Blastocystis hominis and Endolimax nana Co-Infection Resulting in Chronic Diarrhea in an Immunocompetent Male

Blastocystis hominis and Endolimax nana exist as two separate parasitic organisms; however co-infection with the two individual parasites has been well documented. Although often symptomatic in immunocompromised individuals, the pathogenicity of the organisms in immunocompetent subjects causing gastrointestinal symptoms has been debated, with studies revealing mixed results. Clinically, both B. hominis and E. nana infection may result in acute or chronic diarrhea, generalized abdominal pain, nausea, vomiting, flatulence and anorexia. We report the case of a 24-year-old immunocompetent male presenting with chronic diarrhea and abdominal pain secondary to B. hominis and E. nana treated with metronidazole, resulting in symptom resolution and eradication of the organisms. Our case illustrates that clinicians should be cognizant of both B. hominis and E. nana infection as a cause of chronic diarrhea in an immunocompetent host. Such awareness will aid in a timely diagnosis and possible parasitic eradication with resolution of gastrointestinal symptoms

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

The Quran and poverty alleviation: A theoretical model for charity-based Islamic microfinance institutions (MFIS)

Kaleem, A ORCiD: 0000-0002-0939-9922The Quran prohibits interest and encourages trade and charity as alternates. This article seeks guidance from the verses of the Quran and develops a theoretical model of charity-based Islamic microfinance institutions (MFIs), which can be used as an alternative approach to reduce poverty. The article argues that charity-based Islamic MFIs will be financially and socially sustainable as these are to be based on the concepts of brotherhood, local philanthropy, and volunteer services. Charity-based Islamic MFIs will provide money for consumption as well as production purposes and, thus, can broadly target the economic and social needs of the poorest of the poor. They can help minimize indebtedness and reduce unequal distribution of wealth in society. © 2010 SAGE Publications

The Quran and poverty alleviation: A theoretical model for charity-based Islamic microfinance institutions (MFIS)

The Quran prohibits interest and encourages trade and charity as alternates. This article seeks guidance from the verses of the Quran and develops a theoretical model of charity-based Islamic microfinance institutions (MFIs), which can be used as an alternative approach to reduce poverty. The article argues that charity-based Islamic MFIs will be financially and socially sustainable as these are to be based on the concepts of brotherhood, local philanthropy, and volunteer services. Charity-based Islamic MFIs will provide money for consumption as well as production purposes and, thus, can broadly target the economic and social needs of the poorest of the poor. They can help minimize indebtedness and reduce unequal distribution of wealth in society. © 2010 SAGE Publications

Is water scarcity a real constraint for meeting the future food requirements of Pakistan?

Paper presented at the International Conference on Water and Wastewater Management for Developing Countries, Victoria Falls, Zimbabwe, 28-30 July 2004. Productive water for community development and transformation: water for food production (Paper VF 145

Antidiabetic and antioxidant activity of Annona squamosa extract in streptozotocin-induced diabetic rats

Introduction: The aim of the study is to analyse the antioxidant effect of oral administration of aqueous extract of Annona squamosa (A. squamosa) leaf on blood glucose, haemoglobin, glycosylated haemoglobin, plasma insulin, antioxidant enzymes and lipid peroxidation in liver and kidney to streptozotocin (STZ)-induced diabetic rats. Methods: Aqueous extract of A. squamosa on blood glucose, haemoglobin, glycosylated haemoglobin, plasma insulin, serum lipid and the levels of lipid peroxides and antioxidant enzymes, such as catalase, superoxide dismutase, glutathione peroxidase and reduced glutathione, were examined in the liver and kidney tissues of control and experimental groups. Results: Oral administration of A. squamosa aqueous extract to diabetic rats for 30 days significantly reduced the levels of blood glucose, lipids and lipid peroxidation, but increased the activities of plasma insulin and antioxidant enzymes, like catalase, superoxide dismutase, reduced glutathione and glutathione peroxidase. Conclusion: The A. squamosa aqueous extract supplementation is useful in controlling the blood glucose level, improves the plasma insulin, lipid metabolism and is beneficial in preventing diabetic complications from lipid peroxidation and antioxidant systems in experimental diabetic rats; therefore, it could be useful for prevention or early treatment of diabetes mellitus

Beneficial effects of Annona squamosa extract in streptozotocin-induced diabetic rats

Introduction: The present study investigated the possible therapeutic effects of Annona squamosa (A. squamosa) extract on certain biochemical markers in streptozotocin (STZ) -induced diabetes mellitus in rats. Methods: The effects of an aqueous extract of A. squamosa leaves on blood glucose, insulin, C-peptide, albumin, albumin/globulin ratio, urea, uric acid and creatinine and the activities of diagnostic marker enzymes aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and gamma-glutamyl transpeptidase were examined in the plasma, liver and kidney tissues of control and experimental groups. Results: Oral administration of A. squamosa (300 mg/kg) aqueous extract to diabetic rats for 30 days significantly reduced blood glucose, urea, uric acid and creatinine, but increased the activities of insulin, C-peptide, albumin, albumin/globulin ratio and restored all marker enzymes to near control levels. Conclusion: The present results shown that A. squamosa extract has an antihyperglycaemic effect and consequently may alleviate liver and renal damage associated with STZ-induced diabetes mellitus in rats