Aerobic bacteriological analysis of bronchoalveolar lavage fluid in patients with pulmonary infection: a tertiary care hospital study

Background: Respiratory tract infection are an important cause of mortality and morbidity worldwide. The prevalent bacterial agents and their antimicrobial resistance patterns differs, both geographically and over time. Bronchoalveolar lavage has improved sensitivity and specificity of diagnostic techniques in diagnosis of pulmonary infections. The present study aimed to determine the current aerobic bacterial isolates and their sensitivity pattern obtained from the bronchoalveolar lavage (BAL) fluid of patients with pulmonary infection.Methods: BAL samples received from the patients of suspected respiratory tract infections over a period of one year, from June 2018 to May 2019 were processed by standard methods for isolation and identification. The antimicrobial susceptibility was done by the Kirby-Bauer disc diffusion method as per the CLSI guidelines.Results: Out of 322 BAL samples, 84 (26.08%) were found to be culture positive for bacterial isolates. Of those, 44 samples (52.38%) from among males and 40 samples (47.61%) from among females were culture positive .The predominant organism isolated was Pseudomonas aeruginosa 46 (54.76%) followed by Acinetobacter baumanii 13 (15.47%), Escherichia coli 10 (11.90%), Klebsiella pnuemoniae 6 (7.14%) Enterobacter sp 3 (3.57%), Staphylococcus aureus 3 (3.57%), Enterococcus sp 2 (2.38%) and Sphingomonas sp 1 (1.19%). The Gram-negative organisms showed maximum sensitivity to colistin (100%) while as vancomycin and linezolid were the most effective drugs against Gram positive organisms.Conclusions: Bronchoalveolar lavage has improved sensitivity and specificity in diagnosis of pulmonary infections. It is important to have an updated local antibiogram for each hospital and regular surveillance and monitoring of antibiotic resistance and the changing patterns of the bacterial pathogens is a must for better patient management

Effects of Diagenesis on the Reservoir Quality in the Upper Sands of Lower Goru Formation, Badin Block, Lower Indus Basin, Pakistan

The core samples of B member of upper sand reservoir rocks of the lower Goru Formation from three wellsof the Badin block were studied using thin section, XRD, and SEM techniques to investigate the diagenetic trends andtheir effect on reservoir quality. Microscopic study indicates that the B sand unit is mature with quartz as thepredominant mineral constituent with variable amount of feldspar and lithic minerals. The QFL plot indicates that mostof the samples are plotted in the field of quartz arenite, sub-litharenite and sub-arkose respectively. A few samplesbelong to the category of litharenite and feldspathic litharenite. The feldspars were partially to completely altered tokaolinite and other clay minerals. Coarse-crystalline or micro-crystalline calcite is the predominant cementing material.Bulk rock XRD analysis also confirms that the main mineral constituents of there samples are quartz and calcite invariable proportions. The undulose extinction and fracturing of quartz grains indicate that the area remained understress. Moreover, such fracturing is post-depositional and therefore is the product of late diagenesis. Scanning ElectronMicroscopic (SEM) images at 50 micrometer (μm) size show irregular type of fracturing within the quartz grains. Thislate stage fracturing of quartz has also generated various types of channels which may serve as secondary porosity. Thequartz overgrowth was observed in some samples due to late stage diagenesis. The micro-crystalline cement in the formof calcite is mostly present within the pores in fractured quartz. The results indicate that the diagenesis played asignificant role in improving the reservoir characteristics of B sand by increasing the porosity due to quartz fracturing,feldspar dissolution, alteration and quartz corrosion. Hence, better understanding of reservoir heterogeneities inporosity through diagenetic studies can be helpful in evaluating potential reservoir horizons for hydrocarbonaccumulation on spatial and temporal scales

Role of bacillus cereus in improving the growth and phytoextractability of brassica nigra (L.) K. Koch in chromium contaminated soil

Plant growth-promoting rhizobacteria (PGPR) mediate heavy metal tolerance and improve phytoextraction potential in plants. The present research was conducted to find the potential of bacterial strains in improving the growth and phytoextraction abilities of Brassica nigra (L.) K. Koch. in chromium contaminated soil. In this study, a total of 15 bacterial strains were isolated from heavy metal polluted soil and were screened for their heavy metal tolerance and plant growth promotion potential. The most efficient strain was identified by 16S rRNA gene sequencing and was identified as Bacillus cereus. The isolate also showed the potential to solubilize phosphate and synthesize siderophore, phytohormones (indole acetic acid, cytokinin, and abscisic acid), and osmolyte (proline and sugar) in chromium (Cr+3 ) supplemented medium. The results of the present study showed that chromium stress has negative effects on seed germination and plant growth in B. nigra while inoculation of B. cereus improved plant growth and reduced chromium toxicity. The increase in seed germination percentage, shoot length, and root length was 28.07%, 35.86%, 19.11% while the fresh and dry biomass of the plant increased by 48.00% and 62.16%, respectively, as compared to the uninoculated/control plants. The photosynthetic pigments were also improved by bacterial inoculation as compared to untreated stress-exposed plants, i.e., increase in chlorophyll a, chlorophyll b, chlorophyll a + b, and carotenoid was d 25.94%, 10.65%, 20.35%, and 44.30%, respectively. Bacterial inoculation also resulted in osmotic adjustment (proline 8.76% and sugar 28.71%) and maintained the membrane stability (51.39%) which was also indicated by reduced malondialdehyde content (59.53% decrease). The antioxidant enzyme activities were also improved to 35.90% (superoxide dismutase), 59.61% (peroxide), and 33.33% (catalase) in inoculated stress-exposed plants as compared to the control plants. B. cereus inoculation also improved the uptake, bioaccumulation, and translocation of Cr in the plant. Data showed that B. cereus also increased Cr content in the root (2.71-fold) and shoot (4.01-fold), its bioaccumulation (2.71-fold in root and 4.03-fold in the shoot) and translocation (40%) was also high in B. nigra. The data revealed that B. cereus is a multifarious PGPR that efficiently tolerates heavy metal ions (Cr+3 ) and it can be used to enhance the growth and phytoextraction potential of B. nigra in heavy metal contaminated soil

Exopolysaccharides producing bacteria for the amelioration of drought stress in wheat

This research was designed to elucidate the role of exopolysaccharides (EPS) producing bacterial strains for the amelioration of drought stress in wheat. Bacterial strains were isolated from a farmer’s field in the arid region of Pakistan. Out of 24 isolated stains, two bacterial strains, Bacillus subtilis (Accession No. MT742976) and Azospirillum brasilense (Accession No. MT742977) were selected, based on their ability to produce EPS and withstand drought stress. Both bacterial strains produced a good amount of EPS and osmolytes and exhibited drought tolerance individually, however, a combination of these strains produced higher amounts of EPS (sugar 6976 µg/g, 731.5 µg/g protein, and 1.1 mg/g uronic acid) and osmolytes (proline 4.4 µg/mg and sugar 79 µg/mg) and significantly changed the level of stress-induced phytohormones (61%, 49% and 30% decrease in Indole Acetic Acid (IAA), Gibberellic Acid (GA), and Cytokinin (CK)) respectively under stress, but an increase of 27.3% in Abscisic acid (ABA) concentration was observed. When inoculated, the combination of these strains improved seed germination, seedling vigor index, and promptness index by 18.2%, 23.7%, and 61.5% respectively under osmotic stress (20% polyethylene glycol, PEG6000). They also promoted plant growth in a pot experiment with an increase of 42.9%, 29.8%, and 33.7% in shoot length, root length, and leaf area, respectively. Physiological attributes of plants were also improved by bacterial inoculation showing an increase of 39.8%, 61.5%, and 45% in chlorophyll a, chlorophyll b, and carotenoid content respectively, as compared to control. Inoculations of bacterial strains also increased the production of osmolytes such asproline, amino acid, sugar, and protein by 30%, 23%, 68%, and 21.7% respectively. Co-inoculation of these strains enhanced the production of antioxidant enzymes such as superoxide dismutase (SOD) by 35.1%, catalase (CAT) by 77.4%, and peroxidase (POD) by 40.7%. Findings of the present research demonstrated that EPS, osmolyte, stress hormones, and antioxidant enzyme-producing bacterial strains impart drought tolerance in wheat and improve its growth, morphological attributes, physiological parameters, osmolytes production, and increase antioxidant enzymes

Developing counseling skills through pre-recorded videos and role play: a pre- and post-intervention study in a Pakistani medical school

<p>Abstract</p> <p>Background</p> <p>Interactive methods like role play, recorded video scenarios and objective structured clinical exam (OSCE) are being regularly used to teach and assess communication skills of medical students in the western world. In developing countries however, they are still in the preliminary phases of execution in most institutes. Our study was conducted in a naïve under resourced setup to assess the impact of such teaching methodologies on the counseling skills of medical students.</p> <p>Methods</p> <p>Fifty four 4^thyear MBBS students were identified to be evaluated for communication skills by trained facilitators in a pre-intervention OSCE. The same group of students was given a demonstration of ideal skill level by means of videos and role playing sessions in addition to real life interaction with patients during hospital and community rotations. A post-intervention evaluation was carried out six months later through OSCE and direct observation through structured checklist (DOS) in hospital and community settings. The combined and individual performance levels of these students were analyzed.</p> <p>Results</p> <p>There was a statistically significant difference in the communication skills of students when assessed in the post-intervention OSCE (p = 0.000). Individual post-intervention percentages of study participants displayed improvement as well (n = 45, p = 0.02). No difference was observed between the scores of male and female students when assessed for two specific competencies of antenatal care and breast feeding counseling (p = 0.11). The mean DOS (%) score of 12 randomly selected students was much lower as compared to the post-intervention (%) score but the difference between them was statistically non significant, a result that may have been affected by the small sample size as well as other factors that may come into play in real clinical settings and were not explored in this study (59.41 ± 7.8 against 82.43 ± 22.08, p = 0.88).</p> <p>Conclusions</p> <p>Videos and role play in combination with community and clinical exposure are effective modes of teaching counseling skills to medical students. They can be successfully utilized even in a limited resource setup, as demonstrated by our trial.</p

God should give daughters to rich families only: attitudes towards childbearing among low-income women in Punjab, Pakistan

We evaluated perceptions and experiences of bearing sons and daughters among 42 women in Punjab, Pakistan, with special emphasis on son preference, changes in women's status within the marital family and resulting health effects. Data were collected through repeated, in-depth interviews in Urdu or Punjabi in an urban area in Lahore and a village 40 km. outside of Lahore. For triangulation purposes, four focus group discussions were performed with additional women, as well as in-depth interviews with eight mothers-in-law, three traditional practitioners and three medical practitioners. In general, these women felt that they had limited control over their lives, and this was exemplified by early marriages, high expectations on newly wed women to conceive and poor access to contraceptives. Women frequently expressed a strong preference for sons, mostly for economic reasons, reflecting women's subordinate position in society and the low economic value placed on women's work. Mothers of sons mainly discussed health problems during pregnancy and health effects of repeated childbearing. Mothers of daughters and women without children spoke of harassment in the family as well as in society. The results should be of importance in the public health planning in Pakistan as well as for those engaged in women's health issues internationally.Childbearing Pakistan Women Son preference Infertility

Images of health and health care options among low income women in Punjab, Pakistan

We studied women's beliefs and experiences of health and health care among 42 women in an urban slum area in Lahore and a village 40 km outside of Lahore. Data were collected through repeated, in-depth interviews in Urdu or Punjabi totalling 200 hours. For triangulation purposes, four focus group discussions with additional women were performed, as well as in-depth interviews with eight mothers-in-law, three traditional practitioners and three medical practitioners. The women's images of health reflected expectations on the women in society. Women from the village and women from the lowest socioeconomic stratum (SES) spoke of health in terms of physical strength; women from the city and women from low SES spoke of health in terms of mental strength; and women from medium SES discussed it in terms of cultural competence. Overall, health had a very low priority in these women's lives. Two health problems were reported by all women: mental tension leading to headache and white vaginal discharge leading to body pains and fatigue. These health problems were seen as part of womanhood; if treatment was sought, it was often from traditional healers. Village women had a flexible, pragmatic attitude toward health care resources and used all types until treated. Their relation to the doctor was specific; they were mostly concerned with the medical treatment. In contrast, city women chose health care providers depending on type of illness, and being met with respect was for them of equal concern. Childbearing experiences influenced the perceptions of health and health care. Mothers of daughters were seen to both need and deserve less food, health care and attention. These mothers were less vocal about health complaints. Women without children spoke of health in terms of physical strength. These women may have less access to health care because children cannot be used as an "excuse", and because they are not worth spending resources on.women health health care reproduction Pakistan

Factors affecting mode of delivery in a nullipara at term with singleton pregnancy and vertex presentation (NTSV)

Objective: To analyse the factors associated with Caesarean Section (CS) of Nulliparous, Term and Singleton pregnancies with Vertex presentation (NTSV) at a tertiary care hospital.Methods: In this unmatched retrospective case-control study, 212 NTSV patients were identified through computerized medical record systems; the data was collected through predesigned Performa by reviewing medical record charts. One hundred six CS and spontaneous vaginal deliveries (SVD) were taken as cases and controls.Results: The mean maternal age of cases (CS) was 26.64 (SD: 3.9) and of controls (SVD) was 26.7(SD: 3.9) years, whereas mean gestational age was 38.66±1.12 and 38.57±0.9 weeks for cases and controls respectively. Ninety per cent of women in the study group were delivered within 10 hours of active labour. Babies that weighed ≤3kg were 45% and \u3e3kg were 55%. The possibility of being high risk was twice more among those delivered by CS. However, it was not statistically significant (p value 0.077). Labour was induced in 38% patients. The Odds of Induction of Labour (IOL) were two times more and delivering at night was three times more amongst CS. The likelihood of labour exceeding 10 hours was four times (81%) if the patient had a CS. Moreover 48% of the babies weighing \u3e3kg were delivered through CS. Maternal age, high risk pregnancies, gender of baby and epidural analgesia were not statistically significant predictors of mode of delivery (MOD) in this study.CONCLUSION: Induction of Labour, night time delivery, prolonged labour and birth weight \u3c3kg were found to be associated with the increased CS rate among NTSV. Therefore further research is required in order to address these factors and to reduce the increasing Caesarean Section

Prevalent Poisonings in Adolescents and Adults in Dubai: A Compendium from Rashid Hospital

Background: Profile of acute poisonings varies from country to country depending on the ease of availability of substances and socio-economic condition of people; however, very little information from the United Arab Emirates (UAE) have been published, so far. This study was designed to find out the most common causes of overdose and poisoning in patients admitted to the emergency department of Rashid Hospital (RH), Dubai, UAE. Methods: In this retrospective cross sectional study, medical records of poisoned patients admitted to RH from 1st January 2012 to 31st December 2012 were reviewed. Demographic data, types of substances used, intention, length of hospital stay and outcomes were recorded in pre-designed checklists. Results: Overall, 163 patients were studied that among them gender distribution was relatively equal (male: female = 1.04: 1). Mean age of patients was 30.3 ± 11.5 and most patients were in the age group of 20 to 29 years age old (41.7%). Rgarding the type of poisons, the majority of patients were poisoned with pharmaceuticals (55.8%) followed by chemical substances (23.3%). In pharmaceutical poisonings, most cases were due to multi-drug ingestion (22.6%), followed by ingestion of paracetamol (14.1%) and benzodiazepines (4.3%). Considering the gender distribution, women were significantly more involved with pharmaceutical poisoning (P = 0.046), while venomous envenomation occurred only in men indicating a significant difference (P = 0.004). In chemical poisoning, most cases were due to ingestion of corrosive agents (19%). Suicidal poisoning was significantly more common in women (P < 0.001), while abuse was significantly more common in men (P < 0.001). Length of hospital stay averaged on 8.1 days. Only 3 patients died during the admission (mortality rate: 1.8%). Conclusion: Study on, training for and prevention of poisoning should receive more attention in the UAE. Over-the-counter drugs especially paracetamol should be prescribed in a more controlled manner

A comparative study of the influence of N, N '-dialkyl vs. N, N '-diaryl-based electron donor ancillary ligands on photocurrent and photovoltage in dye-sensitized solar cells (DSSCs)

In this study, we report the synthesis of a novel heteroleptic Ru(II)-sensitizer, (Ru(2,2'-bipyridine-4,4'dicarboxylic acid)-4,4'-bis(4-piperidin-1-yl) phenyl ethenyl)-(2,2'-bipyridine) (NCS)(2), denoted as SD-1; moreover, its photophysical, electrochemical, and photovoltaic performances were compared with those of N719 and K77-7 (N, N'-diaryl Ru-sensitizer, namely Ru(2,2'-bipyridine-4,4'-dicarboxylic-acid)4,4'- bis(2-(4-N, N'-diphenylaminophenyl) ethenyl)-2,2'-bipyridine (NCS) 2). The photovoltaic performance of SD-1 outperformed those of N-719 and K77-7, particularly in the red region, and the overall efficiency of SD-1 was 8.5% as compared to 8.0% of K77-7 and 7.7% of N719 under the same experimental device conditions. The superior light harvesting efficiency of SD-1 can be attributed to the strong electron donor sp3-nitrogen, which is attached to two sp3-carbons (dialkyl), whereas in the case of K77-7, all carbon atoms attached to the sp3-nitrogen are sp2, which decrease the electron density on the latter and minimize the electron-donating power of the ancillary ligand in K77-7. To gain a quantitative understanding of the electron density on nitrogen in SD-1 and K77-7, first-principle calculations using molecular and thermodynamic descriptors, such as frontier molecular orbitals, ground-state oxidation potential (GSOP), excited-state oxidation potential (ESOP), optical gap (E0-0), and charge distributions, were conducted in solution. In addition, for understanding the anchored structures of dyes on Ti24O48, density functional theory (DFT) and time-dependent density functional theory (TD-DFT) were utilized. Results of computational studies are in excellent agreement with the experimental results, which can be used as a screening tool for the design of more efficient molecular motifs for DSSCs