Search

Background: The Covid-19 pandemic effected individuals worldwide. A significant number of specimens examined by pathologists are obtained from oropharyngeal region containing a highly viral titer along with increased preference of the virus to these tissues compared to other areas of the body requiring. The need of knowledge, attitudes such as appropriate Personal Protective Equipment (PPE) along with discarding of samples and adherence to protocols while dealing with these samples is necessary. Therefore, we aimed to assess the knowledge, attitude and practices of oral pathologists pertaining to modifications in laboratory protocols issued by various international organizations. Methods: A validated questionnaire with 22 close-ended questions was given to academic faculty, practicing pathologists and trainees of the pathology department working in a government institute (n=37). Statistics were applied and p

Background: This meta-analysis aimed to pool all the available data to provide a well-powered assessment of the role of maternal Vitamin D levels in developing gestational diabetes mellitus (GDM) because already published studies evaluating this association are small in sample size and yielded conflicting findings. Material and Methods: A systematic review and meta-analysis of observational studies was performed. We searched electronic databases (PubMed and Cochrane Central) from inception to April 2021 for published and unpublished observational studies that determined the association between the reduction of Vitamin D levels and the risk of developing GDM in pregnant women. Results from studies were pooled as mean ± standard deviation (SD) and odds ratios (OR) using the random-effects model. Results: Forty-four studies, consisting of 37,838 pregnant women were included in this meta-analysis. Dichotomous studies showed a significant association between maternal Vitamin D deficiency and increased risk of GDM (OR = 1.38; 95% confidence interval [CI] = 1.21-1.57; P < 0.00001). Studies with continuous data also showed a significant association between maternal Vitamin D deficiency and the risk of developing GDM (weighted mean difference (WMD): –5.14 nmol/L, 95% CI = –6.28 to -4.00; P < 0.00001). Moderate heterogeneity was also detected. Conclusion: In conclusion, all studies demonstrated that lower levels of maternal serum Vitamin D were associated with a higher risk of developing GDM in pregnancy.

Despite being responsible for invasive infections, fungal pathogens have been underrepresented in computer aided therapeutic target mining and drug design. Excess of Candida albicans causes candidiasis, causative of thrush and vaginal infection due to off-balance. In this study, we attempted to mine drug targets (n = 46) using a subtractive proteomic approach in this pathogenic yeast and screen natural products with inhibition potential against fructose-bisphosphate aldolase (FBA) of the C. albicans. The top compound selected on the basis of best docking score from traditional Indian medicine/Ayurvedic library was (4-Hydroxybenzyl)thiocarbamic acid, from the ZINC FBA inhibitor library was ZINC13507461 (IUPAC name: [(2R)-2-hydroxy-3-phosphonooxypropyl] (9E,12E)-octadeca-9,12-dienoate), and from traditional Tibetan medicine/Sowa rigpa was Chelerythrine (IUPAC name: 1,2-Dimethoxy-12-methyl-9H-[1,3]benzodioxolo[5,6-c]phenanthridin-12-ium), compared to the control (2E)-1-(4-nitrophenyl)-2-[(4-nitrophenyl)methylidene]hydrazine. No Ames toxicity was predicted for prioritized compounds while control depicted this toxicity. (4-Hydroxybenzyl)thiocarbamic acid showed hepatotoxicity, while Chelerythrine depicted hERG inhibition, which can lead to QT syndrome, so we recommend ZINC13507461 for further testing in lab. Pharmacological based pharmacokinetic modeling revealed that it has low bioavailability and hence, absorption in healthy state. In cirrhosis and renal impairment, absorption and plasma accumulation increased so we recommend further investigation into this occurrence and recommend high dosage in further tests to increase bioavailability.

# Background Research has become a crucial part of restorative sciences. Yet, research ethics are sometimes bypassed. One of the research ethical misconducts, plagiarism has always been prevalent. Studies published on plagiarism have seen an increase recently but mostly they are from the developed part of the world and output from developing countries like Pakistan is low. This study, therefore, aims to compare the knowledge, attitudes, and practices of students from medical and non-medical fields towards plagiarism from different institutions in Karachi, Pakistan. # Methods We conducted an eight-week cross-sectional study in January 2017 in Karachi, Pakistan with 412 undergraduate students of ages 18 and above, using convenience sampling to assess their knowledge, attitudes, and practices regarding plagiarism. The questionnaire was divided into three parts, each focusing on knowledge and its source, attitudes, and practices of an individual towards plagiarism. Chi-squared tests were applied to compare the aforementioned factors of participants belonging to the medical field with those from non-medical fields. # Results A majority of individuals (n=288, 74.6%) were aware of the research ethics and had heard about the term plagiarism (n=353, 91.5%). More than half of the individuals (n=235, 60.9%) had experience with researches. An overwhelming majority of individuals (n=365, 94.6%) considered it important to discuss issues like plagiarism in research ethics. Almost half of them (n=186, 48.2%) plagiarized unintentionally due to lack of knowledge and learned about it later. Majority of the individuals (n=332, 86%) thought plagiarism could be avoided and many (n=303, 78.5%) believed that authors who plagiarize deserve punishment. Statistically significant differences were found to exist when knowledge, attitude, and practices were compared between medical and non-medical students. Medical students were more aware of the research ethics than non-medical students (*P*=0.001). Significantly more medical students considered it important to discuss issues like plagiarism in research ethics than non-medical students (*P*=0.011) and did not believe that plagiarism is justified for short deadlines (*P*\

Respected Editor, Pakistan is one of the Afro Asian countries where the incidence of stone diseases is consistently high because of its presence in Stone Belt countries [1]. Karachi has a hot and arid climate with summer season persisting for the longest time of the year which plays a vital factor in the prevalence of renal stones in our population. A bulk of our dietary consumption is mainly animal protein, contributing to increased uric acid production. Moreover, oxalate concentration also rises with the increased intake of beets, chocolate, tea, nuts, spinach and cola leading to nephrolithiasis. The Dietary Approaches to Stop Hypertension (DASH) diet is used to manage hypertension. It has also been associated with a reduced incidence of renal stone formation [2]. The DASH diet focuses on adequate intake of vegetables and fruits, low-fat dairy products, low animal protein diet which has a decreased amount of cholesterol and fats [2]. Fruits and vegetables are an integral part of DASH style diet. They contain high oxalate content which is a known precipitating agent for calcium oxalate stones, nevertheless, fruits and vegetables also increase levels of citrate in urine which is an important inhibitor and protective factor for calcium stones [2]. Studies have shown that Phytate (Myo-inositol hexaphosphate), a factor in plant matter and a major part of the DASH diet, reduces the risk of stone development [3]. Low intake of animal protein, as recommended in the DASH diet leads to decrease uric acid production and increased urinary pH consequently decreasing the risk of uric acid stone [2]. High urinary pH can lead to the formation of calcium phosphate crystals thus the impact of the DASH diet on the development of calcium phosphate stones is still a topic of much conjecture. Stroke and coronary heart diseases, which are prevalent among our population, can be well managed and prevented with DASH-style diet [4]. Adherence to this diet can also lead to a marked reduction in the likelihood of Type 2 diabetes in a certain population [5]. In conclusion, DASH-style diet is easy to adhere, harmless, affordable and can be proven exponentially beneficial in healthcare like ours, where the cost of treatment has to be borne directly by the patients and patients’ affordability is still a vital drawback. However, it should be catered according to the morbidity of the patient. Counseling of healthy individuals about foods that increase the risk of kidney stones should be carried our to reduce stone related morbidities. Further researches should be conducted in order to determine the efficacy of a DASH-style diet and if established true, this diet should be integrated for the prevention of nephrolithiasis. For, prevention is better than cure.

Respected Editor, Stroke is one of the highest contributors to mortality in South East Asia. Its prevalence in Pakistan is assessed to be 250/100,000 population with 350,000 new cases per annum [1]. Stroke is a leading cause of disability where 20-40% of stroke survivors are affected by spasticity, a complication of upper motor neurons [2]. Spastic paralysis secondary to stroke leads to functional limitations due to ataxia, gait disturbances, joint contracture, and pain that deteriorates the quality of life. Post-stroke spasticity management requires a mix of pharmacological and certain rehabilitative treatments, of which the prevalent ones in Pakistan are virtual reality, early mobilization, movement therapy induced by force and gait training and non-invasive brain stimulation. For the treatment of spasticity, focal muscle vibration (FMV) is more affordable, user-friendly, with no known adverse effects [3]. Despite its promising results, focal muscle vibration has not yet been introduced in Pakistan probably due to lack of literature. Focal muscle vibration (FMV), an effective neuro- rehabilitative procedure, requires the focal application of vibration of appropriate frequency (variable according to the muscle) on the muscle belly. This stretches the muscle by producing muscle waves. The propagation of muscle waves results in muscle stretch which induces the tonic vibration reflex via spinal circuits [4]. Tonic vibration reflex is a phenomenon where vibration induces involuntary contraction in vibrated muscle and a relaxation of its antagonist [5]. Effectiveness of FMV was proven by Costantino C, et al. in their randomized control trial (RCT) published in 2017. A total of 32 post-stroke patients with chronic upper limb spasticity were divided into two groups. The experimental group (17 patients) was given low amplitude (2 mm), high frequency (300 Hz) vibrations for 30 minutes, thrice a week for a month. The control group received sham therapy. Statistically significant difference existed between two groups in modified ashworth scale (MAS) for shoulder (p= 0.007), elbow (p=0.003), and wrist (p < 0.001) [6]. Further promising results were proved in RCT conducted by Oh J, et al. which was published in late 2017. They included hemiplegic patients with calf muscle spasticity and applied 80 Hz vibration with an amplitude of 0.3 mm. It was found that FMV had an antispastic effect on Gastrocnemius. The angle of ankle dorsiflexion and range of movement of the ankle was increased after the application of FMV [7]. Moreover, the use of FMV was found to reduce the risk of falling in the elderly by improving balance [8]. Studies show that FMV has a promising outcome and it can significantly reduce spasticity which can improve quality of life in stroke patients. Further trials should be carried out in our population as well to develop a better understanding of the potential efficacy of FMV. The rehabilitative physicians should be vigilant of newer techniques and modalities being developed across the world and should aim to initiate the use of new scientifically proven beneficial techniques in their practice.

Background: Rg3-ginsenoside, a protopanaxadiol saponin, is a well-known adaptogen used for the prevention of cancer and inflammation. However, despite its distinct biological activity, the concentration of Rg3 in the total ginseng extract is insufficient for therapeutic applications. This study aims to convert PPD-class of major ginsenosides into a mixture of minor ginsenoside, to analyze its immune-regulatory role in macrophage cells., Results: Using heat and organic acid treatment, three major ginsenosides, Rc, Rd, and Rb1, were converted into a mixture of minor ginsenosides, GRg3-mix [Rg3(S), Rg3(R), Rg5, and Rk1]. Purity and content analysis of the transformed compound were performed using thin-layer chromatography (TLC) and high-performance liquid chromatography (HPLC), compared with their standards. Preceding with the anti-inflammatory activity of GRg3-mix, lipopolysaccharide (LPS)-stimulated murine RAW264.7 macrophage cells were treated with various concentrations of GRg3-mix (6.25, 12.5, 25, and 50 μg/mL). The cell viability assay revealed that the level of cell proliferation was increased, while the nitric oxide (NO) assay showed that NO production decreased dose-dependently in activated RAW264.7 cells. The obtained results were compared to those of pure Rg3(S) ≥ 98% (6.25, 12.5, and 25 μg/mL). Preliminary analysis of the CCK-8 and NO assay demonstrated that GRg3-mix can be used as an anti-inflammatory mediator, but mRNA and protein expression levels were evaluated for further confirmation. The doses of GRg3-mix significantly suppressed the initially upregulated mRNA and protein expression of inflammation-related enzymes and cytokines, namely inducible nitric oxide synthase (iNOS), cyclooxygenase-2 (COX-2), nuclear transcription factor kappa B (NF-κB), tumor necrosis factor (TNF-α), and interleukins (IL-6 and IL1B), as measured by reverse transcription-polymerase chain reaction and western blotting., Conclusions: Our pilot data confirmed that the mixture of minor ginsenosides, namely GRg3-mix, has high anti-inflammatory activity and has an easy production procedure., (© 2023. The Author(s).)