Biofilms are matrix-enclosed microbial aggregates that adhere to a biological or nonbiological surface. Biofilm formation is a significant problem in the medical, food, and marine industries and can lead to substantial economic and health problems. The complex microbial community of a biofilm is highly resistant to antibiotics and sanitizers and confers persistent survival that is a challenge to overcome. There are several conventional approaches to combating biofilms, physical and/or mechanical removal, chemical removal, and the use of antimicrobials, sanitizers, or disinfectants to kill biofilm organisms. However, biofilms are highly resistant to these approaches as opposed to planktonic cells. Thus, novel approaches other than the conventional methods are urgently needed. In this review, we discuss current and new advanced antibiofilm strategies that are superior to the conventional method in terms of addressing the biofilm problem for the improvement of healthcare, food safety, and in industrial processes.

https://onlinelibrary.wiley.com/doi/pdf/10.1111/1541-4337.12144

Current and Recent Advanced Strategies for Combating Biofilms

Factors Affecting Small-Group Tutorial Learning: A Review of Research

Background— Blood pressure during childhood is an established predictor of adult blood pressure, which in turn increases mortality as a result of cardiovascular disease. Adult South Asian populatio...

Children in South Asia Have Higher Body Mass–Adjusted Blood Pressure Levels Than White Children in the United States A Comparative Study

In the last decades several studies suggested that vitamin D is involved in the modulation of the reproductive process in women due to the expression of VDR and 1α-hydroxylase in reproductive tissues such as ovary, uterus, placenta, pituitary and hypothalamus. Vitamin D has also a role in the regulation of sex hormone steroidogenesis. Increasing evidence suggests that vitamin D might have a regulatory role in polycystic ovary syndrome (PCOS)-associated symptoms, including ovulatory dysfunction, insulin resistance and hyperandrogenism. Vitamin D deficiency also has been reported to contribute to the pathogenesis of endometriosis due to its immunomodulatory and anti-inflammatory properties. Although most of the studies supported a role of vitamin D in the onset of these diseases, randomized controlled trials to assess the efficacy of vitamin D supplementation have never been performed. In this review we critically discuss the role of vitamin D in female fertility, starting from in vitro and in vivo studies, focusing our attention on the two most frequent causes of female infertility: PCOS and endometriosis.

Shedding new light on female fertility: The role of vitamin D

OBJECTIVE:

The associations of body mass index (BMI) and obesity with ovarian reserve are controversial. This systematic review and meta-analysis was conducted to investigate the associations in reproductive-aged women.
METHODS:

PubMed and Scopus were searched up to December, 2016. Original studies on the association of BMI with ovarian reserve markers, anti-Mullerian hormone (AMH), follicle-stimulating hormone (FSH), inhibin β, and antral follicle count (AFC), either according to BMI categories or a continuous variable, were selected. Analyses were stratified into three groups based on polycystic ovary syndrome (PCOS) and fertility status of women.
RESULTS:

Of 4,055 records identified, 45 studies were eligible for inclusion. Comparing the obese with nonobese, the pooled mean differences (MDs) and 95% confidence intervals (CIs) were -1.08 (95% CIs -1.52, -0.63) ng/mL for AMH, -0.22 (95% CIs -0.39, -0.06) mIU/mL for FSH, -0.09 (95% CIs -0.60, 0.42) for AFC, and -21.06 (95% CIs -41.18, -0.85) pg/mL for inhibin β in overall populations. The MDs were significant for AMH in fertile non-PCOS and PCOS women, and for FSH only in PCOS women. Fisher's Z showed significant correlations of BMI with AMH in the overall populations (-0.15 [95% CIs -0.20, -0.11]) and in all subgroups, and with FSH in the fertile non-PCOS women (-0.16 [95% CIs -0.28, -0.04]).
CONCLUSION:

Ovarian reserve markers of AMH and FSH are significantly lower in obese than in nonobese women, and BMI is negatively correlated with AMH in all study populations, and with FSH in fertile non-PCOS subgroups. PCOS and fertility status do not appear to affect the associations.

Is ovarian reserve associated with body mass index and obesity in reproductive aged women? A meta-analysis

Management of ovarian dysfunctions requires accurate estimation of ovarian reserve (OR). Therefore, reproductive hormones and antral follicle count (AFC) are assessed to indicate OR. Serum anti-Mullerian hormone (AMH) is a unique biomarker that has a critical role in folliculogenesis as well as steroidogenesis within ovaries. Secretion from preantral and early antral follicles renders AMH as the earliest marker to show OR decline. In this review we discuss the dynamics of circulating AMH that remarkably vary with sex and age. As it emerges as a marker of gonadal development and reproductive disorders, here we summarize the role of AMH in female reproductive physiology and provide evidence of higher accuracy in predicting ovarian response to stimulation. Further, we attempt to compile potential clinical applications in children and adults. We propose that AMH evaluation has a potential role in effectively monitoring chemotherapy and pelvic radiation induced ovarian toxicity. Furthermore, AMH guided ovarian stimulation can lead to individualization of therapeutic strategies for infertility treatment. However future research on AMH levels within follicular fluid may pave the way to establish it as a marker of "quality" besides "quantity" of the growing follicles.

/pdf/anti-mullerian-hormone-above-and-beyond-conventional-ovarian-49wl1g65wj.pdf

Anti-Mullerian Hormone: Above and Beyond Conventional Ovarian Reserve Markers.

https://www.ijcmas.com/vol-3-4/Syed%20H.%20Abidi,%20et%20al.pdf

Detection of Mycobacterium Smegmatis Biofilm and its Control by Natural Agents

OBJECTIVE To compare the perception of medical students on the usefulness of the interactive lectures, case-based lectures, and structured interactive sessions (SIS) in teaching and learning of Physiology. METHODS A cross-sectional study was carried out from January to December 2012 at Bahria University Medical & Dental College, Karachi, which had qualitative and quantitative aspects, assessed by self- reported questionnaire and focused group discussion (FGD). The questionnaire was distributed to 100 medical students after completion of first year of teaching of MBBS Physiology. The data was analyzed using SPSS version 15. Differences were considered significant at p-values <0.05 after application of Friedman test. Responses of FGD were analyzed. RESULTS All the teaching methodologies helped in understanding of precise learning objectives. The comprehension of structure and functions with understanding of difficult concepts was made best possible by SIS (p=0.04, p<0.01). SIS enabled adult learning, self-directed learning, peer learning and critical reasoning more than the other teaching strategies (p< 0.01). CONCLUSION SIS involved students who used reasoning skills and power of discussion in a group to comprehend difficult concepts for better understanding of Physiology as compared to interactive and case-based lectures.

A way forward for teaching and learning of Physiology: Students' perception of the effectiveness of teaching methodologies.

Introduction: Staphylococcus epidermidis is one of the most frequent causes of biofilm-associated infections on indwelling medical devices. With the emergence of methicillin-resistant S. epidermidis (MRSE), there is an urgent need to discover novel active agents against a range of Gram-positive pathogens. We screened the clinical isolates of S. epidermidis for susceptibility/resistance against commonly prescribed antibiotics. Furthermore, we tested some natural agents alone and in combination with antibiotics to find possible synergistic antimicrobial effects. Methodology: S. epidermidis clinical isolates were screened for susceptibility/resistance against vancomycin, erythromycin, tetracycline, chloramphenicol, ampicillin, ofloxacin, cephalexin, and gentamicin using the Kirby-Bauer disk diffusion method. The antimicrobial potential of Camellia sinensis , Juglans regia , and Hippophae rhamnoides alone and in combination with antibiotics were examined using the disk diffusion method, where the antimicrobial potential activity was measured in terms of formation of zones of inhibition. Results: Most S. epidermidis isolates were found to be resistant to one or more antibiotics. Gentamycin and ofloxacin were found to be the most effective antibiotics against S. epidermidis isolates. Extracts of Hippophae rhamnoides , Juglans regia , and Camellia sinensis were found to be equally effective against S. epidermidis isolates. In combination with antibiotics, these extracts exhibited appreciable synergistic activity; the highest synergistic activity was observed with erythromycin and cephalexin. In the case of cephalexin, a reversion in resistance was observed. Conclusions: The plant extracts used in the study exhibited additive and synergistic antibacterial activity against S. epidermidis , hence providing an effective alternative to deal with the problem of multidrug resistance.

/pdf/synergy-between-antibiotics-and-natural-agents-results-in-2ipcl5661s.pdf

Synergy between antibiotics and natural agents results in increased antimicrobial activity against Staphylococcus epidermidis.

BACKGROUND Intrauterine growth restriction (IUGR) is the second leading contributor to the prevailing perinatal mortality and morbidity. It affects 23.8% of newborns around the world and 75% of these affected infants are born in Asia. In Pakistan the incidence of IUGR is around 25%, more than the WHO criteria for triggering a public health action. INTRODUCTION IUGR is implicated with profound long-term impacts in adult life; like coronary heart disease, NIDDM and abnormal cortisol levels. The effects of the short and long term sequelae are reviewed. ETIOLOGY IUGR is associated with a wide variety of etiological factors. But the factor unique in its importance to Pakistan is maternal malnutrition. The fetal gene expression is under the influence of nutrition. Growth projection curves showing the interaction between the genetic and environmental factors are discussed. SURVEILLANCE Identification of IUGR baby in a primary care setting and the options in diagnosis in secondary and tertiary care settings are overviewed. CONCLUSION The roots of this problem, with multi factorial causes are in the socioeconomic infrastructure. This calls for a synergistic approach of reducing this public health issue. Women empowerment can help us to get out of this intergenerational cycle of growth failure. Availability of resources aside, it is also a matter of political will to change things for the better.

/pdf/intrauterine-growth-restriction-a-perspective-for-pakistan-4vec2e6kor.pdf

Khalid Ahmed

Papers

Anti-Mullerian Hormone: Above and Beyond Conventional Ovarian Reserve Markers.

Detection of Mycobacterium Smegmatis Biofilm and its Control by Natural Agents

A way forward for teaching and learning of Physiology: Students' perception of the effectiveness of teaching methodologies.

Synergy between antibiotics and natural agents results in increased antimicrobial activity against Staphylococcus epidermidis.

Intrauterine growth restriction: a perspective for Pakistan.