First Report of New Postharvest Rot in Ginger Rhizome by Aspergillus parvisclerotigenus in Pakistan

Ginger (Zingiber officinale) rhizome is widely used in Pakistan as a spice. During the summer of 2013, several ginger sellers in a local vegetable market of Lahore, Pakistan, reported a green powdery mass of an unidentified pathogen that rotted a considerable quantity of ginger in its packaging. As far as we know, this disease was limited to stored rhizomes and not reported in fields. A survey was conducted in August to September of 2013 in three different vegetable markets in Lahore to collect infected samples. From each of three survey points from individual markets, 20 bags (10 kg each) were selected randomly. Average incidence of decay (by weight) was found to be 45%. Initial symptoms appeared as discoloration, soft and slippery skin with abundant green sporulation. Ten samples (rhizomes) from each market were brought to the laboratory for further studies. Isolation of the causal agent was carried out on two growth media: malt extract agar (MEA) and Czapek Dox agar (CZA). Inoculation was carried out by direct transfer of visible green spores as well as transferring a small fragment of surface sterilized infected rhizome to the media. Inoculated media plates were incubated at 25°C for 3 to 4 days. Emerging fungal colonies were sub-cultured to get pure cultures. The fungal colony was powdery, green, 3.5 to 4 cm in diameter, and without zonation after 7 days of incubation. Sclerotia were brown to black and globose. Conidial heads were columnar and biseriate, occasionally unseriate. Conidiophores were 1 to 2.5 mm long. Vesicles were sub-globose to globose and 25 to 30 μm wide. Metulae were 12 to 18 μm high and phialides were 6 to 12 μm. Conidia were globose to sub-globose, green, and 4 to 5 μm in diameter. Based on morphology, the fungus was identified as Aspergillus parvisclerotigenus (1). The identity of the pathogen was confirmed by ITS sequence analysis of two different isolates. For this, ITS1-5.8S-ITS2 nucleotide sequence of ~560 bp was amplified using total fungal genomic DNA as a template and ITS1 forward (5'-TCCGTAGGTGAACCTGCGG-3') and ITS4 reverse primer (5'-TCCTCCGCTTATTGATATGC-3') (2). Sequences from both isolates were 100% similar with each other. A BLAST search showed that this sequence had 99% homology with that A. parvisclerotigenus CBS 121.62 (EF409240.1). A culture of the fungus was deposited in First Fungal Culture Bank of Pakistan (FCBP1352) and the nucleotide sequence of ITS region to GenBank (KJ445022). For completion of Koch's postulates, a spore suspension (10⁵ spores/ml) from a 1-week-old culture was prepared. Ten surface-disinfested, air-dried ginger rhizomes were placed on sterilized wet blotting papers in a glass beaker and inoculated by spore suspension using a hand sprayer. Similarly, 10 control rhizomes were sprayed with sterile distilled water. Rhizomes were incubated at 25°C for 7 days. The experiment was replicated three times. The same symptoms noticed in the vegetable markets were observed in 80% of the inoculated rhizomes while control rhizomes remained healthy. Re-isolation of the pathogen from symptomatic rhizomes fulfilled Koch's postulates. Poor hygiene is thought to be the main cause of rotting; therefore, this disease is not a threat to ginger if stored properly. To our knowledge, this is the first report of postharvest ginger rhizome rot from Pakistan caused by A. parvisclerotigenus. References: (1) J. Varga et al. Stud. Mycol. 69:57, 2011. (2) T. J. White et al. In: PCR Protocols: A Guide to Methods and Applications, page 315. Academic Press, San Diego, CA, 1990.

First Report of Leaf Spot of Rice Caused by Alternaria arborescens in Pakistan

Rice (Oryza sativa) is one of the most profitable and popular cereal crops in Pakistan. In July 2012, symptoms consisting of circular, black, necrotic spots, 2 to 4 mm in diameter, were observed on leaves of a commonly grown rice cultivar, Basmati-198, in private rice fields at Lahore (Punjab). This disease was observed later on rice cultivar KSK-133 grown at Faisalabad (Punjab) during the same cropping season. Disease incidence was ~35% and 25% for Basmati-198 and KSK-133, respectively. To our knowledge, the pathogen was confined only in these areas and cultivars and was not present on other rice varieties or crops. Ten infected plants were selected randomly from each field of two rice cultivars and one infected leaf for each of the 10 infected plants was selected for the isolation of fungal pathogen. Necrotic lesions were cut into pieces of ~2 mm², surface-disinfected with 0.5% sodium hypochlorite, placed on 2% malt extract agar (MEA) (Sigma, Dorset, UK), and incubated at 25 ± 2°C for 4 to 5 days. Emerging fungal colonies were transferred aseptically to fresh MEA petri plates for purification. Alternaria spp. were consistently recovered from infected leaves. Three isolates per variety were selected for detailed morphological studies. Each isolate was grown at 25°C on MEA and potato carrot agar (PCA) for 7 days. All isolates displayed similar morphological features including black radiate, floccose colonies with irregular margins, 6 to 7 cm in diameter on MEA and 2 to 3 cm with 1 to 2 pairs of concentric growth rings on PCA. Conidial chains were not crowded with 1 to 10 conidia per branch and bearing several lateral branches. Conidiophores were tapering and narrow, 40 to 200 × 2 μm. Conidia were ovoid within a size range of 10 to 30 × 5 to 14 μm, with 1 to 5 transverse and 1 longitudinal septum. Conidial color darkens from a dull tan to a medium brown as the culture matures. Based on morphology, the pathogen was identified as Alternaria arborescens (1). A pure culture of the pathogen was deposited in First Fungal Culture Bank of Pakistan (FCBP) with accession FCBP1351. Identification based on morphology was verified by sequencing the internal transcribed spacer (ITS) region. For this, a DNA fragment of ~650 bp was amplified using total genomic DNA as template and ITS1 and ITS4 primers (2). The nucleotide sequence of the ITS region was submitted to GenBank under accession KF679683. Comparison of the sequence with those in GenBank revealed that the sequence was 99% identical with A. arborescens, isolate ALT-242 (KC415808), causing Eucalyptus leaf spot in India and strain STE-U4345 (AF404667), a causal pathogen of apple core rot in South Africa. Pathogenicity testing was performed on both cultivars. One-month-old plants grown in greenhouse were sprayed with 10 ml of spore suspension (2 × 10⁵ spores/ml) as well as 10 ml of this spore suspension in soil at the time of sowing. Control plants were sprayed with sterilized water. The plants were covered with plastic bags for 48 h and kept under observation for 2 weeks in a glasshouse at 30 ± 2°C. Lesions appeared on leaves after 10 days of inoculation whereas control plants remained healthy. Pathogenicity tests were repeated in triplicate. Similar disease symptoms and re-isolation of A. arborescens fulfilled Koch's postulates. To our knowledge, this is the first report of A. arborescens leaf spot of rice in Pakistan. At present, the distribution of this disease is limited to the fields where it was observed. References: (1) E. G. Simmons. Alternaria: An Identification Manual. CBS, Fungal Biodiversity Center Utrecht, The Netherlands, 2007. (2) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.

Chlamydia trachomatis IgM seropositivity during pregnancy and assessment of its risk factors

The study was undertaken to determine socio-demographic and reproductive risk factors associated with Chlamydia trachomaties IgM seropositivity during pregnancy. This cross sectional comparative study was carried out in the obstetrics outdoor of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh in collaboration with the department of Virology between the periods from July 2007 to December 2008. Pregnant women at their first visit to the hospital were approached consecutively and asked to complete a questionnaire and 2cc blood was collected from each subject for Chlamydia trachomatis IgM antibody testing using ELISA method. The study population was divided into two groups according to the presence and absence of serum Chlamydia trachomatis IgM antibody. Finally socio-demographic and reproductive risk factors were compared between the groups. Among 172 women the sero-prevalence of Chlamydia IgM was 41%. The multiple logistic regression model (step wise) finally extracted for characteristics correlated with seropositivity. Ten years or less (≤SSC) education (OR 2.6 95% CI 1.1to 5.9), history of adverse pregnancy outcome (OR 2.8 95% CI 1.2 to 6.5) and multiple sex partner of husband (OR 4.1 95% CI 1.2 to 14.8) were associated with chlamydia infection. The use of condom (OR 0.28 95% CI 0.12 to 0.63) was associated with decreased risk of infection. Chlamydia trachomatis infection during pregnancy is associated with risk factors on the basis of which selective screening can be done.

Lipid profile of women using oral contraceptive pills

Oral contraceptives (OCs) are the most popular type of birth control pills. The study was designed to examine the biochemical changes which occur due to the use of oral contraceptive pills (OCs). The study was based on the questionnaire for having the information of any reproductive history fasting, age, health, nature of menstrual cycle, bleeding, disease etc and blood profiling for biochemical analysis of the women includes high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and triglycerides (TG). Lipid profiling was carried out by using a commercially available diagnostic test kits. SPSS was used to analyze the data. The results showed statistically significant differences among users of OCs compared to non-users. Total cholesterol (242.92 +/- 2.842 mg dL(-1)), HDL-C (58.65 +/- 1.098 mg dL(-1)), LDL-C (115.84 +/- 1.266 mg dL(-1)) and triglycerides (105.56 +/- 2.341 mg dL(-1)) were significantly higher compared to the non-users (Total cholesterol 218.49 +/- 1.762, HDL-C 48.17 +/- 0.543, LDL-C 100.321 +/- 0.951 and triglycerides 83.77 +/- 2.299 mg dL(-1)). The result suggests that OCs increase the level of high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), total cholesterol (TC) and triglycerides (TG).

In vitro synergistic effect of ciprofloxacin with aminoglycosides against multidrug resistant-Pseudomonas aeruginosa

Pseudomonas aeruginosa is an increasingly prevalent nosocomial human pathogen. Infections with multidrug-resistant (MDR) P. aeruginosa are currently a treatment challenge and requires search for better treatment options.

PURPOSE OF STUDY

To determine in vitro synergistic effect of ciprofloxacin in combination with amikacin and gentamicin against MDR P. aeruginosa clinical isolates.

METHODS

Antibiotic resistance pattern of 100 identified clinical isolates of P. aeruginosa was determined against eight antibiotics by disc diffusion method at Microbiology Laboratory, Holy Family Hospital, Rawalpindi. For 30 selected MDR isolates, minimum inhibitory concentrations (MICs) of amikacin and gentamicin were determined separately by agar diffusion method followed by combined activity of ciprofloxacin with amikacin and gentamicin by checkerboard agar dilution technique.

RESULTS

Antibiotic resistance pattern of P. aeruginosa isolates was; gentamicin and carbenicillin (94%), amikacin and piperacillin (92%), ceftazidime (90%), colistin (87%), ciprofloxacin (79%) and imipenem (72%). MICs against 30 selected MDR isolates ranged from 32 to >128μg/mL for amikacin, and >128μg/mL for gentamicin. Synergistic effect was observed in 12/30(40%) isolates for AK+CIP and in 05/30 (16.7%) for CN+CIP.

CONCLUSION

Ciprofloxacin in combination with amikacin and gentamicin showed synergistic effect and no antagonistic effect against MDR P. aeruginosa.

Second-generation surveillance for HIV/AIDS in Pakistan: results from the 4th round of Integrated Behavior and Biological Survey 2011-2012

Objectives

In an effort to fully analyse and understand the HIV situation and its epidemiology in Pakistan, a bilateral collaboration between the National AIDS Control Program and the Canadian International Development Agency resulted in the establishment of an effective second-generation surveillance (SGS) system for HIV/AIDS between 2004 and 2012 in accordance with the published guidelines. This paper presents findings from the 4th round of SGS.

Methods

A mapping exercise was initially conducted for size estimations of the key vulnerable populations: people who inject drugs (PWIDs), male sex workers (MSWs), hijra sex workers (HSWs), and female sex workers (FSWs), followed by an Integrated Behavioral and Biological Surveillance in 20 selected cities across Pakistan.

Results

The estimated sizes of the four key populations mapped in the 20 cities were 89 178 FSWs, 46 351 PWIDs, 23 317 HSWs and 19 119 MSWs. The HIV sero-prevalence among PWIDs was the highest among all key populations surveyed at 37.8% (CI 37.3 to 38.3) nationally, followed by a prevalence of 7.2% (CI 6.8 to 7.5) among HSWs, 3.1% (CI 2.8 to 3.4) among MSWs and 0.8% (CI 0.4 to 1.0) for FSWs. Various key risk behaviours, that is, sharing of syringes by PWIDs and inconsistent use of condoms by sex workers, were documented.

Conclusions

Pakistan's HIV epidemic that once was characterised primarily by transmission among PWIDs is now increasingly characterised by significant sexual transmission, and all types of sex workers (male, hijra and female) exhibit epidemiological proportions of infection. There is a need to develop concrete strategic plans for each vulnerable subpopulation, initially focusing prevention resources on those with a higher risk or vulnerability.

The size and distribution of key populations at greater risk of HIV in Pakistan: implications for resource allocation for scaling up HIV prevention programmes

Background

With competing interests, limited funding and a socially conservative context, there are many barriers to implementing evidence-informed HIV prevention programmes for sex workers and injection drug users in Pakistan. Meanwhile, the HIV prevalence is increasing among these populations across Pakistan. We sought to propose and describe an approach to resource allocation which would maximise the impact and allocative efficiency of HIV prevention programmes.

Methods

Programme performance reports were used to assess current resource allocation. Population size estimates derived from mapping conducted in 2011 among injection drug users and hijra, male and female sex workers and programme costs per person documented from programmes in the province of Sindh and also in India were used to estimate the cost to deliver services to 80% of these key population members across Pakistan. Cities were prioritised according to key population size.

Results

To achieve 80% population coverage, HIV prevention programmes should be implemented in 10 major cities across Pakistan for a total annual operating cost of approximately US$3.5 million, which is much less than current annual expenditures. The total cost varies according to the local needs and the purchasing power of the local currency.

Conclusions

By prioritising key populations at greatest risk of HIV in cities with the largest populations and limited resources, may be most effectively harnessed to quell the spread of HIV in Pakistan.

The organisation, operational dynamics and structure of female sex work in Pakistan

Background

Pakistan is known to have large populations of female sex workers (FSWs) with considerable geographic heterogeneity in their characteristics. In this paper, we describe the social organisation and structural patterns of female sex work in different geographic regions of Pakistan.

Methods

We report geographic and network mapping data collected among FSWs in 15 cities across Pakistan in 2011 as part of the Canada-Pakistan HIV/AIDS Surveillance Project.

Results

A total number of 89 178 FSWs were estimated in the target cities for an average of 7.2 FSWs per 1000 adult males. 55% of the estimated number of FSWs concentrated in Karachi and Lahore. Based on the operations of female sex work, two major typologies of FSWs were identified: establishment-based and non-establishment-based. FSWs were further subtyped into those operating through brothels, homes, kothikhanas, streets and by cell phone. Cities varied considerably in terms of predominance of different FSW typologies.

Conclusions

There is considerable heterogeneity among FSWs in Pakistan, geographically and in terms of operational typology. Understanding the social organisation of sex work and the influence of social-cultural and legal factors in Pakistan is essential for the design of HIV prevention programmes and other services for FSWs.

Prevalence of undifferentiated fever in adults of Rawalpindi having primary dengue fever

The objectives of the study were to highlight early subclinical presentation of dengue viral infection (DVI) as an undifferentiated febrile illness. The descriptive cross-sectional study was carried out at Microbiology Department, Rawalpindi Medical College from March to September 2009. Stratified random sampling was used to select subjects from various urban and rural areas of Rawalpindi, and Serum IgG anti-dengue antibodies were detected by using 3rd generation enzyme-linked immunosorbent assay (ELISA). Out of the total 240 subjects, 69 (28.75%) were found to be positive for anti-dengue IgG antibodies. Of the positive cases, 41 (59.4%) - comprising 31 (44.9%) urban residents - and 10 (14.4%) rural residents presented with a previous history of undifferentiated fever (p<0.05). It was concluded that primary DVI can present as subclinical form in healthy population residing in rural and urban areas of Rawalpindi, which is an alarming situation indicating the spread of disease in the study area.

Growth and antioxidant response of Brassica rapa var. rapa L. (turnip) irrigated with different compositions of paper and board mill (PBM) effluent

Current study presents the effect of irrigation with different compositions (0%, 20%, 40%, 60%, 80% and 100%) of PBM effluent on growth and antioxidant potential of Brassica rapa var. rapa L. plants. Seeds were exposed to different PBM effluent compositions, which resulted in significant decrease in their germination potential with elevated delay index. Significant changes in growth parameters (plant height, number of leaves and leaf area) were recorded for turnip plants at regular intervals (25, 50 and 75 d) as function of PBM effluent proportion. Response of biochemical and antioxidant constituents in different parts of turnip, against stress induced by PBM effluent, was assessed by estimating the contents of chlorophyll (a+b), carotenoids, protein, phenolics, flavonoids, ascorbic acid and malondialdehyde. Antioxidant activity was evaluated by measuring DPPH radical scavenging potential. The results of this study suggest that the impact of PBM effluent irrigation is dependent on concentration of effluent in irrigation mixture and is very clear on plant growth and antioxidant attributes. Maximum benefits were secured at 40% PBM effluent to irrigate turnip plants till maturity while higher concentrations were found useful for shorter period (25-50 d).

Nasal and perirectal colonization of vancomycin sensitive and resistant enterococci in patients of paediatrics ICU (PICU) of tertiary health care facilities

BACKGROUND

Enterococci normally inhabit the intestinal tract of humans and are also a potential pathogen in causing nosocomial infections. The increase in antibiotic resistance and transfer of antibiotic resistance gene to Staphylococcus aureus (S. aureus) due to co-colonization has increased its importance in research. The aim of the study was to evaluate local epidemiology of nasal and rectal colonization with Enterococcus faecalis (E. faecalis) and Enterococcus faecium (E. faecium) in patients of Paediatrics Intensive Care Unit (PICU) and correlation with clinical and socioeconomic factors.

METHODS

The nasal and perirectal swab samples were collected from 110 patients admitted in PICUs of three tertiary care hospitals of Rawalpindi Medical College, Pakistan. The identification of enterococci was done by biochemical tests and by PCR for ddl, vanA and vanB genes. Antibiotic susceptibility testing was performed by disc diffusion and MICs were determined for vancomycin, tetracycline, ciprofloxacin and oxacillin only.

RESULTS

Out of 220 nasal and perirectal samples, 09 vancomycin-resistant enterococci (VRE) and 76 vancomycin-susceptible enterococci (VSE), consisting of 40 E. faecalis and 45 E. faecium were isolated. PCR successfully identified both species with ddl primers and VRE with vanA primer. With disc diffusion method, all isolates were resistant to most of the antibiotics tested except linezolid, quinupristin/dalfopristin, teicoplanin and vancomycin. VRE showed resistance to teicoplanin and vancomycin both and none was resistant to linezolid and quinupristin/dalfopristin. Generally, E. faecium isolates were more resistant than E. faecalis. MICs of vancomycin for nasal and perirectal VRE were 512 mg/L and 64 to 512 mg/L respectively. VRE were more in patients with prolonged hospitalization, from urban localities and those having pneumonia.

CONCLUSION

Present study reveals high colonization and antibiotic resistance in enterococcal isolates from nasal and perirectal area. Nasal colonization by enterococci in PICU is more alarming as VRE may cause infection and can transfer this resistance gene to other microorganisms like S. aureus.

A comparison of the effects of topical green tea and lotus on facial sebum control in healthy humans

BACKGROUND AND AIM

Green tea and lotus hold several synergistic antioxidant compounds. This investigation aimed to assess the efficacy of green tea and green tea plus lotus vs. placebo multiple emulsions in healthy adults for controlling casual sebum secretions.

PARTICIPANTS AND METHODS

After signing informed consents, twenty-two participants were registered in a single-blinded, placebo-controlled, split-face comparative study. Group 1 participants applied a multiple emulsion formulation with green tea extract while group 2 applied a multiple emulsion with green tea plus lotus extract in a 60 days treatment course. A non-invasive photometric device (Sebumeter™) has been used for the measurement of casual sebum secretions on both sides of the face.

RESULTS

Steady and statistically significant reductions in sebum secretions were noted for mono (green tea) and combined treatments (green tea plus lotus) compared to placebo treatment. However, irrespective of the concentration of extracts in active formulations, green tea plus lotus combined treatment produced statistically more sound results (two-tailed p value = 0.0002) than green tea alone (two-tailed p value = 0.0060) in a 60-days treatment course.

CONCLUSIONS

RESULTS suggest that synergistic compounds in green tea and lotus could be a promising choice for cutaneous disorders where elevated sebum levels are involved in the pathophysiology of these disorders.

Varieties of foetal congenital abnormality

The purpose of the study is to determine the type of fetal congenital abnormalities found among high risk pregnancies admitted in Fetomaternal Unit of Obs & Gynae Department in BSMMU. This is a cross sectional study done during the period July 2007 to June 2010. All the patients admitted with congenital abnormality in fetomaternal unit during this study period were included in this study. One hundred five cases had congenital abnormality of fetus among 1134 deliveries. Out of which 46.66% had CNS abnormalities and 19.04% had renal abnormalities. Out of CNS abnormalities Hydrocephalous (40.81%) was the most common, 31.42% patients were of age between 20-24 years, 69.52% patients had parity between 1-3, 35.37% had deliveries ≥ 37 weeks, 69.52% patients had vaginal deliveries, 82.89% patients were terminated by prostaglandins, 96.19% patients had no drug history other than intake of iron and calcium, 26.67% babies had birth weight between 1.1-1.5 kg and 70.4% were of male babies. Advances in ultrasound technology have made possible the prenatal identification of an increasingly large number of fetal congenital malformations. Now fetal anatomical survey is performed routinely between 18 to 22 weeks.

Augmented telomerase activity and reduced telomere length in parthenium-induced contact dermatitis

BACKGROUND

Parthenium dermatitis is a common chronic inflammatory disease with activated T lymphocytes that recognize the antigens, which leads to proliferation and differentiation. Telomeres and telomerase play an important role in the regulation of life span of the cell. Telomere length maintained by telomerase, are specialized repeats present at the end of chromosomes which protect it from degradation, end-to-end fusion and are important for integrity of chromosomes.

OBJECTIVES

The aim of this study was to measure telomerase activity and telomere length in Peripheral blood mononuclear cell (PBMC), CD4(+) and CD8(+) T lymphocytes from parthenium dermatitis patients.

METHODS

The study includes 50 patients of parthenium dermatitis confirmed by patch testing and 50 healthy controls. Telomerase activity was measured using the telomere repeat amplification protocol using PCR-ELISA kit. Telomere length was measured by using Telo TAGGG Telomere Length Assay Kit.

RESULTS

Significantly elevated levels of telomerase activity was observed in PBMC, CD4(+) and CD8(+) T cells of parthenium dermatitis patients as compared with healthy controls. However, significantly reduced telomere length in PBMC, CD4(+) and CD8(+) T cells have been found in patients than healthy subjects, but there was no difference between CD4(+) and CD8(+) T cells in patients.

CONCLUSION

This study might have provided insight into the role of telomerase in parthenium dermatitis that is characterized by the recruitment of T lymphocytes, which play an important role in this inflammatory disease. The augmented telomerase activity and reduced terminal restriction fragment length might be explored as a potential diagnostic/prognostic marker for parthenium dermatitis in future.

The use of botulinum toxin in the management of burns itching: preliminary results

Itching is a common and well recognised problem following burns. As the underlying pathways involved in burns itch have been identified, different pharmacological agents have been introduced to improve the effectiveness of management regimes. We present preliminary data from an on-going study in the use of botulinum toxin as a novel agent in the treatment of this problem.

METHOD

Patients with recalcitrant itching secondary to burns treated with Botox(©) were identified. Data pertaining to burn size, depth and management were recorded. The delay in the onset of the itch, its severity and the speed and duration of any improvement in symptoms were also noted.

RESULTS

10 patients were identified. 1 patient was excluded. Average follow-up was 11.3 months. All patients had deep partial thickness to full thickness burns. Eight patients underwent grafting. The average burn was 24% TBSA. 87.5% of patients rated their burns itch as being severe (>7 on the pain scale). Following the administration of Botox(©) this fell to 0 out of 10 at 4 weeks. The average duration of the symptom free period was nine months (range 3-18 months).

CONCLUSION

Botox(©) can successfully be used to treat burns itch that are resistant to conventional therapies.