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1. Levels of 17-Hydroxyprogesterone, Renin, Testosterone, And Electrolytes in Congenital Adrenal Hyperplasia Patients

Author

Umaira Ahsan, Samia Naz, Faiqa Arshad, Saima Pervaiz, Raisa Maraj, and Omer Shahzad khan Rao

Subjects
Congenital adrenal hyperplasia, 17-hydroxyprogesterone, plasma direct renin, testosterone, serum electrolytes, Medicine
Abstract

Introduction: Congenital adrenal hyperplasia (CAH) is an autosomal-recessive condition primarily caused by 21- hydroxylase deficiency. It is the most common cause of ambiguous genitalia in infants and children. It can be a fatal condition if left untreated. Objectives: The study's objective was to estimate the levels of 17-hydroxyprogesterone, plasma direct renin, testosterone, and electrolytes in patients with CAH. Place and Duration of Study: This cross-sectional study was conducted at the University of Child Health Sciences, Lahore between March 2021 till April 2022. Material & Methods: This study included ninety CAH patients up to 14 years of age who underwent clinical and physical testing without gender restriction. Patients without confirmed CAH but with elevated levels of 17- hydroxyprogesterone were excluded. An ultrasound examination was done to confirm the presence of ambiguous genitalia. ELISA was used to estimate the values of 17-hydroxyprogesterone. Plasma direct renin and testosterone were measured by chemiluminescence immunoassay. The values of sodium, potassium and chloride were measured using an electrolyte analyzer. Data was analyzed using IBM SPSS version 26.0. Results: Of the total 90 patients, 46 (51.11%) were boys and 44 (48.88%) were girls. 55 (61.10%) CAH patients had high levels of 17-OHP. High testosterone and plasma direct renin levels were observed in 31 (34.40%), and 43 (47.80%) CAH patients respectively. Mostly, CAH patients had normal levels of sodium 70 (77.80%), potassium 54 (60.0%), and chloride 57 (63.30%). The difference in 17-OHP (ng/mL) levels was found to be statistically significant (p=0.002) in both genders. Conclusion: There is a significant association between elevated 17-OHP and CAH in the pediatric population, indicating that the 17-OHP can be used as a diagnostic tool for CAH patients.

Published
2024

2. Assessing Radiology and Radiation Therapy Needs for Cancer Care in Low-and-Middle-Income Countries: Insight From a Global Survey of Departmental and Institutional Leaders

Author

Parker, Stephanie A., Weygand, Joseph, Bernat, Beata Gontova, Jackson, Amanda M., Mawlawi, Osama, Barreto, Izabella, Hao, Yao, Khan, Rao, Yorke, Afua A., Swanson, William, Huq, Mohammed Saiful, Lief, Eugene, Biancia, Cesar Della, Njeh, Christopher F., Al-Basheer, Ahmad, Chau, Oi Wai, Avery, Stephen, Ngwa, Wilfred, and Sandwall, Peter A.

Published
2024
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5. Public perception and willingness towards bystander cardiopulmonary resuscitation (CPR) training and performance in Pakistan

Author

Ali Khan Uzair, Ali Khan Ayaan, Ali Khan Zoya, Hinna Rashk E., Bilal Khattak Muhammad, and Saad Ali Khan Rao

Subjects
cardiopulmonary resuscitation (cpr), pakistan, survey, questionnaire, Medicine
Abstract

Background/Aim: Bystander cardiopulmonary resuscitation (CPR) during out of-hospital cardiac arrest increases both survival rates and neurological recovery, but in Pakistan, an alarmingly low 2.3 % of these individuals receive bystander CPR. This study was designed to identify the reasons that affect the perception and willingness of the public toward bystander CPR training and performance in Lahore, Pakistan. Methods: A CPR master trainer from the USA visited various organisations from 1 December 2022 to 31 January 2023, to conduct training sessions. Before and after the training, a questionnaire was distributed among respondents to fill in. The subjects were asked to answer questions about their perception and willingness to perform bystander CPR. Results: Out of 401 participants, 240 completed the survey, with a response rate of 59.85 %. The majority of them were males [146 (60.8 %)], 215 (89.6 %) were below the age of 40, 107 (44.6 %) were graduated, 182 (75.8 %) never participated in any CPR training, mainly due to their ignorance towards the importance of bystander CPR (52.8 %) and 152 (63.3 %) were eager to participate in the CPR training course. Furthermore, the leading problem in providing bystander CPR was lack of technique or fear of possible harm that can be proved fatal (48.8 %), followed by concerns related to involvement in any legal procedure (10.0 %). Conclusions: Bystander CPR is still uncommon in Pakistan. Participants were reluctant to perform bystander CPR because of various concerns and fears. Lack of proper skill and causing additional harm were the main reasons associated with this. Hence, while improving CPR training and public education, these findings must be considered.

Published
2023
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9. Historical progress of stereotactic radiation surgery

Author

Khaledi, Navid, Khan, Rao, and Gräfe, James

Subjects
Brain damage -- Care and treatment, Radiation, Radiosurgery, Medical imaging equipment, Health
Abstract

Byline: Navid. Khaledi, Rao. Khan, James. Gräfe Radiosurgery and stereotactic radiotherapy have established themselves as precise and accurate areas of radiation oncology for the treatment of brain and extracranial lesions. [...]

Published
2023

11. Theophyline versus NSAID in the Treatment of Postdural Puncture Headache in Obstetric Patients.

Author

Mehmood, Tariq, Shan Khan, Rao Ali, Qarni, Muhammad Awais, Majeed, Kaukab, Khalid, Usman, and Iftikhar, Hina

Subjects
*NONSTEROIDAL anti-inflammatory agents, *HEADACHE, *MILITARY hospitals, *VISUAL analog scale, *PREGNANT women
Abstract

Objective: To determine the effectiveness of oral Theophyline compared to Non-Steroidal Anti-Inflammatory Drugs in the management of postdural puncture headache in obstetric patients. Study Design: Quasi-experimental Study. Place and Duration of Study: Anaesthesia Department, Combined Military Hospital, Kharian Pakistan, from Apr to Sep 2018. Methodology: Our study enroled 60 pregnant women suffering from postdural puncture headache. The were divided in to two groups, NSAID-Group (Group-A) who received 30mg of Ketorolac in three divided doses in 24 hours and Theophyline-Group (Group-B) who received 750mg of oral Theophyline in three divided doses in 24 hours after which effects of both drugs were noted. Results: Pregnant women were enroled in NSAID-Group and in Theophyline Group. Mean baseline Visual Analogue Scale score was 7.500±0.97 in NSAID-Group and 7.33±0.92 in Theophyline Group. Mean weight was 66.86±5.25 kg in NSAID-Group and 67.16±7.01 Kg in Theophyline-Group. In NSAID-Group efficacy was noted in 7(23.3%) patients as compared to 25(83.3%) patients in Theophyline-Group, (p<0.001). Conclusion: Theophyline when given oraly in the management of postdural puncture headache proved to be a superior alternative to NSAID medication. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Clinical Response of EMLA Cream in Decreasing Peripheral Cannulation Pain in Children.

Author

Tariq, Sana, Shan Khan, Rao Ali, Shahid, Arooj, Tariq, Hassan, Khan, Tanveer Ahmed, and Khalique, Ahmed Bilal

Subjects
*CHILD patients, *CATHETERIZATION, *LOCAL anesthetics, *MILITARY hospitals, *VISUAL analog scale
Abstract

Objective: To assess the clinical response of EMLA cream (Eutectic Mixture of Local Anaesthetics; 2.5% Lidocaine/2.5% Prilocaine) in decreasing peripheral cannulation pain in children. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from May to Aug 2021. Methodology: This study was conducted on 80 paediatric patients who were classified as American Society of Anesthesiologists (ASA) Grades I and I and selected using non-probability consecutive sample. They underwent peripheral cannulation to maintain intravascular access for surgical procedure. The forty children in EMLA Group (Group-A) were applied 2.5 ml EMLA cream for 60 min, covered by Tegaderm® over suitable vein, while the 40 children in Control Group (Group-B) received no local anesthetic cream. Participants rated pain during venipuncture on Visual Analog Scale (VAS 0-10; 0, no pain; 10, intolerable pain). Results: Out of 80 patients equaly divided into two groups, 40(50%) were males, while 40(50%) were females. The patients included in our study had mean age of 7.35±1.5 years. In EMLA group the mean score of pain was 1.5±0.87 compared to the Control group (mean score = 7.4±1.4; p=0.001). Conclusion: The result of our study suggests that EMLA cream is more efficacious in decreasing venipuncture pain than if no local anaesthetic cream is applied. [ABSTRACT FROM AUTHOR]

Published
2024
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29. Public Perception and Willingness Towards Bystander Cardiopulmonary Resuscitation (CPR) Training and Performance in Pakistan.

Author

Khan, Uzair Ali, Khan, Ayaan Ali, Khan, Zoya Ali, Hinna, Rashk e, Muhammad, Khattak, Bilal, and Ali Khan, Rao Saad

Subjects
CHEST compressions, ARTIFICIAL respiration, BYSTANDER CPR, MEDICAL personnel, MEDICAL students, AGE groups
Abstract

This article discusses a study conducted in Lahore, Pakistan, which aimed to understand the public perception and willingness towards bystander cardiopulmonary resuscitation (CPR) training and performance. The study found that only 2.3% of individuals in Pakistan receive bystander CPR during out-of-hospital cardiac arrest. Lack of awareness about the importance of bystander CPR and fear of causing harm were the main reasons for not participating in CPR training. The study highlights the need to improve CPR training and public education in Pakistan. The study also examines the barriers and driving forces behind bystander CPR in Pakistan, such as fear of disease transmission and legal actions. The authors recommend that the government and organizations create a strategic plan to improve bystander CPR performance through education, legislation, and creating an encouraging atmosphere. However, the study has limitations in terms of sample size and hypothetical analysis. [Extracted from the article]

Published
2023
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30. Does early application of needle-knife sphincterotomy (NKS) in patients with difficult biliary cannulation increase the risk of postERCP pancreatitis? A single centre study.

Author

Khan, Rao Saad Ali, Alam, Laima, Saeed, Farrukh, Sher, Farrukh, and Khan, Rao Zaid Ali

Subjects
*ENDOSCOPIC retrograde cholangiopancreatography, *CATHETERIZATION, *PANCREATITIS, *LOGISTIC regression analysis, *MILITARY hospitals, *AGE groups
Abstract

Objective: To determine that early needle-knife sphincterotomy does not increase post-ERCP pancreatitis in patients with difficult biliary cannulation as compared to standard cannulation. Method: This prospective single-centre cohort study was carried out at Pak Emirates Military Hospital from January 2021 to June 2021. Patients requiring ERCP were enrolled in the study (according to inclusion and exclusion criteria) and were subsequently allotted different groups according to the technique used for deep biliary cannulation. Qualitative data was analysed using frequencies and chi square statistics whereas, quantitative data was analysed using mean±SD and one way ANOVA test. Result: The cohort included 114 patients with 52.6% male patients and predominance of relatively younger age group (31-45 years). The most common indication for ERCP was choledocholithiasis (36%) with an overall technical success rate of 96%. Deep cannulation was achieved either through standard cannulation (56%), double guidewire and/or pancreatic stent assisted (10.5%), use of early Needle-Knife Sphincterotomy (19%), NKS as a last resort (3.5%) or Transpancreatic Stenting and/or combined sphincterotomy (6%). Pancreatitis as a complication occurred in 4(3.5%) patients, bleeding in 2(1.8%), on-table desaturation in 2(1.8%) and perforation in 1(0.9%) patient. The occurrence of pancreatitis was only related significantly to inadvertent PD cannulation through univariate and logistic regression analysis whereas, multiple cannulations (>5), gender, age, classification of papilla and the use of early NKS had no impact on pancreatitis or the occurrence of other complications. Conclusion: NKS is an effective and safe modality for deep biliary cannulation and achieving technical success where cannulation is deemed difficult and does not increase the risk of PEP if done by experienced endoscopists in high volume centres. [ABSTRACT FROM AUTHOR]

Published
2023
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34. The Impacts of Green Human Resource Management Practices on Employees’ Organizational Citizenship Behavior

Author

Khan, Rao Arif Mehmood, Sarwar, Shakeel, Khan, Rao Arif Mehmood, and Sarwar, Shakeel

Abstract

This study aims to investigate the impact of green human resource management (GHRM) practices on organizational citizenship behavior (OCB) and to explore the potential benefits of implementing GHRM practices in organizations across the world. The study adopts a quantitative research design and collects data from 299 organizations that have implemented GHRM practices. The data are gathered through a survey that includes four variables, namely, independent variables, mediating variables, and dependent variables, with 44 constructs adopted from existing literature. The study reveals that human resource departments play a crucial role in promoting GHRM practices in organizations. The research also highlights the importance of GHRM practices, including green collective commitment, collective job satisfaction, and green performance management, in promoting OCB. Additionally, the study introduces the concept of green functions, which adds to the current literature on GHRM practices. The study provides recommendations for implementing effective GHRM practices to promote green practices in organizations. This study adds to the existing literature by examining the mediating effects of collective job satisfaction and Green Collective Commitment between green performance management and OCB in the public education sector of Pakistan. The research provides detailed insights into the implementation of GHRM practices in the education sector, which is a relatively underexplored area. The study's findings can be valuable for organizations worldwide that aim to promote green practices and create a better work environment for their employees.

Published
2023

36. Focal Salmonellosis in a Diabetic Male Involving the Soft Tissue of Anterior Chest Wall from Pakistan.

Author

Abid Khan, Rao Muhammad, Irfan, Muhammad, Faisal, Muhammad, Nadeem, Ali, Kazmi, Kulsoom, and Imran, Muhammad

Subjects
*SALMONELLA diseases, *SOFT tissue infections, *SALMONELLA typhi, *DIFFERENTIAL diagnosis, *ABSCESSES
Abstract

Typhoid fever remains prevalent in Pakistan, with Salmonella Typhi, the causative bacterium, known to occasionally trigger uncommon extra-intestinal ailments. The identification of a focal Salmonella infection poses a frequent challenge. This case report details an instance of an extensively drug-resistant Salmonella infection affecting the soft tissue in the anterior chest wall, effectively managed with antibiotic treatment. Our emphasis is on recognizing the importance of considering focal Salmonella infection as part of the differential diagnosis when confronted with a chronic abscess of unknown origin. [ABSTRACT FROM AUTHOR]

Published
2024

37. Comparing the efficacy of EUS versus MRCP with ERCP as gold standard in patients presenting with partial biliary obstruction – finding a better diagnostic tool.

Author

Ali Khan, Rao Saad, Alam, Laima, Khan, Zoya Ali, and Khan, Uzair Ali

Subjects
*ENDOSCOPIC retrograde cholangiopancreatography, *MILITARY hospitals, *NONPROBABILITY sampling, *RECEIVER operating characteristic curves, *GALLSTONES, *RENAL colic
Abstract

Objective: To evaluate the diagnostic accuracy of different imaging modalities in patients with partial biliary obstruction with no obvious aetiology on initial imaging. Methods: This is a prospective single-centre cohort study carried out at Pak Emirates Military Hospital, Rawalpindi from June 2019 to June 2021 with non-probability consecutive sampling. Patients with ages 16 to 75 years, presenting with partial biliary obstruction and undetermined aetiology on initial imaging (TUS and MRCP) were enrolled. EUS was performed for each of these patients and the case was regarded as “true positive” or “true negative” if the findings of imaging modality correlated to those of ERCP. ROC curve, sensitivity, specificity, PPV, NPV and AUC (with 95% confidence interval) were drawn for all the diagnostic tools using SPSS V. 21. Results: A total of 65 patients were enrolled over a period of two years with male to female ratio of 1.4:1. Fortyfour patients had an intermediate risk of choledocholithiasis upon preliminary evaluation whereas, 48(74%) of the participants had CBD calculi or sludge confirmed upon subsequent ERCP. Trans-abdominal ultrasound showed the lowest sensitivity (29.2%), specificity (85%), NPV 12% and PPV 93% for diagnosing CBD calculi. This was followed by MRCP with a sensitivity of 37.5%, specificity of 100%, NPV of 36.2% and PPV of 100%. EUS showed the maximum diagnostic accuracy with AUC of 1.0 and a 100% sensitivity and specificity when compared with ERCP as gold standard. Conclusion: EUS is superior to MRCP in terms of diagnostic accuracy as minimally invasive diagnostic tool and EUS superiority is particularly relevant in patients with intermediate risk of choledocholithiasis. [ABSTRACT FROM AUTHOR]

Published
2023
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38. Dynamic Evolution of NLR Genes in Dalbergioids

Author

Rani, Shamiza, primary, Zahra, Ramlah, additional, Bakar, Abu, additional, Rizwan, Muhammad, additional, Sultan, Abu-Bakar, additional, Zain, Muhammad, additional, Mehmood, Amna, additional, Danial, Muhammad, additional, Shakoor, Sidra, additional, Saleem, Fozia, additional, Serfraz, Ali, additional, Rehman, Hafiz Mamoon, additional, Khan, Rao Sohail Ahmad, additional, Serfraz, Saad, additional, and AlKahtani, Saad, additional

Published
2023
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42. Tourists’ Attitude Towards Cultural Heritage and their Willingness to Pay to Visit: a Case Study of Lahore, Pakistan

Author

Mahboob, Muhammad Hassan, Ashfaq, Muhammad, Khan, Rao Aamir, Kamal, Yasir, and Humayon, Asad Afzal

Subjects
lahore, 0502 economics and business, 05 social sciences, Arts in general, tourism, 050211 marketing, cultural heritage, willingness to pay, NX1-820, 050212 sport, leisure & tourism
Abstract

Tourists’ interest in traveling to Lahore (more specifically to the Badshahi Mosque and the Royal fort) has increased in recent years and is expected to continue. Despite this, very few facts are known about an individual's attitude towards cultural heritage. This study looks at the pre- and post- visit factors that encourage tourists to come to the cultural heritage sites and also identifies variables that help to estimate their willingness to pay (WTP) for admission to visit them. The data from 200 tourists was collected through a well-prepared questionnaire and then used in the final analysis. The contingent valuation method (CVM), considered to be the most useful, with a dichotomous choice question, was used to estimate the WTP. Two models were used in estimating the WTP, i.e. binary regression and ordinary least squares (OLS). The findings acknowledged that tourists were interested in retaining happy memories, experiences and knowledge through the visit. More than 75% of the tourists were willing to pay for cultural heritage, had a positive attitude toward it and would like to visit these destinations again. Tourists’ income was a positive and significant determiner of WTP; the total cost of the visit and environmental issues were negatively related to WTP. As tourism provides an important source of income, the findings of this study point to some practical recommendations that may be implemented in the future by local authorities., Conservation Science in Cultural Heritage, Vol. 20 (2020)

Published
2021

43. Genome-wide association studies of seedling quantitative trait loci against salt tolerance in wheat.

Author

Ahmad Khan, Rao Waqar, Ahmad Khan, Rao Sohail, Awan, Faisal Saeed, Akrem, Ahmed, Iftikhar, Arslan, Anwar, Farhana Naureen, Alzahrani, Hind A. S., Alsamadany, Hameed, and Iqbal, Rana Khalid

Subjects
LOCUS (Genetics), GENOME-wide association studies, SALT, QUANTITATIVE research, CHROMOSOMES
Abstract

Salinity is one of the significant factors in decreasing wheat yield and quality. To counter this, it is necessary to develop salt-tolerant wheat varieties through conventional and advanced molecular techniques. The current study identified quantitative trait loci in response to salt stress among worldwide landraces and improved varieties of wheat at the seedling stage. A total of 125 landraces and wheat varieties were subjected to salt treatment (50, 100, and 150 mM) with control. Morphological seedling traits, i.e., shoot length, root length, and fresh and dry shoot and root weights for salinity tolerance were observed to assess salt tolerance and genetic analysis using SNP data through DArT-seq. The results showed that, at the seedling stage, 150 mM NaCl treatment decreased shoot length, root length, and fresh and dry weights of the shoot and root. The root length and dry root weight were the most affected traits at the seedling stage. Effective 4417 SNPs encompassing all the chromosomes of the wheat genome with marker density, i.e., 37%, fall in genome B, genome D (32%), and genome A (31%). Five loci were found on four chromosomes 6B, 6D, 7A, and 7D, showing strong associations with the root length, fresh shoot weight, fresh root weight, and dry root weight at the p < 0.03 significance level. The positive correlation was found among all morphological traits under study. [ABSTRACT FROM AUTHOR]

Published
2022
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44. Adsorption studies of Cd(II) on ball clay: Comparison with other natural clays

Author

Rifaqat Ali Khan Rao and M. Kashifuddin

Subjects
Adsorption, Cadmium, Desorption, Kinetics, Point of zero charge, Chemistry, QD1-999
Abstract

Ball clay was found to exhibit excellent adsorption capacity toward Cd(II) ions over a wide concentration range. The adsorption capacity was studied by heating it at different temperatures. It was found that the sample heated at 200 °C showed maximum adsorption capacity toward Cd(II) ions. This research was focused on the effect of pH, time, temperature, adsorbent doses and initial Cd(II) concentration by batch experiments. The equilibrium data of Cd(II) adsorption were explained well by Langmuir and Freundlich adsorption isotherms. The kinetics data for the adsorption process obeyed pseudo-first-order and pseudo-second-order models at lower initial concentrations of Cd(II) while with the increased concentration of Cd(II) pseudo-first-order model failed. The Cd(II) desorption was performed using batch process with various desorbing solutions and 100% desorption was achieved with HCl solution.

Published
2016
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49. The emergence of vancomycin resistance among methicillin-resistant Staphylococcus aureus isolates from post-operative surgical site infections at District Jacobabad

Author

Khan, Rao Muhammad Abid, Ali, Aamir, Parkash, Om, Qazi, Muneer Ahmed, and Nadeem, Ali

Subjects
Staphylococcus aureus, Vancomycin, Prevalence, Emergence, biochemical phenomena, metabolism, and nutrition, Surgical site infections, Methicillin resistance, bacterial infections and mycoses
Abstract

Surgical site infections (SSIs) are the most common post-operative infections and Staphylococcus aureus is the leading microbial cause. SSIs contribute significantly to morbidity and healthcare costs. The epidemiology and susceptibility pattern of S. aureus is fluctuating over time with the propagation of newer clones and the emergence of highly resistant strains. This cross-sectional study was conducted at Jacobabad Institute of Medical Sciences (JIMS) to determine the prevalence and antimicrobial susceptibility pattern of methicillin-resistant Staphylococcus aureus (MRSA) among patients suffering from SSIs from January to October 2021. A total of 180 pus aspirate and pus swabs were collected from patients who had undergone surgical procedures. Of these, 146 (81%) specimens were bacterial culture positive. Mono-bacterial growth was isolated from 111 (76%) patients and the remaining 35 (24%) patients revealed growth of either two organisms or mixed bacterial growth. Diabetes mellitus and chronic liver disease were major underlying medical conditions. The most common bacterial isolate was S. aureus 88 (79%) of which 38 (43%) were MRSA. The highest sensitivity of MRSA was revealed against vancomycin (87%), followed by Amikacin and Doxycyclin 84% and 82% respectively. Minimum inhibitory concentration (MIC) of vancomycin revealed, 5 (13%) of MRSA isolates were resistant to vancomycin exhibiting three isolates MIC 32 ��g/ mL and two isolates MIC 64 ��g/ mL. None of the methicillin-sensitive Staphylococcus aureus (MSSA) was resistant against vancomycin. Among MRSA and MSSA, the highest rate of resistance was observed against sulfamethoxazole+trimethoprime and ciprofloxacin. This report highlight the emergence of a significant fraction of VRSA among MRSA isolates amongst post-operative SSIs. The findings of this study call for regular monitoring of sensitivity patterns and the necessity of new and effective antibiotics., {"references":["1.\tKassavin, D. S., Pascarella, L., & Goldfarb, M. A. (2011). Surgical site infections: incidence and trends at a community teaching hospital. The American journal of surgery, 201(6), 749-753.","2.\tSeni, J., Najjuka, C. F., Kateete, D. P., Makobore, P., Joloba, M. L., Kajumbula, H., Bwanga, F. (2013). Antimicrobial resistance in hospitalized surgical patients: a silently emerging public health concern in Uganda. BMC research notes, 6(1), 1-7.","3.\tShah, S., Singhal, T., & Naik, R. (2015). A 4-year prospective study to determine the incidence and microbial etiology of surgical site infections at a private tertiary care hospital in Mumbai, India. Am J Infect Control, 43(1), 59-62.","4.\tUllah, H., Siraj, M., Ali, A., Khan, M. A. J., Khan, M. S., & Askar, Z. (2018). Infective Organisms and their Changing Antibiotic Sensitivity Trends in Infections Occurring in Orthopaedics Implant Surgery. Journal of Pakistan Orthopaedic Association, 30(01), 01-04.","5.\tKhan, F. U., Fang, Y., Khan, Z., Khan, F. U., Malik, Z. I., Ahmed, N., . . . Rehman, A. u. (2020). Occurrence, associated risk factors, and treatment of surgical site infections in Pakistan. European Journal of Inflammation, 18, 2058739220960547.","6.\tYang, Z., Wang, J., Wang, W., Zhang, Y., Han, L., Zhang, Y., . . . Zhan, S. (2015). Proportions of Staphylococcus aureus and methicillin-resistant Staphylococcus aureus in patients with surgical site infections in mainland China: a systematic review and meta-analysis. PLoS One, 10(1), e0116079.","7.\tDessie, W., Mulugeta, G., Fentaw, S., Mihret, A., Hassen, M., & Abebe, E. (2016). Pattern of bacterial pathogens and their susceptibility isolated from surgical site infections at selected referral hospitals, Addis Ababa, Ethiopia. Int J Microbiol, 2016.","8.\tShariq, A., Tanvir, S. B., Zaman, A., Khan, S., Anis, A., Khan, M. A., & Ahmed, S. (2017). Susceptibility profile of methicillin-resistant Staphylococcus aureus to linezolid in clinical isolates. International journal of health sciences, 11(1), 1.","9.\tNaik, G., & Deshpande, S. (2011). A study on surgical site infections caused by Staphylococcus aureus with a special search for methicillin-resistant isolates. J Clin Diagn Res, 5(3), 502-508.","10.\tGorwitz, R. J., Kruszon-Moran, D., McAllister, S. K., McQuillan, G., McDougal, L. K., Fosheim, G. E., . . . Kuehnert, M. J. (2008). Changes in the prevalence of nasal colonization with Staphylococcus aureus in the United States, 2001–2004. The Journal of infectious diseases, 197(9), 1226-1234.","11.\tZhao, C., Liu, Y., Zhao, M., Liu, Y., Yu, Y., Chen, H., . . . Liu, Y. (2012). Characterization of community acquired Staphylococcus aureus associated with skin and soft tissue infection in Beijing: high prevalence of PVL+ ST398. PLoS One, 7(6), e38577.","12.\tKimura, Y., Morinaga, Y., Akamatsu, N., Matsuda, J., Yamaryo, T., Kawakami, K., . . . Hasegawa, H. (2016). Antimicrobial susceptibility and molecular characteristics of methicillin-resistant Staphylococcus aureus in a Japanese secondary care facility. Journal of Infection and Chemotherapy, 22(1), 14-18.","13.\tGurusamy, K. S., Koti, R., Toon, C. D., Wilson, P., & Davidson, B. R. (2013). Antibiotic therapy for the treatment of methicillin‐resistant Staphylococcus aureus (MRSA) infections in surgical wounds. Cochrane Database of Systematic Reviews(8).","14.\tOrrett, F. A., & Land, M. (2006). Methicillin-resistant S taphylococcus aureus prevalence: Current susceptibility patterns in Trinidad. BMC Infect Dis, 6(1), 1-6.","15.\tUllah, A., Qasim, M., Rahman, H., Khan, J., Haroon, M., Muhammad, N., . . . Muhammad, N. (2016). High frequency of methicillin-resistant Staphylococcus aureus in Peshawar Region of Pakistan. Springerplus, 5(1), 1-6.","16.\tTiwari, H. K., & Sen, M. R. (2006). Emergence of vancomycin resistant Staphylococcus aureus (VRSA) from a tertiary care hospital from northern part of India. BMC Infect Dis, 6(1), 1-6.","17.\tIqbal, M. S., Saleem, Y., Ansari, F., Qamar, M. U., Mazhar, S., Hassan, A., ... & Syed, Q. (2018). Staphylococcus aureus carrying lukS/F Panton-Valentine Leukocidin (PVL) toxin genes in hospitals of Lahore city. The Journal of Infection in Developing Countries, 12(09), 720-725.","18.\tUllah, K., Ahmad, I., & Jalil, F. (2017). BACTERIAL ISOLATES FROM SURGICAL SITE INFECTION AND THEIR PATTERN OF ANTIBIOTICS SENSITIVITY. Journal of Bacha Khan Medical College, 1(2), 8-8.","19.\tAfzal Khan, A., Mirshad, P., & Mohammed Rafiuddin rAshed, G. B. (2013). A study on the usage pattern of antimicrobial agents for the prevention of surgical site infections (SSIs) in a tertiary care teaching hospital. Journal of clinical and diagnostic research: JCDR, 7(4), 671.","20.\tMalik, A. Z. (2015). Surgical site infections after elective surgery in Pakistan: Surgipak Study. Journal of Rawalpindi Medical College, 19(3), 209-214.","21.\tAnwar, J., Zahoor, M. A., Zahoor, M. K., Siddique, A. B., Nawaz, Z., Rasool, M. H., . Yasmin, A. (2018). Efficacy of Azadirachta indica organic extracts against clinical methicillin resistant Staphylococcus aureus isolates. Pakistan journal of pharmaceutical sciences, 31(4 (Supplementary)), 1485-1488.","22.\tAhmad, S., Ahmed, S., Sabir, M. S., Khan, H., Rehman, M., & Niaz, Z. (2020). Frequency and comparison among antibiotic resistant Staphylococcus aureus strains in selected hospitals of Peshawar, Pakistan. The Journal of the Pakistan Medical Association, 70(7), 1199-1202.","23.\tUllah, A., Qasim, M., Rahman, H., Khan, J., Haroon, M., Muhammad, N., . . . Muhammad, N. (2016). High frequency of methicillin-resistant Staphylococcus aureus in Peshawar Region of Pakistan. Springerplus, 5(1), 1-6.","24.\tGhias, W., Sharif, M., Yazdani, F. A., & Rabbani, M. (2016). Isolation and identification of Methicillin and Vancomycin resistance Staphylococcus aureus from pus samples of injured skin patients in Lahore, Pakistan. Biomed Lett, 2(2), 103-112.","25.\tKhorvash, F., Mostafavizadeh, K., Mobasherizadeh, S., Behjati, M., Naeini, A., Rostami, S., . . . Khorvash, F. (2008). Antimicrobial susceptibility pattern of microorganisms involved in the pathogenesis of surgical site infection (SSI); A 1 year of surveillance. Pakistan journal of biological sciences: PJBS, 11(15), 1940-1944.","26.\tAyoub, A., & Iqbal, A. (2018). Past & Current Status of Methicillin-Resistant Staphylococcus aureus & Vancomycin-Resistant Staphylococcus aureus in Pakistan. Microbiology Research Journal International, 1-7.","27.\tMahmood, A. (2000). Bacteriology of surgical site infections and antibiotic susceptibility pattern of the isolates at a tertiary care hospital in Karachi. Infection, 3, 4.","28.\tHubab, M., Ullah, O., Hayat, A., Rehman, M. 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Published
2022
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50. Streptococcus pyogenes strains associated with invasive and non-invasive infections present possible links with emm types and superantigens

Author

Khan, Rao Muhammad Abid, Anwar, Sana, and Pirzada, Zaid Ahmed

Subjects
stomatognathic diseases, antibiotic resistance, stomatognathic system, Short Communication, gas, lcsh:R, lcsh:Medicine, invasive pathogens, exotoxin, mic
Abstract

Objective(s): Streptococcus pyogenes, a notorious human pathogen is responsible to cause a wide range of infections varies from superficial common clinical illness to severe and life threatening infections. To our knowledge this is the first report exploring the emm types and superantigen/exotoxin gene profile of S. pyogenes from Pakistan. Materials and Methods: A total of 89 S. pyogenes strains were collected predominantly from throat swabs followed by pus, tissues and wound swabs. Profile of five superantigen genes speA, speB, speC, speF and ssa was screened for all the emm types. Results: Extensive heterogeneity among S. pyogenes strains was indicated, revealing 34 different emm types/ subtypes. The most prevalent emm types were emm68 and emm104. Some of the emm types were exclusively isolated from invasive infections while others were isolated only from non-invasive infections indicating the possible link between emm types and invasive/ noninvasive infections. Similarly, erythromycin-resistant strains mainly belonged to three particular emm types. Multiplex PCR analysis indicated the presence of speB 100%, speF 76%, speC 20%, speA 18% and ssa 15%. Interestingly, superantigen genes speC and speA were mainly associated with invasive infections. Among the five superantigens tested, one strain of emm12 harbored all the analyzed exotoxin genes, while 4 strains carried 4 superantigen genes. Conclusion: S. pyogenes clones associated with invasive and non-invasive infections in Pakistan present differences in emm types, superantigens and antimicrobial resistance. The present data indicates the possible link between particular genetic lineage of a bacterium with the manifestation of the infection.

Published
2020

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