Molecular detection and prevalence of Theileria ovis and Anaplasma marginale in sheep blood samples collected from Layyah district in Punjab, Pakistan.

Theileria ovis and Anaplasma marginale are intracellular pathogens affecting a wide range of animals, causing huge economic losses worldwide. The present study reports the molecular evidence of Theileria ovis and Anaplasma marginale in sheep blood samples (N = 218) collected from Layyah district in Punjab (Pakistan), where economy heavily relies on livestock. A 520 base pair fragment specific for 18S ribosomal RNA gene of Theileria ovis was PCR amplified in 23/218 (10.6%) sheep blood samples, while for Anaplasma marginale, a 265 base pair fragment specific for msp1b gene was generated in 15/218 (6.9%) sheep blood samples. Two blood samples were found co-infected (0.9%) with both parasites. Amplified PCR products of both parasites were confirmed by DNA sequencing and submitted to GenBank. Prevalence of both Theileria ovis (p = 0.3) and Anaplasma marginale (p = 0.4) varied non-significantly among the investigated sheep breeds. Tick burden on dogs present with sheep herds was found associated with Theileria ovis infection in sheep (p = 0.05). It was observed that lambs (p = 0.009), sheep in small herds (p = 0.04), and tick burden on dogs present with sheep herds (p = 0.01) were associated with Anaplasma marginale infection in sheep during the present study. In conclusion, we are reporting a higher prevalence of Theileria ovis than Anaplasma marginale in blood samples of sheep collected from Layyah district. Tick-infested dogs were found to be risk factors for the transmission of both pathogens in sheep, and tick control strategies should be extended to dogs associated with sheep herds in this area.

Ambulatory cardiac monitoring for discharged emergency department patients with possible cardiac arrhythmias.

INTRODUCTION: Many emergency department (ED) patients have symptoms that may be attributed to arrhythmias, necessitating outpatient ambulatory cardiac monitoring. Consensus is lacking on the optimal duration of monitoring. We describe the use of a novel device applied at ED discharge that provides continuous prolonged cardiac monitoring. METHODS: We enrolled discharged adult ED patients with symptoms of possible cardiac arrhythmia. A novel, single use continuous recording patch (Zio®Patch) was applied at ED discharge. Patients wore the device for up to 14 days or until they had symptoms to trigger an event. They then returned the device by mail for interpretation. Significant arrhythmias are defined as: ventricular tachycardia (VT) ≥4 beats, supraventricular tachycardia (SVT) ≥4 beats, atrial fibrillation, ≥3 second pause, 2nd degree Mobitz II, 3rd degree AV Block, or symptomatic bradycardia. RESULTS: There were 174 patients were enrolled and all mailed back their devices. The average age was 52.2 (± 21.0) years, and 55% were female. The most common indications for device placement were palpitations 44.8%, syncope 24.1% and dizziness 6.3%. Eighty-three patients (47.7%) had ≥1 arrhythmias and 17 (9.8%) were symptomatic at the time of their arrhythmia. Median time to first arrhythmia was 1.0 days (IQR 0.2-2.8) and median time to first symptomatic arrhythmia was 1.5 days (IQR 0.4-6.7). 93 (53.4%) of symptomatic patients did not have any arrhythmia during their triggered events. The overall diagnostic yield was 63.2% CONCLUSION: The Zio®Patch cardiac monitoring device can efficiently characterize symptomatic patients without significant arrhythmia and has a higher diagnostic yield for arrhythmias than traditional 24-48 hour Holter monitoring. It allows for longer term monitoring up to 14 days.

Environmental impact assessment (EIA): an overlooked instrument for sustainable development in Pakistan.

Environmental impact assessment (EIA) is a policy tool used for evaluating a project proposal from physical and socioeconomic environmental perspectives. Its aim is to reduce the impact of development on environment, hence, ensuring environmental sustainability. It is mandatory to submit an Environmental Impact Statement before starting a mega project as required by Environmental Protection Act of 1997 and Environmental Policy of Pakistan. Public consultation plays a key role in an EIA system, identifying the likely aspects and impacts of a development activity. This aspect has been ignored in effective enactment of environmental legislation in Pakistan. Sufficient legislative instruments are there to support EIA system in the country but the agencies responsible for the enforcement of environmental regulations have failed to do so. The current research gives an insight into the actual status of EIA system in Pakistan along with the feedback of EIA specialists and university teachers of the concerned departments. A new index has been devised on the basis of questionnaire response to work out the overall performance of EIA system in Pakistan or any other country. The weaknesses and deficiencies of each EIA stage have been worked out for Pakistan and elaborated with the help of the controversial Zero point Interchange Project in the capital city of Pakistan.

Magnetic resonance spectroscopy as an imaging tool for cancer: a review of the literature.

OBJECTIVES: To review the use of magnetic resonance spectroscopy (MRS) as a clinical tool in the identification of cerebral neoplasia type and grade, as well as neoplasia in the prostate, colon, breast, cervix, pancreas, and esophagus. Also, to review how clinicians are using MRS for surgical planning and longitudinal evaluation of tumors after treatment. DATA SOURCES: Studies and clinical case reports published within the previous 10 years, targeting publications in radiology and oncology journals within the previous 3 years. Sources identified via MEDLINE and PubMed databases. STUDY SELECTION: Studies that contrasted MRS with conventional diagnostic and prognostic methods were considered to yield the most relevant data for this review. Studies discussing cancer staging and grading were also examined to help determine clinical significance of MRS. DATA SYNTHESES: A review of the literature reveals that, although MRS has mainly been used in diagnostics and tumor evaluation for brain cancer, it is becoming an increasingly important adjunct to conventional diagnostic and monitoring procedures for cancer of the prostate, colon, breast, cervix, pancreas, and esophagus. CONCLUSIONS: The clinical usefulness of MRS has yet to be fully substantiated. As MRS availability and access increases, appropriate evaluations of its strengths and weaknesses will be made. The authors conclude that research to date and primary observation indicate that MRS is a promising clinical tool for oncologic management of patients.