Exposure to aflatoxin B1 and associated risk factors in hepatitis C patients in cosmopolitan city of Pakistan: facility-based study

Introduction: population-based follow-up study has been designed to investigate the contributing factors to high exposure to Aflatoxin B1 (AFB1) and the subsequent associated risk factors among hepatitis C-infected patients at a referral centre, Karachi. Pakistan. Hepatitis C infection affects millions of individuals worldwide and confers high morbidity and mortality, especially in lower middle-income countries (LMICs) including Pakistan. A literature review of recent studies has revealed that a number of hepatocellular carcinomas (HCC) cases are markedly increased in Pakistan, where one of the potential causes of HCC is hepatitis C virus. The objectives of this study were to determine frequency of Aflatoxin B1 (AFB1) exposure and other associated characteristics among hepatitis C patients at a referral centre, Karachi, Pakistan. Methods: a semi-structured pre-coded pro forma designed to collect socio-demographic, Pharmacological, biochemical and clinical information from patients and hospital records. Patient´s pre and post polymerase chain reaction (PCR), serum alanine aminotransferase (ALT) levels and other blood parameters were analysed. AFB1 exposure was determined using an ELISA kit and validated through HPLC. Results: AFB1 exposure was found in 30 (34%) patients. Post treatment responders were 49 (55.6%). More than 37% of study participants had a family history of hepatitis C. About 74% had a history of surgical procedure, and around 36% of study participants had a blood transfusion history. Up to 36% participants were fond of spicy food and around 25% study participants were eating roadside food on daily basis. Conclusion: high frequency of AFB1 exposure due to risky dietary habits, low level of formal education and awareness are contributing factors may be responsible for high exposure of AFB1. Effective and multidimensional strategies are needed to prevent advance stage progression of disease and associated complications

Regeneration of Plantlets from various Explants of Tetraploid watermelon

Micropropagation of tetraploid watermelon is important to cope with high cost of seed. Seeds of tetraploid watermelon were grown in vitro to raise seedlings. Hypocotyl and cotyledonary explants and media supplemented with plant growth regulators (BAP and NAA) was explored for callus induction and organogenesis. Data was collected for callus, shoot and root induction. Maximum callus induction was observed at BAP 5 mgL-1 (76.66%) from cotyledon and (73.33%) from hypocotyls explant. The callus induced from different explants was sub-cultured on the shoot regeneration medium. Higher shoot induction (96.66%) was observed  from cotyledon and hypocotyl explant (76.66%) on MS + 1.0 mgL-1 BAP + 0.2 mgL-1 NAA with maximum number (6.3) of shoot per explant and average shoot length 4.5 cm. Among different types (NAA and IAA) and concentrations (0, 0.1, 0.3, 0.7, 1.0 mgL-1) of auxins investigated for root induction, maximum frequency of rooting was observed in 0.1 mgL-1 NAA while no root formation was observed at higher levels of auxin (1.0 mgL-1). Similarly in case of number of roots per shoot maximum root (4.3) was obtained on MS medium supplemented with 0.1 mgL-1 NAA. Key Words: Regeneration, Explant, Tetraploid, Water Mello

Evaluation of seed priming on germination of Gladiolus alatus

Seed priming improves seed performance under environmental conditions. The study was designed to evaluate the effect of different priming treatments on germination behavior of Gladiolus alatus. The experiment was conducted under complete randomized design (CRD) with four replications. Seed priming was done with different concentration of potassium nitrate (KNO3) and hydropriming. All the treatments had significant effect on germination percentage, germination test in growth room, time for 50% germination and mean germination time. Results show that maximum invigoration was observed in seeds osmoprimed at lower concentrations of KNO3 and with hydropriming while minimum invigoration was observed at higher concentration of KNO3-. It was concluded that germination percentage can be increased by using lower concentrations of KNO3 and with hydropriming.Key words: Priming, hydropriming, gladiolus, germination

Covid-19 vaccines status, acceptance and hesitancy among maintenance hemodialysis patients : a cross-sectional study and the implications for Pakistan and beyond

COVID-19 vaccine hesitancy continues to be a widespread problem in Pakistan due to various conspiracy beliefs, myths and misconceptions. Since the hemodialysis population is at higher risk of contracting infections, we sought to investigate the current COVID-19 immunization status and reasons for any vaccine hesitancy among these patients in Pakistan. This cross-sectional study was conducted among maintenance hemodialysis patients at six hospitals of Punjab Province of Pakistan. Data were collected anonymously using a questionnaire. 399 hemodialysis patients took part in the survey, the majority of them were male (56%) and aged 45 – 64 years. 62.4% of the patients reported receiving at least one dose of COVID-19 vaccine. Of those vaccinated (249), 73.5% had received two dose and 16.9% had received a booster dose. The most common reasons for vaccination were “being aware they were at high risk” (89.6%), “fear of getting infected” (89.2%) and “willingness to fight against COVID-19 pandemic” (83.9%). Of the 150 patients who had not yet been vaccinated, only 10 showed willingness to take the COVID-19 vaccine. The major reasons for refusal included “COVID-19 is not a real problem” (75%), “corona vaccine is a con-spiracy (72.1%)” and “I don’t need the vaccine” (60.7%). Our study revealed that only 62% pa-tients receiving hemodialysis were partially or completely vaccinated against COVID-19. Con-sequently, there is a need to initiate aggressive approaches to educate this high-risk population in order to address their vaccine safety and efficacy concerns and correct current myths and mis-conceptions to improve the COVID-19 immunization status in this population

Genome-wide analysis of blood lipid metabolites in over 5000 South Asians reveals biological insights at cardiometabolic disease loci.

The authors would like to thank Michael Inouye for his helpful comments on an earlier version of the manuscript.Peer reviewe

Genome-wide analysis of blood lipid metabolites in over 5000 South Asians reveals biological insights at cardiometabolic disease loci.

Funder: PfizerFunder: NovartisFunder: National Institute for Health ResearchFunder: MerckBackgroundGenetic, lifestyle, and environmental factors can lead to perturbations in circulating lipid levels and increase the risk of cardiovascular and metabolic diseases. However, how changes in individual lipid species contribute to disease risk is often unclear. Moreover, little is known about the role of lipids on cardiovascular disease in Pakistan, a population historically underrepresented in cardiovascular studies.MethodsWe characterised the genetic architecture of the human blood lipidome in 5662 hospital controls from the Pakistan Risk of Myocardial Infarction Study (PROMIS) and 13,814 healthy British blood donors from the INTERVAL study. We applied a candidate causal gene prioritisation tool to link the genetic variants associated with each lipid to the most likely causal genes, and Gaussian Graphical Modelling network analysis to identify and illustrate relationships between lipids and genetic loci.ResultsWe identified 253 genetic associations with 181 lipids measured using direct infusion high-resolution mass spectrometry in PROMIS, and 502 genetic associations with 244 lipids in INTERVAL. Our analyses revealed new biological insights at genetic loci associated with cardiometabolic diseases, including novel lipid associations at the LPL, MBOAT7, LIPC, APOE-C1-C2-C4, SGPP1, and SPTLC3 loci.ConclusionsOur findings, generated using a distinctive lipidomics platform in an understudied South Asian population, strengthen and expand the knowledge base of the genetic determinants of lipids and their association with cardiometabolic disease-related loci

“Sehat Sahulat Program”:A Leap into the Universal Health Coverage in Pakistan

Universal Health Coverage (UHC), initiative from the World Health Organization (WHO), is a means to provide the human right to health by providing essential health services to everyone, enabling disease prevention, treatment, rehabilitation, and palliative care. In line with the WHO recommendations, the UHC was first introduced in Pakistan in Khyber Pakhtunkhwa (KP) province under the name ‘Sehat Sahulat Programme’ (SSP), literally ‘Health Facility Program’ in 2015. The provincial Government in Punjab approved a similar initiative in Punjab, the largest province (by population) of the country, and the program was later rolled out in Islamabad Capital Territory (ICT), Azad and Jammu Kashmir (AJK), Gilgit Baltistan (GB), Sindh, and Baluchistan provinces leaping into the nation-wide coverage. This article provides a current overview of the UHC initiative in Pakistan, analyses its progress in appraising key milestones, and makes recommendations to achieve a robust universal health coverage across Pakistan

Covid-19 Vaccine safety and adverse event analysis from Pakistan

Covid immunization commenced on 2nd Feb 2021 in Pakistan and as of 7th Sep 2021, over 84 million vaccine doses were administered in Pakistan, of which 72% procured by the government, 22% received through Covax and 6% were donated. The vaccines rolled out nationally included: Sinopharm, Sinovac and CanSinoBIO (China), AstraZeneca (UK), Moderna and Pfizer (USA), Sputnik (Russia), and PakVac (China/Pakistan). About half of the eligible population in Pakistan (63 m) had received at least one dose of Covid vaccine as of Sep 2021. Pakistan National Pharmacovigilance Centre (PNPC) in coordination with WHO, MHRA and Uppsala Monitoring Centre (UMC) established pharmacovigilance centers across Pakistan. The Covid vaccine AEFIs in Pakistan were mainly reported via NIMS (National Immunization Management System), COVIM (Covid-19 Vaccine Inventory Management System), 1166 freephone helpline and MedSafety. There have been 39,291 ADRs reported as of 30th Sept 2021, where most reported after the first dose (n = 27,108) and within 24–72 h of immunization (n = 27,591). Fever or shivering accounted for most AEFI (35%) followed by injection-site pain or redness (28%), headache (26%), nausea/vomiting (4%), and diarrhoea (3%). 24 serious AEFIs were also reported and investigated in detail by the National AEFI review committee. The rate of AEFIs reports ranged from 0.27 to 0.79 per 1000 for various Covid vaccines in Pakistan that was significantly lower than the rates in UK (∼4 per 1000), primarily atrributed to underreporting of cases in Pakistan. Finally, Covid vaccines were well tolerated and no significant cause for concern was flagged up in Pakistan's Covid vaccine surveillance system concluding overall benefits outweighed risks