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Type 2 diabetes (T2D) is implicated in the injury of several organs, including the brain resulting in neuronal damage, which may lead to cognitive impairment and dementia. Additionally, it is linked to inflammation, cytokine release, apoptosis and various degenerative conditions. Astrocytes and microglia might have a role in mediating these processes. Caffeine, a psychoactive beverage, has been shown to reduce the risk of cognitive and memory impairment. This study proposes anti-inflammatory and anti-apoptotic role of caffeine, which can be mediated via microglia/astrocyte activation and overexpression of pro-inflammatory molecules. T2D was induced in rats by feeding with high fat high sugar diet and injecting a single low dose streptozotocin (STZ) intraperitoneally. Other diabetic rats were given caffeine orally (in two doses) for 5 weeks, starting 1 week before STZ injection. Measurement of plasma cytokines, TNFα and IL6, was performed using enzyme-linked immunosorbent assay (ELISA) technique. After sacrificing animals, brains were obtained and processed for histological evaluation. Immunohistochemistry was also performed using the following primary antibodies, anti-astrocyte marker GFAP, anti-microglia marker CD11b and apoptotic marker (anti-cleaved caspase-3). There was upregulation of IL6 and TNF-α in diabetic rats. Additionally, histological evaluation of the hippocampus of diabetic rats revealed cellular degeneration. There was increased immunostaining of GFAP, CD11b and cleaved caspase-3 in diabetic rats. Pretreatment with caffeine to diabetic rats, resulted in improvement of structural changes and decrease in cytokine levels and immuno-markers, expression, and this was in a dose-dependent manner. In conclusion, caffeine had an ameliorative role in enhancing hippocampal degenerative changes in T2D.

Background Bone marrow examination is performed by two methods Aspiration and Trephine biopsy. Despite recent advances in eld of molecules hematology and ow cytometry, bone marrow histology remains the corner stone in the diagnosis of acute leukemia. Hence, the present study is taken up to assess the signicance (& complementary roles) of various observations on bone marrow aspiration and trephine biopsy in relation with clinical details and peripheral blood ndings. Methods Retrospective data of leukemic cases whose bone marrow aspiration and Bone marrow biopsy were performed simultaneously were selected ranging from January 2020 to December 2021. Results 30 cases were reviewed retrospectively where bone marrow aspiration and biopsy was done simultaneously. Majority of Patients fall under the age group 31-40 and there was male Predominance. AML was found predominantly followed by CML, of these AML cases most common were of AML M3 type. Out of the 30 cases 22 showed a positive correlation between bone marrow aspiration and bone marrow biopsy; and 26 cases showed concordance on both aspirate and Biopsy. Conclusion Bone marrow evaluation is an important and effective tool in diagnosing and evaluating leukemia

Diabetic ketoacidosis is the complicationof Diabetes mellitus, which can result due to extreme hyperglycemia and ketonaemia. This condition is prevalent among patients with untreated diabetes ordrug incompliance. Hyperglycemic hyperosmolar state can clinically be presented with episodes of seizures with high blood sugar levels and absence of ketones and has low incidence rate. A 55 year old male patient presented with episode of seizure, frothing, tongue bite, uprolling of eyes, shortness of breath, pedal edema and high blood sugar levels. Past medical history includes known hypertensive and diabetic since 10 years and is oninj regular insulin with non-adherence to medication. Lab investigations were performed and patient was diagnosed as hyperglycemic diabetic ketoacidosis secondary to drug incompliance. The patient was managed by insulin regimen- regular and basal insulin, antibiotics, antiepileptic drugs and by continuous monitoring of blood sugar levels every 3rd hourly. Diabetic ketoacidosis was recovered and later, there were no episodes of seizures. Creating awareness and proper patient education regarding the disease state, pharmacotherapy and drug compliance plays a vital role in managing the condition and as well as by preventing further complications that might be fatal in some cases.

Background: Pressure is a localized injury to the skin and underlying tissue usually over a bony prominence, as a result of pressure, or pressure contributing to shear. Objective: The main objective was to determine the prevalence of pressure ulcers in the patients of Ibn e Sina hospital Multan and to determine the risk factors contributing to pressure ulcers by using Braden Scale. Methodology: It was a cross-sectional observational study conducted on 246 patients of Ibn e Sina hospital Multan. During the 6 months of the study, patients were interviewed regarding their demographics and risk factors for pressure ulcers according to the Braden scale. Spss21 was used to analyze the data. Results: Out of 246 patients, 74.8% of male patients had pressure ulcers. The patients were from 25 to 85 years old. The pressure ulcers were more frequent among the 45 to 65 years age group (i.e., 44.7%) and married patients (95.5%). Among 246 patients only 4.5% patients were at extra high risk and most of the patients were at low risk (69.5%) by using the Braden scale. This data will help physicians, researchers, and policymakers in Pakistan and other nations advocate for the needs of pressure ulcer patients. Conclusion: According to this study pressure ulcers were more frequent in male married patients of the middle age group. Most of the patients were at low risk of developing pressure ulcers on the Braden Scale. Keywords: Pressure ulcer PU, Pressure sores, Pressure Injuries, Prevalence, Risk factors, Braden Scale, Braden score, Hospitals, Intensive care units

Aim: This meta-investigation expected to explain the relationship between temperamental body weight by danger of type 2 diabetes mellitus, a connotation that was controversial in longitudinal researches. Methods: The design of this study was an Meta analysis study design. This study was conducted at mayo Hospital Lahore and a total of 160 patients were the participant of this study. Electronic font searches by means of EMBASE and MEDLINE were tracked. The relative risks of T2DM in individuals with moderate d body weight remained pooled by means of opposite change technique. Results: Ten researches qualified for meta-study. Mean period of estimates t of separately. Weight changes. The pooled and follow-up RR (96% annual certainty for learning margin (CI)) T2DM for were the least 13.5vs. moreover the most 10.6 years, stable classification (P=0.049). was Ob 1.34 (1.13-1.58). T2DM was Between study discovered clarified by heterogeneity blood test was really 67.1% of critical the change in risk of was logarithm not huge of RR (P=0.03). (RR (96% In CI), 3 examinations 1.06 (0.91-1.26)). in which blood Furthermore, test distribution was performed, inclination that T2DM extended T2DM danger was measurably identified by Egger's test (P=0.08). Practical Implication: The puspose of this study was to prevail the awareness among the people of the societies about the diabetes and their risk factors and to inform them about prevention of this diseases and what steps should be taken to avoid this diseases. Conclusion: Unsteady body weight may be inconspicuously associated with increased danger of T2DM, although genuine predispositions, for example, propensity to symptomatic doubt and distribution propensity, made it difficult to evaluate this association. Keywords: Type 2 Diabetes Mellitus, CVD Risk Reduction, Pakistan.

Background Current approach to detect the presence of gallbladder carcinoma involves a routine histopathological examination of all gallbladder specimens, regardless of the clinical characteristics of the patient or macroscopic aspect of the gallbladder. Available pathological reports were interpreted for the following parameters: age, gender, and pathological diagnosis. In addition, the demographic information and clinicopathologic characteristics of the patients with histopathologic ndings were assessed in detail, and re-examination of the available specimens was done. Inpatient records of the Methods patients who had been operated for elective and emergency cholecystectomies in the hospital associated with Khaja Bandanawaz University – Faculty of medical Sciences; from January 2018 to November 2022, were retrospectively evaluated. Results A total of 661 gallbladder specimens submitted for histopathological examination during the study period were included in the study. The results of histopathological examination of these gallbladder specimens showed that chronic cholecystitis was found in 535 (81%), acute cholecystitis in 46 (6.99%), cholesterolosis in 44 (6.5%) patients, Dysplasia was found in 34 (5.14%) patients, and gallbladder carcinoma was detected in 2 (0.30%) patients. Conclusion A strategy of selective approach for histopathological examination of gallbladder specimens may be safe in areas with very low incidence of gallbladder carcinoma. Such selective strategy is more cost-effective, reduces the workload of pathologists, and does not appear to compromise patient outcome.

Background: Cervical carcinoma is the commonly known leading malignancy that has the highest prevalence in the developing countries. It shares second rank in the world of cancer. The 80% of the cases of the cervical cancer in the developing countries are reported. It is reported that the one woman die from this cancer after every two minutes. Objective: To identify the risk factors associated with the cervical carcinoma (CC). The role of human papillomavirus (HPV) in aetiology of cervical carcinoma was also evaluated. Study design: It is a hospital based case-control study. Material and Methods: The total 226 ICC cases were included in the study and 234 female were kept in control group. The study was conducted at the Divisional Headquarter Teaching Hospital of Mirpur AJK from May 2020 to May 2022. PCR was used for the evaluation of the HPV DNA in cervical cells. Multiple logistic models were used to compute the 95% confidence intervals CIs and odd ratios ORs. The all control women except one has the HPV infection. Results: The all control women except one has the HPV infection. The HPV of 23 different types associated with the risk of ICC. The HPV 16 was present in most of the patients either belong to case or control group followed by the HPV 18 and 33. HPV 18 has stronger association with ICC. The odd ratio of the single infection was higher than the multiple infections. Other factors such like early menopause, high parity and husband extramarital sexual affairs are also associated with the ICC. Conclusion: The HPV level is considered significant for the cervical carcinoma because of the lack of knowledge about other factors. A number of factors like socio-economic pressure, poor hygiene, menopause, education, and the sexual life of the husband of the patient play a major role in the carcinoma. Keywords: Cervical cell carcinoma, risk factors, human papillomavirus (HPV), squamous cell carcinoma, adenocarcinoma.

Aim: In males, general anesthesia is normally used only once conscious sedation has failed and endoscopic retrograde cholangiopancreatography is being performed. Other variables may be connected with general anesthesia for ERCP in the current organization, it was suggested. The goal of such research aimed to investigate the criteria for ERCP underneath general anesthesia, as well as to compare fundamental disorders, kind, and effectiveness of ERCP during general anesthesia to mindful sedation. Methods: We conducted a retrospective review of 2000 ERCPs achieved below general anesthesia or conscious sedation on individuals. In both sets, the reasons for general anesthesia were documented, as were the fundamental disorders, the kind and efficacy of the procedures, and the grounds of early ERCP discontinuation. Results: Nineteen percent of ERCPs remained conducted underneath general anesthesia, while the remaining 81 percent have been conducted with conscious sedation. The causes for GA included kind of treatment planned (48%), early discontinuation of ERCP below conscious sedation (29%), and other factors. Patients diagnosed sclerosing cholangitis in addition liver transplant patients were more likely to have general anesthesia (37 % vs. 19 %, P = 0.0002 and 23 % vs. 14 %, P = 0.004). Participants with neoplasms and cholelithiasis received conscious sedation at a higher rate (23 % vs. 13 %, P = 0.005 and 14 % vs. 5 %, P = 0.002). Painful dilations were conducted more commonly under general anesthesia (62 % vs. 21 percent, P = 0.003), but large papillotomies were preferred under conscious sedation (35 % vs. 23 percent, P = 0.008). During the same time period, general anesthesia resulted in more interventions per ERCP (P 0.003) than conscious sedation (53 M 29 min vs. 55 M 28 min, P = 0.38). The ERCP probability of failure with conscious sedation remained dual that of general anesthesia (8 percent vs. 15%, P = 0.013), owing mostly to insufficient conscious sedation (62 percent). Conclusion: Our institution's recurrent usage of general anesthesia for ERCP is connected to fundamental disorders, that also remain routinely addressed using difficult and unpleasant ERCP procedures. Whenever difficult and unpleasant percutaneous ERCP procedures are anticipated, the effectiveness of ERCP using general anesthesia indicates a sustained predilection for general anesthetic over conscious sedation. Keywords: General Anesthesia, ERCP, Fundamental Disorders.

Microbial resistance has progressed rapidly and is becoming the leading cause of death globally. The spread of antibiotic-resistant microorganisms has been a significant threat to the successful therapy against microbial infections. Scientists have become more concerned about the possibility of a return to the pre-antibiotic era. Thus, searching for alternatives to fight microorganisms has become a necessity. Some bacteria are naturally resistant to antibiotics, while others acquire resistance mainly by the misuse of antibiotics and the emergence of new resistant variants through mutation. Since ancient times, plants represent the leading source of drugs and alternative medicine for fighting against diseases. Plants are rich sources of valuable secondary metabolites, such as alkaloids, quinones, tannins, terpenoids, flavonoids, and polyphenols. Many studies focus on plant secondary metabolites as a potential source for antibiotic discovery. They have the required structural properties and can act by different mechanisms. This review analyses the antibiotic resistance strategies produced by multidrug-resistant bacteria and explores the phytochemicals from different classes with documented antimicrobial action against resistant bacteria, either alone or in combination with traditional antibiotics.

Corona virus SARS-CoV-2-induced viral disease (COVID-19) is a zoonotic disease that was initially transmitted from animals to humans. The virus surfaced towards the end of December 2019 in Wuhan, China where earlier SARS (Severe Acute Respiratory Syndrome) had also surfaced in 2003. Unlike SARS, SARS-CoV-2 (a close relative of the SARS virus) created a pandemic, and as of February 24 2021, caused 112,778,672 infections and 2,499,252 deaths world-wide. Despite the best efforts of scientists, no drugs against COVID-19 are yet in sight; five vaccines have received emergency approval in various countries, but it would be a difficult task to vaccinate twice the world population of 8 billion. The objective of the present study was to evaluate through in silico screening a number of phytochemicals in Allium cepa (onion) regarding their ability to bind to the main protease of COVID-19 known as the 3C-like protease or 3CLpro, (PDB ID: 6LU7), 3CLpro of SARS (PDB ID: 3M3V), and human angiotensin converting enzyme-2 (ACE-2), [PDB ID: 1R42], which functions as a receptor for entry of the virus into humans. Molecular docking (blind docking, that is docking not only against any target pocket) were done with the help of AutoDockVina. It was observed that of the twenty-two phytochemicals screened, twelve showed good binding affinities to the main protease of SARS-CoV-2. Surprisingly, the compounds also demonstrated good binding affinities to ACE-2. It is therefore very likely that the binding affinities shown by these compounds against both 3CLpro and ACE-2 merit further study for their potential use as therapeutic agents.

Background: We need drugs to decrease inflammation as well as have very less side effects. Review of literature mentioned anti-inflammatory action of Omega 3 fatty acids. Hence, we selected this drug. Aim: Our aim was to find the anti-inflammatory effect of Omega 3 fatty acid using animal model. Study Design: The study is objective animal study where measurement of inflammation was done by observational methodology, for the present study four groups were made- 6 Guinea pigs in each group. Control guinea pigs were fed distilled water, second group standard drug indomethacin 4mg/ kg body wt, test group 1 received 1200mg/kg body wt, test group II received 2400mg/kg body wt of Omega 3 fatty acid. All drugs given orally 30 minutes before exposure to UV radiation of 30 seconds duration was given and inflammation was observed at 6, 12 and 24 hrs after UV exposure in the form of scoring. Statistical significance was calculated using Anova method. For statistical analysis we have used SPSS system version 20. Results: Inflammation was observed in all the four groups of Guinea pigs, there was significant antiinflammatory effect of omega 3 fatty acid in the dose of 1200mg/kg body wt and 2400mg/kg body wt at 12 and 24 hours. Conclusions: Omega 3 fatty acids 1200mg/kg body wt orally produced significant anti-inflammatory effect against UV radiation induced inflammation in Guinea pigs at 12 and 24 hrs. However, standard drug could produce significant anti-inflammatory effect only at 24 hrs in comparison to control group. The anti-inflammatory effects of test 1, test 2 groups and standard group are comparable. Keywords: Inflammation, Omega 3 fatty acid, UV radiation.

Background. Retrospectively evaluation of several patients who had undergone appendectomy in our hospital was carried out which aimed to present the efciency of diagnostic tests and demographic data of cases. Available pathological reports were interpreted for the following parameters: age, gender, and pathological diagnosis. In addition, the demographic information and clinicopathologic characteristics of the subjects with unusual histopathologic ndings were assessed in detail, and re-examination of the available resected appendix specimens was done. Methods Inpatient records of the patients who had been operated for acute appendicitis in the hospital associated with Khaja Bandanawaz University – Faculty of medical Sciences; from January 2018 to November 2022, were retrospectively evaluated. Results Subjects were categorized into 2 groups. Cases with histopathologic examination reported as acute appendicitis constituted group-1, and cases with unusual pathologic ndings other than acute appendicitis constituted group-2. The group-2 consisted of low-grade mucinous neoplasms, mucoceles, carcinoid tumor, granulomatous inammation, intraluminal Enterobius vermicularis, and mesenteric cyst. Conclusion Acute appendicitis is a common surgical emergency condition in the department of General Surgery. Most of the resected specimens of appendectomy revealed typical histopathologic ndings, few showed unusual histopathologic ndings. We suggest routine histopathological examination even if the macroscopic appearance of the specimen is normal.

A Laplacian scoring algorithm for gene selection and the Gini coefficient to identify the genes whose expression varied least across a large set of samples were the state-of-the-art methods used here. These methods have not been trialed for their feasibility in cheminformatics. This was a maiden attempt to investigate a complete comparative analysis of an anthraquinone and chalcone derivatives-based virtual combinatorial library. This computational "proof-of-concept" study illustrated the combinatorial approach used to explain how the structure of the selected natural products (NPs) undergoes molecular diversity analysis. A virtual combinatorial library (1.6 M) based on 20 anthraquinones and 24 chalcones was enumerated. The resulting compounds were optimized to the near drug-likeness properties, and the physicochemical descriptors were calculated for all datasets including FDA, Non-FDA, and NPs from ZINC 15. UMAP and PCA were applied to compare and represent the chemical space coverage of each dataset. Subsequently, the Laplacian score and Gini coefficient were applied to delineate feature selection and selectivity among properties, respectively. Finally, we demonstrated the diversity between the datasets by employing Murcko's and the central scaffolds systems, calculating three fingerprint descriptors and analyzing their diversity by PCA and SOM. The optimized enumeration resulted in 1,610,268 compounds with NP-Likeness, and synthetic feasibility mean scores close to FDA, Non-FDA, and NPs datasets. The overlap between the chemical space of the 1.6 M database was more prominent than with the NPs dataset. A Laplacian score prioritized NP-likeness and hydrogen bond acceptor properties (1.0 and 0.923), respectively, while the Gini coefficient showed that all properties have selective effects on datasets (0.81-0.93). Scaffold and fingerprint diversity indicated that the descending order for the tested datasets was FDA, Non-FDA, NPs and 1.6 M. Virtual combinatorial libraries based on NPs can be considered as a source of the combinatorial compound with NP-likeness properties. Furthermore, measuring molecular diversity is supposed to be performed by different methods to allow for comparison and better judgment.

Background Pediatric ulcerative colitis (UC) treatment has changed dramatically with the introduction of multiple biologics. The goal of this study was to determine the effectiveness of these new biologics on achieving remission, nutritional impact, and eventual need for surgery in children. Methods We retrospectively analyzed hospital records of UC patients (ages 1-19) seen at a pediatric gastroenterology clinic between January 2012 andAugust 2020. Patients were divided into groups: 1) medically without biologics or surgery; 2) patients treated with one biologic; and 3) patients treated with multiple biologics 4)patients that underwent colectomy. Results There were 115 UC patients with a mean follow-up of 5.9 ± 3.7 years (1 month-15.3 years). PUCAI score at diagnosis was mild in 52 patients (45%), moderate in 25 (21%), and severe in 5 (4.3%). PUCAI score for 33 patients (29%) could not be calculated. There were 48 (41.3%) in group 1 with 58% remission, 34 (29.6%) in group 2 with 71% remission, 24 (20.8%) in group 3 with 29% remission, and only 9 (7.8%) in group 4 with 100% remission. The majority (55%) of surgical patients had colectomy within the first year of diagnosis. BMI improved after surgery ( P = 0.001). The change from one biologic to others did not improve nutrition over time. Discussion New biologics are changing the landscape in maintaining remission from UC. The current need for surgery is much lower than previously published studies. In medically refractive UC, nutritional status only improved after surgery. Addition of another biologic for medically refractory ulcerative colitis in order to avoid surgery must take into account the positive impact surgery has on nutrition and disease remission.

Hypertensive disorders complicating pregnancy is the one of the most common medical problem of pregnancy. Worldwide, hypertensive disorders in pregnancy causes complication in about 10 -16% of pregnancies. High blood pressure in pregnant women is related with incidence of large placental infarct and decreased placental growth resulting in intra uterine fetal growth restriction and intrauterine death. Hypertension in pregnancy is diagnosed when blood pressure is 140/90 mm of hg or greater with proteinuria and edema after 20 week of gestation. Plasma lipid and lipoprotein (a) undergo both qualitative and quantitative changes during pregnancy. During the course of normal pregnancy, plasma triglycerides and cholesterol concentration rises by 200-400% and 25-50% respectively. An abnormal lipid profile is known to be strongly associated with atherosclerotic changes and has direct effect on endothelial dysfunction. In preeclampsia women, thromboxane rise more than in normotensive pregnant women. Increased lipid synthesis causes increase in PGI2:TXA2 ratio and plays a role in pathogenesis of pregnancy induced hypertension (PIH), hence the hyperlipidemia may be an important marker of toxemia of pregnancy.To asses and compare the serum levels of lipid and lipoprotein (a) in pregnant women with PIH and normotensive pregnant women.A study conducted on total of 100 pregnant patients (50 cases and 50 controls) selected according to inclusion and exclusion criteria. 3ml of venous blood was drawn to estimate the Serum Cholesterol, Serum Triglycerides, Serum HDL, Serum LDL, Serum VLDL, Serum Lipoprotein (a) levels in each subject. The data was analyzed results were expressed as Mean and standard deviation of various parameters in different group. P value < 0.05 is considered as significant. ROC curve analysis was done to assess maximum sensitivity, specificity and diagnostic efficiencyIn our study the mean ±SD values of total cholesterol, triglycerides, LDL, VLDL, Serum Lipoprotein (a) are statistically significant higher in PIH cases whereas HDL levels are low in cases when compared to controls.A high lipid profile levels is observed to be associate with preeclampsia thus, serum lipid concentration and serum Lipoprotein (a) levels may provide a useful marker for screening patients at risk for developing PIH.

The novel coronavirus known as SARS-CoV-2 and the virus-induced disease COVID-19 has caused widespread concerns due to its contagiousness, fatality rate, and the absence of drug(s). This study investigated Lens culinaris and its phytochemicals, especially the flavonoids. The compounds were assessed through molecular docking studies for their binding abilities with the major protease of the novel coronavirus, SARS-CoV-2 (PDB: 6LU7). A total of 42 phytochemicals of Lens culinaris were analyzed through molecular docking studies for their binding affinities to COVID 3C-like protease. Of them, 23 compounds were found to have binding affinities to the protease of −7.5 kcal/mol or higher. Our study indicates that Lens culinaris contains a number of polyphenolic compounds as well as phytosterols, which can bind to the active site of the protease, and so merits further scientific attention on trials for use as potential anti-COVID-19 drugs.

Background: The present study was conducted to determine Transverse diameter (inter-pedicular distances) of the lumbar spinal canal measured in plain antero-posterior radiograph of 140 subjects (80 males, 60 females) aged between 20 to 60 years in population of Telangana. Subjects and Methods : The present study was conducted in the department of Anatomy, in a teaching medical college and hospital in Hyderabad, Telangana, India. It comprised of antero-posterior plain radiographs of lumbar spine of 140 subjects, aged between 20 to 60 years. Transverse diameter of the lumbar spinal canal or inter-pedicular distances (IPD), and transverse diameter of the vertebral body was measured using electronic Digital Vernier calipers, and the ratio between transverse diameter of vertebral canal and transverse diameter of the corresponding vertebral body were analyzed. Results: Out of 140 patients, males were 80 and females were 60. The mean inter-pedicular distance (IPD) at L1 was 24.2 mm in males and 23.4 mm in females, and at L5 was 30.2 mm in males and 29.6 mm in females. Mean transverse diameter of lumbar vertebral canal (I.P.D) is minimum at L1 vertebra in both sexes. The maximum values of I.P.D were recorded for vertebra L5 for both sexes. The values of IPD are higher in male population in comparison to female counterparts. The mean width of the vertebral body is gradually increasing from L1 to L5. Ratio between transverse diameter of vertebral canal and transverse diameter of the corresponding vertebral body is seen to be constant (0.6) at all lumbar level in both the sexes. Conclusion: Authors found that there is variation in the size of the lumbar vertebral canal between males and females. Even after the revolution of various imaging techniques like CT Scan, MRI, etc., the plain radiography remains the mainstay of investigative procedure particularly in rural setup.

Background: The present study was conducted to assess the association of morphometry of the placenta and birth weight of fetus in hypertensive mothers. Subjects and Methods: The present study was conducted on 74 pregnant women with an uncomplicated pregnancy and those with pregnancy-induced hypertension (PIH). The following morphometric parameters of each placenta were recorded: weight, volume, thickness, transverse diameter, and shape. Gestational age of mothers, sex and birth weight of newborns were recorded. Results: The majority of male babies with weight > 2500 grams had > 37 weeks of gestational age and the majority of female babies with weight >2500 grams had >37 weeks of gestational age. The mean weight of placentae in male babies was 416.7 grams, the mean surface area was 226.5 sq cm, mean volume was 372.2 ml and mean thickness were 2.04 cm. while the mean weight of placentae in female babies was 407.5 grams, the mean surface area was 220.4 sq cm, mean volume was 354.6 ml and mean thickness was 2.10 cm. Statistics show that the highest sensitivity and specificity for determining the low birth weight of babies in hypertensive mothers was seen with a surface area of the placenta which was 82.3% and 75.6% respectively. The positive predictive value for the weight of the placenta was 65.4%, for the surface area it was 67.8% and for the volume of the placenta, it was 64.2%. Conclusion: To conclude, it was found that placental morphometry like weight, surface area, volume and sex of the baby determined the birth weight efficiently in hypertensive mothers.

Introduction: Thyroid lesions are fairly common & have a wide spectrum of diseases ranging from functional, immune mediated to neoplastic lesions. Objectives: 1) To study the occurrence of various lesions of the thyroid. 2) To study and correlate clinico-morphological features. Results/ Observation: All thyroidectomy specimens were included in the study period of two years i.e, from January 2009 to December 2010. A total of 120 specimens were studied by routine paraffin processing and heamatoxylin eosin stain. Detailed histopathological study was done and correlated with age, sex & clinical presentation. Out of 120 cases, non-neoplastic lesions accounted for 83.33% and included thyroglossal duct cyst (2.5%), Hashimoto thyroiditis (9.1%), colloid goitre (29.1%) & multinodular goitre (42.5%). Neoplastic lesions accounted for 16.67% and consisted of follicular adenoma (12.5%) as the only benign lesion. Papillary carcinoma (2.5%), medullary carcinoma (0.83%) and anaplastic carcinoma (0.83%) were malignant lesions found. Conclusion: Thyroid lesions predominantly affects females during 3rd and 4th decades of life and commonly present as neck swelling. Multinodular goitre was the commonest non- neoplastic lesion followed by colloid goitre. Follicular adenoma was the only benign neoplasm seen while papillary, medullary and anaplastic carcinoma were the malignant thyroid neoplasms. Keywords: Thyroid lesions, Non- neoplastic and neoplastic lesions.

The Gram-negative marine bioluminescent bacterium Aliivibrio fischeri is commonly used as a bioreporter in drug inhibition studies. Its bioluminescence is regulated by the gene expression of the luxI-luxR quorum-sensing system. Here, we report the draft genome sequence of A. fischeri ATCC 7744, including identification of the putative lux operon.

Tuberculosis is a contagious disease, but it’s diagnosis is still a difficult and challenging task as it is considered a big threat everywhere on the planet. Literature shows that underdeveloped countries widely use chest radiographs (X ray images) for the diagnosis of tuberculosis. Low accuracy of results and high cost are the two main reasons due to which most of the available methods are not useful for radiologists. In our research, we proposed a detection technique in which features extraction is performed on the basis of their texture, intensity and shape. For evaluating the performance of our proposed methodology, Montgomery Country (MC) dataset is used. It is a publically available data set which consists of 138 CXRs; among them, 80 CXRs are normal and 58 CXRs are malignant. The results of the proposed technique have outperformed state of the art methodologies on the MC dataset as it has shown 81.16% accuracy.

Solid Pseudopapillary Neoplasm (SPN) of the pancreas represents 1-3 % of all exocrine pancreatic tumors and is uncommon in children. We report four pediatric patients with SPN where each patient posed a unique diagnostic and therapeutic challenge. We describe these four cases with detailed clinical-radiological-pathological correlations. All patients are female, with a median age 13.5 years. Two patients presented with abdominal pain, one with jaundice and one with an incidental pancreatic mass on abdominal CT scan. Radiological studies included abdominal ultrasound, CT scan and MRI of abdomen. Pancreaticoduodenectomy was performed in three patients and laparoscopic distal pancreatectomy in one patient. Mean tumor size was 4.5 cm (ranged from 1.9 to 11.5 cm). All SPNs were benign on histological exam. One patient developed pancreatic insufficiency post-surgery. No tumor recurrence was observed over a mean follow up period of 1 year. We conclude that diagnosis of SPN in pediatric population can be challenging due to non-specific clinical findings, and surgical removal of the tumor is usually required for definitive histologic diagnosis and treatment. Most tumors are benign and recurrence is very rare.

The association between coronavirus disease 19 (COVID-19) and autoimmune disease has been mounting, and literature on COVID-19-induced flare-up of systemic lupus erythematosus (SLE) disease is lacking. We describe a case of lupus cerebritis triggered by COVID-19 in a young female with SLE, who presented with fluctuated mentation, psychomotor retardation, slow speech, and intermittent choreiform movement in the upper part of the body. She had a history of COVID-19 infection three weeks back. Her serum immunoglobulin G antibodies were positive against COVID-19. On examination, she had psychomotor agitation, intermittent choreiform movements of upper limbs, and poor speech. Brain magnetic resonance imaging revealed hyperintense signals in the white matter of both hemispheres, suggestive of lupus cerebritis secondary to COVID-19 infection and lack of any other identifiable risk factor. Management included methylprednisolone, prednisone, and olanzapine. The patient was also placed on monthly intravenous cyclophosphamide, and her condition started improving gradually.

Coronavirus disease 2019 (COVID-19) is a pandemic disease of modern time with unique and rapid transmission rate and affected almost all the nations without respecting any border. Coronavirus disease 2019 (COVID-19) is arguably the biggest health crisis the world has faced in 21st century. It is an infectious disease and declared pandemic by the World Health Organization. The coronavirus disease 2019 (COVID-19) outbreak, which originated in Wuhan, China, has now spread to 192 countries and administrative regions infecting nearly 800,000 individuals of all ages as of 31 March 2020. Though most infected individuals exhibit mild symptoms including fever, upper respiratory tract symptoms, shortness of breath, and diarrhoea, or are asymptomatic altogether, severe cases of infection can lead to pneumonia, multiple organ failure, and death. Globally, at least 7900 deaths have been directly attributed to COVID19, and this number is expected to rise with the ongoing epidemic. This is particularly crucial as the current outbreak involves a new pathogen (SARS-CoV-2), on which limited knowledge exists of its infectivity and clinical profile. Research is in progress on therapeutic efficacy of various agents including anti-malarials (Chloroquine and Hydroxychloroquine), antiviral drugs, and convalescent serum of recovered patients. Unani system of medicine is one of the traditional systems of medicine which is being explored for providing preventive, supportive and rehabilitative care to patients. Unani system of medicine has a detailed description of drugs that are utilized in many infectious diseases, including respiratory infections. Immune response is essential to eliminate virus and to preclude disease progression to severe stages. Therefore, it is important to summarize the evidence regarding the preventive measures, control options such as immune-stimulator and prophylactic treatment in Unani medicine against Covid19. This review summarizes various pharmacological actions of Unani formulation Tiryaq-e-Arba in Unani literature and various reported pharmacological activities which can possibly provide prevention, control and reduction of complications of this deadly disease.

This study is conducted to determine the antidiabetic activity capabilities of both aqueous and alcoholic extracts of Senna alata. Route of administration was by oral intubation on diabetic-induced Sprague Dawley rats through single dose intraperitoneal injection of a diabetogenic agent, Streptozotocin 55mg/kg. This study consists of 9 groups with 4 rats each, Group 1 serves as a control group, Group 2 will be treated with a standard antidiabetic drug, Metformin as a positive control, Group 3 acts as a negative control with no treatment, Group 4 to group 6 will be given aqueous extract of doses from 2 to 8g/kg and Group 7 to group 9 were treated with alcoholic extract of the same dosage strength of Group 4 to 6. Group 2 to 9 were fasted prior to the administration of STZ. Blood glucose was measured on the first two days, three times a week after administration of STZ to confirm rats have reached diabetic FBS blood glucose levels of more than 7.5mmol/L. Both aqueous and alcoholic treatments were administrated BID for a duration of 7 days, and blood glucose levels measured at 2-day intervals. There is a significant reduction (P0.05) These groups are Group 6 (high dose aqueous extract 12g/kg) and Group 9 (high dose alcohol extract 12g/kg). Groups administered with alcoholic extracts were shown to lower blood glucose levels compared to aqueous extracts. The alcoholic extract has exhibited significant higher hypoglycemic effects on STZ induced diabetic rats compared to aqueous extract. No side effects were observed during the course of treatment, even with high dosages.

Breast cancer is the second most common cancer among women worldwide. The Wnt??-catenin pathway appears to be deregulated in most cancer cells including breast cancer. The role of zerumbone, the active sesquiterpene from Zingiber zerumbet Roscoe, on the Wnt??-catenin pathway is relatively unknown, especially detailed molecular studies have yet to be published. Using the Chemistry at HARvard Macromolecular Mechanics (CHARMm) force field-based docking protocol, CDOCKER, the molecular interactions between zerumbone and key proteins of the Wnt??-catenin pathway were evaluated in this study. The results suggest that zerumbone has a strong affinity for free ?-catenin in the cytoplasm, as well as the ?-catenin?transcription factor 4 complex in the nucleus. The overall hydrophobic nature of zerumbone allowed its interaction with other hydrophobic residues, such as Trp383, while its active ?,?-unsaturated carbonyl facilitated its interaction with positively charged residues, such as Lys345, Arg386 and Asn415 in the ?-catenin binding pocket. However, the Wnt protein and its frizzled receptor showed no attraction to zerumbone.

In Computer Aided Diagnosis (CAD) tools, vertebra localization and detection are the essential steps for the diagnosis of cervical spine injuries. The accurate localization leads to accurate treatment, which is more challenging in case of poor contrast and noisy radiographs. This paper targets c-spine radiographs for the localization of vertebra using different vertebra templates, vertebra detection at each level using two different clustering techniques and gives a comparison between them. Moreover it separates the regions for each individual c-spine. It takes the poor contrast x-ray as input, enhance the contrast and detect the edges of enhanced image. After the edge detection, manually selected Region of Interest (ROI) helps in getting the edges of area covering C3 – C7 only. These edges along with 4 different template models of vertebra are used for the localization by Generalized Hough Transform (GHT). The results obtained are analyzed visually for the best localization template. Then, on voted points obtained after pruning, two clustering techniques Fuzzy C Means and K-Means are applied separately, to form clusters and centroids for each vertebra. Another part of this paper is to separate vertebra regions. For this, intervertebral points are calculated and then along these points, centroids are rotated using Affine Transformation. It gives parallel lines to vertebrae and joining them gives region for each vertebra. The comparison and testing of proposed technique has been performed using dataset ‘NHANES II’ publicly accessible at ‘The National Library of Medicine’, total 150 cervical spine scans are used securing accuracies 93:76%, 84:21% and 83:1% for FCM, K-Means and region separation, respectively.

Background: Regional anesthesia includes both spinal and epidural anesthesia is being used to relieve labor pain and in C-section. It is a very convenient and suitable choice for surgeons, obstetricians, gynecologists and anesthesiologist. But this may have few complications more commonly low back pain, hypotension, nausea/vomiting, paralysis of respiratory muscles and urinary retention. Regional anesthesia is a central nerve blockade technique which involves the injection of an anesthetic given locally into the lower region of the spine, thus blocking the painful impulses that are generated because of contraction of uterus during labor Objective: To determine the risk factor of low back pain in postpartum women. Material and Methods: Retrospective cohort study was conducted via questionnaires from postpartum females of DHQ Gujranwala. These females fall in age group 21-40 years. Convenient sampling technique was used. Sample size of 138 females was taken. Numeric pain rating scale and Roland Morris low back pain and disability questionnaire was used. Result: Our study resulted that the 23.9% women had mild pain, 42.0% had moderate pain and 34.1% women had severe postpartum low back pain. Conclusion: It is concluded that regional anesthesia is a major risk factor for backache in postpartum women of Gujranwala Pakistan. Some women experience severe backache in ADLs. Women experience backache 52.9%, hypotension 25.4%, nausea/vomiting18.8%, paralysis of respiratory muscles 0.7% and urinary retention 2.2%. Key Words: regional anesthesia, postpartum low back pain, DHQ Gujranwala, C-section.

A lectin gene from the Tiger Milk Mushroom Lignosus rhinocerus TM02® was successfully cloned and expressed via vector pET28a in Escherichia coli BL21(DE3). The recombinant lectin, Rhinocelectin, with a predicted molecular mass of 22.8 kDa, was overexpressed in water-soluble form without signal peptide and purified via native affinity chromatography Ni-NTA agarose. Blast protein analysis indicated the lectin to be homologous to jacalin-related plant lectin. In its native form, Rhinocelectin exists as a homo-tetramer predicted with four chains of identical proteins consisting of 11 beta-sheet structures with only one alpha-helix structure. The antiproliferative activity of the Rhinocelectin against human cancer cell lines was concentration dependent and selective. The IC50 values against triple negative breast cancer cell lines MDA-MB-231 and breast cancer MCF-7 are 36.52 ± 13.55 μg mL-1 and 53.11 ± 22.30 μg mL-1 , respectively. Rhinocelectin is only mildly cytotoxic against the corresponding human nontumorigenic breast cell line 184B5 with IC50 value at 142.19 ± 36.34 μg mL-1 . The IC50 against human lung cancer cell line A549 cells is 46.14 ± 7.42 μg mL-1 while against nontumorigenic lung cell line NL20 is 41.33 ± 7.43 μg mL-1 . The standard anticancer drug, Doxorubicin exhibited IC50 values mostly below 1 μg mL-1 for the cell lines tested. Flow cytometry analysis showed the treated breast cancer cells were arrested at G0/G1 phase and apoptosis induced. Rhinocelectin agglutinated rat and rabbit erythrocytes at a minimal concentration of 3.125 μg mL-1 and 6.250 μg mL-1 , respectively.