Impact of COVID -19 on expanded programme on Immunisation in District Dir lower Khyber Pakhtunkhwa.

Objectives: To study the impact of coronavirus disease-2019 on Expanded Programme on Immunisation in a rural setting. METHODS: The descriptive, cross-sectional study was conducted in five union councils of District Dir Lower, in the Khyber Pakhtunkhwa province of Pakistan. Data was collected from March to August 2020, which was a period of lockdowns in the wake of the coronavirus disease-2019, and then from March to August 2021. The sample comprised children aged <2 years. Data was analysed using SPSS 25. RESULTS: Of the 330 children, 210(63.6%) were boys, and 120(36.4%) were girls, and all 330(100%) were located in rural areas. First-phase data showed that the maximum coverage rate of immunisation was 258(78.2%) noted in OPV1(Oral Polio Vaccine) Penta1(Pentavalent vaccine), PCV10-1 (Pneumococcal pneumonia) and Rota 1(Rota Vaccine), and the least vaccination rate was 68.2% for Measle-1. In the second phase, 23% incline was noted in Measles-2 vaccination, followed by 16.3% in OPV2, Penta 2, PCV10-2 and Rota 2, 16% in Measles-1, 14% in OPV-3, Penta-3, PCV10-3, Rota-3 and IPV, 11.5% in OPV-1, Penta-1, PCV10-1, and Rota-1, and 10.6% in OPV-0 and BCG-0. CONCLUSIONS: Immunisation programme was affected by lockdowns during the active phase of the coronavirus disease-2019 pandemic.

Comparative Efficacy of Anti-vascular Endothelial Growth Factor (Anti-VEGF) Agents and Corticosteroids in Managing Diabetic Retinopathy-Associated Diabetic Macular Edema: A Meta-Analysis and Comprehensive Systematic Review.

Diabetic macular edema (DME) is a significant condition linked to diabetes that can result in visual loss. In recent times, there has been a notable change in the desire for treatment, with a shift toward anti-vascular endothelial growth factor (anti-VEGF) therapy and intravitreal steroids while moving away from conventional laser therapies. This comprehensive meta-analysis explicitly compares the efficacy of two therapies for DME: anti-VEGF therapy and corticosteroid. We conducted a thorough search using PubMed and Google Scholar to identify publications that compare the effects of anti-VEGF therapy and corticosteroid implants on DME. Using Review Manager 5.0 (RevMan), we incorporated data from nine research studies, which involved a total of 877 people. The group was split into two factions: 453 patients were administered corticosteroids, while 466 patients underwent treatment with anti-VEGF therapy. Our investigation demonstrated that both corticosteroid and anti-VEGF therapy positively improved the best-corrected visual acuity (BCVA) and reduced the central macular thickness (CMT). Nevertheless, comparing the mean BCVA on the logarithm of the minimum angle of resolution (logMAR) scale revealed no statistically significant changes between the two treatments. This indicates considerable inconsistency, as evidenced by the weighted mean difference (WMD) of -0.13 (-0.41, 0.16) with a P-value of 0.39 and an I2 value of 99%. In addition, both treatments improved BCVA compared to the initial measurement. However, there was no statistically significant benefit for corticosteroid over anti-VEGF therapy, as indicated by the WMD of 0.03 (-0.07, 0.13) with a P-value of 0.55 and an I2 value of 80%. The examination of the average CMT also yielded findings that lacked statistical significance, displaying a significant amount of variation (WMD -36.37, 95% confidence interval [-127.52, 54.78], P = 0.43, I2 = 98%). Remarkably, there were no significant alterations among the anti-VEGF therapy group despite a rise in CMT from the initial measurement. The main conclusion drawn from our research is that corticosteroid demonstrates encouraging immediate enhancements in BCVA and CMT. However, anti-VEGF therapy seems to provide more significant long-term advantages. Nevertheless, it is crucial to acknowledge that the corticosteroid group had a greater susceptibility to acquiring elevated intraocular pressure (IOP) and the possibility of glaucoma.

Synthesis and Antimicrobial Analysis of High Surface Area Strontium-Substituted Calcium Phosphate Nanostructures for Bone Regeneration.

Continuous microwave-assisted flow synthesis has been used as a simple, more efficient, and low-cost route to fabricate a range of nanosized (<100 nm) strontium-substituted calcium phosphates. In this study, fine nanopowder was synthesized via a continuous flow synthesis with microwave assistance from the solutions of calcium nitrate tetrahydrate (with strontium nitrate as Sr2+ ion source) and diammonium hydrogen phosphate at pH 10 with a time duration of 5 min. The morphological characterization of the obtained powder has been carried out by employing techniques such as transmission electron microscopy, X-ray diffraction, and Brunauer-Emmett-Teller surface area analysis. The chemical structural analysis to evaluate the surface properties was made by using X-ray photoelectron spectroscopy. Zeta potential analysis was performed to evaluate the colloidal stability of the particles. Antimicrobial studies were performed for all the compositions using four bacterial strains and an opportunistic human fungal pathogen Macrophomina phaseolina. It was found that the nanoproduct with high strontium content (15 wt% of strontium) showed pronounced antibacterial potential against M. luteus while it completely arrested the fungal growth after 48 h by all of its concentrations. Thus the synthesis strategy described herein facilitated the rapid production of nanosized Sr-substituted CaPs with excellent biological performance suitable for a bone replacement application.

Cardiac Rehabilitation in the Modern Era: Optimizing Recovery and Reducing Recurrence.

Cardiovascular diseases (CVDs) continue to be a prominent issue in global health, emphasizing the necessity for efficient cardiac rehabilitation programs. This narrative review provides a detailed analysis of the current state of cardiac rehabilitation, focusing on maximizing recovery and minimizing the likelihood of recurrence. This paper examines the historical progression of cardiac rehabilitation, explores the epidemiological background of cardiovascular disease (CVD), and provides an overview of the many stages of the rehabilitation process. The assessment of patients plays a crucial role in healthcare, serving as a fundamental basis that incorporates medical, psychological, and social aspects. The utilization of risk stratification techniques further enhances this process. The present study investigates exercise training, particularly emphasizing the current recommendations and the mutually beneficial effects of aerobic and resistance regimens. In addition to physical therapies, this study emphasizes the importance of nutrition, lifestyle adjustments, and the significant effects of medication. Psychosocial assistance is a crucial element that addresses the significant psychological effects of cardiac disease and provides comprehensive techniques for overall well-being. Technological advancements are significantly transforming the domain of cardiac rehabilitation, encompassing the integration of wearable technologies and telemedicine solutions. The convergence of artificial intelligence and data analytics can enhance the customization of healthcare services. Through a comprehensive rehabilitation program, patients can achieve an improved quality of life and enhanced functional outcomes. However, it is essential to acknowledge that obstacles still hinder individuals from accessing and completing educational programs. Therefore, it is crucial to engage in a discourse on potential tactics that may be employed to address these issues, considering the various cultural and socioeconomic aspects that contribute to them. The analysis focuses on the economic dimension, examining the cost-effectiveness of rehabilitation programs and their congruence with healthcare policies. In anticipation of future developments, the study provides valuable perspectives on the prospective trajectory of cardiac rehabilitation. It delves into nascent patterns and examines the potential ramifications of precision medicine and genetics for tailoring treatment strategies to individual patients. In brief, this narrative review comprehensively examines the various dimensions of contemporary cardiac rehabilitation. It offers a comprehensive perspective on its significance in enhancing recuperation and mitigating the likelihood of the recurrence of cardiovascular ailments. The significance of this review lies in its ability to enhance patient outcomes, thereby making a valuable contribution to the worldwide endeavor to address the burden of cardiovascular disease.

Recent developments and challenges in uranium extraction from seawater through amidoxime-functionalized adsorbents.

As per statistical estimations, we have only around 100 years of uranium life in terrestrial ores. In contrast, seawater has viable uranium resources that can secure the future of energy. However, to achieve this, environmental challenges need to be overcome, such as low uranium concentration (3.3 ppb), fouling of adsorbents, uranium speciation, oceanic temperature, and competition between elements for the active site of adsorbent (such as vanadium which has a significant influence on uranium adsorption). Furthermore, the deployability of adsorbent under seawater conditions is a gigantic challenge; hence, leaching-resistant stable adsorbents with good reusability and high elution rates are extremely needed. Powdered (nanostructured) adsorbents available today have limitations in fulfilling these requirements. An increase in the grafting density of functional ligands keeping in view economic sustainability is also a major obstacle but a necessity for high uranium uptake. To cope with these challenges, researchers reported hundreds of adsorbents of different kinds, but amidoxime-based polymeric adsorbents have shown some remarkable advantages and are considered the benchmark in uranium extraction history; they have a high affinity for uranium because of electron donors in their structure, and their amphoteric nature is responsible for effective uranium chelation under a wide range of pH. In this review, we have mainly focused on recent developments in uranium extraction from seawater through amidoxime-based adsorbents, their comparative analysis, and problematic factors that are needed to be considered for future research.

Curcumin nanoparticles: physicochemical fabrication, characterization, antioxidant, enzyme inhibition, molecular docking and simulation studies.

Curcumin is an extensively studied natural compound due to its extensive biological applications. However, there are some drawbacks linked to this compound such as poor absorption, low water-solubility, quick systemic elimination, fast metabolism, poor pharmacokinetics, low bioavailability, low penetration targeting efficacy and low stability. To overcome these drawbacks, curcumin is encapsulated in nano-carriers. In the current studies, we synthesized nanoparticles of curcumin without using nanocarriers by different methods such as nano-suspension (Cur-NSM), sonication (Cur-SM) and anti-solvent precipitation (Cur-ASP) to enhance the solubility of curcumin in water. The prepared nanoparticles were characterized by FTIR, SEM and XRD analysis. These curcumin nanoparticles were screened for their solubilities in water, DPPH scavenging, amylase, α-glucosidase and ß-glucosidase enzymatic activities. The particle size of nano-curcumin was found to be in the 47.4-98.7 nm range. The reduction in particle size of curcumin dramatically increases its solubility in water to 79.2 µg mL-1, whereas the solubility of curcumin is just 0.98 µg mL-1. Cur-ASP showed the highest free radical scavenging potential (48.84 ± 0.98%) which was comparable with standard BHT (50.48 ± 1.11%) at 75.0 µg mL-1. As well, Cur-ASP showed the highest inhibition of α-amylase (68.67 ± 1.02%), α-glucosidase (58.30 ± 0.52%), and ß-glucosidase (64.80 ± 0.43%) at 100 µg mL-1 which is comparable with standard drug acarbose. The greater surface area of nanoparticles exposes the various groups of curcumin for blocking the binding sites of enzymes. This strategy may be helpful in designing curcumin as a potent therapeutic agent against diabetes mellitus. Further, the molecular interactions of curcumin with α-amylase, α-glucosidase, ß-glucosidase, and polyphenol oxidase were assessed by analyzing the plausible binding modes of curcumin in the binding pocket of each receptor. The best binding mode of curcumin was used to make complexes with the target proteins and their stability was confirmed by 50 ns MD simulation.

Exploring the Mechanism of Anionic Chemosensing by Imidazoles: A Review.

Chemosensing of ions has gained considerable attention by chemists. Insight into the mechanism involved between sensors and ions always fascinates researchers to develop economical, sensitive, selective, and robust sensors. This review comprehensively explores the mechanism of interaction between Imidazole sensors and anions. With most of the research concentrating only on fluoride and cyanide, this review has highlighted a large gap in various anions detection including SCN-, Cr2O72-, CrO42-, H2PO4-, NO2-, and HSO4-.This study also includes a critical analysis of different mechanisms and their respective limits of detection, with a discussion of the reported results.

Treatment of Autism Spectrum Disorders by Mitochondrial-targeted Drug: Future of Neurological Diseases Therapeutics.

Autism is a neurodevelopmental disorder with a complex etiology that might involve environmental and genetic variables. Recently, some epidemiological studies conducted in various parts of the world have estimated a significant increase in the prevalence of autism, with 1 in every 59 children having some degree of autism. Since autism has been associated with other clinical abnormalities, there is every possibility that a sub-cellular component may be involved in the progression of autism. The organelle remains a focus based on mitochondria's functionality and metabolic role in cells. Furthermore, the mitochondrial genome is inherited maternally and has its DNA and organelle that remain actively involved during embryonic development; these characteristics have linked mitochondrial dysfunction to autism. Although rapid stride has been made in autism research, there are limited studies that have made particular emphasis on mitochondrial dysfunction and autism. Accumulating evidence from studies conducted at cellular and sub-cellular levels has indicated that mitochondrial dysfunction's role in autism is more than expected. The present review has attempted to describe the risk factors of autism, the role of mitochondria in the progression of the disease, oxidative damage as a trigger point to initiate mitochondrial damage, genetic determinants of the disease, possible pathogenic pathways and therapeutic regimen in vogue and the developmental stage. Furthermore, in the present review, an attempt has been made to include the novel therapeutic regimens under investigation at different clinical trial stages and their potential possibility to emerge as promising drugs against ASD.

Screening of ionic liquids as green entrainers for ethanol water separation by extractive distillation: COSMO-RS prediction and aspen plus simulation.

Ionic liquids (ILs) have been demonstrated as promising alternatives to conventional entrainers in separation of azeotropic mixtures mostly investigating phase equilibrium and process design scenarios. However, proper selection of ILs for a specific task always remains challenging. Hence a simulation tool, i.e. conductor like screening model for real solvents (COSMO-RS) was applied to address this challenge. Furthermore, screened ILs were simulated as entrainers for ethanol water separation by extractive distillation. The current study also aims to demonstrate a systematic approach to retrofit existing processes, by employing ILs as green entrainers. Screening of twenty-five (25) ILs was carried out using COSMO-RS to select suitable ILs as green entrainers based on activity coefficient, capacity and selectivity. Results illustrated that tetramethylammonium chloride ([TMAm][Cl]) due to its strong hydrogen bonding ability was found to be the best ILs entrainer. Moreover, in order to reduce the operating costs without compromising desired product purity (ethanol purity ≥99.5% in top product), the selected ILs (8 kg/h) in a mixture with ethylene glycol (72 kg/h) were simulated using Aspen plus v.11. The simulation results revealed that by combining tetramethylammonium chloride (2 kg/h) with ethylene glycol (78 kg/h) reduced 7.26 tons of CO2 emissions/year through heat integration by saving 1.49*108 kJ/year energy besides minimizing operating costs. In conclusion, the systematic selection of ILs as green entrainers in combination with ethylene glycol and then the appropriate simulation of the whole system will ultimately reduce the cost of the separation process and reduce the emission of greenhouse gases as well utilization of toxic conventional entrainers.

Green synthesis of coumarin derivatives using Brønsted acidic pyridinium based ionic liquid [MBSPy][HSO4] to control an opportunistic human and a devastating plant pathogenic fungus Macrophomina phaseolina.

An eco-friendly simple protocol has been devised for the preparation of coumarin derivatives using doubly Brønsted acidic task specific ionic liquid (TSIL) as a catalyst. Solvent-free conditions were employed for the reaction of different substituted phenols with ß-ketoester in TSIL to produce corresponding substituted coumarin derivatives in good to excellent yields at ambient conditions; at room temperature and with reduced reaction times. The ionic liquid catalyst can be recycled and reused up to five times. All the synthesized coumarins were evaluated for their antifungal activities against Macrophomina phaseolina, a plant as well as an opportunistic human pathogenic fungus affecting more than 500 plant species worldwide and with no registered commercial fungicide available against it, to date. Amongst all the coumarins tested, compounds 3f and 3i showed excellent antifungal activity comparable to reference fungicide mancozeb. The current methodology provides an easy and expedient way to access the coumarin core in search of potential fungicides for sustainable agriculture.

Neurotization of musculocutaneous nerve with intercostal nerve versus phrenic nerve - A retrospective comparative study.

Background: Brachial plexus injuries are common after both blunt and penetrating traumas resulting in upper limb weakness. The nerve transfer to the affected nerve distal to the injury site is a good option where proximal stump of the nerve is unhealthy or absent which has shown early recovery and better results. Commonly used procedures to restore elbow flexion are ipsilateral phrenic or ipsilateral intercostal nerves (ICNs) in global plexus injuries. The use of both intercostal and phrenic nerves for elbow flexion is well described and there is no definite consensus on the superiority of one on another. Methods: All patients presented in the outpatient department of LNH and MC from January 2014 to December 2017 with pan plexus or upper plexus injury with no signs of improvement for at least 3 months were included in the study. After 3 months of conservative trial; surgery offered to patients. Results: A total of 25 patients (n = 25) were operated from January 2015 to December 2017. Patients were followed to record Medical Research Council (MRC) grades at 3, 6, 9, 12, and 18 months. The patients achieved at least MRC Grade 3; 70% at 12 months follow-up to 80% at 18 months in the phrenic nerve transfer group. While in the ICN transfer group, it is 86% and 100% at 12 and 18 months postoperative, respectively. Conclusion: Our study has shown better results with ICN transfers to musculocutaneous nerve, recorded on MRC grading system.

Antagonistic activity of Aspergillus versicolor against Macrophomina phaseolina.

The present study was carried out to evaluate the antagonistic efficacy of Aspergillus versicolor against the soil and seed inhibiting destructive plant pathogen Macrophomina phaseolina. The tested antagonist was confirmed by rDNA sequencing of ITS and ß-tubulin genes with respective accession numbers MN719083 and MN736397. In dual culture bioassays, A. versicolor showed potent antagonist activity and reduced the pathogen's growth by 60% over control. To understand the mechanism of antagonistic fungus, DNA of the pathogenic fungus was incubated in secondary metabolites produced by the A. versicolor for 24 and 48 h. After 48 h, metabolites of A. versicolor fully degraded the DNA of M. phaseolina. Moreover, for the identification of bioactive compounds, the chloroform and ethyl acetate fractions of A. versicolor culture filtrates were subjected to GC-MS analysis. A total of 10 compounds were identified in each of the two fractions. Among these, chondrillasterol (37.43%) followed by 1,2-benzedicarboxylic acid, diisooctyl ester (25.93%), decane (16.63%), 9,12-octadecadienoic acid (Z,Z)- (13.32%), stigmasterol (11.16%), undecane (10.93%), cis-1-chloro-9-octadecene (8.66%), benzene, 1,3,5-trimethyl (8.46%), and hexadecanoic acid, 2-hydroxy-1-(hydroxymethyl) ethyl ester (8.13%) were the major compounds. Some of the identified compounds are known to possess strong antifungal, antibacterial, nematicidal, and antioxidant properties. The present study concludes that A. versicolor is an effective antagonist against M. phaseolina.

Biocontrol Aspergillus species together with plant biomass alter histochemical characteristics in diseased mungbean plants.

In the present study, two Aspergillus species as biocontrol agents together with Chenopodium quinoa dry biomass were used to investigate their effects on histochemical features of mungbean plant inoculated with M. phaseolina. In a pot experiment, Aspergillus flavipes and Aspergillus versicolor were added either alone or together with 1%, 2%, and 3% dry biomass of quinoa (DBQ) to the pot soil already inoculated with M. phaseolina. After 4 weeks of sowing, root and lower-stem sections of the mungbean plants were stained with ferric chloride, phloroglucinol-HCl and Lugol's iodine to detect the presence of polyphenols, lignin, and starch granules, respectively, and observed under light microscope. Stem and root sections were also observed under scanning electron microscope (SEM) to reveal the effect of soil amendments on cell structures. The findings revealed that mungbean plant cross sections from all the treatments except positive control (only inoculated with M. phaseolina) showed very clear cell structures. In positive control, distorted, fragmented, and collapsed cell structures were observed. Moreover, M. phaseolina blocked vascular vessels in comparison to negative control where the cell structures were intact and normal in size. Plant sections from treatments with A. flavipes and A. versicolor alone or together with DBQ were without pathogen colonization, with normal cell structures and a high deposition of gel. The results suggested that the two Aspergillus spp. and C. quinoa induced defense responses in mungbean plants. HIGHLIGHTS: Macrophomina phaseolina causes significant yield losses in mungbean. Pot soil was amended with two species of Aspergillus as biocontrol agents along with plant biomass. Aspergillus spp. markedly saved the root and stem structures from the damage caused by M. phaseolina.

Dental age estimation of Malaysian children: a comparison of two-dimensional versus three-dimensional imaging analyses of the developing root apices.

AIM: This study compared the effectiveness of the three-dimensional (3D) cone beam computed tomography (CBCT) method of age estimation developed by Asif et al. with two-dimensional Cameriere's method. SUBJECTS AND METHODS: CBCT images belonging to 129 Malaysian Chinese and Malay ethnic groups aged 7-14 years were investigated and analysed. RESULTS: The results indicated a strong correlation between chronological age and the predictor variables for both Cameriere's (r = 0.984) and Asif's (r = 0.988) methods of age estimation. Fisher Z test analysis indicated no statistically significant difference in the correlation values between the two methods. Mean absolute error (MAE) value of 0.613 was observed for Cameriere's and 0.290 was observed for Asif's method. CONCLUSIONS: The results indicated that the methods of age estimation from both Asif et al. and Cameriere et al. are applicable on Malaysian children. However, Asif et al.'s 3D CBCT method of age estimation resulted in greater accuracy and reliability in estimating chronological age.

Histopathological changes in root and stem of mungbean exposed to Macrophomina phaseolina and dry biomass of Chenopodium quinoa.

Mungbean production is affected by a fungal pathogen Macrophomina phaseolina. A pot experiment was carried out to check the effect of quinoa (Chenopodium quinoa Willd.) dry biomass on the histopathological features of mungbean exposed to M. phaseolina. For this, 1%, 2% and 3% (wt/wt) of C. quinoa dry biomass was mixed in the soil inoculated with M. phaseolina. The highest disease incidence (36%) was recorded in the positive control (only M. phaseolina). Different treatments of quinoa dry mass reduced disease incidence to 4-7%. After 4 weeks of germination, stem and root sections were stained in phloroglucinol-HCl, ferric chloride and Lugol's iodine stains for the detection of lignin, polyphenols and starch granules, respectively, and studied under light microscope. Plants of positive control showed damaged cells, and heavy deposition of lignin, phenolics and starch granules as compared to plants of the negative control and those grown in the soil amended with different doses of dry biomass of quinoa. For better understanding, plant root and stem sections were studied under a scanning electron microscope. Plant sections from positive control exhibited the presence of M. phaseolina sclerotial bodies and hyphal growth, whereas in negative control normal cell structures were observed. However, C. quinoa amended stem and root sections revealed the presence of high gel deposition with normal cell structures and no pathogen establishment. This study concludes that application of C. quinoa is an effective and natural remedy to activate the resistance mechanism in plants and to combat the adverse effects of M. phaseolina. HIGHLIGHTS: Macrophomina phaseolina causes charcoal rot in mungbean. Chenopodium quinoa amendment significantly reduced incidence of charcoal rot disease. M. phaeolina increased concentrations of polyphenols, lignin and starch granules in mungbean.

Role of tele-rehabilitation in patients following total hip replacement: Systematic review of clinical trials.

OBJECTIVE: Tele-rehabilitation to explore current evidence on the effectiveness of tele-rehabilitation compared to face-to-face rehabilitation for patients after total hip replacement. METHODS: The systematic review of clinical trials comprised search of Cochrane, Medline, Embase and PEDro databases from 2000 to date for English-language, human studies dealing with postoperative rehabilitation of total hip replacement patients. A thorough search was performed to retrieve articles missed through databases as well as unpublished grey literature. Methodological quality assessment was done using the Cochrane risk of bias tool, and the studies were critically appraised using the PEDro scale. RESULTS: Of the 150 studies initially found on the databases, 11(7.3%) were subjected to detailed review; 4(36.4%) randomised trials, 3(27.3%) randomised controlled protocols, 3(27%) randomised pilot studies, and 1(9%) prospective cohort study. Overall, 8(72.7%) studies were of 'high' quality and 3(27.3%) fell under the category of 'fair'. CONCLUSIONS: Tele-rehabilitation group reported similar improvement in terms of activities of daily living and quality of life as did those exposed to traditional rehabilitation.

DNA cleavage of the fungal pathogen and production of antifungal compounds are the possible mechanisms of action of biocontrol agent Penicillium italicum against Macrophomina phaseolina.

In the present study, five Penicillium species, namely, P. italicum, P. expansum, P. simplicissimum, P. oxalicum, and P. citrinum, were identified using ITS (internal transcribed spacer) and ß-tubulin markers and screened for their in vitro antagonistic potential against a soil-borne fungal pathogen, Macrophomina phaseolina, in a dual-culture plate assay. Among all the tested strains, P. italicum showed the highest antagonistic potential against M. phaseolina by reducing its growth up to 57% over control, followed by P. citrinum (42%), P. simplicissimum (21%), P. expansum (11%), and P. oxalicum (9%). In order to find out the mechanism of action of P. italicum, genomic DNA of M. phaseolina was exposed to P. italicum secondary metabolites. The findings showed that these metabolites completely degraded the fungal DNA after the 48-h incubation period. To further explore the antifungal mechanism of action of P. italicum, chloroform and ethyl acetate fractions of its metabolites were subjected to gas chromatography-mass spectrometry (GC-MS) analysis. The major compounds identified in these fractions were 9,12-octadecadienoic acid (Z,Z)- (25.19%), decane (19.72%), dodecane (18.05%), benzene, nitro- (14.62%), benzene, 1,3,5-trimethyl (14.37%), benzene, 1,4-diethyl (11.62%), 1,2-benzenedicarboxylic acid, mono(2-ethylhexyl) ester (9.02%), and 1-nonadecene (8.99%), which could be responsible for control of M. phaseolina growth.

Correlation of ERCC5 polymorphisms and linkage disequilibrium associated with overall survival and clinical outcome to chemotherapy in breast cancer.

Purpose: ERCC5 is a DNA endonuclease and nucleotide excision repair gene; its mutations lead to a lack of activity by this enzyme, causing oxidative DNA damage. This study aimed to assess the role of four selected single nucleotide polymorphisms (SNPs) in ERCC5 and their linkage disequilibrium associated with survival analysis and clinical outcomes in breast cancer. Patients and methods: Four SNPs (rs751402, rs17655, rs2094258, and rs873601) of the ERCC5 gene were analyzed using the PCR-RFLP technique, followed by sequencing in 430 breast cancer (BC) cases and 430 cancer-free individuals. Statistical analysis was performed using MedCalc 17 and SPSS version 24, while bioinformatic analysis of linkage disequilibrium was performed using Haploview software 4.2. Results: Multivariate analysis showed that the rs751402 and rs2094258 polymorphisms were significantly associated with an elevated risk of BC (P < 0.001), while the other two SNPs, rs17655 and rs873601, did not show any association (P > 0.001). Survival analysis revealed that rs751402 and rs2094258 had longer overall survival periods (P <0.001) than rs17655 and rs873601. Moreover, rs751402 and rs2094258 also had significantly longer overall survival (log-rank test, P < 0.005) for all three survival functions (positive family history, ER+PR status, and use of contraceptives), while rs17655 and rs873601 did not show any significant association. Only rs873601 showed a strong negative correlation with all the chemotherapeutic groups. Conclusion: The current results suggest that variations in ERCC5 may contribute to BC development and that their genetic anomalies may be associated with cancer risk and may be used as a biomarker of clinical outcome.

Effects of dry needling in lower extremity myofascial trigger points.

OBJECTIVE: To explore the current evidences on effects of trigger point dry needling as a treatment strategy on pain and range of motion among subjects with lower extremity myofascial trigger areas. METHODS: The systematic review was conducted at the University Institute of Physical Therapy, Lahore, Pakistan, from February to August 2019, and comprised search of studies on Cochrane Library, PubMed, SPORTDiscus and PEDro databases published in the English language from 2000 to July 2019. The search terms used were 'Dry needling', 'Trigger points', 'Myofascial trigger points', 'Trigger area', 'Acupuncture therapy', 'Lower extremity' and 'Acupuncture'. Cochrane Risk of Bias tool was used to assess the randomised and non-randomised controlled trials. Methodological assessment was performed using Physiotherapy Evidence Database 10-point scale. Data synthesis was performed through vote counting method. RESULTS: Of the 564 articles initially found, 30(5.3%) were shortlisted for full-text assessment. Of them, 10(33.3%) were selected for final assessment; with 7(70%) scoring high and 3(30%) fair on the PEDro scale. All the 10(100%) studies documented improvement in the pain over time with dry needling strategy. None of the studies targeted any other outcome, like anxiety and sleep disturbances, related with myofascial trigger points. CONCLUSIONS: On basis of the best evidences available, dry needling seemed to be effective in pain reduction related to lower extremity myofascial trigger points. Evidence also suggested that there was not much positive effect of myofascial trigger point dry needling on depression, anxiety, muscular strength and quality of life.