Diversity and biological characteristics of macrofungi of district Bajaur, a remote area of Pakistan in the Hindu Kush range.

The present study was carried out to document the diversity and ecological characteristics of macrofungi of Bajaur, Pakistan. The diversity of macrofungi comprised 51 species belonging to 22 families and 37 genera. The families Agaricaceae (7 species) and Psathyrellaceae (7 species) were found dominant followed by Tricholomataceae (4 species), Fomitopsidaceae and Polyporaceae (4 species each) and Amanitaceae (3 species). White (23 species), brown (11 species), and yellow were the most prevalent morphological colours in basidiocarps (8 species). Among the identified species, 32 were saprophytic in nutrition followed by 7 parasitic, 6 saprophytic and parasitic both, while 6 mycorrhizal that make association with higher plants. The distribution of macrofungal species in the three tehsils of Bajaur was also evaluated based on Shannon diversity index, Simpson diversity index and evenness. The highest Shannon diversity index and Simpson diversity index were found for tehsil Utman Kheil at 3.73 and 0.97, while the maximum value of evenness for tehsil Khar with 0.92 value. The results indicate a very high species richness of the study site. Four species out of the total were identified to be new reports from Pakistan. This survey's findings suggested that there is a wide variety of macrofungi that might be used as food and alternative medications if further research is carried out.

Clinical factors and comorbidities affecting health-related quality of life in postrenal transplant patients.

BACKGROUND: Health-related quality of life is different among different transplant cohorts with respect to different variables which predict mortality and graft survival. The aim of this study was to identify the effects of clinical factors on the health-related quality of life in postrenal transplant patients. METHODS: This census study was conducted at the Institute of Kidney Diseases Peshawar, Pakistan. Data were collected on a questionnaire " Kidney Diseases Quality of Life-Short Form-1.3 Urdu version" and were analyzed in the 3 main domains, for example, physical component summary (PCS), mental component summary, and kidney disease component summary using SPSS version 21. Mean scores for patients with diabetes mellitus (DM), hypertension, levels of hemoglobin, and serum creatinine were compared by unpaired t-test. RESULTS: A total of 277 men (87.9%) and 38 (12.1%) women participated in the study. Mean age was 37.26 (±10.14) years (range 18-65 years). Hypertension was reported in 72.2% and DM in 10.8%. Hemoglobin was <12.5g% in 26.0% patients. Patients with DM had significant lower PCS (P = .001) and mental component summary (MCS; P = .001) scores. Patients with hypertension had significant lower MCS score (P = .01). Patients with hemoglobin <12.5g% had significantly lower PCS (P = .001) score than those with hemoglobin >12.5 g%. The PCS score in patients with serum creatinine level >2 mg% was significantly lower (P = .02) than those with serum creatinine <2 mg%. CONCLUSION: Lower graft function and DM were associated with lower PCS and MCS scores. Hypertension was associated with lower MCS score and anemia with lower PCS score.

Synergistic Effect Of Oral Allopurinol And Intralesional Sodium Stibogluconate In The Treatment Of Cutaneous Leishmaniasis.

BACKGROUND: Leishmaniasis is an endemic disease and a major public health problem throughout the world. Its geographic distribution has been extended over the past few years in Pakistan. The available treatment options of Leishmaniasis are limited and mostly parenteral, and hence a nontoxic oral alternative therapy is urgently needed to overcome the problem. The objective of this study was to evaluate the synergistic effect of Allopurinol as an adjunct therapy along with conventional intra-lesional sodium Stibogluconate in the treatment of cutaneous Leishmaniasis. METHODS: This single blinded randomized controlled trial was carried out at the tertiary care hospitals of district Peshawar, Pakistan. A total of one hundred and sixty-four (164) patients of age range from 19-56 years, consisting of both genders were included in this study. All subjects were randomly allocated to Group-1 and Group-2 where each group had 82 patients of comparable age and genders. Group-1 patients were given an intra-lesional injection of sodium Stibogluconate at a dose of 1-5 ml depending on the lesion size, where one ml injection contained 100 mg of the drug. Group-2 patients were given combination therapy of oral Allopurinol (20 mg/kg/day in divided doses) along with the same intra-lesional sodium Stibogluconate dose as group-1 until complete cure of the lesion. RESULTS: Combination therapy of sodium Stibogluconate along with Allopurinol was found superior to sodium Stibogluconate alone in terms of duration of treatment. Group-1, patients who received only sodium Stibogluconate required prolonged treatment duration of 6-9 weeks depending upon the lesion size, while group-2 patients who received combination therapy of sodium Stibogluconate and Allopurinol responded more quickly and their lesions cured in 3-6 weeks depending upon the lesion size. CONCLUSIONS: Oral Allopurinol has a synergistic effect when used with intra-lesional sodium Stibogluconate and effectively reduces the treatment duration required for complete cure of cutaneous Leishmaniasis. Treatment duration was reduced by 3 weeks in the present study when combination therapy was given to the patients of cutaneous Leishmaniasis.

Inducible clindamycin resistance in Staphylococcus species.

OBJECTIVE: To determine the frequency of inducible clindamycin resistance in clinical isolates of Staphylococcus species by phenotypic D-test. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: Ziauddin University Hospital, Karachi, from July to December 2011. METHODOLOGY: Consecutive clinical isolates of Staphylococcus species were collected and identified by conventional microbiological techniques. Antimicrobial susceptibility testing and inducible clindamycin resistance was carried out by performing D-test using CLSI criteria. Methicillin resistance was detected by using Cefoxitin disk as a surrogate marker. Statistical analysis was performed by SPSS version-17. RESULTS: A total of 667 clinical isolates of Staphylococcus species were obtained during the study period. In these isolates, 177 (26.5%) were Staphylococcus aureus, and 490 (73.5%) were coagulase negative Staphylococci. The total frequency of inducible clindamycin resistance among isolates of Staphylococcus species was 120/667 (18%). Frequency of inducible clindamycin resistance among coagulase negative Staphylococci group and Staphylococcus aureus group were 18.57% and 16.38% respectively. Median age of patients in D-test positive group was 19.5 (1 - 54) years. CONCLUSION: The frequency of inducible clindamycin resistance among Staphylococcus species may differ in different hospital setup. Clinical microbiology laboratories should implement testing simple and effective D-test on all Staphylococcus species. D-test positive isolates should be reported clindamycin resistant to decrease treatment failure.