Newcastle disease (ND) is one of the most deadly diseases of poultry around the globe. The disease is endemic in Pakistan and recurrent outbreaks are being reported regularly in wild captive, rural and commercial poultry flocks. Though, efforts have been made to characterize the causative agent in some of parts of the country, the genetic nature of strains circulating throughout Pakistan is currently lacking.
Material and methods
To ascertain the genetics of NDV, 452 blood samples were collected from 113 flocks, originating from all the provinces of Pakistan, showing high mortality (30–80%). The samples represented domesticated poultry (broiler, layer and rural) as well as wild captive birds (pigeons, turkeys, pheasants and peacock). Samples were screened with real-time PCR for both matrix and fusion genes (1792 bp), positive samples were subjected to amplification of full fusion gene and subsequent sequencing and phylogenetic analysis.
The deduced amino acid sequence of the fusion protein cleavage site indicated the presence of motif (112RK/RQRR↓F117) typical for velogenic strains of NDV. Phylogenetic analysis of hypervariable region of the fusion gene indicated that all the isolates belong to lineage 5 of NDV except isolates collected from Khyber Pakhtunkhwa (KPK) province. A higher resolution of the phylogenetic analysis of lineage 5 showed the distribution of Pakistani NDV strains to 5b. However, the isolates from KPK belonged to lineage 4c; the first report of such lineage from this province.
Taken together, data indicated the prevalence of multiple lineages of NDV in different poultry population including wild captive birds. Such understanding is crucial to underpin the nature of circulating strains of NDV, their potential for interspecies transmission and disease diagnosis and control strategies.
Lineages; Newcastle disease virus; Pakistan; Phylogenetic analysis; Poultry
Emphysematous pyelonephritis, though uncommon, is a severe necrotizing kidney infection common in patients with diabetes. Surgical treatment has been advocated as the treatment of choice in most of the patients. We present the clinical course of an elderly lady who presented with emphysematous pyelonephritis and was successfully managed with medical treatment despite the presence of adverse prognostic factors like acute renal failure and thrombocytopenia.
Conservative treatment; diabetes; emphysematous pyelonephritis
This paper is a part of the helminthological studies carried out on school-going children of the Kashmir Valley and deals with the status of intestinal helminths in the children of Gurez Valley and to assess epidemiological factors associated with the extent of endemic disease so that control measures are adopted.
Material and Methods:
Stool samples were collected from 352 children from Gurez Valley. The samples were processed using Kato-Katz thick smear technique, and microscopically examined for intestinal parasites.
Of the 352 children surveyed, 75.28% had one or more types of intestinal helminthes. Prevalence of Ascaris lumbricoides was highest (71.18%), followed by Trichuris trichiura (26.42%), Enterobius vermicularis (13.92) and Taenia saginata (5.39%). Conditions most frequently associated with infection included the water source, defecation site, personal hygiene, and the extent of maternal education.
The study shows a relatively high prevalence of intestinal helminths and suggests an imperative for the implementation of control measures.
Children; Gurez valley; Helminth infection; Prevalence rates
Tracheobronchial foreign bodies can be sometimes very difficult to remove. This may be related to the location and type of foreign body, experience of the bronchoscopist and the availability of appropriate instruments. We report a case of an uncommon foreign body (artificial denture) in the trachea in an adult female following extubation after Lower Segment Caesarian Section (LSCS) in whom conventional methods to remove it failed. The foreign body was eventually removed via tracheostome using rigid bronchoscope and forceps.
Tracheostomy; foreign body; and denture
Mating is a physiological process of crucial importance underlying the size and maintenance of mosquito populations. In sterile and incompatible insect technologies (SIT and IIT), mating is essential for mass production, persistence, and success of released individuals, and is a central parameter for judging the effectiveness of SIT/IIT programs. Some mosquitoes have an enormous reproductive potential for both themselves and pathogens and mating may contribute to persistence of infection in nature. As Aedes albopictus can transmit flaviviruses both sexually and horizontally, and as infected insects are usually derived from laboratory colonies, we investigated the implications of mating between a long-term laboratory colony of Ae. albopictus and wild populations.
Through a series of mating experiments, we examined the reproductive outcomes of sexual cross-affinity between laboratory-raised and wild adults of Ae. albopictus.
The results indicated appreciable mating compatibility between laboratory-reared and wild adults, and equivalent levels of egg production among reciprocal crosses. We also observed comparable larval eclosion in lab females mated with wild males, and increased adult longevity in female offspring from wild females|×|laboratory males crosses.
Taken together, these data suggest that Ae. albopictus can preserve its reproductive fitness over a long period of time in the laboratory environment and has valuable attributes for SIT application. These observations together with the ability to successfully inseminate heterospecific females indicate the potential of Ae. albopictus to act as an ecological barrier if non-sterilized males are massively released in areas occupied by Aedes aegypti. The observed substantial reproductive fitness combined with the capability to reproduce both, itself and viruses illustrates the potential of Ae. albopictus to pose a serious threat if infected and released accidentally.
Aedes albopictus; Laboratory strain; Wild strain; Mating affinity; Containment
Cholecystectomy for symptomatic gallstones is mainly performed after the acute cholecystitis episode settles because of the fear of higher morbidity and conversion from laparoscopic cholecystectomy to open cholecystectomy during acute cholecystitis.
To evaluate the safety and feasibility of laparoscopic cholecystectomy for acute cholecystitis and to compare the results with delayed cholecystectomy.
Materials and Methods:
This was a prospective and randomized study. For patients assigned to early group, laparoscopic cholecystectomy was performed as soon as possible within 72 hours of admission. Patients in the delayed group were treated conservatively and discharged as soon as the acute attack subsided. They were subsequently readmitted for elective laparoscopic cholecystectomy 6-12 weeks later.
There was no significant difference in the conversion rates, postoperative analgesia requirements, or postoperative complications. However, the early group had significantly more blood loss, more operating time, and shorter hospital stay.
Early laparoscopic cholecystectomy within 72 hours of onset of symptoms has both medical as well as socioeconomic benefits and should be the preferred approach for patients managed by surgeons with adequate experience in laparoscopic cholecystectomy.
Acute cholecystitis; Cholecystectomy; Laparoscopic
Malaria still remains a public health problem in Iran. There are different vector control interventions such as insecticide spraying. The present study was carried out to determine the susceptibility status of Anopheles stephensi larvae to temephos as a national plan for monitoring and mapping of insecticide resistance
Eight different localities in two main malarious provinces were determined as field collecting sites. Mosquitoes were collected from the field and reared in an insectray. Susceptibility assays were carried out according to the WHO method. The laboratory reared susceptible Beech-Lab strain was used for comparison. Data were analyzed using Probit analysis to determine LC50 and LC90 values.
Susceptibility of An. stephensi to temephos indicated that the LC50 ranged from 0.0022 mg/l to 0.0141 mg/l. Although all field strains were susceptible to temephos, considerable variations in temephos resistance ratios of field strains were noticed from all the localities studied in comparison with the susceptible strain. A low level of resistance ratio was noticed in An. stephensi populations except for the Chabahar strain (RR= 4.27 fold). All field-collected An. stephensi populations exhibited homogeneity to the larvicide except for Bandar Abbas and Hormoodar village strains (P> 0.05%).
Due to intensive use of temephos in the neighboring countries and occurrence of resistant to this insecticide in the main malaria vector in the region, insecticide resistance gene may evolve in the populations of An. stephensi. If temephos be applied as a larvicide it should be used judiciously for resistance management, as rotation strategy.
Anopheles stephensi; Temephos; Susceptibility; Iran; Larvicide resistance
Fat embolism syndrome (FES) is a clinical problem arising mainly due to fractures particularly of long bones and pelvis. Not much literature is available about FES from the Indian subcontinent.
Materials and Methods:
Thirty-five patients referred/admitted prospectively over a 3-year period for suspected FES to a north Indian tertiary care center and satisfying the clinical criteria proposed by Gurd and Wilson, and Schonfeld were included in the study. Clinical features, risk factors, complications, response to treatment and any sequelae were recorded.
The patients (all male) presented with acute onset breathlessness, 36-120 hours following major bone trauma due to vehicular accidents. Associated features included features of cerebral dysfunction (n = 24, 69%), petechial rash (14%), tachycardia (94%) and fever (46%). Hypoxemia was demonstrable in 80% cases, thrombocytopenia in 91%, anemia in 94% and hypoalbuminemia in 59%. Bilateral alveolar infiltrates were seen on chest radiography in 28 patients and there was evidence of bilateral ground glass appearance in 5 patients on CT. Eleven patients required ventilatory assistance whereas others were treated with supportive management. Three patients expired due to associated sepsis and respiratory failure, whereas others recovered with a mean hospital stay of 9 days. No long term sequelae were observed.
FES remains a clinical challenge and is a diagnosis of exclusion based only on clinical grounds because of the absence of any specific laboratory test. A high index of suspicion is required for diagnosis and initiating supportive management in patients with traumatic fractures, especially in those having undergone an invasive orthopedic procedure.
Accidents; ARDS; fat embolism syndrome; trauma
To investigate the prevalence of container breeding mosquitoes with emphasis on the seasonality and larval habitats of Aedes aegypti (Ae. aegypti) in Makkah City, adjoining an environmental monitoring and dengue incidence.
Monthly visits were performed between April 2008 and March 2009 to randomly selected houses. During each visit, mosquito larvae were collected from indoors and outdoors containers by either dipping or pipetting. Mosquitoes were morphologically identified. Data on temperature, relative humidity, rain/precipitations during the survey period was retrieved from governmental sources and analyzed.
The city was warmer in dry season (DS) than wet season (WS). No rain occurred at all during DS and even precipitations did fall, wetting events were much greater during WS. Larval survey revealed the co-breeding of Aedes, Culex and Anopheles in a variety of artificial containers in and around homes. 32 109 larvae representing 1st , 2nd, 3rd, and 4th stages were collected from 22 618 container habitats. Culicines was far the commonest and Aedes genus was as numerous as the Culex population. Ae. aegypti larval abundance exhibited marked temporal variations, overall, being usually more abundant during WS. Ten types of artificial containers were found with developing larvae. 70% of these habitats were located indoors. 71.42% of indoor containers were permanent and 28.58% was semi-permanent during WS. Cement tanks was the only container type permanent during DS. Ae. aegypti larval indices (CI, HI, BI) recorded were greater during WS.
Taken together, these results indicate a high risk of dengue transmission in the holy city.
Aedes aegypti; Larval indices; Environmental factors; Dengue incidence
Skeletal dysplasia is an uncommon cause of short stature in children. An 11-year-old girl was evaluated for severe short stature in a tertiary care hospital. Clinical examination revealed severe disproportionate short stature and classical triad of multiple supernumerary teeth, and complete absence of clavicles and open sagittal sutures and fontanelles. Skeletal survey confirmed these findings, in addition to other features associated with the syndrome.
Short stature; Skeletal dysplasia; Cleidocranial dysplasia
Calcium (Ca+2) is a ubiquitous messenger in eukaryotes including Caenorhabditis. Ca+2-mediated signalling processes are usually carried out through well characterized proteins like calmodulin (CaM) and other Ca+2 binding proteins (CaBP). These proteins interact with different targets and activate it by bringing conformational changes. Majority of the EF-hand proteins in Caenorhabditis contain Ca+2 binding motifs. Here, we have performed homology modelling of CaM-like proteins using the crystal structure of Drosophila melanogaster CaM as a template. Molecular docking was applied to explore the binding mechanism of CaM-like proteins and IQ1 motif which is a ∼25 residues and conform to the consensus sequence (I, L, V)QXXXRXXXX(R,K) to serve as a binding site for different EF hand proteins. We made an attempt to identify all the EF-hand (a helix-loop-helix structure characterized by a 12 residues loop sequence involved in metal coordination) containing proteins and their Ca+2 binding affinity in Caenorhabditis by analysing the complete genome sequence. Docking studies revealed that F165, F169, L29, E33, F44, L57, M61, M96, M97, M108, G65, V115, F93, N104, E144 of CaM-like protein is involved in the interaction with IQ1 motif. A maximum of 170 EF-hand proteins and 39 non-EF-hand proteins with Ca+2/metal binding motif were identified. Diverse proteins including enzyme, transcription, translation and large number of unknown proteins have one or more putative EF-hands. Phylogenetic analysis revealed seven major classes/groups that contain some families of proteins. Various domains that we identified in the EF-hand proteins (uncharacterized) would help in elucidating their functions. It is the first report of its kind where calcium binding loop sequences of EF-hand proteins were analyzed to decipher their calcium affinities. Variation in Ca+2-binding affinity of EF-hand CaBP could be further used to study the behaviour of these proteins. Our analyses postulated that Ca+2 is likely to be key player in Caenorhabditis cell signalling.
Good quality deoxyribonucleic acid (DNA) is the pre-requisite for its downstream applications. The presence of high concentrations of polysaccharides, polyphenols, proteins, and other secondary metabolites in mango leaves poses problem in getting good quality DNA fit for polymerase chain reaction (PCR) applications. The problem is exacerbated when DNA is extracted from mature mango leaves. A reliable and modified protocol based on the cetyltrimethylammonium bromide (CTAB) method for DNA extraction from mature mango leaves is described here. High concentrations of inert salt were used to remove polysaccharides; Polyvinylpyrrolidone (PVP) and β-mercaptoethanol were employed to manage phenolic compounds. Extended chloroform-isoamyl alcohol treatment followed by RNase treatment yielded 950‒1050 µg of good quality DNA, free of protein and RNA. The problems of DNA degradation, contamination, and low yield due to irreversible binding of phenolic compounds and coprecipitation of polysaccharides with DNA were avoided by this method. The DNA isolated by the modified method showed good PCR amplification using simple sequence repeat (SSR) primers. This modified protocol can also be used to extract DNA from other woody plants having similar problems.
Extraction buffer; Mango; Polyphenols; DNA isolation; Simple sequence repeat (SSR); Secondary metabolites
There has been a steep rise in incidence of liver injury in the past few years because of increase in incidence of road traffic accidents. The aim of this study was to evaluate the role of non-operative management of liver injury due to blunt abdominal trauma.
Materials and Methods:
All patients with liver injury from blunt trauma abdomen were studied between January 2000 and January 2010. A total of 152 patients with liver injury were put on conservative management. Hundred and three (67.77%) patients were males and 49 (32.23%) were females with an age range of 15-60 years (32.8 years). Most of the injuries were because of road traffic accidents (81.57%). Liver injuries were graded according to Moore's classification using computed tomography. Patients with Grade V and VI were excluded from the study. Patients who were unstable hemodynamically on admission were also excluded from the study.
There was no mortality in our series. Eight patients needed exploration because they developed hemodynamic instability. Four of the patient developed post-operative liver abscess which was treated conservatively.
Non-operative management of liver injury due to blunt trauma abdomen is a safe, effective and treatment modality of choice in hemodynamically stable Moore's grade I to Grade IV injury.
Computed tomography; liver injury; Moore's grade
Presentation of primary antiphospholipid syndrome (APS) is usually untrustworthy and unusual presentations are difficult to diagnose on the basis of clinical features alone. This is true especially in young and elderly patients. Cerebral venous thrombosis (CVT) is less frequent than arterial thrombosis in APS. CVT has a wide spectrum of signs and symptoms, which may evolve suddenly or over weeks. It mimics many neurological conditions such as meningitis, encephalopathy, benign intracranial hypertension and stroke. Headache is the most frequent symptom in patients with CVT, and is present in about 80% of cases. The most common pattern of presentation is with a benign intracranial hypertension-like syndrome. Sixth cranial nerve palsy usually manifests as a false localising sign. Patients may have recurrent seizures. Cranial nerve syndromes are seen with venous sinus thrombosis. We present a case of APS with lower cranial nerve palsy, aseptic meningitis and hydrocephalus initially treated as tuberculous meningitis.
Adenine and guanine phosphates are involved in a number of biological processes such as cell signaling, metabolism and enzymatic cofactor functions. Binding sites in proteins for these ligands are often detected by looking for a previously known motif by alignment based search. This is likely to miss those where a similar binding site has not been previously characterized and when the binding sites do not follow the rule described by predefined motif. Also, it is intriguing how proteins select between adenine and guanine derivative with high specificity.
Residue preferences for AMP, GMP, ADP, GDP, ATP and GTP have been investigated in details with additional comparison with cyclic variants cAMP and cGMP. We also attempt to predict residues interacting with these nucleotides using information derived from local sequence and evolutionary profiles. Results indicate that subtle differences exist between single residue preferences for specific nucleotides and taking neighbor environment and evolutionary context into account, successful models of their binding site prediction can be developed.
In this work, we explore how single amino acid propensities for these nucleotides play a role in the affinity and specificity of this set of nucleotides. This is expected to be helpful in identifying novel binding sites for adenine and guanine phosphates, especially when a known binding motif is not detectable.
Terbutaline sulfate (TBS) was assayed in biological samples by validated HPTLC method. Densitometric analysis of TBS was carried out at 366 nm on precoated TLC aluminum plates with silica gel 60F254 as a stationary phase and chloroform–methanol (9.0:1.0, v/v) as a mobile phase. TBS was well resolved at RF 0.34 ± 0.02. In all matrices, the calibration curve appeared linear (r2 ⩾ 0.9943) in the tested range of 100–1000 ng spot−1 with a limit of quantification of 18.35 ng spot−1. Drug recovery from biological fluids averaged ⩾95.92%. In both matrices, rapid degradation of drug favored and the T0.5 of drug ranged from 9.92 to 12.41 h at 4 °C and from 6.31 to 9.13 h at 20 °C. Frozen at −20 °C, this drug was stable for at least 2 months (without losses >10%). The maximum plasma concentration (Cpmax) was found to be 5875.03 ± 114 ng mL−1, which is significantly higher than the maximum saliva concentration (Csmax, 1501.69 ± 96 ng mL−1). Therefore, the validated method could be used to carry out pharmacokinetic studies of the TBS from novel drug delivery systems.
Terbutaline sulfate; High-performance thin-layer chromatography; Biological fluids; Ex vivo stability; Pharmacokinetic study
Acute disseminated encephalomyelitis (ADEM) also known as post infectious encephalomyelitis is a demyelinating disease of the central nervous system (CNS) that typically presents as a monophasic disorder associated with multifocal neurological symptoms and disability. It may follow vaccination in children or infection. Viral infection like measles, rubella, influenza, Epstein bar, HIV, herpes, cytomegalusvirus (CMV) and West Nile virus have been implicated in the causation. Among bacteria, group A hemolytic streptococcus, mycoplasma pneumonia, Chlamydia, Rickettesia and leptospira have been shown to cause ADEM. There are few reports of ADEM due to tuberculosis (TB). We describe acute disseminated encephalomyelitis due to tuberculosis in a 35 year old female who initially started with neuropsychiatric manifestations and later developed florid neurological deficit and classical magnetic resonance imaging (MRI) lesions suggestive of the disease. The patient recovered completely after antitubercular therapy and is following our clinic for the last 12 months now.
acute disseminated encephalomyelitis; tuberculosis
Vallecular cyst, a benign yet rare laryngeal lesion, may cause stridor and even life-threatening upper airway obstruction in infants. It can cause apnoea and poor feeding habits, thus reducing the chance of survival. Although laryngomalacia remains the most common cause of stridor in this age group, awareness and a high level of suspicion for this condition can help lead to early management and intervention. Direct laryngoscopy is accepted as the gold standard for diagnostic purposes, and marsupialisation of the cyst is the preferred treatment. We describe 2 cases of vallecular cysts in infants admitted to our hospital where timely diagnoses led to appropriate treatment.
cyst; infant; laryngoscopy; magnetic resonance imaging; stridor; medical sciences
Obesity is increasing at an alarming rate throughout the world. Today it is estimated that there are more than 300 million obese people world-wide. Obesity is a condition of excess body fat often associated with a large number of debilitating and life-threatening disorders. It is still a matter of debate as to how to define obesity in young people. Overweight children have an increased risk of being overweight as adults. Genetics, behavior, and family environment play a role in childhood overweight. Childhood overweight increases the risk for certain medical and psychological conditions. Encourage overweight children to expand high energy activity, minimize low energy activity (screen watching), and develop healthful eating habits. Breast feeding is protective against obesity. Diet restriction is not recommended in very young children. Children are to be watched for gain in height rather than reduction in weight. Weight reduction of less than 10% is a normal variation, not significant in obesity.
Obesity; overweight; skins fold thickness; body mass index; WHO
Trace element deficiency or excess is implicated in the development or progression in some cancers. Here we report the elevated levels of copper and low level of zinc in the plasma of esophageal cancer patients in Kashmir India- a high incidence area. The average level of copper was significantly higher for patients than for controls (p<0.0001) with a mean concentration of 169 μg/dl and 149 μg/dl for patients and controls, respectively. In contrast, the average level of zinc in patients was significantly lower than in controls (p<0.0001) with a mean concentration of 86.8 μg/dl and 96.1 μg/dl for patients and controls, respectively. No significant difference in copper and zinc levels was observed for different age groups in controls or patients. For controls, the level of copper was not significantly different in males and females (median: 155 μg/dl for males and 144 μg/dl for females, p=0.10), but we observed a higher level of zinc in females (median: 90.5 μg/dl for males and 101 μg/dl for females, p=0.03). Copper or zinc concentrations were not significantly associated with gender, tumor site, green tea with salt (nun chai) consumption, smoking habits or snuff in cases. Patients with poorly differentiated tumors had a higher copper concentration than those with moderately or well-differentiated tumors (p<0.0001). No association was found between copper concentration and TP53 mutation status but patients with TP53 mutant tumor had lower zinc levels than those with no mutation. Our results point towards a role of the trace element imbalance in the esophageal tumorigenesis in high risk Kashmiri population exposed to a range of nitroso compounds or their precursors. Further prospective cohort studies are warranted to determine whether change in the plasma zinc and copper homeostasis may represent an independent risk factor for this malignancy as well as possible target for preventive intervention.
Esophgeal squamous cell carcinoma; Trace elements; copper excess; Zinc deficiency; TP53 mutations; Kashmir
Diarrhoea is a major health problem for children worldwide, accounting for 5–8 million deaths each year. Arque-Ajeeb (AA) is a compound formulation of Unani medicine. It is reputed for its beneficial effects in the treatment of diarrhoea and cholera, but the claim of its efficacy is yet to be tested. Therefore the present study has been planned to investigate the real efficacy of this drug in rats.
The effect of Arque-Ajeeb was investigated for antidiarrhoeal activity against charcoal-induced gut transit, serotonin-induced diarrhoea and PGE2-induced small intestine enteropooling in rats. The control, standard and test groups of experimental animals were administered with normal saline (p.o.), diphenoxylate hydrochloride (5 mg/kg, p.o.) and Arque-Ajeeb (0.07 ml and 0.14 ml/kg, p.o.) respectively except the control group of PGE2-induced small intestine enteropooling which received only 5% ethanol in normal saline (i.p.). Charcoal (10 ml/kg, p.o.) and serotonin (600 μg/kg, i.p.) were administered after 30 min, while PGE2 (100 μg/kg, p.o.) was administered immediately afterwards. The distance traveled by charcoal in small intestine was measured after 15 and 30 min of charcoal administration, diarrhoea was observed every 30-min for six hour after serotonin administration and the volume of intestinal fluid was measured after 30 min of PGE2 administration.
Arque-Ajeeb (0.07 ml and 0.14 ml/kg) significantly inhibited the frequency of defaecation and decreased the propulsion of charcoal meal through the gastrointestinal tract, reduced the wetness of faecal droppings in serotonin-induced diarrhoea and also reduced the PGE2-induced small intestine enteropooling.
Arque-Ajeeb may have potential to reduce the diarrhoea in rats. Thus the drug may prove to be an alternate remedy in diarrhoea.
Benign primary tumors of facial nerve are rare, difficult to diagnose due to their subtle and variable clinical manifestations and these are usually misdiagnosed as idiopathic facial nerve paralysis. A case of facial nerve sehwannoma in internal auditory meatus presenting as a tumor indistinguishable from acoustic neuroma clinically is presented here. Difficalties in patient assessment, inadequacy of diagnostic techniques presently available and surgical technique of the removal of the tumor will be discussed.
Facial Nerve; Schwannoma