Home > Clinical and Phylogenetic Analysis of Hepatitis B Virus Infection and Associations of its Genotypes With Antiviral Therapy in Pakistani Patients.
Clinical and Phylogenetic Analysis of Hepatitis B Virus Infection and Associations of its Genotypes With Antiviral Therapy in Pakistani Patients.
Genotypes of hepatitis B virus and their role in disease severity and treatment response has not been studied from all over the Pakistan. This research was aimed to study HBV genotype prevalence in all parts of Pakistan, relationship of HBV genotypes with viral and biochemical factors, influence of different treatments and pretreatment factors on patients'' response, and the mutations responsible for resistance. A total of 840 samples was collected from all over the Pakistan and genotyped by type specific primer PCR method. Viral load, ALT and HBsAg tests were performed for 154 treatment naive patients and the values were compared by ANOVA. One hundred and sixty two chronic HBV patients were compared for three treatments viz. Tenofovir, Entecavir and Peg-Interferon. Patients were monitored for virological response, combined response, HBsAg clearance and HBeAg clearance. The data was analyzed by logistic regression and Chi square tests. Viral reverse transcriptase domain of 20 non-responder patients was sequenced and mutations were detected by aligning the sequences with wild type strains. Genotype D was found to be the most prevalent genotype from all parts of the country as it was present in 71.2% of the samples. The second major sample population (17.3%) was found to be infected with a mixture of different combinations of genotypes, with the dominant combination of A+D (13.7%) while genotype A was the third more prevalent genotype (7.7%). Genotypes B, C and E were found from less than 1% of the samples. Significantly higher values of viral load were found in patients with genotype A+D while no relation of genotype with ALT and HBsAg levels was found. Correlation, however was found between the levels of HBsAg and the HBV DNA quantities of the patients having HBeAg negative infection. Combine response of peginterferon treated patients was higher than entecavir and tenofovir treated patients which have higher rate of virological response than peginterferon treated patients. Genotype A and low baseline viral load were associated to better treatment response. HBV genotype, baseline viral load, HBeAg and ALT were found to be significant factors in at least two of the treatment arms. In tenofovir group, only HBeAg and ALT had a significant influence on response rate, where high base line ALT and negative HBeAg were related with better virologic response. In both entecavir and peginterferon arms, genotype A, low viral load, low ALT and negative HBeAg were associated with better virologic response of the patients. Universally accepted resistant mutations were identified from 8 samples while some new mutations were also found which are still not known for their role in resistance. Known mutations rtL180M/I and rtA181V were found from 6 (30%) samples while rtM204V and rtV173L were found from 5 (25%) samples each. New mutations, rtY135S and rtN248H were found from 13 (65%) and 12 (60%) samples respectively. The study concludes that HBV/D is the most prevalent HBV genotype in Pakistan followed by A+D and A genotypes. Mix infection with A+D is associated with high HBV DNA quantities and low rate of treatment response. Genotype A or D alone, low viral load and negative HBeAg, are significant predictors of high response rate. Treatment with tenofovir and entecavir have better virologic response rate as compared to peginterferon treatment.
غلام غوث غلامی (۱۹۴۰۔۱۸۴۷)میترانوالی سیالکوٹ میں پیدا ہوئے۔انھوں نے ملا عبد الحکیم سے ادب وفقہ کی تعلیم حاصل کی۔ آپ نے فردوسی کے شاہنامہ کے مقابلہ میں سیالکوٹ کے ایک مشہور راجہ سا لباہن کی مختصر مثنوی لکھی ہے۔ آپ کی تالیفات قریش (خود نوشت سوانح) ‘ فرہنگ‘ منتخبات ‘ عربی بہ فارسی سوانح حضرت بلالؒ (منظوم) ‘خزینہ کرامات‘ سفر نامہ مجاز‘ فیروز نامہ حجاز‘ تلبیس ابلیس‘ زہدتہ القواعد در علم صرف‘ تازیانہ‘ غفلت ‘ درعیوب ہندوستان اور انشا غلامی ہیں جو بہت کوشش کے باوجود بازیاب نہیں ہو سکیں۔(۲۹)
The emergence of human milk banks for premature and underweight babies in the early twentieth century raised many questions about the proscription of breastfeeding kinship as are in Islamic jurisprudence. Many Islamic scholars tries to find its solution in the light of Quran, Sunnah and the sayings of early Imams of Fiqh, but their opinion about this matter was different like the differences of sayings of some Imams, until Islamic Organization for Medical Sciences based in Kuwait and Islamic fiqh Academy Jeddah, called Summits on this issue and decided against the establishment of such banks in Islamic world. The issue seemed to be almost solved until European Council for Fatwa and Research launched an appeal in 2003 against their solution and demanded to legitimate the use of Human Milk from these banks for the children of Muslim families in Europe and USA using the public scourge canon (Umum al Balwa) of fiqh. This appeal once again opened the door of discussion on this matter. This article is an overview of the sayings of early and modern jurisprudents and pros and cons of human milk banks in the quest of solution of this modern problem in the light of Islamic shariah, so that a just and balanced opinion may be adopted in this matter as it is motto of Islamic Law. This discussion will also affect many new problems faced by Muslim communities in European countries as well as Islamic countries in modern era
Production of sourdough bread is a natural biotechnological process. For fulfilling the increasing consumer demand for healthier and natural foods, sourdough bread was produced by using the multigrain flour. During this study, different wheat varieties were analyzed to assess their suitability for the production of sourdough bread. On the basis of physico-chemical, rheological and sensory characteristics of the sourdough bread, wheat variety Millat-2011 was found the most suitable for the production of sourdough bread. Consequently, this variety was milled to get the straight grade flour for further use in multigrain sourdough bread. The anti-nutritional factors in Indian vetch were determined after steeping and fermentation. Both these processes significantly reduced the level of anti-nutritional factors. Sourdough multigrain bread was prepared by using the barley, Indian vetch and wheat. The levels of barley and Indian vetch in composite flour were optimized by using response surface methodology and their effects on the textural and sensory properties were studied. The optimized levels of barley (16.48%) and Indian vetch (12.35%) in multigrain bread formulation generated through RSM resulted in sensory acceptable multigrain bread. After this, the processing parameters (time and temperature) were optimized by using the response surface methodology. The increase in fermentation time and temperature significantly affected the textural and sensory properties of bread and the best quality attributes were obtained at a temperature and time combination of 29ºC and 19 h, respectively. Sourdoughs were analyzed for pH, acidity, organic acids and volatile compounds. Optimized multigrain breads were analyzed for physic-chemical parameters such as texture, proximate composition, organic acids, volatile compounds, in-vitro protein and starch digestibilities, glycemic index, minerals and amino acid profiles. All these parameter except mineral contents were significantly affected by the time and temperature of sourdough fermentation. The in-vitro starch digestibility and glycemic index of the body were found to reduce and in-vitro protein digestibility was improved. The multigrain sourdough bread prepared at 29ºC for 19h was found best regarding the sensory attributes than the yeast leavened bread.