Investigating Urinary Pathogens and Their Antibiotic Resistance: A Cross-Sectional Urine Culture Study.

INTRODUCTION: Urinary tract infections (UTIs) are among the most prevalent infectious diseases. Females are more affected than males. The primary culprit is Escherichia coli. Multiple research investigations have documented widespread antimicrobial resistance in uropathogens, sparking global concerns, especially regarding the rise of multidrug resistance (MDR). METHODOLOGY: This cross-sectional study was conducted from December 2023 to March 2024. A non-probability purposive sampling technique was employed to select participants, and informed consent was obtained from them. Data were extracted from the culture and sensitivity reports of these patients. The collected data were meticulously entered into IBM SPSS Statistics for Windows, Version 21 (IBM Corp., Armonk, NY). The findings were then presented using a blend of percentages and numerical figures, offering a clear and concise representation of the data. RESULTS: Our study of 313 participants showed a higher prevalence of UTIs in females (219, 70%) compared to males (94, 30%). E. coli and Citrobacter were the predominant pathogens, with E. coli and Citrobacter more common in females, while Enterobacter and Staphylococcus were more prevalent in males. Antibiogram analysis revealed sensitivities to specific drugs like nitrofurantoin and meropenem, while resistance was observed against others, including polymyxin B and ampicillin. These findings stress the need for tailored UTI treatment approaches. CONCLUSIONS: In conclusion, our research highlights a concerning trend of escalating antibiotic resistance among Pakistani patients with UTIs. Tobramycin B, ticarcillin-clavulanic acid, ampicillin, and clotrimazole exhibited the highest resistance rates, while imipenem, meropenem, nitrofurantoin, sulfonamides, and tigecycline demonstrated notable sensitivity. These findings emphasize the urgent need for the exploration of alternative treatment options to combat rising resistance levels effectively.

Comprehensive Analysis of Breastfeeding's Influence on Child Health Outcomes: A Cross-Sectional Study.

Background Breastfeeding is recognized as a crucial determinant of child health and development, yet its multifaceted effects remain underexplored in many contexts. This cross-sectional study investigates the association between breastfeeding practices and various health and developmental outcomes in infants and young children, focusing on exclusive breastfeeding, partial breastfeeding, and formula feeding. Done at Khyber Teaching Hospital, Pakistan, the research aims to provide comprehensive insights into the nuanced impacts of breastfeeding on child well-being. Objectives This study aims to assess the association between breastfeeding duration and practices with the incidence of infectious diseases in infants and young children. It investigates the relationship between different breastfeeding practices: exclusive breastfeeding, partial breastfeeding, and formula feeding and cognitive development outcomes in early childhood. Additionally, the study evaluates the role of breastfeeding in the development of motor skills in infants and young children. Methodology A cohort of 390 participants, aged one month to three years, participated in the study. Data collection encompassed parental interviews, clinical assessments using standardized tools such as the Bayley Scales of Infant Development, and reviews of medical records. Statistical analyses, including frequency analysis and chi-square tests, were conducted to elucidate the relationships between breastfeeding practices and health outcomes. Results Exclusive breastfeeding exhibited a significantly lower incidence of infectious diseases compared to partial breastfeeding and formula feeding. Specifically, among exclusively breastfed children, incidences of colds, pneumonia, and diarrhea were 32%, 39.7%, and 40%, respectively. These rates were notably higher in partially breastfed and formula-fed children. Cognitive development outcomes also varied significantly across feeding groups. Exclusively breastfed children demonstrated superior cognitive performance, with 34.2% rated above average, compared to only 6.5% in the formula-fed group. Additionally, the prevalence of developmental delays was lowest among exclusively breastfed children (14.1%), contrasting with 62.8% in the partial breastfeeding group and 77.0% in the formula-feeding group. Conclusions The study underscores the pivotal role of exclusive breastfeeding in promoting optimal child health and development. Exclusive breastfeeding is associated with significantly reduced incidences of infectious diseases, superior cognitive development outcomes, and a lower prevalence of developmental delays. These findings highlight the importance of supportive interventions and policies aimed at encouraging exclusive breastfeeding practices, ultimately enhancing child well-being and developmental trajectories.

Dietary Habits and Their Impact on Gastroesophageal Reflux Disease (GERD).

Introduction Gastroesophageal reflux disease (GERD) is marked by the frequent occurrence of stomach acid flowing back into the esophagus, causing symptoms such as heartburn and acid regurgitation at least once a week. When reflux leads to troublesome symptoms and esophageal damage and adversely affects quality of life, it is diagnosed as GERD. Age, gender, ethnicity, genetic predispositions, and aspects of diet and lifestyle, including factors like obesity and smoking, are associated with GERD. Methodology This cross-sectional study was conducted within the Departments of General Medicine, Surgery, and Gastroenterology at Khyber Teaching Hospital (KTH) in Peshawar, spanning from January 2024 to June 2024. Patients who visited these departments or the Outpatient Department within the specified period with GERD were included in the study. A non-probability purposive sampling technique was used. For the analysis, we utilized IBM SPSS Statistics version 21. Results This study consists of 280 participants. The mean age of the participants in this study was 44.60 years. GERD has a significant association with obesity (69.99) and lack of exercise (80%), and a negative association was found between other gastrointestinal conditions (55.71%) and smoking (64.28). Common symptoms among GERD patients were swallowing difficulty, regurgitation, heartburn, and chest pain. Conclusion Our study is the first to examine the relationship between lifestyle factors and GERD among Pakistani patients. Our findings highlight significant associations between GERD and several factors, including gender, BMI, dietary habits, and lack of exercise. Notably, cultural and regional differences appear to influence GERD prevalence and its risk factors, as demonstrated by the minimal impact of alcohol consumption in our study population.

A novel assessment of potentially toxic elements (PTEs) in water and sediment samples from the Indus River, Pakistan: An ecological risk assessment approach.

Pakistan, a country with limited water resources and highly vulnerable to the adverse effects of climate change, faces numerous challenges in managing its water supply. In this sense, this study assessed potentially toxic elements (PTEs) in the surface water and sediments of Pakistan's Indus River and its tributaries. Key water quality parameters such as pH, electrical conductivity (EC), and total dissolved solids (TDS) were determined, with respective average values of 7.1, 40 µS/cm, and 208 mg L-1. The concentrations of Cd, Cr, Cu, Ni, and Zn in surface water samples averaged 26 µg L-1, 0.9 µg L-1, 1.4 µg L-1, 22 µg L-1, and 2.1 µg L-1, respectively. The general sediment PTE profile was Ni > Cd > Zn > Cu > Cr. Certain PTE levels exceeded recommended thresholds, indicating the establishment of environmental pollution. Calculated geo-accumulation index values suggested moderate to heavy pollution levels in sediment, with PERI (404) values reinforcing the ecological risk posed by elevated PTE concentrations. Furthermore, significant correlations were observed between specific PTE pairs in both water and sediment samples. This study contributes with novel insights into the distribution and ecological implications of PTE contamination in the Indus River and its tributaries, paving the way for ecological risk management efforts.

Comprehensive Analysis of Salmonella Species Antibiogram and Evolving Patterns in Empirical Therapy: Insights From Tertiary Care Hospitals in Peshawar, Pakistan.

Background Typhoid fever presents a significant challenge in developing nations, exacerbated by the emergence of antibiotic-resistant strains due to widespread prevalence and overuse of antibiotics. This study seeks to assess the antibiogram profiles of Salmonella species isolated from blood cultures of patients hospitalized at two prominent tertiary care hospitals in Peshawar, Pakistan: Khyber Teaching Hospital (KTH) and Hayatabad Medical Complex (HMC). By examining these profiles, the research aims to provide valuable insights into the evolving landscape of antibiotic resistance in the context of typhoid fever management. Materials and Methods This retrospective cross-sectional study utilized data gathered from two hospitals in Peshawar, KTH and HMC. Cases of enteric fever were identified based on positive blood cultures for Salmonella species. The study encompasses demographic information, seasonal prevalence, and antibiogram profiles of 3,137 cases that were presented between 2017 and 2023. Results Among the total 3,137 cases, males accounted for the majority, comprising 63% (2,044 cases). Particularly notable was the clustering of cases among children and adolescents aged one to 24 years. The incidence peaked during the months of summer and spring, from April to September. In terms of Salmonella Typhi isolates, considerable resistance was noted against first-line antibiotics such as amoxicillin/clavulanate (80.1%), co-trimoxazole/trimethoprim-sulfamethoxazole (66.6%), and chloramphenicol (86.9%), as well as against ceftriaxone (79.7%) and ciprofloxacin (51.6%). Conversely, certain antibiotics displayed higher sensitivity patterns, including meropenem (97.8%), doripenem (99.5%), imipenem (97.7%), ertapenem (96.5%), polymyxin B (99.4%), colistin (98.1%), and tigecycline (97.3%). Despite a limited sample size of 214 specimens, fosfomycin demonstrated a remarkable sensitivity of 93.4%. Sensitivities of amikacin and gentamicin were 90.7% and 81.5%, respectively. However, the sensitivity of azithromycin was concerning, standing at 66.5%. The antibiogram pattern for Salmonella exhibited significant and drastic changes. Conclusion In conclusion, this study sheds light on a higher prevalence of typhoid fever among males, with a notable seasonal peak observed during the summer and spring months. The age group most affected spans from one to 24 years. Salmonella isolates displayed significant resistance to conventional first-line antibiotics, alongside ciprofloxacin and third-generation cephalosporins. Azithromycin exhibited lower sensitivity compared to amikacin, gentamicin, and fosfomycin. The research advocates for the empirical use of amikacin, gentamicin, fosfomycin, and meropenem in the treatment of typhoid fever in Pakistan. Urgent measures, including regular Salmonella antibiogram surveillance, antibiotic stewardship, public health education, and Salmonella vaccination programs, are deemed crucial for primary disease prevention.

Zinc Foliar Application Mitigates Cadmium-Induced Growth Inhibition and Enhances Wheat Growth, Chlorophyll Contents, and Yield.

Cadmium (Cd) is a toxic heavy metal that significantly threatens plants and the environment. Its toxicity in plants can result in various adverse effects, including reduced growth, altered metabolism, and cell damage. Cadmium can also interfere with nutrient uptake, particularly zinc (Zn), leading to Zn deficiency and further exacerbating Cd toxicity. On the other hand, foliar application of zinc might be a useful strategy to mitigate cadmium (Cd) toxicity in plants. Hence, a pot experiment was conducted with three replications. The wheat plants were treated with various concentrations of Zn as a foliar spray (control, 0.1, 0.2, 0.4, and 0.5%) in Cd-spiked soil in pots. The results showed that foliar use of Zn at 0.4 or 0.5% resulted in higher plant height, grain yield, and dry matter yield than the control group. Using Zn as foliar spray enriched shoot and grain Zn content while reducing Cd content in the shoot and grain. The leaf's electrolyte leakage (EL) decreased by 15.4, 29.8, 40.7, and 45.9% in the Zn 0.1%, Zn 0.2%, Zn 0.4%, and Zn 0.5% treatments, respectively, compared to the control treatment. Regarding superoxide dismutase (SOD) activity, Zn 0.5% treatment showed a decrease of 42.9% over control. Specifically, the Zn 0.1% showed a 27.2%, Zn 0.2% showed a 56.8%, Zn 0.4% showed a 91.1%, and Zn 0.5% showed a 133.7% increase in total chlorophyll content than control. Based on the results, it is recommended that 0.4% Zn solution may be used for foliar application for enhancing crop productivity and Zn concentration in plants under high Cd stress. Additionally, continued research on the mechanisms of cadmium uptake, transport, and detoxification in plants may lead to the identification of new targets for intervention.

Evaluating the Efficacy of Activated Carbon in Minimizing the Risk of Heavy Metals Contamination in Spinach for Safe Consumption.

Toxicity induced by heavy metals is a major concern in agriculture as it decreases crops' growth and yield and leads to the deterioration of food quality. Recently, activated carbon has been identified as a possible solution. It can potentially improve crop nutrition and immobilize heavy metals in soil. That is why a glasshouse trial was conducted to investigate the effects of sugarcane bagasse-derived biochar on spinach growth and the availability of cadmium (Cd) and chromium (Cr) in artificially contaminated soil. The soil was placed in pots and contaminated with Cd and Cr at a rate of 10 mg kg-1. Biochar was added to the soil at concentrations of 0 (control), 0 (contaminated control), 100, 150, and 200 g, and 10-day-old nursery spinach plants were transplanted to the pots. The results showed that applying 200 g of biochar significantly increased shoot weight (235 g), soil pH, electrical conductivity, and organic matter. The highest levels of Cd (27.71 mg kg-1) and Cr (20.44 mg kg-1) were observed in the contaminated control pots, while the lowest levels of Cd (16.80 mg kg-1) and Cr (9.80 mg kg-1) were found in pots treated with 200 g of biochar (2%). Similarly, the highest levels of Cd (35.80 mg kg-1) and Cr (40.24 mg kg-1) in the roots were found in the contaminated control pots, while the lowest levels of Cd (19.26 mg kg-1) and Cr (21.34 mg kg-1) were observed in pots treated with 200 g of biochar. Biochar application at a rate of 2% can immobilize Cd and Cr in the soil and improve chlorophyll contents, carotenoids, photosynthetic rate, transpiration rate, and stomatal conductance in spinach in Cd- and Cr-contaminated soils. Further long-term field studies will be necessary to determine the feasibility of applying biochar as an organic amendment for enhancing spinach growth and reducing Cd and Cr bioavailability in contaminated soil.

Geochemistry of subsurface water of Swabi district and associated health risk with heavy metal contamination.

Heavy metal (HM) contamination in the drinking water is a serious threat to the consumers and has drawn the global attention. In the current study, twenty six (26) groundwater samples including tube well and domestic bores were collected randomly from fourteen union councils (UCs) of tehsil Swabi. Depth of the tube wells ranged between 100 and 400 feet, while in domestic bore water, it ranged from 22 to 140 feet. Samples were analyzed for different parameters. Concentrations of the heavy metals (HMs) were found in the following increasing orders of Pb > Zn > Cr > Cu > Ni > Cd > Co in domestic well water while in tube well water, the increasing order was Cu > Ni > Co > Zn > Cr > Cd. In the domestic well samples, Cd, Cr, Ni, and Pb were found above the World health organization (WHO), permissible limits. Based on the Water Quality Index (WQI), samples collected from domestic wells were found of poor quality with WQI value of 208, while tube well waters were found of excellent quality, with WQI value of 40. This indicates that domestic well waters are more prone to HM contamination due to low depth. Health risk data showed significantly high risk (HQ > 1) for children upon domestic well water consumption, due to high concentrations of Cr and Pb. No significance relationship was observed between the various parameters which indicate the input of these contaminants from multiple sources.

Organic and Inorganic Mercury in Biological Samples of Flouresecent Lamp Industries Workers and Health Risks.

OBJECTIVE: The present study aims to investigate the concentrations of Hg and its aspects methyl mercury (Me-Hg) and inorganic mercury (I-Hg) in the biological samples (BSs) of fluorescent lamp industries workers (FLIWs). METHODOLOGY: Different BSs including red blood cells (RBCs), plasma, urine, hair and nails were collected from the workers exposed to Hg and unexposed persons were selected as control group to measure both the T-Hg concentration as well as its species in different biological samples through quantitative analysis. Health data was collected through questionnaire survey. RESULTS: The mean concentrations of T-Hg (31.9 µg/L), Me-Hg (27.7 µg/L), and I-Hg (5.36 µg/L) in RBCs were found significantly ( P < 0.001) higher among the workers ( n = 40) as compared to the control group ( n = 40). Similarly the mean Hg concentrations in plasma, urine, hair and nails were also significantly higher among the workers than the control group. The statistical relation between Hg concentration and demographic characteristics observed that workers experience and fish consumption has increased the Hg concentration while age, weight and smoking found no significant effect on Hg concentration in the BSs. CONCLUSION: The study observed that the workers were highly exposed to high concentration of Hg and they are at a high health risk.

Dioxin leaching risk assessment through selected soils by estimating distribution coefficient and breakthrough curves.

From health and environmental point of views, dioxins are important due to their toxicity and persistence. Dioxins have the potential to reside in the environment for longer time if sorbed onto the clay and organic content of the soil matrix. Their transport or leaching under certain environmental conditions such as preferential flow can increase the risk of groundwater contamination. In the current study, breakthrough curves (BTCs) against time were plotted for selected dioxin transport prediction; based on measured distribution coefficient (Kd), dispersion coefficient (D), and retardation factor (R). Three representative soil series named Burhan, Warsak, and Kunda were selected. For dibenzo-p-dioxin (DD), Kd values followed the order as: Burhan> Warsak > Kunda, while for 2-chloro dibenzo-p-dioxin (2 Cl-DD), Kd values followed an order as: Kunda > Burhan > Warsak. Dioxin transport was measured at two different linear velocities (20 and 50 cm day-1). Attainment of equilibrium was verified to be dependent upon the Kd, R, D, and chlorination on dioxin. Kunda series with low OM (0.6%), clay (0.2%), and R (377) was found to have relatively high DD transport potential under normal velocity, due to high dispersion values for its sandy nature. Under the steady or preferential flow conditions, all the plots obtained were identical irrespective of soil type and dioxin nature.

Arsenic and heavy metals contamination, risk assessment and their source in drinking water of the Mardan District, Khyber Pakhtunkhwa, Pakistan.

The present study was conducted to investigate the physico-chemical characteristics in drinking water of Mardan District, Pakistan. Furthermore, water quality was evaluated for the risk assessment of arsenic and heavy metals (HMs) and their contamination sources. Representative groundwater samples of shallow and deep sources were collected in the study area. These samples were analyzed for physical parameters, anions, light metals (LMs) and HMs. Results were compared with the drinking water guideline values set by the World Health Organization and the US Environmental Protection Agency. Average concentrations of anions, LMs and HMs were found within the maximum allowable contaminant levels except for bicarbonates, Fe, Cu, and Pb. Results revealed that hazard quotients >1 were observed for shallow groundwater for 10% samples only, suggesting potential health risk from water consumption. Correlation analysis and principal component analysis showed a relationship among various physico-chemical parameters in both shallow and deep groundwater. Statistical analyses suggested the geogenic and anthropogenic sources for possible enhancement of various physico-chemical parameters in the aquifer system of the study area.

Wild plant assessment for heavy metal phytoremediation potential along the mafic and ultramafic terrain in northern Pakistan.

This study investigates the wild plant species for their phytoremediation potential of macro and trace metals (MTM). For this purpose, soil and wild plant species samples were collected along mafic and ultramafic terrain in the Jijal, Dubair, and Alpuri areas of Kohistan region, northern Pakistan. These samples were analyzed for the concentrations of MTM (Na, K, Ca, Mg, Fe, Mn, Pb, Zn, Cd, Cu, Cr, Ni, and Co) using atomic absorption spectrometer (AAS-PEA-700). Soil showed significant (P < .001) contamination level, while plants had greater variability in metal uptake from the contaminated sites. Plant species such as Selaginella jacquemontii, Rumex hastatus, and Plectranthus rugosus showed multifold enrichment factor (EF) of Fe, Mn, Cr, Ni, and Co as compared to background area. Results revealed that these wild plant species have the ability to uptake and accumulate higher metals concentration. Therefore, these plant species may be used for phytoremediation of metals contaminated soil. However, higher MTM concentrations in the wild plant species could cause environmental hazards in the study area, as selected metals (Fe, Mn, Cr, Ni, Co, and Pb) have toxicological concerns.