Vertical Transmission of SARS-CoV-2 from COVID-19 Infected Pregnant Women: A Review on Intrauterine Transmission

BACKGROUND

Fetal safety is a major concern with the global spread of COVID-19, but there is scarce information regarding vertical transmission and how it affects the fetus.

OBJECTIVE

To assess and summarize the currently available evidence on vertical transmission (probable/confirmed) of SARS-CoV-2 along with fetal outcomes.

METHODS

The current review was carried out from March to October 2020. Relevant databases were searched electronically. Pertinent articles were selected according to eligibility criteria and information was compiled.

RESULTS

In 16 selected articles there were total 498 COVID-19 infected pregnant women ranging in age between 15 and 45 years. Gestational age at the onset of COVID-19 symptoms ranged from 25-41 weeks. Vertical transmission (probable and confirmed) rate from series was 4.883% (23/471). Of 17 affected newborns (information available), 08 required NICU admission, 04 developed pneumonia and 04 required mechanical ventilation.

CONCLUSION

There is probable intrauterine transmission of SARS-CoV-2. Few adverse fetal outcomes are associated with COVID-19.

Toxic effect of some heavy metals on hematology and histopathology of major carp (Catla catla)

The current study was conducted to assess the hematological and histopathological changes in major carp (Catla catla) exposed to different concentrations of copper (Cu) and cadmium (Cd). For this purpose, Catla catla fish, weighing approximately 230-235 g, were randomly divided into four groups and then exposed to acute doses of Cu (1.25 ppm), Cd (4.5 ppm), and their mixture (2.25 ppm) for 96 h and then 20, 30, and 40% respectively for a period of 30 days. Results showed that red blood cells (RBCs), hemoglobin (Hb), hematocrit (Hct), lymphocyte, and monocyte decreased significantly, while the total white blood cell count and neutrophil population significantly increased in experimental groups as compared with the control one. Histopathological examination of liver tissues showed karyorrhexis, hepatic cells degeneration, congestion, and hemorrhages. Microscopic analysis of gills' sections revealed lamellar atrophy, telangiectasia, and necrosis of lamellar epithelial cells. In the kidneys, different histopathological ailments like atrophy of glomeruli, necrosis of renal tubular cells, increased urinary spaces, degeneration of renal tubules, and melanomacrophage aggregates were observed, while in the intestine, atrophy of villi, sloughing of epithelial villi, and congestion were seen after 30 days of exposure. In conclusion, the study indicates that exposure to Cu and Cd for longer period of time causes adverse hematological and histopathological changes in Catla catla fish.

Helminthological studies in francolins (Galliformes: Phasianidae) of Sindh, Pakistan with two new species and epidemiological parameters

Francolins are among the very gregarious variety of game birds severely infected by various parasites that may cause an important source for infection transmission in humans by eating them very fondly in the country. During this study, two commonly found francolins species of the region; Francolinus francolinus (Black Francolin) and F. pondicerianus (Grey Francolin), were examined for helminthes fauna. The study deals with the primary survey of helminthic infection occur in the francolin birds (Phasianidae: Perdicinae) with reference to their forage in gut content. It is the first helminthological and epidemiological study in Sindh, Pakistan. At present, a total of 20 birds were examined, out of which 17 were found infected with cestode larvae of two species of genus Cotugnia and genus Raillietina, one species of trematode, Prosthogonimus potentially new species; one new species of acanthocephalan, Mediorhynchus francolinae sp. nov.; one species of nematode, Subulura brumpti (López-Neyra, 1922) were recovered, with new host records. The forage content and comparative incidence of helminth species were also observed and discussed in the current study, which revealed the high prevalence of infection in grey francolins than that of black francolin. The mean intensity of infection relative to the forage in guts of hosts was found significant (P < 0.05), observed 9.14 ± 1.65 in black francolins than in grey francolins (5.8 ± 0.51). The parasitic abundance was compared using Fisher's Exact Test, which showed no significant difference between cestodes and nematodes in the two hosts, however trematode and acanthocephalan was found only in grey francolin. The parasitic frequencies along with the confidence intervals were recorded higher in black francolins by cestodes and nematodes than the black francolins during the present study.

Marine oil spill detection using Synthetic Aperture Radar over Indian Ocean

Four oil spill events over the Indian Ocean including Chennai, Sharjah, Al Khiran and Mubarak Village are analyzed using Sentinel-1 satellite data. General National Oceanic and Atmospheric Administration (NOAA) Operational Modeling Environment (GNOME) model is utilized for oil spills trajectory production, whereas oil spills weathering processes are modeled using Automated Data Inquiry for Oil Spill (ADIOS). Synthetic Aperture Radar (SAR) based oil spill detection technique provided reliable results at the wind speed between 3 to 9 m/s for all events. Maximum oil spill movement (33 km) from the source point is observed in the Al Khiran, whereas evaporation rate of crude (degraded) oil is observed as high (low). The Near Real Time (NRT) detection of oil spill using SAR imagery needs high computational power, however, provides better results. This study concludes that SAR based oil spill detection is a cost-effective technique and can be utilized for mapping of oil spills.

Characterization and Comparative Evaluation of Milk Protein Variants from Pakistani Dairy Breeds

The aim of study was to scrutinize the physicochemical and protein profile of milk obtained from local Pakistani breeds of milch animals such as Nilli-Ravi buffalo, Sahiwal cow, Kajli sheep, Beetal goat and Brela camel. Physicochemical analysis unveiled maximum number of total solids and protein found in sheep and minimum in camel. Buffalo milk contains the highest level of fat (7.45%) while camel milk contains minimum (1.94%). Ash was found maximum in buffalo (0.81%) and sheep (0.80%) while minimum in cow's milk (0.71%). Casein and whey proteins were separated by subjecting milk to isoelectric pH and then analyzed through sodium dodecyl sulphate-polyacrylamide gel electrophoresis (SDS-PAGE). The results showed heterogeneity among these species. Different fractions including α_S1, α_S2, κ-casein, β-casein and β-lactoglobulen (β-Lg) were identified and quantitatively compared in all milk samples. Additionally, this electrophoretic method after examining the number and strength of different protein bands (α_S1, α_S2, β-CN, α-LAC, BSA, and β-Lg, etc.), was helpful to understand the properties of milk for different processing purposes and could be successfully applied in dairy industry. Results revealed that camel milk was best suitable for producing allergen free milk protein products. Furthermore, based on the variability of milk proteins, it is suggested to clarify the phylogenetic relationships between different cattle breeds and to gather the necessary data to preserve the genetic fund and biodiversity of the local breeds. Thus, the study of milk protein from different breed and species has a wide range of scope in producing diverse protein based dairy products like cheese.

In vivo analgesic, anti-inflammatory, and sedative activity and a molecular docking study of dinaphthodiospyrol G isolated from Diospyros lotus

BACKGROUND

Analgesic, anti-inflammatory, and sedative drugs are available with potential side effects such as peptic ulcer and addiction among other things. In this regard, research is underway to find safe, effective, and economical drugs free of these side effects. In this study, an isolated natural product from Diospyros lotus, was tested for the aforementioned bioactivities.

OBJECTIVES

To evaluate analgesic, anti-inflammatory, and sedative potential of D. lotus extracts in animal paradigms using BALB/c mice as experimental model.

METHODS

Analgesic, anti-inflammatory and sedative activities of dinaphthodiospyrol G (1) isolated from the chloroform fraction of D. lotus were evaluated using different experimental procedures. Anti-inflammatory effect was evaluated using the carrageenan and histamine-induced paw edema, whereas the antinociceptive effect was quantified by means of the hot plate analgesiometer. On the other hand, the sedative effect was determined using animal assay for screening the locomotors effects of compound 1. Compound 1 was also subjected to molecular modeling studies against cyclooxygenase enzymes.

RESULTS

Results from this investigation showed that the extract is devoid of anti-inflammatory and antinociceptive potentials but has a significant sedative effect, whereas the tested compound exhibited 55.23 and 78.34% attenuation in paw edema by carrageenan and histamine assays, respectively. A significant (p < 0.001) and dose-dependent antinociceptive and sedative effects were demonstrated by the isolated compound. Molecular docking and dynamics simulation studies of the isolated compound against cyclooxygenase enzyme indicated that compound 1 forms specific interactions with key residues in the active site of the target receptor, which validates the potential use of the isolated compound as cyclooxygenase inhibitor.

CONCLUSIONS

Compound 1 exhibited remarkable analgesic, anti-inflammatory, and sedative activities. These findings strongly justify the traditional use of D. lotus in the treatment of inflammation, pain, and insomnia.

An annotated list of the species of lice (Insecta: Phthiraptera) described by Mohammad A.-R. Ansari

Mohammad Atiq-ur-Rahman Ansari (1911-1979) was an Indian phthirapterist who contributed to the knowledge of parasitic lice (Insecta: Phthiraptera) from the Indian subcontinent with 41 papers published from 1944 to 1968. He described 195 new species and subspecies of chewing lice from birds and redescribed 182 previously known species of all groups of lice. Among the new species, 155 are still considered valid. We list all the species and subspecies described by Ansari under their original binomial or trinomial names, adding for each one: subsequent references by Ansari, current taxonomic status (i.e. taxa placed now in different genera, or with senior synonyms), type host, type locality, and deposition of type material when still extant. About 120 (62%) of Ansari's primary type specimens are deposited at museums in the United Kingdom and the U.S.A., with the remaining 75 primary types presumed lost. Four species are here considered species inquirenda, because the morphological data published by Ansari are not consistent with diagnostic characters of the genera in which he placed them, and their types could not be located to confirm their correct generic placement. They are Capraiella masumae Ansari, 1955; Craspedorrhynchus chicquera Ansari, 1955; Cuculicola jamilae Ansari, 1955 and Cuculoecus distinctus Ansari, 1955. We propose the name Philopterus ansarii nomen novum as a replacement for Philopterus kalkalichi Ansari, 1956e-preoccupied by Philopterus kalkalichi Ansari, 1955e-and designate a neotype for it. We also designate a neotype for Alcedoecus anularis Ansari, 1955e and Alcedoecus annulatus Tendeiro, 1965a, placing the latter name as an absolute junior synonym of the former.

Comparative Study of Selenides and Tellurides of Transition Metals (Nb and Ta) with Respect to its Catalytic, Antimicrobial, and Molecular Docking Performance

The present research is a comparative study that reports an economical and accessible method to synthesize niobium (Nb) and Tantalum (Ta) selenides and tellurides with useful application in the removal of pollutants in textile, paper, and dyeing industries as well as in medical field. In this study, solid-state process was used to generate nanocomposites and various characterization techniques were employed to compare two groups of materials under investigation. Structure, morphology, elemental constitution, and functional groups of synthesized materials were analyzed with XRD, FESEM coupled with EDS, FTIR, and Raman spectroscopy, respectively. HR-TEM images displayed nanoscale particles with tetragonal and monoclinic crystal structures. The optical properties were evaluated in terms of cut-off wavelength and optical band gap using UV-visible spectroscopy. A comparative behavior of both groups of compounds was assessed with regards to their catalytic and microcidal properties. Extracted nanocomposites when used as catalysts, though isomorphs of each other, showed markedly different behavior in catalytic degradation of MB dye in the presence of NaBH₄ that was employed as a reducing agent. This peculiar deviation might be attributed to slight structural differences between them. Escherichia coli and Staphylococcus aureus (G -ve and + ve bacteria, respectively) were designated as model strains for in vitro antibacterial tests of both clusters by employing disk diffusion method. Superior antibacterial efficacy was observed for telluride system (significant inhibition zones of 26-35 mm) compared with selenide system (diameter of inhibition zone ranged from 0.8 mm to 1.9 mm). In addition, molecular docking study was undertaken to ascertain the binding interaction pattern between NPs and active sites in targeted cell protein. The findings were in agreement with antimicrobial test results suggesting NbTe₄ to be the best inhibitor against FabH and FabI enzymes.

Knowledge, attitude, practice and perceived barriers among healthcare workers regarding COVID-19: a cross-sectional survey from Pakistan

A self-administered validated (Cronbach's alpha=0.077) questionnaire was used to assess knowledge, attitude and practice among healthcare workers (HCWs) in Pakistan regarding coronavirus disease 2019 (COVID-19). Findings showed that HCWs have good knowledge (93.2%, N=386), a positive attitude [mean 8.43 (standard deviation 1.78)] and good practice (88.7%, N=367) regarding COVID-19. HCWs perceived that limited infection control material (50.7%, N=210) and poor knowledge regarding transmission (40.6%, N=168) were the major barriers to infection control. Regression analysis indicated that pharmacists were more likely to demonstrate good practice than other HCWs (odds ratio 2.247, 95% confidence interval 1.11-4.55, P=0.025). This study found that HCWs in Pakistan have good knowledge, but there are gaps in specific aspects of knowledge and practice that warrant attention.

Knowledge, attitude, practice and perceived barriers among healthcare workers regarding COVID-19: a cross-sectional survey from Pakistan

A self-administered validated (Cronbach's alpha=0.077) questionnaire was used to assess knowledge, attitude and practice among healthcare workers (HCWs) in Pakistan regarding coronavirus disease 2019 (COVID-19). Findings showed that HCWs have good knowledge (93.2%, N=386), a positive attitude [mean 8.43 (standard deviation 1.78)] and good practice (88.7%, N=367) regarding COVID-19. HCWs perceived that limited infection control material (50.7%, N=210) and poor knowledge regarding transmission (40.6%, N=168) were the major barriers to infection control. Regression analysis indicated that pharmacists were more likely to demonstrate good practice than other HCWs (odds ratio 2.247, 95% confidence interval 1.11-4.55, P=0.025). This study found that HCWs in Pakistan have good knowledge, but there are gaps in specific aspects of knowledge and practice that warrant attention.

Dye degradation performance, bactericidal behavior and molecular docking analysis of Cu-doped TiO2 nanoparticles

Copper-doped TiO2 was prepared with a sol-gel chemical method. Various concentrations (3, 6, and 9 wt%) of Cu dopant were employed. Several techniques were implemented to assess the structural, optical, morphological and chemical properties of the synthesized samples. Evaluation of elemental composition using SEM-EDS and XRF techniques showed the presence of dopant element in the prepared samples. XRD analysis confirmed the presence of anatase (TiO2) phase with interstitial doping. Incorporation of dopant was observed to enhance the crystallinity and increase the crystallite size of the synthesized products. SAED profiles revealed a high degree of crystallinity in the prepared specimens, which was also evident in the XRD spectra. Optical properties studied using UV-vis spectroscopy depicted a shift of the maximum absorption to the visible region (redshift) that signified a reduction in the band gap energy of Cu-doped TiO2 samples. Examination of morphological features with scanning and high-resolution transmission electron microscopes revealed the formation of spherical nanoparticles with a tendency to agglomerate with increasing dopant concentration. Molecular vibrations and the formation of Ti-O-Ti bonds were revealed through FTIR spectra. PL spectroscopy recorded the trapping efficiency and migration of charge carriers, which exhibited electron-hole recombination behavior. Doped nanostructures showed enhanced bactericidal performance and synergism against S. aureus and E. coli. In summary, Cu-doped TiO2 nanostructures were observed to impede bacteria effectively, which is deemed beneficial in overcoming ailments caused by pathogens such as microbial etiologies. Furthermore, molecular docking analysis was conducted to study the interaction of Cu-doped TiO2 nanoparticles with multiple proteins namely β-lactamase (binding score: -4.91 kcal mol-1), ddlB (binding score: -5.67 kcal mol-1) and FabI (binding score: -6.13 kcal mol-1) as possible targets with active site residues. Dye degradation/reduction of control and Cu-doped samples were studied through absorption spectroscopy. The obtained outcomes of the performed experiment indicated that the photocatalytic activity of Cu-TiO2 enhanced with increasing dopant concentration, which is thought to be due to a decreased rate of electron-hole pair recombination. Consequently, it is suggested that Cu-TiO2 can be exploited as an effective candidate for antibacterial and dye degradation applications.

Bimetallic Ag/Cu incorporated into chemically exfoliated MoS2 nanosheets to enhance its antibacterial potential: in silico molecular docking studies

Bimetallic Ag and Cu (1:1 wt%) nanoparticles (NPs) were synthesized and annealed at temperatures of 400 °C, 600 °C, and 800 °C using chemical reduction techniques. High temperature annealed (at 800 °C) Ag:Cu sample ratios (5 and 10 wt%) were used to dope MoS₂. A wide variety of techniques including X-ray diffraction, Fourier transform infrared spectroscopy, field emission scanning, high resolution transmission electron microscopy, differential scanning calorimetry, thermogravimetric analysis, Raman, photoluminescence, and ultraviolet visible spectrophotometry were used to study the morphology, structure, functional groups, excitons recombination, and thermal and optical properties of both annealed and doped samples. The antimicrobial activity of the prepared products was tested on the MRSA-superbug with ciprofloxacin antibiotic as the reference drug. Statistically significant (P < 0.05) inhibition zones (mm) were recorded for the as-synthesized Ag-Cu, heat-treated samples at 400 °C, 600 °C, and 800 °C, doped Ag-Cu/MoS₂ 5% and Ag-Cu/MoS₂ 10% which ranged from 6.35-9.85 mm and 8.60-11.75 mm at (0.5, 1.0 mg 50 μl^-1) concentrations compared with ciprofloxacin 12.55 mm and DIW 0 mm inhibition zones, respectively. Overall Ag-Cu NPs alone and with different temperature treatments showed less antibacterial efficacy compared with Ag-Cu/MoS₂ 5% and 10%. Furthermore, molecular docking studies were employed to unveil the binding interaction pattern of NPs in the active pocket of β-lactamase enzyme suggested that it could be a potential inhibitor that could be further evaluated for its enzyme inhibition characteristics.

Photocatalytic and bactericidal properties and molecular docking analysis of TiO2 nanoparticles conjugated with Zr for environmental remediation

Despite implementing several methodologies including a combination of physical, chemical and biological techniques, aquatic and microbial pollution remains a challenge to this day. Recently, nanomaterials have attracted considerable attention due to their extraordinary prospective for utilization toward environmental remediation. Among several probable candidates, TiO₂ stands out due to its potential for use in multifaceted applications. One way to improve the catalytic and antimicrobial potential of TiO₂ is to dope it with certain elements. In this study, Zr-doped TiO₂ was synthesized through a sol–gel chemical method using various dopant concentrations (2, 4, 6, and 8 wt%). Surface morphological, microstructural and elemental analysis was carried out using FESEM and HR-TEM along with EDS to confirm the formation of Zr–TiO₂. XRD spectra showed a linear shift of the (101) anatase peak to lower diffraction angles (from 25.4° to 25.08°) with increasing Zr⁴⁺ concentration. Functional groups were examined via FTIR, an ample absorption band appearing between 400 and 700 cm⁻¹ in the acquired spectrum was attributed to the vibration modes of the Ti–O–Ti linkage present within TiO₂ nanoparticles, which denotes the formation of TiO₂. Experimental results indicated that with increasing dopant concentrations, photocatalytic potential was enhanced significantly. In this respect, TiO₂ doped with 8 wt% Zr (sample 0.08 : 1) exhibited outstanding performance by realizing 98% elimination of synthetic MB in 100 minutes. This is thought to be due to a decreased rate of electron–hole pair recombination that transpires upon doping. Therefore, it is proposed that Zr-doped TiO₂ can be used as an effective photocatalyst material for various environmental and wastewater treatment applications. The good docking scores and binding confirmation of Zr-doped TiO₂ suggested doped nanoparticles as a potential inhibitor against selected targets of both E. coli and S. aureus. Hence, enzyme inhibition studies of Zr-doped TiO₂ NPs are suggested for further confirmation of these in silico predictions.

Despite implementing several methodologies including a combination of physical, chemical and biological techniques, aquatic and microbial pollution remains a challenge to this day.

Proanthocyanidins: A comprehensive review

Proanthocyanidins are condensed tannins with various pharmacological properties. These phytochemicals are considered as 'offense and defense molecules because of their human health benefits. The validation of their diverse health aspects, namely, antioxidant, anticancer, antidiabetic, neuroprotective, and antimicrobial has earned them repute in thermochemistry. Proanthocyanidins are oligo- or polymers of monomeric flavan-3-ols produced as an end product of flavonoid biosynthetic pathway. Agricultural wastes and food processing wastes contain immense amount of proanthocyanidins, exploitation of which can be a sustainable source of dietary supplements and functional ingredients. The current review article discusses recent developments in the health promoting properties of proanthocyanidins and the associated hurdles.

Biochemical changes in cultivars of sweet oranges infected with citrus tristeza virus

Citrus fruit production occupies a place of considerable importance in the economy of the world including Pakistan. Tristeza disease caused by Citrus Tristeza Virus (CTV) exists in various forms that may or may not cause symptoms in the plants. The bioactive compounds and antioxidants are naturally present in plants and provide a defense mechanism that is generally accelerated in response to a stress. The objective of the present study was to target and analyze the citrus plants that were CTV positive to observe the changes in the enzymatic and non-enzymatic antioxidants of citrus (Sweet Oranges only). It was observed that in response to CTV infection, both the non-enzymatic antioxidants (total flavonoid, ascorbic acid, phenolic acid) and enzymatic antioxidants (catalase, superoxide dismutase and peroxidase) activities showed an increasing trend overall. The profiling of antioxidants in response to a viral infection may help in the discovery of new biomarkers that can be used as a monitoring tool in disease management.

Effect of heating on the oxidative stability of corn oil and soybean oil

The effects of conventional and microwave heating on the oxidative properties of corn and soybean oil were evaluated. The results showed that acid value, peroxide value, oxidative indices, total oxidation value, and p-anisidine values changed significantly with the rise in temperature (p < 0.05). The peroxide and p-anisidine values for corn oil (PV: 50.670 meqO2/kg, p-AV: 8.248) were greater than soybean oil (PV: 41.694 meqO2/kg, p-AV: 7.566) for conventional heating. The peroxide and p-anisidine values for soybean oil (PV: 6.545 meqO2/kg, p-AV: 76.539) were greater compared to corn oil (PV: 5.074 meqO2/kg, p-AV: 65.360) for microwave heating. The results concluded that microwave heating had a greater impact on the chemical degradation of the fatty acids of the oil. The FT-IR spectra showed peak changes at 3743 cm-1 and 1739 cm-1 and confirmed the rancidity of the oils from microwave heating due to the formation of secondary oxidation products. It was concluded that corn oil showed more oxidative changes compared to soybean oil.

Activation of integrated stress response pathway regulates IL-1β production through posttranscriptional and translational reprogramming in macrophages

Immune cells sense and programme its cellular machinery appropriately to the environmental changes through the activation of cytoprotective adaptive pathway so-called the "integrated stress response (ISR)". However, the mechanisms implicated in ISR-induced protective responses are poorly understood. Here, we show that ISR activation by arsenite (Ar) results in suppression of IL-1β production in macrophages and inhibition of DSS-induced colitis in a murine model through a novel posttranscriptional and translation regulatory (PTR) mechanism. Ar triggers PTR events through eIF2α-phosphorylation, which results in the attenuation of active polysome formation leading to the accumulation of translationally stalled IL-1β mRNAs. Translationally stalled IL-1β mRNAs recruit RNA-binding proteins (TIA-1/TIAR), resulting in the formation of RBP-RNA complexes known as stress granules (SGs). The SGs bound IL-1β mRNAs might undergo degradation through induction of autophagy. Also, we show that Ar posttranslationally impairs processing and secretion of IL-1β by diminishing inflammasome activation. Altogether, this study unveils a novel mechanism of IL-1β regulation and further suggests that pharmacological activation of cytoprotective ISR pathway might provide an effective therapeutic intervention against inflammatory diseases.

Cutaneous Leishmaniasis in the Metropolitan City of Multan, Pakistan, a Neglected Tropical Disease

Cutaneous leishmaniasis is a vector-borne infection caused by flagellated parasitic protozoans in the genus Leishmania. Promastigotes are the infective stage, which are transmitted by the bite of female sand flies of the genera Phlebotomus or Lutzomyia. Three clinical forms of Leishmania infection are recognized in humans, and they are caused by different Leishmania species. They are cutaneous leishmaniasis (CL), mucocutaneous leishmaniasis (ML), and visceral leishmaniasis (VL). Up to 2 million cases of leishmaniasis are reported annually worldwide. In Pakistan, CL is widely distributed in endemic areas. In the current study, a survey was conducted to investigate the occurrence of CL in an endemic area of the metropolitan city of Multan, Pakistan. The material for diagnosis of CL was obtained from 461 patients from 239 clinical laboratories and health care centers in Multan. Of these patients, 42.9% (198 of 461) having positive findings of amastigotes in Giemsa stained tissue impression smears. The distribution of CL skin lesions was highly variable. Most patients (76.2%) had a single lesion. Most CL lesions were found on a single hand (23.7%). The prevalence of two CL lesions per patient was 21.7%, while three or more positive CL lesions were observed in 2.0% of patients. The 198 CL-positive patients ranged in age 10-40 yr old, 101 were males, and 97 were females. Logistic regression analysis of leishmaniasis versus age and gender showed that both the age and gender had a significant (P < 0.05) effect on the occurrence of infection. Outbreaks of CL were reported in 14 of the 68 Union Councils of Multan.

Prevalence of Smokeless Tobacco Use in Pakistan: Insight from the Global Adult Tobacco Survey Pakistan (GATS Pakistan-2014)

OBJECTIVE

Prevalence of tobacco consumption is increasing including both smoked and smokeless tobacco. The objective of this paper is to highlight the prevalence of smokeless tobacco use, its demographic trends as well as socioeconomic determinants based on Global Adult Tobacco Survey 2014 (GATS) -Pakistan.

METHODS

Secondary analysis of GATS data was done which was a nationally representative survey, conducted among non-institutionalized males and females aged 15 years and above. The survey included a total of 9,856 households which were selected using multistage stratified cluster sampling technique.

RESULTS

Secondary analysis of GATS data revealed that 8.6% of the Pakistani population was current users of smokeless tobacco; among them, 8.0% were daily users and 0.6% were less than daily users. Prevalence of SLT use was higher in males (13.7%) compared to females (3.9%) (p = 0.000). Mean age of male users was 39.96±14.43 years and of females was 47.71±16.21 (p=0.000). Males (3.959 95% CI = 3.291-4.764) and respondents with primary or less education (2.216 95%CI = 1.841-2.668) were at higher odds of SLT use prevalence. Among daily users, Naswar was the preferred (71.8%) SLT product in males, compared to females (p = 0.000). Whereas, in females, use of Paan with tobacco (26.4%) (P = 0.000) and Naas (20.9%) (P = 0.000) was more common compared to males. Among SLT users, 71.1% participants used to spend 1-100 Rs (0.0095-0.95USD) per week on purchase of SLT products. However 28.9% were spending more than one dollar on the purchase of SLT products including 19.1% who were spending Rs 101-200 (0.96-1.9USD) followed by 7.2% spending Rs 201-300 (1.91-2.85 USD) and 2.6% spending Rs. >300 (>2.85 USD).

CONCLUSIONS

Males and less educated individuals should be targeted with behavioral interventions for control of SLT use. Males started SLT use at an earlier age compared to females which can result in premature morbidity and mortality in males. SLT products are cheaper compared to cigarettes, therefore, taxes need to be levied on SLT products.

Determinants of Smoked Tobacco Consumption among Pakistani Adults: An Analysis from GATS Pakistan 2014

OBJECTIVE

An in-depth analysis of GATS 2014 is performed to study the various demographic determinants of smoked tobacco consumption among Pakistani adults.

METHODS

The Global Adult Tobacco Survey (GATS) is a standardized surveillance mechanism regarding monitoring of tobacco consumption globally, that uses three stage cluster random sampling technique to have a representative data. We performed the complex data set analysis using SPSS V 15. The associations were determined by carrying out univariate analysis, and determining chi squares for categorical variables.

RESULTS

Overall current smoking prevalence was found to be 12.4%. The univariate analysis revealed male gender (OR: 14.1 CI= 11.2-17.7, p value 0.000), little or no education (OR: 1.4 CI=1.2-1.6, p-value 0.000), living in urban areas (OR: 0.7 CI= 0.6-0.8, p-value 0.000) and avoiding smoking attempts in young age till 25 years (OR: 0.2 CI= 0.1-0.2, p value 0.000) were determinants. Assosiation of demographic determinants with cessation behaviour showed that the health concern was the primary reason to ever stop smoking among both urban rural dwellers, educated and uneducated and respondents aged 25 years and above. Educational status, age of respondent and residence had almost no significant effect on cessation behaviour of smoked tobacco users.

CONCLUSIONS

Males having low education and living in rural area puts an adult Pakistani at high risk of becoming the user of smoked tobacco. Health education involving primary health care providers particularly focusing on rural areas will reduce the prevalence of smoking.

Comparison of Tobacco Consumption among Adults in SAARC Countries (Pakistan, India and Bangladesh)

OBJECTIVE

To compare the findings of Global adult tobacco surveys (GATS) conducted in SAARC Countries.

METHODS

The national representative data from Pakistan, India, and Bangladesh was used as GATS was done in these three countries of SAARC. The key variables were selected where information was consistently taken like current smokers, smokeless tobacco users, exposure to second-hand smoke, advise by health care provider to quit, monthly expenditure and noticing of health warning label and other information related to daily tobacco users (smoke, smokeless) mean age of initiation and mean number of cigarettes consumed per day were also collected. Chi-square test was applied and p-value was considered significant at <0.05.

RESULTS

Overall tobacco consumption was significantly high (43.3%) in Bangladesh (Pakistan 19.1% and India 34.6%). Similarly, current smokers were significantly more in Bangladesh 23% (India 14% and Pakistan 12%) and smokeless tobacco was significantly more in Bangladesh 27.2% (India 25.9% and Pakistan 7.7%). Exposure to second-hand smoke at work was 69.1% in Pakistan (63% in Bangladesh and 29.9% in India). Monthly expenditure on cigarettes was also high in Pakistan 7.51 USD (India 6.26 USD and Bangladesh 4.57USD). Mean age of initiation was 18.8 years in Bangladesh, (17.8 India and 18.7 Pakistan). Mean number of cigarettes consumed was significantly high in Pakistan i.e. 13.6 (6.2 in India and 5.1 Bangladesh).

CONCLUSIONS

All the three South Asian countries have a high prevalence of tobacco consumption. Tobacco use was high in Bangladesh but smokeless tobacco among males was high in India and mean number of cigarettes daily was high in Pakistan.

Exposure of the Adult Pakistani Population to Second-Hand Smoke - An insight from Global Adult Tobacco Survey of Pakistan 2014

OBJECTIVE

About one-third of the world population is exposed to second hand smoke (SHS) with estimated 600,000 annual deaths. The objective of this article is to determine the exposure of adult Pakistani population to SHS and its association with different demographic variables based on data of Global Adult Tobacco Survey (GATS) conducted in 2014 in Pakistan.

METHODS

Secondary analysis of Global Adult Tobacco Survey (GATS) data was done which is a global standard used for systematically monitoring use of both smoked and smokeless tobacco products. GATS Pakistan was a nationally representative survey, conducted in all four provinces among adult males and females aged15 years and above. Using multistage stratified cluster sampling technique a total of 9,856 households were selected and finally 7,831 individuals were enrolled.

RESULTS

At homes around 43.3% individuals were exposed to SHS. Univariate analysis revealed that overall males (Odds Ratio, OR: 1.17 CI: 1.04-1.30, p=0.006) and less educated (OR: 1.30, CI: 1.16-1.46, p=0.000) group were at higher odds of being exposed to SHS at homes. Over all exposure to second hand smoke at home was also significantly high among urban residents (p = 0.000). Among nonsmokers age group 15 -35 years (odds ratio, 1.24 CI:1.09-1.04, P=0.01) and less educated group (OR 1.24, CI: 1.09-1.40, p=0.001) were at higher odds of being exposed to SHS at home At indoor workplaces, overall 69.1% and among non-smokers, 65.3% individuals were exposed to SHS. Univariate analysis has shown that less educated group (OR: 1.525, CI: 1.012-2.298, p=0.043) was at higher odds of being exposed to SHS at indoor workplaces. Among various public places exposure of participants to SHS was highest (86%) at restaurants, followed by public transport (74%), marriage halls (65%), universities (46%), health care facilities (35%) and least at schools (20%)..

CONCLUSIONS

Less educated males were more exposed to second-hand smoke both at work places and public places; therefore to start with interventions, work places and public places should be a priority as at home results could be confounded by self-smoking as well.

Amino acid starvation sensing dampens IL-1β production by activating riboclustering and autophagy

Activation of the amino acid starvation response (AAR) increases lifespan and acute stress resistance as well as regulates inflammation. However, the underlying mechanisms remain unclear. Here, we show that activation of AAR pharmacologically by Halofuginone (HF) significantly inhibits production of the proinflammatory cytokine interleukin 1β (IL-1β) and provides protection from intestinal inflammation in mice. HF inhibits IL-1β through general control nonderepressible 2 kinase (GCN2)–dependent activation of the cytoprotective integrated stress response (ISR) pathway, resulting in rerouting of IL-1β mRNA from translationally active polysomes to inactive ribocluster complexes—such as stress granules (SGs)—via recruitment of RNA-binding proteins (RBPs) T cell–restricted intracellular antigen-1(TIA-1)/TIA-1–related (TIAR), which are further cleared through induction of autophagy. GCN2 ablation resulted in reduced autophagy and SG formation, which is inversely correlated with IL-1β production. Furthermore, HF diminishes inflammasome activation through suppression of reactive oxygen species (ROS) production. Our study unveils a novel mechanism by which IL-1β is regulated by AAR and further suggests that administration of HF might offer an effective therapeutic intervention against inflammatory diseases.

Reduced intake of food (also known as dietary restriction) without malnutrition has been shown to benefit health in humans and animals, including an increase in life expectancy, metabolic fitness, and resistance to acute stress. Recent studies have attributed the benefits associated with dietary restriction to the reduced intake of amino acids. However, the underlying mechanisms through which amino acid restriction regulates various homeostatic processes are poorly defined. Here, we show that activation of amino acid starvation response (AAR) by the small molecule Halofuginone (HF) results in a significant inhibition of production of interleukin 1β (IL-1β), a proinflammatory mediator. We find that AAR provides protection from intestinal inflammation–associated pathology in a mouse model of colitis through a novel mechanism involving the formation of riboclusters (groups of RNA-binding proteins (RBPs) and stalled mRNA complexes) and autophagy. We further show that HF-mediated inhibition in IL-1β production is dependent on general control nonderepressible 2 kinase (GCN2), an amino acid deprivation sensor. This study provides the mechanisms regulating AAR-induced benefits in the context of inflammation and further suggests that the administration of HF might offer an effective therapeutic intervention against inflammatory diseases in mammals.

Vitex negundo induces an anticonvulsant effect by inhibiting voltage gated sodium channels in murine Neuro 2A cell line

Vitex negundo (Vn) extract is famous for the treatment of neurological diseases such as migraine and epilepsy. These neurological diseases have been associated with abnormally increased influx of sodium ions into the neurons. Drugs that inhibit voltage gated sodium channels can be used as potent anti-epileptics. Till now, the effects of Vn on sodium channels have not been investigated. Therefore, we have investigated the effects of methalonic fraction of Vn extract in Murine Neuro 2A cell line. Cells were cultured in a defined medium with or without the Vn extract (100 μg/ml). Sodium currents were recorded using whole-cell patch clamp method. The data show that methanolic extract of Vn inhibited sodium currents in a dose dependent manner (IC50 =161μg/ml). Vn (100 μg/ml) shifted the steady-state inactivation curve to the left or towards the hyper polarization state. However, Vn did not show any effects on outward rectifying potassium currents. Moreover, Vn (100 μg/ml) significantly reduced the sustained repetitive (48±4.8%, P<0.01) firing from neonatal hippocampal neurons at 12 DIV. Hence, our data suggested that inhibition of sodium channels by Vn may exert pharmacological effects in reducing pain and convulsions.

Raman spectroscopy for the characterization of different fractions of hemp essential oil extracted at 130°C using steam distillation method

In this study, Raman spectroscopy along with Principal Component Analysis (PCA) is used for the characterization of pure essential oil (pure EO) isolated from the leaves of the Hemp (Cannabis sativa L.,) as well as its different fractions obtained by fractional distillation process. Raman spectra of pure Hemp essential oil and its different fractions show characteristic key bands of main volatile terpenes and terpenoids, which significantly differentiate them from each other. These bands provide information about the chemical composition of sample under investigation and hence can be used as Raman spectral markers for the qualitative monitoring of the pure EO and different fractions containing different active compounds. PCA differentiates the Raman spectral data into different clusters and loadings of the PCA further confirm the biological origin of the different fractions of the essential oil.

A Comprehensive Gene Expression Meta-analysis Identifies Novel Immune Signatures in Rheumatoid Arthritis Patients

Rheumatoid arthritis (RA), a symmetric polyarticular arthritis, has long been feared as one of the most disabling forms of arthritis. Identification of gene signatures associated with RA onset and progression would lead toward development of novel diagnostics and therapeutic interventions. This study was undertaken to identify unique gene signatures of RA patients through large-scale meta-profiling of a diverse collection of gene expression data sets. We carried out a meta-analysis of 8 publicly available RA patients’ (107 RA patients and 76 healthy controls) gene expression data sets and further validated a few meta-signatures in RA patients through quantitative real-time PCR (RT-qPCR). We identified a robust meta-profile comprising 33 differentially expressed genes, which were consistently and significantly expressed across all the data sets. Our meta-analysis unearthed upregulation of a few novel gene signatures including PLCG2, HLA-DOB, HLA-F, EIF4E2, and CYFIP2, which were validated in peripheral blood mononuclear cell samples of RA patients. Further, functional and pathway enrichment analysis reveals perturbation of several meta-genes involved in signaling pathways pertaining to inflammation, antigen presentation, hypoxia, and apoptosis during RA. Additionally, PLCG2 (phospholipase Cγ2) popped out as a novel meta-gene involved in most of the pathways relevant to RA including inflammasome activation, platelet aggregation, and activation, thereby suggesting PLCG2 as a potential therapeutic target for controlling excessive inflammation during RA. In conclusion, these findings highlight the utility of meta-analysis approach in identifying novel gene signatures that might provide mechanistic insights into disease onset, progression and possibly lead toward the development of better diagnostic and therapeutic interventions against RA.

Effect of collection tube type and freeze-thaw cycles on myeloperoxidase concentrations in blood samples of acute coronary syndrome patients

Background Myeloperoxidase has shown potential as a marker for prognosis of coronary artery disease, but presently little is known about preanalytical handling of samples for quantifying myeloperoxidase. The present study was conducted to evaluate the effect of collection tube and freeze-thaw cycles on myeloperoxidase concentrations. Methods Acute coronary syndrome patients ( n = 88) were enrolled after obtaining written informed consent from coronary care unit of a tertiary care hospital (January 2012-June 2014). About 5 mL venous blood was collected from patients and divided into serum, lithium heparin, ethylenediaminetetraacetic acid and sodium citrate tubes. Except serum, all tubes were kept on ice immediately after collection. Samples were centrifuged at -4℃, separated immediately after centrifugation and stored at -40℃ until analysis. Myeloperoxidase was quantified by in-house and commercial assays and re-quantified after five freeze-thaw cycles. Results Myeloperoxidase concentrations, (serum samples) determined by commercial and in-house assays correlated well (r = 0.946) ( P < 0.001) and were higher in serum samples. Within plasma, myeloperoxidase concentrations were slightly higher in ethylenediaminetetraacetic acid (307.7 ± 52.1) and lower in lithium heparin (290.3 ± 49.2) and sodium citrate (221.4 ± 40.3) but not statistically significant. Correlation between myeloperoxidase concentrations (in-house enzyme-linked immunosorbent assay) after first cycle and fifth freeze-thaw cycle dropped to r = 0.448 ( P < 0.001). Conclusion Myeloperoxidase concentrations are comparable in three types of plasma tubes when samples are placed on ice immediately, centrifuged at low temperatures and separated immediately after centrifugation. Multiple freeze-thaw cycles have an effect on myeloperoxidase and should be avoided for quantifying myeloperoxidase.

Development of a high sensitivity C-reactive protein immunoassay and comparison with a commercial kit

C-reactive protein (CRP) is intricately sensitive marker of inflammation, infection, and tissue damage. Role in the prognosis of heart diseases has been recently discovered. This study aimed to develop a cost-effective and high-sensitivity CRP immunoassay for use in cardiac risk assessment. Assay was optimized for coating, blocking of capturing antibody, dilution, and reaction time of the conjugate and sample volume. For normal reference range, CRP was determined in serum samples from apparently healthy volunteers. For clinical validation, CRP was determined in samples of acute coronary syndrome patients by in-house and commercial assays. The lower detection limit of in-house assay was 0.16 µg/L. Intra and inter assay imprecision was 4.39%, 4.6% and 8.6%, 9.3%, respectively. The correlation between the CRP levels by the two assays was r = 0.861. Sensitivity, specificity, predictive value for a positive test, and a negative test of in-house assay was 95.3%, 92.8%, 95.3%, and 92.8%, respectively. At lower-end CRP levels of both kits correlated very well but showed variation at upper end. In-house assay showed high sensitivity and reliability at lower end and it is hoped that will help to evaluate cardiac risk assessment (after improvement at upper end) in clinically poor settings.

New species of Genus Diplotriaena Railliet and Henry, 1909 (Filariidae: Nematoda) from Passer domesticus Linnaeus and P. pyrhonotus Blyth (Passeridae: Passeriformes) in Jamshoro, Sindh, Pakistan

OBJECTIVE

The present study was conducted to examine the filarial nematodes of house sparrow [Passer domesticus (Linnaeus, 1758)] and Sindh sparrow (P. pyrrhonotus Blyth, 1844) from Jamshoro, Sindh, Pakistan.

METHODS

Twenty-three house sparrows and 12 Sindh sparrows were examined for nematode parasites. A total of seven birds were found infected by 16 filarial worms belonging to the genus Diplotriaena Railliet and Henry, 1909. Birds were dissected and parasites were processed through the standard method of temporary slide mounting. Live worms were found embedded in the lungs of the host.

RESULT

The present specimens were known to be new to science. It is the first record of species of both domestic and Sindh sparrows in Pakistan. The prevalence and male-female ratio of the present species were conducted.

CONCLUSION

The present species was named as Diplotriaena passeri. This name is given to new nematode species on the name of its type host. It was compared with previously known species of the genus Diplotriaena on the basis of their diagnostic characteristics.

Experiences of stigma among hepatitis B and C patients in Rawalpindi and Islamabad, Pakistan

Hepatitis B and C are chronic diseases with mental and social impacts which can result in poor quality of life. The aim of this study was to determine the experiences of stigma in a sample of hepatitis B- and C-positive patients in Pakistan. In a cross-sectional study, 140 inpatients and outpatients from 3 tertiary-care hospitals in Islamabad and Rawalpindi answered a semi-structured questionnaire about stigma experienced from relatives, friends, spouse and health-care providers, and about work/financial problems. The majority of patients (75%) said they had had to change their lifestyle, and significantly more were males than females. Stigma was marked in terms of disease transmission, with 66% of patients fearing that they could transmit the infection to others; 19% said that family members avoided sharing towels, soap and eating and drinking utensils. Marital relationships were affected for 51% of married patients who had told their spouse. Patients' comments showed a sense of family and societal discrimination resulting in feelings of disappointment and isolation.

Chest X-ray: an unfair screening tool

BACKGROUND

Chest radiography is considered as the sole screening tool for chest pathologies as prerequisite for overseas employment during their medical examinations. The aim was to evaluate the role of CXR as a screening tool in the diagnosis of different lung pathologies in general and TB in particular.

METHODS

In this descriptive case series, reports of 63,648 Pakistani candidates, who took chest X-rays during medical screening for employment abroad under the rules of Gulf Coordination Council (GCC), were analysed. The reports were collected over a three year period (2008-2011). All the candidates were apparently healthy males of ages ranging between 18-50 years with average age of 27.4 years.

RESULTS

Out of 63,648 candidates examined over a three year period, 1368 (2.15%) were declared unfit on the basis of CXR. There were 359 cases of calcified granulomas, 318 of costophrenic angle obliteration, 174 of apical scaring; 144 of pulmonary scars, 123 of fibrocalcific lesion, 82 of soft shadows in lung, 51 of nodular lung shadows, 42 of lymphadenopathy, 30 of pleural effusion, 26 of interstitial lung shadow and 19 of calcification. A closer scrutiny of these cases revealed that over 90% of the CXRs of the candidates declared as having lung pathologies displayed scars rather than active disease.

CONCLUSION

A normal CXR by itself, neither categorically rules out problems in the chest nor does any finding in it confirm some disease. Unfitness on the basis of CXR alone, unless substantiated by further investigation, is questionable to say the least.

Novel lip pit phenotypes and mutations of IRF6 in Van der Woude syndrome patients from Pakistan

The role of interferon regulatory factor 6 (IRF6) gene mutations in causing Van der Woude syndrome (VWS) and poplyteal pterygium syndrome has been described in different populations worldwide. The former is one of the major syndromes of cleft lip and/or cleft palate (CL/P) with the distinct phenotype of presence of pits with or without sinuses on the lower lip. We identified seven probands with VWS from Punjab province of Pakistan and recognized two previously unreported lip pit phenotypes. The mutational analysis of IRF6 in this cohort revealed four novel and two previously reported mutations. The newly identified mutations include three frameshifts (c.635delG; c.21_33del13; c.627delC) and one transition mutation (c.2T>C) affecting the first codon of IRF6. Together with a past epidemiological study on VWS in Pakistan, the frequency of this syndrome among CL/P individuals from Punjab was calculated to be 1.17%.