Biofilm Forming Bacteria Isolated from Medical Implants

Background: Biofilm formation in indwelling medical devices poses serious risk of infection and increases the likelihood of  recurrence of infections. The study was carried out to identify the microbes which form biofilms on medical implants and are thus involved in nosocomial infections, to assess the potential of biofilm producing ability of these isolated microbes and to determine antibiotic resistance towards ampicillin, vancomycin ceftazidime, streptomycin and tetracycline.Methods: For this, 11 samples of 5 different implants were taken from Tertiary Care Hospital Multan, Pakistan. Bacteria were isolated and identified by culture plate method. Tryptone soy broth (TBS) media was used for biofilm development by microbes in plastic tubes. Developed biofilm in tubes was visualized with crystal violet staining method and then biofilm forming potential was estimated by measuring the optical density through spectrophotometer. Antibiotic susceptibility was done by Kirby Bauer disk diffusion method to determine the resistance and susceptibility pattern of biofilm producers.Results: Out of 11 different samples of indwelling medical devices, a total of 131 bacterial strains were isolated. The percentage of bacterial isolates which produced biofilms were Staphylococcus spp. (41%) followed by Escherichia coli (18%), Pseudomonas spp. (4%), Proteus spp. (7.2%), Klebsiella spp. (8.6%), Bacillus spp. (8.6%), Fusobacterium spp. (1.4%) Clostridium spp.(1.4%), Enterococcus spp. (7.2%) and Neisseria spp. (1.4%). Sixty-nine isolates were considered positive for biofilm formation while 58 were considered negative. The resistance was maximum against ampicillin (42%) followed by ceftazidime (17.1%), tetracycline (34%) and streptomycin (30%) while against vancomycin no resistance was observed.Conclusion: Biofilms produced on medical implants by different bacteria are considered to be the major cause of hospital acquired infections and are very difficult to eradicate. These biofilms associated implant infections are challenging to treat because of their resistance towards various antibiotic therapies. Therefore, some efficient methods of prevention of biofilm formation should be introduced.Keywords: Bacterial biofilms; Biofilm associated infections; Medical implants; Hospital acquired infections; Antibiotic resistance  

Willingness to pay for improved drinking water facility in Samsani Khui, Johar Town, Lahore, Pakistan

Quality of drinking water is a universal problem specifically faced by many developing countries. Willingness to pay for improved drinking water facility of the people of a rural settlement, Samsani Khui, Johar Town in Lahore, Pakistan was assessed by questionnaire survey. This article intends to scrutinize the strong relation of these dynamics with willingness to pay by correlating them using chi square and multiple regression. Conferring to results, health status of the people of selected area revealed that 50% adults and 31.9 % children suffered from diarrhea within last 6 months. Education level of 48.6% people is middle school. Income of people lies between 5000-30,000 Rupees per month. People with poor health status held strong association with willingness to pay while low income level and low education level had weak association with willingness to pay. The highest and lowest value calculated are 53.969, -4.83, respectively and the mean ratio of willingness to pay was 1.835. The average willingness to pay calculated was between Rs. 1 to 5. This study depicted that various dynamics including health status, monthly income and education level of the people are the determinants of willingness to pay (WTP) for improved drinking water facility

Long-Term Outcomes of Drug-Coated Balloon Angioplasty in The Treatment of Small Vessel Coronary Artery Disease

Long-Term Outcomes of Drug-Coated Balloon Angioplasty in The Treatment of Small Vessel Coronary Artery Disease Objectives: To determine the outcomes in patients with small-vessel disease (SVD) who underwent percutaneous coronary intervention (PCI) with a drug-coated balloon (DCB) and correlate these adverse outcomes with various risk factors. Methodology: The prospective cohort study was conducted at the Rawalpindi Institute of Cardiology (RIC) from January 2020 to December 2022. After being approved by the Hospital Ethics Committee, fifty-four patients who presented with SVD were enrolled using non-probability consecutive sampling. Written informed consent was obtained from the patients. They were treated with DCB and observed clinically on follow-ups at 15, 30, 60, and 90 days, & later after every 6 months for up to 2 years. Only those patients who presented with symptoms underwent repeat angiography. The outcomes assessed were cardiovascular mortality, myocardial infarction (MI), and target lesion revascularization (TLR). Results: Cardiovascular mortality occurred in 2(3.7%), MI in 3(5.6%) and TLR in 2(3.7%) patients. There was a significant association between cardiovascular mortality, MI, and TLR with diabetes mellitus and BMI. Age was only significantly related to cardiovascular mortality. Conclusion: A drug-coated balloon is an effective and feasible treatment modality for small vessel disease. The incidence of outcomes of cardiovascular mortality, MI, and TLR after DCB is low, making it a safe modality. Advanced age, obesity, and diabetes mellitus alone or with hypertension are the predicting factors of adverse outcomes after DCB in patients with SVD. Keywords: Drug-coated balloon, DCB, Small vessel coronary artery disease, SV

Mapping Turbidity Levels in the Lake’s Water using Satellite Remote Sensing Technique

Haleji lake, Thatta, Sindh, has been affected by water pollution in the past decades. This study focuses on mapping water pollution at Haleji lake using turbidity as the pollution indicator. In this study, an algorithm was developed by correlating satellite reflectance data and in-situ turbidity measurements using regression analysis. The determination coefficient R2 of the developed algorithm showed a value of 0.83 that is evidence of a good correlation between field-based and mapped turbidity. Moreover, a temporal analysis was carried out using the same algorithm for the years 1999 and 2011. Results of temporal analysis confirmed that the turbidity levels in Haleji lake have increased from below 5 NTU to around 15 – 30 NTU. This is a clear sign of lake pollution in the interim of the past twelve years

Cotton microbiome profiling and Cotton Leaf Curl Disease (CLCuD) suppression through microbial consortia associated

The failure of breeding strategies has caused scientists to shift to other means where the new approach involves exploring the microbiome to modulate plant defense mechanisms against Cotton Leaf Curl Disease (CLCuD). The cotton microbiome of CLCuD-resistant varieties may harbor a multitude of bacterial genera that significantly contribute to disease resistance and provide information on metabolic pathways that differ between the susceptible and resistant varieties. The current study explores the microbiome of CLCuD-susceptible Gossypium hirsutum and CLCuD-resistant Gossypium arboreum using 16 S rRNA gene amplification for the leaf endophyte, leaf epiphyte, rhizosphere, and root endophyte of the two cotton species. This revealed that Pseudomonas inhabited the rhizosphere while Bacillus was predominantly found in the phyllosphere of CLCuV-resistant G. arboreum. Using salicylic acid-producing Serratia spp. and Fictibacillus spp. isolated from CLCuD-resistant G. arboreum, and guided by our analyses, we have successfully suppressed CLCuD in the susceptible G. hirsutum through pot assays. The applied strains exhibited less than 10% CLCuD incidence as compared to control group where it was 40% at 40 days post viral inoculation. Through detailed analytics, we have successfully demonstrated that the applied microbes serve as a biocontrol agent to suppress viral disease in Cotton

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Formulation and In-Vitro Evaluation of Gabapentin Loaded Transferosomal Gel

Gabapentin is an anticonvulsant which is primarily used to treat peripheral neuropathy. It belongs to class III drugs having High solubility and low permeability. The present study is carried out on formulation and invitro evaluation of Gabapentin Transferosomal gel by using various surfactants, polymers. The Transferosomes were prepared by thin film hydration technique. Different proportions of surfactants have been utilized such as span 80 and tween 80. 8 distinctive formulations of Gabapentin transferosomes had been formulated and evaluated for parameters like FTIR, Organoleptic evaluation, Drug content, Entrapment efficiency, Invitro diffusion studies, SEM, Zeta potential and particle size analysis, pH, Spreadability, Viscosity, Stability testing and Kinetic studies. The optimized formulation Gf6 confirmed Entrapment efficiency of 86.54%, Drug content 96.11% Zeta potential of -31.64Mv, particle size of 164.2nm, In-vitro drug release ranging from (75.15- 89.37%). The drug release data of selected formulation confirmed desirable fit into Zero order and Peppas release Kinetics. Overall, it can be concluded that the transferosomal gel can overcome problems associated with convectional routes of drug delivery. Keywords: Gabapentin, Transferosomes, Edge activators, Thin film hydration method

SOCIAL CLASSES AND CULTURE OF POVERTY: A CASE STUDY

ABSTRACT: Disparities in social classes and their cultures prevail in all societies. There is an inequality in our society on the basis of resources, wealth, power and means of production. The aim of the study was to explore how the culture of the poor is influenced by class struggle. The method of the study was qualitative. This study used data from 100 semi structured questionnaire to better understand the effort of people. The locale of the study was in different areas of Rawalpindi. The conclusion of the study is that everyone is trying to raise their status. The people are struggling from dawn to dusk to gain status high in society

Bacillus spp. as Bioagents: Uses and Application for Sustainable Agriculture

Food security will be a substantial issue in the near future due to the expeditiously growing global population. The current trend in the agriculture industry entails the extravagant use of synthesized pesticides and fertilizers, making sustainability a difficult challenge. Land degradation, lower production, and vulnerability to both abiotic and biotic stresses are problems caused by the usage of these pesticides and fertilizers. The major goal of sustainable agriculture is to ameliorate productivity and reduce pests and disease prevalence to such a degree that prevents large-scale damage to crops. Agriculture is a composite interrelation among plants, microbes, and soil. Plant microbes play a major role in growth promotion and improve soil fertility as well. Bacillus spp. produces an extensive range of bio-chemicals that assist in plant disease control, promote plant development, and make them suitable for agricultural uses. Bacillus spp. support plant growth by N fixation, P and K solubilization, and phytohormone synthesis, in addition to being the most propitious biocontrol agent. Moreover, Bacilli excrete extracellular metabolites, including antibiotics, lytic enzymes, and siderophores, and demonstrate antagonistic activity against phytopathogens. Bacillus spp. boosts plant resistance toward pathogens by inducing systemic resistance (ISR). The most effective microbial insecticide against insects and pests in agriculture is Bacillus thuringiensis (Bt). Additionally, the incorporation of toxin genes in genetically modified crops increases resistance to insects and pests. There is a constant increase in the identified Bacillus species as potential biocontrol agents. Moreover, they have been involved in the biosynthesis of metallic nanoparticles. The main objective of this review article is to display the uses and application of Bacillus specie as a promising biopesticide in sustainable agriculture. Bacillus spp. strains that are antagonistic and promote plant yield attributes could be valuable in developing novel formulations to lead the way toward sustainable agriculture

Efficacy of Catheter Ablation for Atrial Fibrillation in Hypertrophic Cardiomyopathy: A Systematic Review and Meta-Analysis.

Atrial fibrillation (AF) is the most common arrhythmia in patients with hypertrophic cardiomyopathy (HCM). Catheter ablation (CA) has emerged as an effective therapy for AF. We conducted a meta-analysis to update the current clinical evidence on the efficacy of CA for AF in patients with HCM. We searched PubMed, Embase, Cochrane and Clinicaltrials.gov for interventional and observational studies assessing single and multiple procedure success rate of CA in HCM patients. Our meta-analysis included 25 studies involving 1817 patients. Success rate following single procedure was 40.4% (95% CI 33.1 to 48.0%) at latest follow-up. The pooled success rate following multiple procedures was 51.4% (95% CI 42.9% to 60.0%) at latest follow-up. In the subgroup analysis for AF subtype, TCA was more successful for paroxysmal AF compared to non-paroxysmal AF. For the subset of studies reporting drug-free success rate, single and multiple procedures had a success rate of 33.4% (95% CI 19.3 to 49.1%) and 51.8% (95% CI 41.3 to 62.2%) at latest follow-up, respectively. CA is a suitable option for AF in patients with HCM. Success rate is greater in paroxysmal AF, after multiple procedures and with antiarrhythmic drugs