BMedCon ’18kmu.edu.pk/bmedcon/downloads/Program-Booklet-Final.pdf · 2018-10-20 · Dr. Akifullah Khan ( Director, SINOR, Swat) Dr. Ehtesham (Assistant Professor, IBMS, KMU) Mueen

BMedCon ’18

rd th23 - 25 October 2018“Challenges & Opportunities”

International Basic Medical Sciences Conference 1st

BMSINSTITUTE OF BASIC

Medical ScienceKHYBER MEDICAL UNIVERSITY

Institute of Basic Medical Sciences, Khyber Medical University, Peshawar

Institute of Basic Medical Sciences, Khyber Medical University, Peshawar

Pakistan

WIN

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:091

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BMedCon 18



Messages 01

Conference Committees 05

Preconference workshops 07

Conference Program Day 1 09

Conference Program Day 2 18

Abstract of Keynote 1 26

Abstracts of Plenary Sessions 26

Abstract of Keynote 2 40

Abstracts of Scientific Sessions 73

Abstracts of Poster Sessions 77

Notes 105





Message of Vice Chancellor Khyber Medical Universiy

I have joined Khyber Medical University (KMU) at an exciting and indeed a

challenging time, where the university finds itself at the cross roads of its

embryonic development and being a driver of societal change. Leading a

university is an intellectually rewarding venture, but one that is far from

easy. It requires certain equipoise between efficient management and the

recognition and enhancement of intellectual freedom and creativity. KMU

was brought into existence with the very idea that it will assume a

stewardship role for health education and research in the Khyber

Pakhtunkhwa province and through the work of my predecessors; KMU

has been able to launch multiple academic programs to fulfil that role.

As a part of several academic activities, Khyber medical university has been

organizing conferences both at national and international levels. It allows

the faculty and students of KMU to project their knowledge, skills and

enthusiasm at at various levels. The 1st International Basic medical Science

conference is another leap forward. It will give a platform to all the

budding and experiences researchers to share their knowledge and

expertise.

It gives me immense pleasure to be hosting 1st International Basic Medical

Sciences Conference, where imminent International and national speakers

will deliver their talks and will share their experiences from the filed of basic

medical sciences. I certainly look forward to come thought provoking and

valuable discussions.

Prof. Dr. Arshad Javaid

01 02

Message of DeanBasic Medical sciences

“It is an honour to serve as Dean basic Medical sciences in Khyber Medical

University and my goal as Dean is to work with colleagues, student's

friends and alumi to promote basic medical sciences' distinctive place in

our university. By supporting existing and new collaborations with other

institutes both nationally and internationally, the institute of basic medical

sciences will continue to play a crucial role in furthering the university's

mission of learning, discovery, service and inclusion.”

Pro- VC Prof Dr Jawad Ahmed MBBS,MSc PhD Microbiology

University of Leeds, UK





Message of Director

“It is with great pleasure that I congratulate the organizing team of

BMedCon'18. Since assuming the responsibility of leading the institute of

Basic medical sciences it has been a dream turned to reality of having one

platform for all medical and allied health sciences to gather under the

umbrella of basic medical sciences to foster a collaborative environment

for students and faculty. I believe that the sciences today are merging and

re-emerging transforming and breaking the concrete boundaries of

subjects. This conference is a first step towards future projects and

conferences. In carrying forward the torch of innovation and leadership

the sky is not the limit: as I stand with all excellent and dynamic persons of

this institute as part of the galaxy, which is our university.”

Dr Zilli Huma Associate Professor

03 04

Introduction

The institute of Basic Medical Sciences specialises in cutting edge

basic sciences and translational research. In addition to fixing

focus on faculty development, research and technology and

bringing it at par with international standards, the areas of

interest are:-

1. To focus on further development of faculty member of all

medical institutes in their respective capacities by offering MPhil/

PhD Programs.

2. Provision and expansion of the research activities in

organized form.

3. Institutionalizing research in all affiliated medical and

health institutions.

4. Provision of quality diagnostic services at competitive

rates to the community.

BMedCon 18, COMMITTEES





ORGANIZING COMMITTEE:

Dr Syed Hamid Habib

Dr Sadia Fatima

Mr Tahir Ayub

Mr Nasir Saleem

Mr Muhammad Anwar

SCIENTIFIC COMMITTEE

Dr Tayyab Rehman

Dr. Najma Baseer

Dr S. Hamid Habib

Dr. Hafsah Muhammad

BUDGET & FINANCE COMMITTEE

Prof Dr. Jawad Ahmed

Dr Yasar Yousafzai

Prof. Dr Shafiq Ahmed

Dr. Sami Siraj

Mr Muhammad Anwar

Mr. Zafar Hayat

PRINTING & PUBLISHING COMMITTEE

Dr Asif Ali

Dr. Najma Baseer

PUBLICITY & PUBLIC RELATIONS COMMITTEE

Dr. Najma Baseer

Mr Shahzad

Dr Sadia Fatima

Mr. Rehmat Zada

Mr. Abdullah

STUDENT'S COMMITTEE

Sana Khan Biochemistry, IBMS

Ayesha Gul Microbiology, IBMS

Fawad Ahmed, IPMS

SafiUllah , INS

Dr Irum Abbas Anatomy IBMS

Chief Organiser: Dr Zilli Huma

Finance Chair: Prof Dr Jawad Ahmed

Program Chair: Dr Tayyab Ur Rehman

Publications & Publicity: Dr Najma Baseer

05 06

Places to visit in Peshawar

Balahisar Fort Heritage Trail

Balahisar Fort

Balahisar Fort Sethi House

PRE-CONFERENCE WORKSHOPS (October 23rd, 2018)





WorkshopsTime/VenueS.No.

W01

W02

W03

W04

W05

W06

8:30AM to 04:00PM

Academic Block

Ground Floor,

Microbiology Lecture

room

8:30AM to 01:00PM

Academic Block

1st floor,

MPH Lecture room

8:30AM to 04:00PM

Academic Block

Basement,

Haematology Lecture

room

8:30AM to 01:00PM

Academic Block

Ground Floor Anatomy

Lecture Room

8:30AM to 01:00PM

Academic Block

1st Floor,

Metabolic room

Common Tumor

Pathologies: A

diagnostic

Algorithm

Patient derived

cancer cell culture

and its clinical

applications

Diagnostic and

treatment

approach to

haemophilia

Animal use in

laboratory

sciences (Pre-

requisite to

animal use in

research)

Basic Nutritional

Assessment

Methods: Hands-

Onarch)

Brig (Rtd) Dr Iqbal Khan – Professor of

Pathology at Rehman Medical Institute, Peshawar.

Prof Dr Shahid Pervez – Professor of

Pathology at Agha Khan University, Karachi.

Prof Dr Anwar Ul Haq – Professor of

Pathology at North West School of Medicine,

Peshawar.

Dr Shagufta Nasir – Consultant Pathologist

/Associate Professor, Institute of Kidney Disease,

Peshawar

Dr. Asif Ali (Assistant Prof. IBMS, KMU)

Dr. Ishaq Khan (Assistant Professor IBMS

KMU)

Dr. Ihsanullah (Assistant Professor, IBMS,

KMU)

Dr. Natasha Aly (Associate Professor, Agha

Khan University Hospital, Karachi)

Dr. Shabneez Hussain (Consultant

Haematologist, Fatimid Foundation, Karachi)

Dr. Yasar Yousafzai (Assistant Professor,

IBMS, KMU)

Dr. Rafique Dar (Assistant Professor,

University of Management and Technology

Lahore)

Dr. Zilli Huma (Associate Professor, IBMS,

KMU)

Dr. Najma Baseer (Assistant Professor IBMS,

KMU)

Dr. Syed Hamid Habib (Assistant Professor

IBMS, KMU)

Prof. Dr. Rubina Nazli, (Professor, IBMS,

KMU)

Dr. Sadia Fatima, (Assistant Professor, IBMS,

KMU)

Dr. Shahzad Muhammad, (Assistant

Professor, IBMS, KMU)

Dr. Hafsah Muhammad (Molecular Biology

& Genetics, IBMS, KMU)

Dr.Akhtar Nadhman (Assistant Professor,

Institute of Integrative Biosciences CECOS

University, Peshawar)

Biosafety in

Biomedical

Laboratories

8:30AM to 04:00PM

Academic Block

Ground Floor,

Biosafety Training Lab

W07

W08

W09

W10

W11

W12

W13

8:30AM to 01:00PM

Academic Block

3rd Floor,

Conference room-2

8:30AM to 04:00PM

Academic Block

3rd floor,

Video conference room

8:30AM to 04:00PM

Academic, Block

Basement

PhD Lecture room

8:30AM to 01:00PM

Multipurpose Hall

Committee Room:

8:30AM to 01:00PM

Academic Block 2nd

Floor, Physiology

Lecture room

8:30AM to 04:00PM

(Academic Block

Basement, Lecturers

room

8:30AM to 01:00PM

Multipurpose hall

MBG Lecture room

Principles and

Practices of Flow

Cytometry

Single Nucleotide

Polymorphism (SNP)

Genotyping: Theory,

Practice and

significance

Hands on

programming with R

Molecular Imaging

and theranostics: The

future of personalized

management

Hands-on training on

power lab in research

protocols

Experimental Designs

in Basic Medical

Sciences

NGS (Next generation

sequencing) data

analysis

Dr. Mohsin Shah, (Assistant Professor,

IBMS, KMU)

Dr. Omar Malik (Assistant Professor,

IBMS, KMU)

Dr. Asif Naseer (Assistant Professor,

IBMS, KMU)

Dr Inayat Shah (Assistant Professor, IBMS,

KMU

Dr. Sami Siraj (Assistant Professor, IBMS

KMU)

Prof. Dr. Shafiq Ahmad Tariq, (Professor, IBMS KMU)

Nafees Ahmad, PhD (NA) – Nafees

Ahmad, PhD. Principal Scientist, Institute of

Biomedical and Genetic Engineering (IBGE).

Islamabad.

Dr. Roshan Ali (Assistant Professor,

IBMS, KMU)

Mr. Hamayoon Shah – Statistics expert,

Institute of Management Sciences

Mr. Tanveer Hussain- University of

Peshawar, Peshawar

Dr. Akifullah Khan ( Director, SINOR,

Swat)

Dr. Ehtesham (Assistant Professor, IBMS,

KMU)

Mueen Ahmad Choudhry Assistant

Professor The University of Lahore.

Dr. Syed Hamid Habib Assistant

Professor Khyber Medical University.

Syed Azeem Shah Country Manager-

Pakistan ADInstruments Australia.

Dr Muhammad MarwatAssistant Professor Ophthalmology

Gomal Medical College D.I.Khan

Dr M.Tahir SarwarAssistant Professor, Molecular Biology and

Genetics, IBMS, KMU

07 08

BMedCon 18, Conference Day 1





October 24, 2018

08:00 – 09:00 RegistrationReception area

Academic Block

09:00 – 09:05

09:05 – 09:10

09:10 – 09:20

09:20 – 09:30

Qirat – Qari Fawad

Research Furth of IBMS by Dean BMS

Address by Vice Chancellor

Address by Chief Guest

Opening Ceremony (Multipurpose Hall)

Moderator: Dr. Najma Baseer, AP, IBMS,KMU

Chair(s): Maj Gen [Retd] Professor Dr. Muhammad Aslam

Prof Arshad Javaid Vice Chancellor, KMU

Prof Dr Jawad Ahmed Pro-VC, KMU

Chief Guest if any???

Plenary – I

9:30 – 11:00PROOF OF CONCEPTS IN MEDICAL SCIENCES Multipurpose Hall

Moderator: Dr. Ishaq Khan AP IBMS

Rapporteur: Dr. Nazish Waheed

KN-01

09:30 – 09:50

Keynote Speaker

Learning Basic Medical Sciences (BMS) as

Foundation of Medicine: A Challenge

Maj Gen [Retd]Professor Dr.

Muhammad Aslam

Pro-VC, NUMS

PL-1.1

09:50 – 10:05

Global Advances and challenges for the

treatment of Central Nervous System Tumors: In

situ characterization of stem cells-like biomarkers

in meningiomas

Dr. Dima Hussein

AP, King Abdulaziz

University, Jeddah

PL-1.2

10:05 – 10:15

Oral Carcinogenesis: Role of human

papillomavirus in a high risk populationProf. Dr. Shahid Pervez

AKU, Karachi

PL-1.3

10:15 – 10:30Antioxidants in the Treatment of Leukemia

Dr. Steve Harakeh

Professor & Head Faculty

of Medicine, King Abdul

Aziz University, Jeddah

PPL-1.4

10:30– 10:40

The Influence of Various Pharmacological Agents

on Thyroid Gland Functions, in health and

disease states.

Dr. Akif Ullah

Director, SINOR

PL-1.5

10:40 – 10:50

Tumour Heterogeneity: Implications for Targeted

Therapeutics

Muhammad Ishfaq

Institute of Biomedical

and Allied Health

Sciences, UHS Lahore

PL-1.6

10:50-11:00

Chick Micromass culture; as a tool for

teratological screening

Professor Dr. Samreen Memon

Liaquat University of

Medical & Health

Sciences, Jamshoro,

11:00 – 11:10 Souvenirs Distribution

Working Tea, Poster & Model viewing (Front Sheds)11:00 – 11:10

Poster-1

Panel

Prof. Dr. Rashid Mehmood, Rehman Medical College

Dr. Irfan AP Peshawar Medical College

Dr Mohsin Shah AP, IBMS, KMU

Moderator: Dr Sadia Fatima AP, IBMS, KMU

PT-1.1Efficacy of multiple micronutrients

supplementation on energy intake calcium and

vitamin D levels in underweight children.

Akhlaq Ahmad, Sadia

Fatima, Rubina Nazli,

Syed Hamid Habib

PT-1.2Effect of body lotions on human skin bacterial

microflora.

Aqsa Sulaiman,

Ashfaq Haider

PT-1.3

Plasma vitamin d status and their relationship

with dietary intake and body mass index in

antenatal women; a pilot study

Babar Shahzad,

Muhammad Jaffar khan,

Muhammad Shahzad,

Hafia Bibi

PT-1.4

Histoprotective role of curcumin in

deltamethrin-induced gastric damage in adult

wistar rats

Amna Halima, Zilli Huma

PT-1.5

Frequency and Risk Factors of Mycobacterium

Tuberculosis in Khyber Pakhtunkhwa.

Fatma Ayaz, Arshad

Javaid, Anila Basit, Rubina

Nazli, Mazhar Ali Khan,

Sadia Fatima, Asma Ayaz

PT-1.6Quercetin protect against ethanol-induced

neurodegeneration in adult rat cortex.

Haroon Badshah,

Usman Ali

PT-1.7Oxidative Stress and DNA damage in Recurrent

Depressive Disorder (rDD) Patients

Muhammad Ateeq

Qureshi, Sana Noor, Sana

Javed, Kehkashan Sabir

PT-1.8

Synergistic activities of Jatropha curcas pressed

cake and oil in combination with antibiotics

against clinical and multidrug resistant bacterial

strains.

Abdul Haq, Maleeha

Siddiqi, Syeda Zakia

Batool, Malik Badshah

09 10





PT-1.20

Childhood leukemias in Khyber Pakhtoonkhwa

and afghan children, visiting to Hayatabad

medical complex hospital.

Shahtaj Khan, Awal Mir

Khattak, Baber Rehman

Khattak, Yousef Khan

SPEAR HEADING BASIC MEDICAL RESEARCHPlenary – II

11:30 – 01:00

Chair/s:Prof. Dr.Nicola Lowe, University of Central Lancashire, UKDr. Vimal Karani S, AP Nutrigenetics, University of Reading, UK

Prof. Dr. Shahid Pervaiz AKU, Karachi Moderator: Dr. Sami Siraj AP, IBMS

Rapporteur: Dr Junaid Haider

PL-2.1

11:30 – 11:40

Gene Silencing and Drug Delivery to overcome

Drug Resistance in Leishmania

Dr Akhtar Nadhman

AP, Institute of Integrative

Biosciences, CECOS

PL-2.2

11:40 – 11:55

The emergence of CA-MRSA - its impact on 'One

Health'

Dr. Shafi Sahibzada

Murdoch University, Perth,

Australia

PL-2.3

11:55 – 12:05

Next generation DNA Sequencing, Implication

for genomic medicine

Dr. Kamran Azeem

Dean, Faculty of Life

Sciences, Mohammad Ali

Jinnah University

PL-2.4

12:05 – 12:15

Challenges of conducting animal based research

in medical colleges and universities

Dr. Fazal M. Arain

AP, Aga Khan University

PL-2.5

12:15 – 12:25

Chronophysiology of Brain Derived Neurotrophic

Factor and Cognition

Dr. Muhammad Rafiq Dar

AP, University of

Management and

Technology, Lahore

Enhanced antibiogram of mycogenized silver

nanoparticles against multi drug resistant

bacterial isolates

Dr. Syed Zeeshan Haider

Institute of Molecular

Biology and Biotechnology

(IMBB), The University of

Lahore

PT-1.9In-silico Subtractive proteomics Analysis

Approach for the Discovery of Potential Drug

targets in Streptococcus pyogenes M1 GAS.

Noor Rahman,

Mohibulla Shah

PT-1.10

Frequency of non-alcoholic fatty liver disease in

non-obese type 2 diabetic patients and its

association with control of diabetes.

Muhammad Umair,

Muhammad Omar Malik,

Syed Hamid Habib

PT-1.11 The First Functional KPK Clinical Trial Room.Sadia Fatima, Rubina

Nazli , Aqsa Zubair,

Fouzia Nawab

PT-1.12Use of Cancer Biomarkers in Detection of

Chemotherapeutic Resistance in Brain Tumours.

Shabnam Wazir,

Muhammad Usman,

Zilli Huma, Ishaq Khan

PT-1.13

Correlation of plasma kisspeptin with total

testosterone levels in smokeless (dipping)

tobacco users and cigarette smokers in general

population of Peshawar

Syed Salman Shah,

Mohsin Shah, Hamid

Habib, Muhammad Omer

Malik

PT-1.14Impact of biofortified wheat flour on plasma zinc

and Enterobacteria in children

Usama, Muhammad

Jaffar Khan, Sadia Fatima

PT-1.15

Association of serum Leptin level with body mass

index and lipid profile in Diacetylmorphine

(Heroine) addicts versus healthy controls

Syeda Huma Khizar,

Syed Hamid Habib,

Muhammad Omar Malik,

Muhammad Tariq.

PT-1.16Multi-drug resistant listeria monocytogens

isolated from dairy products of Peshawar, Pakistan.

Ayesha Nasir,

Faryal Khattak

PT-1.17

Microbiological examination of fecal coliforms

contamination in water samples of Peshawar

university region.

Saba Rahim,

Adeed Khan

PT-1.18 Antimicrobial activity of garlic

Khushnuma, Hafsah

Muhammad, Roshan Ali,

Tayyab Ur Rehman

PT-1.19 Pattern of adulthood hematological

malignancies in Khyber Pakhtunkhwa.

Awal Mir Khattak, Shahtaj

Khan, Baber Rehman

Khattak, Mehreen Hameed,

Yousef Khan

Multipurpose Hall

PL-2.6

12:25 – 12:35

Exome sequence analysis in consanguineous

Pakistani families inheriting Bardet Biedle

syndrome determined founder effect of mutation

c.299delC (p. Ser100Leufs*24) in BBS9 gene

Dr Muzammil Ahmed Khan

AP, Gomal University

PL-2.7

12:35 – 12:45

12:45– 01:00 Souvenirs Distribution

12:45– 01:00 Lunch & Prayer (Academic Block Top floor)

02:00 – 02:45 3 Minutes Thesis Contest Multipurpose Hall

11 12





3MT-03

02:13 – 02:16Elephant has two sets of teeth-one to show off

and the other to chew with.

Dr Aisha Sadaf

(Mphil, Anatomy, IBMS)

3MT-05

02:21 – 02:24Benefit of ventilator in modern era

Kashif Wakeel

IPMS, KMU

02:30 – 04:00Scientific Session A (1)

MICROBIAL SCIENCES: THE BOTTOM LINE

Committee Room,

Multipurpose Hall

Panel

PAR-1.1

02:30-02:40

Antibacterial Activity Of Garlic And Ginger

Against Human Pathogens

Khushunuma,

Sawera Khan Yaqoob ,

Dr. Nasir Ali

PAR-1.2

02:40-02:50

An M13 Phagemid Based Therapy Using non-

coding Synthetic RNAs Against Virulence Genes of

Avian Pathogenic Escherichia coli.

Sayed Abdullah &

Dr. Fazal Adnan

PAR-1.3

02:50-03:00Gedunin, a novel Hsp90 inhibitor, suppresses

dengue virus replication in cell culture

Deeba Amraiz, Najam-us-

Sahar Sadaf Zaidi,

Munazza Fatima

PAR-1.5

03:10-03:20

Detection and distribution of virulence and

antibiotic resistance genes in Diarrheagenic types

of E. coli in children

Sher Bahadar Khan,

Mumtaz ali Khan, Irshad

Ahmad, Sher Ali Khan5,

Shakoor Ahmad

PAR-1.6

03:20-03:30

Genotypic Distribution and Epidemiology of

Hepatitis C infection among Afghan Refugees

coming to Peshawar, Pakistan

Fatima Khan, Fahad Hassan

Shah, Jamshaid Ahmad,

Irshad Ur Rehman.

PAR-1.7

03:40-03:50

Montage of Cutaneous leishmaniasis at HMC,

Peshawar: A Pictorial Review of Clinical

Presentation

Dr. Fatima Humara

Abdullah, MPhil Scholar

KMU.Dr. Saeed ur Rahman

03:50-04:00 Souvenir Distribution


TRANSLATIONAL MEDICINE: UP & RUNNING

Anatomy Lecture Room

Ground Floor, Academic

Block

Identification of differentially expressed PLK1

phosphorylation targets in oesophageal cancer

cell lines: A crosstalk between p53 and PLK1-

linked function

Nousheen Bibi, Ted Hupp ,

Mohammad Amjad Kamal,

Sajid Rashid

PAR-2.1

02:30 – 02:40

Germline Mutation/Polymorphism (s) in p53 and

p16 Gene are associated with Oral Squamous

Cell Carcinoma: Novel Molecular Targets for

Future Therapies

Saima Saleem, Abdul

Hameed, Zubair Abbasi,

Uzma Zareef , Navid

Rashid Qureshi, Mansoor

Ahmed Khan, Madiha

Kanwal, Syed Aqib Ali

Zaidi , Abid Azhar

PAR-2.2

02:40-02:50

Panel

Dr. Ehtisham AP, IBMS, KMU

Dr. Ishaq Khan AP, IBMS, KMU

Dr. Ihsan Ullah AP, IBMS, KMU

Moderator: Dr Hafsah Muhammad AP, IBMS, KMU

Rapporteur: Dr Noman Wazir

3MT-01

02:05 – 02:08

Knockout of cancerous gene through crisper

technology

SherShah

(Mphil MBG, IBMS)

Thesis Title

3MT-02

02:09 – 02:12SiRNA mediated gene silencing

Yaseen Anwar

(Mphil MBG, IBMS)

Dr Akhtar Nadhman, AP, CECOS University, Peshawar

Dr. Syed Zeeshan Haider, University of Lahore

Moderator: Dr Ihsan Ullah AP, IBMS, KMU

PAR-1.4

03:00-03:10

Molecular characterization of antimicrobial

resistance and genotyping of Enterococcus

faecalis isolates from health care facilities

Muhammad Farman,

Muhammad Yasir, Rashad

Rizk Al-Hindi, Asif Ahmad

Jiman-Fatani, Maha Alawi,

Hani Ahmed Ibrahim

Shukri, Esam I. Azhar

Prof. Dr Shahid Pervez, Aga Khan University,

Karachi

Dr. Akifullah Director, SINOR

Moderator: Dr. Asif Ali, AP, IBMS, KMU

Rapporteur: Dr AbduSalam

Panel

Incidence and association of B-RAF gene

mutation in papillary thyroid cancer in infected

individuals of KP-Pakistan

Rabia Sana, Najeeb

Ullah, Noreen Asim and

Aqib Iqbal

PAR-2.3

02:50-03:00

Breast cancer awareness amongst female

teenagers studying in the federal territory of

Pakistan

Hamna Atique, Hurmat

Fatima Azeem, Dr. Sidra

Hamid, Dr. Tahmina

Yousaf

PAR-2.4

03:00-03:10

A randomized, clinical trial comparing the efficacy

of metformin and combination of metformin plus

pioglitazone therapy on serum levels of IL-6 and

IL-8 in polycystic ovary syndrome

Durr-e-Shehwar, Mohsin

Shah, Asif Ali,

Muhammad Omar Malik

PAR-2.5

03:10-03:20

13 14





Panel

PAR-3.1

02:30 – 02:40

Association between Polymorphism in Mu

Opioid Receptor (ORPM1) Gene with Drug and

Opioid Addiction in Subjects from Khyber

Pakhtunkhwa

Faisal Ali and

Aqib Iqbal

Microbiology Lecture room,

Ground Floor

Academic block

PAR-3.2

02:40-02:50

Association of Genetic Polymorphism in Folate

Metabolism Related Genes with Idiopathic Male

Infertility in Population from Khyber Pakhtunkhwa

Sartaj Khan and

Aqib Iqbal

PAR-3.3

02:50-03:00

Association study of Inflammatory Genes

Polymorphism with susceptibility to Rheumatic

Heart Diseases in Population from Khyber

Pakhtunkhwa

Uzair Ali and

Aqib Iqbal

PAR-3.7

03:30-03:40

A novel recessive frame-shift variant in the

LHCGR gene is associated with primary ovarian

insufficiency in a Pakistani family

Amanda Colvin Zielen,

Muhammad Jaseem Khan,

Nijole Pollock, Huiayang

Jiang, Rubina Nazli, Jawad

Ahmed, Musarat Jabin,

Alexander Yatsenko,

Aleksandar Rajkovic



TRANSLATIONAL MEDICINE: UP & RUNNING

PhD Lecture Hall,

Basement, Academic block

Effect of omega 3 fatty acids on lipid profile in

healthy volunteers

Naheed Junnet, Rubina

Nazli, Sadia Fatima

PAR-4.1

02:30 – 02:40

Serum Soluble Endoglin levels as a predictor of

preeclampsia

Asthma Mehmood,

Rubina Nazli,

PAR-4.2

02:40-02:50

PAR-2.7

03:30-03:40

Complementary and alternative remedies for

diabetes associated depression: a prospective

human study

Saara Ahmad Muddasir

Khan, Asra Khan, Zehra

Batool, Saida Haider

Prof. Dr. Kamran Azeem, Muhammad Ali Jinnah

University, Karachi

Dr. Muzammil Ahmed Khan, AP, Gomal University

Moderator: Dr. Tahir Sarwar, AP, IBMS, KMU

PAR-3.4

03:00-03:10

Biallelic variants in DYNC1I2 cause syndromic

microcephaly with intellectual disability, global

developmental delay and dysmorphic facial

features

Muhammad T. Sarwar,

Sohail Aziz Paracha,

Jamshed Ahmed,

Muhammad Ansar,

Jawad Ahmed

Prof. Dr. Amin Jan, KGMC

Dr. Khalid Iqbal, AP, IBMS, KMU

Moderator: Dr. Shehzad, AP, IBMS

Rapporteur: Hafsah Zafar

Panel

The clinical outcomes of high-caloric Lipid-based

nutritional supplements on Energy Intake and

Lipid Profile of Moderate Underweight Children:

A Randomized control trial

Aqsa Zubair, Sadia

Fatima, Fouzia Nawab,

M. Jaffar Khan,

Rubina Nazli

PAR-4.3

02:50-03:00

Impact of High Energy Lipid-based Nutritional

Supplements on Energy Intake and Micronutrient

Status in Moderate Underweight Children: A

Randomized control trial

Fouzia Nawab, Sadia

Fatima, Aqsa Zubair, M.

Jaffar Khan, Rubina Nazli

PAR-4.4

03:00-03:10

Frequency of Dyslipidemia in Young Overweight

and Obese Students (Age 10-16 Years) in Private

Schools of Swat Pakistan

Prof. Dr. Rubina Nazli, Dr.

Fawad Ali Khan. Dr. Sadia

Fatima, Aqsa Zubair

PAR-4.5

03:10-03:20

PAR-2.6

03:20-03:30

Sex Hormone Binding Globulin levels in patients

with Polycystic Ovary Syndrome

Madiha Khattak,

Nuzhat Sultana



GENOMICS: GET YOUR WIRES CROSSED

PAR-3.5

03:10-03:20

Evaluation Of Serotonin Transporter Gene

Insertion/Deletion Polymorphism As A Risk

Factor Of Coronary Artery Disease In Population

Of Khyber Pakhtunkhwa

Muhammad Shehzad

Saleem, Dr. Zahid Khan

PAR-3.6

03:20-03:30

Whole Genome Sequencing instead of Whole

Exome Sequencing is required to identify the

Genetic Causes of Polycystic Ovary Syndrome in

Pakistani families

Muhammad Jaseem Khan,

Rubina Nazli, Jawad

Ahmed, Sulman Basit

Use of probiotics in antibiotic associated diarrheaKiran Konain, Sadia,

Ramsha Khalid, Mehwish

Shah, Fahad Hassan Shah

PAR-4.6

03:20-03:30

Serum visfatin level and its relationship to

anthropometric and metabolic parameters in

pregnancy complicated by hypertension.

Asmat Shaheen, Tanveer

Shafqat ,Rubina Nazli, Sadia

Fatima ,Muhammad Jaffar

PAR-4.7

03:30-03:40

Effect of Duration of Use of COCs on serum Lipid

Profiles, Fasting Blood Sugar, Blood Pressure and

BMI in Child Bearing Age Women

Dr.Nabila Sher,

Dr Rubina Nazli

PAR-4.8

03:40-03:50

15 16





Panel

PAR-5.1

02:30 – 02:50

Updates on the diagnosis and management of

Acute Myeloid LeukaemiaDr Natasha Ali

Microbiology Lecture room,

Ground Floor

Academic block

PAR-5.2

02:50-03:10Personalized management of Haemaophilia Dr Shabneez Hussain

PAR-5.3

03:10-03:20Time dependent morphological changes in Red

Blood cells during storage

Syed Tahir Ali Shah, Najma

Baseer, Yasar Yousafzai

09:00 – 10:00 Scientific Session – B (6)

RESEARCH COCKTAIL

Role of Dissection in UndergraduatesProf. Dr Maqbool Ilahi

NWSM, Peshawar

PAR-6.1

09:00-09:10

Genome Editing and Nanoscience, the Arising

Debates in Safe Science

Dr. Nadia Batool Zahra

Qarshi University, Lahore,

Pakistan

PAR-6.2

09:10-09:20

Prof. Dr. Malik Zeb, Inst. of Kidney Diseases

Dr Saiqa Zahoor, AP KGMC

Moderator: Dr. Asif Naseer, AP, IBMS, KMU

Rapporteur: Dr. Ahmed Rizwan

PAR-5.4

03:20-03:30Transfusion of blood-bank stored blood to

transfusion dependent thalassemia patientsDr Usman Naeem

Tiny technologies for healthcare applicationsDr. Shah Rukh Abbas,

AP, NUST, Islamabad

PAR-6.3

09:20-09:30

Phage therapy, Synthetic sRNA and Quorum

Quenching; the futuristic strategies to combat

bacterial infections

Dr. Fazal Adnan

AP, NUST Islamabad

PAR-6.4

09:30-09:40

Is Suicidal and Homicidal impact being due to

Toxoplasma Gondii Infection? Evidences from

target subjects' investigation

Prof. Dr Aziz Marjan

KIMS, Kohat

PAR-6.5

09:40-9:50



TRUE BLOOD: LIGHT YEARS AHEAD

PAR-5.5

03:30-03:40

Utilization Of Blood And Its Components –

experience from a tertiary care centreDr Nadia Altaf


Introduction to Nutritional Supplements Dr. Rafi Khattak

Nutritional MedicinePAR-6.6

09:50-10:00

Souvenir Distribution10:00

Multipurpose Hall

Chair/s: Dr. Shafi Sahabzada Murdoch University, Perth, Australia

Dr. Ijaz Ali, Head of Biosciences Department COMSATs Islamabad

Dr Muhammad Ismail, Director IBGE

Moderator: Dr. Inayat Shah, AP, IBMS, KMU

Rapporteur:

Scientific Session B (7)NEURONS & HORMONES: ITS NOT ROCKET

SCIENCE

09:00 – 10:00 Committee Room,

Multipurpose Hall

Dr. Fazal Arain, AP, AKU

Dr. Rafiq Dar, AP, University of

Management and Technology

Moderator: Dr Omar Malik, AP, IBMS, KMU

Rapporteur:

Panel

BMedCon 18, Conference Day 2

October 25, 2018

17 18





PAR-7.3

09:20-09:30

PAR-7.4

09:30-09:40

Role of physical activity in mental well being of

medical students of Pakistan

Yusra Bint-e-Hafeez, Dr.

Sidra Hamid

Dr Sameena Gul

PAR-7.5

09:40-9:50

Relationship of Apolipoprotein CIII with Beta Cell

Function, Insulin Resistance and Triglycerides to

HDL ratio in Healthy Young Individuals with and

without Family History of Diabetes Mellitus

Sara, Omar Malik

PAR-8.4

09:30-09:40

Virtual screening for the identification of

potential inhibitor for marburg virus vp35.Siddiqua Ijaz, Parkha

Tariq, Hafsah Muhammad

10:00 Souvenir Distribution

09:00 – 10:00Scientific Session B (9)

BENCH TO BED: BEST OF BOTH WORLDS

Microbiology Lecture

room, Ground Floor

Academic block

The hepatitis B and C co-infection and liver

function tests in HIV positive patients at Family

Health Care Centre HMC Peshawar

Bela Inayat, Rubina NazliPAR-9.1

09:00-09:10

Screening of adult dental patients visiting Khyber

College of Dentistry, Peshawar for HBV and HCV

infections and identifying the associated risk

factors

Jamila Haider, Ghosia

Lufullah, Rubina Nazli,

Tasleem Akhtar,

Asthma Shah

PAR-9.2

09:10-09:20

PAR-7.2

09:10-09:20

Protective role of glutathione against Oxaliplatin

induced neurotoxicity in adult mice Dr Pashmina Shaikh

Protective role of Vitamin E against Cisplastin

induced neurotoxicity by performing the

behavioral tests and gross examination in adult

mice

10:00 Souvenir Distribution

Prof Dr. Ijaz Khan, Principal NWMS

Prof. Dr. Ghosia University of Peshawar.

Prof. Dr. Muhammad Tariq NWMS

Moderator: Dr. Roshan Ali, AP, IBMS, KMU

Rapporteur:

Panel

Noninvasive Parameters in Chronic HCV Patients

in Teaching Hospital of Peshawar

Abdur Rahim,

Tanveer Shafqat

PAR-9.3

09:20-09:30

Association of Serum CTX-I Levels with Hormone

Replacement and Interleukin Inhibitor Therapy in

Peri-Menopausal Women Presenting in a Tertiary

Care Hospital of Peshawar, KPK.

Mehwish Durrani.

Muhammad

Aslam Qamar,

Muhammad Abubakar.

Muhammad Shafiq

PAR-9.4

09:30-9:40

The effect of different exercise intensities on

plasma vascular endothelial growth factor (VEGF)

in healthy volunteers

Inayat Shah, Muhammad

Omar Malik, Ghareeb

Alshuwaier, Ronald H

Baxendale

PAR-9.5

09:40-09:50

PAR-7.1

09:00-09:10

Psycho-neurological Impediments in Diabetes

Mellitus

Saara Ahmad Muddasir

Khan, Asra Khan, Zehra

Batool, Saida Haider

PAR-8.1

09:00-09:10

Comparative in-vitro antimicrobial activities of

Fluoroqinolones with macrolidesSana Shamim, mahwish

Akhtar, Somia Gul

PAR-8.3

09:20-09:30

Insilco integrative approach for identification of

putative multifunctional inhibitor of anthrax

toxins

Nousheen Bibi, Sehraiz

Razzaq, Faisal Nouroz,

Taiba Anwar, Ghulam

Mujtaba Shah

Souvenir DistributionPAR-9.6

09:50-10:00

Scientific Session B (10)PHARMACOTHERAPY: THE NEW FRONTIERS

Anatomy Lecture Room

Ground Floor, Academic

Block

08:40 – 10:00

09:00 – 10:00Scientific Session B (8)

DRUGS VERSUS MICROBES: A BITTER PILL

PhD Lecture Hall,

Basement, Academic block

Panel

Prof. Dr. Abid Ali, NWMS

Prof. Dr. Shafiq Ahmed IBMS, KMU

Moderator: Dr. Haji Bahadar, AP, IPMS, KMU

Rapporteur:

PAR-8.2

09:10-09:20

Design, synthesis, characterization, in vitro

antimicrobial studies of fluoroquinolones-amide

derivatives

Mahwish Akhtar, Tanveer

Ahmed Siddiqui, Mehreen

Sohail3, Sana Shamim

PAR-8.5

09:40-9:50

Finding Potential Inhibitors for LEISHMANIA

(Arginase) by Using Pharmacophore SearchingDr. Musadiq Ibrahim

PAR-8.6

09:50-10:00

Antibiotic self prescribed of families in Peshawar

districtZufishah rahat, Dr Yasar

Yousafzai

19 20





PAR-10.3

09:00-09:10

Mr. Nasir Ahmad PhD

Scholar IBMS, KMU

PAR-10.4

09:10-09:20

Off label and unlicensed drug use in pediatric

medical wards of tertiary care hospitals of Pakistan

Dr. Muhammad Aamir

(Pharm-D, Ph.D.University

of Peshawar)

PAR-10.2

08:50-09:00

New directly acting antiviral agents in HCV

treatment and their limitations.

Mr. Abdul Majid PhD

Scholar University of

Peshawar

Using PCR for analysis of drug resistance in BCR-

ABL positive Chronic Myeloid Leukaemia

09:50 - 10:00 Souvenir Distribution

PAR-10.1

08:40 – 08:50

Overcoming the mucosal barrier via proteolytic

enzyme decorated nano- and microcarriers

Dr. Arshad Mehmood

Malik- Assistant Professor

COMSATS Abbottabad.

BMT-01

10:05-10:15

The Good, The Bad and The Ugly of Ambitious

People- When They Go Up the Ladder Prof Dr Arshad Javaid

VC, KMU

BMT-03

10:25-10:35Women in Sciences

Prof. Dr Anisa Qamar

Peshawar University

10:00 – 11:00 Bmed Talks Multipurpose Hall

BMT-02

10:15-10:25

Nano blaster- A Dream Technique To Conquer

Cancer

Dr Asif Ali

AP, IBMS, KMU

Moderator: Dr Yasar Yousafzai AP IBMS, KMU

Rapporteur: Dr Farooq Khan

BMT-04

10:35-10:45Chemistry For a Healthier World Prof. Dr Jasmin Shah

Peshawar University

PT-2.2

PT-2.3

Knowledge, Attitude and Practices of Healthcare

Workers Regarding Hospital Waste

Management.

Hoor Kakakhel, Komal

Salam, Khushbakht Razna,

Behram Ahmed,

Mohammad Hassan

Kalsoom Noor, Syed

Waseem Ahmad, Amna

Diversity of wasp fauna (hymenoptera: vespidae)

of tehsil Babozai, district Swat.PT-2.4

Perception of Students about the Integrated

Modular Curriculum.

Saman Khan, Omar Iqbal,

Taimoor Ahmad Khan,

Ahsan Nadeem, Ghazala

Munawar, Akbar Ali Khan,

Hira Tarakai, Mujeeb Ur

Rehman

Nida Khan

Effect of Iron Deficiency Anemia on Intelligence

Quotient (IQ) in scholl going children of

Peshawar City

PT-2.5

Kiran Konain, Sadia, Turfa

Nadeem, Adeed Khan,

Warda Iqbal, Arsalan, Amir

Javed, Ruby Khan, Kainat

Jamil, Saleha Qazi

Importance of probiotics in gastrointestinal tract.PT-2.6

Sher shah, Yaseen Anwar,

Hafsah Muhammad, Ishaq

Khan, IBMS

Comparison between CRISPR technology and

siRNA gene silencingPT-2.7

Panel

Dr. Nafees Ahmad, Principal Scientist, IBGE, Islamabad

Dr. Sagheer Ahmad

Dr. Rashida Abbasi Senior Scientific Officer, IBGE

Moderator: Dr. Sami Siraj, AP, IBMS

Rapporteur: Imran Khan

PAR-10.5

09:20-9:30

Evaluation of multipronged neuroprotective

regimen system for the treatment of diversified

neurodegenerative diseases .

Mr. Ijaz Khattak

PhD Scholar, Quaid-i-

Azam, University (QAU)

Islamabad.

PAR-10.6

09:30-09:40

Association of GGCX Gene Polymorphism with

Warfarin Dose AdjustmentFaryal Shams

PAR- 10. 7

09:40- 09:50 DNA Barcoding Prof. Dr. Maroof Shah

BMT-05

10:45-10:50

An Imperfect Intelligently Designed Creation:

the Underestimated

Dr Tayyab Ur Rehman

AP, IBMS,KMU

11:00 – 11:30 Working Tea, Poster and model viewing (Front Sheds)

POSTER II

Panel

Dr Zeeshan Kibria Deputy Director ORIC, KMU

Dr Tahir sarwar AP, IBMS, KMU

Dr Tariq Masood North West Hospital

PT-2.1Smoking as risk factor for Chronic kidney failure

among type 2 diabetes 2

Muhammad Hamza, Aneela

khan, Salman Zahir, Laraib

Gul, Sana Basharat

Khayam Ul Haq, Shazia

Noreen, Amjad Essa,

Mahreen ul Hassan,

Waheed Iqbal, Masroor

Hussain, Hamid Hussain,

Jawad Ahmed, Shafiq

Ahmad Tariq, Sami Siraj

Association of Virulence Genes with Antibiotic

Resistance in Pakistani Uropathogenic E. coli

Isolates.

PT-2.8

21 22





PT-2.20Antibiotic sensitivity testing of Staphylococcus

aureus strains from urinary catheters at a tertiary

care hospital in Haripur

Sidra Noor¹, Ayaz

Saleem¹, Bushra Fatima¹,

Muhammad Mumtaz

Khan¹, Amir Ali Khattak²,

Muhammad Ali Syed¹

Multipurpose HallTOWARDS GLOBAL SOLUTIONPlenary - III

11:30 – 01:00

Chair/s: Prof. Dr.Steve Harakeh King Abdul Aziz University, Jeddah.

Dr Dima Hussein AP, King Abdul Aziz University, Jeddah

Dr. Sara Shawqi, Taiz University, Yemen

Moderator: Dr Hamid Habib AP, IBMS, KMU

Rapporteur: Dr Shahabuddin

Dr. Muhammad Ismail

Director

(IBGE), KRL, Islamabad

Nanomedicine: An interdisciplinary play to

combat diseasesPL-3.1

11:30-11:40

PT-2.12

PT-2.13

Variation in the origin of obturator artery in

human. Nabila Momin, Zilli Huma

Zainab Anum, Qurat ul ain

Khan, Zainab Hunaid,

Mujeeb ur Rahman

Prevalence of neck, shoulder and back pain and

its associated risk factors in secondary school

female students in Hayatabad, Peshawar.PT-2.14

Interobserver variability in interpretation of

endometrial biopsies in infertile women.

Sabeen Nasir,

Muhammad Mumtaz

Khan, Naveed Sharif

Gul Andama , Arooba

Sajjad , Farheen Khan ,

Ramash Aqeel ,

Khurram Shahzad,

Mujeeb ur Rahman

Prevalence of occupation related postural pain in

the teachers of Peshawar University.PT-2.15

Syeda Mahnoor Murtaza¹,

Maria Rukan¹, Nayab

Anwer¹, Aamer Ali Khatak²,

Afshan Saleem¹, Assad

Zaib², Mushtaq Ahmed

Khan³, Bilal Ahmed³,

Muhammad Ali Syed¹

Knowledge, attitude and practice about atypical

pertussis and adult vaccination among physicians

in Khyber Pakhtunkhwa, Pakistan.PT-2.16

Maria Rukan, M.Phil¹,

Humaira Jamil, M.Phil¹,

Habib Ali Bokhari, PhD.²,

Allah Nawaz Khan, M.S.²,

Sarfaraz Hussain MBBS,

FCPS³, Muhammad Ali

Syed,

Nasal carriage of highly resistant methicillin

resistant Staphylococcus aureus (MRSA) strains

by hospital staff in Hazara region of Pakistan.

PT-2.17

Ayaz Saleem¹, Neelum

Ashfaq¹, Bushra Fatima¹,

Faisal uz Zaman¹, Izhar Ul

Haq¹, Bilal Ahmed²,

Mushtaq Ahmed Khan¹,

Aamer Ali Khattak²,

Muhammad Ali Syed¹.

Characterization of Staphylococcus aureus strains

from skin and soft tissue infection cases at

selected hospitals of Hazara Division of Pakistan

PT-2.18

Ayaz Saleem¹, Neelum

Ashfaq¹, Bushra Fatima¹,

Faisal uz Zaman¹, Izhar Ul

Haq¹, Bilal Ahmed²,

Mushtaq Ahmed Khan¹,

Aamer Ali Khattak²,

Muhammad Ali Syed¹.

Detection And Molecular Characterization Of

Staphylococci From Eggs Of Domesticated

ChickensPT-2.19

Prof. Dr. Nicola Lowe

University of Central

Lancashire, UK

The Global Challenge of Hidden Hunger:

research to find a sustainable solution in PakistanPL-3.2

11:40 – 11:55

Dr. Vimal Karani S

AP, Nutrigenetics

University of Reading,UK

Nutrigenetics and Personalized Nutrition in the

Genetic AgePL-3.3

11:55 – 12:10

Khushal Khan, Niaz AliInvestigation of the Laxative Activity of

methanolic extract of Tamarix aphylla L. Karst

(Saltcedar) in experimental animals.

PT-2.9

Rooh Ullah, Shafiq Ahmed

Tariq

Antihyperglycemic effect of methanol extract of

Tamarix aphylla L. Karst (Saltcedar) in

streptozocin–nicotinamide induced diabetic rats.

PT-2.10

Arooba Khan, Aliya Ayub,

Rabia Shafiq, Asif Ali,

Qurat ul ain Khan

Physiotherapy management of lymphedema

after breast cancer surgery.PT-2.11

23 24





PL-3.8

12:50-1:00

The Clinical Outcomes of High Energy Lipid-

based Nutritional Supplements on Energy Intake,

Lipid Profile and Micronutrient Status in

Moderate Underweight Children: A Randomized

control trial

Dr. Sadia Fatima

AP, IBMS KMU

Dr. Allah Rakha

Head of Forensic

Department

AP, UHS Lahore

Pharmacogenomics augmenting the

Personalised Justice

PL-3.9

1:00-1:10

Dr. Zarina HasanKey Note Speaker KN-02

1:10 – 1:20

Souvenirs Distribution01:20 – 01:30

Multipurpose Hall

Closing Ceremony

Moderator: Dr Najma Baseer, AP, IBMS, KMU

Chair(s): Prof Arshad Javaid Vice Chancellor, KMU

Prof. Dr Jawad Ahmed Pro-VC, KMU

Dr Zarina Hasan

Chief Guest if any??

Address by the Chief Guest

Address by Guest of honor Brig. Amir Ikram, Director, NIH

Award of Excellence

Closing Remarks by Director IBMS

Souvenirs and Prize distribution

KEYNOTE OPENING CEREMONYLearning Basic Medical Sciences (BMS) as Foundation of Medicine: A ChallengeMuhammad Aslam, National University of Medical Sciences (NUMS), The Mall, Rawalpindi, Pakistan.

Background of the Study: Traditionally, the BMS were taught in the initial three years of MBBS studies

and in the last two years, Clinical Subjects are learnt. Then reframing was done in mid 70's and first two

years were specified to preclinical, the 3rd year to para-clinical and in the last two years clinical subjects

of MBBS were learnt. With the advancement in medical education, it is advocated that a holistic

approach to learning medicine be adopted to benefit the patients better. Aim(s):

a. To learn BMS as the foundation of Medicine

b. To understand the underpinning pathophysiological principle(s) of diseases during the preclinical

years.

Overview: Currently, in many of the Medical Colleges/ Universities, the subjects of BMS are taught

separately (in isolation) for the human systems for MBBS/ BDS Curriculum. The medical education is

outlined in the benchmarks of the curriculum under the abbreviation of SPICES (Student-Focused,

Patient-Directed, Integrated, Community–Oriented, Elective Driven, and Systematic). Furthermore,

Ronald M Harden advocated 11 steps for integration of learning (Isolation, Awareness, Harmonisation,

Nesting, Temporal Coordination, Sharing, Correlation, Complementary Program, Multidisciplinary,

Interdisciplinary, and Transdisciplinary). It was also advised that medical education may focus more on

contextual (relevant) learning than on content overload of the individual subject(s).

Conclusion/Significance: In view of rationalisation, the curriculum be designed accordingly to

epidemiology of diseases in the region and its delivery may be focussed around the symptoms of the

patient(s). The above paradigm shift of learning, if adopted, may utilise BMS to trigger, energise, re-

energise and enlighten medicine and act as a foundation of medicine.

ABSTRACTS PLENARY SESSIONS

PLENARY I

PL-1.1: Global Advances and challenges for the treatment of Central Nervous System Tumors: In

situ characterization of stem cells-like biomarkers in meningiomas.

Dr. Dima Hussein Assistant Professor, King Fahd Medical Research Centre, King Abdulaziz

University, Jeddah, KSA.�

Background: Meningioma cancer stem cells (MCSCs) contribute to tumor aggressiveness and drug

resistance. Successful therapies developed for inoperable, recurrent, or metastatic tumors must target

these cells and restrict their contribution to tumor progression. Unfortunately, the identity of MCSCs

remains elusive, and MSCSs' in situ spatial distribution, heterogeneity, and relationship with tumor

grade, remain unclear.

Methods: Seven tumors classified as grade II or grade III, including one case of metastatic grade III,

and eight grade I meningioma tumors, were analyzed for combinations of ten stem cell (SC)-related

markers using immunofluorescence of consecutive sections. The correlation of expression for all

markers were investigated. Three dimensional spatial distribution of markers were qualitatively

analyzed using a grid, designed as a repository of information for positive staining. All statistical

01:30 - 01:40

01:40 - 01:50

01:50 - 01:55

01:55 - 02:05

02:05 - 02:30

Dr. Sara Shawqi

Faculty of Medicine and

Health Sciences, Taiz

University, Yemen

Association Between al-Qat Chewing and Anemia

among 15– 49 Years Old Yemeni WomenPL-3.5

12:20 – 12:30

Dr. Ijaz Ali

Associate Professor &

Head of the Biosciences

Department

COMSATs Islamabad

Parasites and Human EvolutionPL-3.4

12:10 – 12:20

Prof. Dr. Zia Ul Haq

Director IPH&SS, KMU

Ready to Use Supplementary Foods (RUSF) to

prevent stunting among children under fiveyears

in district Kurram - Trial update

PL-3.6

12:30-12:40

02:30 LUNCH

25 26





The leukemogenesis of the virus is mainly attributed to the viral oncoprotein Tax. Tax activates the

Nuclear Factor kappa B (NF-�B) which stimulates the activity and expression of the matrix

metalloproteinase-9 (MMP-9). The objective of this presentation is to explore the underlying

mechanisms of antioxidants involved in the treatment of leukemia. To achieve the objectives, efficacy

of non-cytotoxic concentrations of certain antioxidants were investigated on proliferation, apoptosis

induction, Tax expression, NF-�B levels as well as on MMP activity and expression both at the

transcriptional and translational levels against both Human T-cell Lymphotrophic Virus Type-1 (HTLV-

1)-infected and non-infected T lymphocytes. Four leukemia cell lines were used. C91-PL and HuT-102

are HTLV-1 positive cell lines whereas CEM and Jurkat are HTLV-1 negative. The antioxidants used

included: Ascorbic acid, Epigallocatechin-3-gallate (EGCG) and a formulation containing a

combinations of those with other antioxidants and minerals. Cytotoxicity of the tested compounds

was assayed using CytoTox 96 Non-radioactive and proliferation was measured using Cell Titer96TM

Nonradioactive Cell Proliferation kit (MTT- based assay). Enzyme linked immunosorbant assay (ELISA)

and electrophoretic mobility shift assay (EMSA) was used to assess the effect of test compounds on

NF-�B mobility. Zymography was used to determine the effects of test compounds on the activity and

secretion of MMP-9. The expression of MMP-9 was done using RT-PCR at the translational level and

Immunoblotting at the transcriptional level. Results: A significant inhibition of proliferation was seen

in all the cell lines in a dose dependent manner. The test compounds induced a dose dependent

decrease in Tax expression, which was paralleled by a down-regulation of the nuclearization of NF-�B.

This culminated in the inhibition of the activity of MMP-9 and their expression both at the

transcriptional and translational levels. Conclusions: The results indicated that the tested compounds

targeted multiple levels pertinent to the progression of ATL at various capacities. Their activities were

mediated through the NF-�B pathway, and hence has the potential to be integrated in the treatment

of this disease as a natural potent anticancer agent.

PL-1.4: The Influence of Various Pharmacological Agents on Thyroid Gland Functions, in health

and disease states.

Dr. Aakif Ullah Khan, Director Swat Institute of Nuclear Medicine, Oncology and

Radiotherapy.(SINOR)

The correct interpretation of thyrotropin (TSH) and thyroid hormone (TH) levels is vital for the proper

evaluation of thyroid function. Various medications interfere with these and other thyroid function

tests. Some drugs lead to thyroid dysfunction, whereas others merely complicate the analysis of TFT

results. In this presentation we will discuss the effects of various pharmacological agents at different

levels of thyroid hormone synthesis and control. Drugs may affect thyrotrope function in the pituitary,

some may cause directly hypothyroidism or hyperthyroidism, while some others medications may

affect hyroid hormone–binding proteins. There are certain pharmacological agents that cause a

decrease in conversion of thyroxine to triiodothyronine and some cause increase thyroid hormone

metabolism. Those medicines will also be discussed that interfere with the absorption of thyroid

related medicine from the gastrointestinal tract. This talk will attract scholars from both basic as well as

analyses were completed using Statistical Analysis Software Package.

Results: The patterns of expression for SC-related markers were determined in the context of two

dimensional distribution and cellular features. All markers could be detected in all tumors, however,

Frizzled 9 and GFAP had differential expression in grade II/III compared with grade I meningioma

tissues. Correlation analysis showed significant relationships between the expression of GFAP and

CD133 as well as SSEA4 and Vimentin. Data from three dimensional analysis showed a complex

distribution of SC markers, with increased gene hetero-expression being associated with grade II/III

tumors. Sub regions that showed multiple co-staining of markers including CD133, Frizzled 9, GFAP,

Vimentin, and SSEA4, but not necessarily the proliferation marker Ki67, were highly associated with

grade II/III meningiomas.

Conclusion: The distribution and level of expression of CSCs markers in meningiomas are variable and

show hetero-expression patterns that have a complex spatial nature, particularly in grade II/III

meningiomas. Thus, results strongly support the notion of heterogeneous populations of CSCs, even

in grade I meningiomas, and call for the use of multiple markers for the accurate identification of

individual CSC subgroups. Such identification will lead to practical clinical diagnostic protocols that

can quantitate CSCs, predict tumor recurrence, assist in guiding treatment selection for inoperable

tumors, and improve follow up of therapy.

PL-1.2: Oral Carcinogenesis: Role of humanpapillomavirus in a high risk population.

Shahid Pervez, Professor & Consultant, Section of Histopathology, Department of Pathology &

Laboratory Medicine, Aga Khan University, Karachi, Pakistan.

Background: Oral Cancer (OC) is extremely prevalent in Karachi and as per 2017 'Karachi Cancer

Registry'; it is the most common cancer in males and second most common in females. Over 75% of the

OC are diagnosed in chewers of Pan, Gutka, Chalia, Tobacco & Naswar.

Aim of Study: To study the association and prevalence of high risk HPV 16 in 'Oral Squamous Cell

Carcinomas (OSCC)' in diverse and multiethnic population of Karachi.

Methods: From 143 samples of Oral Squamous Cell Carcinomas (OSCC,) DNA was isolated by using

Qiagen FFPE kit and was confirmed by B-globin primers in PCR (product length 120 bps).

PCR for HPV 16 (spanning E6 region and product length 110 bps) was run in those samples which had

sufficient DNA. IHC for p16 was also done on a subset of samples and was recorded as per CAP

guidelines

Results: Out of 143 samples of OSCC 25 (17.4%) were positive for HPV 16 by PCR.

Conclusion: In contrast to 'orophyrangeal squamous cell carcinoma', where high risk HPV prevalence is

high and its prognostic and predictive role is well established. In OSCC prevalence of high risk HPV is

relatively low likely due to hyperkeratosis particularly in chewers physically blocking the penetration of

virus.

PL-1.3: Mechanism of Action of Antioxidants Involved in the Treatment of Leukemia

Steve Harakeh, Ph.D.Special infectious agents unit, King Fahd Medical Research Center, King

Abdulaziz University (KAU

Background: Adult T-cell Leukemia (ATL) is a disease with no known cure. The disease manifests itself

as an aggressive proliferation of CD4+ cells with the human T-cell Lymphotropic virus type 1 (HTLV-1).

27 28





because mammalian assays are time consuming, require animal housing and maintenance and mating

to get the embryos at the required age and there is no need to sacrifice the mother. Moreover the

development of embryos can be postponed by storing eggs at desired temperature. In order to assess

early developmental defects, and to get the maximum tissue from each embryo, cells could be

collected from different systems at embryonic day 5 and plated at high density. The organs at day 5

have still the ability to differentiate and can be clearly identified. Once the cells are cultured in high

density they can then be exposed to the test chemicals in replicates and observed for cytotoxic effects

by the use of relevant endpoints, i.e. differentiation, and cytotoxicity assays. The successful validation

of this assay by the European Center for the Validation of Alternative Methods (ECVAM) makes it an in

vitro embryotoxicity test with high accuracy and predictability.

PLENARY II

PL-2.1 Gene Silencing and Drug Delivery to overcome Drug Resistance in Leishmania

Akhtar Nadhman, Institute of Integrative Biosciences, CECOS University of IT and Emerging

sciences, Peshawar, Pakistan

Leishmaniasis is a complex disease caused by intracellular, flagellated protozoan belonging to genus

Leishmania. It is a severe health problem, presenting high mortality and morbidity rate in tropical and

subtropical regions. It is a complex of diseases with numerous clinical manifestations including skin

lesions, severe disfigurement, and chronic systemic infection in the liver and spleen. The high

prevalence of leishmaniasis and the appearance of resistance to classical drugs reveal the need for

novel, less toxic, and lower cost therapies. Thus, the current work describes the mechanisms of drug

resistance in Leishmania and identifies potential drug targets.

The mechanisms of Leishmania drug resistance include increased efflux, decreased uptake, drug

target modifications, over-expression of drug transporters, and increased expression of degrading

enzyme/s. Silencing of genes involved in resistance has shown promise as a way to reduce drug

resistance, emphasizing the potential that gene silencing or mutation could be exploited for new

therapeutic approaches.

Based on previous studies in literature, candidate targets include the trypanothione system, polyamine

biosynthesis (S-adenosyl methionine decarboxylase), surface lipids including ergosterol pathway

(squalene epoxide and 24, 25-sterol methyltransferase) and efflux pumps (ATP-binding cassette

transporters including MRP1 [now termed as MRPA; gene symbol ABCC1] and P-glycoprotein [P-gp;

gene symbol ABCB1]).

These candidate genes or their products (enzyme) may be targeted using nanomedicine based drugs

and gene delivery systems designed to synergistically and selectively inhibit Leishmania. Further

investigation of these candidate targets will be required to determine their potential, including

investigations of their role in Leishmania survival, and homology studies to determine the possibility of

selective inhibition without off-target effects in the mammalian host.

clinical medical sciences.

PL-1.5: Tumour Heterogeneity: Implications for Targeted Therapeutics

Muhammad Ishfaq, Institute of Biomedical and Allied Health Sciences, University of Health

Sciences, Lahore, Pakistan.

Tumor genetics of any particular cancer type is singularly unique with an array of mutations, either

alone or in combination, driving cancer development and malignant transformation. Based on the

mutation profile, certain therapies although effective in one group of patients will not be suitable for

the other. Tailored personalized therapy based on patient's mutation profile is therefore a need of the

day that will lead to improvements in treatment and outcome. Next Generation DNA Sequencing

revolutionizing our approach to define mutation status and suggest potential therapeutics in defined

groups of patients. This always provides a strong foundation for certain clinical trials to be conducted

and therapeutic strategies developed. Lymphoproliferative diseases (LPDs) are characterized by an

extremely heterogeneous clinical course with differing clinical, histopathological, immunophenotypic

and molecular characteristics, all of which are important in therapeutic decision and better disease

management. Being one of the most common malignancies in the western world, a large deal of

research effort is dedicated to determine the cellular and molecular changes in tissues derived from

these patients with the aim to identify new targets for therapeutic intervention. The aim of my

presentation would be to focus on genetic aberrations and molecular biological processes involved in

LPDs e.g. CLL and FL/DLBCL and correlate that to our understanding of personalized medicine.

PL-1.6: Chick Micromass culture; as a tool for teratological screening

Professor Samreen Memon, Department of Anatomy, Liaquat University of Medical & Health

Sciences, Jamshoro, Pakistan

Environmental agents responsible for the birth defects are amenable to control if identified and

averted. Few of these agents are tested for teratogenicity till date despite the fact that every day

thousands of new chemicals are introduced. There is now an absolute need for alternatives to

conventional animal-based methods for teratogenicity testing due to the fact that every year

hundreds of drugs are introduced to the market and pregnant women are exposed to thousands of

toxic substances. The Micromass system involves the culture of primary cells, isolated either from the

mesencephalon, heart or the limb buds of developing embryos, plated at high density. The most

important mechanisms of development including cell–cell communication, cell proliferation,

cell–matrix interactions and differentiation, are found in micromass cultures. The basic principle of

assay is the potential of teratogens to disrupt normal differentiation of primary embryonic cells in vitro.

Formation of neuronal tissues, chondrocytes or contractile cardiomyocytes is the basis of the

endpoints used along with cell viability measurements. The chick MM assay utilizes primary cells

obtained from midbrain, limbs or heart of chick embryos. This assay is superior to mammalian assays

29 30





patients of genetic disorders using Illumina NGS technology. The resultant genomic data can be

applied for diagnosis and management in clinical setup. This lecture will highlight applications of NGS

with clinical perspective using a number of case studies.

PL-2.4: Challenges of conducting animal based research in medical colleges and universities

Fazal M. Arain Assistant Professor, Biological and Biomedical Sciences, Aga Khan University

Karachi, Pakistan

There have been numerous studies, which show that results of experiments conducted on animals are

affect by how the animals are kept in animal care facilities both during and prior to conducting

experiments on them. Overcrowding in cages, food and water availability, altered circadian rhythm

and housing temperature can have immediate and long term effects on animal's physiology.

Furthermore, the genetic background of the animals must be monitored, as the animals cannot be

mated indefinitely. Congenic background of animals needs to be specially maintained as genetic drift

can significantly alter the experimental results and replicability. The international animal welfare

guidelines are very clear in this regard. However, Pakistan Medical and Dental Council provides

inadequate and vague guidelines for animal care facilities in the research labs of medical colleges and

universities. Our recent study explains the major challenges faced by some of these facilities and

provides suggestions regarding how the situation can be improved.

PL-2.5: Chronophysiology of Brain Derived Neurotrophic Factor and Cognition

Muhammad Rafiq. Institute of Clinical Psychology, University of Management and Technology,

Lahore

Background: Some previous studies showed daily variations of brain BDNF but have failed to

evidence any circadian rhythm: the level of BDNF mRNA was increased in hippocampus and cortex

during the light as compared to dark period of the day. However there is not yet any data on the daily

variation of the expression of BDNF protein in the brain. Objective: To examine any circadian rhythm

of BDNF protein in hippocampus and cortex of nocturnal rats. Methods: Male young Sprague Dawley

rats were sacrificed at six different time points during 24 hours of the day. The brains were removed,

cortex and hippocampus structures were separated and homogenates were prepared. The BDNF

protein was quantified by using ELISA. Results: ANOVA detected a significant effect of time (F (5, 30) =

5.971; P< .001) on the BDNF protein content in the hippocampus and (F (5, 30) = 20.16; P< .001 in the

cortex. Conclusion: Our results provided first evidence that BDNF protein expression follows a

physiological circadian rhythm in hippocampus and cortex with a maximum activity evidenced at

Zeitgeber Time 5 (5h after light on). So, this biochemical profile of BDNF variation during the 24 hours

may be implicated in the ciracidan variation of cognitive processes including learning and memory.

Further, this may also help in chrono-therapeurtic approach.

PL-2.6: Enhanced antibiogram of mycogenized silver nanoparticles against multi drug resistant

PL-2.2: The emergence of CA-MRSA - its impact on 'One Health'

Shafi Sahibzada, School of Veterinary and Life Sciences, Murdoch University, Murdoch,

Australia

Methicillin-resistant Staphylococcus aureus (MRSA) is an opportunistic pathogen of humans that

causes skin and soft tissue infections with potential to progress to fatal bacteraemia. Animals usually

carry livestock-associated (LA) MRSA asymptomatically which could transfer to humans; however, this

lineage is believed to be less pathogenic in humans compared to community-associated (CA) MRSA.

Recently, a high carriage of MRSA has been reported on livestock farms in Australia with recurrent

MRSA outbreaks among workers.

Aim

The aim of this study was to explore a unique outbreak of MRSA in workers and to identify the potential

risk factors for MRSA carriage associated with the occupational activity.

Methods

Isolates were subjected to antibiotic susceptibility testing, DNA microarray, whole genome

sequencing, multilocus sequence typing, virulence and resistance gene characterization and

phylogenetic analysis.

Results

The outbreak investigation revealed the occurrence of bidirectional transmission of MRSA between

livestock and humans. MRSA were isolated from 60% of farm workers where 84% of isolates returned

CA-MRSA and 16% LA-MRSA. Similarly, a large proportion of farm animals (75%) were found positive

for MRSA carriage with 71% of the MRSA isolates returned as CA-MRSA. Over 95% of the isolates were

multi-drug resistant. Workers having contact with farm animals had 24 times the odds of MRSA

carriage compared to workers with no direct contact.

Conclusion

The outcomes of this study indicate that in Australia, and probably elsewhere, greater scrutiny of

staphylococcal infections in humans and animals is warranted, in the form of coordinated investigation

of outbreaks to identify the factors predisposing each host species to infection and emergence of

virulent pathogens with novel resistance traits.

PL-2.3: Next generation DNA sequencing: implications for genomic medicine.

M. Kamran Azim, Department of Biosciences, Muhammad Ali Jinnah University, Karachi,

Pakistan

The ultra-high throughput 'next generation DNA sequencing' technology has remarkable applications

in biotechnology and medicine. Next generation sequencing (NGS) provides information for accurate

diagnosis and better treatment decisions for genetic disorders. We have several years of experience of

translational genomics research using NGS technology followed by bioinformatics analyses. In

collaboration with tertiary care hospitals in Karachi, we have carried out genome sequencing of several

31 32





Herein the present genetic report, we analysed two apparently un-related consanguineous BBS

families from rural area of district D.I.Khan, Pakistan. Whole exom sequencing in both families

determined a recently reported single base deletion mutation c.299delC in 4th exon of BBS9 gene. The

identified frame-shift mutation predictably causes premature truncation of protein product

(p.Ser100Leufs*24).

This mutation has previously been mapped in a consanguineous Pakistani family, and it is the second

report of screening same mutation in two additional families. Nonetheless, the currently recruited

families showed wide-spectrum of intra and inter-familial clinical differences.

Conclusion

We speculate the evolutionary significance of mutation c.299delC and assume its strong founder

effect in Khaisoori tribe of D.I.Khan. Based on these findings, we suggest to develop a molecular

diagnostic test that may be used for pre-marital and prenatal screening as a genetic counselling

approach. While, differential clinical spectrum helped in phenotype-genotype correlation.

PLENARY III

PL-3.1: Nanomedicine: An interdisciplinary play to combat the diseases

Muhammad Ismail, PhD, Director, Institute of Biomedical & Genetic Engineering (IBGE),

Islamabad

Interdisciplinary research has revolutionized the field of medicine and we have witnessed exponential

increase in the high-impact research in past few decades. Rapidly developing resistance, modest

clinical outcome and off-target effects are some of the major stumbling blocks, which have

confounded standardization of therapy. Medicinal chemistry and nanotechnology may have the

answers to outstanding questions of clinicians and can prove to be efficient in successful translation of

therapeutics from bench-top to the bedside. Excitingly, many bioactive ingredients isolated from

natural sources having experimentally proven efficacy are currently being tested for improved

bioavailability by conjugation with different nanoparticles or by using different nanotechnologically

assisted delivery systems.

Our group has worked on silver nanoparticles synthesized through microalgae demonstrated

considerable anticancer, anti-bacterial and antiviral activity. We also tested different plants for

biological activities. Cassia angustifolia was noted to be an effective against different cancer cell lines

and microbes. Structures of the bioactive compounds isolated from Cassia angustifolia were

elucidated by NMR and ESI-MS spectrometry. Pine roxburgii and Ricinus communis were effective

against multi-drug resistant Klebsiella pneumonae. Moreover biological applications of Ce doped

CuO nanoparticles, Cu and Mg Doped ZnO Nanoparticles alone or in conjugation with extract from

medicinal plants. We have reported significant antibacterial activity displayed by these conjugates. We

also provide evidence of targeted killing of Multi-drug Resistant Bacteria by Ni Doped ZnO Nanorods

and Ag doped ZnO nanorods. Recently, we have experimentally verified that Sn doping induced

enhancement in the activity of ZnO nanostructures against antibiotic resistant S. aureus bacteria.

bacterial isolates.

Syed Zeeshan Haider,� Institute of Molecular Biology and Biotechnology (IMBB), The

University of Lahore, Pakistan

Bacterial resistance to antibiotics has emerged as big threat to the world. To overcome this issue a new

approach is gaining attention of the researchers that is the use of Nanoparticles. Mostly silver

nanoparticles (AgNPs) are used as antimicrobial agents. In our current perspectives, we have utilized

AgNPs obtained from mycological origin and compared its antibacterial activity with certain standard

antibiotics. For this purpose, we scrutinized eight different bacterial isolates and ten different standard

antibiotics.

AgNPs were utilized in the form of suspension to judge their antibacterial activity against the bacterial

species. Firstly, the efficacy of biological AgNPs was determined against the eight different bacterial

isolates using the disk diffusion method. Secondly, the antibiogram of ten standard antibiotics against

eight different bacterial isolates were determined by the same technique. A new approach that we had

applied is the formation of the amalgam of Biological AgNPs plus antibiotics and the antibacterial

activity was determined against the bacterial isolates. Lastly, we have compared the results obtained

from the biological NPs, standard antibiotics and their combinations. All the zones of inhibition

obtained in each case were recorded in millimeters. All those bacteria that were resistant towards the

antibiotics alone became sensitive when they were treated against the amalgam of antibiotics and

nanoparticles. A more prolong work has to be carried out in this particular field so that the AgNPs

could be used in the antibiotics for the treatment of bacterial infections. The idea allows different

researchers and health authorities to continue and pursue in this new field of research.

PL-2.7: Exome sequence analysis in consanguineous Pakistani families inheriting Bardet Biedle

syndrome determined founder effect of mutation c.299delC (p.Ser100Leufs*24) in BBS9 gene

Muzammil Ahmad Khan, Gomal Centre of Biochemistry and Biotechnology, Gomal University,

D.I. Khan, Khyber Pakhtunkhwa, Pakistan.

Background of the Study

Bardet biedl syndrome (BBS), a condition of defective ciliogenesis, is characterized by heterogeneous

phenotypic spectrum that involves retinopathy, intellectual disability, obesity, polydactyly, and kidney

dysfunctions as the major clinical feature. Genetic investigations have reported 21 BBS genes, the

product of which are mostly localized to centrosome, basal body or the ciliary transition zone.

Aim

To investigate the genetic entity causing BBS syndrome

Methods

A combinatorial approach of homozygosity mapping and whole exome sequencing. While,

segregation analysis was performed through Sanger sequencing

Results and Discussion

33 34





individuals respond differently to various lifestyle factors such as diet and physical activity. These

genetic differences are the key enabler of the emerging nutrigenetics area of research. Metabolic

diseases such as obesity and diabetes are heritable traits that arise from the interactions between

multiple genes and lifestyle factors such as unhealthy diet and physical inactivity. Dietary factors play

an important role in the development of metabolic diseases because of the variation in the food that is

being consumed in different parts of the world. Although several studies have examined the gene-

nutrient interactions, the findings have been quite inconsistent and hence, unable to develop an

optimum diet for each ancestral population. With genome-wide association study (GWAS) data now

available on numerous large cohorts, it has become possible to embed candidate gene studies within

GWASs, testing for association on a much larger number of candidate genes than previously possible.

In order for nutrigenetics to become a useful public health tool, there is a great need to use

bioinformatics and data integration tools to develop strategies to examine the combined impact of

gene variants on a range of health outcomes and establish how these associations can be modified

using combined dietary strategies.

PL-3.4: Parasites and Human Evolution

Dr. Ijaz Ali, Associate Professor & Head of the Biosciences Department, COMSATs University

Islamabad.

Modern humans started their journey to far-flung areas of the world from Africa approximately

100,000 years ago. They settled in areas where they had to adapt to challenging and unfamiliar

climates, find different ways to feed themselves and fight off new pathogens. Modern studies suggest

that it was the pathogens, particularly parasitic worms, that had the biggest role in driving natural

selection — but that genetic adaptation to them may also have made humans more susceptible to

autoimmune diseases. This presentation will help explain the impact of parasites on the evolution of

human genome.

PL-3.5: Association Between al-Qat Chewing and Anemia among 15 – 49 Years Old Yemeni

Women

Sarah Shawqi Al-Sakkaf, MBBS, MPH, Faculty of Medicine and Health Sciences, Taiz University,

Yemen

Background: Anemia is a global health burden. Research has revealed that women are considered

one of the risk groups particularly those inhabiting the global south e.g.: Yemen. A number of studies

have described the relationship between various risk factors and anemia in females in their

reproductive years. However, to our knowledge, there is no or scarce knowledge clarifying the

association of anemia and al-Qat. Al-Qat is an evergreen plant that is chewed by the majority of

populations residing in some African countries and the Arabian Peninsula including Yemen.

Aim: To determine the association between al-Qat chewing and anemia among Yemeni women

whose ages are in between 15 and 49 years in 2013 using secondary data analysis from the databases

of the demographic and health Surveys (DHS) Program.

Future studies must converge on a better and considerably improved understanding of the healing

effect and toxicological profiling of the nanotechnologically delivered drugs in animal models.

PL-3.2: The Global Challenge of Hidden Hunger: research to find a sustainable solution in

Pakistan

Nicola Lowe, International Institute of Nutritional Sciences and Applied Food Safety Studies,

University of Central Lancashire, Preston, United Kingdom.

Zinc and iron deficiencies are a global public health problem. Zinc deficiency affects 17% of the world's

population and iron deficiency anaemia (IDA) is the world's most common micronutrient disorder,

with the greatest burden in low and middle-income countries (LMICs)1,2. The most recent national

nutrition survey in Pakistan indicated that over 40% of women were zinc deficient and 20% had IDA3.

The health consequences of zinc deficiency include stunted growth and impaired neurodevelopment

in children, increased susceptibility to infections in children and adults, and complications during

pregnancy and childbirth4. IDA affects maternal and child mortality, physical and cognitive

development in children and work productivity in adults5. Consequently, social and economic

development are limited in areas where zinc and iron deficiencies are common. It is imperative for

global development that sustainable, cost-effective solutions to zinc and iron deficiencies are found.

Attempts to alleviate zinc and iron deficiencies (as well as other micronutrient deficiencies) in LMICs

have followed several strategies, including supplementation and food fortification. Whilst preventive

zinc and/or iron supplementation and food fortification programmes have demonstrated positive

outcomes on health and wellbeing6, such strategies are resource-intensive, are difficult to implement

and sustain, and often exclude hard to reach rural communities where most food is grown and

processed locally. Over 60% of Pakistan's wheat harvest is retained by farmers for self-consumption or

used as in-kind payments to labourers7. Most of this wheat is ground locally and not in the large

industrial mills where flour fortification occurs. To date, there have been few reports of the impact of

zinc biofortified crops on zinc intake and status. This is an exciting and emerging field of research, and

there are currently studies underway to examine the efficacy of this approach. Whatever the model for

enhancing zinc intake, the challenge is to ensure that it is effective, sustainable and efficiently

delivered, preferably through existing platforms.

PL-3.3: 'Nutrigenetics and Personalised Nutrition in the Genetic Age'.

Dr Vimal Karani S, Assistant Professor in Nutrigenetics & Programme Director for Nutrition

Degree Programmes, University of Reading, Reading, UK

The ability of Nutrigenetics to determine what nutrients will produce the desired impact on metabolic

balance (as influenced by individual genetic make-up) is at the core of Personalized Nutrition.

Nutrigenetics serves as a novel tool for nutritional research and helps in mitigating the health related

problems of humans. Individuals differ from each other in their genetic makeup due to which

35 36





intake during pregnancy, maternal weight gain, exclusive breast feeding up-to 6 months, and birth

weight.

When is the study starting and how long is it expected to run for?

July 2017 to December 2020

Who is funding the study?

United Nations World Food Programme (WFP)

Amount 9 crore PKR

Results: Baseline results will be presented

PL-3.7: Modelling of dietary intake data: New insights and research needs

Dr Khalid Iqbal, AP, Human Nutrition, IBMS, KMU

Diet is an important determinant of health. Therefore, assessment of usual or long-term dietary intake

is critical to evaluate nutrient adequacy of a population and for relevant public health policy

formulation. Nevertheless, limitations in existing dietary assessment tools and within person variation

in dietary intake pose a big challenge in the analysis and interpretation of usual intake data. Recent

developments in analysis approaches that combine information from multiple or mixed tools offer to

reduce within-person variation in the consumption data. One such approach i.e. National Cancer

Institute (NCI) method has been extended to include influence of covariates on estimation of usual

intake. Only few characteristics like age, sex, and day of week appears to influence usual intake.

However, further research is needed to reach a definitive conclusion. In addition, there is little

evidence, on how dietary patterns are formed and what factors influence intake patterns. A recent

study indicated role of larger meals in pattern formation but also hinted at caution when interpreting

the results. These findings reinforce need for further research using creative approaches to assess

dietary intake with minimum measurement error. Such developments, which is part of Human

Nutrition research at IBMS, KMU, will assist in establishing nutrient adequacy as well as precise diet-

health relationships subsequently leading to formulation of effective nutrition policies.

PL3.8: The Clinical Outcomes of High Energy Lipid-based Nutritional Supplements on Energy

Intake, Lipid Profile and Micronutrient Status in Moderate Underweight Children: A

Randomized control trial

Dr. Sadia Fatima, AP, Biochemistry, IBMS, KMU

Background: Lipid-based nutritional supplements (LNS) strategies might improve undernourishment

and micronutrient deficiencies in children from low and middle-income countries (LMICs) but it also

affects lipid profile.

Objective: This study aims to investigate the effect of four weeks of LNS on energy intake, lipid profile

and micronutrient status of moderately underweight children.

Methods: Thirty-four moderately underweight 5-10 years old children (mean ± SDS 7.08 ± 1.47 years)

Methods: Data from the 2013 Yemen National Demographic and Health Survey (YNDHS) will be

analyzed using chi square test and multivariate logistic regression to determine the association

between al-Qat chewing and anemia among Yemeni women whose ages ranged between 15 to 49

years.

Significance of the Project: Al-Qat chewing is a common practice among Yemenis; males and

females. Anemia is prevalent among Yemeni females and hence impacting the health of generations of

those current and future mothers. The results of this project will reveal whether there is an effect of al-

Qat chewing on female anemia.

PL-3.6: Ready to Use Supplementary Foods (RUSF) to prevent stunting among children under

five years in district Kurram - Trial update

Zia Ul-Haq Institute of Public Health & Social Sciences, Khyber Medical University, Peshawar,

KP, Pakistan

Background and study aims

The Ex-Federally Administered Tribal Areas (FATA) of Pakistan, represent the worst nutrition situations

at national level due to the series of natural disasters and the challenge of militancy and responding

military operations limiting access and development of livelihood/economic activities and agriculture.

The National Nutrition Survey (NNS) 2011 reflects 58% stunting rates in children under 5 years of age

in FATA. This study will review and test Ready to Use Supplementary Foods (RUSF) in a cohort of

pregnant (group 1), lactating women (group 2), children 6-23 (group 3) and 24-59 months (group 4)

and the subsequent impact on stunting prevention in under 5 children. The aim of this study is to

evaluate the effectiveness of selected nutrition-specific interventions improving childhood length for

age scores.

Different Groups to be followed?

Group 1: Pregnant woman

Group 2: Lactating women

Group 3: Children aged six to 23 months

Group 4: Children aged 24-59 months

What does the study involve?

Participants are allocated to groups selected from 12 health facilities catchment areas. Groups that

have a community healthcare worker receive the treatment while groups in the area without a

community healthcare worker receive their standard level of care. Those in group 1 and 2 receive a

certain type of RUSF. This is given in daily rations throughout pregnancy and the first six months of

breastfeeding. Those in the group 3 receive RUSF in daily rations for 18 months. Those in group 4

receive a RUSF daily for 36 months. Data is collected at baseline and followed up with

bodymeasurements conducted monthly from each study participant. Participants are followed up for

their length for age scores at the end of the project i.e. 3 years. They are also assessed for nutritional

37 38





Scientific Session A (1)

MICROBIAL SCIENCES: THE BOTTOM

1.1 Antibacterial Activity Of Garlic And Ginger Against Human Pathogens

Khushunuma¹, Sawera Khan Yaqoob² , Dr. Nasir Ali³

Institute Of Basics Medical Sciences Khyber Medical University Peshawar Pakistan,

Department Of Microbiology And Biotechnology Sarhad University Of Science And Information

Technology Peshawar Pakistan

Assistant Professor, Department Of Microbiology And Biotechnology Sarhad University Of Science

And Information Technology Peshawar Pakistan

The use of plant for medication has been realized since ancient times. In ancient times, several

indigenous plants were used in the diagnosis, prevention and elimination of physical, mental or social

imbalance. Herbal medicines are bio-chemicals originated from plant and used for the treatment of

diseases and for maintenance of better health.

with BMI-Z score between -2 and -3 SDS were randomized to receive either LNS (535 kcal) or Placebo

(90 kcal). Two main trial days were conducted before and after 4 weeks of supplementation at clinical

trial room. The supplement or placebo was added to the regular diet of participants for 4 weeks. On

both trial days fasting blood samples and anthropometric measurements were obtained, and energy

intake was recorded during ad libitum buffet breakfast and ad libitum buffet lunch served post-

supplementation.

Results: The comparison of data after four weeks of supplementation showed that the energy intake

(P<0.001), weight (P< 0.001), mid-upper arm circumference (P=0.005) and BMI-Z score (P= 0.002)

were significantly increased in LNS group as compared to Placebo. Similarly, Hb (P=0.007) and fasting

glucose (P=0.005) were significantly raised. Increase in total cholesterol (P= 0.005) and plasma

concentration of iron (Fe) was also highly significant (P<0.001).

Conclusion: LNS is effective in improvement of nutritional outcomes and micronutrient levels,

however, it remains unclear to what extent LNS alone can be used to improve micronutrient status

among children. Although the LNS increased the energy intake on main trial days but it also induces

hyperglycemia and hyperlipidemia, if consumed for a longer period.

Recommendation: Nutritional programs should be adjunct with nutritional counseling regarding

dietary adequacy and supplement use which can be used as an effective strategy at addressing

nutritional problems in moderate underweight children.

PL-3.9: Pharmacogenomics augmenting the Personalised Justice

Dr. Allah Rakha, AP, University of Health Sciences Lahore

The expanding of human genome data and advancement of related technologies have contributed to

the field of forensic science, especially studies on the genetic basis of most important pharmacological

diseases leading to Pharmacogenomics. Pharmacogenomics utilizes all kinds of available genetic

databases in predicting personalized medicine as well as it also helps in investigating the genetic bases

of an individual's response towards a drug. It has played a key role in Personalized Justice (PJ), as it

explains that inter-individual differences are caused primarily by genetic and environmental factors.

The role of Pharmacogenomics in investigating the individual's genetic variations towards a drug

response makes it useful in solving certain medicolegal cases. The racial and ethnic genetic differences

are well documented in predicting how patients will respond to medications. The genetic information

is drawn from various population genetic databases; however, forensic / population databases are

quite useful for providing data regarding races and ethnicities. The geographical ancestry data

interpretation and analysis are needed for drug development and global health. Pharmacogenomics

requires high-quality databases for authentic interpretations as unprecedented standards set by

forensic population databases.

Dr. Zarina Hasan, (MBBS, KMC, Peshawar) MSc, Molecular Biology and Pathology of Viruses,

Imperial College of Science, Medicine and Technology, University of Lundon).

Dare to dream

Abstract:

Our brain defines, but we can also change our brain's structure and function. I am a living proof of

neuroplasticity, which is the ability of the brain to change in response to an adequate and repetitive

stimulus. I lost sight 8 years ago due to Glaucoma. Being a doctor and a scientist, I cannot help but

wonder and marvel at how I manage to paint, relying primarily on my imagunation and touch.

I strongly feel there is neuroplasticity at play, building new neural connections, compensating a break

in the visual pathway with alternative wiring between the fingers tips and visual cortex. Thensame

principle must apply to visualisingnthe alphabet by feeling the raised bumps while reading Braille. I

want to encourage people to disregard thenlimitations of conventional wisdom. To dare tondream

and strive to realise their dreams. It breaks my heart to witness children and individuals handed a life

sentence of inability to learn. Neuroscience and education can merge to harness the power of the mind

to mould, the brain. Redefine boundaries. The human brain has 86 billion neurons. To put this in

perspective, the human population of the world is a mere 7 or 8 billion. The neuronal connections

within the brain amount to trillions. Far more than all the stars in the Milky Way galaxy, put together.

No two brains are alike. The differences between them outnumber the differences between the

physical features of any two people. This complex organ defines us, those around us, our world, and

our place in the world.

KEYNOTE CLOSING SESSION

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1.2 : An M13 Phagemid Based Therapy Using non-coding Synthetic RNAs Against Virulence Genes of Avian Pathogenic Escherichia coli.

Sayed Abdullah and Dr. Fazal Adnan, National University of Sciences and Technology (NUST), Islamabad.

Background of the Study:

The extraintestinal pathogen termed Avian Pathogenic Escherichia coli (APEC) is known to cause

colibacillosis and different other infections in chickens. Due to APEC infection in boiler chickens a

huge economical loss occurs every year. Some studies also showed zoonotic potential of the APEC.

Many genes are involved in infection, like Type 1 fimbria (major subunit fimA) and curli (major subunit

csgA) involved in initial adhesion and colonization which is the first step to infection. Extensive use of

antibiotics against these bacteria led to resistance, to overcome the problem new strategies are being

developed.

Aim: To develop a feasible approach to overcome the antibiotic Resistance through M13 Phagemid

mediated delivery using non-coding synthetic RNAs silencing, by optimizing the technique against

csgA and fimA genes of Avian Pathogenic E. coli (APEC).

Methods:

A non-coding synthetic RNA sequences against csgA and fimA genes will be inserted in to pab001

plasmid comprise of expression Cassette (Promoter, Micc scaffold and terminator). The expression

vector (pab001-ncRNA) will be then co-transformed into the expression system (DH5� E. coli) with M13

helper plasmid. A phagemid produced by expression system will be transduced to APEC for expression

of anti- csgA ncRNA, followed by analysis of of csgA gene, through Real Time PCR, with addition of

Motility test, MTTS assays and Antibiotic assays. In vivo expression analysis needs to be designed

against chick model. The results will be then analyzed by using statistical tools.

Conclusion: This study will optimize the feasible therapy against Multidrug resistant bacteria,

bypassing resistance evolution. The therapy can be extended to many other virulence genes of multi

drug resistance bacteria involve in Infections and diseases. The route of treating bacteria as phagemid

base delivery is almost safer and commercially used as a therapeutic delivery system for many diseases

and infection in many countries. However more knowledge about causing infection agents of bacteria

and in vivo effect of bacteriophages is necessary to designing a suitable and safer therapy.

1.3 Gedunin, a novel Hsp90 inhibitor, suppresses dengue virus replication in cell culture

Deeba Amraiz, Najam-us-Sahar Sadaf Zaidi, Munazza Fatima


Dengue, an arthropod-borne virus of the Flaviviridae family has recently emerged as a major global

threat causing dengue fever, dengue hemorrhagic fever and dengue shock syndrome. Despite the

enormous efforts, there is still no licensed vaccine or therapeutic agent available that provides a

balanced and long-term protection in dengue virus infected patients of all age groups. Due to major

complications associated with the disease, there is a need to develop antiviral agents that effectively

inhibit viral replication.

Aim

This study was designed to evaluate the antiviral potential of a tetranortriterpenoid, gedunin, against

dengue virus (DENV) replication by targeting the host chaperone heat shock protein 90 (Hsp90).

Methods

The compound, gedunin, was tested against the replication of DENV in vitro using BHK-15 cells

transfected with DENV subgenomic replicon expressing Renilla luciferase as reporter as well as against

virus propagation using standard plaque assay. Molecular docking of gedunin with Hsp90 protein was

performed for evaluation of mode of action, using the bioinformatics tool, Autodock vina.

Results

The compound significantly inhibited the DENV replication in vitro using both subgenomic replicon

based assay and virus titer reduction assay with EC50 of 10 µM and 8.5 µM respectively. In silico

molecular docking revealed that gedunin has strong potential interactions with the N-terminal ATP

binding site of Hsp90 with an estimated average free binding energy of -8.9 kcal/mol.

Conclusion

Results in the present study showed promising findings and validated gedunin as a potential antiviral

candidate for the treatment of DENV infections. This study will also help to develop therapeutic

strategies that could lead to the identification of novel drug candidates targeting specific pathways in

viral life cycle.

1.4 Molecular characterization of antimicrobial resistance and genotyping of Enterococcus faecalis isolates from health care facilities

Muhammad Farman, Muhammad Yasir, Rashad Rizk Al-Hindi, Asif Ahmad Jiman-Fatani, Maha Alawi,

Hani Ahmed Ibrahim Shukri, Esam I. Azhar

Background

Garlic and Ginger have been used as a source of food and medicine for thousands of years. Given that

both contains different biologically active materials having antimicrobial activity

Aim

To determine the antimicrobial activity of Garlic and ginger extracts against gram positive and gram

negative pathogenic bacteria.

To investigate whether the plants we have chosen are effective against the bacteria causing specific

diseases.

Methods

In present study the antibacterial activity of methanolic extracts of garlic and ginger plant against

E.coli, Staph agalactiae, Pseudomonas, Staph aureus, Staph Epidermidis and Klebsiella was assessed

based on Disk Diffusion method in MHA media. Three concentrations of the extracts (⁵⁰⁰, ²⁵⁰ and ¹²⁵

mg/L DMSO) were used.

Results

The antibacterial activity of garlic methanolic extract against E.coli, Staph Agalactiae, Pseudomonas,

Staph aureus, Staph Epidermidis and Klebsiella was assessed on the basis of Disk Diffusion method in

MHA media. All the concentration of the methanolic extract did not show any activity on Pseudomonas

and Klebsiella but they showed activity on E.coli, Staph Agalactiae, Staph aureus and Staph

Epidermidis.

The Methanolic extract of ginger demonstrated antibacterial activity against Staph Epidermidis while

no activity was noted on Staph aureus, Staph Agalactiae, E.coli and Klebsiella.

Conclusion

The most potent sample among the garlic and ginger was garlic methanolic extract, which inhibit the

growth of many pathogenic bacteria. Garlic methanolic extract inhibited the growth of (E.coli, Staph

Agalactiae, Staph aureus and staph Epidermidis) bacteria tested on different concentrations.

Ginger methanolic extract against Staphylococcus epidermidis have a little inhibitory effect on

different concentrations.

41 42





Enterococcus faecalis is a ubiquitous member of gastrointestinal tract, and have emerged as an

important, multidrug- resistant nosocomial pathogen. They are also known for their ability to transfer

antibiotic resistance to other pathogens. Limited knowledge is available about the potential clones of

this specie circulating in Saudi Arabia.

Objective

The aim of this study was to determine the antimicrobial resistance of E. faecalis clinical isolates from

various sources, with emphasis on susceptibility to glycopeptides, aminoglycosides and quinolones.

Using a 7 multilocus sequence typing (MLST) scheme, we investigate an evolving and widespread

clonality of E. faecalis, that has caused the outbreak and life-threating infections in health care-

settings.

Methodology

A total of 155 E. faecalis isolates were identified and screened for multidrug resistance via MALDI-TOF

and VITEK-2 COMPACT (automated) microbiological system, respectively. Genotypic characterization

was performed with Pulse-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST).

Resistant and virulence genes were investigated by PCR using specific primers.

Results

The E. faecalis isolates displayed multi-drug resistant phenotypes, with resistance to clindamycin,

erythromycin, quinupristin/dalfopristin, tetracycline, as well as high level of aminoglycoside resistance.

Multilocus sequence typing showed that most of the isolates were belonged to E. faecalis sequence

types (ST): ST16, ST6 and ST480. The genomes of 44 isolates were sequenced to identify the

antimicrobial resistances and other varying traits. Antimicrobial resistant genes identified aac (6')-aph

(2"), aph (3')-III, ant (6)-Ia, tetM, ermB, str, tetL, cat, and dfrG, lnu(B)-like lsa(A)-like, fexA, optrA and

aadE. These isolates also harbored multiple virulence factors including cytolysin factors in ST179, ST16

and ST6 isolates. The biofilm-associated genes (esp, agg, ace, SrtA, gelE, ebpABC), survival genes (ElrA,

tpx) and hyaluronidases (hylA, hylB) genes were confirmed in CC6 and CC16 isolates in abundance. The

presence of antimicrobial resistance and virulence factors genes in E. faecalis isolates provides the best

opportunity to understand the basis of continuous persistence of this pathogen in healthcare.

Conclusion

In conclusion, overall low vancomycin resistance was observed in E. faecalis isolates. This is the first

report of MLST with two novel sequence types circulating in Saudi Arabia which has uncovered the

genetic diversity within the E. faecalis and CC16 and CC6, two of the biggest CCs in the world, were

evidently circulating in Saudi Arabia with multi-drug resistance and virulence traits.

1.5 Detection and distribution of virulence and antibiotic resistance genes in Diarrheagenic types of E. coli in children

Sher Bahadar Khan, Mumtaz ali Khan, Irshad Ahmad, Sher Ali Khan5, Shakoor Ahmad

Background of the Study: Diarrheagenic types of E. coli are the most important pathogens

responsible for diarrhea which causes huge morbidity and mortality in children.

Aim: To find out the prevailing status of antimicrobial resistance in different types of Diarrheagenic E.

coli responsible for diarrhea in children.

Methods: A total of 290 stool samples were processed for isolation of DEC using MacConkey agar

followed by identification through colonial, microscopic morphology, biochemical testing and

detection of virulence genes specific for enteroaggregative E. coli (EAEC), nterotoxigenic E. coli (ETEC),

enteropathogenic E. coli (EPEC), enteroinvasive E. coli (EIEC) and enterohaemorrhagic E. coli (EHEC)

through PCR. DEC isolates were tested for 15 antibiotics using disc diffusion method followed by

detection of their respective antimicrobial resistant genes through PCR.

Results: A total of 185 DEC were isolated and among them the most prevalent were EPEC (71/185),

followed by EAEC (58/185), EIEC (40/185), DAEC (14/185) and ETEC (2/185). Over all the high

resistance was found against AMX (95.1%) followed by LIN (90.2%), AMP (67%), TET (59.4%), CHL

(51.3%), SXT (48.6%), STR (40.5%), CLR (28.6%), OFX (20.5%), GEN (18.3%), AZM (15.6%), LFX (12.4%)

and CIP (9.7%). The highest prevalent gene was blaCMY-2 (96.7%, 179/185) followed by blaTEM

(76.6%, 142/185), tetA (59.4%, 110/185), aadA (58.9%, 109/185), tetB (56.7%, 105/185), strA/strB

(55.1%, 102/185), tetC (50.2%, 93/185), sul1(26.4%, 49/185) and sul2 (25.4%, 47/185). The frequency

distribution of virulence and antibiotic resistance genes was found different in different types of DEC.

Conclusion: The drug of choice against DEC are CRO and GAT. Systemic and molecular epidemiology

can be applied for accurate tracking the infection and AMR development source.

1.6 Genotypic Distribution and Epidemiology of Hepatitis C infection among Afghan Refugees coming to Peshawar, Pakistan

Fatima Khan, Fahad Hassan Shah, Jamshaid Ahmad, Irshad Ur Rehman.


The interrelation between the prevalence of hepatitis C virus (HCV) and immigration is rarely studied,

especially when it comes to such refugees that have crossed borders for resettlement. Comparatively

few number of researches have been published on Afghan Refugees residing in Peshawar, Pakistan.

Aim

The objectives of this study were to determine: (1) the prevalence of HCV in Afghan refugees moving to

Pakistan, which have been congregated in Peshawar. (2) The distribution of HCV genotype among

these refugees and its correspondence with different demographic factors.

Methods

Participants chosen for this review study were Afghani refugees, residing in the Peshawar, Pakistan.

Over the course of 3 years (2011-2013), a sum of 2567 serum samples were evaluated. Data related to

socio-demographics, ethnicity, and geographical variables were collected through participant medical

history taken by the physicians of different hospitals. The serum samples collected were tested for anti-

HCV antibody by Immunochromatographic Test and different genotypic assay tools were employed to

determine the genotype.

Results

Out of 2567 blood samples, patients having active infection were 10.9% (28). The pattern of incidence

studies revealed that the refugees coming from Afghanistan, there was a substantial increase of HCV

infection ranges from 1.1% to 14.3%. Prominent HCV Genotypes found in these immigrants were G3

(93%) as compared to G2 (5%) and G1 (1.1%). A small populace of mixed genotypes (0.9%) was

reported.

Conclusion

Our results reflect that there is considerable HCV incidence among these Afghani refugees and caused

great genetic diversity among HCV genotypes in Peshawar. Now it's time to develop such guidelines

and policies which could lead us to prevent these viral epidemics as well as genotype distribution both

in Peshawar and Afghanistan.

1.7 Montage of Cutaneous leishmaniasis at HMC, Peshawar: A Pictorial Review of Clinical Presentation

Dr. Fatima Humara Abdullah, MPhil Scholar KMU.Dr. Saeed ur Rahman

Leishmaniasis is caused by 'Leishmania' protozoon, which spreads through the bite of infected sand

flies. 1,2 It is endemic in 98 tropical and subtropical countries with anincidence of 2 million new cases

per year and more than 250 million people at risk. 3,4 Recently cutaneous leishmaniasis has emerged

as a great public health problem inKPK. It exhibited various clinical presentations from a non-ulcerative

papule to a largemutilating ulcer. 5,6 It often heals with disfiguring scar that is often associated with

morbidity, psychological trauma and socioeconomic issues. The diagnosis of the lesionis easy but

43 44





unusual clinical presentations are problem in early diagnosis and treatment. Clinical presentation of

lesion depends upon species of parasite and immune status of the patient. Sometimes it can resemble

a malignant neoplasm or lupus.

Aim

The aim of this presentation is to share our experience for create awareness among

doctors regarding early diagnosis of cutaneous leishmaniasis based on clinical

presentation.

Methods

This is hospital based clinical study at HMC, Peshawar. Consent was taken. Patients' data,

characteristics of sore and photographs of the wound were taken with Nokia mobile camera. Smears

were prepared from tissue fluid taken from raised or swollen edges and base of wound under strict

aseptic precaution. Slide were stained with Giemsa stain and examined microscopically for

amastigotes of Leishmania tropica.

Results

The yearly diagnosed cases of cutaneous leishmaniasis are 240 – 272 at HMC,

Peshawar. Lesions with typical presentation are 66 – 70%, atypical are 30 – 34%. Male

to female ratio is 1.2:1; while children to adult ratio is 1.5:1.

Conclusion

Cutaneous leishmaniasis has turned into an epidemic in KPK with various clinical presentations. Every

suspected and non-healing sore must be screened for cutaneous

leishmaniasis. 7 Early diagnosis, treatment and public health strategies for prevention of this spreading

infection are necessary.

Scientific Session A (2)TRANSLATIONAL MEDICINE: UP & RUNNING

2.1 Identification of differentially expressed PLK1 phosphorylation targets in oesophageal cancer cell lines: A crosstalk between p53 and PLK1-linked function

Nousheen Bibi, Ted Hupp , Mohammad Amjad Kamal, Sajid Rashid

Abstract

Oesophgeal adenocarcinoma (OAC) is the most frequent cause of cancer death. POLO-like kinase 1

(PLK1) is overexpressed in broad spectrum of tumors and has prognostic value in many cancers

including esophageal cancer, suggesting its potential as a therapeutic target. p53, the guardian of

genome is most important tumor suppressors which represses the promoter of PLK1, whereas tumor

cells with inactive p53 are arrested in mitosis due to DNA damage. PLK1 expression has been linked to

the elevated p53 expression and has been shown to form part of a biomarker that predicts poor

prognosis in OAC. Here we set up a phosphor-proteomic screen to identify PLK1 responsive target

proteins in p53WT (CP-A) and p53MUT (OE33) cell lines in response to a PLK1 inhibitor, CYC4 (4-(2,4-

Dimethyl-1,3-thiazol-5-yl)-N-[4-(trifluoromethyl)phenyl]-2-pyrimidinamine). We investigated

approximately 1300 potential PLK1-dependent phosphopeptides by LC-MS/MS. Moreover, 2216 and

1155 high confidence phosphosites were identified in CP-A and OE33 cell lines due to CYC4 treatment.

Taken together, our study suggests that PLK1 may serve as a potential therapeutic target in human

esophageal cancer. The data highlight the efficacy of small molecule PLK1 kinase inhibitors to identify

novel signaling pathways in vivo.

2.2 Germline Mutation/Polymorphism (s) in p53 and p16 Gene are associated with Oral Squamous Cell Carcinoma: Novel Molecular Targets for Future Therapies

Saima Saleem, Abdul Hameed, Zubair Abbasi, Uzma Zareef , Navid Rashid Qureshi, Mansoor Ahmed

Khan, Madiha Kanwal, Syed Aqib Ali Zaidi , Abid Azhar


Oral squamous cell carcinoma (OSCC) is the most prevalent among all the cancers in Pakistan. It can be

attributed to cultural habits and use of some harmful chewing materials like Gutka, Manpuri, Niswar,

tobacco, Paan and Chaliya. Reported studies suggest that these contain nitrosamines, polyphenols

and alkaloids that are known mutagens and have genotoxic activity.

Aim

The aim of the study is to screen the possible mutation(s) p53 and p16 in OSCC patients exposed to

these mutagen(s) present in the chewing chemicals in Pakistan.

Methods

A total of 260 OSCC patient's tissue and blood specimens were collected with informed consent from

local hospitals of Karachi. Mutations in exons 2-11 of p53 gene and exon 1 and 2 of p16 were

investigated by polymerase chain reaction and single stranded conformational polymorphisms (PCR-

SSCP) and directly sequenced.

Results (skip if it's only a proposal)

The current study revealed a novel mutation in exon 7 of p53 gene. This mutation was observed only in

the tumors of the OSCC patients. The “AGT” to “ACT” missense mutation was identified at position 719

at p53. Eight different alterations in response to different chewing habits were found in exon 1 at p16.

Two were silent mutations at codon 30 and 81 that do not result in change in the amino acid(s) in p16

protein. Other missense mutations were at codon 24, 88, 91, 108, 112 and 125.

Conclusion (or significance of the study, if it's a proposal)

Mutations were found in both blood and tissue of cancer patients but the frequency was higher in

tissue samples. It can be suggested that mutations caused by the harmful chemicals present in these

chewing materials could pass through generations and further acquired mutations can play a vital role

in rapid progression of oral carcinoma.

Key Words: p53 gene, p16 gene, OSCC, Missense mutations, Direct DNA sequencing

2.3 Incidence and association of B-RAF gene mutation in papillary thyroid cancer in infected individuals of KP-Pakistan

Rabia Sana, Najeeb Ullah, Noreen Asim and Aqib Iqbal

Background of the Study: Thyroid gland is located in front of neck under the Adam's apple, having an

important role in production of thyroid hormones, which helps in maintaining the body metabolism.

Variation in concentration and secretion of thyroid hormones (T3 and T4) either low or high results in

thyroid disorders. Thyroid cancer is one of such gland disorder having different types; common of all is

endocrine malignancies is papillary thyroid cancer (PTC). RAF (rapidly accelerated fibro adenoma)

family gene B-RAF is responsible for mutation in PTC, which is located on chromosome 7 comprising of

2513bp nucleotides sequence.

Aim: Current research is based on identification and association of BRAF gene mutation at exon 15

with PTC and to analyse the effect of V600E mutation on BRAF protein structure through insilico

analysis.

Methods: Blood samples were collected from 70 PTC individuals (62 female and 8 male) of KP

including 30 healthy controls. All the samples were processed for DNA extraction via phenol

chloroform method. Allele specific PCR was conducted to know the mutation (T1796A) in BRAF gene at

exon 15.

45 46





Results: The PCR result revealed that 64 (58 female and 6 male) samples were BRAF positive.

Genotyping was done in order to find out the prevalent PTC genotypes in all the PTC positive patients

and control samples. The homozygous (AA) genotype was found significant (OR 3.3529, CI 1.051 to

10.6919) in PTC patients as compared to control samples, followed by heterozygous mutation (AA) (OR

1.4701, CI 0.8445 to 2.5590). The insilico analysis of BRAF protein also revealed that V600E mutation

results in �C helix distortion leading to 5.4Ao shift at the C-terminal.

Conclusion: The PTC variants were identified in KP individuals and AA genotype is associated to PTC

(odd ratio 3.3529, 95% confidence interval, 1.051-10.6919, p-value 0.04). Therefore, BRAF mutation

may be a useful molecular marker to assist the risk management for patients with PTC.

2.4 Breast cancer awareness amongst female teenagers studying in the federal territory of Pakistan

Hamna Atique, Hurmat Fatima Azeem, Dr. Sidra Hamid, Dr. Tahmina Yousaf

Background:

Breast cancer is the most prevalent cancer amongst women worldwide. A general lack of public

awareness regarding the disease and its symptoms often results in late diagnosis and poor treatment

outcomes. Breast cancer awareness amongst Pakistanis is limited owing to low literacy rate and

general taboo associated with cancer of gender-specific parts in the human body. Adolescence is a

period of rapid change; thus, proper health education during this time is essential to instill good health

behaviors. Therefore, this study was conducted to determine knowledge of Breast Cancer, its risk

factors and screening methods amongst teenage females in the Federal territory of Pakistan.

Material & Methods:

Using a descriptive study design, data was collected using a self-administered, close-ended

questionnaire containing questions on socio-demographic characteristics, and subjective knowledge

of breast cancer covering its symptoms, risk factors, screening methods and practice of breast self-

exam, which was distributed amongst 450 female teenagers studying in various institutions in

Islamabad, Pakistan by convenient sampling during March 2018. Three groups were compared by

applying One-way-ANOVA followed by Post hoc Turkey test. The significance value was set at p<0.05.

Data was analyzed by Statistical Package for Social Sciences Version 23. The awareness levels were

categorized on numerical scale of 0 to16; (0-5=unaware), (6-10=moderately aware), (11-16=

satisfactorily aware).

Results:

The mean age of the participants was 16.46 + 1.65). Only 47.6% of the participants were aware of the

incidence of breast cancer in Pakistan (n=450). The percentage of the minimally aware teenagers, (cut-

off value=0) was 1.1%, of moderately aware ones (cut off value=10) 5.5%, while only 0.2% females (cut-

off value=15) were maximally aware. There was significant relationship between age of the individuals

and awareness levels (p=0.00).The total awareness score and knowledge of all risk factors of breast

cancer was significantly related to education level of individuals, p=0.00 and p=0.007, respectively.

Conclusion:

Our study indicated that the knowledge of risk factors was significantly better in older females. But the

knowledge regarding breast cancer was still found to be insufficient amongst majority of the

participants.

2.5 A randomized, clinical trial comparing the efficacy of metformin and combination of metformin plus pioglitazone therapy on serum levels of IL-6 and IL-8 in polycystic ovary syndrome

Durr-e-Shehwar, Mohsin Shah, Asif Ali, Muhammad Omar Malik

Abstract

Context: Elevated serum levels of inflammatory biomarkers reflect low-grade chronic inflammation

and have been linked to insulin-resistant states in women with PCOS. Therefore, insulin-sensitizing

agents have been recommended to improve the low grade chronic inflammation and insulin

resistance in PCOS.

Objective: We compared metformin and combination of metformin plus pioglitazone on menstrual

cyclicity, hormonal parameters, insulin resistance and inflammatory biomarkers in women with PCOS.

Design: Two-arm randomized clinical trial.

Setting: Khyber Medical University and OPD of Mardan Medical Complex.

Patient(s): One hundred and two women with PCOS participated in the study.

Intervention(s): All subjects were randomized in to two-arm interventions. Arm-1: metformin 1000

mg (BD) daily. Arm-2: Combined (metformin 1000 mg BD and pioglitazone 30 mg BD) for 12 weeks.

Main Outcome Measure(s): The primary outcome measure was serum level of IL-6 and IL-8 using ELISA

assay. Secondary outcome was insulin resistance assessed using HOMA-IR.

Result(s): At baseline women with PCOS had significantly elevated circulating concentrations of IL-6

and IL-8. Their levels were influenced by treatment with metformin and pioglitazone combination as

demonstrated by decreased IL-6 and IL-8 levels after three months of therapy. HOMA-IR decreased

with a similar decrease in insulin sensitivity in both groups (P < 0.000). Hirsutism score (P < 0.05) and

serum concentrations of free testosterone (P = 0.000), LH (P = 0.013) and FSH (P = 0.000) declined to a

similar extent after treatment with either drugs. Interestingly, treatment with metformin or

combination metformin and pioglitazone was associated with the reduction in menstrual irregularities

and hirsutism in both groups.

Conclusion(s): Combination of metformin and pioglitazone therapy could be more effective

compared to metformin alone in reducing the levels of IL-6 and IL-8 as well as insulin resistance in

PCOS.

2.6 Sex Hormone Binding Globulin levels in patients with Polycystic Ovary Syndrome

Madiha Khattak, Nuzhat Sultana


Polycystic ovary syndrome is the most common Endocrinopathy of women of reproductive age group.

Rotterdam criteria which is used to diagnose PCOS states that a patient should have two of the

following three features: Oligomenorrhoea or amenorrhoea, clinical or biochemical

hyperandrogenism, polycystic ovary on ultrasound. Hormonal imbalances include elevated total

testosterone, high LH: FSH ratio (40% of the cases), metabolic derangements which include

hyperinsulinemia, insulin resistance, deranged OGTT. These patients are frequently obese, infertile,

have irregular menses, have hirsutism and have PCO on ultrasound. The cause of this pathology may

be hyperinsulinemia or hyperandrogenism, however the exact cause is not known. Genes and

environment are thought to play a role in the development of this disease. Its management includes

treating menstrual irregularities, infertility, obesity, hyperinsulinemia and hyperandrogenism. SHBG is

a protein secreted by the liver and it transports sex steroids such as testosterone and estradiol.

47 48





Hyperinsulinemia decreases the secretion of SHBG and results in excess of free androgens in the

blood. SHBG levels are frequently low in PCOS.

Aim

To find out if Sex Hormone Binding Globulin levels are decreased resulting in Hyperandrogenemia in

patients with Polycystic Ovary Syndrome.

Methods

We took 40 cases of PCOS and 40 controls of infertility without PCOS. History was taken and general

physical examination was done. Blood samples were taken and centrifuged to separate the serum from

each sample. The tests carried out included total testosterone, estradiol, LH, FSH and SHBG. BMI, Waist:

hip ratio and FAI were calculated.

Results

Total testosterone levels, BMI, FAI were high in the cases as compared to controls (p-value < 0.05).

SHBG in majority of the patients was in the lower half of normal range and central obesity was present

in both the groups. There was no difference in the LH, FSH, LH: FSH ratio, estradiol levels in both the

groups. Hirsutism was present in most of the cases but total testosterone was not necessarily raised

however FAI was raised in majority of cases with hirsutism.

Conclusion

SHBG levels were low in most of the patients with PCOS and should be measured in patients suspected

of having PCOS as total testosterone was not raised in every case and did not match the presence of

hirsutism in each case. FAI calculated from SHBG and total testosterone was a better measure of

hyperandrogenism. Thus SHBG should be calculated along with total testosterone in each patient

suspected of PCOS.

Keywords: Sex Hormone Binding Globulin (SHBG), Luteinizing Hormone (LH), Follicle Stimulating

Hormone (FSH), Leuteinizing Hormone to Follicle Stimulating Hormone Ratio (LH:FSH), Polycystic

Ovary Syndrome (PCOS), Total Testosterone, Estradiol, Body Mass Index (BMI), Free Androgen Index

(FAI), Hirsutism.

2.7 Complementary and alternative remedies for diabetes associated depression: a prospective human study

Saara Ahmad Muddasir Khan, Asra Khan, Zehra Batool, Saida Haider


Depression is a major clinical outcome of diabetes mellitus. Allopathic medication are expensive and

not devoid side effects, therefore, potential functional foods with anti-acetylcholinestrase activity are

now in trials for treatment of diabetes and its associated complications.

Aim

The potential herbs matricaria chamomile (MC) and Crocus sativus (CS) for their known anti

acetylcholinestrase activity are used in the present study on allaxon-induced diabetes in rats for

evaluation of effects on depression.

Methods

Fifty rats were made diabetic by the intra-peritoneal administration of 160 mg/kg allaxon. Body

weight, food and water intake was monitored daily. Light and Dark box test (LDBT), Open field test

(OFT) and forced swim test (FST) were done for the assessment of depression through ambulation on

11th day after diabetes induction.

Results

Results showed significant increase in food and water intake but no effect on body weight. The

comparison was made in between disease control (DC), healthy controls (HC) and CS, MC and CS+MC

administrated diabetic rats. The analysis showed exploratory activity in DC rats was significantly

decreased marking profound depression in all tests as compared to HC and CS, MC and CS+MC

treated rats. While significant improvement on MC (p<0.05), CS (p<0.05) and MC+CS (p<0.001) rats in

depression was seen as compared to DC rats.

Conclusion

The present study indicates that herbal complementary and alternative remedies including saffron and

combination of Saffron and Chamomile may reverse depression in diabetic rats. Keywords:

Depression, Diabetes Mellitus, Saffron, Chamomile, anticholinesterase activity

Scientific Session A (3)GENOMICS: GET YOUR WIRES CROSSED

3.1 Association between Polymorphism in Mu Opioid Receptor (ORPM1) Gene with Drug and Opioid Addiction in Subjects from Khyber Pakhtunkhwa

Faisal Ali and Aqib Iqbal


Drug and opioid addiction is a brain disease which is characterized by the abandoned drug use

which have many social and health implications. The mu opioid receptor gene (OPRM1) present in

exon 1 chromosome 6 (q24-q25) contains several single nucleotide polymorphism. Two of them

A118G (rs1799971) andC17T (rs1799972) are associated with opioid and drug addiction.

Aim:

The aim of this case and control study was to determine the addiction rate of different drugs, to

find the association of drug addiction with different social and environmental risk factors and to

find the relationship of genetic polymorphism in mu opioid receptor gene with opioid and drug

dependence in subjects from selected districts of Khyber Pakhtunkhwa (KP).

Aim:

The aim of this case and control study was to determine the addiction rate of different drugs, to find the

association of drug addiction with different social and environmental risk factors and to find the

relationship of genetic polymorphism in mu opioid receptor gene with opioid and drug dependence in

subjects from selected districts of Khyber Pakhtunkhwa (KP).

Methods:

In this study the Addiction Severity Index was used as a tool to determine the use of different drugs and

socio-psychological risk factors in total of 425 drug addicts from Peshawar, Mardan and Swabi.

Furthermore, randomly selected drug addicts (n=36) and healthy controls (n=36) were recruited for

analysis of genetic polymorphism of Mu Opioid Receptor 1 (OPRM1) gene through allele specific

polymerase chain reaction (ARMS-PCR) procedure.

Results:

Cannabis was the most prevalent drug / substance of abuse among the drug addicts from Peshawar,

Mardan and Swabi and is also having the maximum relative risk of addiction. Among the socio-

psychological addiction risk factors, the peers have the highest contribution (39%) and are having a

high relative risk for drug addiction. The frequency of the G allele was 0.544 and 0.486 at OPRM1

A118G locus for drug addicts and healthy controls, respectively. Similarly, the frequencies of T allele

were 0.444 and 0.417 at the OPRM1 C17T for drug addicts and healthy controls, respectively.

Univariate multi-regression analysis revealed high and significant association between the T allele (OR

= 18.4) C17T (rs1799972) locus with drug addiction. Similarly, individuals with CT or TT genotype were

at a significantly higher risk of drug addiction.

Conclusion:

The single nucleotide polymorphism in C17T locus of the ORPM1 gene was found to play important

role in drug addiction in our studied population and offers an opportunity to determine genetic

influence in the initiation and maintenance of drug use and to develop more effective personalized

therapies and preventive strategies.

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3.2 Association of Genetic Polymorphism in Folate Metabolism Related Genes with Idiopathic Male Infertility in Population from Khyber Pakhtunkhwa

Sartaj Khan and Aqib Iqbal


Methylene-tetrahydrofolate-reductase (MTHFR), methionine-synthase (MTR) and methionine-

synthase-reductase (MTRR) are the three main enzymes of folate and homocysteine metabolic

pathways and play a critical role in DNA synthesis and methylation reactions. This research was

designed to determine the importance of mutations in folate metabolism related MTHFR, MTR and

MTRR genes and susceptibility to male infertility among individuals from Khyber Pakhtunkhwa,

Pakistan.

Aim:

This study was aimed to determine the association of idiopathic male infertility with genetic

polymorphisms in the three selected genes involved in folate metabolism. Beside the identification of

genetic pre-disposition, other risk factors for male infertility and their correlation with these genetic

mutations were also determined in sample population from Khyber Pakhtunkhwa.

Methods:

The studied population included fifty four idiopathic infertile patients and forty five fertile men.

Genotyping of the single-nucleotide polymorphism (SNP) was performed by allele specific PCR and

association between genetic polymorphism male infertility with or without other risk factors was

determined through odds ratios (95% CI).

Results:

The individuals having T allele at C677T and the C allele at A1298C loci of MTHFR gene have an

increased likelihood of being infertile (OR = 1.79 and 1.11 respectively). The individuals having the

homozygous mutant (TT or CC) and heterozygous genotypes (CT or AC) of MTHFR C677T and A1298C

loci were more likely to be infertile (OR = 2.68 and 1.13 respectively) compared to homozygous wild

type genotypes (CC and AA). The mutant G allele of MTR-2756A>G and MTRR-66A>G locus were also

associated with an increased likelihood of male infertility (OR = 1.10 and 1.52 respectively), though less

strongly compared with mutations in MTHFR gene. It was found that the individuals having (T) and (C)

alleles of MTHFR-677C>T and 1298A>C loci, (G) allele at the MTR A2756G and (G) allele at MTRR-A66G

locus and exposed to smoking or taking poor diet have an even increased likelihood to be infertile

[(OR= 1.56, 1.26, 1.34 and 1.39), (1.60, 1.34, 1.72 and 1.58) respectively] compared to the presence of

wild type alleles at the respective loci in population from Khyber Pakhtunkhwa.

Conclusion:

This study demonstrated for the first time the importance of mutations in folate metabolism related

MTHFR, MTR and MTRR genes and susceptibility to male infertility among individuals from Khyber

Pakhtunkhwa, Pakistan. Furthermore, the mutations in different folate metabolism related genes

exacerbated the risk of infertility when coupled with smoking and poor diet. Further functional studies

are needed to elucidate the role of folate metabolism related genes by categorizing the infertile men

into various infertility subgroups to understand the pathogenesis of different types of infertility.

3.3 Association study of Inflammatory Genes Polymorphism with susceptibility to Rheumatic Heart Diseases in Population from Khyber Pakhtunkhwa

Uzair Ali and Aqib Iqbal


Rheumatic heart disease (RHD) is an inflammatory cardiovascular disease that develops as a result of

an autoimmune reaction during immune system response to a strep throat causing Group A

Streptococcus (GAS) bacteria. The global burden of RHD is approximately 34.5 million and Pakistan is

among the countries with highest reported cases of RHD due to overpopulation, poor economic and

hygienic conditions and poor life style of people. Single nucleotide polymorphisms (SNP) in several

inflammatory genes have been associated with RHD pathogenesis revealing its genetic background.

Aim:

In the current experiment, the association of SNPs in six inflammatory genes with susceptibility to

rheumatic heart disease including TGF-β1 869TC, IL-6 -174GC, IL-10 1082GA, TNF-� 308GA, IL-1β -

511CT and IL-1Ra VNTR were studied in the population of Khyber Pakhtunkhwa.

Methods:

A total of 30 RHD and healthy control subjects were recruited for this study and the allele and genotype

frequencies were determined by using allele specific polymerase chain reaction (ARMS-PCR)

procedure.

Results:

In univariate logistic regression analysis significant association was found between variant T allele and

genotypes (T/T) of TGF-β1 869T/C [rs1982073]; [p < 0.02 and 0.04, OR (95% CI)=2.25 (1.08-4.60) and

3.70 (1.03-13.60), respectively], the C allele and variant genotype (C/C) of IL-1β -511C/T [rs2853550]; [p

< 0.045 and 0.031, OR (95% CI)= 2.10 (1.02-4.30) and 4.50 (1.09-18.50), respectively] and the G allele

and G/G genotype of IL-6 -174G/C (rs1800795) [p < 0.010 and 0.015, OR (95% CI)= 4.70(1.83-12.10)

and 4.37 (1.32-14.50), respectively] SNPs with RHD risk. In addition, high association of serum C-

reactive protein was observed as rheumatic activity in RHD patients as compared to control where

normal level of CRP was reported (<6mg/dl). No significant variation in the genotypes of IL-1Ra VNTR,

IL-10 1082GA and TNF-alpha 308GA were found among RHD patients and control subjects.

Conclusion: The single nucleotide polymorphism in TGF-β1 869T/C, IL1β -511 C/T and IL-6 -174 G/C

inflammatory genes were found to play important role in susceptibility to rheumatic heart disease

development in our studied population.

3.4 Biallelic variants in DYNC1I2 cause syndromic microcephaly with intellectual disability, global developmental delay and dysmorphic facial features

Muhammad T. Sarwar, Sohail Aziz Paracha, Jamshed Ahmed, Muhammad Ansar, Jawad Ahmed

DYNC1I2 (Dynein Cytoplasmic 1 Intermediate Chain 2) (OMIM#603331) encodes a protein that is part

of the cytoplasmic intermediate dynein 1 complex. It is involved in motor activity of microtubules and

participates in cargo transport. We characterized a consanguineous Pakistani family of three affected

individuals with microcephaly, severe intellectual disability (ID), developmental delay and facial

dysmorphism. Exome sequencing and genotyping identified a homozygous variant in a splice donor

site of DYNC1I2 (NM_001378:c.607+1G>A), predicted to produce an early termination. Through

GeneMatcher, we identified two additional cases from the USA who harbored biallelic deleterious

variants in DYNC1I2: One was a compound heterozygous of p.Tyr247Cys and a complete gene

deletion. The second unrelated case had compound heterozygous variants, p.Gln290Ter and

p.Tyr247Cys. A brain MRI in one affected revealed mega-cisterna magna, absence of the rostrum and

genu of the corpus callosum and the septum pellucidum, and partial absence of the splenium.

Structural analysis suggested that Tyr247Cys disrupts the interactions between light and intermediate

chain of dynein 1 complex; furthermore, it influences protein folding by creating nonnative disulphide

bonds. In sum, we provide strong evidence that DYNC1I2 is a novel cause of an autosomal recessive

microcephaly syndrome with ID and facial dysmorphism. Other members of the dynein complex cause

similar features (DYNC1H1; OMIM#600112), and our data highlight further the importance of the

dynein complex in neurodevelopment.

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3.5 Evaluation Of Serotonin Transporter Gene Insertion/Deletion Polymorphism As A Risk Factor Of Coronary Artery Disease In Population Of Khyber Pakhtunkhwa

Muhammad Shehzad Saleem, Dr. Zahid Khan

Background: Serotonin, a derivative of tryptophan acts as an agonist to platelets in blood clotting and

induces platelets aggregation. Serotonin is transported by serotonin transporter protein into the

platelets granules. Serotonin transporter gene polymorphism affects the transport of serotonin and

thus effect the amount of serotonin in the platelets. The polymorphic variant results in long and short

alleles. The dominant short allele is associated with production and transcription of fewer serotonin

transporters and vice versa. The long allele has been associated with increased platelet activation and

risk of coronary artery disease.

Methods: Total of 220 samples including patients (116) and controls (104) were genotyped for

the insertion/deletion polymorphism. Platelet aggregation was assessed by bleeding time and

compared with short and long allele.

Results: Serotonin transporter gene polymorphism was a significant determinant of bleeding

time. Insertion genotype predicted in decrease bleeding time due to more platelet aggregation.

The insertion genotype was present at a significantly higher frequency in patients <55 years old

compared with controls (P=0.0002; OR= 5.74, 95% CI= 2.32-14.18). The odd ratio for the patients

>55 years has a non significant value (P=0.0094; OR= 0.30, 95% CI= 0.12-0.74).

Conclusion: Younger patients with coronary artery disease having homozygous insertion genotype

carried about 1/3 of our population. The insertion genotype is also associated with decrease bleeding

time. Serotonin transporter gene polymorphism in platelet aggregation may be a contributing

mechanism.

3.6 Whole Genome Sequencing instead of Whole Exome Sequencing is required to identify the Genetic Causes of Polycystic Ovary Syndrome in Pakistani families

Muhammad Jaseem Khan, Rubina Nazli, Jawad Ahmed, Sulman Basit

ABSTRACT

Background & Objective: Polycystic Ovary Syndrome (PCOS) is the major cause of infertility in

females.

PCOS is a complex and multifactorial disease, genetic and environmental factors being important

predisposing factors. Diagnosis of PCOS is difficult due to the complexity of this disease; hence, better

diagnostic tests are required to improve its management. Aim of the study was to elucidate the genetic

causes of PCOS in three Pakistani families.

Methods: Three Pakistani families segregating PCOS in an apparently autosomal recessive mode were

recruited. Whole genome Single Nucleotide Polymorphism (SNP) genotyping and Whole Exome

Sequencing (WES) were carried out to identify the candidate genes.

Results: SNP genotypes data analyses identified multiple regions of homozygosity on different

chromosomes. WES was performed in affected members of the family. Screening for pathogenic

mutations in homozygous regions failed to detect any mutation/variant of interest.

Conclusion: PCOS is multifactorial and complex disease so variants in the coding as well as in non-

coding

regions may be the genetic causes of the disease. To elucidate the genetic cause(s) of the PCOS, Whole

Genome Sequencing (WGS) is recommended to cover both coding and non-coding regions of the

genome.

3.7 A novel recessive frame-shift variant in the LHCGR gene is associated with primary ovarian insufficiency in a Pakistani family

Amanda Colvin Zielen, Muhammad Jaseem Khan, Nijole Pollock, Huiayang Jiang, Rubina Nazli, Jawad

Ahmed, Musarat Jabin, Alexander Yatsenko, Aleksandar Rajkovic

ABSTRACT:

Primary Ovarian Insufficiency (POI) is a genetically heterogeneous condition characterized by

hypergonadotropic hypogonadism, amenorrhea, and infertility. In this study, we investigated a

consanguineous Pakistani family with two daughters displaying primary amenorrhea, elevated

LH/FSH levels, atrophic uteri, reduced ovarian reserves, and normal 46, XX karyotypes. Whole exome

sequencing analysis of five family members (parents, two affected daughters, and one unaffected

daughter) revealed a novel frame-shift variant in the luteinizing hormone/choriogonadotropin

receptor (LHCGR) gene. Affected daughters were homozygous for a likely pathogenic variant

(c.709delC, p.Leu237fs). This loss of function variant, located in exon 9 of LHCGR affects the

extracellular domain of the receptor; more specifically, at a conserved residue in the eighth leucine rich

repeats. Seven other variants in LHCGR have previously been reported to be associated with female

infertility, and none were in the extracellular domain. Our study describes a novel POI-associated

variant in the LHCGR extracellular domain, and further supports the importance of LHCGR function in

female reproduction across ethnicities.

Scientific Session A (4)HUMAN METABOLOMICS: COUCH POTATO

4.1 Effect of omega 3 fatty acids on lipid profile in healthy volunteers

Naheed Junnet, Rubina Nazli, Sadia Fatima

Fatty acids are organic acids. Omega 3 fatty acids having Carboxyl group (COOH terminal) and

aliphatic chain with double bonds known as polyunsaturated fatty acids (PUFA). These are especially

found in fish oil, vegetable oils, canola oil, linseed oil and walnuts. Omega 3 fatty acids may reduce

lipid.

Omega 3 fatty acids fish oil supplements decrease the level of bad cholesterol and increase the level of

good cholesterol from lipid profile.

Omega 3 fatty acids fish oil capsules may decrease total cholesterol (TC), triglycerides (TG), very low-

density lipoprotein cholesterol (VLDL-C), low density lipoprotein cholesterol (LDL-C) and may increase

high density lipoprotein cholesterol (HDL-C).

The study was undertaken on 100 healthy volunteers.100 healthy volunteers not using omega 3 fatty

acids supplements and without a personal and family history of hypertension, diabetes mellitus,

cardiovascular diseases, familial tendency of obesity and smoking were selected.

Serum lipids were analyzed enzymatically by using chemistry auto analyzer, and Omega 3 Fatty acids,

eicosapentanoic acid (EPA) and docosahexanoic acid (DHA) were measured by Gas Chromatography

mass sepectrometery (GC-MS).

The quasi experimental/analytical study was conducted in the COMLABS at COMSATS Institute of

Information Technology University Abbottabad (CIIT). The analytical work was done in COMSATS

Institute of Information Technology University Abbottabad and in Institute of Basic Medical Sciences

Khyber Medical University, Peshawar.

Our study showed that a positive decrease in bad cholesterol of lipid profile of healthy volunteers after

using omega 3 fatty acid fish oil capsules about one month. A significant association present between

lipid profile and omega 3 fatty acid fish oil capsules. Our study demonstrates the need to do these

53 54





parameters and proper physical checkup of the healthy volunteers before prescribing omega 3 fatty

acid fish oil capsules analyse periodically at each visit specially those who are on these supplements for

long time. Our study will help the physician to reduce the lipid profile in healthy person to upcoming

heart problems and so many others health problems related to lipid profile. And preventing the

cardiovascular disease in people by prescribing the correct dosage, duration of usage, and proper

checkups before prescribing omega 3 fatty acid fish oil capsules and recommended to provide third

generation omega 3 fatty acid fish oil capsules with less side effects to family department.

4.2 Serum Soluble Endoglin levels as a predictor of preeclampsia

Asma Mehmood, Rubina Nazli,

Abstract

This cross sectional study was performed on 138 pregnant women attending the gynae and

obstretics department of tertiary care hospital lady reading hospital Peshawar . A total of 138

pregnant women in their 27th to 30th week of gestation were registered in the study after

taking their informed consent.

The study group was divided into two groups , one is patient group with hypertension of

greater than 140 and 90 and proteinuria of greater than 300 mg in 24 hours . The other group

with normal pregnancy as control group.

History of patient was recorded on predesigned questionnaire . Patients with kidneys diseases

and chronic hypertension ,diabetes etc were excluded from the study. Weight ,height , blood

pressure and urinary albumin was measured . 5ml of venous blood was taken by aseptic

technique from both groups . 3ml blood was transferred to gel tube for the determination

serum soluble endoglin and 2ml blood was used for the determination of hemoglobin and platelet

count.

The blood in gel tube was centrifuged at 1000 rounds per minute and serum soluble endoglin

levels were stored at minus 20 centigrade. Serum soluble endoglin levels were determined by

elisa technique performed at institute of basic medical sciences Khyber medical university

Peshawar.

For data analysis computer software package spss version 16 was applied. Statistically high

association of less than 0.001 was observed between serum soluble endoglin and preeclampsia.

Association between endoglin and proteinuria ,systolic and diastolic blood pressure ,platelet

count hemoglobin and BMI was found to be significant with a p-value of less than 0.005.

4.3 The clinical outcomes of high-caloric Lipid-based nutritional supplements on Energy Intake and Lipid Profile of Moderate Underweight Children: A Randomized control trial

Aqsa Zubair, Sadia Fatima, Fouzia Nawab, M. Jaffar Khan, Rubina Nazli

Rationale: Lipid based nutritional supplements (LNS) strategies might improve undernourishment in

children from low and middle-income countries (LMICs). This study aims to investigate the effect of

four weeks of LNS on energy intake and lipid profile of moderately underweight children.

Methods: Thirty-four moderate underweight children with BMI-Z score between -2 SDS and -3 SDS

and age 5-10 years (mean ± SDS 7.08 ± 1.47 years) were recruited. The participants were randomized

into LNS and Placebo group for two main trial days at clinical trial room. On 1st trial day, baseline

fasting blood samples and anthropometric measurements were obtained. Then they were served

either LNS (535kcal) or Placebo (90kcal). An ad libitum buffet breakfast and ad libitum buffet lunch was

provided 90 and 240 minutes post supplementation to measure the energy intake. In addition, the

participants received LNS and Placebo as supplements to their regular diet for four weeks. After

supplementation, on 2nd trial day, anthropometric measurements and fasting blood samples were

collected.

Results: Comparison of data showed that before and after four weeks of supplementation, on both

trial days, the energy intake was significantly increased (P<0.001) in LNS group as compared to

Placebo. Similarly, there was a significant increase in weight (P< 0.001), mid upper arm circumference

(P=0.005) and BMI-Z score (P= 0.002) in LNS group as compared to Placebo. The Hb (P=0.007), fasting

glucose (P=0.005) and total cholesterol (P= 0.005) were also significantly higher in LNS group.

Conclusion: LNS is effective in improvement of nutritional outcomes and increases the energy intake.

However, it induces hyperglycemia and hyperlipidemia if consumed for a longer period.

4.4 Impact of High Energy Lipid-based Nutritional Supplements on Energy Intake and Micronutrient Status in Moderate Underweight Children: A Randomized control trial

Fouzia Nawab, Sadia Fatima, Aqsa Zubair, M. Jaffar Khan, Rubina Nazli

Background: Lipid-based nutritional supplements (LNS) have been proposed as a nutritional

intervention for the treatment of micronutrients malnutrition which is a major public health issue

affecting children in developing countries. This study examines the effect of four weeks of LNS on

energy intake and micronutrient (Fe, Cu, Zn) status in moderately underweight children.

Methods: Thirty-four moderately underweight children (5-10y) with BMI-Z score between -2 and -3

SDS were randomized into LNS and PLACEBO groups. On 1st trial day, baseline fasting blood samples

and anthropometric measurements were obtained. Later they were served with LNS (535kcal) or

PLACEBO (92kcal). For measuring energy intake, ad libitum buffet breakfast and lunch was given at 90

and 240 minutes post supplementation respectively. Participants then receive LNS and PLACEBO as a

supplement to their regular diet. After four weeks of supplementation, on 2nd trial day, again fasting

blood samples were collected and anthropometric measurements and energy intake was recorded.

Results: After four weeks of supplementation, the energy intake (P<0.001), weight (P< 0.001), mid-

upper arm circumference (P=0.005) and BMI-Z score (P= 0.002) were significantly increased in LNS

group as compared to Placebo. Similarly, Hb level (P=0.007) was significantly raised in LNS group.

Increase in plasma concentration of iron was also highly significant (P<0.001) however, a non-

significant increase was observed in the level of copper in LNS.

Conclusion: LNS is effective in improvement of nutritional outcomes and micronutrient levels,

however, it remains unclear to what extent LNS alone can be used to improve micronutrient status

among children. Moreover, LNS also increased the energy intake on main trial days.

Recommendation: Nutritional programs should be adjunct with nutritional counseling regarding

dietary adequacy and supplement use which can be used as an effective strategy for addressing

nutritional problems in children.

4.5 Frequency of Dyslipidemia in Young Overweight and Obese Students (Age 10-16 Years) in Private Schools of Swat Pakistan

Prof. Dr. Rubina Nazli,, Dr. Fawad Ali Khan. Dr. Sadia Fatima, Aqsa Zubair

Abstract:

Background: Obesity is a chronic health problem which can manifest itself well before adulthood. The

prevalence of overweight and obesity in children has increased throughout the world. The lipid

abnormalities in obese children lead to dyslipidemia which is a potential risk factor for CV diseases and

Diabetes. Thus, the objective of the current study was to estimate the frequency of Pediatric

dyslipidemia by determining the serum lipid concentration in overweight and obese children.

55 56





Methods: It was a questionnaire based cross-sectional study conducted in three private schools of

district Swat over a period of 6 months. Study analysis was done in Research laboratories of

Biochemistry Department, Institute of Basic medical Sciences (IBMS), Khyber Medical University

Peshawar. Well-designed questionnaires were used for screening of 99 out of 1374 students, including

both girls and boys. Anthropometric measurements were taken. Blood samples were collected for the

analysis of serum lipids using an Automated Cobas Analyzer. SPSS version 20, Student's t test and

Logistic regression method was used for statistical analysis.

Results: The prevalence of dyslipidemia was measured to be 42.4%. Significant direct association was

found between the rate of dyslipidemia and BMI. Highly significant P values were found for serum

lipids in obese children as compared to overweight children thus showing strong association between

the biochemical Parameters and BMI. Even though rate of dyslipidemia was measured to be a little

higher in boys as compared to girls, no statistically significant gender differences were found in serum

lipid levels.

Conclusion: Reduce long-term complications in adulthood is possible through controlling the serum

lipid levels of children and adolescents

4.6 Use of probiotics in antibiotic associated diarrhea

Kiran Konain, Hafsah Muhammad, Roshan Ali, Tayyab Ur Rehman


Probiotics are microorganisms that are incapable of causing disease and when consumed, they impact

the host positively. Using antibiotics to treat infections of the GIT can affect GIT micro flora. Therefore,

using Probiotics may help to restore ordinary bacterial microflora. The addition of useful bacterial

species to the GIT may be an effective method to prevent disease and to restore the microbial

equilibrium. Mostly used bacterial genera in the preparation of probiotics i.e. Escherichia, Bacillus,

Streptococcus, Bifidobacterium, Lactobacillus, and Enterococcus. Moreover, few strains of fungi

belonging to Saccharomyces are also utilized in probiotics preparation.

Aim

To find out results of different probiotics used in antibiotic associated diarrhea and to determine its

effect in this treatment.

Methods

Administration methods: the method of administration by which microorganisms that can be utilized

as probiotics involves different strategies such as probiotics supplements, yogurt and milk

Patient selection and data collection: the hospital staff will distinguish between potential patients. A

proper informed consent was acquired and initial information will be collected.

Prescription of probiotic supplement: Randomized study drinks will be prescribed to the selected

patients.

Conclusion

Probiotics can affect the gut micro-flora utilizing different mechanisms. There is a wide range of

different probiotics in existence and every single one of them possesses its own effects. As these

probiotics can decrease the rate of antibiotic associated diarrhea, probiotics supplements can be used

effectively for its treatment.

4.7 Serum visfatin level and its relationship to anthropometric and metabolic parameters in pregnancy complicated by hypertension.

Asmat Shaheen, Tanveer Shafqat ,Rubina Nazli, Sadia Fatima ,Muhammad Jaffar

Abstract

Back ground

Preeclampsia remains a serious and poorly understood complication of pregnancy, identification of

epidemiological and clinical risk factors to predict PE, before it threatens the survival of both mother

and fetus, is required.

Human adipose tissue is an important regulator of endocrine functions through its multisystem effects

such as through the secretion of plasma adipocytokines. Out of these visfatin, dysregulation

participates in the pathogenesis of obesity-associated disorders such as type 2 diabetes,

hyperlipidemia or hypertension, preeclampsia and small for gestational age.

Objectives

The purpose of the current study is to investigate the relationship of serum visfatin level, with

haematological parameters, liver function tests, serum electrolytes, and plasma lipid profile in

preeclampsia and eclampsia in 3rd trimester women

Methods

This was a cross sectional study conducted in three tertiary care hospitals of Peshawar. Serum visfatin

levels (ng/mL) were determined by enzyme linked immune sorbent assay Haematological parameters,

liver function tests and serum electrolytes were determined by Sysmex haemotolgy analyzer

(Automated hemotology analyzer). The blood urea and Lipid parameters were determined by

automated chemistry analyzer in PGMI-LRH by using enzymatic kits of Roche diagnostics. BMI was

calculated using weight and height values. For data MINITAB® version 17 was used for further

analysis. Data was presented as median and interquartile range (IQR).

Results. A strong positive and statistically significant association of visfatin was observed for monthly

income (R2=7.75 and p-value <0.001). Similar result were obtained for still birth, caesearen section,

low birth babies, family history of hypertention, systolic and diastolic BP, serum visfatin, serum

albumin, serum ALP, serum chloride, serum HDL, serum LDL. Ratios ofTC:HDL-C , LDL:HDL,TG:HL and

VLDL:HDL were having a positive and significant correlation.

Conclusion. Serum visfatin was significantly associated with hematological parameters, liver function

tests, serum electrolytes, and plasma lipid profile.

4.8 Effect of Duration of Use of COCs on serum Lipid Profiles, Fasting Blood Sugar, Blood Pressure and BMI in Child Bearing Age Women

Dr.Nabila Sher, Dr Rubina Nazli

Background: Combined Oral Contraceptives Pills (COCs) are effective and widely used method for

contraception.There is a positive relationship between COCs and lipid and carbohydrate metabolism

in previous studies. We haveseen the effect of duration of COCs (0.3mg norgestrel and 0.03mg ethinyl

estradiol) used in tertiary care hospitals ofPeshawar Khyber Pukhtunkhawa Pakistan on the lipid and

carbohydrate metabolism in women taking combined oralcontraceptives.Study Design: This cross

sectional analytical study included 100 participants women of child bearing age 14-49yrsusing COCs

divided in three groups according to the duration of use group A at least 6 month COCs users, groupB

were 1 year COCs users , group C more than 1 year COCs users. Serum Total cholesterol (TC) ,

triglyceride (TG),high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol

(LDL-C), very low density

Methods: lipoprotein cholesterol (VLDL-C), fasting blood sugar(FBS) were determined by using

standard colorimetrictechniques BMI and BP were also measured in all subjects. Their levels were

found gradually increasing from6months to those who are using it for 1 year and more than 1year.

Results: To estimate the effect of duration of use of combined oral contraceptives on the levels of

differentbiochemical parameters, the results showed significant elevation of cholesterol (p-0.0003 ),

HDL-C (p-0.0229),LDL-C (p-0.0271),VLDL-C (p- 0.0004), Triglycerides (p- 0.0006) levels in the group of

more than 1 year userfemales when compared with 6 months users.

57 58





Conclusion: The levels of cholesterol, HDL, LDL, VLDL and Triglyceride levels were found to be

increased withthe duration of use in the women of child bearing age of Khyber Pukhtunkhwa.

Scientific Session A (5)TRUE BLOOD: LIGHT YEARS AHEAD

5.1 Updates on the diagnosis and management of Acute Myeloid Leukaemia

Dr Natasha Ali, Department of Haematology, Agha Khan University Hospital, Karachi

Intensive chemotherapy followed by autologous stem cell transplantation is the treatment of choice

for patients with hematological malignancies. The objective of the present study was to evaluate the

outcomes of patients with mainly lymphoma and multiple myeloma after autologous stem cell

transplant. The pretransplant workup consisted of the complete blood count, an evaluation of the liver,

kidney, lung, and infectious profile, chest radiographs, and a dental review. For lymphoma, all patients

who achieved at least a 25% reduction in the disease after salvage therapy were included in the study.

Mobilization was done with cyclophosphamide, followed by granulocyte colony-stimulating factor,

300 µg twice daily. The conditioning regimens included BEAM (carmustine, etoposide, cytarabine,

melphalan) and high-dose melphalan. A total of 206 transplants were performed from April 2004 to

December 2014. Of these, 137 were allogeneic transplants and 69 were autologous. Of the patients

receiving an autologous transplant, 49 were male and 20 were female. Of the 69 patients, 26

underwent transplantation for Hodgkin's lymphoma, 23 for non-Hodgkin's lymphoma, and 15 for

multiple myeloma and 4 and 1 for Ewing's sarcoma and neuroblastoma, respectively. The median age

± SD was 34 ± 13.1 years (range, 4–64). A mean of 4.7 × 108 ± 1.7 mononuclear cells per kilogram were

infused. The median time to white blood cell recovery was 18.2 ± 5.34 days. Transplant-related

mortality occurred in 10 patients. After a median follow-up period of 104 months, the overall survival

rate was 86%. High-dose chemotherapy, followed by autologous stem cell transplant, is an effective

treatment option for patients with hematological malignancies, allowing further consolidation of

response.

Conclusion:

This report presents the results of autologous stem cell transplant in hematological malignancies from

a developing country. This is a large cohort from Pakistan, with overall survival comparable to that from

international data.

5.2 Personalized management of Haemaophilia

Dr Shabneez Hussain, Fatmid Foundation

Background: Patient registry is a powerful tool for planning health care and setting groundwork for

research.

Methods and results: This survey reports a detailed registry of inherited bleeding disorders (IBD) and

their management at a not-for-profit organization in a developing country to form the basis for

planning development and research. We reviewed medical records of patients with IBD from 8

hemophilia treatment centers of Fatimid Foundation located in various cities. Information collected

included sociodemographic data, diagnostic tests, severity of hemophilia A and B, number of bleeding

episodes per year, site and frequency of hemarthrosis, and seropositivity for viral diseases. We

analyzed 1497 patients from November 1, 2015, to April 30, 2016. There were 1296 (87%) males and

201 (13%) females with a mean age of 24.5 (11) years (range, 6 months to 65 years). Hemophilia A

constituted the bulk of IBD (848, 57%) followed by von Willebrand disease (172, 11%), hemophilia B

(144, 10%), platelet function defect (106, 7%), and rare bleeding disorders (70, 5%). Mucocutaneous

bleeding (1144, 76%) and hemarthrosis (1035 patients, 69%) were the main complications. There were

1026 (69%) patients who received only blood components for treatment of any bleeding episode while

the remaining 464 (31%) were on combination therapy (blood components and factor concentrate).

Seroreactivity for hepatitis C was frequent (28%), while hepatitis B (1%) and human immunodeficiency

virus (0.01%) were less commonly seen.

Conclusion: This study was an important step toward a patient registry in a hemophilia treatment

center in Pakistan. Hemophilia A is the most common bleeding disorder and hepatitis C is the most

frequent treatment-related complication.

5.3 Time dependent morphological changes in Red Blood cells during storage

Syed Tahir Ali Shah, Najma Baseer, Yasar Yousafzai

Background of the Study: Blood is a specialized connective tissue in which cells are suspended in

fluid plasma. Blood is composed of plasma and cells such as red blood cells, white blood cells and

platelets. Human erythrocyte is a flexible non nucleated biconcave disk. The blood is routinely stored in

CPDA-1 solution. During storage the blood passes through different morphological, structural and

metabolic changes. These changes are called storage lesions. In this study we stored blood in CPDA-1

at 2 to 6 °C for 20 days.

Aim: To assess various red cell parameters like osmotic fragility, hemoglobin, MCV, MCH, MCHC and

correlate them with the morphological changes.

Methods: This is experimental study of 6 months duration. A total 20 healthy blood donors-Blood

bags were taken, ten from each center i.e. MMCTH blood bank Mardan and KTH blood bank Peshawar.

The blood samples examined at 5 days interval till 20th day.

Results: In this study we observed the significant changes in RBCs and haemoglobin levels, where

insignificant changes in MCV, MCH and MCHC on day 0,5th, 10th,15th and 20th . The significant

changes were observed in morphology in stored RBCs examined by light and scanning electron

microscope on day 5th of blood storage. The osmotic fragility increased over period of time.

Conclusion: We observed the significant hematological and morphological changes, when blood

stored for up to 20 days. These findings suggested that approximately a week old stored blood is as

good as the fresh blood.

5.4 Transfusion of blood-bank stored blood to transfusion dependent thalassemia patients

Dr Usman Naeem, Dr Usman Naeem, Dr Najma Baseer, Dr Tariq Masood, Dr Yasar Yousafzai

Background: Audit of blood utilization helps in effective management of blood stock to meet present

and future demands.

Objective: To determine utilization of blood and its components in a Tertiary care hospital.

Material and Methods: A retrospective audit was carried out in Blood Bank at a Tertiary Care Hospital

of Pakistan from January 2017 to December 2017. Included all consecutive patients who were admitted

and received blood components transfusion in inpatient, emergency and ICU departments. All

transfusions included in this study were allogenic. Children registered in thalassemia center receiving

transfusions were excluded from the study. The frequency of whole blood, packed red blood cells

,fresh frozen plasma and platelet utilization was calculated.

Results: In our study a total of 28963 blood and its components were utilized for inpatients at tertiary

care hospital. Whole blood transfusion (41%) were maximum done followed by Packed red blood cells

(25%). Male patients (57.5%) had received maximum transfusions as compared to females

59 60





(42.4%).Most blood transfusions were seen in the age group of 20-50 years. The clinical specialty which

required high rate of utilization of blood and its components was Medicine (23.3%). Maximum RBC

transfusions were prescribed by Gynaecology and Obstetrics (23.8%) while highest Platelets and FFPs

transfusions were seen by Medicine (43.1%) and Gynaecology & Obstetrics (23.1%) respectively.

Conclusion: The high rate of utilization of blood and its components in our study reinforces the

importance of justified use of blood and its components in the clinical practice by implementation of

guidelines of use of various blood products to meet demands keeping in view shortage of valuable

blood components.

5.5 Utilization Of Blood And Its Components – experience from a tertiary care centre

Dr Nadia Altaf, Dr Shahtaj Khan, Afzal Shah, Department Of Pathology Hayatabad Medical Complex ,

Peshawar-Pakistan.

Background: Audit of blood utilization helps in effective management of blood stock to meet present

and future demands.

Objective: To determine utilization of blood and its components in a Tertiary care hospital.

Material and Methods: A retrospective audit was carried out in Blood Bank at a Tertiary Care Hospital

of Pakistan from January 2017 to December 2017. Included all consecutive patients who were admitted

and received blood components transfusion in inpatient, emergency and ICU departments. All

transfusions included in this study were allogenic. Children registered in thalassemia center receiving

transfusions were excluded from the study. The frequency of whole blood, packed red blood cells

,fresh frozen plasma and platelet utilization was calculated.

Results: In our study a total of 28963 blood and its components were utilized for inpatients at tertiary

care hospital. Whole blood transfusion (41%) were maximum done followed by Packed red blood cells

(25%). Male patients (57.5%) had received maximum transfusions as compared to females

(42.4%).Most blood transfusions were seen in the age group of 20-50 years. The clinical specialty which

required high rate of utilization of blood and its components was Medicine (23.3%). Maximum RBC

transfusions were prescribed by Gynaecology and Obstetrics (23.8%) while highest Platelets and FFPs

transfusions were seen by Medicine (43.1%) and Gynaecology & Obstetrics (23.1%) respectively.

Conclusion: The high rate of utilization of blood and its components in our study reinforces the

importance of justified use of blood and its components in the clinical practice by implementation of

guidelines of use of various blood products to meet demands keeping in view shortage of valuable

blood components .

Scientific Session – B (6)RESEARCH COCKTAIL

6.1 Role of Dissection in Undergraduates

Prof. Dr Maqbool Ilahi, Head of department Anatomy, Northwest Medical School, Peshawar


Human cadavers allow medical students to observe muscles, bones and organs in a life sized mode.

This gives students a more accurate perspective of size and location that cannot be obtained using

computer models and text books. The study of gross anatomy in early times of medical education was

based around cadaveric dissection as it was the only available method of three dimensional studies of

the gross anatomical structures. With the passage of time many changes were made in the medical

school curricula that resulted in fading away of traditional dissection in our medical schools

Aim:

To discuss the advantages of cadaveric dissection in the current technology world.

Methods:

Review of articles based on advantages and shortcomings of dissection in undergraduate studies

A Pub med and Google scholar search was conducted using two key words cadaveric studies and

undergraduate curriculum. Boolean command AND and OR were used. Twenty articles were finally

selected based on availability of full text.

Conclusion

Many medical graduates continue their professional careers as general practitioners, some specialize

in surgery-or medicine- allied fields, the rest adopt teaching as a career. It is a common anecdotal

argument that graduates who do not become surgeons or anatomy teachers' do not need extensive

dissection skills. However in today's medical world the sub specialties in interventional medicine, such

as cardiology, gastroenterology, nephrology and pulmonolgy require a good knowledge of human

body for the safe procedural practice. At the very least, a sound knowledge of anatomy would behove

practitioners to understand patient's symptoms and relate them to the organs involved.

6.2 Genome Editing and Nanoscience, the Arising Debates in Safe Science

Dr. Nadia Batool Zahra, AP, Qarshi University, Lahore

The cutting edge and rapidly growing technologies of genome editing and nanosciences are

revolutionizing the science but the moral dilemmas associated with the advent of these technologies

can temper with the human dignity. Genome editing and nanoscience is giving way to novel avenues

of theranostics including prevention, diagnosis and treatment. The genome editing is highly regulated

in both US and UK but it is not illegal to edit one's own DNA. The recent experiment of an ex-NASA

worker JOSIAH ZAYNER has made him the first known person to have edited his own DNA with the

CRISPER tool in a bid to make himself a super-human, with boosted strength and senses. However,

what will be the ethical and societal implications of such technology in future? Research innovations

through nanoscience on the interface of various convergent disciplines like medicine and smart

materials has exciting applications but at the same time raises a dual use dilemma and dual use

research concerns (DURC). The slogan of “size matters” in nanotechnology is ambivalent. Where it

makes the nanotechnology attractive, it also raises the concerns of unforeseen novel hazards of these

nano-structured materials. The promotion of professional auto regulation and personal integrity as a

core ethical value is of paramount importance. It implies a global strategy because now the science is

hugely transnational, particularly the science in developing countries including Middle East and South

Asian region where there is deficit in political freedom and lack of infrastructure which may influence

the environment in which research is conducted. Extreme poverty and varied politico-economic

structures of this region has heightened the imbalance in the research environment among the high

income countries and the medium-low income countries. Similarly, the concepts of bioethics

prevailing in Western countries are not applicable in the countries having dissimilar religious, social

and cultural values. There is a dire need to define regional ethical policies to promote the safe and

secure science in the developing region.

6.3 Tiny technologies for healthcare applications

Dr. Shah Rukh Abbas, AP, NUST Islamabad

Tiny technologies; micro and nano-sized constructs, are being developed and investigated for many

healthcare related applications such as diagnostics and therapeutics. Gas/air core microbubbles have

been successively used as effective Ultrasound contrast agents. Commercially available contrast

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agents are mostly phospholipid or protein based which suffer from polydispersity and stability issues.

Improvements have been considered by employing different organic and inorganic materials for the

shell component in micro constructs; however, safety concerns still limit their application as USCAs for

in vivo use. Micron and/or nanoparticles from natural polymers and liposome composites, are

developed and investigated for their drug delivery applications in tumor and angiogenesis

environment. In addition to colloidal synthesis, polymeric composites are being investigated for use in

biosensing disease analytes are thus developed for use in biosensor applications.

The talk will cover how natural materials, chitosan and alginate, can be used to fabricate these tiny

technologies: micro and/or nano-bubbles and use them as a potential Ultrasound contrast agent

(USCA) for both passive and active targeted imaging, and drug delivery applications, and

nanocomposite synthesis for biosensor applications. The author is inspired to explore Nanoconstructs

from natural materials in Pakistan to device cost effective biosensors and imaging agents for heathcare

applications.

6.4 Phage therapy, Synthetic sRNA and Quorum Quenching; the futuristic strategies to combat bacterial infections

Dr. Fazal Adnan, Atta ur Rahman School of Applied biosciences (ASAB) NUST Islamabad

The emergence of resistance in bacteria against antibiotics and the dwindling number of new

antibiotics pose a double threat to our continued protection from bacterial pathogens.

Advancement in the field of functional genomics has led to many evidences that small regulatory RNA

plays a pivotal role in gene regulation in all living organisms. In bacteria, sRNA are non-coding

transcripts (50 –300 nucleotides) that recruits RNA chaperone proteins, majorly the Hfq, and affects

mRNA stability and expression level. These natural sRNAs have inspired the design of synthetic trans-

acting RNA molecules to efficiently control gene expression in microorganisms. Reversion of antibiotic

resistance using synthetic RNAs can be a potential tool in combating antibiotic resistance in

pathogenic bacteria. The enterohemorrhagic E. coli (EHEC), a cause of worldwide outbreaks is a food

borne pathogen. Its strong pathogenicity is due to virulence factors such as shiga toxin 1 (Stx- 1) and

shiga toxin 2 (Stx-2), commonly known as Vero toxins owing to their cytotoxic effect on vero cell lines.

In our study, effect of anti-shiga sRNA on the mRNA level of the target gene was determined by

quantitative real time RT-PCR, while toxin level was verified via MTT cell viability assay. Synthetic sRNA

could be a revolutionary approach for targeting multidrug resistant bacteria. Interrupting expression

of resistance genes using synthetic sRNA, we can not only restore the antibiotic susceptibility of these

bacteria extending the lifespan of existing antibiotics but can also efficiently eradicate their infections

sustainably.

Quorum sensing (QS) is a communicating mechanism among bacteria and a vital factor in enhancing

resistance against most of the antibacterial agents. Gram-negative bacteria have been reported to use

N-acyl homoserine lactones (AHLs) as QS signals. This cell-cell communication system plays a critical

role in the coordination of their gene expression and thus in the formation of the biofilms. Therefore,

quorum quenching (QQ) is a promising new alternative for the control of infections in multi-drug

resistant bacteria. It is basically enzymatic interruption of QS and poses fewer resistance risks. In one of

our study, bacterial strains were isolated and its QQ ability was analyzed against the pathogenic

Pseudomonas aeruginosa. Specific genes encoding the QQ enzymes were screened and confirmed via

sequencing. Strategy for enhanced production of these enzymes in E. coli was devised and proceeded

for further evaluation. Our results has predicted and verified the AHL degrading enzymes, lactonases

and acylases in the novel identified bacterial strains.

6.5 Is Suicidal and Homicidal impact being due to Toxoplasma Gondii Infection? Evidences from target subjects' investigation

Prof. Dr Aziz Marjan, Jaffar Khan2

1: Professor of Pathology KIMS 2: Assistant Professor KUST

Background: Suicides and homicides are day to day problems not only of medical but also of social

sciences. Beyond mental disorders different typologies have been related with these acts

Aim: In the evidence based medicine, microbiological factor e.g. Toxoplasma Gondii (Toxo. gondii)

may play some role to ignite.

Methods: This study was conducted in the department of Pathology KIMS, during September 2013 to

August 2014. Imprisons (suicides, homicides) and controls from different rural localities in Kohat and

Karak. Blood samples were collected after consent and inclusion criteria. Anti-toxoplama gondii

immunoglobulins G (ATG-IgG) were confirmed by ELISA quantitative. Statistically analysis done by

SPSS version 22.

Results: Imprisons as cases, there were 30 male and 25 females and control enrolled were 18 males

and 23 females. The mean of ages cases was 35.05±13.08 years and Controls 36.24±10.84 years. The

two groups were age match statistically (P value more than 0.05).

Seropositivity for cases was 49.09% and for controls 43.90%. The mean value of ELISA of ATG-IgG in

55 Cases was 45.32±51.68 and in 41 as Controls was 33.60±29.80 IU/ml. The mean values of ELISA for

Cases and Controls were statistically insignificant (P value was > 0.05). ELISA mean value of ATG-IgG in

Imprisons groups homicides was 58.14±64.24 and in suicides was 32.96±32.32 IU/ml. Mean values of

ATG-IgG ELISA of homicides were compared with that of controls, there was significant difference (P

value .04).

Scientific Session B (7)NEURONS & HARMONES: ITS NOT ROCKET SCIENCE

7.1 Psycho-neurological Impediments in Diabetes Mellitus

Saara Ahmad Muddasir Khan, Asra Khan, Zehra Batool, Saida Haider


Diabetes mellitus (DM) is the most common serious metabolic and endocrine disorder characterized

by hyperglycemia resulting from decreased insulin production/secretion resulting impaired fat

metabolism, hypercholesterolemia and structural and functional neuronal disorders due to reduced

serum tryptophan transport through blood brain barrier decreasing serotonin production in brain.

Aim

This study was designed to determine an association of diabetes mellitus and hypercholesterolemia

with depression.

Methods

This case-control study involved 30 patients diagnosed with type 2 Diabetes Mellitus (DM) and

hyperlipidemia (HL), and 30 non-diabetic healthy individuals having normal glucose tolerance test and

no other co-morbidity. All subjects were of average 40 years of age. Blood samples from all

participants were collected for determination of the serum tryptophan levels through HPLC-EC

method. PHQ9 score questionnaire for depression was asked from all subjects.


Patients suffering with diabetes mellitus and hypercholesterolemia significantly reduced serum

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tryptophan levels and higher incidence of depression compared to healthy subjects (p<0.05).

Conclusion (or significance of the study, if it's a proposal)

Depression with reduced serum tryptophan was more prevalent in diabetic and hypercholesterolemic

patients.

7.2 Protective role of glutathione against Oxaliplatin induced neurotoxicity in adult mice

Dr Pashmina Shaikh

Oxaliplatin (Ox), is a drug of choice in colorectal cancers and other tumors. Adverse effects include

peripheral Neuropathies, neurotoxicity, ototoxicity, weight loss and GIT Symptoms. The antioxidants

have been used to reduce the toxicities produced by chemotherapeutic drugs. This study is aimed to

assess the preventive role of glutathione on Ox induced neurotoxicity of adult albino mice. The study

was conducted at Anatomy department LUMHS and animal House Sindh Agriculture University Tando

Jam for the period of 1 year. Adult mice of 32 to 35g were divided into 3 groups and were given divided

doses for 8 weeks. GROUP A (control), GROUP B: OX treated mice (0.02 mg/sc), GROUP C: mice given

OX (0.02 mg/sc with glutathione 500mg/PO). Gross examination and behavioral tests were observed

during the whole duration. On histological examination, the control group showed normal

arrangement of cells in all areas of the brain, however group B showed diffuse and focal infiltration of

lymphocytes, focal area of necrosis, gliosis, astrocytosis, apoptosis and increased cellularity and

fibrosis. These changes are indicative of necrotic damage and cell death with resultant decreased

nervous functions, whereas group C showed few lymphocytic infiltration. This study showed the toxic

side effects of histological appearance of adult albino mice. However addition of glutathion

dramatically reversed the toxicity produced by OX.

KEY WORDS: Oxaliplatin, glutathione, neurotoxicity, albino mice

7.3 Protective role of Vitamin E against Cisplastin induced neurotoxicity by performing the behavioral tests and gross examination in adult mice

Dr Sameena Gul

Cisplatin is the platinum based chemotherapeutic drug that has an ability to combat various solid

tumors of the body but it causes several toxicities including neurotoxicity. Tocopherol or Vitamin E is a

known antioxidant with proven results on prevention of toxic effects of chemotherapy. This study was

aimed to assess the protective role of Vitamin E against Cisplatin induced neurotoxicity by performing

the behavioral tests and gross examination in adult mice. This experimental study was conducted at

LUMHS & Animal house of Sindh Agriculture University Tando Jam for period of 1 year. Total 60 adult

mice with average weight of 25 to 45 gms were randomly divided into 3 groups as Group A (Control),

Group B (Cisplatin only), Group C (Cisplatin + Vitamin E). Gross examination and Behavioral Tests were

performed during the entire study period. The variables were analysed by using ANNOVA & Post hoc

test. Weight & hair loss was significant in Group B as compare to Group C (p < 0.05). Other parameters

such as paw edema or paralysis, mental orientation, object recognition, noise stimulation, heat and

cold stimulation tests exhibit significant difference between three groups (p < 0.05). However, Vitamin

E was successful in reversing the effects of Cisplatin to a certain extent in Group C. (p < 0.05). Addition

of Vitamin E reversed the toxic effects of Cisplatin on gross morphological and behavioral tests in

Group C .

7.4 Role of physical activity in mental well being of medical students of Pakistan

Yusra Bint-e-Hafeez, Dr. Sidra Hamid, Rawalpindi Medical University, Rawalpindi

Background: Now-a-days, there is high prevalence of mental disorders among general population.

Physical activities improve disease outcomes but it is not an easy task for medical students to manage

them in their daily routine.

Aims and Objectives: To formulate the relationship between mental status and physical activities

through which we can work for the betterment of health conditions among medical students.

Material and Methods: A cross-sectional qualitative study was conducted at Rawalpindi Medical

University. Students from all five years of MBBS participated in study (female =275 male=125). The

questionnaires administered were Hospital Anxiety and Depression scale (HADS) for mental status

assessment and International Physical Activity Questionnaire (IPAQ) for estimating the level of physical

activity.

The results were categorized into active, minimally active and totally inactive for estimation of physical

activity and four classes as normal (0-7), mild (8-10), moderate (11-15) and severe (16-21) were made

for assessment of anxiety and depression). One-way ANOVA was used for relating class groups with

above mentioned variables followed by post hoc Tukey test, while chi square test was used for gender

comparison with anxiety, depression and physical activity.

Results: Mean age of participants was 20.54±1.866. Mean value of anxiety was 8.29±3.89 and

depression was 5.49±3.31. Non-anxietic students were 43% and non-depressed were 74.25%.

Association between anxiety and students studying in specific year of MBBS was significant as shown

by (p=0.00) --ANOVA. Anxiety and depression had significant correlation (p=0.00) which shows that

their occurrence among students is linked. Only 68.8% males and 56.73% females were active. Alliance

of gender with levels of physical activity was established (p=0.007). Anxiety and depression were low

among active group and high among inactive group.

Conclusions: Existence of mental disarray is quite prominent and on the other hand physical activity is

scarce and negligible among medical students. Their involvement in some kind of healthy recreation

can contribute to better doctors' output in future for beneficence of human being.

7.5 Relationship of Apolipoprotein CIII with Beta Cell Function, Insulin Resistance and Triglycerides to HDL ratio in Healthy Young Individuals with and without Family History of Diabetes Mellitus

Sara, Omar Malik, AP, IBMS, KMU

Background: Apolipoprotein C3 (ApoC3) plays an important role in triglyceride rich lipoprotein

metabolism, an increase in its level leads to inhibition of lipoprotein lipase which causes reduced

uptake of triglycerides leading to hypertriglyceridemia and thus contributing to obesity. ApoC3 has

also been linked to T2DM as high serum ApoC3 levels increases insulin resistance and has an adverse

effect on β- cell function which along with hypertriglyceridemia can lead to T2DM. Recent research

shows that reversing the levels of ApoC3 by ASO (antisense oligonucleotide) treatment can reverse

obesity and improves glucose tolerance while lowering of plasma ApoC3 by Volanesorsen drug

improves glucose disposal and insulin sensitivity. We sought to examine the possible association of

ApoC3 with Family history of T2DM in healthy young individuals.

Aim: In this study we compared the association of ApoC3 on insulin resistance, β-cell function and

triglyceride to HDL ratio in healthy young individuals with and without family history of diabetes.

Methods: A total of 80 healthy young individuals were recruited, they were divided into eight

subgroups with 10 participants in each group. L= lean, O= Obese, B= boys, G= girls, + = family history

(parents/siblings) positive for diabetes, - = family history negative for diabetes. Groups are as follows;

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1) Group L+G, 2) Group L+B, 3) Group O+G, 4) Group O+B, 5) Group L-G, 6) Group L-B, 7) Group O-G, 8)

Group O-B

Anthropometric measures were recorded, information regarding physical activity was taken using

IPAQ, history regarding food intake was also recorded. Blood sample was collected for determination

of glucose, serum insulin, triglyceride, HDL and ApoC3 levels.

Results: ApoC3 was strongly corelated with age (r=0.27, p=0.008) and waist circumference (r=0.34,

p=0.001). TG and TG: HDL were strongly associated with waist circumference (r= 0.37, p=0.00 and

r=0.30, p=0.003). Using multiple regression, ApoC3 was found to be independently associated with

age (β=0.241, P= 0.017)] and waist circumference (β=0.307, P= 0.004), after adjusting for TG, TG/HDL

and groups. However, no significant correlation was found between ApoC3 and groups based on

family history of diabetes.

Conclusion: Apoc3 is independently related with Waist Circumference and Age, however, not related

with family history of diabetes.

Scientific Session B (8)DRUGS VERSUS MICROBES: A BITTER PILL,

8.1 Comparative in-vitro antimicrobial activities of Fluoroqinolones with macrolide

Sana Shamim, mahwish Akhtar, Somia Gul


Macrolides and quinolones both has been used \widely for the treatment of patients with an acute

bacterial exacerbation of chronic bronchitis in terms of short-term effectiveness.

Aim: The aim of the study is to find the effective drug against specific organism

Methods:

Presently, comparative in-vitro antimicrobial activity of some selected fluroquinolones (gemifloxacin,

moxifloxacin and sparfloxacin) with macrolides (azithromycin, clarithromycin and roxithromycin) has

been studied at three different concentration levels (5, 10 and 20 �g ml-1) via disk diffusion method.

These antibiotics were analyzed against some Gram-positive (Bacillus subtilis, Micrococcus luteus,

Staphylococcus aureus, and Streptococcus features) and Gram-negative bacteria (Salmonella typhi,

Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, Escherichia coli, Citrobacter and

Shigella flexneri).

Results:

Antibacterial activity was evaluated by measuring zone of inhibitions produced around the disk by

these mentioned antibiotics. Data was analyzed by applying One way ANOVA which reveals that

mentioned antibiotics showed variation in their antibacterial activity from specie to specie but among

them azithromycin exhibits better antibacterial activities when judged against all tested species except

Streptococcus features where moxifloxacin proved as best.

Conclusion:

It has been concluded that macrolides are better antibacterial agents as compare to the advance

fluroquinolones against the mentioned tested species.

8.2Design, synthesis, characterization, in vitro antimicrobial studies of fluoroquinolones-amide derivatives

Mahwish Akhtar, Tanveer Ahmed Siddiqui, Mehreen Sohail3, Sana Shamim

8.3 Insilco integrative approach for identification of putative multifunctional inhibitor of anthrax toxins

Nousheen Bibi, Sehraiz Razzaq, Faisal Nouroz, Taiba Anwar, Ghulam Mujtaba Shah

Abstract

Intentional dissemination of the “anthrax letter” led the researchers to increase their efforts towards

development of medical countermeasures against anthrax bioterrorism. Three toxin proteins

(protective antigen, lethal factor and edema factor) are produced by virulent strain of Bacillus anthracis

and considered as causative agent of anthrax and serious biological weapons. Limited existing

therapeutics options to combat anthrax prompted us to design multifunctional inhibitor instead of

traditional one–bug-one-drug approach that binds simultaneously with the protective antigen (PA),

lethal factor (LF) and edema factor (EF) for their binding sites. Ligand-based pharmacophore features

were integrated with the virtual screening and molecular interaction analysis in context of unique

structural characteristics of deadly anthrax toxins. Initially 56,000 natural compounds were screened

against designed pharmacophore model that returned ~2000 hits. Resulting ~2000 compounds after

enrichment returned 351 hits that were subjected to docking analysis against active binding site of

anthrax deadly toxins. 15 high energy scoring hits were further filtered out on the basis of affinity

profile for three toxins simultaneously. Among 15 shortlisted putative multifunctional hits, one was

subjected to deep structural analysis in milieu of anthrax toxins binding pockets to gauge critical

structural crunch. The present integrative approach provides novel therapeutic window to develop a

small molecular inhibitor that simultaneously target three component of anthrax deadly toxin at

molecular level to elicit desired biological process.

Key words: Anthrax, multifunctional inhibitors, pharmacophore, virtual screening, molecular docking.

8.4 virtual screening for the identification of potential inhibitor for marburg virus vp35.

Authors' Name: Siddiqua Ijaz, Parkha Tariq, and Hafsah Muhammad

Background of the Study: This study is on marburg virus (MARV) which belongs to filoviridae

family.MARV causes sever hemorrhagic fever and there is no drug or vaccine available to treat

MARV.The mortality rate of MARV has 23%-90% mortality rate.MARV has seven proteins used for its

different functions but vp35 is one of the most important protein which take part in replication and

transcription and it also act as interferone antagonist.Vp35 also has other functions like it is important

for another protein i-e nucleoprotein to function properly by binding with it.So because of its

multifunction it is a good option to create inhibitor for vp35 and block multiple functions.As to bring a

drug in the market is very expensive and time consuming process it is easy to do this job through

coputational methods by using different techniques.

Aim: The aim of this study is to design any possible inhibitor of vp35 protein of marburg virus to stop

the virus from replication and transcription.

Methods: computational

Results

Conclusion: Because there is yet no treatment available for MARV and only supportive tretment is

there which is not 100% successful and because of which its mortality rate is 23%-90%.So through this

study if we get any possible inhibitor against its vp35 protein it will be easy to bring a drug which will be

a good success to control the mortality and morbidity of MARV

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8.5 Finding Potential Inhibitors for LEISHMANIA (Arginase) by Using Pharmacophore Searching

Dr. Musadiq Ibrahim


Leishmaniasis is a disease caused by parasites of the Leishmania type. It is spread by the bite of certain

types of sandflies. The disease can present in three main ways: cutaneous, mucocutaneous, or visceral

leishmaniasis. Arginase (PDB: 1T4R) is one of the important enzymes present in the life cycle of

Leishmaina and has a vital role in its metabolism. In the absence or Inhibition of Arginase, the

protozoan, Leishmania is unable to grow and reproduce.

Aim

Arginase has a very important role in the life cycle of leishmania, it catalyzes the hydrolysis of L-

arginine to form L-ornithine and urea, the aim of the study is to find potential inhibitors for this

enzyme.

Methods

Computational tools, like Discovery studio Visualizer, Accelrys, Catalyst, Maybridge database and

Pharmacophore searching were used during this research project.

Results

best fitting hits were selected after a rigrorous searching of the database (53,000 compounds) on the

basis of following points:

1. They make more chemical sense with respect to the receptor active site

2. Their Mr is closed to the original substrate (arginine)

3. The functional groups are mostly present in all the hits as found in the substrate i.e:NH2, NH, CH3 &

OH

Conclusion

1. The best fitting hits provide essential chemical knowledge for the design of new anti-leishmania

drugs.

2. The selected hits can be tested for enzyme inhibition assays

3. The developed pharmacophore and receptors model can be used as a tool for rational design of a

new actives and selective compounds which can have increased affinity for the target receptors sites.

4. As pharmacophore searching is relatively quick in comparison to Docking therefore new leads can

be identified promptly thereby shortening the time consuming drug designing process.

8.6 Antibiotic self prescribed of families in Peshawar district

Zufishah rahat, Dr Yasar Yousafzai

Scientific Session B (9)BENCH TO BED: BEST OF BOTH WORLDS

9.1 The hepatitis B and C co-infection and liver function tests in HIV positive patients at Family Health Care Centre HMC Peshawar

Bela Inayat, Rubina Nazli

ABSTRACT

Background: The HIV transmitted through blood and body fluids affects the body's immune system

eventually causing AIDS. Later on patients start suffering from opportunistic infections e.g Hepatitis B,

hepatitis C and tuberculosis. HBV, a DNA virus persists in the liver indefinitely forming a stable circular

covalently closed DNA. Individuals with previous infection (core antibody positivity), immuno

compromised ,those on chemotherapy or on prolonged steroids therapy are more prone to have their

HBV re activated .Hepatitis C caused by the HCV i-e an enveloped RNA virus is responsible for causing

acute and chronic liver diseases like chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. The

route of transmission for both HIV and HBV infections is through blood and unsafe sexual activity. 90-

95% of AIDS patients had serological evidence of present or past HBV infection. The HCV infection is

also transmitted through parenteral routes and co-infection with HIV are common among intravenous

drug users (IVDU) or blood transfusion. It is less clear whether HCV is sexually transmitted like HIV.A

study in California found 11.7% prevalence of HCV/HIV co-infection which could not be accounted for

either by IVDU or blood transfusion. According to Western studies up to 90% of AIDS patients had

abnormal liver enzymes. Etiological factors were multiple like infections, neoplasms and medications.

Neither type of enzyme abnormality could predict a particular infection , neoplasm or drug use.

Materials and Methods: This study was conducted at Family Care Centre Hayatabad Medical

Complex Peshawar Khyber Pukhtunkhwa. Study design was descriptive cross sectional study while the

study period was six months in which a total of 139 patients were observed by using 90% prevalence of

HBS in HIV patients, with 95% confidence level and 5% margin of error, under WHO software for

sample size determination. More over convenience purposive sampling technique was used for

sample collection. Adult (> 16 yrs) HIV positive patients registered at the Family Care Centre HMC ,

Peshawar , KPK ,with history of IVDU or blood transfusion were included while HIV patients with

vertically transmitted disease (< 16 yrs) were excluded form the study.

Results: In this study Mean age was 37.0432 years with SD ± 1.134. Thirty two percent patients were

male and 68% patients were female. Eleven percent patients were employees, 11% patients were

shopkeepers, 7% patients were students/ teachers, 32% patients were house wife, 3% patients were

formers, 36% patients were servants. Eleven percent patients were referred by NGOs, 6% patients were

refereed by Hospitals, 14% patients were referred by physicians, 3% patients were referred by media

while 1% patients were servants. Eight percent patients had elisa, 1% patients had elisa/PCR, 78%

patients had elisa/rapid, 1% patients had elisa/WB, 1% patients had PCR, 1% patients had PCR/ rapid.

Fifty six percent patients were married, 40% patients were unmarried, 1% patient was widow, 4%

patients were divorced. Sixty five percent patients were illiterate, 20% patients had primary education,

11% patients had secondary education, 6% patient were graduate. Five percent patients had HIV due

to male sex worker, 32% patients had HIV due to female sex worker, 7% patients had HIV due to Hijras

sex worker, 5% patients had HIV due to IDU, 12% patients had HIV due to blood products, 3% patients

had HIV due to vertical transmission, 19% patients had HIV due to occupational workers, 19% patients

had HIV but the exposure was unclear. Co infection among 139 patients was analyzed as 19(14%)

patients had HBV positive, 22(16%) patients had HCV positive and 3(2%) patients had positive

pulmonary tuberculosis.

Conclusion: Our study concludes that the HIV-infected patients in this region have a high risk of

acquiring HBV/HCV co-infections through the shared routes of transmission. Hence, HIV patients

should routinely be tested for HBV and HCV markers. Screening the high-risk population for these

infections would aid in prompt diagnosis and treatment with improved outcomes in these patients

which in turn may decrease the further spread of these chronic viral infections.

9.2 Screening of adult dental patients visiting Khyber College of Dentistry, Peshawar for HBV and HCV infections and identifying the associated risk factors

Jamila Haider, Ghosia Lufullah, Rubina Nazli, Tasleem Akhtar, Asthma Shah

ABSTRACT

Objective: To screen out adult patients for HBV and HCV infections visiting Khyber College of

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Dentistry

Peshawar (KCD) for different dental treatments and to identify the associated risk factors.

Method: This cross-sectional study was conducted at Khyber College of Dentistry, Peshawar in the

year

2013. A total of 1540 patients >15 years, visiting KCD for seeking different dental treatments were

screened for hepatitis B & C. Informed consent was taken before blood collection and filling of a

structured questionnaire. Blood samples were tested against HBsAg and anti HCV by using ICT that

were further confirmed by ELISA. The data was analyzed using Epi info version 6.

Results: A total of 1540 patients were screened during the study. Among these 36.4%(561) were males

and 63.6%(979) were females. Overall prevalence of HBV and HCV was 5.12%(79). On screening,

2.14%(33)were found to be HBs Ag positive of which 2.5%(14) were males and 1.9%(19) were females.

HCV was foundpositive in 2.98%(46) individuals having male to female ratio of 1.6% and 3.8%.

Frequency of HBsAg was high in age group 56-65 year and HCV in 36-45 year group. Previous history

of IV/IM injections, spouse patient of hepatitis, blood transfusion, surgical operation were found

significant risk factors in the transmission of both hepatitis B and C, while previous history of dental

treatment and sharing of clippers were significant risk factor in spreading hepatitis C infection only.

Conclusions: Overall prevalence of HCV was higher than HBV. Previous history of injections, spouse

patient of hepatitis, blood transfusion, surgical operation were found significant risk factors in the

transmission of both hepatitis B and C.

9.3 Noninvasive Parameters in Chronic HCV Patients in Teaching Hospital of Peshawar

Abdur Rahim, Tanveer Shafqat

A series of carboxamide derivatives of fluoroquinolones has been synthesized. The structures of

synthesized derivatives have been confirmed by spectroscopic technique such as IR, UV, H1NMR and

Mass spectra. In present work, we focused on C-3 and C-7 positions of moxifloxacin, levofloxacin and

ciprofloxacin. The incoming group occupied azabicylo groups of selected fluoroquinolones at 7th

position and carboxylic group at 3rd position. Screening of their antimicrobial activities have been

systematically carried out against various Gram-positive, Gram-negative organisms and fungi then

compared with parent drugs. Statistical analysis has been carried out by SPSS and results were analyses

by one-way ANOVA. The biological data revealed that the derivative of fluoroquinolones have good

activities against P. aeruginosa and B. subtilis. Furthermore, all derivatives showed excellent activity

against T. rubrum and F. solani. They were more potent antibacterial and antifungal agents as

compared to parent drug.

Keywords: fluoroquinolones, carboxamide derivatives, biological evaluation, ANOVA.

ABSTRACT

Objective: The aim of this study was to utilize simple biochemical parameters and fibroscan as non-

invasive tool for the determination of various stages in chronic hepatitis C patients, since the

combination of fibroscan and biochemical markers can be utilized as noninvasive tools to assess

severity of hepatic fibrosis and cirrhosis which is the result of complications in chronic HCV disease.

Methodology: Total 759 participants were recruited from Lady Reading hospital and Al-Hayat

Medical Center Dabgri garden Peshawar to be analyzed for biochemical markers. On the basis of liver

stiffness, 609 HCV patients were categorized in 05 groups as per fibroscan findings i.e. F0 (no fibrosis),

F1 (minimal fibrosis), F2 (fibrosis), F3 (advance fibrosis) and F4 (cirrhosis) while the control group

comprised of 150 normal healthy individuals. Data collected from the patients was recorded on a

predesigned proforma.

Results: Patient groups with advanced stage disease (F3, F4 group) showed elevated level of AST, GGT,

AST/ALT, T. Bilirubin and DDimer, and lower level of Albumin and Haptoglobin as compared to

controls and were found statistically significant (P<0.01). Patients group with cirrhosis showed

elevated level of AST, GGT, ALP, AST/ALT and T. Bilirubin when compared to patients group with no

liver complications and were significant statistically (P<0.01). ALB and Haptoglobin levels were also

significantly lower (P<0.05) in patients with cirrhosis as compared to patients without liver

complications.

Conclusion: These results showed that the combination of fibroscan and routinely available

biochemical parameters are helpful in identifying liver fibrosis and cirrhosis in chronic HCV patients.

9.4 Association of Serum CTX-I Levels with Hormone Replacement and Interleukin Inhibitor Therapy in Peri-Menopausal Women Presenting in a Tertiary Care Hospital of Peshawar, KPK.

Mehwish Durrani. Muhammad Aslam Qamar, Muhammad Abubakar. Muhammad Shafiq

Objective: To determine the association of serum CTX-I levels with hormone replacement and

Interleukin inhibitor therapies

Study Design: Descriptive cross-sectional study

Place and Duration of Study: This study was conducted at the Hayatabad Medical Complex

(HMC), Peshawar from June 2012 to August 2012.

Materials and Methods: A total of 100 peri-menopausal women were included in the study to

determine the association of serum of CTX-I levels with hormone replacement therapy (HRT) and

interleukin inhibitors. These females were randomly selected and screened for osteoporosis. The age

of study population was between 45-55 years. Informed consent was taken. Detailed history was

obtained regarding occupation, income, family history, number of pregnancies and medications.

Women with complaints of joint pains, history of osteoarthritis, rheumatoid arthritis and any other

bone disease were excluded from the study. They were radiologically assessed for osteoporosis by

using Singh index as I to VI. Ethical approval for the study was taken from the Institutional Ethical

Research Committee (IERC) of HMC. Blood samples were taken for estimation of hemoglobin, ESR,

calcium, alkaline phosphatase and CTX-I.

Results: The levels of CTX-I were elevated in peri-menopausal women who were radiographically

diagnosed as osteoporotic patients. However, CTX-I levels were either normal or insignificantly raised

in women taking either HRT or interleukin inhibitors. The data were subjected to statistical analysis

using Chi-square test on computer software SPSS-17. Results were expressed in form of tables.

Association and their significance were sorted out on the software. There was a significant association

of CTX-I levels with both HRT & interleukin inhibitors (p = 0.000)

Conclusion: This study revealed a significant association of serum CTX-I levels with both hormone

replacement and interleukin inhibitor therapies.

9.5 The effect of different exercise intensities on plasma vascular endothelial growth factor (VEGF) in healthy volunteers

Inayat Shah, Muhammad Omar Malik, Ghareeb Alshuwaier, Ronald H Baxendale

Background:

The balance between angiogenesis and angiostasis is important in growth and developmental

processes in the body. Angiogenic and angiostatic mediators control this balance. Endostatin is one of

the prominent angiostatic mediators. The marked angiostatic effect of endostatin includes inhibiting

endothelial cell migration, proliferation and apoptosis.

Physical activity decreases the risk and development of many angiogenesis related health problems

including atherosclerosis and numerous cancers. Physiological influences of different physical

activities on plasma endostatin concentration are controversial and not completely clear. Moreover,

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correlation of physical characteristics and metabolic predictors during physical activity on circulating

endostatin is indistinct and poorly speculated. The study aimed to determine the effects of mild,

moderate and vigorous exercise on the concentration of endostatin in plasma.

Methodology:

22 participants, 16 males (age = 30.6 ± 7.8 years) and 6 females (age = 26.5 ± 5 years) were recruited.

Weekly session of different intensities exercise based on the predicted maximum heart of the

participants [60%(low), 70% (moderate) and 80% (vigorous)] were carried out. The duration and work

rate for each participant was determined through sub-maximal exercise. Standardization of the

session was done on total energy expenditure of the participants per session. One pre exercise and two

post exercise samples were taken at intervals of 10 and 60 minutes.

Results:

Pre-exercise mean endostatin was 101 ± 20 ng/dl. Low intensity exercise insignificantly decreased the

endostatin concentration in plasma at 10 and 60 minutes 97 ± 20 ng/dl (p= 0.5), 98 ± 23 ng/dl (p=

0.8)).However, moderate (p= 0.022, 0.004) and vigorous intensities (p=< 0.001, 0.02) increased the

endostatin concentrations significantly at both 10 and 60 minutes intervals respectively. The effects

were not significantly influenced by gender, exercise mode (walking vs. running), components of

exercise (HR, Speed, Gradients, distance, duration) or metabolism during exercise (VO2 max, VCO2,

RER, Energy expenditure, rate of carbohydrate or fats oxidation).

Conclusion:

Low intensity exercises did not influence endostatin concentration. However, moderate to high

intensity exercises significantly increase endostatin concentration and may have potential benefits.

Scientific Session B (10)PHARMACOGENOMICS: OUT OF THIS WORLD

10.1:

10.2: Off label and unlicensed prescriptions in pediatric medical units at tertiary care hospitals of Pakistan

Dr. Muhammad Aamir (Pharm-D, Ph.D.University of Peshawar), Dr. Jamshaid Ali Khan

(Corresponding author) (Ph.D. Professor at department of Pharmacy, University of Peshawar), Dr.

Faisal Shakeel (Ph.D. Assistant Professor at department of Pharmacy, Sarhad University of Science

and Information , Mr Waheed Iqbal (Pharm-D, Ph.D. Scholar at department of Pharmacology,

Khyber medical University).

Off label and unlicensed drug use are dilemmas known internationally in pediatric

pharmacotherapy. Despite the highest development in pediatric regimen in the past decade,

limitations still exist in the use of medications to treat children

Aim The study was designed to investigate the prevalence and predictors of off label and

unlicensed prescriptions at pediatric medical wards in Pakistan.

Methods The prospective, observational survey was performed over one year in medical units of

four tertiary care hospitals. Drug profiles of 1375 patients were evaluated using Micromedex

DRUGDEX.

Results A total of 100 different drugs were prescribed 5708 times to patients admitted in medical

wards, of which 34.34% prescriptions were unlicensed by FDA and 52.99% prescriptions were off

label. Regression analysis revealed that pediatric patients receiving 5 or more drugs had also

significantly 18% increase in odds receiving off label drugs (OR 0.180, CL95% 0.073-447) in

reference to corresponding category. Similarly pediatric patients receiving 5 or more drugs

significantly had 11% increase in odds of receiving unlicensed prescriptions (OR 0.112, CL95%

0.027-0.461) as compared to patients who received less than 5 drugs.

Conclusion Considerable prevalence of unlicensed and off label drug prescribing was observed in

medical wards of pediatric department in current study. Despite the very high advancements and

developments in the field of medicine, pediatric pharmacotherapy is still neglected. Thus, there is a

need of improved prescribing strategies and advance formulations in order to reduce unlicensed

and off label drug use for better health care of pediatrics.

10.3 Overcoming the mucosal barrier via proteolytic enzyme decorated nano- and microcarriers”

Dr Arshad Mahmood, Department of Pharmacy, COMSATS University Islamabad, Abbottabad


Mucosal barrier is a hindrance to absorption of drugs via the surfaces (such as gastro-intestinal,

respiratory, vaginal and ocular mucosa) that are easily accessible. However, a significant amount of

drug must permeate this barrier in order to have an effective mucosal delivery.

Aim

The aim of this project is to explore whether immobilization of proteolytic enzymes to components

used in development of nano- and microparticles can result in their enhanced penetration into

mucus.

Methods

Proteases such as papain, bromelain and trypsin can be covalently attached to a suitable carboxylic

acid containing moiety e.g. polyacrylates via amide bond formation. Nano- and micro carriers

comprising these conjugates are initially characterized for their size, surface charge, morphology,

enzyme activity and drug loading. Afterwards, these carriers are evaluated in-vitro regarding mucus

penetration potential and mucus permeation on freshly collected intestinal mucus and intact

intestinal mucosa and later in-vivo performance in rats.

Results

Initially, promising results have been demonstrated in solid carriers with mean diameter ranging

around 200 nm to 2–3 µm and surface charge between −7 to −18 mV. In comparison to

control/unmodified carriers, proteolytic enzyme decorated nano- and microparticles illustrate a

decrease in dynamic viscosity in porcine intestinal mucus. Further in-vitro studies described a

higher mucosal permeation and higher extent of mucus diffusion analyzed in silicon tube assay for

enzyme modified carriers. Moreover, high degree of mucosal retention was observed during both

in-vitro evaluation on porcine intact mucosa and in-vivo in Sprague–Dawley rats for papain and

bromelain decorated carriers.

Conclusion

Overcoming the mucus barrier and delivery of drug at absorption epithelial lining via proteolytic

enzyme decorated nano- and micro carriers seems a promising strategy that will offer wide ranging

applications for mucosal drug delivery.

10.4: Evaluation of multipronged neuroprotective regimen system for the treatment of diversified neurodegenerative diseases.

Muhammad Ijaz Khan, Assistant Professor, Department of Pharmacy, University of Swabi, Anbar,

Pakistan


Neurological disorders (NDs) ranked first for DALYs (10.2%) and second-leading cause of deaths

(16.8%) globally in 2015.The major spectrum of NDs is covered by wide range of

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neurodegenerative diseases (NDDs) including Alzheimer's disease the most common followed by

Parkinson's disease. NDDs sporadically increase with aging including other causes like Obesity,

cardiovascular diseases, mental health, diabetes mellites, environmental pollution and many

common life problems; suggesting its global prevalence. Alternatively, these diseases share some

common pathologies like compromised neurovascular unit, Oxidative stress, mitochondrial

dysfunction, neuroinflammation, aggregation of misfolded protein and neurodegeneration while

the affected site of brain reveals the type of disease. Although prophylactic neuroprotective

measures work better but until the damage starts. Therefore, the treatment of such commonalities

is a gateway to treat diverse neurodegenerative diseases with a common regimen system.

Aim

To evaluate the individual and combinatorial effect of GM-CSF (antiapoptotic, neuro-regenerative,

neuro-proliferative), Creatine (mitochondrial restorative, bioenergetic, antioxidant), Curcumin (anti-

inflammatory, antioxidant, ant-amyloid) for multimodal additive and or synergistic neuroprotective

effect in the primary neuronal culture system.

Methods

Rat-fetal neurons from E17-19 pregnant sparge-dolly rat was grown on PDL coated plates and

maintained at 37oC 5% CO2 incubator in Neuroobasal+ neuronal culture system. Initially the

culture was treated with antibiotics, horse serum and Cytosine �-D Arabinofuranoside to promote

the growth of neurons. At day 11-15 the neurons were pretreated with serially diluted drugs

followed by intoxication with pretreated Aβ1-40. Various assays were performed to evaluate

viability, antioxidant, neuroprotective effect and antiapoptotic, anti-inflammatory and

neuroproliferative factors.

Results

The optimized dose-combination comprising Curcumin:Creatine:GM-CSF(1:5:.0025) showed

maximum viability (MTT assay) and least cytotoxicity (LDH release assay) as compare to positive

control. The same results were confirmed through Immunohistochemistry, Western-blotting and

real-time-qPCR. However, the full strength of the same was toxic compare to positive control but

effective in case of individual drugs.

Conclusion

The combination of drugs showed improved pharmacological effects over the same concentration

of individual drugs. The toxicity of 15µM A�1-40 was well tolerated and improved neuroprotection

was observed through extended period of time (48 & 72hrs post treatment).

10. 5: Association of GGCX Gene Polymorphism with Warfarin Dose Adjustment

Faryal Shams, Shafiq Ahmad Tariq*, Sami Siraj, Waheed Iqbal, Abdur Razaq.


Warfarin is widely used as anticoagulant drug in conditions like atrial fibrillation, stroke,

Thromboctomy and after valve replacement surgeries. Numbers of adverse reactions are reported

due to its not proper dose, that's why dose adjustment of warfarin based on INR is a usual practice.

There are various factors which affect warfarin dose like age, weight, body surface area, sex, ethnic

differences and the most important the genetic makeup of an individual. Different genes have

been reported to affect the dose of warfarin. Two widely studied genes are VKORC1which affect

the pharmacodynamics of warfarin and CYP2C9 which affect the pharmacodynamics of warfarin.

The Gene Gamma glutamyl carboxylase (GGCX (rs 2592551) ) affect the pharmacodynamics of

warfarin and few studies are there on various ethnic groups regarding its relation with

pharmacodynamics of warfarin. Gene responsible for encoding information of GGCX enzyme is

GGCX gene. It is located in reverse strand of chromosome 2.p11.2.Chromosomal position in

assembly GRCh38.p7: 85,544,723–85,561,509). It has total of 15 exons with total length of 7569

Nucleotides. Total number of nucleotides encodes for 758 amino acid protein located throughout

the body. It has not been studied yet in Pakistani population. The project is designed to find the

association between GGCX (rs 2592551) gene and warfarin dose in Pakistani population.

Aim

To determine possible association between GGCX gene polymorphism and Warfarin

pharmacodynamics

Methods

The study included 148 samples: Patients having indication for warfarin and having stable INR of 2-

3 in his/her last 2 to 3 visits were included in our study. The blood was taken and DNA was

extracted. C to T polymorphism of GGCX gene studied using specific primers.

Results:

The GGCX genotype distribution in 148 warfarin using patients was CC 119 (80.3%), CT 28 (19%)

and TT 1 (0.7%). The p-value of CC vs CT .002 which show significant association of CC genotype

with warfarin Pharmacodynamics while CC vs TT have p-value .118 and CT vs TT have p-value .824.

Average daily dose of all patients having stable INR was also found. Minimum dose calculated were

1.25mg daily while maximum dose with stable INR was 11.50mg daily. Average dose of patients

calculated were 4.8 mg. There is significant difference between the means daily dose of CC, CT and

TT genotypes as shown by ANOVA with P<0.01. mean daily dose of CC=4.64, CT=5.63 and

TT=11.5. Means weekly dose for CC=32.5, CT=37.4 and TT= 78.7 with p<0.01.

Conclusion:

Altogether, our findings revealed that C to T genotype has strong association with warfarin dose

but not a risk factor. In this connection, a multicenter study is suggested to perform to ascertain

the risk of C to T variation with GGCX gene polymorphism.

10.6: Using PCR for analysis of drug resistance in BCR-ABL positive Chronic Myeloid Leukaemia

Nasir Ahmad, Abid Jamil, Sami Siraj, Yasar Yousafzai*, *Assistant Professor, Institute of Basic

Medical Sciences, Khyber Medical University


Chronic Myeloid Leukaemia (CML) is a type of blood neoplasm characterized by the translocation

of ABL and BCR gene resulting in chimeric BCR-ABL transcript that codes for uncontrolled tyrosine

kinase protein. The translocation involves various different positions amongst which the most

common is e13a2 (b2a2) and/or e14a2 (b3a2) fusion transcript that codes p210, BCR-ABL protein.

Molecular monitoring of BCR-ABL is the most sensitive and gold standard technique for diagnosis

and minimal residual disease monitoring in CML.

Prognosis of BCR-ABL positive Chronic Myeloid Leukaemia has significantly improved with the

discovery of BCR-ABL tyrosine Kinase inhibitors (TKIs) such as Imatinib and Nilotinib. However,

significant challenges remain. A significant proportion of patients either fail to achieve complete

molecular remission or develop relapse. This study aims to investigate the role of drug transporters

in resistant to TKIs. In the first phase of this research, our objective was to optimize the PCR

methods for identification of BCR-ABL mutation, identification of gene expression of drug

transporters SLC22A1, ABCB1, and ABCG2, and identification of Single Nucleotide Polymorphisms

in the aforementioned genes.

Aim

Annotating resistance mechanisms offered by drug transporters to TKIs in CML patients

Methods

Detection of BCR-ABL mutation is an essential criteria for the diagnosis of CML. Therefore, an FDA-

approved BCR-ABL testing kit was used. Whole blood from newly diagnosed CML patients was

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obtained, RNA isolated and converted to cDNA. PCR was performed using BCR-ABL P210 (Mbcr)

One-Step Detection Kit (EntroGen) for BCR-ABL analysis. For gene expression analysis, SYRB green

method was chosen. Primers were designed using Primer3 software. For SNP analysis, a first-round

PCR and subsequent sequencing analysis approach was chosen. Briefly, genomic DNA was isolated

using silica column method and conventional PCR performed using primers containing the SNP

region. A pilot set of 10 sample was sent for Sanger Sequencing.

Results

Since the commencement of study, BCR-ABL amplification for the enrolled patients have been

performed. Initial optimization data identified a number of technical challenges in RNA isolation,

and PCR protocol. After careful evaluation, PCR method was optimized and reporting based on

international scale. BCR-ABL p210 transcripts were analysed and found in 96% of patients.

In an initial cohort of patients, gene expression analysis shows successful amplification of SLC22A1,

ABCB1 and ABCG2 gene.

In an initial pilot study for genotyping, Sanger sequencing was successfully performed showing

evidence of SNPs.

Conclusion

For analysis of genetic polymorphisms, gene expression and mutation detection, PCR technique is

highly sensitive. However, initial optimization and quality control steps are necessary for reliable

results. Further experimental work for comparative gene expression and genotyping between drug

resistant diseased versus drug sensitive diseased are under way.

Abstracts of Posters for Day 1

PT-1.1 Efficacy of multiple micronutrients supplementation on energy intake calcium and vitamin D levels in underweight children.

Akhlaq Ahmad, Sadia Fatima, Rubina Nazli, Syed Hamid Habib

Background of the Study: Under-nutrition is a major public health issue worldwide, especially in

developing countries. Several studies have documented the effects of individual vitamin D and calcium

supplements in healthy children and in children with bone abnormalities but the effects of multiple

micronutrients supplementation on calcium and vitamin D status in underweight children is limited in

literature

Aim: The current study aims to investigate the effect of multiple micronutrient supplements on energy

intake, vitamin D and calcium levels in underweight children.

Methods: According to inclusion criteria 76 participants were recruited. In two groups of nineteen

subjects, each subject will be given supplement and placebo respectively in a single control

randomized trial. On the first day of experimental trial the baseline fasting 5cc blood samples was

collected and anthropometric measurements were made. These measurements include height,

weight, mid-upper arm circumference, head circumference, waist to hip ratio, triceps, biceps, sub-

scapular and abdominal skinfold. High nutritional supplements and placebo was provided to the

participants. For measuring energy intake ad libitum breakfast and lunch was given after one month of

compliance follow up on day 31 the same procedure was repeated and vitamin D and calcium levels

was analyzed using cobas c411 and micro- lab 300.

Results: After one month of supplementation, the energy intake (P<0.001), weight (P< 0.001), mid-

upper arm circumference (P=0.005) and BMI-Z score (P= 0.002) were significantly increased in

Nutritional Supplement group as compared to Placebo. However, no improvement was observed in

the plasma vitamin D and calcium levels (P> 0.005) of underweight children in both groups.

Conclusion: Although Multi micronutrients supplements are effective in improvement of nutritional

outcomes and the energy intake. However, these supplements did not show any positive response in

increasing the levels of vitamin D and calcium which may be due to short time duration. Or are not

helpful in increasing the levels of vitamin D and calcium in underweight children for short time

duration.

PT-1.2 Effect of body lotions on human skin bacterial microflora.

Aqsa Sulaiman, Ashfaq Haider

Background of the Study: Human skin is protected from intrusion of external substances by skin flora

and the most dominant group are bacteria which protect us from different pathogens by colonizing on

the skin by competitive exclusion phenomena. Sometimes, this microflora gets disturbed by the

chemical components contained in skin care products.

Aim: The aim of this study is to determine the effect of the body lotion on the protective capabilities of

the bacterial community in human forearm skin.

Methods: Different types of lotions were applied on the left forearm skin of different 20 participants

while right forearm was remained untouched. Samples were taken from both arms using sterilized

cotton swabs and then inoculated in nutrient agar media. A variety of bacterial colonies were seen

which was identified by a various biochemical method, in accordance with Bergey's manual of

systematic bacteriology.

Results: The participant's right forearm had a comparatively higher amount of bacterial colonies on

their skin, as compared to the left forearm. The moisturized cream area contained microorganisms

such as Penicillium and some colonies of dermatophytes i.e. Trichophyton spp. While the bacterial

colonies that were observed in the non-lotioned area, had Pseudomonas aeruginosa, Staphylococcus

aureus, S. epidermis, S. saprophyticus, Bacillus spp, and Propionibacterium spp.

Conclusion: Thus, it is concluded from the study that body lotion's chemical components are

responsible for causing fluctuations in skin bacterial communities that can lead to many human skin

diseases.

PT-1.3 Plasma vitamin d status and their relationship with dietary intake and body mass index in antenatal women; a pilot study.

Babar Shahzad, Muhammad Jaffar khan, Muhammad Shahzad, Hafia Bibi

Background of the Study: The term micronutrient is used to describe “vitamins and minerals” required

by the body to maintain normal cellular function and metabolic activity. Although required in minute

quantities, the effects of micronutrients are vast. Deficiency of micronutrient causes different diseases

some of which are reversible with supplementation while others are irreversible and can even lead to

death. Overall, 10% of global disease burden is attributed to the deficiency of micronutrients.

Approximately more than 2 billion people have micronutrient deficiency worldwide, of which the

deficiency of vitamin A, zinc, iron, and iodine remain the most common. Micronutrients assessment in

antenatal women can be a significant indicator of impaired nutritional status of the mother. Although

deficiency of micronutrients is reported in Pakistan, very few studies have assessed micronutrient

status using quantitative methods. Through this pilot project, we aim to introduce HPLC and ELISA

techniques for micronutrients assessments for the first time in KP.

Aim: The objective of our study was to determine the relationship of plasma vitamins status in

antenatal women with dietary intake and body mass index.

Study design: It was a cross-sectional pilot study.

Setting: The study was conducted in Leady Reading Hospital Peshawar and Khyber Medical University

Peshawar.

Subjects: A total of 88 antenatal women, age 18-40 years attending antenatal clinic at LRH, Peshawar

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were included.

Methods: Dietary intake of vitamins was evaluated using 24 hours' dietary recall questionnaire and

plasma vitamin D status was analyzed through Diasorin radioimmunoassay ELISA kit.

Results: Plasma vitamin D were measured through ELISA. Median plasma 25-OH vitamin D levels were

41.71 ng/mL (IQR=17.29). Of the 88 pregnant females 8 (9.09%) had vitamin D deficiency (<15 ng/mL),

10 (11.36%) had insufficiency (15-30 ng/mL), and 70 (79.54%) had adequate (>30 ng/mL) levels of

plasma vitamin D. Among the other variables, only height had a tendency of positive correlation

(r=0.19; p=0.06) with plasma vitamin D status. Dietary intake of vitamin A (p=0.01, Kruskal Wallis test)

and thiamine (p=0.04, Kruskal Wallis test) were significantly different between the three groups

(Deficient, sufficient, adequate). Socioeconomic status was significantly associated with plasma

vitamin D in binary logistic regression analysis [Odds ratio (95% confidence interval); 3.498(0.9432,

12.978), p=0.03], while there was no significant association of other parameters with plasma vitamin D

status

Conclusion: Plasma vitamin D status is not related to nutritional intake and body mass index in

antenatal women in this study. Further large scale studies are recommended in good laboratory

settings to support this assertion.

PT-1.4 HISTOPROTECTIVE ROLE OF CURCUMIN IN DELTAMETHRIN-INDUCED GASTRIC DAMAGE IN ADULT WISTAR RATS

Dr.Amna Halima, M.Phil Anatomy Khyber Medical University, Dr Zilli Huma, Director IBMS

Background: Stomach is a primary organ in starting the digestive process and is exposed to all types

of toxins which enters with our food. Deltamethrin is a useful pesticide when applied judiciously to

crops. However, it has also dose-dependent toxic effects on stomach. Its permissible limit as pesticide

food residues based on MRL (Maximum Residual Level – 5mg/kg body weight for this study) is usually

violated which causes potential health hazard. Curcumin, a culinary herb and antioxidant agent, can

play a beneficial role for various health issues especially gastric inflammation.

The present study aimed to: to see the morphological changes in the gastric mucosa caused by the

residual particles of Deltamethrin present in the food items.

Deltamethrin and curcumin both are our common household products, and thus, we have the

advantage that the harmful effects of Deltamethrin is counteracted and reversed by use of curcumin

which is a part of turmeric in our daily used spices.

Objectives and Goals

Ÿ To study the possible histomorphological changes in gastric mucosa of rats in maximum residual

level (MRL) of Deltamethrin.

Ÿ To study the auto reversal of these changes after stoppage of Deltamethrin within a given time

period.

Ÿ To investigate curative roles of curcumin on gastric mucosa of rats which were given Deltamethrin.

Ÿ To find the protective role of curcumin against Deltamethrin

Methods: In this two-phase subacute toxicity study of seven weeks, forty Sprague Dawley rats were

divided into ten subgroups. Two positive control groups were kept on normal diet while two positive

control groups were given oral indomethacin (2mg/kg body weight) in phase I. One of each control

groups was then dissected, while other one left under observation for autoreversal in phase II. Two

treatment groups were given deltamethrin (5mg/kg body weight) orally along with curcumin

(100mg/kg body weight. and 200mg/kg body weight) in phase I and then dissected. The rest of the

four treatment groups were all first given deltamethrin (5mg/kg body weight) in phase I. Of these 4

groups, first group was dissected after phase I, while second group was left under observation for

autoreversal, third group was given curcumin (100mg/kg body weight) and the fourth group was also

given curcumin (200mg/kg body weight) during phase II and all were culled at its end. The stomach

samples were collected and processed to obtain histology slides for histopathological analysis via

microscopy. Grading was done to look for changes according to the “Visual analogue scale and

Operative Link on Gastritis Assessment( OLGA)”.

Results: Deltamethrin only group when compared to negative and positive control groups, revealed

moderate severity changes in stomach histomorphology. Similarly, autoreversal group showed mild

severity changes. In the deltamethrin groups followed by curcumin's curative doses (100mg/kg and

200mg/kg), minimal severity changes were revealed. While in the groups given deltamethrin

simultaneously with curcumin's protective doses (100mg/kg and 200mg/kg), there were no severity

changes.

Conclusion Deltamethrin when administered even in a permissible dose of MRL proved to be toxic.

Curcumin showed significant curative effect on stomach when given after deltamethrin intake by

reversing the toxic changes caused by deltamethrin. Similarly, gastroprotective effect of curcumin was

also demonstrated when it was given side by side with deltamethrin. Also, both the gastrocurative and

gastroprotective effects of curcumin were more in the higher study dose. The spontaneous

autoreversal of the deltamethrin induced gastritis was achieved which shows the potential persistent

danger of deltamethrin once it has been introduced into the body.

PT-1.5 Frequency and Risk Factors of Mycobacterium Tuberculosis in Khyber Pakhtunkhwa.

Fatma Ayaz, Arshad Javaid, Anila Basit, Rubina Nazli, Mazhar Ali Khan, Sadia Fatima, Asma Ayaz

Background of the study: Tuberculosis (TB) has infected about 10.4 million people and took away the

lives of 1.7 million in 2016. There are many risk factors that contributing to the high prevalence in the

low- and middle-income countries.

Aim: To identify the frequency of TB and drug-resistant TB and factors responsible for it in Khyber

Pakhtunkhwa.

Methods: This was a quantitative, descriptive statistical base research in Lady reading hospital

Peshawar, Pakistan. A total of 1691specimens were analyzed by light-emitting diodes- fluorescence

microscopy (LED-FM) and Gene Xpert. SPSS version 22 was used to analyze bivariate and multivariate

logistic regression for the frequencies and relevant associations.

Results: The prevalence of TB was found 60% while MDR-TB accounted for 14%. Significant risk factors

for TB/MDR-TB are: Residency (OR = 0.509, 95% CI [.418-.621], p = .001), Smoker (OR = 1.465, 95% CI

[1.205-1.781], p = .001), Productive cough for <then 2 months (OR = 2.299, 95% CI [1,609-3.283], p =

.001), Hemoptysis (OR = 0.443, 95% CI [.361- .544], p = .001), Weight loss (OR = 5.315, 95% CI [4.293-

6.580], p = .001), Positive bacillary load (OR = 3.236, 95% CI [2.627-3.985], p = .001) and Diabetes (OR =

0.437, 95% CI [4.293-6.580], p = .001).

Conclusion: Residencies, smoker, productive cough for > then 2 months, hemoptysis, weight loss,

bacillary load, and diabetes were found to be associated with developing TB/MDR-TB. The present

study also a base for our future research project about a correlation of Vitamin D and immunity

markers in MDR-TB patients at KPK.

PT-1.6 Quercetin protect against ethanol-induced neurodegeneration in adult rat cortex.

Haroon Badshah, Usman Ali

Background of the Study: Chronic ethanol ingestions has been shown to produce neurotoxicity in

distinct regions of brain which may results in a number of neurodegenerative disorders like

Huntington's disease, Alzheimer's disease or Parkinson's disease. Quercetin, a naturally occurring

flavonoid, has been reported to possess several pharmacological activities including neuroprotective

properties in different in vitro and in vivo models.

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Aim: In order to elucidate the neuroprotective property of quercetin, we investigated quercetin activity

against chronic ethanol-induced neurodegeneration in adult rat cortex.

Methods: Adult rats were treated with ethanol for 3 months while quercetin was treated for the last 20

days along with ethanol to the respective experimental groups. Elements of mitochondrial apoptotic

pathway i.e. proapoptotic protein Bax, cytochrome C release and activation of caspase-9 and caspase-

3 were determined after respective drug treatment.

Results: Our results revealed that quercetin treatment offered neuroprotection in the cortex against

ethanol induced neurodegeneration. Quercetin reversed the ethanol-induced apoptotic trend via

down regulating Bax, preventing cytochrome C release and inhibition of caspase cascade (caspase3

and caspase-9). Furthermore, DNA damage observed by chronic ethanol treatment with increased

expression of PARP-1 was also reversed by quercetin treatment. Immunohistological findings i.e.

caspase-3 immunoreactivity, Nissl staining and Fluorojade-B staining also revealed significant

neuronal survival with quercetin against ethanol-induced neuronal cell death.

Conclusion: Our findings suggest that quercetin has effective therapeutic potential to attenuate

neurotoxic effects and it can used as neuroprotective agent against alcoholic neurotoxicity.

PT-1.7 Oxidative Stress and DNA damage in Recurrent Depressive Disorder (rDD) Patients

Muhammad Ateeq Qureshi1, Sana Noor1, Sana Javed1, Kehkashan Sabir1

Depressive disorder (DD), which include recurrent depressive disorder (rDD), is a severe mental

disease, which influences a large percent of the people around the globe across all sexes, ethnicities

and age barriers. Therefore, the existing study was undertaken to analyse the oxidative stress

parameters and DNA damage in patients with depression. The level of DNA damage in lymphocytes

was evaluated by the comet assay. Oxidative stress parameters (SOD, MDA, GSH) were analysed by

commercial kit. The results showed that in blood of patients, DNA damage, superoxide dismutase

(SOD) and malondialdehyde (MDA) levels were significantly higher (p<0.001), while glutathione (GSH)

level was significantly lower (p<0.001) in patients as compared to control group. We also found an

elevated number of DNA damage in patients as compared to control group. For the first time we tend

to showed that patients with depression, compared with non-depresses people, had more DNA

damage due to high oxidative stress. Our study revealed that depressive disorder can cause oxidative

stress which leads to DNA damage.

PT-1.8 Synergistic activities of Jatropha curcas pressed cake and oil in combination with antibiotics against clinical and multidrug resistant bacterial strains.

Abdul Haq, Maleeha Siddiqi, Syeda Zakia Batool, Malik Badshah

Background of the Study: With the current significant upsurge in multidrug resistant bacterial strains

and subsequently antibiotics inefficacies, the use of antibiotics in combination with medicinal plant

extracts against pathogenic bacteria has become an important strategy.

Aim: In this study, interactions between Jatropha curcas crude extracts and antibiotics were

investigated against clinical and multidrug resistant bacterial strains

Methods: Antibacterial potentials of J. curcas seed extracts and the selected commercially available

antibiotics were evaluated using agar well diffusion method. An AutoDock 4 on Intel was used for

molecular docking of chemical compounds detected in methanolic residues by GC-MS analysis.

Minimum inhibitory concentration of all test samples (extracts and antibiotics) were determined.

Synergistic antibacterial potential of each J. curcas seed extract in combination with ofloxacin,

ciprofloxacin, moxifloxacin, cefotaxime and rifampicin was determined against selected bacterial

strains by fractional inhibitory concentration index (FICI).

Results: Highest antibacterial activities exhibited by methanolic extracts against Staphylococus aureus

followed by methicillin-resistant Staphylococcus aureus (MRSA) strains; MRSA4, MRSA5, MRSA1, S.

aureus and MRSA3 with inhibition zone of 21, 17.3, 17, 16.3, 15 and 15 mm, respectively. Molecular

docking demonstrated that beta-monolaurin from methanolic extract has the highest affinity

conformation for the MurF ligase active pocket with binding energy of -7.3 kcal/mol. For antibiotics,

the highest activity was shown by moxifloxacin against E. coli ATCC with 50 mm zone of inhibition

followed by ofloxacin against P(Full name please) chlororaphis (47.3 mm), moxifloxacin against P(Full

name) monteilii (47 mm), Pseudomonas aeruginosa (46.3 mm), MRSA2 (46 mm) and ofloxacin against

S. aureus ATCC (45.7 mm). In combination study, methanolic extract showed highest synergism

followed by n-hexane, aqueous and oil using FICI. All extracts showed strong synergism with

rifampicin, ofloxacin, ciprofloxacin and cefotaxime against most of the tested bacterial strains. While

moxifloxacin exhibited highest antagonism. The methanolic, n-hexane, aqueous and oil extracts

showed 40, 32, 9.4 and 26 % synergism, respectively.

Conclusion: Combination study showed that potency of antibiotics was improved in combination with

J. curcas seed's components encouraging its use as a source to tackle down bacterial infections.

PT-1.9 In-silico Subtractive proteomics Analysis Approach for the Discovery of Potential Drug targets in Streptococcus pyogenes M1 GAS.

Noor Rahman, Mohibulla Shah

Background: Group A Streptococcus (GAS) is a gram-positive human pathogen that causes a variety of

diseases, such as pharyngitis, cellulitis, bacteremia, streptococcal toxic shock syndrome, acute

rheumatic fever, rheumatic heart disease, and glomerulonephritis.

Aim: In computer aided drug discovery, target identification is the first step. In the present study an

attempt has been made for subtractive proteomics analysis approach for potential drug targets in

Streptococcus pyogenes M1 GAS by the use of computational tools.

Methods: Primary data was retrieved from different Databases for subsequent analysis to investigate

putative drug targets. Paralogous, redundant and less than 100 amino acid protein sequences were

removed by using CD-HIT. Further detection of bacterial proteins which are non-homologous to host

and are essential for the survival of pathogens by using BLASTp against host proteome and DEGs

respectively with E-value 10-5. Comparative Metabolic pathways analysis was carried out to find

unique and common metabolic pathways. Virulence Factors Database (VFDB) was used to determine

virulent protein sequences in the shortlisted sequences with percent identity >30% and bit score > 50

respectively. The non-redundant, non-homologous essential proteins were BLAST against approved

drug targets for drug target while Psortb was used for subcellular localization.

Results: There were 1693 protein sequences present in NCBI Database for Streptococcus pyogenes M1

GAS out of these 326 were essential proteins which were non-homologous to human. Among these

essential proteins, 230 proteins were involved in 26 unique metabolic pathways. The shortlisted

protein sequences contains 31 virulent proteins, these proteins were further BLAST against approved

drug targets with percent identity ≥35% in which 10 cytoplasmic proteins showed drugability.

Conclusion: In our results we determined 10 drug targets which are non-redundant, non-homologous

to host, virulent and are indispensable for pathogen growth. Most of them are reported in literature

which shows the validation of our results and can be used as a therapeutic drug targets.

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PT-1.10 Frequency of non-alcoholic fatty liver disease in non-obese type 2 diabetic patients and its association with control of diabetes.

Muhammad Umair, Muhammad Omar Malik, Syed Hamid Habib

Background of the Study: NAFLD is defined as accumulation of lipid layer within hepatocytes, greater

than 5% weight of liver in absence of hepatitis B, hepatitis C and excessive ethanol intake (>20g/day).

Available studies show the association of NAFLD with obesity and development of type 2 diabetes

mellitus (T2DM); however, limited data is available showing its frequency in non-obese T2DM.

Aims: To determine the frequency of NAFLD in non-obese T2DM patients and to find the influence of

NAFLD in control of diabetes; through measurement of HbA1c levels, FBS and PPHG. Moreover, to

check if NAFLD had different association with control of diabetes in different age and sex groups.

Methods: The study was a six months cross sectional study. It was conducted in District Head Quarter

(DHQ) Hospital Dera Ismail Khan (D.I.Khan). The inclusion criteria involved already diagnosed T2DM

patients within the BMI range of 18.5–29.9, and age limit from 30-60 years. The exclusion criteria

included, history of alcohol or drugs which cause fatty liver, have BMI< 18.5 and > 29.9 or having any

acute or chronic medical condition (hepatitis B surface antigen or Anti Hepatitis C Virus (Anti HCV)

positive, renal and cardiac diseases). A sample size of 100 patients were included, chi square,

independent t-test and multiple regression were performed for analysis.

Results: In our study, 55 (55%) were male and 45 (45%) were female. Fifty eight (58%) of these patients

had fatty liver. Mean age of the patients was 46.78 ± 8.39 years, with males and females of almost equal

age. Only general weakness (p= 0.001), neuropathy (p= 0.004), myopathy (p= 0.008) were significantly

different between males and females. In univariate and multiple regression, NAFLD was not associated

with HbA1c, FBS and RBS levels. NAFLD had no significant association with different age (< 45 years

and ≥ 45 years, p= 0.847) and sex groups (p= 0.392), although males were found to have higher

prevalence than females (61.8 % vs. 53.3 %).

Conclusion: NAFLD is a highly prevalent (58%) disorder in non-obese T2DM patients. NAFLD is not

associated with control of diabetes in terms of HbA1c, FBS and RBS levels and hence does not play any

significant role after the development of diabetes.

PT-1.11 The First Functional KPK Clinical Trial Room.

Sadia Fatima, Rubina Nazli , Aqsa Zubair, Fouzia Nawab

Background: Clinical trial room (CTR) is a specialized biomedical research room that can help to design

and coordinate clinical trials. It is much like a centralized shared resource that provides access to

instruments, services and expert consultation to research students. The purpose of the clinical trial

room is to improve the clinical encounter through the design of the clinical environment.

Aim: Our aim is to facilitate the implementation of practices that will help to improve the efficiency and

quality of the clinical trials. With the establishment of the clinical trial room we introduce tools

required for innovative and evidence based studies.

Methods: Our CTR is established with the purpose of providing assistance in the development,

application, and implementation of clinical trials in compliance with Good Clinical Practice (GCP),

quality assurance and other ethical guidelines. This approach is cost-effective because it allows for the

sharing of knowledge and expensive resources within an institution. It has available institutional

resources to manage and complete a research study especially when there are limited funds for a

project.

Impact: Currently 6 trials are in progress in our CTR. The participants include children and pregnant

women. CTR provides a comfortable and cozy environment to the participants since they are usually

sensitive to their surroundings. A study determined that the design of a trial room affects the clinical

encounter. It also protects the integrity and confidentiality of trial subjects thus participants cooperate

earnestly. The children are allowed to play in the “play area” to not let them loose their interest during

the trial. Trained study staff at CTR increased participant involvement in information-intensive

encounters which has a positive impact on the way participant experience the consultation. All the

trials are carried out according to CRT protocols. Among them the most important one is to pay special

attention to the hygiene of participants and the surroundings.

PT-1.12 Use of Cancer Biomarkers in Detection of Chemotherapeutic Resistance in Brain Tumours.

Shabnam Wazir, Muhammad Usman, Zilli Huma, Ishaq Khan

Background of the Study: Brain tumours are collection of large spectrum of neoplasms, each having its

own feature, location, morphology, prognosis and treatment. Brain tumours contains a small

population of cells called as Cancer stem cells (CSCs). These CSCs have pivotal role in tumorigenesis,

metastasis and relapse via their self-renewal and therapeutic resistan properties. CSCs are identified

using certain biomarkers like Cd133, SOX-2, ABCG2 etc.

Aim: a. To establish primary the brain tumours's cells from Pakistani population.

b. To detect the CSCs biomarker using Immunoflourescence

c. To study the effects of chemotherapeutics alone and in combination with the Transporter-proteins

inhibitors.

Methods: 1) Tumour retrieval, cell lines generation.

2) Morphological profiling and drug inhibition assays.

3) CSCs and transporter proteins expression via Immunoflourescence

4) Metastatic potential via scratch assays.

Results: The CSCs biomarkers like CD133, SOX-2, ABCG2 expression have been detected in the primary

cell lines generated at our cell culture lab, IBMS. Drug combination/s inhibited the cancer in a dose-

dependant manner.

Conclusion: The therapeutic resistance is due to the presence of the CSCs in the brain tumours, which

are detected using specific biomarkers. Inhibition of a specific marker protein/s will increase

chemotherapeutic response. It will lead to a personalized chemotherapy in brain tumours.

Such type of Biomarkers' analysis may benefit the patient as the information could influence patient's

management and treatment protocols

PT-1.13 Correlation of plasma kisspeptin with total testosterone levels in smokeless (dipping) tobacco users and cigarette smokers in general population of Peshawar

Syed Salman Shah, Mohsin Shah, Hamid Habib, Muhammad Omer Malik, IBMS, KMU

Background of the Study: Infertility in males is a worldwide population health issue. Multiple factors

are responsible for it. Smoking has been reported to affect reproductive system in both males and

females. Decreased fertility has been observed in male cigarette smokers. There are conflicting results

about the effect of tobacco use on reproductive hormones and to the best of our knowledge no study

in humans has been conducted so far that focuses on effects of tobacco use on the level of kisspeptin in

fertile men. This study aims to determine the correlation of kisspeptin and total testosterone levels in

naswar users (smokeless tobacco users), cigarette smokers and controls.

Aim: The objective of the current study was to determine the correlation of plasma kisspeptin with

total testosterone levels in smokeless (dipping) tobacco users and cigarette smokers.

Methods: A total of 180 subjects were selected using simple random sampling technique. The

consenting candidates (controls, naswar users and cigarette smokers) were selected according to the

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inclusion criteria of the study. Non fasting blood samples (5 ml) were drawn from the antecubital vein

and plasma was collected and rapidly stored at -80oC till further analysis. ELISA technique was used for

the evaluation of plasma levels of kisspeptin and total testosterone. Data was analyzed using SPSS

version 20 and appropriate statistical measures were taken to address the study objective.

Results: Demographically the three groups were comparable with no significant difference in the

mean age, height and weight. Total testosterone was found to be significantly high in smokers and

naswar users as compared to controls. However, when smokers and naswar users were compared no

statistically significant difference was observed in the level of total testosterone between the two

groups. Kisspepin was found to be significantly high in naswar users as compared to controls; however,

no significant difference was observed between smokers and controls. Furthermore, the levels of

cholesterol were significantly low in naswar users as compared to controls. Triglycerides were found to

be significantly high in naswar users when compared with controls .HDL levels were significantly high

in naswar users as compared to controls. On the other hand only triglycerides were observed to be

significantly high in smokers as compared to controls. No significant difference was observed in LDL

and RBS levels among the study groups.

Conclusion: According to the findings of the current study, it can be concluded that tobacco use has

impact on HPG axis by affecting kisspeptin levels. The alteration in kisspeptin levels can affect

hypothalamic function leading to pituitary and gonadal dysfunction and impairment of reproduction.

The finding that naswar raises kisspeptin significantly as compared to smokers strengthens the idea

that naswar use has more potent effects centrally than smoking.

PT-1.14 Impact of biofortified wheat flour on plasma zinc and Enterobacteria in children

Usama, Muhammad Jaffar Khan, Sadia Fatima

Background of the Study: Zinc deficiency affects 39% children in Pakistan, according to the recent

National Nutritional Survey 2011. Keeping in view deficiency states of zinc in our population,

interventional strategies have been employed such as fortification of cereals, food products, and zinc

preparations in suspension forms. Zinc biofortification is a better option as wheat flour is most

common and easily assessed food in resource-poor settings compared to the other fortification

methods. Although zinc has been used in the prevention and treatment of diarrhoea, the relationship

of plasma zinc status with potentially pathogenic bacteria have not been studied.

Aim: Primary objective of this study was to assess the impact of zinc biofortified wheat flour on plasma

zinc status in resource-poor rural settings of Peshawar where wheat is a major food staple.

Furthermore, the secondary objective was to observe the relationship of change in zinc concentration

(with biofortified wheat flour) with absolute quantities of potentially pathogenic gut bacteria such as

Campylobacter jejuni.

Methods: Dietary zinc intake was assessed using 24 hours' dietary recall, Plasma zinc and selenium

status were analyzed through Inductively Coupled Plasma Mass Spectrometry ICP-MS and

Enterobacteria (Campylobacter jejuni) was amplified with TaqMan probes and primers through 7500

Real-Time qPCR.

Results: No difference in the plasma zinc and selenium levels was observed in pre- and post-

intervention (918.0 µg/L & 90.7 µg/L VS 880.9 µg/L & 78.5 µg/L). Similarly, no significant difference in

the change in plasma zinc (ΔZn = 37.1 µg/L) and selenium (ΔSe = 12.2 µg/L) was observed between the

two groups. 16S RNA gene qPCR amplification of Campylobacter jejuni was negative in all the samples

from both the groups before and after the intervention.

Conclusion: Biofortified flour consumption did not affect plasma zinc and selenium status although

this may be because of a small sample size. Large community-based studies are needed to study the

effectiveness of this intervention.

PT-1.15 Association of serum Leptin level with body mass index and lipid profile in Diacetylmorphine (Heroine) addicts versus healthy controls

Syed Hamid Habib, Syeda Huma Khizar, Muhammad Omar Malik, Muhammad Tariq

Abstract

Background: Diacetylmorphine (DAM) addiction commonly known as heroin addiction, is a common

socioeconomic problem markedly affecting the nutritional and metabolic status of the individuals. The

circulating adipose tissue derived hormone Leptin is an important marker in regulating body weight

and lipid metabolism. Previous reports suggest derangement of Leptin in DAM addicts. In this study

our study was to compare circulating concentration leptin and its relationship to body mass index and

lipid profile in DAM addicts in comparison to normal healthy individuals.

Methodology: This was a cross sectional analytical study including 41 male DAM addicts and 41 male

healthy controls between 25 to 46 years of age. Detail history and physical examination along with

baseline laboratory tests for exclusion of infection were performed before recruiting the subjects for

participation in the study. Standard method was used to calculate the anthropometric measures.

Blood samples were corrected to calculate serum lipid profile, complete blood picture. Serum leptin

was calculated using enzyme linked immunosorbent assay (ELISA) technique. All statistical analysis

was done using SPSS version 22. Ethical approval was obtained from the ethical review committee of

Khyber Medical University, Peshawar, Pakistan.

Results: Basal serum leptin levels in DAM addicts were significantly decreased compared to controls

(3.08 ± 0.13 pg/ml vs 3.24 ± 0.24 pg/ml; p<0.001). Furthermore, LDL and hemoglobin were also

significantly reduced in the addicts compared to controls (71.8 ± 25.99 vs 105.39 ± 39.09; p<0.001 and

13.44 ± 0.78 vs 14.73 ± 0.91; p<0.001) respectively. The difference between other parameters were no

significant. Univariate and Multivariate regression did not find any significant association between in

DAM addicts (p=0.198), however, it had significant association in normal subjects (p=0.027).

Conclusion: In conclusion, circulating concentrations of leptin are decreased in heroin addiction.

Moreover, positive correlation of serum leptin levels with body mass index and lipid profile is lost in

addicts in contrast to control group

PT-1.16 Multi-drug resistant listeria monocytogens isolated from dairy products of Peshawar, Pakistan.

Ayesha Nasir, Faryal Khattak

Background of the Study: Human's consumption of raw milk and dairy products in rural areas gives rise

to many foodborne infections which causes death of millions of people around the world. These

infectious agents, most of the time are bacteria which are present in these products. Listeria

monocytogens is one of the pathogenic bacteria resides in unpasteurized milk and their products

which causes listeriosis in humans which became very difficult to treat due to antibiotic resistance

showed by them.

Aim: The present study is focused on isolating Listeria monocytogens from different dairy products

manufactured in remote areas of Peshawar, Pakistan and to determine their resistance profile to

several antibiotics.

Methods: Total 110 samples of different dairy products were analyzed by plating on non-specific

bacteriological medium and the isolated colonies were identified using biochemical techniques. After

identification, their antibiotic sensitivity was carried out by Agar Disk Diffusion Method.

Results: In this study, estimated 17 colonies of L. monocytogens were isolated in which most of the

colonies were resistant to numerous antibiotics except ofloxacin, cephalosporin respectively

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Conclusion: From our results, it is concluded that the listeria monocytogenes resistance is evolving

which creates many problems in choosing right treatment for the individuals suffering from listeriosis.

PT-1.17 Microbiological examination of fecal coliforms contamination in water samples of Peshawar University region.

Saba Rahim, Adeed Khan

Background of the Study: Water play an important role in regulating human body homeostasis as well

as work as an intermediate in many metabolic pathways. Billions of people are suffering from

numerous waterborne diseases due to consumption of poor quality of water. According to World

Health Organization guidelines, water should be tested regularly for public health concerns.

Aim: The aim of this study was to carry out bacteriological analysis of water samples collected from

various source in Peshawar University area.

Methods: Almost 10 samples were taken from different drinking water sources of Peshawar University

area such as departments, hostels, and cafeteria which were then inoculated into Nutrient agar by Pour

plate method and then incubated at 37oC. Isolated colonies were identified by using several

biochemical tests.

Results: Our results revealed that almost 6 (60%) of drinking water supply was contaminated with

Escherichia Coli, Pseudomonas, Bacillus Cereus, and Salmonella while the rest of 4 (40%) found out to

be satisfactory.

Conclusion: Hence it is concluded that, most of the drinking water supply that does not meet WHO

requirements and has a high risk of contamination of fecal coliforms, resulting in water that is unfit for

human consumption.

PT-1.18 Antimicrobial Acitivity of Garlic

Khushnuma, Hafsah Muhammad, Roshan Ali, Tayyab Ur Rehman

To determine the antimicrobial activity of Garlic and ginger extracts against gram positive and gram

negative pathogenic bacteria.

To investigate whether the plants we have chosen are effective against the bacteria causing specific

diseases.

Methods

In present study the antibacterial activity of methanolic extracts of garlic and ginger plant against

E.coli, Staph agalactiae, Pseudomonas, Staph aureus, Staph Epidermidis and Klebsiella was assessed

based on Disk Diffusion method in MHA media. Three concentrations of the extracts (500, 250 and 125

mg/L DMSO) were used.

Results

The antibacterial activity of garlic methanolic extract against E.coli, Staph Agalactiae, Pseudomonas,

Staph aureus, Staph Epidermidis and Klebsiella was assessed on the basis of Disk Diffusion method in

MHA media. All the concentration of the methanolic extract did not show any activity on Pseudomonas

and Klebsiella but they showed activity on E.coli, Staph Agalactiae, Staph aureus and Staph

Epidermidis.

The Methanolic extract of ginger demonstrated antibacterial activity against Staph Epidermidis while

no activity was noted on Staph aureus, Staph Agalactiae, E.coli and Klebsiella.

Conclusion

The most potent sample among the garlic and ginger was garlic methanolic extract, which inhibit the

growth of many pathogenic bacteria. Garlic methanolic extract inhibited the growth of (E.coli, Staph

Agalactiae, Staph aureus and staph Epidermidis) bacteria tested on different concentrations.

PT-1.19 Pattern of adulthood hematological malignancies in Khyber Pakhtunkhwa.

Awal Mir Khattak, Shahtaj Khan, Baber Rehman Khattak, Mehreen Hameed, Yousef Khan

Background of the Study: The reason for conduction of this study is to determine the pattern of

different adulthood hematological malignancies from different districts of Khyber Pakhtunkhwa

–Pakistan and to drag the attention of concerned to wield the fatal conditions leading to unending

massacre of human lives.

Aim: To evaluate the frequency of adulthood hematological malignancies in Khyber Pakhtunkhwa

population

Methods: Descriptive observational study was conducted at diagnostic laboratory Rehman Medical

Institute (RMI) and Hayatabad Medical Complex, Peshawar Pakistan, from December 2014 to

December 2017. A total of 571 adult patients who suspected to have Hematological malignancies were

included in the study. All these patients were examined in clinics by different physicians and referred to

pathology department for bone marrow aspiration and trephine biopsy. Two milliliter of peripheral

blood was collected in EDTA vacutainer tube and complete blood count, retic count along with

peripheral film examination was done. Bone marrow aspiration and trephine biopsy samples were

taken from all patients. Aspiration and trephine biopsy slides were examined and further

immunohistochemistry and flowcytometry was done for complete diagnosis. All data was recorded,

analyzed and presented in tables.

Results: In 571 suspected adult patients, 259 patients were diagnosed with different types of

hematological malignancies. Out of total diagnosed patients, 186 (71.8%) were male and 73 (28.2%)

were female. The age ranges of studied population were from 18 to 84 year with average age of 46.21

years. Out of them 96 (37.1%) were diagnosed with myeloid hematological malignancies and 163

(62.9%) were diagnosed with lymphoid hematological malignancies. Acute myeloid leukemia (22.3%),

acute lymphoblastic leukemia (21.6%) and chronic lymphocytic leukemia (18.9%) were more prevalent

hematological malignancies in this region while plasma cell leukemia, polycythemia rubra vera and

hairy cell leukemia were least common hematological malignancies were found in adults. The

frequencies of other hematological malignancies were lymphoma (10.4%), multiple myeloma (9.7%),

chronic myeloid leukemia (7.3%), primary myelofibrosis (2.7%), Myelo dysplastic syndrome (2.7%) and

essential thrombocythemia (1.1%) in total hematological malignancies.

Conclusion: Hematological malignancies are common in this part of the world, with lymphoid

malignancies being more common than myeloid malignancies, and no age or gender is exempted.

PT-1.20 Childhood leukemias in Khyber Pakhtoonkhwa and afghan children, visiting to Hayatabad medical complex hospital.

Shahtaj Khan, Awal Mir Khattak, Baber Rehman Khattak, Yousef Khan

Background of the Study: Khyber Pakhtoonkhwa and Afghanistan located in south central Asia which is

most prevalent area for childhood leukemia. In this region no previous data or study was available on

estimated cases per year of different types of childhood leukemia. The aim of the present study is to

evaluate the frequency of different types of childhood leukemia in the children from different districts

of Khyber Pakhtoonkhwa (KP) and Afghanistan presenting to Hayatabad Medical Complex Hospital,

Peshawar.

Aim: The aim and designed of the present study is to evaluate the prevalence of different types of

childhood leukemia in children from different districts of Khyber Pakhtoonkhwa (Pakistan) and

Afghanistan presenting to a tertiary care hospital, Hayat abad Medical complex Peshawar.

Methods: This descriptive cross sectional study was conducted in Pathology department Hayatabad

Medical Complex hospital, Peshawar, Pakistan. Duration of the present study was, from January 2014

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to December 2016. A total number of 605 children were enrolled up to 15 years of age, who were

suspected to have leukemia, went through bone marrow examination. 3 ml blood was collected in

EDTA tube (purple top) and complete blood count was performed by hematology analyzer (Ruby cell

dyne, Abbott, USA). By aseptic techniques bone marrow aspiration and bone marrow trephine biopsy

samples were collected from all patients. Slides were papered from Bone marrow aspirates, fixed with

methanol and stained with Giemsa, Myeloperoxidase and periodic acid Schiff stain. Trephine biopsy

slides were stained by Hematoxylene & Eosin and Reticulin stain. Immunohistochemistry was

done after initially examining bone marrow aspirate slides. All data was documented and statistical

analysis was performed by SPSS-20 software.

Results: Among 605 children suspected to have leukemia, 281(46.5%) children were diagnosed with

different types of childhood leukemia. Out of 281diagnosed patients, 231(82.2%) were Pakistani

children and rest of the 50 (17.8%) were Afghani children. The studied population consist of

173(61.6%) males and 108(38.4) females. Their age ranged from 3 months to 15 years with median age

of 9.8 years. Out of 281 cases, 210(74.73%) were diagnosed to have acute lymphoblastic leukemia and

rest of the children were 62 (22.06%) acute myeloid leukemia, 7 (2.44%) chronic myeloid leukemia, 2

(0.71%) had juvenile chronic Myelomonocytic leukemia (JMML) and 1 (0.35%) child was report with

Chronic Myelomonocytic leukemia (CMML).There was no significant differences seen in prevalence

among Afghan children and Pakistani children except ALL,which is more frequent in afghan children

compared to Pakistani children and no single case of CMML, were diagnosed in afghan children.

Conclusion: In the present study acute lymphoblastic leukemia is most frequent leukemia in the

children of Khyber Pakhtoonkhwa and Afghanistan. Juvenile chronic Myelomonocytic leukemia is

found the less common leukemia in the present study.

Scientific Session B (5)PHARMACOTHERAPY: THE NEW FRONTEIRS

10.1 Overcoming the mucosal barrier via proteolytic enzyme decorated nano- and microcarriers

Dr Arshad Mahmood


Mucosal barrier is a hindrance to absorption of drugs via the surfaces (such as gastro-intestinal,

respiratory, vaginal and ocular mucosa) that are easily accessible. However, a significant amount of

drug must permeate this barrier in order to have an effective mucosal delivery.

Aim

The aim of this project is to explore whether immobilization of proteolytic enzymes to components

used in development of nano- and microparticles can result in their enhanced penetration into mucus.

Methods

Proteases such as papain, bromelain and trypsin can be covalently attached to a suitable carboxylic

acid containing moiety e.g. polyacrylates via amide bond formation. Nano- and micro carriers

comprising these conjugates are initially characterized for their size, surface charge, morphology,

enzyme activity and drug loading. Afterwards, these carriers are evaluated in-vitro regarding mucus

penetration potential and mucus permeation on freshly collected intestinal mucus and intact intestinal

mucosa and later in-vivo performance in rats.

Results

Initially, promising results have been demonstrated in solid carriers with mean diameter ranging

around 200 nm to 2–3 µm and surface charge between −7 to −18 mV. In comparison to

control/unmodified carriers, proteolytic enzyme decorated nano- and microparticles illustrate a

decrease in dynamic viscosity in porcine intestinal mucus. Further in-vitro studies described a higher

mucosal permeation and higher extent of mucus diffusion analyzed in silicon tube assay for enzyme

modified carriers. Moreover, high degree of mucosal retention was observed during both in-vitro

evaluation on porcine intact mucosa and in-vivo in Sprague–Dawley rats for papain and bromelain

decorated carriers.

Conclusion

Overcoming the mucus barrier and delivery of drug at absorption epithelial lining via proteolytic

enzyme decorated nano- and micro carriers seems a promising strategy that will offer wide ranging

applications for mucosal drug delivery.

10.2 New Directly Acting Antiviral Agents in Hcv Treatment & Their Limitations

Abdul Majid, Sanaullah Khan, Sami Siraj, Najib ul Haq

Background of the Study Interferon/Ribavirin therapy has been replaced by DAAs due to emergence

of RAVs and decrease sustained virologic response. We analyzed treatment response of Sofosbuvir

and Ribavirin in chronic HCV patients.

Methods Total 241 HCV patients with genotype-1, 2 and 3 received sofosbuvir/ribavirin according to

international standards. HCV RNA presence in serum was used as marker for end treatment response

and SVR24 in each case. The primary end point was SVR24.

Results Among total 43 patients with genotype-1, 37(86.04%) reached ETR and SVR24 statistically

non-significant (P<0.05) while 6(13.95%) failed to achieve SVR24 and become resistant statistically

significant (P>0.05). 2 patients infected with HCV genotype 2 resulted in good ETR and SVR24. Of the

190 patients infected with genotype-3, 179(94.21%) attained good ETR and SVR24 while 11(5.78%)

resulted into virologic break through, statistically significant P>0.05. All 6 HCV patients having co-

infection, achieved good ETR and SVR24. Rate of SVR24 among HCV genotype-1 patients varied

according to treatment history. All 23(100%) treatment naïve patients resulted into SVR24 whereas

among treatment experienced patients 14/20(70%) lead into SVR24. All 108 treatment naïve

participants of HCV genotype-3 resulted into SVR24 while 71/82(86.58%) who had previous treatment

experience lead into SVR24. All the resistant patients 17(6 HCV-1, 11 HCV-3) of the current study were

previously either resistant to INF/relapsed cases.

Conclusion Oral therapy of sofosbuvir is effective against HCV infection. However, history of

treatment may influence the efficacy of treatment. We report first resistivity to sofosbuvir therapy

which is alarming because it may face the same fate in future like previous therapies.

10.3 Using PCR for analysis of drug resistance in BCR-ABL positive Chronic Myeloid Leukemia

Nasir Ahmad, Abid Jamil, Sami Siraj, Yasar Yousafzai


Chronic Myeloid Leukaemia (CML) is a type of blood neoplasm characterized by the translocation of

ABL and BCR gene resulting in chimeric BCR-ABL transcript that codes for uncontrolled tyrosine kinase

protein. The translocation involves various different positions amongst which the most common is

e13a2 (b2a2) and/or e14a2 (b3a2) fusion transcript that codes p210 BCR-ABL protein. Molecular

monitoring of BCR-ABL is the most sensitive and gold standard technique for diagnosis and minimal

residual disease monitoring in CML.

Prognosis of BCR-ABL positive Chronic Myeloid Leukaemia has significantly improved with the

discovery of BCR-ABL tyrosine Kinase inhibitors (TKIs) such as Imatinib and Nilotinib. However,

significant challenges remain. A significant proportion of patients either fail to achieve complete

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molecular remission or develop relapse. This study aims to investigate the role of drug transporters in

resistant to TKIs. In the first phase of this research, our objective was to optimize the PCR methods for

identification of BCR-ABL mutation, identification of gene expression of drug transporters SLC22A1,

ABCB1, and ABCG2, and identification of Single Nucleotide Polymorphisms in the aforementioned

genes.

Aim

Annotating resistance mechanisms offered by drug transporters to TKIs in CML patients

Methods

Detection of BCR-ABL mutation is an essential criteria for the diagnosis of CML. Therefore, an FDA-

approved BCR-ABL testing kit was used. Whole blood from newly diagnosed CML patients was

obtained, RNA isolated and converted to cDNA. PCR was performed using BCR-ABL P210 (Mbcr) One-

Step Detection Kit (EntroGen) for BCR-ABL analysis. For gene expression analysis, SYRB green method

was chosen. Primers were designed using Primer3 software. For SNP analysis, a first-round PCR and

subsequent sequencing analysis approach was chosen. Briefly, genomic DNA was isolated using silica

column method and conventional PCR performed using primers containing the SNP region. A pilot set

of 10 sample was sent for Sanger Sequencing.

Results

Since the commencement of study, BCR-ABL amplification for the enrolled patients have been

performed. Initial optimization data identified a number of technical challenges in RNA isolation, and

PCR protocol. After careful evaluation, PCR method was optimized and reporting based on

international scale. BCR-ABL p210 transcripts were analysed and found in 96% of patients.

In an initial cohort of patients, gene expression analysis shows successful amplification of SLC22A1,

ABCB1 and ABCG2 gene.

In an initial pilot study for genotyping, Sanger sequencing was successfully performed showing

evidence of SNPs.

Conclusion

For analysis of genetic polymorphisms, gene expression and mutation detection, PCR technique is

highly sensitive. However, initial optimization and quality control steps are necessary for reliable

results. Further experimental work for comparative gene expression and genotyping between drug

resistant diseased versus drug sensitive diseased are under way.

10.4 Off label and unlicensed prescriptions in pediatric medical units at tertiary care hospitals of Pakistan

Muhammad Aamir, Dr. Jamshaid Ali Khan*, Dr. Faisal Shakeel, Waheed Iqbal.


Off label and unlicensed drug use are dilemmas known internationally in pediatric pharmacotherapy.

Despite the highest development in pediatric regimen in the past decade, limitations still exist in the

use of medications to treat children

Aim

The study was designed to investigate the prevalence and predictors of off label and unlicensed

prescriptions at pediatric medical wards in Pakistan.

Methods

The prospective, observational survey was performed over one year in medical units of four tertiary

care hospitals. Drug profiles of 1375 patients were evaluated using Micromedex DRUGDEX.

Results A total of 100 different drugs were prescribed 5708 times to patients admitted in medical

wards, of which 34.34% prescriptions were unlicensed by FDA and 52.99% prescriptions were off label.

Regression analysis revealed that pediatric patients receiving 5 or more drugs had also significantly

18% increase in odds receiving off label drugs (OR 0.180, CL95% 0.073-447) in reference to

corresponding category. Similarly pediatric patients receiving 5 or more drugs significantly had 11%

increase in odds of receiving unlicensed prescriptions (OR 0.112, CL95% 0.027-0.461) as compared to

patients who received less than 5 drugs.

Conclusion

Considerable prevalence of unlicensed and off label drug prescribing was observed in medical wards

of pediatric department in current study. Despite the very high advancements and developments in

the field of medicine, pediatric pharmacotherapy is still neglected. Thus, there is a need of improved

prescribing strategies and advance formulations in order to reduce unlicensed and off label drug use

for better health care of pediatrics.

10.5 Evaluation of multipronged neuroprotective regimen system for the treatment of diversified neurodegenerative diseases.

Muhammad Ijaz Khan*, Howard Eliot Gendelman


Neurological disorders (NDs) ranked first for DALYs (10.2%) and second-leading cause of deaths

(16.8%) globally in 2015.The major spectrum of NDs is covered by wide range of neurodegenerative

diseases (NDDs) including Alzheimer's disease the most common followed by Parkinson's disease.

NDDs sporadically increase with aging including other causes like Obesity, cardiovascular diseases,

mental health, diabetes mellites, environmental pollution and many common life problems;

suggesting its global prevalence. Alternatively, these diseases share some common pathologies like

compromised neurovascular unit, Oxidative stress, mitochondrial dysfunction, neuroinflammation,

aggregation of misfolded protein and neurodegeneration while the affected site of brain reveals the

type of disease. Although prophylactic neuroprotective measures work better but until the damage

starts. Therefore, the treatment of such commonalities is a gateway to treat diverse neurodegenerative

diseases with a common regimen system.

Aim

To evaluate the individual and combinatorial effect of GM-CSF (antiapoptotic, neuro-regenerative,

neuro-proliferative), Creatine (mitochondrial restorative, bioenergetic, antioxidant), Curcumin (anti-

inflammatory, antioxidant, ant-amyloid) for multimodal additive and or synergistic neuroprotective

effect in the primary neuronal culture system.

Methods

Rat-fetal neurons from E17-19 pregnant sparge-dolly rat was grown on PDL coated plates and

maintained at 37oC 5% CO2 incubator in Neuroobasal+ neuronal culture system. Initially the culture

was treated with antibiotics, horse serum and Cytosine β-D Arabinofuranoside to promote the growth

of neurons. At day 11-15 the neurons were pretreated with serially diluted drugs followed by

intoxication with pretreated Aβ1-40. Various assays were performed to evaluate viability, antioxidant,

neuroprotective effect and antiapoptotic, anti-inflammatory and neuroproliferative factors.


The optimized dose-combination comprising Curcumin:Creatine:GM-CSF(1:5:.0025) showed

maximum viability (MTT assay) and least cytotoxicity (LDH release assay) as compare to positive

control. The same results were confirmed through Immunohistochemistry, Western-blotting and real-

time-qPCR. However, the full strength of the same was toxic compare to positive control but effective

in case of individual drugs.

Conclusion

The combination of drugs showed improved pharmacological effects over the same concentration of

individual drugs. The toxicity of 15µM Aβ1-40 was well tolerated and improved neuroprotection was

observed through extended period of time (48 & 72hrs post treatment).

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10.6 Association of GGCX Gene Polymorphism with Warfarin Dose Adjustment

Faryal Shams, Shafiq Ahmad Tariq*, Sami Siraj, Waheed Iqbal, Abdur Razaq.


Warfarin is widely used as anticoagulant drug in conditions like atrial fibrillation, stroke,

Thromboctomy and after valve replacement surgeries. Numbers of adverse reactions are reported due

to its not proper dose, that's why dose adjustment of warfarin based on INR is a usual practice. There

are various factors which affect warfarin dose like age, weight, body surface area, sex, ethnic

differences and the most important the genetic makeup of an individual. Different genes have been

reported to affect the dose of warfarin. Two widely studied genes are VKORC1which affect the

pharmacodynamics of warfarin and CYP2C9 which affect the pharmacodynamics of warfarin.

The Gene Gamma glutamyl carboxylase (GGCX (rs 2592551) ) affect the pharmacodynamics of warfarin

and few studies are there on various ethnic groups regarding its relation with pharmacodynamics of

warfarin. Gene responsible for encoding information of GGCX enzyme is GGCX gene. It is located in

reverse strand of chromosome 2.p11.2.Chromosomal position in assembly GRCh38.p7:

85,544,723–85,561,509). It has total of 15 exons with total length of 7569 Nucleotides. Total number of

nucleotides encodes for 758 amino acid protein located throughout the body. It has not been studied

yet in Pakistani population. The project is designed to find the association between GGCX (rs 2592551)

gene and warfarin dose in Pakistani population.

Aim

To determine possible association between GGCX gene polymorphism and Warfarin

pharmacodynamics

Methods

The study included 148 samples: Patients having indication for warfarin and having stable INR of 2-3 in

his/her last 2 to 3 visits were included in our study. The blood was taken and DNA was extracted. C to T

polymorphism of GGCX gene studied using specific primers.

Results:

The GGCX genotype distribution in 148 warfarin using patients was CC 119 (80.3%), CT 28 (19%) and TT

1 (0.7%). The p-value of CC vs CT .002 which show significant association of CC genotype with warfarin

Pharmacodynamics while CC vs TT have p-value .118 and CT vs TT have p-value .824. Average daily

dose of all patients having stable INR was also found. Minimum dose calculated were 1.25mg daily

while maximum dose with stable INR was 11.50mg daily. Average dose of patients calculated were 4.8

mg. There is significant difference between the means daily dose of CC, CT and TT genotypes as shown

by ANOVA with P<0.01. mean daily dose of CC=4.64, CT=5.63 and TT=11.5. Means weekly dose for

CC=32.5, CT=37.4 and TT= 78.7 with p<0.01.

Conclusion:

Altogether, our findings revealed that C to T genotype has strong association with warfarin dose but

not a risk factor. In this connection, a multicenter study is suggested to perform to ascertain the risk of

C to T variation with GGCX gene polymorphism.

Abstracts of Posters for Day 2

PT-2.1 Smoking as risk factor for Chronic kidney failure among type 2 diabetes 2

Muhammad Hamza, Aneela khan, Salman Zahir, Laraib Gul, Sana Basharat

Background of the Study: Different offical websites data, world kidney day data and specialist doctor

data are used for research.

Aim: In Pakistan, it is estimated that the prevalence of tobacco smoking is 36% for males and 9% for

females. Among young adults especially the university students in Pakistan. Approximately 1,200

children start smoking everyday. So it is for purpose of awareness.

Methods: Surveys: Different surveys conducted by Pakistan today etc which is used in the research.

Results: Cigarette smoking causes most cases of diseases but Smoking is risk factor for chronic kidney

failure among type 2 diabetes patient.

Conclusion: In short, Smoking cessation should be valued and treated in the same manner in which

one deals with other renal disease progression factors such as anemia, hyperphosphatemia,

hypertension, proteinuria, and secondary hyperparathyroidism.

PT-2.2 Knowledge, Attitude and Practices of Healthcare Workers Regarding Hospital Waste Management.

Hoor Kakakhel, Komal Salam, Khushbakht Razna, Behram Ahmed, Mohammad Hassan

Background: Health-care waste includes the waste generated by medical activities within healthcare

premises. Lack of awareness about the health hazards related to health-care waste amongst

healthcare workers can put hospital patients, health workers and the general public at risk to diseases

and infections.

Objective: To evaluate the existing state of waste management in both private and public sector

hospitals in Peshawar.

Methods: A cross sectional study was conducted in two hospitals of Peshawar, one private and one

public over a period of two months. A well-structured and self-reporting survey questionnaire was

used as an instrument for data collection and examination.

Results: Out of the 100 participants in the study, 41% were doctors, 38% were nurses, followed by

housekeeping staff (21%). 7% of the total number of respondents lacked awareness regarding proper

waste management procedures. Inductions sessions were not attended by all workers, 97% claimed

that waste bags were removed at least daily, segregation of waste was not performed by all

respondents.

Conclusion: Proper waste management is of utmost importance to prevent the spread of diseases and

maintain a clean environment. Doctors especially need to be made aware of the procedures and

training sessions should be mandatory.

PT-2.3 Perception of Students about the Integrated Modular Curriculum.

Saman Khan, Omar Iqbal, Taimoor Ahmad Khan, Ahsan Nadeem, Ghazala Munawar, Akbar Ali Khan, Hira Tarakai, Mujeeb Ur Rehman

Background: The integrated modular curriculum is a course outline for the undergraduate medical

students which emphasizes on the combination of both basic and clinical aspects of medical science.

This is important so that the information can be delivered in a more organized manner thus making

learning more effective and interesting. Therefore, integrated modular curriculum is a preferred mode

of education both nationally and internationally, also it is vital to identify various loop holes so they can

be improved or irradiated.

Objective: To understand undergraduate medical students' perceptions about the integrated modular

curriculum and also to identify the strengths and weaknesses of the integrated modular system from

students' point of view.

Methodology: This was a cross sectional descriptive study with a total of 180 students of medical

colleges participating in it where the integrated modular system was implemented. A self-validated

questionnaire was used as an instrument to collect data through convenience sampling technique. The

study duration was of two months.

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Results: A total of 79% of students had a positive perception regarding the integrated modular system;

also about 73.88% of students agreed that the integrated modular system was managed well in their

college.

Conclusion: The integrated Modular curriculum is beneficial for the students for better learning.

Students have better perception of integrated Curriculum and its management.

Keywords: Perception, Integrated, Modular Curriculum

PT-2.4 Diversity of wasp fauna (hymenoptera: vespidae) of tehsil babozai, district Swat.

Kalsoom noor, Syed waseem Ahmad, Amna

Background of the Study: The name wasp is used for insects having two pairs of wings, which belong to

order hymenoptera and suborder apocritait is considered that these insects are neither a bee nor ant.

Wasp is a social insects, which lives in colonies where they are categorized mainly into three adults,

among them one is queen, the second is worker and third one is the male (drone) which is only used for

mating purposes.

Aim: To disclose the wasps fauna of tehsil Babozai District swat .

Methods: 1) The cobra spray and hand nets were used for the capturing of wasps.

2) The collected samples were then transferred to the zoological lab for prevention and identification.

Results: A total of 32 specimens were identified belonging to two subfamilies (Polistinae and

Vespinae). The species richness index from different union councils. The Vespa Valutina belonging

subfamily vespinae and polistes watti belonging to the subfamily polistinae are the dominant species.

Conclusion: This was an attempt to explore the wasp fauna of swat region .It is accepted that in future

the more species of wasp should be reported from swat and the significant literature should be added.

PT-2.5. Effect of iron deficiency anemia on intelligence quotient (IQ) in school going children of Peshawar city

Nida Khan, BS Chemistry, Institute of Chemical Sciences, University of Peshawar, Dr. Zahid Khan,

Assistant Professor Biochemistry, ICS University of Peshawar, Prof. Dr. Rubina Nazi, Professor

Biochemistry, IBMS, KMU Peshawar, Dr. Sadia Fatima, Assistant Professor, Biochemistry, IBMS, KMU

Peshawar , Saima Arzeen, Lecturer Psychology, Physiology Dptt. University of Peshawar, Naeema

Arzeen, Lecturer Psychology, Deptt. Of Applied Psychology, NUML Islamabad.


Iron deficiency anemia (IDA) is a hematological disorder especially in children. Many studies have

found association between IDA and cognitive function, IDA cause weakness, poor physical growth and

a weak immune system. It also affects cognitive performance and interrupt psychomotor

development.

Aim

The aim of this study was to estimate the prevalence of IDA and its effect on intelligence quotient (IQ)

in school going children of Peshawar city.

Methods

The research study conducted on 51 children of age 7-11 years, consisting of both genders.

Questionnaires were designed for the collection of data. Blood specimens were collected in EDTA

(ethylenediaminetetraacetic acid) and gel tubes. Complete blood count (CBC) was analyzed using fully

automatic hematology analyzer (Model Sysmex XP-100, serial no. B2444) in EDTA blood. Ferritin levels

were analyzed using chemistry analyzer (Model: Cobas e-6000), Electro Chemolumensis

Immunosorbent Assay (ECLIA) in serum. Raven Colored Progressive matrices (RCPM) was used for

finding IQ of children. Statistical analysis was done using SPSS-16.

Results

The prevalence of IDA was found to be 11.7% in children of specified age. The IQ, hemoglobin (Hb),

ferritin, hematocrit (HCT), Mean Corpuscular Hemoglobin (MCH), Mean Corpuscular Hemoglobin

Concentration (MCHC) decreases significantly with decreasing body mass index (BMI). The IQ reduces

with decrease in Hb.

Conclusion

The effect of IDA on intelligence of children was found significant in this study.

PT-2.6 Importance of probiotics in gastrointestinal tract.

Kiran Konain, Sadia, Turfa Nadeem, Adeed Khan, Warda Iqbal, Arsalan, Amir Javed, Ruby Khan, Kainat

Jamil, Saleha Qazi

Background of the Study: Probiotics are those microorganisms that are incapable of causing any

disease and when consumed, they impact the host positively. GIT infection is one of the significant

cause of death around the globe due to severe dehydration and diarrhea. The addition of Probiotics to

the GIT may be an effective method to prevent these diseases and also to restore the microbial

equilibrium

Aim: We tried to assess the significance of probiotics in gastrointestinal tract as well as their adverse

effect are studied

Methods: This review study was carried out by using different resources like digital libraries, scientific

databases like Scopus, Cochrane, PubMed to find out related articles that had probiotics,

Gastrointestinal Diseases Management. Out of 1300 articles, only 25 articles were selected

Results: Mostly used bacterial genera in the preparation of probiotics are Escherichia, Bacillus,

Streptococcus, Bifidobacterium, Lactobacillus, Bifidobacterium and Enterococcus. Moreover, few

strains of fungi belonging to Saccharomyces are utilized in probiotics preparation. Introduction of

probiotics orally has been appeared to fortify the different lines of the gut defense system. Probiotics

likewise fortify non-particular host resistance to microbial pathogens and in this manner guide in their

eradication.

Conclusion: Numerous types of probiotics exist and it should be acknowledged that all probiotics are

not made equivalent. Efficacy may be because of single strain or numerous strain or mix of both.

PT-2.7 Comparison between CRISPR technology and siRNA gene silencing

Sher shah, Yaseen Anwar, Hafsah Muhammad, Ishaq Khan, IBMS (MBG)

Both RNA interference (RNAi) and clustered regularly-interspaced short palindromic repeats (CRISPR)

technologies allow for the sequence-specific inhibition of gene function and therefore have the

potential to be used as therapeutic modalities. By judging the current public and scientific journal

interest, it would seem that CRISPR, by enabling clean, durable knockouts, will dominate therapeutic

gene inhibition, also at the expense of RNAi. It is found that largely because of their broadly

overlapping delivery constraints, while CRISPR presents formidable competition for DNA-directed

RNAi strategies, its impact on RNAi therapeutics triggered by synthetic oligonucleotides will likely be

more moderate. Instead, RNAi and genome editing, and in particular CRISPR, are poised to jointly

promote a further shift toward sequence-targeted precision medicines.

Aim

Aims to look behind prevailing sentiments and to more clearly define the likely scope of the

therapeutic applications of the more recently developed CRISPR technology and its relative strengths

and weaknesses with regards to RNAi.

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Methods

Steps in CRISPR methodology

1. Gene selection

2. Guide RNA and cas9 selection through bioinformatics tools.

3. Target specificity through tools.

4. Transfection of gRNA and cas9 through transfection reagent.

5. Double strand break of cas9 and targeted gene knockout.

Steps in siRNA gene silencing

1. Obtaining effective siRNA

2. Optimizing siRNA delivery to maximize gene knock down and minimizing toxicity.

3. Degradation of mRNA.

4. Examination of target gene silencing.

Results

We will put previous results to compare these two technologies.

Conclusion

After studying the literature review we come to the conclusion that crispr technology and siRNA gene

silencing are the two technologies that specifically knockout and degraded the targeted genes.

PT-2.8 Association of Virulence Genes with Antibiotic Resistance in Pakistani Uropathogenic E. coli Isolates.

Khayam Ul Haq, Shazia Noreen, Amjad Essa, Mahreen ul Hassan, Waheed Iqbal, Masroor Hussain, Hamid Hussain, Jawad Ahmed, Shafiq Ahmad Tariq, Sami Siraj

Background of the Study: Various strains of Escherichia coli can cause alarmingly serious infections.

Countries like Pakistan harbour the class of bacteria with one the highest rates of resistance, but very

little has been done to explore their genetic pool.

Aim: This study was designed to find out the frequency of virulence genes of UropathogenicE. coli and

their association with antibiotic resistance.

Methods: Isolates from 120 urinary tract infected patients were collected. Antibiotic sensitivity was

detected by the disk diffusion method and DNA extraction was done by the boiling lysis method

followed by PCR-based detection of virulence genes. Final results were analysed using the chi-square

test.

Results The isolates were found to be least susceptible to nalidixic acid, followed by ampicillin,

cotrimoxazole, cefotaxime, ciprofloxacin, aztreonam, amoxicillin, gentamycin, nitrofurantoin and

imipenem. The iucC was the most common virulence gene among the resistant isolates. About 86% of

the collected samples were found to be multi-drug resistant. Statistical analysis revealed a significant

association between the iucC gene and resistance to ampicillin (P=0.03) and amoxicillin (P=0.04), and

also between fimHand resistance to aztreonam (P=0.01). Acute toxicity study showed that the extract

was safe and did not show any toxicity upto 1500mg/kg so 150mg/kg, 300mg/kg and for

pharmacological evaluation 450mg/kg dose was selected. Significant increase in movement of

charcoal meal was produced at 300mg/kg dose of extract when compared to normal control group. In

weight of the feaces matter method faecal output of rats were increased significantly at doses of 300

and 450 mg/kg when compared to normal control group.

Conclusion: Our results indicate the high frequency of the iucC and fimH virulence genes. This, along

with their positive association with resistance to beta-lactam antibiotics in our sampling frame,

indicates their important role in establishing complicated UTIs.

Key words: Urinary tract infection, UropathogenicE. Coli, Virulence, drug resistance

PT-2.9 Investigation of the Laxative Activity of methanolic extract of Tamarix aphylla L. Karst (Saltcedar) in experimental animals.

Khushal Khan, Niaz Ali

Background of the Study: Chronic constipation is the most common amongst functional

gastrointestinal disorder (FGID) in general population, which may be due to dietary, psychological, as

well as anatomical disorder. In chronic constipation, laxatives are the most commonly suggested

drugs, but current drug therapies carries a risk as well. Based on low level of satisfaction both with

treatment and adverse effect with synthetic drugs, majority of chronic constipation patients are

turning to Herbal products. Tamarix Aphylla (L.) Karst, mentioned in the Holy Quran, is one amongst

different plants used traditionally as laxative. Its Arabic name is Abal /Tarfaa /Ghaz /Athel while English

name is Farash belongs to family Tamaracaceae. Keeping in view the traditional use of Tamarix aphylla

as laxative, activities were conducted and its use was scientifically validated.

Aim: To examine the laxative activity of Tamarix Aphylla (L.) Karst in experimental animals.

Methods: For checking the safe dose range of Tamarix Aphylla (L.) Karst methanol extract acute toxicity

study was done. Phytochemical screening of the extract showed the presence of Steroids, Terpenoids,

Flavonoids, Tannins, Cardiac glycosides, Anthraquinones, Reducing sugar and Gum. Two methods

were used for evaluation of the laxative potential of extract i.e. charcoal meal gastrointestinal transit

test and weight of the feaces matter .To demonstrate charcoal meal gastrointestinal transit test mices

were divided into four groups of six animals each, first group as negative control, second group as

positive control (Neostigmine) while group third and fourth were treated with methanolic extract of

Tamarix Aphylla at doses of 150mg/kg and 300mg/kg p.o. respectively. On the other hand, for weight

of the faecal matter method rats were divided in five groups of six animal each, first group as negative

control, second group as positive control (Neostigmine) while group third, fourth and fifth were

treated with methanolic extract of Tamarix Aphylla at doses of 150mg/kg, 300mg/kg and 450mg/kg

p.o. respectively.

Results: Acute toxicity study showed that the extract was safe and did not show any toxicity upto

1500mg/kg so 150mg/kg, 300mg/kg and for pharmacological evaluation 450mg/kg dose was

selected. Significant increase in movement of charcoal meal was produced at 300mg/kg dose of

extract when compared to normal control group. In weight of the feaces matter method faecal output

of rats were increased significantly at doses of 300 and 450 mg/kg when compared to normal control

group.

Conclusion: The results proved that the methanolic extract of Tamarix Aphylla (L.) Karst has a

significant laxative activity.

PT-2.10 Antihyperglycemic effect of methanol extract of Tamarix aphylla L. Karst (Saltcedar) in streptozocin–nicotinamide induced diabetic rats.

Rooh Ullah, Shafiq Ahmed Tariq

Background of the Study: Diabetes mellitus is the world major endocrine disorder having various

etiologies i.e. Insulin deficiency and/or insulin resistance affecting more than 220 million individuals

worldwide. The current available antidiabetic drugs have restricted use due to its associated side

effects profile. Nature remained a foundation of therapeutic cures for thousands of decades. Tamarix

aphylla (T. aphylla) L. Karst (Tamaricaceae) is the leading known species of tamarix having height: up to

18 m. This species has a range of common name i.e. Athel pine, Athel tree, Athel tamarisk, and

Saltcedar. Though T. aphylla has been evaluated for its several medicinal properties. Nevertheless,

there were no evidences on the antidiabetic action of the plant. Therefore this study was carry out to

validate the antidiabetic activity of methanol extract of T. aphylla in Streptozocin–Nicotinamide

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induced diabetic rats on scientific grounds.

Aim: To evaluate the antihyperglycemic potential of Tamarix aphylla leaves in STZ–NIC induced

diabetes in Wister Albino rats.

Methods: Acute toxicity study was done to check the toxicity of T. aphylla (L. Karst) Methanol extract. T.

aphylla leaves extract was administered intraperitoneally (100 mg, 250 mg and 400 mg/kg body

weight per day) to diabetic Wister rats for 21 days. The Various parameters were studied including

fasting blood glucose levels, hemoglobin and glycosylated hemoglobin.

Results: The treatment groups with the extract at three dose levels expressively decrease the intensities

of blood glucose and Glycosylated Hemoglobin. The earlier detected reduced level of plasma

hemoglobin of the diabetic rats was raised to near normalcy with treatment of extract.

Conclusion: The results of the current study confirm that the leaves extract of T. aphylla are nontoxic

and have antidiabetic nature.

PT-2.11 Physiotherapy management of lymphedema after breast cancer surgery.

Arooba Khan, Aliya Ayub, Rabia Shafiq, Asif Ali, Qurat ul ain Khan

Background: Lymph edema is the most common complication after breast cancer surgeries. Different

physiotherapy techniques can be used to manage lymph edema after breast cancer surgeries which

improve quality of life of such patients afterwards.

Objective: This research was conducted to find out the physiotherapy management techniques used in

the lymph edema after breast cancer surgeries..

Methodology: Lymph edema can be prevented and managed by different physiotherapy techniques

which include the use of compression bandages, complex decongestive physiotherapy (CDP), manual

lymphatic drainage (MLD), gentle skin massage, range of motion exercises for upper limb and neck.

Results: The most effective physiotherapy technique used for lymph edema was found to be manual

lymphatic drainage (MLD) as it drains the lymph proximally towards heart. It decreases the arm

swelling by 21.3% hence reducing arm circumference and volume whereas compression bandages

were found ineffective because they put nerves under compression, also increasing arm swelling.

Conclusion: The most effective physiotherapy technique is manual lymphatic drainage as it reduces

arm swelling and enhances quality of life of patients following breast cancer surgery.

Keywords: Lymph edema, Physiotherapy Management, Breast Cancer.

PT-2.12 Variation in the origin of obturator artery in human

Nabila Momin, Zilli Huma

Background of the Study: The Obturator artery predominantly arises from the anterior division of

internal illiac artery. However, controversy still exists regarding the origin of obturator artery from

other vessels.

Aim: The aim of this review was to find out other possible variations as regards its origin by studying

articles that have used cadaveric dissections as the main tool. Further I wanted to also refine a possible

simple classification to be used surgically.

Methods: I selected Topic through Pub-med. 15 articles were found in which I selected dissection done

on cadavers in both male and female and excluded the dissection done on one side of pelvis so at the

end 5 articles were selected. I interpreted the result and analyzed the data.

Results: The reviewed report shows that obturator artery originated mostly from anterior division of

internal iliac artery (70%). The commonest variation was from posterior division of internal iliac artery

(12%) and from external illiac artery(18%). During this analysis there were many other origins, for

example from superior gluteal and inferior epigastric arteries, but these were very rare.

Conclusion: Because of high incidence of variations in branching pattern of obturator artery it is very

important to have a thorough knowledge of these variants and identify them so as to prevent injuries

and increase rate of success of the surgical and interventional procedures.

PT-2.13 Interobserver variability in interpretation of endometrial biopsies in infertile women.

Sabeen Nasir, Muhammad Mumtaz Khan, Naveed Sharif

Background: In histopathology a single diagnosis cannot be relied upon in most of the cases due to

subjective interpretation leading to interobserver variability. Endometrial biopsies are one of them

where multiple influences make the interpretation difficult. The aim of the article was to find the

interobserver variability level two consultants on endometrial biopsies by applying kappa analysis.

Material and Methods: This prospective study consisted of endometrial biopsies of 102 infertile

women referred to Department of Pathology Peshawar Medical College Peshawar from Health Care

Centre, University Town, Peshawar from March to August 2013. Endometrial biopsy was taken at 22nd

or 23rd day of their menstrual cycle. The specimens were routinely processed and slides were stained

with H&E for morphological studies. All the 102 cases were examined by two consultants separately

and formed their opinions independent of each other according to Noyes criteria. Their opinions were

categorized as those in agreement, with minor disagreement and with marked difference of opinion.

Results: Regarding reporting of endometrial biopsies by consultants, agreement of opinion was

established only in 34 (33.3%) cases. However, in majority of the case, 68 (66.7%) there was

disagreement. Furthermore, out of these 68 cases, 46 (68%) cases belong to category of major

conflicting opinion. In case of minor conflicting opinion, there was difference of opinion over the

specific day of phase of menstrual cycle. The Kappa coefficient statistics was performed which gave the

results as fair agreement.

Conclusion: The main cause of disagreement was lack of definitive criteria leading to subjective

interpretation.

PT-2.14 Prevalence of neck, shoulder and back pain and its associated risk factors in secondary school female students in Hayatabad, Peshawar.

Zainab Anum, Qurat ul ain Khan, Zainab Hunaid, Mujeeb ur Rahman

Background: It is common to find school children experiencing musculoskeletal pains. Serious health

conditions may occur if these pains are ignored. Neck, shoulder and back pain have been found to be

linked to heavy school bags, prolonged use of mobile or computer and school furniture.

Objective: This research was conducted to find out the prevalence of neck, shoulder, back pain and

associated risk factors in females of secondary schools in Hayatabad, Peshawar, Pakistan.

Methodology: Schools were selected by simple random sampling. A modified version of Nordic and

Dutch questionnaire was handed over to 323 female students of 14-16 years and response rate was

100%. The following risk factors were measured: school bag, gadget use, school furniture, sleeping

surface and mode of transport to school.

Results: These pains were most prevalent among those females who belonged to Peshawar (22%).

Neck pain was found among 7.1% of the students, shoulder pain was 10.2% and back pain was 23.2%.

Among the girls of sixteen years, the occurrence of back pain was higher. Strong connection was found

between neck-shoulder-back pain and school bags, school furniture and prolonged gadget use.

Sitting, standing and being in an uncomfortable posture for a long time proved to be the risk factors

for these musculoskeletal conditions.

Conclusion: The neck, shoulder and back pain was more among the female secondary school students

who belonged from Peshawar. These pains were associated with heavy school bags, prolonged gadget

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use, school furniture but not with body mass index.

Keywords: Neck pain, shoulder pain, back pain, female students, secondary school, gadget use, heavy

school bags, school furniture.

PT-2.15 Prevalence of occupation related postural pain in the teachers of Peshawar University.

Gul Andama , Arooba Sajjad , Farheen Khan , Ramash Aqeel , Khurram Shahzad, Mujeeb ur Rahman IPM&R, KMU

Background: According to WHO, the contributing factors for work related disorders are work

environment and performance at work. Neck and shoulder pain among teachers is associated with

prolonged standing, sitting, static posture and uncomfortable back support. A study conducted in

Saudi Arabia found musculoskeletal problems as the cause of early retirement. Therefore, this study

was conducted to investigate the prevalence of occupation related postural pain in teachers of the

University of Peshawar.

Objective:

To determine the prevalence of occupation related postural pain in the teachers of Peshawar

University.

Methods:

This survey was conducted in different departments of University of Peshawar from August to October

2017. A total of 108 teachers from 18 departments of University of Peshawar were screened after their

consent. 30 Teachers were excluded due to the history of trauma or a systemic illness. Six teachers from

each department were questioned using a modified Cornell Musculoskeletal Discomfort

Questionnaires. Sampling technique was convenient sampling. The data was analysed using SPSS

version 23.

Result: Out of 78, 59(75.6%) subjects were found to be affected with occupation related postural pain.

The most prevalent region was lower back pain with percentage of 37.7%. 36.4% teachers had neck

pain. The lowest percentage (2.6%) of pain was reported in the forearms. Teachers belonging to age

group 30-40 years were found to have the highest frequency of pain.

Conclusion After analysing the data, it was found that 75.6% teachers were having pain related to poor

posture at work. This reflects the poor posture and emphasize on the need of postural education

among teachers. Further research is needed to investigate about the ergonomics, working

environment and objective assessment of the posture.

PT-2.16: Knowledge, attitude and practice about atypical pertussis and adult vaccination among physicians in Khyber Pakhtunkhwa, Pakistan.

Syeda Mahnoor Murtaza1, Maria Rukan1, Nayab Anwer1, Aamer Ali Khatak2, Afshan Saleem1, Assad

Zaib2, Mushtaq Ahmed Khan3, Bilal Ahmed3, Muhammad Ali Syed1*, 1. Department of Microbiology,

University of Haripur, Haripur, Pakistan., 2. Department of Medical Lab Technology, University of

Haripur, Islamabad, 3 Department of Microbiology, Hazara University Mansehra.

Background of the study:

Pertussis or whooping cough is an acute, vaccine preventable, infectious disease caused by a Gram

negative bacterial species Bordetella pertussis. Most of the pertussis cases occur in infants and

children. Nevertheless, the disease is also common among adolescents and adults, characterized by its

atypical manifestation i.e. persistent cough. Adult formulation of diphtheria , tetanus, pertussis vaccine

(Tdap) is long available in Western countries and those adults at risk of getting or transmitting disease

are recommended for vaccination with Tdap.

Aim:

The main aim of the present study was to assess knowledge, attitude and practices of health care

professionals about atypical and adult pertussis as well as Tdap.

Methods:

Study participants included physicians and medical specialists belonging to different cities of Khyber

Pakhtunkhwa such as Peshawar, Haripur, Abbottabad, and Mansehra. A number of 239 participants

took part in this study, who were solely on volunteer basis. All study participants attended were

personally approached and requested to fill in the questionnaire having questions related to pertussis

and vaccine used against it. Although informed consent was taken, participants were not given the

background information before filling in the forms to keep the results reliable.

Results:

Fifty nine percent (59%) of the participants have ever treated the pertussis patients. Fifty four percent

(54%) knew about typical symptoms of pertussis. Forty nine percent (49%) knew about atypical

pertussis cases. Fifty one percent (41%) of the participants knew about adult pertussis and its

transmission to children from parents. Forty nine (49%) percent of the participants were in favor of

adult formulation of DTP (Tdap) for mothers and 73% think that there is need of vaccine booster doses

for school going children.

Conclusion:

Survey concluded that there exists little knowledge among participants about adult pertussis,

especially atypical pertussis cases among adults. Physicians are should be made more aware about the

adolescent and adult pertussis as well as adult pertussis vaccination.

PT-2.17: Nasal carriage of highly resistant methicillin resistant Staphylococcus aureus (MRSA) strains by hospital staff in Hazara region of Pakistan.

Maria Rukan, M.Phil1, Humaira Jamil, M.Phil1, Habib Ali Bokhari, PhD.2, Allah Nawaz Khan, M.S.2,

Sarfaraz Hussain MBBS, FCPS3, Muhammad Ali Syed, PhD.1* 1. Department of Microbiology, The

University of Haripur, Pakistan.. 2.Department of Biosciences, COMSATS Institute of Information

Technology, Islamabad, Pakistan.3. District Head Quarter Hospital, Haripur, Pakistan.

Abstract:

Objective:

The study was aimed at isolation and characterization of multidrug resistant strains of Staphylococcus

aureus from healthcare workers who are in direct contact with the patients and are potential risk of

nosocomial infection.

Study design area:

An observational/ cross sectional study covering ward and operation theater staff working at different

hospitals of Haripur and Abbottabad.

Methods:

In the present study, 208 swab samples were collected during the period from November 2014 to April

2015. The isolates were identified on the basis of microbiological and biochemical tests and further

confirmed by polymerase chain reaction (PCR). Disc diffusion method was used for antibiotic

sensitivity testing and pvl and mecA genes were detected by PCR.

Results:

S. aureus was detected from 80% (n=167) participants, whereas prevalence of MRSA was 38%.

Antibiotic resistance profiles are as following: (Me= 45%, OFX= 36%, E=91%, DO=31%, MY=76% ,

AMC= 32% , CIP= 40% , CRO=53%.

Conclusion:

The results of our study reveal that a high number of hospitals staff including those working in

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operation theater carry MRSA and multidrug resistant strains in their nasal passage that may be a

source of infection to patients.

Key words:

Methicillin resistance, Nosocomial infections, Vancomycin, mecA gene, pvl gene.

PT 2.18: Characterization of Staphylococcus aureus strains from skin and soft tissue infection cases at selected hospitals of Hazara Division of Pakistan

Ayaz Saleem1, Neelum Ashfaq1, Bushra Fatima1, Faisal uz Zaman1, Izhar Ul Haq1, Bilal Ahmed2, Mushtaq Ahmed Khan1, Aamer Ali Khattak2, Muhammad Ali Syed1.

1. Department of Microbiology, The University of Haripur, Haripur, Pakistan. 2. Department of Medical Lab Technology, The University of Haripur, Haripur, Pakistan.

Objective:

To determine the level of antibiotic resistance and pvl gene detection in Staphylococcus aureus strains

isolated from skin and soft tissue infection cases at local hospitals.

Place of study:

Study participants were skin and soft tissue infection patients at DHQ Hospital Haripur, Ayub Medical

Complex Abbottabad and Yahya Hospital Haripur and DHQ Hospital Abbottabad.

Methodology:

Four hundred and five samples were collected from during the period from June 2016 and March 2017.

Antibiotic sensitivity testing was carried out by using disc diffusion assay, whereas presence of Panton

Valentine Leukocidin (PVL) and mecA genes were determined by using PCR.

Results:

One hundred and five samples showed presence of S. aureus (25.9%). Eighty percent of the isolated

strains have been identified as methicillin resistant Staphylococcus aureus (MRSA), whereas resistance

to other antibiotics was also higher.

Conclusion: The level of antibiotic resistance is higher than all previous studies from the country.S.

aureus strains from both healthcare associated as well as community acquired infection cases carries

pvl gene.

Key words: Staphylococcus aureus, Panton Valentine Leukocidin, mecA, antibiotic resistance,

Polymerase chain reaction.

PT-2.19: Antibiotic sensitivity testing of Staphylococcus aureus strains from urinary catheters at a tertiary care hospital in Haripur

Sidra Noor1, Ayaz Saleem1, Bushra Fatima1, Muhammad Mumtaz Khan1, Amir Ali Khattak2, Muhammad Ali Syed1*1. Department of Microbiology, The University of Haripur, Haripur., 2.Department of Medical Lab Technology, The University of Haripur.

Staphylococcus aureus is a medically significant bacterial species that can cause a range of infections

including superficial skin infections, catheter associated infections, urinary tract infections, food

poisoning, necrotic pneumonia etc. A large number of S. aureus may be present in hospital

environment as well as on patient body that may cause catheter associated infections among

catheterized patients. Recent studies from different cities of Pakistan report a high level of antibiotic

resistance to commonly used antibiotics against S. aureus. Further, nosocomial transmission of MRSA

among catheterized patients may complicate their treatment. The aim of the present study was to

isolate S. aureus from urinary catheters of hospitalized patients and determine antibiotic resistance

profiles of these strains. One hundred thirty seven swab samples were collected from gynae ward of

DHQ hospital Haripur, KPK Pakistan. The swab sample was taken by rubbing the sterile swab on the

used urinary catheters by the patient. Strains were identified by using different microbiological and

biochemical assays. Antibiotic sensitivity testing was performed by disc diffusion assay. The isolated

strains of S. aureus show resistance against a number of antibiotics used in our study. The overall

resistance profiles of the strains are as following, 83% (n=33) resistance to lincomycin, 75% (n=30) to

bacitracin, 65% (n=26) to cefoxitin, 60% (n=24) to ceftriaxone and rifampin, 45% (n=18) to

erythromycin, 38% (n=15) to doxycycline and ciprofloxacin, 35% (n=14) to gentamycin and 30%

(n=12) to sulpamethoxazole. The percentages of MRSA and MSSA are 65% and 35% respectively. The

results of this study reveal that strains isolated from urinary catheters are highly resistant to all tested

antibiotics and there is a high risk of nosocomial infection among those receiving urinary catheters.

Key words:

Staphylococcus aureus, nosocomial infections, urinary catheters, biofilms.

PT-20: Detection And Molecular Characterization Of Staphylococci From Eggs Of Domesticated Chickens

M. A. Syed1*, C. R. Jackson2, R. Afridi3, S. Bano1, S. Bibi1, B. Fatima1, S. Tabassum3, B. Jamil4, J. B.

Barrett2, T. A. Woodley2;1Univ. of Haripur, Haripur, Pakistan, 2ARS USA, Athens, GA, 3Hazara Univ.,

Mansehra, Pakistan, 4Natl. Univ. of Med. Sci., Rawalpindi, Pakistan.


Eggs of domesticated hens are considered as more nutritious and healthier than eggs of farmed

chickens. Previously, many studies have reported the presence of pathogenic bacteria inside eggs.

Nonetheless, these studies were conducted on eggs of farmed chickens. No study has been carried out

on isolation and characterization of bacteria from eggs of domesticated chickens, that are free living in

the natural habitat, fed on diverse types of foods and have longer life as compared to farmed chickens.

Aim:

The aim of the present study was to isolate and characterize strains of staphylococci from eggs of

domesticated chickens.

Methods:

Eggs (n=275) of domesticated hens were collected from different villages of Khyber Pakhtunkhwa

province of Pakistan from November 2016 to March 2017. Presence of staphylococci was determined

by inoculating the egg content on a selective medium i.e. mannitol salt agar. Initial identification of

staphylococci was made on the basis of microbiological assays such as microscopy, biochemical tests,

and growth characteristics. Genus specific primers for staphylococci, species specific primers for

Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) were used for PCR. Further

identification to species level was made using Vitek 2 system. Antibiotic susceptibility was performed

using disc diffusion agar assay. Genetic fingerprinting of Staphylococcus xylosus strains was carried

out using Pulsed field gel electrophoresis (PFGE).

Results:

Sixty two eggs were positive for staphylococci identified as S. xylosus, S. lentus, S. sciuri, S.

haemolyticus, S. gallinarium and S. aureus. The predominant isolated species was S. xylosus, which was

isolated from 26 eggs. PFGE patterns show heterogeneity. S. aureus were isolated from two eggs and

only one was identified as MRSA.

Conclusion:

In contrast to our previous study in which a high number S. aureusstrains were isolated that showed

high level of antibiotic resistance, most of the strains isolated from the brown eggs were non-

pathogenic species. Further comparative studies are suggested.





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Notes

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BMedCon ’18kmu.edu.pk/bmedcon/downloads/Program-Booklet-Final.pdf · 2018-10-20 · Dr. Akifullah Khan ( Director, SINOR, Swat) Dr. Ehtesham (Assistant Professor, IBMS, KMU) Mueen