Exploration of reducing and stabilizing phytoconstituents in Arisaema dracontium extract for the effective synthesis of Silver nanoparticles and evaluation of their antibacterial and toxicological proprties.

Medicinal plants have been widely used for their antimicrobial properties against various microorganisms. Arisaema dracontium a familiar medicinal plant, was analyzed and silver nanoparticles (AgNPs) were synthesized using extracts of different parts of its shoot including leaves and stem. Further, the antimicrobial activity of different solvent extracts such as ethyl acetate, n-hexane, ethanol, methanol, and chloroform extracts were analyzed. AgNPs were prepared using aqueous silver nitrate solution and assessed their antibacterial activity against multidrug-resistant (MDR) and Non-multidrug-resistant bacteria. The characterization of AgNPs was done by Scanning Electron Microscopy (SEM), Transmission Electron Microscopy (TEM), UV-visible spectroscopy, Fourier Transform Infrared (FTI), and X-ray Diffraction approaches. The leaf extract contained Tannins, Flavonoids, Terpenoids, and Steroids while Alkaloids, Saponins, and Glycosides were undetected. The stem extract contained Alkaloids, Tannins, Flavonoids, Saponins, Steroids, and Glycosides while Terpenoids were not observed. The AgNPs synthesized from stem and leaf extracts in the current study had spherical shapes and ranged in size from 1 to 50 nm and 20-500 nm respectively as were visible in TEM. The leaf extract-prepared AgNPs showed significantly higher activities i.e., 27.75 mm ± 0.86 against the MDR strains as compared to the stem-derived nanoparticles i.e., 24.33 ± 0.33 by comparing the zones of inhibitions which can be attributed to the differences in their phytochemical constituents. The acute toxicity assay confirmed that no mortality was noticed when the dosage was 100 mg per kg which confirms that the confirms that the AgNPs are not toxic when used in low quantities. It is concluded that leaf extract from A. dracontium could be used against pathogenic bacteria offering economic and health benefits compared to the chemical substances.

A short report on the current landscape of Artificial Intelligence (AI) in vascular surgery in Pakistan.

This study focuses on the current applications, potential, and challenges to Artificial Intelligence (AI) integration in vascular surgery with specific emphasis on its relevance in Pakistan. Despite the benefits of AI in vascular surgery, there is a substantial gap in its adoption in Pakistan compared to global standards. In our context with limited resources and a scarcity of vascular surgeons, AI can serve as a promising solution. It can enhance healthcare accessibility, improve diagnostic accuracy, and alleviate the workload on vascular surgeons. However, hurdles including the absence of a comprehensive vascular surgery database, a shortage of AI experts, and potential algorithmic biases pose significant challenges to AI implementation. Despite these obstacles, the study underscores the imperative for continued research, collaborative efforts, and investments to unlock the full potential of AI and elevate vascular healthcare standards in Pakistan.

Predictors of cognitive impairment and its association with mortality in maintenance hemodialysis patients: A prospective follow-up study.

Objective: To determine predictors of cognitive impairment (CI) and its association with mortality in maintenance haemodialysis (MHD) patients. Methods: This prospective follow up study was conducted at HD Department, Mayo Hospital, Lahore from September, 2021 to November, 2022. All patients undergoing MHD for more than three months and having age between 18-65 years were included while those with dialysis duration less than three months, history of neuropsychiatric illness was excluded. Cognitive function was assessed using British Columbia Cognitive Complaints Inventory (BC-CCI) questionnaire. CI was defined on Likert scale as mild, moderate, and severe. Patients were followed up to one year regarding outcome measures. Results: One hundred and four patients were included in the study. Mean age was 45.86±11.11 years and Diabetes Mellitus (DM) was the most common cause of End Stage Renal Disease (ESRD) in 39(37.5%) patients. CI was found in 86(82.7%) patients in following order of severity: mild 61(58.7%), moderate 19(18.3%) and severe 6(5.9%). Increasing age (≥50 years), gender (female), Diabetes Mellitus (DM), unemployment and education <10th grade were found as significant predictors of CI (p<0.05). Significant positive correlations of CI score with age (r=0.338, p<0.001) and MHD duration (r=0.211, p=0.032) were found. However, the CI was not significantly associated with mortality (p=0.302). Conclusion: CI was common in MHD patients. Factors affecting CI were increasing age, female gender, DM, unemployment and low education level. CI was not associated with mortality in MHD patients.

Risk factors for Hyponatremia in COVID-19 hospitalised patients.

Objectives: To determine the risk factors for Hyponatremia in Coronavirus disease 2019 (COVID-19) patients. Methods: Medical records of all patients admitted in COVID-19 Isolation Intensive Care Unit of Farooq Hospital Westwood Branch, Lahore from 1st July to 30th September, 2020 were retrospectively reviewed. Patients with confirmed diagnosis of COVID-19 by Real Time Polymerase Chain Reaction (RT-PCR) and having Hyponatremia (serum Sodium (s/Na+ <135mEq/L) were included, patients with Eunatremia (s/Na+ within 135 - 145mEq/L) were taken as control while subjects with Hypernatremia (s/Na+ >145mEq/L) at admission, incomplete medical records and pregnant females were excluded from the study. Demographic, clinical and laboratory data at time of admission in hospital was extracted. Results: Of 182 included patients, 79.1% (n=144) were male 40.7% (n=74) had Diabetes Mellitus (DM) and 44.5% (n=81) were hypertensive. Forty seven percent (n=86) patients had Hyponatremia while 52.7% (n=96) were eunatremic. Forty nine percent (n=90) patients had Acute Kidney Injury (AKI) and 4.9% (n=9) patients died. Risk factors for Hyponatremia were age >60 years (OR=2.52, p=0.006); DM (OR=2.79, p=0.001); Hypoxemia (OR=3.74, p<0.001); Lymphopenia (OR=7.62, p<0.009); Hypoalbuminemia (OR=9.15, p<0.001); high serum Ferritin (OR=4.46, p<0.001), high Neutrophil to Lymphocyte Ratio (NLR) (OR=3.58, p<0.001) and AKI (OR=3.40, p<0.001). Conclusions: Hyponatremia was common in COVID-19 hospitalized patients. Increasing age, DM, Hypoxemia, Hypoalbuminemia, high serum Ferritin and AKI were the most significant risk factors for Hyponatremia. Hyponatremic patients had comparatively higher mortality than Eunatremic patients.

Biological control of fungal pathogens of tomato (Lycopersicon esculentum) by chitinolytic bacterial strains.

The need to increase food production and to reduce the pollution caused by synthetic chemicals has led to a search for biocontrol agents against plant pathogens. In the present study, a total of 37 chitinolytic bacteria were isolated from the rhizospheric soil of tomatoes using a chitin agar medium. In vitro bacterial isolates, that is, TD9, TD11, TD15, and TD24 showed strong antagonistic and enzymatic activities against Rhizoctonia (8%-55%), Fusarium (31%-48%), Colletotrichum (24%-49%), and Aspergillus on a dual culture plate and enzyme assay. Furthermore, these putative antagonistic bacterial isolates were identified as Pantoea agglomerans (TD9), Bacillus subtilis (TD11), Bacillus cereus (TD15 and TD24) using 16S rRNA sequence analysis. Additionally, in culture filtrate in vivo assay, the isolates TD11 and TD15 inhibited the growth of Rhizoctonia solani about 40% and Fusarium oxysporum about 80%. However, in the pot trials, these two bacterial isolates (TD11 and TD15) considerably suppressed the disease rate in tomatoes caused by Fusarium and Rhizoctonia fungal species. Moreover, it was concluded that B. subtilis (TD11) was found to be the most promising putative biocontrol agent, inhibiting the fungal diseases of tomatoes by 50% and showing versatile antagonistic potential.

Association of Chest Xray (CXR) findings with outcomes in COVID-19 Patients.

Objective: To investigate chest radiography findings in suspected coronavirus disease-2019 patients in a tertiary care setting. METHODS: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of coronavirus disease-2019 cases admitted to the tertiary care centre from March 1 to March 30, 2020. A predesigned proforma was used to gather data, including demographics, like age and gender, co-morbidities, presenting symptoms and chest radiography findings during the admission. Length of stay and mortality were the outcome measures. Data was analysed using SPSS 22. RESULTS: Of the 154 suspected cases, 46(29.8%) tested positive for coronavirus disease-2019; 29(63%) males and 17(37%) females with a mean age of 50.7±19.1 years. Abnormal chest radiography was noted in 25(54.3%) cases, with bilateral pulmonary infiltrates being the most common finding 19(41.3%). Mortality was the outcome in 7(28%) of these cases, and the mean length of hospital stay was 9.3±7.3 days. Abnormal chest radiography findings were associated with an increased risk of mortality (p=0.009) and a longer hospital stay (p=0.017). Conclusion: Abnormal chest radiography findings were frequently seen in coronavirus disease-2019 patients and were also associated with increased risk of mortality and prolonged hospital stay.

Frequency and Risk Factors for Acute Kidney Injury in patients with COVID-19.

Objective: To determine the frequency of Acute Kidney Injury (AKI) and its underlying risk factors in patients with Coronavirus Disease (COVID-19). Methods: This retrospective study was conducted by reviewing the medical records of patients admitted in Covid-19 Intensive Care Unit (ICU) of Farooq Hospital, West Wood Branch, Lahore during the period from 1st April, 2020 to 30th June, 2020. COVID-19 was diagnosed on basis of Real Time Polymerase Chain Reaction (RT-PCR) through nasal swab. Demographic, clinical and laboratory data were collected at the time of admission in the hospital. AKI was diagnosed on basis of ≥ 0.3 mg/dl increase in serum Creatinine (sCr) from baseline during the hospital stay. The outcome of study was AKI. Results: One hundred and seventy-six patients who fulfilled the inclusion criteria were recruited of which most were males (78.4%). The mean age was 51.26 ± 15.20 years and the frequency of AKI was 51.1%. The risk factors for AKI were increasing age (OR=2.10, p=0.017); presence of COVID-19 symptoms (OR=6.62, p=0.004); prolonged hospital stay (OR=2.26, p=0.011); Diabetes Mellitus (OR=1.81, p=0.057); hypoxemia (OR=5.98, p=0.000); leukocytosis (OR=2.91, p=0.002); lymphopenia (OR=5.77, p=0.000); hypoalbuminemia (OR=4.94, p=0.000); elevated C-reactive protein (CRP) (OR=6.20, p=0.000) and raised D-diamers (OR=3.16, p=0.000). Conclusions: AKI was present in half of the COVID-19 patients. The most significant risk factors for AKI were increasing age, prolonged hospital stay, hypoxemia, hypoalbuminemia, DM and raised inflammatory markers.

Comparison between different methods of calculating Kt/V as the marker of adequacy of dialysis.

OBJECTIVES: To compare different methods of calculating adequacy of hemodialysis in terms of Kt/V. METHODS: This was an observational, quantitative study undertaken after the approval of Internal Review Board at the Hemodialysis Unit of Nephrology department, Mayo Hospital, Lahore from 1st December 2018 to 30th June 2019. Sixty hemodynamically stable patients of end stage renal disease undergoing hemodialysis for more than three months with age 18 to 70 years were included in the study by convenience non probability sampling. Critically ill patients with multiple co-morbidities like sepsis (i.e. total leukocyte count >11000 or <4000 x 109/L), ischemic heart disease, pace- makers, malignancies, cirrhosis etc. were excluded. Patients who were not adherent to dialysis prescription or hemodynamically unstable were also excluded. One way ANOVA and Pearson's correlation were used to find correlation between three methods of measuring Kt/V. RESULTS: Mean ultrafiltration was 2.1+ 0.76 liter/session. Pre dialysis weight was 64.7 +14.7 kgs, mean post dialysis weight was 62.5 + 14.7 kgs. For every patient blood flow rate was 300 ml/m and dialysis flow rate was 500 ml/min. The mean values of Kt/V measured by Daugirdas formula was 1.35 ± 0.33, mean online clearance monitoring (OCM) value was 1.17 ± 0.29 and by normogram was 1.36 ± 0.33. There was positive significant correlation between values of Daugirdas formula, Normogram and online clearance monitoring (OCM) i.e. r = 0.897 (p-value < 0.001) measured by Pearson's correlation and one way-ANOVA. CONCLUSION: Online clearance monitoring can be used for measuring adequacy of hemodialysis, but OCM slightly underestimates Kt/V as compared to Daugirdas formula and Normogram.

An integrated transcriptome and metabolome approach reveals the accumulation of taste-related metabolites and gene regulatory networks during watermelon fruit development.

MAIN CONCLUSION: Accumulation patterns and gene regulatory networks of sugars and cucurbitacins and related primary and secondary metabolites during cultivated watermelon 'Cheng Lan' and wild watermelon 'PI 632,751' fruit development were identified. Metabolites are the end products of cellular regulatory processes and play important roles in fruit taste formation. However, comprehensive studies on the accumulation patterns of watermelon fruit metabolites and transcriptional regulatory networks are still scarce. In this study, 451 annotated metabolites were identified at four key fruit developmental stages in wild watermelon 'PI 632,751' and modern cultivated watermelon 'Cheng Lan'. Interestingly, 11 sugars and 25 major primary metabolites were mainly accumulated in 'Cheng Lan' during fruit development, which are considered to be the potential metabolites beneficial to the formation of watermelon taste. Cucurbitacins and the main flavonoids were mainly specifically accumulated in 'PI 632,751', not being considered to be responsible for the taste. Moreover, forty-seven genes involved in carbohydrate metabolism, glycolysis, and TCA cycle were highly expressed in 'Cheng Lan', which was positively correlated with the accumulation of major primary metabolites. Alternatively, seven UDP-glycosyltransferase genes are closely related to the glycosylation of cucurbitacins through co-expression analysis. Our findings established a global map of metabolite accumulation and gene regulation during fruit development in wild and cultivated watermelons and provided valuable information on taste formation in watermelon fruit.

Molecular detection of Cryptosporidium: an emerging parasite in different water sources of 2010 flood-affected district Nowshera, Pakistan.

Cryptosporidium is a water-borne zoonotic parasite worldwide, usually found in lakes and rivers contaminated with sewage and animal wastes, causing outbreaks of cryptosporidiosis. In this study, 300 water samples were collected from four designated places of flood-affected district Nowshera consist of different water sources to find out the prevalence of Cryptosporidium via polymerase chain reaction (PCR). The overall prevalence of Cryptosporidium was 30.33% (91/300) with more prevalent 44% in drain water and low 5% in bore/tube well water. The prevalence in open well and tap water was recorded 33% and 20%, respectively. The highest prevalence was recorded in summer (June-September). The result of this study ensures enormous contamination of drinking water that requires appropriate treatment, cleaning and filtration to provide safe drinking water. Preventing water-borne disease and proper treatment of water supplies is essential to public health.

Prevalence and antifungal drug resistance of dermatophytes in the clinical samples from Pakistan.

Dermatophytosis is a major health problem all over the world including Pakistan. This is the first report of detection of dermatophytes and their antifungal drug resistance in the Northern and Western parts of Pakistan. A total of 154 samples were collected from different hospitals of Khyber Pakhtunkhwa, and out of them 136 samples were found positive. Tinea corporis (35%) was the most predominant type of infection followed by Tinea capitis (22%). The fungi identified in Tinea corporis infection types were identified as Trichophyton rubrum, Trichophyton mentagrophytes, Epidermophyton floccosum. The fungi identified in Tinea capitis included Trichophyton violaceum, T. mentagrophytes, Microsporum ferrugineum. The gender wise distribution showed both males (52%) and females (48%) were infected with the fungi. More cases belonged to the rural parts of the country. Age wise distribution showed that the infection was more prevalent in the children and the prevalence decreased with the increase in age. The positive samples were checked against two antifungal agents: fluconazole and nystatin. Among 136 positive samples, none of the isolates showed resistance to nystatin while 7% of the samples showed resistance to fluconazole. The resistant isolates were then identified by amplifying the 18S rRNA gene, using universal primers (ITS1, ITS4). Among the 9 resistant isolates, 5 isolates were identified as Trichophyton spp., 3 as Microsporum spp. and 1 as Epidermophyton spp.

Relation of total bilirubin and QT interval prolongation (from the Third National Health and Nutrition Examination Survey).

OBJECTIVE: The association of bilirubin with cardiovascular disease (CVD) is controversial. We sought to explore the association of total bilirubin (TB) levels with QT interval in a multiracial cohort. METHODS: A total of 6,627 participants (59.0 ± 13.3 years; 52.6% women, 49.7% Non-Hispanic Whites) without CVD from the Third National Health and Nutrition Examination Survey were included in this analysis. QT was automatically measured from digital 12-lead electrocardiogram in a central reading center. A multivariable logistic regression model was used to examine the cross-sectional association between tertiles of TB and prolonged QT interval (≥450 ms in men and ≥460 ms in women). RESULTS: The prevalence of prolonged QT was higher among those with higher levels of TB (prolonged QT prevalence was 4.7%, 6.8%, and 7.0% across TB lower (0-0.4 mg/dl), middle (0.5-1.6 mg/dl), and higher (0.70-4.30 mg/dl) tertiles, respectively). In a model adjusted for potential confounders, participants within the highest TB tertile had significantly greater odds of the prolonged QT interval (Odds ratios [95% confidence interval] 1.53 [1.16-2.02]) compared to those with bilirubin levels in the first tertile. Each 0.29 mg/dl increase in TB levels was associated with a 12% (p-value <.0001) increase in the prevalence of prolonged QT interval. This association was stronger in men than in women (interaction p-value = .04). CONCLUSION: Elevated bilirubin levels are associated with a prolonged QT interval. This finding extends our current knowledge on the relationship between serum bilirubin and CVD by demonstrating a link between higher TB and abnormal cardiac repolarization.

Role of halotolerant and chitinolytic bacteria in phytoremediation of saline soil using spinach plant.

Novel technologies are required for rapid reclamation of saline soils. The halotrophic and chitinolytic bacterial strains were used for phytoremediation of saline soils using spinach plants (Spinacia oleracea L.). The previously isolated chitinolytic bacteria showed high antifungal potential against Fusarium oxysporum, and Alternaria spp. The halotolerant bacterial strains were previously isolated showing a salt tolerance of up to 20% in culture media. Specially designed microcosms were used here to investigate the reclamation of saline soil by bacteria. The soil salinity was reduced by both types of bacteria (from 6.5 to 2 dS/m). A decline in Na contents from 22-24 to 9-12 meq/L and in sodium adsorption ratio from 10-11 to 7-8 was also observed in saline soils. The Ca/Mg contents increased from 24 to 30-33 meq/L. The bioassays were performed to evaluate the effect of the bacteria on the phytoremediation. The shoot, root weights (both fresh (1.927 g, 0.244 g) and dry (0.387 g, 0.104 g)) increased by bacterial inoculation as compared to control in saline soils. The Na/K ratio decreased in plant tissues. Here we report the increased efficacy of phytoremediation by combined inoculation of chitinolytic and halotolerant bacterial strains in soil which has never been reported before.

Association of vitamin D deficiency with electrocardiographic markers of left atrial abnormalities.

OBJECTIVE: Electrocardiographic markers of left atrial (LA) abnormalities are linked to increased risk of cardiovascular disease (CVD). We examined the relationship of vitamin D deficiency with prolonged P wave duration and PR interval as markers of LA abnormalities. METHODS: This analysis included 5,894 participants (58.12 ± 12.9 years; 54.7% women; 49.8% non-Hispanic Whites) without clinical CVD from NHANES III. A multivariable logistic regression model was used to examine the association of vitamin D categories (<20 ng/ml, 20-29 ng/ml and >30 ng/ml (reference) with prolonged P wave duration (≥120 ms) and PR interval (≥200 ms). RESULTS: There was an incremental increase in the prevalence of prolonged P wave duration and PR interval across vitamin D categories with the highest prevalence in study participants with vitamin D levels <20 ng/ml, followed by 20-29 ng/ml and then >30 ng/ml (trend p-value < 0.0001). Vitamin D deficiency (<20 ng/ml) was associated with prolonged P wave duration (OR [95% CI]: 1.22 [1.03-1.45], p = 0.02) and prolonged PR interval (OR [95% CI]: 1.48 [1.12-1.97], p = 0.006) in multivariable logistic regression models adjusted for demographics, CVD risk factors, and other potential confounders. These associations were consistent across subgroups stratified by age, sex, and race. CONCLUSIONS: Vitamin D deficiency is associated with an increased risk of LA abnormalities. This association elucidates an alternate pathway through which vitamin D deficiency may increase CVD risk. Whether vitamin D supplementation would improve LA abnormalities requires further investigation.

Changes in the Soil Microbiome in Eggplant Monoculture Revealed by High-Throughput Illumina MiSeq Sequencing as Influenced by Raw Garlic Stalk Amendment.

The incorporation of plant residues into soil can be considered a keystone sustainability factor in improving soil structure function. However, the effects of plant residue addition on the soil microbial communities involved in biochemical cycles and abiotic stress phenomena are poorly understood. In this study, experiments were conducted to evaluate the role of raw garlic stalk (RGS) amendment in avoiding monoculture-related production constraints by studying the changes in soil chemical properties and microbial community structures. RGS was applied in four different doses, namely the control (RGS0), 1% (RGS1), 3% (RGS2), and 5% (RGS3) per 100 g of soil. The RGS amendment significantly increased soil electrical conductivity (EC), N, P, K, and enzyme activity. The soil pH significantly decreased with RGS application. High-throughput Illumina MiSeq sequencing revealed significant alterations in bacterial community structures in response to RGS application. Among the 23 major taxa detected, Anaerolineaceae, Acidobacteria, and Cyanobacteria exhibited an increased abundance level. RGS2 increased some bacteria reported to be beneficial including Acidobacteria, Bacillus, and Planctomyces (by 42%, 64%, and 1% respectively). Furthermore, internal transcribed spacer (ITS) fungal regions revealed significant diversity among the different treatments, with taxa such as Chaetomium (56.2%), Acremonium (4.3%), Fusarium (4%), Aspergillus (3.4%), Sordariomycetes (3%), and Plectosphaerellaceae (2%) showing much abundance. Interestingly, Coprinellus (14%) was observed only in RGS-amended soil. RGS treatments effectively altered soil fungal community structures and reduced certain known pathogenic fungal genera, i.e., Fusarium and Acremonium. The results of the present study suggest that RGS amendment potentially affects the microbial community structures that probably affect the physiological and morphological attributes of eggplant under a plastic greenhouse vegetable cultivation system (PGVC) in monoculture.

Increased Viability of Sugar Transport-Deficient Mutant of the Periodontal Pathogen, Aggregatibacter actinomycetemcomitans.

The periodontal pathogen, Aggregatibacter actinomycetemcomitans is extremely sensitive to even a mildly acidic pH resulting from metabolic acids secreted during growth, losing viability rapidly as the pH goes below 6.0. Cells grown at high glucose concentration grow fast but rapidly lose viability. However, if the cells are grown at low glucose concentration, the pH of the growth medium first decreases slowly for about 24 h and then starts to increase. This increase of pH is indicative of cell death since the spontaneous rise of pH due to the presence of bicarbonate can no longer be opposed by secreted metabolic acids. By monitoring these pH changes on a petri dish, a method was developed to screen for sugar transport-deficient mutants from a library of transposon insertion mutants. Isolation of a mannose phosphotransferase mutant strain is described. The mutant cells were found to be more viable and for a longer period of time than wild-type cells both in high and low glucose concentrations due to slower metabolism and less acid secreted. This observation highlights the concern that spontaneous mutations in the sugar transport genes may be selected for in patients due to increased viability of the mutant cells especially in a biofilm.

Socio-economic factors affecting quality of life of Hemodialysis patients and its effects on mortality.

OBJECTIVE: Many factors affect quality of life (QOL) of dialysis patients. This study was conducted to determine the effect of socio-economic factors effecting QOL of hemodialysis patients. METHODS: This descriptive multi-centric, follow up study was conducted at Department of Nephrology, Mayo Hospital, Lahore, from February 2015 to August 2017. All patients who were on regular maintenance hemodialysis (MHD) for more than three months and able to read and understand Urdu version of Kidney Disease Quality Of Life (KDQOL) tool were included in the study. Patients were included from hemodialysis units of Mayo Hospital (MH), Shalamar Hospital (SH), and Shaikh Zayed hospital (SZH), Lahore. Patients with less than three-month duration on dialysis, with cognitive impairment, dementia, active psychosis, non-Urdu readers/speakers were excluded. Demographic data and lab data was collected on predesigned pro forma. Patients were divided into different groups on the basis of education, monthly income, source of funding for treatment and employment. Patients were followed up for two years to determine the effect of QOL on mortality. RESULTS: One hundred and thirty-five patients were included in the study. Socio-economic factors like education, employment, income, funding was compared with KDQOL sub scales and were found statistically significant (p-value (<0.05). We found that patients with higher income had better work status (p=0.039) but social (0.04) and sexual function (p=0.029) were relatively better in patients with low income. Employed patients had better work status (p=0.01), ability to do social function (p=0.027) but they had more pain (0.049), symptoms/problems of disease (p=0.05) and effect of kidney disease (p=0.015). Those patients whose dialysis were funded by their family could socially interact (p=0.012) better and deal more efficiently with effect of kidney disease (p=0.007). Higher education was associated with better emotional well being (p=0.045), patient satisfaction (p=0.046) and staff encouragement (p=0.045) then patient with lower level of education. QOL had no effect on mortality. CONCLUSION: The socio-economic factors consisting of education, employment, income and funding are important parameters affecting QOL of kidney patients. QOL does not affect mortality of the dialysis patients.

Identification for the First Time of Cyclo(d-Pro-l-Leu) Produced by Bacillus amyloliquefaciens Y1 as a Nematocide for Control of Meloidogyne incognita.

The aim of the current study was to describe the role and mechanism of Bacillus amyloliquefaciens Y1 against the root-knot nematode, Meloidogyne incognita, under in vitro and in vivo conditions. Initially, the exposure of the bacterial culture supernatant and crude extract of Y1 to M. incognita significantly inhibited the hatching of eggs and caused the mortality of second-stage juveniles (J2), with these inhibitory effects depending on the length of incubation time and concentration of the treatment. The dipeptide cyclo(d-Pro-l-Leu) was identified in B. amyloliquefaciens culture for the first time using chromatographic techniques and nuclear magnetic resonance (NMR ¹H, 13C, H-H COSY, HSQC, and HMBC) and recognized to have nematocidal activity. Various concentrations of cyclo(d-Pro-l-Leu) were investigated for their effect on the hatching of eggs and J2 mortality. Moreover, the in vivo nematocidal activity of the Y1 strain was investigated by conducting pot experiments in which tomato plants were inoculated with M. incognita. Each and every pot was amended 50 mL of fertilizer media (F), or Y1 culture, or nematicide (N) (only once), or fertilizer media with N (FN) at 1, 2, 3, 4 and 5 weeks after transplantation. The results of the pot experiments demonstrated the antagonistic effect of B. amyloliquefaciens Y1 against M. incognita as it significantly decreases the count of eggs and galls per root of the tomato plant as well as the population of J2 in the soil. Besides, the investigation into the growth parameters, such as the length of shoot, shoot fresh and dry weights of the tomato plants, showed that they were significantly higher in the Y1 strain Y1-treated plants compared to F-, FN- and N-treated plants. Therefore, the biocontrol repertoire of this bacterium opens a new insight into the applications in crop pest control.