Cervical cancer screening practices in HIV positive females - a missing link in health care delivery in Pakistan.

Objectives: To probe cervical cancer screening practices in local women positive for human immunodeficiency virus, and to determine the cervical cytological changes in them. METHODS: The serial cross-sectional study was conducted at the Jinnah Hospital and Services Hospital, Lahore, Pakistan, from April 2019 to October 2020, and comprised female patients aged 18-45 years who were positive for human immunodeficiency virus or acquired immunodeficiency syndrome and were registered with the relevant programme being run by the provincial government in Punjab. Blood samples of all the patients were collected for the determination of human immunodeficiency virus viral load and cluster of differentiation 4+ count. Cervical smears were taken for cytopathological analysis, while the swabs were analysed for culture sensitivity. The same individuals were subjected to the same testing one year later, and the status of the disease and clinical stability or disease progression was explored. Data was analysed using SPSS 25. RESULTS: There were 150 women with mean age 32.08±7.13 years (range: 21-45 years). Age at marriage/sexual activity was 17.33±4.73 years in 15(10%) subjects. Cytological examination showed atypical squamous cells of undetermined significance in 6(4%) of the cases whereas 3(2%) cases showed atypical squamous cells, which cannot rule out high grade squamous intraepithelial lesion on cytology, while the rest were classified as negative for intraepithelial lesion or malignancy. Cervical microbial changes revealed methicillin-resistant staphylococcus aureus infection in 9(6%) cases, extended-spectrum beta-lactamase in 15(10%) cases, whereas fungal infection and trichomonas vaginalis infection were found in 30(20%) smears. There was a significant association between cluster of differentiation 4+ cell count and stability of high-risk patients (p<0.001). After one year, 84(56%) patients remained clinically stable, while 51(34%) developed some chronic illness. There was a significant association between cluster of differentiation 4+ cell count <200/mm3 and the risk of developing a chronic illness (p<0.001). CONCLUSIONS: There was a dire need to educate healthcare workers to offer regular cervical screening to patients with high-risk sexually-transmitted infections to prevent them from the morbidity and mortality related to cervical cancer.

An investigation of Ca-doped MgO nanoparticles for the improved catalytic degradation of thiamethoxam pesticide subjected to visible light irradiation.

The remediation of pesticides from the environment is one of the most important technology nowadays. Herein, magnesium oxide (MgO) nanoparticles and calcium-doped magnesium oxide (Ca-doped MgO) nanoparticles were synthesized by the co-precipitation method and were used for the degradation of thiamethoxam pesticide in aqueous media. Characterization of the MgO and Ca-doped MgO nanoparticles were performed by XRD, SEM, EDX, and FT-IR analysis to verify the synthesis and variations in chemical composition. The band gap energy and crystalline size of MgO and Ca-doped MgO nanoparticles were found to be 4.8 and 4.7 eV and 33 and 34 nm respectively. The degradation of thiamethoxam was accomplished regarding the impact of catalyst dosage, contact time, temperature, pH, and initial pesticide concentration. The pH study indicates that degradation of thiamethoxam depends on pH and maximum degradation (66%) was obtained at pH 5 using MgO nanoparticles. In contrast, maximum degradation (80%) of thiamethoxam was observed at pH 8 employing Ca-doped MgO nanoparticles. The percentage degradation of thiamethoxam was initially increasing but decreased at higher doses of the catalysts. The degradation of the pesticide was observed to be increased with an increase in contact time while high at room temperature but decreased with a temperature rise. The effect of the initial concertation of pesticide indicates that degradation of pesticide increases at low concentrations but declines at higher concentrations. This research study reveals that doping of MgO nanoparticles with calcium enhanced the degradation of thiamethoxam pesticide in aqueous media.

Appraisal of anti-arthritic potential of Coronopus didymus (L.) Sm. aqueous extract and its safety study in Wistar rats.

The current study aimed to find out the anti-arthritic activity and safety study of Coronopus didymus aqueous extract (CDAE) as well as its chemical characterization by HPLC-DAD. Safety study including acute and subacute toxicity studies of the plant aqueous extract was also performed. In complete Freund's adjuvant-induced arthritic model (CFA), 0.15 ml CFA was injected in the left hind paw at day 1 in all rats except normal rats. Treatment with CDAE at 200, 400, and 800 mg/kg and methotrexate (1 mg/kg) was administered at day 8 and continued till 28th day using oral gavage. The CDAE considerably (p < 0.05) reduced the paw swelling and arthritic score, and reinstated the body weight and blood parameters. The CDAE considerably modulated superoxide dismutase, catalase, reduced glutathione, and malondialdehyde level in liver homogenate in contrast to disease control. The CDAE at 400 mg/kg considerably reduced IL-6, IL -1ß, COX-2, and NF-ĸß, whereas elevated IL-10, IL-4, and I-kappa ß as equated to disease and standard groups. The LD50 of CDAE > 2000 mg/kg. In subacute toxicity study, CDAE at 200-800 mg/kg did not exhibit clinical signs of toxicity, mortality, hematological, biochemical, and histological alteration in the liver heart, kidney, and lungs in contrast to the normal group. It was concluded that the presence of delphinidine-3-glucoside, diosmetin, 3-feruloyl-4,5-dicaffeoyl quinic acid, and gallic acid in CDAE might be accountable for its anti-arthritic activity and safe use for a long period.

Enhancement of photocatalytic activity of Ba-doped CoO for degradation of Emamectin benzoate in aqueous solution.

The present study was focused on the preparation of cobalt oxide (CoO) and barium-doped cobalt oxide (Ba-doped CoO) by following the co-precipitation method for the degradation of Emamectin benzoate pesticide in the aqueous medium. The prepared catalysts were characterized using SEM, EDX, and XRD to confirm the formation of catalysts and to observe the variation in the composition of catalysts during the degradation study. It can be suggested from the results of SEM, EDX, XRD, and FTIR analyses that Ba atom has successfully incorporated in the crystalline structure of CoO. The degradation of Emamectin benzoate pesticide was studied under the influence of different factors like solution pH, the dose of catalyst, contact time, temperature, and initial concentration of pesticide. It was observed that solution pH affects the degradation of the pesticide, and maximum degradation (23% and 54%) was found at pH 5.0 and 6.0 using CoO and Ba-doped CoO, respectively. The degradation of pesticides was found to be increased continuously (27-35% in case of CoO while 47-58% in case Ba-doped CoO) with the time of contact. However, the degradation was found to be decreased (23-3% in case of CoO while 47-44% in case Ba-doped CoO) with an increase in temperature. Likewise, in the beginning, degradation was observed to be increased up to some extent with the dose of catalyst and initial concentration of pesticide but started to decrease with further augmentation in the dose of catalyst and initial concentration of pesticide. It may be concluded from this study that doping of Ba considerably enhanced the photocatalytic ability of CoO for Emamectin benzoate pesticide.

Challenges in screening of sexually transmitted viral infections of the female genital tract: Where do we stand? - A scoping review.

Globally more than a million sexually transmitted infections occur daily, and over 53 000 [47,000-60,000] women aged 15 and over were living with human immunodeficiency virus / acquired immunodeficiency syndrome in Pakistan by the year 2020. This situation becomes graver when the sexually transmitted infections exist as co-infections while remaining undiagnosed or under-diagnosed. Additionally, herpetic or papillomavirus lesions are more recurrent, more extensive and have more serious consequences in human immunodeficiency virus-positive patients. Literature shows a dramatic increase in morbidity and mortality due to the occurrence of malignancies in genital co-infections. There is a key concern that every single adolescent female living in Pakistan is at a high risk of acquiring viral sexually transmitted infections along with malignancy of the cervix. As such, the health and future of this age group is already imperilled. Needless to mention that the practice of routine cervical screening and diagnostic laboratory services offered to a common woman in Pakistan have been less than satisfactory for decades. Therefore, to meet the minimum expectations regarding the Millennium Development Goals for sexual and reproductive health and rights 2030, it has now become imperative for the health sector to develop and implement scientific and community-based policies for comprehensive and multidisciplinary diagnostic strategies leading to early and effective management of viral sexually transmitted infections and subsequent neoplasia.

HPLC -DAD analysis, anti-inflammatory and anti-arthritic potentials of Coronopus didymus (L.) Sm. extracts: effects on pro- and anti-inflammatory cytokines, COX-2, I-κß, NF-κß and oxidative stress biomarkers.

Coronopus didymus (L.) Sm. (CD) has been traditionally used to treat pain, rheumatism, and inflammation. This study was planned to appraise the anti-oxidant, anti-inflammatory and anti-arthritic potentials of CD (whole plant) aqueous ethanolic (CDAEE) and aqueous extracts (CDAE) and chemical characterization by high-performance liquid chromatography-diode array detector. In vivo anti-inflammatory (Carrageenan induced paw edema, and Xylene induced ear edema assays) and anti-arthritic potentials were evaluated in Wistar rats. Both extracts showed significant (p < 0.0001) in vitro free radical scavenging and in vitro anti-arthritic potentials by inhibition of protein denaturation and stabilization of the HRBC membrane and anti-oedematogenic potential, whereas more activity was expressed by CDAEE. In complete Freund's adjuvant-induced arthritic model, the CDAEE at 200, 400, and 800 mg kg-1 and methotrexate (1 mg kg-1) profoundly (p < 0.05) reduced the arthritic score and paw edema, restored body and immune organ weight, and altered blood parameters and oxidative stress biomarkers. The qRT-PCR analysis revealed that CDAEE at 400 mg kg-1 significantly (p < 0.0001) downregulated TNF-α (2.22 ± 0.16 fold), IL-6 (2.29 ± 0.05 fold), IL-1ß (2.10 ± 0.01 fold), COX-2 (2.45 ± 0.02 fold), and NF-Ä¸ß (2.72 ± 0.06 fold) and considerably upregulated IL-10 (58.84 ± 0.67%), IL-4 (76.16 ± 2.79%) and I-kß (75.45 ± 0.17%) in arthritic rats in contrast to disease control and methotrexate as evidenced from the joint histology. These findings suggested the antioxidant, anti-inflammatory and anti-arthritic activities of C. didymus, which might be due to the presence of quercetin, ferulic acid, dihydromyricetin, apigenin, vitexin, and kaempferol in CDAEE.

Copper complexes of bioactive ligands with superoxide dismutase activity.

Free radicals or reactive oxygen species (ROS) are highly toxic and their damaging effects result in a variety of detrimental health issues such as neurodegenerative, cardiovascular and age-related diseases. Human body has evolved an effective defense system including superoxide dismutase (SOD) and catalase against the toxicity of these free radicals. SOD is a metalloenzyme and it acts as an excellent antioxidant to protect the body from superoxide radicals that are generated in the biological system. However, the clinical use of SOD is limited due to its short in vivo life span, and its large size that hampered its penetration across the cell membranes. Pharmaceuticals that provide ROS scavenging systems are the most effective when the production of ROS exceeds the scavenging capacity of endogenous SOD as a result of aging or pathological processes. Inspired by the Nature, scientists have designed metal-based mimics of the superoxide dismutase. This review focuses on different copper complexes that are developed from bioactive ligands and mimic the protecting action of the SOD.