Middle East respiratory syndrome coronavirus (MERS-CoV) is a betacoronavirus which can cause acute respiratory distress in humans and is associated with a relatively high mortality rate.Since it was first identified in a patient who died in a Jeddah hospital in 2012,the World Health Organization has been notified of 1735 laboratory-confirmed cases from 27 countries,including 628 deaths.Most cases have occurred in Saudi Arabia.MERS-CoV ancestors may be found in Old World bats of the Vespertilionidae family.After a proposed bat to camel switching event,transmission of MERS-CoV to humans is likely to have been the result of multiple zoonotic transfers from dromedary camels.Human-to-human transmission appears to require close contact with infected persons,with outbreaks mainly occurring in hospital environments.Outbreaks have been associated with inadequate infection prevention and control implementation,resulting in recommendations on basic and more advanced infection prevention and control measures by the World Health Organization,and issuing of government guidelines based on these recommendations in affected countries including Saudi Arabia.Evolutionary changes in the virus,particularly in the viral spike protein which mediates virus-host cell contact may potentially increase transmission of this virus.Efforts are on-going to identify specific evidence-based therapies or vaccines.The broad-spectrum antiviral nitazoxanide has been shown to have in vitro activity against MERS-CoV.Synthetic peptides and candidate vaccines based on regions of the spike protein have shown promise in rodent and non-human primate models.GLS-5300,a prophylactic DNA-plasmid vaccine encoding S protein,is the first MERS-CoV vaccine to be tested in humans,while monoelonal antibody,m336 has given promising results in animal models and has potential for use in outbreak situations.

Type 2 diabetes mellitus (DM) is becoming major health threat worldwide and it is extremely common in clinical setting. Malaysia is one of the highest diabetic populations among Asian countries and the new cases are increasing day to day. Early detection of people with high risk of Type 2 DM by using simple, easy and cost-effective assessment tool is the better way to identify and prevent the community from this non-communicable disease. The objectives of the study were to identify those are high risk to become type 2DM among Malaysians by using risk scoring form and to educate them how to prevent it. Total 591 subjects were recruited from the health screening programs carried out by the collaboration of Petaling Jaya Development Council (MBPJ) and Lincoln University College, Malaysia. Modified form of Finnish Type 2 Diabetes Risk Assessment Tool was used to identify people at risk of becoming type 2 DM. Descriptive analysis was performed for all included variables in this study by using SPSS version 21. The study found out that almost half of the participants were found to have family history of DM, 60% of them were overweight and obese and 47% were having above normal waist circumference. We observed that nearly 60 % of participants in the study were having moderate to high risk of becoming type 2 DM in next 10 years. To conclude, the result of our study would be helpful in implementation of cost-effective, convenient Type 2 DM risk assessment tool which has yet to be implemented in Malaysia.
Type 2 diabetes mellitus ; assessment tool ; health screening ; prevention

Objective: To establish quality control parameters of a locally occurring medicinal plant, Malva parviflora which is utilized as folk medicine in Sialkot area in Pakistan. Methods: In pharmacognostic studies different types of evaluations were carried out that focus on microscopic, macroscopic, fluorescence analysis and organoleptic evaluations. Results: The distinguishing characters of stem were the presence of parenchyma, cork cells, irregular shape calcium oxalate crystals, simple and compound starch granules and fusiform fibers with pits. Root microscopic characters were presence of simple and spherical starch granules with rounded or slit hilum, groups of lignified xylem fibers, reticulate vessels, and sieve tissues. Leaves microscopy indicated the presence of paracytic stomata, lignified fibers having pits, spiral and annular vessels, numerous sclereids while in fruit microscopy epicarp, thin walled cells endocarp, thin walled parenchyma and collenchyma of mesocarp and abundant thick walled endospermic cells containing aleurone grains and micro rosette crystals. Macroscopic study of leaves showed, 5-7 lobed reniform-shape, glabrous-surface, reticulate-venation in the leaves. Macroscopic features of roots showed type of root-taproot, surface-glabrous and stem was 1-10 dm tall simple to branched and may be prostrate or ascending. Similarly fruit was of schizocarp type. Conclusions: This study provides the scientific data for the proper identification and establishment of standards for the use of Malva parviflora.

Background: Rare inherited coagulation factor deficiencies constitute an important group of bleeding disorders. A higher frequency of these disorders is seen in areas of high consanguinity.Our aim was to study the prevalence and spectrum of rare inherited bleeding disorders, characterize the severity of the deficiencies, identify different clinical manifestations, and evaluate different treatments provided. Methods: This cross-sectional study was conducted in the Department of Haematology, Armed Forces Institute of Pathology Rawalpindi, between January 2014 and December 2018.A detailed history was taken, and an examination was performed. The signs and symptoms were noted, and the patients were diagnosed on the basis of a coagulation profile. The disease severity was assessed using factor assays. Results: Among 2,516 patients with suspected coagulation disorders, 774 (30.8%) had an inherited bleeding disorder. Of the 774 patients, 165 (21.3%) had a rare bleeding disorder;91 (55.2%) of them were males, and 74 (44.9%) were females, with a male-to-female ratio of 1.2:1. The median patient age was 9 years 3 months. The most common disorder was factor VII deficiency (46 patients, 27.9%). The most common clinical presentation was bruising in 102 (61.8%) and gum bleeding in 91 (55.2%) patients. Conclusion The most common rare bleeding disorder in our population is factor VII deficiency. The prevalence of these bleeding disorders is high in our population due to a high number of consanguineous marriages.

This study was aimed to determine the efficiency of synthetic protein-free media in spermatozoa washing, preparationand retention of the activity of washed spermatozoa over short periods in vitro. Normozoospermic semen samples (n =71) were equally apportioned and washed using synthetic protein-free medium (PFM), minimum essential medium + HSA(MEM) or commercial protein-containing medium (CPC). Washed spermatozoa were cultured in vitro using PFM, MEM orCPC media and held for 24 hrs at 4°C, 15°C, 22°C or 37°C. Spermatozoa activity was evaluated at 0 hr, 4 to 7 hrs and24 hrs post-wash. The effects of PFM on spermatozoa motility, vitality, membrane integrity and DNA fragmentation levelwere not significantly different from that of MEM and CPC media at 0 hr, 4 to 7 hrs and 24 hrs post-wash in vitro. SyntheticPFM, MEM and CPC retained spermatozoa activity highest when specimen were held at 22°C and it was significantly higher(p < 0.05) than that at 37°C after 24 hrs incubation in vitro. However, no significant changes (p > 0.05) were notedin spermatozoa DNA fragmentation (SDF) levels when specimen were held at 22°C or 37°C at 4 to 7 hrs and also after24 hrs post-wash in vitro in all media. The use of synthetic PFM as an alternative to the commercial protein-containingmedia in human spermatozoa washing and preparation procedure for an efficient and safer (Assisted ReproductionTechnology) ART outcome. Spermatozoa activity can be successfully retained at room temperature post-wash over shortperiods; spermatozoa may lose viability rapidly if held for long hours at 37°C in a