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Introduction: The diagnosis of diabetic foot osteomyelitis is crucial and challenging for the proper management of diabetic foot. 99m Tc labelled Ceftizoxime was used as a non-invasive diagnostic agent for diabetic foot osteomyelitis.Methods: Ceftizoxime [CFT], a third generation cephalosporin, was used in a simple and direct method for the synthesis of 99m TcO4- labelled infection imaging agent with stannous chloride as reducing agent. Its radiochemical purity was checked by thin Layer chromatography. Partition co-efficient was measured with phosphate buffer and chloroform. The radiochemical complex was injected to control and infected animal model for 3 hours in-vivo localization studied with the help of dual head gamma camera. The labelled complexes were injected to 5 patients of known type II diabetes mellitus suspected of diabetic foot osteomyelitis. All patients underwent dynamic and static 99m Tc-MDP and 99m Tc-CFT scans.Results: The synthesized radio labelled complex was 98.8% pure, with hydrophilic character. When injected to animal model, at 120 minutes, 49.3% was localized in foci of infection with 3.35% in liver and excretion through kidney. Human studies were interpreted as true or false positive and true or false negative based on bone histopathology/culture and clinical follow-up. We found that of 5 patients, 2 were true positive, 2 as true negative with no false positive or negative and 01 patient had soft tissue infection.Conclusion: This study showed that 99m Tc-CFT labelled complex could be used for detection of diabetic foot osteomyelitis; however, further confirmation of results with a larger patient population would be optimal. [ABSTRACT FROM AUTHOR]

Background: To determine the effects of previous overt hyperthyroidism due to Graves' disease on BMD in euthyroid pre and post menopausal females. Methods: In this cross-sectional, non-interventional study, fifty patients with previous hyperthyroidism due to Graves' disease (premenopausal: 25, postmenopausal: 25) who remained euthyroid for at least 6 months prior to study were included and compared with fifty-matched respective controls. Free thyroxine (FT4), TSH, and BMD were measured. Comparison was made between two groups and also between patients and controls in each group. Results: Statistically significant (p <.0.05) lower whole body BMD expressed as Z-score was observed in post-menopausal women having history of hyperthyroidism due to Graves' disease than matched controls. Bone mineral density, expressed as Z-score in whole body and lumbar spine was significantly lower in group II (post-menopause) in comparison to group I (pre-menopause) patients. Time of euthyroidism and time of evolution of disease has significant effect on BMD in post-menopausal women. Conclusion: Graves' hyperthyroidism affects BMD only in post menopausal females even after achievement of euthyroid status. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the prevalence of paratuberculosis in cattle and buffaloes at twelve public dairy farms in Punjab, Pakistan. Methods: A total of 2,181 more than two-year-old animals (1,242 cattle and 939 buffaloes) were tested by avian tuberculin, i.e., killed purified protein derivative of Mycobacterium avium paratuberculosis and indirect enzyme linked immunosorbent assay (ELISA). Blood and fecal samples were collected from tuberculin positive animals. These samples were further processed by indirect ELISA. The data were analyzed using frequency analysis and logistic analysis procedures. Results: The prevalence of paratuberculosis at public dairy farms was 3.8%, as determined by tuberculin+ELISA test. It varied from 0.71% to 13.5% with a 100% herd prevalence. Multivariate logistic regression analysis revealed that species, milk production, total animals, total small ruminants, and total buffaloes were significantly associated with the occurrence of paratuberculosis. Odd ratio analysis revealed that with a one-kilogram increase in body weight, there will be a 0.006% increase in disease occurrence. With the increase in one animal in small ruminants and buffaloes, there will be 0.008% and 0.42% greater chances of developing paratuberculosis, respectively. Bivariate logistic regression analysis of cattle and buffaloes revealed that farm number, age, and total number of cattle were significantly associated with the occurrence of paratuberculosis. A one-month increase in lactation length increases the chance of tuberculosis by 0.004%; similarly, a one-liter increase in milk production increases the chance of disease by 10%. With each additional buffalo in the herd, there will be a 0.007% greater chance for the occurrence of paratuberculosis. Conclusion: This study concluded that tuberculin testing can be used in conjunction with ELISA to screen animals for paratuberculosis in countries with scarce resources, such as Pakistan. The efficacy of disease diagnosis can be improved by combining multiple tests. [ABSTRACT FROM AUTHOR]

Enzootic bovine leucosis is caused by bovine leukaemia virus (BLV), a Deltaretrovirus belonging to the family Retroviridae. BLV causes huge economic losses to the dairy industry in the form of decreased milk production, premature culling, and poor reproductive performance of the animals. The aim of the present study was to determine the seroprevalence of BLV infection in buffalo in two districts of Punjab, Pakistan. A total of 384 samples were collected and analysed using a commercial indirect enzyme-linked immunosorbent assay (ELISA) to investigate the seroprevalence of BLV through the detection of the anti-BLV gp51 antibody. A predesigned data questionnaire proforma was employed to find out the association of risk factors with disease. Overall, 18.2% of buffaloes were seropositive for BLV in the study population. The results revealed a significant association (P < 0.05) of age with BLV infection. Furthermore, milk yield and pregnancy had a significant association with the seroprevalence of BLV infection in buffalo whereas no significant association was found with sex, breeding, and health status. Biochemical and oxidative stress markers revealed a significant decrease in liver enzymes alanine transaminase (ALT) and aspartate transaminase (AST), glutathione peroxidase (GPX), and superoxide dismutase (SOD) in seropositive animals as compared to healthy animals. It is concluded that BLV has a considerable prevalence in buffalo in Punjab, Pakistan and there is a dire need to investigate the disease epidemiology at both national and international levels and strategies should be developed to implement an effective control program. [ABSTRACT FROM AUTHOR]

Background: To study the effect of high dose ginger on plasma testosterone and leutinising hormone levels in male rats after lead induced toxicity Methods: In this quasi experimental study, 30 adult male Sprague Dawley rats were divided in two equal groups. Group A was given 0.3% lead acetate in drinking water and kept as lead control while the Group B was given a dose of 1.5gm/kg body weight ginger orally along with 0.3% lead for 42 consecutive days. Rats were then sacrificed and serum testosterone and LH levels were analyzed using ELISA technique. Data was expressed as mean±SD. P-values <0.05 were considered as statistically significant. Results: At the end of 42 days, mean serum testosterone level in Group A (control Group) was 2.2667± 0.45617ng/ml as compared to Group B (Experimental Group) 2.2667 ± 0.45617ng/ml and showed statistically insignificant change(p>0.05). Comparison of mean serum LH levels in Group A (5.3200 ± 0.72526ng/ml)revealed statistically insignificant difference (p>0.05) as compared to Group B (5.7467 ± 0.70190ng/ml). Conclusion: High dose ginger (>1gm/kg body weight) failed to enhance the suppressed testosterone level due to lead toxicity in male rats. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic is an ongoing global pandemic. The knowledge, attitude, and practices toward COVID-19 play a fundamental role in determining a society’s predisposition to accept behavioral changes advised by health authorities. The aim of this study was to assess the knowledge, attitude and practices about COVID-19 among a convenient sample of patients and their attendants visiting the nuclear medicine department in Pakistan. Methods: A cross-sectional study was conducted through a comprehensive questionnaire consisting of four sections including demographics, knowledge, attitude, and practices among patients and their attendants coming to the nuclear medicine department of AECH-NORI, from different areas of Pakistan over the duration of 2.5 months from mid-April to June 2020. The data from 231 participants (n = 231) were collected and results were compiled. A p-value of < 0.05 was considered statistically significant. Results: Gender was a significant predictor of the level of knowledge and practices concerned (p < 0.05). Education had a statistically significant correlation with attitudes and practices in addition to knowledge (p < 0.05). Young and middle-aged patients were more concerned about the disease when compared to the elderly population. Majority of the participants had sufficient knowledge about the disease (75.8%) and good attitude (66.3%), but having poor practices (48.5%) toward the disease prevention. Conclusion: The study suggests that majority of the patients and their attendants have adequate knowledge and awareness related to COVID-19. However, some aspects of practice were found to be deficient. Consistent counseling and awareness programs are still required to manage the pandemic in Pakistan in order to limit the related morbidity and mortality. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study is to ascertain the utility of Technetium (Tc)-99m-labeled levofloxacin in diagnosing musculoskeletal infections and also to observe its biodistribution in the human body. Patients who were referred with the clinical suspicion of having osteomyelitis underwent Tc-99m levofloxacin imaging. Methods: Tc-99m-labeled levofloxacin scintigraphy was carried out in 30 patients with musculoskeletal infections and the results were compared with the culture and sensitivity of suspected lesions. Results: Fifteen patients were true-positive, 2 were false-positive, 1 was false-negative, and 12 were true-negative. The sensitivity and specificity were 93.8% and 85.7%, respectively. The positive and negative predictive values were 88.2% and 92.3%, respectively. The biodistribution studies revealed that 7.74% ± 0.42% of the injected dose at 1 hour decreased to 5.45% ± 0.37% at 2 hours, and to 2.49% ± 0.55% at 4 hours. The liver showed a mean uptake value of 5.58% of injected activity at 1 hour, which decreased to 3.52% ± 0.30% and 2.00% ± 0.5 0% at 2 and 4 hours, respectively. The activity in the bladder increased from the mean percentage uptake value of 5.45% ± 0.84% at 1 hour to 20.00% ± 3.67% at 2 hours and 39.67% ± 4.23% at 4 hours. The results of Student's t-test showed significant differences in the uptake values of infected and noninfected sites. Chi-square results confirmed strong association between osteomyelitis and Tc 99m Levofloxacin uptake. Conclusion: Tc-99m-labeled levofloxacin has the potential of simulating an infection-imaging agent. [ABSTRACT FROM AUTHOR]

Background: Despite the excellent prognosis, recurrence rate of differentiated thyroid carcinoma (DTC) is 20%-40%, hence long-term follow-up is needed. Thyroglobulin (Tg) measurement is important for follow up and assessment of recurrence in DTC but in the presence of antiTg autoantibody (ATgAb), a negative Tg result may be false negative. Recent guidelines recommend assessing ATgAb, along with measurement of serum Tg, every 6-12 months postsurgery. Persistence of ATgAb after the treatment or increasing concentrations indicates persistent or recurrent DTC. Methods: A total of 90 patients of DTC who underwent total thyroidectomy along with I-131 ablation, with TSH stimulated Tg < 2 ng/ml were included in this study. Serial assessment of Tg and ATgAb level was done in these patients. Conclusion were extracted after the comparison of ATgAb level with available imaging modalities, i.e., whole body scan, ultrasound, chest X-ray, bone scintigraphy, CT, and magnetic resonance imaging and response to therapy. Results: Out of total 90 patients, 43% had increased ATgAb. There was no significant difference in gender (p < 0.48) or multifocality (p < 0.04) between ATgAb positive and negative groups. Compared with ATgAb negative group, a greater number of ATgAb positive patients had lymph nodal metastasis (p < 0.004) and extrathyroidal extension (p < 0.002). Raised ATgAb levels and disease status are very well correlated p < 0.05. Out of 39 patients, 17.98% with positive ATgAb showed recurrence, whereas only 3.92% of 51 patients with negative ATgAb had recurrence during the follow up (p < 0.028). Recurrence rate was (0%) in group I, (10%) in group II, and (45%) in group III. Conclusion: ATgAb is also a tumor marker, rising when tumor is present and falling when it has been destroyed. There is a statistically significant correlation between the complete disappearance of thyroid tissue and that of ATgAb so serial measurement of ATgAb levels in the follow up of patients of DTC is as important as the measurement of Tg level. [ABSTRACT FROM AUTHOR]