Poverty-associated emerging infection of Cystic Echinococcosis in population of Northern Pakistan: A hospital based study.

Cystic Echinococcosis (CE) is one of the most important zoonotic parasitic diseases in human, livestock, and wildlife globally. The prevalence of CE depends upon human behavioral risk factors, the diversity and ecology of animal host interactions and the genetic diversity within Echinococcus species which differ in their zoonotic potential and pathogenicity. It is a neglected, economic and socio-cultural problem in Pakistan. The available data about the incidence of CE is very limited and no extensive study has been reported in Pakistan. The current study was aimed to analyze the hospital reported cases of CE and the associated risk factors related to the incidence of CE. The hospital-based data of CE for the time period of January 2012-December 2017 was collected from Islamabad, Rawalpindi and Peshawar. The data covered demographic characteristics including age, gender, and cyst localization of infected individuals and socioeconomic determinants. The data was analyzed based upon different risk factors along with the different socioeconomic parameters that has an important impact on the distribution of disease. A total of 228 cases were presented in the selected hospitals of different cities during the study period. Out of total 228 patients, 59.21% were males and 40.78% were females (P<0.001). Most infections have been recorded in young adults (>20-30) showing 22.8% of total infected individuals followed by children (0-10) showing 10.5% (n=24), respectively (P<0.001). Liver was the most vulnerable organ (58.77%, n=134) followed by lungs (14.47%, n=33) (P<0.001). The infection was higher among rural communities (84.2%) than urban (12.8%) (P<0.001). Socioeconomic and demographic factors had an important impact on the intensity of disease (P<0.001). The occurrence of cases in children and young adults was an important finding as it indicated an active transmission of the parasite in Pakistan along with the poverty index. Emergence of echinococcosis in Pakistan showed that emerging health issues in Pakistan could bring the disease to limelight for future research. This finding, together with the fact that 1 hospital reported 214 cases over 6 years 325 underlines the need for a program for prevention/control of this disease in Pakistan. The timely measure needs to be taken to hamper the disease development and establishment. In order to control the disease, complete surveillance should be done which in turn weighs down the disease progress.

Poverty-associated emerging infection of Cystic Echinococcosis in population of Northern Pakistan: A hospital based study

@#Cystic Echinococcosis (CE) is one of the most important zoonotic parasitic diseases in human, livestock, and wildlife globally. The prevalence of CE depends upon human behavioral risk factors, the diversity and ecology of animal host interactions and the genetic diversity within Echinococcus species which differ in their zoonotic potential and pathogenicity. It is a neglected, economic and socio-cultural problem in Pakistan. The available data about the incidence of CE is very limited and no extensive study has been reported in Pakistan. The current study was aimed to analyze the hospital reported cases of CE and the associated risk factors related to the incidence of CE. The hospital-based data of CE for the time period of January 2012-December 2017 was collected from Islamabad, Rawalpindi and Peshawar. The data covered demographic characteristics including age, gender, and cyst localization of infected individuals and socioeconomic determinants. The data was analyzed based upon different risk factors along with the different socioeconomic parameters that has an important impact on the distribution of disease. A total of 228 cases were presented in the selected hospitals of different cities during the study period. Out of total 228 patients, 59.21% were males and 40.78% were females (P<0.001). Most infections have been recorded in young adults (>20-30) showing 22.8% of total infected individuals followed by children (0-10) showing 10.5% (n=24), respectively (P<0.001). Liver was the most vulnerable organ (58.77%, n=134) followed by lungs (14.47%, n=33) (P<0.001). The infection was higher among rural communities (84.2%) than urban (12.8%) (P<0.001). Socioeconomic and demographic factors had an important impact on the intensity of disease (P<0.001). The occurrence of cases in children and young adults was an important finding as it indicated an active transmission of the parasite in Pakistan along with the poverty index. Emergence of echinococcosis in Pakistan showed that emerging health issues in Pakistan could bring the disease to limelight for future research. This finding, together with the fact that 1 hospital reported 214 cases over 6 years 325 underlines the need for a program for prevention/control of this disease in Pakistan. The timely measure needs to be taken to hamper the disease development and establishment. In order to control the disease, complete surveillance should be done which in turn weighs down the disease progress.

The gum exudate from Combretum nigricans gum, the major source of West African 'gum combretum'.

Gum samples from six individual Combretum nigricans trees and two additional reference samples have been characterized. 13C Fourier-transform NMR spectra show that all have the same structure and confirm that the variations observed in their analytical parameters reflect only small fine-structural differences. NMR spectra also reveal that eight West African 'gum combretum' samples from reputable commercial sources originated from Combretum nigricans. This identification is important because gum combretum, which is not permitted as a food additive, has been exploited as an adulterant and misrepresented as gum arabic, for which not even the 1990 Revised Specification is sufficiently rigorous to detect such commercial deceptions. NMR spectroscopy has also shown that the rhamnose and uronic acid contents of gum combretum are located within internal polysaccharide chains. This explains the well-known difference in emulsification functionality between gum arabic, in which all rhamnose and uronic acid groups chain-terminal, and gum combretum which is, in addition, markedly hygroscopic and characterized commercially by its tendency to 'block' in transit and storage.

Gum arabic (Acacia senegal): unambiguous identification by 13C-NMR spectroscopy as an adjunct to the Revised JECFA Specification, and the application of 13C-NMR spectra for regulatory/legislative purposes.

The JECFA Specification for gum arabic was revised in 1990 to reflect more closely the specification of the Test Article used in evaluations that led to its classification 'ADI not specified' in 1982/83. Some producers and traders have objected to the Revised Specification; in contrast, consumer-protection groups consider that it remains too lax to provide the degree of safety assurance expected. This paper presents analytical data that confirm the mean values previously established for nitrogen and the specific rotation of bulk commercial gum arabic from Acacia senegal. The data also establish that natural gum arabic imported into the USA and Europe in 1989/91 met the Revised Specification, but that a disturbingly high proportion of spray-dried, processed gums sold as 'gum arabic' did not. NMR spectroscopy has (a) indicated that some such samples are based on non-permitted gums and (b) confirmed that the 1983 Test Article represents not only typical 1990/91 shipments but also a wide range of reference gum arabic samples from other reputable sources. Details of a representative 13C-NMR spectrum, derived by averaging the relative intensities for the characteristic resonances of 35 gum arabic samples, are given for future regulatory/legislative purposes. Some limitations of the Revised Specification and its susceptibility to commercial exploitation are discussed.