Publications by authors named "Safdar Abbas"

24 Publications

  • Page 1 of 1

Saponin toxicity as key player in plant defense against pathogens.

Toxicon 2021 Apr 26;193:21-27. Epub 2021 Jan 26.

Shenzhen Key Laboratory of Marine Bioresource & Eco-environmental Sciences, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen, Guangdong, 518071, China. Electronic address:

Microbial pathogens attack every plant tissue, including leaves, roots, shoots, and flowers during all growth stages. Thus, they cause several diseases resulting in a plant's failure or loss of the whole crop in severe cases. To combat the pathogens attack, plants produce some biologically active toxic compounds known as saponins. The saponins are secondary metabolic compounds produced in healthy plants with potential anti-pathogenic activity and serve as potential chemical barriers against pathogens. Saponins are classified into two major groups the steroidal and terpenoid saponins. Here, we reported the significance of saponin toxins in the war against insect pests, fungal, and bacterial pathogens. Saponins are present in both cultivated (chilies, spinach, soybean, quinoa, onion, oat, tea, etc.) and wild plant species. As they are natural toxic constituents of plant defense, breeders and plant researchers aiming to boost plant imm unity should focus on transferring these compounds in cash crops.
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http://dx.doi.org/10.1016/j.toxicon.2021.01.009DOI Listing
April 2021

Novel homozygous variant in the TPO gene associated with congenital hypothyroidism and mild-intellectual disability.

Hum Genome Var 2020 Nov 27;7(1):41. Epub 2020 Nov 27.

Department of Chemistry, Swabi University, KPK, Pakistan.

Congenital hypothyroidism (CH) is one of the most common hereditary disorders affecting neonates worldwide. CH is a multifactorial complex disorder and can be caused by either environmental factors or genetic factors. We studied one Pakistani family with segregating mutations in CH inherited in an autosomal recessive manner. Using whole-exome sequencing (WES), we found a novel homozygous missense variant (c.2315A>G; p.Tyr772Cys) in the thyroid peroxidase (TPO) gene. Different bioinformatics prediction tools and Sanger sequencing were performed to verify the identified variant. Our findings highlight the importance of this gene in causing CH and mild-intellectual disability (ID) in two affected brothers. WES is a convenient and useful tool for the clinical diagnosis of CH and other associated disorders.
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http://dx.doi.org/10.1038/s41439-020-00129-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7695822PMC
November 2020

Exome sequencing of a Pakistani family with spastic paraplegia identified an 18 bp deletion in the cytochrome B5 domain of FA2H.

Neurol Res 2021 Feb 27;43(2):133-140. Epub 2020 Nov 27.

Diagnostic and Research Institute of Human Genetics, Medical University of Graz , Graz, Austria.

Hereditary spastic paraplegias (HSPs) are a diverse class of neurodegenerative disorders that mainly affect the corticospinal tract of the body and result in various clinical conditions such as lower limb spasticity and muscle weakness in the lower extremities. Worldwide, more than 70 chromosomal loci/genes have been reported to be associated with HSPs, out of which, six genes viz., and have been mapped in Pakistani families. In the present genetic study, we report on a large consanguineous Pakistani family with a complex form of HSP segregating with a 18 bp deletion in the first exon of the Fatty Acid 2-Hydroxylase () gene (NM_024306.5:c.159_176del). The identified in-frame deletion results in loss of six amino acids (p.Arg53_Ile58del) within the cytochrome B5 domain of the protein. FA2H is required for alpha-hydroxylation of free fatty acids to form alpha-hydroxylated sphingolipids. Its cytochrome b5-like heme-binding domain, which spans from residues 15 to 85, imparts the redox activity to FA2H. This mutation has previously been reported in a Pakistani family presenting with a similar form of complex HSP. Together with our findings the pathogenic role of the observed variant is further supported. Mutation studies on additional Pakistani families for will further elucidate its mutational spectrum, which may help in developing a prenatal diagnostic test for Khyber Pakhtunkhwa resident Pakistani families.
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http://dx.doi.org/10.1080/01616412.2020.1831329DOI Listing
February 2021

Variations in Mineral/heavy Metals Profiling and Preventive Role of Trichomes in Peach Fruits Treated with CaC.

Comb Chem High Throughput Screen 2021 ;24(4):598-604

Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.

Background: Phytonutrients in peach fruits have health-promoting antioxidants against various chronic diseases. However, there is no extensive data to show the nutritional values of Local peach cultivars after post-harvest treatments.

Objective: Mainly this study was objective to determine the effect of calcium carbide on nutritional value and quality of fruits of Pakistani peach cultivars.

Methods: The peach fruits were collected from three different peach orchids of KPK and the fruits were divided into 4 groups while 5th group was collected from a local fruit shop. Each experimental group was treated with different concentrations of calcium carbide whereas control group was not treated. The peel and pulp samples were oven dried and ground to fine powder separately. The elemental compositions were determined using Particle Induced X-ray emission and Pelletron Tandem Accelerator.

Results: Sixteen elements were identified in peach fruits and the elements were Al, P, S, Cl, K, Ca, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, and Se. In peel, the concentration of some elements increased or decreased after treatment with CaC while in pulp the conc. of nearly all detected elements was increased in treated samples. We found a significantly higher amount of heavy metals traces, including As, Se, Co, Si, and P in peach fruits treated with CaC Interestingly, the presence of trichomes in peach skin prevents the transfer of these heavy metals deep into the pulp which was also verified by the elemental profiling of nectarines.

Conclusion: Conclusively, the artificial ripening with CaC changed the nutritional value of peach fruits that has higher health risks if consume with the peel. According to our best knowledge, this is the first report that highlights the effects of CaC which deteriorate the nutritional value of peach fruits in Pakistan.
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http://dx.doi.org/10.2174/1386207323666200808175723DOI Listing
January 2021

Biallelic variants in four genes underlying recessive osteogenesis imperfecta.

Eur J Med Genet 2020 Aug 13;63(8):103954. Epub 2020 May 13.

Medical Genomics Research Department, King Abdullah International Medical Research Center (KAIMRC), King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard-Health Affairs, P.O. Box 3660, Riyadh, 11481, Saudi Arabia. Electronic address:

Osteogenesis imperfecta (OI) is an inherited heterogeneous rare skeletal disorder characterized by increased bone fragility and low bone mass. The disorder mostly segregates in an autosomal dominant manner. However, several rare autosomal recessive and X-linked forms, caused by mutations in 18 different genes, have also been described in the literature. Here, we present five consanguineous families segregating OI in an autosomal recessive pattern. Affected individuals in the five families presented severe forms of skeletal deformities. It included frequent bone fractures with abnormal healing, short stature, facial dysmorphism, osteopenia, joint laxity, and severe scoliosis. In order to search for the causative variants, DNA of at least one affected individual in three families (A-C) were subjected to whole exome sequencing (WES). In two other families (D-E), linkage analysis using highly polymorphic microsatellite markers was followed by Sanger sequencing. Sequence analysis revealed two novels and three previously reported disease-causing variants. The two novel homozygous variants including [c.824G > A; p.(Cys275Tyr)] in the SP7 gene and [c.397C > T, p.(Gln133*)] in the SERPINF1 gene were identified in families A and B, respectively. The three previously reported homozygous variants including [c.497G > A; p.(Arg166His)] in the SPARC gene, (c.359-3C > G; intron 2) and [c.677C > T; p.(Ser226Leu)] in the WNT1 gene were identified in family C, D, and E. In conclusion, our findings provided additional evidence of involvement of homozygous sequence variants in the SP7, SERPINF1, SPARC and WNT1 genes causing severe OI. It also highlights the importance of extensive genetic investigations to search for the culprit gene in each case of skeletal deformity.
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http://dx.doi.org/10.1016/j.ejmg.2020.103954DOI Listing
August 2020

Identification of a novel biallelic missense variant in the KIAA0825 underlies postaxial polydactyly type A.

Genomics 2020 07 5;112(4):2729-2733. Epub 2020 Mar 5.

Department Biochemistry, Abdul Wali Khan University, Mardan, Khyber Pakhtunkhwa, Pakistan. Electronic address:

Postaxial polydactyly (PAP) is characterized by development of extra digits, which mostly segregates in autosomal recessive pattern. The underlying genetic cause of recessive non-syndromic PAP type A has been associated with sequence variants in five different genes (ZNF141, IQCE, GLI1, FAM92A, KIAA0825). The present study was aimed to investigate clinical and genetic causes of PAPA in a consanguineous family of Pakistani origin. Microsatellite-based linkage analysis was used to search for the disease-causing gene. Linkage in the family was established at chromosome 5q15 harbouring a candidate gene KIAA0825. Subsequently, Sanger sequencing revealed a novel homozygous missense variant [c.50T>C; p. (Leu17Ser)] in the gene, which co-segregated with the disease within the family. Protein structural analysis predicted a substantial change in the secondary structure of the mutant protein affecting its function. This is the third disease causing variant identified in the KIAA0825. This has not only expanded spectrum of the mutations in the gene but also further substantiated its role in the limb development in human.
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http://dx.doi.org/10.1016/j.ygeno.2020.03.006DOI Listing
July 2020

Genetic study of Khyber-Pukhtunkhwa resident Pakistani families presenting primary microcephaly with intellectual disability.

J Pak Med Assoc 2019 Dec;69(12):1812-1816

Gomal Centre of Biochemistry and Biotechnology, Gomal University, D.I. Khan, Khyber Pakhtunkhwa, Pakistan.

Objective: To investigate the genetic factor responsible for causing microcephaly and determine allelic heterogeneity of Abnormal spindle microtubule gene.

Methods: The genetic study was conducted at the Kohat University of Science and Technology, Kohat, and Gomal University, D.I.Khan, Pakistan, during 2017-18, and comprised 5 consanguineous families from South Waziristan, Kurram Agency, Karak, Bannu and Dera Ismail Khan regions of the country's Khyber Pakhtukhwa province. Blood samples from all available and cooperative family members (including normal and affected) were obtained, and molecular analysis was carried out through whole genome single nucleotide polymorphisms genotyping, exome sequencing and Sanger sequencing.

Results: Of the 15 patients, 9(60%) were males and 6(40%) were females. Genetic mapping revealed linkage to the MCPH5 locus which harbours the microcephaly-associated abnormal spindle-like microcephaly gene. Mutation analysis of the gene identified missense mutation c.3978G>A (p.Trp1326*) in families A, B and C, a deletion mutation c.7782_7783delGA (p.(Lys2595Serfs*6)) in family D, and a splice site defect c.2936+5G>A in family E.

Conclusions: There was suggestion of strong founder effect of mutation c.3978G>A (p.Trp1326*).
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http://dx.doi.org/10.5455/JPMA.300681DOI Listing
December 2019

Correction to: Homozygous missense variant in the TTN gene causing autosomal recessive limb-girdle muscular dystrophy type 10.

BMC Med Genet 2019 Dec 12;20(1):195. Epub 2019 Dec 12.

McKusick-Zhang Center for Genetic Medicine, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.

Please be advised that following publication of the original article [1], the authors have identified the following errors with the scientific content.
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http://dx.doi.org/10.1186/s12881-019-0929-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6907177PMC
December 2019

Homozygous missense variant in the TTN gene causing autosomal recessive limb-girdle muscular dystrophy type 10.

BMC Med Genet 2019 10 29;20(1):166. Epub 2019 Oct 29.

McKusick-Zhang Center for Genetic Medicine, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical College, Beijing, China.

Background: Limb-girdle muscular dystrophies (LGMDs) are large group of heterogeneous genetic diseases, having a hallmark feature of muscle weakness. Pathogenic mutations in the gene encoding the giant skeletal muscle protein titin (TTN) are associated with several muscle disorders, including cardiomyopathy, recessive congenital myopathies and limb-girdle muscular dystrophy (LGMD) type10. The phenotypic spectrum of titinopathies is expanding, as next generation sequencing (NGS) technology makes screening of this large gene possible.

Aim: This study aimed to identify the pathogenic variant in a consanguineous Pakistani family with autosomal recessive LGMD type 10.

Methods: DNA from peripheral blood samples were obtained, whole exome sequencing (WES) was performed and several molecular and bioinformatics analysis were conducted to identify the pathogenic variant. TTN coding and near coding regions were further amplified using PCR and sequenced via Sanger sequencing.

Results: Whole exome sequencing analysis revealed a novel homozygous missense variant (c.98807G > A; p.Arg32936His) in the TTN gene in the index patients. No heterozygous individuals in the family presented LGMD features. The variant p.Arg32936His leads to a substitution of the arginine amino acid at position 32,936 into histidine possibly causing LGMD type 10.

Conclusion: We identified a homozygous missense variant in TTN, which likely explains LGMD type 10 in this family in line with similar previously reported data. Our study concludes that WES is a successful molecular diagnostic tool to identify pathogenic variants in large genes such as TTN in highly inbred population.
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http://dx.doi.org/10.1186/s12881-019-0895-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6819411PMC
October 2019

Biallelic Missense Mutation in the Underlies Distal Arthrogryposis Type 5 (DA5D).

Front Pediatr 2019 28;7:343. Epub 2019 Aug 28.

Department of Chemistry, Women University Swabi, Swabi, Pakistan.

Distal arthrogryposis (DA) is a heterogeneous sub-group of arthrogryposis multiplex congenita (AMC), mostly characterized by having congenital contractures affecting hands, wrists, feet, and ankles. Distal arthrogryposis is mostly autosomal dominantly inherited, while only one sub-type DA type 5D is inherited in an autosomal recessive manner. Clinically, DA5D is described having knee extension contractures, micrognathia, distal joint contractures, clubfoot, ptosis, contractures (shoulders, elbows, and wrists), and scoliosis. Using whole exome sequencing (WES) followed by Sanger sequencing, we report on a first familial case of DA5D from Pakistani population having a novel biallelic missense mutation (c.158C>A, p.Pro53Leu) in the gene. Our result support that homozygous mutations in causes DA5D and expands the clinical and allelic spectrum of related contracture syndromes.
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http://dx.doi.org/10.3389/fped.2019.00343DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6724761PMC
August 2019

Exome sequence analysis in consanguineous Pakistani families inheriting Bardet-Biedle syndrome determined founder effect of mutation c.299delC (p.Ser100Leufs*24) in BBS9 gene.

Mol Genet Genomic Med 2019 08 11;7(8):e834. Epub 2019 Jul 11.

Institute of Human Genetics, Medical University of Graz, Graz, Austria.

Background: Bardet-Biedl syndrome (BBS) is characterized by a heterogeneous phenotypic spectrum of retinopathy, intellectual disability (ID), obesity, polydactyly, and kidney dysfunctions as the major clinical features. Genetic investigations have reported 21 BBS genes, the products of which are mostly located at the centrosome, basal body or the ciliary transition zone.

Methods: In the present genetic report, we analyzed two apparently unrelated consanguineous BBS families from Dera Ismail Khan (D.I.Khan) district, Pakistan. Genetic mapping was performed using Whole exome sequencing and Sanger sequencing.

Results: Whole exome sequencing identified a recently reported single base deletion NM_001033604.1:c.299delC in the fourth exon of BBS9 in both families. The identified frameshift mutation is predicted to cause premature truncation of the expressed protein (p.Ser100Leufs*24). This mutation has previously been mapped in a consanguineous Pakistani family; therefore this is the second report of this particular mutation in two additional BBS families originating from different locations.

Conclusion: We speculate the evolutionary significance of this mutation and assume its strong founder effect in the Khaisoori tribe of D.I.Khan. Based on these findings, we suggest developing a molecular diagnostic test that may be used for premarital and prenatal screening of families at risk of BBS.
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http://dx.doi.org/10.1002/mgg3.834DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687644PMC
August 2019

Homozygous Nonsense Mutation (p.Arg97) Causing Limb-Girdle Muscular Dystrophy Type 2F (LGMD2F) in a Consanguineous Family, a Case Report.

Front Genet 2018 23;9:727. Epub 2019 Jan 23.

Department of Biochemistry, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan.

Limb-girdle muscular dystrophy (LGMD) is an increasingly heterogeneous category of inherited muscle diseases, mainly affecting the muscles of shoulder areas and the hip, segregating in both autosomal recessive and dominant manner. To-date, thirty-one loci have been identified for LGMD including seven autosomal dominant (LGMD type 1) and twenty four autosomal recessive (LGMD type 2) inherited loci. The present report describes a consanguineous family segregating LGMD2F in an autosomal recessive pattern. The affected individual is an 11-year-old boy having two brothers and a sister. Direct targeted next generation sequencing was performed for the single affected individual (VI-1) followed by Sanger sequencing. Targeted next generation sequencing revealed a novel homozygous nonsense mutation (c.289C>T; p.Arg97) in the exon 3 of the delta-sarcoglycan () gene, that introduces a premature stop codon (TCA), resulting in a nonsense mediated decay or a truncated protein product. This is the first report of LGMD2F caused by an variant in a Pakistani population. The mutation identified in the present investigation extends the body of evidence implicating the gene in causing LGMD2F and might help in genetic counseling, which is more important to deliver the risk of carrier or affected in the future pregnancies.
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http://dx.doi.org/10.3389/fgene.2018.00727DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6354032PMC
January 2019

Role of secondary metabolites in plant defense against pathogens.

Microb Pathog 2018 Nov 23;124:198-202. Epub 2018 Aug 23.

PARC Institutes of Advanced Studies in Agriculture, NARC, Islamabad, Pakistan.

Pathogens get entry into host cell, reproduce there and use biological machinery of host plants which is threat to global crop production. Integrated management strategies based upon minimizing population and use of resistant cultivars can address this potential problem. In developing world farmers are less likely to adopt these approaches instead they prefer the use of chemical pesticides. Reckless use of chemical pesticides is destroying our ecosystem. That's why it is required to explore ecofriendly alternatives, like plant based metabolites to control pathogens. Studies conducted on different plant-metabolites reported that these metabolite can potentially combat plant pathogens. In this study we have also discussed some of plant secondary metabolites including alkaloids, flavonoids and phenolics. In this review we tried to highlight the new trends in utilizing secondary metabolites for controlling bacterial, viral and fungal pathogens with the hope that upcoming drugs will be human and ecosystem friendly.
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http://dx.doi.org/10.1016/j.micpath.2018.08.034DOI Listing
November 2018

Long non-coding RNAs as molecular players in plant defense against pathogens.

Microb Pathog 2018 Aug 31;121:277-282. Epub 2018 May 31.

Institute of Horticulture, Bahauddin Zakariya University Multan, Pakistan.

Long non-coding RNAs (lncRNAs) has significant role in of gene expression and silencing pathways for several biological processes in eukaryotes. lncRNAs has been reported as key player in remodeling chromatin and genome architecture, RNA stabilization and transcription regulation, including enhancer-associated activity. Host lncRNAs are reckoned as compulsory elements of plant defense. In response to pathogen attack, plants protect themselves with the help of lncRNAs -dependent immune systems in which lncRNAs regulate pathogen-associated molecular patterns (PAMPs) and other effectors. Role of lncRNAs in plant microbe interaction has been studied extensively but regulations of several lncRNAs still need extensive research. In this study we discussed and provide as overview the topical advancements and findings relevant to pathogen attack and plant defense mediated by lncRNAs. It is hoped that lncRNAs would be exploited as a mainstream player to achieve food security by tackling different plant diseases.
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http://dx.doi.org/10.1016/j.micpath.2018.05.050DOI Listing
August 2018

Knowledge of Medicinal Plants for Children Diseases in the Environs of District Bannu, Khyber Pakhtoonkhwa (KPK).

Front Pharmacol 2017 17;8:430. Epub 2017 Jul 17.

Department of Chemistry, COMSATS Institute of Information TechnologyAbbottabad, Pakistan.

Medicinal plants are important treasures for the treatment of different types of diseases. Current study provides significant ethnopharmacological information, both qualitative and quantitative on medical plants related to children disorders from district Bannu, Khyber Pakhtunkhwa (KPK) province of Pakistan. The information gathered was quantitatively analyzed using informant consensus factor, relative frequency of citation and use value method to establish a baseline data for more comprehensive investigations of bioactive compounds of indigenous medicinal plants specifically related to children disorders. To best of our knowledge it is first attempt to document ethno-botanical information of medicinal plants using quantitative approaches. Total of 130 informants were interviewed using questionnaire conducted during 2014-2016 to identify the preparations and uses of the medicinal plants for children diseases treatment. A total of 55 species of flowering plants belonging to 49 genera and 32 families were used as ethno-medicines in the study area. The largest number of specie belong to Leguminosae and Cucurbitaceae families (4 species each) followed by Apiaceae, Moraceae, Poaceae, Rosaceae, and Solanaceae (3 species each). In addition leaves and fruits are most used parts (28%), herbs are most used life form (47%), decoction method were used for administration (27%), and oral ingestion was the main used route of application (68.5%). The highest use value was reported for species and (1 for each) and highest Informant Consensus Factor was observed for cardiovascular and rheumatic diseases categories (0.5 for each). Most of the species in the present study were used to cure gastrointestinal diseases (39 species). The results of present study revealed the importance of medicinal plant species and their significant role in the health care of the inhabitants in the present area. The people of Bannu own high traditional knowledge related to children diseases. In conclusion we recommend giving priority for further phytochemical investigation to plants that scored highest FIC, UV values, as such values could be considered as good indicator of prospective plants for discovering new drugs and attract future generations toward traditional healing practices.
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http://dx.doi.org/10.3389/fphar.2017.00430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5511814PMC
July 2017

Molecular genetic analysis of consanguineous families with primary microcephaly identified pathogenic variants in the ASPM gene.

J Genet 2017 Jun;96(2):383-387

Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar.

Autosomal recessive primary microcephaly is a rare genetic disorder that is characterized by reduced head circumference and a varying degree of intellectual disability. Genetic studies on consanguineous families with primary microcephaly have identified 15 (MCPH) causative genes that include MCPH1, WDR62, CDK5RAP2, CASC5, ASPM, CENPJ, STIL, CEP135, CEP152, ZNF335, PHC1, CDK6, CENPE, SASS6 MFSD2A ANKLE2 and CIT (Khan et al. 2014; Yamamoto et al. 2014; Alakbarzade et al. 2015;Morris-Rosendahl and Kaindl 2015; Basit et al. 2016). Physiologically, most of these MCPH proteins are involved in cell cycle and its regulation. In the present clinical genetic study, we have present two consanguineous Pakistani families segregating primary microcephaly and intellectual disability. These families were ascertained from the Saraiki ethnic part of Khyber-Pakhtunkhwa province in Pakistan. Whole exome sequencing in one family revealed a novel 1-bp deletion NM_018136.4: c.10013delA (p.Asp3338Valfs*2), while the other family showed a previously reported nonsense mutation NM_018136.4: c.9730C>T (rs199422195 (p.Arg3244*)) in ASPM gene. The novel frame-shift mutation (p.Asp3338Valfs*2) in ASPM presumably truncates the protein synthesis that results in loss of armadillo-type fold domain.
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http://dx.doi.org/10.1007/s12041-017-0759-xDOI Listing
June 2017

Manual Vacuum Aspiration (MVA) - A safe option for evacuation of first trimester miscarriage in cardiac patients.

J Pak Med Assoc 2017 Jun;67(6):948-950

Department of Obs Gyne, Department of Cardiac Anesthesia, AFIC/NIHD, Rawalpindi, Pakistan.

This case series was done at Armed Forces Institute of Cardiology, National Institute of Heart Disease, Rawalpindi, to observe safety and efficacy of manual vacuum aspiration and frequency of complications in cardiac patients with missed abortion. All cardiac patients presenting in first trimester with diagnosed early foetal demise (missed miscarriage) or incomplete miscarriage were included. Manual vacuum aspiration was done as an outpatient procedure. Cardiac and procedure related complications including arrhythmias, thromboembolism, heart failure and ischaemia were noted. A total of 34 patients were enrolled. Mean age and parity was 25.9±2.25 years and 1.18±1.02. Mitral valve was the dominant valve involved in 20(58.8%) followed by double valve replacement in 5(14.7%), dilated cardiomyopathy 4(11.76%), aortic valve involvement in 3(8.8%) and supra ventricular tachycardia in 2(5.9%) patients. Complete evacuation was achieved in 100% patients and there were no major cardiac or gynaecological complications except arrhythmia in 1(2.9%) patient. MVA seems to be a safe and cost effective intervention compared to other modalities of miscarriage management even in high risk cardiac patients.
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June 2017

Circumstances leading to intimate partner violence against women married as children: a qualitative study in Urban Slums of Lahore, Pakistan.

BMC Int Health Hum Rights 2015 Aug 25;15:23. Epub 2015 Aug 25.

Institute of Social and Cultural Studies, University of the Punjab, Lahore, Pakistan.

Background: Child marriage (<18 years) is prevalent in Pakistan which is associated with negative health outcomes including intimate partner violence (IPV). Our aim is to describe the types and circumstances of IPV against women who were married as children in urban slums of Lahore, Pakistan.

Methods: Women of reproductive age (15-49 years) who were married prior to 18 years, for at least 5 years were recruited from most populous slum areas of Lahore, Pakistan. Themes for the interview guide were developed using published literature and everyday observations of the researchers. Interviews were conducted by trained interviewers in Urdu language and were translated into English. The interviews were tape-recorded, transcribed, analyzed and categorized into themes.

Results: All 19 participants were married between 11 and 17 years. Most respondents were uneducated, poor and were working as housemaids. Majority of participants experienced verbal abuse, and threatened, attempted and completed physical violence by their husbands. A sizeable number of women reported unwanted sexual encounters by their husbands. Family affairs particularly issues with in-laws, poor house management, lack of proper care of children, bringing insufficient dowry, financial problems, an act against the will of husband, and inability to give birth to a male child were some of the reasons narrated by the participants which led to IPV against women.

Conclusions: Women married as children are vulnerable to IPV. Concerted efforts are needed from all sectors of society including academia, public health experts, policy makers and civil society to end the child marriage practice in Pakistan.
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http://dx.doi.org/10.1186/s12914-015-0060-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4549016PMC
August 2015

Knowledge and attitude towards child marriage practice among women married as children-a qualitative study in urban slums of Lahore, Pakistan.

BMC Public Health 2014 Nov 6;14:1148. Epub 2014 Nov 6.

Department of Public Health Medicine, School of Public Health, Bielefeld University, Bielefeld, Germany.

Background: Child marriage (<18 years) is prevalent in Pakistan which is associated with negative health outcomes. Our aim is to describe women's knowledge and attitude towards child marriage practice who themselves were married as children.

Methods: Women of reproductive age (15-49 years) who were married prior to 18 years, for at least 5 years and had at least one child birth were recruited from most populous slum areas of Lahore, Pakistan. Themes for the interview were developed using published literature and everyday observations of the researchers. Interviews were conducted by trained interviewers in Urdu language and were translated into English. The interviews were tape-recorded, transcribed, analyzed and categorized into themes.

Results: Nineteen of 20 participants who agreed to participate were married between 11-17 years. Most respondents were uneducated, poor and were working as housemaids. The majority participants were unaware of the negative health outcomes of child marriages. They appeared satisfied by the decision of their parents of marrying them before 18 years, and even condemned banning child marriages in Pakistan. Strong influence of culture and community perceptions, varying interpretation of religion, and protecting family honor are some of the reasons that were narrated by the participants, which seems playing a role in continuation of child marriage practice in Pakistan.

Conclusion: Raising awareness of the negative health outcomes of child marriage, implementing and enforcing strict laws against child marriage practice, promoting civil, sexual and reproductive health rights for women, can help eliminate child marriages in Pakistan.
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http://dx.doi.org/10.1186/1471-2458-14-1148DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289044PMC
November 2014

Should we routinely expose recurrent laryngeal nerve(s) during thyroid surgery?

J Coll Physicians Surg Pak 2013 Mar;23(3):186-9

Department of Surgery, Military Hospital, Street 8, Valley Road, Rawalpindi.

Objective: To compare the frequency of recurrent laryngeal nerve(s) (RLNs) palsy after various thyroid procedures with and without identification of recurrent laryngeal nerve during the operation.

Study Design: Randomized controlled trial.

Place And Duration Of Study: Department of Surgery, Military Hospital, Rawalpindi, from August 2008 to April 2010.

Methodology: Patients undergoing indirect laryngoscopy with normal vocal cords and those with carcinoma and re-do surgery having normal vocal cord were included in the study. Patients with hoarseness of voice, abnormal vocal cord movements and with solitary nodule in the isthmus were excluded. These patients were randomly divided into 2 groups of 50 each using random number tables. RLN was identified by exposing the inferior thyroid artery and traced along its entire course in group-A. Whereas, in group-B, nerves were not identified during the operations. Immediate postoperative direct laryngoscopy was performed by a surgeon with the help of an anaesthesiologist for the assessment of vocal cords. Patients with persistent hoarseness of voice were followed-up with indirect laryngoscopy at 3 and 6 months.

Results: Temporary unilateral recurrent laryngeal nerve palsies occurred in 2 (4%) patients in group-A where the voice and cord movements returned to normal in 6 months. In group-B, it occurred in 8 (16%) patients, 2 bilateral (4%) injuries requiring tracheostomy and 6 unilateral injuries (12%). Among the 2 bilateral recurrent laryngeal nerve injuries, the tracheostomy was removed in one case after 6 months with persistent hoarseness of voice but no respiratory difficulty during routine activities. Tracheostomy was permanent in the other case. Among the 6 cases of unilateral nerve injuries, the voice improved considerably in 4 cases within 6 months but in 2 cases hoarseness persisted even after 6 months. Frequency of recurrent laryngeal nerve palsies was significantly lower in group-A as compared to group-B (p = 0.046).

Conclusion: For safe thyroid surgery, recurrent laryngeal nerve(s) should be routinely exposed in its entire course.
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http://dx.doi.org/03.2013/JCPSP.186189DOI Listing
March 2013

Role of magnesium in preventing post-operative atrial fibrillation after coronary artery bypass surgery.

J Ayub Med Coll Abbottabad 2009 Apr-Jun;21(2):27-9

Department of Anaesthesia, Armed Forces Institute of Cardiology, Rawalpindi, Pakistan.

Objective: To assess the role of 3 days of magnesium infusion after coronary artery bypass graft (CABG) surgery in preventing postoperative atrial fibrillation (AF).

Place And Duration Of Study: Armed Forces Institute of Cardiology (AFIC) & National Institute of Heart Diseases (NIHD), Rawalpindi, from July 2006 to June 2007.

Design: Prospective, randomized, non-blinded.

Methods: All patients undergoing isolated, initial CABG surgery, and having sinus rhythm before surgery were alternatively randomized into the study or the control group. The exclusion criteria included: history of AF, implanted pacemaker, myocardial infarction postoperatively, use of left ventricular assist devices and renal failure. The patients in the study group received 10 mmol of magnesium sulphate (2.47 gm) dissolved in 100 ml of saline solution infused intravenously over 4 hours, for 3 days. The end point was development of AF for at least 15 minutes or more, or if an episode of AF had to be treated because of symptoms.

Results: A total of 220 patients were included in the study, 110 in each group. The incidence of AF was 9% in patients who received the three days of magnesium infusion. The patients without magnesium had an AF incidence of 23% (p < 0.001). The hospital stay was also less in the treated group (p = 0.055).

Conclusion: A 3-days postoperative infusion of magnesium is safe and effective in reduction of possibly life-threatening AF, in patients undergoing primary coronary artery bypass surgery.
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June 2011

Antibiotic prophylaxis in clean general surgery.

J Coll Physicians Surg Pak 2007 Aug;17(8):462-4

Department of Surgery, Combined Military Hospital, Multan.

Objective: To find out the incidence of surgical site infection in clean general surgery cases operated without prophylactic antibiotics.

Design: A comparative study.

Place And Duration Of Study: The study was carried out in Combined Military Hospital, Pano Aqil Cantonment, from July 2003 to December 2004.

Patients And Methods: One hundred and twenty-four clean surgical cases operated without antibiotic prophylaxis between July 2003 and December 2004, were studied and these were compared with similar number of cases who received antibiotics. The data was collected and analyzed using software SPSS (version 10.0). Chi-square and student "t" test were used to analyze the association between antibiotics and wound infection.

Results: The most frequent operation was repair of various hernias, 69.3% in group A and 75% in group B. More operations were carried out between 21-30 years, 38.7% in group A and 41.9% in group B. Surgical site infection occurred in one patient (0.8 %) in each group. Chi- square test (0.636) applied to group A and B showed no association of infection and administration/ no administration of antibiotics (p > 0.25). The "t" test applied on group A and B (t=0) also showed no significant difference between administration of antibiotics/ no antibiotics and infection (p > 0.25).

Conclusion: The use of prophylactic antibiotic in clean, non implant and elective cases is unnecessary.
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http://dx.doi.org/08.2007/JCPSP.462464DOI Listing
August 2007

Cardiac trauma with gunshot injuries.

J Coll Physicians Surg Pak 2004 Jan;14(1):41-2

Department of Anaesthesia and Intensive Care, Combined Military Hospital, Pano Aqil.

Penetrating cardiac injuries, secondary to gunfire, constitute the most lethal forms of cardiothoracic trauma with their potential fatality. We report our experience of managing two such cases who presented with haemorrhagic shock and cardiac tamponade, in a collapsed state. Prompt resuscitation and early surgical intervention (midline sternotomy and cardiorrhaphy) was successfully performed with a favourable outcome.
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http://dx.doi.org/01.2004/JCPSP.4142DOI Listing
January 2004

Is mechanical bowel preparation really necessary in colorectal surgery?

J Coll Physicians Surg Pak 2003 Nov;13(11):637-9

Department of Surgery, Combined Military Hospital, Pano Aqil Cantt.

Objective: To determine the outcome of colorectal surgery without mechanical bowel preparation.

Design: A descriptive, analytical and observational study.

Place And Duration Of Study: Combined Military Hospital, Kharian and Pano Aqil, from September 1998 to April 2003.

Subjects And Methods: Forty-seven patients underwent debridement/resection and repair/primary anastomosis of colon and upper rectum without bowel preparation. Of these, 16 patients were operated in emergency. The anastomosis was carried out with polyglactin (vicryl) interrupted, full thickness single layer and no patient had defunctioning colostomy. Third generation cephalosporin, cefotaxime or ceftazidime and metronidazole were given perioperatively, repeated during surgery if lasted for more than 2 hours and continued for 3-5 days postoperatively.

Results: Anastomoses were ileocolic in 29.7%, colicocolic in 61.7% and colorectal in 14.8% cases. Anastomotic failure was seen in 4.2% and wound infection in 8.5% cases. There was one mortality (2.1%) due to unrelated cause.

Conclusion: Mechanical bowel preparation is not necessary for safe colorectal surgery.
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http://dx.doi.org/11.2003/JCPSP.6376339DOI Listing
November 2003