THE UNDERUSE OF SPIROMETERY IN ROUTINE MEDICAL PRACTICE FOR DIAGNOSIS AND MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS IN KARACHI, PAKISTAN

Introduction: Spirometry is important in the diagnosis and management of chronic obstructive pulmonary disease (COPD), yet it is a common clinical observation that it is underused though the extent is unclear. This survey aims to examine the use of spirometry in the diagnosis and management of COPD patients in districts of, Karachi. Material and Methods: It is a cross-sectional survey involving four clinic settings: hospital-based respiratory specialist clinic, hospital-based mixed medical specialist clinic, general outpatient clinic (primary care), and tuberculosis and chest clinic. Thirty physician-diagnosed COPD patients were randomly selected from each of the four clinic groups. All of them had a forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio less than 0.70 and had been followed up at the participating clinic for at least 6 months for COPD treatment. Results: Of the 120 COPD patients, there were 111 males and mean post-bronchodilator FEV1 was 46.2% predicted. Only 22 patients (18.3%) had spirometry done during diagnostic workup, and 64 patients (53.3%) had spirometry done ever. Conclusion: We conclude that spirometry is underused in general but especially by non-respiratory physicians and family physicians in the management of COPD patients. More effort at educating the medical community is urgently needed. KEYWORDS: Pulmonary function tests; Specialist; Forced expiratory volume in 1 second (FEV1); Forced vital capacity (FVC)

THE UNDERUSE OF SPIROMETERY IN ROUTINE MEDICAL PRACTICE FOR DIAGNOSIS AND MANAGEMENT OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS IN KARACHI, PAKISTAN

Introduction: Spirometry is important in the diagnosis and management of chronic obstructive pulmonary disease (COPD), yet it is a common clinical observation that it is underused though the extent is unclear. This survey aims to examine the use of spirometry in the diagnosis and management of COPD patients in districts of, Karachi. Material and Methods: It is a cross-sectional survey involving four clinic settings: hospital-based respiratory specialist clinic, hospital-based mixed medical specialist clinic, general outpatient clinic (primary care), and tuberculosis and chest clinic. Thirty physician-diagnosed COPD patients were randomly selected from each of the four clinic groups. All of them had a forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) ratio less than 0.70 and had been followed up at the participating clinic for at least 6 months for COPD treatment. Results: Of the 120 COPD patients, there were 111 males and mean post-bronchodilator FEV1 was 46.2% predicted. Only 22 patients (18.3%) had spirometry done during diagnostic workup, and 64 patients (53.3%) had spirometry done ever. Conclusion: We conclude that spirometry is underused in general but especially by non-respiratory physicians and family physicians in the management of COPD patients. More effort at educating the medical community is urgently needed. KEYWORDS: Pulmonary function tests; Specialist; Forced expiratory volume in 1 second (FEV1); Forced vital capacity (FVC)

Functional and structural analysis of predicted proteins obtained from homo sapiens' minisatellite 33.15-tagged transcript pAKT-45 variants

The spermatozoa are transcriptionally dormant entities which have been recognized to be an archive of mRNA, coding for a variety of functionally crucial cellular proteins. This significant repository of mRNA is predicted to be associated with early embryogenesis and postfertilization. The mRNA transcripts which are tagged with minisatellites have been involved in the regulation of the gene functions as well as their organization. However, very little information is available regarding the expression of the transcripts tagged with minisatellites in spermatozoa. Therefore, in order to understand the functions and the conformational behavior of the proteins expressed from these minisatellite-tagged transcripts, we have performed a detailed in silico analysis using the sequences of the transcripts. The protein predicted from KF274549 showed the functionalities similar to uncharacterized C4orf26 proteins, while that obtained from KF274557 predicted to be a metallophosphoesterase. Furthermore, the structural folds in the structure of these predicted proteins were analyzed by using the homology modeling and their conformational behaviors in the explicit water conditions were analyzed by using the techniques of Molecular Dynamics (MD) simulations. This detailed analysis will facilitate the understanding of these proteins in the spermatozoon region and can be used for uncovering other attributes of the metabolic network

In vitro inhibition of biofilm and virulence factor production in azole-resistant strains of Candida albicans isolated from diabetic foot by Artemisia vulgaris stabilized tin (IV) oxide nanoparticles

The advent of nanotechnology has been instrumental in the development of new drugs with novel targets. Recently, metallic nanoparticles have emerged as potential candidates to combat the threat of drug-resistant infections. Diabetic foot ulcers (DFUs) are one of the dreadful complications of diabetes mellitus due to the colonization of numerous drug-resistant pathogenic microbes leading to biofilm formation. Biofilms are difficult to treat due to limited penetration and non-specificity of drugs. Therefore, in the current investigation, SnO2 nanoparticles were biosynthesized using Artemisia vulgaris (AvTO-NPs) as a stabilizing agent and were characterized using ultraviolet–visible (UV–vis) spectroscopy, Fourier transform infrared spectroscopy (FT-IR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX). Furthermore, the efficacy of AvTO-NPs against biofilms and virulence factors of drug-resistant Candida albicans strains isolated from DFUs was assessed. AvTO-NPs displayed minimum inhibitory concentrations (MICs) ranging from 1 mg/mL to 2 mg/mL against four strains of C. albicans. AvTO-NPs significantly inhibited biofilm formation by 54.8%–87%, germ tube formation by 72%–90%, cell surface hydrophobicity by 68.2%–82.8%, and exopolysaccharide (EPS) production by 69%–86.3% in the test strains at respective 1/2xMIC. Biosynthesized NPs were effective in disrupting established mature biofilms of test strains significantly. Elevated levels of reactive oxygen species (ROS) generation in the AvTO-NPs-treated C. albicans could be the possible cause of cell death leading to biofilm inhibition. The useful insights of the present study could be exploited in the current line of treatment to mitigate the threat of biofilm-related persistent DFUs and expedite wound healing

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Revision of Indian species of Caenohomalopoda Tachikawa (Hymenoptera: Encyrtidae)

Fatima, Farha, Zeya, Shahid Bin (2022): Revision of Indian species of Caenohomalopoda Tachikawa (Hymenoptera: Encyrtidae). Zootaxa 5133 (2): 247-269, DOI: https://doi.org/10.11646/zootaxa.5133.2.

STOCHASTIC COMPROMISE MIXED ALLOCATION

Clark and Steel [3] worked out the optimum allocation of sample sizes to strata and stages with additional constraints to use different type of allocations in different strata. Ahsan et al. [1] used the same idea to introduced “Mixed Allocation” for univariate stratified populations that maximizes the precision of the estimate of the population mean. Ahsan et al. [2] worked out the Mixed Allocation for fixed precision to minimize the cost of the survey for univariate stratified populations. Later on Varshney and Ahsan [13, 14] extended these works for multivariate stratified populations to obtain a ‘Compromise Mixed Allocation’. This paper, studies a more realistic situation in multivariate stratified sampling. Often the stratum variances  are unknown and estimated by their sample estimates  that are random variables. The cost of measurement may also vary randomly during the course of sampling. Thus it will be more appropriate to consider the problem of finding a compromise mixed allocation as a Stochastic Nonlinear Programming Problem (SNLPP). The SNLPP is solved using Chance Constrained Technique. The application of this approach is exhibited through a numerical example assuming normal distributions of the random parameters. The numerical results are obtained by using the optimization software LINGO [9]

Comparative Pan-Genomic Analysis Revealed an Improved Multi-Locus Sequence Typing Scheme for Staphylococcus aureus

The growing prevalence of antibiotic-resistant Staphylococcus aureus strains mandates selective susceptibility testing and epidemiological investigations. It also draws attention to an efficient typing strategy. Whole genome sequencing helps in genetic comparison, strain differentiation, and typing; however, it is not that cost-effective. In comparison, Multi-Locus Sequence Typing (MLST) is an efficient typing method employed for bacterial strain typing and characterizations. In this paper, a comprehensive pangenome and phylogenetic analysis of 502/1279 S. aureus genomes is carried out to understand the species divergence. Additionally, the current Multi-Locus Sequence Typing (MLST) scheme was evaluated, and genes were excluded or substituted by alternative genes based on reported shortcomings, genomic data, and statistical scores calculated. The data generated were helpful in devising a new Multi-Locus Sequence Typing (MLST) scheme for the efficient typing of S. aureus strains. The revised scheme is now a blend of previously used genes and new candidate genes. The genes yQil, aroE, and gmk are replaced with better gene candidates, opuCC, aspS, and rpiB, based on their genome localization, representation, and statistical scores. Therefore, the proposed Multi-Locus Sequence Typing (MLST) method offers a greater resolution with 58 sequence types (STs) in comparison to the prior scheme&rsquo;s 42 STs

Fabrication of High Surface Area TiO₂-MoO₃ Nanocomposite as a Photocatalyst for Organic Pollutants Removal from Water Bodies

A nanocomposite (NC) of titanium (IV) oxide (TiO2) and molybdenum (VI) oxide (MoO3) was synthesized using a hydrothermal route. Detailed analyses using transmission electron microscopy, X-ray diffraction, X-ray fluorescence (XRF), Brunauer–Emmett–Teller (BET) isotherms, X-ray photoelectron spectroscopy, Raman, and diffuse reflectance infrared Fourier transform spectroscopy were carried out and confirmed the successful formation of pure TiO2-MoO3 (Ti-Mo) NC. The Ti-Mo NC possesses sizes in the range of 150–500 nm. XPS, Raman, and DRIFT shift measurements confirmed the formation of mixed oxide linkage in the form of Ti-O-Mo. Sorption of nitrogen isotherms revealed a significant increase in the number and pore widths of mesopores in the NC. Water sorption isotherms revealed enhanced affinity of the nanocomposites for water relative to the pure metal oxides. The BET surface area for Ti-Mo NC from the nitrogen adsorption isotherm was 129.3 m2/g which is much higher than the pure metal oxides (i.e., 37.56 m2/g for TiO2 and 2.21 m2/g for MoO3). The Ti-Mo NC provided suitable adsorption sites that captured the studied carbamates from the solution and promoted their photodegradation process. The photocatalytic degradation of MB in the presence of the catalyst was enhanced by 2.9 and 5.5 folds upon irradiation with white LED and 302 nm UV light sources, respectively

Fabrication of High Surface Area TiO2-MoO3 Nanocomposite as a Photocatalyst for Organic Pollutants Removal from Water Bodies

A nanocomposite (NC) of titanium (IV) oxide (TiO2) and molybdenum (VI) oxide (MoO3) was synthesized using a hydrothermal route. Detailed analyses using transmission electron microscopy, X-ray diffraction, X-ray fluorescence (XRF), Brunauer&ndash;Emmett&ndash;Teller (BET) isotherms, X-ray photoelectron spectroscopy, Raman, and diffuse reflectance infrared Fourier transform spectroscopy were carried out and confirmed the successful formation of pure TiO2-MoO3 (Ti-Mo) NC. The Ti-Mo NC possesses sizes in the range of 150&ndash;500 nm. XPS, Raman, and DRIFT shift measurements confirmed the formation of mixed oxide linkage in the form of Ti-O-Mo. Sorption of nitrogen isotherms revealed a significant increase in the number and pore widths of mesopores in the NC. Water sorption isotherms revealed enhanced affinity of the nanocomposites for water relative to the pure metal oxides. The BET surface area for Ti-Mo NC from the nitrogen adsorption isotherm was 129.3 m2/g which is much higher than the pure metal oxides (i.e., 37.56 m2/g for TiO2 and 2.21 m2/g for MoO3). The Ti-Mo NC provided suitable adsorption sites that captured the studied carbamates from the solution and promoted their photodegradation process. The photocatalytic degradation of MB in the presence of the catalyst was enhanced by 2.9 and 5.5 folds upon irradiation with white LED and 302 nm UV light sources, respectively