Chronic suppurative otitis media: a clinico-microbiological menace

Background: Chronic Suppurative Otitis Media (CSOM) is an important cause of preventable hearing loss. Global emergence of resistant strains is of great concern. The aim of the present study was to determine the etiology and antibiotic sensitivity pattern of bacterial isolates from CSOM cases with special emphasis on ESBL (Extended Spectrum Beta- Lactamases) and AmpC beta lactamases.Methods: Patients with sign and symptoms suggestive of CSOM, ESBL (Extended Spectrum Beta-Lactamases), AmpC beta lactamases and MBLs (Metallo beta lactamases) were included. Two ear swabs were taken from all the patients and cultured on blood agar and MacConkeyagar. Bacterial identification of isolates was done using standard biochemicals. Antimicrobial susceptibility was performed by Kirby-Bauer's disc diffusion method as per the Clinical Laboratory Standards Institute (CLSI) guidelines using antibiotic discs (HI MEDIA).Results: Out of 130 patients, 110(84.62%) had bacterial growth. The common pathogenic species were Pseudomonas aeruginosa 36(37.89%), Staphylococcus aureus 31(32.63%), Citrobacter koseri 9(9.47%) and Proteus vulgaris 6(6.32%). P. aeruginosa showed maximum sensitivity to colistin (94.4%), polymixin-B (91.3%) and imipenem (91.3%). Gram positive cocci showed maximum sensitivity to vancomycin (99%).MRSA (Methicillin Resistant Staphylococcus aureus) and HLAR (High Level Aminoglycoside Resistance) were detected in 9(29%) S. aureus and 1(50%) Enterococcus faecalis respectively. ESBL and AmpC were detected in 11(18.3%) and 12(20%) Gram negative bacteria, respectively and MBL producer was not detected.Conclusion: P. aeruginosa was found to be the most common isolate in CSOM cases and colistin, polymixin-B and imipenem was found to be most effective antibiotics.

In Vitro Chloroquine Resistance in Plasmodium falciparum Isolates from Tertiary Care Hospital

Chloroquine (CQ) has been the mainstay of treatment of malaria for decades. This cost-effective and safe drug has become ineffective for treatment of falciparum malaria in many parts of the world due to development of resistance by the parasite. In addition CQ is not gametocytocidal for P. falciparum and thus cannot block transmission. The extent of problem of chloroquine resistance in P. falciparum is increasing every year. The study was done in period of 2 years. A total of 5653 specimens were examined for malarial infection by employing different diagnostic modalities. Four hundred and thirty-five were found to be positive for P. falciparum by using different diagnostic techniques. All positive specimens were cultured on RPMI 1640 medium; only 108 were found to be culture positive. Sensitivity of isolates to chloroquine was done using Mark III WHO sensitivity plates. The prevalence of malaria infection was found 9.54% in 2010. There were schizont formation at 8 pmol/liter or more of chloroquine concentration in 26 isolates. The emergence of chloroquine (CQ) resistance pattern in Aligarh isolates increases. Antimalarial agents should be used with caution; monotherapies should be avoided

Comparison of different diagnostic techniques in Plasmodium falciparum cerebral malaria

Background & objectives: Plasmodium falciparum cerebral malaria remains a major health problemin India. The efficacy of treatment of cerebral malaria lies in its early diagnosis through rapid diagnosticmethods. ParaSights-F test detects HRP-2 antigen secreted by parasitised red blood cells andquantitative buffy coat assay (QBC) is examination of buffy coat for the presence of malarial parasitestained with acridine orange. This study was performed to evaluate the effectiveness of ParaSight-F test and QBC assay as diagnostic methods in the patients of cerebral malaria.Methods: Fifty clinically diagnosed patients of cerebral malaria were included in the study.ParaSight-F test, QBC and conventional blood smear examination was done. Patients who were incoma and there were no obvious features of bacterial or viral etiology were investigated for cerebralmalaria by these diagnostic methods.Results: ParaSight-F test, QBC and peripheral blood smears were examined. Patients were followedupfor signs of clinical recovery. ParaSight-F test was positive in 47 patients, QBC in 46 while bloodsmear examination was positive in 28 cases.Interpretation & conclusion: Sensitivity and specificity of ParaSight-F test were found to be 96.6 and94% while QBC showed 97.8 and 100% respectively. ParaSight-F test and QBC were found to be novelmethods for diagnosis of cerebral malaria especially in the cases where diagnosis can not be made byconventional blood smear examination due to low parasitaemia. These rapid diagnostic methods helpin early therapeutic intervention

GREEN SYNTHESIS OF SILVER NANOPARTICLES USING THE LEAF EXTRACT OF PUTRANJIVA ROXBURGHII WALL. AND THEIR ANTIMICROBIAL ACTIVITY.

 Objective: This study deals with the synthesis of silver nanoparticles (AgNP's) from the extract of the leaves of the plant Putranjiva roxburghii wall.Using biological method, i.e., green synthesis.Methods: The extract from the leaves acts as a reducing and stabilizing agent for the AgNP's. Further characterization was done using varioustechniques like ultraviolet (UV)-visible spectrophotometry, which shows surface plasmon resonance, Fourier transform infra-red spectroscopyanalysis shows formation of various bonds, scanning electron microscope (SEM) and transmission electron microscope (TEM) analysis depictsthe distribution and average size of nanoparticles. The antimicrobial activity was also checked against various bacteria and fungi using minimuminhibitory concentration and well diffusion assay.Result: UV analysis shows strong plasmon resonance between 420 and 480 nm SEM analysis shows the distribution of synthesized nanoparticles,whereas TEM analysis shows the average particle size to be near about 5 nm and well diffusion assay proved that these nanoparticles are effectiveagainst different microorganisms.Conclusion: P. roxburghii wall. shows strong potential for the reduction of silver from Ag+ to Ag0 and nanoparticles so formed are strongly activeagainst various microorganism.Keywords: Putranjiva roxburghii, Fourier transform infra-red, Scanning electron microscope, Transmission electron microscope

Awareness regarding causes of infertility among out-patients at a tertiary care hospital in Karachi, Pakistan

Introduction: Infertility is the inability of a couple to achieve pregnancy within 12 months of sexual intercourse without the use of contraceptives. The Pakistani population, belonging to a low-middle income country, has a high prevalence of infertility due to a low knowledge and awareness regarding its causes, and lack of healthcare-seeking behavior for this medical issue. The prevalence of infertility in Pakistan is reported as 22%, with primary infertility accounting for 4% of the total cases. This leads to psychological trauma among women as societal norms equate infertility with failure on a personal, emotional, and social level. In this study, we aimed to assess among this population the general awareness regarding infertility and its causes; and identify any key knowledge gaps pertaining to the subject.Methods: A cross-sectional study was carried out between June 2019 and November 2019, at a public hospital (Civil Hospital Karachi) in Karachi, Pakistan. Convenience sampling technique was used to collect data from adult participants (older than 18 years) via an interview-administered questionnaire. The questionnaire was based on the Cardiff Fertility Knowledge Scale (CFKS) and assessed the knowledge regarding causes of infertility such as smoking, healthy lifestyle, contraceptives, genital tract infections among others. We also determined the association between socio-demographic variables with mean knowledge scores. Data were analyzed using Statistical Package for Social Sciences (SPSS), version 20.0.Results: The majority of the participants were married (n=342, 68.8%) and more than half were unemployed (n=259, 52.1%). Approximately, two-quarters (n=250, 50.3%) did not believe that equal proportions of males and females contribute to infertility. The mean knowledge score of our study population was 12.95 ± 2.48 points. An overwhelming proportion of the participants (n=326, 65.6%) falsely believed that the usage of the intra-uterine device contributes to infertility. Additionally, more than half of the responders (n=278, 55.9%) incorrectly believed that a male achieving erection is an indication of fertility. Education (p=0.019), vehicle ownership (p=0.018), and marital status (p=0.031) were the only demographic factors that showed significant differences with mean knowledge scores.Conclusion: Awareness regarding the causes of infertility among the general population was found to be inadequate. Emphasis on targeted fertility education, in association with general public awareness programs regarding its causes and risk factors may help mitigate this problem by potentially reducing the prevalence of this condition, and increasing the number of affected individuals who seek medical care in a timely fashion

The Perception of People Regarding Selection of Petrol Pump in Karachi

The objective of the study is to get an idea about people’s perception on the choice of petrol pumps in Karachi. To accomplish the purpose, it was hypothesized that (1) Location has a significant impact on the choice of Petrol Service Stations (2) Quality has a significant impact on the choice of Petrol Service Stations (3) Rewards has a significant impact on the choice of Petrol Service Stations. A sample of 200 respondents was randomly selected who filled a self reporting questionnaire. One sample t-test was applied on gathered data to assess the observations. It was revealed that neither quality nor location and reward have an influence on the consumer choice over selection of petrol pump

Analyzing the Factors for Creating Competition among Products

There are so many reasons of competition among products; the purpose of this study was to find different factors on which competition was dependent. Hypotheses were generated to find the impact of factors on competition. A cross-sectional design research study was conducts through a survey form where a total of 260 respondents participated. Result was derived with the help of statistical tool i.e. one sample T-test and mean value was assigned 4. The end result concluded that competition is dependent on all the factors (availability of goods, delivery on time, discounted pricing by suppliers, cost of products, quality of products, promotional activities and number of variations) except one factor (product support services). This study to some extend gave a view that product services created no difference for customers to buy but other factors related to cost and quality mattered

Analyzing the Factors for Creating Competition among Products

There are so many reasons of competition among products; the purpose of this study was to find different factors on which competition was dependent. Hypotheses were generated to find the impact of factors on competition. A cross-sectional design research study was conducts through a survey form where a total of 260 respondents participated. Result was derived with the help of statistical tool i.e. one sample T-test and mean value was assigned 4. The end result concluded that competition is dependent on all the factors (availability of goods, delivery on time, discounted pricing by suppliers, cost of products, quality of products, promotional activities and number of variations) except one factor (product support services). This study to some extend gave a view that product services created no difference for customers to buy but other factors related to cost and quality mattered

Genetic Profiling of the Plasmodium falciparum

About 50% of malaria infections in India are attributed to Plasmodium falciparum but relatively little is known about the genetic structure of the parasite populations. The molecular genotyping of the parasite populations by merozoite surface protein (msp1 and msp2) and glutamate-rich protein (glurp) genes identifies the existing parasite population in the regions which help in understanding the molecular mechanisms involved in the parasite’s drive for survival. This study reveals the genetic profile of the parasite population in selected regions across the country with varying degree of endemicity among them. We also report the prevalence of Pfcrt mutations in this parasite population to evaluate the pattern of drug resistance development in them

Newer Horizon of Mesenchymal Stem Cell-Based Therapy in the Management of SARS-CoV-2-Associated Mucormycosis: A Safe Hope for Future Medicine

SARS-CoV-2-infected patients are reported to show immunocompromised behavior that gives rise to a wide variety of complications due to impaired innate immune response, cytokine storm, and thrombo-inflammation. Prolonged use of steroids, diabetes mellitus, and diabetic ketoacidosis (DKA) are some of the factors responsible for the growth of Mucorales in such immunocompromised patients and, thus, can lead to a life-threatening condition referred to as mucormycosis. Therefore, an early diagnosis and cell-based management cosis is the need of the hour to help affected patients overcome this severe condition. In addition, extended exposure to antifungal drugs/therapeutics is found to initiate hormonal and neurological complications. More recently, mesenchymal stem cells (MSCs) have been used to exhibit immunomodulatory function and proven to be beneficial in a clinical cell-based regenerative approach. The immunomodulation ability of MSCs in mucormycosis patient boosts the immunity by the release of chemotactic proteins. MSC-based therapy in mucormycosis along with the combination of short-term antifungal drugs can be utilized as a prospective approach for mucormycosis treatment with promising outcomes. However, preclinical and in mucormyIn mucormycosis, the hyphae of clinical trials are needed to establish the precise mechanism of MSCs in mucormycosis treatment