Post-harvest bacterial contamination of fish, their assessment and control strategies.

Healthy fish populations lead to healthy aquatic ecosystems and it is our responsibility to be a part of the solution. Fish is one of the most favored foods and is suitable for people of all ages. Fish is an essential source of protein, vitamins, and minerals and a source of income for millions of people. Human population growth and climate change are putting a strain on our food system, demanding the development of sustainable services to enhance global food production and its security. Food safety is an intricate problem in both developed and developing countries. Fresh fish is a highly perishable food with a limited life span; as a result, it must be delivered and kept carefully to minimize deterioration and assure safety. Fish spoilage is linked to biochemical changes that occur post-harvest, such as storage and transportation. These modifications can account for fish spoilage by altering the taste, texture, and appearance. Fish harvesting, distribution, and post-harvest handling are all unhygienic, resulting in poor and unpredictable fish quality in the market. Many innovative and effective control measurements of various bacteria in fish have been proposed and evaluated. This review is a systematic approach to investigating post-harvest fish spoilage, its assessment, and control strategies.

Bilateral Tibial Tuberosity Periosteal Sleeve Fracture in an Adolescent: A Case Report.

Tibial tuberosity avulsion fracture is a rare injury, and bilateral occurrence is more uncommon. Periosteal sleeve fracture is a unique fracture pattern which was first described in the lower pole of patella in children. We are reporting a rare case of bilateral tibial tuberosity sleeve fracture in a teenage boy which occurred while sprinting. The patient underwent open reduction, pull through suture fixation of the bilateral tibial tuberosity and screw fixation of left tibial tuberosity. Post-operative rehabilitation included gradual increment of range of motion with hinged brace and quadriceps muscle strengthening. Close follow-up was done to monitor the progression of his recovery. At six months follow-up, the patient recovered well. Both knees had full range of motion with an intact extensor mechanism.

Training workshops in problem-based learning: changing faculty attitudes and perceptions in a Pakistani medical college.

BACKGROUND: Problem-based learning (PBL) has over the years become a learning strategy established for teaching students in medicine. In order to use PBL as a teaching tool, faculty must be familiar with PBL and comfortable with the role transition from 'teacher' to 'facilitator'. This transition is critical for the success of PBL. This article describes the faculty development process undertaken in Pakistan at the onset of introduction of PBL in the curriculum. METHODS: At the Foundation University Medical College (FUMC), we initiated a faculty development program in PBL. The program consisted of two-day, hands-on facilitator training workshops conducted five times over the year and led by in-house faculty. A total of 180 faculty members completed these workshops. The workshops consisted of interactive sessions on the philosophy of PBL, small group dynamics, the role of the facilitator, an introduction to case design, wrap-up PBL sessions and assessment in PBL. Participants were provided with pre-workshop reading material in the form of 'PBL Handbooks', which contained details of the PBL process and specific responsibilities of the facilitator. Participants were also given a chance to experience the role of the facilitator by facilitating the faculty-learner group through a PBL session and receiving feedback. A retrospective pre-post survey was conducted to gauge changes in participants' perceptions of PBL. RESULTS: The faculty reported a significant increase in their regard for PBL as an instructional paradigm (p=<0.001). They also generally became more interested in empowering students with self-directed learning using PBL as a teaching tool and showed a greater desire to be facilitators (p=<0.001). CONCLUSION: This evaluation reveals that facilitator training workshops can help not just to improve the facilitation skills of participants but also to stimulate interest amongst faculty to use PBL in the curriculum. Such workshops can be run in Pakistan at minimal cost: the only cost we incurred was for photocopying the reading material. How much difficulty the faculty will actually have serving as facilitator in the PBL process will only become evident when they lead PBL groups over the coming year.

Oral Verruciform Xanthoma of lateral border of tongue - a sheep in wolf's clothing.

Oral Verruciform Xanthoma (OVX) is an uncommon benign lesion of the oral cavity. Most authors consider it to develop as a response to chronic local irritation. It usually presents as a pink, yellow or greyish flat mass occurring on the gingiva, alveolar ridge or hard palate. This paper reports to you the management of a case of Oral Verruciform Xanthoma occurring on the latero-ventral border of the tongue in a young male patient, which is a rare location for this lesion. It goes on to discuss the etiopathogenesis and clinical features of this rare lesion and emphasizes the importance of having a broad knowledge of oral pathologic lesions especially for lesions that resemble malignant or pre-malignant pathologies in the oral cavity.

Genetic Mutations Underlying Phenotypic Plasticity in Basosquamous Carcinoma.

Basosquamous carcinoma (BSC) is an aggressive skin neoplasm with the features of both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). While genetic drivers of BCC and SCC development have been extensively characterized, BSC has not been well studied, and it remains unclear whether these tumors originally derive from BCC or SCC. In addition, it is unknown which molecular pathways mediate the reprogramming of tumor keratinocytes toward basaloid or squamatized phenotypes. We sought to characterize the genomic alterations underlying sporadic BSC to elucidate the derivation of these mixed tumors. We identifed frequent Hedgehog (Hh) pathway mutations in BSCs, implicating Hh deregulation as the primary driving event in BSC. Principal component analysis of BCC and SCC driver genes further demonstrate the genetic similarity between BCC and BSC. In addition, 45% of the BSCs harbor recurrent mutations in the SWI/SNF complex gene, ARID1A, and evolutionary analysis revealed that ARID1A mutations occur after PTCH1 but before SCC driver mutations, indicating that ARID1A mutations may bestow plasticity enabling squamatization. Finally, we demonstrate mitogen-activated protein kinase pathway activation and the loss of Hh signaling associated with the squamatization of BSCs. Overall, these results support the genetic derivation of BSCs from BCCs and highlight potential factors involved in modulating tumor reprogramming between basaloid and squamatized phenotypes.

Epithelioid hemangioendothelioma of the liver.

Epithelioid hemangioendothelioma is an intermediate grade malignant neoplasm of vascular origin. The tumor involves the liver and lungs, but other organs are affected too. The key to the diagnosis is identification of cells of endothelial origin containing Factor VIII R antigen. Surgical resection of isolated lesions is the treatment of choice; with unpredictable results reported for chemotherapy, radiotherapy, and resection of multiple lesions. The prognosis is very variable, and ranges from few months to more than 25 years.

Hepatitis C as a cause of chronic liver disease in northern Pakistan.

The antibodies to hepatitis C virus (HCV) were tested in 45 histologically confirmed cases of chronic liver disease. Twelve cases had chronic hepatitis, 24 cirrhosis and 9 hepatocellular carcinoma. Anti-HCV was detected in 6 patients. Two (16.67%) were suffering from chronic hepatitis, 3 (12.5%) had cirrhosis and one (11.11%) hepatocellular carcinoma. None of the anti-HCV positive cases had past history of blood transfusion. The patients of chronic liver disease in this study had a much higher prevalence of HBV infection which indicates that in northern Pakistan hepatitis C virus infection is not a common cause of chronic liver disease whereas HBV infection plays an aetiological role in a much larger number of these cases.

The use of ORS (Nimkol) in management of childhood diarrhoea by mothers in the suburbs of Rawalpindi-Islamabad.

A total of 595 respondents (200 from urban Kachi-abadis and 395 from rural communities of Rawalpindi-Islamabad) were interviewed for their knowledge about the use of ORS (Nimkol) in childhood diarrhoea. Most of the respondents were mothers with low literacy rate (23%). The prevalence of current diarrhoea among children was 36.8% on the day of interview whereas 57% of the children had history of having suffered from an episode of diarrhoea during the past two weeks. About 75% respondents claimed that they had an experience of using ORS (Nimkol). Most of them (72.1%) had used ORS (Nimkol) for childhood diarrhoea and dehydration and 28% had used it for diseases other than childhood diarrhoea or on doctor's advice. Only 11% mothers of children who were currently suffering from diarrhoea were using ORS (Nimkol) and a few mothers mentioned of giving home made fluid remedies like salt-water, salt-sugar-water or lemon-sugar-salt water for childhood diarrhoea. The use of ORS (Nimkol) was more common among the families with higher income. Regarding the preparation of ORS (Nimkol) solution, 57.8% respondents had fairly accurate knowledge. Fifty percent of the respondents had procured ORS (Nimkol) from the hospitals or clinics.

Bilateral Tibial Tuberosity Periosteal Sleeve Fracture in an Adolescent: A Case Report

@#Tibial tuberosity avulsion fracture is a rare injury, and bilateral occurrence is more uncommon. Periosteal sleeve fracture is a unique fracture pattern which was first described in the lower pole of patella in children. We are reporting a rare case of bilateral tibial tuberosity sleeve fracture in a teenage boy which occurred while sprinting. The patient underwent open reduction, pull through suture fixation of the bilateral tibial tuberosity and screw fixation of left tibial tuberosity. Post-operative rehabilitation included gradual increment of range of motion with hinged brace and quadriceps muscle strengthening. Close follow-up was done to monitor the progression of his recovery. At six months follow-up, the patient recovered well. Both knees had full range of motion with an intact extensor mechanism.

Knowledge, attitudes and practices regarding tuberculosis in two districts of Punjab, Pakistan.

SETTING: Pakistan ranks eighth among the world's highest tuberculosis (TB) burden countries, and Punjab province accounts for 60% of TB cases nationally. OBJECTIVE: To explore knowledge, attitudes and practices regarding TB in the general population of two districts of Punjab province, and the effect of socio-economic determinants. DESIGN: In a cross-sectional survey, subjects aged > or =20 years were randomly selected using multistage cluster sampling and interviewed. A knowledge score was formulated based on nine questions. Bivariate analysis using the chi(2) test was employed to independently correlate socio-economic factors with understanding of disease and information sources. Attitudes, practices and information sources were also compared with TB knowledge. RESULTS: Forty-two per cent of the surveyed population had good knowledge about TB, which was associated with better education, high income and good housing (all P < 0.001). Despite the fact that the majority (82.2%) knew about correct treatment, less than half (48.8%) were aware that diagnosis and treatment were free. Intended health-seeking behaviour was determined by better education (P = 0.011), good housing (P = 0.004) and good knowledge about TB (P < 0.001). Television (69.4%) and health workers (43.6%) were the main sources of information. CONCLUSION: Socio-economic factors should be considered when designing communication strategies and prioritising TB prevention and control interventions.