Synergistic impact of heat and salicylic acid pretreatment on gluten films: Characterization and functional properties.

This study investigates how wheat gluten (WG) films in the presence of salicylic acid are influenced by thermal pretreatment. Unlike previous methods conducted at low moisture content, our procedure involves pretreating WG at different temperatures (65 °C, 75 °C, and 85 °C), in a solution with salicylic acid. This pretreatment aims to enhance protein unfolding, thus providing more opportunities for protein-protein interactions during the subsequent solvent casting into films. A significant increase in ß-sheet structures was observed in FTIR spectra of samples pretreated at 75 °C and 85 °C, showing a prominent peak in the range of 1630-1640 cm-1. The pretreatment at 85 °C was found to be effective in improving the water resistivity of the films by up to 247 %. Moreover, it led to a significant enhancement of 151 % in tensile strength and a 45 % increase in the elastic modulus. The reduced solubility observed in films derived from pretreated WG suggests the development of an intricate protein network arising from protein-protein interactions during the pretreatment and film formation. Thermal pretreatment at 85 °C significantly enhances the structural and mechanical properties of WG films, including improved water resistivity, tensile strength, and intricate protein network formation.

Unkinking The Kinked: A Rare Intussusception In The Paediatric Emergency Department.

Intussusception is the introversion of the proximal intestinal loop into the distal downstream part of the intestinal loop, leading to gut wall oedema and restriction of blood supply. A high index of suspicion is required to diagnose it timely. Mostly infants aged less than a year are vulnerable to this surgical emergency presenting mostly with abdominal distension, vomiting, reluctance to feed and bright red jelly-like stools which, if left unrecognised, may result in the development of ischaemic portion of the gut and catastrophic outcomes. We present the case of a 60-day-old baby who presented in the Paediatric Emergency Department with progressive abdominal distension and bloody stools. Abdominal X-ray showed dilated bowel and ultrasound imaging showed a target sign positive for intussusception. The baby was rushed to the operating room (OR) due to delayed presentation, where an uneventful exploratory laparotomy was performed. Acute intestinal intussusception remains a cause of low morbidity and mortality rates if recognised earlier.

Paediatric Emergency Medicine: Reality, Expectation, Experience, and Need for Improvements from a Low- Income Settings.

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The Efficacy of Psychedelic-Assisted Therapy in Managing Post-traumatic Stress Disorder (PTSD): A New Frontier?

Post-traumatic stress disorder (PTSD) is a significant public health concern for which existing therapies are only marginally effective. Indisputably, the primary line of treatment for PTSD is psychotherapy, according to current treatment guidelines. However, PTSD continues to be a chronic condition even after psychotherapy, with high psychiatric and medical illness rates. There is a dire need to search for new compounds and approaches for managing PTSD. The usage of psychedelic substances is a potential new method. This article reviews the efficacy of psychedelic-assisted therapy in treating PTSD and improving patient outcomes. It will examine current research on the topic and evaluate the benefits and drawbacks of different therapies. The current evidence for the use of four different types of psychedelics (3,4-methylenedioxymethamphetamine, ketamine, classical psychedelics, and cannabis) in the treatment of PTSD will be reviewed. It will also include an overview of the therapeutic justification, context of use, and level of evidence available for each drug. Several questions are formulated that could be studied in future research in order to gain a better understanding of the topic.

To evaluate rising caesarean section rate and factors contributing to it by using Modified Robson's Criteria at a tertiary care hospital.

Objectives: To determine the frequency of caesarean section with its indication by grouping according to Modified Robson's Criteria at JPMC. Methods: This is a retrospective study done from 1st January to 30th June 2018. Records of all Caesarean Section performed during the study period were retrieved from elective and emergency operation theatres. Data was extracted from the emergency and elective Theatres registers. and entered in study proforma. Patients with missing data were contacted via a given phone number on file and data collected. None of the Patients Data was totally missing ,as all entries made were done very carefully .Data was entered in SPSS version 26.0. Group-11 and 12 were added in order to identify the main reason for the increase in caesarean sections. Results: Total number of deliveries in six months were 3400. Our study showed a Caesarean Section rate of 36.5 per all live births. The major group contributing was Group-5 (56%). Foetal distress (Group-12) and Primigravida with Inductions or caesarean section before labour (Group-2) showed nearly the same percentages 13.5% and 14% respectively. Conclusions: Planning of the caesarean section of primigravida should be carefully decided. The role of safe VBAC plays the key role in decreasing Cesarean Section rate. Moreover, foetal distress and caesareans in Primigravida should be evaluated with great accuracy to decrease the caesarean section rate.

Raoultella Species Associated Sepsis in Children: A Case Series at a Tertiary Hospital, Karachi.

OBJECTIVE: To determine the clinical outcome and management options of gram-negative Raoultella species reported at a tertiary care pediatric Hospital in Karachi. STUDY DESIGN: Descriptive study. PLACE AND DURATION OF STUDY: Pediatric and child Health department of The Aga Khan University Hospital from January 2017 to June 2020. METHODOLOGY: A retrospective chart review was done. Data was extracted for 20 patients with culture-positive Raoultella species. Study variables included demographic features, infection site, antibiotic sensitivities, Hospital duration, clinical outcome, and management options. Data were summarised using descriptive statistics and Kaplan-Meier plots using SPSS version 22. RESULTS: A total of twenty-three site cultures positive with Raoultella species were isolated among 20 children with a wide array of clinical symptoms and disease severity. Predominantly the organism was isolated in blood with 12 positive cultures (60%). Eleven (55%) of the patients were females having a median age of 9.5 months. Multidrug-resistant (MDR) and extensively drug-resistant species (XDR) were isolated from eleven (47.8%) and ten (43.5%) culture sites respectively. Combination therapy of colistin or fosfomycin with carbapenem and tigecycline (triple regimen) was used in seven (35%) patients with severe sepsis. Microbiological clearance (sterility) was achieved in twelve (60%) children. Eight children (40%) died of MDR/XDR Raoultella associated sepsis. CONCLUSION: Highly resistant Raoultella species were associated with high mortality among reported cases, with a limited choice of antibiotics and combination therapy. The management of Raoultella species is required with a multi-specialty approach. Furthermore, strict antimicrobial stewardship measures are required to control an outbreak of MDR and XDR infections in Pakistan. KEY WORDS: Raoultella species, Enterobacteriaceae, Children, Multidrug-resistant, Antimicrobial resistance.

Apps on Google Play Store to assist in self-management of hypertension in Indian context: features analysis study.

Background: A large number of individuals with hypertension are turning to the Internet and m-health technologies for assistance. There is a need to study the content of smartphone applications on hypertension. The study aimed to review and investigate the functional and analytical characteristics of apps related to the self-management of hypertension available on Google Play Store. Methods: Search was conducted in February 2021 in India using the Google Play Store database to identify currently available Android-based apps related to self-management of hypertension/high blood pressure (BP). Keywords used were: 'Hypertension', 'High blood pressure', 'DASH diet', 'Hypertension diet', and 'Blood pressure diet'. A total of 822 apps were screened based on the duplicates, inclusion, and exclusion criteria. A total of 210 were included for further analysis. Results: Eighteen percent (n=37) of the apps had an overall rating of 4.5 or above. About 41% of the apps belonged to the medical category and 41% of the apps were characterized in the health and fitness category. Feature of logging/recording the BP measurement was seen in 73% of the apps. In-app graphing to analyze BP trends was reported in 64 % of the included apps. A few apps focused on tracking medication (n=19), sodium intake (n=2), and calorie intake (n=4). Conclusions: The features were common across all the included apps and were focusing only on recording the BP, providing statistics and trends of BP, and providing educational information. App developers should now aim to provide other components of self-management techniques to help individuals tackle hypertension.

Root Cultures, a Boon for the Production of Valuable Compounds: A Comparative Review.

Medicinal plants are an inevitable source of pharmaceutical drugs and most of the world population depends on these plants for health benefits. The increasing global demand for bioactive compounds from medicinal plants has posed a great threat to their existence due to overexploitation. Adventitious root and hairy root culture systems are an alternative approach to the conventional method for mass production of valuable compounds from medicinal plants owing to their rapid growth, biosynthetic and genetic stability. The main purpose of this review is to investigate the recent scientific research published worldwide on the application of adventitious and hairy root cultures to produce valuable compounds from medicinal plants. Furthermore, a comparison of adventitious root vs. hairy root cultures to produce valuable compounds has also been discussed. Various aspects such as medium composition, carbon source, pH, amount of macronutrients, optimization strategy, scale-up cultures, and use of biotic abiotic and nano-elicitors at various concentrations are the topic of discussion in this review. Several studies on adventitious and hairy root cultures of Polygonum multiflorum¸ Withania somnifera¸ Echinacea purpurea and Ajuga bracteosa have been discussed in detail which highlights the importance of elicitation strategies and bioreactor system, presenting commercial applications.

Rhesus Isoimmunization: Late-onset Hemolytic Disease of the Newborn Without Jaundice.

Rhesus (Rh) isoimmunization commonly presents with anemia and jaundice of varying intensity in the early postnatal period and is usually treated with phototherapy and exchange transfusion. Rarely, babies with mild or no symptoms at birth may present later with severe hemolytic anemia. This report describes a newborn infant with no postnatal jaundice who presented during the second week of life with severe anemia. These findings indicate the importance of regular follow-up and close monitoring of Rh-isoimmunized infants during the first two months of life for delayed onset anemia.

Risk Factors For Heat Related Deaths During The June 2015 Heat Wave In Karachi, Pakistan.

BACKGROUND: Mortality as a consequence of heat related illness is a public health concern. Emergency department (ED) experiences increased patients' flow and decreased survival as a consequence of heat stroke during the episodes of heat wave. The present study was conducted to identify the risk factors for mortality among victims of heat wave (17th - 23rd June), 2015 evaluated in the Emergency Department of The Indus Hospital (TIH), Karachi. METHODS: In this cross-sectional study data was retrospectively collected. Out of 2278 patients, 150 patients who satisfied the inclusion criteria (core body temperature >38 °C, dehydrated and CNS dysfunction without infection) were included. Data was analysed using SPSS version 21 (IBM). RESULTS: Among 150 patients included for analysis, the mortality was observed in twenty-four patients (16%). Majority (64.7%) of the patients included in this retrospective study were males and older with median age of 51.5 years. It was identified that non-survivors had significantly lower diastolic blood pressure and oxygen saturation compared to survivors along with higher median reparatory rate, pulse rate, temperature, and length of stay in emergency, shock index, and proportion of unconscious level. CONCLUSIONS: The study concluded that heat stroke patients with decreased diastolic blood pressure and oxygen saturation as well as patients with increased shock index, low conscious level and higher core temperature, respiratory and pulse rate should be considered for more intensive management in Intensive Care Unit (ICU) to decrease mortality rate during future heat stroke episodes.