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Background: Asthma is a chronic inflammation of airways, associated with hyper-responsiveness of the bronchial tree, resulting in reiterated attacks of cough, wheezing, chest tightness, and breathlessness. Aapproximately 4 Pakistani adults out of 100 persons have been reported to suffer from asthma in year 2002-03.This study focuses on determining interleukin-13 (IL-13) and immunoglobulin E (IgE) in asthma patients and healthy subjects. Settings and Design: Methods and Material: The study assessed the level and correlation of IL-13 and IgE in bronchial asthma patients. Fifty bronchial asthma patients with allergy history and thirty healthy individuals were included. The patients were selected from Gulab Devi Chest Hospital, Lahore, Pakistan. Total serum IgE and IL-13 were determined by ELISA technique.SPSS (Version 20.0) software was used for statistical analysis. Kolmogorov-Smirnov, Shapiro-Wilk test, Student t-test and Mann-Whitney test have been used in analysis. Results: The mean (±SD) values of IL-13 concentration (pg/ml) in asthmatics and controls (healthy) were 1574 (± 409) and 390 (± 23). Moreover, median (IQR) value for both groups were 1415.8 (1398-1554) and 394.3 (384.3- 404.3), respectively. Conclusions: To sum up, we have found that bronchial asthma patients had significantly increased level of total serum IgE and IL-13 and we found a positive correlation between these parameters. Bangladesh Journal of Medical Science Vol. 21 No. 03 July’22 Page: 596-600

Benzimidazole ring system is an important pharmacophore with diverse pharmacological activities. In this study, we explored the anti-arthritic effects of newly synthesized acetamide derivatives of 2-aminobenzimidazole (N1 and N2) in rats. FTIR and NMR spectroscopies were used to characterize these compounds. Carrageenan (CRG) induced paw edema model was used to test the acute anti-inflammatory activity of various doses (10, 20 and 30 mg/kg) of N1 and N2 compounds. Based on acute anti-inflammatory effects, the most potent dose of each compound was selected and investigated in complete freund's adjuvant (CFA) induced inflammatory arthritis (RA) model (n = 4 in each group). Histopathological, hematological, radiographic, and RT-qPCR analyses were performed to assess the progression or resolution of inflammatory arthritis. The tested compounds produced a dose-dependent anti-inflammatory activity against CRG induced paw inflammation and similarly reduced edema in CFA induced inflammatory arthritis model. Histopathological and X-ray analyses of ankle joints revealed minimal inflammation and normal joint structures in N1 and N2 treated groups. The tested compounds also reduced the levels of autoantibodies and restored hematological parameters. Interestingly, the tested compounds did not elevate aspartate aminotransferase and alanine transaminase levels and displayed a better safety profile than methotrexate. N1 and N2 compounds also attenuated the transcript levels of IRAK1, NF-kB1, TNF-α, IL-1β, IL17 and MMP1. In addition, N1 displayed a greater inhibition of mRNA levels of COX1, COX2, mPGES1 and PTGDS as compared to N2. Our findings demonstrate that N1 and N2 compounds possess strong anti-arthritic activity which can be attributed to the suppression of pro-inflammatory mediators.

The regulation of immune mechanisms is controlled by major histocompatibility complex/human leukocyte antigen (MHC/HLA). Polymorphisms of the HLA region have an impact on susceptibility to complex infectious and autoimmune diseases. The present study was carried out to determine the frequencies of ASMA, AMA, ANA, dsDNA, and anti-LKM-1 auto-antibodies in hepatitis C patients and to determine their association with the HLA DRβ1 (*04) locus. It was a cross-sectional, analytical study, and 86 patients with chronic HCV were recruited. The presence of auto-antibodies (ASMA, AMA, ANA, dsDNA, and anti-LKM-1) was determined by indirect immunofluorescence and ELISA, while the HLA DRβ1 (*04) allele was assessed by sequence-specific conventional PCR. ANA was detected in 41%, ASMA in 17.4%, AMA in 7%, LKM-1 in 5.8% dsDNA in 4.6% of CHC patients while HLA-DRβ1 (*04) was present in 3.5% of patients, but this was not significantly associated with these auto-antibodies.

Faiqa Arshad,1 Sidrah Saleem,1 Romeeza Tahir,2 Shah Jahan,2 Kokab Jabeen,3 Aneela Khawaja,4 Zille Huma,1 Muhammad Roman,1 Faheem Shahzad2 1Department of Microbiology, University of Health Sciences, Lahore, Punjab, Pakistan; 2Department of Immunology, University of Health Sciences, Lahore, Punjab, Pakistan; 3Department of Pathology, Ammer ud Din Medical College, PGMI, Lahore, Punjab, Pakistan; 4Department of Pathology, Rahbar Medical & Dental College, Lahore, Punjab, PakistanCorrespondence: Faiqa Arshad, Department of Microbiology, University of Health Sciences, Khayaban-e-Jamia, Block D Muslim Town, Lahore, Punjab, 54600, Pakistan, Email drfaiqaimran@gmail.comBackground: The association of treatment failure and mortality with vancomycin minimum inhibitory concentration creep (MIC) is a matter of serious concern in patients with severe methicillin resistant Staphylococcus aureus (MRSA) infections. The purpose of the study was to identify and characterize staphylococcal cassette chromosome mec (SCCmec) and clonal types of MRSA strains, exhibiting the vancomycin MIC creep phenomenon.Methods: A total of 3305 S. aureus strains were isolated from various clinical samples of Lahore General Hospital, Lahore, Pakistan. MRSA strains were identified by cefoxitin resistant (≤ 21mm) followed by mecA and mecC gene genotyping. Vancomycin MIC creep was determined by E-test. Isolates having MIC values > 1.5 μg/mL were further subjected for SCCmec typing (I–V and XI) and multiple-locus variable number tandem repeat analysis (MLVA) by amplification of spa, sspA, clfA, clfB, and sdrCDE genes. A dendrogram was created based on the similarity index using bioneumerics software.Results: About 13.3% (440/3305) isolates were MRSA with 99.3% (437/440) and 0.7% (3/440) carried mecA and mecC genes, respectively. In 120 MRSA isolates, the MIC of vancomycin was > 1.5μg/mL. In MRSA isolates with high vancomycin MIC (> 1.5μg/mL), the most common SCCmec type was SCCmec III (38.3%), followed by SCCmec IVa (15.8%), SCCmec IIIa (13.3%,), SCCmec IVc (7.5%), SCCmec IVe (5.8%), SCCmec IVd (5.8%), SCCmec IVb (4.2%), SCCmec II (2.5%), SCCmec V (1.7%), SCCmec I (1.7%) and SCCmec XI (1.7%). MLVA revealed 60 genotypic groups of MRSA isolates having a 92% similarity index.Conclusion: SCCmec III was the most common type in genetically related MRSA isolates showing vancomycin MIC creep. The presence of SCCmec XI may further add burden to infection control measures.Keywords: methicillin resistant Staphylococcus aureus, staphylococcal chromosomal cassette, multilocus variable number tandem repeat analysis

Currently major challenge for scientists is to cope with Coronavirus infection that alters host immune response in different ways There is variability in immune response in diverse populations against this infection and particularly immunity of a certain population against SARS-CoV-2is not clear Many factors such as viral and host genetics that play crucial in this infection but immunological aspects are more important in infection and disease progression Its different patterns of spread and severity needs timely focus to design strategies against this disease This review sums up the concepts related to host immune response to SARS-CoV-2, cellular and humoral immunity, cytokines storm and immunization against COVID-19 [ABSTRACT FROM AUTHOR] Copyright of Biomedica is the property of Knowledge Bylanes and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

SARS-CoV-2 is a causative agent for COVID-19 disease, initially reported from Wuhan, China. The infected patients experienced mild to severe symptoms, resulting in several fatalities due to a weak understanding of its pathogenesis, which is the same even to date. This cross-sectional study has been designed on 452 symptomatic mild-to-moderate and severe/critical patients to understand the epidemiology and clinical characteristics of COVID-19 patients with their comorbidities and response to treatment. The mean age of the studied patients was 58 ± 14.42 years, and the overall male to female ratio was 61.7 to 38.2%, respectively. In total, 27.3% of the patients had a history of exposure, and 11.9% had a travel history, while for 60% of patients, the source of infection was unknown. The most prevalent signs and symptoms in ICU patients were dry cough, myalgia, shortness of breath, gastrointestinal discomfort, and abnormal chest X-ray (p < 0.001), along with a high percentage of hypertension (p = 0.007) and chronic obstructive pulmonary disease (p = 0.029) as leading comorbidities. The complete blood count indicators were significantly disturbed in severe patients, while the coagulation profile and D-dimer values were significantly higher in mild-to-moderate (non-ICU) patients (p < 0.001). The serum creatinine (1.22 μmol L-1; p = 0.016) and lactate dehydrogenase (619 μmol L-1; p < 0.001) indicators were significantly high in non-ICU patients, while raised values of total bilirubin (0.91 μmol L-1; p = 0.054), C-reactive protein (84.68 mg L-1; p = 0.001), and ferritin (996.81 mg L-1; p < 0.001) were found in ICU patients. The drug dexamethasone was the leading prescribed and administrated medicine to COVID-19 patients, followed by remdesivir, meropenem, heparin, and tocilizumab, respectively. A characteristic pattern of ground glass opacities, consolidation, and interlobular septal thickening was prominent in severely infected patients. These findings could be used for future research, control, and prevention of SARS-CoV-2-infected patients.

Tuberculosis (TB) is caused by Mycobacterium tuberculosis. Host genetic factors are important for the detection of TB susceptibility. SLC11A1 is located in monocyte phagolysosomes that help to limit M. tuberculosis growth by transferring divalent cations across the membrane. Genetic variation in SLC11A1 may alter its expression and increase the susceptibility of individuals to TB. The current study aimed to provide insight into host genetic variations and gene expression in TB patients. A total of 164 TB patients and 85 healthy controls were enrolled in this study. SLC11A1 polymorphisms were detected by PCR-RFLP. Real-time qPCR was used for SLC11A1 gene expression, and ELISA was used for protein estimation. GTEx Portal was used for quantitative trait loci analysis, while the STRING (v.11) web platform was used for gene interactive network construction. Data were analyzed using SPSS, GraphPad Prism, Haploview, and SNPstats. SLC11A1 polymorphisms and combinatorial genotypes were strongly associated with TB susceptibility, which may explain the greater prevalence of tuberculosis in the local population. Polymorphisms in SLC11A1 have also been linked to gene expression variation. Furthermore, the expression of SLC11A1 was downregulated in TB patients, which may influence the function of other associated genes and may impair the immunological response to tuberculosis.

SARS-CoV-2 is a causative agent for COVI-19 disease, initially reported from Wuhan, China. Infected Patients experienced mild to severe symptoms, resulting in several fatalities due to a weak understanding of its pathogenesis, which is the same even to date. This cross-sectional study has been designed on four hundred and fifty-two symptomatic, mild-to-moderate, and severe/critical patients to understand the epidemiology and clinical characteristics of COVID-19 patients with their comorbidities and response to treatment. The mean age of studied patients was (58±14.42) years, and the overall male to female ratio was 61.7 to 38.2%, respectively. 27.3% of the patients had a history of exposure, 11.9% travel history, while for 60% of patients, the source of infection was unknown. The most prevalent signs and symptoms in ICU patients were dry coughs, myalgias, shortness of breath, gastrointestinal discomfort, and abnormal Chest X-ray (pp=0.007) and COPD (p=0.029) as leading comorbidities. Complete Blood Counts indicators were significantly increased in severe patients, while the Coagulation Profile and D-dimer values were significantly higher in mild-to-moderate (non-ICU) patients (p < 0.001). Serum Creatinine (1.22 umole L-1; p = 0.016) and LDH (619 umol L-1; p < 0.001) indicators were significantly high in non-ICU patients while, raised values of Total Bilirubin (0.91 umol L-1; p = 0.054), CRP (84.68 mg L-1; p = 0.001) and Ferritin (996.81 mg L-1; p < 0.001) were found in ICU patients. Drug Dexamethasone was the leading prescribed and administrated medicine to the COVID-19 patients, followed by Remdesivir, Meropenem, Heparin, and Tocilizumab, respectively. A characteristic pattern of Ground glass opacities (GGO), consolidation, and interlobular septal thickening were prominent in severely infected patients. These findings could be used for future research, control, and prevention of SARS-CoV-2 infected patients.

Background:Long term microvascular complications of DM includes: nephropathy, retinopathy, and neuropathy. Increased level of IL-6 and its polymorphism have been associated with diabetic nephropathy.The present study was designed to determine serum level of IL-6 and C/G polymorphism at − 634 position in the promoter region of IL-6 gene in patients with type 2 diabetes mellitus (T2DM) with and without nephropathy. Method: This comparative study was comprised of 164 subjects, divided into two groups of 82 subjects in each. The subjects who had diabetes for more than 5 years without nephropathy were labeled as group-I and the subjects who had diabetes for more than 5 years with nephropathy were labeled as group-II. IL-6 polymorphism was detected by RFLP and its level was determined by ELISA technique. Data was analyzed using SPSS 20.0. Results: In group-I, 14 (17.1%) patients had CC, 47 (57.3%) had CG and 21 (25.6%) had GG polymorphism. In group-II, 9 (11%) patients had CC, 69 (84.1%) had CG and 4 (4.9%) had GG polymorphism. Pearson’s correlation test determined significant association of IL-6 polymorphism (CC,CG,GG) in both the groups (p

Background: Dental caries is characterized by demineralization of inorganic portion of tooth and destruction of organic substances of tooth, which often leads to cavitation. The immune mechanisms play an important role in the pathogenesis of dental caries.This study was designed to determine the levels of salivary IgA, TGF-β and IL-17 in patients with dental caries. Methodology: This was a comparative study of 87 individuals (29 healthy controls and 58 patients with dental caries) recruited from the Punjab Dental Hospital, Lahore. Group I included patients with dental caries up to 5 DMFT score (Decayed Missing Filled Teeth), group II had patients with 6 or more DMFT score and group III consisted of healthy individuals without dental caries. Commercially available ELISA kits were used for the detection of salivary IgA, TGF β and IL-17. Results: Highest mean ± SD level of IL-17(2.99±1.11ng/L)and TGFβ (127.8 ±74.0ng/L) were detected in group III. While highest mean ± SD level of salivary IgA (μg/ mL) was detected in the group I (34.64±6.37μg/mL) Conclusion: Level of salivary IgA was increased in patients of dental caries while levels of IL-17and TGFβ were decreased in patients of dental caries as compared to healthy individuals. Bangladesh Journal of Medical Science Vol.18(3) 2019 p.536-539

Objective: To assess vancomycin MIC creep phenomenon in methicillin-resistant Staphylococcus aureus isolated from clinical specimens. Methods: This descriptive study was conducted in Microbiology department of University of Health Sciences, Lahore from January 2016- December 2019. In this study, vancomycin MICs were revealed by E test method for clinical MRSA strains. For the final evaluation, a single isolate from each patient was taken. The reported vancomycin MICs results were used and the values were not rounded up to the next upward value. For every study year, MIC50, MIC90, median and geometrical mean MIC, percentages of susceptible and resistant strains were calculated. Results: A total of 352 MRSA strains were isolated out of 2704 staphylococcal isolates. Our study showed elevated vancomycin MIC among MRSA isolates. The majority of isolates showed MIC values ≥1.5µg/ml. MIC50, MIC 90 was constant throughout four years period. However, geometric mean MIC increased gradually during the study period. The MIC greater than base year median was overall 17.3%. A complete shift can be observed between MIC “1.0” and “2.0” the percent of cases with MIC “1.0” decreased and with MIC “2.0” increased over time crossing each other in 2017. Conclusion: Vancomycin MIC creep was identified in clinical isolates of MRSA, during four years of study period. Even though there is an absence of VISA and VRSA strains; this significant increase in vancomycin MIC trend is indeed worrying for the clinicians about the threat of potential failure of treatment in MRSA infections. doi: https://doi.org/10.12669/pjms.36.7.3273 How to cite this:Arshad F, Saleem S, Jahan S, Tahir R. Assessment of Vancomycin MIC Creep Phenomenon in Methicillin-Resistant Staphylococcus aureus isolates in a Tertiary Care Hospital of Lahore. Pak J Med Sci. 2020;36(7):1505-1510. doi: https://doi.org/10.12669/pjms.36.7.3273 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: Polycystic ovary syndrome (PCOS), the most prevalent hormonal disorder in females, is characterized by low levels of progesterone, which causes increased estrogen levels leading to production of various anti and auto-antibodies. This study aimed to estimate and compare levels of anti-nuclear antibodies (ANA), anti-thyroid peroxidase (anti-TPO), anti-thyroglobulin (anti-TG), and anti-islet cell antibodies (anti-ICAb) in patients with PCOS and healthy controls. Methods: The present comparative study included 82 subjects divided into two groups with 41 individuals in each group. Group I included healthy subjects, while Group II included patients diagnosed with PCOS. Blood samples were collected to determine serum levels of ANA, anti-TPO, anti-TG, and anti-ICAb using commercially available ELISA kits. Data were analyzed by using SPSS 20.0. Results: Two (4.8%) subjects in Group II had ANA, but none of the other healthy individuals had these auto-antibodies. Levels of anti-TPO were higher in Group II (6.01 IU/ml) than in Group I (5.98 IU/ml). Levels of anti-TG and anti-ICAb were higher in Group I (19.86 and 32.49 IU/ml, respectively) than in Group II (19.78 and 26.07 IU/ml, respectively). Conclusion: Levels of ANA and anti-TPO were higher in patients with PCOS than in controls. By contrast, levels of anti-TG and anti-ICAb were higher in controls than in patients with PCOS.

BACKGROUND: Tuberculosis (TB) is an infectious disease that affects millions of people around the world. The innate immune response against TB starts by interaction of several receptors on monocytes with mycobacterium tuberculosis (MTB). CD14 is one of these receptors present on the monocytes which facilitate the entry of MTB into the cell. Certain polymorphisms in CD14 gene, for example, CD14 (−159 C>T) in the promotor region have suggested susceptibility of TB. AIM: This study was designed to determine and compare CD14 (−159 C>T) gene polymorphism and its surface expression in pulmonary TB patients (before and during anti-TB treatment) and healthy controls. MATERIALS AND METHODS: The study population comprised three groups (pulmonary TB patients before treatment, pulmonary TB patients during treatment, and healthy controls) whereas 53 blood samples were collected from each group. The percentage of monocytes and CD14 mean fluorescence intensity (MFI) was measured by flow cytometry whereas polymerase chain reaction-restriction fragment length polymorphism was used to determine gene polymorphism. RESULTS: CD14 MFI was significantly high in healthy controls than in TB patients (432 as compared to 193 and 365, p < 0.0001). There was no significant difference in CD14 single nucleotide polymorphism allele frequencies or genotypes between TB patients and healthy controls. CONCLUSION: CD14 gene (−159 C>T) polymorphism was not associated with pulmonary TB disease in a sample of Pakistani population and surface expression of CD14 receptor on peripheral blood monocytes decreases with active TB disease and during treatment.

Quinine and its less toxic derivatives have served humanity for decades as potent antimalarial drugs. Emergence of drug resistance has narrowed the usage of these drugs in malaria prevention and treatment. Fortunately, these drugs have roles in the treatment of other diseases as well including rheumatic disorders and viral infections. Quinine derivatives have proven antiviral effects, especially against human immunodeficiency virus (HIV), Zika virus (ZiKV), herpes simplex virus (HSV), Ebola virus and dengue virus (DENV). The prophylactic and therapeutic role of Chloroquine/hydroxychroquine has become a topic of interest after the recent outbreak of novel Corona virus-19 (nCoV-19). This virus is also named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and WHO has officially named this disease as Corona virus disease 2019 (COVID-19). This lethal virus has affected almost 186 countries of the world till to date just in a period of four months of its outbreak. No approved antiviral drug is existed for the treatment of COVID-19. Therefore, this review is focused on potential prophylactic and therapeutic role of chloroquine/hydroxychlroquine for COVID-19.

Unusual presentation of multiple myeloma (MM) poses a diagnostic dilemma. The objective of this case report is to document the unique presentation of MM and to highlight the importance of backache which could be the only indicator for the diagnosis of MM. Although a history of trauma in the past is present in this case, but there is no molecular basis/evidence to declare trauma as a risk factor for MM. It can be concluded that the patients with backache should be thoroughly investigated to rule out any possibility of malignant disease process.Bangladesh Journal of Medical Science Vol.17(2) 2018 p.311-315

Background/Purpose. Chronic periodontitis is an inflammatory disease of gums that causes loss of supporting structures of teeth, that is, gingiva, periodontal ligament, cementum, and alveolar bone. Levels of various cytokines in the serum, gingival tissues, and gingival crevicular fluid in patients with chronic periodontitis have been studied, but limited data are available on the level of cytokines in saliva. Therefore, a study was designed to determine levels of salivary IL-6 and IL-17 in patients with calculus associated chronic periodontitis. Materials and Methods. It was a comparative, cross-sectional study that is comprised of 41 healthy controls and 41 calculus associated chronic periodontitis patients (CP patients). According to the degree of attachment loss, CP patients were subcategorized as mild (CAL 1-2 mm), moderate (CAL 3-4 mm), and severe (CAL > 5 mm) forms of periodontitis. Salivary levels of IL-6 and IL-17 were determined using enzyme-linked immunosorbent assay (ELISA) technique. Data was analyzed using SPSS 20.0. Results. Between healthy controls and CP patients (moderate and severe disease), a statistically significant difference was observed in the concentrations of IL-6 and IL-17. In CP patients, the highest mean ± SD of salivary IL-6 and IL-17 was observed in severe CP, followed by moderate and mild CP. Regarding level of IL-6, a statistically significant difference was observed between mild and severe disease and between moderate and severe subcategories of CP patients. Similarly, statistically significant difference was observed in the level of IL-17 between mild and moderate, mild and severe disease, and moderate and severe disease. Conclusion. The levels of salivary IL-6 and IL-17 were increased significantly in calculus associated CP patients as compared to healthy controls and these levels increased with the progression of CP. Clinical Significance. Salivary levels of IL-6 and IL-17 may help in the subcategorization of CP.

Introduction/background: Rheumatoid factor (RF) is a widely used serological marker for the diagnosis of rheumatoid arthriris (RA). RF can be detected in up to 70 to 80% of RA patients and it is associated with disease activity, bone erosion, and disease outcome. RF is an autoantibody targeting the 'fraction crystallizable' (Fc) region of IgG antibodies and exists as IgA, IgG and IgM isotypes. The objective of this study was to compare the RF isotypes IgM, IgG and IgA with disease activity score 28 in rheumatoid arthritis patients. Materials and Methods: This was a descriptive study, which included 83 RA patients. Blood samples of the patients were collected from the Department of Rheumatology, Sheikh Zayed Hospital Lahore. The levels of different isotypes of RF i.e. IgM, IgG and IgA were determined by ELISA technique. Data was analysed by SPSS 20.0. Results: RF, IgM, IgG, and IgA isotype, was detected in 83%, 10%, and 40% of RA patients respectively. RF istoypes were compared with DAS28. There was no significant association between DAS 28 and RF IgM [Odd ratio (CI)] [0.5(0.07-3.18)], RF IgG [3.0(0.27-32.20)] and RF IgA [0.4(0.43-0.13)]. Disease duration was also compared with RF isotypes but no significant association found. There was no significant association between disease duration and RF IgM [Odd ratio (CI)] [1.4(0.46-4.86)], RF IgG [1.6(0.50-5.0)] and RF IgA [1.1(0.53-2.7)]. Conclusion: All the isotypes of RF were detected in RA patients. As a screening method for rheumatoid arthritis the IgM-RF is superior to other RF isotypes. RF titer may be valueable in estimation of disease activity and other inflammatory parameters in RA patients.

The unique specificity of the B cell receptor is generated by an ordered sequence of gene rearrangement events. Once IGH genes have rearranged, rearrangement at the IGK locus is initiated followed by the IGL locus if functional IGK rearrangement is not achieved. Receptor specificity can subsequently be altered by secondary light chain editing based on the features of the heavy and light chain combination. The final profile of expressed genes is not random and biases in this profile are associated with several autoimmune diseases. However, how and when biases are created is not known. To increase our understanding of the processes of selection and editing of IGK rearrangements, we compared four groups of rearrangements of IGK acquired by next generation sequencing. First, expressed rearrangements of IGK from cDNA of IGK expressing B cells. Second, productive rearrangements of IGK from DNA of the same kappa expressing B cells. Third, non-productive rearrangements of IGK from DNA of IGK and IGL expressing B cells, and fourth productively rearranged IGK from DNA of IGL expressing B cells. The latter group would have been rejected during B cell development in favour of rearrangement at the IGL locus and are therefore selected against. We saw evidence that rearranged IGK segments can be selected at a checkpoint where the decision to rearrange the IGL locus is made. In addition, our data suggest that mechanisms regulating the expression or not of IGK rearrangements may also contribute to repertoire development and also that this latter component of the selection process is defective in SLE.

Typhoid Fever is a systemic disease which is more prevalent in under-developed countries. Drug resistance has been developed against antibiotics used for the treatment of typhoid. It is very important to set the basis of alternative medicines for management of typhoid. Garlic is one of the natural plants being used as spicy food and folk medicine. Various beneficial therapeutic effects of garlic have been documented including anti-microbial, hypolipodemic and anti-oxidant. The objective of present study was to explore anti-bacterial activity of aqueous garlic extract against Salmonella typhi. A total of 50 clinical isolates of S. typhi including 30 multi-drug resistant (MDR) and 20 antibiotic sensitive isolates were investigated to check the inhibitory effects of garlic extract; screening was done by agar well diffusion assay and minimal inhibitory concentration (MIC) was performed by agar dilution technique. MIC of garlic extract ranged from 18-22 mg/ml; showing the inhibitory activity of garlic extract against S. typhi isolates. It is worth describing that garlic might be utilized as anti-typhoid agent after determining its pharmacokinetics and pharmacodynamics.

Staphylococcus aureus is a gram positive bacterium that causes a number of diseases such as abscesses, infective endocarditis, septic arthritis, etc. It is acquiring resistance against many antibiotics like methicillin; therefore its control is becoming increasingly difficult. Peripheral blood phagocytes particularly polymorphonuclear leucocytes play an important role in the protective mechanisms against these organisms. Phagocytes interact with bacteria and phagocytose these microorganisms to kill them.Phenotypically different isolates of Staphylococcus aureus including methicillin resistant Staphylococcus aureus (MRSA) and methicillin sensitive Staphylococcus aureus (MSSA) were collected from various hospitals of Lahore, Pakistan. Fresh polymorphonuclaer leucocytes were obtained from healthy individuals by centrifugation using Ficol-Hypaque gradient combined with dextran sedimentation. Microbiological method was used for the determination of phagocytic index of phenotypic variants of Staphylococcus aureus.A significant difference was observed between the phagocytic index of both bacterial groups. MSSA group showed the Mean +/- SD of 79.46% +/- 3.9 while MRSA group showed 72.350% +/- 2.5.Significant difference in phagocytic index indicates that it can be one of the mechanisms of MRSA to evade host immune system as compare to MSSA.