Anterior and Posterior Pituitary Function in Patients with Sheehan Syndrome - Combining the use of Insulin Tolerance Test and Copeptin Assay.

Introduction: Sheehan syndrome (SS) typically involves the loss of anterior pituitary cells and rarely affects the posterior pituitary. The water deprivation test (WDT) is the gold standard for diagnosing central diabetes insipidus (CDI), but it is cumbersome. Serum copeptin measurements are an alternative for CDI diagnosis. In this study, we measured hypoglycaemia-stimulated serum copeptin in SS patients to assess posterior pituitary function alongside anterior pituitary hormone levels. Methods: This study recruited 43 patients with SS on stable hormonal replacement except for growth hormone (GH), 18 patients with CDI, and 19 body mass index (BMI) and parity-matched controls. All patients with SS and four patients with CDI underwent an insulin tolerance test (ITT), and hypoglycaemia-stimulated copeptin levels were measured at 0, 30, 45, and 90 minutes after insulin injection. Results: The mean serum copeptin level among patients with SS (26.01 ± 12.41 pmol/L) was significantly lower than that in healthy controls (31.92 ± 7.85 pmol/L) and higher than that in patients with CDI (1.81 ± 0.14 pmol/L). Using pre-defined cut-offs for CDI, basal serum copeptin <2.69 pmol/L and stimulated levels <4.92 pmol/L for complete central DI, and basal copeptin levels >2.69 pmol/L and stimulated copeptin <4.92 pmol/L for partial central DI, 9.2% (n = 4) of patients with SS had CDI, of which half had complete CDI and half had partial CDI. Conclusion: A significant number of patients with SS who are on hormone replacement therapy show involvement of the posterior pituitary, despite not displaying symptoms.

Smart transactive energy based approach for planning and scheduling in multi-looped microgrid distribution network across planning horizon.

In this paper, an innovative transactive energy approach is proposed as viable option for coordinated distribution system planning across a certain horizon. The proposed approach is evaluated across a multi-looped (meshed) test system and is implemented with load growth having prosumers participating in the electrical market in transactive energy system aiming at evaluation on techno-economic basis. Apart from prosumer sensitivity analysis, evaluations have been carried across reducing total production cost of energy, reduction in per unit price, active power losses. Whereas improving voltage profile, cost of scheduling and consumer per kWh purchase and sales in comparison with traditional counterpart. The proposed framework includes optimization algorithm aiming at sources scheduling and IEEE 69 system for validation. The algorithm minimizes cost, maximizes energy efficiency, increases renewable energy mix and reduces consumers cost of energy purchase. Reduction of 51.44 % in cost of energy is achieved, whereas loss reduction of 12.6% is achieved. The comparison of IEEE 69-bus base case with the 10 %, 15% and 20% transactive energy applied with simulations to evaluate performance parameters that will directly benefit both prosumers and utility alike in-terms of low bills and further reduction of stress on the grid amid load growth across multiple years.

Uncovering the secret weapons of an invasive plant: The endophytic microbes of Anthemis cotula.

Understanding plant-microbe interaction can be useful in identifying the microbial drivers of plant invasions. It is in this context that we explored the diversity of endophytic microbes from leaves of Anthemis cotula, an annual plant that is highly invasive in Kashmir Himalaya. We also tried to establish the role of endophytes in the invasiveness of this alien species. We collected and processed leaf samples from three populations at three different sites. A total of 902 endophytic isolates belonging to 4 bacterial and 2 fungal phyla were recovered that belonged to 27 bacterial and 14 fungal genera. Firmicutes (29.1%), Proteobacteria (24.1%), Ascomycota (22.8%) and Actinobacteria (19%) were dominant across all samples. Plant growth promoting traits, such as Ammonia production, Indole Acetic Acid (IAA) production, Phosphate solubilization and biocontrol activity of these endophytes were also studied and most of the isolates (74.68%) were positive for ammonia production. IAA production, phosphate solubilization and biocontrol activity was present in 39.24%, 36.70% and 20.26% isolates, respectively. Furthermore, Botrytis cinerea, a pathogen of A. cotula in its native range, though present in Kashmir Himalaya does not affect A. cotula probably due to the presence of leaf endophytic microbial antagonists. Our results highlight that the beneficial plant growth promoting interactions and enemy suppression by leaf endophytes of A. cotula, may be contributing to its survival and invasion in the Kashmir Himalaya.

Patterns and associated factors of shisha usage among the undergraduate students of Jouf University, Saudi Arabia: A cross-sectional study.

INTRODUCTION: Shisha tobacco use is gaining popularity around the world, especially among young people and college students. Shisha users are exposed to many of the same harmful substances as cigarette smokers but at much higher levels, which could have more serious adverse health impacts. The aims of this study were to: 1) determine the patterns of shisha smoking among university students in the Northern Province of Saudi Arabia; 2) identify the reasons for using shisha tobacco; and 3) ascertain whether usage of shisha smoking differs by their sociodemographic characteristics. METHODS: A cross-sectional survey was conducted among students of seven different colleges at a public university between October and December 2022. A modified version of the Global Youth Tobacco Survey questionnaire was used to collect information specifically on shisha smoking. After adjusting for confounding variables, a logistic regression analysis was used to determine the related factors. RESULTS: A total of 418 participants were included in the study. Of the studied population, shisha smoking was seen in 73.7% (n=308). Out of 308 shisha smokers, 208 (67.5%) had their first session of shisha smoking within the past two years; 34.4% of participants had used it in the past 30 days (current users), of which 27.4% had smoked shisha from 1 to 7 days during the past 30 days. The majority of respondents (63.6%) reported having friends that smoke. The most popular flavor among respondents (24.6%) was apple. For quitting attempts, 46.4% reported a 24-hour quit attempt in the previous year. Stress (23.0%) was reported as the main reason for beginning shisha use. Shisha smoking was significantly associated with age (Ref. 18-20 years; 24-26 years, AOR=0.08; 95% CI: 0.02-0.33, p<0.001; ≥27 years, AOR=0.12; 95% CI: 0.02-0.62, p=0.01), living status (Ref. alone; with family, AOR=0.23; 95% CI: 0.11-0.47, p<0.001; with friends, AOR=0.36; 95% CI: 0.18-0.76, p<0.001), with parents having higher education level (Ref. primary school and lower; Bachelor's, AOR=0.33; 95% CI: 0.14-0.76, p<0.001; diploma, AOR=0.33; 95% CI: 0.15-0.73, p<0.001; PhD, AOR=5.15; 95% CI: 1.00-9.65, p=0.05). CONCLUSIONS: Shisha use was more frequent among Saudi Arabian college students, especially those who were aged 18-20 years, living alone, and having highly educated parents.

2D MXene-Based Nanoscale Materials for Electrochemical Sensing Toward the Detection of Hazardous Pollutants: A Perspective.

MXenes (Mn+1XnTx), a subgroup of 2-dimensional (2D) materials, specifically comprise transition metal carbides, nitrides, and carbonitrides. They exhibit exceptional electrocatalytic and photocatalytic properties, making them well-suited for the detection and removal of pollutants from aqueous environments. Because of their high surface area and remarkable properties, they are being utilized in various applications, including catalysis, sensing, and adsorption, to combat pollution and mitigate its adverse effects. Different characterization techniques like XRD, SEM, TEM, UV-Visible spectroscopy, and Raman spectroscopy have been used for the structural elucidation of 2D MXene. Current responses against applied potential were measured during the electrochemical sensing of the hazardous pollutants in an aqueous system using a variety of electroanalytical techniques, including differential pulse voltammetry, amperometry, square wave anodic stripping voltammetry, etc. In this review, a comprehensive discussion on structural patterns, synthesis, properties of MXene and their application for electrochemical detection of lethal pollutants like hydroquionone, phenol, catechol, mercury and lead, etc. are presented. This review will be helpful to critically understand the methods of synthesis and application of MXenes for the removal of environmental pollutants.

Species composition of root-associated mycobiome of ruderal invasive Anthemis cotula L. varies with elevation in Kashmir Himalaya / La composición de especies del micobioma asociado a las raíces de la invasora ruderal Anthemis cotula L. varía con la elevación en Cachemira Himalaya

Investigating the microbial communities associated with invasive plant species can provide insights into how these species establish and thrive in new environments. Here, we explored the fungal species associated with the roots of the invasive species Anthemis cotula L. at 12 sites with varying elevations in the Kashmir Himalaya. Illumina MiSeq platform was used to identify the species composition, diversity, and guild structure of these root-associated fungi. The study found a total of 706 fungal operational taxonomic units (OTUs) belonging to 8 phyla, 20 classes, 53 orders, 109 families, and 160 genera associated with roots of A. cotula, with the most common genus being Funneliformis. Arbuscular mycorrhizal fungi (AMF) constituted the largest guild at higher elevations. The study also revealed that out of the 12 OTUs comprising the core mycobiome, 4 OTUs constituted the stable component while the remaining 8 OTUs comprised the dynamic component. While α-diversity did not vary across sites, significant variation was noted in β-diversity. The study confirmed the facilitative role of the microbiome through a greenhouse trial in which a significant effect of soil microbiome on height, shoot biomass, root biomass, number of flower heads, and internal CO2 concentration of the host plant was observed. The study indicates that diverse fungal mutualists get associated with this invasive alien species even in nutrient-rich ruderal habitats and may be contributing to its spread into higher elevations. This study highlights the importance of understanding the role of root-associated fungi in invasion dynamics and the potential use of mycobiome management strategies to control invasive species.(AU)

Fluoroquinolone and macrolide co-resistance in clinical isolates of Campylobacter species: a 15-year study in Karachi, Pakistan

Fluoroquinolone and macrolide antibiotics are generally considered as first-line drugs for the treatment of severe campylobacteriosis. This study was conducted to analyse the trend of erythromycin and ofloxacin resistance among Campyiobacter spp. isolated from stool specimens over a period of 15 years [1992-2007] at The Aga Khan University clinical laboratory in Karachi, Pakistan. A total of 83 396 stool specimens were processed, with a 14% isolation rate for enteric pathogens. The isolation rate of Campylobacter spp. was low during 1992-93 [6%-13%], peaked in 1996 [46%], then ranged from 20% to 40%. We report a rising trend in ofloxacin resistance, re-emergence of erythromycin resistance and indications of co-resistance to both drugs in clinical isolates of Campylobocter spp.

Essential medicines management during emergencies in Pakistan

This paper illustrates the experiences of essential medicine management in providing cure and care to victims of Pakistan's 2005 earthquake in a safe, rational and effective mode. The health interventions assured access to essential medicine, sustained supply, inventory control through a computerized logistic support system and rational use of medicines. World Health Organization Pakistan outlined modalities for acceptance of donated medicines, assisted in speedy procurement of medicines and designed customized kits. Proper storage of medicines at controlled temperature was ensured in warehousing facilities in 12 locations. A steady supply of medicines and their consumption without stock-outs in the 56 first-level care facilities of calamity-hit areas helped to ascertain the average consumption and cost of essential medicines and supplies for the catchment population. Tools for quantification and forecasting of medicines and supplies were developed and shared. Medicines and medical supplies were efficiently used resulting in minimum wastage

Increased isolation of Vibrio cholerae O1 serotype Inaba over serotype Ogawa in Pakistan

Although the predominant Vibrio cholerae serotype in Pakistan is Ogawa and serotype Inaba is rare, there has been a significant increase in the isolation of Inaba in our referral laboratory in Karachi. This paper reports this observation and further analysis of previous cholera data from 1993 to 2005 to assess the trend of occurrence and resistance pattern of V. cholerae strains. From January to September 2005, 245/3292 [7.4%] specimens yielded growth of V. cholerae. Of these, 243 were serotype Inaba, outnumbering serotype Ogawa. This recent Inaba strain is 100% resistant to cotrimoxazole, 3% resistant to chloramphenicol and not resistant to ampicillin, tetracycline and ofloxacin. This sensitivity pattern is almost similar to that of the previous predominant serotype Ogawa