Impact of cobalt and proline foliar application for alleviation of salinity stress in radish.

Salinity stress ranks among the most prevalent stress globally, contributing to soil deterioration. Its negative impacts on crop productivity stem from mechanisms such as osmotic stress, ion toxicity, and oxidative stress, all of which impede plant growth and yield. The effect of cobalt with proline on mitigating salinity impact in radish plants is still unclear. That's why the current study was conducted with aim to explore the impact of different levels of Co and proline on radish cultivated in salt affected soils. There were four levels of cobalt, i.e., (0, 10, 15 and 20 mg/L) applied as CoSO4 and two levels of proline (0 and 0.25 mM), which were applied as foliar. The treatments were applied in a complete randomized design (CRD) with three replications. Results showed that 20 CoSO4 with proline showed improvement in shoot length (∼ 20%), root length (∼ 23%), plant dry weight (∼ 19%), and plant fresh weight (∼ 41%) compared to control. The significant increase in chlorophyll, physiological and biochemical attributes of radish plants compared to the control confirms the efficacy of 20 CoSO4 in conjunction with 10 mg/L proline for mitigating salinity stress. In conclusion, application of cobalt with proline can help to alleviate salinity stress in radish plants. However, multiple location experiments with various levels of cobalt and proline still needs in-depth investigations to validate the current findings.

Safety of Clopidogrel vs. Ticagrelor in Dual Antiplatelet Therapy Regimens for High-Bleeding Risk Acute Coronary Syndrome Patients: A Comprehensive Meta-analysis of Adverse Outcomes.

INTRODUCTION: Patients of acute coronary syndrome (ACS) at a high-bleeding risk (HBR) often require dual antiplatelet therapy (DAPT) to reduce the risk of recurrent cardiovascular events. Clopidogrel and ticagrelor are the most commonly used antiplatelet agents in DAPT regimens. However, the safety profiles of these drugs in ACS patients at HBR remain a subject of ongoing debate. AIM: To investigate any difference between the safety of clopidogrel and ticagrelor used as a part of DAPT regimen in ACS patients at HBR. METHODS: A systematic search on PubMed, Cochrane Library, and Google Scholar was conducted to identify experimental and observational studies published up to the knowledge cutoff date in September 2023. Studies comparing the safety of clopidogrel and ticagrelor in ACS patients at HBR were included for analysis. The primary outcomes assessed were major bleeding events, stroke, and myocardial infarction (MI), while secondary outcomes included all-cause mortality, major adverse cardiac and cerebrovascular events (MACCE), and net adverse clinical and cerebral events (NACCE). RESULTS: We included a total of 8 observational studies in our meta-analysis. The pooled analysis revealed a statistically significant increase in the risk of MI (pooled RR = 1.43; 95% CI 1.12-1.83; P = 0.005) in the patients using clopidogrel. There were no statistically significant differences in major bleeding events (pooled RR = 0.94; 95% CI 0.82-1.09; P = 0.44), stroke (pooled RR = 1.36; 95% CI 0.86-2.14; P = 0.18), all-cause mortality (pooled RR = 1.17; 95% CI 0.97-1.41; P = 0.10), MACCE (pooled RR = 1.07; 95% CI 0.76-1.50; P = 0.69) and NACCE (pooled RR = 0.95; 95% CI 0.66-1.37; P = 0.78) between the two groups. Subgroup analyses based on region were performed. CONCLUSION: Both drugs are generally safe for treating ACS patients with HBR at baseline, although a higher risk of MI was observed with the use of clopidogrel. Nevertheless, drug choice should factor in regional variations, patient-specific characteristics, cost, accessibility, and potential drug interactions.

Effects of floods on the mental health of Pakistanis: a commentary.

Over the years, worsening climate change has led to multiple spells of heavy rain and floods in Pakistan, with the 2022 floods ranked as the deadliest in world history. To top it off, decades of political instability, mental health stigma, and lack of psychological support have tipped the after-effects over the edge. These floods have taken a toll on more than 13 000 people, with inaccessibility to vital necessities leading to further deaths every week. Local and international support is imminent for better handling of the crisis and reducing the incidence of post-traumatic stress disorders and other mental health-related issues.

Fighting Pandemics With Augmented Reality and Smart Sensing-Based Social Distancing.

In a postpandemic world, remaining vigilant and maintaining social distancing are still crucial so societies can contain the virus and the public can avoid disproportionate health impacts. Augmented reality (AR) can visually assist users in understanding the distances in social distancing. However, integrating external sensing and analysis is required for social distancing beyond the users' local environment. We present DistAR, an android-based application for social distancing leveraging AR and smart sensing using on-device analysis of optical images and environment crowdedness from smart campus data. Our prototype is one of the first efforts to combine AR and smart sensing technologies to create a real-time social distancing application.

Sole and combined effect of foliar zinc and arbuscular mycorrhizae inoculation on basmati rice growth, productivity and grains nutrient.

Mismanagement in foliar fertilizer application at different crop stages decreases the productivity of the crop. Likewise, higher application of phosphorus (P) beyond recommended application rates not only decrease zinc (Zn) uptake in rice but also increase fertilizer use cost. Inoculation of arbuscular mycorrhizae (AMF) may optimize the uptake of P and improve crops production via organic secretions. That's why the current study was conducted to examine the individual and coordinated effects of 0.5% Zn (0.5Zn) foliar spray (tillering (T) and/or panicle (P) initiation stage) and AMF application. Application of foliar 0.5Zn at tillering+panicle stage remained significantly better for significant enhancement in plant height, spike length, gas exchange attributes and total chlorophyll contents than control. A significant decrease in electrolyte leakage Also validated the effectiveness of treatment 0.5ZnT+P compared to control. Compared to control, the maximum increase in N (14.5 and 25.7%), P (42.1 and 33.3%), K (22.2 and 30.0%) and Zn (19.3 and 27.8%) accumulation was also found in 0.5ZnT+P, with and without AMF, respectively. In conclusion, 0.5ZnT+P with AMF is a better approach than sole application of Zn at tillering or panicle initiation stages. Nevertheless, more investigations are suggested at field level under variable climatic zones to confirm the effectiveness of 0.5ZnT+P with AMF for improvement in rice growth and production.

Assessing the potential of exogenous caffeic acid application in boosting wheat (Triticum aestivum L.) crop productivity under salt stress.

Caffeic acid (CA) is known as an antioxidant to scavenge reactive oxygen species (ROS), but the underlying mechanism of mediation of plant salt tolerance against various abiotic stresses by caffeic acid is only partially understood. A field experiment (120 days duration) was conducted to investigate the protective role of caffeic acid under a high saline medium (EC 8.7 dS m-1 and textural class: sandy loam) in two wheat genotypes (FSD -08 and Zincol-16). Two levels of caffeic acid (50 µM and 100 µM) were applied exogenously in combination with the salinity stress and results revealed that salt alleviation is more prominent when caffeic acid was applied at the rate of 100 µM. Under saline conditions, wheat genotypes show poor fresh and dry matter accumulation, chlorophyll contents, relative water contents (RWC), membrane stability index (MSI) and activities of antioxidant enzymes and increased uptake of Na+ ions. However, wheat genotype FSD-08 eminently responded to caffeic acid application as compared to wheat genotype Zincol-16 as demonstrated by higher growth indicators, RWC, MSI, activities of antioxidant enzymes, accumulation of mineral ions in grain along with yield attributes. In addition, caffeic acid also mitigated salt-induced oxidative stress malondialdehyde (MDA) and hydrogen peroxide (H2O2) contents as well as significantly reduced Na+ uptake. It can be concluded that caffeic acid-induced salinity tolerance in wheat is attributed to improved plant water relations, K+ uptake, yield contents and activities of antioxidant stress enzymes.

The influence of environmental factors on seed germination of Xanthium strumarium L.: Implications for management.

Xanthium strumarium L. (Common cocklebur) is a noxious weed prevailing in different ecosystems around the world. It incurs significant yield and economic losses in different cropping systems globally. Successful management of any weed species depends on sound knowledge of seed germination biology. However, detailed knowledge on seed germination biology of the species is missing. Therefore, we investigated the impact of different environmental factors on seed germination and seed burial depths on seedling emergence of two X. strumarium populations. The impact of different sorghum mulch doses (0-10 t ha-1) on seedling emergence of the tested populations was also explored. Seed germination was evaluated under different photoperiods (0, 12 and 24), constant temperatures (0-50°C with 5°C stepwise rise), and different levels of pH (3-12), salinity (0-600 mM) and osmotic potential (0 to -1.6 MPa). Seedling emergence was observed for seeds buried at different depths (0-15 cm). Seeds of both populations proved non-photoblastic; however, higher germination was recorded under 12-hour photoperiod. The seeds germinated under a wide range of constant temperatures (10-45°C), pH (4-10), osmotic potentials (0 to -0.8 MPa) and salinity levels (0-400 mM NaCl). However, the highest germination was observed under 30-31°C temperature and neutral pH (7.51-7.52). Seeds were able to withstand 400 mM salinity and -1.00 MPa osmotic potential. Seedling emergence was initially improved with increasing burial depth and then a sharp decline was noted for the seeds buried >3 cm depth. Most of the seeds of both populations did not emerge from >8 cm depth. Different sorghum mulch doses linearly suppressed seedling emergence of tested populations, and 5.83-5.89 t ha-1 mulch application suppressed 50% of seedling emergence. Seedling emergence was completely retarded with 8 t ha-1 sorghum mulch. The tested populations germinated under diverse environmental circumstances indicating that the species can become troublesome in marginal habitats and cropped lands. Deep burial of seeds and application of sorghum mulches suppressed seedling emergence. Thus, deep burial followed by shallow tillage and application of sorghum mulches could be used as a successful strategy to manage the species in agricultural fields. Nonetheless, management strategies must be developed to control the species in other habitats.

The impact of seed burial depths and post-emergence herbicides on seedling emergence and biomass production of wild oat (Avena fatua L.): Implications for management.

Wheat (Triticum aestivum L) is among the most important cereal crops widely cultivated in the world. Wild oat (Avena fatua L.) competes with wheat for moisture, sunlight, space and nutrition. The successful management of weeds requires sound knowledge of their biology and response to different herbicides. This study inferred the impact of different constant temperature regimes and seed burial depths on seedling emergence and biomass production of wild oat. Moreover, the impact of different post-emergence herbicides applied at different growth stages on biomass production of wild oat was tested. The influence of different wild oat-wheat density (WWD) combinations on biomass production of wheat and wild oat was also inferred. Different constant temperature regimes significantly altered seed germination and biomass production of wild oat. The highest seed germination percentage and biomass production were noted under 15°C and 20°C, whereas the lowest values were recorded under 30°C. Similarly, days to start emergence, seedling emergence percentage and biomass production of wild oat was significantly affected by different seed burial depths. The lowest and the highest values of these parameters were observed under 4 and 10 cm depth, respectively. Different post-emergence herbicides and wild oat growth stages significantly altered biomass production. The highest reduction in fresh and dry biomass was recorded with herbicides' application at 2-4 leaf stage compared with anthesis stage. Clodinofop resulted in higher reduction of fresh biomass, whereas higher reduction in dry biomass was noted with Sulfosulfuron. Seed germination of both species was not affected by different WWD combinations, except for the treatment where no seed was sown of both species. These results indicate that deep burial of seeds could prevent seedling emergence, whereas post-emergence herbicides must be applied at 2-4 leaf stage of wild oat for its effective management.

Pulmonary Tuberculosis After Gastric Bypass: A Very Rare Complication.

Laparoscopic Roux-en-Y gastric bypass (RYGB) is the most commonly performed bariatric surgical procedure with successful outcomes. RYGB has multiple positive outcomes, including sustained weight reduction, resolution of co-morbidities and improvement in the overall health. RYGB has many complications like any other surgery, but the development of tuberculosis (TB) either pulmonary or extra-pulmonary secondary to RYGB is very rare. We present a 32-year-old female with the history of a successful RYGB three years ago, who presented with signs and symptoms of possible TB which was later confirmed with sputum acid-fast bacilli and sputum culture. She was treated with anti-tuberculosis treatment (ATT) drugs for six months with complete resolution of her symptoms. We recommend raising awareness in the health care professionals about this rare complication of RYGB in the need of time.

A Rare Case of Raoultella planticola Urinary Tract Infection in a Patient With Immunoglobulin A Nephropathy.

Raoultella planticola is a gram-negative, aerobic, nonmotile mostly found in environments with high prevalence in soil and water. This organism is a very rare human pathogen as only 29 cases of Raoultella planticola-related infections have been reported until 2017, with only 7 cases in the United States. Only 3 cases of urinary tract infection secondary to R planticola have been reported, 1 in a pediatric patient and 2 in adults. In this article, we present a case of R planticola urinary tract infection in a 65-year-old male with immunoglobulin A nephropathy. On investigation, the patient was found to be septic and empirical antibiotic was started for gram-negative coverage. The patient showed remarkable improvement and discharged on oral antibiotic for 7 days. R planticola rarely cause infection in humans, with overall good prognosis.

Prostate Abscess Caused by Community-Acquired Methicillin-Resistant Staphylococcus aureus.

A 60-year-old male presented with complaints of fever, chills, cough, and shortness of breath. He denied abdominal pain, urgency, dysuria, or hematuria. His laboratory data revealed an elevated white blood cell count and lactic acid, and one set of blood culture stained positive for gram-positive cocci. He was empirically started on intravenous antibiotics. On the next hospital day, the patient complained of hematuria and lower abdominal discomfort. A computed tomography scan of his abdomen and pelvis was obtained that revealed a focal hypodensity relating to prostate abscess, which was subsequently confirmed on magnetic resonance imaging of the prostate. Final report of blood cultures stated methicillin-resistant Staphylococcus aureus. He was treated with intravenous vancomycin and transurethral resection and deroofing of the prostate gland with drainage that resulted in complete resolution of his symptoms.

Slipping Rib Syndrome in a Female Adult with Longstanding Intractable Upper Abdominal Pain.

Slipping rib syndrome is a rare cause of abdominal or lower chest pain that can remain undiagnosed for many years. Awareness among health care personnel of this rare but significant disorder is necessary for early recognition. Prompt treatment can avoid unnecessary testing, radiographic exposure, and years of debilitating pain. A 52-year-old female was evaluated for a 3-year history of recurrent abdominal and lower chest pain. Pain was sharp, primarily located in the lower chest and subcostal region left more than right, waxing and waning, nonradiating, and aggravates with specific movements. She underwent frequent physical therapies, treated with multiple muscle relaxants and analgesics with minimal improvement. Imaging modalities including CT scan, MRI, and X-rays performed on multiple occasions failed to signify any underlying abnormality. Complete physical examination was unremarkable except for positive hooking maneuver. Dynamic flow ultrasound of lower chest was performed which showed slipping of the lowest rib over the next lowest rib bilaterally left worse than right, findings consistent with slipping rib syndrome. Slipping rib syndrome is caused by hypermobility of the floating ribs (8 to 12) which are not connected to the sternum but attached to each other with ligaments. Diagnosis is mostly clinical, and radiographic tests are rarely necessary. Hooking maneuver is a simple clinical test to reproduce pain and can aid in the diagnosis. Reassurance and avoiding postures that worsen pain are usually helpful. In refractory cases, nerve block and surgical intervention may be required.

Shewanella putrefaciens: An Emerging Cause of Nosocomial Pneumonia.

Gram-negative infections are a rising concern faced by the medical community. Approximately 30% of nosocomial bloodstream infections in intensive care units in the United States are caused by these gram-negative species. Emergence of multidrug-resistant organisms further complicate this issue. In this article, we report a case of an 84-year-old Caucasian male who was diagnosed with Shewanella pneumonia treated with cefepime with minimal to no improvement in his symptoms. To the best of our knowledge, this is the third reported case of Shewanella putrefaciens nosocomial pneumonia and first case of bacteremia secondary to pneumonia by Shewanella putrefaciens.

Clostridium difficile Colitis Leading to Reactive Arthritis: A Rare Complication Associated With a Common Disease.

The relationship between reactive arthritis and enteric infections caused by Yersinia enterocolitica, Campylobacter jejuni, and Salmonella typhimurium is well documented. Clostridium difficile colitis is a less recognized cause of reactive arthritis. We present a case of a 58-year-old woman with Clostridium difficile colitis complicated by reactive arthritis. A 58-year-old woman with no significant past medical history presented to our hospital with complaints of nonbloody watery diarrhea, abdominal pain for the past 1 week, and right knee pain starting 1 day prior. The patient had recently used antibiotics for a respiratory tract infection. On examination, the patient had a swollen and erythematous right knee. While in the hospital the patient also developed a similarly painful and swollen left knee. The patient was found to be positive for C difficile toxin in stool. Synovial fluid analysis of both the knee joints revealed a sterile and inflammatory fluid, negative for crystals and showing no growth on gram stain. We diagnosed the patient with reactive arthritis secondary to C difficile colitis once all other causes of the bilateral knee joint symptoms were ruled out with appropriate laboratory and imaging studies. Treatment with oral vancomycin and an anti-inflammatory was initiated, and the patient had complete resolution of symptoms. This case illustrates the importance of recognizing C difficile colitis as a potential differential for reactive arthritis under the appropriate circumstances. The treatment of reactive arthritis is mainly supportive and treating the underlying cause, which happens to be C difficile in this case.

Opana ER (Oxymorphone)-Induced Thrombotic Microangiopathy: An Atypical Presentation in a Patient With Hepatitis C.

Oxymorphone is a semisynthetic extended release opiate used to treat moderate to severe chronic pain. The Food and Drug Administration approved the oral form of oxymorphone available as Opana and Opana ER (extended release) since 2006. The Food and Drug Administration and the Centers for Disease Control and Prevention issued warning against intravenous use of Opana ER. We are presenting a case report of a 37-year-old female with a history of active intravenous drug abuse who presented to our hospital with acute kidney injury. Urinalysis showed red blood cell sediments, many dysmorphic red blood cell casts along with nephrotic range proteinuria of 12 g/deal per day. Kidney biopsy showed microscopic thrombotic microangiopathy (TMA) involving glomeruli and vessels. Further workup was undertaken for TMA, and apart from mildly elevated lactate dehydrogenase of 380 (normal <243), active hepatitis C, and slightly low ADAMTS-13 (55%), there was no other laboratory evidence of TMA. On literature search, we found that intravenous injection of chronic Opana ER has been reported to cause TMA resulting in chronic kidney disease. Our patient also admitted to use of intravenous Opana ER abuse for the past 5 years. She had a normal platelet count and an absence of schistocytes, which makes it an atypical presentation of TMA resulting in chronic kidney disease in an opiate user. We strongly urge physicians to avoid prescribing opiates for chronic pain, especially Opana ER, which if injected intravenously for recreational purposes can lead to serious side effects like TMA. Treatment is mainly supportive and avoidance of drug in future.

A Rare Case of Sphingomonas paucimobilis Meningitis in the Absence of Cerebrospinal Fluid Pleocytosis.

Sphingomonas paucimobilis is a nonfermentative gram-negative bacillus of low pathogenicity. The organism has been involved in causing a wide range of infections in community and hospital settings. Only 3 cases of meningitis caused by this organism have been reported so far. We report a rare case of S paucimobilis meningitis who presented with atypical symptoms. A 50-year-old female presented with headache, dizziness, chills, shakiness, and neck pain along with nuchal rigidity. On physical examination, severe neck rigidity along with decreased range of motion was noticed. Her cerebrospinal fluid showed gram-negative rods, and she was started on meropenem. The cerebrospinal fluid grew S paucimobilis sensitive to meropenem. She subsequently showed significant improvement and was discharged home on intravenous meropenem for 21 days and showed complete recovering in 5 weeks.

Invasive Listeria monocytogenes Gastroenteritis Leading to Stupor, Bacteremia, Fever, and Diarrhea: A Rare Life-Threatening Condition.

Listeria monocytogenes is a gram-positive, rod-shaped organism that can cause serious infections such as meningitis, invasive gastroenteritis, and endocarditis. Every year 1600 people in the United States are affected, with significant mortality of 260 people annually. Listeria gastroenteritis has the third highest mortality rate among all the food-borne infection. Invasive listeriosis most commonly affect pregnant women, those in extremes of ages, people with comorbid diseases, and people with weakened immune response. In this article, we present a rare case of invasive Listeria gastroenteritis in an 83-year-old female with multiple comorbid conditions and past medical history of type 2 diabetes mellitus and multiple risk factors who was brought to the hospital with altered mental status. She had history of fever, abdominal pain, and watery diarrhea up to 14 episodes in 24 hours for the last 7 days. Her stool culture grew Listeria monocytogenes sensitive to penicillin. She was started on penicillin for 2 weeks. She had subsequently complete resolution of fever, diarrhea, and abdominal pain. High index of suspicion is the key to ensure timely initiation of appropriate empirical treatment in the setting of invasive gastroenteritis, especially in people who have high risk factors for listeriosis. We recommend raising awareness in the health care profession about invasive listeriosis in the need of time. Intravenous ampicillin or penicillin G is the treatment of choice, with meropenem as an alternative.

Plastibell Device Circumcision versus Bone Cutter Technique in terms of Operative Outcomes and Parent's Satisfaction.

OBJECTIVE: To compare the rate of complications of Plastibell and bone cutter circumcision technique and recognition of top worries and satisfaction rate in the mind of parents before and after the procedure of Plastibell device (PD) circumcision in infants less than 6 months of age. METHODS: It was a descriptive prospective study conducted at department of surgery Sheikh Zayed Hospital, Rahim Yar Khan. Two hundred parents of infants of less than six months of age were recruited for this study. Infants were divided into two equal groups. Group I included Plastibell circumcision technique and Group II included Bone Cutter Circumcision technique. Data was analyzed using SPSS Version 17. Independent sample t-test and chi-square test was used to compare quantitative and qualitative variables respectively. P-value <0.05 was taken as significant difference. RESULTS: Total number of two hundred infants were included in this study. Most common worries of parents about Plastibell Device circumcision were; fear of fever (42.0%). Fear of pain and bleeding (66.0%). Plastibell Device method was associated with less operation time and bleeding as compared to bone cutter method (P-value <0.0001 and <0.0001 respectively). Incidence of complications other than bleeding and infection was 3.0% in bone cutter method and 1.0% in Plastibell device method. Pain score was significantly less in plastibell device group (p-value <0.0001). Post-operatively, 98% parents showed complete procedural satisfaction in Plastibell group versus 87% parents in bone cutter one month after surgery (P-value 0.003). About 4% parents in bone cutter method group showed cosmetic displeasure versus only 1% parents in plastibell device group. CONCLUSION: The study concluded that Plastibell Device circumcision is a safer technique for circumcision and is associated with highest level of parent's satisfaction.

Antiacanthamoebic properties of natural and marketed honey in Pakistan

Objective: To determine antiacanthamoebic activity of natural and marketed honey samples. Methods: Natural honey samples were collected directly from the bee hive and marketed honey samples were purchased from the local market in Karachi, Pakistan. Both honey samples were tested for their flavonoid content (quercetin equivalent per gram of the extract) and phenolic content (gallic acid equivalent per gram). Furthermore, their anti-oxidant activity was determined by measuring 2,2-diphenyl-1-picrylhydrazyl. Using amoebistatic and amoebicidal assays, the effects of honey samples were tested against growth and viability of Acanthamoeba parasites. Results: Natural honey exhibited potent amoebistatic and amoebicidal effects, in a concentration-dependent manner. Honey-treated Acanthamoeba castellanii showed loss of acanthopodia, following which amoebae detached, rounded up, reduced in size, decreased in cytoplasmic mass and they were observed floating in the culture medium. Importantly, honey-treated amoebae did not revive when inoculated in fresh growth medium, however, glycerol-treated amoebae exhibited viable trophozoite and active growth. In contrast, marketed honey samples varied in their efficacy against Acantha-moeba castellanii. The proportion of flavonoid, as determined by quercetin measurements and the proportion of phenolic, as determined by gallic acid measurements was higher in natural honey compared with marketed honey. Similarly, the antioxidant activity, as determined by 2,2-diphenyl-1-picrylhydrazyl scavenging activity was higher in natural honey vs. marketed honey. Conclusions: This study shows that natural honey has antiacanthamoebic properties and possesses higher flavonoid, phenolic and antioxidant properties compared with the marketed honey. These findings are of concern to the public, health officials, and to the manufacturers regarding production of honey for medical applications.