A comprehensive study of the interactions in the B. subtilis degradosome with special emphasis on the role of the small proteins SR1P and SR7P.

Here, we employ coelution experiments and far-western blotting to identify stable interactions between the main components of the B. subtilis degradosome and the small proteins SR1P and SR7P. Our data indicate that B. subtilis has a degradosome comprising at least RNases Y and PnpA, enolase, phosphofructokinase, glycerol-3-phosphate dehydrogenase GapA, and helicase CshA that can be co-purified without cross-linking. All interactions were corroborated by far-western blotting with proteins purified from E. coli. Previously, we discovered that stress-induced SR7P binds enolase to enhance its interaction with and activity of enolase-bound RNase Y (RnY), while SR1P transcribed under gluconeogenic conditions interacts with GapA to stimulate its interaction with and the activity of RnjA (RnjA). We show that SR1P can directly bind RnjA, RnY, and PnpA independently of GapA, whereas SR7P only interacts with enolase. Northern blotting suggests that the degradation of individual RNAs in B. subtilis under gluconeogenic or stress conditions depends on either RnjA or RnY alone or on RnjA-SR1P, RnY-SR1P, or RnY-Eno. In vitro degradation assays with RnY or RnjA substrates corroborate the in vivo role of SR1P. Currently, it is unknown which substrate property is decisive for the utilization of one of the complexes.

Suffering doubly: How victims of coworker incivility risk poor performance ratings by responding with organizational deviance, unless they leverage ingratiation skills.

Building on conservation of resources theory, this study investigates the relationship between employees' exposure to coworker incivility and their job performance ratings, while also considering the mediating role of their deviant work behaviors and the moderating role of their ingratiation skills. Results based on multisource, three-wave data from employees and their supervisors in Pakistani organizations show that disrespectful coworker treatment diminishes employees' performance evaluations, because they seek purposefully to cause harm to their employing organization, as a way to vent their frustrations. This mediating role of organizational deviance is mitigated to the extent that employees have a greater ability to ingratiate with others though. This study accordingly identifies a key mechanism - deviant work behaviors that undermine organizational well-being - through which coworker incivility leads to negative performance consequences, and it reveals how organizations can subdue this process by honing pertinent personal resources within their ranks.

Chest X-rays findings in COVID 19 patients at a University Teaching Hospital - A descriptive study.

OBJECTIVE: To analyze Chest X-ray findings in COVID 19 positive patients, presented at corona filtration center, Benazir Bhutto Hospital Rawalpindi, based on CXR classification of British Society of Thoracic Imaging (BSTI). METHODS: In this study, all RT-PCR COVID-19 positive patients screened at corona filtration center, Benazir Bhutto hospital Rawalpindi from 20th March 2020 to 10th April 2020 were included. Mean age of the cohort with age range was calculated. Presenting complaints & Co-morbid were analyzed and tabulated in frequencies and percentages. Portable CXR findings were classified according to BSTI classification and documented in frequencies and percentages. RESULTS: Mean age of the patients was 44 years. Presenting complaints were cough 20 (67%), fever 18 (60%), shortness of breath 11 (37%), sore throat six (20%), loss of sense of taste and smell four(13%). Main co-morbid was hypertension six (20%). Two (7%) patients had normal and seven (23%) had classical COVID CXRs. 21 (70%) patients were in indeterminate group with only one (3%) having unilateral lung disease. Three (10%) patients had diffuse lung involvement and 18(60%) had peripheral lung involvement. Majority of patients 19 (63%), had bilateral middle and lower zonal involvement. CONCLUSIONS: In this study, COVID-19 CXRs generally manifested a spectrum of pure ground glass, mixed ground glass opacities to consolidation in bilateral peripheral middle and lower lung zones. BSTI CXR reporting classification of COVID-19 is valid in our patients with addition of middle zonal involvement in classical COVID-19 criteria as opposed to just lower zone involvement.

When ethics create misfit: Combined effects of despotic leadership and Islamic work ethic on job performance, job satisfaction, and psychological well-being.

This study applies social exchange and person-environment fit theories to predict that despotic leaders tend to hinder employee job performance, job satisfaction, and psychological well-being, whereas employees' own Islamic work ethic (IWE) enhances these outcomes. Also, IWE moderates the relationship of despotic leadership with the three outcomes, such that it heightens the negative impacts, because employees with a strong IWE find despotic leadership particularly troubling. A multi-source, two-wave, time-lagged study design, with a sample (303 paired responses) of employees working in various organisations, largely supports these predictions. Despotic leadership and IWE relate significantly to job performance, job satisfaction and psychological well-being in the predicted directions, except that there is no significant relationship between IWE and job satisfaction. A test of moderation shows that the negative relationships of despotic leadership with job outcomes are stronger when IWE is high. These findings have pertinent implications for theory, as well as for organisational practice.

The Relationship between Workplace Incivility and Helping Behavior: Roles of Job Dissatisfaction and Political Skill.

This article investigates the mediating role of job dissatisfaction in the relationship between employees' perceptions of workplace incivility and their helping behavior, as well as the buffering role of political skill in this process. Three-wave, time-lagged data collected from employees and their supervisors revealed that employees' exposure to workplace incivility diminished their helping behavior through their sense of job dissatisfaction. This mediating role of job dissatisfaction was less salient, however, to the extent that employees were equipped with political skill. For organizations, this study accordingly pinpoints a key mechanism-namely, unhappiness about their job situation-through which rude coworker treatment links to lower voluntary workplace behaviors among employees, and it reveals how this mechanism can be better contained in the presence of political skill.

Efficacy Of Intravenous Lignocain Vs Sevoflurane In Prevention Of Coughing And Desaturation At Extubation In Children.

BACKGROUND: Inadvertent coughing and desaturation are the most commonly faced and feared respiratory complications in post-anaesthesia period. The study was done to compare the efficacy of intravenous lignocaine versus sevoflurane in prevention of coughing and desaturation at extubation in children less than 6 years of age. METHODS: This Randomized Control Trial was carried out from May 2013 to May 2016, at Combined Military Hospital Nowshera after obtaining approval from the hospital ethics committee (IREC-0003/5/13/Aneas). Children aged three months to six years undergoing surgical procedures requiring the placement of definitive airway were randomly assigned into two groups. Patients were anaesthetized by standardized balanced anaesthesia technique. In Group A (n=355), three minutes prior to extubation lignocaine 2% was used intravenously. In Group B (n=355), isoflurane was switched off, breathing circuit changed and sevoflurane started at minimum alveolar concentration (MAC 3-4%) for 3 minutes prior to extubation. Assessment for extubation was clinical. Oxygen saturation and severity of coughing were noted for 5 consecutive minutes, after extubation. RESULTS: In group-A, 156 patients were less than 2 years of age while in group-B, 135 patients were less than 2 years old. In group-A, 199 and in group-B, 220 children were 2-6 years of age respectively. Post stratification the p-value for weight was 0.17 (p-value >0.05) and t-statistic was 1.36. Post stratification p-value for gender was 0.12 (p-value>0.05) and chi square statistic was 2.49. Group A had more eventful extubation with 270 cases of cough (76%) as compared to group-B where it was noted in 199 cases (56%). Similarly, desaturation was observed in 85 cases in group-A (24%) as compared to 28 cases (8%) in group-B. The difference between the groups was statistically significant. CONCLUSIONS: Sevoflurane based anaesthetic vapours mixture causes statistical significant prevention from events like coughing episodes and desaturation in post-extubation in children less than six years of age undergoing elective surgery.

Does Despotic Leadership Harm Employee Family Life: Exploring the Effects of Emotional Exhaustion and Anxiety.

Research has not focused on the negative effects of despotic leadership on subordinates' life satisfaction and the interface between work and family. Drawing on the Conservation of Resources theory, this research investigates the mediating effect of emotional exhaustion through which despotic leadership transcends from the workplace to subordinates' personal lives, resulting in work-family conflict and decreased life satisfaction. The research also examines the moderating effect of subordinates' anxiety on the relationship of their perceptions of despotic leadership with work-family conflict and life satisfaction. Three waves of time-lagged data was collected from 224 book sellers who work in publishing houses. We used Hayes' PROCESS to test moderation and SEM to test mediation. The results of the study suggest that despotic leadership is related to work-family conflict via emotional exhaustion, but offer no support for its relationship with life satisfaction. As expected, when subordinates' anxiety increases, the positive relationship between a supervisor's despotism and his or her subordinates' work-family conflict and the negative relationship between despotic leadership and life satisfaction both strengthen. The results suggest that despotic leaders harm their subordinates' non-work lives, and these effects intensify when subordinates have high levels of anxiety. These findings have important implications for service organizations in mitigating the negative effects of despotic leadership by minimizing subordinates' anxiety through coping mechanisms and giving reward and incentives.

QT interval prolongation in hospitalized patients on cardiology wards: a prospective observational study.

PURPOSE: Prolonged QT interval may lead to a lethal form of arrhythmia, torsades de pointes (TdP), which is associated with cardiovascular mortality. Therefore, we aimed to identify prevalence of QT interval prolongation, compare clinical characteristics of patients with normal and prolonged QT interval, and identify predictors of QT interval prolongation. METHODS: A prospective observational study was conducted in cardiology wards of two teaching hospitals in Pakistan. Bazett's correction formula was used for the calculation of QTc interval. Prevalence of QT prolongation and pro-QTc scores were calculated. Comparative analysis was performed with respect to various clinical characteristics by applying t test and chi-square test. Odds ratios were calculated using regression analysis. RESULTS: Among 417 patients, 44.6% were found having prolonged QT interval, of which, 17.3% presented with an abnormally high QTc interval (> 500 ms). Significant difference was recorded between the groups (normal vs. prolonged) with respect to age, all prescribed medications, QT drugs, number of risk factors, QT-DDIs (QT-prolonging drug-drug interactions), gender, and diuretics use. Multivariate logistic regression analysis showed significant results for various predictors such as male gender (p = 0.03), various age categories 41-50 years (p = 0.04), 51-60 years (p = 0.01), and > 60 years (p < 0.001), and diuretics (p = 0.008). CONCLUSION: A substantial number of patients in cardiology wards presented with QT prolongation. Proper considerations are needed in order to minimize the associated risk particularly in patients with abnormally high QT prolongation, old age, polypharmacy, one or more QT-prolonging drugs, and high pro-QTc scores.

Provenance based data integrity checking and verification in cloud environments.

Cloud computing is a recent tendency in IT that moves computing and data away from desktop and hand-held devices into large scale processing hubs and data centers respectively. It has been proposed as an effective solution for data outsourcing and on demand computing to control the rising cost of IT setups and management in enterprises. However, with Cloud platforms user's data is moved into remotely located storages such that users lose control over their data. This unique feature of the Cloud is facing many security and privacy challenges which need to be clearly understood and resolved. One of the important concerns that needs to be addressed is to provide the proof of data integrity, i.e., correctness of the user's data stored in the Cloud storage. The data in Clouds is physically not accessible to the users. Therefore, a mechanism is required where users can check if the integrity of their valuable data is maintained or compromised. For this purpose some methods are proposed like mirroring, checksumming and using third party auditors amongst others. However, these methods use extra storage space by maintaining multiple copies of data or the presence of a third party verifier is required. In this paper, we address the problem of proving data integrity in Cloud computing by proposing a scheme through which users are able to check the integrity of their data stored in Clouds. In addition, users can track the violation of data integrity if occurred. For this purpose, we utilize a relatively new concept in the Cloud computing called "Data Provenance". Our scheme is capable to reduce the need of any third party services, additional hardware support and the replication of data items on client side for integrity checking.

Distal Duodenal Varices: First Presentation of Upper Gastrointestinal Bleeding.

Varices are abnormal dilated veins which result from increased pressure in the portal circulation. Although the oesophagus and stomach are the most common sites for varices to develop, they may also occur as ectopic varices in the duodenum, rectum, and retroperitoneal areas. Isolated duodenal varices involving distal duodenum, particularly the fourth part of the duodenum, are extremely rare. However, such ectopic varices are associated with an increased risk of bleeding and mortality. Not only are they a diagnostic challenge, particularly if they present as a first manifestation of portal hypertension, they are also very difficult to treat due to their location. We present an interesting case of upper gastrointestinal bleeding where ectopic varices in the fourth part of the duodenum presented as a first manifestation of upper gastrointestinal bleeding. Gastroscopy did not reveal the source of bleeding and thus CT angiogram was performed in order to confirm the diagnosis. Radiological intervention by embolisation resulted in successful treatment.

Serological Evidence of Scrub Typhus among Cases of PUO in the Kashmir Valley- A Hospital Based Study.

INTRODUCTION: Rickettsial infections are being increasingly recognized as a cause of acute febrile illnesses and should be considered a distinct possibility in patients presenting with suggestive clinical features. Their diagnosis remains a challenge in a country like ours where tests like immunofluorescence assay cannot be routinely done. Results of serological tests, when correlated with patients clinical profile can aid in the timely diagnosis of scrub typhus. AIM: To find out the extent to which scrub typhus contributes to Pyrexia of Unknown Origin (PUO) in patients admitted to or attending the OPD of our hospital using simple tests like Weil-Felix Agglutination Test (WFT) and Enzyme Linked Immunosorbent Assay (ELISA). MATERIALS AND METHODS: A cross-sectional study was carried out in the Department of Microbiology, Government Medical College and Hospital, Srinagar, over a period of eight months (1(st) March to 31(st) October 2015). Serum samples from patients suffering from Pyrexia of Unknown Origin (PUO) were processed for the detection of Scrub typhus. A total of 162 samples were included in the study. These were subjected to WFT using OX-K strain. The serum samples were diluted 1/20 to 1/640 and a titre of ≥ 1:160 was considered as positive. The samples were also tested for IgM and IgG antibodies for scrub typhus by ELISA and tube agglutination test was done to detect typhoid fever and brucellosis. RESULTS: Of the 162 serum samples tested 22.8% tested positive scrub typhus by WFT. IgM ELISA and IgG was positive in 8 (4.9%) and 15 (9.3%) samples respectively. Sensitivity, specificity, positive and negative predictive values of WFT; taking IgM ELISA as a reference standard were 75%, 79.9%, 16.2% and 98.4% respectively. CONCLUSION: Scrub typhus is prevalent in our state and the results of WFT supplemented by those of ELISA can aid in its diagnosis. However the results of these tests should always be regarded in light of the clinical condition of the patient.

Potential drug-drug interactions in medical intensive care unit of a tertiary care hospital in Pakistan.

Background Patients admitted to intensive care unit (ICU) present with severe and life-threatening illnesses. Most of them suffer from various comorbidities. They usually receive complex pharmacotherapy with large number of medicines which increase the risk of drug-drug interactions (DDIs). Objective The present report aimed to investigate prevalence and levels of potential DDIs (pDDIs) in medical ICU. Methods Medications profiles of 416 patients were checked for pDDIs using Micromedex Drug-Reax(®). Prevalence, levels of severity and levels of documentation were reported. Results Of total 416 patients, 310 were exposed to pDDIs (overall prevalence = 74.5 %). Likewise, a prevalence rate of 13.9 % was recorded for contraindicated pDDIs, 52.2 % for major pDDI and 58.4 % for moderate pDDI. This study reported 740 interacting drug pairs that were presented in total 1686 pDDIs. Of 1686 pDDIs, 4.3 % were of contraindicated severity, 33.8 % of major severity and 49.6 % of moderate severity, whereas 45.5 % were of fair scientific evidence and 41.4 % of good scientific evidence. Conclusion In this study, pDDIs were found highly prevalent in ICU patients at a rate of 74.5 %. Most of the pDDIs had moderate severity; however, substantial number of interactions (38.1 %) had major and contraindicated severity.

Formative research and development of an evidence-based communication strategy: the introduction of Vi typhoid fever vaccine among school-aged children in Karachi, Pakistan.

The authors conducted formative research (a) to identify stakeholders' concerns related to typhoid fever and the need for disease information and (b) to develop a communication strategy to inform stakeholders and address their concerns and motivate for support of a school-based vaccination program in Pakistan. Data were collected during interactive and semi-structured focus group discussions and interviews, followed by a qualitative analysis and multidisciplinary consultative process to identify an effective social mobilization strategy comprised of relevant media channels and messages. The authors conducted 14 focus group discussions with the parents of school-aged children and their teachers, and 13 individual interviews with school, religious, and political leaders. Parents thought that typhoid fever was a dangerous disease, but were unsure of their children's risk. They were interested in vaccination and were comfortable with a school-based vaccination if conducted under the supervision of trained and qualified staff. Teachers and leaders needed information on typhoid fever, the vaccine, procedures, and sponsors of the vaccination program. Meetings were considered the best form of information dissemination, followed by printed materials and mass media. This study shows how qualitative research findings can be translated into an effective social mobilization and communication approach. The findings of the research indicated the importance of increasing awareness of typhoid fever and the benefits of vaccination against the disease. Identification and dissemination of relevant, community-based disease and vaccination information will increase demand and use of vaccination.

Schools as potential vaccination venue for vaccines outside regular EPI schedule: results from a school census in Pakistan.

BACKGROUND: Vaccines are the most effective public health intervention. Expanded Program on Immunization (EPI) provides routine vaccination in developing countries. However, vaccines that cannot be given in EPI schedule such as typhoid fever vaccine need alternative venues. In areas where school enrolment is high, schools provide a cost effective opportunity for vaccination. Prior to start of a school-based typhoid vaccination program, interviews were conducted with staff of educational institutions in two townships of Karachi, Pakistan to collect baseline information about the school system and to plan a typhoid vaccination program. Data collection teams administered a structured questionnaire to all schools in the two townships. The administrative staff was requested information on school fee, class enrolment, past history of involvement and willingness of parents to participate in a vaccination campaign. RESULTS: A total of 304,836 students were enrolled in 1,096 public, private, and religious schools (Madrasahs) of the two towns. Five percent of schools refused to participate in the school census. Twenty-five percent of schools had a total enrolment of less than 100 students whereas 3% had more than 1,000 students. Health education programs were available in less than 8% of public schools, 17% of private schools, and 14% of Madrasahs. One-quarter of public schools, 41% of private schools, and 43% of Madrasahs had previously participated in a school-based vaccination campaign. The most common vaccination campaign in which schools participated was Polio eradication program. Cost of the vaccine, side effects, and parents' lack of information were highlighted as important limiting factors by school administration for school-based immunization programs. Permission from parents, appropriateness of vaccine-related information, and involvement of teachers were considered as important factors to improve participation. CONCLUSIONS: Health education programs are not part of the regular school curriculum in developing countries including Pakistan. Many schools in the targeted townships participated in immunization activities but they were not carried out regularly. In the wake of low immunization coverage in Pakistan, schools can be used as a potential venue not only for non-EPI vaccines, but for a catch up vaccination of routine vaccines.

Choroidal metastasis from renal cell carcinoma presenting with cataract.

We report a case of rare involvement of the eye with choroidal metastasis from renal cell carcinoma presenting 08 years after the primary tumor was removed. The patient initially presented with cataract most probably induced by the tumor. After cataract extraction, tumor was detected when it induced vitreous involvement and retinal detachment. Enucleation was performed and an extraocular mass was also excised. Histopathology confirmed the diagnosis of metastasis from renal cell carcinoma in the ocular tumor, extraocular mass and the vitreous.

Pseudoxanthoma elasticum and nephrolithiasis: a rare association.

Pseudoxanthoma elasticum (PXE) is a multi-systemic, genetic disorder of connective tissue characterized by progressive calcification and fragmentation of elastic fibers in skin, retina and cardiovascular system. A young patient reported to urologist in emergency with azotemia secondary to acute bilateral obstructive uropathy. Upon successful management, he was found to have full-blown skin and eye manifestations and was evaluated thoroughly regarding extent and potential systemic complications of Pseudoxanthoma elasticum.

Mucormycosis: a devastating fungal infection in diabetics.

Mucormycosis is a highly invasive, devastating and usually fatal fungal infection of the sinuses, brain, or lungs that occurs primarily in people with immune disorders. Despite advances in diagnosis and treatment, a high mortality still exists. We present a middle aged diabetic male with this serious fungal infection involving nose, paranasal area and adjacent periorbital regions with a high risk of progressing further towards the dura mater. He was promptly diagnosed and managed with serial surgical debridements with systemic antifungals and was later fitted with a nasal prosthesis.

Elevated levels of plasma homocysteine in hypertensive patients with diabetes mellitus.

BACKGROUND: Homocysteine generates oxygen radicals (superoxide anion and hydrogen peroxide) that are known to produce vasoconstriction. Hypertension is a common problem in individuals with diabetes mellitus. It is possible that hypertension in diabetic patients may be due to increased levels of plasma homocysteine. We investigated the plasma levels of homocysteine, factors involved in homocysteine metabolism (serum folic acid and vitamin B12) and lipid peroxidation product in the serum of diabetic patients with hypertension. METHODS AND RESULTS: The studies were conducted in three groups: 1) healthy controls, and diabetic patients who were 2) normotensive and 3) hypertensive. Plasma homocysteine, serum malondialdehyde (a lipid peroxidation product), vitamin B12, and folic acid were measured in these patients. Plasma homocysteine and serum malondialdehyde levels were elevated in diabetic patients compared to the control group. Plasma levels of homocysteine and serum levels of malondialdehyde were higher in the hypertensive diabetic patients than in those who were normotensive. Levels of serum folate were lower in hypertensive diabetic patients compared to the normotensive group. Levels of serum vitamin B12 were similar in both the normotensive and hypertensive diabetic patients. CONCLUSIONS: Levels of plasma homocysteine and serum malondialdehyde are elevated in hypertensive diabetic patients. Hyperhomocysteinemia may be involved in the induction and sustaining of hypertension in diabetic patients.