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Red kidney bean protein isolate was prepared and incorporated into wheat flour at levels of 0, 5, 10, 15, and 20% to prepare protein-enriched cookies which were then evaluated for various quality attributes. Nutritional evaluation of cookies showed that the supplementation of bean protein isolate increased the protein content of the cookies from 7.87% in T1 (control or wheat flour cookies) to 16.92% in T6 (cookies supplemented with 20% bean protein isolate), which indicated a 115% increase in protein content. The physical characteristics of cookies such as width, thickness and spread factors differed significantly. Sensory attributes of all the supplemented cookies were within the acceptable range but cookies supplemented with 20% level of protein isolate were less preferred due to slightly darker colour and harder texture. Conclusively, the red kidney bean protein isolate can be successfully utilised for the production of high-protein cookies. Such high-protein products can be advantageously utilised to cope with the problem of protein-energy malnutrition. Moreover, such nutritious products can also be used as emergency foods during natural disasters as well as during war times.

Endopolygalacturonase (EndoPGase), EC: 3.2.1.15. is one of the crucial pectinases belonging to the class of carbohydrase. The catalytic action of EndoPGase captivates the attention of the production of this extremely valuable catalyst in the industrial sector. The main focus was to ascertain a potential bacterial candidate for endoPGase production. The isolated bacterial strain was further identified by 16S rRNA gene sequencing. The parameters for enzyme biosynthesis were optimized by a single and multiple factor approach at a time. The results of our investigation led to the identification of a potent strain of Bacillus subtilis NR2 [strain 168]. The sequence of 16S rRNA amplified from the isolated bacterium has been submitted to GenBank under accession number ON738697. The strain was found active for pectic enzyme activity under shaking- flask fermentation at pH 5.0 and 50 °C temperature of incubation. Among all monomeric and polymeric substrates (inducer-substrates), citrus pectin, followed by potato starch and pectin (Sigma) were considered the best enzyme inducers at 1% concentration. In comparison, an increased wheat bran concentration at 5% was proved to be ideal for EndoPGase biosynthesis Moreover, an increasing trend in enzyme activity was observed with the increasing concentration of inducer. The combined effect of three variables (pH, inducer-substrates, and inducer-substrate concentration) was explored by response surface methodology (RSM) involving a Box–Behnken design (BBD). Based on the results, we concluded that the soil-isolated B. subtilis can be effectively utilized for commercial-scale pectinase enzyme biosynthesis.

The current study aimed to produce synbiotic cheese, adding inulin and Bifidobacterium animalis subsp. lactis as prebiotics and probiotics, respectively. The physicochemical analysis, minerals and organic acids content, sensory evaluation, and probiotic count of the cheese were performed during the ripening. The significant effect of inulin (p ≤ 0.01) was found during the ripening period, and changes in physiochemical composition, minerals, and organic acid contents were also observed. Scanning electron microscopy (SEM) of the cheese revealed that inulin could improve the cheese structure. Meanwhile, inulin increased the likeliness of the cheese, and its probiotic viability remained above 107 colony forming unit (CFU) per gram during ripening.

Abstract Background Currently, cheese fat is a major component of human diet due to change in eating habits. It contains a number of health destroying as well as health promoting fatty acids. Bovine milk cheese fatty acid composition is regulating by many factors. These may be breed of animal, animal health condition like mastitis and stage of lactation. It also differs with feed and dietary fat intake and seasons. Many studies demonstrated physicochemical, textural and sensory characteristics of Mozzarella cheese with variation in technological process but no literature found about the fatty acid profile and potential influence of milling pH on the fatty acid composition of buffalo Mozzarella cheese. Methods Buffalo Mozzarella cheeses were manufactured at 5.2, 5.1, 5.0, 4.9 and 4.8 milling pH, vacuum packaged and stored at 4 °C and analyzed for quality characteristics, mineral composition and fatty acid profile on days 1, 45, and 90. Results were analyzed by ANOVA according to complete randomized design. Results This study evaluated the effect of milling pH on chemical composition, mineral and fatty acid profile of buffalo Mozzarella cheese. Experimentally induced milling pH differences persisted and significantly affected chemical composition during first day of manufacturing but have no effect on fatty acid profile of cheese. However, storage effects significantly on chemical composition and fatty acid profile of cheese. Decreasing milling pH from 5.2–4.9 resulted in decrease in moisture content of cheese. As a result of changes in milling pH, all the cheeses experienced a significant loss in protein content. In contrast to protein content, fat content of cheese increases with decreasing milling pH. Ash contents of cheese decreased with decreasing milling pH. The level of calcium decreases from 77.82 mg/g to 69.1 mg/g with decreasing milling pH while there is no clear trend observed for potassium and sodium during change in milling pH. Saturated fatty acids presented higher concentrations reaching values of about 71.38 g/100 g throughout storage while monounsaturated fatty acids decreases with storage from 26.72 to 22.06 g/100 g. On the other hand, total polyunsaturated fatty acids exhibited lower concentrations than total monounsaturated fatty acids reaching values of 3.2 g/100 g and its value also decreased with ripening and reached to 1.6 g/100 g. Concentration of C18:1 t10–11 was observed 1.89% in freshly prepared cheese. Milling pH did not influence C18:1 t10–11 concentration but storage days significantly (p

Objective The aim of present study was to assess the anti-oxidant potential of water-soluble peptides (WSPs) extract derived from buffalo and cow milk Cheddar cheeses at different stages of ripening. Methods The antioxidant potential of WSPs extract was assessed through 2,2’-azinobis-3-ethylbenzothiazoline-6sulfonic acid (ABTS)-radical scavenging activity. In addition, impact of WSPs extract on cell viability and production of reactive oxygen species (ROS) in human colon adenocarcinoma Caco-2 (tert-butylhydroperoxide-induced) cell lines was also evaluated. Results The ABTS-radical scavenging activity increased progressively with ripening period and dose-dependently in both cheeses. However, peptide extract from buffalo milk Cheddar cheese demonstrated relatively higher activity due to higher contents of water-soluble nitrogen. Intracellular ROS production in Caco-2 cells decreased significantly (p

This study was carried out to examine the physicochemical and functional characteristics of quince fruit pulp. The matured quince fruits were collected from different locations of Poonch, AJ&K, Pakistan. Significant differences (P ˂ 0.05) were found among fruits collected from these locations. The quince pulp has the following characteristics: pH (3.43), total soluble solids (14.22°Brix), acidity (1.25%), carbohydrate (13.38 g/100 g), reducing sugar (5.15 g/100 g), non-reducing sugar (4.61 g/100 g), moisture (84.27 g/100 g), ash (0.62 g/100 g), fat (0.24 g/100 g), protein (0.49 g/100 g), fiber (1.65 g/100 g), ascorbic acid (15.46 mg/100 g), and total phenolic (68.13 mg gallic acid equivalent/100 g) and antioxidant activity (50.05%). This exploration is the basic direction, which highlights the nutritional characteristics of quince fruit grown in AJ&K, Pakistan.

Milk composition is an imperative aspect which influences the quality of dairy products. The objective of study was to compare the chemical composition, nitrogen fractions and amino acids profile of milk from buffalo, cow, sheep, goat, and camel. Sheep milk was found to be highest in fat (6.82%±0.04%), solid-not-fat (11.24%±0.02%), total solids (18.05%±0.05%), protein (5.15%±0.06%) and casein (3.87%±0.04%) contents followed by buffalo milk. Maximum whey proteins were observed in camel milk (0.80%±0.03%), buffalo (0.68%±0.02%) and sheep (0.66%±0.02%) milk. The non-protein-nitrogen contents varied from 0.33% to 0.62% among different milk species. The highest r-values were recorded for correlations between crude protein and casein in buffalo (r = 0.82), cow (r = 0.88), sheep (r = 0.86) and goat milk (r = 0.98). The caseins and whey proteins were also positively correlated with true proteins in all milk species. A favorable balance of branched-chain amino acids; leucine, isoleucine, and valine were found both in casein and whey proteins. Leucine content was highest in cow (108±2.3 mg/g), camel (96±2.2 mg/g) and buffalo (90±2.4 mg/g) milk caseins. Maximum concentrations of isoleucine, phenylalanine, and histidine were noticed in goat milk caseins. Glutamic acid and proline were dominant among non-essential amino acids. Conclusively, current exploration is important for milk processors to design nutritious and consistent quality end products.

Objective: To determine the hepatoprotective effect of Aqueous extract of Stem Bark of Berberis Lycium Royale in Isoniazid (INH) induced hepatotoxicity in mice. Study Design: Experimental study. Place and Duration of Study: The study was conducted from 7 April 2014 till 7 May 2014 at animal house of National Institute of Health, Islamabad. Materials and Methods: Fifty six male albino Balb/C mice were randomly divided into four groups i.e Group I: Control group (C), Group II: Drug treated group (D), Group III: Low Aqueous group (LA), Group IV: High Aqueous group (HA) of 14 mice each. INH (50 mg/kg) was given to induce hepatotoxicity in all groups except control group (C). Aqueous extract of stem bark of Berberis Lycium Royle was given in low doses (150 mg/kg) to Low Aqueous group (LA) and in high doses (200 mg/kg) to High Aqueous group (HA). Blood samples were collected at day (0, 15 & 30 ) for estimation of Liver function tests (LFTs). At the end samples for liver histopathology were taken. Results: INH produced severe hepatotoxicity as depicted by raised LFT's & severe steatosis, hepatocytic ballooning & inflammation. In animals of Low Aqueous group (LA) and High Aqueous group (HA) , serum levels of biomarkers were decreased and their liver sections showed improved histological picture but the reduction in toxic effects were more pronounced in animals treated with high Aqueous group. (HA). Conclusion: Aqueous extract of stem bark of Berberis Lycium Royale has more significant hepatoprotective potential in high doses as compare to low doses.

The present study used descriptive sensory analysis (DSA) to compare Pizza cheeses prepared from various combinations of fresh Mozzarella and semi-ripened Cheddar cheeses and cooked under conventional and microwave cooking methods. A cheese sensory lexicon was developed, and descriptive sensory profiles of the Pizza cheeses were evaluated using a panel of semi-trained judges (n = 12). The following characteristics, flavor (cheddar, acidic, rancid, bitter, salty, creamy, and moldy), texture (stringiness, stretchability, firmness, and tooth pull), and appearance (meltability, oiliness, edge browning, and surface rupture) of Pizza cheeses were analyzed and compared with control samples. The sensory analysis of Pizza cheeses showed more preference toward a higher level of ripened Cheddar cheese (4 months), which was cooked using the microwave. However, the scores for texture properties were decreased with the addition of the semi-ripened cheese. The scores for stretchability and tooth pull were high in the microwave cooked samples compared with the conventionally cooked samples. The appearance attributes (meltability, oiliness, and edge browning) scores were increased with the increasing of ripened Cheddar cheese content while surface rupture was decreased. Microwave cooked Pizza cheese showed better meltability and oiliness but lower edge browning scores. The results showed that amalgamations of fresh Mozzarella and semi-ripened Cheddar cheese had a significant (p < 0.05) and positive effects on the sensory qualities of Pizza cheeses.

Abstract Membrane consisting of ordered sub-nanochannels has been pursued in ion separation technology to achieve applications including desalination, environment management, and energy conversion. However, high-precision ion separation has not yet been achieved owing to the lack of deep understanding of ion transport mechanism in confined environments. Biological ion channels can conduct ions with ultrahigh permeability and selectivity, which is inseparable from the important role of channel size and “ion-channel” interaction. Here, inspired by the biological systems, we report the high-precision separation of monovalent and divalent cations in functionalized metal-organic framework (MOF) membranes (UiO-66-(X)2, X = NH2, SH, OH and OCH3). We find that the functional group (X) and size of the MOF sub-nanochannel synergistically regulate the ion binding affinity and dehydration process, which is the key in enlarging the transport activation energy difference between target and interference ions to improve the separation performance. The K+/Mg2+ selectivity of the UiO-66-(OCH3)2 membrane reaches as high as 1567.8. This work provides a gateway to the understanding of ion transport mechanism and development of high-precision ion separation membranes.

Lung cancer remains a global health crisis, responsible for significant morbidity and mortality. Late-stage diagnosis often limits treatment options and patient survival. Therefore, identifying reliable and sensitive biomarkers for early detection is crucial. Glycosylation, the addition of glycans to protein/RNA/lipid, is a vital cellular process. Normal glycosylation regulates healthy cell function, while alterations, particularly in fucosylation and sialylation, contribute to lung cancer development and progression. These aberrant glycosylation patterns are associated with processes such as immune modulation, cell migration, proliferation, and cell-cell recognition. Fucosylation, a specific type of glycosylation, is frequently altered in lung cancer, with high levels detected in tumors. Understanding the mechanisms behind this altered fucosylation holds immense potential. It can pave the way for the development of novel therapeutic and diagnostic tools for lung cancer. By analyzing specific fucosylation patterns in bodily fluids, it could lead to early-stage diagnosis. This review delves into the mechanisms of fucosylation in lung cancer initiation and metastasis, proposing promising strategies to target the mechanisms, aiming to inhibit tumor growth and disease progression.

Objective: To compare three consecutive days of hyperglycemic response following antenatal Dexamethasone regimens of 12mg or 6mg in diet-controlled gestational diabetes, administered for fetal lung maturity. Study Design: Quasi-experimental study Place and Duration of Study: Department of Obstetrics and Gynaecology, Combined Military Hospital, Kharian Pakistan, from Oct 2020 to Mar 2021. Methodology: Forty women who met inclusion criteria were selected and assigned to two Groups. Group-A was administered quartered 24 mg steroids 6 hours daily, and Group-B was administered halved 24mg 12 hours daily. Blood sugar levels (BSL) were recorded before and after meals, thrice a day for three consecutive days, and on proforma. Results: Among the selected patients, the mean age was 25.5±2.9 years, and the mean gestational age (duration of pregnancy) was 30.3±2.0 weeks. Out of six blood sugar levels recorded daily for three consecutive days, the episodes of hyperglycemia in the (Group-B) 12-hourly steroid dose were found to be less significant than those in the (Group-A) split 6-hourly dose. Conclusion: The recommended 12 mg, twice-a-day regimen of antenatal corticosteroids was better than the proposed 6mg, four times a day regimen as it caused fewer hyperglycemic episodes in gestational diabetics.

In order to protect the web against automated attacks, CAPTCHAs are most widely used mechanism on the internet. Numerous types of CAPTCHAs are introduced due to weaknesses in the earlier designs. Animated CAPTCHAs are one of the design alternatives. Instead of presenting the whole information at once, animated CAPTCHAs present information in various frames over the specific interval of time. As CATPCHAs are ubiquitously used to avoid the serious threats from bots therefore it is important to verify their effectiveness. In this research we have verified their robustness against machine learning attacks. It has been proved that adding the extra time dimension does not necessarily ensure protection against automated attacks. We have attacked the Hello CAPTCHA scheme, which is the most popular animated CAPTCHA scheme available on the internet. By applying novel image processing and machine learning techniques, these CAPTCHAs are decoded with high precision. A pre-trained CNN is used to recognize the extracted characters. In this research, 6 popular types of animated CAPTCHAs along with 41 sub types were successfully deciphered with an overall precision of up to 99.5 %.

Abstract The encapsulation of plant extract in nanomatrices has limitations due to its adhesion to walls, size control, high cost and long durations that results in low yield. Macroscale and microscale level techniques for development of micro/nanoparticles may impact the encapsulation of plant extract. This study aimed to evaluate the relative efficiency of microscale and macroscale techniques for encapsulation of plant extract, which is not compared yet. Keeping this in view, encapsulation of Calotropis gigantea leaves extract (CaG) was attained in silver-conjugated poliglusam nanomatrices (POL/Ag) to induce apoptosis in invasive ductal carcinoma (IDC) cells. The ethanolic CaG extract was prepared using percolation method and characterized by chemical tests for its active phytochemical compounds. The droplet-based microfluidic system was utilized as microscale encapsulation technique for CaG in nanomatrices at two different aqueous to oil flow rate ratios 1.0:1.5, and 1.0:3.0. Moreover, conventional batch system was utilized as macroscale encapsulation technique consisted of hot plate magnetic stirrer. The prepared nanomatrices were analysed for antioxidant activity using DPPH test and for cytotoxicity analysis using MCF-7 cells. The characteristic peaks of UV–Vis, FTIR and XRD spectrum confirmed the synthesis of CaG(POL/Ag) by both the encapsulation methods. However, microfluidic system was found to be more expedient because of attaining small and uniform sized silver nanoparticles (92 ± 19 nm) at high flow rate and achieving high encapsulation efficiency (80.25%) as compared to the conventional batch method (52.5%). CaG(POL/Ag) nanomatrices found to have significant antioxidant activity (p = 0.0014) against DPPH radical scavenging activity. The CaG(POL/Ag) of the smallest sized formulated by the microfluidic system has also shown the highest cytotoxicity (90%) as compared to batch method (70%) at 80 µg/mL. Our results indicate that the microscale technique using microfluidic system is a more efficient method to formulate size-controlled CaG(POL/Ag) nanomatrices and achieve high encapsulation of plant extract. Additionally, CaG(Pol/Ag) was found to be an efficient new combination for inducing potent (p

Objective: To explore the perceptions of students and examiners regarding objective structured clinical examination (OSCE). Study Design: Cross-sectional study. Place and Duration of Study: University College of Medicine & Dentistry, Lahore Pakistan from Dec to Apr 2023. Methodology: Data was collected through Google Forms, which served as a secure and user-friendly platform for survey administration. Data was collected from the students who were enrolled in the integrated curriculum. The research involved administering a pre-validated questionnaire to 40 examiners and 272 fourth- and final-year MBBS students. The questionnaire aimed to gather insights into various aspects of the objective structured clinical examination (OSCE), including its attributes, structure, and validity. Results: The mean attributes of OSCE were analysed, the students' perceptions of organization, validity, and reliability were 3.52±0.72, 3.6±0.79, and 3.69±0.75, respectively. Examiners addressed clinical knowledge, skills, and station organisation SCE's positive impact. 47.5% of faculty faced equipment challenges, while 30% of examiners did not find OSCE stressful. Conclusion: The study examines organisational and examiner views on OSCE, highlighting its effectiveness in teaching clinical skills and knowledge.

Objective: To determine post procedural immediate and short-term outcomes of transcatheter Ventricular Septal Defect (VSD) device closure. Study Design: Longitudinal Cross-sectional study. Place and Duration of Study: Pediatric Cardiology Unit at Tertiary Cardiac Care Centre, Rawalpindi, Pakistan, from Feb to Oct 2022. Methodology: Total of 62 patients fulfilling inclusion and exclusion criteria who underwent transcatheter VSD device closure were retrospectively identified from our institutional database by non-probability consecutive sampling technique. Preprocedural evaluation [Transthoracic Echocardiography (TTE) & Electrocardiography(ECG)], procedural details and immediate post procedure outcomes were documented. Follow-up evaluations were done at 6 and 12 months. It included clinical examination, TTE and 12 lead ECG. New onset and status of old complications were documented in each visit. SPSS version 24.00 was used to analyze data. Chi-square test was used to find association between study variables. p-

We report a case of successful hybrid device closure of large mid muscular Ventricular Septal Defect (VSD) in an infant for the very first time in Pakistan. Increasing collaboration between pediatric cardiac interventionalists and congenital cardiac surgeons has resulted in introduction of various hybrid procedures in the management of Congenital Heart Diseases (CHD). Advantages of hybrid procedures include complex interventions by using minimally invasive methods, avoidance of cardiopulmonary bypass, shorter procedure and recovery time leading to subsequent decrease in complications. A large VSD in an infant carries an increased risk of morbidity including failure to thrive, congestive cardiac failure, and recurrent respiratory tract infections. Timely and safely the successful perventricular closure of large VSD using hybrid approach is a milestone in the management of VSDs in infants.

Co3O4 and Fe2O3 composite nanoparticles with different Fe2O3/Co3O4 molar ratios were synthesized using the sol-gel auto-combustion method. The morphology and microstructure of the composite samples were studied by field emission scanning electron microscope (FESEM) and X-ray diffraction (XRD). FESEM images highlighted the nanocomposite particles' spherical shape and uniform distribution, having an average size of 31±3 nm. XRD analysis revealed the presence of face centered cubic Fe2O3 and rhombohedral Co3O4 crystalline nanoparticles. The room temperature antiferromagnetic (RT-AFM) behavior of the composites was assessed by vibrating-sample magnetometry (VSM). This behavior was related to the interaction of the localized spins of the Co ions with the oxygen vacancies. I-V measurements highlight the ohmic behavior of the prepared samples, showing that the composites with higher Fe2O3 loading were the most noticeably conductive. Tests carried out demonstrated that the Fe2O3/Co3O4 composites proved suitable ethanol gas sensor towards low concentration (between 0 and 150 ppm) at low temperatures (150 °C) with quick response (2–10 sec) /recovery (18–50 sec) time and a LOD is around 4 ppm.

Background and Objective: Pandemics like COVID-19 adversely affect children’s behavior and psychological development by disrupting routine life activities. Children of healthcare workers are exposed additionally due to the fear of parental exposure to the virus. The objective of this study was to assess the perception of frontline healthcare workers (HCWs) regarding the psychological impact of the COVID-19 pandemic on their children. We also sought to identify the difference of the psychological impact on children of the male and female healthcare workers.Methods: A survey questionnaire was developed comprising 10 questions about the perception of HCWs regarding the psychological impact of COVID-19 on their children. It was distributed both online and face to face among 150 healthcare professionals, working in training and non-training posts in 4 public and 5 nongovernment hospitals of Pakistan. The mean and standard deviation were calculated for each survey item using Statistical Package for the Social Sciences 26.0. Results: The response rate was 71.3% and majority (64.2%) of the healthcare professionals were ≥30 years of age. Ninety-two HCWs (85.98%) either agreed or strongly agreed that the parental separation from their kids for long hours during the pandemic had a negative psychological impact on their children. There was a significant difference in perceived psychological impact of COVID-19 on the children of male and female HCWs, with a mean survey score of 2.29 ± 1.82 and 1.69 ± 0.79, respectively (t = 2.29, p-value = 0.024).Conclusion: Children of the healthcare workers experience more stress and anxiety because of long duty hours and working in high-risk settings. Continuous psychological support and counseling services may be adopted formally to prevent unforeseen adverse events or any long-term negative impact on their physical and mental health.

Heat generation as a result of the exothermic reaction reaches the environment mainly due to the conduction through the walls of the vessel. The balance between the heat generated and the heat conducted away, resulting in the explosion is described by the Frank-Kamenetzkii (FK) parameter ρ. The critical value of FK for which the explosion occurs depends upon the shape of the vessel, which requires the solution of governing singular nonlinear Poisson-Boltzmann equation. Owing to the exponential nonlinearity and singularity the analytical exact solution for the non-integer k values does not exist. This work focuses on implementing the polynomial collocation by exploiting the global optimization features of the genetic algorithm to solve the Poisson-Boltzmann equation for integer and non-integer shape factors (k). The governing equation was converted into coupled nonlinear algebraic equations and an objective function was formulated. The method was examined for six different configurations of the control parameters of GA to find the best set of parameters. The solution for temperature distribution is obtained for cylindrical (k = 1), parallelepiped (k = 0.438, 0.694), and an arbitrary shape (k = 0.5) respectively. The solution obtained from Polynomial Collocation Genetic Algorithm (PCGA) remained in good agreement with the corresponding analytical results for k = 1, with the minimum absolute error of 10−10. The critical values of the FK are obtained as 1.5,1.4,and1.7 for shape factor k=0.438,0.5,and0.694 respectively with the convergence of the order of 10−6to10−5. The obtained solution is fairly stable over appropriate independent runs with the variation in the fitness value ranging from 10−05to10−03. Further simulations were performed to validate the results through statistical error indices. The diminutive errors of the order of 10−6 confirm reliable optimum solution, accuracy, and stability.

Objectives: To evaluate and compare the pharmacokinetic parameters, especially bioavailability, of annatto-based tocotrienol with palm tocotrienol-rich fraction in healthy human volunteers for better therapeutic outcome. Method: The systematic review was conducted between April and August 2021 in accordance with the Preferred Reporting Items for Systematic Review and Meta Analysis guidelines, and comprised search on PubMed, Google Scholar, Pakmedinet and Google search engines for open-label or double-blind randomised controlled trials involving healthy human volunteers published till January 2021. Key words used included annatto-based tocotrienol, palm tocotrienol-rich fraction, absorption and bioavailability. Boolean operators were also used, like tocotrienol AND bioavailability, annatto tocotrienol AND pharmacokinetics. Results: Of the 230 articles identified, 50(21.7%) articles met the eligibility criteria. Of them, 7(14%) were selected for data extraction and detailed analysis. Pharmacokinetic parameters of annatto-based tocotrienol were better than palm-derived tocotrienol. Oral administration of all the isomers of annatto-based tocotrienols resulted in dose-dependent increase in area under curve and plasma levels. Amongst all the isomers of annatto-based and palm-derived tocotrienol, delta isomer of annatto-based tocotrienol had the highest bioavailability with area under curve 7450±89 ng/ml, time to reach peak plasma levels 4 hours, maximum plasma concentration 1591±43 ng/nl and elimination half-life 2. 68 ±0.29 hrs. Pharmacokinetic parameters of delta isomer of annatto-based tocotrienol was greater than palm tocotrienol-rich fraction. Conclusion: Bioavailability of annatto-based tocotrienol was better than that of palm-derived tocotrienol-rich fraction. Delta isomer of annatto-based tocotrienol had the highest bioavailability amongst all isomers of tocotrienol.

Critical congenital pulmonary stenosis with intact interventricular septum is a cyanotic and potentially lethal neonatal cardiac anomaly. Percutaneous transcatheter balloon pulmonary valvuloplasty for critical pulmonary stenosis often presents technical difficulties due to supra-systemic pressure in right ventricle. Using transjugular approach instead of the femoral vein helps in dealing with this issue. We describe the successful use of right internal jugular vein approach in a case of critical pulmonary stenosis.

Objective: To assess the immediate and short-term efficacy and safety of transcatheter closure of cardiac defects with Lifetech™ Konar-MFO in a Tertiary Cardiac Care Center. Study Design: Descriptive cross-sectional study. Setting and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi Pakistan, from Mar 2019 to Dec 2021 Methodology: Patients of all ages and both gender undergone transcatheter closure of a cardiac defect with Konar-MFO from Jan 2021 to Dec 2021 were included in the study through non-probability consecutive sampling and approval by the institutional ethical review committee was taken prior to data collection. Data of patients undergone transcatheter closure with Konar-MFO from Mar 2019 to Dec 2020 was extracted retrospectively to assess the immediate and short-term efficacy and safety of the occluder. SPSS version-23 was used for data entry and analysis. Results: A total of 138 patients had transcatheter closure of a cardiac defect with Lifetech™ Konar-MFO during the study period. Case of VSD were 124(89.9%), PDA 9(6.5%), post-operative cases were 4(2.9%) along with 1(0.7%) case of coronary artery fistula (CAF) to the right ventricle. Out of 138 patients, 73(52.9%) were females while 65(47.1%) were males. The mean age was 9.3 ±8.1 years with a range of 6 months to 36 years. Mean fluoroscopy time was 13.68±9.74 min. The procedure was successful in 137(99.27%) cases. The device embolized in 2(1.45%) cases. Conclusion: In selected cases of VSD, PDA and in some post-operative cases the occlusion with Lifetech™ Konar-MFO is safe and efficacious with the added benefits of softness and versatility of the approach.

Atrial flutter (AFL) is a rare arrhythmia in neonatal and infantile period. Potentially, AFL might lead to severe morbidity and even a fatal outcome. However it can have a good prognosis with early diagnosis and prompt appropriate treatment. Synchronized electrical cardioversion or transoesophageal atrial overdrive pacing is recommended in both stable and unstable cases. Antiarrhythmic drugs can be tried in stable newborns though the sinus rhythm takes some time to return to normal.Excellent prognosis has been noted in newborns and infants having AFL after sinus rhythm has been restored. The risk of recurrence is low and prolonged antiarrhythmic therapy is less likely to be required. However follow-up after discharge is essential to look for any possibility of recurrent arrhythmia and possible untoward effects of treatment.

Recent increase in deployment of trans-catheter devices such as septal or ductal occluding coils and devices has been a possible risk factor for infective endocarditis, predominantly in the initial post deployment period before endothelialization has ensued. Though a long-term study of trans-catheter Atrial Septal Defect (ASD) closure revealed no cases of Infective Endocarditis, some case reports of endocarditis in trans-catheter device closure of ASD, VSD and Patent ductus arteriosus(PDA) advocate that residual defect after device occlusion may be a factor in the risk for Infective Endocarditis. We herein describe the case of a 9-month-old female patient who underwent device closure for peri-membranous ventricular septal defect (VSD) and developed fungal infective endocarditis in early post occlusion period which was confirmed on blood culture. Despite treatment with appropriate antifungal as per sensitivity, clinical condition of the patient deteriorated and it was decided to manage her with surgical explanation of device and closure of defect.

Endometrial stromal sarcoma is rare gynecological malignancy. A proper preoperative diagnosis is difficult and most of cases diagnosed on histopathology. This is case of endometrial stromal sarcoma infiltrating to both ovaries that is stage II A.A 44year old female presented with complaint of irregular heavy vaginal bleeding and history of loss of weight, appetite and altered bowel habits. Clinical diagnosis of Leiomyosarcoma was in mind but on histopathology endometrial stromal sarcoma infiltrating to both ovaries confirmed.

Objective: To determine the frequency and antibiotic susceptibility pattern of Staphylococcus aureus and coagulase negative staphylococci isolated from clinical specimens as a result of culture and sensitivity. Materials & Methods: This cross sectional study was carried out in POF Hospital Microbiology laboratory from January 2019 to September 2020. One hundred and eighty four staphylococci isolated from clinical specimens were processed as per standard methodology. Results: Out of 148, methicillin resistant S.aureus and methicillin resistant coagulase negative staphylococci were 38.04% and13.04% respectively. Infections caused by Methicillin resistant staphylococcal isolates were higher among the age group 31-40 years (71.4%, OR=2.68). Out of thirty expired patients, 53.3% had been infected with methicillin resistant staphylococcal infections. The methicillin resistant staphylococci were most frequent in miscellaneous category of clinical specimens (80.0%, OR=4.63). The susceptibility analysis revealed that methicillin resistant staphylococci are 100% resistant to penicillin, meropenem and amoxycillin-clavulanate (p=0.000). A significant association of methicillin resistance was also noticed against amikacin (p=0.002), ciprofloxacin (p=0.001), clindamycin (p=0.005) and erythromycin (p=0.000). Moxifloxacin, linezolid and vancomycin are the most effective choice for infections caused by methicillin resistant staphylococci. Conclusions: The methicillin-resistant staphylococci are highly resistant to commonly prescribed oral as well as injectable antibiotics. Establishment and implementation of infection control policies are required to combat the grave situation of increasing antibiotic resistance.

Introduction: Despite major expansion and elaboration in treatment protocols of septic patients, mortality rate is still very high due to multiple organ damage including hepatotoxicity. We in study evaluated the role of two strong anti-inflammatory agents, melatonin and pentoxifylline, as a combined treatment in lipopolysaccharide induced hepatic dysfunction in white albino mice. Material and Methods: Endotoxemia was reproduced in white albino mice through intraperitoneal administration of lipopolysaccharide (LPS) of serotype E.Coli. Therapeutic potential of the both melatonin and pentoxifylline alone and as combined therapy was adjudged by administering agents 2 hours after LPS delivering. The extent of liver damage was evaluated via serum alanine aminotransferases (ALT) and aspartate aminotransferase (AST) estimation along with histopathological examination of liver tissue. Results: Lipopolysaccharide administration (Group 2) resulted in marked hepatotoxicity as evident by statistically raised serum ALT ((p≤0.01) and AST (p≤0.01) at the end of experimentation. Also liver cross section examination showed marked distortion of liver parenchyma. Melatonin (Group 3) was prosperous in aversion of LPS invoked hepatotoxicity as proved by lessening of augmented ALT (p≤0.01) and AST (p≤0.01) along with restoration of pathological changes on liver sections (p≤0.05). Pentoxifylline generated similar results and serum ALT, AST and histological alteration abated considerably (p≤ 0.05).Combination therapy in animals of Group 5 also tapered LPS evoked hepatic dysfunction statistically considerably. Conclusion: Melatonin and pentoxifylline alone and as combination therapy as effective in countering LPS induced hepatotoxicity. However the combination therapy did not yield synergistic effects. Keywords: Lipopolysaccharides, Endotoxin, Hepatotoxicity, Melatonin, Pentoxifylline.

Abstract Unintended pregnancy is a major global issue. Women who experience an unintended pregnancy have a significant risk of morbidity and mortality. Additionally, these women also experience substantial financial hardships. Many women, particularly women of color, do not have adequate access to reliable and affordable contraception resulting in major health disparities among this group. This review explores the relationship between unintended pregnancy and inadequate access to contraception and is divided into 5 sections: addressing problems associated with unintended pregnancies, unintended pregnancy rate in the US, disparities of unintended pregnancy rates and access to care, addressing potential solutions, and finally conclusions. Keyterms unintended pregnancy, healthcare disparities, contraception, access to care.