GC-MS metabolic profiling and anti-urease activity of nonpolar fractions of Calligonum Polygonoides L. (Polygonaceae) and Crateva Adansonii DC. Prodr. (Capparaceae)

Purpose: To determine the urease-inhibitory activity and chemical constituents of fractions of Calligonum polygonoides and Crateva adansonii separated by physical properties. Methods: The anti-urease activities of different fractions of the plants (methanol, n-hexane, CHCl3, nbutanol) were evaluated using a standard procedure. The chemical constituents of the extracts with the highest urease-inhibitory activity were determined by gas chromatography-mass spectrometry. Results: The n-hexane fractions of both plants had higher urease-inhibitory activity and a lower halfmaximal inhibitory concentration (IC50) than the other extracts. GC-MS evaluation revealed that nhexane fraction of C. polygonoides was rich in fatty acids (39.36 %), sterols (22.29 %), long chain alkanes (98.5 %), and a few volatiles (5.26 %), while the n-hexane fraction of C. adansonii had high levels of alkanes (35.03 %), sterols (10.46 %), fatty acid esters (46.82 %), and triterpenes (23.76 %). Conclusion: The n-hexane fractions of the plants demonstrate high urease-inhibitory activity. Thus, these plant-based anti-urease fractions can potentially serve as a starting point for the development of novel antibacterial agents with enhanced efficacy and reduced antibiotic resistance in the treatment of pathological conditions and infections associated with urease

Synthesis and characterization of some new Schiff base derivatives of gabapentin, and assessment of their antibacterial, antioxidant and anticonvulsant activities

Purpose: To synthesize and characterize some new gabapentin Schiff base derivatives, and to assess their antibacterial, antioxidant and antiepileptic activities.Methods: Four Schiff base derivatives of gabapentin, termed G1, G2, G3 and G4, were synthesized by condensation with benzoin, vanillin, acetophenone, and benzophenone, respectively. Their chemical identities were established by FTIR, 1 H NMR and 13C NMR techniques. The new compounds were screened for antibacterial activity using agar well method, antioxidant activity by DPPH assay, and anticonvulsant activity against pentylenetetrazole (PTZ) induced seizures in mice.Results: All the compounds showed antibacterial activity against the test strains to variable degrees, while the parent drug did not exhibit antibacterial activity. The zones of inhibition of compound G2 against Micrococcus luteus (36.2 ± 1.0 mm) and Serratia marcescens (28.2 ± 1.0 mm), and of compound G4 against Stenotrophomonas maltophilia (36.8 ± 1.0 mm) were larger compared to thestandard drug, doxycycline, exhibiting zones of inhibition 28.2 ± 1.3, 28.2 ± 0.9 and 20.0 ± 0.9 mm, respectively. In addition, compounds G1 and G2 possessed significantly greater (p < 0.05) radical scavenging activity (82.3 ± 1.8 and 92.3 ± 2.2 %, respectively) than the precursor drug, gabapentin (63.2± 2.6 %). The seizure scores for compounds G1 (0.7 ± 0.06) and G2 (0.9 ± 0.07) were comparable(p ˃ 0.05) with gabapentin (0.8 ± 0.06), while compounds G3 and G4 were less active (p < 0.05) than gabapentin.Conclusion: Compounds G1 and G2 exhibit good antibacterial and antioxidant activities while retaining the anticonvulsant activity of the parent drug, gabapentin, thus making them suitable candidates for further development for the treatment of neurodegenerative pathologies associated with bacterial infections. Keywords: Gabapentin, Antibacterial, Seizures, Antioxidant, Anticonvulsan

Are we doing enough? Evaluation of the Polio Eradication Initiative in a district of Pakistan's Punjab province: a LQAS study

<p>Abstract</p> <p>Background</p> <p>The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. The aim of the study was to establish valid and reliable estimate for: routine oral polio vaccine (OPV) coverage, logistics management and the quality of monitoring systems in health facilities, NIDs OPV coverage, the quality of NIDs service delivery in static centers and mobile teams, and to ultimately provide scientific evidence for tailoring future interventions.</p> <p>Methods</p> <p>A cross-sectional study using lot quality assessment sampling was conducted in the District Nankana Sahib of Pakistan's Punjab province. Twenty primary health centers and their catchment areas were selected randomly as <it>'lots'</it>. The study involved the evaluation of 1080 children aged 12-23 months for routine OPV coverage, 20 health centers for logistics management and quality of monitoring systems, 420 households for NIDs OPV coverage, 20 static centers and 20 mobile teams for quality of NIDs service delivery. Study instruments were designed according to WHO guidelines.</p> <p>Results</p> <p>Five out of twenty lots were rejected for unacceptably low routine immunization coverage. The validity of coverage was questionable to extent that all lots were rejected. Among the 54.1% who were able to present immunization cards, only 74.0% had valid immunization. Routine coverage was significantly associated with card availability and socioeconomic factors. The main reasons for routine immunization failure were absence of a vaccinator and unawareness of need for immunization. Health workers (96.9%) were a major source of information. All of the 20 lots were rejected for poor compliance in logistics management and quality of monitoring systems. Mean compliance score and compliance percentage for logistics management were 5.4 ± 2.0 (scale 0-9) and 59.4% while those for quality of monitoring systems were 3.3 ± 1.2 (scale 0-6) and 54.2%. The 15 out of 20 lots were rejected for unacceptably low NIDs coverage by finger-mark. All of the 20 lots were rejected for poor NIDs service delivery (mean compliance score = 11.7 ± 2.1 [scale 0-16]; compliance percentage = 72.8%).</p> <p>Conclusion</p> <p>Low coverage, both routine and during NIDs, and poor quality of logistics management, monitoring systems and NIDs service delivery were highlighted as major constraints in polio eradication and these should be considered in prioritizing future strategies.</p

Cracking Behavior of RC Beams Strengthened with Different Amounts and Layouts of CFRP

The bending and shear behavior of RC beams strengthened with Carbon Fiber-Reinforced Polymers (CFRP) is the primary objective of this paper, which is focused on the failure mechanisms and on the moment-curvature response prior-to, and post, strengthening with different amounts and layouts of the CFRP reinforcement. Seven reinforced concrete beams were tested in 4-point bending, one without any CFRP reinforcement (control beam, Specimen C1), four with the same amount of CFRP in flexure but with different layouts of the reinforcement for shear (Specimens B1&ndash;B4), and two with extra reinforcement in bending, with and without reinforcement in shear (Specimens B6 and B5, respectively). During each test, the load and the mid-span deflection were monitored, as well as the crack pattern. The experimental results indicate that: (a) increasing the CFRP reinforcement above certain levels does not necessarily increase the bearing capacity; (b) the structural performance can be optimized through an appropriate combination of CFRP flexural and shear reinforcement; and (c) bond properties at the concrete&ndash;CFRP interface play a vital role, as the failure is very often triggered by the debonding of the CFRP strips. The experimental values were also verified analytically and a close agreement between the analytical and experimental values was achieved

Height, weight and BMI percentiles and nutritional status relative to the international growth references among Pakistani school-aged children

Abstract Background Child growth is internationally recognized as an important indicator of nutritional status and health in populations. This study was aimed to compare age- and gender-specific height, weight and BMI percentiles and nutritional status relative to the international growth references among Pakistani school-aged children. Methods A population-based study was conducted with a multistage cluster sample of 1860 children aged five to twelve years in Lahore, Pakistan. Smoothed height, weight and BMI percentile curves were obtained and comparison was made with the World Health Organization 2007 (WHO) and United States' Centers for Disease Control and Prevention 2000 (USCDC) references. Over- and under-nutrition were defined according to the WHO and USCDC references, and the International Obesity Task Force (IOTF) cut-offs. Simple descriptive statistics were used and statistical significance was considered at P Results Height, weight and BMI percentiles increased with age among both boys and girls, and both had approximately the same height and a lower weight and BMI as compared to the WHO and USCDC references. Mean differences from zero for height-, weight- and BMI-for-age z score values relative to the WHO and USCDC references were significant (P Conclusion Pakistani school-aged children significantly differed from the WHO and USCDC references. However, z score means relative to the WHO reference were closer to zero and the present study as compared to the USCDC reference. Overweight and obesity were significantly higher while underweight and thinness/wasting were significantly lower relative to the WHO reference as compared to the USCDC reference and the IOTF cut-offs. New growth charts for Pakistani children based on a nationally representative sample should be developed. Nevertheless, shifting to use of the 2007 WHO child growth reference might have important implications for child health programs and primary care pediatric clinics.</p

Barriers and enablers for adherence to antiretroviral therapy among people living with HIV/AIDS in the era of COVID-19:A qualitative study from Pakistan

Background: With the increased availability of safe antiretroviral therapy (ART) in recent years, achieving optimal adherence and patient retention is becoming the biggest challenge for people living with HIV (PLWH). Care retention is influenced by several socioeconomic, socio-cultural, and government policies during the COVID-19 pandemic. Therefore, we aim to explore barriers and facilitators to adherence to ART among PLWH in Pakistan in general and COVID-19 pandemic related in particular. Methods: Semi-structured interviews were conducted among 25 PLWH from December 2020 to April 2021 in the local language (Urdu) at the ART centre of Pakistan Institute of Medical Sciences, Islamabad, Pakistan. Interviews were audio-recorded in the local Urdu language, and bilingual expert (English, Urdu) transcribed verbatim, coded for themes and sub-themes, and analyzed using a phenomenological approach for thematic content analysis. Results: Stigma and discrimination, fear of HIV disclosure, economic constraints, forgetfulness, religion (Ramadan, spiritual healing), adverse drug reactions, lack of social support, alternative therapies, and COVID-19-related lock-down and fear of lesser COVID-19 care due to HIV associated stigma were identified as barriers affecting the retention in HIV care. At the same time, positive social support, family responsibilities, use of reminders, the beneficial impact of ART, and initiation of telephone consultations, courier delivery, and long-term delivery of antiretrovirals during COVID-19 were identified as facilitators of HIV retention. Conclusion: Improving adherence and retention is even more challenging due to COVID-19; therefore, it requires the integration of enhanced access to treatment with improved employment and social support. HIV care providers must understand these reported factors comprehensively and treat patients accordingly to ensure the continuum of HIV care. A coordinated approach including different stakeholders is required to facilitate patient retention in HIV care and consequently improve the clinical outcomes of PLWH

Stigma, social support, illicit drug use, and other predictors of anxiety and depression among HIV/AIDS patients in Pakistan:A cross-sectional study

Introduction: Anxiety and depression in people living with HIV/AIDS (PLWHA) can lead to non-adherence to antiretroviral therapy (ART), morbidity, and mortality. Therefore, assessing the stigma, social support, and other determinants of anxiety and depression in PLWHA are important for developing further interventions. Methods: An institution-based cross-sectional study was conducted in 505 PLWHA, approached through systematic sampling, who paid routine visits to the ART center, Pakistan Institute of Medical Sciences (PIMS), Islamabad. Data was collected by pretested validated hospital anxiety and depression scale (HADS). Version 26 of the SPSS was used to apply Logistic regression analysis to identify determinants, and the 95% confidence interval (CI) adjusted odds ratio (AOR) was calculated to assess the magnitude of the relationships. Results: In PLWHA, the prevalence of co-morbid depression and anxiety was 80%. Separately, 89.9% had depression, and 80.3% had anxiety. Use of illicit drugs [AOR = 1.87, 95% CI (1.01, 3.27)], low social support [AOR = 1.21, 95% CI (1.02, 2.25)], being male [AOR = 2.21, 95% CI (1.11, 5.49)], and HIV related stigma [AOR = 2.48, 95% CI (1.25, 6.02)] were significant predictors of depression. Having detectable viral load [AOR = 3.04, 95% CI (1.04, 8.86)], young age [AOR = 5.31, 95% CI (1.19, 29.39)], no formal education [AOR = 21.78, 95% CI (4.03, 117.62)], low [AOR = 1.70, 95% CI (1.12, 6.93)] or moderate [AOR = 2.20, 95% CI (1.79, 6.09)] social support, illicit drugs addiction [AOR = 1.17, 95% CI (1.03, 2.55)], and HIV stigma [AOR = 54.3, 95% CI (21.20, 139.32)] had a remarkable association with anxiety. Conclusions: Given the high prevalence of anxiety and depression among PLWHA, the Pakistan Ministry of Health should focus more on monitoring mental health, expanding mental health services, and developing interventions based on identified factors to treat depression and anxiety among PLWHA

Whole-genome sequencing of SARS-CoV-2 reveals the detection of G614 variant in Pakistan.

Since its emergence in China, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide including Pakistan. During the pandemic, whole genome sequencing has played an important role in understanding the evolution and genomic diversity of SARS-CoV-2. Although an unprecedented number of SARS-CoV-2 full genomes have been submitted in GISAID and NCBI, data from Pakistan is scarce. We report the sequencing, genomic characterization, and phylogenetic analysis of five SARS-CoV-2 strains isolated from patients in Pakistan. The oropharyngeal swabs of patients that were confirmed positive for SARS-CoV-2 through real-time RT-PCR at National Institute of Health, Pakistan, were selected for whole-genome sequencing. Sequencing was performed using NEBNext Ultra II Directional RNA Library Prep kit for Illumina (NEW ENGLAND BioLabs Inc., MA, US) and Illumina iSeq 100 instrument (Illumina, San Diego, US). Based on whole-genome analysis, three Pakistani SARS-CoV-2 strains clustered into the 20A (GH) clade along with the strains from Oman, Slovakia, United States, and Pakistani strain EPI_ISL_513925. The two 19B (S)-clade strains were closely related to viruses from India and Oman. Overall, twenty-nine amino acid mutations were detected in the current study genome sequences, including fifteen missense and four novel mutations. Notably, we have found a D614G (aspartic acid to glycine) mutation in spike protein of the sequences from the GH clade. The G614 variant carrying the characteristic D614G mutation has been shown to be more infectious that lead to its rapid spread worldwide. This report highlights the detection of GH and S clade strains and G614 variant from Pakistan warranting large-scale whole-genome sequencing of strains prevalent in different regions to understand virus evolution and to explore their genetic diversity