Tuberculosis prevalence and demographic characteristics of population in Azad Jammu and Kashmir (Pakistan): A retrospective study

Tuberculosis (TB) remains a serious problem for public health and a leading cause of death after COVID-19 and superior to even HIV/AIDS. It is a social health issue and can cause stigma and economic loss as the person cannot perform professionally due to lethargy caused by disease. It is a retrospective study done on data from National TB program Muzaffarabad chapter. The details were noted on SPSS and analysis was done to find important demographic characteristics. The total number of patients was 3441; among which 48.76% were males. Most of them (81.11%) belonged to the Muzaffarabad division of Azad Jammu and Kahmir (AJK). The microbiologically or culture positive cases were 440. Rifampicin resistance was present in 147 cases, further categorized as high (n = 143), very high (n = 3), or true positive (n = 1) resistance. Muti drug resistance was found in 19 cases. The microscopy culture is more sensitive (AUC = 0.511) than MTB/RIF or serology (AUC = 0.502) according to ROC. The rate of positive smear results is not very satisfactory in the present study as it cannot detect dormant or latent cases. There is a need to establish more sensitive tests for detection of cases and more research to combat the disease.

Assessment of renal function and prevalence of acute kidney injury following coronary artery bypass graft surgery and associated risk factors: A retrospective cohort study at a tertiary care hospital in Islamabad, Pakistan

Acute kidney injury (AKI) is a sudden decline in renal function after cardiac surgery. It is characterized by a significant reduction in glomerular filtration rate, alterations in serum creatinine (S.Cr) levels, and urine output. This study aimed to retrospectively analyze a cohort of 704 patients selected using stringent inclusion and exclusion criteria. AKI was defined by an increase of 0.3 mg/dL in S.Cr levels compared to baseline. Data were collected from the hospital and analyzed using SPSS 16.0. Data analysis revealed that 22% (n = 155) of the patients developed AKI on the second post-operative day, accompanied by a substantial increase in S.Cr levels (from 1.064 ± 0.2504 to 1.255 ± 0.2673, P < .000). Age and cardiopulmonary bypass duration were identified as risk factors along with ejection fraction and days of hospital stay, contributing to the development of AKI. Early renal replacement therapy can be planned when the diagnosis of AKI is established early after surgery.

Response of Rhizobacterial strains and organic amendments on chickpea growth

Plant Growth Promoting Rhizobacteria (PGPR) are beneficial bacteria that colonize plant roots and promote plant growth through a variety of mechanisms such as phosphate solubilization, phytohormones production, antifungal activity and also improve plant growth and yield. Field experiment was carried out to investigate the residual effect of organic amendments plus soil microbes along with integrated nutrient management. (PGPR) are important soil organism that promotes plant growth and yield root colonization is an example of a direct and indirect mechanism. The treatments included control, (inorganic fertilizer and no organic fertilization).Five bacterial strains were identified morphologically and biochemically screened from the rhizospheres of chickpea, lentil, barseem, mungbean, and sesame. The experiment was conducted at the Arid Zone Research Center in D.I.Khan (Pakistan). The majority of isolates resulted in significant increase in shoot length, root length, and dry matter production of Cicer arietinum seedlings' shoot and root. The experiment represented that isolates treated plots with rhizobium strain inoculation resulted in greater plant height (35.000 cm) and nodule count (38.00) No of pods per plant-1 (44.66) when compared to the control treatment, While (Mesorhizobium cicero) along with organic amendments showed significant response the greater root length (50 cm) was observed in T4 treatment. The Performance of rhizobial strains on chickpea germination in an arid environment was found to significantly increase crop germination percentage. This combination thus increases nitrogen and phosphorus uptake in inoculation treated plots. The study found that plots with inoculation treatments yielded significantly higher than non-treated plots Treatment with Mesorhizobium Cicero and compost resulted in a higher grain yield (8%) as compared to the control. The greater grain yield was observed in Treatment T4 (183.67).The result showed that use of PGPR have the potential to increase nutrient absorption from soil while improved growth of chickpea.

The Pathological Mechanisms and Treatments of Tinnitus

Tinnitus is defined as the ringing, hissing, clicking or roaring sounds an individual consciously perceives in the absence of an external auditory stimulus. Currently, the literature on the mechanism of tinnitus pathology is multifaceted, ranging from tinnitus generation at the cellular level to its perception at the system level. Cellular level mechanisms include increased neuronal synchrony, neurotransmission changes and maladaptive plasticity. At the system level, the role of auditory structures, non-auditory structures, changes in the functional connectivities in higher regions and tinnitus networks have been investigated. The exploration of all these mechanisms creates a holistic view on understanding the changes the pathophysiology of tinnitus undertakes. Although tinnitus percept may start at the level of cochlear nerve deafferentation, the neuronal changes in the central auditory system to the neuronal and connectivity changes in non-auditory regions, such as the limbic system, become cardinal in chronic tinnitus generation. At the present moment, some tinnitus generation mechanisms are well established (e.g., increased neuronal synchrony) whereas other mechanisms have gained more traction recently (e.g., tinnitus networks, tinnitus-distress networks) and therefore, require additional investigation to solidify their role in tinnitus pathology. The treatments and therapeutics designed for tinnitus are numerous, with varied levels of success. They are generally two-fold: some treatments focus on tinnitus cessation (including cochlear implants, deep brain stimulation, transcranial direct current stimulation and transcranial magnetic stimulation) whereas the other set focuses on tinnitus reduction or masking (including hearing aids, sound therapy, cognitive behavioral therapy, tinnitus retraining therapy, and tailor made notched musical training).  Tinnitus management has focused on implementing tinnitus masking/reducing therapies more than tinnitus cessation, since cessation treatments are still lacking in streamlined treatment protocols and long-term sustainability and efficacy of the treatment. This review will focus on concisely exploring the current and most relevant tinnitus pathophysiology mechanisms, treatments and therapeutics.

Migrainous Infarction and Cortical Spreading Depression

Migraine is a very common disorder of the nervous system. It shares similar physiological processes with stroke. Migrainous infarction is a rare complication of migraine with aura. The neuro-logical symptoms of migraine aura correspond to the cortical spreading depression and this depression can lead to a migrainous infarction. It is pertinent to state that the investigation and detection of the cortical depression might have a great clinical significance. Blood vessels in the cranium play an important role in the pathophysiology of migraine.  In the case of injured states of brain, the cortical spreading depression causes extreme vasoconstriction rather than vasodilation. The endothelial damage caused by the cortical spreading depression can result in hypercoagulability, leading to an increased risk of stroke. There are many genetic disorders in which migraine and stroke are the major symptoms and an insight into these disorders can help us in the understanding of complex mechanisms of migrainous infarction. It is pertinent to state that some derangements in the vascular function accompany migraine which may also serve as targets for research and treatment. This article will describe the hemodynamic and genetic relationship between migraine induced stroke and how it relates to the cortical spreading depression.

Epileptic seizures

Epilepsy is a condition marked by abnormal neuronal discharges or hyperexcitability of neurons with synchronicity and is recognized as a major public health concern. The pathology is categorized into three subgroups: acquired, idiopathic, and epilepsy of genetic or developmental origin. There are approximately 1000 associated genes and the role of γ-aminobutyric acid (GABA) mediated inhibition, as well as glutamate mediated excitation, forms the basis of pathology. Epilepsy is further classified as being of focal, general or unknown onset. Genetic predisposition, comorbidities and novel biomarkers are useful for prediction. Prevalent postictal symptoms are postictal headache and migraine, postictal psychosis and delirium, postictal Todd's paresis and postictal automatisms. Diagnostic methods include electroencephalography (EEG), computed tomography scan, magnetic resonance imaging (MRI), positron emission tomography, single photon emission computed tomography and genetic testing; EEG and MRI are the two main techniques. Clinical history and witness testimonies combined with a knowledge of seizure semiology helps in distinguishing between seizures. Clinical information and patient history do not always lead to a clear diagnosis, in which case EEG and 24-hour EEG monitoring with video recording (video-EEG/vEEG) help in seizure differentiation. Treatment includes first aid, therapeutics such as anti-epileptic drugs, surgery, ketogenic diet and gene therapy. In this review, we are focusing on summarizing published literature on epilepsy and epileptic seizures, and concisely apprise the reader of the latest cutting-edge advances and knowledge on epileptic seizures.

Pathology and Therapeutics of COVID-19: A Review

COVID-19 pandemic has taken over the world. Spreading form its epicenter in a seafood market in Wuhan to more than 200 countries, it has caused alarming situations. The viral infection is caused by an RNA virus called SARS-CoV-2. Its genome resembles the SARS-CoV-1 and MERS-CoV genome. COVID-19 cases were first reported in December 2019 in China; it affects the lungs causing mild to severe respiratory disease. No antiviral drug for the infection has been approved yet, but certain drugs are under consideration including Chloroquine, Hydroxychloroquine and Teicoplanin. The review article will first present the structure of the SARS-CoV-2 and compare it to SARS-CoV-1 and MERS-CoV. The article will then highlight its effect on different organs. Finally, it will highlight the therapeutics which are in consideration and which are being used. The article will provide a good insight into the COVID-19 infection.