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Abstract Intraperitoneal administration of BromAc (bromelain + acetylcysteine) is currently undergoing a phase 1 clinical trial for pseudomyxoma peritonei at our institution. This study reports on analysis of routine blood parameters before and after treatment for a series of 25 patients in this trial. Blood parameters assessed included full blood count, electrolytes, urea, and creatinine, liver function tests, coagulation studies, as well as inflammatory markers (CRP). Certain parameters such as CRP, and white cell count, were significantly elevated after treatment whilst serum albumin level was reduced indicating an inflammatory reaction. However, liver enzymes, coagulation studies, and other parameters were not affected. Therefore, there are no additional safety signals evident upon analysis of routine blood parameter testing.

Bacterial infection of hernia mesh with the formation of biofilms presents a barrier to antibiotic treatment with subsequent surgical intervention and hospitalization. Hence, in the current study, we examined the effect of BromAc, a mucolytic agent, on the dissolution of biofilm formed by three different strains of Pseudomonas aeruginosa. Pseudomonas aeruginosa was carefully grown on hernia mesh and treated with various concentrations of bromelain, NAC, and their combinations at 37 °C over 4 h in vitro. Then, the biofilm dissolution activities of the agents were evaluated. Moreover, the combination index (CI) was analyzed to determine the synergy of the bromelain and NAC combination. The results indicated that biofilms were more susceptible to degradation by bromelain, whilst NAC showed growth enhancement in two of the strains. However, in combination (BromAc), the three strains were dramatically affected by the agents, with more than 80% debridement fir a suitable combination of bromelain and NAC that was also strain-specific. Hence, the current study shows that the biofilms formed by these three strains of Pseudomonas aeruginosa were adversely affected by a single treatment of BromAc, with more than 80% debridement, indicating that subsequent treatment may abolish the biofilm completely.

Objective: The objective of study was to find out serum uric acid level in normal andpreeclamptic pregnant women of third trimester visiting outpatient department of obstetrics and gynecology of Bahawal Victoria Hospital, Bahawalpur. Methodology: It was a cross sectional descriptive study conducted form July 2018 to June 2019. All primigravida women of age 18-35 years in third trimester of singleton pregnancy attending in Obstetrics and Gynecology Outpatient Department of Bahawal Victoria Hospital in study duration were included in the study. Statistical analysis was performed by using SPSS version 14. Chi-square test was performed to find the statistical difference regarding uric acid distribution between groups and ‘p’ value

Background: Obesity is a major epidemic of developed world that is now extending to developing countries and is the risk factor of pre-eclampsia which is the major contributor to maternal and foetal morbidity & mortality. Objective: To determine the frequency of preeclampsia in obese primigravida women visiting the Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan. Methodology: This cross-sectional descriptive study was conducted in Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan from January 2018 to December 2018. All the Primigravida women with singleton pregnancy of gestational age ? 26 weeks assessed by ultrasound between 20-35 years of age were included in the study by non-probability consecutive method. After obtaining ethical approval from hospital ethical committee and informed written consent from all the study subjects, relevant data were documented in a predefined data sheet and body mass index (BMI) was calculated by using the formula: Weight (kg) / Height2 (m). Women having blood pressure (BP) of 140/90 mmHg or above in third trimester of gestation measured on at least two occasions, 6 hours or more apart accompanied by proteinuria of 300 mg per 24 hours or above in previously normotensive were labelled as preeclampsia and first-time pregnant women having BMI ? 30 were taken as obese. Statistical analysis was performed by using computer-based software, Statistical Package for Social Science (SPSS) for windows version 17.0. Mean and standard deviation was calculated for numerical data like age. Frequencies and percentages were calculated for categorical variables. Chi-square test was performed to find the statistical difference regarding preeclampsia distribution between groups and ‘p’ value

Severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection is the cause of a worldwide pandemic, currently with limited therapeutic options. The spike glycoprotein and envelope protein of SARS-CoV-2, containing disulfide bridges for stabilization, represent an attractive target as they are essential for binding to the ACE2 receptor in host cells present in the nasal mucosa. Bromelain and Acetylcysteine (BromAc) has synergistic action against glycoproteins by breakage of glycosidic linkages and disulfide bonds. We sought to determine the effect of BromAc on the spike and envelope proteins and its potential to reduce infectivity in host cells. Recombinant spike and envelope SARS-CoV-2 proteins were disrupted by BromAc. Spike and envelope protein disulfide bonds were reduced by Acetylcysteine. In in vitro whole virus culture of both wild-type and spike mutants, SARS-CoV-2 demonstrated a concentration-dependent inactivation from BromAc treatment but not from single agents. Clinical testing through nasal administration in patients with early SARS-CoV-2 infection is imminent.

ABSTRACT: OBJECTIVE:The main objective of the study was to assess the immunization coverage in children 12-23 months of age in urban slums of Bahawalpur City. METHODOLOGY: A cross sectional descriptive study was conducted in slum areas of Bahawalpur City from July 2014 to December 2014 to assess the vaccination coverage of children less than 12-23 months of age after ethical approval of Institutional review board. Sample size calculated for the survey at 95% level of confidence, 5% margin of error and anticipated population proportion of 71.9%6 was 306. A multistage sampling technique was used for the survey. At first stage one slum area out of total 11 was selected by simple random method was Tibba Badar Sher and in second stage the households within area were selected by systematic random sampling technique. A preformed questionnaire (translated in local language) used to collect the data comprised of two parts. First part consists of sociodemographic variables of parents and second part was about the status of vaccination. The data was collected from mother/father of child present at home at the time of survey. Immunization status of child was assessed on the basis of immunization card. For those without immunization card information from mother/father were collected. The definitions for vaccination status were based on reception of injectable vaccines (BCG, pentavalent, pneumococcal and measles) because oral polio vaccine is provided on special polio days. No vaccination was defined as reception of no injectable vaccine included in the EPI schedule. Incomplete vaccination was defined as reception of at least one injectable vaccine but having not received all vaccines included in the EPI. Complete vaccination was defined as reception of all the injectable vaccines included in EPI in the first year of life. Data was entered and analyzed by using SPSS version 17. Chi square test was applied to see any statistical difference between the groups. P value ≤0.05 was taken as significant. RESULTS: Out of total 306 children surveyed, immunization card was available for only 26% children. Only 48% children completed their immunization while half were partially immunized. Among the individual vaccines the highest coverage was of BCG vaccine 86% followed by first dose of petavalent and pneumococcal vaccine (84%), second dose of petavalent and pneumococcal vaccine (78%). First dose of measles vaccine was received by 84% children while second dose coverage against measles was only 42%. Among children which had completed their immunization schedule 59.2% mothers had intermediate and above education and only 6.8% were illiterate while 50% mothers of non-immunized children were illiterate. Monthly family income of 74.1% children which received complete immunization was more than 20,000 and 83.3% children which were not immunized had monthly family income of less than 10,000. CONCLUSION: Our study results concluded that most of the children in 12-23 months of age are partially immunized.

Background: To assess the existing health care waste management practices in public and private sector hospitals of Bahawalpur City. Methods: In this cross sectional descriptive study all private hospitals of Bahawalpur City and 24 public sector sites from four hospitals were selected by simple random sampling for observation of practices of hospital waste management.The scoring system for the observation checklist consisted of giving a score one for step done correctly, while the step not done was given zero. Fisher’s exact test was applied to see any statistical difference in practices of public and private sector hospitals and ‘p’ value

Background: To find out the relationship between educational level and fertility behavior. Methods: In this cross sectional study Bahawalpur (municipality area) was stratified on the judgmental basis into relatively upper, middle and lower class localities. On the basis of contraceptive prevalence rate (CPR) 23.20%7 the minimum sample size of 733 was calculated with 3% precision and at 95% confidence interval. A list of all households with married women of reproductive age (15-49 years) having at least one child of more than 2 years of age was obtained from LHWs of the area. Out of 4884 households 733 eligible women were included in the study by simple random sampling procedure by taking proportionate sample of all classes (133 out of 884, 173 out of 1154 and 427 out of 2846). Data was collected by using pretested structured questionnaire with the help of lady health workers of that area with their supervisors. Collected data was entered and analyzed by using SPSS 17. Results: In a total of 733 married women in the study, 53.4% (392) women were literate. Among the literate women 81% were matriculate and above. Among literate women 74.7% were user of contraceptive methods compared with 51.3% illiterate women. Number of children of respondents with level of education showed that significant relationship (p