Rejuvenating potato growth and yield in challenging semiarid and saline sandy Cholistan: harnessing PGPB-coated N and P application strategies.

BACKGROUND: Potato serves as a major non-cereal food crop and income source for small-scale growers in Punjab, Pakistan. Unfortunately, improper fertilization practices have led to low crop yields, worsened by challenging environmental conditions and poor groundwater quality in the Cholistan region. To address this, we conducted an experiment to assess the impact of two fertilizer application approaches on potato cv. Barna using plant growth-promoting bacteria (PGPB) coated biofertilizers. The first approach, termed conventional fertilizer application (CFA), involved four split applications of PGPB-coated fertilizers at a rate of 100:75 kg acre-1 (N and P). The second, modified fertilizer application (MFA), employed nine split applications at a rate of 80:40 kg acre-1. RESULTS: The MFA approach significantly improved various plant attributes compared to the CFA. This included increased plant height (28%), stem number (45%), leaf count (46%), leaf area index (36%), leaf thickness (three-folds), chlorophyll content (53%), quantum yield of photosystem II (45%), photosynthetically active radiations (56%), electrochromic shift (5.6%), proton flux (24.6%), proton conductivity (71%), linear electron flow (72%), photosynthetic rate (35%), water use efficiency (76%), and substomatal CO2 (two-folds), and lowered non-photochemical quenching (56%), non-regulatory energy dissipation (33%), transpiration rate (59%), and stomatal conductance (70%). Additionally, the MFA approach resulted in higher tuber production per plant (21%), average tuber weight (21.9%), tuber diameter (24.5%), total tuber yield (29.1%), marketable yield (22.7%), seed-grade yield (9%), specific gravity (9.6%), and soluble solids (7.1%). It also reduced undesirable factors like goli and downgrade yields by 57.6% and 98.8%, respectively. Furthermore, plants under the MFA approach exhibited enhanced nitrogen (27.8%) and phosphorus uptake (40.6%), with improved N (26.1%) and P uptake efficiency (43.7%) compared to the CFA approach. CONCLUSION: The use of PGPB-coated N and P fertilizers with a higher number of splits at a lower rate significantly boosts potato production in the alkaline sandy soils of Cholistan.

Monitoring plant responses in field-grown peanuts exposed to exogenously applied chitosan under full and limited irrigation levels.

In recent decades, numerous studies have examined the effects of climate change on the responses of plants. These studies have primarily examined the effects of solitary stress on plants, neglecting the simultaneous effects of mixed stress, which are anticipated to transpire frequently as a result of the extreme climatic fluctuations. Therefore, this study investigated the impact of applied chitosan on boosting the resistance responses of peanuts to alkali and mixed drought-alkali stresses. Peanuts were grown in mid-alkaline soil and irrigated with full irrigation water requirements (100%IR), represented alkali condition (100% IR × alkali soil) and stress conditions (70% IR × alkali soil-represented mixed drought-alkali conditions). Additionally, the plants were either untreated or treated with foliar chitosan. The study evaluated various plant physio-chemical characteristics, including element contents (leaves and roots), seed yield, and irrigation water use efficiency (IWUE). Plants that experienced solitary alkali stress were found to be more vulnerable. However, chitosan applications were effective for reducing (soil pH and sodium absorption), alongside promoting examined physio-chemical measurements, yield traits, and IWUE. Importantly, when chitosan was applied under alkali conditions, the accumulations of (phosphorus, calcium, iron, manganese, zinc, and copper) in leaves and roots were maximized. Under mixed drought-alkali stresses, the results revealed a reduction in yield, reaching about 5.1 and 5.8% lower than under (100% IR × alkali), in the first and second seasons, respectively. Interestingly, treated plants under mixed drought-alkali stresses with chitosan recorded highest values of relative water content, proline, yield, IWUE, and nutrient uptake of (nitrogen, potassium, and magnesium) as well as the lowest sodium content in leaves and roots. Enhances the accumulation of (N, K, and Mg) instead of (phosphorus, calcium, iron, manganese, zinc, and copper) was the primary plant response to chitosan applications, which averted severe damage caused by mixed drought-alkali conditions, over time. These findings provide a framework of the nutrient homeostasis changes induced by chitosan under mixed stresses. Based on the findings, it is recommended under mixed drought-alkali conditions to treat plants with chitosan. This approach offers a promising perspective for achieving optimal yield with reduced water usage.

Gall bladder sludge and stones in multitransfused Egyptian thalassaemic patients.

One hundred Egyptian beta-thalassaemic patients on a long-term transfusion/chelation programme were evaluated for the prevalence of gall bladder sludge and stones and the associated risk factors. Fifty healthy individuals served as controls. Abdominal ultrasonography revealed that 14% of the thalassaemic patients had gall bladder sludge or stones (6% stones and 8% sludge). The thalassaemic patients with this complication were older, had a higher prevalence of gall bladder symptoms, higher levels of pretransfusion haemoglobin, larger amounts of transfused red cells, and more were regularly transfused. Multiple logistic regression analysis revealed that the presence that gall bladder symptoms and the amount of transfused red cells were the only significant predictors of the occurrence of gall bladder sludge or stones.

Gall bladder sludge and stones in multitransfused Egyptian thalassaemic patients

One hundred Egyptian beta-thalassaemic patients on a long-term transfusion/chelation programme were evaluated for the prevalence of all bladder sludge and stones and the associated risk factors. Fifty healthy individuals served as controls. Abdominal ultrasonography revealed that 14% of the thalassaemic patients had gall bladder sludge or stones [6% stones and 8% sludge]. The thalassaemic patients with this complication were older, had a higher prevalence of gall bladder symptoms, higher levels of pretransfusion haemoglobin, larger amounts of transfused red cells, and more were regularly transfused. Multiple logistic regression analysis revealed that the presence that gall bladder symptoms and the amount of transfused red cells were the only significant predictors of the occurrence of gall bladder sludge or stones

Prevalence of hepatitis C virus (HCV) infection and its vertical transmission in Egyptian pregnant women and their newborns.

We studied the prevalence of hepatitis C virus (HCV) antibody seropositivity using ELISA (Ortho Diagnostic system, 3rd generation test) polymerase chain reaction testing of HCV-RNA (PCR, Promega) and serum alanine transferase (ALT) level in 100 healthy, HIV-negative, pregnant women who delivered spontaneously at the Alexandria University Hospital, and their newborns. Some risk factors were studied using Fisher's exact test. Nineteen per cent of pregnant women were HCV seropositive and 14 of them (14/19) had circulating HCV-RNA, detected by PCR. Nine of the babies born to the 19 HCV seropositive females had circulating antibodies, whereas HCV-RNA was detected in five of them. This gives a vertical transmission risk of 5/14 (36 per cent) for mothers carrying the HCV-RNA and 5/19 (26 per cent) for those having circulating HCV antibodies. History of previous blood transfusion, elevated serum ALT level, and history of infection with schistosomiasis were significant risk factors for HCV infection in mothers. In addition to the previous factors, maternal history of jaundice, stillbirth and hepatomegaly were significant risk factors for neonatal infection. The occurrence of early jaundice and the presence of congenital anomalies in the newborns were non-significant risk factors. In conclusion, our data indicate a high prevalence of HCV seropositivity in Egyptian HIV-negative pregnant women with a significant high rate of vertical transmission of HCV.

Balloon dilation of the right ventricular outflow tract in tetralogy of Fallot: a palliative procedure.

Fifteen patients requiring palliation for tetralogy of Fallot were treated by balloon dilation because of hypercyanotic spells. The mean age at dilation was 1.9 +/- 0.7 years (range 0.5-3), and the mean weight 9.8 +/- 2.1 kg (range 6.0-13.5). Dilation of the outflow tract was combined with dilation of the left and/or right pulmonary arteries in 5 patients. Successful dilation was achieved in 12 patients (80%), but failed in 3 patients with hypoplastic pulmonary arteries. In one patient, the stenosis of the right pulmonary artery could not be dilated because of a very sharp angle at the site of the stenosis. Two of the 3 patients in whom the procedure failed died of severe cyanotic spells within 24 hours of the unsuccessful procedure. No major complications occurred during or after the procedure in the cases undergoing successful dilation. The arterial oxygen saturation increased significantly, from 71 +/- 5.7% to 89 +/- 3.9%, immediately after the procedure (p < 0.005). During a period of follow up of 6 +/- 3.7 months (range 1-13), the procedure was repeated on 3 occasions, and successfully accomplished in 2 of these. In conclusion, balloon dilation is a satisfactory palliative procedure for tetralogy of Fallot in those units in which total correction is not performed under 2 to 3 years of age.

Prevalence of rheumatic heart disease among school children in Alexandria, Egypt: a prospective epidemiological study.

The aim of this work was to study the epidemiologic features of Rheumatic Heart Disease (RHD) among basic education students in Alexandria, including the demographic and clinical profiles as well as risk factors for RHD development. A stratified random sampling technique was used to allocate 5465 school children in the six educational zones of Alexandria. Clinical RHD cases were confirmed by using chest X-ray, ECG and echocardiography. Factors related to occurrence of RHD were studied using a case control design. Thirty four RHD cases (with an estimated prevalence of 6.2/1000 students) were diagnosed. Low socioeconomic status, chronic tonsillitis, positive family history of acute rheumatic fever/RHD and paternal consanguinity were significantly associated with the occurrence of RHD. Almost all previously diagnosed cases were enrolled in a prophylaxis program, with a defaulter rate of 31%. More than half of the identified cases had moderately severe valvular lesions. We recommend the implementation of an educational program targeted to both parents and teachers; the training of upgrading of school health physicians, and the standardization of secondary prophylaxis programs nationwide, with emphasis on assurance of compliance.

Rheumatic fever prophylaxis using benzathine penicillin G (BPG): two- week versus four-week regimens: comparison of two brands of BPG.

OBJECTIVE: This prospective study was aimed at answering two important questions: 1) Is a biweekly schedule of 1.2 million U intramuscular benzathine penicillin G (BPG) superior to a 4-week one in the prevention of upper respiratory Group A beta-hemolytic streptococcal (GABHS) infections and rheumatic fever (RF) recurrences? 2) Is there a difference in the bioavailability of BPG obtained from different manufacturers? METHODOLOGY: Three hundred sixty rheumatic patients aged 4 to 20 years were randomly assigned to either a biweekly (190 patients) or 4-week (160 patients) BPG prophylactic schedule and were followed-up monthly for 2 years by clinical examination, throat swab culture for GABHS and measurement of antistreptolysin O titer to detect GABHS infection and/or recurrences of RF (according to revised Jones' Criteria). Thereafter, 34 rheumatic subjects, aged 8 to 16 years were randomly assigned to receive a 4-week injection of 1.2 million U of either a locally manufactured BPG brand (22 patients) or an imported one (12 patients). Sera of all patients were tested for penicillin level by plate diffusion method on days 1, 2, 3, 4, 5, 6, 7, 14, 21, and 28 after the intramuscular injection of BPG. RESULTS: The GABHS infection rate was found to be 0.2% and 0.3% for patients on the biweekly and 4-week BPG schedules, respectively, with no significant differences between them. However, the RF recurrence rate/patient/year for the 4-week schedule patients (0.12) was double that for the biweekly schedule ones (0.06). Estimation of the bioavailability of the two different brands of BPG demonstrated a difference in their pharmacokinetics and a decrease in the serum penicillin concentration below the minimum inhibitory concentration 3 weeks after the injection of either brand. CONCLUSION: Although a biweekly schedule may not be superior in preventing upper respiratory GABHS infection, it may play a role in preventing the sequelae of such infections. The short duration of penicillinemia explains the superiority of the 2-week schedule in RF prophylais. The difference in the pharmacokinetics of penicillin brands might contribute to the high recurrence rate of RF reported in Egypt.

Reversibility of mitral regurgitation following rheumatic fever: clinical profile and echocardiographic evaluation.

The clinical disappearance of the murmur of rheumatic mitral regurgitation after period of time has been documented by many researchers. However no studies have related the disappearance of the murmur with the functional or anatomical state of the mitral valve. This study was done to elucidate the mitral valve status using doppler and color coded echocardiography among those children who have lost their apical pansystolic murmur on auscultation following a documented attack of rheumatic fever. The study sample consisted of 51 patients including 31 patients in whom the murmur has disappeared (group I), and 20 patients with persistent isolated mitral regurgitation (group II). Patients of group I had significantly lower grades of murmur intensity, lower incidence of cardiomegaly, and had no heart failure in the initial attack. They were more compliant with prophylaxis and had less recurrences than patients of group II. The murmur disappeared in patients of group I from 1/2 to 14 years after the initial attack. Echocardiography revealed that such patients had a normal mitral valve apparatus, and a normal heart size and function. Only 5 patients of this group had a significant regurgitant jet demonstrated by colour doppler. We concluded that recovery of the mitral valve and return of cardiac functions to normal is possible in patients who had mitral regurgitation following rheumatic fever. Some of them may still have an inaudible mild regurgitation. Patients who have lost their murmur may be allowed to exercise freely, yet penicillin prophylaxis should not be discontinued.

Coxsackie virus infections in rheumatic fever.

The close relationship between Group A beta Hemolytic Streptococci (GABS) and rheumatic fever is a well established one. However, the concept of the streptococcus as the sole etiologic agent of the rheumatic heart disease (RHD) has been challenged over the past years. Since coxsackievirus group B (CVB) has long been proposed as a cause of acquired valvular disease simulating rheumatic fever, we attempted in this study to document infections with this group of viruses in patients with rheumatic fever. We obtained blood samples from 106 patients with old (quiescent) rheumatic fever/rheumatic heart disease [group I], 94 patients with acute rheumatic fever (ARF) [group II], and 74 normal matched controls. We tested for the presence of neutralizing antibodies to the 6 serotypes of CVB by a micro neutralization test. We have found that infection with CVB, especially types B2 and B4, was common in the studied population. Forty-two percent of normal individuals had evidence of infection with any of the 6 serotypes of CVB. Patients of group I had significantly more frequent infections with CVB 2. Patients in group II had significantly more frequent infections with CVB 2 and CVB 6. There was no clear correlation between such infections and the clinical course of rheumatic fever. There was no difference in the incidence of CVB infections between patients with definite ARF, and patients with suspected ARF. We set a low order association between rheumatic fever and infection with CVB types B2 and B6. We emphasize the importance of pursuing the investigation of the role of CVB in relation to RHD.

An international comparison of the prevalence of streptococcal infections and rheumatic fever in children.

Differences in the socioeconomic standards of living remain an important and feasible partial explanation for the difference in incidence of rheumatic fever following GABHS infection in Egyptian compared with American children. However, past and ongoing studies of the epidemiology, diagnosis, and treatment of GABHS infections in Egypt, the United States, and elsewhere suggest other significant factors are relevant. Additional knowledge about the rheumatogenic GABHS serotypes that are most prevalent in all countries is an important area where additional research is needed. Streptococcal research will help not only in improving the quality of primary prevention of rheumatic fever, but also in developing streptococcal vaccines.

Benzathine penicillin G for rheumatic fever prophylaxis: 2-weekly versus 4-weekly regimens.

Rheumatic fever is still one of the major public health problems in Egypt and the developing countries. It is characterized by a high tendency to recur following streptococcal infections. The use of long acting penicillin for prophylaxis against strep infections was a good achievement in this field, yet, recurrences have been reported in patients following monthly prophylactic programs. Clinical experience in Alexandria have shown for a long time that giving penicillin every 2 weeks is followed by less recurrences of rheumatic fever. Recently, reports came showing that effective penicillin levels are not maintained except for 2 to 3 weeks after the injection. In the present study, we compared two regimens of prophylaxis with 190 patients in the 2-weekly regimen, and 170 patients in the 4-weekly regimen being followed up for 2 consecutive years. Two hundred and sixty nine streptococcal infections occurred during this period. Although the streptococcal infection rate was equal in both groups, the rheumatic fever recurrence rate and the RF attack rate were significantly higher in the group of patients on the 4-weekly schedule. The results of this study have shown the superiority of the 2-weekly schedule in the adequate control of RF recurrences. We suggest that this schedule should be implemented for secondary prophylaxis of rheumatic fever in Egypt and other areas with severe RF.

Antibody production and complement system in protein energy malnutrition.

Antibody production in kwashiorkor and marasmic infants was studied by dividing them into three groups and giving the first group a single dose of trivalent live attenuated polio virus, the second group live attenuated measles virus and the third group diphtheriatoxoid. The production of antibodies was found to be deficient in PEM as compared to normals and diminished more in kwashiorkor than in marasmus cases. The individuals of the complement system were significantly lower in kwashiorkor than in normal controls. However, C3 was the only fraction which is significantly diminished in marasmic infants. The results are discussed and as a conclusion it is suggested that deficient production of antibodies and diminution in the complement system in PEM may explain the susceptibility of such infants to repeated attacks of infection.

Histopathological and histochemical studies on the tonsils in children with rheumatic heart disease.

The tonsils were studied histologically and histochemically in 67 children with rheumatic heart disease, 33 children with chronic tonsillitis and 5 normal children. The tonsils of rheumatic children showed hyperplasia and hyperactivity of lymphocytes and paucity of phagocytes. It was suggested that these peculiar findings might contribute to the pathogenesis of rheumatic fever.

Calcium and phosphorus metabolic changes in children with hepatic bilharziasis.

Investigations were done to study the calcium and phosphorus metabolic changes in 35 children with hepatic bilharziasis, of whom 12 were ascitic. Thirteen normal children served as controls. Despite a normal serum level of both calcium and inorganic phosphate in the Bilharzial group, yet both were increased in urine. The mean values obtained from the ascitic fluid were 70% and 90.2% of their serum levels, respectively. The corrected creatinine clearance was significantly diminished, while PEI was significantly increased, and the % TRP significantly decreased, with still a more marked decrease in the ascitic cases. Following a phosphate lead the serum inorganic phosphate level showed a significantly more rapid lowering in both bilharzial groups, as compared to the control group. On the other hand bilharzial cases responded to the intravenous calcium load by a significant retention of calcium in the serum.