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Objective: To investigate the association of vascular endothelial growth factor A gene polymorphisms 2578C/A (rs699947) and 1154G/A (rs1570360) with type 2 diabetes mellitus, diabetic retinopathy and serum vascular endothelial growth factor levels in Pakistani patients., Methods: The case-control study was conducted from Jan 2017 to Dec 2018 after approval from the ethics review board of Riphah International University, Islamabad, Pakistan, and comprised type 2 diabetes mellitus patients of either gender with diabetic retinopathy in group A, and without diabetic retinopathy in group B. Non-diabetic healthy individuals were enrolled in control group C. Genotyping was done by amplification refractory mutation system-polymerase chain reaction and serum vascular endothelial growth factor levels were measured using enzyme-linked immunosorbent assay. Data was analysed using SPSS 22., Results: Of the 450 subjects, 150(33.3%) were in each of the 3 groups. The mean age in group A was 58.16±9.42, in group B 56.25±8.5 years and in group C it was 55.90±10.90. The proportion of Punjabi ethnicity was significantly high in group B compared to other groups (p<0.05). There was no significant association of rs699947 and rs1570360 genotypic and allelic frequencies in group B compared to group A. Further, rs699947 AA genotype was significantly associated with proliferative diabetic retinopathy compared to group A (p<0.05). Minor allele A showed significant association in groups A and B compared to group C (p<0.05). Significantly raised serum vascular endothelial growth factor levels were found in group B compared to group A (p<0.05), and were associated with rs699947 and rs1570360 heterozygosity in group A (p<0.05). Also, rs699947 genotype showed significant association with groups A and B in Punjabi and Pathan ethnicities (p<0.05) and with Kashmiri ethnicity in group B (p<0.05)., Conclusions: There was a strong association of vascular endothelial growth factor 2578C/A (rs699947) gene polymorphism with proliferative diabetic retinopathy in type 2 diabetic Pakistani patients, suggesting its role in the pathogenesis of this condition.

Objectives: To test various items in hospital environment as reservoirs of bacteria. Methods: This simple descriptive study was conducted between June and December 2014. Pediatric wards of 4 different hospitals of Faisalabad, Pakistan were selected and 8 different items per hospital were sampled (n=160). Poisson regression analysis was carried out with R software and using lme4 package. Results: There were no differences between the  hospitals regarding total number of bacterial isolates or bacterial isolates per sample source or prevalent bacterial species. Utensile tables were significantly the least contaminated source when comparing all sample sources from all hospitals (p=0.05). When testing if the bacterial species differed significantly between sample sources, Escherichia coli (p=0.05) and Bacillus (p=0.04) were found significantly high on utensils, while Pseudomonas was found significantly less on curtains (p=0.03) and doors (p=0.02). Conclusion: Due to unhygienic practices in hospitals children are exposed to pathogens steers to life threatening infection. A good control strategy should be implemented to avoid health care-associated infection.

MicroRNAs (miRNA) have emerged as central regulators of diverse biological processes and contribute to driving pathology in several diseases. Acute graft-versus-host disease (aGvHD) represents a major complication after allogeneic hematopoietic stem cell transplantation, caused by alloreactive donor T cells attacking host tissues leading to inflammation and tissue destruction. Changes in miRNA expression patterns occur during aGvHD, and we hypothesized that we could identify miRNA signatures in target tissues of aGvHD that may potentially help understand the underlying molecular pathology of the disease. We utilized a rat model of aGvHD with transplantation of fully MHC-mismatched T cell depleted bone marrow, followed by infusion of donor T cells. The expression pattern of 423 rat miRNAs was investigated in skin, gut, and lung tissues and intestinal T cells with the NanoString hybridization platform, in combination with validation by quantitative PCR. MHC-matched transplanted rats were included as controls. In the skin, upregulation of miR-34b and downregulation of miR-326 was observed, while in the intestines, we detected downregulation of miR-743b and a trend toward downregulation of miR-345-5p. Thus, tissue-specific expression patterns of miRNAs were observed. Neither miR-326 nor miR-743b has previously been associated with aGvHD. Moreover, we identified upregulation of miR-146a and miR-155 in skin tissue of rats suffering from aGvHD. Analysis of intestinal T cells indicated 23 miRNAs differentially regulated between aGvHD and controls. Two of these miRNAs were differentially expressed either in skin (miR-326) or in intestinal (miR-345-5p) tissue. Comparison of intestinal and peripheral blood T cells indicated common dysregulated expression of miR-99a, miR-223, miR-326, and miR-345-5p. Analysis of predicted gene targets for these miRNAs indicated potential targeting of an inflammatory network both in skin and in the intestines that may further regulate inflammatory cytokine production. In conclusion, comprehensive miRNA profiling in rats suffering from aGvHD demonstrate tissue-specific differences in the expression patterns of miRNA that may not be detected by profiling of peripheral blood T cells alone. These tissue-specific miRNAs may contribute to distinct pathologic mechanisms and could represent potential targets for therapy.

Objectives: To analyse the results of Endonasal Endoscopic Dacrocystorhinostomy regarding complications and success rate., Methods: The prospective quasi-experimental study was conducted at the Departments of Otolaryngology and Ophthalmology of Islamic International Medical College Teaching Hospital, Rawalpindi, from August 2008 to July 2012. Patients presenting with epiphora and diagnosed with chronic nasolacrimal duct obstruction were included in the study. Endonasal Endoscopic Dacrocystorhinostomy was performed under general anaesthesia. Patients were followed up for at least 6 months after the removal of dacrocystorhinostomy tube. Complications during and after the procedure were recorded., Results: Of the 31 patients in the study, 27 (87%) were females and 4 (13%) were males with an overall mean age of 45.7 +/- 13.4 years (range: 21-70). The duration of symptoms ranged between 6 months and 13 years (Mean: 4.1 +/- 3.2). Average duration of endoscopic dacrocystorhinostomy was 40 +/- 17.5 minutes (range: 25-70). The tube was removed 6 months after operation in 27 (87%) patients and after 3 months in 4 (13%). Complications encountered were peroperative haemorrhage in 4 (13%), ecchymosis in 2 (6%), nasal adhesions in 3 (9.6%), granulations at osteotomy site in 1 (3.2%), retrograde tube displacement in 3 (9.6%) and symblepheron in 1 (3.2%) patient. Of the total, 26 (84%) patients were symptom-free 6 months after the removal of the tube. Two (6.4%) patients underwent revision surgery and were symptom-free 6 months after the removal of the tube. Overall success rate of the procedure was 28 (90%)., Conclusions: Endonasal Endoscopic Dacryocystorhinostomy is an effective procedure with high success rate and minimal complications.

Significantly drastic effects of storage on the potency of the alum-precipitated haemorrhagic septicaemia (APHS) vaccine are reported. The APHS vaccine, studied through challenge infection of vaccinated rabbits (post-60 days of vaccination), showed 100% potency when stored at 4 degrees C for 30 days. The potency dropped to 20% when storage period was extended to 60 or more days. At 30 degrees C, the potency reduced by 40, 40 and 60%, respectively, after 30, 60 and 90 days of storage, while, at 37 degrees C, the decrease was 60, 60 and 100% after 30, 60 and 90 days of storage, respectively. In view of this, the oil-adjuvant (OA) HS vaccine was developed by culturing Pasteurella multocida on a medium comprising yeast extract, sucrose, trypticase and sodium bicarbonate, under continuous aeration at 37 degrees C. This gave a far better bacterial count (maximum count 15 x 10(8)/ml) than the conventional APHS vaccine (maximum count 6 x 10(8)/ml). The OAHS vaccine-carrying water-in-oil emulsion remained stable at room temperature for 1 year. The log protection values of the two batches of the OAHS vaccine, studied in mice, were 5.2 and 5.3, as against 1.9 of the APHS vaccine.