Aims: Nowadays, Staphylococcus aureus, especially methicillin resistant Staphylococcus aureus (MRSA), emerged as a major pathogenic agent of nosocomial infection and sepsis worldwide. Infections caused by these bacteria are often difficult to treat because of the development of antibiotic resistance. Biofilm formation is an important factor in the pathogenicity of staphylococcal infections and one of the reason of antibiotic treatment failure. In this study, the relationship between biofilm formation properties, the presence of mecA, icaA/D genes and antimicrobial resistance pattern were investigated in 10 methicillin sensitive Staphylococcus aureus (MSSA) and 10 MRSA clinical isolates. Methodology and results: Staphylococcal strains were identified by conventional microbiological methods, while determination of methicillin susceptibility was distinguished by the presence of mecA gene. To investigate biofilm production, congo red agar and microtiter plate test were performed. PCR was done to detect the presence of icaA/D genes, which responsible for biofilm production. Antibiotic sensitivity was carried out by agar diffusion method. The majority of MRSA isolates (90%) were not able to form biofilm, only one isolate (10%) showed capability of weak biofilm producer. Meanwhile, fully established biofilms were formed by all of MSSA isolates (100%). In addition, all MRSA and almost MSSA isolates (90%) harboured both icaA/D genes in their chromosomes. Antibiotic resistance profile of MRSA was more dominant than MSSA isolates. Conclusion, significance, and impact of study: Biofilm production of staphylococci showed difference regulation with regard to methicillin susceptibility. Antibiotic resistance profile was more dominant in MRSA, however biofilm production was found mostly in MSSA isolates.
Biofilms

Background: To assess antimicrobial susceptibility of extended-spectrum β-lactamase- (ESBL-) producing Klebsiella pneumoniae and Escherichia coli isolates from Hospital Tengku Ampuan Afzan (HTAA), as well as to identify ESBL genes. Methods: Non-duplicate K. pneumoniae and E. coli isolates were recovered from various clinical samples. Isolates were screened for antimicrobial resistance by disc diffusion method. Isolates resistant to oxyimino-cephalosporins were subjected to phenotypic ESBL production. Detection of resistance genes was then performed using primers specific for ESBL genes (blaCTX-M, blaSHV and blaTEM). Results: Piperacillin/tazobactam and carbapenems remained the active β-lactam antibiotic against K. pneumoniae and E. coli. ESBLs were detected among 35.5% (39/110) of K. pneumoniae and 18.8% (28/149) of E. coli isolates. CTX-M β-lactamase was detected in 90% of all ESBL-positive isolates, whereas blaSHV and blaTEM genes were found among 56% and 52% of them, respectively. Twenty-eight percent (28%) of the total ESBL-positive isolates harboured the three ESBL genes, while 50% carried two of the tested ESBL genes. Conclusion: ESBLs encoded by at least one ESBL genes are frequently isolated among K. pneumoniae and E. coli in HTAA. The significant proportion rate of these resistant determinants is alarming, thus monitoring their transmission and dissemination is essential to control it at an early phase.

Nabais Sa-de Vries syndrome (NSDVS) is a neurodevelopmental disorder first described in 2020. The syndrome is caused by de novo missense mutations in speckle-type pox virus and zinc finger protein (SPOP) on chromosome 17q21. In this report, we present a four-year-old girl who had microcephaly, a long face, a wide and thick arched eyebrow, widely spaced eyes, a prominent and wide nasal bridge, a wide and bulbous nasal tip, micrognathia and pointed chin. She also had microcytic hypochromic anemia. Her clinical features are suspected of NSDVS1 and thalassemia along with refractory iron deficiency anemia. Genetic evaluation confirmed the presence of both SPOP and hemoglobin gene mutations. The concurrence of both genetic mutations and above hematological manifestations has not been reported previously thus further studies are needed to better understand the associated mechanisms and disease course involved.

OBJECTIVE: Schizophrenia is a chronic neuropsychiatric disease afflicting around 1.1% of the population worldwide. Recently, MIR137, CACNA1C, CSMD1, DRD2, and GRM3 have been reported as the most robustly emerging candidates involved in the etiology of schizophrenia. In this case control study, we performed an association analysis of rs1625579 (MIR137), rs1006737, rs4765905 (CACNA1C), rs10503253 (CSMD1), rs1076560 (DRD2), rs12704290, rs6465084, and rs148754219 (GRM3) in Pakistani population. METHODS: Schizophrenia was diagnosed on the basis of the Diagnostic and Statistical Manual of Mental Disorders 4th ed (DSM-IV). Detailed clinical information, family history of all patients and healthy controls were collected. RFLP based case control association study was performed in a Pakistani cohort of 508 schizophrenia patients and 300 healthy control subjects. Alleles and genotype frequencies were calculated using SPSS. RESULTS: A significant difference in the genotype and allele frequencies for rs4765905, rs1076560 and rs6465084 were found between the patients and controls (p=0.000). CONCLUSION: This study provides substantial evidence supporting the role of CACNA1C, GRM3 and DRD2 as schizophrenia susceptibility genes in Pakistani population.
Alleles ; Case-Control Studies ; Cohort Studies ; Diagnostic and Statistical Manual of Mental Disorders ; Gene Frequency ; Genotype ; Humans ; Pakistan ; Polymorphism, Restriction Fragment Length ; Schizophrenia*

One of the possible causes of chronic constipation is colonic duplication. Although seldom asymptomatic, its diagnosis is important due to the risk of malignancy that it carries. We present a case of a young female patient with long-standing constipation who was referred to Kolorektal Cerrahi Clinic (Izmir, Turkey) after scans revealed tubular type of colonic duplication. We successfully performed a laparoscopic total colectomy, and she recovered well. Identifying the type of duplication is important to ensure adequate resection and treatment. A proper workup, including carcinoembryonic antigen levels, must be done as well. Multiple surgical techniques and procedures have been introduced for this condition, but resection of the duplicated colon with its native lumen should be the management of choice, especially in tubular type of duplications such as in our case. In centers where laparoscopic services are available, laparoscopy could be a better option, as it provides multiple benefits of minimally invasive surgery. Attention should also be paid to anatomical details during surgery to ensure better results and outcomes.

Toxoplasmosis is a protozoan disease that is caused by Toxoplasma gondii in livestock and humans. Due to its medical and veterinary importance, it is essential to study the seroprevalence of T. gondii infection among humans and animals in various parts of the world. The major objective of this study was to determine the seroprevalence and spatial distribution of toxoplasmosis in small ruminants (sheep and goats) of north-eastern region, Pakistan. A total of 1,000 animals comprising of sheep (n=470) and goats (n=530) were examined for T. gondii infection by using ELISA. An epidemiological data was collected in the form of questionnaire. A surface has been generated by using method of interpolation in Arc GIS with the help of IDW (inverse distance weight). The results showed higher seroprevalence of T. gondii in goats (42.8%) as compared to sheep (26.2%). The seroprevalence was higher in females as compared to males in all examined ruminants. Similarly, there is a wide variation in the seroprevalence of T. gondii in different breeds of sheep and goats showing higher seroprevalence in Teddy (52.8%) and Damani breed (34.5%) of goat and sheep's, respectively. The geographical and spatial distribution of T. gondii shows that it is widely distributed in different parts of the north-eastern region of Pakistan. Our results suggest widespread environmental contamination with T. gondii oocysts. It suggests us that small ruminants could be a potentially important source of T. gondii infection if their infected meat is consumed undercooked.
Animals ; Enzyme-Linked Immunosorbent Assay ; Female ; Goats* ; Humans ; Livestock ; Male ; Meat ; Methods ; Oocysts ; Pakistan* ; Ruminants ; Seroepidemiologic Studies* ; Sheep* ; Toxoplasma ; Toxoplasmosis*

An antimicrobial compound has been isolated from the leaves of Glochidion superbum. The compound was determined as methyl 3, 4, 5-trihydroxybenzoate (methyl gallate), based on ultraviolet (UV), infrared (IR), nuclear magnetic resonance (NMR) and mass spectroscopy (MS) analysis. The isolated compound exhibited potent antimicrobial activity against three clinical isolates of methicillin resistant Staphylococcus aureus (MRSA) by qualitative agar disc diffusion method and quantitative broth dilution method. Agar disc diffusion was done in a dose-dependent manner for each bacterial isolate at disc potencies of 25, 50, 100, and 150 µg/disc. The zones of inhibition were on average equal to 12.27, 14.20, 15.43, and 24.17 mm respectively. The inhibition zones were compared with that of vancomycin disc at 30 µg as a reference standard. The MIC and MBC values were 50 µg/mL and 100 µg/mL respectively. The results of anti MRSA activity were analyzed using one-way ANOVA with Turkey's HSD and Duncan test. In conclusion, methyl gallate which was isolated from G. superbum showed the inhibition activity against methicillin resistant S. aureus.
Agar ; Diffusion ; Magnetic Resonance Spectroscopy ; Mass Spectrometry ; Methicillin Resistance* ; Methicillin* ; Methicillin-Resistant Staphylococcus aureus ; Methods ; Staphylococcus aureus* ; Staphylococcus* ; Vancomycin

Dengue virus syndrome is an emerging global health challenge which is endemic in tropical countries like Pakistan. In recent years dengue incidences have increased considerably in different areas of Pakistan with more sever impacts on urban and peri-urban populations. This review is an effort to highlight the changing epidemiology of dengue fever, role of Government of Pakistan in disease management and control using preventive and community based approaches in the region. Moreover, there is an emphasis on application of Wolbachia as novel, inexpensive and environmentally benign candidate for control and eradication of dengue transmitting vectors.

Purpose: We investigated research barriers among Jordanian medical postgraduates to understand the current context of the local health research landscape and improve scholarly output. Methods: Using a validated questionnaire, Jordanian interns, residents, specialists, and consultants were examined for their perceived attitudes and barriers towards research. Participants were conveniently sampled from public, university, military, and private institutions. Differences in responses were examined using the Student t-test and analysis of variance. Binary logistic regression was utilized to examine predictors of being able to publish. Results: A total of 1,141 Jordanian medical postgraduates were recruited, of which 61.3% were junior postgraduates (i.e., interns and residents in their first 2 years of residency) while 38.7% were senior postgraduates (i.e., senior residents, specialists, and consultants). Around 76.0% of participants had no peer-reviewed publications. Of those with least one publication (n=273), only 31.1% had first authorships. Participants portrayed dominantly positive attitudes towards the importance of research. There were no significant differences between junior and senior postgraduates for overall attitudes (p=0.486) and knowledge barriers scores (p=0.0261). Conversely, senior postgraduates demonstrated higher mean organizational barriers (p<0.001). Seniority (odds ratio [OR], 5.268; 95% confidence interval [CI], 3.341–8.307), age (OR, 1.087; 95% CI, 1.019–1.159), academic standing (OR, 1.730; 95% CI, 1.103–2.715), and confidence (OR, 1.086; 95% CI, 1.009–1.169) were positive predictors of publication in peer reviewed journals. Conclusion The Jordanian medical research landscape is riddled with all forms of different barriers. The reworking of current and integration of new research training programs are of utmost importance.

Objective: In the present study the empathy-altruism hypothesis was studied. According to empathy-altruism hypothesis, altruistic acts stimulated by empathy, are directed to improve another person's welfare. Purpose of this study was to investigate the relationship of the emotional empathy and altruism and to determine the predictive power of emotional empathy for altruism among health professionals. Methods: Correlational and cross-sectional research designs were used for the present study. Sample size was estimated through G*power and 200 health professionals (100 MBBS and 100 BDS) were taken from different government and private hospitals and health institutes through purposive sampling technique. Age range of participants was 24-35 years (M=31.45, SD=3.39). Bio data form, Multidimensional Emotional Empathy Scale and Helping attitude scale were used to get demographic information and to assess the emotional empathy and altruistic behaviour respectively of health professionals. Data were analysed by using SPSS 23. Results: Results of the present study showed strong and positive relationship between emotional empathy and altruism among health professionals. Hierarchical regression analysis was run to find the predictive power of emotional empathy for altruistic behaviour of the health professionals. After controlling age, gender, level of education and marital status, emotional empathy emerged as the strong predictor for altruistic behaviour among health professional. Emotional empathy accounted 31.3 % variance for altruistic behaviour. This study can create awareness about the role of health professionals and their behaviour towards patients. Health professional’s emotional empathy is the compulsory factors for defining their attitude towards their patients. Conclusion Emotional empathy plays an important role in the altruistic attributes of health professionals. Some training programs must be arranged to enhance their emotional empathy