Bioaerosols in residential micro-environments in low income countries: A case study from Pakistan

Our knowledge of the concentrations of bioaerosols in residential micro-environments in low income countries is scanty. The present investigation was conducted to assess the culturable concentration and size distribution of bacteria, gram negative bacteria and fungi in two rural and an urban site in Pakistan. The highest indoor culturable bacteria concentration was found at Rural Site II (14,650 CFU/m 3) while the outdoor maximum occurred at the urban site (16,416 CFU/m 3). With reference to fungi, both indoor and outdoor concentrations were considerably higher at Rural Site I than the other sites. The size distribution of culturable bacteria at all sites showed greater variability than that of culturable fungi. At all sites more than the half (55-93%) of the culturable bacterial and fungal counts were observed in the respirable fraction (<4.7 μm) and so had the potential to penetrate into lower respiratory system. © 2012 Elsevier Ltd. All rights reserved

Assessment of Airborne Microflora in the Indoor Micro-Environments of Residential Houses of Lahore, Pakistan

The presence of micro-organisms in air is taken for granted, but understanding the identities, distribution and abundance of airborne micro-organisms remains in its infancy. Indoor exposure to micro-organisms has been related to range of adverse health outcomes. The indoor levels of particulate matter and bioaerosols were monitored in thirty houses across Lahore, Pakistan. Two DustTrak aerosol monitors (model 8520, TSI Inc.) were run simultaneously in the kitchens and living rooms of the selected sites to measure fine particulate matter. At the same time, agar coated petri plates were exposed face upwards for twenty minutes to sample the micro-organisms present in surrounding air of both micro-environments. A total of 7 bacterial species and 11 fungal species were identified including Staphylococcus spp., Bacillus spp., Micrococcus spp. and Serratia spp. while the predominant fungal species were Alternaria alternata and Aspergillus spp. The concentrations (cfu m–3) for bacteria ranged from 472 to 9829 in the kitchens and from 275 to 14469 in the living rooms. Likewise, the fungal cfu m–3 ranged between 236 and 1887 in the kitchen and from 315 to 1887 in the living room. A seasonal variation in bioaerosols was evident in the kitchens while being not so pronounced in the living rooms. A linear regression model showed a direct association of temperature with bacteria and fine particulate matter but not with fungi. Ventilation was also observed to have a significant impact upon PM levels. Out of 30 households sixteen had the presence of at least one individual with allergenic reactions. These findings highlight the enhanced risk of exposure to fine particulate matter as well as bioaerosols in the urban residential built environment in Pakistan

Plants as Useful Vectors to Reduce Environmental Toxic Arsenic Content

Arsenic (As) toxicity in soil and water is an increasing menace around the globe. Its concentration both in soil and environment is due to natural and anthropogenic activities. Rising arsenic concentrations in groundwater is alarming due to the health risks to plants, animals, and human beings. Anthropogenic As contamination of soil may result from mining, milling, and smelting of copper, lead, zinc sulfide ores, hide tanning waste, dyes, chemical weapons, electroplating, gas exhaust, application of municipal sludge on land, combustion of fossil fuels, As additives to livestock feed, coal fly ash, and use of arsenical pesticides in agricultural sector. Phytoremediation can be viewed as biological, solar-driven, pump-and-treat system with an extensive, self-extending uptake network (the root system) that enhances the natural ecosystems for subsequent productive use. The present review presents recent scientific developments regarding phytoremediation of arsenic contaminated environments and its possible detoxification mechanisms in plants

Technology-assisted peer therapy: a new way of delivering evidence-based psychological interventions

In low-income settings, ninety percent of individuals with clinical depression have no access to evidence-based psychological interventions. Reasons include lack of funds for specialist services, scarcity of trained mental health professionals, and the stigma attached to mental illness. In recent years there have been many studies demonstrating effective delivery of psychological interventions through a variety of non-specialists. While these interventions are cost-effective and less stigmatising, efforts to scale-up are hampered by issues of quality-control, and what has been described by implementation scientists as ‘voltage-drop’ and ‘programme-drift.’ Using principles of Human Centred Design in a rural setting in Pakistan, we worked with potential users to co-design a Tablet or Smartphone-based App that can assist a lay-person deliver the Thinking Healthy Programme, a World Health Organization-endorsed evidence-based intervention for perinatal depression. The active ingredients of this cognitive-therapy based intervention are delivered by a virtual ‘avatar’ therapist incorporated into the App which is operated by a ‘peer’ (a woman from the neighbourhood with no prior experience of healthcare delivery). Using automated cues from the App, the peer reinforces key therapeutic messages, helps with problem-solving and provides the non-specific but essential therapeutic elements of empathy and support. The peer and App therefore act as co-therapists in delivery of the intervention. The peer can deliver the intervention with good fidelity after brief automated in-built training. This approach has the potential to be applied to other areas of mental health and help bridge the treatment gap, especially in resource-poor settings. This paper describes the process of co-development with end-users and key features of the App

Soil bacteria showing a potential of chlorpyrifos degradation and plant growth enhancement

ABSTRACT Background: Since 1960s, the organophosphate pesticide chlorpyrifos has been widely used for the purpose of pest control. However, given its persistence and toxicity towards life forms, the elimination of chlorpyrifos from contaminated sites has become an urgent issue. For this process bioremediation is the method of choice. Results: Two bacterial strains, JCp4 and FCp1, exhibiting chlorpyrifos-degradation potential were isolated from pesticide contaminated agricultural fields. These isolates were able to degrade 84.4% and 78.6% of the initial concentration of chlorpyrifos (100 mg L-1) within a period of only 10 days. Based on 16S rRNA sequence analysis, these strains were identified as Achromobacter xylosoxidans (JCp4) and Ochrobactrum sp. (FCp1). These strains exhibited the ability to degrade chlorpyrifos in sterilized as well as non-sterilized soils, and were able to degrade 93-100% of the input concentration (200 mg kg-1) within 42 days. The rate of degradation in inoculated soils ranged from 4.40 to 4.76 mg-1 kg-1 d-1 with rate constants varying between 0.047 and 0.069 d-1. These strains also displayed substantial plant growth promoting traits such as phosphate solubilization, indole acetic acid production and ammonia production both in absence as well as in the presence of chlorpyrifos. However, presence of chlorpyrifos (100 and 200 mg L-1) was found to have a negative effect on indole acetic acid production and phosphate solubilization with percentage reduction values ranging between 2.65-10.6% and 4.5-17.6%, respectively. Plant growth experiment demonstrated that chlorpyrifos has a negative effect on plant growth and causes a decrease in parameters such as percentage germination, plant height and biomass. Inoculation of soil with chlorpyrifos-degrading strains was found to enhance plant growth significantly in terms of plant length and weight. Moreover, it was noted that these strains degraded chlorpyrifos at an increased rate (5.69 mg-1 kg-1 d-1) in planted soil. Conclusion The results of this study clearly demonstrate that the chlorpyrifos-degrading strains have the potential to develop into promising candidates for raising the productivity of crops in pesticide contaminated soils

Role of Culture Free Rapid ImmunoAssay (ELISA) and Genexpert (MTB/RIF) Technology in the Diagnosis of Tuberculosis

Introduction: Prolonged laboratory processes are major hurdles in the early diagnosis of tuberculosis. Prompt management of this disease is utmost necessary to control its spread. For this purpose, use of rapid and reliable laboratory testing methods for the diagnosis of Mycobacterium tuberculosis are crucial alongwith timely infection management and preventing its transmission to the close contact population. Aims and Objective: The aim of this study was to establish a diagnostic-connection between culture free cost effective rapid immuno-assay (IgG and IgM) and GeneXpert (MTB/RIF) technology for the detection of Mycobacterium tuberculosis within the shortest possible turnaround time. Place and Duration of Study: This cross-sectional study was carried out at Institute of Microbiology and Molecular Genetic, University of the Punjab, Pakistan in collaboration with the Department of Pulmonology and TB Outpatient Department (OPD) at Jinnah Hospital, Lahore over the time of one year (2019-2020). Material and Methods: To achieve the aim, a total of 180 (pulmonary and extra-pulmonary) samples along with blood samples were collected from clinical suspects of Tuberculosis. All collected samples were subjected to AFB microscopy, GeneXpert (MTB/RIF) assay and Enzyme-linked Immunosorbent Assay (ELISA) for IgG and IgM. The diagnostic sensitivity and specificity of both methods were determined by using the solid culture as the gold standard.Study data collected through questionnaire was entered and analyzed using Statistical Package for Social Sciences (SPSS version 20).p value of ? 0.05 was considered significant. Results: The overall sensitivity and specificity of GeneXpert (MTB/RIF) assay were 98.2 % and 82.4% respectively, whereas, for IgG (ELISA) antibodies, it was 50.0% and 76.4% and for IgM (ELISA) antibodies 50.4% and 97.1% respectively. Conclusion: It was concluded that with fully automated GeneXpert (MTB/RIF) technology, maximum sensitivity and specificity can be achieved for diagnosis of tuberculosis within 2 hours

Frequency of hearing impairment in children between the age of 2 to 10 years with middle ear infection

This study was conducted to find out frequency of hearing impairment in middle ear infection. The study design was a cross- sectional survey, conducted from August 2018 to January 2019 in the ENT Department of Children's Hospital Lahore. The data was collected through convenience sampling technique among 52 patients of middle ear infection. The measurements for level of hearing impairment were taken. The data was analyzed using statistical package for social sciences, SPSS 20.0 Out of total 52, There were found 15 (28.8%) had once a month ear infection and 37 (71.2%) had off and 35 (67.3%) patients had mild hearing, 13 (25%) had moderate, 2(3.8%) severe and 2 (3.8%) had normal hearing loss. It was concluded that most of the participants having middle ear infections had hearing loss. Keywords: Hearing Impairment, Middle Ear Infection, Continuous..

Bacterial ventriculoperitoneal shunt infections: changing trends in antimicrobial susceptibility, a 7-year retrospective study from Pakistan

Abstract Background Ventriculoperitoneal (VP) shunt infections in adults represent a severe complication and make treatment more challenging. Therefore, drug susceptibility patterns are crucial for therapeutic decisions and infection control in neurosurgical centers. This 7-year retrospective study aimed to identify the bacteria responsible for adult VP shunt infections and determine their drug susceptibility patterns. Methods This single-center study was performed from 2015 to 2021 in Lahore, Pakistan, and included CSF cultures from VP shunt infections. Demographic data, causative organisms, and antimicrobial susceptibility testing results were collected. Multivariate analysis of variance (MANOVA) and two-sample t-tests were used to analyze and compare the antibiotic sensitivity trends over the study period. Results 14,473 isolates recovered from 13,937 CSF samples of VP shunt infections were identified and analyzed for their susceptibility patterns to antimicrobials. The proportion of Gram-negative and Gram-positive bacteria were 11,030 (76%) and 3443 (24)%, respectively. The predominant bacteria were Acinetobacter species (n = 5898, 41%), followed by Pseudomonas species (n = 2368, 16%) and coagulase-negative Staphylococcus (CoNS) (n = 1880, 13%). 100% of Staphylococcus aureus (S.aureus) and CoNS were sensitive to vancomycin and linezolid (n = 2580). However, 52% of S. aureus (719/1,343) were methicillin-resistant Staphylococcus aureus (MRSA). Acinetobacter showed maximum sensitivity to meropenem at 69% (2759/4768). Pseudomonas was 80% (1385/1863 sensitive to piperacillin-tazobactam, Escherichia coli (E. coli) showed 72% to amikacin (748/1055), while Klebsiella spp. was 57% (574/1170) sensitive to piperacillin-tazobactam. The sensitivity of piperacillin-tazobactam and meropenem for Gram-negative bacteria decreased significantly (p < 0.05) over 7 years, with 92.2% and 88.91% sensitive in 2015 and 66.7% and 62.8% sensitive in 2021, respectively. Conclusion The significant decrease in the effectiveness of carbapenem and beta-lactam/beta-lactamase inhibitor combination drugs for the common Gram-negative causative agents of VP shunt infections suggests that alternative antibiotics such as colistin, fosfomycin, ceftazidime/avibactam, ceftolozane/tazobactam, and tigecycline should be considered and in consequence included in testing panels. Additionally, it is recommended to adopt care bundles for the prevention of VP shunt infection