Patients' perception and actual practice of informed consent, privacy and confidentiality in general medical outpatient departments of two tertiary care hospitals of Lahore

<p>Abstract</p> <p>Background</p> <p>The principles of informed consent, confidentiality and privacy are often neglected during patient care in developing countries. We assessed the degree to which doctors in Lahore adhere to these principles during outpatient consultations.</p> <p>Material & Method</p> <p>The study was conducted at medical out-patient departments (OPDs) of two tertiary care hospitals (one public and one private hospital) of Lahore, selected using multi-stage sampling. 93 patients were selected from each hospital. Doctors' adherence to the principles of informed consent, privacy and confidentiality was observed through client flow analysis performed by trained personnel. Overall patient perception was also assessed regarding these practices and was compared with the assessment made by our data collectors.</p> <p>Results</p> <p>Some degree of informed consent was obtained from only 9.7% patients in the public hospital and 47.8% in the private hospital. 81.4% of patients in the public hospital and 88.4% in the private hospital were accorded at least some degree of privacy. Complete informational confidentiality was maintained only in 10.8% and 35.5% of cases in public & private hospitals respectively. Informed consent and confidentiality were better practiced in the private compared to the public hospital (two-sample t-test > 2, p value < 0.05). There was marked disparity between the patients' perspective of these ethical practices and the assessment of our trained data collectors.</p> <p>Conclusion</p> <p>Observance of medical ethics is inadequate in hospitals of Lahore. Doctors should be imparted formal training in medical ethics and national legislation on medical ethics is needed. Patients should be made aware of their rights to medical ethics.</p

Inoculation With Azospirillum spp. Acts as the Liming Source for Improving Growth and Nitrogen Use Efficiency of Potato

Nitrogen (N) is one of the limiting factors for plant growth, and it is mainly supplied exogenously by fertilizer application. It is well documented that diazotrophic rhizobacteria improve plant growth by fixing atmospheric N in the soil. The present study investigates the nitrogen-fixing potential of two Azospirillum spp. strains using the 15N isotope-dilution method. The two diazotrophic strains (TN03 and TN09) native to the rhizosphere of potato belong to the genus Azospirillum (16S rRNA gene accession numbers LN833443 and LN833448, respectively). Both strains were able to grow on an N-free medium with N-fixation potential (138–143 nmol mg−1 protein h−1) and contained the nifH gene. Strain TN03 showed highest indole acetic acid (IAA) production (30.43 μg/mL), while TN09 showed highest phosphate solubilization activity (249.38 μg/mL) while both diazotrophs showed the production of organic acids. A 15N dilution experiment was conducted with different fertilizer inputs to evaluate the N-fixing potential of both diazotrophs in pots. The results showed that plant growth parameters and N contents increased significantly by the inoculations. Moreover, reduced 15N enrichment was found compared to uninoculated controls that received similar N fertilizer levels. This validates the occurrence of N-fixation through isotopic dilution. Strain TN09 showed higher N-fixing potential than TN03 and the uninoculated controls. Inoculation with either strain also showed a remarkable increase in plant growth under field conditions. Thus, there were remarkable increases in N use efficiency, N uptake and N utilization levels. Confocal laser scanning and transmission electron microscopy showed that TN03 is an ectophyte, i.e., present outside root cells or within the grooves of root hairs, while TN09 is an endophyte, i.e., present within root cells, forming a strong association withroot it. This study confirms that diazotrophic Azospirillum spp. added to potato systems can improve plant growth and N use efficiency, opening avenues for improvement of potato crop growth with reduced input of N fertilizer

Lead-Resistant Morganella morganii Rhizobacteria Reduced Lead Toxicity in Arabidopsis thaliana by Improving Growth, Physiology, and Antioxidant Activities

Biological remediation serves as a powerful technique for addressing heavy metals toxicity in metals-contaminated soils. The present study aimed to evaluate the efficacy of lead (Pb)-resistant rhizobacterial strains on growth, photosynthetic traits, and antioxidant activities of the Arabidopsis plant under lead toxicity in pot conditions. Two pre-isolated and pre-characterized Pb-resistant Morganella morganii (ABT3) and Morganella morganii (ABT9) strains were used for inoculating Arabidopsis plants grown under varying Pb concentrations (1.5 mM and 2.5 mM) using PbNO3 as the lead source. The treatments were set up in a completely randomized design with four replications. Data on growth parameters, physiological characteristics, lipid peroxidation, and antioxidant activities were recorded at harvesting. It was observed that Pb contamination caused a significant reduction in Arabidopsis growth, chlorophyll content and quantum yield at both lead concentrations. The Pb concentration of 2.5 mM, showed a substantial decrease in all parameters, including shoot fresh weight (58.72%), shoot dry weight (59.31%), root fresh weight (67.31%), root dry weight (67.28%), chlorophyll content (48.69%), quantum yield (62.36%), catalase activity (65.30%), superoxide dismutase (60.88%), and peroxidase activity (60.54%) while increasing lipid peroxidation (113.8%). However, the inoculation with Pb-resistant M. morganii strains (ABT3 and ABT9) improved plant growth, photosynthesis and antioxidant activities, while reduced the malondialdehyde content of Arabidopsis compared to control plants without inoculation. The M. morganii strain ABT9 showed a maximum increase in the shoot fresh weight (67.18%), shoot dry weight (67.96%), root fresh weight (94.04%), root dry weight (93.92%), shoot length (148.88%), root length (123.33%), chlorophyll content (52.53%), quantum yield (58.57%), catalase activity (39.46%), superoxide dismutase (21.84%), and peroxidase activity (22.34%) while decreasing lipid peroxidation (35.28%). PCA analysis further showed that all nine treatments scattered differently across the PC1 and PC2, having 81.4% and 17.0% data variance, respectively, indicating the efficiency of Pb-resistant strains. The heatmap further validated that the introduction of Pb-resistant strains positively correlated with the growth parameters, quantum yield, chlorophyll content and antioxidant activities of Arabidopsis seedlings. Both Pb-resistant strains improved Arabidopsis plant growth and photosynthetic efficiency under lead stress conditions. Thus, both Morganella morganii ABT3 and Morganella morganii ABT9 strains can be considered as bio-fertilizer for reducing lead toxicity thereby improving plant growth and physiology in metal-contaminated agricultural soils.11s

Inoculation With Azospirillum spp. Acts as the Liming Source for Improving Growth and Nitrogen Use Efficiency of Potato

Nitrogen (N) is one of the limiting factors for plant growth, and it is mainly supplied exogenously by fertilizer application. It is well documented that diazotrophic rhizobacteria improve plant growth by fixing atmospheric N in the soil. The present study investigates the nitrogen-fixing potential of two Azospirillum spp. strains using the 15N isotope-dilution method. The two diazotrophic strains (TN03 and TN09) native to the rhizosphere of potato belong to the genus Azospirillum (16S rRNA gene accession numbers LN833443 and LN833448, respectively). Both strains were able to grow on an N-free medium with N-fixation potential (138–143 nmol mg−1 protein h−1) and contained the nifH gene. Strain TN03 showed highest indole acetic acid (IAA) production (30.43 μg/mL), while TN09 showed highest phosphate solubilization activity (249.38 μg/mL) while both diazotrophs showed the production of organic acids. A 15N dilution experiment was conducted with different fertilizer inputs to evaluate the N-fixing potential of both diazotrophs in pots. The results showed that plant growth parameters and N contents increased significantly by the inoculations. Moreover, reduced 15N enrichment was found compared to uninoculated controls that received similar N fertilizer levels. This validates the occurrence of N-fixation through isotopic dilution. Strain TN09 showed higher N-fixing potential than TN03 and the uninoculated controls. Inoculation with either strain also showed a remarkable increase in plant growth under field conditions. Thus, there were remarkable increases in N use efficiency, N uptake and N utilization levels. Confocal laser scanning and transmission electron microscopy showed that TN03 is an ectophyte, i.e., present outside root cells or within the grooves of root hairs, while TN09 is an endophyte, i.e., present within root cells, forming a strong association withroot it. This study confirms that diazotrophic Azospirillum spp. added to potato systems can improve plant growth and N use efficiency, opening avenues for improvement of potato crop growth with reduced input of N fertilizer