ABSTRACT
BACKGROUND: The latest-generation Evolut FX TAVR system (Medtronic) offers several potential design improvements over its predecessors, but early reported experience has been limited. OBJECTIVES: This study sought to report our multicenter, limited market release, first-in-human experience of transcatheter aortic valve replacement (TAVR) with the Evolut FX system and compare it with a single-center PRO+ (Medtronic) experience. METHODS: From June 27 to September 16, 2022, 226 consecutive patients from 9 US centers underwent transfemoral TAVR with the Evolut FX system for native aortic stenosis (89.4%) or prosthetic valve degeneration (10.6%). Commissural alignment was defined as 0° to 30° between native and FX commissures. Patient, anatomical, and procedural characteristics were retrospectively reviewed, and 30-day clinical and echocardiographic outcomes per Valve Academic Research Consortium-3 definitions were reported. RESULTS: Of 226 patients, 34.1% were low risk, 4% had a bicuspid valve, and 11.5% had a horizontal root (≥60°). Direct Inline sheath (Medtronic) was used in 67.6% and Lunderquist stiff wire (Cook Medical) in 35.4% of cases. Optimal hat marker orientation during deployment was achieved in 98.4%, with commissural alignment in 96.5%. At 30 days, 14.3% mild, 0.9% moderate, and no severe paravalvular leak were observed. Compared with the Evolut PRO+ experience from 1 center, FX had a more symmetrical implantation with shallower depth at the left coronary cusp (P < 0.001), fewer device recaptures (26.1% vs 39.5%; P = 0.004), and improved commissural alignment (96.5% vs 80.2%; P < 0.001). CONCLUSIONS: The Evolut FX system demonstrated favorable 30-day outcomes with a significant improvement over PRO+ in achieving commissural alignment, fewer device recaptures, and more symmetrical implantation. These features may benefit younger patients undergoing TAVR with the supra-annular, self-expanding valve, where lifetime management would be important.
Subject(s)
Aortic Valve Stenosis , Transcatheter Aortic Valve Replacement , Humans , Transcatheter Aortic Valve Replacement/adverse effects , Retrospective Studies , Treatment Outcome , Aortic Valve Stenosis/diagnostic imaging , Aortic Valve Stenosis/surgery , CathetersABSTRACT
Environmental contamination with heavy metals is a threat to the organisms due to their toxicity, persistence and bioaccumulation in food chains. The study was aimed to assess cadmium (Cd) effect on calcium (Ca) level in bones of a freshwater fish Channa gachua. 42 fish individuals were kept into six (6) aquaria; labelled aq.0, 1, 2, 3,4 and 5 in the laboratory for treatment. Aq.0 was control group and aq.1, 2,3,4,5 were experimental with treatment solution of Cd 0, 0.1ppm, 0.5ppm, 1ppm, 2.5ppm and 5ppm respectively for three months. After exposure, bones tissue were examined for Cd accumulation and Ca concentration. Highest accumulation of Cd were recorded in aq.5 mean 46.86 ± 0.46 mgkg-1 .and lowest in the control group with mean 0.61 ± 0.06 mgkg-1. The order of Cd bioaccumulation in bones were aq.5 > aq.4 >aq.3 > aq.2 > aq.1 > aq.0. Highest concentration of Ca were noted in aq.0 (Control group) mean 7888.06 ± 4827.22 mgkg-1 and lowest were 1132.36 ± 203.73 mgkg-1 in aq.5 (at 5.0 ppm). Generally a pattern of decreasing Ca level were observed with each rise of Cd bioaccumulation aq.0 > aq.1 > aq.2 > aq.3 > aq.4 > aq.5. Current study indicated that Cd accumulation have substantial effect on Ca level in bones and hence on skeleton system. Strict rules must be implemented by government to control metals pollution and exploitations of biota.
Subject(s)
Metals, Heavy , Water Pollutants, Chemical , Animals , Bone and Bones/chemistry , Cadmium/toxicity , Calcium , Calcium, Dietary , Fishes , Fresh Water , Water Pollutants, Chemical/analysis , Water Pollutants, Chemical/toxicityABSTRACT
Illnesses caused by human pinworm remains a pediatric health problem in developing nations including Pakistan. This study aimed to investigate the prevalence of Enterobius vermicularis in school children of four districts in Malakand region, Pakistan. Four hundred faecal specimens were screened from May 2014 to July 2017 using normal saline and Lugol Iodine solution. Twenty three (5.75%) individuals were found infected with E. vermicularis. Five children (1.25%) were infected with only E. vermicularis and eighteen (4.5%) were mixed with other helminths. E. vermicularis 23 (5.75%), hookworm 11 (2.75%), Ascaris lumbricoides 5 (1.25%), Taenia saginata 2 (0.5%) and Trichuris trichuira 4 (1%) were detected. Age wise 5-8 years were more parasitized followed by 13-15 and 9-12 years of age (0.0296, P<0.05). Male children were highly (0.06700, P<0.05) infected than female. Children in Malakand district were found more infected followed by Dir Upper, similar infection rate was noted in children of districts Lower Dir and Swat (0.0192, P<0.05). Children in primary level were highly (0.0013, P<0.05) infected than those of middle and high levels. Enterobiosis is still the most common parasitic diseases in children. Studies on enterobiosis should be conducted time by time to recognize the hazardous of such parasitic infection in remote areas of the country.
As doenças causadas pela traça humana continuam sendo um problema de saúde pediátrica nos países em desenvolvimento, incluindo o Paquistão. Este estudo teve como objetivo investigar a prevalência de Enterobius vermicularis em escolares de quatro distritos na região de Malakand, Paquistão. Quatrocentos espécimes fecais foram selecionados de maio de 2014 a julho de 2017, usando solução salina normal e solução de lugol iodo. Vinte e três (5,75%) indivíduos foram encontrados infectados por E. vermicularis. Cinco crianças (1,25%) foram infectadas apenas com E. vermicularis e dezoito (4,5%) foram misturadas com outros helmintos. Foram detectados E. vermicularis 23 (5,75%), ancilóstomo 11 (2,75%), Ascaris lumbricoides 5 (1,25%), Taenia saginata 2 (0,5%) e Trichuris trichuira 4 (1%). Com relação à idade, 5-8 anos foram mais parasitados, seguidos por 13-15 e 9-12 anos de idade (0,0296, P <0,05). Crianças do sexo masculino foram altamente (0,06700, P <0,05) infectadas do que as do sexo feminino. As crianças no distrito de Malakand foram encontradas mais infectadas, seguidas por Dir Upper, taxa de infecção semelhante foi observada em crianças dos distritos Lower Dir e Swat (0,0192, P <0,05). As crianças do nível primário foram altamente (0,0013, P <0,05) infectadas do que as dos níveis médio e alto. A enterobiose ainda é a doença parasitária mais comum em crianças. Os estudos sobre enterobiose devem ser conduzidos periodicamente para reconhecer a periculosidade dessa infecção parasitária em áreas remotas do país.
Subject(s)
Male , Female , Humans , Child , Neglected Diseases , Enterobius/parasitology , Enterobiasis/diagnosis , Enterobiasis/parasitology , Intestinal Diseases, Parasitic/diagnosis , HelminthiasisABSTRACT
Abstract Illnesses caused by human pinworm remains a pediatric health problem in developing nations including Pakistan. This study aimed to investigate the prevalence of Enterobius vermicularis in school children of four districts in Malakand region, Pakistan. Four hundred faecal specimens were screened from May 2014 to July 2017 using normal saline and Lugol Iodine solution. Twenty three (5.75%) individuals were found infected with E. vermicularis. Five children (1.25%) were infected with only E. vermicularis and eighteen (4.5%) were mixed with other helminths. E. vermicularis 23 (5.75%), hookworm 11 (2.75%), Ascaris lumbricoides 5 (1.25%), Taenia saginata 2 (0.5%) and Trichuris trichuira 4 (1%) were detected. Age wise 5-8 years were more parasitized followed by 13-15 and 9-12 years of age (0.0296, P 0.05). Male children were highly (0.06700, P 0.05) infected than female. Children in Malakand district were found more infected followed by Dir Upper, similar infection rate was noted in children of districts Lower Dir and Swat (0.0192, P 0.05). Children in primary level were highly (0.0013, P 0.05) infected than those of middle and high levels. Enterobiosis is still the most common parasitic diseases in children. Studies on enterobiosis should be conducted time by time to recognize the hazardous of such parasitic infection in remote areas of the country.
Resumo As doenças causadas pela traça humana continuam sendo um problema de saúde pediátrica nos países em desenvolvimento, incluindo o Paquistão. Este estudo teve como objetivo investigar a prevalência de Enterobius vermicularis em escolares de quatro distritos na região de Malakand, Paquistão. Quatrocentos espécimes fecais foram selecionados de maio de 2014 a julho de 2017, usando solução salina normal e solução de lugol iodo. Vinte e três (5,75%) indivíduos foram encontrados infectados por E. vermicularis. Cinco crianças (1,25%) foram infectadas apenas com E. vermicularis e dezoito (4,5%) foram misturadas com outros helmintos. Foram detectados E. vermicularis 23 (5,75%), ancilóstomo 11 (2,75%), Ascaris lumbricoides 5 (1,25%), Taenia saginata 2 (0,5%) e Trichuris trichuira 4 (1%). Com relação à idade, 5-8 anos foram mais parasitados, seguidos por 13-15 e 9-12 anos de idade (0,0296, P 0,05). Crianças do sexo masculino foram altamente (0,06700, P 0,05) infectadas do que as do sexo feminino. As crianças no distrito de Malakand foram encontradas mais infectadas, seguidas por Dir Upper, taxa de infecção semelhante foi observada em crianças dos distritos Lower Dir e Swat (0,0192, P 0,05). As crianças do nível primário foram altamente (0,0013, P 0,05) infectadas do que as dos níveis médio e alto. A enterobiose ainda é a doença parasitária mais comum em crianças. Os estudos sobre enterobiose devem ser conduzidos periodicamente para reconhecer a periculosidade dessa infecção parasitária em áreas remotas do país.
ABSTRACT
Illnesses caused by human pinworm remains a pediatric health problem in developing nations including Pakistan. This study aimed to investigate the prevalence of Enterobius vermicularis in school children of four districts in Malakand region, Pakistan. Four hundred faecal specimens were screened from May 2014 to July 2017 using normal saline and Lugol Iodine solution. Twenty three (5.75%) individuals were found infected with E. vermicularis. Five children (1.25%) were infected with only E. vermicularis and eighteen (4.5%) were mixed with other helminths. E. vermicularis 23 (5.75%), hookworm 11 (2.75%), Ascaris lumbricoides 5 (1.25%), Taenia saginata 2 (0.5%) and Trichuris trichuira 4 (1%) were detected. Age wise 5-8 years were more parasitized followed by 13-15 and 9-12 years of age (0.0296, P<0.05). Male children were highly (0.06700, P<0.05) infected than female. Children in Malakand district were found more infected followed by Dir Upper, similar infection rate was noted in children of districts Lower Dir and Swat (0.0192, P<0.05). Children in primary level were highly (0.0013, P<0.05) infected than those of middle and high levels. Enterobiosis is still the most common parasitic diseases in children. Studies on enterobiosis should be conducted time by time to recognize the hazardous of such parasitic infection in remote areas of the country.
As doenças causadas pela traça humana continuam sendo um problema de saúde pediátrica nos países em desenvolvimento, incluindo o Paquistão. Este estudo teve como objetivo investigar a prevalência de Enterobius vermicularis em escolares de quatro distritos na região de Malakand, Paquistão. Quatrocentos espécimes fecais foram selecionados de maio de 2014 a julho de 2017, usando solução salina normal e solução de lugol iodo. Vinte e três (5,75%) indivíduos foram encontrados infectados por E. vermicularis. Cinco crianças (1,25%) foram infectadas apenas com E. vermicularis e dezoito (4,5%) foram misturadas com outros helmintos. Foram detectados E. vermicularis 23 (5,75%), ancilóstomo 11 (2,75%), Ascaris lumbricoides 5 (1,25%), Taenia saginata 2 (0,5%) e Trichuris trichuira 4 (1%). Com relação à idade, 5-8 anos foram mais parasitados, seguidos por 13-15 e 9-12 anos de idade (0,0296, P <0,05). Crianças do sexo masculino foram altamente (0,06700, P <0,05) infectadas do que as do sexo feminino. As crianças no distrito de Malakand foram encontradas mais infectadas, seguidas por Dir Upper, taxa de infecção semelhante foi observada em crianças dos distritos Lower Dir e Swat (0,0192, P <0,05). As crianças do nível primário foram altamente (0,0013, P <0,05) infectadas do que as dos níveis médio e alto. A enterobiose ainda é a doença parasitária mais comum em crianças. Os estudos sobre enterobiose devem ser conduzidos periodicamente para reconhecer a periculosidade dessa infecção parasitária em áreas remotas do país.
Subject(s)
Animals , Male , Female , Child, Preschool , Child , Enterobiasis/epidemiology , Helminths , Pakistan/epidemiology , Schools , Prevalence , Enterobius , FecesABSTRACT
Illnesses caused by human pinworm remains a pediatric health problem in developing nations including Pakistan. This study aimed to investigate the prevalence of Enterobius vermicularis in school children of four districts in Malakand region, Pakistan. Four hundred faecal specimens were screened from May 2014 to July 2017 using normal saline and Lugol Iodine solution. Twenty three (5.75%) individuals were found infected with E. vermicularis. Five children (1.25%) were infected with only E. vermicularis and eighteen (4.5%) were mixed with other helminths. E. vermicularis 23 (5.75%), hookworm 11 (2.75%), Ascaris lumbricoides 5 (1.25%), Taenia saginata 2 (0.5%) and Trichuris trichuira 4 (1%) were detected. Age wise 5-8 years were more parasitized followed by 13-15 and 9-12 years of age (0.0296, P<0.05). Male children were highly (0.06700, P<0.05) infected than female. Children in Malakand district were found more infected followed by Dir Upper, similar infection rate was noted in children of districts Lower Dir and Swat (0.0192, P<0.05). Children in primary level were highly (0.0013, P<0.05) infected than those of middle and high levels. Enterobiosis is still the most common parasitic diseases in children. Studies on enterobiosis should be conducted time by time to recognize the hazardous of such parasitic infection in remote areas of the country.
Subject(s)
Enterobiasis , Helminths , Animals , Child , Child, Preschool , Enterobiasis/epidemiology , Enterobius , Feces , Female , Humans , Male , Pakistan/epidemiology , Prevalence , SchoolsABSTRACT
OBJECTIVES: To compare transcatheter aortic valve replacement (TAVR) with surgical aortic valve replacement (SAVR) for patients in shock. BACKGROUND: There are minimal data on the clinical and echocardiographic outcomes for patients in shock that undergo TAVR and no data comparing these outcomes to similar patients undergoing SAVR. METHODS: This is a single center, retrospective cohort study of patients having Society of Thoracic Surgeons (STS)-defined urgent or emergent AVR for aortic stenosis with clinical signs and symptoms of shock. Inclusion criteria were based on the Society of Cardiovascular Angiography & Interventions (SCAI) shock consensus statement and included: the need for inotropic or vasopressor agents, mechanical ventilation, continuous renal replacement therapy or newly initiated hemodialysis, and/or utilization of mechanical hemodynamic support. Clinical and echocardiographic outcomes for TAVR and SAVR were compared. RESULTS: Thirty-seven patients met the inclusion criteria for this study (17 TAVR, 20 SAVR). TAVR patients had a higher STS Predicted Risk of Mortality (PROM) score of 22.3% compared to 11.8% for SAVR patients (p = 0.001). No significant differences were found in baseline echocardiographic results. TAVR procedures required less procedure room time (185.9 min TAVR, 348.5 min SAVR, p < 0.001) and fewer intraoperative packed red blood cell (pRBC) transfusions (0.2 units TAVR, 3.4 units SAVR, p < 0.001). TAVR patients also had lower rates of prolonged postoperative ventilation compared to SAVR patients (38.5% TAVR, 75.0% SAVR, p = 0.047). TAVR and SAVR had similar rates of mortality at discharge (2 TAVR, 1 SAVR, p = 0.584), 30-days (2 TAVR, 1 SAVR, p = 0.584), and 1-year (8 TAVR, 5 SAVR, p = 0.149). CONCLUSIONS: Despite a higher risk TAVR group, patients in shock undergoing either TAVR or SAVR have similar 30-day mortality. At one year, SAVR patients have a numerically better, though not statistically significant, survival. These findings support the use of TAVR for patients in shock with aortic stenosis.
Subject(s)
Aortic Valve Stenosis , Aortic Valve , Heart Valve Prosthesis Implantation , Transcatheter Aortic Valve Replacement , Aortic Valve/surgery , Aortic Valve Stenosis/surgery , Humans , Retrospective Studies , Risk Factors , Treatment OutcomeSubject(s)
Angina Pectoris/therapy , Coronary Artery Disease/therapy , Coronary Stenosis/therapy , Heart-Assist Devices , Percutaneous Coronary Intervention , Vascular Calcification/therapy , Ventricular Dysfunction, Left/therapy , Aged , Angina Pectoris/etiology , Angioplasty, Balloon, Coronary , Aortic Diseases/complications , Atherectomy, Coronary , Atherosclerosis/complications , Coronary Angiography , Coronary Artery Disease/complications , Coronary Stenosis/complications , Humans , Iliac Artery , Male , Myocardial Infarction/etiology , Severity of Illness Index , Systole , Ventricular Dysfunction, Left/complicationsABSTRACT
BACKGROUND: Regional cerebral oxygen saturation (rSO2) as assessed by near infrared frontal cerebral spectroscopy decreases in circulatory arrest and increases with high-quality cardiopulmonary resuscitation. We hypothesized that higher rSO2 during cardiopulmonary resuscitation and after return of spontaneous circulation (ROSC) would predict survival to discharge and neurological recovery. METHODS AND RESULTS: This prospective case series included patients experiencing in-hospital cardiac arrest. Cerebral oximetry was recorded continuously from initiation of resuscitation until ROSC and up to 48 hours post-arrest. Relationships between oximetry data during these time periods and outcomes of resuscitation survival and survival to discharge were analyzed. The cohort included 27 patients. Nineteen (70.3%) achieved ROSC, and 8 (29.6%) survived to discharge. Median arrest duration was 20.8 minutes (range=8 to 74). There was a significant difference in rSO2 between resuscitation survivors and resuscitation nonsurvivors at initiation of the resuscitative efforts (35% versus 17.5%, P=0.03) and during resuscitation (36% versus 15%, P=0.0008). No significant association was observed between rSO2 at ROSC or during the post-arrest period and survival to discharge. Among patients who survived to discharge, there was no association between cerebral performance category and rSO2 at ROSC, during resuscitation, or post-arrest. CONCLUSIONS: Higher rSO2 levels at initiation of resuscitation and during resuscitation are associated with resuscitation survival and may reflect high-quality cardiopulmonary resuscitation. However, in this small series, rSO2 was not predictive of good neurological outcome. Larger studies are needed to determine whether this monitoring modality can be used to improve clinical outcomes.
Subject(s)
Cardiology Service, Hospital/standards , Cardiopulmonary Resuscitation/standards , Cerebrovascular Circulation , Heart Arrest/diagnosis , Heart Arrest/therapy , Inpatients , Oximetry/standards , Oxygen/blood , Quality Indicators, Health Care/standards , Spectroscopy, Near-Infrared/standards , Aged , Biomarkers/blood , Cardiopulmonary Resuscitation/adverse effects , Cardiopulmonary Resuscitation/mortality , Female , Heart Arrest/blood , Heart Arrest/mortality , Heart Arrest/physiopathology , Hospital Mortality , Humans , Male , Middle Aged , Oximetry/methods , Patient Discharge , Predictive Value of Tests , Prospective Studies , Recovery of Function , Time Factors , Treatment OutcomeSubject(s)
Coronary Stenosis/therapy , Fluid Therapy , Heart Block/therapy , Intra-Aortic Balloon Pumping , Myocardial Infarction/therapy , Pacemaker, Artificial , Percutaneous Coronary Intervention , Shock, Cardiogenic/therapy , Vasoconstrictor Agents/therapeutic use , Cardiac Catheterization , Coronary Angiography , Coronary Stenosis/complications , Coronary Stenosis/diagnostic imaging , Extracorporeal Membrane Oxygenation , Heart Block/etiology , Humans , Male , Middle Aged , Myocardial Infarction/complications , Shock, Cardiogenic/etiologyABSTRACT
This article discusses the approach to the management of myocardial infarction (MI) in the intensive care unit setting. It includes an overview of the definition, classification, and underlying pathologic conditions of acute MI and specifically discusses the diagnosis and management of unstable angina, non-ST elevation MI, and ST-segment elevation MI. Diagnosis and treatment of the acute complications of MI are also reviewed.
Subject(s)
Angina, Unstable/diagnosis , Angina, Unstable/therapy , Critical Care Nursing/methods , Myocardial Infarction/diagnosis , Myocardial Infarction/therapy , Critical Care Nursing/standards , Humans , Practice Guidelines as Topic , Risk FactorsABSTRACT
During a survey in May 2011, tomato (Lycopersicon esculentum Mill.) plants were observed exhibiting wilt symptoms on the vegetable farm of the University of the Punjab Lahore (31°32'59â³ N, 74°20'37â³ E), Pakistan. Plants were pale yellow and stunted. Diseased plants were scattered in the field either singly or in groups of two or three. Lower leaves turned yellow following necrosis and shedding from the plants. Roots of diseased plants were dark brown in comparison to the healthy ones. Vascular browning was observed when infected stems were split longitudinally and sectioned transversely. Necrotic vascular strands were also observed in infected stems. With a stereoscope, white hyphae were noticed in the vascular region of infected plants. Stained cross sections of stems of wilted plants showed fungal hypha. A diseased plant sample was taken to the First Fungal Culture Bank of Pakistan (FCBP) for identification of the pathogen. Conidia appeared on potato dextrose agar after incubation in diurnal light, and were unicellular, smooth, thin-walled, and oval in shape (3 to 6 × 1 to 3 µm), forming aggregations on the tip of conidiophores. With the help of diagnostic keys and available literature, the isolated fungus was identified as Acremonium strictum W. Gams. The fungus formed whitish flat colonies with deposition of gum granules on its surface. Hyphae and phialides were hyaline and non-pigmented. Phialides with expanded bottoms were elongated measuring 25 to 40 µm and solitary in position at right angles to the filament. To further confirm identification, amplification of the ITS1 and ITS2 regions was performed with universal primers ITS1 and ITS4 (4). The ITS sequence obtained was submitted to NCBI as accession JQ916901. The culture was deposited in FCBP (1099), Institute of Agricultural Sciences, University of the Punjab, Pakistan. A pathogenicity test of the isolated fungus was performed by inoculating 15 healthy tomato plants cv. Rio Grande in three replicates. The spore suspension (2 × 105 conidia/ml of sterile distilled water) was prepared from 12-day-old cultures of the fungus grown from a single spore on PDA in continuous light. Control plants were treated with sterile distilled water. Tomato plants inoculated with the fungus started showing wilting symptoms within 2 weeks, while the control remained healthy. A. strictum was re-isolated from inoculated wilted plants, thus satisfying Koch's postulates. Previously, A. strictum was a reported cause of wilt in many plants including Chrysanthemum maximum (2), watermelon (1), and Gladiolous grandiflorus (3). To our knowledge, wilt in tomatoes has been reported only from Fusarium oxysporum and Pseudomonas solanacearum from Pakistan. To our knowledge, this is the first record of Acremonium wilt in this economically important crop. References: (1) B. D. Bruton et al. Plant Dis. 79:754, 1995. (2) A. R. Chase. Calif. Agric. 32(10):21, 1978. (3) E. Gonzalez-Perez. J. Plant Pathol. 90:586, 2008. (4) T. J. White et al. Pages 315-322 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.
ABSTRACT
In October 2012, reddish brown, oblong lesions with chlorotic centers were observed on the leaves of Sorghum bicolor in Punjab Province, Pakistan. Early symptoms appeared as reddish brown circular spots on the leaves. These spots increased in size and coalesced to form oblong lesions. Entire fields were severely affected by the disease. Pathogen isolations were made on malt extract agar (MEA) media. Symptomatic leaf samples were cut into 4 to 6 mm2 pieces, surface sterilized (10% bleach for 1 min, 90% ethanol for 30 sec) and rinsed in sterilized water several times, followed by air drying. These samples were plated onto 2% MEA media, supplemented with 10 mg/liter chloramphenicol, and incubated at 25°C for 6 days in the dark. A mitosporic fungus of dark brown colony, bearing large stroma, appeared on the media. Conidiophores were brown, septate, geniculate, simple or unbranched, with dark brown scar. Conidia were brown, straight to pyriform, with 3 to 4 cells, with large and curved central cells, smooth walled, ranging in size from 7.3 to 21.26 µm, and produced apically in a sympodial manner. Based on morphological characteristics, the pathogen was identified as Curvularia lunata (Wakk.) Boedijn. (1,2). Morphological identification was also confirmed by the First Fungal Culture Bank of Pakistan (FCBP), Institute of Agricultural Sciences, University of the Punjab, Lahore, Pakistan, and samples were submitted to FCBP (Accession No. 1201). The fungus was further identified by amplifying internal transcribed spacer region sequences (ITS1, rDNA, ITS2) by using ITS4 and ITS5 primers (4). The resulting 584-bp sequence was submitted to GenBank with Accession No. HG326308. This sequence showed 99% homology with C. lunata strain pingxiang (GenBank Accession No. JQ701897), causing leaf spots of lotus in China. Pathogenicity assay was conducted on 20-day-old seedlings of S. bicolor variety Indian Gold, grown from surface sterilized seeds. Fifteen replicate plants were sprayed with a spore suspension of 1 × 106 spore/ml in distilled sterilized water, prepared from 1-week-old fungal culture, grown in the dark on 2% MEA media. Five replicate plants were sprayed with distilled sterilized water as control. Plants were covered with transparent polyethylene bags to retain moisture and enhance disease development, and kept in a greenhouse at ~30°C. Bags were removed after 5 days of incubation. Inoculated plants developed lesions similar to those observed on naturally infected plants. No symptoms were observed on control plants. The pathogen was re-isolated from infected leaves, and the morphology features were again studied, matching those of the pathogen isolated from field samples. Curvularia leaf spot diseases, caused by different Curvularia species, have been previously found on many grass species worldwide (3). To our knowledge, this is the first report of C. lunata leaf spots on S. bicolor in Pakistan. References: (1) M. B. Ellis. Dematiaceous Hyphomycetes. Commonwealth Mycological Institute, Kew, Surrey, England, 1971. (2) F. B. Rocha et al. Austral. Plant Pathol. 33:601, 2004. (3) J. D. Smith et al. Fungal diseases of amenity turf grasses. E & F.N. Spon., New York, 1989. (4) T. J. White et al. Page 315 in: PCR Protocols: A Guide to Methods and Applications. Academic Press, San Diego, CA, 1990.
ABSTRACT
BACKGROUND: Vitamin D is an essential nutrient, and there is a growing appreciation of its clinical significance. In addition, there has recently been a discussion as to the best method of measuring this analyte in serum: immunoassay, HPLC or LC-MS/MS. Due to the increased interest in vitamin D, there has been an exponential increase in the number of clinicians testing their patients and therefore also in the volume of this test run in clinical laboratories. METHODS: Vitamin D levels were determined by chemiluminescence immunoassay in a reference laboratory and a subset by LC-MS/MS at San Francisco General Hospital. RESULTS: We developed a robust and rapid LC-MS/MS assay to detect 25-hydroxyvitamin D3 and D2 in serum for use in the routine clinical laboratory. Additionally, we determined that 71% of patients served by San Francisco General Hospital have insufficient serum vitamin D levels (≤29 ng/ml) and that these levels are significantly associated with parathyroid hormone levels, total calcium concentration, age and ethnicity. CONCLUSIONS: The high degree of vitamin D insufficiency at San Francisco General Hospital may be reflective of the status of the patients served by this county hospital; largely an underserved, multi-ethnic urban population.
