Fasciola hepatica

Fasciolosis is the burning problem of the livestock rearing community having huge morbidity, mortality, and economic losses to livestock industries in our country Pakistan. The faecal and liver biopsy samplings were examined by polymerase chain reaction (PCR) and microscopy technique during the entire study. A total of 307 samples including 149 samples from Karak and 158 samples from Kohat abattoirs were examined by PCR method and overall prevalence of fasciolosis was 5.86% (18/307), amongst theses 8.05% (12/149) in liver biopsy and 3.79% (6/158) in feacal samples of cattle and Buffaloes were recorded. Similarly the microscopy based detection was 3.58% (11/307) including 4.61% (7/149) in liver biopsy and 2.5% (4/158) in faecal samples accordingly. Furthermore the areawise prevalence of fasciolosis in abattoirs by PCR method was found to be 7.59% (12/158) in Kohat and 4.02% (6/149) in Karak. A 618 pb DNA was amplified in 2% agarose gel electrophoreses. It is concluded from the study that prevalence of fasciolosis was higher in abattoir of district Kohat and PCR was a more sensitive method of diagnosis than microscopy

ESBL determination and antibacterial drug resistance pattern of Klebsiella Pneumoniae amongst patients at PIMS Islamabad

Background: A number of life threatening infections due to various bacterial pathogens are major cause  of death in Pakistan. In a situation like the other developing countries, there is a general increase in the  drug resistance due to the irrational use of the antibiotics. The present study was carried out to evaluate the prevalence and development of resistance in Klebsiella pneumoniae against commonly used antibiotics.Methods and Materials: A total of 200 samples from different wards of the hospitals were received by the pathology laboratory of Pakistan Institute of Medical Sciences, Islamabad, which comprised of urine  65, blood 50 and other miscellaneous samples from various sources. Klebsiella pneumoniae was isolated and characterized using morphological, cultural, and biochemical methods and were further confirmed by using commercially available API 20E kit. The isolates were subjected to culture sensitivity test using  Kirby Bauer disc diffusion method.Results: The organism was found to be the most prevalent Gram-negative bacilli. K. pneumoniae showed  highest resistance against coamoxiclav and cephalosporins.Conclusion: The study revealed that ESBL producing strains were resistant to most of the beta-lactam antibiotics. This trend therefore has become a significant problem and can be controlled with continued surveillance or monitoring for rationally improved antibiotics usage, in order to prevent the drug resistance and re-emergence of infection.Key words: Klebsiella pneumoniae, ESBL (Extended-spectrum beta-lactamase), API (Analytical Profile Index

Therapeutic potential of Pegnum harmela against Schistosoma bovis in buffaloes

Background: Peganum harmala have many biological and pharmacological activities such as antifungal, antibacterial, analgesic and antiinflammatory. The present study was carried out to evaluate the  antischistosomal activities of Peganum harmala with special reference to bovine schistosomiasis in naturally infected buffaloes.Methods and Materials: A total of 54 naturally infected buffaloes with “Schistosomiasis” of ages around five years were used for anthelmintic studies. All of the buffaloes were properly marked so as to make a distinction from one other. A doctor of veterinary was available for daily checkup. Samples prepared according to the available methods in literature.Results: In the present study, naturally infected buffaloes with Schistosoma bovis were treated with  Peganum harmala (Harmal, seed), with dose 75 mg/kg, 150 mg/kg and 225 mg/kg body weight  respectively, and their impact on various parameters like eggs reduction, milk production, weight gain and feed intake was noted. Furthermore, their efficiency (%) was evaluated with “Praziquantel”  (allopathic drug) at “10mg/Kg body weight” dose level. After first dose of “Praziquantel” hundred percent effectiveness was noted, while the same result obtained for herbal drug after giving second dose of  “225mg/kg body weight”. To evaluate the effect of herbal medicines on protein portions, sera of treated and control buffaloes were also investigated.Conclusion: From present findings, it is concluded that the herb Peganum harmala can easily replace  Praziquantal (PZQ) with almost same efficiency (%). Furthermore, the herb is easily available at cheap price at local market and it will be good for the economy of Pakistan Key words: Pegnum harmela, Schistosoma, infectio

ESBL DETERMINATION AND ANTIBACTERIAL DRUG RESISTANCE PATTERN OF KLEBSIELLA PNEUMONIAE AMONGST PATIENTS AT PIMS ISLAMABAD

Background: A number of life threatening infections due to various bacterial pathogens are major cause of death in Pakistan. In a situation like the other developing countries, there is a general increase in the drug resistance due to the irrational use of the antibiotics. The present study was carried out to evaluate the prevalence and development of resistance in Klebsiella pneumoniae against commonly used antibiotics. Methods and Materials: A total of 200 samples from different wards of the hospitals were received by the pathology laboratory of Pakistan Institute of Medical Sciences, Islamabad, which comprised of urine 65, blood 50 and other miscellaneous samples from various sources. Klebsiella pneumoniae was isolated and characterized using morphological, cultural, and biochemical methods and were further confirmed by using commercially available API 20E kit. The isolates were subjected to culture sensitivity test using Kirby Bauer disc diffusion method. Results: The organism was found to be the most prevalent Gram-negative bacilli. K. pneumoniae showed highest resistance against coamoxiclav and cephalosporins. Conclusion: The study revealed that ESBL producing strains were resistant to most of the beta-lactam antibiotics. This trend therefore has become a significant problem and can be controlled with continued surveillance or monitoring for rationally improved antibiotics usage, in order to prevent the drug resistance and re-emergence of infection

ANTIBIOTIC SUSCEPTIBILITY PATTERN OF ESCHRICHIA COLI ISOLATES FROM CLINICAL SPECIMENS AT PIMS, ISLAMABAD

Background: E. coli is the most common producer of extended spectrum beta lactamase enzyme (ESBL) which confers broad spectrum resistance to antibiotics like penicillin, cephalosporin and monobactum. Methods and Materials: The present study was carried out at Pakistan Institute of Medical Sciences, Islamabad. The marked resistance was viewed against amoxicilline-clavulanic acid, ceftriaxone and ceftazidime. The most effective drugs established were sulbactum-cefoparazone, amikacin, pepircillin-tazobactum. A total of 220 samples of wide range were selected, i.e., blood, urine, pus, sputum, etc. and were analyzed using various techniques of Gram staining and biochemical identification. Results: After performing antibiotic sensitivity tests, 83% samples came out to be ESBL positive and 17% were ESBL negative. Conclusion: It was concluded that to ensure adequate treatment of infections arising especially from urinary pathogens and controlling spread of bacterial resistant strains, the continuous monitoring by bacterial susceptibility testing is essential

THERAPEUTIC POTENTIAL OF PEGNUM HARMELA AGAINST SCHISTOSOMA BOVIS IN BUFFALOES

Background: Peganum harmala have many biological and pharmacological activities such as antifungal, antibacterial, analgesic and antiinflammatory. The present study was carried out to evaluate the antischistosomal activities of Peganum harmala with special reference to bovine schistosomiasis in naturally infected buffaloes. Methods and Materials: A total of 54 naturally infected buffaloes with “Schistosomiasis” of ages around five years were used for anthelmintic studies. All of the buffaloes were properly marked so as to make a distinction from one other. A doctor of veterinary was available for daily checkup. Samples prepared according to the available methods in literature. Results: In the present study, naturally infected buffaloes with Schistosoma bovis were treated with Peganum harmala (Harmal, seed), with dose 75 mg/kg, 150 mg/kg and 225 mg/kg body weight respectively, and their impact on various parameters like eggs reduction, milk production, weight gain and feed intake was noted. Furthermore, their efficiency (%) was evaluated with “Praziquantel” (allopathic drug) at “10mg/Kg body weight” dose level. After first dose of “Praziquantel” hundred percent effectiveness was noted, while the same result obtained for herbal drug after giving second dose of “225mg/kg body weight”. To evaluate the effect of herbal medicines on protein portions, sera of treated and control buffaloes were also investigated. Conclusion: From present findings, it is concluded that the herb Peganum harmala can easily replace Praziquantal (PZQ) with almost same efficiency (%). Furthermore, the herb is easily available at cheap price at local market and it will be good for the economy of Pakista

TREATMENT OF BOVINE SCHISTOSOMIASIS WITH MEDICINAL PLANT VERONIA ANTHELMINTICA (KALIZIRI), AN ALTERNATIVE APPROACH

Background: Veronia anthelmintica (Kaliziri) is a medicinally very important plant as being reported for remarkable therapeutic potential. The present research evaluates its antischistosomal activity. Methods and Materials: 54 buffaloes naturally infected with Schistosomiasis were used for anthelmintic trails. All animals for the study were tagged so as to distinguish from others. The animals were checked up on routine basis by a veterinary doctor. Preparation of samples of herbal drug and experiment was design according to available literature. Results: During present studies, buffalos naturally infected with Schistosomiasis were treated with Veronia anthelmintica (Kaliziri), with dose 75 mg/kg, 150 mg/kg and 225 mg/kg body weight respectively, and their impact on various parameters like eggs reduction, milk production, weight gain and feed intake was noted. Furthermore, their efficiency (%) was compared with standard drug “Praziquantel” (allopathic drug) at “10mg/Kg” body weight dose level. The effectiveness (%) of “Praziquantel” was noted as hundred after first dose, while the effectiveness for the herbal drug get to this level after injecting of second dose of “225mg/kg body weight”. Statistically significant (

Phytochemical and Biological Activities of Four Wild Medicinal Plants

The fruits of four wild plants, namely, Capparis decidua, Ficus carica, Syzygium cumini, and Ziziphus jujuba, are separately used as traditional dietary and remedial agents in remote areas of Khyber Pakhtunkhwa, Pakistan. The results of our study on these four plants revealed that the examined fruits were a valuable source of nutraceuticals and exhibited good level of antimicrobial activity. The fruits of these four investigated plants are promising source of polyphenols, flavonoids, alkaloids, terpenoids, and saponins. These four plants' fruits are good sources of iron, zinc, copper, manganese, selenium, and chromium. It was also observed that these fruits are potential source of antioxidant agent and the possible reason could be that these samples had good amount of phytochemicals. Hence, the proper propagation, conservation, and chemical investigation are recommended so that these fruits should be incorporated for the eradication of food and health related problems

Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

Background: In an era of shifting global agendas and expanded emphasis on non-communicable diseases and injuries along with communicable diseases, sound evidence on trends by cause at the national level is essential. The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) provides a systematic scientific assessment of published, publicly available, and contributed data on incidence, prevalence, and mortality for a mutually exclusive and collectively exhaustive list of diseases and injuries. Methods: GBD estimates incidence, prevalence, mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) due to 369 diseases and injuries, for two sexes, and for 204 countries and territories. Input data were extracted from censuses, household surveys, civil registration and vital statistics, disease registries, health service use, air pollution monitors, satellite imaging, disease notifications, and other sources. Cause-specific death rates and cause fractions were calculated using the Cause of Death Ensemble model and spatiotemporal Gaussian process regression. Cause-specific deaths were adjusted to match the total all-cause deaths calculated as part of the GBD population, fertility, and mortality estimates. Deaths were multiplied by standard life expectancy at each age to calculate YLLs. A Bayesian meta-regression modelling tool, DisMod-MR 2.1, was used to ensure consistency between incidence, prevalence, remission, excess mortality, and cause-specific mortality for most causes. Prevalence estimates were multiplied by disability weights for mutually exclusive sequelae of diseases and injuries to calculate YLDs. We considered results in the context of the Socio-demographic Index (SDI), a composite indicator of income per capita, years of schooling, and fertility rate in females younger than 25 years. Uncertainty intervals (UIs) were generated for every metric using the 25th and 975th ordered 1000 draw values of the posterior distribution. Findings: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates. After taking into account population growth and ageing, the absolute number of DALYs has remained stable. Since 2010, the pace of decline in global age-standardised DALY rates has accelerated in age groups younger than 50 years compared with the 1990–2010 time period, with the greatest annualised rate of decline occurring in the 0–9-year age group. Six infectious diseases were among the top ten causes of DALYs in children younger than 10 years in 2019: lower respiratory infections (ranked second), diarrhoeal diseases (third), malaria (fifth), meningitis (sixth), whooping cough (ninth), and sexually transmitted infections (which, in this age group, is fully accounted for by congenital syphilis; ranked tenth). In adolescents aged 10–24 years, three injury causes were among the top causes of DALYs: road injuries (ranked first), self-harm (third), and interpersonal violence (fifth). Five of the causes that were in the top ten for ages 10–24 years were also in the top ten in the 25–49-year age group: road injuries (ranked first), HIV/AIDS (second), low back pain (fourth), headache disorders (fifth), and depressive disorders (sixth). In 2019, ischaemic heart disease and stroke were the top-ranked causes of DALYs in both the 50–74-year and 75-years-and-older age groups. Since 1990, there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries. In 2019, there were 11 countries where non-communicable disease and injury YLDs constituted more than half of all disease burden. Decreases in age-standardised DALY rates have accelerated over the past decade in countries at the lower end of the SDI range, while improvements have started to stagnate or even reverse in countries with higher SDI. Interpretation: As disability becomes an increasingly large component of disease burden and a larger component of health expenditure, greater research and developm nt investment is needed to identify new, more effective intervention strategies. With a rapidly ageing global population, the demands on health services to deal with disabling outcomes, which increase with age, will require policy makers to anticipate these changes. The mix of universal and more geographically specific influences on health reinforces the need for regular reporting on population health in detail and by underlying cause to help decision makers to identify success stories of disease control to emulate, as well as opportunities to improve. Funding: Bill & Melinda Gates Foundation. © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licens

Mortality of emergency abdominal surgery in high-, middle- and low-income countries

Background: Surgical mortality data are collected routinely in high-income countries, yet virtually no low- or middle-income countries have outcome surveillance in place. The aim was prospectively to collect worldwide mortality data following emergency abdominal surgery, comparing findings across countries with a low, middle or high Human Development Index (HDI). Methods: This was a prospective, multicentre, cohort study. Self-selected hospitals performing emergency surgery submitted prespecified data for consecutive patients from at least one 2-week interval during July to December 2014. Postoperative mortality was analysed by hierarchical multivariable logistic regression. Results: Data were obtained for 10 745 patients from 357 centres in 58 countries; 6538 were from high-, 2889 from middle- and 1318 from low-HDI settings. The overall mortality rate was 1⋅6 per cent at 24 h (high 1⋅1 per cent, middle 1⋅9 per cent, low 3⋅4 per cent; P < 0⋅001), increasing to 5⋅4 per cent by 30 days (high 4⋅5 per cent, middle 6⋅0 per cent, low 8⋅6 per cent; P < 0⋅001). Of the 578 patients who died, 404 (69⋅9 per cent) did so between 24 h and 30 days following surgery (high 74⋅2 per cent, middle 68⋅8 per cent, low 60⋅5 per cent). After adjustment, 30-day mortality remained higher in middle-income (odds ratio (OR) 2⋅78, 95 per cent c.i. 1⋅84 to 4⋅20) and low-income (OR 2⋅97, 1⋅84 to 4⋅81) countries. Surgical safety checklist use was less frequent in low- and middle-income countries, but when used was associated with reduced mortality at 30 days. Conclusion: Mortality is three times higher in low- compared with high-HDI countries even when adjusted for prognostic factors. Patient safety factors may have an important role. Registration number: NCT02179112 (http://www.clinicaltrials.gov)