Mitigating chromium toxicity in rice (Oryza sativa L.) via ABA and 6-BAP: Unveiling synergistic benefits on morphophysiological traits and ASA-GSH cycle

In recent years, the use of plant hormones, such as abscisic acid (ABA) and 6-benzylaminopurine (6-BAP), has gained significant attention for their role in mitigating abiotic stresses across various plant species. These hormones have been shown to play a vital role in enhancing the ascorbate-glutathione cycle and eliciting a wide range of plant growth and biomass, photosynthetic efficiency, oxidative stress and response of antioxidants and other physiological responses. While previous research has been conducted on the individual impact of ABA and 6-BAP in metal stress resistance among various crop species, their combined effects in the context of heavy metal-stressed conditions remain underexplored. The current investigation is to assess the beneficial effects of single and combined ABA (5 and 10 μM L-1) and 6-BAP (5 and 10 μM L-1) applications in rice (Oryza sativa L.) cultivated in chromium (Cr)-contaminated soil (100 μM). Our results showed that the Cr toxicity in the soil showed a significant declined in the growth, gas exchange attributes, sugars, AsA-GSH cycle, cellular fractionation, proline metabolism in O. sativa. However, Cr toxicity significantly increased oxidative stress biomarkers, organic acids, enzymatic and non-enzymatic antioxidants including their gene expression in O. sativa seedlings. Although, the application of ABA and 6-BAP showed a significant increase in the plant growth and biomass, gas exchange characteristics, enzymatic and non-enzymatic compounds and their gene expression and also decreased the oxidative stress, And Cr uptake. In addition, individual or combined application of ABA and 6-BAP enhanced the cellular fractionation and decreases the proline metabolism and AsA-GSH cycle in rice plants. These results open new insights for sustainable agriculture practices and hold immense promise in addressing the pressing challenges of heavy metal contamination in agricultural soils.

Foliar application of iron-lysine to boost growth attributes, photosynthetic pigments and biochemical defense system in canola (Brassica napus L.) under cadmium stress

In the current industrial scenario, cadmium (Cd) as a metal is of great importance but poses a major threat to the ecosystem. However, the role of micronutrient - amino chelates such as iron - lysine (Fe - lys) in reducing Cr toxicity in crop plants was recently introduced. In the current experiment, the exogenous applications of Fe - lys i.e., 0 and10 mg L - 1, were examined, using an in vivo approach that involved plant growth and biomass, photosynthetic pigments, oxidative stress indicators and antioxidant response, sugar and osmolytes under the soil contaminated with varying levels of Cd i.e., 0, 50 and 100 µM using two different varieties of canola i.e., Sarbaz and Pea - 09. Results revealed that the increasing levels of Cd in the soil decreased plant growth and growth-related attributes and photosynthetic apparatus and also the soluble protein and soluble sugar. In contrast, the addition of different levels of Cd in the soil significantly increased the contents of malondialdehyde (MDA) and hydrogen peroxide (H2O2), which induced oxidative damage in both varieties of canola i.e., Sarbaz and Pea - 09. However, canola plants increased the activities of superoxide dismutase (SOD), peroxidase (POD), catalase (CAT), and non-enzymatic compounds such as phenolic, flavonoid, proline, and anthocyanin, which scavenge the over-production of reactive oxygen species (ROS). Cd toxicity can be overcome by the supplementation of Fe - lys, which significantly increased plant growth and biomass, improved photosynthetic machinery and sugar contents, and increased the activities of different antioxidative enzymes, even in the plants grown under different levels of Cd in the soil. Research findings, therefore, suggested that the Fe - lys application can ameliorate Cd toxicity in canola and result in improved plant growth and composition under metal stress.

Simmons-Smith Cyclopropanation: A Multifaceted Synthetic Protocol toward the Synthesis of Natural Products and Drugs: A Review

Simmons-Smith cyclopropanation is a widely used reaction in organic synthesis for stereospecific conversion of alkenes into cyclopropane. The utility of this reaction can be realized by the fact that the cyclopropane motif is a privileged synthetic intermediate and a core structural unit of many biologically active natural compounds such as terpenoids, alkaloids, nucleosides, amino acids, fatty acids, polyketides and drugs. The modified form of Simmons-Smith cyclopropanation involves the employment of Et2Zn and CH2I2 (Furukawa reagent) toward the total synthesis of a variety of structurally complex natural products that possess broad range of biological activities including anticancer, antimicrobial and antiviral activities. This review aims to provide an intriguing glimpse of the Furukawa-modified Simmons-Smith cyclopropanation, within the year range of 2005 to 2022.

Application of silicon and sodium hydrosulfide alleviates arsenic toxicity by regulating the physio-biochemical and molecular mechanisms of Zea mays

Soil contamination with toxic heavy metals (such as arsenic (As)) is becoming a serious global problem due to rapid development of social economy, although the use of silicon (Si) and sodium hydrosulfide (NaHS) has been found effective in enhancing plant tolerance against biotic and abiotic stresses including the As toxicity. For this purpose, a pot experiment was conducted using the different levels of As toxicity in the soil, i.e., (0 mM (no As), 50, and 100 µM) which were also supplied with the different exogenous levels of Si, i.e., (0 (no Si), 1.5, and 3 mM) and also with the NaHS, i.e., (0 (no NaHS), 1, and 2 mM) on growth, photosynthetic pigments, gas exchange characteristics, oxidative stress biomarkers, antioxidant machinery (enzymatic and non-enzymatic antioxidants), and their gene expression, ion uptake, organic acid exudation, and As uptake of maize (Zea mays L.). Results from the present study showed that the increasing levels of As in the soil significantly (P < 0.05) decreased plant growth and biomass, photosynthetic pigments, gas exchange attributes, sugars, and nutritional contents from the roots and shoots of the plants. In contrast, increasing levels of As in the soil significantly (P < 0.05) increased oxidative stress indicators in terms of malondialdehyde, hydrogen peroxide, and electrolyte leakage and also increased organic acid exudation patter in the roots of Z. mays, although the activities of enzymatic antioxidants and the response of their gene expressions in the roots and shoots of the plants and non-enzymatic such as phenolic, flavonoid, ascorbic acid, and anthocyanin contents were initially increased with the exposure of 50 µM As, but decreased by the increasing the As concentration 100 µM in the soil. The negative impact of As toxicity can overcome the application of Si and NaHS, which ultimately increased plant growth and biomass by capturing the reactive oxygen species and decreased oxidative stress in Z. mays by decreasing the As contents in the roots and shoots of the plants. Our results also showed that the Si was more sever and showed better results when we compared with NaHS under the same treatment of As in the soil. Research findings, therefore, suggest that the combined application of Si and NaHS can ameliorate As toxicity in Z. mays, resulting in improved plant growth and composition under metal stress, as depicted by balanced exudation of organic acids.

Multiple strategies for the development of multienzyme complex for one-pot reactions

The main intention in the modern era is to make life and activities on earth more comfortable by adding necessary products through biological machinery. Millions of tons of biological raw materials and lignocellulosic biomass are wasted by burning each year without providing benefits to living organisms. Instead of being the cause of disturbing the natural environment by increasing global warming and pollutants worldwide, now, it is the need of the hour to develop an advanced strategy to utilize these biological raw materials to produce renewable energy resources to meet the energy crisis. The review presents the idea of multiple enzymes in one step to hydrolyze complex biomaterials into useful products. The paper discusses how multiple enzymes are arranged in a cascade for complete hydrolysis of raw material in one-pot to prevent multistep, time consuming, and expensive methods. Furthermore, there was the immobilization of multiple enzymes in a cascade system with in vitro and in vivo conditions for reusability of enzymes. The role of genetic engineering, metabolic engineering, and random mutation techniques is described for the development of multiple enzyme cascades. Techniques that are involved in the improvement of native strain to recombinant strain for the enhancement of hydrolytic capacity were used. The preparative steps, before enzymatic hydrolysis like acid, and base treatment methods are more effective for improving the hydrolysis of biomass by multiple enzymes in a one-pot system. Finally, the applications of one-pot multienzyme complexes in biofuel production from lignocellulosic biomass, biosensor production, medicine, food industry, and the conversion of biopolymers into useful products are described.

Structure-Based Virtual Screening of Furan-1,3,4-Oxadiazole Tethered N-phenylacetamide Derivatives as Novel Class of hTYR and hTYRP1 Inhibitors

Human tyrosinase (hTYR) is a key and rate-limiting enzyme along with human tyrosinase-related protein-1 (hTYRP1), which are among the most prominent targets of inhibiting hyper pigmentation and melanoma skin cancer. In the current in-silico computer-aided drug design (CADD) study, the structure-based screening of sixteen furan-1,3,4-oxadiazole tethered N-phenylacetamide structural motifs BF1-BF16 was carried out to assess their potential as hTYR and hTYRP1 inhibitors. The results revealed that the structural motifs BF1-BF16 showed higher binding affinities towards hTYR and hTYRP1 than the standard inhibitor kojic acid. The most bioactive lead furan-1,3,4-oxadiazoles BF4 and BF5 displayed stronger binding in affinities (-11.50 kcal/mol and -13.30 kcal/mol) than the standard drug kojic acid against hTYRP1 and hTYR enzymes, respectively. These were further confirmed by MM-GBSA and MM-PBSA binding energy computations. The stability studies involving the molecular dynamics simulations also provided stability insights into the binding of these compounds with the target enzymes, wherein it was found that they remain stable in the active sites during the 100 ns virtual simulation time. Moreover, the ADMET, as well as the medicinal properties of these novel furan-1,3,4-oxadiazole tethered N-phenylacetamide structural hybrids, also showed a good prospect. The excellent in-silico profiling of furan-1,3,4--oxadiazole structural motifs BF4 and BF5 provide a hypothetical gateway to use these compounds as potential hTYRP1 and hTYR inhibitors against melanogenesis.

Statin as Repurposed Drug in Ovarian Cancer: A Comprehensive Review

With a prevalence rate of 6.6 per 100,000 women, ovarian cancer is the third most lethal gynecological tumor in the world. Several factors like family history, nulliparity, late menopause, genetic mutation, and an unhealthy lifestyle contribute to increasing the risk of ovarian cancer development. Novel research studies suggest that ovarian cancer may be caused by changes in the lipid metabolic profile that trigger inflammatory responses. Moreover, ovarian cancer patients will eventually experience chemoresistance. Statin, a competitive inhibitor of HMG-CoA reductase that is a lipid-lowering drug with pleiotropic effects, seems to be the best choice to deal with this therapeutic issue. The aim of this review is to highlight the pharmacotherapeutic potential of statins, especially the repurposing of statin drugs for antitumor mechanisms. This review will also provide a brief summary of the meta-analysis, and case-control observational studies carried out to examine the impact of statins on risk reduction and survival in ovarian cancer patients. Furthermore, this review will discuss the nanotechnological approach for improving the drug's bioavailability and safe and targeted delivery with controlled release of active ingredients, making statins more effective in preventing and treating ovarian cancer.

Mitsunobu Reaction: A Powerful Tool for the Synthesis of Natural Products: A Review

The Mitsunobu reaction plays a vital part in organic chemistry due to its wide synthetic applications. It is considered as a significant reaction for the interconversion of one functional group (alcohol) to another (ester) in the presence of oxidizing agents (azodicarboxylates) and reducing agents (phosphines). It is a renowned stereoselective reaction which inverts the stereochemical configuration of end products. One of the most important applications of the Mitsunobu reaction is its role in the synthesis of natural products. This review article will focus on the contribution of the Mitsunobu reaction towards the total synthesis of natural products, highlighting their biological potential during recent years.

Bioremediation of Cadmium Toxicity in Wheat (Triticum aestivum L.) Plants Primed with L-Proline, Bacillus subtilis and Aspergillus niger

Cadmium toxicity is one of the deleterious abiotic factors that reduce wheat production. Two different cultivars (Akbar and Dilkash) were compared for their cadmium (0, 40 and 80 mg/kg) tolerance and responses towards Bacillus subtilis NA2, Aspergillus niger PMI-118 and L-proline. Both microbes were tested for heavy metal tolerance and production of various plant hormones and biological active enzyme characteristics under normal and cadmium stress. A completely randomized design (two cultivars × four treatments × three cadmium levels × three replicates) was adopted using distilled water as a control. The growth promotion potential of these strains under cadmium stress was determined by N-fixation, IAA synthesis, P-solubilization, amylase and proteases production. A pot experiment under controlled conditions was conducted to evaluate the effect of bacteria, fungi, and L-proline under cadmium stress. It was indicated from the result that plant biomass (46.43%), shoot length (22.40%), root length (25.06%), chlorophyll (17.17%), total sugars (27.07%), total proteins (86.01%) and ascorbic acid (83.27%) were improved with inoculation under control and cadmium stress. The accumulation of total flavonoids (48.64%), total phenolics (24.88%), hydrogen peroxide (53.96%) and activities of antioxidant enzymes CAT (26.37%) and APX (43.71%) were reduced in the plants treated with bacteria, fungi and L-proline than those under control. With parallel aids, Bacillus subtilis NA2 showed a higher cadmium tolerance and plant growth stability as compared to Aspergillus niger PMI-118 and L-proline and may be adopted in the future.

163 Anterior Sacral Meningocystocele Manifesting as Vague Gastrointestinal and Urinary Syndromes – Two Case Reports

Aim

Anterior Sacral Meningocystocele (ASM) carries a unique place in the current literature regarding its rarity. The condition arises in association with a congenital defect of the sacrum and coccyx through which the caudal part of the meninges may herniate to form a cyst-like structure. The disorder derives from a genetic defect of the coccyx and sacrum of which some meningeal segments protrude or herniate, forming a cyst-like entity.

Method

We report two cases of ASM. The first is a 65-year-old male with active complaints of urinary retention and hesitancy for two weeks and chronic constipation associated with lower back pain. The second, a 17-year-old girl, was presenting with abdominal bloating, pain, and backache. Magnetic resonance imaging (MRI) of the pelvis and lumbosacral spine was conducted for both patients, respectively, each scan exhibiting evidence of ASM development. Surgical correction and closure of the ASM's were performed via a posterior midline approach, which successfully alleviated the symptoms presented clinically by both patients.

Conclusions

ASM may develop asymptomatically, often with incidental discovery. Although ASM is well-regarded as a rare anomaly, diagnosis of such a defect must always be kept pertinent when a cystic structure in the pelvis is unveiled on ultrasound or during surgery. Puncture or aspiration of the cyst should be avoided if the diagnosis is in doubt. A posterior midline approach with careful obliteration of the meningocele sac opening may be curative.

POS0208 STRESS AT HOME IS COMMON AND HAS SIGNIFICANT ASSOCIATION WITH MARITAL STATUS, HIGHER DISEASE ACTIVITY, COMORBIDITIES, AND WORSE QUALITY OF LIFE AMONG PATIENTS WITH RHEUMATOID ARTHRITIS: SINGLE CENTRE RESULTS FROM THE PRIME REGISTRY COHORT

Background

In chronic inflammatory diseases like rheumatoid arthritis (RA), psychological stress is widely recognised as an important risk factor to negatively affect the disease course. Perceived stress can potentially induce the disease exacerbation, but on the other hand, the disease itself might produce significant stress to patients thus the vicious circle is formed and maintained.

Objectives

We aimed to examine the prevalence of mental/emotional stress at home and its associations among patients with Rheumatoid arthritis. We addressed this question using real-world data from the PRIME registry.

Methods

This was a cross-sectional study conducted using data collected at the time of patient enrolment in the PRIME registry. The PRIME Registry is a large, independent, prospective, observational cohort initiated in October 2019 that comprises patients diagnosed with RA, SLE, PsA or AS by a rheumatologist, and is being actively followed up. IRB approval and informed consent was obtained. We assessed the data for RA patients. The clinical variables studied were gender, age, smoking habits, body mass index, education status, marital status, disease duration, comorbidities (using Charlson Comorbidity Index). Education status was stratified by whether participants completed secondary (high) school education. The SF-12 Physical Component Score (PCS-12) and Mental Component Score (MCS-12) was also measured. Evaluation of disease activity and severity was made as per internationally agreed definitions, such as: swollen joint counts, tender joint counts, deformed joint counts, and DAS-28. All participants were directly inquired at the interview during the time of patient enrolment about the presence or otherwise of mental/emotional stress at home, and to rate it from 1-3 (mild, moderate, severe). For better understanding and ease of statistical analysis, dichotomous variable was made with moderate-to-severe stress patients were categorised into one group and none-to-mild stress patients into second group.

Results

The data from consecutive 1016 RA patients (mean age 40.8±13 years, 78.6% female, disease duration of 65±67 months) was reviewed. Forty-nine percent of patients accepted to have moderate-severe stress at home. Female gender (p=0.003), low education status (p=0.050), being unmarried (p=0.051), and MCS, PCS, CCI (p<0.001) were associated with moderate-severe stress. However, no statistical association of age and disease duration was noted. On univariate analysis, significant association of moderate-severe stress at home was noted with deformed joint counts (p=0.003), higher DAS-28 scores (p<0.001), low education status (p=0.02) and being married (p<0.001). Weak statistical association of age (p=0.30), disease duration (p=0.12), low education status (p=0.14), female gender (p=0.24) was noted. On multiple logistic regression analysis, a significant association of moderate-severe stress at home was observed with higher DAS-28 scores (OR 2.38, CI 2.00-2.84, p<0.001), MCS-12 (OR 0.65, CI 0.61-0.69, p<0.001), comorbidities-CCI (OR 1.41, CI 1.15-1.74, p=0.001) and being unmarried (OR 0.55, CI 0.36-0.83, p=0.005). The final regression model resulted in a statistically significant improved association/prediction of worse moderate-severe stress at home (R square=71%). Following variables were included in multiple stepwise regression analysis: age, disease duration, gender, education status, marital status, comorbidities index, major trauma/stress in last one year, DAS-28, MCS-12 and PCS-12 scores.

Conclusion

Nearly half of the cohort was noted to have moderate-severe level of stress at home, and is associated with important adverse clinical outcomes. These findings demonstrate an important need for integration of rheumatologic, social workers and mental health services

Disclosure of Interests

Muhammad Haroon Speakers bureau: Novartis, Abbvie, Pfizer, Roche, Grant/research support from: Abbvie, Sadia Asif: None declared, Saadat Ullah: None declared, Farzana Hashmi: None declared, Saba Javed: None declared

POS0574 FEMALE GENDER AND STRESS ARE MAIN DETERMINANTS OF NON-ADHERENCE AND NEGATIVE ILLNESS PERCEPTION AMONG PATIENTS WITH RHEUMATOID ARTHRITIS: SINGLE CENTRE RESULTS FROM THE PRIME REGISTRY COHORT

Background

Adherence to medications among patients with RA is traditionally considered to be low. Little is known about the indicators and the outcomes of patients having good adherence to medications among Pakistani RA patients.

Objectives

We aimed to assess the level of non-adherence and its associations with clinical indicators and outcomes using validated measures in a large consecutive Pakistani RA population. Moreover, we measured illness perception using additional validated tools to help us better understand this concept.

Methods

This was a cross-sectional study conducted using data collected at the time of patient enrolment in the PRIME registry. IRB approval and informed consent was obtained. The clinical variables studied were gender, age, smoking habits, body mass index, education status, marital status, disease duration, Charlson Comorbidity Index. Education status was stratified by whether participants completed secondary (high) school education. Evaluation of disease activity and severity was made as per internationally agreed definitions. To measure adherence, the instrument used in the study was the Urdu version of the General Medication Adherence Scale (GMAS), which has been validated for RA patients. Brief Illness Perception Questionnaire (BIPQ) is the simplified version of the Illness Perception Questionnaire (IPQ). BIPQ is a nine-item scale designed to rapidly assess the cognitive and emotional representations of illness. To facilitate interpretation of results in daily clinical practice and to identify patients with the most negative illness perception, we dichotomized the BIPQ scores using the 75th interquartile range score as cutoff, as previously done.

Results

The data of consecutive 320 RA patients enrolled in PRIME registry (mean age 37.4±13.4 years, 74% female, disease duration of 73±68 months, 30% rural residents, 32.5% had low education status of ≤primary school, and 35% of the cohort was employed) was reviewed. Thirty six percent of the cohort (n=116) was noted to have non adherence. On multiple logistic regression analysis, a significant association of moderate-severe stress (OR 1.85, CI 1.04-3.2, p=0.03), DAS-28 scores (OR 1.83, CI 1.52-2.21, p<0.001), HAQ scores (OR 1.77, CI 1.07-2.92, p=0.02), deformed joint counts (OR 1.30, CI 1.15-1.46, p<0.001). We further examined the concept of non-adherence among our cohort across three domains or components of GMAS questionnaire individually. Firstly, on multivariate regression analysis showed that non-adherence due to patient behavior had significant association with male gender (OR 0.48, p=0.01), unemployment (OR 1.82, p=0.02), stress (OR 2.17, p=0.001), DAS-28 (OR 1.15, p=0.050), worse HAQ scores (OR 1.83, p=0.005). Secondly, multivariate regression analysis showed that non-adherence due to comorbidity and pill burden was associated with age of onset of arthritis (OR 1.02, p=0.006), DAS-28 (OR 1.18, p=0.03), and HAQ (OR 1.81, p=0.008). Thirdly, multivariate regression analysis showed that cost-related non-adherence had no significant association with patient related demographics and traits, but was noted to have significant association with worse DAS-28 and HAQ scores. The mean total BIPQ score of the cohort was 62±8.8. Twenty six percent of the cohort (n=86) was noted to have the most negative illness perception (BIPQ score of >68). On multiple logistic regression analysis, a significant protective association of male gender (OR 0.24, CI 0.11-0.53, p<0.001) and age of onset of arthritis (OR 0.96, CI 0.94-0.99, p=0.01), along with significant association of worse HAQ scores (OR 3.7, CI 2.2-6.1, p<0.001) was noted with the most negative illness perception.

Conclusion

Non-adherence is common and its main determinants were female gender and stress, along with associated adverse clinical outcomes. Gender-based discrimination in low socioeconomic states along with associated stress is a plausible explanation.

Disclosure of Interests

Farzana Hashmi: None declared, Muhammad Haroon Speakers bureau: Novartis, Roche, Abbvie, Pfizer, Grant/research support from: Abbvie, Pfizer, Sadia Asif: None declared, Saadat Ullah: None declared, Saba Javed: None declared.

Chromium Stress Tolerance of a C4 (Zea mays L.) and C3 (Vigna radiata L.) Plants Primed with UV and Gamma-Treated Bacillus subtilis

Chromium stress is one of the deleterious abiotic factors that reduce crop production. Two anatomically different crops (C3 and C4) were compared for their chromium (0 and 50 ppm) tolerance and responses towards Bacillus subtilis (B. subtilis). Strains of B. subtilis were exposed to UV (30–210 min) and gamma irradiation (1–4 KGy), and the best mutants were selected on petri plates containing selective markers. Maize and mungbean were supplied with selected strains or the parent strain in rooting medium, along with a nutrient broth. A completely randomized design (five replicates) was adopted using nutrient broth as a control. Stress negatively affected plants grown without strains. Mungbean was more sensitive towards stress and treatments, maize had better root and shoot fresh weights, root and shoot lengths, proline levels, and MDA and GR activity. All strains of B. subtilis (parent, γ-irradiated and UV-irradiated) enhanced proline, total soluble protein, chlorophyll a, a + b and a/b levels, with negligible effects upon antioxidant enzymes. Irradiated strains proved their superiority to the parent strain, with reductions in H₂O₂ and MDA content. With comparable benefits, γ and UV irradiation may be adopted in future based upon technical availability.

Green synthesis of nickel oxide nanoparticles using Allium cepa peels for degradation of Congo red direct dye: an environmental remedial approach

Direct dyes are used in different textile operations and processings. The textile industries are disposing of unused direct dyes into the aquatic environment which is posing a serious alarming threat to aquatic lives. The current study deals with the synthesis of nickel oxide nanoparticles using Allium cepa peels aqueous extract. Nickel oxide nanoparticles (NiO-NPs) were characterized by scanning electron microscopy (SEM). Synthesized NiO-NPs were used to remove Congo red direct dye. Various experimental factors like concentration of dye and nanoparticles, pH, and temperature were optimized. Congo red direct dye was decolorized up to 90% at optimized conditions (Congo Red Direct dye concentration 0.02%, catalyst dose 0.003 g·L^-1, pH 6, and temperature 50 °C). The real textile industry effluent disclosed 70% decolorization at optimized conditions. The percent reduction in total organic carbon (TOC) and chemical oxygen demand (COD) was found to be 73.24% and 74.56% in the case of Congo red dye catalytic treatment and the percent reduction in TOC and COD was found to be 62.47% and 60.23%, respectively, in the treatment of textile effluent using nickel oxide nanoparticles as a catalyst. Treated and untreated dye samples were exposed to Fourier transform infrared (FTIR) and UV-Visible spectral analyses too. The reaction products were studied by degradation pathway.

Associations between serum triglycerides and abdominal aortic calcification in a cross-sectional study from the United States of America

Background

Abdominal aortic calcification (AAC) has recently been recognised as a risk factor for cardiovascular disease, as it shares pathophysiological mechanisms with coronary artery disease.

Purpose

We investigated relationships between AAC and traditional cardiovascular risk factors in a cross-sectional epidemiological cohort from the USA

Methods

We used data from the National Health and Nutrition Evaluation Survey (NHANES) from the years 2103–2014. Dual-energy X-ray absorptiometry (DXA scans) were performed for a subset of 3140 NHANES participants over the age of 40. The images were scored according to ACC-24, a 24-point scale.

We performed binary logistic regression to investigate relationships between demographic variables (age, sex, poverty income ratio, & educational status) CV risk factors (triglycerides (fasting, and non-fasting) LDL-C, HDL-C systolic blood pressure, body mass index, smoking status & diabetes) medicine use (statins, antihypertensives and antiplatelets) and AAC status (patients with a score ≥2 on the 24-point scale were considered AAC positive). Non normally-distributed variables were categorised for the purposes of analysis.

Results

Participants with AAC were older (mean 65.5 years ± SD 11.7) than unaffected individuals (56.1±11.1) AAC was also associated with higher BMI (28.7±5.8 v. 27.6±4.8 kg/m2), and higher systolic blood pressure (131.3±19.5 v 125.8±18.4 mmHg).

We found a strong relationship between plasma triglyceride concentrations and AAC. In univariate analysis, fasting triglycerides above the first quartile were associated with approximately double the risk of AAC, compared to those in the first quartile (see table). This relationship persisted when the analysis was adjusted for demographics, risk factors and medicine use. A similar pattern was seen with non-fasting triglycerides (see table).

Conclusions

We found a strong relationship between triglycerides and AAC. Further work is required to determine whether this observation can be validated in other cohorts, and whether interventions to reduce triglyceides can alter the progression of AAC.

Funding Acknowledgement

Type of funding sources: None. Odds ratios (95% CI) for AAC

191 Improving Consent and Legibility in Orthopaedic Surgery Through Introducing Pre-Populated Stickers

Aim

Incomplete informed consent can lead to patient dissatisfaction and litigation.1 Time constraints, legibility, human error, limit completion of consent forms, putting surgeons and trusts at risk of litigation.2 The aim of this project was to assess legibility and completeness of handwritten consent forms, with the objective to improve legibility to 100% and risks listed to 100% of those endorsed by the British Orthopaedic Association (BOA).3

Method

An initial baseline study in multiple hospitals across the UK identified 113 patients who underwent hemiarthroplasties. The consent forms were assessed for legibility and risks included, compared to those listed by the BOA. Pre-populated risks stickers were introduced in 1 district general hospital (DGH) and 2 cycles repeated again (62 patients identified).

Results

Overall, 35% of consent forms 1 were illegible; 100% of the time in the risks section. Mean number of risks missing was 2.34 and most frequently missed risk was ‘death’ (missing on 35.5% of consent forms). In the DGH that introduced stickers, consent forms were 100% legible and 100% compliant to the standards set by the BOA when the stickers were used. However, sticker use remained low; only used 20% of the time in the second cycle, marginally increased from the previous cycle (18%).

Conclusions

A high proportion of consent forms are not completed to BOA standards and are illegible. Pre-populated stickers could aid in achieving 100% legibility and 100% risk inclusion. The stickers will be implemented in other trusts and methods to increase compliance with sticker use will be trialled.

O44 Gender bias and sexual discrimination in orthopaedics: time for change

Introduction

Gender bias and sexual discrimination (GBSD) have been widely recognized across a range of fields and are now part of the wider social consciousness. Such conduct can occur in the medical workplace, with detrimental effects on recipients. The aim of this review was to identify the prevalence and impact of GBSD in orthopaedic surgery, as well as mitigating strategies.

Method

A systematic review was conducted by searching Medline, EMCARE, CINAHL, PsycINFO, and the Cochrane Library Database. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Original research papers pertaining to the prevalence and impact of GBSD, or mitigating strategies, within orthopaedics were reviewed.

Result

Of 570 papers, 27 were eligible for inclusion. These were published between 1998 and 2020. 13 papers discussed the prevalence of GBSD, 13 related to the impact of these behaviours, and six discussed mitigating strategies. GBSD was found to be common in the orthopaedic workplace, with all sources showing women to be the subjects. Effects include poor workforce representation, lower salaries, and less career success for women in orthopaedics. Mitigating strategies in the literature are focused on providing female role models, mentors, and educational interventions.

Conclusion

GBSD is common in orthopaedic surgery, with a substantial impact on sufferers. A small number of mitigating strategies have been tested but these are limited in their scope. As such, the orthopaedic community is obliged to participate in more thoughtful and proactive strategies that mitigate against GBSD, by improving female recruitment and retention within the specialty.

Take-home Message

Gender bias and sexual discrimination remain common within orthopaedics. The international orthopaedic community is obliged to do more to tackle this problem.

Bioevaluation of agro-waste for postprandial glucose and insulin concentration in blood

OBJECTIVE

To evaluate the effect of cookies supplemented with apple pomace and mango-peel powder on postprandial glucose and insulin concentration.

METHODS

The experimental study was conducted from February to August, 2018, at the Nutrition Counselling Centre, Government College Women University, Faisalabad, Pakistan. Different cookies with apple pomace and mango-peel powder were prepared and the most nutritive acceptable cookies were used to determine their postprandial effect on glucose and insulin concentrations against the control cookies made with white flour only in female subjects. Adult women were selected through advertisement with normal body mass index. Data was analysed using SPSS 17.

RESULTS

All the 30 subjects received enriched and control cookies at different time slots during the study. The overall mean age of the sample was 25±10 years and each subject had body mass index <25kg/m2. Overall blood glucose and insulin concentrations were significantly lower with treatment cookies , compared to the control cookies (p<0.05).

CONCLUSIONS

It was evident that fruit processing waste can be used as a nutraceutical agent in diet-based modules.

Synthesis and evaluation of coastal and marine biodiversity spatial information in the United Arab Emirates for ecosystem-based management

The United Arab Emirates (UAE) host valuable coastal and marine biodiversity that is subjected to multiple pressures under extreme conditions. To mitigate impacts on marine ecosystems, the UAE protects almost 12% of its Exclusive Economic Zone. This study mapped and validated the distribution of key coastal and marine habitats, species and critical areas for their life cycle in the Gulf area of the UAE. We identified gaps in the current protection of these ecological features and assessed the quality of the data used. The overall dataset showed good data quality, but deficiencies in information for the coastline of the north-western emirates. The existing protected areas are inadequate to safeguard key ecological features such as mangroves and coastal lagoons. This study offers a solid basis to understand the spatial distribution and protection of marine biodiversity in the UAE. This information should be considered for implementing effective conservation planning and ecosystem-based management.

988 The Prevalence and Incidence of Gender Bias and Sexual Discrimination in Orthopaedics, and Mitigating Strategies: A Systematic Review

Background

The aim of this systematic review was to outline the prevalence and impact of Gender bias and sexual discrimination (GBSD) in orthopaedics, and to investigate interventions countering such behaviours.

Method

Original research papers pertaining to the prevalence and impact of gender bias or sexual discrimination, or mitigating strategies in orthopaedics, were suitable for inclusion. PRISMA guidelines were adhered to in this review.

Results

Of 570 papers, 27 were eligible for inclusion. A total of 13 papers discussed the prevalence of GBSD, whilst 13 related to the impact of these behaviours, and 6 discussed mitigating strategies. GBSD were found to be prevalent in the orthopaedic workplace, with all sources showing females to be the victims. The impact of GBSD includes poor workforce representation, lower salaries, barriers to career progression, and reduced academic output for females in orthopaedics. Mitigating strategies in the literature are focussed on encouraging females to apply for orthopaedic training programmes, by providing female role models, mentors, and educational interventions.

Conclusions

GBSD are highly prevalent in orthopaedic surgery, impacting females at all stages of their careers. Mitigating strategies have been tested but are limited in their scope. As such, the orthopaedic community as a whole is obliged to do more to tackle GBSD.

Diabetic peripheral neuropathy in people with type 2 diabetes: too little too late

Diabetic peripheral neuropathy in people with type 2 diabetes is poorly managed because of its insidious onset, delayed diagnosis and more complex aetiology resulting from the contribution of not only hyperglycaemia, but also ageing, hyperlipidaemia, hypertension and obesity. Because there is no US Food and Drug Adminstration-approved disease-modifying therapy for diabetic peripheral neuropathy, the key to ameliorating it in type 2 diabetes has to be through earlier diagnosis and timely multi-factorial risk factor reduction. The management of painful diabetic peripheral neuropathy also requires a detailed appraisal of the choice of therapy, taking into account efficacy, patient wishes, comorbidities, side effect profile and potential for abuse.

Investigation of the Physiochemical Properties of Beauty Soaps Available in Pakistan

This study is aimed to examine the quality of beauty soap bars available to the consumers in Pakistan. A range of soap bars manufactured by local small-scale manufacturers from Pakistan were analyzed for their physiochemical properties such as pH, foaming, total fatty substances, matter insoluble in alcohol, free fatty acids, total alkali and moisture contents. The quality of the Pakistani local soap brands was compared to that of imported soaps or those made by multi-national conglomerates. The products were examined following the national standards set by Pakistan standards and quality control authority (PSQCA). The results showed that pH and total alkali level in the local beauty soaps was ((9,40–9,75) ± 0,03) and ((0,100–0,120) ± 0,02). The values of other physiochemical properties were: total fat matter ((62–71) % ± 0,50) %), matter insoluble in alcohol ((15–21) % ± 0,32 %), free fatty acid ((0,05–0,275) % ± 0,01 %) and moisture content ((10–16) % ± 0,50 %). The results demonstrate that Pakistani locally made soap products showed a relatively low amount of total fatty matter as defined by PSQCA and are required to improve their quality in terms of total fat matter. The products made by multi-national companies were superior for most of the examined features.

Evaluation of structurally different benzimidazoles as priming agents, plant defence activators and growth enhancers in wheat

Priming is a valuable, facile and well-established technique used to enhance seed quality to achieve rapid germination, establishment of stress resistance and improvement of crop yields. Different natural and synthetic priming agents have been used for better crop performance and abiotic stress management. In this study, four different benzimidazoles were selected as priming agents and their comparative effects were evaluated on different biochemical attributes including total soluble protein, total oxidant status, MDA contents, antioxidant enzymes (SOD, POD) and hydrolytic enzymes (protease, estrases) compared to control. Treatments with 2-thio-1-H-benzimidazole reduced total soluble proteins and increased total oxidant status significantly but no considerable effect was observed on other parameters. Priming with 2-(4-chlorophenyl)-1-H-benzimidazole considerably increased the total oxidant status and a little improvement was observed in total soluble proteins. Seeds primed with 1-H-benzimidazole showed a noticeable decrease in the protease activity while all other priming treatments were unable to induce any detectable change compared to control. The treatment with 2-(4-methoxyphenyl)-1-H-benzimidazole induced maximum reduction in MDA contents and POD activity. Moreover, all benzimidazole priming treatments reduced mean germination time, increased germination percentage and germination rate of wheat seeds.

4119Predictors of progression of preclinical left ventricular diastolic dysfunction to clinical heart failure in patients with malignancy

Background

Preclinical diastolic dysfunction PDD is a well-known but poorly understood risk factor for clinical heart failure CHF. Preclinical diastolic dysfunction and predictors of progression of PDD to CHF in patients with malignancy has never been studied.

Purpose

The purpose of our study was to determine the incidence of CHF in cancer patients who have preexisting preclinical diastolic dysfunction, with a particular focus on identifying the risk factors contributing to progression of PDD to CHF.

Study design

We retrospectively sought all the patients who underwent echocardiography from 2003 to 2008 and were found to have preclinical diastolic dysfunction at our institution. PDD was defined as presence of grade I diastolic dysfunction, LVEF ≥50%, and free of clinical diagnosis of heart failure. Of these, only the patients who had a confirmed histopathological diagnosis of malignancy were included in the study. The end point was incidence of clinical heart failure, HFrEF and HFpEF. Multivariable adjusted Cox proportional hazards regression were performed to study the predictors of CHF.

Results

Out of 1086 patients with PDD and a histopathological diagnosis of malignancy, 208 patients were diagnosed with new onset CHF during the 10 years follow-up. Incidence of CHF, HFpEF and HFrEF was found to be 32.1 per 1,000 person-year, 13.9 per 1,000 person-year and 2.93 per 1,000 person-year respectively. Patients who developed clinical heart failure were found to have more hypertension, diabetes, myocardial infarction, peripheral vascular disease, pulmonary disease, renal disease, hematological malignancies and metastatic disease when compared to patients who did not develop heart failure. In multivariable adjusted Cox regression analysis, age at index date (HR 1.02, 95% CI 1.01–1.04, p=0.001), diabetes (HR 1.74, 95% CI 1.28–2.35, p<0.001), myocardial infarction (HR 2.19, 95% CI 1.49–3.20, p<0.001), lung disease (HR 1.53, 95% CI 1.14–2.06, p=0.004) and renal disease (HR 2.03, 95% CI 1.45–2.84, p<0.001) were independent predictors of CHF in patients with PDD and malignancy. Among chemotherapy agents, Vincristine, Ifosfamide, transtuzumab and Bortezomib were found to be associated with CHF.

Conclusion

This is the first study ever to report the incidence of CHF, HFrEF and HFpEF and identify a distinct set of predictors of heart failure in patients with PDD and malignancy. We estimated a much higher incidence of CHF (19%) in our study population, when compared to the general population with malignancy. Our study also depicted a significantly high incidence of HFpEF compared to HFrEF (8.3% vs 1.75%). Our study shows that patients with malignancy are at a significantly higher risk of developing heart failure if they have preexisting diastolic dysfunction. This emphasizes the importance of identifying patients with diastolic dysfunction and a more rigorous cardiovascular surveillance to prevent them from potential heart failure.

Acknowledgement/Funding

None

Retrospective cohort study of 925 OAGB procedures. The UK MGB/OAGB collaborative group

BACKGROUND

Mini-One Anastomosis Gastric Bypass is a new operation that provides comparable outcomes to the common bariatric procedures. Revisional surgery is still needed after a number of MGB-OAGB procedures. The aim of this study is to report the causes and management of these revisions.

METHODS

From 2010 to 2018, 925 MGB-OAGB operations were performed at 7 bariatric units across the United Kingdom and included in this retrospective cohort study. The data was retrospectively collected and analysed. The primary end point was the identification of the causes and management of revisions. Follow up ranged from 6 months to 3 years.

RESULTS

Twenty-two patients [2.3%] required revisional surgery after MGB-OAGB. Five patients [0.5%] developed severe diarrhoea managed by shortening the bilio-pancreatic limb to 150 cm. Four patients [0.4%] developed afferent loop syndrome and bile reflux was reported in another 3 [0.3%] cases; all were managed by either conversion to Roux en Y Gastric Bypass or a Braun anastomosis. Postoperative bleeding was controlled laparoscopically in 3 patients [0.3%]. Liver decompensation that was reported in 2 patients [0.2%] was treated by shortening the BPL in one patient and a reversal to normal anatomy in another. The liver failure resolved in both patients. Other indications for revision included two gastro-jejunal stenosis [0.2%], one perforated ulcer [0.1%], one patient [0.1%] with excessive weight loss and one case [0.1%] of protein malnutrition. None of the 22 patients undergoing revisional surgery after MGB-OAGB died. Lost to follow up rate was 0.2%.

CONCLUSION

Complications requiring revisional surgery after MGB-OAGB are uncommon [2.3%] and the majority can be managed by bilio-pancreatic limb shortening, the addition of a Braun side-to-side anastomosis or conversion to RYGB. Bilio-pancreatic limb length of 200 cm or more resulted in serious complications of liver failure, protein malnutrition, excessive weight loss and diarrhoea.

Synthesis of a Fluorescent Whitening Molecule and its Application to Wool Fibres

Aim and Objective:

Reactive dye molecules are commonly employed to dye or modify colour characteristics of wool fibres. Yellowness of wool fibres poses a challenge and here, we report synthesis of a reactive fluorescent molecule and its application to wool fibres to reduce yellowness of the wool fibre and improve its colour features.

Material and Methods:

The new molecule was based upon 7-amino-4-methylcoumarin (AMC) and 2,4,6- trichloro-1,3,5-triazine (TZT). The synthesis involved a two-step chemical reaction, initiated by the nucleophilic substitution of a chloro group on the triazine ring with the hydroxyl group of 4-hydroxybenzenesulfonic acid. The substitution of 2nd chloro group at triazine ring with the amino group of 7-amino-4-methylcoumarin resulted in a novel molecule with a monofunctional reactive chloro group (AMC-MCT molecule).

Results:

The new molecule was applied to the wool fibres using exhaust dyeing method. This exhibited a high exhaustion value; however low fixation and total efficiency values were observed for the new molecule. The resultant wool fibres exhibited fluorescence which shows that aminocoumarin fluorophore retained its fluorescence when incorporated in the new molecule. An assessment of the molecule for yellowness index in a controlled exposure to UV radiation suggested an improvement in whiteness of wool fibre.

Conclusion:

A novel aminocoumarin based fluorescent whitening molecule 2 has been synthesised and applied to the wool fibres. The new molecule continued to exhibit fluorescence after its application to the wool fibres. These results will encourage researchers to explore further possibilities for reactive whitening agent for wool fibres.

Characterization of Tween® Surfactants by MALDI TOF-MS and High Performance Liquid Chromatography in a Ternary Mobile Phase

Different hydrophobic and hydrophilic functionalities are produced in the reaction mixture of Tween® surfactants which affect the physiochemical properties of the final product. Only hydrophilic fractions and monoesters were separated in the binary mobile phase. MALDI TOF-MS of Tween® 40 revealed the identification of peaks separated in binary mobile phase (methanol-water). Liquid adsorption chromatography was performed on a gradient system on a SynergiTM fusion reverse phase column. Mobile phase composition used for this separation was a ternary phase gradient starting from 41 % methanol, 47 % acetone and going to 96 % acetone for the analysis time of 60 minutes. In the ternary mobile phase, gradient all the species such as polyethylene glycol, sorbitan and isosorbide ethoxylates, mono-, di- and triesters of sorbitan and isosorbide ethoxylates were well resolved in an of 60 minutes analysis time. The above separation mechanism can be employed for the analysis of polymeric multifunctional surfactant compositions.

Subpectoral biceps tenodesis using a novel anterior cortical button technique

BACKGROUND

Various surgical treatments are described in the literature for biceps pathology.

METHOD

The techniques currently described for subpectoral tenodesis involve the use of suture anchors, interference screws, bicortical suture buttons or unicortical suture buttons.

RESULTS

A review of 31 patients with a subpectoral biceps tenodesis using the anterior cortical button technique is presented.

CONCLUSIONS

We describe a novel technique, which provides an opportunity to obtain a robust cortical and intramedullary tenodesis, performed under direct vision without the risk of drilling the far cortex and therefore avoiding any potential for neurological injury. There is no cortical implant, which may lead to a diaphyseal stress riser and subsequent fracture risk.

Should all acromioclavicular joint injections be performed under image guidance?

INTRODUCTION

Steroid and local anaesthetic injection to the acromioclavicular joint (ACJ) is a very common diagnostic and therapeutic procedure, which is often performed in the outpatient department. However, it can be difficult to localize this joint because of its small size, presence of osteophytes and variable morphology in the population. We performed a study to determine whether the use of an image intensifier (X-ray guidance), in theatre, improves the accuracy of this injection.

METHODS

This was a prospective study carried out between March 2014 and March 2015. The injections were performed by two senior orthopaedic surgeons. First, we clinically palpated the ACJ and marked the area over this point as A. Then, with the use of a needle and an image intensifier in a single plane, we identified the actual location of the ACJ and marked this point as B. We measured the distance between A and B in millimetres (mm) and determined the accuracy of the injections. Further analysis taking into account the ACJ capsular attachments was also performed.

RESULTS

In total, 45 patients and 50 injections were included in the study; five patients had repeated injections at different times. We found that only 12 injections (24%) were palpated to be correct with no discrepancies between A and B (95% confidence interval: 14-37%). For the remaining 38 injections (76%), the use of an image intensifier had significantly improved the accuracy of ACJ location ( p < 0.05). Taking the capsular attachments of the ACJ into consideration reduced the number of inaccurate injections to 27 (54%).

CONCLUSION

We recommend the use of an image intensifier (or ultrasound guidance) to accurately determine the location of the ACJ for steroid and local anaesthetic injections. This prevents an injection into the wrong place, which can lead to wrong diagnosis and/or suboptimal treatment.

Facile and Green Synthesis of Saturated Cyclic Amines

Single-nitrogen containing saturated cyclic amines are an important part of both natural and synthetic bioactive compounds. A number of methodologies have been developed for the synthesis of aziridines, azetidines, pyrrolidines, piperidines, azepanes and azocanes. This review highlights some facile and green synthetic routes for the synthesis of unsubstituted, multisubstituted and highly functionalized saturated cyclic amines including one-pot, microwave assisted, metal-free, solvent-free and in aqueous media.

An ethnopharmacological evaluation of Navapind and Shahpur Virkanin district Sheikupura, Pakistan for their herbal medicines

BACKGROUND

The chief aim of this study was to enlist the ethnobotanical uses of wild plants in district Sheikhupura, province Punjab, Pakistan. Due to extreme geographical and climatic conditions, Pakistan has a great floral diversity. Plants have been used by the indigenous people for treatment of different ailments since long. They are still dependent on the plants for their domestic purposes. Moreover, plants are used as first aid to treat diverse ailments such as cold, cough, influenza, asthma, cancer, antidote, gastric and hepatic disorders. The traditional uses of medicinal plants lead to the discovery of natural drugs. This is first quantitative ethnobotanical documentation of medicinal plants in NavaPind and ShahpurVirkan district Sheikhupura, province Punjab, Pakistan.

METHODS

This ethnobotanical information was collected from about 400 informants including male and female. Sample size was determined by statistical formula. The informative data was based on semi-structured interviews, group discussions, Questionnaire and field visits. Then the data was analyzed by applying different quantitative indices such as Informant Consent Factor (ICF), Use value (UV), Relative Frequency of Citation (RFC), the Fidelity level (FL) and Jaccard Index (JI).

RESULTS

Almost 96 plants belonging to 34 families were reported. Most-frequently cited families were Poaceae (16 species) and Fabaceae (15 species). The most dominant life form was herbs (30.20%). The most-used plant parts were leaves (31.14%), followed by whole plant (24.59%), Most common mode of administration is extraction (81.25%). Generally herbal medicines were acquired from fresh plant material. Among all 54.16% plants were toxic, 31.25% were nontoxic, whereas the remaining 14.58% may be toxic or nontoxic because of their dual attitude. Almost 34 species were reported with their different medicinal uses as has been reported in literature.

CONCLUSIONS

This ethnobotanical documentation revealed that the plants are still used by natives of rural areas in their day-to-day lives. This study provides basis for the conservation of local flora. Plants with high ICF, UV and FL can be further used for phytochemical and pharmacological studies. This documentation could provide baseline information which can be used to develop new plant-based commercial drugs.

Application of real-time quantitative polymerase chain reaction assay to detect Legionella pneumophila in patients of community-acquired pneumonia in a tertiary care hospital

Legionella pneumophila is one of the important pathogen responsible for community -acquired pneumonia attributing for 1-5% of cases. Since early and accurate therapy reduces mortality, rapid and reliable diagnostic methods are needed. A total of 134 samples of blood, urine and respiratory tract fluids were collected. Blood was tested for IgG, IgM and IgA antibodies using commercially available kits. A total of 8 (6%) samples were found to be positive for L. pneumophila by quantitative reverse transcription polymerase chain reaction (qRT-PCR), compared to conventional PCR where 6 (4.4%) samples were positive. Serology was positive in a total of 32 (23%) cases though only 3 (2.2%) of the PCR-positive cases were positive by serology as well. These results suggest that real-time PCR can detect Legionella infection early in the course of the disease before serological response develops.

Effect of some phytoconstituents on Fe2+/ascorbate induced lipid peroxidation

Transition metals like iron and copper, present inside the body system play a key role in the production of reactive oxygen radicals. These free radicals, causative agents of lipid peroxidation, not only damage proteins and DNA but also gradually changes the cellular membrane structure and ultimately leads to the loss of function and integrity. Uncontrolled lipid peroxidation results in various age related diseases, malignancy, infective diseases and injuries. Antioxidants and other phytochemical constituents present in the various plants are known to protect cells from such reactive oxygen species (ROS)-mediated damages. Here, we evaluated the effect of certain phytoconstituents present in the well-known medicinal plants on ROS scavenging using rat liver homogenate. The basal lipid peroxidation was found to be 0.1625±0.0095 ngMDA/min/mg protein, which got induced to 0.7938±0.0478 ngMDA/min/mg protein in the presence of Fe2+/ascorbate system. In this context, acteoside, berberine, catechin, 3´5-dihydroxyflavone7-o-ß-D-galacturonide-4-o-ß-D-glucopyranoside (a flavonoid glycoside from cumin), silibin and tetrahydrocurcumin decreased both basal and Fe2+/ascorbate induced lipid peroxidation as determined by thiobarbituric acid reaction. On the other hand, agnuside, andrographolide, picroside-I, negunoside, oleanolic acid, and glycerrihizin, showed enhancement in both basal and induced lipid peroxidation. Phytoconstituents which have decreased both basal and Fe2+/ascorbate induced lipid peroxidation may act as defensive against the deadly effects of ROS, causative agents of lipid peroxidation and other diseases either alone or in combination with diet/nutritional supplements.

Risk factors involved in spread of HCV in patients from sub urban Rawalpindi and their association with existing genotypes

The current epidemiological study was designed to trace the involved risk factors in Hepatitis C Virus (HCV) spread and to identify any association between HCV genotypes and risk factors. Blood samples were taken from 400 participants and viral genotyping was performed in order to find any possible relationship between the risk factors and genotypes. Major genotypes included 3, 1, 4 and several untypeable ones with prevalence rates 65%, 22.5%, 2.75% and 9.75% respectively. Surgery and dental procedure were strongly related to the spread of genotype 3b, while genotype 1b was strongly related to blood transfusion and dental procedures as a single combination risk factor. On the other hand genotypes 1a, 3a, 4 and the untypeable genotypes, were equally affected by all reported risk factors. The probability of occurrence of genotype 3a with reference to dental procedures was 11%. Dental procedures, unsafe injection and surgical procedures are the main risk factors while the blood transfusion in combination with dental procedures has emerged as a potent risk factor in the transmission of HCV.

Relationship of oxidative stress with elevated level of DNA damage and homocysteine in cardiovascular disease patients

Amounts of DNA damage and homocysteine (Hcy) in heart patients blood may have strong function in the causation of cardiovascular disease (CVD). The main objective of this work was to know experimentally the role of total oxidants (produced by Reactive Oxygen species (ROS), clinical biochemical indices, their oxidized products and total antioxidant status (TAS) among such patients to find the association of homocysteine, total oxidation status (TOS) and oxidative DNA damage with other clinical parameters in sixty positive CVD patients compared with those of 60 normal subjects. As compared to healthy individuals, CVD patients had significantly higher concentrations of homocysteine (p<0.0001), total oxidants stress (TOS) (p<0.0001), serum total lipids (p<0.04), malondialdehyde (MDA) (p<0.001), high density lipoprotein-cholesterol (HDL-C) (p<0.0001), and low density lipoprotein cholesterol (LDL-C) (p<0.01), than those of healthy individuals. Plasma Hcy content, TOS and amount of DNA were positively and significantly associated with cholesterol, triglycerides, systolic blood pressure, urea, and albumin (p values<0.01). TOS, Hcy and oxidative DNA damage were negatively correlated with HDL-c, TAS and proteins. It is suggested that these parameters have pivotal role in diagnostic process of determining severity in CAD patients. Oxidized products of macromolecules in blood of CVD patients impart major functions in causing CVD disease.

Efficacy of differently applied tyrosine and tryptophan for modulation of phenolic metabolism in Trachyspermum ammi (L.) sprague seedlings

Phenolics are pharmaceutically important molecules. Tyrosine and tryptophan are precursors of phenolic metabolism. It was aimed to investigate the potential of exogenously introduced precursors on the phenolic contents in Trachyspermum ammi (L.) Sprague seedlings. The seeds of two local varieties (Chakwal and Desi) were grown in completely randomized design in a growth chamber at 19 ± 2°C with two amino acids (tyrosine and tryptophan) applied (priming and supplementation in rooting medium) at two treatment levels (0, and 1%). Ten days old seedlings were harvested and subjected for growth (root and shoot length, fresh weight and dry weight) and phenolic estimation was done by HPLC method. Presence of seven phenolic acids including quercitin, chromatotropic acid, gallic acid, chlorogenic acid, sinnapic acid, trans 4 hydroxy 3 methoxy cinamic acid and P-courmeric acid was confirmed in both varieties with dissimilar fraction. Poor growth was observed by "Desi" under controlled conditions that were efficiently enhanced by tyrosine and tryptophan treatments. As precursors both amino acids differed for allosteric regulation of the pathway. That varied from application to application and variety to variety too for a pattern of phenolic accumulation. In conclusion, tyrosine and tryptophan application can be useful for farmers for improved growth of T. ammi and for pharmaceutical scientists to modulate metabolites of interest.

Reduced length of stay with minimally invasive repair of ruptured achilles tendon

Minimally invasive techniques to repair ruptured achilles tendons have been developed to enhance recovery following tendon repair and decrease wound complications associated with open repair. We investigated outcomes of minimally invasive and open repair of acutely ruptured achilles tendons at our institution. We compared all cases of achilles tendon repair at our department, using open techniques and minimally invasive techniques with the Achillon device, over a two year period. Length of stay and operating time was recorded, as were any complication rates, including tendon re-rupture. Post-operatively functional outcome questionnaires were sent to all patients. In total 39 patients underwent open repair and 26 underwent minimally invasive repair. Length of stay was significantly shorter in the minimally invasive group, with 58% of minimally invasive cases performed as a day case, compared to 31.1% of open cases (p = 0.02). There was no difference in complication rates, including re-rupture, or functional outcome scores. Minimally invasive repair of ruptured achilles tendons results in reduced length of stay, compared to open repair. There is no evidence of weaker tendon repairs with minimally invasive techniques. Overall functional outcomes between both groups appear similar. Level of Evidence : III.

Estimation of Antifungal Activity of Mevastatin Produced by Aspergillus terreus GCBL-03 on pretreated substrate in solid state fermentation

This project was planned to study the production of cholesterol lowering drug mevastatin by Aspergillus terreus GCBL-03 on pretreated substrate bagasse in solid state fermentation. Bagasse was pretreated by potassium hydroxide to delignify the substrate to readily become available to microorganism. It was noticed that pretreated bagasse exhibited 13.69±0.64 mg/100mL yield of mevastatin and 6.63±0.48 g dry cell mass as compared to nontreated substrate that showed 7.04±0.81 mg/100 mL and 6.04±0.24 g dry cell mass. The fermentation profile like pH (5.5), temperature (30 °C), moisture contents (60%) inoculum size (2 mL), and incubation time (72 h) showed the optimum production (30.63±1.24 mg/100 mL) of mevastatin. Furthermore, fermented drug showed noteworthy antifungal activity against battery of selected fungal strains assessed by disc diffusion and measurement of minimum inhibitory concentration by micro dilution method. It was concluded from the study that fermented mevastatin was effective against fungal strains.

Burning through the pain: treatments for diabetic neuropathy

The rise in the global burden of diabetes is spurring an increase in the prevalence of its complications. Diabetic peripheral neuropathy (DPN) is a common and devastating complication of diabetes, with multiple clinical manifestations. The most common is a symmetrical length-dependent dysfunction and damage of peripheral nerves. The management of DPN rests on three tenets: intensive glycaemic control, even though the evidence of benefit is questionable in people with type 2 diabetes; pathogenetic therapies; and symptomatic treatment. A number of pathogenetic treatments have been evaluated in phase III clinical trials, including α-lipoic acid (stems reactive oxygen species formation), benfotiamine (prevents vascular damage) and aldose-reductase inhibitors (reduce flux through the polyol pathway), protein kinase C inhibitors (prevent hyperglycaemia-induced activation of protein kinase C), nerve growth factors (stimulate nerve regeneration) and Actovegin® (improves tissue glucose and oxygen uptake). However, none have gained US Food and Drug Administration or European Medicines Agency (EMA) approval, questioning the validity of current trial designs and the endpoints deployed to define efficacy. For painful diabetic neuropathy, clinical guidelines recommend: atypical analgesics for pain relief, including duloxetine and amitriptyline; the γ-aminobutyric acid analogues gabapentin and pregabalin; opioids, including Tapentadol; and topical agents such as lidocaine and capsaicin. No single effective treatment exists for painful DPN, highlighting a growing need for studies to evaluate more potent and targeted drugs, as well as combinations. A number of novel potential candidates, including erythropoietin analogues and angiotensin II type 2 receptor anatagonists are currently being evaluated in phase II clinical trials.

Rowena: the trainee’s perspective on simulation

A time-saving and cost-effective way to practise basic neurosurgical techniques.