Ochrobactrum, bacillus and Enterobacter isolates of Hot Water Spring Augment the Growth of Zea Mays Seedlings

Hot springs situated at high altitudes is a kind of remarkable ecosystem for the exploration of microbial flora. It was hypothesized that hot springs can harbor bacteria with plant growth-promoting and exopolysaccharides (EPS) producing ability that can favour the growth of plants. For the investigation of this hypothesis, seven EPS producing bacterial isolates were isolated from a water sample of hot water spring of Tattapani, Azad Kashmir and characterized morphologically and biochemically. Three out of seven isolates (BE1, BN1 and BN3) showed significant production of EPS (14-15 mg / 100 ml). Growth kinetics study revealed that optimum EPS production was attained at pH 9, with fructose as a carbon source and peptone as a nitrogen source. Inoculation of these isolates caused augmentation in seed germination (27-38 %), shoot length (27-35 %), seedling length (10-14 %), number of roots (12-25 %) of Zea mays (variety-MMRI yellow) seedlings and significant rise in auxin (28-51 %) and soluble protein content (50-68 %) as compared to non-inoculated treatment. Alcian blue staining unveiled the good colonization potential of these isolates on inoculated roots. Bacterial isolates were identified as Ochrobactrum intermedium (BE1), Bacillus pumilus (BN1) and Enterobacter cloacae (BN3), respectively through 16S rRNA analysis. Bacterial strain BN3 showed promising results for plant growth promotion along with EPS production. Fourier-transform infrared (FTIR) spectroscopy of EPS produced by strain BN3 revealed the complex composition of EPS. We concluded that hot springs can be the possible home for EPS producing bacteria with plant growth promotion capability

Haemovigilance as a quality indicator in transfusion medicine: Pakistan’s perspective

In transfusion medicine, the concept of haemovigilance has emerged during the last three decades. It is structured and systematic surveillance of the entire vein-to-vein transfusion chain and a powerful quality tool. Haemovigilance has become an integral component of transfusion medicine. It helps increase safety and improves quality during blood donation and blood transfusion, from the blood donor to recipient of blood and blood components. The haemovigilance can be successfully implemented and maximum benefit obtained if the data analysis and resulting conclusions are mutually shared with the shareholders. Although haemovigilance has proven to be an effective tool to influence policy development, it is is not well established in Pakistan. The government’s Safe Blood Transfusion Programme has taken key initiatives to introduce, support, and consolidate the haemovigilance system necessitating many changes, in the system, in the institutions, in attitude, and behaviour. The implementation of haemovigilance in Pakistan will require a major paradigm shift. It will be a stepwise or staged approach, starting from institutional to regional/provincial levels and ending at the national level

Coping strategies and impact of disease among people living with HIV/AIDS: A qualitative study

Objective: The current study was undertaken to qualitatively investigate the coping strategies and impact of disease in HIV/AIDS patients. Methodology: The study was conducted at the Divisional Headquarters Teaching Hospital, Mirpur, Azad Jammu and Kashmir. The hospital is a divisional hospital for three districts namely Mirpur, Kotli, and Bhimber catering to a population of approximately 1.5 million. In-depth interviews and focus group discussions were conducted with twenty HIV/AIDS patients. For the analysis, the Interpretative Phenomenological Analysis technique was used. The major domain of the impact of HIV/AIDS was further divided into nine major themes. The other major domain was coping with HIV/AIDS which included themes of spiritual coping, problem-focused coping, and avoidance coping. Results: Findings highlighted depression among people living with HIV/AIDS. The first sub-theme was the positive aspect which explains the family attitude towards illness as now they have become more caring and supportive towards the participant. The impact of disease is multifaceted including social, emotional, financial, and occupational. The participants were more inclined towards spiritual coping and problem-focused coping as compared to the avoidance coping. Conclusion: The findings of the study highlighted the need of the assessment and management of the participants through a psychologist. HIV/AIDS patients need counseling and awareness on the disease and the things to consider while on treatment to cope with the stress. They must be provided the updated information on HIV/AIDS. The management of HIV/AIDS patients requires that issues of psychological stresses be coped with professionalism

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Inventory of current EU paediatric vision and hearing screening programmes

Background: We examined the diversity in paediatric vision and hearing screening programmes in Europe. Methods: Themes relevant for comparison of screening programmes were derived from literature and used to compile three questionnaires on vision, hearing and public-health screening. Tests used, professions involved, age and frequency of testing seem to influence sensitivity, specificity and costs most. Questionnaires were sent to ophthalmologists, orthoptists, otolaryngologists and audiologists involved in paediatric screening in all EU fullmember, candidate and associate states. Answers were cross-checked. Results: Thirty-nine countries participated; 35 have a vision screening programme, 33 a nation-wide neonatal hearing screening programme. Visual acuity (VA) is measured in 35 countries, in 71% more than once. First measurement of VA varies from three to seven years of age, but is usually before the age of five. At age three and four picture charts, including Lea Hyvarinen are used most, in children over four Tumbling-E and Snellen. As first hearing screening test otoacoustic emission (OAE) is used most in healthy neonates, and auditory brainstem response (ABR) in premature newborns. The majority of hearing testing programmes are staged; children are referred after one to four abnormal tests. Vision screening is performed mostly by paediatricians, ophthalmologists or nurses. Funding is mostly by health insurance or state. Coverage was reported as >95% in half of countries, but reporting was often not first-hand. Conclusion: Largest differences were found in VA charts used (12), professions involved in vision screening (10), number of hearing screening tests before referral (1-4) and funding sources (8)

Monitoring the Causes of Blood Donation Deferrals among Prospective Blood Donors in Northwest Region of Pakistan

Objective: To evaluate and monitor the causes of blood donor deferrals at a Regional Blood Centre in northwest Pakistan. Methodology: This was a retrospective study of blood donor deferrals at the Regional Blood Centre in Peshawar. The blood donor data were extracted from the ZAAVIA blood transfusion information system (BTIS) database. The information and data expropriated from the database comprised of those from donor medical history questionnaire, physical examination (e.g. haemoglobin estimation), TTI screening results, and a decision on deferral (temporary and permanent). Results: The study included a total of 42,570 potential donors presented for blood donation over a four years period (June 2016 – May 2020), out of which 41,817 donors met the inclusion criteria and donated blood. The total deferral rate was 6.37% (n=2,682). Among these deferred donors, 44.44% (n=1,192) were deferred temporarily whereas 55.56% (n=1,490) were deferred permanently. The leading causes of temporary deferrals included syphilis (14.16%), low haemoglobin (8.28%), and underweight (5.97%). On the other hand, hepatitis B (30.38%) was the main cause of permanent deferral followed by hepatitis C (21.59%). The general percentage of deferrals was higher among those less than 32 years of age (P&lt;0.001), were females (P&lt;0.001), and were first-time blood donors (P&lt;0.001). Conclusion: Blood donor deferral was responsible for 6.37% of all blood donations. The findings of the current study demands adequate preventive strategies to address the prevailing causes of deferrals such as low haemoglobin levels and infections with HBV and HCV

Genotyping of Platelet Alloantigens by DNA Sequencing in Pakistani Population

Introduction: Single-nucleotide polymorphism (SNP) in human platelet antigens (HPAs) glycoproteins leads to alloimmunizations and platelet disorders such as posttransfusion purpura, neonatal alloimmune thrombocytopenia, and refractoriness to platelet transfusion. To study the prevalence in a particular ethnic group, genomic DNA is used to genotype HPAs. Detection of these polymorphisms is imperative to identify the risk of alloimmunization and the provision of HPAs. Current study was planned to determine the frequency of HPAs in the Pakistani population of blood donors. Methodology: Genomic DNA was extracted from blood samples of 300 randomly selected platelet donors from five major cities of Pakistan (Islamabad, Peshawar, Karachi, Quetta, and Mirpur). This study was approved by the ethical committee of Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan. Prior informed consent was taken from all the participants. Sequence-specific primers for platelets glycoprotein genes were designed using Primer 3 online software. The distinct targets were amplified through PCR. Amplified PCR products were eluted from the gel after electrophoresed, purified and sequenced. All the sequences and data obtained were analyzed through SPSS version 25. Results: Genotyping of samples showed that among the subjected HPA systems, HPA-1, HPA-5, HPA-7w, HPA-19w, and HPA-21w systems were found to have both a and b alleles in the Pakistani population while only aa genotype was found in HPA-4, HPA-6w, HPA-8w, HPA-10w, HPA-11w, HPA-16w, and HPA-23w. The frequency of HPA-1a was 0.9333 and HPA-1b was 0.0666, HPA-5a was 0.8033 and HPA-5b was 0.1966, HPA-7wa was 0.98 and HPA-7wb was 0.02, HPA-19wa was 0.95 and HPA-19wb was 0.05 and HPA-21wa was 0.9866 and HPA-21wb was 0.0133. Among the analyzed HPAs, the mismatch probability was higher in HPA-5 while it was lower in HPA-21w. Conclusion: HPA-4b, HPA-6b, HPA- 8b, HPA-10b, HPA-11b, HPA-16b and HPA-23b were absent. No homozygosity was found in the remaining genotyped HPAs. Our study suggests that it is necessary to establish HPA screening sites in blood banks to have HPA typed donor registry providing compatible therapeutic platelets to all unimmunized patients. Our data will be useful to understand and better treat the alloimmune-mediated platelet disorders. Key words: Alloantigens, Genotyping, Sequencing, Platelets, Platelet alloantigen

Extracranial internal carotid artery calcium volume measurement using computer tomography

BACKGROUND: The extent of calcium volume in the carotid arteries of contrast-based computer tomography (CT) is a valuable indicator of stroke risk. This study presents an automated, simple and fast calcium volume computation system. Since the high contrast agent can sometimes obscure the presence of calcium in the CT slices, it is therefore necessary to identify these slices before the corrected volume can be estimated. METHODS: The system typically consists of segmenting the calcium region from the CT scan into slices based on Hounsfield Unit-based threshold, and subsequently computing the summation of the calcium areas in each slice. However, when the carotid volume has intermittently higher concentration of contrast agent, a dependable approach is adapted to correct the calcium region using the neighboring slices, thereby estimating the correct volume. Furthermore, mitigation is provided following the regulatory constraints by changing the system to semi-automated criteria as a fall back solution. We evaluate the automated and semi-automated techniques using completely manual calcium volumes computed based on the manual tracings by the neuroradiologist. RESULT S: A total of 64 patients with calcified plaque in the internal carotid artery were analyzed. Using the above algorithm, our automated and semi-automated system yields correlation coefficients (CC) of 0.89 and 0.96 against first manual readings and 0.90 and 0.96 against second manual readings, respectively. Using the t-test, there was no significant difference between the automated and semi-automated methods against manual. The intra-observer reliability was excellent with CC 0.98. CONCLUSIONS: Compared to automated method, the semi-automated method for calcium volume is acceptable and closer to manual strategy for calcium volume. Further work evaluating and confirming the performance of our semi-automated protocol is now warranted