Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.757
Filtrar
1.
Strabismus ; : 1-10, 2024 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-39351897

RESUMEN

Purpose: Strabismus is an ocular condition characterized by misalignment of the visual axis. The global prevalence of strabismus is about 2-3%, which varies between different countries and ethnicities. The aim of this study was to conduct a meta-analysis of studies, which had previously reported the prevalence of strabismus in Pakistan, in order to obtain the overall prevalence of strabismus in the country. Methods: All community-based studies reporting the prevalence of strabismus from Pakistan were searched using international databases and local ophthalmology journals. Information about sample size, number of individuals with strabismus, and location and duration of the study was recorded. Statistical analysis including heterogeneity testing, pooled prevalence calculation and regression analysis were done using the R software. Results: Heterogeneity tests, Pheterogeneity < .01, suggested high heterogeneity between the different studies. The pooled prevalence of strabismus was 0.7% [95% confidence interval (CI): 0.39%-1.23%] according to the random effects model, with a decreasing trend in prevalence from 1995 to 2020. Esotropia was more frequent than exotropia in both population-based and clinic-based studies. Conclusion: The prevalence of strabismus in Pakistan is comparatively lower than the worldwide prevalence, and it appears to be decreasing over the last three decades, consistent with global trends.

2.
Parasitology ; : 1-14, 2024 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-39355937

RESUMEN

The genus Ornithodoros is notably diverse within the family Argasidae, comprising approximately 134 species distributed among 4 subgenera, 1 of which is the subgenus Pavlovskyella. In an earlier study, we identified distinct soft ticks as Ornithodoros (Pavlovskyella) sp., which were collected from animal shelters in Khyber Pakhtunkhwa, Pakistan. Providing additional collections from that same locality and a comprehensive analysis involving detailed morphological and mitogenome-based comparisons with closely related species, this study formally designates a novel species for these specimens. Adults and late-instar nymphs of the new species display a dorsoventral groove, small cheeks not covering the capitulum, 5 small even humps on tarsus I and a transverse postanal groove intersecting the median postanal groove perpendicularly. It also lacks a tuft of setae on the ventral surface of the hood which separates the novel species from Ornithodoros papillipes. Ventral chaetotaxy of tarsus IV indicates 4­7 setal pairs in nymphs and 5­7 pairs in adults that separate the new species from Ornithodoros tholozani sensu stricto and Ornithodoros crossi, 2 morphologically closely related species that occur in geographical proximity. Phylogenetic analyses of the full-length mitochondrial genome and the 18S and 28S ribosomal RNA genes, combined with pairwise nucleotide comparisons of cox1, cox2, atp8, atp6, cox3, nad3, nad5, nad4, nad4L, nad6, cytb, nad1, nad2, 12S rDNA, 16S rDNA, 18S rDNA and 28S rDNA further support that the new species belongs to the Pavlovskyella subgenus, clustering with O. tholozani, Ornithodoros verrucosus and Ornithodoros tartakovskyi.

3.
Cureus ; 16(8): e68266, 2024 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-39350806

RESUMEN

Background Acute coronary syndrome (ACS) is a significant cause of mortality and morbidity globally, necessitating effective intervention strategies. Early invasive procedures such as percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are often recommended for high-risk patients. However, their cost-effectiveness in low-income regions remains uncertain, particularly in Pakistan, where healthcare resources are limited. Objective This study aims to evaluate the cost-effectiveness of early invasive procedures compared to standard care for ACS in low-income regions of Pakistan. Methods We conducted a prospective cohort study from January 1, 2021, to January 31, 2021, at four major hospitals in Pakistan: Army Cardiac Center Combined Military Hospital (CMH) Lahore, National Institute of Cardiovascular Diseases in Karachi, Lady Reading Hospital in Peshawar, and Mardan Medical Complex. The participants included 436 patients diagnosed with ACS aged 18 years or older and presenting within 24 hours of symptom onset. The patients were divided into two groups: the early invasive procedure group (n = 218) and the standard care group (n = 218). The primary outcome was the 30-day mortality rate. Secondary outcomes included recurrent myocardial infarctions, hospital readmissions, healthcare costs, and procedural complications. Data were analyzed using SPSS version 25.0 (IBM SPSS Statistics, Armonk, NY), employing descriptive statistics, chi-square tests, independent t-tests, and Kaplan-Meier survival analysis. Results The early invasive procedure group showed a mortality rate of 18 (8%) compared to 33 (15%) in the standard care group, demonstrating a significant reduction in mortality (p = 0.01). Additionally, the average healthcare cost was significantly lower in the early invasive group, with mean costs of Pakistani rupee (PKR) 187,200 (US dollar {USD} 1,200) compared to PKR 280,800 (USD 1,800) in the standard care group (p < 0.01). Recurrent myocardial infarctions occurred in 11 (5%) of the early invasive group versus 26 (12%) in the standard care group (p < 0.05). Hospital readmission rates were lower in the early invasive group, 22 (10%) compared to 39 (18%) in the standard care group (p < 0.05). Healthcare costs were significantly lower in the early invasive group, with mean costs of PKR 187,200 (USD 1,200) compared to PKR 280,800 (USD 1,800) in the standard care group (p < 0.01). Conclusion Early invasive procedures for ACS significantly improve survival rates, reduce complications, and lower healthcare costs in low-income regions of Pakistan. These findings suggest that such strategies should be considered in resource-limited settings to optimize patient outcomes and healthcare resource utilization.

4.
Ann Burns Fire Disasters ; 37(3): 226-232, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39350893

RESUMEN

The management of burn wounds is a major challenge throughout the globe. Superficial and partial-thickness burns generally do not need any surgical intervention, however, severe cases of burn injury require dressings (antimicrobial) and surgery in the worst-case scenario. The present study was conducted to assess the efficacy of bacterial nanocellulose dressing versus hydrocolloid dressing. All patients presenting with partial-thickness second-degree burns from June 2021 to May 2022 were screened for this randomized control trial; 65 burn patients were included in each group of this trial. The control group of patients was treated with hydrocolloid dressing and the experimental group with bacterial nanocellulose dressing sheets. Every third day, the wound was assessed. Other data collected included age, sex, %TBSA burned, signs of infection, time for epithelialization, and length of hospital stay. Statistical analyses were performed to see the significance of differences between the treatment groups by adjusting for size and depth of burn, and the patient's age. There were 130 patients (65 in each group). The median age for the whole group was 17.4 years, and 51.53% (n=67) were males. The average TBSA was 22.4%, with a minimum of 10% and a maximum of 31%. Eleven of the patients had their burns excised, and four were given skin grafts in the control group. In the case of the experimental group, four excisions were performed, and one skin graft. Wound-related pain scores were low (mean of 2.6) for the bacterial nanocellulose group and higher for the hydrocolloid group. Hydrocolloid dressing is more cost effective than bacterial nanocellulose dressing. However, the pain scores were high, and healing time was less in the bacterial nanocellulose group. Moreover, the hydrocolloid group is more prone to infection due to frequent dressing changes.


La prise en charge des brûlés est un problème mondial de santé publique. Si les brûlures superficielles et intermédiaires guérissent habituellement spontanément, les plus sévères nécessitent une prise en charge chirurgicale, après pansements antibactériens. Cette étude a pour but de comparer l'efficacité des pansements à l'hydrocellulose bactérien et l'hydrocolloïde. Tous les patients souffrant de brûlures intermédiaires vus entre juin 2021 et mai 2022 ont été tirés au sort pour former 2 groupes de 65, de 17,4 ans d'âge médian avec une légère prédominance masculine (67 soit 51,53%), brûlés sur 22,4% de SCT en moyenne (10-31). Le groupe contrôle avait des pansements à l'hydrocolloïde (HC), le groupe à l'étude au nanocellulose bactérien (NB), la plaie étant évaluée tous les 3 jours. Les variables à l'étude étaient l'âge, le sexe, la surface brûlée, les signes d'infection, le délai d'épithélialisation et la durée de séjour. Les comparaisons ont été ajustées sur la surface, la profondeur et l'âge. Dans le groupe HC, 11 patients ont été excisés et 4 greffés contre 4 et 1 dans le groupe NB. La douleur des NB était à 2,6 ; elle était plus élevée dans le groupe HC. Le NB est plus cher que le HC. Il faut toutefois rapporter ce coût à une douleur moindre et à une cicatrisation plus rapide. Qui plus est, les patients sous HC sont plus à risque d'infection en raison de changements de pansements plus fréquents.

5.
Acta Trop ; 260: 107421, 2024 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-39357565

RESUMEN

Plasmodium vivax Duffy binding protein (PvDBP) is crucial for erythrocyte invasion, interacting with the Duffy Antigen Receptor for Chemokines (DARC) on the erythrocyte surface. The amino-terminal cysteine-rich region II of PvDBP (PvDBPII) is a promising blood stage vaccine candidate, yet the genetic polymorphisms of this protein in global P. vivax isolates complicate the design of effective vaccines against vivax malaria. This study analyzed the genetic polymorphism of PvDBPII in Pakistan P. vivax isolates. A total of 29 single nucleotide polymorphisms (SNPs), including 22 nonsynonymous SNPs, were identified in 118 Pakistan PvDBPII. Most amino acid substitutions occurred in subdomains II and III, with six commonly observed in the global PvDBPII population. The amino acid change patterns in Pakistan PvDBPII generally mirrored those in global PvDBPII, although the frequencies of amino acid changes varied by country. Nucleotide diversity in Pakistan PvDBPII was comparable to that found in global PvDBPII. Evidence of natural selection and recombination in Pakistan PvDBPII aligned with observations in global PvDBPII. Analysis of the haplotype network of global PvDBPII revealed a complexed network of 167 haplotypes, but no geographical clustering was observed. The findings are crucial for understanding the genetic characteristics of Pakistan PvDBPII. A comprehensive analysis of nucleotide diversity and evolutionary trends in the global PvDBPII population offers valuable insights for the development of vivax malaria vaccines based on this antigen.

6.
Comp Immunol Microbiol Infect Dis ; 114: 102248, 2024 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-39378535

RESUMEN

Cysticercosis, caused by larval stage of Taenia (T.) hydatigena is a disease of veterinary concern which causes major economic losses in livestock sector globally. Although livestock is the most productive part of Pakistan's economy, the epidemiological prevalence and genetic diversity of T. hydatigena has not been studied in great detail. Current study was undertaken for the estimation of the prevalence and genetic diversity of T. hydatigena among the goats and sheep of Multan in South Punjab, Pakistan. A PCR protocol targeting the cytochrome c oxidase subunit 1 (cox1) gene of T. hydatigena revealed an overall prevalence of 31.33 % among the small ruminants with higher prevalence in females (40.86 %) and older age group of >3-≤5 years (40.74 %). A total of 30 isolates were sequenced for partial mitochondrial cox1 gene which yielded 12 haplotypes with a haplotype diversity of 0.798 ± 0.68 and nucleotide diversity of 0.0046 ± 0.00183. A star like configuration was demonstrated in the haplotype network with a centrally positioned haplotype. Neutrality indices like Tajima's D and Fu's Fs were also biased towards negativity, a characteristic which suggests an expanding parasitic population. Moreover, the genetic diversity of T. hydatigena was also computed for the partial cox1 gene sequences available on GenBank, NCBI. A total of 415 sequences were retrieved out of which 142 haplotypes were identified having a haplotype diversity of 0.9150 ± 0.012 coupled with a nucleotide diversity of 0.00830 ± 0.00043. The haplotype profile of T. hydatigena population displayed an absence of a central haplotype, however, considerable genetic variation was ascertained. All the populations except Africa had a high haplotype diversity (>0.9), however, high Fst values were observed for a few populations which elucidated limited gene flow among the populations of Central/East Asia, Middle East, Europe and South Asia.

7.
J Hazard Mater ; 480: 136064, 2024 Oct 05.
Artículo en Inglés | MEDLINE | ID: mdl-39369674

RESUMEN

High arsenic (As), fluoride (F-), and microbial pathogens coexist in semiarid conditions afflicting > 240 million people worldwide including Pakistan. Groundwater quality has declined due to geogenic and manmade activities providing suitable ground for ubiquity, bioavailability, and toxicity of contaminants. We tested the health hazard, distribution, and apportionment of As, F-, and microbes in groundwater around coal mines in Quetta, Pakistan. The range of As, and F- concentrations in groundwater were 0.2-16.6 µg/L, 0.4-18.5 mg/L. Both, As and F- correlate with high HCO3-, pH, Na+, SO42-, Fe, and Mn, and negatively with Ca2+ water. The coalfield showed many folds higher As 15.8-28.5 µg/L, and F- 10.8-34.5 mg/L compared to groundwater-wells. Geochemical phases revealed saturation of groundwater with calcite, dolomite, fluorite, gypsum, and undersaturation with halite-mirabilite, and arsenopyrite minerals. The positive matrix factorization (PMF) model assessed five-factor solutions: geogenic, industrial, coal mining, sulfide & fluoride-bearing mineral-dissolution, and agriculture pollution delivered As, F-, and microbial contamination. About 24.6 % and 64.4 % of groundwater samples exceeded the WHO guidelines of As 10 µg/L, F- 1.5 mg/L. The carcinogenicity, and non-carcinogenicity of As, and F- were higher in children than adults. Therefore, health hazards in children are of great concern in achieving sustainable management goals.

9.
Antonie Van Leeuwenhoek ; 118(1): 16, 2024 Oct 09.
Artículo en Inglés | MEDLINE | ID: mdl-39382798

RESUMEN

Streptococcus pneumoniae is a major cause of meningitis in under developed countries with low vaccination rates and high antibiotic resistance. This study aimed to analyze 83 suspected meningitis patients in Karachi for the detection of S. pneumoniae followed by its whole genome sequencing and Pan Genome analysis. Out of the 83 samples collected, 33 samples with altered physical (turbidity), cytological (white blood cell count) and biochemical (total protein and total glucose concentrations) parameters indicated potential meningitis cases, while these parameters were within normal healthy ranges in remaining 50 samples. Latex particle agglutination (LPA) was performed on the 33 samples, revealing 20 positive cases of bacterial meningitis. The PCR and culturing methods revealed 5 S. pneumoniae isolates. Antibiotic susceptibility tests showed that one S. pneumoniae strain was resistant to erythromycin, levofloxacin, and tetracycline. Whole-genome sequencing of this resistant strain was performed and S. pneumoniae was confirmed with MLST analysis, while it had > 2.3 Mb genome and a single repUS43 plasmid. In CARD analysis, the strain had tet(M), ermB, RlmA(II), patB, pmrA, and patA ARGs, which could provide resistance against tetracycline, macrolide, fluoroquinolone, and glycopeptide antibiotics. Phylogenetic analysis revealed that the isolate was closely related to strains from Hungary and the USA. Pan-genome analysis with 144 genome assemblies from NCBI database showed that 1101 non-redundant core genes were shared between all strains. This study gives valuable understanding into the prevalence and characterization of meningitis-causing bacteria in Karachi, Pakistan  with prime focus on multi-drug resistant S. pneumoniae.


Asunto(s)
Antibacterianos , Farmacorresistencia Bacteriana Múltiple , Genoma Bacteriano , Pruebas de Sensibilidad Microbiana , Filogenia , Streptococcus pneumoniae , Secuenciación Completa del Genoma , Streptococcus pneumoniae/genética , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pneumoniae/aislamiento & purificación , Humanos , Farmacorresistencia Bacteriana Múltiple/genética , Antibacterianos/farmacología , Líquido Cefalorraquídeo/microbiología , Masculino , Femenino , Preescolar , Genómica , Tipificación de Secuencias Multilocus , Meningitis Neumocócica/microbiología , Meningitis Neumocócica/líquido cefalorraquídeo , Pakistán , Niño , Meningitis Bacterianas/microbiología , Meningitis Bacterianas/líquido cefalorraquídeo , Adulto , Lactante
10.
Cureus ; 16(9): e69958, 2024 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-39445238

RESUMEN

BACKGROUND: Ventriculoperitoneal (VP) shunts are a common medical intervention used to treat hydrocephalus, a condition characterized by the accumulation of cerebrospinal fluid (CSF) in the brain's ventricles, leading to increased intracranial pressure. While VP shunts are effective in managing hydrocephalus, they can lead to complications such as the formation of abdominal pseudocysts, which can compromise the functionality of the shunt and pose significant health risks. OBJECTIVE: The primary objective of this study was to determine the incidence of pseudocyst formation in patients with VP shunts in Pakistan. The secondary objective was to evaluate the outcomes of conservative versus surgical management strategies and identify risk factors associated with pseudocyst recurrence in this population. METHODS: This prospective observational study was conducted at Jinnah Teaching Hospital, Pakistan, from January 2021 to December 2022. The study included 50 patients diagnosed with pseudocysts associated with VP shunts. Participants were managed with either conservative (observation and aspiration) or surgical interventions (shunt revision, relocation, removal, or pseudocyst excision). The primary outcome measures were the resolution rates of pseudocysts and the incidence of complications. Statistical analysis was performed using chi-square tests, t-tests, and Kaplan-Meier survival analysis, with significance set at p<0.05. RESULTS: The study found a 3.5% incidence of pseudocysts among 1400 VP shunt patients. The median time to pseudocyst formation was 22 months (IQR 18-30). Surgical management yielded an 85% resolution rate compared to 60% for conservative management (p = 0.02). The recurrence of pseudocysts was significantly associated with advanced age (HR 1.8, 95% CI 1.1-3.2), a higher BMI (HR 2.1, 95% CI 1.3-3.7), and the presence of hydrocephalus (HR 1.6, 95% CI 1.2-2.9). Although surgical interventions had a higher complication rate (14% vs. 6% for conservative management), the difference was not statistically significant (p = 0.1). CONCLUSION: The study highlights a 3.5% incidence of pseudocysts in VP shunt patients, with surgical management proving more effective than conservative methods despite a slightly higher, non-significant risk of complications. These findings underscore the importance of tailored patient management, particularly for those at higher risk of recurrence, and suggest the need for further research to enhance surgical techniques and outcomes, especially in resource-limited settings.

11.
Gates Open Res ; 8: 94, 2024.
Artículo en Inglés | MEDLINE | ID: mdl-39429544

RESUMEN

Maternal immunization is a critical strategy to prevent both maternal and infant morbidity and mortality from several infectious diseases. When the first COVID-19 vaccines became available during the pandemic, there was mixed messaging and confusion amongst the broader public and among those associated with health care systems about the recommendations for COVID-19 vaccinations in pregnancy in many countries. A multi-country, mixed-methods study is being undertaken to describe how vaccine decision-making occurs amongst pregnant and postpartum women, with a focus on COVID-19 vaccines. The study is being conducted in Brazil, Ghana, Kenya, and Pakistan. In each country, participants are being recruited from either 2 or 3 maternity hospitals and/or clinics that represent a diverse population in terms of socio-economic and urban/rural status. Data collection includes cross-sectional surveys in pregnant women and semi-structured in-depth interviews with both pregnant and postpartum women. The instruments were designed to identify attitudinal, behavioral, and social correlates of vaccine uptake during and after pregnancy, including the decision-making process related to COVID-19 vaccines, and constructs such as risk perception, self-efficacy, vaccine intentions, and social norms. The aim is to recruit 400 participants for the survey and 50 for the interviews in each country. Qualitative data will be analyzed using a grounded theory approach. Quantitative data will be analyzed using descriptive statistics, latent variable analysis, and prediction modelling. Both the quantitative and qualitative data will be used to explore differences in attitudes and behaviors around maternal immunization across pregnancy trimesters and the postpartum period among and within countries. Each country has planned dissemination activities to share the study findings with relevant stakeholders in the communities from which the data is collected and to conduct country-specific secondary analyses.


Asunto(s)
Vacunas contra la COVID-19 , COVID-19 , Toma de Decisiones , Mujeres Embarazadas , Humanos , Femenino , Embarazo , Estudios Transversales , Ghana , Kenia/epidemiología , COVID-19/prevención & control , COVID-19/epidemiología , Vacunas contra la COVID-19/administración & dosificación , Brasil/epidemiología , Mujeres Embarazadas/psicología , Pakistán , SARS-CoV-2/inmunología , Adulto , Vacunación/psicología , Vacunación/estadística & datos numéricos , Complicaciones Infecciosas del Embarazo/prevención & control
12.
BMC Public Health ; 24(1): 2897, 2024 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-39434086

RESUMEN

BACKGROUND: Adverse Childhood Experiences are a significant global public health concern as these experiences have adverse effects on all the health determinants. METHODS: The interpretive phenomenological research design was used to explore the implications of adverse childhood experiences on the adult life of university students. An interpretive thematic analysis method was employed to analyze this study. RESULTS: Five major themes emerged after a comprehensive review of the information obtained from the interviews with the ten selected participants. These were (1) Chronic health struggles (2) Mental health disorders (3) Emotional and social difficulties (4) Paranoia and distrust and (5) Academic and professional under-performance. CONCLUSION: This study concludes that adverse childhood experiences have long-lasting negative effects on university students' health and behaviour, preventing them from leading healthy lives and excelling academically and professionally.


Asunto(s)
Experiencias Adversas de la Infancia , Investigación Cualitativa , Estudiantes , Humanos , Universidades , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Pakistán , Femenino , Masculino , Experiencias Adversas de la Infancia/psicología , Experiencias Adversas de la Infancia/estadística & datos numéricos , Adulto Joven , Adulto , Trastornos Mentales/psicología
13.
BMC Public Health ; 24(1): 2886, 2024 Oct 19.
Artículo en Inglés | MEDLINE | ID: mdl-39427150

RESUMEN

BACKGROUND: Emergency contraceptive pills (ECPs) are significantly underutilized in many parts of the world, especially in South-Asia. Within Pakistan, despite the population surge, the utilization of ECPs remains alarmingly low. The purpose of this study was to investigate the knowledge and practices regarding ECPs amongst married women and men in Karachi, Pakistan and the possible barriers hindering access to and use of these contraceptives. METHODOLOGY: A multi-centric cross-sectional study was conducted in Karachi, Pakistan. Interviews were conducted with participants using validated questionnaire involving different sections on demographics, knowledge, practices, and barriers to ECP use. Categorical variables were summarized as frequencies and percentages while continuous variables were characterized using mean and standard deviation. A chi-square test of variance was used for association between knowledge scores and different categorical values. A p-value of < 0.05 at 95% CI was statistically significant. RESULTS: Over half of the respondents (52.5%) were not using any method of contraception. 11.1% of respondents had used ECP at some point in their life. 337 (85.8%) participants had low knowledge, 55 (14%) had moderate while only 1 (0.25%) had high knowledge regarding ECPs. There was no significant association of knowledge scores with gender, age, employment status or parity. However, participants who had received counseling for family planning in the past or had previously used ECPs had significantly higher knowledge regarding ECPs. A majority 58% (221) of the participants expressed concerns about the potential side effects and 128 (33.9%) of them believed that ECPs were in contradiction to their religious and moral values. CONCLUSION: Our study in Karachi, Pakistan, highlights critical challenges in ECP awareness, utilization, and family planning. Although the results show improved ECP usage than studies previously done in Pakistan, there is a further need to increase the reach of ECPs through a variety of methods. Persistent myths and misconceptions and a severe lack of awareness further hinders their use.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Accesibilidad a los Servicios de Salud , Humanos , Pakistán , Estudios Transversales , Femenino , Adulto , Masculino , Accesibilidad a los Servicios de Salud/estadística & datos numéricos , Adulto Joven , Anticonceptivos Poscoito , Persona de Mediana Edad , Encuestas y Cuestionarios , Adolescente
14.
Antibiotics (Basel) ; 13(10)2024 Oct 04.
Artículo en Inglés | MEDLINE | ID: mdl-39452204

RESUMEN

Background: Wastewater is a major source of Antibiotic-Resistant Bacteria (ARB) and a hotspot for the exchange of Antibiotic-Resistant Genes (ARGs). The occurrence of Carbapenem-Resistant Bacteria (CRB) in wastewater samples is a major public health concern. Objectives: This study aimed to analyze Antibiotic resistance in bacteria from wastewater sources in Pakistan. Methods: We analyzed 32 bacterial isolates, including 18 Escherichia coli, 4 Klebsiella pneumoniae, and 10 other bacterial isolates using phenotypic antibiotic susceptibility assay and whole-genome sequencing. This study identified the ARGs, plasmid replicons, and integron genes cassettes in the sequenced isolates. One representative isolate was further sequenced using Illumina and Oxford nanopore sequencing technologies. Results: Our findings revealed high resistance to clinically important antibiotics: 91% of isolates were resistant to cefotaxime, 75% to ciprofloxacin, and 62.5% to imipenem, while 31% showed non-susceptibility to gentamicin. All E. coli isolates were resistant to cephalosporins, with 72% also resistant to carbapenems. Sequence analysis showed a diverse resistome, including carbapenamases (blaNDM-5, blaOXA-181), ESBLs (blaCTX-M-15, blaTEM), and AmpC-type ß-lactamases (blaCMY). Key point mutations noticed in the isolates were pmrB_Y358N (colistin) and ftsI_N337NYRIN, ftsI_I336IKYRI (carbapenem). The E. coli isolates had 11 different STs, with ST410 predominating (28%). Notably, the E. coli phylogroup A isolate 45EC1, (ST10886) is reported for the first time from wastewater, carrying blaNDM-5, blaCMY-16, and pmrB_Y358N with class 1 integron gene cassette of dfrA12-aadA2-qacEΔ1 on a plasmid-borne contig. Other carbapenamase, blaNDM-1 and blaOXA-72, were detected in K. pneumoniae 22EB1 and Acinetobacter baumannii 51AC1, respectively. The integrons with the gene cassettes encoding antibiotic resistance, and the transport and bacterial mobilization protein, were identified in the sequenced isolates. Ten plasmid replicons were identified, with IncFIB prevalent in 53% of isolates. Combined Illumina and Oxford nanopore sequencing revealed blaNDM-5 on an IncFIA/IncFIC plasmid and is identical to those reported in the USA, Myanmar, and Tanzania. Conclusions: These findings highlight the environmental prevalence of high-risk and WHO-priority pathogens with clinically important ARGs, underscoring the need for a One Health approach to mitigate ARB isolates.

15.
J Fungi (Basel) ; 10(10)2024 Oct 08.
Artículo en Inglés | MEDLINE | ID: mdl-39452653

RESUMEN

Potato (Solanum tuberosum L.) is one of the emerging staple crops in Pakistan, with Punjab producing over 95% of the country's potatoes. Wilt is an emerging threat to the potato crop worldwide, including in Pakistan. We identified and characterized Fusarium species associated with potato wilt in Pakistan through morphological and molecular analyses. Samples were collected during the 2020-2022 potato seasons from five major potato-growing regions: Sahiwal, Chichawatni, Pakpattan, Kamalia, and Faisalabad. Morphological characterization, internal transcribed spacer (ITS) sequencing, specific translation elongation factor 1-alpha (TEF) sequencing, and phylogenetic analysis were used to identify six different Fusarium species: F. oxysporum, F. equiseti, F. incarnatum, F. fujikuroi, F. annulatum and F. thapsinum. Pathogenicity tests in a greenhouse revealed that F. oxysporum and F. equiseti were responsible for Fusarium wilt in all sampled regions, with F. oxysporum being more prevalent in wilted samples. This is the first report of F. equiseti on wilted potatoes in Pakistan. In vitro biocontrol tests using Trichoderma harzianum showed 89% inhibition against F. equiseti and 65% inhibition against F. oxysporum. These findings on F. equiseti will aid in developing future control strategies, including biocontrol measures for Fusarium wilt in potatoes.

16.
Sci Rep ; 14(1): 25613, 2024 10 27.
Artículo en Inglés | MEDLINE | ID: mdl-39463378

RESUMEN

Hepatitis C virus (HCV) transmission remains a significant public health concern. It is well documented globally, however, Nowshera district, Pakistan, is lacking such profile. This study aims to explore the relationship between HCV infection and several risk factors, including socio-demographic, clinical and personal life-style factors. This study using a cross-sectional design, examined 606 randomly selected individuals visiting the Pathology department at Qazi Hussain Medical Complex and District Headquarter (DHQ) Hospital Nowshera between May 1, 2022 and Jun 30, 2023. This research investigation employed a methodical approach involving formal interviews in conjunction with structured questionnaires to gather comprehensive information related to socio-demographic characteristics, clinical history, and personal hygiene practices. We collected 10 ml of blood samples and tested the separated serum to identify markers using the Immuno-Chromatographic Test (ICT) and the Enzyme-Linked Immunosorbent Assay (ELISA). IBM SPSS Statistics version 27 was used for data analysis. To measure the association between dependent variable and independent variables, a chi-square and risk analysis was carried out; multiple logistic regression was employed for modeling the risk factors associated with independent variable. A statistical significance level was established at a P-value of less than 0.05. In present study, which included 606 participants, 12% were found to be infected with HCV. Importantly it revealed that facial shave at barber (adjusted odds ratio, aOR = 40.65, p = 0.000) represents the most prevalent mode of HCV transmission. Additionally, a strong association was observed between HCV infection and history of past surgery (RR = 2.98, p = 0.001), HCV infected family member (aOR = 4.28, p = 0.001), workplace injuries (aOR = 6.68, p = 0.000), history of hospital admission (RR = 2.09), practicing ear and nose piercing (aOR = 5.01, p = 0.001), dental treatment (RR = 2.31) and the frequency of injections (aOR = 8.607, p = 0.000). These findings underscore the pressing need for targeted interventions. This study highlights the paramount importance of understanding the modes of HCV transmission and their associated risk factors. The results emphasize the need for educational initiatives, both within the healthcare sector and among the general public, to combat HCV transmission effectively. By implementing sterilization procedures and increasing awareness, we can make significant strides in reducing the burden of HCV infection. Moreover, proactive measures within families can help contain the spread of the virus, ultimately contributing to improved public health.


Asunto(s)
Hepatitis C , Humanos , Pakistán/epidemiología , Hepatitis C/epidemiología , Hepatitis C/transmisión , Femenino , Masculino , Factores de Riesgo , Adulto , Estudios Seroepidemiológicos , Persona de Mediana Edad , Estudios Transversales , Adulto Joven , Adolescente , Hepacivirus , Anciano
17.
World Neurosurg ; 2024 Oct 07.
Artículo en Inglés | MEDLINE | ID: mdl-39384111

RESUMEN

BACKGROUND: A low neurosurgeon-to-patient ratio persists to be a problem in many developing nations including Pakistan. Concurrent gender disparities further exacerbate the challenges posed by the already limited workforce. An understanding of the perceptions of neurosurgery among female early career doctors is crucial in the evolution of the field in terms of both, workforce strength and inclusivity. METHODS: A cross-sectional study was conducted across public and private medical schools of Pakistan. A close-ended self-administered questionnaire was employed to assess subject-reported challenges and perceptions regarding neurosurgery. Statistical analysis was performed using SPSS version 28, and p< 0.05 was considered significant. The influence of these perceptions on the choice of neurosurgery as a career was determined by binary logistic regression analysis. RESULTS: Of the 387 responses received from over 45 institutions across the country, 55.6% were females and 44.4% were male respondents. Compared to men, women were more likely to opt out of neurosurgery due to fear of problems with parenting (p<0.001), absence of daycare facilities (p<0.001), lack of female role models (p=0.001), fear of gender discrimination (p<0.001), and the mental (p=0.04) and physical distress (p=0.008) associated with neurosurgery. Binary logistic regression revealed that these concerns were responsible for an increased likelihood of opting out of neurosurgery among female medical students and intern doctors. CONCLUSIONS: Significant differences exist in how male and female medical students perceive neurosurgery as a career choice. Interventions including availability of day care facilities for children, creation of inclusive workplace environment, and promotion of mentorship programs catering to women can help bridge this gap and contribute to evolution of the field of neurosurgery in the developing world.

19.
Int J Health Care Qual Assur ; ahead-of-print(ahead-of-print): 1-23, 2024 Oct 17.
Artículo en Inglés | MEDLINE | ID: mdl-39404099

RESUMEN

PURPOSE: The main objective of this study was to understand why employees engage in time theft behavior and what is the behavioral consequence of this deviant behavior. To do this, the conservation of resources theory helps to examine the role of organizational cronyism behind employee time theft behavior and decreased proactive behavior. DESIGN/METHODOLOGY/APPROACH: A three-wave self-administered employee survey was used for data collection. The data were collected through an adopted questionnaire from nurses working in the public sector hospitals of Pakistan. Structural equation modeling (SEM) was used to analyze data collected from 256 respondents. FINDINGS: The results of this three-wave study supported the hypotheses which are: (1) Organizational cronyism positively predicts employee involvement in time theft behavior. (2) Employee time theft behavior negatively impacts their proactive behavior. (3) Organizational cronyism is detrimental to employee proactive behavior. (4) The relationship between organizational cronyism and proactive behavior is mediated by time theft. PRACTICAL IMPLICATIONS: In the presence of organizational cronyism, employees use time theft as a dysfunctional coping strategy to conserve their valued resources rather than allowing the organization to consume them. Organizational leaders of public sector hospitals must promote merit-based HRM practices to discourage time theft behavior as well as to improve the proactive performances of the nurses. ORIGINALITY/VALUE: This study is one of the initial attempts to extend the scant literature on the antecedents and consequences of time theft behavior and its dimensions in the South Asian context.


Asunto(s)
Hospitales Públicos , Personal de Enfermería en Hospital , Humanos , Pakistán , Hospitales Públicos/organización & administración , Personal de Enfermería en Hospital/psicología , Personal de Enfermería en Hospital/organización & administración , Femenino , Adulto , Masculino , Cultura Organizacional , Encuestas y Cuestionarios , Actitud del Personal de Salud
20.
Int J Ment Health Syst ; 18(1): 32, 2024 Oct 23.
Artículo en Inglés | MEDLINE | ID: mdl-39438896

RESUMEN

BACKGROUND: Pakistan faces profound mental health challenges, which necessitate the urgent need for a comprehensive assessment of its mental healthcare system. A holistic understanding of the mental health landscape is essential to identify strengths, weaknesses, and existing gaps within the system, which can inform targeted interventions and policy enhancements to improve mental healthcare accessibility. OBJECTIVE: The primary objective of this desk research is to conduct an in-depth analysis of Pakistan's mental healthcare system across various dimensions, guided by the World Health Organization's Assessment Tool for Mental Health Systems (WHO-AIMS). METHODS: Data for this desk research and scoping was obtained through desk research, including an examination of existing policies and legislation and consultations with various health facilities across Pakistan. This comprehensive analysis focused on six critical domains within the WHO-AIMS framework: policy and legislation, mental health services, integration of mental health into primary care, public awareness and collaboration with other sectors, human resources, and monitoring and research initiatives. RESULTS: The findings provides a snapshot of strength and opportunities for improvement in Pakistan's mental healthcare system that can serve as the foundation for revising and updating national priorities. Key areas of focus include enhancing policy and legislation, expanding access to mental health services, improving existing initiatives for better integration of mental health into primary care, improving public awareness and sector collaboration, addressing human resource challenges, and strengthening monitoring and research initiatives. CONCLUSION: This desk research provides a roadmap for refining and enhancing Pakistan's mental health ecosystem and informs the prioritization of mental health campaigning efforts.

SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA