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Background. The mixing of cereals and legumes with nuts and seeds can produce various products that can be optimal for consumption with respect to their nutritional density. The use of legumes in gluten-free foods is becoming very prominent with increase in advancement in food engineering and technology. This study was aimed to develop a gluten-free product (cupcake) enriched with chick pea flour, almonds, and flaxseeds for celiac disease patients. Materials and Methods. The procured raw material including almonds, chickpea flour, and flaxseeds was mixed in appropriate amounts, and cupcakes were formulated following a specified recipe. The cupcakes were divided in five groups based on their recipe. First one was wheat based; 2nd one was corn and rice based; and next 3 were chickpea, almond, and flaxseed based, respectively. The cupcakes were checked for their proximate analysis parameters (carbohydrate, protein, and nitrogen-free extract), gluten and heavy metals (lead, chromium, and arsenic), bacterial load (E. coli, total coliforms, salmonella, yeast, and molds), fatty acid, texture parameters (firmness, cohesiveness, gumminess, and chewiness), and physical parameters (weight, height, volume, and specific volume). All these parameters were compared with wheat-based cupcakes to assess the product’s quality. Results. The volume of intervention cupcakes was a bit low compared to wheat/rice-based cupcakes but the specific volume was comparable. In texture analysis, firmness, gumminess, and chewiness were enhanced in intervention cupcakes compared to control but cohesiveness was comparable also. The carbohydrate contents were significantly lower in intervention cupcakes 22–30% compared to control cupcakes. Protein, fiber, and fat contents were significantly higher 11–14, 8–10, and 40%, respectively, with improvement (2-3 folds) in calcium, zinc, and iron contents in intervention cupcakes. All the safety parameters including heavy metals and bacterial and fungal load were found normal. The sensory attributes like size and color were found to be less acceptable but odor and taste were comparatively high in formulated products. Conclusion. The use of chickpeas, almonds, and flaxseeds in high concentration was first-time used to formulate a recipe of gluten-free cupcake. These cupcakes were more nutritious compared to available conventional recipes. Apparently, no health hazard was found in these cupcakes. Some sensory characteristics of cupcakes were slightly lower and comparable to wheat/rice-based cupcakes.

Background: The most effective and commonly used control therapy for asthma is oral or parenteral corticosteroids, which are quite effective. But at the same time, they are considered notorious for their side effects like contributing to increasing rates of related metabolic disorders for eg: obesity and type 2 diabetes. Studies of blood glucose and lipid profiles in relation to severe persistent asthma are still a few, and the results are ambiguous. Objectives: The aim of current study was to evaluate the changes in Fasting Plasma Glucose (FPG), Lipid profile (LP) and Small Dense Lipoprotein Cholesterol (Sd-LDL-C) in Severe Persistent Asthmatic (SPA) patients in comparison with non-asthmatic adults, and their correlations with absolute eosinophil count. Methodology: This study was a cross sectional comparative research conducted at Medsol Clinical Lab, Blue Area, Islamabad. In this study, 40 pre-diagnosed SPA and 40 non-asthmatic adults were enrolled. Blood Absolute Eosinophil Count (AEC) was performed on haematology analyser (Mindray BC 50), FPG and Lipid Profile were measured by commercially available kits of spin react on Microlab 300, and Sd-LDL-C were measured by precipitating lipoproteins using heparin-MnCl2 solution and measuring Sd-LDL-C from supernatant by spectrophotometric method in SPA and non-asthmatic adults. Data was analyzed by SPSS 20.2. Results: Pair-wise comparison between SPA and non-asthmatic group was performed by two sample t-test. In SPA group, FPG (95 ± 8mg/dl), Triglycerides (162 ± 14mg/dl), LDL (97 ± 10mg/dl) and Sd-LDL-C (48 ± 4mg/dl) were significantly higher (p < 0.05) than non-asthmatic adults, while HLD in SPA (38 ± 4.4mg/dl) was significantly lower than non-asthmatic adults (42 ± 3.9mg/dl). We also observed strong positive association of FPG (0.54), Triglycerides (0.38) LDL (0.23) and Sd-LDL-C (0.60) with AEC of SPA group and strong negative correlation for HDL (0.50) and AEC in SPA. Conclusion: Dyslipidaemia, hyperglycaemia and elevated levels of Sd-LDL-C are associated complication of severe persistent asthma and high levels of Sd-LDL-C in severe persistent asthma are a potential risk factor to induce atherosclerosis.

The present study was conducted to evaluate the effects of storage time and temperature on physicochemical and sensory properties and to measure the spoilage of pasteurized fluid milk stored at different temperatures via nanoparticles on pasteurized fluid milk. The mean values for pH of milk samples decreased (from 6.81 to 6, 5.46, and 4.37), acidity increased (10%, 21%, and 35%), fat contents decreased (13%, 24%, and 32%), protein contents decreased (7%, 18%, and 24%), lactose contents decreased (5%, 7%, and 12%), and total free fatty acids increased (14%, 19%, and 27%) respectively at 4°C, 7°C, and 10°C. Similarly, the score of sensory parameters like aroma, taste, and overall acceptability decreased 16%, 23%, and 45%; 31%, 43%, and 52%; and 33%, 42%, and 53% respectively in linear pattern along with increasing the time and temperature. The L* values were non-significantly changed or decreased with mean values of 64.82 ± 0.08 to 64.13 ± 0.07 at 4°C and significantly with 64.81 ± 0.03 to 63.87 ± 0.07 and 64.77 ± 0.02 to 61.43 ± 0.05 at 7°C and 10°C respectively at 0–19th day of milk storage. During storage, the pasteurized milk stored at all temperatures 4°C, 7°C, and 10°C showed that a* value non-significantly decreased from 48.69 ± 0.18 to 48.63 ± 0.18, 48.74 ± 0.14 to 48.57 ± 0.11, and 48.68 ± 0.18 to 47.97 ± 0.07 respectively. Values of b* decreased non-significantly at 4°C and 7°C with the values of −17.56 ± 0.23 to −18.58 and −17.54 ± 0.25 to −19.85 ± 0.85 but significantly decreased at 10°C from −17.56 ± 0.23 to −43.22 ± 0.11. The results suggested that pasteurized milk can be kept for 17–19 days at 4°C but this shelf life drastically reduced at 7°C and 10°C. Color of nanoparticles was significantly changed from pink to dark blue from 14th day of storage onwards to the end at 10°C. Conclusively, nanoparticles can be used for the rapid and at the post-spoilage measurement of pasteurized milk.

The manifestation of aflatoxins in feed and food is a major issue in the world as its presence leads to some health problems. This study investigates the incidence of aflatoxin M1 (AFM1) contamination in raw milk samples which were collected from Punjab, Pakistan. The Cluster Random Sampling technique was used to collect 960 milk samples from five different regions, and samples were collected every month. The AFM1 level in raw milk was analyzed by the ELISA technique. The findings demonstrate that 70% of samples exceeded the United States permissible maximum residue limits (MRL 0.50 µg/L), with an overall AFM1 level that ranged from 0.3 to 1.0 µg/L. AFM1 contamination varied with the season: The highest average contamination was detected in winter (0.875 µg/L), followed by autumn (0.751 µg/L), spring (0.654 µg/L), and summer (0.455 µg/L). The Eastern region exhibited the highest average AFM1 contamination (0.705 µg/L). Milk samples from the Northern region were found to be widely contaminated, as 86.9% samples exceeded the US MRL, followed by the Eastern region, with 72.3% samples being contaminated with >0.5 µg/L AFM1. The study indicated that the raw milk supply chain was heavily contaminated. Recommendations and remedial measures need to be developed by regulatory authorities to improve the raw milk quality.

(1) Background: Multiple attempts have been conducted to correlate milk keeping quality with chemical, physical or bacteriological parameters. These methods only measure the chemical changes in milk produced by bacteria. Headspace solid-phase micro-extraction (HS-SPME) is an economic and recent method used to measure both volatile compounds and microbial load in milk, also allowing to keep the quality of the milk product. (2) Methods: The present study was conducted to identify and measure the off-flavoring volatile compounds through gas chromatography coupled with flame ionization detector (GC-FID) and the microbial load of pasteurized fluid milk stored at different temperatures, as a possible indicator of its keeping quality. (3) Results: The highest results were obtained to acetone, followed by butanone, pentanal and ethanol. These mean values were significantly enhanced from the 0 to 19th day of storage, at 10 °C. At day 19th, the minimum score for aroma, flavor and overall acceptability were also recorded as 4.33 ± 0.17, 4.02 ± 0.06, 4.00 ± 0.04, respectively. Likewise, maximum values for standard plate count (Log10 CFU 15.54 ± 0.40 mL−1) and total psychotroph count (Log10 CFU 11.67 ± 0.30mL−1) were reported at 10 °C and 4 °C. (4) Conclusion: HS-SPME/GC-FID methodology revealed to be very sensitive and capable to be applied in volatile compounds quantification in pasteurized milk produced during the storage period at different temperatures.

Category: Ankle Arthritis Introduction/Purpose: Ankle arthritis is a leading cause of pain and disability. The effect of this condition on physical and mental health is similar to end stage hip arthritis. There is paucity of literature on PROMS outcomes following total ankle replacements (TAR) in comparison to total hip replacement (THR) or knee replacement (TKR). We aimed to study the 5 year outcomes of TAR in comparison with TKR and THR Methods: PROMS data from patients who underwent a primary THR, TKR or TAR from March 2003 to 2013 were collected from our hospital patient registry. They were divided into 3 groups based on the type of primary joint replacement. Patient demographics and patient reported outcomes (WOMAC, SF-36 scores and patient satisfaction scores at follow up) were compared at pre-op and 5 year follow up. Results: There was data available on 1920 THR, 2582 TKR and 248 TAR patients. Pre-operatively, TAR patients reported higher function scores when compared to THR and TKR (40.2 vs. 34.2 and 35.8; p < 0.05). For SF-36 scores, there was no difference between groups for general health, role emotional components (P>0.05); TAR patients reported similar scores to TKRs for physical domains; to THRs for the mental domains (P>0.05). At 5 years post-op, TARs reported lower scores than THRs and TKRs for function and stiffness. For SF-36 scores, TARs reported similar outcomes to THR and TKR for mental health components (p>0.05), similar scores to TKR for 3/4 physical domains (p < 0.05), but lower satisfaction rates for ADL and recreation when compared to THR (P < 0.05). Conclusion: TAR patients had similar outcomes to THR or TKR patients for disease specific and mental health domains, and lower patient satisfaction rates in terms of pain relief, ADL and recreation. Further research is warranted including clinical outcomes along with PROMS with a long term follow up.

IntroductionThe ongoing global expansion of salt-affected land is a significant factor, limiting the growth and yield of crops, particularly rice (Oryza sativa L). This experiment explores the mitigation of salt-induced damage in rice (cv BRRI dhan100) following the application of plant growth-promoting rhizobacteria (PGPR).MethodsRice seedlings, at five- and six-weeks post-transplanting, were subjected to salt stress treatments using 50 and 100 mM NaCl at seven-day intervals. Bacterial cultures consisting of endophytic PGPR (Bacillus subtilis and B. aryabhattai) and an epiphytic PGPR (B. aryabhattai) were administered at three critical stages: transplantation of 42-day-old seedlings, vegetative stage at five weeks post-transplantation, and panicle initiation stage at seven weeks post-transplantation.ResultsSalt stress induced osmotic stress, ionic imbalances, and oxidative damage in rice plants, with consequent negative effects on growth, decrease in photosynthetic efficiency, and changes in hormonal regulation, along with increased methylglyoxal (MG) toxicity. PGPR treatment alleviated salinity effects by improving plant antioxidant defenses, restoring ionic equilibrium, enhancing water balance, increasing nutrient uptake, improving photosynthetic attributes, bolstering hormone synthesis, and enhancing MG detoxification.DiscussionThese findings highlight the potential of PGPR to bolster physiological and biochemical functionality in rice by serving as an effective buffer against salt stress–induced damage. B. subtilis showed the greatest benefits, while both the endophytic and epiphytic B. aryabhattai had commendable effects in mitigating salt stress–induced damage in rice plants.

Patellar tuberculosis (TB) is a rare manifestation of musculoskeletal tuberculosis, accounting for a small proportion of cases. This case report presents a detailed analysis of a female patient in her early 30s who presented with isolated TB of the patella without concurrent pulmonary involvement. The patient received antitubercular chemotherapy, consisting of a 4-month intensive phase followed by an 8-month continuation phase. This case report underscores the rarity and diagnostic complexities associated with patellar TB. The condition often presents with non-specific symptoms, often mimicking prepatellar bursitis, necessitating a high level of clinical suspicion, particularly in patients from the endemic areas. Radiographic imaging and histopathological examination play crucial roles in establishing an accurate diagnosis. Antitubercular chemotherapy forms the cornerstone of treatment while surgical intervention is reserved for cases of extensive bone destruction or treatment failure. [ABSTRACT FROM AUTHOR]

Introduction: It is crucial for the anaesthesia and surgical teams to be aware of potential hemodynamic changes associated with the use of bone cement in order to minimise hazards. The purpose of this study was to identify and mitigate the risks of potential hemodynamic alterations and associated factors in total hip arthroplasty candidates utilising bone cement. Methods: During June 2019-2022, 126 applicants for total hip arthroplasty in the department of orthopaedic surgery at a hospital in India were the subject of a descriptive-analytical study. Three minutes before, during, and three minutes after applying bone cement, the hemodynamic status (heart rate, blood pressure, and arterial oxygen saturation (SPO2) of all patients was monitored and changes were calculated. Results: Before and after applying bone cement, there was a statistically insignificant rise in heart rate (P=0.125), diastolic and systolic blood pressure (P=0.221, P=0.195, and P=0.125, respectively). The patients' arterial oxygen saturation, however, stayed the same (P=0.999). Conclusion: The findings demonstrated that utilising bone cement leads in small alterations in heart rate and blood pressure (systolic and diastolic). [ABSTRACT FROM AUTHOR]

Objective: Adhesive capsulitis or frozen shoulder is a painful condition affecting up to 5% of the general population. We conducted this study with the aim of evaluating the results of physiotherapy plus intra-articular methylprednisolone injection versus physiotherapy alone in idiopathic frozen shoulder.Methods: This prospective clinical study was conducted in a tertiary care center between August 2016 and August 2018. Patients who were diagnosed with idiopathic frozen shoulder were included in the study, and each patient was randomly allocated to one of two groups: physiotherapy alone (group A) and physiotherapy plus intra-articular steroid injection (group B).Results: A total of 52 cases diagnosed with idiopathic frozen shoulder were included and treated with the two modalities. There was a significant improvement in group B compared to group A at 6 weeks and 3 months in the range of flexion, abduction, and external rotation. The Shoulder Pain and Disability Index showed improvement in both pain and disability score in group B -compared to group A, and improvement was significant at 6 weeks and 3 months.Conclusion: The results demonstrate the advantages of physiotherapy plus intra-articular steroid injection in idiopathic frozen shoulder. The predictability of results with physiotherapy plus intra-articular steroid injection in selected patients is excellent, and it is a better modality of treatment compared to physiotherapy alone. [ABSTRACT FROM AUTHOR]

Background: Fractures of the distal third of the tibia are mostly associated with a fibular fracture that often requires fixation. The preferred treatment of distal tibial fracture is the minimally invasive percutaneous plate osteosynthesis (MIPPO) procedure. However, there are no clear cut guidelines on fixation of the fibular fracture and currently most orthopedic surgeons use a plate osteosynthesis for the fibula as well. A common complication associated with dual plating is an increased chance of soft tissue necrosis, infection, and in some cases resulting in an exposed implant. We conducted a prospective study to analyze the results of fractures of the distal in both leg bones managed by the MIPPO procedure for tibial fractures and a rush nail for fibular fractures., Methods: The study was conducted in a tertiary care hospital from November 2012 to May 2014, a total of 30 fractures in 30 patients (18 males, 12 females) with a mean age of 42.4 years (26-60 years) were treated in our institution in the aforesaid time period with MIPPO for tibia and rush nail for fibular fractures. All the cases were operated on by a single surgeon in emergency within 24 hours. The patients with skin blistering and compound fractures were excluded from this study. Rehabilitative measures were proceeded as per patient's pain profile, isometric and isotonic exercises were started on the first post-operative day, with full weight bearing at 10-12 weeks after assessing clinical and radiological union. Regular follow up of patients was done, radiographs were taken at the immediate post-operative period and at 3, 6, 12 and 24 weeks., Results: All the patients were available for regular follow up. Radiological and clinical union proceeded normally in all the patients, no patients had signs of any deep infection, delayed union or nonunion, three patients had a superficial infection of the tibial incision that healed with a change in antibiotic., Conclusions: The use of dual plating for fixation of the lower tibia and fibula fractures is often associated with soft tissue complications, exposed implant, and increased risk of infection. We conclude that in fractures of the distal tibia and fibula it is better to use a rush nail for the fibula with a concurrent MIPPO for the tibia for the reasons cited above. Moreover, with the use of rush nail the cost of implant is also reduced, which is a very important factor in developing countries.