Susceptibility Pattern Of Pseudomonas Aeruginosa Against Various Antibiotics

P. aeruginosa, an increasingly prevalent opportunistic human pathogen, is the most common gram-negative bacterium responsible for the nosocomial and community acquired infections. The excessive use of antibiotics has not only led to treat the infections but also the emergence of antibiotic resistance. Multidrug resistant P. aeruginosa development is currently one of the greatest challenges. Total 100 clinical isolates of P. aeruginosa from inpatient and outpatient were studied. Uropathogenic P. aeruginosa infections were higher in females than males, ratio was found more among young and elderly debilitated patients. 99% of the clinical isolates were resistant to six commonly used antibiotics with the most resistant pattern being Ampicillin (100%), Amoxycillin (99%), Co-trimoxazole (99%), Tetracycline (99%), Cefazoline (99%) and Cefuroxime (100%). The invitro sensitivity pattern of 100 isolates of P. aeruginosa showed Imipenem (97%), Amikacin (79%), Tobramycin (70%), Ceftazidime (62%), Ciprofloxacin (73%), Cefoperazone (60%), Piperacillin (65%), Gentamycin (34%) and Cefotaxime (14%) sensitivity. ESBLs producing strains (33%) were also less in number but were much more resistant to ?-lactam and other antibiotics. Docking of both effective drugs against bacteria (Amikacin and Imipenem) with least resistance 21% and 3%, respectively, analyzed how these drugs interact with envelope protein to stop its growth

Chemical Characterisation, Antidiabetic, Antibacterial, and In Silico Studies for Different Extracts of Haloxylon stocksii (Boiss.) Benth: A Promising Halophyte

The objective of the study is to evaluate the chemical characterisation, and biological and in silico potential of Haloxylon stocksii (Boiss.) Benth, an important halophyte commonly used in traditional medicine. The research focuses on the roots and aerial parts of the plant and extracts them using two solvents: methanol and dichloromethane. Chemical characterisation of the extracts was carried out using total phenolic contents quantification, GC-MS analysis, and LC-MS screening. The results exhibited that the aerial parts of the plant have significantly higher total phenolic content than the roots. The GC-MS and LC-MS analysis of the plant extracts revealed the identification of 18 bioactive compounds in each. The biological evaluation was performed using antioxidant, antibacterial, and in vitro antidiabetic assays. The results exhibited that the aerial parts of the plant have higher antioxidant and in vitro antidiabetic activity than the roots. Additionally, the aerial parts of the plant were most effective against Gram-positive bacteria. Molecular docking was done to evaluate the binding affinity (BA) of the bioactive compounds characterised by GC-MS with diabetic enzymes used in the in vitro assay. The results showed that the BA of γ-sitosterol was better than that of acarbose, which is used as a standard in the in vitro assay. Overall, this study suggests that the extract from aerial parts of H. stocksii using methanol as a solvent have better potential as a new medicinal plant and can provide a new aspect to develop more potent medications. The research findings contribute to the scientific data of the medicinal properties of Haloxylon stocksii and provide a basis for further evaluation of its potential as a natural remedy

Application of effluent reduction methods and treatment using advanced oxidation process at leather chemicals and tanning industries

The current study set out to assess and create long-term solutions for improving environmental performance concerning water use, wastewater production, and treatment at Syntan plant (glass-lined vessel unit) and application laboratory (small-scale leather retanning. Based on evaluations and analyses, best available techniques including water gauging, pressurized vessel washing, dedication of vessels to similar production, reuse techniques, developing commercial grade intermediate products from wash water, managing cooling water and developing reuse methods of reverse osmosis reject water were applied to reduce water consumption and effluent generation in process and non-process activities. Furthermore, the reduced effluent was subjected to treat using electrochemical processes, i.e., electrocoagulation and electro-Fenton, before it was drained to outside environment. As a result of the applications, 0%–100% change was measured in various process and non-process activities, whereas, 12.8%–100% reduction was measured in effluent. Soft cooling water consumption was reduced by 46.7%. The results of treated effluent parameters were compared and found the final removal efficiencies of total dissolved solids (51.4%), total suspended solids (99.2%), chemical oxygen demand (98.5%) and electric conductivity (67.7%). It is concluded that this study can be considered as a successful model to increased water efficiency in chemical industries, Furthermore, it could serve as a building block for the incorporation of cleaner and sustainable production approach into national agenda and to overcome stern issues of high-water and energy consumption and effluent management in different industries

Effectiveness of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years postnatal: a cluster randomised trial in Pakistan

Maternal depression has a recurring course that can influence offspring outcomes. Evidence on how to treat maternal depression to improve longer-term maternal outcomes and reduce intergenerational transmission of psychopathology is scarce, particularly for task-shifted, low-intensity, and scalable psychosocial interventions. We evaluated the effects of a peer-delivered, psychosocial intervention on maternal depression and child development at 3 years postnatal

Predictors of Prenatal Depression: A Cross-Sectional Study in Rural Pakistan

Objective: To determine the prevalence and association of prenatal depression with socioeconomic, demographic and personal factors among pregnant women living in Kallar Syedan, Rawalpindi, Pakistan. Methods: Five hundred women in the second and third trimester of pregnancy, living in Kallar Syedan, a rural area of district Rawalpindi Pakistan, were included in the study. Depression was assessed using “Patient health questionnaire” (PHQ9) in Urdu, with a cut-off score of 10. Multi-dimensional scale of perceived social support (MSPSS) was used to assess perceived social support. Life Events and Difficulties Schedule (LEDS) were used to measure stressful life events in past 1 year. Tool to assess intimate partner violence (IPV) was based on WHO Multi Country Study on “Women's Health and Domestic Violence against Women.” Results: Prevalence of prenatal depression was found to be 27%. Number of pregnancies was significantly associated with prenatal depression (p < 0.01). Women living in a joint family and those who perceived themselves as moderately satisfied or not satisfied with their life in the next 4 years were found to be depressed (p < 0.01, OR 6.9, CI 1.77–26.73). Depressive symptomatology in women who experienced more than five stressful life events in last 1 year was three times higher (p < 0.001, OR 3.2, CI 1.68–5.98) than in women with 1–2 stressful events. Women who were supported by their significant others or their family members had 0.9 times (p < 0.01, OR 0.9, CI 0.85–0.96) less chance of getting depressed. Pregnant women who were psychologically abused by their partners were 1.5 times more depressed (p < 0.05 CI 1.12–2.51). Odds of having depression was also high in women who had less mean score of MSSI (p < 0.05, OR 1.1, CI 1.01–1.09). Women who had suitable accommodation had 0.5 times less chance of having depression than others (p < 0.05, OR 0.5, CI 0.27–0.92). Conclusion: Over a quarter of the women in the study population reported prenatal depression, which were predicted predominantly by psychosocial variables

Delivering the Thinking Healthy Programme for Perinatal Depression Through Volunteer Peers: A Cluster Randomised Controlled Trial in Pakistan

Background The Thinking Healthy Programme (THP), which is endorsed by WHO, is an evidence-based intervention for perinatal depression. We adapted THP for delivery by volunteer peers (laywomen from the community) to address the human resource needs in bridging the treatment gap, and we aimed to assess its effectiveness and cost-effectiveness in Rawalpindi, Pakistan. Methods In this cluster randomised controlled trial, we randomly assigned 40 village clusters (1:1) to provide either THP peer-delivered (THPP) and enhanced usual care (EUC; intervention group) or EUC only (control group) to the participants within clusters. These villages were randomly selected from eligible villages by an independent researcher. The participants were pregnant women aged 18 years or older who had scored at least 10 on the Patient Health Questionnaire-9 (PHQ-9), who we recruited from households within communities in Rawalpindi, Pakistan. The research teams who were responsible for recruiting trial participants were masked to treatment allocations. Participants attended follow-up visits at 3 and 6 months after childbirth. The primary outcomes were the severity of depressive symptoms (assessed by PHQ-9 score) and the prevalence of remission (defined as a PHQ-9 score of less than 5) in participants with available data 6 months after childbirth, which was assessed by researchers who were masked to treatment allocations. We analysed outcomes by intention to treat, adjusting for covariates that were defined a priori or that showed imbalance at baseline. The trial was registered with ClinicalTrials.gov, number NCT02111915. Findings Between April 15 and July 30, 2014, we randomly selected 40 of 46 eligible village clusters for assessment, as per sample size calculations. Between Oct 15, 2014, and Feb 25, 2016, we identified and screened 971 women from 20 village clusters that had been randomly assigned to the THPP and EUC group and 939 women from 20 village clusters that had been randomly assigned to the EUC only group. In the intervention group, 79 women were ineligible for inclusion, 11 women refused screening, 597 women screened negative on the PHQ-9, and one woman did not consent to participate. In the control group, 75 women were ineligible for inclusion, 14 women refused screening, 562 women screened negative on the PHQ-9, and one woman did not consent to participate. We enrolled 283 (29%) women in the intervention group and 287 (31%) women in the control group. At 6 months after childbirth, 227 (80%) women in the THPP and EUC group and 226 (79%) women in the EUC only group were assessed for the primary outcome. The severity of depression (assessed by PHQ-9 scores; standardised mean difference −0·13, 95% CI −0·31 to 0·06; p=0·07) and prevalence of remission (49% in the intervention group vs 45% in the control group; prevalence ratio 1·12, 95% CI 0·95 to 1·29; p=0·14) did not significantly differ between the groups 6 months after childbirth. There was no evidence of significant differences in serious adverse events between the groups. Interpretation THPP had no effect on symptom severity or remission from perinatal depression at 6 months after childbirth, but we found that it was beneficial on some other metrics of severity and disability and that it was cost-effective. THPP could be a step towards use of an unused human resource to address the treatment gap in perinatal depression

Effectiveness of the Thinking Healthy Programme for perinatal depression delivered through peers: Pooled analysis of two randomized controlled trials in India and Pakistan

BACKGROUND: The Thinking Healthy Programme (THP) is recommended to treat perinatal depression in resource-limited settings, but scale-up is hampered by a paucity of community health workers. THP was adapted for peer-delivery (THPP) and evaluated in two randomized controlled trials in India and Pakistan. Our aim was to estimate the effectiveness of THPP on maternal outcomes across these two settings, and evaluate effect-modification by country and other pre-defined covariates. METHODS: Participants were pregnant women aged≥18 years with depression (Patient Health Questionnaire (PHQ-9) score≥10), randomized to THPP plus enhanced usual care (EUC) or EUC-only. Primary outcomes were symptom severity and remission (PHQ-9 score<5) 6 months post-childbirth. Secondary outcomes included further measures of depression, disability and social support at 3 and 6 months post-childbirth. RESULTS: Among 850 women (280 India; 570 Pakistan), 704 (83%) attended 6-month follow-up. Participants in the intervention arm had lower symptom severity (PHQ-9 score adjusted mean difference -0.78 (95% confidence interval -1.47,-0.09)) and higher odds of remission (adjusted odds ratio 1.35 (1.02,1.78)) versus EUC-only. There was a greater intervention effect on remission among women with short chronicity of depression, and those primiparous. There were beneficial intervention effects across multiple secondary outcomes. LIMITATIONS: The trials were not powered to assess effect-modifications. 10-20% of participants were missing outcome data. CONCLUSIONS: This pooled analysis demonstrates the effectiveness, acceptability and feasibility of THPP, which can be scaled-up within a stepped-care approach by engaging with the existing health care systems and the communities to address the treatment gap for perinatal depression in resource-limited settings

Recreational and Leisure Time Activities Available for the Persons with Disabilities

Leisure time activities defined as which we perform in free time. This study aims to explore the availability of leisure and recreational activities for the persons with disabilities. The population of the study was special educationist, students of the different special school of the Lahore and the people of community live in Lahore. &nbsp;A number of 30 persons with disabilities were selected through convenient sampling technique from the higher educational institutes, special education institutions and from the different areas of Lahore city. This study is conducted through the questionnaire the first part of questionnaire was comprised of demographic information (Name, Age, Class, Gender and school) and the second part comprised of 22 statements with the five point Licker Scale. The scale was comprised of 5 options, 1=Yes, 2=Greater-extent, 3= Some-extent 4=Neutral and 5= No. The second part of questionnaire was comprised of 22 statements about the availability of leisure and recreational activities in Lahore. Content validity of the instrument was estimated through experts’ opinion relevant to the field of special education. Reliability was estimated through Cronbach alpha which was .75. Results showed that 86.7% of the respondents agreed upon that their school encourage their participation in leisure and recreational activities. A very good number of the respondents 90% agreed that they feel confident after leisure time activities. Conclusion: The study concluded that only few and unvaried leisure time and recreational activities are available for persons with disabilities.&nbsp;&nbsp

Extraction and characterization of starch from low-grade potatoes and formulation of gluten-free cookies containing modified potato starch

Potatoes are among the leading staple crops due to nutritional value and high demand. The undersized and damaged potatoes are considered low grade and mainly dumped as a waste or used in animal feed. The study aimed to extract starch from low grade potatoes, its modification to improve the starch properties and formulation of gluten free cookies using modified starch (MS). The starch was extracted from low-grade potatoes of three varieties known as Asterix, Kruda and Mosaic, using the water steeping method. The native starch (NS) was modified using lintnerization and repetitive autoclaving. MS contains high amylose content which is associated with health benefits. NS and MS were characterized for amylose content, color attributes, granular morphology, water solubility index (WSI), water absorption index (WAI), thermogravimetric analysis (TGA) and Fourier transform infrared spectrometer (FTIR) analysis. Gluten-free cookies were formulated by adding potato NS and MS. The cookies were characterized by sensory evaluation, proximate and textural analysis. The starch yield extracted from three different varieties of potatoes i.e. Asterix, Kruda, Mosaic was 11.53%, 11.32% and 11.24%, respectively. The amylose content of potato starch was significantly (p < 0.05) increased for all varieties (33.61–37.74%) after modification of NS, which was in the range of 25.71–26.60% for different potato varieties. The granules of MS were observed as amorphous structures in comparison to NS granules with smooth surfaces. The addition of MS significantly (p < 0.05) decreased the hardness of the cookies in comparison to NS. Overall, no significant difference was observed in the sensory attributes of control, NS and MS containing cookies. Therefore, in comparison to other dietary fibers, MS can be used as a functional ingredient in food products without compromising the texture and sensory attributes

Pattern of medication utilization in hospitalized patients with COVID-19 in three District Headquarters Hospitals in the Punjab province of Pakistan

PURPOSE: In Pakistan, a wide range of repurposed drugs are recommended to manage hospitalized patients with COVID-19. Therefore, the current study was conducted to evaluate the pattern of utilization of repurposed drugs and other potential therapeutic options among hospitalized patients with COVID-19 in Pakistan. METHODS: This retrospective, multicenter, descriptive study enrolled consecutive hospitalized patients with COVID-19 who were admitted between March 1, 2021, and April 30, 2021, from three District Headquarter Hospitals in the Punjab province of Pakistan. We describe patient and clinical characteristics and medications, stratified by COVID-19 severity during hospitalization: mild, moderate, and severe. In addition, an analytical study of drug utilization was conducted. FINDINGS: A total of 444 hospitalized patients with COVID-19 were included. Remdesvir, corticosteroids, antibiotics, and antithrombotics were administered to 45.0%, 93.9%, 84.9%, and 60.1% of patients, respectively. Specifically, dexamethasone was the most commonly used corticosteroid among the included patients (n = 405; 91.2%), irrespective of their clinical severity. Only 60.1% of patients hospitalized with COVID-19 in our cohort received antithrombotic therapy, and the prevalence of use was especially low (27.8%) in patients with mild illness. Of 444 patients records screened, 399 (89.9%) patients had been discharged, and 45 (10.1%) died. IMPLICATIONS: We provided an important glimpse into the utilization patterns of several medications of interest for the treatment of COVID-19, which had not been entirely evidence-based, especially concerning systemic corticosteroids and antibiotics