Transfusion strategies for neonates: current perspectives

Background

Blood transfusion intervention has been proven to be a crucial therapeutic aid for preterm infants with serious morbidities such as sepsis, intraventricular hemorrhage, and cardiopulmonary insufficiencies. However, blood transfusion practices have also been shown to cause significant adverse outcomes, which may negate the therapeutic effect of the intervention. To address the varying policies regarding the administration of blood products, healthcare professionals have adopted a consensus-based approach. The absence of a standard protocol has resulted in conflicting outcomes in previous clinical studies.

Objective

This study aimed to evaluate the effectiveness of blood transfusion practices in preterm infants by analyzing past clinical research and identifying the current trends that have emerged as a result of recent trials.

Results

Recent trials have demonstrated comparable trends in mortality rates and other primary outcomes, including retinopathy of prematurity, intraventricular hemorrhage, bronchopulmonary dysplasia, and brain injury, following transfusion of blood products in both groups. Nevertheless, employing restrictive thresholds rather than adopting a liberal approach can reduce these outcomes.

Conclusion

The current literature does not provide clear support for either technique as opposing and contradictory results are evident. However, there is a slight inclination toward the restrictive transfusion threshold due to recent trials, which warrants further in-depth investigation into this issue.

Habitat suitability modelling of Koklass pheasant (Pucrasia macrolopha) in moist temperate forest

The decreasing status of on IUCN of Koklass pheasant (Pucrasia macrolopha) belongs to the family Phasianidae and the order Galliform needs the attention of researchers. The species with habitats as low as 6,000 feet and as high as 11,000 feet certainly cover a broad variety of habitats, such a wide altitude range embraces a diverse range of habitats. Insufficient research has been conducted on the suitability of moist temperate forests as a potential habitat for the Koklass pheasant. Therefore, this study was carried out to explore habitat suitability in 15 different sites which were located in the 4 districts of Hazara Division using GIS data science and environmental variables. A random sampling technique was used for laying out the transect. Overall, 45 line transects (Length 2-4 km, Width 10-30 m) were laid out in study sites. The size of sample plots for trees was 10x10m, for shrubs (4 x4m), and herbs and grasses 1x1m. The other habitat parameters like elevation, slope, cover, and frequency of plant at each point were also considered. We found the uneven distribution of Koklass pheasant in the Hazara Division. There were 59 occurrence points identified and highlighted the distribution of Koklass pheasant in the study area. Although all environmental variables were preferred by Koklass pheasant in its habitat statistical analysis proved that slope, level of disturbance, tree and shrub frequency of habitat contributed mostly to the presence of Koklass in each study site except the contribution of soil and herbs. The potential suitable habitat of Koklass pheasant was estimated to be 439.6 km2 areas starting from Abbottabad to Mansehra in the Hazara division. Awareness and enforcing legal protection are recommended for the conservation of Koklass Pheasant in Moist temperate forest.

Diagnostic and therapeutic value of EVs in lungs diseases and inflammation

Extracellular vesicles (EVs) are membrane-derived messengers which have been playing an important role in the inflammation and pathogenesis of lung diseases. EVs contain varieties of DNA, RNA, and membrane receptors through which they work as a delivery system for bioactive molecules as well as intracellular communicators. EV signaling mediates tumor progression and metastasis. EVs are linked with many diseases and perform a diagnostic role in lung injury and inflammation so are used to diagnose the severity of diseases. EVs containing a variety of biomolecules communicate with the recipient cells during pathophysiological mechanisms thereby acquiring the attention of clinicians toward the diagnostic and therapeutic potential of EVs in different lung diseases. In this review, we summarize the role of EVs in inflammation with an emphasis on their potential as a novel candidate in the diagnostics and therapeutics of chronic obstructive pulmonary disease, asthma, and sarcoidosis.

Association of genotypes at rs438228855 in bovine SLC35A3 receptor gene of Pakistani cattle with the susceptibility to develop complex vertebral malformation

The aim of this study was to report the genotype and allelic frequency at rs438228855 (G > T) in SLC35A3 receptor gene and its association with a complex vertebral malformation (CMV) in the enrolled Pakistani cattle. Our results indicated that allelic and genotype frequency at rs438228855 varied non-significantly (p > .05) among the three enrolled cattle breeds. GT (heterozygous) genotype was most abundant (0.54) followed by GG (wild type) genotype (0.45) while the mutant genotype (TT) was not observed among the enrolled cattle. It was observed that the Holstein Friesian breed had more GG (wild) than GT (heterozygous) genotypes while Sahiwal and cross cattle breed had more heterozygous (GT) combination at rs438228855 than the wild (GG) genotype. Significant variations in white blood cell count, % lymphocytes, red blood cell count, % monocytes, haemoglobin, mean corpuscular volume and mean corpuscular haemoglobin concentration were observed when compared between the enrolled cattle breeds. Most of the studied haematological parameters showed no association with the genotype at rs438228855. In conclusion, the heterozygosity at rs438228855 is not limited to the Holstein Friesian breed as local Sahiwal and crossbred cattle had also higher heterozygosity at rs438228855. We recommend that animals must be genotyped for rs438228855 before their selection as breeders to prevent economic losses.

Tirzepatide - A major breakthrough in the fight against obesity

Madam, inflating numbers of sufferers of Type 2 Diabetes and obesity have led scientists to coin the term ‘diabesity,’ which signifies a pathogenic link between obesity and diabetes. Obesity, defined as a BMI of at least 30 kg/m2,1 is a complex, chronic, relapsing illness characterized by an excessive fat build-up. According to the World Obesity Atlas, one billion people will be obese (BMI 30kg/m2) by 2030.2 Obesity is not an illness. Still it is a substantial risk factor for cardiovascular disease and Type 2 diabetes, which are major morbid disease burdens.1 Obesity has genetic, biological, psychological, social, economic, and environmental bases. A complex network of neurohormonal, physiological, and behavioural systems that regulate body weight, combined with different risk factors that impair weight loss pathways, renders lifestyle therapy ineffective in managing obesity. Several clinical guidelines now promote anti-obesity treatments for successful management and considerable outcomes.3 Considering a recent study published on June 4th from a phase three Randomized Control Trial conducted in nine countries, Tirzepatide, originally used to treat diabetes, showed efficacy and safety as an anti-obesity medicine in 2539 non-diabetic patients. When combined with Glucose-dependent Insulinotropic polypeptide and Glucagon-Like Peptide-1 Receptor Agonist, weight-loss efficacy increased. The trial assigned individuals to receive Tirzepatide or placebo subcutaneously once weekly for 72 weeks. In the SURMOUNT-1 research, subjects on 5mg, 10mg, and 15mg lost 35.5lbs, 48.9lbs, and 52lbs, respectively, compared to 5.3lbs on placebo. Compared to the 35% of placebo-takers who dropped 5% or more weight, those taking the medication at 5mg, 10mg, and 15mg lost 85%, 89%, and 91%. In the intervention group, waist circumference, blood pressure, insulin, cholesterol, and aspartate aminotransferase also improved. No direct trial has compared Tirzepatide to Semaglutide or bariatric surgery, but the findings imply it's more effective than the current anti-obesity therapies. However, mild to moderate gastrointestinal side effects do happen.4 By 2030, Pakistan's obesity pandemic will have reached a peak of 12.9%.2 This, coupled with the fact that we have the highest Diabetes rate in South Asia,5 makes these findings a huge milestone since Tirzepatide can act simultaneously as an anti-diabetic and anti-obesity drug. However, because the drug must be prescribed for an extended period, more testing is required before it can be made available to the public. The cost must also be considered to ensure affordability. Nonetheless, the study's findings are encouraging and may lead to novel obesity and diabetes care methods.

Cat scratch disease in a 23-year-old male-Case report

Cat-scratch disease (CSD) is an infectious disease that usually presents with fever, headache, loss of appetite, weight loss, tender lymphadenopathy, and other symptoms. CSD is also the most common cause of infectious lymphadenitis in children, adolescents, and young adults. This contagious disease most often results from a scratch or bite of a cat. The course of this disease depends on the patient's immune status. CSD sometimes presents as a systemic disease and leads to various disease entities. In this study, we describe the case of a 23-year-old man exhibiting fever, generalized weakness, and neck swelling. The patient was unconscious when presented to the Emergency Department. He was given at least 3-4 liters IV bolus of 0.9% normal saline, but it failed to raise the blood pressure. He was then given an inotropic drug (noradrenaline) for low blood pressure and antibiotics (azithromycin) for fever. Venereal disease research laboratory (VDRL) and human immunodeficiency virus (HIV) serology came out negative. Histopathology ruled out tuberculosis and malignancy and confirmed necrotizing/suppurative granulomatous inflammation. These features favor the diagnosis of CSD.

Study on Body Mass Index, Serum Total Cholesterol and Serum Triglycerides in Adult Male Hypertensive Patients

Hypertension or elevated blood pressure is a serious medical condition that significantly increases the risks of heart, brain, kidney and other diseases. An estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, most (two-thirds) living in low- and middle-income countries. An estimated 46.0% of adults with hypertension are unaware that they have the condition. In Bangladesh, 21.3 million of the adult population has hypertension and that is 21.0% of total population. About half of them (48.7%) with hypertension are diagnosed and 34.9% are under treatment. One of the global targets for non communicable diseases is to reduce the prevalence of hypertension by 33.0% between 2010 and 2030. This study was done to evaluate the effects of hypertension and to find out the major complications occurring due to hypertension. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from January 2021 to December 2021. A total number of 120 male subjects, age ranged from 20-59 years was included in this study. Among them, sixty (60) hypertensive subjects were taken as study group (Group II) and sixty (60) ages matched normotensive adult male subjects were taken as control group (Group I). The results were calculated and analyzed by using Statistical package for social science (SPSS). Anthropometric measurements such as height and weight were taken in meter and kilogram respectively. Systolic and diastolic blood pressure were measured by Aneroid Sphygmomanometer (ALPK2, Japan), laboratory analysis of fasting serum total cholesterol by CHOD-POD method, fasting serum triglycerides by GPO-POD method. In this study we found that in study group Mean±SD of body mass index (29.36±2.60, p<0.001), fasting serum total cholesterol (232.05±11.18, p<0.001) and fasting serum triglycerides (180.67±19.44, p<0.001) which were significantly increased with comparison to control group. It's concluded from this study we recommended that routine estimation of these parameters is important for prevention of complication related to hypertension for leading a healthy life.

Monkeypox - a cause of concern?

Madam, the Monkeypox disease is a zoonotic infection caused by the Monkeypox virus of the Orthopoxvirus genus in the Poxviridae family. With a similar clinical presentation as the now eradicated smallpox, which includes fever, rash, and lymphadenopathy [1], the disease has remained endemic in Africa since the first reported case in the Democratic Republic of Congo in 1970. However, the latest news coverage has revealed new outbreaks of Monkeypox in non-endemic regions, which has left us wondering, ‘are we seeing the beginnings of a new Epidemic?’ Since its discovery, the number of reported cases of Monkeypox are on the rise, with the first case reported from outside Africa in 2003, when a Monkeypox outbreak reported from U.S.A following a shipment of Prairie dogs received from Ghana [2]. Between 2010-2019, cases were reported in the United Kingdom, Israel, and Singapore, all of which were associated with a recent travel history to Monkeypox endemic countries. As of 21 May 2022, the WHO reports 92 confirmed and 28 suspected cases of Monkeypox in humans from countries where the disease is non-endemic, with the highest numbers being reported in the UK, Spain, and Portugal. These cases are unique because the individuals involved were all infected locally, most of whom were men who had  sex with men (MSMs) [3] , indicating a sexual mode of transmission that warrants  further investigation. The cases being reported in the U.S.A and the U.K are concerning given the high number of international visitors to these countries, who may then spread the infection to their home countries. We believe that the emerging disease poses serious challenges within Pakistan and abroad. While new therapeutic agents (Tecovirimat) and a vaccine (MVA-BN) have been approved for Monkeypox, their availability remains limited. This issue would further be exacerbated by the challenges faced during the vaccination strategies used against Covid-19 in Pakistan [4]. Moreover, Human-to-human transmissions via sharing of beds and eating utensils has also been identified [5], which is concerning given Pakistan’s high population density and low socioeconomic status. We request that the respective Health authorities act to raise awareness of the disease. This may be accomplished by launching an Awareness Campaign using telecommunications and social media. Furthermore, screening of those with a recent travel history to countries with reported outbreaks should be conducted to curtail the spread of disease. --Continue

Efficacy of mindfulness-based intervention for the treatment of chronic headaches: A systematic review and meta-analysis

Background

Mindfulness-based stress reduction/cognitive therapy has attained popularity as an adjunctive treatment for a plethora of medical and psychiatric conditions, however, its impact on chronic headaches is inconclusive. This review aims to assess the impact of MBSR/MBCT in alleviating the symptoms of chronic headaches.

Data sources and data selection

PubMed and Cochrane CENTRAL were searched from inception till 1st May 2021. Randomized Control Trials evaluating mindfulness-based stress reduction/cognitive therapy with either passive comparators (usual care) or active comparators (e.g., Health education or cognitive behavioral therapy) for chronic headaches (Migraine, Tension-type, or cluster headaches), which evaluated either headache frequency, pain intensity or headache duration as primary outcome were eligible for inclusion. The Risk of Bias was evaluated using the Cochrane Collaboration's Risk of Bias Tool.

Results

A total of ten Randomized Controlled Trials (five on migraine; three on tension-type; two with mixed samples) were evaluated. In comparison to usual care, mindfulness-based stress reduction/cognitive therapy did not illustrate significant changes in headache frequency (MD = −0.14; 95% CI -1.26 to 0.97; P = 0.80; Moderate Certainty), headache duration (MD = −0.27; 95% CI -3.51 to 2.97, P = 0.87; Low Certainty) or pain intensity (MD = −0.19; 95% CI -0.46 to 0.07; P = 0.15; Moderate Certainty)

Conclusion

The results found are insignificant for the three primary outcomes, which may be due to the low number of participants and often a high or unclear risk of bias in the randomized control trials included. Perhaps more aggressive clinical trials with a larger sample size effectively demonstrate differences in outcomes before and after therapy for MBSR/MBCT could provide a more significant change.

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Mindfulness-based therapy for treatment of chronic headache.

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Mindfulness vs usual care for treating patients with chronic headache.

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Effect of different mindfulness-based techniques over headache frequency, intensity and duration.

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Efficacy of Mindfulness-based therapy in achieving mindfulness in pts with chronic headache.

Demonstration of microbiological status of fresh fruits and determining the efficiency of different decontaminating agents against the isolated bacteria

Consumption of fresh fruits increases along with the promotion of healthier lifestyles. However, many foodborne illnesses have been reported due to the consumption of contaminated fruits. Fresh produces are subjected to various treatments for minimizing these outbreaks. The present study demonstrates the role of various simple household methods including water washing and some other common chemical treatments for the removal of bacterial load. By performing the spread plate technique, total heterotrophic bacteria, Escherichia coli, Staphylococcus spp., Salmonella spp. and Listeria spp. were determined in 60 samples of 6 categories including Apple (Malus domestica); Grape (Vitis vinifera); Guava (Psidium guajava); Strawberry (Fragaria ananassa); Indian jujube (Ziziphus mauritiana); Malabar plum (Syzygium cumini) before and after washing with tap water, hot water, 100 mg/L sodium hypochlorite (NaOCl), 50 mg/L calcium lactate, 4% acetic acid and 2 mL/L CleanAva for 20 mins at room temperature. All the tested solutions were found to be effective and reduced bacterial loads in fruits compared to the unwashed fruits samples (P<0.01). Treatment with NaOCl, calcium lactate, acetic acid and CleanAva was the more effective washing technique rather than hot water wash. Two to three log of the bacterial load was reduced when samples were subjected to treatment with chemical decontaminating agents. The efficiency of washing depends on the purity of water, and the types and concentration of the disinfectant solutions. An appropriate washing technique needs to implicate to diminish bacterial load and the risk of foodborne infections caused by fruits.

Isolation and characterization of peroxidase P7-like gene and Rab-GDI like gene from potential medicinal plants: A step toward understanding cell defense signaling

Defensin genes form part of a plant's defense system and are activated when exposed to biotic or abiotic stress. They play a vital role in controlling many signaling pathways involved in various plant defense mechanisms. This research aimed to isolate and characterize novel defensin genes from selected medicinally important plants to explore their signaling mechanisms and defense associated roles for breeding. The DNA of Albizia lebbeck and Moringa oleifera was subjected to PCR amplification using gene-specific primers of defensin genes. Two novel defensin genes were isolated in each species, with sequence lengths of 300 bp in A. lebbeck and 150 bp in M. oleifera. In-silico analysis undertaken to retrieve and align their orthologous sequences revealed 100% similarity of the A. lebbeck gene with the Musa acuminate peroxidase P7-like gene and 85% similarity of the M. oleifera gene with the Manihot esculenta GDP dissociation inhibitor gene. The reliability, stability and physiochemical properties of homology models of these sequences was confirmed through online computational studies. This preliminary study confirmed the presence of novel genes with peroxidase P7 and Rab GDP dissociation inhibitor gene-like activity in A. lebbeck and M. oleifera, respectively, and their potential defense role in plants. Thus, the defensin genes of both species could be used in the synthesis of transgenic self-defensive plants with increased disease resistance and as potential candidates for improved crop production and thraputic formulation in the future.

Forest yield prediction under different climate change scenarios using data intelligent models in Pakistan

This study aimed to develop and evaluate data driven models for prediction of forest yield under different climate change scenarios in the Gallies forest division of district Abbottabad, Pakistan. The Random Forest (RF) and Kernel Ridge Regression (KRR) models were developed and evaluated using yield data of two species (Blue pine and Silver fir) as an objective variable and climate data (temperature, humidity, rainfall and wind speed) as predictive variables. Prediction accuracy of both the models were assessed by means of root mean squared error (RMSE), mean absolute error (MAE), correlation coefficient (r), relative root mean squared error (RRMSE), Legates-McCabe's (LM), Willmott's index (WI) and Nash-Sutcliffe (NSE) metrics. Overall, the RF model outperformed the KRR model due to its higher accuracy in forecasting of forest yield. The study strongly recommends that RF model should be applied in other regions of the country for prediction of forest growth and yield, which may help in the management and future planning of forest productivity in Pakistan.

Detection of microorganisms with antibacterial activities from different industrial wastes and GC-MS analysis of crude microbial extract

Many soil microorganisms' i.e., bacteria and fungi produce secondary metabolites called antibiotics. These are used for the treatment of some of the bacterial, fungal and protozoal diseases of humans. There is a need for isolation of a broad spectrum of antibiotics from microorganisms due to the emergence of antibiotic resistance. In the present study two antibiotic producing bacteria Klebsiella pneumoniae and Bacillus cereus were isolated from pharmaceutical and poultry feed industry of Hattar, Haripur Pakistan. Total 10 waste samples were collected from different industries (Marble, Ghee, Soap, Mineral, Steel, Poultry Feed, Pharmaceutical, Qarshi, Cosmetic and Glass). Thirty-three bacterial strains were isolated from industrial wastes of these ten different industries. Fourteen out of thirty-three bacterial strains exhibited antimicrobial activities against at least one of the test microbes considered in this study including Escherchia coli, Staphylococcus aureus and Salmonella typhi. The bacteria were isolated by standard serial dilution spread plate technique. Morphological characterization of the isolates was done by Gram staining. Nine bacterial isolates out of fourteen were initially identified as B. cereus and five as K. pneumoniae through biochemical characterization. The antibacterial activities were tested by well diffusion method. Maximum number of antibiotic producing bacteria were isolated from pharmaceutical and poultry feed industry based on the results of primary screening, the most potential isolates S9, S19, S20, S22 and S23 were selected for secondary screening. The maximum activity against E. coli and S. aureus was recorded by bacterial isolate S19 i.e zones of inhibition of 6.5mm and 9mm while S20 showed 7.5mm and 6mm zones respectively. Molecular identification was carried out on the basis of 16S rRNA sequence analysis. Finally, the isolates were identified as B. cereus accession number LC538271and K. pneumoniae accession number MT078679. Analysis of bacterial extract S20 through GC-MS indicated the presence of 8 compounds of diverse nature and structure. Present study suggests that wastes of pharmaceutical and poultry feed industry may have antibiotic producing bacteria. These bacteria could be utilized for the production of antibiotics. B. cereus and K. pneumoniae isolated from wastes of poultry feed and pharmaceutical industries have the potential to produce antibiotics and could be used to control the microbial growth.

Genetic similarities and phylogenetic analysis of Muntjac (Muntiacus spp.) by comparing the nucleotide sequence of 16S rRNA and cytochrome B genome

This study aimed to identify the phylogenetic similarities among the muntjac (Muntiacus spp.). The phylogenetic similarities among seven major muntjac species were studied by comparing the nucleotide sequence of 16s rRNA and cytochrome b genome. Nucleotide sequences, retrieved from NCBI databases were aligned by using DNASTAR software. A phylogenetic tree was created for the selected species of muntjac by using the maximum likelihood method on MEGA7 software. The results of nucleotide sequences (16s rRNA) showed phylogenetic similarities between, the M. truongsonensis and M. rooseveltorum had the highest (99.2%) while the lowest similarities (96.8%) found between M. crinifrons and M. putaoensi. While the results of nucleotide sequences (Cty b) showed the highest similarity (100%) between M. muntjak and M. truongsonensis and the lowest s (91.5%) among M. putaoensis and M. crinifrons. The phylogenetic tree of muntjac species (16s rRNA gene) shows the main two clusters, the one including M. putaoensis, M. truongsonensis, M. rooseveltorum, and M. muntjak, and the second one including M. crinifrons and M. vuquangensis. The M. reevesi exists separately in the phylogenetic tree. The phylogenetic tree of muntjac species using cytochrome b genes shows that the M. muntjak and M. truongsonensis are clustered in the same group.

The Siberian pine growth dynamics in Altai Mountains, China

Climatic factors play an essential role in the growth of tree ring width. In this study, we aimed to evaluate the correlation between climatic variables and tree-ring growth characteristics of Pinus sibirica in Altai mountains, northwestern China. This study being is first of its kind on climate growth analysis of Pinus sibirica in northwestern China. The study showed great potential to understand the species growing under the specific climatic conditions. Total of 70 tree cores collected from three sites in the sampling area, out of which 63 tree cores considered for this study. The effect of climatic variables which was studied include precipitation, temperature and PDSI. Our results showed that Tree Ring Width chronology has a significantly positive correlation with the late winter (March) temperature and significant negative correlation with the July temperatures. A significant correlation was observed with the late summer precipitation whereas no significant relation found with the Palmer Drought Severity Index. These significant correlations with temperature and precipitation suggested that this tree species had the potential for the reconstruction of the past climate in the area.

Comparison of different diagnostic modalities for isolation of Mycobacterium Tuberculosis among suspected tuberculous lymphadenitis patients

Tuberculosis is a communicable disease with high morbidity and mortality rates in developing countries. The study's primary objective is to compare conventional methods such as acid-fast bacillus (AFB) culture and microscopy with rapid diagnostic methods. The secondary objective is to compare histopathological and microbiological findings in suspected patients with tubercular lymphadenitis. A total of 111 samples (August 2018 to September 2019) of lymph nodes were processed for AFB microscopy, AFB cultures, drug-susceptibility testing (DST), histopathology, and Xpert Mycobacterium Tuberculosis (MTB)/resistance to Rifampin (RIF) assays. Out of 111 lymph node samples, 6 (5.4%) were positive for AFB smear microscopy, 84 (75.6%) were positive for AFB culture, 80 (70.7%) were positive on Gene Xpert, and 102 (91.8%) were indicative of tuberculosis for histopathology studies. Mycobacteria growth indicator tube (MGIT) culture positivity was 84 (75.6%) higher than solid Lowenstein-Jensen (LJ) culture 74 (66.6%). Positive cultures underwent phenotypic DST. Two cases were Multidrug-resistant (MDR) on DST, while three cases were Rifampicin resistant on Gene Xpert. The sensitivity of Genexpert was (62%) against the conventional AFB culture method. The poor performance of conventional lymphadenitis diagnostic methods requires early and accurate diagnostic methodology. Xpert MTB/RIF test can help in the treatment of multidrug-resistant TB cases. Nonetheless, rapid and conventional methods should be used for complete isolation of Mycobacterium tuberculosis.

Payment for ecosystem services (PES): a holistic tool for sustainable forest management-a case study from Pakistan

Economic valuation of ecosystem services is a new concept in forest management. Economic valuation provides basis for payment for ecosystem services (PES). Therefore, objective of this study was to evaluate eco-tourism and carbon stock services of the Maindam valley, District Swat, Pakistan. For the carbon stock calculation, a sample size of 155 plots of 0.1 hectare (Ha) was taken using preliminary survey at 95% confidence interval and 10% allowable error. The data for tourism services was collected from owners of all the hotels, 100 tourists and key informants of the area at 10% sampling intensity on pretested questionnaire for twenty years period (1997-2017). Results showed that Miandam valley has carbon stock worth US$ 16,306,000 while the value of eco-tourism was US$ 1,578,458 on annual basis. The results also showed that trend of tourism has drastically declined after the 9/11 incident for foreigners and locals and the situation was further deteriorated during the era of Talibanization or militancy from 2008-2011. This study recommends implementation of PES strategy at the rate of 5%, thus a total of US$ 78,922 can be earned from eco-tourism and carbon crediting in the study area annually, which could play important role in sustainable forest management.

Major threats and habitat use status of Demoiselle crane (Anthropoides virgo), in district Bannu, Pakistan

Cranes are the large and attractive Creatures of nature with long necks, legs, and life-span. Adults of both sexes are the same with similar color patterns. Demoiselle cranes spend most of their lifespan on dry grasses. They are also found around the stream, rivers, shallow lakes, natural wetlands, and depressions. To evaluate the current status of habitat use and major threats a study was conducted in tehsil Domel district Bannu. Line transect method and water quality tests (temperature, PH, contamination of E-coli bacteria) were used. To determine the major threats questionnaire method was used. The whole data was analyzed by using SPSS 21 version. Based on the distribution four study sites were selected and four water samples from each study site were taken. Most sites were moderate to highly degraded except Kashoo and kurram river mixing point which was low degraded with livestock grazing and human activities. Water quality tests showed PH ranges from 7-9, temperature 6.5-8.5, and contamination of E-coli in all samples. The social survey revealed that hunting, habitat degradation, and pollution as major threats. Effective long-term conservation and management in the study area are needed to focus on the protection of disturbance-free habitat.

Identification and crop damage assessment of indian crested porcupine (Hystrix indica) in selected zones of Abbottabad, Pakistan

Indian crested porcupine is the largest rodent pest that damages a wide variety of crops, vegetables, and tree species which ultimately causes huge economic loss in Pakistan, which is an agricultural country. It prefers to live in hilly terrain but common in temperate and tropical forests, shrublands, and grasslands. This study focused on the identification and assessment of crops damaged along with the main precautionary measures used by the local farmers. The data was collected from twenty-four villages of two union councils i.e. Chamhad and Slahad of district Abbottabad. Two types of data (primary and secondary) were collected from the study area. Primary data was collected for identification and estimation calculation of total crop damaged through direct field observation by taking random quadrates in each village of the study area. The damage in the crop was assessed by randomly selecting a quadrate of 1x1 m2 for the wheat, pearl millet, and Sorghum fields. While 4x4 m2 quadrates were taken for maize and vegetables. At least three quadrate samples were taken from each field including one quadrate taken from the center of the field area. In union council Chamhad, damage to maize (11.31%) and wheat (0.73%) by the Indian crested porcupine while in union council Salhad, damage of maize (6.95%) and wheat (1.6%) was observed. In the entire study area, overall damage to maize crop (8.01%) and wheat (0.88%) was calculated. Based on information obtained from the farmers, the Indian porcupine inflicted damage to potato, tomato, cauliflower, chili pepper, turnip, radish, pea, and onion, etc. Secondary data obtained through a questionnaire survey to explore the human porcupine conflict and precautionary measures used by the farmers and landowners. Open and close-ended questionnaires (159) highlighted the presence of Indian crested porcupine in the study area and 96% of the respondents have seen porcupine directly. Many types of precautionary measures were used by the farmers such as fencing, night stay, night firing, and dogs to decrease the crop damage, respondents (63.91%) use guns for hunting. however, due to the largely agricultural area and nocturnal behavior of Indian crested porcupine majority of the respondents (51.57%) did not use any precautionary measure. Biological control of Indian porcupine is recommended in the study area. Farmers should be encouraged and provide incentives and killing through current should be banned while proper hunting license should be issued to overcome overhunting. Scientific studies are required to control the reproduction of porcupine specifically in the more damaged areas.

Seasonal distribution and habitat use preference of Barking deer (Muntiacus vaginalis) in Murree-Kotli Sattian-Kahuta National Park, Punjab Pakistan

Microhabitat factors associated with the habitat of barking deer (Muntiacus vaginalis) were examined and compared between summer and winter seasons. Habitat characteristics and preferred habitat were measured by locating direct and indirect signs. To quantify the habitat utilization of barking deer, each selected study site was sampled for floral diversity from 2015 to 2017. Quadrats were deployed along transect lines to determine seasonal distribution. Barking deer were not evenly distributed across vegetation types in the study area; they occurred more often in the broad-leaved forest than in Chir pine forest, at an elevational range of 550-850 m, in thick vegetation on steep slopes. The most preferred habitat included trees and shrubs with 30% and 69% cover, respectively. Barking deer avoided thicker tree cover, possibly as it hinders movement and escape from predators. No significant difference (χ2 = 6.37, df = 3, p = 0.19) in seasonal vegetation cover was recorded.

An ethno-botanical study of indigenous medicinal plants and their usage in rural valleys of Swabi and Hazara region of Pakistan

An ethnobotanical study was conducted to document indigenous medicinal plants and their usage from knowledgeable and elderly persons in Razzar and Gadoon valley of Swabi and Allai and Tanawal valley of Hazara region of Pakistan during 2016-2019. Several systematic field visits and questionnaire surveys were carried out in selected sites of the study area to gather relevant information from the local community. Rapid assessment method was adopted for data collection by interviewing the local people having enough knowledge of medicinal plants use for treatment of different ailments. UV (UV) formula was applied to calculate the relative importance of medicinal plant species in each site of the study area. In the present study, 221 medicinal plants belonging to 105 families have been reported through 580 respondents (385 males, 138 females and 57 local health healer) from the Swabi and Hazara region. The main sources of herbal medicines were leaves (21%) followed by fruits (21%), seeds (17%), whole plants (14%), roots (9%), bark (9%), flowers (7%) and gum (2%). Mentha spicata L. and Berberis lycium Royle were reported with highest UV (UV) i.e. 0.92 and 0.68 in Razzar tehsil and Gadoon valley of Swabi, whereas Mentha longifolia L and Geranium wallichianum D were reported with highest UV i.e. (0.65) and (0.88) in Allai and Tanawal valley of Hazara region, respectively. It was concluded that Swabi and Hazara region is rich in medicinal plants species and associated traditional knowledge. Moreover, ethno-medicines have played significant role in the indigenous healthcare system of the study area. However, uprooting the entire plant for ethno-medicine is a big threat to conservation of medicinal plants diversity in the study area.

Euphlyctis Cyanophlyctis Schneider, 1799 (Amphibia: Dicroglossidae) in district Lower Dir, Pakistan

Euphlyctis cyanophlyctis (the skittering frog) is one of the most widespread species in Pakistan. Present study was aimed to know the presence of Euphlyctis cyanophlyctis in urban and rural areas of Lower Dir, the North-western Pakistan. A total of 33 frogs were collected, including 15 from rural and 18 from urban areas. The frogs were caught by hands covered with gloves instead of using nets. The collection was managed from August to October 2016 and from April to May 2018. Morphometric analysis, coloration as well as photographs of the frogs have been provided in detail. Skittering frogs were seen frequent in swampy areas near the water bodies. These frogs were mostly seen after sunset.

Environmental impacts, water footprint and cumulative energy demand of match industry in Pakistan

A comprehensive life cycle assessment (LCA) was conducted for the matchsticks industry in the Khyber Pakhtunkhwa province of Pakistan to quantify environmental footprint, water footprint, cumulative energy use, and to identify improvement opportunities in the matchsticks manufacturing process. One carton of matchsticks was used as reference unit for this study. Foreground data was collected from the matchsticks industry through questionnaire surveys, personal meetings, and field measurements. The collected data was transformed into potential environmental impacts through the Centre for Environment Studies (CML) 2000 v.2.05 method present by default in the SimaPro v.9.1 software. Water footprint was calculated using methodology developed by Hoekstra et al., 2012 (water scarcity index) V1.02 and cumulative energy demand by SimaPro v.9.1 software. The results showed that transport of primary material (wood logs), sawn wood for matchsticks, red phosphorous, acrylic varnish, and kerosene fuel oil contributed to the overall environmental impacts. Transport of primary materials and sawn timber for matchsticks contributed significantly to abiotic depletion, global warming, eutrophication potential, ozone depletion, corrosion, human toxicity, and aquatic ecotoxicity effects. The total water footprint for manufacturing one carton of matchsticks was 0.265332 m3, whereas the total cumulative energy demand was 715.860 Mega Joules (MJ), mainly sourced from non-renewable fossil fuels (708.979 MJ). Scenario analysis was also conducted for 20% and 30% reduction in the primary material distance covered by trucks and revealed that reducing direct material transport distances could diminish environmental impacts and energy consumption. Therefore, environmental footprint could be minimized through diverting matchsticks industries freight from indigenous routes to high mobility highways and by promoting industrial forestry close to industrial zones in Pakistan. Many industries did not have emissions control systems, exceeding the permissible limit for emissions established by the National Environmental Quality Standards (NEQS) of Pakistan. Thus, installation of emissions control system could also diminish emissions from match industry in Pakistan.

Effect of different protein based feed on the growth of mahseer

For the proper growth of fish, it is necessary to feed the fish with a proper and balanced diet. A study was conducted to find out the effect of different protein-based diets on fingerlings of Tor putitora (mahseer). A feed with dietary protein levels of 35%, 40%, 45%, and 50% were prepared. The effect of different protein-based feed on weight gain, standard growth rate (SGR), food conversion ratio (FCR), percent weight gain, food conversion efficiency (FCE), and protein efficiency ratio (PER) was studied. An increase was observed in the growth rate with an increase in protein concentration up to 45%. The fingerlings fed a 45% protein diet shown the highest growth, followed by 50%, 40%, and 35%. The SGR value was greatest for 45% protein diet (8.56) followed by 50% and 40%, while the least values were observed for 35% protein feed (1.57). The same trend was observed for FCE. The highest PER values was observed in fishes fed 45% protein-based feed (0.65) followed by 50% (0.56), 40% (0.38) and35% (0.17). The food conversion ratio was lowest for 45% protein diet (3.41), while the greatest for 35% protein feed (16.85). It was concluded that a 45% protein-based diet was the best feed formulation for higher production of Tor putitora. However, research on the same percentage of protein diet is recommended for yearlings.

Evaluation of Hepato-protective and Nephron-Protective Potential of Euphorbia nivulia Buch.-Ham. Against Carbon Tetrachloride-induced Toxicity in Sprague Dawley Rats

Background: Euphorbia nivulia Buch.-Ham (En) is one of the members of Euphorbiaceae family that is rich in phytochemicals including flavonoids, triterpenes and polyphenolics. Purpose: To evaluate hepato-nephronprotective potential of Euphorbia nivulia. Study Design: Sprague Dawley rats were used as animal models in the study. Methods: En hydro alcoholic extract was standardized and managed in high dose (300 mgkg−1 body weight (BW) and low dose  (150 mgkg−1 BW) to Sprague Dawley rats, administered with CCl4 (1mlkg−1BW). Silymarin (50 mgkg−1 BW) was taken as positive control. The treatments were given thrice a week. Consequently, blood and hepatic homogenates were collected after 4 weeks of treatment. While the situation of kidney was explored through measurement of serum creatinine, serum urea, sodium and albumin levels. Hepatic and renal samples of rats treated with both 150 and 300 mg/kg of the extract were used for tissue pathological study. Results: En extract revealed dose dependent moderate level of shelter against CCl4 intoxicated hepato-nephrotoxicity as directed from the acquired results. The decrease of the albumin levels by the maximum dose of the extract exceeded similar to that attained with Silymarin, and the protecting effects of the extract against oxidative destruction were evaluated. Examination of serum show significant (p < 0.05) elevation in the level of aspartate transaminase(AST), alkaline phosphatase(ALP), alanine transaminase(ALT), whereas decline were noted for albumin in CCl4 treated rats. Histopathological cuts and damages were seen in hepatic cells and kidney of rats managed by CCl4. But, co-administration of En extract, dose dependently, improved the CCl4-carried hepatic harms in these limits. Conclusion: These effects propose that the phyto-ingredients of En extract with known polyphenols were able to improve the oxidative stress brought along with CCl4 and may be a useful healing mediator to manage oxidative stress related disorders like hepato-nephro toxicity.

Distribution of commensal rodents in rain-fed and irrigated areas of Swat district, Khyber Pakhtunkhwa, Pakistan

Distribution pattern and relative abundance of the agricultural rodent pests of rain-fed and irrigated areas of district Swat Khyber Pakhtunkhwa, Pakistan were recorded from April 2011 to November 2013 using wire mesh live traps. A total of 350 rodents (269 Rattus rattus and 81 Mus musculus) were captured under 2268 trap nights (trap success: 0.15). Regression of daily captures on cumulative captures revealed an estimate of 350 rodents from all the sampled structures with an average of 21.8 rodents per crop field. House rats (R. rattus; 76.8% of captures) were numerically dominant in almost all types of agricultural fields, and were significantly different from the mice (Mus musculus; 23.1% of captures). Both species were found together in some fields. The sex ratio revealed that males outnumbered the females in both of the reported species.

Feeding habits and habitat use of barking deer (Muntiacus vaginalis) in Himalayan foothills, Pakistan

Northern red muntjac (Muntiacus vaginalis; "barking deer") is a shy and small-sized cervid mammal, limited to the outer Himalayan foothill forests in Pakistan. Habitat characteristics were measured by locating direct and indirect signs. To quantify habitat utilization of barking deer, 80 field surveys were conducted in the study area along transects. 1200 Quadrats at 50 m intervals were deployed along these transect lines to determine microhabitat factors associated with seasonal distribution. The food composition of the barking deer was determined through fecal droppings analysis by micro-histological technique. Forty-five fecal samples of barking deer were collected from the study area (Murree-Kotli Sattian-Kahuta National Pak); summer (28) and winter (17). The micro-histological analysis revealed that more plant species are available in its habitat during the summer season (27) as compared to winter (19). Due to browsing nature barking deer mostly feed on trees in both seasons. While shrubs are slightly higher in winters. In summer barking deer consumed 10 Trees, 6 Shrubs, 5 Herbs, and 6 kinds of grass species. Dominant tree species were Phyllanthus emblica and Acacia modesta. Dominant shrub species were Ziziphus nummularia and Justicia adhatoda. In winter barking deer consumed 8 Trees, 7 Shrubs, 3 Herbs, and 1 Grass. Dominant tree species were Bauhinia variegata and Acacia modesta while shrubs included Ziziphus nummularia and Carissa opaca.

Antibacterial Activity of Tris NaCl and PBS Buffer Protein Extract of Cassia fistula, Saccharum officinarum, Albizia lebbeck and Cymbopogon citrates Against Bacterial Strains

Medicinal plants are gaining popularity over synthetic medicines because antibiotic resistance demands the alternative source of medication. In the present research, the crude protein extraction of 4 medicinal plants Cassia fistula, Saccharum officinarum, Albizia lebbeck and Cymbopogon citrates was carried out. Crude protein extraction was done by 2 different buffers i.e. Tris NaCl buffer and PBS buffer. Protein confirmation was done by Bradford assay in the spectrophotometer. Antibacterial potential was checked and compared against Escherichia coli, Bacillus subtilis, Neisseria gonorrhoea, Bacillus cereus and Proteus mirabilis. Antibacterial assay was performed by disc diffusion method, agar well method and zones of inhibition were calculated. The study results indicated that Tris NaCl extracts' antimicrobial potential is higher than that of the PBS buffer. On disc diffusion method the Tris NaCl buffer extracts of Cymbopogon citrates showed maximum zone of inhibition 11 mm and 9 mm against Bacillus subtilis and Bacillus cereus respectively and control chloramphenicol showed maximum zone of inhibition 26 mm against Bacillus subtilis. Cassia fistula showed maximum zone of inhibition of 7 mm against Bacillus cereus while Saccharum officinarum and Albizia lebbeck didn't show the any antibacterial activity. On the other hand, Protein extracts from PBS buffer didn't show zone of inhibition against any bacteria. Only Albizia lebbeck showed minute zone of inhibition against Neisseria gonorrhea. On well diffusion method, Cassia fistula Tris NaCl protein extract showed the maximum zone of inhibition 20 mm and 18 mm against Proteus mirabilis and Bacillus subtilis respectively. While Albizia lebbeck PBS protein extract showed the maximum zone of inhibition 19 mm and 17 mm against Bacillus subtilis and Bacillus cereus. The results revealed that the protein extract of Albizia lebbeck, Cymbopogon citrates and Cassia fistula can be used tosynthesize antimicrobial drugs to treat the bacterial infections.

Prevalence and risk factors associated with prenatal depression among pregnant women in Faisalabad, Pakistan

To determine the prevalence of prenatal depression and explore its association with socio-demographic risk factors, stressful life events and women autonomy/decision-making. The recognition of these problems would play a substantial role in the strategic development of interventions for those Pakistani women who have been suffering from prenatal depression. Analytical cross-sectional study conducted in Allied hospital Faisalabad during a period of 18 months (1st Jan 2019 to 30 June 2020). Data was collected by using simple random sampling technique. EPDS was used to measure prenatal depression. A modified kuppuswamy scale, Life Events and Difficulties Schedule (LEDS) and women autonomy/decision making scale was used to assess the risk factors. A total of 380 women were included in the study. The mean age (in years) ± SD was 29.37±5.27. According to cut-off score >10 on Edinburg postnatal depression scale the prevalence of depression was found as 51.6%. The findings revealed that women education, socio-economic class, BMI, pregnancy duration, history of miscarriage, contraception, stressful life events and women autonomy had significant association with prenatal depression (P<0.05). Socio-demographic factors, stressful life events in previous life and women autonomy are significant predictors of prenatal depression that need to be addressed in order to sustain safe motherhood.

Alleviative role of exogenously applied mannitol in maize cultivars differing in chromium stress tolerance

A pot experiment was performed to examine the role of foliar applied mannitol (M) in chromium (Cr) stress alleviation in different maize cultivars. Two maize cultivars, one tolerant (6103) and one sensitive (9108) to chromium stress, were grown in soil treated with three concentrations of Cr (0, 5, and 10 mg kg^-1) and three levels of mannitol (0, 50, and 100 mg L^-1). Chromium stress decreased the overall growth of plants by reducing the plant height, root/shoot dry weight, chlorophyll contents, and enzymatic activities, while exacerbated the severity of reactive oxygen species in both maize cultivars. Chromium-induced reduction in growth attributes of maize plants was relatively higher in sensitive cultivar than that of tolerant one. Uptake of Cr by the plants and its translocation from roots to shoots increased with increasing concentration in the soil. However, foliar application of mannitol significantly alleviated the Cr stress and improved growth, biomass, and photosynthetic pigments of maize plants. Mannitol also considerably reduced Cr contents in leaves and roots of both cultivars. Hence, it is concluded that mannitol can be helpful for crops grown on heavy metal, especially Cr, contaminated soils for remediation purpose.

In vitro antifungal activity of 9, 10-dihydrophenanthrene-2-carboxylic acid isolated from a marine bacterium: Pseudomonas putida

An antifungal compound 9, 10-dihydrophenanthrene - 2 - carboxylic acid was isolated from a marine derived bacterium Pseudomonas putida isolated from surface water samples of Karachi fish harbor coast line. The structure was explored using extensive 1D- and 2D-NMR spectroscopic techniques. The compound was found to be active against fungal strains obtained from clinical samples whereas strong activity was noted against Candida albicans with a MIC value of 20μg/ml, as the purified compound showed promising anticandidal activity a multidisciplinary approach is needed to explore further this compound as potential pharmacological lead compound against Candida spp and will add in the global hunt for clinically functional antifungal agents.

Knowledge and practices of teachers associated with eye health of primary school children in Rawalpindi, Pakistan

PURPOSE

Teachers' perspectives on eye health can be limited, particularly in developing countries. The aim of this study was to assess teachers' knowledge and practices associated with eye health of primary students in Rawalpindi, Pakistan.

METHODS

This was a cross-sectional survey of primary school teachers. Simple random sampling technique was used to select 443 participants from 34 private and 17 public schools. A self-administered questionnaire was used.

RESULTS

Teachers' knowledge ranged from "high" (35.89%), "moderate" (49.89%), and "low" (14.22%). Teachers' practices associated with students' eye health ranged from "high" (10.16%), "moderate" (23.02%), and "low" (66.82%). The teachers' knowledge index scores increased 4.28 points with successive age groups and increased 2.41 points with each successive level of education. For teachers whose close relatives experienced eye disease, their knowledge index score was 4.51 points higher than those teachers whose relatives never had any eye disease. Teachers' age, education level, and their close relatives experiencing eye disease were significant predictors of their knowledge (R² = 0.087, P < 0.001). Female teachers' practices index score was 10.35 points higher than the male teachers and public school teachers had 10.13 points higher than the private school teachers. Teachers' gender and type of school were significant predictors of their practices (R² = 0.06, P < 0.001).

CONCLUSION

There was a significant gap among primary school teachers' knowledge and practices related to students' eye health. Innovative strategies are needed to improve how teachers address students' eye health issues in the classroom.

EDTA enhanced plant growth, antioxidant defense system, and phytoextraction of copper by Brassica napus L

Copper (Cu) is an essential micronutrient for normal plant growth and development, but in excess, it is also toxic to plants. The present study investigated the influence of ethylenediaminetetraacetic acid (EDTA) in enhancing Cu uptake and tolerance as well as the morphological and physiological responses of Brassica napus L. seedlings under Cu stress. Four-week-old seedlings were transferred to hydroponics containing Hoagland's nutrient solution. After 2 weeks of transplanting, three levels (0, 50, and 100 μM) of Cu were applied with or without application of 2.5 mM EDTA and plants were further grown for 8 weeks in culture media. Results showed that Cu alone significantly decreased plant growth, biomass, photosynthetic pigments, and gas exchange characteristics. Cu stress also reduced the activities of antioxidants, such as superoxide dismutase (SOD), peroxidase (POD), ascorbate peroxidase (APX), and catalase (CAT) along with protein contents. Cu toxicity increased the concentration of reactive oxygen species (ROS) as indicated by the increased production of malondialdehyde (MDA) and hydrogen peroxide (H2O2) in both leaves and roots. The application of EDTA significantly alleviated Cu-induced toxic effects in B. napus, showing remarkable improvement in all these parameters. EDTA amendment increased the activity of antioxidant enzymes by decreasing the concentrations of MDA and H2O2 both in leaves and roots of B. napus. Although, EDTA amendment with Cu significantly increased Cu uptake in roots, stems, and leaves in decreasing order of concentration but increased the growth, photosynthetic parameters, and antioxidant enzymes. These results showed that the application of EDTA can be a useful strategy for phytoextraction of Cu by B. napus from contaminated soils.

Comparative study of immunochromatographic assay (IgM) and widal test for early diagnosis of typhoid fever

Typhoid fever is a severe systemic infection endemic in many developing countries, including Bangladesh. Present study evaluated immunochromatographic test (ICT) and Widal test in the early diagnosis of typhoid fever cases. The study was carried out in the department of Microbiology, Mymensingh Medical College, Mymensingh between July, 2010 and June, 2011, including 200 individuals of different age and sex. Of them, 150 were clinically suspected cases of typhoid fever and 50 age-sex matched controls. Among 150 blood samples from the suspected cases 106(70.7%) were positive for IgM of Salmonella typhi by ICT and 67(44.7%) were positive by Widal test. Whereas, among the 50 controls 4(8%) were positive by ICT and 6(12%) were positive by Widal test. The sensitivity, specificity, positive and negative predictive value of the ICT was found as 83.3%, 92.00%, 91.9% and 83.6% respectively. On the other hand corresponding values for Widal test were of 44.4%, 88%, 80% and 59.5% respectively. Thus, The ICT (IgM) is better alternative to Widal test for early and accurate diagnosis of typhoid fever. The ICT (IgM) is rapid, easy to perform, applicable for field use and highly sensitive and specific for detection of antibodies in patients with typhoid fever.

Enteropathogens associated with acute diarrhea in a tertiary hospital of Bangladesh

Acute diarrheal diseases are great concern throughout the world, as they are responsible for considerable morbidity and mortality, especially in developing countries. The present study was carried out during the period from January' 2011 to December' 2011 in the Department of Microbiology, Mymensingh Medical College. A total of 300 stool specimens were examined by standard laboratory methods for identification of enteropathogens. Rotavirus was detected by Polyacrylamide Gel electrophoresis (PAGE). Different diarrheagenic E. coli (DEC) were detected by Multiplex PCR following standard methods. Of the 300 stool specimens examined, Enteropathpgens were detected in 160(53.5%) cases. Rota virus was detected in 82(27.5%) cases, followed by DEC in 54(18%), Shigella spp. in 8(2.4%), Salmonella spp. in 5(1.6%), Entameoba histolytica in 4(1.5%) and Giardia lamblia in 3(1.0%) cases. Among the DEC, the Enterotoxigenic E. coli (ETEC) was most prevalent (72%, 39/54). The present study revealed a high prevalence of rotavirus and DEC as the predominant causes of diarrhea in this region.

Personalizing Stem Cell Research and Therapy: The Arduous Road Ahead or Missed Opportunity?

The euphoria of stem cell therapy has diminished, allowing scientists, clinicians and the general public to seriously re-examine how and what types of stem cells would effectively repair damaged tissue, prevent further tissue damage and/or replace lost cells. Importantly, there is a growing recognition that there are substantial person-to-person differences in the outcome of stem cell therapy. Even though the small molecule pharmaceuticals have long remained a primary focus of the personalized medicine research, individualized or targeted use of stem cells to suit a particular individual could help forecast potential failures of the therapy or identify, early on, the individuals who might benefit from stem cell interventions. This would however demand collaboration among several specialties such as pharmacology, immunology, genomics and transplantation medicine. Such transdisciplinary work could also inform how best to achieve efficient and predictable stem cell migration to sites of tissue damage, thereby facilitating tissue repair. This paper discusses the possibility of polarizing immune responses to rationalize and individualize therapy with stem cell interventions, since generalized "one-size-fits-all" therapy is difficult to achieve in the face of the diverse complexities posed by stem cell biology. We also present the challenges to stem cell delivery in the context of the host related factors. Although we focus on the mesenchymal stem cells in this paper, the overarching rationale can be extrapolated to other types of stem cells as well. Hence, the broader purpose of this paper is to initiate a dialogue within the personalized medicine community by expanding the scope of inquiry in the field from pharmaceuticals to stem cells and related cell-based health interventions.