Biomedica最新文献

Dr. Shehla Javed Akram's candidacy during the  six months certificate course of Medical Editing and Journalism at University of Health Sciences, Lahore, Pakistan, is not only marked by her academic excellence but also by her exemplary character. In a world that sometimes equates privilege with success, Dr. Shehla's demeanor serve as a refreshing reminder that true achievements are built on a foundation of humility, unwavering dedication, and a commitment to the principles of equity, fairness and professionalism. We are proud to have such dedicated individuals among us, and she truly is a beacon of inspiration for us all.

Background and Objective: Typhoid fever caused by Salmonella typhi (S. typhi) is an important cause of morbidity and mortality worldwide. The emergence of resistance against the first and second line of drugs has limited the range of drug choices for its treatment. Therefore, the present study was designed to assess the status of drug resistance in S. typhi isolated from the blood samples of pediatric patients reporting at a leading tertiary care hospital in Lahore.

Methods: This descriptive study was conducted at the Pathology Department of Allama Iqbal Medical College, Lahore, Pakistan, over a period of 2 years. A total of 1,306 blood samples were aseptically collected from the pediatric population of Jinnah Hospital, Lahore, Pakistan, after obtaining informed assent from the parents/guardians. The samples were transferred into a Bact/Alert blood culture bottle. After the detection of microbial growth by the Bact/Alert 3-D system, bacterial isolates were identified by standard microbiological procedures. VITEK 2 compact automated identification and antimicrobial susceptibility testing instrument (bioMerieux) was used for the antimicrobial sensitivity testing. Data were entered and analyzed by using Statistical Package for the Social Sciences version 21.0.

Results: A total of 235 out of 1,306 (17.9%) blood culture samples yielded bacterial growth, among which 62.5% (n = 147) were S. typhi. Among 147 S. typhi isolates, 70.6% were multidrug resistant, while 63% were extensively drug resistant (XDR). Maximum resistance against first-line drugs observed was for ampicillin (79.4) and co-trimoxazole (67.2).

Conclusion: The emergence and spread of XDR S. typhi with a high level of resistance are quite alarming, leaving limited treatment options for the pediatric population. Moreover, increasing resistance to antibiotics demonstrates the quick waning of the efficacy of available first and second-line drugs in the treatment of typhoid fever.

Background and Objective: Procedural error reporting system is an effective step towards patient safety. In Pakistan adverse event reporting system is deficient. The study aimed to identify the presence of procedural error reporting system and their referral in endodontic clinics of private and public dental institutes in Punjab.

Methods: This study was conducted in six private and two public dental institutes in Punjab via questionnaires developed by the authors and distributed online using Google forms. The questionnaire had 14 items targeting demographics, a procedural error reporting system, and ways to manage procedural errors.

Results: The majority of the dental colleges, both private and public, did not have any procedural error reporting system or a hierarchical order (70.1%) for the management of errors in their endodontic departments (60.5%). The most frequent approach was self-management of errors (86.5%), followed by referring to a senior endodontist (45%) and asking colleagues for help (36.5%). 13% of the respondents never informed patients, while 6% never reported procedural errors to their departments. There was a statistically significant difference between house officers, postgraduate trainees and demonstrators regarding self-management of errors and putting patients on follow-up.

Conclusion: Most endodontic departments lack a system for reporting procedural errors, with no significant difference between private and public institutes. Most respondents report errors to patients and departments, with self-management being the most common approach. Postgraduate trainees tend to manage errors independently. It is imperative to create a comprehensive error reporting system that could be implemented progressively

Cystadenoma is a benign salivary gland tumor that develops very infrequently. The commonest site for their occurrence is minor salivary glands, where these present as cystic growths with papillary projections. Cystadenomas are often interpreted as mucous retention cysts. Therefore, histopathological confirmation is essential for further treatment and follow-up of the patients, even after the surgery, to keep a check on the recurrence and, in the long run, the exclusion of the possibility of malignant transformation. We report a case of mucinous cystadenoma of the salivary gland occurring in a 44-year-old male who presented with a painless mass, gradually increasing in size over the period of 3 years. The radiological evaluation reported it as a retention cyst. Fine needle aspiration cytology was performed, followed by complete surgical excision of the lesion. Diagnosis of mucinous cystadenoma in the parotid gland was made. There are only a few cases of mucinous cystadenoma of the parotid gland reported so far from the world, and to the best of author’s knowledge, it is the first case of its kind reported from Pakistan.

Background and Objective: Oral health is significantly impacted by an individual’s social interactions and quality of life. The aim of this study was to evaluate the association between oral health status and socio-demographic factors, in particular, monthly income and level of education, of a rural community in Pakistan.

Methods: This cross-sectional survey study was conducted among n = 380 people from the Jahangirabad community of Multan from July 2021 to September 2021. A validated questionnaire was designed to be filled by the subjects or the researchers in case of low literacy levels. Two qualified oro-dental examiners assessed all the subjects for their oral health status by using the community periodontal index of the treatment needs (CPITN index).

Results: There were 209 males and 171 females. As regards the status of education, 27% of the subjects had no formal education, 21% of respondents were primary (5th grade) pass, 31.9% attended secondary school, 10.7% got higher secondary school education, whereas 9.4% of respondents had passed the college/university examination. The majority of the participants (46.7%) had income within the range of 10,000-20,000 Pakistani rupees per month, whereas only 12.8% of subjects reported earning more than Rs. 50,000 per month. No significant association was found between average monthly income and oral health status; however, the CPITN score and the higher level of education (high school and college/university) showed a significant association (p-value = 0.012).

Conclusion: Level of education, independent of socioeconomic status, is identified as a potential risk factor for poor oral health status among the rural community in Pakistan. Dental practitioners should consider enhancing timely screening and awareness campaigns, especially within this specific class of community, to improve oral health outcomes.

Background and Objective: Berberine has anti-inflammatory properties through pathways that are also involved in asthma. Therefore, it is postulated that it will be effective in reducing airway inflammation in the allergic asthmatic model. The objective of the current study was to observe the effects of berberine on the histopathology of lungs in sensitized Guinea pigs and compare the changes with that of the standard drug, dexamethasone.

Methods: This experimental study was conducted at the Postgraduate Medical Institute, Lahore, Pakistan, from February 2016 to April 2016. Twenty-four healthy Guinea pigs were divided randomly into four groups: normal control, Ovalbumin (OVA ) group, OVA + berberine group, and OVA + dexa group. The last three groups were sensitized on days 0 and 14 and challenged on days 25, 26, and 27 with OVA. Berberine and dexamethasone were administered intraperitoneally to the respective groups before each challenge. The animals were then sacrificed on day 28 under anesthesia, lungs were dissected, and tissue samples were assessed microscopically for morphology and status of inflammation in each group. Data were analyzed by applying the Kruskal-Wallis analysis of variance test followed by the Mann Whitney U test using SPSS 20.

Results: The comparison of histopathological changes revealed that the infiltration of inflammatory cells in the lung airways was significantly higher (p-value ≤0.01) in the OVA group as compared to the normal control group. Both OVA + berberine and OVA + dexa groups showed a reduction in total lung inflammation (p-value ≤0.01 vs. OVA group) equally. The effect of berberine on epithelial changes was nonsignificant (p-value 0.206 vs. OVA group), while dexamethasone showed significant improvement as compared to the OVA group (p-value 0.007). However, the difference between berberine and dexamethasone treatment was nonsignificant (p-value ≤0.05).

Conclusion: It was concluded that berberine improved the histopathological score of lung inflammation in sensitized Guinea pigs, equivalent to that of dexamethasone, with lesser effects on epithelial changes.

Introduction: The COVID-19 pandemic pressured health care systems to remain alert and active in their vector-borne disease control and prevention programs, leading to changes in vector control strategies in urban areas affected by dengue, Zika and chikungunya.Objective: To describe the adaptations made to the vector control and surveillance program in Medellín during the COVID-19 health emergency.Materials and methods: Once the health emergency started, biosecurity protocols were developed. Entomological surveillance was strengthened from the institutional environment instead of homes. Data was collected in Medellín from 2018 to 2021 during the vector control and surveillance program activities, which included epidemiological and entomovirological surveillance, entomological index survey, ovitrap monitoring, community mobilization, search and elimination of mosquito breading sites, and chemical control. These actions were adapted and/or increased to promote self-care among communities in total and partial confinement, and to develop prevention and control measures.Results: Mosquito monitoring was increased by 40% using ovitraps, entomological virological surveillance showed an increase in 2020 of 34,4% compared to 2019 and virtual media was used to keep and improve contact with the community.Conclusion: The COVID-19 pandemic had a significant impact on arbovirus prevention and control programs. The city of Medellín quickly adapted its entomo-virological surveillance activities, control measures, and the contact with the community during the pandemic, which allow the Integrated Vector Management program to remain active in the city.

Fungal sinusitis is a pathology that can occur in patients with diabetes mellitus and be associated with a hyperglycemic crisis. It is an aggressive entity with local complications that include involvement of the orbit or the central nervous system, and vascular involvement. Despite surgical and antifungal treatment, mortality raises up to 75%.We report the case of a female patient with a diagnosis of diabetic ketoacidosis and signs of unilateral ophthalmoplegia, which led to the study with magnetic resonance imaging of the central nervous system, finding signs of sinusitis, meningitis, and cerebritis. Initial microbiological studies were negative, and biomarkers such as serum galactomannan and Cryptococcus antigen were also negative. After surgical management and the identification of Aspergillus flavus and Rhizopus spp. in sinus tissue, the patient received treatment with posaconazole and after two months of follow-up she presented clinical improvement. Dual fungal infection and infection by A. flavus are uncommon and clinically relevant entities, with no cases previously reported in our country, therefore this corresponds to a case of clinical interest.

Introduction: Diabetes mellitus is one of the most prevalent chronic diseases in the pediatric and juvenile population that affects the quality of life of patients.Objective: To evaluate the quality of life of a pediatric population under 18 years of age diagnosed with type 1 diabetes from two pediatric institutions in the city of Bogotá.Material and methods: We collected of sociodemographic data and clinical variables and application of the PedsQL 4.0™ questionnaire, and the diabetes module 3.2 version validated in Spanish. The sociodemographic data, the clinical variables and the PedsQL™ were processed in the statistical software Stata 17™.Results: In the global score of the PedsQL™ 3.2, diabetes version, men presented better quality of life compared to women. The correlation between the hemoglobin A1c (HbA1c) values and the PedsQL scale in the global score was evaluated. Patients with HbA1c values below 9% presented a better health-related quality of life, while in the group with HbA1c greater than 9% a perception of low quality of life was observed (p=0.025). Regarding the type of therapy and the relationship with the domains of the PedsQL 3.2, diabetes version, patients who used insulin pumps had better scores in the domains barriers, adherence, concern, communication and in the global score compared to patients who used multiple daily injections of insulin as treatment (p=0.0363).Conclusions: In our patients, a better metabolic control (measured by the HbA1c value) and the use of an insulin pump contribute to a better perception of quality of life.

Introduction: It has been shown that the transmission of SARS-CoV-2 occurs mainly by air, and the risk of infection is greater in closed spaces.

Objective: To describe the epidemiology, virology and molecular characterization of a COVID-19 outbreak at a closed vaccination point during the third wave of SARS-CoV-2 in Colombia.

Materials and methods: Diagnostic tests, interviews, sampling, cell cultures and viral sequencing were carried out, the latter being molecular characterization and lineage identification.

Results: Seven workers were positive for SARS-CoV-2; among these, 3 samples were analyzed, plus an additional sample belonging to the mother of the presumed index case; all samples were identified with lineage B.1.625, with a maximum of 2 nucleotides difference between them.

Conclusions: Variant B.1.625 was identified as the cause of the COVID-19 outbreak, and a co-worker was also identified as the index case. Unexpectedly, attending a vaccination day became a risk factor for acquiring the infection.