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Muhammad J, Rabbani M, Shabbir MZ, Muhammad K, Ghori MT, Chaudhry HR, Ul Hassnain Z, Jamil T, Abbas T, Chaudhry MH, Haisem-Ur-Rasool M, Ali MA, Nisar M, Kirimanjeswara GS, Jayarao BM. Cross Sectional Study and Risk Factors Analysis of Francisella tularensis in Soil Samples in Punjab Province of Pakistan. Front Cell Infect Microbiol 2019; 9:89. [PMID: 31024860 PMCID: PMC6460113 DOI: 10.3389/fcimb.2019.00089] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 03/12/2019] [Indexed: 12/16/2022] Open
Abstract
Tularemia is an endemic zoonotic disease in many parts of the world including Asia. A cross-sectional study was conducted to determine genome-based prevalence of Francisella tularensis (Ft) in soil, assess an association between its occurrence in soil and likely predictors i.e., macro and micro-nutrients and several categorical variables, and determine seroconversion in small and large ruminants. The study included a total of 2,280 soil samples representing 456 villages in eight districts of the Punjab Province of Pakistan followed by an analysis of serum antibodies in 707 ruminants. The genome of Ft was detected in 3.25% (n = 74, 95% CI: 2.60-4.06) of soil samples. Soluble salts (OR: 1.276, 95% CI: 1.043-1.562, p = 0.015), Ni (OR: 2.910, 95%CI: 0.795-10.644, p = 0.106), Mn (OR:0.733, 95% CI:0.565-0.951, p = 0.019), Zn (OR: 4.922, 95% CI:0.929-26.064, p = 0.061) and nutrients clustered together as PC-1 (OR: 4.76, 95% CI: 2.37-9.54, p = 0.000) and PC-3 (OR: 0.357, 95% CI: 0.640, p = 0.001) were found to have a positive association for the presence of Ft in soil. The odds of occurrence of Ft DNA in soil were higher at locations close to a water source, including canals, streams or drains, [χ2 = 6.7, OR = 1.19, 95% CI:1.05-3.09, p = 0.004] as well as places where animals were present [χ2 = 4.09, OR = 2.06, 95% CI: 1.05-4.05, p = 0.02]. The seroconversion was detected in 6.22% (n = 44, 95% CI: 4.67-8.25) of domestic animals. An occurrence of Ft over a wide geographical region indicates its expansion to enzootic range, and demonstrates the need for further investigation among potential disease reservoirs and at-risk populations, such as farmers and veterinarians.
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Affiliation(s)
- Javed Muhammad
- University of Veterinary and Animal Sciences, Lahore, Pakistan.,University of Swabi, Swabi, Pakistan
| | - Masood Rabbani
- University of Veterinary and Animal Sciences, Lahore, Pakistan
| | | | - Khushi Muhammad
- University of Veterinary and Animal Sciences, Lahore, Pakistan
| | | | | | - Zia Ul Hassnain
- University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Tariq Jamil
- University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Tariq Abbas
- Department of Epidemiology and Public Health, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan
| | | | | | | | - Muhammad Nisar
- Department of Epidemiology and Public Health, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan
| | | | - Bhushan M Jayarao
- The Pennsylvania State University, University Park, PA, United States
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Abstract
Dobutamine, a derivative of dopamine, was infused at a rate of 10 mug/kg per min in 15 patients with severe congestive heart failure. Cardiac output increased from an average of 3.1 to 5.6 liters/min (P less than 0.001) with no change in mean arterial pressure (93.3 to 98.2 mm Hg) and only a slight increase in heart rate (98.5 to 105.2 beats/min) (P less than 0.02). Pulmonary wedge pressure was decreased from an average of 27.4 to 21.1 mm Hg (P less than 0.001). In seven patients a dose of 5 mug/kg per min also produced a significant increase in cardiac output but the effect was less than with the 10 mug/kg per min dose. No side effects were observed during the infusion. Dobutamine therefore is a potent inotropic drug with limited chronotropic and peripheral vascular effects and deserves therapeutic trial in the short-term management of low output heart failure.
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