 (IL-31) is a novel T-helper-lymphocyte-derived cytokine that plays an important role in human T-cell-mediated skin diseases. When overexpressed in transgenic mice, IL-31 induces severe pruritus resembling eczema in humans. Serum IL-31 was previously found overexpressed in adults with atopic dermatitis (AD). The novelty of this study is the use of a pediatric patient group as well as comparison of IL-31 levels during flare and quiescence. OBJECTIVE: This case-controlled longitudinal study was designed to determine the levels of IL-31 in serum of AD children and its associations in relation to disease activity and severity. METHODS: Sera were obtained from 50 AD children and 40 healthy volunteers. IL-31 levels were measured using a sandwich ELISA. All AD patients were followed up and re-sampled for serum IL-31 after clinical remission. Serum IL-31 levels were correlated with AD disease activity and severity variables. RESULTS: Serum IL-31 levels were significantly higher whether during AD flare [median, 1600; mean (SD)=1457.8±770.4 pg/mL] or quiescence (1040; 958.7±419.5 pg/mL), than those in controls (220; 197.3±91.9 pg/mL). Serum IL-31 levels were significantly higher in the high disease severity group compared with the moderate or low severity group. Moreover, serum IL-31 levels correlated positively with the calculated severity scores (LSS, SSS and SCORAD index). CONCLUSION: The results of this study confirm the importance of IL-31 in AD pathophysiology. Serum IL-31 level is an objective reliable marker of AD severity in children. It may represent a novel target for antipruritic drug development.

Valvular heart disease in pregnancy: maternal and fetal outcome.

The aim of this study was to evaluate the maternal and fetal outcome of pregnancy in Valvular Heart Disease (VHD). A better understanding of the effects of valvular abnormalities on pregnancy outcome is of value for risk assessment and the design of a therapeutic plan from the available information of a series of patient. A multicenter prospective study was carried out over a period of 5 years (2005-2009) involving 60 pregnant patients with valvular heart disease. Thirty eight patients (64%) had single valve involvement and mitral stenosis was the most predominant lesion (50%). Ten patients (16.7%) had undergone interventional and surgical correction prior to the pregnancy. Fourteen (24%) patients were identified as a NYHA class III-IV. Women with VHD had 8.35% pulmonary edema, 15.03% developed different types arrhythmia. The incidence of preterm birth and small for gestational age newborn was 11.69% and 13.36% respectively. There was one (1.67%) maternal death. Pregnancy in women with valvular heart disease is associated with remarkable unfavourable effect on maternal and fetal outcome which are related to severity of disease.

An overview of the taxonomic instability of endangered Golden and Zhobi mahseer in Pakistan.

In South and South East Asia three genera of fish species i.e. Tor, Neolissochilus and Naziritor are commonly known as Mahseer with at least 47 species. Among these 23 belongs to genus Tor, 22 to Neolissochilus and one to Naziritor i.e. Naziritor zhobensis. Recently another species added to genus Naziritor is Naziritor chelynoides in India. Among Tor species Tor putitora (Hamilton) is the most widely distributed Mahseer in Pakistan and other countries of the Indian subcontinent. However, based alone on morphological characters some authors identify the Pakistani counterparts as Tor macrolepis (Heckel), (a species presumed to be found exclusively in the Indus River system) distinct from Tor putitora (a species found in Ganga Brahmaputra River system). In order to resolve this taxonomic ambiguity, present study carried out meristic and morphometric measurements of Mahseer collected from a total of 11 water bodies of Pakistan. Ratios between the morphometric characters were calculated and statistically analyzed using t-test and correlation coefficient. Two species identified as Tor putitora and Naziritor zhobensis were the sole Mahseer inhabitants of Indus system in Pakistan. Tor putitora occurred at all surveyed sites while Nazirtor zhobensis had a distribution range from river Zhob to tributaries of river Gomal the right bank tributaries of River Indus. The study corroborates that there are no unequivocal morphological synapomorphies in any existing populations of both species. The study further demonstrates that head length, a character frequently used in Mahseer taxonomy, is not a good measure for species identification. Finally the present study establishes that Naziritor zhobensis still exists in the water bodies of Pakistan and that golden Mahseer occurring in Indus riverine system of Pakistan is Tor putitora.