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Objective: To determine the frequency and antimicrobial susceptibility pattern of pathogens responsible for superadded bacterial infection in COVID-19 patients and correlate the association of these infections with serological markers. Study Design: Cross-sectional study. Place and Duration of study: Department of Pathology, Combined Military Hospital, Multan Pakistan, from Jan to Dec 2021. Methodology: A total of 290 patients having positive RT-PCR for SARS CoV-2 were included. All samples were processed per Clinical Laboratory Standard Institute (CLSI) protocols. API 20E and API 20NE were used for the identification of Gramnegative rods. Antimicrobial susceptibility testing was performed by the modified Kirby Bauer disc diffusion method. Serological markers, including C-reactive protein (CRP), total leucocyte count (TLC) and serum Ferritin, were determined and compared for significance in positive and negative culture cases. Results: A total of 75 patients had positive bacterial cultures. Among these, 42(56%) were blood culture, 26(35 %) were respiratory culture and 7(9%) were urine culture. Commonly isolated organisms were Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa, i.e., 23(31%), 20(27%), 13(17%), and 12(16%) respectively. CRP, TLC and S. ferritin were markedly raised in superadded bacterial infection compared to patients with COVID-19 infection only. Conclusion: The frequency of superadded bacterial infections in COVID-19 patients is high. The pathogens isolated in these cases were multidrug-resistant, reflecting mostly hospital-acquired flora. The association of serological markers in depicting superadded infection is statistically significant and may be used to screen for superadded bacterial infection in COVID-19 patients. [ABSTRACT FROM AUTHOR]

The family Euphorbiaceae ranks as the sixth largest among the Anthophyta class of plants and has 340 genera and 9000 species and is found in many parts of the world. Plants of this family exhibit various habits, including annuals, perennial herbs, shrubs, and trees. The distinguishing trait of plants in this family is the production of milky latex due to their succulent nature, enabling them to withstand or withstand water scarcity conditions. Various ecotypes of this species were gathered from distinct regions within the Faisalabad area. Various species of the Euphorbia helioscopia genus were randomly collected for morpho-anatomical examinations of their roots, stems, and leaves. The freehand sectioning technique was employed to perform section cutting of roots, stems, and leaves. Slides were prepared for long-term use after undergoing the staining process. Furthermore, the data was processed by using ANOVA technique. The primary objective of this investigation is to analyze, categorize, and confirm the existing classification of these taxa. This study presented information regarding the morphological and anatomical adaptations of Euphorbia helioscopia in response to different environmental changes. Anatomical modifications, such as enhanced thicknesses of root epidermis and endodermis, increased stem area, and greater thickness and cell area of the cortical region, have a notable impact in various habitats. Ultimately, Euphorbia helioscopia exhibited distinct alterations in its physical structural characteristics, which indicate its ability to thrive in diverse environments. [ABSTRACT FROM AUTHOR]

Euphorbiaceae is the sixth largest family amongst the Anthophyta class of plants. it consists of 340 genera and 9000 species and is cosmopolitan distributed throughout the world. The habits of plants are annuals, perennial herbs, shrubs, and trees. The identifying characteristic feature of plants in this family is the formation of milky latex, because of their succulent nature; they can tolerate or resist water deficit conditions. Different ecotypes of this genus were collected from different areas of Faisalabad region. Different species of this genus Euphorbia hitra was collected by random collection method for morpho-anatomical studies of roots stems, and leaves. After collection, samples were handled carefully and preserved in plastic bottles for sectioning 70% ethanol, and 30% water was used to prepare the solution. The freehand sectioning technique was used for section cutting of roots, stems, and leaves. Permanent slides were prepared after staining. Moreover, the data were subjected to one-way ANOVA (Analysis of Variance) to study morpho-anatomical features of Euphorbia hitra species from Faisalabad regions. This study provided evidence about morphological and anatomical modifications of Euphorbia hitra in response to various environmental fluctuations. Anatomical adaptations such as increased root epidermal and endodermal thicknesses, greater stem area, and large cortical region thickness and cell area play a significant role in different habitats. In conclusion, Euphorbia hitra showed very specific modifications in morphological and anatomical attributes that reveal their ecological success in a variety of habitats. [ABSTRACT FROM AUTHOR]

Objective: To compare visual outcomes and differences in surgically induced astigmatism between superior and supero-temporal incisions in manual small incision cataract surgery (MSICS). Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalakot Pakistan, from Jan to Jun 2017. Methodology: Sixty patients were selected and divided into two groups of 30 patients each. One Group was given a superior incision, the other was made the supero-temporal incision, and Manual small incision cataract surgery was performed. Preoperative and postoperative visual acuity, keratometry and refractive data were collected for all patients. In addition, surgically induced astigmatism (SIA) was analysed using a line SIA calculator. Results: The mean age of our patients was 59.57±10.13 years. Post-operatively, the visual acuity significantly improved in both groups. Mean induced astigmatism due to surgery came out to be 0.75±0.44 D for the superior incision and 0.45±0.18 D for the supero-temporal incision. The study found that in the Superior Incision-Group, induced astigmatism was slightly higher than in the Supero-Temporal-Group. Moreover, the Supero-Temporal-Group had a better uncorrected visual outcome than the Superior Incision-Group. Conclusion: Overall, manual small incision cataract surgery has good visual outcomes. Manual small incision cataract surgery through supero-temporal incision was found to have a better visual outcome with less surgically induced astigmatism than the superior incision. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic accuracy of Colistin agar for detection of Colistin resistance in clinical isolates of Multi- Drug Resistant Gram-Negative Bacilli. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Feb to Aug 2019. Methodology: A total of 100 Multi-Drug Resistant Gram-Negative Bacilli in clinical isolates were included. Isolates were identified using Gram stain, Catalase, Oxidase, API 20E, and API 20NE. After approval from the institutional ethical review committee, Colistin susceptibility was determined simultaneously by Colistin agar and Broth Micro Dilution Minimum Inhibitory Concentration method as per CLSI. For susceptibility criteria, EUCAST guidelines were followed. Results were validated with the gold standard test, i.e., Broth Micro Dilution. Results: Out of 100 Multi-Drug Resistant clinical isolates, the distribution was K. pneumoniae n=60, E.coli n=16, A. baumannii n=11, C. freundii n=8, and E. cloacae n=5. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of Colistin agar for detection of Colistin resistance, keeping Broth Micro Dilution Minimum Inhibitory Concentration method as the gold standard was 96.67%, 97.14%, 93.55%, 98.55%, and 97%, respectively. Conclusion: Colistin agar has excellent diagnostic accuracy for the detection of colistin resistance with standardized inoculum density. Due to its ease of use, cost-effectiveness, and accurate results, it can be used in lab setups deficient in manpower and advanced equipment for Broth Micro Dilution or genetic sequencing. [ABSTRACT FROM AUTHOR]

Objective: To determine the diagnostic accuracy of PANBIO COVID-19 rapid antigen method in nasopharyngeal swab, for screening of COVID-19 infection in emergency cases. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Microbiology, Combined Military Hospital, Multan, from Jan to Mar 2021. Methodology: After taking approval from institutional ethical review committee, total 1539 patients were included in this study according to sample size. With informed consent, nasopharyngeal swab specimens were taken for PANBIO COVID-19 rapid antigen method from each patient presenting as emergency medical/surgical case to Combined Military Hospital Multan as well as for Polymerase Chain Reaction for SARS CoV-2 RNA. PANBIO COVID-19 rapid antigen method and polymerase chain reaction for SARS CoV-2 RNA were performed simultaneously on swabs. Polymerase chain reaction for SARS CoV-2 RNA was considered to be the gold standard for comparison with the PANBIO COVID-19 rapid antigen method. Results: A total of 21 patients had SARS CoV-2 RNA detected by polymerase chain reaction indicating COVID-19 infection. Out of polymerase chain reaction positive patients, PANBIO™ COVID-19 Ag test was able to detect 19 cases. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy was calculated and found to be 90.47%, 100%, 100%, 99.8% and 99.8% respectively. Conclusion: PANBIO™ COVID-19 rapid antigen method was found to have excellent diagnostic accuracy in detection of COVID-19 infection. It can provide as a good alternate test for screening of masses with a short turnaround time of only 15 minutes. [ABSTRACT FROM AUTHOR]

Objective: to find out the predisposing factors for the cases of mocrobial keratitis in patients with red eye reporing to the Military Hospital. Study Design: Cross-sectional study. Place and Duration of Study: Ophthalmology deparment, Military Hospital Rawalpindi during 06 months from 1st Jun 2001 to 31st Dec 2001. Methodology: This was cross-sectional study which included consecutive cases of red eye. Cases referred from other military hospitals and field medical units were also included in the study. Inclusion Criteria was serving officers and their family members including parents, wife and children, retired JCOs/NCOs/Other ranks. Exclusion criteria was all cases of cataract surgery who had transient period of red eye were excluded from the study. Results: Out of 857 patients who reported with red eye during 06 months 32 cases fulfilled the criteria for microbial keratitis. The frequency of microbial keratitis in our population sample was found to be 3.7%. Out of 32 patients of microbial keratitis predisposing factors were found in most of the cases. These included history of accidental trauma in 14 patients (43.75%), bullous keratopathy in 3 patients (9.37%), corneal exposure in 3 (9.37%), contact lens wear in 2 (6.25%), dry eyes in 2 (6.75%), and corneal graft in one patient (3.13%). Two patients had history of excessive and prolonged use of topical steroids (6.25%). Conclusion: The frequency of microbial keratitis in our population sample was quite common. Patients coming with ophthalmic problems, i.e., red eye, photophobia, irritation and watering to the general practitioner should be referred as soon as possible to the ophthalmology department. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To assess characteristics of coronary arterial lesion (CAL) by means of invasive coronary angiography in young patients, aged <35 years, who sustained acute myocardial infarction (AMI). METHODS: This prospective study of one-year duration was conducted from December 2009 to November 2010 at the cardiology departments of three teaching hospitals in Peshawar, Pakistan. All patients aged <35 years, evaluated angiographically after an AMI, were included. The individual CAL were characterized. RESULTS: About 101 patients with AMI underwent coronary angiography. Mean age of the patients was 32.56±3.26 years (range 22-35 years). Out of 101 patients, 86 (78.18%) were males, while 15 (21.81%) were females. On coronary angiography, there were 25 (24.8%) patients with nonatherosclerotic coronary arteries, 39 (38.6%) with single vessel disease (SVD), 18 (17.8%) had double vessel disease (DVD), and 19 (18.8%) had triple vessel disease (TVD). Of the total, 3 patients (2.97%) had disease in the left main stem. One hundred thirty-two lesions (39x1=39 in SVD; 18x2=36 in DVD & 19x3=57 in TVD) were studied. The lesions were mostly discrete to tubular with less diffuse involvement and had either no or mild calcification. Thrombus was found in 5 patients with SVD (12.82%), 2 with DVD (11.11%) and 1 with TVD (1.75%). CONCLUSION: This study showed that young (age <35 years) patients who have sustained AMI, have less extensive coronary artery disease but complex morphologic features. There was a higher incidence of normal vessels on coronary angiography with a very few cases of left main coronary arterial involvement. [ABSTRACT FROM AUTHOR]

Paper manufacturing industry is characterized by large amount of water consumption and hence high rate of wastewater generation which is concern to water pollution. This study considers the characterization of paper mill effluents for recovery in the form of Total Suspended Solids (TSS) in relation to decrease in organic waste in the form of Biochemical Oxygen Demand (BOD5) and Chemical Oxygen Demand (COD). For this purpose sedimentation and coagulation were applied. Coagulation was performed using "Alum" to check its efficiency. The effects of dose rate and settling time of solids were observed for TSS, BOD5 and COD removal. The average concentrations of TDS (860-881 mg/L), TSS (822-836 mg/L), BOD (261-275 mg/L) and COD (519-550 mg/L) were determined above the permissible limits. By comparing the level of these parameters after sedimentation a visible decrease was observed. TDS, TSS, COD and BOD5 decrease by 19%, 37%, 17.3% and 18%, respectively. In coagulation treatment the decrease was 84%, 89%, 86% respectively for TSS, COD and BOD5. The study observed maximum recovery in the form TSS (84%) along with BOD5 and COD. Therefore, coagulation treatment for paper recycling mill is recommended. [ABSTRACT FROM AUTHOR]

Objective: To determine the status of thyroid functions in patients of β Thalassemia Major, reporting to OPD of Military Hospital, Rawalpindi. Study Design: Descriptive cross sectional study. Place and Duration of Study: Paediatric Outpatients Department of Military Hospital, Rawalpindi from 1st Jan to 30th Jun 2012. Material and Methods: After taking informed consent from the parents of all the children fulfilling the inclusion criteria, detailed history was taken and blood samples were drawn by strict aseptic means. Samples taken from these patients included complete blood and thyroid profile (serum thyroxine T4, triiodothyronine T3 and thyroid stimulating hormone TSH). These blood samples were labeled and sent to Armed Forces Institute of Pathology (AFIP), Rawalpindi for analysis by enzyme-linked immunosorbent assay (ELISA). Primary hypothyroidism was defined by TSH levels >4IU/ml. Statistical analysis was done at the end of study using SPSS version 10. Significance for association was calculated using student t-test. Results: Sixty patients fulfilled the inclusion criteria out of these sixty four patients lost the follow up while 56 patients completed the study. Out of 56 patients, 21 (37.5%) had biochemical evidence of hypothyroidism. Mean Ferritin level was 3924 ± 1247ng/ml in hypothyroid and 3136 ± 1387ng/ml in euthyroid patients indicating a significant difference in mean serum ferritin levels between hypothyroid patients and others. Conclusion: The study demonstrates hypothyroidism in a significant number of hyper transfused β-thalassemic patients, emphasizing the importance of monitoring thyroid functions in thalassemic patients, particularly in those receiving suboptimal chelation. [ABSTRACT FROM AUTHOR]

In this study, leaf anatomical characteristics of 17 species belonging to 9 genera of tribe Paniceae, native the Salt Range, Pakistan, were evaluated. Two Urochloa species, U. deflexa and U. ramosa, were distinguished from the rest of the species by absence of median vascular bundles. Presence of sclerenchyma strands on the abaxial side only makes the genus Cenchrus distinct from the remaining species within the tribe. The distribution pattern of bulliform cells proved to be helpful in the differentiation among Cenchrus species. Large macrohairs with deep penetration on the adaxial surface are characteristic of Digitaria nodosa. The observed diversity in anatomical markers could be used to clarify the status of problematic taxa in tribe Paniceae. Saddle shaped silica bodies, microhairs and bulliform cells deeply penetrating the mesophyll are the prominent characters of this tribe, which justify placing all these species in the same tribe. Anatomical markers of taxonomic importance are the nature and size of macro- and micro-hairs, shape of bulliform cells, arrangement of vascular bundles and amount of sclerification present in the leaves, which may be used for resolving taxonomic problem of problematic genera within tribe Paniceae. © 2015 Friends Science Publishers [ABSTRACT FROM AUTHOR]

Objective: To determine the immunization status of children between 1-3 years of age, reported at children OPD; Military Hospital, Rawalpindi. Study Design: Descriptive cross sectional study. Place and Duration of Study: Paediatric outpatients department of Military Hospital, Rawalpindi from January to June 2010. Material and Methods: Vaccination data of 2200 children of 1-3 years of age coming to outpatients department, regarding seven EPI target diseases was collected using a standard proforma. Statistical analysis was done at the end of study using SPSS version 14.0. Results: Out of 2200 children, 1256 (57.1%) were completely immunized, 740 (33.6%) were partially immunized and 204 (9.3%) were unimmunized. Conclusions: This study concludes that immunization indicators have not met the expected benchmarks and achievements are inadequate as compared to the regional and global immunization level. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the factors associated with under utilization of anticoagulation in patients with atrial fibrillation (AF) with high risk profile for thromboembolism. METHODS: This descriptive cross-sectional study was conducted at Cardiovascular Department Lady Reading Hospital Peshawar, Pakistan and Cardiology Department Hayatabad Medical Complex Peshawar, Pakistan from 01-12-2014 to 28-02-2015. All patients visiting OPD of respective hospitals with electrocardiogram (ECG) evidence of AF and CHADS VASC score 2 or more and mitral stenosis and AF were included. RESULTS: Out of 205 patients, 114 (55.6%) were males and mean age was 60.7±4.7 years. Out of 205, 149 (72.7%) were candidates for anticoagulation. AF patients with CHA2DS2 VASc score of ≥2 were 130 while patients with mitral stenosis and AF were 19. Only 41(27.5%) patients were adequately treated with anticoagulant therapy using vitamin K antagonist (VKA) or novel oral anticoagulant drugs. Factors associated with underutilization of anticoagulant therapy were, patient preference 27.8%, older age of 65 and above 17.6%, use of dual antiplatelet therapy 28.7 %, monitoring issue 9.3%, affordability 8.3% and prior complications due to anticoagulation therapy in 8.3%. CONCLUSION: Patients refusal of taking anticoagulation therapy, poverty, older age, lack of monitoring facility, previous complications or use of anti-platelet therapy are major causes of under utilization of anticoagulant therapy in patients with AF. [ABSTRACT FROM AUTHOR]

Abstract: The lesser grain borer, Rhyzopertha dominica and red flour beetle, Tribolium castaneum are considered most destructive pests of storages commodities worldwide. Unfortunately, due to multiple applications of synthetic pyrethroids and fumigants some major pests of stored grains has develops resistance against them. Resistance mechanisms in R. dominica and T. castaneum against these control agents at different geographical locations was largely unknown. To overcome this gap our research was undertaken to evaluate the resistance mechanism in lab and field collected strains of R. dominica and T. castaneum against deltamethrin and phosphine. Results indicated significant difference between lab and field collected pests strains regarding their resistance mechanisms to deltamethrin as well as phosphine treatments. Field strains collected from various geographical locations were observed more resistant then lab strains. Calculated LC50 values was very less in field strains as compared to lab strains. Maximum mortality of lab and field collected strains of R. dominica and T. castaneum was observed against phosphine than against deltamethrin. Our results suggest that field strains experienced with different out door conditions was less susceptible as compared to lab strains which proved to be more susceptible and findings of this study could be helpful for effective management of these key pests keeping in mind the issue of resistance development.\ [ABSTRACT FROM AUTHOR]

Highlights from the article: Chemical analysis of leaves and roots extracts revealed the presence of alkaloids, saponins, cardiac glycosides, Analysis of aqueous methanolic extracts and crude saponins isolated from leaves and roots of Sarcococca Saligna. Table 2: Antibacterial screening of S. saligna aqueous methanolic extracts of leaves and roots as well as crude saponins Table 3: Antifungal screening of S. saligna aqueous methanolic extracts of leaves and roots as well as crude saponins.