Micro(nano)plastic pollution in terrestrial ecosystem: emphasis on impacts of polystyrene on soil biota, plants, animals, and humans.

Pollution with emerging microscopic contaminants such as microplastics (MPs) and nanoplastics (NPs) including polystyrene (PS) in aquatic and terrestrial environments is increasingly recognized. PS is largely used in packaging materials and is dumped directly into the ecosystem. PS micro-nano-plastics (MNPs) can be potentially bioaccumulated in the food chain and can cause human health concerns through food consumption. Earlier MP research has focused on the aquatic environments, but recent researches show significant MP and NP contamination in the terrestrial environments especially agricultural fields. Though PS is the hotspot of MPs research, however, to our knowledge, this systematic review represents the first of its kind that specifically focused on PS contamination in agricultural soils, covering sources, effects, and ways of PS mitigation. The paper also provides updated information on the effects of PS on soil organisms, its uptake by plants, and effects on higher animals as well as human beings. Directions for future research are also proposed to increase our understanding of the environmental contamination of PS in terrestrial environments.

Frequency Of Undiagnosed Chronic Obstructive Pulmonary Disease In Patients With Coronary Artery Disease.

BACKGROUND: Chronic obstructive airway disease (COPD) is considered as risk factor for coronary artery disease (CAD) along with other risk factors. This study was conducted to determine the frequency of undiagnosed chronic obstructive pulmonary disease in patients with coronary artery disease. METHODS: This cross-sectional study was conducted in the Pulmonology and Cardiology wards/OPD's of Khyber Teaching Hospital Peshawar. Patients more than 35 years of age, diagnosed with CAD of either gender were included. Patients already diagnosed with COPD, recent myocardial infarction (within 7 days), left ventricular impairment, pneumothorax, bronchiectasis, comatose patient, asthmatic and those with chest trauma were excluded. All the patients underwent spirometry examination before and after administration of salbutamol (5 mg for 5 minutes) via nebulizer. FEV1/FVC less than 70% confirmed the presence of COPD. RESULTS: Out of 151 patients, 57 (37.7%) were found to have COPD. Among them, 39 (68.42%) were male and 18 (31.57%) were female. Among male patients with COPD, 82.05% (n=32) were smokers and 17.94% (n=7) were nonsmokers while in females with COPD no one was smoker. CONCLUSIONS: COPD is an under-diagnosed progressive disease in patients with high risk patients with coronary artery disease.

Learning environment, approaches to learning and learning preferences: medical students versus general education students.

OBJECTIVE: The main objective of the study was to see whether medical students use more desirable approaches to studying than general education students. METHODS: Survey method was used to collect data from both the medical students and the general education students. The survey of the medical students was carried out between January and March, 2012. The survey was administered to all the medical students present in lecture halls on day of data collection, while general education students were randomly selected from four subject areas at two universities. RESULTS: In total, 976 medical students and 912 general students participated in the study. Of the general students, 494(54%) were boys and 418(46%)were girls with an overall mean age of 20.53±1.77 years (range: 17-27 years). The medical students' perceptions of their learning environment and their learning preferences were broadly similar to that of general education students with the exception of workload. The medical students perceived the workload to be less appropriate (Mean = 2.06±0.72) than the students in general education (Mean = 2.84±0.90). The medical students were more likely to use the deep approach to studying (Mean = 3.66±0.59) than the students in general education (Mean = 3.16±0.91). The students in general education were slightly more likely to use the organized studying (Mean = 3.44±0.90) than the medical students (Mean =3.23±0.90). Both medical students and the students in general education tended to use the surface approaches along with other approaches to studying. CONCLUSIONS: There was not a great difference between the medical students and the students pursuing general education with regard to perceptions of the learning environment and approaches to learning.

Systematic review on antibacterial photodynamic therapeutic effects of transition metals ruthenium and iridium complexes.

The prevalence of antibiotic-resistant pathogenic bacteria poses a significant threat to public health and ranks among the principal causes of morbidity and mortality worldwide. Antimicrobial photodynamic therapy is an emerging therapeutic technique that has excellent potential to embark upon antibiotic resistance problems. The efficacy of this therapy hinges on the careful selection of suitable photosensitizers (PSs). Transition metal complexes, such as Ruthenium (Ru) and Iridium (Ir), are highly suitable for use as PSs because of their surface plasmonic resonance, crystal structure, optical characteristics, and photonics. These metals belong to the platinum family and exhibit similar chemical behavior due to their partially filled d-shells. Ruthenium and Iridium-based complexes generate reactive oxygen species (ROS), which interact with proteins and DNA to induce cell death. As photodynamic therapeutic agents, these complexes have been widely studied for their efficacy against cancer cells, but their potential for antibacterial activity remains largely unexplored. Our study focuses on exploring the antibacterial photodynamic effect of Ruthenium and Iridium-based complexes against both Gram-positive and Gram-negative bacteria. We aim to provide a comprehensive overview of various types of research in this area, including the structures, synthesis methods, and antibacterial photodynamic applications of these complexes. Our findings will provide valuable insights into the design, development, and modification of PSs to enhance their photodynamic therapeutic effect on bacteria, along with a clear understanding of their mechanism of action.

One-pot in situ synthesis of an NS-ligand co-doped metal-organic framework for the enhanced adsorption-assisted photocatalytic decontamination of metronidazole.

Doping active agents into metal-organic frameworks (MOFs) is widely sought after owing to its potential to enhance adsorption and photocatalytic efficiency, surpassing the potential of bare frameworks. This study incorporated a catalytically active NS-ligand (1,2-benzisothiazolin-3-one) into a very stable and porous PCN-600 MOF via an in situ synthesis approach. The NS-ligand, which matched with the host ligands of PCN-600, enabled the highly efficient synthesis of NS-co-doped MOFs. The pristine PCN-600 framework and morphology were retained in the MOF altered with the NS-ligand, as demonstrated by XRD, FTIR, and SEM characterizations. A high electron density was generated due to the synergistic effect between the defects in the NS-co-doped photocatalyst and engineered active sites. This facilitated the adsorption-assisted photocatalytic decontamination of metronidazole with an 87% removal by PCN-600-NS-10 compared to 43% by pristine PCN-600 within a total time of 150 min. The MOF doped with the NS-ligand exhibited a reduced band gap and enhanced adsorption and photocatalytic capabilities compared to pristine PCN-600. The impact of operational parameters, such as catalyst dosage, initial solution pH, and MNZ concentration, was also explored. Pseudo-second and pseudo-first order models were found to describe the adsorption and degradation kinetics of metronidazole and the Dubinin-Radushkevich model was found to fit the equilibrium adsorption results. The thermodynamic characteristics of adsorption processes (ΔGads, ΔHads, and ΔSads) demonstrated that adsorption was physical, spontaneous, and exothermic and resulted in increased entropy.

Phytoremediation of Arsenic (As) in rice plants, mediated by Bacillus subtilis strain IU31 through antioxidant responses and phytohormones synthesis.

Bacteria-assisted phytoremediation uses bacteria to promote plant health and improve its ability to remediate toxic heavy metals like Arsenic (As). Here, we isolated rhizobacteria and identified them as Bacillus subtilis strain IU31 using 16S rDNA sequencing. IU31 showed phosphate solubilization potential on Pikovskaya agar medium and produced siderophores, which were detected on Chromium Azurol-S (CAS) agar medium. Indole-3-acetic acid (IAA) and gibberellins (GAs), namely GA1, GA3, GA4, GA7, GA9, GA12, GA15, and GA24, were quantified by GC/MS-SIM analysis. The expression levels of genes involved in GA and IAA biosynthesis, such as cyp112, cyp114, trpA, and trpB, were assessed using semi-quantitative RT-PCR. Plant bioassays showed that As at a 15 mg/kg concentration reduced plant growth, chlorophyll content, and biomass. However, IU31 inoculation significantly improved plant growth dynamics, enhancing As accumulation by up to 50% compared with uninoculated plants. IU31 inoculation induced the bioconcentration factor (BCF) and bioaccumulation factor (BAF) of As in plants compared to uninoculated plants, but the translocation factor (TF) of As was unaffected by IU31 inoculation. IU31 inoculation effectively restored glutathione-S-transferase (GST) and catalase (CAT) enzyme activities, as well as glutathione (GSH) and hydrogen peroxide concentrations to nearly normal levels, which were significantly elevated in plants exposed to As stress. These results show that IU31 improves plant health and growth by producing IAA and GAs, which might contribute to the uptake and detoxification of As.

Persistence of Root Exudates of Sorghum bicolor and Solidago canadensis: Impacts on Invasive and Native Species.

Root exudates of the invasive Solidago canadensis and the cereal crop Sorghum bicolor (L.) Moench cv. 'Hybridsorgo' were tested for allelopathic interactions against native and invasive plant species in a controlled environment. After the surface was sterilized, the seeds of two invasive species (Bromus sterilis and Veronica persica) and two native species (Youngia japonica and Rumex acetosa) were germinated and transplanted into the soil (1:1 mixture of coco peat and sand) that had been conditioned for one month by the cultivation of Solidago canadensis and Sorghum bicolor, both in combination or as unplanted controls. After an additional eight weeks of growth, morphometric measurements of the shoot and root, including foliar characteristics and above- and below-ground biomass accumulation, were performed. The results revealed significant inhibitory effects of root exudates released by Sorghum bicolor and Solidago canadensis on native species' productivity and physiology. The invasive species exhibited variable growth responses, with Veronica persica showing reduced shoot and root expansion, but Bromus sterilis revealed increased shoot and root biomass allocation and nutrition under the exudate treatments. Exudates from Solidago canadensis and Sorghum bicolor together showed synergistic negative effects on native species, while they promoted growth and nutrition in Veronica persica. Taken together, the differential species responses indicate that the tested native species were more sensitive to the allelopathic compounds than the invasive species, which is in line with the theory of novel weapons. The legacy effects of root exudates of both Sorghum bicolor and Solidago canadensis could promote invasive establishment through imposing allelochemical interference competition against native plant species. Understanding the specific allelopathic mechanisms may help with the development of integrated strategies for managing invasive species.

Increased burden of MDR bacterial infections; reflection from an antibiogram of ICUs of a tertiary care hospital.

INTRODUCTION: Infectious disease management in intensive care units (ICUs) is becoming more difficult due to increasing antimicrobial resistance. Hence, the aim of this study was to explore the nature of pathogens mostly encountered in an ICU and determine their antibiotic susceptibility through the compilation of ICU-specific antibiogram. METHODOLOGY: A descriptive cross-sectional study of the culture and sensitivity reports of ICU patients was conducted in a tertiary care hospital. An antibiogram was created according to the Clinical Laboratory Standards Institute (CLSI) M39-A4 guidelines. RESULTS: Of the total 597 reports, the most common specimen type were respiratory secretions (n = 174), followed by blood (n = 128), wounds (n = 108), and urine (n = 80). Out of 597 isolates, the most frequently isolated bacteria were Klebsiella species (n = 156), Pseudomonas aeruginosa (n = 117), Escherichia coli (n = 112), Enterobacter species (n = 56), Acinetobacter species (n = 52), Proteus species (n = 39), Staphylococcus aureus (n = 34) and coliform species (n = 31). An 84% multidrug resistance (MDR) rate was reported among the isolates studied, with Acinetobacter species being at the top with a 98% MDR rate. CONCLUSIONS: A substantial and alarming MDR rate was observed in our study. Furthermore, our findings demonstrated a potential interest in developing an ICU-specific antibiogram that is informative to clinicians in their clinical decision-making related to antibiotic therapy.

Insights into the Mechanisms Involved in Lead (Pb) Tolerance in Invasive Plants-The Current Status of Understanding.

Invasive plant species possess remarkable abilities to establish themselves in new environments and to displace native species. Their success can be attributed to various physiological and biochemical mechanisms, allowing them to tolerate adverse environmental conditions, including high lead (Pb) toxicity. Comprehension of the mechanisms responsible for Pb tolerance in invasive plants is still limited, but it is rapidly evolving. Researchers have identified several strategies in invasive plants to tolerate high levels of Pb. This review provides an overview of the current understanding of the ability of invasive species to tolerate or even accumulate Pb in plant tissues, including vacuoles and cell walls, as well as how rhizosphere biota (bacteria and mycorrhizal fungi) help them to enhance Pb tolerance in polluted soils. Furthermore, the article highlights the physiological and molecular mechanisms regulating plant responses to Pb stress. The potential applications of these mechanisms in developing strategies for remediating Pb-contaminated soils are also discussed. Specifically, this review article provides a comprehensive understanding of the current status of research on the mechanisms involved in Pb tolerance in invasive plants. The information presented in this article may be useful in developing effective strategies for managing Pb-contaminated soils, as well as for developing more resilient crops in the face of environmental stressors.

Plant Growth Regulators with a Balanced Supply of Nutrients Enhance the Phytoextraction Efficiency of Parthenium hysterophorus for Cadmium in Contaminated Soil.

Heavy metal contamination in soil, such as cadmium (Cd), poses a serious threat to global food security and human health. It must be managed using environmentally friendly and cost-effective technologies. Plants with high resistance to Cd stress and high biomass production could be potential candidates for the phytoremediation of Cd-contaminated soils to improve Cd phytoextraction. In this regard, the present study was carried out to determine the effect of gibberellic acid (GA3), indole acetic acid (IAA), and fertilizers (N, P, and K) on Parthenium hysterophorus growth and biomass production as well as Cd phytoextraction capabilities. A pot experiment was conducted with various combinations of PGRs and fertilizers, with treatments arranged in five replicates using a completely randomized design. After harvesting, each plant was divided into various parts such as stems, roots, and leaves, and different growth, physiological, and biochemical parameters were recorded. Results showed that under Cd stress, growth, physiological, and biochemical parameters were all significantly decreased. With the combined application of plant growth regulators (GA3 and IAA) and nutrients, Cd stress was alleviated and all parameters significantly improved. In comparison to the control treatment, the combined application of N + P + K + GA3 + IAA resulted in the highest fresh and dry biomass production of the root (12.31 and 5.11 g pot-1), shoot (19. 69 and 6.99 g pot-1), leaves (16.56 and 7.09 g pot-1), and entire plant (48.56 and 19.19 g pot-1). Similarly, the same treatment resulted in higher chlorophyll a and b and total chlorophyll contents under Cd stress, which were 2.19, 2.03, and 3.21 times higher than the control, which was Cd stress without any treatment. The combination of N + P + K + GA3 + IAA also resulted in the highest proline and phenolic contents. In the case of different enzyme activities, the combined application of N + P + K + GA3 + IAA under Cd stress led to a high increase in catalase (2.5 times), superoxide (3.5 times), and peroxidase (3.7 times) compared to the control. With the combined application of N+ P+ K + GA3 + IAA, the maximum values of BCF (8.25), BAC (2.6), and RF (5.14%) were measured for phytoextraction potential. On the basis of these findings, it is concluded that P. hysterophorus has a high potential to grow, produce the most biomass, and act as a Cd hyperaccumulator in Cd-contaminated soil.

A Patient With Fever, Loose Motions and Jaundice: Hickam's Dictum or Occam's Razor.

Infectious diseases like malaria, typhoid, leptospirosis, and dengue fever are the leading causes of morbidity and mortality in developing countries like Pakistan. Although rare, it is possible to have coinfection with organisms that are endemic in a region, causing diagnostic and therapeutic dilemmas. Leptospirosis is caused by Gram-negative spirochetes. Leptospira are widely distributed and are transmitted by contamination of water and food by the urine of infected animals like rodents. Leptospirosis is characterized by fever, body aches, abdominal pain, and hepatic and renal involvement. Laboratory abnormalities include cytopenia, elevated bilirubin, alanine aminotransferase, and abnormal renal function tests. Typhoid fever is caused by Salmonella typhi (S. typhi), which is transmitted by fecal contamination of drinking water and food items. The clinical manifestations of typhoid fever include fever, abdominal pain, and diarrhea. Laboratory abnormalities include cytopenia and mildly deranged liver function tests. A strain of S. typhi resistant to all antibiotics except azithromycin and carbapenems was isolated in 2016 in Pakistan. Most of the clinical manifestations and laboratory abnormalities of leptospirosis and typhoid fever overlap. There have been case reports of coinfection of S. typhi and Leptospira, but there is no report of coinfection of extensively drug-resistant (XDR) S. typhi and Leptospira. We present a case of a 20-year-old man with fever, loose motions, and jaundice from Peshawar, Pakistan who had coinfection of Leptospira and XDR S. typhi. The attending physicians should adopt Hickam's dictum instead of Occam's razor approach.

Women's Entrepreneurial Contribution to Family Income: Innovative Technologies Promote Females' Entrepreneurship Amid COVID-19 Crisis.

Women entrepreneurs innovate, initiate, engage, and run business enterprises to contribute the domestic development. Women entrepreneurs think and start taking risks of operating enterprises and combine various factors involved in production to deal with the uncertain business environment. Entrepreneurship and technological innovation play a crucial role in developing the economy by creating job opportunities, improving skills, and executing new ideas. It has a significant impact on the income of the household. The study focused on investigating the role of women's entrepreneurship and innovation technologies in contributing to household income in the challenging situation of the pandemic COVID-19. The paper emphasized identifying the determinants of female entrepreneurial contribution toward household income. This study collected data from selected rural and urban areas of district Faisalabad through a self-administered questionnaire. Investigators interviewed female entrepreneurs and chose them through the snowball sampling technique from a population of purposively selected female-run businesses. Interviews were conducted with women entrepreneurs to gather relevant information for the survey investigation at their workplaces and home. The effects of various factors, including age, education, family size, income from other sources, time allocated to entrepreneurial activity, firm size, and location (rural/urban) were estimated empirically using an ordered logit model. The study findings exhibited a positive and significant role of respondents' education, family size, time allocated to entrepreneurial activities, and firm size. The survey outcomes also indicated that the contribution of entrepreneurial income to household income in the rural areas is significantly higher than that in urban areas. This study signifies that regulations against gender discrimination in public and private institutions are helpful. Besides, encouraging an environment for entrepreneurial culture among women in the country would increase family income. The study's findings and policy implications directly link to Sustainable Development Goal (SDGs) 5 of Gender Equality (GE) and SDG 8 related to decent work and economic growth.

Do Laboratory Biomarkers Predict Survival In Severe Covid-19? A Cross-Sectional Study.

Background: This study aims to compare lymphocyte count, C-reactive protein (CRP), ferritin, Lactate Dehydrogenase (LDH) and D-dimer among survivors and non-survivors of severe COVID-19. Methods: This retrospective cross-sectional analytical study included 69 patients for whom a record of the biomarkers and survival status was available. Baseline and peak values were selected for serum CRP, ferritin, LDH and D-Dimer. Baseline and trough lymphocyte counts were selected. Data were analyzed using SPSS version 21. Mean and standard deviation were used to compare the biomarkers with paired t-test. p-value <0.05 was taken as significant. Results: The mean age of the study population was 55.5±9.1 years and 50 (72.5%) were male. Among survivors, the increase in CRP level was not significant (from 15.80±9.8 mg/dl to 17.87±8.4 mg/dl, p=0.45) while it was significant in non-survivors (from 16.68±10.90 mg/dl to 20.77±12.69 mg/dl, p=0.04). There was no significant rise in LDH levels in survivors (from 829.59±499 U/L to 1018.6±468 U/L, p=0.20) while it increased significantly in non-survivors (from 816.2±443.08 U/L to 1056.61±480.54 U/L, p=0.003). The decrease in lymphocyte count and increase in D-Dimers in both the groups was significant (p=0.001). There was no significant elevation in ferritin in both the groups (p>0.05). Conclusion: In severe COVID-19 patients, serum CRP and LDH can be used for risk stratification and predicting survival. Lymphopenia, increase in serum ferritin and D-dimers may not predict survival.

Sorghum Allelopathy: Alternative Weed Management Strategy and Its Impact on Mung Bean Productivity and Soil Rhizosphere Properties.

The reduction of herbicide use and herbicide-resistant weeds through allelopathy can be a sustainable strategy to combat the concerns of environmental degradation. Allelopathic crop residues carry great potential both as weed suppressers and soil quality enhancers. The influence of sorghum crop residues and water extracts on the weed population, soil enzyme activities, the microbial community, and mung bean crop productivity was investigated in a two-year experiment at the Student Research Farm, University of Agriculture Faisalabad. The experimental treatments comprised two levels of sorghum water extract (10 and 20 L ha-1) and two residue application rates (4 and 6 t ha-1), and no sorghum water extract and residues were used as the control. The results indicated that the incorporation of sorghum water extract and residue resulted in significant changes in weed dynamics and the soil quality indices. Significant reduction in weed density (62%) and in the dry weight of weeds (65%) was observed in T5. After the harvest, better soil quality indices in terms of the microbial population (72-90%) and microbial activity (32-50%) were observed in the rhizosphere (0-15 cm) by the same treatment. After cropping, improved soil properties in terms of available potassium, available phosphorus soil organic matter, and total nitrogen were higher after the treatment of residue was incorporated, i.e., 52-65%, 29-45%, 62-84%, and 59-91%, respectively. In the case of soil enzymes, alkaline phosphatase and dehydrogenase levels in the soil were 35-41% and 52-77% higher, respectively. However, residue incorporation at 6 t ha-1 had the greatest effect in improving the soil quality indices, mung bean productivity, and reduction of weed density. In conclusion, the incorporation of 6 t ha-1 sorghum residues may be opted to improve soil quality indices, suppress weeds, harvest a better seed yield (37%), and achieve higher profitability (306 $ ha-1) by weed suppression, yield, and rhizospheric properties of spring-planted mung beans. This strategy can provide a probable substitute for instigating sustainable weed control and significant improvement of soil properties in the mung bean crop, which can be a part of eco-friendly and sustainable agriculture.

Air pollution and its economic impacts at household level: willingness to pay for environmental services in Pakistan.

Air pollution has become a major global problem. Thus, the goal of this study was to find out the economic impacts (treatment cost) of air pollution on households as well as the principal factors inducing an individual's willingness to pay for better air quality. District Faisalabad was purposively selected for sampling, as it is a major industrial hub in Pakistan. The required information was collected from 120 sampled respondents through a structured questionnaire. The ordinary least squares method was used for assessing the impact of various factors on the treatment cost of the most recent episode of ailment related to air pollution. The ordered logit model was used to assess the impacts of factors affecting the willingness to pay for programs aimed at the provision of better environmental services. The results revealed that high air pollution in the urban area resulted in more lost workdays and higher health costs. The findings also showed that people were willing to pay for better air quality in urban areas than in rural areas. Based on the findings, it is suggested that the incentive schemes may be designed for the promotion of cleaner services in rural and urban areas.

The fabrication of TiO2-supported clinoptilolite via F- contained hydrothermal etching and a resultant highly energetic {001} facet for the enhancement of its photocatalytic activity.

TiO2-supported clinoptilolite (TiO2/CP) was synthesized in the presence of F- ions. Various characterizations demonstrated that the particle size of loaded TiO2 increased linearly with an increase in the temperature and concentration of F- ions. In particular, the additive F- ions were favored to produce the mutually independent co-exposed {001} and {101} facets of loaded TiO2, while TiO2/CPs synthesized in the absence of F- ions were dominated by the thermodynamically stable {101} facet. As photocatalysts for the removal of crystal violet or methyl orange dyes under UV-irradiation in aqueous solutions, TiO2/CPs (ACP6) synthesized in the presence of F- ions significantly improved the degradation efficiency, as compared to ACP3 obtained in the absence of F- ions. These results elucidated that the highly energetic {001} exposed facet, large particle size and fine dispersion of loaded TiO2 in TiO2/CP accounts for its best photocatalytic performance. The effected mechanism of operational parameters on the degradation performances is proposed.

Co-infection With Dengue Virus and Extensively Drug-Resistant Salmonella typhi.

In South Asia, infectious diseases are associated with significant morbidity and mortality. Malaria, typhoid, and dengue are the most common infectious diseases, and patients may be co-infected with these diseases, resulting in diagnostic and treatment dilemmas. Dengue is caused by the Arboviridae family of viruses and is transmitted by Aedes aegypti. Dengue virus has four serotypes and the symptoms of dengue fever mimic those of other infectious diseases such as malaria, chikungunya, Zika virus disease, influenza A, enteric fever, and coronavirus disease 2019, which are also prevalent in areas of frequent dengue fever outbreak. Dengue fever is characterized by fever, severe myalgia, retro-orbital pain, skin rashes, and bone pain, which is why dengue fever is also referred to as breakbone fever. Patients with secondary dengue virus infection more commonly present with abdominal pain when compared with those with primary dengue virus infection. Salmonella typhi causes enteric fever, which is a human infection with no animal reservoir, but the symptoms of enteric fever closely resemble those of dengue fever. Concurrent infections with multiple organisms are especially difficult to diagnose. In this report, we present the case of a 15-year-old boy from Peshawar, Pakistan, who was co-infected with the dengue virus and extensively drug-resistant Salmonella typhi. To the best of our knowledge, this is the first reported case of co-infection with dengue virus and extensively drug-resistant Salmonella typhi.

Safety and Efficacy of Aminophylline in Intrathecal Methotrexate-related Neurological Toxicity in Large Pediatric Oncology Centre.

Children with acute lymphoblastic leukemia, receiving intrathecal methotrexate (IT-MTX), develop acute and subacute neurological dysfunction in 3-15% of cases. Altered level of consciousness, seizure, and stroke-like manifestations are among the most common presentations. MRI of the brain in an early stage is consistent with white matter leukoencephalopathy. There are no specific guidelines for the treatment of such a syndrome. An elevated cerebrospinal fluid (csf) adenosine concentration causes vasodilatation in the brain and leads to cerebral ischemia, which may be reduced by aminophylline infusion. The study is a retrospective data analysis in which electronic data records of 30 patients, collected from September 2017 - August 2019. The primary objective of the study was to evaluate the safety and efficacy of aminophylline in IT-MTX induced neurotoxicity. Aminophylline infusion was used in 30 patients with IT-MTX neurotoxicity. Twenty-five patients (83.33%) showed dramatic improvement of neurologic signs and symptoms within 48 hours. Aminophylline was, hence, coined as a salvageable therapy. No noticeable side effects were observed during treatment with aminophylline infusion. Key Words: Intrathecal methotrexate, Neurotoxicity, Children, Cancer, Aminophylline.

Microplastics interaction with terrestrial plants and their impacts on agriculture.

Microplastics (MPs) are widespread in natural ecosystems and have attracted considerable attention from scientists all over the world because they are believed to threaten every life form. In addition to their potential physical and chemical effects on organisms, MPs may act as a carrier for many micropollutants, including antibiotics, heavy metals, and others. Over the last 10-15 yr, extensive research has been carried out on MPs in marine environments regarding their sources, fate, and toxicity. However, studies concerning their accumulation in the soil ecosystem, uptake, internalization, and impacts on photosynthetic components of the terrestrial ecosystem and risk assessments have been scanty. Thus, there is a large knowledge gap on the extent to which terrestrial environments, especially agroecosystems, are affected by MPs and their subsequent risks to human health. This review summarizes up-to-date findings about MPs on terrestrial environments and provides guidelines for future studies regarding the phytotoxic effects of MPs on plants; the mechanism of uptake and translocation in plant tissues; detection tools for MPs in plants; impacts on plant growth, plant development, and agricultural productivity; and, most important, the future prospects of MPs interaction and accumulation in plants.

Efficacy and Safety of Phosphate Enema as a therapeutic agent in Hypophosphatemia in Critically Ill Children.

The aim of the study was to evaluate the safety and efficacy of oral administration of phosphorous enema in hypophosphatemia (HP) in critically ill children admitted in the pediatric intensive care unit (PICU) of The Indus Hospital, Karachi, from September 2018 to August 2019. This was a retrospective review of 31 critically ill children with hypophosphatemia who received 1 ml/kg/day of phosphate enema through nasogastric tube or orally for phosphate replacement, with serial phosphorus level monitoring along with observation for its side effects. The results showed that the rise of serum phosphorus level was observed in all cases and 64.5% of cases achieved target phosphorus level with no adverse reactions observed. Sample size although limited, it is safe to state that oral phosphate enema is safe and effective for correction of hypophosphatemia in critically ill children. Key Words: Hypophosphatemia, Enema, Pediatric intensive care unit.