Auxiliary-cavity-enhanced quantum estimation of optorotational-coupling strength.

A scheme is proposed to achieve significantly enhanced quantum estimation of optorotational-coupling (ORC) strength by coupling a driven auxiliary cavity to a Laguerre-Gaussian (L-G) rotational cavity, where the ORC originates from the exchange of orbital angular momentum between a L-G light and rotational mirror. The results indicate that, by appropriately designing the auxiliary-cavity mechanism, the estimation error of the ORC parameter is significantly reduced, and revealing the estimation precision has a much stronger thermal noise and dissipation robustness in comparison with the unassisted case. Our study paves the way toward achieving high-precision quantum sensors.

Cobalt oxide modified sulfur and phosphorus Co-doped g-C3N4 for screening of urinary human albumin.

The fabrication of a heteroatom-doped nanocomposite based on cobalt oxide modified sulfur, phosphorus co-doped carbon nitride (Co3O4/SP-CN) with increased active sites is reported. The synthesized nanocomposite offers surprisingly high electrocatalytic oxidation efficacy toward human albumin (HA) despite its agglomeration. This improved efficacy of Co3O4/SP-CN nanocomposite could be attributed to its increased adsorption sites and surface defects, fast charge transportation capability, and conductivity. Additionally, morphological and compositional analysis of the fabricated Co3O4/SP-CN material has been performed  through scanning electron microscopy (SEM), X-ray diffraction (XRD), X-ray photon spectroscopy (XPS), and Raman spectroscopy. The fabricated electrode shows remarkable amperometric response against the HA with a limit of detection of 8.39 nM and linear range of 20-4000 nM at applied potential of 0.25 V versus Ag/AgCl in 0.1 M PBS (pH 8.2). The designed Co3O4/SP-CN electrode has been successfully applied to monitor HA in  urine samples of diabetic patient with recovery percentage from 94.1 and 92.1% and with relative standard deviation (RSD) values of 5.8 and 7.8%. According to the best of our knowledge, this is the first report to use a Co3O4/SP-CN-based graphitic pencil (GP) electrode for monitoring of HA for early diagnosis of diabetic nephropathy.

In-situ synthesized ZIF-67 graphene oxide (ZIF-67/GO) nanocomposite for efficient individual and simultaneous detection of heavy metal ions.

Heavy metals are ubiquitous in water bodies as a result of anthropogenic activities and over time they accumulate in body thus posing serious health problems. Therefore, it is essential to improve sensing performance, for determination of heavy metal ions (HMIs), of electrochemical sensors. In this work, cobalt-derived MOF (ZIF-67) was in-situ synthesized and incorporated onto the surface of graphene oxide (GO) by simple sonication method. The prepared material (ZIF-67/GO) was characterized by FTIR, XRD, SEM, and Raman spectroscopy. Afterwards, a sensing platform was made by drop-casting synthesized composite onto glassy carbon electrode for individual and simultaneous detection of heavy metal ions pollutants (Hg2+, Zn2+, Pb2+, and Cr3+) with estimated detection limits of 2 nM, 1 nM, 5 nM, and 0.6 nM, respectively, when determined simultaneously, that are below the permissible limit by World Health Organization. To the best of our knowledge, this is first report of HMIs detection by ZIF-67 incorporated GO sensor which can successfully determine the Hg+2, Zn+2, Pb+2, and Cr+3 ions simultaneously with lower detection limits.

Black phosphorus nanosheets/poly(allylamine hydrochloride) based electrochemical immunosensor for the selective detection of human epididymis protein 4.

In this work, an electrochemical immunosensor based on black phosphorus nanosheets (BPNS)/poly(allylamine hydrochloride) (PAH) nanocomposite modified glassy carbon electrode was developed for the detection of ovarian cancer biomarker HE4. PAH has been applied to retain BPNS in its original honeycomb structure and to anchor biomolecules electrostatically on the transducer surface. The as synthesized nanocomposite was characterized by zeta potential analysis, scanning electron microscopy, x-ray photoelectron spectroscopy, transmission electron microscopy, high-resolution transmission electron microscopy. Subsequently, the performance of the electrochemical immunosensor was evaluated through cyclic voltammetry, differential pulse voltammetry and electrochemical impedance spectroscopy. Under the optimal condition, the developed electrochemical immunosensor permitted to detect HE4 with a linear range of 0.1-300 ng ml-1and a detection limit of 0.01 ng ml-1. The developed sensor exhibited good selectivity and specificity to HE4 with negligible interference effect from common biomolecules like bovine serum albumin, lysozyme, protamine, glucose, fructose, hemoglobin and fetal bovine serum. Further, practical application of developed electrochemical immunosensor was demonstrated in spiked human serum which showed satisfactory recovery percentages.

Non-enzymatic electrochemical sensing of dopamine from COVID-19 quarantine person.

The worldwide outbreak of COVID-19 pandemic, is not only a great threat to the victim life but it is leaving invisible devastating negative affect on mental health of quarantined individual because of isolation, depression, bereavement, and loss of income. Therefore, the precise monitoring catecholamine neurotransmitters specifically of dopamine (DA) is of great importance to assess the mental health. Thus, herein we have synthesized Co-based zeolitic imidazolate framework (ZIF-67) through solvothermal method for precise monitoring of DA. To facilitate the fast transportation of ions, highly conductive polymer, poly(3,4-ethylenedioxythiophene; PEDOT) has been integrated on the surface of ZIF-67 which not only provides the smooth pathway for ions/electrons transportation but also saves the electrode from pulverization. The fabricated ZIF-67/PEDOT electrode shows a significant sensing performance towards DA detection in terms of short diffusion pathways by expositing more active sites, over good linear range (15-240 µM) and a low detection limit of (0.04 µM) even in the coexistence of the potentially interfering molecules. The developed ZIF-67/PEDOT sensor was successfully employed for sensitive and selective monitoring of DA from COVID-19 quarantined person blood, thus suggesting reliability of the developed electrode.

Probing 4-(diethylamino)-salicylaldehyde-based thiosemicarbazones as multi-target directed ligands against cholinesterases, carbonic anhydrases and α-glycosidase enzymes.

With the fading of 'one drug-one target' approach, Multi-Target-Directed Ligands (MTDL) has become a central idea in modern Medicinal Chemistry. The present study aimed to design, develop and characterize a novel series of 4-(Diethylamino)-salicylaldehyde based thiosemicarbazones (3a-p) and evaluates their biological activity against cholinesterase, carbonic anhydrases and α-glycosidase enzymes. The hCA I isoform was inhibited by these novel 4-(diethylamino)-salicylaldehyde-based thiosemicarbazones (3a-p) in low nanomolar levels, the Ki of which differed between 407.73 ± 43.71 and 1104.11 ± 80.66 nM. Against the physiologically dominant isoform hCA II, the novel compounds demonstrated Kis varying from 323.04 ± 56.88 to 991.62 ± 77.26 nM. Also, these novel 4-(diethylamino)-salicylaldehyde based thiosemicarbazones (3a-p) effectively inhibited AChE, with Ki values in the range of 121.74 ± 23.52 to 548.63 ± 73.74 nM. For BChE, Ki values were obtained with in the range of 132.85 ± 12.53 to 618.53 ± 74.23 nM. For α-glycosidase, the most effective Ki values of 3b, 3k, and 3g were with Ki values of 77.85 ± 10.64, 96.15 ± 9.64, and 124.95 ± 11.44 nM, respectively. We have identified inhibition mechanism of 3b, 3g, 3k, and 3n on α-glycosidase AChE, hCA I, hCA II, and BChE enzyme activities. Hydrazine-1-carbothioamide and hydroxybenzylidene moieties of compounds play an important role in the inhibition of AChE, hCA I, and hCA II enzymes. Hydroxybenzylidene moieties are critical for inhibition of both BChE and α-glycosidase enzymes. The findings of in vitro and in silico evaluations indicate 4-(diethylamino)-salicylaldehyde-based thiosemicarbazone scaffold to be a promising hit for drug development for multifactorial diseases like Alzheimer's disease.

Carbon-dot wrapped ZnO nanoparticle-based photoelectrochemical sensor for selective monitoring of H2O2 released from cancer cells.

This study reports on a simple approach for the fabrication of an electrode modified with biocompatible C-dot wrapped ZnO nanoparticles for selective photoelectrochemical monitoring of H2O2 released from living cells. The biocompatibility of the ZnO nanoparticles was confirmed through in-vitro cellular testing using the MTT assay on Huh7 cell lines. The ZnO nanoparticles wrapped with dopamine-derived C-dots possess numerous catalytically active sites, excessive surface defects, good electrical conductivity, and efficient separation ability of photo-induced electrons and holes. These properties offer highly sensitive and selective non-enzymatic photo-electrochemical monitoring of H2O2 released from HeLa cells after stimulation with N-formylmethionyl-leucyl-phenylalanine. The sensor has a wide linear range (20-800 nM), low detection limit (2.4 nM), and reliable reproducibility, this implying its suitability for biological and biomedical applications. Graphical abstract Schematic of the fabrication of ZnO nanoparticles by using a plant extract as a reducing agent. Wrapping of ZnO with C-dots enhances the photoelectrocatalytic efficacy. Sensitive and selective photoelectrochemical monitoring of H2O2 released from cancer cells is demonstrated.

Assessment of knowledge, attitude and practice towards hepatitis among patients visiting the hepatitis clinic in tertiary care hospital, Rawalpindi, Pakistan.

OBJECTIVE: To assess the knowledge, attitude and practice of hepatitis B and C patients towards the disease. METHODS: The cross-sectional, descriptive, questionnaire-based study was conducted at the Rawalpindi Medical University (RMU) and its allied hospitals, Rawalpindi, Pakistan, from October to December 2017, and comprised hepatitis B and C patients aged ≥18 years who were visiting the outpatient department. A structured, close-ended, 30-item questionnaire was used to collect data which was then analysed using SPSS 23. . RESULTS: Of the 399 patients, 230(57.6%) were women, 103(26%) did not have any formal education, and TV, radio and the internet was the main source of information regarding hepatitis for 138(34.6%) patients. The overall mean age was 42.82}11.78 years. The sample showed poor knowledge with a mean score of 7.33}2.03, adequate attitude with a mean of 4.33}1.19, and poor practice with a mean of 2.97}1.05. Correlation was statistically significant between knowledge and practice (p<0.01). CONCLUSIONS: Lack of imperative knowledge of hepatitis in patients was the main reason for negative attitude and poor practices.

Design of Gravel-Sand Filter for Arsenic Removal: A Case Study of Muzaffargarh District in Pakistan.

Arsenic decontamination of drinking water has grabbed significant attention due to arsenic's serious effects on health. A novel gravel-sand filter (GSF) holding zero-valent iron plates was designed and constructed in Muzaffargarh district (Pakistan) for arsenic removal from drinking water with lower iron concentration (0.3 ppm). The GSF efficiently removed arsenic up to 99.99% with long-term stability. The GSF provides 800 liters of arsenic-free drinking water in 39 hours with a rate of 2.5 L/h. A tentative mechanism for arsenic removal is evaluated and described on the basis of oxidation-coagulation-adsorption processes. Chemical composition of underground water is also analyzed and discussed. This GSF design will open a new avenue for arsenic removal and can be extended to other parts of the world.

Evaluation of the antibacterial activity of selected Pakistani honeys against multi-drug resistant Salmonella typhi.

BACKGROUND: The development of resistance to conventional anti-typhoid drugs and the recent emergence of fluoroquinolone resistance have made it very difficult and expensive to treat typhoid fever. As the therapeutic strategies become even more limited, it is imperative to investigate non-conventional modalities. In this context, honey is a potential candidate for combating antimicrobial resistance because it contains a broad repertoire of antibacterial compounds which act synergistically at multiple sites, thus making it less likely that the bacteria will become resistant. The in vitro antibacterial activity of 100 unifloral honey samples against a blood culture isolate of multi-drug resistant (MDR) Salmonella typhi were investigated. METHODS: All honey samples were evaluated for both total (acidity, osmolarity, hydrogen peroxide and non-peroxide activity) and plant derived non-peroxide antibacterial activity by agar well diffusion assay at 50% and 25% dilution in sterile distilled water and 25% in catalase solution. Manuka (Unique Manuka Factor-21) honey was used for comparison. The phenol equivalence of each honey sample from 2% to 7% (w/v) phenol was obtained from regression analysis. The antibacterial potential of each honey sample was expressed as its equivalent phenol concentration. The honey samples which showed antibacterial activity equivalent to or greater than manuka honey were considered therapeutically active honeys. RESULTS: Nineteen honey samples (19%) displayed higher hydrogen peroxide related antibacterial activity (16-20% phenol), which is more than that of manuka honey (21-UMF). A total of 30% of the honey samples demonstrated antibacterial activity between 11 and 15% phenol similar to that of manuka honey while 51% of the honey samples did not exhibit any zone of inhibition against MDR-S. typhi at 50% (w/v) dilution. None of the indigenous honey samples displayed non-peroxide antibacterial activity. Only manuka honey showed non-peroxide antibacterial activity at 25% dilution (w/v) in catalase solution. CONCLUSIONS: The honey samples which displayed antibacterial activity equal to or greater than manuka honey may be useful in the clinical conditions where higher hydrogen peroxide related antibacterial activity is required. Manuka honey, which is known to possess non-peroxide antibacterial activity, warrants further evaluation in a suitable typhoid animal model.

Diagnosis of ''Helicobacter pylori infection of the gastric biopsy'' by rapid urease test, histopathology and Raman spectroscopy.

This study aim to investigate the diagnostic potential of Raman spectroscopy in comparison with rapid urease test and histopathology in diagnosis of H. pylori infection. A comparative study was conducted at Pathology Laboratory and a total of 94 samples were collected from patients based on Rome IV criteria. Sensitivity, specificity and accuracy of histopathology, rapid urease test and for Raman spectroscopy were investigated. Rapid urease test showed 23 false negative results of H. pylori as compared to Raman spectroscopy and histopathology. We concluded that Raman spectroscopy showed sensitivity (94.5%), accuracy (94.0%) and specificity of (87.5%) in the diagnosis of H. pylori infection. However rapid urease test showed specificity of 92.5% while low sensitivity 75%, and 78% accuracy as compared to Raman spectroscopy and histopathology . This study illustrates the applicability of Raman spectroscopy as a potent innovative detection tool for the molecular detection of H. pylori infection in gastritis.

Genomic blueprints of soybean (Glycine max) pathogen resistance: revealing the key genes for sustainable agriculture.

Soybean (Glycine max ) is an important oilseed, protein and biodiesel crop. It faces significant threats from bacterial, fungal and viral pathogens, which cause economic losses and jeopardises global food security. In this article, we explore the relationship between soybeans and these pathogens, focusing on the molecular responses that are crucial for soybeans defence mechanisms. Molecular responses involve small RNAs and specific genes, including resistance (R) genes that are pivotal in triggering immune responses. Functional genomics, which makes use of cutting-edge technologies, such as CRISPR Cas9 gene editing, allows us to identify genes that provide insights into the defence mechanisms of soybeans with the focus on using genomics to understand the mechanisms involved in host pathogen interactions and ultimately improve the resilience of soybeans. Genes like GmKR3 and GmVQ58 have demonstrated resistance against soybean mosaic virus and common cutworm, respectively. Genetic studies have identified quantitative trait loci (QTLs) including those linked with soybean cyst nematode, root-knot nematode and Phytophthora root and stem rot resistance. Additionally, resistance against Asian soybean rust and soybean cyst nematode involves specific genes and their variations in terms of different copy numbers. To address the challenges posed by evolving pathogens and meet the demands of a growing population, accelerated soybean breeding efforts leveraging functional genomics are imperative. Targeted breeding strategies based on a deeper understanding of soybean gene function and regulation will enhance disease resistance, ensuring sustainable agriculture and global food security. Collaborative research and continued technological advancements are crucial for securing a resilient and productive agricultural future.

A novel methodology for stabilization of silver nanoparticles on cotton, nylon and cotton/nylon fabrics using chitosan and triethyl orthoformate for enhanced and elongated antibacterial performance.

In the present study, the commercially available three different fabrics cotton, nylon and cotton/nylon were modified by chitosan and silver nanoparticles using a crosslinker triethyl orthoformate (TEOF). Resulted cotton­silver (Ag-Cs-Cot), nylon­silver (Ag-Cs-Nyl) and cotton-nylon silver (Ag-Cs-Cot-Nyl) fabrics showed significant anti-bacterial activity even after 50 washing cycles. Silver nanoparticles were prepared by reducing silver nitrate through sodium borohydride at 0 °C. In FTIR spectra the peak at near 1650 cm-1 confirmed that TEOF mediated attachment of chitosan with fabrics (due to C=N) and the stretching of secondary amine near the 3375 cm-1 indicated the silver attachment to the amine group of the chitosan. In Scanning Electron Microscope (SEM) images smooth surfaces of fabrics without any damage by modification process were observed. The antibacterial activity was Analyzed by agar diffusion and broth dilution assays against Escherichia coli and Staphylococcus aureus bacterial strains and results showed 90% bacterial inhibition against E. coli and 89% bacterial inhibition against S. aureus. For testing the antibacterial durability, the modified fabrics were washed with non-ionic detergent (10g/l) for 15 minutes under aggressive stirring (100 rpm) at room temperature. The modified fabrics retained antibacterial activity over the 50 washing cycles. Finally, the commercial potential of cotton-silver fabric was evaluated by stitching it with the socks of football players and interestingly results showed that the modified fabric on the socks showed more than 90% bacterial inhibition as compared to the plain fabric after 70 minutes of playing activity.

Machine learning powered CN-coordinated cobalt nanoparticles embedded cellulosic nanofibers to assess meat quality via clenbuterol monitoring.

The World Anti-Doping Agency (WADA) has prohibited the use of clenbuterol (CLN) because it induces anabolic muscle growth while potentially causing adverse effects such as palpitations, anxiety, and muscle tremors. Thus, it is vital to assess meat quality because, athletes might have positive test for CLN even after consuming very low quantity of CLN contaminated meat. Numerous materials applied for CLN monitoring faced potential challenges like sluggish ion transport, non-uniform ion/molecule movement, and inadequate electrode surface binding. To overcome these shortcomings, herein we engineered bimetallic zeolitic imidazole framework (BM-ZIF) derived N-doped porous carbon embedded Co nanoparticles (CN-CoNPs), dispersed on conductive cellulose acetate-polyaniline (CP) electrospun nanofibers for sensitive electrochemical monitoring of CLN. Interestingly, the smartly designed CN-CoNPs wrapped CP (CN-CoNPs-CP) electrospun nanofibers offers rapid diffusion of CLN molecules to the sensing interface through amine and imine groups of CP, thus minimizing the inhomogeneous ion transportation and inadequate electrode surface binding. Additionally, to synchronize experiments, machine learning (ML) algorithms were applied to optimize, predict, and validate voltametric current responses. The ML-trained sensor demonstrated high selectivity, even amidst interfering substances, with notable sensitivity (4.7527 µA/µM/cm2), a broad linear range (0.002-8 µM), and a low limit of detection (1.14 nM). Furthermore, the electrode exhibited robust stability, retaining 98.07% of its initial current over a 12-h period. This ML-powered sensing approach was successfully employed to evaluate meat quality in terms of CLN level. To the best of our knowledge, this is the first study of using ML powered system for electrochemical sensing of CLN.

Second-generation surveillance for HIV/AIDS in Pakistan: results from the 4th round of Integrated Behavior and Biological Survey 2011-2012.

OBJECTIVES: In an effort to fully analyse and understand the HIV situation and its epidemiology in Pakistan, a bilateral collaboration between the National AIDS Control Program and the Canadian International Development Agency resulted in the establishment of an effective second-generation surveillance (SGS) system for HIV/AIDS between 2004 and 2012 in accordance with the published guidelines. This paper presents findings from the 4th round of SGS. METHODS: A mapping exercise was initially conducted for size estimations of the key vulnerable populations: people who inject drugs (PWIDs), male sex workers (MSWs), hijra sex workers (HSWs), and female sex workers (FSWs), followed by an Integrated Behavioral and Biological Surveillance in 20 selected cities across Pakistan. RESULTS: The estimated sizes of the four key populations mapped in the 20 cities were 89 178 FSWs, 46 351 PWIDs, 23 317 HSWs and 19 119 MSWs. The HIV sero-prevalence among PWIDs was the highest among all key populations surveyed at 37.8% (CI 37.3 to 38.3) nationally, followed by a prevalence of 7.2% (CI 6.8 to 7.5) among HSWs, 3.1% (CI 2.8 to 3.4) among MSWs and 0.8% (CI 0.4 to 1.0) for FSWs. Various key risk behaviours, that is, sharing of syringes by PWIDs and inconsistent use of condoms by sex workers, were documented. CONCLUSIONS: Pakistan's HIV epidemic that once was characterised primarily by transmission among PWIDs is now increasingly characterised by significant sexual transmission, and all types of sex workers (male, hijra and female) exhibit epidemiological proportions of infection. There is a need to develop concrete strategic plans for each vulnerable subpopulation, initially focusing prevention resources on those with a higher risk or vulnerability.

The organisation, operational dynamics and structure of female sex work in Pakistan.

BACKGROUND: Pakistan is known to have large populations of female sex workers (FSWs) with considerable geographic heterogeneity in their characteristics. In this paper, we describe the social organisation and structural patterns of female sex work in different geographic regions of Pakistan. METHODS: We report geographic and network mapping data collected among FSWs in 15 cities across Pakistan in 2011 as part of the Canada-Pakistan HIV/AIDS Surveillance Project. RESULTS: A total number of 89 178 FSWs were estimated in the target cities for an average of 7.2 FSWs per 1000 adult males. 55% of the estimated number of FSWs concentrated in Karachi and Lahore. Based on the operations of female sex work, two major typologies of FSWs were identified: establishment-based and non-establishment-based. FSWs were further subtyped into those operating through brothels, homes, kothikhanas, streets and by cell phone. Cities varied considerably in terms of predominance of different FSW typologies. CONCLUSIONS: There is considerable heterogeneity among FSWs in Pakistan, geographically and in terms of operational typology. Understanding the social organisation of sex work and the influence of social-cultural and legal factors in Pakistan is essential for the design of HIV prevention programmes and other services for FSWs.

The size and distribution of key populations at greater risk of HIV in Pakistan: implications for resource allocation for scaling up HIV prevention programmes.

BACKGROUND: With competing interests, limited funding and a socially conservative context, there are many barriers to implementing evidence-informed HIV prevention programmes for sex workers and injection drug users in Pakistan. Meanwhile, the HIV prevalence is increasing among these populations across Pakistan. We sought to propose and describe an approach to resource allocation which would maximise the impact and allocative efficiency of HIV prevention programmes. METHODS: Programme performance reports were used to assess current resource allocation. Population size estimates derived from mapping conducted in 2011 among injection drug users and hijra, male and female sex workers and programme costs per person documented from programmes in the province of Sindh and also in India were used to estimate the cost to deliver services to 80% of these key population members across Pakistan. Cities were prioritised according to key population size. RESULTS: To achieve 80% population coverage, HIV prevention programmes should be implemented in 10 major cities across Pakistan for a total annual operating cost of approximately US$3.5 million, which is much less than current annual expenditures. The total cost varies according to the local needs and the purchasing power of the local currency. CONCLUSIONS: By prioritising key populations at greatest risk of HIV in cities with the largest populations and limited resources, may be most effectively harnessed to quell the spread of HIV in Pakistan.

Nasal and perirectal colonization of vancomycin sensitive and resistant enterococci in patients of paediatrics ICU (PICU) of tertiary health care facilities.

BACKGROUND: Enterococci normally inhabit the intestinal tract of humans and are also a potential pathogen in causing nosocomial infections. The increase in antibiotic resistance and transfer of antibiotic resistance gene to Staphylococcus aureus (S. aureus) due to co-colonization has increased its importance in research. The aim of the study was to evaluate local epidemiology of nasal and rectal colonization with Enterococcus faecalis (E. faecalis) and Enterococcus faecium (E. faecium) in patients of Paediatrics Intensive Care Unit (PICU) and correlation with clinical and socioeconomic factors. METHODS: The nasal and perirectal swab samples were collected from 110 patients admitted in PICUs of three tertiary care hospitals of Rawalpindi Medical College, Pakistan. The identification of enterococci was done by biochemical tests and by PCR for ddl, vanA and vanB genes. Antibiotic susceptibility testing was performed by disc diffusion and MICs were determined for vancomycin, tetracycline, ciprofloxacin and oxacillin only. RESULTS: Out of 220 nasal and perirectal samples, 09 vancomycin-resistant enterococci (VRE) and 76 vancomycin-susceptible enterococci (VSE), consisting of 40 E. faecalis and 45 E. faecium were isolated. PCR successfully identified both species with ddl primers and VRE with vanA primer. With disc diffusion method, all isolates were resistant to most of the antibiotics tested except linezolid, quinupristin/dalfopristin, teicoplanin and vancomycin. VRE showed resistance to teicoplanin and vancomycin both and none was resistant to linezolid and quinupristin/dalfopristin. Generally, E. faecium isolates were more resistant than E. faecalis. MICs of vancomycin for nasal and perirectal VRE were 512 mg/L and 64 to 512 mg/L respectively. VRE were more in patients with prolonged hospitalization, from urban localities and those having pneumonia. CONCLUSION: Present study reveals high colonization and antibiotic resistance in enterococcal isolates from nasal and perirectal area. Nasal colonization by enterococci in PICU is more alarming as VRE may cause infection and can transfer this resistance gene to other microorganisms like S. aureus.

Prevalence of undifferentiated fever in adults of Rawalpindi having primary dengue fever.

The objectives of the study were to highlight early subclinical presentation of dengue viral infection (DVI) as an undifferentiated febrile illness. The descriptive cross-sectional study was carried out at Microbiology Department, Rawalpindi Medical College from March to September 2009. Stratified random sampling was used to select subjects from various urban and rural areas of Rawalpindi, and Serum IgG anti-dengue antibodies were detected by using 3rd generation enzyme-linked immunosorbent assay (ELISA). Out of the total 240 subjects, 69 (28.75%) were found to be positive for anti-dengue IgG antibodies. Of the positive cases, 41 (59.4%) - comprising 31 (44.9%) urban residents - and 10 (14.4%) rural residents presented with a previous history of undifferentiated fever (p<0.05). It was concluded that primary DVI can present as subclinical form in healthy population residing in rural and urban areas of Rawalpindi, which is an alarming situation indicating the spread of disease in the study area.

In vitro synergistic effect of ciprofloxacin with aminoglycosides against multidrug resistant-Pseudomonas aeruginosa.

UNLABELLED: Pseudomonas aeruginosa is an increasingly prevalent nosocomial human pathogen. Infections with multidrug-resistant (MDR) P. aeruginosa are currently a treatment challenge and requires search for better treatment options. PURPOSE OF STUDY: To determine in vitro synergistic effect of ciprofloxacin in combination with amikacin and gentamicin against MDR P. aeruginosa clinical isolates. METHODS: Antibiotic resistance pattern of 100 identified clinical isolates of P. aeruginosa was determined against eight antibiotics by disc diffusion method at Microbiology Laboratory, Holy Family Hospital, Rawalpindi. For 30 selected MDR isolates, minimum inhibitory concentrations (MICs) of amikacin and gentamicin were determined separately by agar diffusion method followed by combined activity of ciprofloxacin with amikacin and gentamicin by checkerboard agar dilution technique. RESULTS: Antibiotic resistance pattern of P. aeruginosa isolates was; gentamicin and carbenicillin (94%), amikacin and piperacillin (92%), ceftazidime (90%), colistin (87%), ciprofloxacin (79%) and imipenem (72%). MICs against 30 selected MDR isolates ranged from 32 to >128µg/mL for amikacin, and >128µg/mL for gentamicin. Synergistic effect was observed in 12/30(40%) isolates for AK+CIP and in 05/30 (16.7%) for CN+CIP. CONCLUSION: Ciprofloxacin in combination with amikacin and gentamicin showed synergistic effect and no antagonistic effect against MDR P. aeruginosa.