JA-Regulated AaGSW1-AaYABBY5/AaWRKY9 Complex Regulates Artemisinin Biosynthesis in Artemisia annua.

Artemisinin, a sesquiterpene lactone obtained from Artemisia annua, is an essential therapeutic against malaria. YABBY family transcription factor AaYABBY5 is an activator of AaCYP71AV1 (cytochrome P450-dependent hydroxylase) and AaDBR2 (double-bond reductase 2); however, the protein-protein interactions of AaYABBY5, as well as the mechanism of its regulation, have not yet been elucidated. AaWRKY9 protein is a positive regulator of artemisinin biosynthesis that activates AaGSW1 (glandular trichome-specific WRKY1) and AaDBR2 (double-bond reductase 2). In this study, YABBY-WRKY interactions are revealed to indirectly regulate artemisinin production. AaYABBY5 significantly increased the activity of the luciferase (LUC) gene fused to the promoter of AaGSW1. Toward the molecular basis of this regulation, AaYABBY5 interaction with AaWRKY9 protein was found. The combined effectors AaYABBY5 + AaWRKY9 showed synergistic effects toward the activities of AaGSW1 and AaDBR2 promoters, respectively. In AaYABBY5 overexpression plants, the expression of GSW1 was found to be significantly increased when compared to that of AaYABBY5 antisense or control plants. In addition, AaGSW1 was identified as an upstream activator of AaYABBY5. Further, it was found that AaJAZ8, a transcriptional repressor of jasmonate signaling, interacted with AaYABBY5 and attenuated its activity. Co-expression of AaYABBY5 and anti-AaJAZ8 in A. annua increased the activity of AaYABBY5 toward artemisinin biosynthesis. This current study provides the first indication of the molecular basis of regulation of artemisinin biosynthesis through YABBY-WRKY interactions, which are regulated through AaJAZ8. This knowledge presents AaYABBY5 overexpression plants as a powerful genetic resource for artemisinin biosynthesis.

Integrated metasurface for efficient polarization conversion and high-gain, low-RCS EM radiation.

This paper presents an innovative design that combines the functionalities of a polarization convertor and an electromagnetic (EM) radiator into a single integrated metasurface. The metasurface consists of two identical metallic split-rings, a circular-shaped patch structure, a dielectric layer, and a reflective metallic ground. The polarization convertor component efficiently converts waves polarized in the x- or y-direction into cross-polarized waves within a frequency range of 8-13 GHz. It exhibits wideband resonances and achieves a high conversion efficiency. In the context of low-observable platforms, traditional high-gain antennas often suffer from a large radar cross section (RCS). To overcome this challenge, the same metasurface is utilized for EM radiation, enabling a high gain of 16.5 dBi while maintaining a low RCS. This is accomplished by strategically rotating the double-slotted metallic split-rings at 90 ∘, 180 ∘, and 270 ∘ in four distinct regions. Through this rotation, destructive interference cancellation occurs, resulting in wideband reduction of the RCS. Experimental results validate the effectiveness of the proposed metasurface in serving both applications, namely polarization conversion and EM radiation.

Molecular approaches to enhance astaxanthin biosynthesis; future outlook: engineering of transcription factors in Haematococcus pluvialis.

Microalgae are the preferred species for producing astaxanthin because they pose a low toxicity risk than chemical synthesis. Astaxanthin has multiple health benefits and is being used in: medicines, nutraceuticals, cosmetics, and functional foods. Haematococcus pluvialis is a model microalga for astaxanthin biosynthesis; however, its natural astaxanthin content is low. Therefore, it is necessary to develop methods to improve the biosynthesis of astaxanthin to meet industrial demands, making its commercialization cost-effective. Several strategies related to cultivation conditions are employed to enhance the biosynthesis of astaxanthin in H. pluvialis. However, the mechanism of its regulation by transcription factors is unknown. For the first time, this study critically reviewed the studies on identifying transcription factors, progress in H. pluvialis genetic transformation, and use of phytohormones that increase the gene expression related to astaxanthin biosynthesis. In addition, we propose future approaches, including (i) Cloning and characterization of transcription factors, (ii) Transcriptional engineering through overexpression of positive regulators or downregulation/silencing of negative regulators, (iii) Gene editing for enrichment or deletion of transcription factors binding sites, (iv) Hormonal modulation of transcription factors. This review provides considerable knowledge about the molecular regulation of astaxanthin biosynthesis and the existing research gap. Besides, it provides the basis for transcription factors mediated metabolic engineering of astaxanthin biosynthesis in H. pluvialis.

Enhancing osteoblast differentiation through small molecule-incorporated engineered nanofibrous scaffold.

OBJECTIVE: This study aimed to investigate the effect of small molecules incorporated into the engineered nanofibrous scaffold to enhance the osteoblast differentiation MATERIALS AND METHODS: Poly-ε-caprolactone (PCL) nanofiber matrices with lithium chloride (LiCl) were fabricated using the electrospinning technique. Scaffolds were characterized using scanning electron microscopy (SEM) and energy-dispersive X-ray (EDX). Scaffolds were seeded with MC3T3-E1 cells and assessed using Western blots (ß-catenin), alamarBlue assay (proliferation), qPCR (osteoblast differentiation), and mineralization (Alizarin Red staining). RESULTS: We observed LiCl nanofiber scaffolds induced concentration-dependent cell proliferation that correlated with an increased ß-catenin expression indicating sustained Wnt signaling. Next, we examined osteoblast differentiation markers such as osteocalcin (OCN) and Runt-related transcription factor 2 (Runx2) and noted increased expression in LiCl nanofiber scaffolds. We also noted increased bone morphogenetic protein (BMP-2, 4, and 7) expressions suggesting activated Wnt can promote cures to further osteogenic differentiation. Finally, Alizarin Red staining demonstrated increased mineral deposition in LiCl-incorporated nanofiber scaffolds. CONCLUSIONS: Together, these results indicated that LiCl-incorporated nanofiber scaffolds enhance osteoblast differentiation. CLINICAL RELEVANCE: Small molecule-incorporated nanofibrous scaffolds are an innovative clinical tool for bone tissue engineering.

Heterogeneous Diffusion and Nonlinear Advection in a One-Dimensional Fisher-KPP Problem.

The goal of this study is to provide an analysis of a Fisher-KPP non-linear reaction problem with a higher-order diffusion and a non-linear advection. We study the existence and uniqueness of solutions together with asymptotic solutions and positivity conditions. We show the existence of instabilities based on a shooting method approach. Afterwards, we study the existence and uniqueness of solutions as an abstract evolution of a bounded continuous single parametric (t) semigroup. Asymptotic solutions based on a Hamilton-Jacobi equation are then analyzed. Finally, the conditions required to ensure a comparison principle are explored supported by the existence of a positive maximal kernel.

The ameliorative effects of exogenous inoculation of Piriformospora indica on molecular, biochemical and physiological parameters of Artemisia annua L. under arsenic stress condition.

Aim of the current study was to investigate the effect of exogenously inoculated root endophytic fungus, Piriformospora indica, on molecular, biochemical, morphological and physiological parameters of Artemisia annua L. treated with different concentrations (0, 50, 100 and 150 µmol/L) of arsenic (As) stress. As was significantly accumulated in the roots than shoots of P. indica-inoculated plants. As accumulation and immobilization in the roots is directly associated with the successful fungal colonization that restricts most of As as compared to the aerial parts. A total of 4.1, 11.2 and 25.6 mg/kg dry weight of As was accumulated in the roots of inoculated plants supplemented with 50, 100 and 150 µmol/L of As, respectively as shown by atomic absorption spectroscopy. P. indica showed significant tolerance in vitro to As toxicity even at high concentration. Furthermore, flavonoids, artemisinin and overall biomass were significantly increased in inoculated-stressed plants. Superoxide dismutase and peroxidase activities were increased 1.6 and 1.2 fold, respectively under 150 µmol/L stress in P. indica-colonized plants. Similar trend was followed by ascorbate peroxidase, catalase and glutathione reductase. Like that, phenolic acid and phenolic compounds showed a significant increase in colonized plants as compared to their respective control/un-colonize stressed plants. The real-time PCR revealed that transcriptional levels of artemisinin biosynthesis genes, isoprenoids, terpenes, flavonoids biosynthetic pathway genes and signal molecules were prominently enhanced in inoculated stressed plants than un-inoculated stressed plants.

A Single-Fed Multiband Antenna for WLAN and 5G Applications.

In this paper, a slotted conical patch connected to a small triangular patch multiband antenna for both microwave and millimeter-wave applications is presented. The designed antenna has three characteristics. The proposed antenna is a multiband, having a compact size of 0.35λ0 × 0.35λ0 × 0.004λ0 at its lowest operational frequency, i.e., 2.4 GHz, and more importantly, it can cover both the microwave and millimeter-wave bands with a single feeding. According to the -10 dB matching bandwidth, experimental results show that the antenna operates at (2.450-2.495) GHz, (5.0-6.3) GHz, and (23-28) GHz. The reduced size, simple design, and multiband large bandwidth are some of the advantages over the reported designs in the latest literature. Both simulated and experimental results show a good agreement, and the proposed antenna can be used for wireless local area network (WLAN) applications and fifth-generation (5G) wireless communication devices.

Molecular mechanism underlying Piriformospora indica-mediated plant improvement/protection for sustainable agriculture.

The beneficial endophytic microorganisms have received significant attention in agriculture because of their exceptional capabilities to facilitate functions like nutrient enrichment, water status, and stress tolerance (biotic and abiotic). This review signifies the molecular mechanisms to better understand the Piriformospora indica-mediated plants improvement or protection for sustainable agriculture. P. indica, an endophytic fungus, belonging to the order Sebacinales (Basidiomycota), is versatile in building mutualistic associations with a variety of plants including pteridophytes, bryophytes, gymnosperms, and angiosperms. P. indica has enormous potential to manipulate the hormonal pathway such as the production of indole-3-acetic acid which in turn increases root proliferation and subsequently improves plant nutrient acquisition. P. indica also enhances components of the antioxidant system and expression of stress-related genes which induce plant stress tolerance under adverse environmental conditions. P. indica has tremendous potential for crop improvement because of its multi-dimensional functions such as plant growth promotion, immunomodulatory effect, biofertilizer, obviates biotic (pathogens) and abiotic (metal toxicity, water stress, soil structure, salt, and pH) stresses, phytoremediator, and bio-herbicide. Considering the above points, herein, we reviewed the physiological and molecular mechanisms underlying P. indica-mediated plants improvement or protection under diverse agricultural environment. The first part of the review focuses on the symbiotic association of P. indica with special reference to biotic and abiotic stress tolerance and host plant root colonization mechanisms, respectively. Emphasis is given to the expression level of essential genes involved in the processes that induce changes at the cellular level. The last half emphasizes critical aspects related to the seed germination, plant yield, and nutrients acquisition.

Fibrin-Enhanced Canonical Wnt Signaling Directs Plasminogen Expression in Cementoblasts.

Cementum is a mineralized layer on the tooth's root surface and facilitates the biomechanical anchoring of fibrous connective tissues as a part of tooth-supportive complexes. Previously, we observed that OCCM30 cementoblasts cultured on fibrin matrices underwent apoptosis due to fibrin degradation through the expression of proteases. Here, we demonstrated that OCCM30 on fibrin matrices (OCCM30-fibrin) enhanced canonical Wnt signaling, which directed to plasminogen expression. The OCCM30-fibrin showed higher levels of Wnt3a expression, nuclear translocation of ß-catenin, and T-cell factor (TCF) optimal motif (TOP) reporter activity than the cells on tissue culture dishes (OCCM30-TCD), indicating that the OCCM30-fibrin enhanced canonical Wnt/ß-catenin signaling. Also, OCCM30-fibrin expressed biomineralization-associated markers at higher levels than OCCM30-TCD, of which levels were further increased with LiCl, a Wnt signaling activator. The OCCM30 cementoblasts simultaneously showed that high levels of plasminogen, a critical component of fibrinolysis, were expressed in the OCCM30-fibrin. Activation of canonical Wnt signaling with LiCl treatment or with forced lymphoid enhancer factor 1 (LEF1)-expression increased the expression of plasminogen. On the contrary, the inhibition of canonical Wnt signaling with siRNAs against Wnt3a or ß-catenin abrogated fibrin-enhanced plasminogen expression. Furthermore, there are three conserved putative response elements for the LEF1/ß-catenin complex in the plasminogen proximal promoter regions (-900 to +54). Site-directed mutations and chromatin immunoprecipitation indicated that canonical Wnt signaling directed plasminogen expression. Taken together, this study suggests that fibrin-based materials can modulate functional periodontal formations in controlling cementoblast differentiation and fibrin degradation.

Intercomparison of environmental gamma doses measured with A NaI (Tl) survey meter and thermoluminescent dosimeters (TLDs) in the Poonch division of Azad Kashmir, Pakistan.

This study presents the intercomparison of the outdoor environmental gamma dose rates measured using a NaI (Tl) based survey meter along with thermoluminescent dosimeters (TLDs) and estimation of excess lifetime cancer risk (ELCR), for the inhabitants of Poonch division of the Azad Kashmir, Pakistan. CaF2: Dy (TLD-200) card dosimeters were installed at height of 1 m from ground at fifteen different locations covering the entire Poonch division comprising of three districts. During three distinct two month time periods within the six month study period, all the installed dosimeters were exposed to outdoor environmental gamma radiations, retrieved and read out at Radiation Dosimetry Laboratory, Health Physics Division, PINSTECH laboratory, Islamabad. The ambient outdoor gamma dose rate measurements were also taken with NaI (Tl) based portable radiometric instrument at 1 m above the ground. To estimate the annual gamma doses, NaI (Tl) based survey data were used for one complete year following the deployment of the dosimeters. The mean annual gamma dose rates measured by TLDs and survey meter were found as 1.47±0.10 and 0.862±0.003 mGy/y respectively. Taking into account a 29% outdoor occupancy factor, the annual average effective dose rate for individuals was estimated as 0.298±0.04 and 0.175±0.03 mSv/y by TLDs and survey meter, respectively. For outdoor exposure, the ELCR was calculated from the TLD and survey meter measurements. The environmental outdoor average annual effective dose obtained in present study are less than the estimated world average terrestrial and cosmic gamma ray dose rate of 0.9 mSv/y reported in UNSCEAR 2000. The possible origins of gamma doses in the area and incompatibilities of results obtained from the two different measurement techniques are also discussed.

The potential impact of digital economy on energy poverty in the context of Chinese provinces.

This study focused on exploring the impact of the digital economy (DE) on energy poverty (EP) across Chinese provinces from 2004 to 2018, motivated by the critical need to understand how technological advancements in the digital sector influence energy accessibility and sustainability. Conducted against the backdrop of global digital transformation, the research aimed to dissect the nuanced ways in which the DE contributes to mitigating EP, employing dynamic panel threshold and indirect effect models to capture both the direct and nuanced, and intermediate effects of digital progress on energy deprivation. Key findings revealed a significant reduction in EP attributed to the advancements in DE, with the most notable improvements observed in Eastern China where strategic energy policies and management practices enhanced the positive impacts of digitalization. The study highlighted the DE's role in improving energy access, efficiency, and environmental sustainability, although it also pointed out the potential for regressive effects in areas with lower levels of technological advancement. These findings are of substantial value as they offer empirical evidence of the DE's capacity to alleviate EP, underlining the importance of integrating digital strategies into energy policy planning. The research provides critical insights for policymakers, stakeholders in the energy sector, and scholars interested in the synergies between digital innovation and energy security, suggesting that leveraging digital technologies could accelerate efforts towards achieving sustainable energy access and combating energy poverty in China and potentially in other contexts facing similar challenges.

Metabolites-induced co-evolutionary warfare between plants, viruses, and their associated vectors: So close yet so far away.

Agriculture and global food security encounter significant challenges due to viral threats. In the following decades, several molecular studies have focused on discovering biosynthetic pathways of numerous defensive and signaling compounds, as key regulators of plant interactions, either with viruses or their associated vectors. Nevertheless, the complexities of specialized metabolites mediated plant-virus-vector tripartite viewpoint and the identification of their co-evolutionary crossroads toward antiviral defense system, remain elusive. The current study reviews the various roles of plant-specialized metabolites (PSMs) and how plants use these metabolites to defend against viruses. It discusses recent examples of specialized metabolites that have broad-spectrum antiviral properties. Additionally, the study presents the co-evolutionary basis of metabolite-mediated plant-virus-insect interactions as a potential bioinspired approach to combat viral threats. The prospects also show promising metabolic engineering strategies aimed at discovering a wide range of PSMs that are effective in fending off viruses and their related vectors. These advances in understanding the potential role of PSMs in plant-virus interactions not only serve as a cornerstone for developing plant antiviral systems, but also highlight essential principles of biological control.

Urbanization influences the indoor transfer of airborne antibiotic resistance genes, which has a seasonally dependent pattern.

Over the last few years, the cumulative use of antibiotics in healthcare institutions, as well as the rearing of livestock and poultry, has resulted in the accumulation of antibiotic resistance genes (ARGs). This presents a substantial danger to human health worldwide. The characteristics of airborne ARGs, especially those transferred from outdoors to indoors, remains largely unexplored in neighborhoods, even though a majority of human population spends most of their time there. We investigated airborne ARGs and mobile genetic element (MGE, IntI1), plant communities, and airborne microbiota transferred indoors, as well as respiratory disease (RD) prevalence using a combination of metabarcode sequencing, real-time quantitative PCR and questionnaires in 72 neighborhoods in Shanghai. We hypothesized that (i) urbanization regulates ARGs abundance, (ii) the urbanization effect on ARGs varies seasonally, and (iii) land use types are associated with ARGs abundance. Supporting these hypotheses, during the warm season, the abundance of ARGs in peri-urban areas was higher than in urban areas. The abundance of ARGs was also affected by the surrounding land use and plant communities: an increase in the proportion of gray infrastructure (e.g., residential area) around neighborhoods can lead to an increase in some ARGs (mecA, qnrA, ermB and mexD). Additionally, there were variations observed in the relationship between ARGs and bacterial genera in different seasons. Specifically, Stenotrophomonas and Campylobacter were positively correlated with vanA during warm seasons, whereas Pseudomonas, Bacteroides, Treponema and Stenotrophomonas positively correlated with tetX in the cold season. Interstingly, a noteworthy positive correlation was observed between the abundance of vanA and the occurrence of both rhinitis and rhinoconjunctivitis. Taken together, our study underlines the importance of urbanization and season in controlling the indoor transfer of airborne ARGs. Furthermore, we also highlight the augmentation of green-blue infrastructure in urban environments has the potential to mitigate an excess of ARGs.

Yellow scorpion (Buthus sinidicus) venom peptides induce mitochondrial-mediated apoptosis in cervical, prostate and brain tumor cell lines.

Scorpion venoms are known to contain over 100,000 biologically active constituents. However, only a few of them have been studied. The major constituents of venom are proteins and peptides, which exhibit various biological and pharmacological properties, including anticancer activities. In the current study, the venom of yellow scorpions (Buthus sindicus) found in Sindh, Pakistan, was extracted and evaluated for its anti-cancer and anti-inflammatory activities. The crude venom showed a dose dependent inhibition of phagocyte oxidative burst from human whole blood cells (28.3% inhibition at highest tested concentration of 300 µg/mL). In-vitro cytotoxicity of crude venom was evaluated against human prostrate (PC3), cervical (HeLa) and neuroblastoma (U87-MG) cell lines, along with cytotoxicity against normal human fibroblast (BJ) cells. Crude venom was cytotoxic to all cell lines, with prominent inhibitory effect on PC3 cells. Crude venom was fractionated through RP-UPLC, resulted in fifteen fractions, followed by evaluation of their anticancer potential. Among all, the fraction I significantly (P < 0.001) reduced the cell viability of all three cancer cell lines, and exhibited insignificant cytotoxicity against normal cell line. Furthermore, the apoptotic cell death pathway was evaluated for crude venom, and fraction I, in most sensitive cell line PC3, by using flow-cytometry analysis. Both crude venom and its fraction I caused a mitochondrial-mediated apoptosis in prostate cancer cells (PC3). To the best of our knowledge, this is the first report of the anticancer and anti-inflammatory activity of venom of Pakistani yellow scorpions. Results indicate their therapeutic potential, and a case for further purification and validation studies.

Modulating plant-soil microcosm with green synthesized ZnONPs in arsenic contaminated soil.

Biogenic nanoparticle (NP), derived from plant sources, is gaining prominence as a viable, cost-effective, sustainable, and biocompatible alternative for mitigating the extensive environmental impact of arsenic on the interplay between plant-soil system. Herein, the impact of green synthesized zinc oxide nanoparticles (ZnONPs) was assessed on Catharanthus roseus root system-associated enzymes and their possible impact on microbiome niches (rhizocompartments) and overall plant performance under arsenic (As) gradients. The application of ZnONPs at different concentrations successfully modified the arsenic uptake in various plant parts, with the root arsenic levels increasing 1.5 and 1.4-fold after 25 and 50 days, respectively, at medium concentration compared to the control. Moreover, ZnONPs gradients regulated the various soil enzyme activities. Notably, urease and catalase activities showed an increase when exposed to low concentrations of ZnONPs, whereas saccharase and acid phosphatase displayed the opposite pattern, showing increased activities under medium concentration which possibly in turn influence the plant root system associated microflora. The use of nonmetric multidimensional scaling ordination revealed a significant differentiation (with a significance level of p < 0.05) in the structure of both bacterial and fungal communities under different treatment conditions across root associated niches. Bacterial and fungal phyla level analysis showed that Proteobacteria and Basidiomycota displayed a significant increase in relative abundance under medium ZnONPs concentration, as opposed to low and high concentrations, respectively. Similarly, in depth genera level analysis revealed that Burkholderia, Halomonas, Thelephora and Sebacina exhibited a notably high relative abundance in both the rhizosphere and rhizoplane (the former refers to the soil region influenced by root exudates, while the latter is the root surface itself) under medium concentrations of ZnONPs, respectively. These adjustments to the plant root-associated microcosm likely play a role in protecting the plant from oxidative stress by regulating the plant's antioxidant system and overall biomass.

Correction: Zaman et al. Synthesis and Evaluation of Thiol-Conjugated Poloxamer and Its Pharmaceutical Applications. Pharmaceutics 2021, 13, 693.

In the original publication, there was a mistake in one author name, Mohammed Alasmari should be Mohammed S [...].

Advances in Regenerative Dentistry: A Systematic Review of Harnessing Wnt/ß-Catenin in Dentin-Pulp Regeneration.

Dentin pulp has a complex function as a major unit in maintaining the vitality of teeth. In this sense, the Wnt/ß-Catenin pathway has a vital part in tooth development, maintenance, repair, and regeneration by controlling physiological activities such as growth, differentiation, and migration. This pathway consists of a network of proteins, such as Wnt signaling molecules, which interact with receptors of targeted cells and play a role in development and adult tissue homeostasis. The Wnt signals are specific spatiotemporally, suggesting its intricate mechanism in development, regulation, repair, and regeneration by the formation of tertiary dentin. This review provides an overview of the recent advances in the Wnt/ß-Catenin signaling pathway in dentin and pulp regeneration, how different proteins, molecules, and ligands influence this pathway, either upregulating or silencing it, and how it may be used in the future for clinical dentistry, in vital pulp therapy as an effective treatment for dental caries, as an alternative approach for root canal therapy, and to provide a path for therapeutic and regenerative dentistry.

Graphene enhances artemisinin production in the traditional medicinal plant Artemisia annua via dynamic physiological processes and miRNA regulation.

We investigated the effects of graphene on the model herb Artemisia annua, which is renowned for producing artemisinin, a widely used pharmacological compound. Seedling growth and biomass were promoted when A. annua was cultivated with low concentrations of graphene, an effect which was attributed to a 1.4-fold increase in nitrogen uptake, a 15%-22% increase in chlorophyll fluorescence, and greater abundance of carbon cycling-related bacteria. Exposure to 10 or 20 mg/L graphene resulted in a âˆ¼60% increase in H2O2, and graphene could act as a catalyst accelerator, leading to a 9-fold increase in catalase (CAT) activity in vitro and thereby maintaining reactive oxygen species (ROS) homeostasis. Importantly, graphene exposure led to an 80% increase in the density of glandular secreting trichomes (GSTs), in which artemisinin is biosynthesized and stored. This contributed to a 5% increase in artemisinin content in mature leaves. Interestingly, expression of miR828 was reduced by both graphene and H2O2 treatments, resulting in induction of its target gene AaMYB17, a positive regulator of GST initiation. Subsequent molecular and genetic assays showed that graphene-induced H2O2 inhibits micro-RNA (miRNA) biogenesis through Dicers and regulates the miR828-AaMYB17 module, thus affecting GST density. Our results suggest that graphene may contribute to yield improvement in A. annua via dynamic physiological processes together with miRNA regulation, and it may thus represent a new cultivation strategy for increasing yield capacity through nanobiotechnology.

Frequency and survival of Covid associated mucormycosis patients at tertiary care hospitals in Pakistan: A retrospective observational study.

Background: Mucormycosis is a serious fungal infection associated with uncontrolled diabetes and immunocompromised patients. This angioinvasive infection emerged as a post-covid complication worldwide especially in developing countries. Due to the common socio-demographic status of South Asian countries, we expected a surge in mucormycosis cases in Pakistan. This study aims to observe the frequency and survival of Covid associated mucormycosis patients at tertiary care hospitals in Pakistan during the third wave of Covid-19 in 2021. Materials and Methods: In this retrospective study, we collected the data of clinically and histopathologically confirmed cases of rhino-occipito-cerebral mucormycosis from three tertiary care hospitals of Lahore. These cases were analysed for history of Covid-19 and other associated comorbidities using SPSS28. History of steroid medication was also taken. Data were retrieved from May to July 2021 after the approval from the ethical review board. Results: Out of the total 43 reported patients of mucormycosis in the set time frame only 22 cases had a history of Covid-19. The mean age was 50 ± 13.27 years with slight male predilection (60%). Diabetes mellitus was the most common comorbidity (88.4%) and all the patients with covid associated mucormycosis (CAM) had taken corticosteroid regimen for covid management (p < 0.0001). The survival of the patient was not significantly different between CAM and non-CAM patients of Mucormycosis (p = 0.747). Conclusion: Covid-19 and mucormycosis make a lethal duo against the weakened health system of Pakistan. This problem can be prevented by avoiding nonjudicial use of corticosteroids and proper diabetes control program following Covid-19 infection. Furthermore, large-scale epidemiological studies should be carried out to evaluate the true burden of Mucormycosis in the population.