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Background: subacromial-subdeltoid chronic bursitis is one of the main causes of shoulder pain syndrome. There are various causes of shoulder pain syndrome including chronic bursitis. The sonographic appearances of chronic bursitis vary from patient to patient, depending upon the underlying cause. However, rice bodies are the rare sonographic presentation among them. Rice bodies can be associated with atypical mycobacterial tenosynovitis, bursitis, mycobacterium tuberculosis and infections, but very rarely occur in the chronic subacromial-subdeltoid bursitis. Its unique sonographic presentation makes it easy to be diagnosed confidently, but it is difficult to be recognized, interpret and distinguish from other pathologies due to its rare occurrence. It is therefore intended to present this rare and interesting sonographic presentation of chronic subacromial-subdeltoid bursitis as a case report., Case-Presentation: A 36-year-old male suffering from swelling and pain on his left shoulder for 6 months came to the clinic with Grade-3 impingement syndrome. Free-floating echogenic rice bodies were identified in the subacromial-subdeltoid bursa during ultrasound examination, which was also confirmed with Magnetic resonance imaging (MRI) and serological tests of the specimen after surgery., Conclusion: The unique sonographic presentation of rice bodies in the chronic subacromial-subdeltoid bursitis makes it easy to be diagnosed confidently, but it is difficult to be recognized, due to its rare occurrence.

Objective: To identify determinants of health facility births in Pakistani pregnant women.., Methods: The retrospective study was conducted at Chulalongkorn University from June to September 2017 and comprised data files of three Pakistan Demographic Health Surveys conducted in 1991, 2007 and 2013. The files were downloaded from the online database. Only data of women who had given at least one birth were included. Logistic regression was applied to see the relation between dependent and independent multivariable models. Confidence intervals were measured around odds ratio at 95% level. All analyses were done on the basis of survey years using SPSS 16., Results: Of the 30192 women interviewed, 17126(56.7%) had given birth during the period: 4,039(61%) out of 6611 in 1991; 5648(56.3%) out of 10023 in 2007; and 7439(54.8%) out of 13558 in 2013. Health facility births increased from 551(13.6%) in 1991 to 2013 (37.2%) in 2007 to 3844 (51.7%) in 2013. Women from rural areas (odds ratio = 0.29, 0.689, 0.92; 95% confidence interval [0.23, 0.38], [0.6, 0.8], [0.81, 1.04]) were less likely to deliver in health facilities., Conclusions: Health facility births increased to almost 50% in 22 years.

Background: Chronic non-specific low back is the most common musculoskeletal complaint that significantly affects the general population. Exercises are advocated as the main part of treatment for chronic low back pain., Objective: The purpose of this study was to compare the effects of workouts of the core musculature and routine physical therapy exercise training for the treatment of disability caused by chronic low back pain., Methods: In this single-blinded, randomized, controlled trial, 120 patients with non-specific low back pain were examined in Lahore, Pakistan. They were randomly allocated into treatment groups A and B. Group A performed core stabilization workouts and Group B had routine physical therapy. The Oswestry Disability Index (ODI) was used to evaluate the outcome of each treatment. Statistical analysis was performed using SPSS v16.0 and a p value < 0.05 was considered significant., Results: Significant reduction in disability was observed in both groups at the end of the second, fourth, and sixth week of treatment (p value < 0.05). The mean reduction in disability as measured by ODI score was 39.44 ± 14.64 for Group A and 31.91 ± 12.31 for Group B., Conclusion: A larger reduction in disability was observed for subjects treated with core stabilization exercises in comparison to those treated with routine physical therapy.

Objective: To find out the association of seeking ophthalmic assessment in children with parental history of refractive errors., Methods: After the approval of ethical review board, an analytical cross-sectional study was conducted in eight high schools of public and private sector at Lahore during the period of seven months from August 2017 to March 2018. Multistage random sampling technique was opted and 2000 study subjects were recruited including 50% boys and 50% girls. Informed consent was obtained and data was collected on a structured questionnaire. The data was organized, entered in version 23 of IBM SPSS and analyzed by the use of statistical tools., Results: Age of the respondents ranged between nine to 18 years with a mean of 13.40 ± 1.82 SD.Parental history of wearing spectacles was present in 21.3% of the fathers and 28.6% of the mothers. Moreover, 72.4% of the participants never visited eye care professional. Among private schools, an association was found between the visit of boys to eye care professional and maternal positive history of wearing spectacles (p-value 0.019). A significant association was found between the positive paternal history of wearing spectacles and visit of the female strudy subjects to an eye care professional (p-value 0.001). In public schools, there was an association between visit of children to eye care services and positive history of mothers about the use of spectacles (p-value 0.018)., Conclusions: This study concludes that positive maternal history of wearing spectacles is associated with the ophthalmic examination of children in both public and private school.

Objective: The aim of this study is to determine the effect of scale/pulse repetition frequency (PRF) on the appearance of color Doppler twinkling artifact., Materials and Methods: We commenced this cross-sectional study for 20 months from November 2014 to July 2016. During routine ultrasound examination, we observed multiple case of twinkling artifact produced by renal stones, calcifications in the thyroid nodules, bony fragments and intestinal gases, etc., We observed twinkling artifact with low- and high-PRF settings in 500 different structures. A total of 500 other structures were included wherein there was no Doppler twinkling artifact produced by them, with usual optimum PRF settings. These structures were also evaluated with low- and high-PRF to determine the effect of PRF on twinkling artifact effectively. All the patients were examined according to the AIUM guideline for appropriate examination protocol. Data were collected from the observation of twinkling artifact with low- and high-PRF/scale and evaluated with the help of IBM SPSS 24 package, the results were summarized as follow., Results: Change in scale/PRF could not affect the twinkling artifact. The twinkling artifact observed with low-PRF was the same as seen with high-PRF. There was a significant agreement between low- and high-PRF in the production of color twinkling artifact. The kappa value of agreement was estimated as 0.96, whereas the Pearson's correlation was significant with the value of 0.001. Same twinkling artifact was created with low- and high-PRF, with no significant variation., Conclusion: Twinkling artifact is independent of PRF/Scale., Competing Interests: There are no conflicts of interest.

Diet plays a key role to maintaining healthy life. Many natural products present in our diet, such as flavonoids, can prevent the progression of cancer. Quercetin, a distinctive bioactive flavonoid, is a dietary component that has attracted the attention of dietitians and medicinal chemists due to its numerous health-promoting effects. It is an outstanding antioxidant that has a well-documented role in reducing different human cancers. Quercetin exhibits direct proapoptotic effects on tumor cells and thus can inhibit the progress of numerous human cancers. The anticancer effect of quercetin has been documented in numerous in vitro and in vivo studies that involved several cell lines and animal models. On the other hand, the high toxic effect of quercetin against cancer cells is accompanied with little or no side effects or harm to normal cells. Accordingly, this review presents an overview of recent developments on the use of quercetin against different types of cancer along with mechanisms of action. In addition, the present review summarizes the literature pertaining to quercetin as an anticancer agent and provides an assessment of the potential utilization of this natural compound as a complimentary or alternative medicine for preventing and treating cancer., (© 2018 John Wiley & Sons, Ltd.)

Background: Body mass index (BMI) is used for the assessment of obesity and overweight worldwide. When body fat is increased BMI is also increased. Ultrasound is a reliable method to assess body fat. We have selected only one suprapubic region for the assessment of fat which is very easy to measure even in routine pelvic and abdominal ultrasound examination. During our routine examination, we can measure abdominal fat and inform the patient about his/her health state regarding obesity. It was a hypothesis that increases in abdominal subcutaneous fat will increase in BMI., Objective: The objective is to correlate subcutaneous fats measured on ultrasound with BMI., Materials and Methods: It was a cross-sectional study, which was performed in Gilani ultrasound center, Lahore, Pakistan. A total of 384 participants were included with simple random sampling technique. Individuals of 16-60 years age of both genders were included in that study. Pregnant ladies, athletes, children, and elderly participants were not included in that study. Toshiba (Xario) and Mindray (Z5) ultrasound machine were used for subcutaneous fats measurement. Participants were scanned in the supine position. Subcutaneous fats were measured on the suprapubic region in three different trials. Compression was avoided. Compression artifacts were avoided by applying more quantity of gel between transducer and skin. Stadiometer was used for the measurement of weight and height. To calculate BMI, Quetelet index was used. BMI was calculated with that formula BMI = weight (kg) divided by height (m 2 )., Results: The result was made by calculation of mean and standard deviation. We calculated Pearson correlation between BMI and subcutaneous fats measured on ultrasound at the suprapubic region. It showed a significant high correlation between BMI and subcutaneous fat ( P = 0.0000 which is < 0.001)., Conclusion: There is a significantly high correlation between BMI and subcutaneous fat measured on ultrasound. Ultrasound is a reliable method to assess subcutaneous fat. It can be a predictor of obesity like BMI., Competing Interests: There are no conflicts of interest.

Background: The purpose of the research is to know the sonographic evaluation of urolithiasis formation with positive family history in population of Lahore because urolithiasis is a major problem in Pakistan. According to a survey in 1985-1987 the incidence rate reaches to 8.3/100,000 individuals in the Punjab. In Pakistan, urolithiasis is the sixth major cause of surgery. The study was conducted to rule out the role of positive family history in people suffering from urolithiasis., Materials and Methods: This was an observational cross-sectional study conducted at the Radiology department of the University of Lahore teaching hospital and Gilani Ultrasound center-Afro-Asian Institute, Lahore, Pakistan. A total of 125 patients were included in the study which were diagnosed with urolithiasis and individuals with any other abnormality were excluded from the study. The duration of the study was from January 2017 to April 2017. Data were tabulated and analyzed using SPSS version 24. The data were reported using descriptive and inferential statistics. The quantitative variable like age was assessed using mean standard deviation and standard errors. The qualitative variables like gender were reported using percentages and frequencies., Results: Urolithiasis is commonly seen in the males (77 individuals out of 125) as compared to females (48 individuals out of 125) and mid pole of right kidney is the most common site of the renal stones deposition (13.6%), and the relationship of father is mostly seen as familial history (39.2%)., Conclusion: It is concluded that positive family history is the major predisposing factor in urolithiasis and one of the cause in the development of stones in the urinary tract or in other words people who have a history of urolithiasis in blood relations have more tendency of stone formation in any part of their lives. Its positive aspect is that we can do a screening in blood relations, especially whose parents or family members diagnosed with stones and can do preventive measures for that. Moreover, its negative aspect is that there are several causes of the stone formation in the urinary tract., Competing Interests: There are no conflicts of interest.

Olive fruit is a significant and promising source of potential bioactive compounds such as oleuropein and hydroxytyrosol. Oleuropein is the ester of elenolic acid and 3,4-dihydroxyphenyl ethanol (HT). It is the main glycoside in olives, the degradation of which results in the formation of hydroxytyrosol in olive oil. Both plays a significant role in the reduction of coronary heart diseases and a certain type of cancers. Both olive oil phenols have an effective role counter to cell proliferation, cell growth, migration, invasion, and angiogenesis. They down regulate the expression of BCL-2 and COX-2 proteins, and reduced DNA damage. Hydroxytyrosol and oleuropein inhibited the multiple stages in colon carcinogenesis; initiation, promotion, and metastasis. They also provide protection against various human cancers including colorectal, skin, breast, thyroid, digestive, lung, brain, blood, and cervical. This review article discusses the anticancer perspectives and mechanisms of oleuropein and hydroxytyrosol in cell cultures and animal and human studies., (© 2018 Institute of Food Technologists®.)

Nucleic acid & serology based methods have revolutionized plant disease detection, however, they are not very reliable at asymptomatic stage, especially in case of pathogen with systemic infection, in addition, they need at least 1-2days for sample harvesting, processing, and analysis. In this study, two reflectance spectroscopies i.e. Near Infrared reflectance spectroscopy (NIR) and Fourier-Transform-Infrared spectroscopy with Attenuated Total Reflection (FT-IR, ATR) coupled with multivariate exploratory methods like Principle Component Analysis (PCA) and Partial least square discriminant analysis (PLS-DA) have been deployed to detect begomovirus infection in papaya leaves. The application of those techniques demonstrates that they are very useful for robust in vivo detection of plant begomovirus infection. These methods are simple, sensitive, reproducible, precise, and do not require any lengthy samples preparation procedures., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Although abundantly present in soils, inorganic phosphate (Pi) acquisition by plants is highly dependent on the transmembrane phosphate transporter (PT) gene family. Cucumber (Cucumis sativus) requires a large amount of phosphorus (P). The purpose of this study was to isolate the CsPT2-1 from cucumber roots, and to determine the influence of Pi nutrition on cucumber growth, metabolism and transcript levels of CsPT2-1 in tissues. Full length CsPT2-1 was cloned and phylogenetically identified. In two greenhouse experiments, P-deficient seedlings provided with low or high P concentrations were sampled at 10 and 21 days post treatment, respectively. Addition of P dramatically reduced growth of roots but not shoots. Supplying plants with high P resulted in increased total protein in leaves. Acid phosphatase activity increased significantly in leaves at any rate higher than 4 mM P. Increasing P concentration had a notable decrease in glucose concentrations in leaves of plants supplied with >0.5 mM P. In roots, glucose and starch concentrations increased with increasing P supply. Steady-state transcript levels of CsPT2-1 were high in P-deprived roots, but declined when plants were provided >10 mM P. To our knowledge, this is the first report focusing on a PT and its expression levels in cucumber., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Detection of adulteration in carbohydrate-rich foods like fruit juices is particularly difficult because of the variety of the commercial sweeteners available that match the concentration profiles of the major carbohydrates in the foods. In present study, a new sensitive and robust assay using Fourier Transform Near-Infrared Spectroscopy (FT-NIRS) combined with partial least square (PLS) multivariate methods has been developed for detection and quantification of saccharin adulteration in different commercial fruit juice samples. For this investigation, six different commercially available fruit juice samples were intentionally adulterated with saccharin at the following percentage levels: 0%, 0.10%, 0.30%, 0.50%, 0.70%, 0.90%, 1.10%, 1.30%, 1.50%, 1.70% and 2.00% (weight/volume). Altogether, 198 samples were used including 18 pure juice samples (unadulterated) and 180 juice samples adulterated with saccharin. PLS multivariate methods including partial least-squares discriminant analysis (PLS-DA) and partial least-squares regressions (PLSR) were applied to the obtained spectral data to build models. The PLS-DA model was employed to differentiate between pure fruit juice samples and those adulterated with saccharin. The R 2 value obtained for the PLS-DA model was 97.90% with an RMSE error of 0.67%. Similarly, a PLS regression model was also developed to quantify the amount of saccharin adulterant in juice samples. The R 2 value obtained for the PLSR model was 97.04% with RMSECV error of 0.88%. The employed model was then cross-validated by using a test set which included 30% of the total adulterated juice samples. The excellent performance of the model was proved by the low root mean squared error of prediction value of 0.92% and the high correlation factor of 0.97. This newly developed method is robust, nondestructive, highly sensitive and economical.

Flavonoids are natural antioxidants derived from plants and commonly found in a variety of foods to sequester free radicals. Quercetin, belonging to flavonol subclass of flavonoids, has received considerable attention because of its wide uses as a nutritional supplement as well as a phytochemical remedy for a number of diseases. In the current study, quantification of quercetin was carried out in two medicinally important flavonoid rich plant Ziziphus mucronata and Ziziphus sativa. Emission spectroscopy was utilized as a new method coupled with Partial Least Squares Regression (PLSR) and the cross validation was done by UV-Visible spectroscopy. The results indicated the higher quercetin content in Z. mucronata (1.50±0.034%) than Z. sativa (1.21±0.052%), and were further verified through Folin-Ciocalteu Colorimetric method (Z. mucronata; 1.41±0.26% and Z. sativa; 1.13±0.136%). In this study the sensitivity was explained in term of slope i.e. Slope=0.9973., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Objective: To determine the effect of low glycaemic index diet on weight loss among obese post-partum women.., Methods: This randomised controlled trial study was conducted at the National Hospital and Medical Centre, and Services Hospital, Lahore, from April to June 2015, and comprised obese post-partum women. Subjects in the intervention group were assigned low glycaemic index diet for 12 weeks while the control group was advised to continue routine diet. SPSS 22 was used for data analysis., Results: Of the 74 participants, 38(51.4%) were in the interventional group and 36(48.6%) in the control group. The low glycaemic index diet had a significant effect on weight reduction in the intervention group compared to the control group (83.6±0.75 vs. 89.1±2) (p=0.02). Low glycaemic diet also had a positive impact on body mass index (p=0.02), body fat percentage (p=0.03) and fat mass (p=0.02). Significant changes were found in the intervention group after 12 weeks in terms of body mass index, body fat percentage, and fat mass, fat-free mass and muscle mass. On the other hand, no changes were established in the control group after 12 weeks of the study period.., Conclusions: Low glycaemic index diet was effective for reducing weight among obese post-partum women.

The objective of this study was to evaluate the diagnostic accuracy of sonoelastography in patients of primary and secondary health care settings. Google scholar, PubMed, Medline, Medscape, Wikipedia and NCBI were searched in October 2017 for all original studies and review articles to identify the relevant material. Two reviewers independently selected articles for evaluation of the diagnostic accuracy of sonoelastography in different diseases based on titles and abstracts retrieved by the literature search. The accuracy of sonoelastography in different diseases was used as the index text, while B-mode sonography, micro pure imaging, surgery and histological findings were used as reference texts. Superficial lymph nodes, neck nodules, malignancy in thyroid nodules, benign and malignant cervical lymph nodes, thyroid nodules, prostate carcinoma, benign and malignant breast abnormalities, liver diseases, parotid and salivary gland masses, pancreatic masses, musculoskeletal diseases and renal disorders were target conditions. The data extracted by the two reviewers concerning selected study characteristics and results were presented in tables and figures. In total, 46 studies were found for breast masses, lymph nodes, prostate carcinoma, liver diseases, salivary and parotid gland diseases, pancreatic masses, musculoskeletal diseases and renal diseases, and the overall sensitivity of sonoelastography in diagnosing all these diseases was 83.14% while specificity was 81.41%. This literature review demonstrates that sonoelastography is characterized by high sensitivity and specificity in diagnosing different disorders of the body.

Sudden unexpected perinatal collapse is a major trauma for the parents of victims. Sudden infant death syndrome (SIDS) is unexpected and mysterious death of an apparently healthy neonate from birth till 1 year of age without any known causes, even after thorough postmortem investigations. However, the incidence of sudden intrauterine unexplained death syndrome (SIUDS) is seven times higher as compared with SIDS. This observation is approximated 40-80%. Stillbirth is defined as death of a fetus after 20th week of gestation or just before delivery at full term without a known reason. Pakistan has the highest burden of stillbirth in the world. This basis of SIDS, SIUDS, and stillbirths eludes specialists. The purpose of this study is to investigate factors behind failure in control of these unexplained deaths and how research may go ahead with improved prospects. Animal models and physiological data demonstrate that sleep, arousal, and cardiorespiratory malfunctioning are abnormal mechanisms in SIUDS risk factors or in newborn children who subsequently die from SIDS. This review focuses on insights in neuropathology and mechanisms of SIDS and SIUDS in terms of different receptors involved in this major perinatal demise. Several studies conducted in the past decade have confirmed neuropathological and neurochemical anomalies related to serotonin transporter, substance P, acetylcholine α7 nicotine receptors, etc., in sudden unexplained fetal and infant deaths. There is need to focus more on research in this area to unveil the major curtain to neuroprotection by underlying mechanisms leading to such deaths.

Objective: To determine the effect of mobilization and routine physiotherapy on pain, disability, neck range of motion (ROM) and neck muscle endurance (NME) in patients having chronic mechanical neck pain (NP)., Methods: Sixty eight patients with chronic mechanical NP were randomly allocated into two groups by using a computer generated random sequence table with 34 patients in the multi-modal mobilization group and 34 patients in the routine physiotherapy group. Baseline values for pain, disability, NME, and neck ROM were recorded using visual analogue scale (VAS), neck disability index (NDI), neck flexor muscle endurance test and universal goniometer respectively, before the treatment. Each patient received 10 treatment sessions over a period of four weeks and at the end of four weeks all the outcome measures were recorded again., Results: A paired t-test revealed significant pre to post treatment differences for all outcome measures in both groups (p ≤ 0.001 in all instances). An independent t-test revealed statistically significant differences for pain, disability, NME, and neck ROM in favor of the multi-modal mobilization group with a between group difference of 1.57 cm for VAS (p < 0.001), 11.74 points for NDI (p = 0.001), 18.45 s for NME (p < 0.001) and 6.06-8.24° for neck ROM (p < 0.05)., Conclusion: The results suggest that a combination of cervical mobilization with routine physiotherapy is more effective for reducing pain and disability and improving NME and neck ROM in patients with chronic mechanical NP compared to routine physiotherapy alone., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

There is an ongoing hunt for biologically active compounds that can combat phytopathogenic fungi and improve plant growth without causing any hazards to the environment. Consequently the present study aims at deciphering the plant growth promotion and antifungal capability of Lysinibacillus sphaericus ZA9. The bacterium was previously isolated and identified in our laboratory from maize rhizosphere using 16S rRNA gene sequencing. The test bacterium L. sphaericus ZA9 was found to produce high quantity of IAA (697 μg/ mL); siderophores (195.79 μg/ mL), HCN and hydrolytic enzyme as compared to the reference strain Bacillus sphaericus Z2-7. The bacterium was also capable of solubilizing silicates (Si), phosphates (P), and potassium (K). The bacterium enhanced the seedling vigor and germination of seeds pretreated with it and promoted the shoot length of both cucumber and tomato seeds in greenhouse experiment. L. sphaericus ZA9 and its cell free culture supernatant showed varied antagonistic behavior against Alternaria alternata, Curvularia lunata, Aspergillus sp., Sclerotinia sp., Bipolaris spicifera, Trichophyton sp. Fermentation broth culture of L. sphaericus ZA9 was then used to isolate antifungal metabolites by silica column chromatography. Identification and determination of antifungal compounds was carried out by Thin-layer chromatography (TLC) followed by NMR spectroscopy. Two compounds were isolated and identified as 2-pentyl-4-quinolinecarboxylic acid (C 15 H 17 NO 2 ) which is a quinoline alkaloid and 1- methylcyclohexene which is a cycloalkene. Compound 1; 2-Penthyl-4-quinolinecarboxylic acid was found to be highly antagonistic against most of the fungi tested as compared to the bacterium itself. Its activity was comparable to that of fungicide Benlate, while compound 2; 1- methylcyclohexene did not show any antifungal activity.

[Purpose] The purpose of this study was to assess intra-rater and inter-rater reliability of musculoskeletal ultrasound (MSKUS) as a tool to measure supraspinatus tendon thickness in healthy subjects. [Subjects and Methods] Twenty healthy subjects were assessed in similar sitting position. Two experienced musculoskeletal ultrasound specialists measured supraspinatus tendon thickness. Tendon was measured twice in one day by each of two raters with an interval of one hour for within day reliability and was re-measured following one week for between days reliability. Data analysis was performed using the intraclass correlation coefficient (ICC) and standard error of measurement (SEM). [Results] Results reflected excellent within day intra-rater and inter-rater reliability with Mean ± standard deviation (SD)=5.14 ± 0.83 and 5.17 ± 0.78, ICC (2,1)=0.89-0.93 and ICC (2,2)=0.98 (0.95-0.99) and SEM=0.18-0.18 and 0.17 while between days intra-rater rater and inter-rater reliability with Mean ± SD=5.14 ± 0.83 and 5.17 ± 0.78, ICC(2,1)=0.88-0.90 and ICC(2,2)=0.95 (0.88-0.98), SEM=0.17-0.38 and 0.17 [Conclusion] The results of the current study indicate that MSKUS is a reliable tool for measuring supraspinatus tendon thickness in healthy subjects.

Background & Objective: Low back pain is a frequent problem faced by the majority of people at some point in their lifetime. Exercise therapy has been advocated an effective treatment for chronic low back pain. However, there is lack of consensus on the best exercise treatment and numerous studies are underway. Conclusive studies are lacking especially in this part of the world. Thisstudy was designed to compare the effectiveness of specific stabilization exercises with routine physical therapy exerciseprovided in patients with nonspecific chronic mechanical low back pain., Methods: This is single blinded randomized control trial that was conducted at the department of physical therapy Orthopedic and Spine Institute, Johar Town, Lahore in which 120 subjects with nonspecific chronic low back pain participated. Subjects with the age between 20 to 60 years and primary complaint of chronic low back pain were recruited after giving an informed consent. Participants were randomly assigned to two treatment groups A & B which were treated with core stabilization exercise and routine physical therapy exercise respectively. TENS and ultrasound were given as therapeutic modalities to both treatment groups. Outcomes of the treatment were recorded using Visual Analogue Scale (VAS) pretreatment, at 2 nd , 4 th and 6 th week post treatment., Results: The results of this study illustrate that clinical and therapeutic effects of core stabilization exercise program over the period of six weeks are more effective in terms of reduction in pain, compared to routine physical therapy exercise for similar duration. This study found significant reduction in pain across the two groups at 2 nd , 4 th and 6 th week of treatment with p value less than 0.05. There was a mean reduction of 3.08 and 1.71 on VAS across the core stabilization group and routine physical therapy exercise group respectively., Conclusion: Core stabilization exercise is more effective than routine physical therapy exercise in terms of greater reduction in pain in patients with non-specific low back pain.

New experimental designs for the extraction of polyphenols from different seeds including Basil seed, Red seed, Sesame seeds and Ajwan seeds were investigated. Four variables the concentration and volume of methanol and NaOH solutions as well as the temperature and time of extraction were varied to see their effect on total phenol extraction. The temperature was varied in the range from 25°C to 200°C while the time in the range from 30 to 200minutes. Response surface methodology was used to optimize the extraction parameters. The estimation of polyphenols was measured through phenols reduction UV-Vis spectroscopic method of phosphotungstic-phosphomolybdic acids (Folin-Ciocalteu's reagent). Calibration curve was made by using tannic acid as a polyphenols standard in the concentration range from 0.1 to 10ppm. The regression line obtained shows the value of correlation coefficient i.e. R=0.930 and Root mean square error of cross validation (RMSEC) value of 0.0654. The Basil seeds were found containing the highest amount of total phenols i.e. 785.76mg/100g. While the Sesame seeds having the least amount i.e. 33.08mg/100g. The Ajwan seeds and the Red seeds are containing the medium amounts i.e. 379mg/100g and 220.54mg/100g respectively., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Despite the wide use of the neck disability index (NDI) for assessing disability in patients with neck pain, the NDI has not yet been translated and validated in Urdu. The first purpose of the present study was to translate and cross-culturally adapt the NDI into the Urdu language (NDI-U). The second purpose was to investigate the reliability, validity and responsiveness of the NDI-U in Urdu-speaking patients experiencing chronic mechanical neck pain (CMNP)., Methods: Translation and cross-cultural adaptation of the original version of the NDI were carried out using previously described procedures. Seventy-six patients with CMNP and thirty healthy participants were recruited for the study. NDI-U and visual analogue scales for pain intensity (VAS pain ) and disability (VAS disability ) were administered to all the participants at baseline and to the patients 3 weeks after receiving physiotherapy intervention. The global rating of change scale (GROC) was also administered at this time. Test-retest reliability and internal consistency were carried out on forty-six randomly selected patients two days after they completed the NDI-U. The NDI-U was evaluated for factor analysis, content validity, construct validity (discriminative and convergent validity) and responsiveness., Results: An intra-class correlation coefficient (ICC 2,1 ) revealed excellent test-retest reliability for all items (ICC 2,1  = 0.86-0.98) and total scores (ICC 2,1  = 0.99) of the NDI-U. The NDI-U was found internally consistent with a Cronbach's alpha of 0.90 and a fair to good correlation between single items and the NDI-U total scores (r = 0.34 to 0.89). Factor analysis of the NDI-U produced two factors explaining 66.71% of the variance. Content validity was good, as no floor or ceiling effects were detected for the NDI-U total score. To determine discriminative validity, an independent t-test revealed a significant difference in the NDI-U total scores between the patients and healthy controls (P < 0.001). For convergent validity, Pearson's correlation coefficient showed a strong correlation between NDI-U and VAS disability (r = 0.83, P < 0.001) and a moderate correlation between NDI-U and VAS pain (r = 0.62, P < 0.001). To measure responsiveness, an independent t-test showed a significant difference in the NDI-U change scores between the stable and the improved groups (P < 0.001). Furthermore, moderate correlations were found between the NDI-U change scores and the GROC (r = 0.50, P < 0.001), VAS disability change scores (r = 0.58, P < 0.001) and VAS pain change scores (r = 0.55, P < 0.001)., Conclusion: The results showed that the NDI-U is a reliable, valid and responsive questionnaire to measure disability in Urdu-speaking patients with CMNP.

Medicinal plants have been used by marginal communities to treat various ailments. However, the potential of endophytes within these bio-prospective medicinal plants remains unknown. The present study elucidates the endophytic diversity of medicinal plants (Caralluma acutangula, Rhazya stricta, and Moringa peregrina) and the endophyte role in seed growth and oxidative stress. Various organs of medicinal plants yielded ten endophytes, which were identified as Phoma sp. (6 isolates), Alternaria sp. (2), Bipolaris sp. (1), and Cladosporium sp. (1) based on 18S rDNA sequencing and phylogenetic analysis. The culture filtrates (CFs; 25%, 50%, and 100% concentrations) from these endophytes were tested against the growth of normal and dwarf mutant rice lines. Endophytic CF exhibited dose-dependent growth stimulation and suppression effects. CF (100%) of Phoma sp. significantly increased rice seed germination and growth compared to controls and other endophytes. This growth-promoting effect was due to the presence of indole acetic acid in endophytic CF. The gas chromatography/mass spectrometry (GC/MS) analysis showed the highest indole acetic acid content ((54.31±0.21) µmol/L) in Bipolaris sp. In addition, the isolate of Bipolaris sp. exhibited significantly higher radical scavenging and anti-lipid peroxidation activity than the other isolates. Bipolaris sp. and Phoma sp. also exhibited significantly higher flavonoid and phenolic contents. The medicinal plants exhibited the presence of bio-prospective endophytic strains, which could be used for the improvement of crop growth and the mitigation of oxidative stresses., Competing Interests: Compliance with ethics guidelines: Wen-xu LI, San-ling WU, Yan-hua LIU, Gu-lei JIN, Hai-jun ZHAO, Long-jiang FAN, and Qing-yao SHU declare that they have no conflict of interest. This article does not contain any studies with human or animal subjects performed by any of the authors.

Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome. It occurs predominantly among younger females, typically in the absence of atherosclerotic coronary artery disease. Presentations vary greatly and this condition can be fatal. Given its rarity, there are no management guidelines. We present six patients with SCAD with different presentations and treatment approaches as examples in our literature review. Two patients presented with ST elevation myocardial infarction (STEMI), two with non-STEMI (NSTEMI), and two with cardiac arrest. Patients were treated according to the presentation, clinical stability, and extension and distribution of the dissection. Four patients underwent emergent percutaneous coronary intervention (PCI) and one was clinically stable and treated medically initially and underwent an elective PCI after 4 weeks when coronary angiogram showed persistent dissection. Another patient was treated medically as he was hemodynamically stable and the dissection affected a small branch. Intravascular ultrasound (IVUS) or optical coherence tomography (OCT) was used for diagnosis confirmation as well as during and after PCI to assure good stent apposition. All patients had excellent outcome. SCAD is a rare cause of acute coronary syndrome and a high index of suspicion is crucial for early diagnosis. In patients with early presentation, limited disease, and ongoing symptoms, emergent cardiac catheterization with PCI has excellent outcome. However, in stable patients, medical management and elective PCI in few weeks if the dissection persists is a more reasonable approach. IVUS and OCT are invaluable especially in ambiguous cases.

Background We aimed to carry out comparison of different bleeding avoidance strategies in doing primary percutaneous coronary intervention (PPCI) using either radial or femoral as access of choice and either bivalirudin or unfractionated heparin as anticoagulant of choice. In this analysis, we analyzed the influence of major bleeding definition on bleeding outcomes as well. Methods We did a retrospective analysis of 139 patients with ST-segment elevation myocardial infarction (STEMI) who had PPCI in our academic center from January 2010 till October 2013. The primary outcome at 30 days was a composite of death from any cause or stent thrombosis or non-coronary artery bypass grafting (CABG) related major bleeding (CathPCI Registry definition) and secondary outcomes were individual components of primary outcome and the hospital length of stay. Results There was no significant difference among different access/anticoagulant combinations with regards to primary outcome (22% in radial/bivalirudin vs. 5% in radial/heparin vs. 17% in femoral/bivalirudin vs. 28% in femoral/heparin group; p = 0.2) as well as its individual components except the hospital length of stay (2.56 vs. 3 vs. 3.97 vs. 4.4 days each; p < 0.0001). The overall rate of major bleeding was 11.5%. When we use HORIZON-AMI bleeding definition, it went up to 25 % due to one particular component (p < 0.004). Conclusions This single center observational study doing PPCI did not show any superiority of one bleeding avoidance strategy over others with regard to primary outcome and its individual components except the hospital length of stay. It also shows the importance of bleeding definition on bleeding outcomes.

Objective: To assess the nutritional values and antioxidant analysis of 22 varieties of date palm (Phoenix dactylifera) fruit collected from various regions of the Sultanate of Oman., Methods: Nutritional parameters including moisture, fats, fiber, proteins, carbohydrates, and energy value were determined using standard methods of Association of Official Analytical Chemists. The antioxidant activity was screened for their free radical scavenging properties using ascorbic acid as a standard antioxidant. Free radical scavenging activity was evaluated using 1,1-diphenyl-2-picrylhydrazyl free radical., Results: The results of the date fruits (dried/tamar stage) revealed significantly higher moisture (15%-21%), dry matter (78%-86%), ash content (1.0%-2.0%), fiber (1.0%-2.5%), fat (0.1%-0.7%), protein (1.8%-3.8%), nitrogen (0.25%-0.55%), carbohydrates (74.5%-82.4%), and energy values (307-345.5 kcal/100 g). The antioxidant activity ranged between 40% and 86% depending upon the type of date and location. Overall, Khalas, Fardh and Khasab have significantly higher nutritional attributes; however, other varieties such as Barshi, Qush LuLu, Handal, and Khunaizi also have comparable nutritional values. The cluster analysis further evidenced the correlation of proximate parameters in different locations. Moreover, the nutritional and antioxidant attributes of similar date varieties collected from different locations were slightly varied., Conclusions: The present finding helps in understanding the nutritional significance of different date varieties in Oman while the lesser known varieties can be improved through sustainable horticultural practices as a valuable product. The study further reveals that the consumption of these dates' fruits would exert several beneficial effects by virtue of their antioxidant activity., (Copyright © 2014 Hainan Medical College. Published by Elsevier B.V. All rights reserved.)

An endophytic fungus was isolated from the roots of tomato (Solanum lycopersicum Mill) and identified as Penicillium janthinellum LK5. The culture filtrate (CF) of P. janthinellum significantly increased the shoot length of gibberellins (GAs) deficient mutant waito-c and normal Dongjin-beyo rice seedlings as compared to control. The CF of P. janthinellum contained GAs (GA3, GA4, GA7 and GA12). To assess endophyte-growth promoting and stress-tolerance potential, the CF along with the propagules of endophyte was applied to tomato-host and abscisic acid (ABA)-deficient mutant Sitiens plants under sodium chloride (NaCl) induced salinity stress. Sitiens plants had retarded growth under normal and salinity stress however its growth was much improved during P. janthinellum-association. The endophyte inoculation reduced the membrane injury by decreasing lipid peroxidation as compared to non-inoculated control under salinity. Endophyte-associated Sitiens plants have significantly higher catalase, peroxidase and glutathione activities as compared to control. Endophyte-infected host and Sitiens plants had low level of sodium ion toxicity and high calcium contents in its root as compared to control. P. janthinellum LK5 helped the Sitiens plants to synthesis significantly higher ABA and reduced the level of jasmonic acid to modulate stress responses. The results suggest that endophytes-association can resist salinity stress by producing gibberellins and activating defensive mechanisms of host and Sitiens plants to achieve improved growth.

Objective: To evaluate the ductus venosus hemodynamic parameters in 31-40 weeks gestation normal fetus in the Pakistani population using Doppler ultrasonography., Material and Methods: In a standardized protocol 106 pregnant women (31 to 40 gestation weeks) were scanned. The peak systolic velocity (maximum velocity during S wave) (PSV), peak velocity index (peak velocity S wave minus peak velocity A wave/peak velocity D wave) (PVI), and S/A ratio (peak velocity S wave/peak velocity A wave) were measured., Results: Out of 106 patients, 100 patients were successfully scanned (94% success rate). In the 31-35 weeks gestational age group the mean PSV was 59.7 cm/s, PI 0.7, and S/A 2.16. In the 36-40 weeks gestational age group the mean PSV was 72.9 cm/s, PI 0.42, and S/A 2.46., Conclusions: As the normal pregnancy advances the PSV, the flow resistance and S/A ratio in ductus venosus increase.

Inula britannica L., family Asteraceae, is used in traditional Chinese and Kampo Medicines for various diseases. Flowers or the aerial parts are a rich source of secondary metabolites. These consist mainly of terpenoids (sesquiterpene lactones and dimmers, diterpenes and triterpenoids) and flavonoids. The isolated compounds have shown diverse biological activities: anticancer, antioxidant, anti-inflammatory, neuroprotective and hepatoprotective activities. This review provides information on isolated bioactive phytochemicals and pharmacological potentials of I. britannica.

Rhazya stricta Decne. is an important medicinal species that is rich in alkaloids containing anticancer alkaloids also. This paper reviews phytochemical, pharmacological and ethnobotanical studies of R. stricta. Phytochemical and pharmacological aspects of the species have been thoroughly explored. Over 100 alkaloids have been isolated from R. stricta, but the pharmacological activities are known for only a few of these compounds. Very few ethnobotanical studies of R. stricta have been done, and there is a particular need for such studies in various regions of South Asia and in Middle Eastern countries where the species grows. These ethnobotanical studies should investigate herbal recipes of R. stricta and their use for curing diseases. The genetic diversity, chemotaxonomy and allelopathy of R. stricta have not yet been explored, and these studies are recommended, with the ultimate goal of benefiting local communities in regions where R. stricta grows. This should be achieved by sharing knowledge and through the manufacture of herbal drugs from R. stricta's active chemical constituents, while protecting intellectual property rights and following the World Health Organization's guidelines for safety and efficacy.

The interaction of himbacine with carbachol was studied and compared with that of homatropine in guinea-pig atria and rat stomach fundus. Himbacine was a competitive antagonist of carbachol in both preparations. In atria, himbacine had similar affinity for the muscarinic receptors associated with force (pA2 = 8.33) and rate of contraction (pA2 = 8.42). In stomach, himbacine had a pA2 value of 7.29 which corresponds to a 10-fold less affinity than for atria. In contrast, homatropine had similar affinities for muscarinic receptors in stomach (pA2 = 7.13) and for those in atria mediating force (pA2 = 7.21) and rate (pA2 = 7.07) responses. These results indicate that himbacine distinguishes between cardiac and smooth muscle muscarinic receptors whereas it is unable to distinguish between possible subtypes of cardiac receptors associated with force and rate responses.