Iron biofortification: a much-needed strategy for prevailing conditions of micronutrient malnutrition

Micronutrient-malnutrition is one of the most serious battle human beings are fighting. The so-called Hidden hunger is all because of micronutrient deficiencies. Iron deficiency anemia is affecting more people than any other prevailing disorder. However, iron-supplementation aggravate the infectious diseases and present policies of iron therapy carefully evaluate the pros and cons. In current review, we have evaluated the biofortification approaches for combating hidden hunger, in the light of medical and nutritional advancements. Enhancement of iron in edible plant parts is expected to improve nutrient status of human beings via crops. The density of minerals and vitamins in staple foods consumed by the poor can be raised using either traditional plant breeding or transgenic approaches, a process known as biofortification. Microbial iron biofortification is a valuable approach for human being especially in developing countries where poor people cannot afford to buy expensive supplementation. Moreover, prevailing condition of Covid-19 demands a fighting immune system and iron is likely to play vital role in improving human immune system

Pulse Oximeter Perfusion Index as an Early Indicator of Onset of Sympathectomy After Epidural Anaesthesia

Objective: To establish a reliable indicator of epidural effectiveness, we compared the frequency of subjects achieving sympathectomy onset in patients undergoing lower limb surgeries under lumbar epidural anaesthesia in terms of changes in perfusion index (PI), mean arterial pressures (MAP), and toe temperature. Methodology:  This descriptive case series study was conducted at the Department of Anesthesiology, Holy Family Hospital, Rawalpindi from July 2018 - January 2019. A total of 96 patients were included, all of them received lumbar epidural catheters for lower limb surgeries and were given 10 ml of epidural bupivacaine 0.5% through the epidural catheter. Baseline values were recorded for PI in toe, MAP and temperature of toe. At 5, 10 and 20 minutes after epidural anaesthesia, these values were re-recorded. Data collection was completed before the start of surgery. Criteria for clinically evident sympathectomy was defined beforehand. The frequency of subjects reaching these predefined targets were analyzed at said time intervals using Mc-Nemar test at each time interval. Results: For PI 66/96, 88/96 and 96/96 of subjects in the study fulfilled the criteria of achieving sympathectomy at 5, 10 and 20 minutes , respectively, compared to 7/96 , 15/96 and 59/96 for MAP changes and 0/96, 29/96 and 45/96 for changes in temperature of toe. Conclusion: As per this study, PI seemed to be a faster, clearer and a more objective indicator of the onset of sympathectomy after epidural anaesthesia than toe temperature or MAP

Scalable Screening and Treatment Response Monitoring for Perinatal Depression in Low- and Middle-Income Countries

Common perinatal mental disorders such as anxiety and depression are a public health concern in low- and middle-income countries. Several tools exist for screening and monitoring treatment responses, which have frequently been tested globally in clinical and research settings. However, these tools are relatively long and not practical for integration into routine data systems in most settings. This study aims to address this gap by considering three short tools: The Community Informant Detection Tool (CIDT) for the identification of women at risk, the 4-item Patient Health Questionnaire (PHQ-4) for screening women at high-risk, and the 4-item Hamilton Depression Rating Scale (HAMD-4) for measuring treatment responses. Studies in rural Pakistan showed that the CIDT offered a valid and reliable key-informant approach for the detection of perinatal depression by utilizing a network of peers and local health workers, yielding a sensitivity of 97.5% and specificity of 82.4%. The PHQ-4 had excellent psychometric properties to screen women with perinatal depression through trained community health workers, with a sensitivity of 93.4% and specificity of 91.70%. The HAMD-4 provided a good model fit and unidimensional construct for assessing intervention responses. These short, reliable, and valid tools are scalable and expected to reduce training, administrative and human resource costs to health systems

Biofortification: way forward toward micronutrient deficiency

Half of the World’s people are being affected by micronutrient-deficiencies. Mostly in developing countries, the human development, along with economic development are hindered by malnutrition. The World Health Organization (WHO) have made fighting micronutrient malnutrition, profoundly known as “Hidden Hunger”, the most important priority. The micronutrient deficiency like zinc, iron and vitamin A are the most demolishing among the World’s poor. The organization have focused on food fortification and supplementation to deal with micronutrient. Biofortification is a novel approach in this regard to provide nutrient enrich food staples. WHO emphasize on biofortification through the Harvest Plus-challenge-program to improve micronutrient of the food staple through biotechnological and breeding approaches. Biofortification is cost-effective approach for delivering of micronutrient enrich food crops to poor people, where people cannot afford to use supplementation. Biofortified crops can be a good source of nutrition to the poor people of developing countries. Here, in this review we discussed the biofortification, its discovery leading to development, benefits and prospects towards the development of biofortified food-crops

Growth response of cowpea (Vigna unguiculata L.) exposed to Pseudomonas fluorescens, Pseudomonas stutzeri, and Pseudomonas gessardii in lead contaminated soil

Lead (Pb) is a major contaminant among heavy metals in the soil environment that has negative impacts on the growth of plants, which ultimately cause health risk via entering into the food chain. In this regard, plant growth promoting rhizobacteria (PGPR) might improve plant growth by counteracting the harmful effects of Pb stress. Therefore, the present pot study was conducted to evaluate the role of PGPR in improving the growth of cowpea in Pb-contaminated soil. Three different concentrations of Pb (250, 350, and 750 mg kg−1) were applied alone (control) and in combination with bacterial inoculums [S1 (Pseudomonas fluorescens), S2 (Pseudomonas stutzeri) and S3 (Pseudomonas gessardii)] using completely randomized design each with three replicates. Results showed that plant fresh weight, plant dry weight, shoot length, root length, and chlorophyll contents of cowpea plants were improved significantly (P ≤ 0.05) by applying bacterial isolates as compared to the un-inoculated contaminated control. Among bacterial isolates, S3 performed better as compared to other bacterial isolates. The maximum increase in plant fresh weight, plant dry weight, shoot length, root length, and chlorophyll content was observed under S3 bacterial strain. Bacterial inoculation also enhanced the Pb concentration in the plant and the maximum uptake was recorded under S3 bacterial strain at 750 mg kg−1. Consequently, it has been concluded that PGPR has the great potential to enhance the plant growth and physiological characteristics of cowpea in Pb-contaminated sites and can also be used for bioremediation purposes

Technology-assisted cognitive-behavior therapy delivered by peers versus standard cognitive behavior therapy delivered by community health workers for perinatal depression: study protocol of a cluster randomized controlled non-inferiority trial

Abstract Background The lack of trained mental health professionals is a key barrier to scale-up of evidence-based psychological interventions in low and middle-income countries. We have developed an app that allows a peer with no prior experience of health-care delivery to deliver the cognitive therapy-based intervention for perinatal depression, the Thinking Healthy Programme (THP). This trial aims to assess the effectiveness and cost-effectiveness of this Technology-assisted peer-delivered THP versus standard face-to-face Thinking Healthy Programme delivered by trained health workers. Methods We will employ a non-inferiority stratified cluster randomized controlled trial design comparing the two formats of intervention delivery. A total of 980 women in the second or third trimester of pregnancy with a diagnosis of Major Depressive Episode, evaluated with the Structured Clinical Interview for DSM-V Disorders (SCID), will be recruited into the trial. The unit of randomization will be 70 village clusters randomly allocated in a 1:1 ratio to the intervention and control arms. The primary outcome is defined as remission from major depressive episode at 3 months postnatal measured with the SCID. Data will also be collected on symptoms of anxiety, disability, quality of life, service use and costs, and infant-related outcomes such as exclusive breastfeeding and immunization rates. Data will be collected on the primary outcome and selected secondary outcomes (depression and anxiety scores, exclusive breastfeeding) at 6 months postnatal to evaluate if the improvements are sustained in the longer-term. We are especially interested in sustained improvement (recovery) from major depressive episode. Discussion This trial will evaluate the effectiveness and cost-effectiveness of a technology-assisted peer-delivered cognitive behavioral therapy-based intervention in rural Pakistan. If shown to be effective, the novel delivery format could play a role in reducing the treatment gap for perinatal depression and other common mental disorders in LMIC. Trial registration The trial was registered at Clinicaltrials.gov (NCT05353491) on 29 April 2022

Chemical composition and antioxidant, antimicrobial and haemolytic activities of crambe cordifolia roots

In the current study, we investigated the chemical composition, in vitro antioxidant, antimicrobial and haemolytic activities of the crude (methanolic) and n-hexane, chloroform, and ethyl acetate extracts of roots of Crambe cordifolia Steven. The GC-MS analysis led to identification of erucic acid (20.8%), p-cymene (20.9%), palmitic acid (19.2%) and vitamin E (13.8%) as major components of methanol, n-hexane, chloroform and ethyl acetate extracts respectively. The results of spectrophotometric assays showed that the methanol extract had the highest total phenolic contents (210.3 ± 0.74 μg GAE/mg of dry plant material), total flavonoid contents (75.5 ± 0.32 μg QE/mg of dry plant material) and antioxidant potential. It was established by disc diffusion and minimum inhibitory concentration methods that, overall, the methanol extract exhibited the highest antimicrobial activity against most of the tested microbial strains (Escherichia coli, Bacillus subtilis, Pasteurella multocida, Staphylococcus aureus, Aspergillus niger and Fusarium solani) as compared with the nhexane, chloroform, and ethyl acetate extracts. The outcome of the haemolytic assay showed that the tested extract and different solvent fractions were safe to human erythrocyte membran