Urbanization influenced the interactions between dissolved organic matter and bacterial communities in rivers.

Increased urbanization and anthropogenic activities can alter dissolved organic matter (DOM) and complicate its interaction with bacteria in rivers' ecosystems, however, there is limited information about how bacterial communities respond to DOM components in rivers with different urbanization levels. Here, we combined spectroscopy-based DOM analysis and 16S rRNA gene amplicon sequencing to investigate the associations of bacterial taxa and DOM properties as well as the impacts of DOM on bacterial niche breadth in North River (NR) and West River (WR) of Jiulong River watershed, southern China, which had low and high urbanization levels, respectively. Spectroscopy analysis showed that hydrophilic DOM was predominant in both rivers whereas chromophoric DOM was higher in WR. Network analysis indicated that only seven bacterial genera (i.e., hg clade, chthoniobacter, Geobacter, Acidibacter, Alphal Cluster, Fluviicola, and Lacunisphaera) showed strong associations with DOM optical variables in both rivers, whereas more than 85% of DOM-bacterial genera associations were different between rivers. These results suggest that the relationship between DOM and bacterial communities had different responses in rivers with different urbanization levels. The partial least square path model indicated that the total standardized effect of physico-chemicals on bacterial niche breadth was higher in NR (0.62) than in WR (0.35), whereas humic substances showed an opposite pattern (NR: -0.42; WR: 1.67). The distinct effects of physico-chemicals and DOM on bacterial niche breadths between rivers could be due to the different effects of urbanization and human activities on the environmental conditions of riverine ecosystems. Our findings revealed a huge dissimilarity in the bacteria-DOM co-occurrence networks between rivers with different urbanization levels and provide a novel insight that urbanization may enhance DOM's importance to bacterial niche breadths.

Insight into variation and controlling factors of dissolved organic matter between urban rivers undergoing different anthropogenic influences.

Dissolved organic matter (DOM), known as a key to the aquatic carbon cycle, is influenced by abiotic and biotic factors. However, the compositional variation and these factors' effects on fluorescence DOM (FDOM) in urban rivers undergoing different anthropogenic pressure are poorly investigated. Herein, using fluorescence excitation-emission matrix and parallel factor analysis (EEM-PARAFAC), four FDOM components (C1, C2, C3, and C4) were identified in a less urbanized north river (NR) and a more urbanized west river (WR) of Jiulong River Watershed in Fujian province, China. C1, C2, and C4 were related to humic-like substances (HLS) and C3 to protein-like substances (PLS). HLS (63.9% in WR and 36.4% in NR) and PLS (62.7% in WR and 37.3% in NR) exhibited higher fluorescence in the more urbanized river. We also found higher PLS in winter, but higher HLS in summer for both rivers. Although the coefficient of variation indicated a difference in FDOM components stability to some extent between the two rivers, the typhoon event that occurred in summer had a stronger disruptive impact on the CDOM and FDOM of a more urbanized river than that of a less urbanized river. We explore abiotic and biotic factors' effects on FDOM using the partial least squares path model (PLS-PM). PLS-PM results revealed higher significant influences of biotic factors on FDOM in the more urbanized river. This study enhances our understanding of FDOM dynamics of rivers with different anthropogenic pressure together with the abiotic and biotic factors driving them.

Factors leading to the academic failure of undergraduate medical students - Predict early to prevent.

Objectives: The main objective of the study was to explore the factors to predict academic failure before the first major assessment. Methods: An exploratory qualitative study was conducted from March 2021 to August 2021 at Riphah International University. Using the purposive sampling technique, 16 students and seven teachers were included in the study. Eight online interviews were conducted with students who were academic failures and two focus group discussions were held with eight high achievers and seven teachers. The data was analyzed and thematic analysis was done. Results: Thematic analyses deduced relevant themes which were: Educational Journey Does past matter? Essential for learning, Personality and psychological make-up, and assessment of behaviour. The factors identified were performance record, learning difficulty, educational dislocation, missionless and purposeless, against free will, tuition, poor self-regulation, low effort, procrastination, non-reflective practice, cognitive load mismanagement, limited remediation, hesitant help-seeking, low self-efficacy, introvert behaviour, demotivation, emotional imbalance, observation of student behaviour, assessment of assigned task. Conclusion: Academic failure can be predicted early and salvaged.

Horizontal and vertical gene transfer drive sediment antibiotic resistome in an urban lagoon system.

Rapid urbanization has resulted in pervasive occurrence of antibiotic resistance genes (ARGs) in urban aquatic ecosystems. However, limited information is available concerning the ARG profiles and the forces responsible for their assembly in urban landscape lagoon systems. Here, we employed high-throughput quantitative PCR (HT-qPCR) to characterize the spatial variations of ARGs in surface and core sediments of Yundang Lagoon, China. The results indicated that the average richness and absolute abundance of ARGs were 11 and 53 times higher in the lagoon sediments as compared to pristine reference Tibetan lake sediments, highlighting the role of anthropogenic activities in ARG pollution. Co-occurrence network analysis indicated that various anaerobic prokaryotic genera belonging to Alpha-, Deltaproteobacteria, Bacteroidetes, Euryarchaeota, Firmicutes and Synergistetes were the potential hosts of ARGs. The partial least squares-path modeling (PLS-PM) analysis revealed positive and negative indirect effects of physicochemical factors and heavy metals on the lagoon ARG profiles, via biotic factors, respectively. The horizontal (mediated by mobile genetic elements) and vertical (mediated by prokaryotic communities) gene transfer may directly contribute the most to drive the abundance and composition of ARGs, respectively. Furthermore, the neutral community model demonstrated that the assembly of sediment ARG communities was jointly governed by deterministic and stochastic processes. Overall, this study provides novel insights into the diversity and distribution of ARGs in the benthic habitat of urban lagoon systems and underlying mechanisms for the spread and proliferation of ARGs.

Volumetric Modulated Arc Therapy (VMAT): A modern radiotherapy technique - A single institutional experience.

OBJECTIVE: To evaluate VMAT plans for conformity and homogeneity of radiation dose to the target in order to share our experience as a pioneering institute to use VMAT technology in Pakistan. METHODS: Since December 2014 to January 2018, 530 patients of various anatomical sites were treated by VMAT technique at Neurospinal Cancer Care Institute (NCCI) Karachi Pakistan. ERGO++ planning system (Version 1.7.2) was used to develop VMAT plans with single or multiple arcs by the rotation of couch and gantry. The plans were evaluated by calculating Conformity Index (CI) and Homogeneity Index (HI) and critical organ (OARs) doses of individual tumor sites. RESULTS: The average CI of various sites was 1.4 (range: 1.0-2.0) and average HI of various sites was 1.20 (range: 1.07-1.374), respective critical organ doses were adequately achieved. CONCLUSIONS: VMAT treatment planning technique showed good conformal and homogeneous target coverage with sparing of organs at risk and reduced treatment delivery time. With these features, safety of VMAT technique may allow its routine clinical use, though it is still under investigation in many areas.

Deterministic and stochastic processes driving the shift in the prokaryotic community composition in wastewater treatment plants of a coastal Chinese city.

Wastewater treatment plants (WWTPs) rely mainly on the microbial assemblages to contribute significantly for the removal of organic pollutants and nutrients. However, limited information is available on the ecological driving forces underlying the turnover of prokaryotic communities across wastewater treatment processes (i.e., from influents (IFs) and effluents (EFs)) within WWTPs. Here, we used a combination of the 16S rRNA gene amplicon sequencing and a quantitative ecological null model analysis to explore the ecological processes governing the turnover of the prokaryotic communities and the dominant taxonomic taxa across wastewater treatment processes of five full-scale WWTPs in China. Our results indicated that a significant variation in the composition of prokaryotic communities and the dominant taxa between IFs and EFs. The analysis of the environmental sources of indicator OTUs showed that a relatively lower abundance of the sludge/sewage and human guts associated OTUs in EFs than in IFs. Ecological null models revealed that among the ecological processes, deterministic processes were dominant in controlling the turnover of the overall communities from IFs to EFs, whereas the relative importance of deterministic processes varied among the dominant taxa (i.e., Bacteroidetes > Proteobacteria > Gammaproteobacteria > Firmicutes > Betaproteobacteria). However, the assembly of IF and EF communities was influenced mainly by the deterministic and stochastic processes, respectively. In addition, our results indicated that EF communities have a higher phylogenetic diversity than those of the IF communities, but the abundance of prokaryotic 16S rRNA genes was lower in EFs than in IFs. Overall, our study provides a novel insight of the assembly mechanisms underlying the turnover of prokaryotic communities during wastewater treatment processes.

Cattle egrets as a biosentinels of persistent organic pollutants exposure.

We investigated selected chlorinated pollutants (ß-HCH, γ-HCH, DDDs, DDEs, o,p'-DDT, p,p'-DDT, heptachlor, aldrin, dieldrin, and endrin) in the Lahore and the Sialkot districts of Pakistan, using eggs of cattle egret (Bubulcus ibis) collected during May and June 2007. The pollutant with highest level and frequency was ΣDDT, followed by ß-HCH, γ-HCH, heptachlor, aldrin, dieldrin, and endrin in descending order. The concentration(s) were significantly higher in Sialkot heronry for all the pollutants (except p,p'-DDT) than in Lahore. The values for DDTs, ß-HCH, γ-HCH, and heptachlor were significantly higher (p < 0.05) in the egg(s) than in sediment(s) and in the chicks' diet, due to biomagnification. Among DDTs analogues, p,p'-DDD was the major contaminant with >60 % of total DDT burden, reflecting the widespread aged as well as recent use of DDT as well as anaerobic degradation (DDD/DDE > 1 in many cases) in the nearby paddy soils. In few samples, p,p'-DDT/(DDD + DDE) > 0.5 suggested the recent emission patterns from surrounding contaminated areas of demolished DDT units and obsolete pesticide stores. The higher levels of HCHs (i.e., ß-HCH) in the samples collected from Sialkot indicate exposure from long-term agricultural use. Overall, concentrations of all studied POPs were less than the threshold levels known to affect reproduction. Nevertheless, total DDTs and/or HCHs burdens in some eggs contained concentrations of greater than what would educe adverse effects on birds. This is among few studies on OCPs exposure to avian species, which provide the evidence of Pakistan's contribution toward the Global POPs emission.

Metabolisms and multiple functions of laminaran in marine algae under global change: A critical review.

Laminaran is a major storage of carbohydrate in marine algae. Its high content and potential functions draw increasing attention. However, our understanding of its metabolisms and functions is still fragmented. After reviewing, marine algae exhibit a spectacular capacity of laminaran accumulation especially in the diatom Odontella aurita (65 % DW). Marine particulate organic carbon (POC) also has high contents of laminaran (42 ± 21 % DW). Laminaran shows a diel variation trend in marine algae, the content of which increases in the day but decreases at night. Laminaran also significantly accumulates in the stationary phase of algal growth. Furthermore, the metabolic pathway of laminaran and the remolding carbon mechanism in response to marine nitrogen limitation are proposed and comprehensively discussed. Laminaran production in marine phytoplankton is predicted to increase in future warmer and CO2-enriched oceans. Laminaran has diverse biological functions, including antioxidant, antimicrobial, anti-cancer, immunomodulatory, wound healing, and prebiotics. In addition, laminaran is also a major carbon storage compound in marine algae, suggesting its significant ecological function in marine carbon cycle. This study provides new insight into algal laminaran functions and its response mechanisms to environmental and climate changes.

Poultry manure gleaned antibiotic residues in soil environment: A perspective of spatial variability and influencing factors.

The antibiotics released by human and animals end up in the environmental sinks like soil and water to cause contamination and induce resistance in the microflora. The knowledge of fate and behavior of antibiotics in diverse geographical, climatological, and physicochemical is limited. Therefore, present study investigated the spatial distribution of antibiotics and their relationship with various factors and the source-sink relationship between soil and poultry manure. This was achieved by employing spatially constrained hierarchical clustering, global and local spatial autocorrelation, and spatial regression techniques. Most of the antibiotics co-occurred in both soil and poultry manure matrices, however antibiotic concentration in soil (1.20 µg kg-1 < antibiotics ≤21.38 µg kg-1) was lower than that in the poultry manure (7.05 µg kg-1< antibiotics ≤60.2 µg kg-1). Majority of the antibiotics showed spatial independence in both poultry manure and soil, except for sulfadiazine, sulfanilamide and sulfapyridine with Moran's I > - 0.111. Local indicator of spatial association indicated localized spatial clustering and outlier behavior of antibiotics. The underlying reasons for spatial heterogeneity of antibiotics resolved by spatial regression models indicated elevation, S%, C%, pH and mean annual temperature as the major factors. The influence of antibiotic concentration in poultry manure as a source was significant but marginal compared to the other predictors of spatial heterogeneity.

Spatiotemporal profile and ecological impacts of major and trace elements in surface sediments of marginal seas of the Arctic and Northern Pacific Oceans.

The status and ecological impacts of sedimentary elements of the marginal seas of Arctic and Northern Pacific Oceans was investigated during 2016 to 2018 by using inductively coupled plasma mass spectrometry. Industrial (0.006 mg kg-1-64.6 g kg-1), precious (0.003-43.8 mg kg-1), rare earth (0.006-112.9 mg kg-1), and heavy metal (0.009-398.9 mg kg-1) elements showed spatial variation, and temporal uniformity. The results indicated ΣREEs and light REEs enrichment compared to chondrite and heavy REEs, respectively, while nonsignificant positive and negative δCe and δEu anomalies existed, respectively. High contamination and extreme enrichment of priority control, industrial (As, Mo, Re, Sb), precious (Au, Ir, Pd, Pt, and Ru) and RE elements indicated potential moderate to high ecological and biological risks. The study highlighted the ecological importance and fragile nature of these ecosystems and calls for an urgent action to ensure sustainability of these ecosystems.

Transmission mechanisms of antibiotic resistance genes in arsenic-contaminated soil under sulfamethoxazole stress.

Numerous studies have revealed the spread mechanism of antibiotic resistance genes (ARGs) in single antibiotic-contaminated soils. However, the comprehensive impacts of heavy metals and antibiotics on ARGs and the underlying mechanisms are still unknown. Here, high-throughput quantitative PCR and high-throughput sequencing were used to investigate changes in ARGs and bacterial communities under various sulfamethoxazole (SMX) regimes (0, 1, 10, 50 mg kg-1) in arsenic (As) contaminated soils. The study found that the abundances of ARGs, mobile genetic elements (MGEs), and heavy metal resistance genes (HMRGs) significantly increased in the soil fortified at 10 and 50 mg kg-1 SMX concentrations. The ARGs abundance increased with the increase in the MGEs abundance. Many significant positive correlations between various ARGs subtypes and HMRGs subtypes were found. These results indicate that the HMRGs and MGEs positively contributed to the enrichment of ARGs in As-contaminated soils under SMX stress. Meanwhile, the abundance of copiotrophic (Actinobacteriota) reduced and oligotrophic (Gemmatimonadota) increased, indicating that the life history strategy of the community changed. In addition, Gemmatimonadota was positively correlated to ARGs, HMRGs, and MGEs, suggesting that Gemmatimonadota, which can cope with As and SMX stress, was the host for resistance genes in the soil. Finally, the study found that MGEs play a determinant role in ARGs proliferation due to the direct utilization of HGT, and the indirect effect for ARGs spread under a co-selection mechanism of ARGs and HMRGs, while the bacterial community showed indirect influences by altering environmental factors to act on MGEs. Collectively, this study revealed new insights into the mechanisms of resistance gene transmission under combined SMX and As contamination in soil ecosystems.

Resolving the dynamics of chrysolaminarin regulation in a marine diatom: A physiological and transcriptomic study.

Diatom containing different active biological macromolecules are thought to be an excellent microbial cell factory. Phaeodactylum tricornutum, a model diatom, is a superb chassis organism accumulating chrysolaminarin with important bioactivities. However, the characteristic of chrysolaminarin accumulation and molecular mechanism of the fluctuated chrysolaminarin in diatom are still unknown. In this study, physiological data and transcriptomic analysis were carried out to clarify the mechanism involved in chrysolaminarin fluctuation. The results showed that chrysolaminarin content fluctuated, from 7.41 % dry weight (DW) to 40.01 % DW during one light/dark cycle, increase by day and decrease by night. The similar fluctuated characteristic was also observed in neutral lipid content. Genes related to the biosynthesis of chrysolaminarin and neutral lipid were up-regulated at the beginning of light-phase, explaining the accumulation of these biological macromolecules. Furthermore, genes involved in carbohydrate degradation, cell cycle, DNA replication and mitochondria-localized ß-oxidation were up-regulated at the end of light phase and at the beginning of dark phase hinting an energy transition of carbohydrate to cell division during the dark period. Totally, our findings provide important information for the regulatory mechanism in the diurnal fluctuation of chrysolaminarin. It would also be of great help for the mass production of economical chrysolaminarin in marine diatom.

Microalgal mediated antibiotic co-metabolism: Kinetics, transformation products and pathways.

The mutual interaction of a microalga Chlorella vulgaris with four antibiotics viz. sulfamethoxazole (SMX), trimethoprim (TMP), azithromycin (AZI), and levofloxacin (LEV) individually and in mixture was studied in batch culture. SMX, TMP, and LEV stimulated algal growth, while AZI inhibited its growth. The Combination Index (CI)-isobologram indicated antagonism of the antibiotic mixture on the growth of C. vulgaris. Higher removal efficiency was observed in the mixed antibiotic than in the single antibiotic batch cultures. Biodegradation was the main antibiotic removal mechanism with a similar antibiotic biosorption pattern in single and mix antibiotic cultures. Scanning electron microscopy and Fourier transform infrared spectrophotometry showed minor biochemical alterations on algal cells surface and a stable algal population. Monod kinetics model was successfully applied to understand the growth with respect to the removal efficiency of C. vulgaris in single and mix antibiotic batch cultures. Results indicated relatively higher specific growth rate in the mix antibiotic batch culture with removal efficiency in the order of SMX > LEV > TMP > AZI. In total, 46 metabolites with 18 novel ones of the four antibiotics were identified by using high-resolution mass spectrometry based on the suspect screening approach to propose the potential transformation pathways. Most of the transformation products demonstrated lower toxicity than their respective parents. These findings implied that C. vulgaris could be an outstanding candidate for advanced treatment of antibiotic removal in wastewater.

Spatial autocorrelation and temporal variation of contaminants of emerging concern in a typical urbanizing river.

The distribution and fate of contaminants of emerging concern (CECs) was studied in relation to hydrological conditions, land use characteristics, and spatial contiguity in Houxi River. Thirty-four CECs were detected in the surface water during a three-year sampling campaign. Caffeine was most prevalent (99% frequency), while bisphenol A had the highest median concentration (78.2 ng/L) among the detected CECs. Caffeine and the other prevalent CECs lincomycin and bisphenol A, with median concentrations of 3.89 ng/L, 0.26 ng/L, and 78.2 ng/L, respectively, were positively correlated with land use types related to anthropogenic activities (grass, barren, built up, and cropland areas and landscape indexes for human activities). The analysis of similarities revealed significant annual variations, with increasing trends in both the concentrations and detection frequencies of CECs. Spatial variations were demonstrated by higher concentrations and detection frequencies downstream compared to upstream. The singular value decomposition analysis revealed that the downstream sites were the major contributors (55.6%-100%) to the spatial variability of most CECs. Moran's I analysis based on downstream contiguity indicated strong spatial autocorrelation among the connected sites for most CECs. This was further supported by longer correlation lengths for 18 CECs than the average distance between the sampling sites. The spatial autocorrelation can be attributed to the physicochemical properties of CECs and local hydrological dynamics, including temperature, wind speed, and sunshine hours. For most CECs, local contribution predominated over neighbor influence with an average value of 75.5%. The results of this study provide new insight to evaluate CEC distributions, which will be beneficial to policymakers for the management and prioritization of CEC contaminants in the Houxi watershed.

Double flap patch closure of VSD with elevated pulmonary vascular resistance: an experience at AFIC/NIHD.

OBJECTIVE: To determine the 30 days outcome measured in terms of morbidity and mortality in cases of ventricular septal defect (VSD) with increased pulmonary vascular resistance (PVR) managed with double flap patch closure. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Armed Forces Institute of Cardiology (AFIC/NIHD), Rawalpindi, from December 2005 to December 2008. METHODOLOGY: Forty patients with VSD having PVR 9.58 + 4.33 wood units underwent double flap patch closure. The patch was fenestrated as one half of the expected aortic annulus diameter. A separate flap patch 5 mm larger than fenestration was attached to superior upper one third margins of fenestration. The patch was placed with flap to open towards the left ventricular apex. Modified ultra filtration (MUF) was employed in every case and sildenafil was given postoperatively. RESULTS: The age of patients ranged from 1 to 28 years with a mean of 6.66 + 5.70 years. There were 22 males and 18 females. All patients were weaned off from inotropic and ventilatory support as earlier as possible postoperatively with intensive care unit (ICU) stay of 77.15 + 54.56 hours. Postoperative pulmonary artery pressures were reduced to 42.63 + 10.86 mmHg as compared to pre-operative pulmonary artery pressures of 88.3 + 15.2 mmHg. Postoperatively 11 patients with suprasystemic pulmonary artery pressures and desaturation went into pulmonary hypertensive crisis in which immediate 2D echo evidenced the functioning flap valve with right to left shunt. There was only one death (early) out of 40 patients with an overall mortality of 2.5% along with limited morbidity. CONCLUSION: Double flap patch is an inexpensive, easy to construct technique with low morbidity and mortality in cases of VSD with raised PVR.

Integrated assessment of major and trace elements in surface and core sediments from an urban lagoon, China: Potential ecological risks and influencing factors.

Marine sediments serve as a sink for contaminants of anthropogenic origin. Here, 25 major and trace elements were determined in surface and core sediments from an urban lagoon (Yundang Lagoon), China. The median concentrations of Pb, Cd, Cu, and Zn in both surface and core sediments exceeded global and crustal averages. Principal component analysis for the elements and ecological impact of the heavy metals indicated spatial heterogeneity in core sediments from different lagoon areas; however, no such pattern was observed in surface sediments. Geodetector analysis indicated spatial locations of lakes, pH, N%, C%, and S% as the major factors influencing the heterogeneity of potential ecological risk index, a cumulative measure of the ecological impact of heavy metal. The interaction detector indicated nonlinear and bivariate enhancement between different physicochemical parameters. Besides, a depth profile of the elements in different samples was also elucidated.

Co-selection of antibiotic resistance genes, and mobile genetic elements in the presence of heavy metals in poultry farm environments.

Environmental selection of antibiotic resistance genes (ARGs) is considered to be caused by antibiotic or metal residues, frequently used in livestock. In this study we examined three commercial poultry farms to correlate the co-occurrence patterns of antibiotic and metal residues to the presence of ARGs. We quantified 283 ARGs, 12 mobile genetic elements (MGEs), 49 targeted antibiotics, 7 heavy metals and sequenced 16S rRNA genes. The abundance and type of ARG were significantly enriched in manure while soil harbored the most diverse bacterial community. Procrustes analysis displayed significant correlations between ARGs/MGEs and the microbiome. Cadmium (Cd), arsenic (As), zinc (Zn), copper (Cu) and lead (Pb) were responsible for a majority of positive correlations to ARGs when compared to antibiotics. Integrons and transposons co-occurred with ARGs corresponding to 9 classes of antibiotics, especially Class1 integrase intI-1LC. Redundancy analysis (RDA) and Variance partitioning analysis (VPA) showed that antibiotics, metals, MGEs and bacteria explain solely 0.7%, 5.7%, 12.4%, and 21.9% of variances of ARGs in the microbial community, respectively. These results suggested that bacterial composition and horizontal gene transfer were the major factors shaping the composition of ARGs; Metals had a bigger effect on ARG profile than detected antibiotics in this study.

Induced remote ischemic pre-conditioning on ischemia-reperfusion injury in patients undergoing coronary artery bypass.

OBJECTIVE: To determine the role of remote ischemic pre-conditioning (rIPC) on myocardium, against ischemia reperfusion injury in patients undergoing coronary artery bypass graft (CABG) surgery by measuring CKMB levels. STUDY DESIGN: A randomized controlled trial. PLACE AND DURATION OF STUDY: The Surgical Department of Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, from January to June 2008. METHODOLOGY: One hundred patients with double and triple vessels coronary artery disease were randomized in two groups of 50 each. rIPC protocol consisted of 3 x 5 minutes of forearm ischemia, induced by a blood pressure cuff inflated to 200 mmHg, with an intervening 5 minutes of reperfusion, during which the cuff was deflated. Patients in the control group were not subjected to limb ischemia. The protocol of induced ischemia was completed before placing patients on extracorporeal bypass circuit. At the end of surgery serum CKMB levels were measured and compared at 8, 16, 24 and 48 hours from both the groups. Written informed consent was taken from patients. Study was approved by the hospital ethical committee. RESULTS: Remote ischemic pre-conditioning significantly reduced CKMB levels at 8, 16, 24 and 48 hours after surgery with p-values of 0.026, 0.021, 0.052 and 0.003 respectively. There was mean reduction of 3 iu/l in CKMB levels, in patients who underwent rIPC protocol prior to CABG surgery, compared to control group. CONCLUSION: This study showed a significant reduction of enzyme marker CKMB in patients subjected to rIPC prior to CABG surgery. This suggests lesser degree of myocardial damage compared to control group in CABG patients.

Role of neo-adjuvant chemoradiation in locally advanced rectal cancers.

OBJECTIVE: To determine the radiologic downstaging and histological response after neo-adjuvant concurrent chemoradiation in locally advanced rectal cancers. STUDY DESIGN: Case series. PLACE AND DURATION OF STUDY: Radiation Oncology department of Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from December 2004 to November 2005. METHODOLOGY: Thirty patients with histopathologically confirmed locally advanced carcinoma rectum who had not received any treatment (chemotherapy, radiotherapy or surgery) prior to presentation were enrolled. Radiation therapy was delivered with a three-field technique to a dose of 50.4 Gy over 5 weeks at the rate of 1.8 Gy/day. Two cycles of chemotherapy were given synchronously, which comprised of 5-fluorouracil 350 mg/m2 and folinic acid 20 mg/m2 continuous intravenous infusion over first five days and last five days of radiotherapy. Surgery was planned 4-6 weeks later to chemoradiation after radiologic post therapy staging. Viable specimens were identified and toxicity was observed. RESULTS: All patients completed treatment without modification. Radiologic downstaging was found in 56.7%, stable disease was seen in 30.0% and progressive disease was present in 13.3% of the patients. Radiologically complete resolution of tumour was not observed. Pathological complete resolution of tumour was achieved in 3.3% and near complete resolution was observed in 13.3% of the patients. In 86.6% cases, a total gross tumour resection with no macroscopic residual disease was possible. All the patients tolerated the treatment well. CONCLUSION: Neo-adjuvant chemoradiation for locally advanced rectal cancers is associated with high resectability rate and is relatively safe with acceptable morbidity which favours its use in future.

Checklist of earthworm species (Oligochaeta) of the North Eastern Region of India.

A checklist of earthworm species hitherto recorded from North Eastern Region (NER) of India is presented. In total, 128 species/subspecies belonging to 26 genera spread over 9 families are listed. Of these, 72 species are recognized as endemics, 18 as near endemics, 5 as native peregrines and 32 as exotics. The checklist includes literature citation to the original description, type locality, important synonyms and the state-wise distributional records for each species/subspecies.