Seroprevalence of Fasciola-infection using Enzyme-linked immunosorbent assay in large ruminants from Pakistan

Fasciolosis, caused by liver fluke species of the genus Fasciola, are well recognized because of its high veterinary impact. Stool examination for Fasciola eggs is not a sensitive method, and limited efforts to find a reliable and cheaper means of detection are available. The present study aimed to develop rapid diagnostic ELISA test against fasciolosis. The excretory/secretory (ES) and somatic (SA) products of Fasciola helminths were analysed using polyacrylamide gel electrophoresis (PAGE). Immunogenicity was evaluated by immunoblotting using hyperimmune sera raised in rabbits and seroprevalence was determined by indirect ELISA.  The results of SA antigen of Fasciola species showed polypeptide bands ranged from 10kDa-100kDa, while ES antigen of Fasciola showed bands of 15kDa-55kDa. The immunoblotting results showed the most prominent bands against ES antibodies were 25, 35, 55-70, 100 and 250 kDa and SA antigens showed 10, 15-25, 35, 70, 100 and 250 kDa polypeptide bands. The sensitivity and specificity of developed indirect ELISA for SA antigens was 95.45% and 87.1%, while for ES antigens was 100% and 77.42% respectively. The overall seroprevalence recorded for fascioliasis based on SA antigen was 39.8% and 29.8% for ES antigen. The fasciolosis did not show significant association with host type, sex and age groups of examined animals, however significantly higher infection was found in months of September and October. The result provides sensitive in house immunodetection assay for diagnosis of fasciolosis alternative to commercial kits with high import cost.

The MEMORY Study: MulticentEr study of Minimally invasive surgery versus Open Radical hYsterectomy in the management of early-stage cervical cancer: Survival outcomes

OBJECTIVE

The Laparoscopic Approach to Cervical Cancer (LACC) trial found that minimally invasive radical hysterectomy compared to open radical hysterectomy compromised oncologic outcomes and was associated with worse progression-free survival (PFS) and overall survival (OS) in early-stage cervical carcinoma. We sought to assess oncologic outcomes at multiple centers between minimally invasive (MIS) radical hysterectomy and OPEN radical hysterectomy.

METHODS

This is a multi-institutional, retrospective cohort study of patients with 2009 FIGO stage IA1 (with lymphovascular space invasion) to IB1 cervical carcinoma from 1/2007-12/2016. Patients who underwent preoperative therapy were excluded. Squamous cell carcinoma, adenocarcinoma, and adenosquamous carcinomas were included. Appropriate statistical tests were used.

RESULTS

We identified 1093 cases for analysis-715 MIS (558 robotic [78%]) and 378. OPEN procedures. The OPEN cohort had more patients with tumors >2 cm, residual disease in the hysterectomy specimen, and more likely to have had adjuvant therapy. Median follow-up for the MIS and OPEN cohorts were 38.5 months (range, 0.03-149.51) and 54.98 months (range, 0.03-145.20), respectively. Three-year PFS rates were 87.9% (95% CI: 84.9-90.4%) and 89% (95% CI: 84.9-92%), respectively (P = 0.6). On multivariate analysis, the adjusted HR for recurrence/death was 0.70 (95% CI: 0.47-1.03; P = 0.07). Three-year OS rates were 95.8% (95% CI: 93.6-97.2%) and 96.6% (95% CI: 93.8-98.2%), respectively (P = 0.8). On multivariate analysis, the adjusted HR for death was 0.81 (95% CI: 0.43-1.52; P = 0.5).

CONCLUSION

This multi-institutional analysis showed that an MIS compared to OPEN radical hysterectomy for cervical cancer did not appear to compromise oncologic outcomes, with similar PFS and OS.

Seroepizootiological investigation on Goat Warble Fly Infestation (Przhevalskiana silenus) in Pothwar Plateau, Pakistan

Goat Warble Fly Infestation (GWFI) is also known as subcutaneous myiasis caused by Przhevalskiana silenus (Diptera: Oestridae). It is widely distributed in tropical and sub-tropical areas of the world. In goats, WFI is usually detected through conventional procedure which underestimated the infestation. The current study was designed to determine the serodiagonsis of GWFI (through IDEXX Hypodermosis serum antibody test) and also aimed to investigate its seroepizootiological profile in Pothwar region, Pakistan from 2013-14. The results showed that average seropositivity (ELISA kit) of GWFI was 18.5% whereas, it was 11% by using conventional procedure (Palpation method) depicting a significant difference (p<0.05). Higher seropositivity (30.8%) was observed in Jhelum district as compared to e Attock district (6%). The L1 larvae were found in September, while nodules start appearing in October to December and last until the end of February. The month wise peaks of optical density (OD) was higher in December which gradually decrease along with the end of winter season. The prevalence of GWFI revealed no significant difference among three host breeds (Jattal, Beetal and Tedy). According to the results, high infestation rate (28%) was observed in young animals of age group < 1 year as compared to old animals (> 2 years). Topographically, hilly areas (33%) provide favourable climatic conditions for the propagating of larval stages. Sex difference showed no significant difference. The seroprevalence varied significantly with respect to age, month, districts and topographical location. The current study proved that serologic diagnosis (commercial ELISA kit) as more sensitive and accurate for timely diagnosis of GWFI than traditional method. The information on the epizootiology of P. silenus in goats of Pothwar region would help in devising effective control strategies.

Measurement of Ascaris lumbricoides IgG antibody, associated risk factors and identification of serum biochemical parameters as biomarkers of pathogenicity: among patients with gastrointestinal complains in Pakistan

Soil transmitted helminths are causing significant morbidity worldwide and the most common infection is Ascaris lumbricoides in developing countries. The present study aimed to determine the immuno-epidemiological status of ascariasis among patients with gastrointestinal complaints and to identify the associated risk factors and eventual changes in serum biochemical parameters to reflect its pathogenicity. This study was conducted on 700 respondents aged between 5-45 years. A total of 356 patients participated in an enzymelinked immunosorbent assay (ELISA) study to determine anti-Ascaris IgG levels and biochemical parameters. The overall seroprevalence was 58.4%, with 100% sensitivity and 84.4% specificity of the assay. The infection was highest among the 21-28 year age group (14.0%), and ascariasis was found to be not significantly (P>0.05) different between the age groups. The results showed that the risk of ascariasis was significantly (P<0.05) increased in individuals who had no contact with soil (OR=4.6, 95% CI: 1.9-10.8), eating unwashed vegetables one month prior to the study (OR=2.7, 95% CI: 1.4-5.2), eating mixed food (OR=2.4, 95% CI: 1.2-4.7), drinking pressure pump water (OR=3.4, 95% CI: 1.9-6.1), and those who had no complain of vomiting (OR=3.1, 95% CI: 1.6-5.8) and nausea (OR=1.9, 95% CI: 1.1-3.2). The results showed significantly (P<0.05) elevated level of serum alanine aminotransferase, alkaline phosphatase, serum cholesterol, total protein and globulin in anti-Ascaris IgG positive cases than the control group. The study concluded that patients who visited health care centres with gastrointestinal complain were at higher risk of ascariasis as compared to other diseases. In conclusion epidemiological studies are needed to establish baseline data for public health authorities in order to plan and implement health education programs to reduce the impact of the disease.

Prevalence and risk factors associated with intestinal parasitic infections among schoolchildren in Punjab, Pakistan

Intestinal parasitic infections (IPIs) are a major cause of morbidity worldwide and have been described as an important public health concern. The present study aimed to determine the prevalence and identification of risk factors associated with IPIs among 3-15 years old school age children residing in Mandi Bahauddin, Pakistan from 2011- 2013. A cross sectional school-based study was conducted using a structured pre-tested questionnaire. Anthropometric tools and stool tests were used to obtain epidemiological and disease data. The direct wet mount preperation in saline/iodine/haematoxylin stain and Kato-Katz methods were used for stool examination. Data were analysed using appropriate descriptive, univariate and multivariable logistic regression methods. Of the 1,434 children studied (mean age of 8.6±3.6 years) the overall prevalence rate for intestinal parasitic infections was found to be 33.3%. Children infected with single parasite accounted for 27.6% and 5.7% were detected with poly-parasitism. The study showed that helminths (21.4%) were more prevalent than protozoans (17.9%). Ascaris lumbricoides (17.5%), Giardia lamblia (9.8%), Entamoeba histolytica (8.2%), Hymenolepis nana (2.0%), Trichuris trichiura (1.3%) and Taenia saginata (0.7%) were identified in children living in irrigated areas. The multiple logistic regression model indicated that age of the child, gender, family size, source of drinking water, type of milk used, house condition, feeding habit, personal hygiene and socioeconomic status were significantly (p<0.05) associated with the IPIs. Intestinal parasites were prevalent in varying magnitude among the schoolchildren located in irrigated areas. We conclude that there is a need for mass scale campaigns to create awareness regarding health and hygiene in children, and the need for development of effective poverty control programmes because deworming alone is not adequate to control parasitic infections.

In vitro and in vivo anthelmintic activity of extracts from Artemisia parviflora and A. sieversiana

In the northern areas of Pakistan, the use of Artemisia based therapeutics is a common practice. Plants of genus Artemisia are known to possess anthelmintic and therapeutic effect. Infections caused by gastrointestinal nematodes are major threat to livestock industry across the world resulting in loss of production and indirect economic losses due to high cost of anthelmintic drugs. Present study was carried out to evaluate in vitro and in vivo effect of Artemisia sieversiana and Artemisia parviflora on Haemonchus contortus, a parasitic nematode of small ruminants. Methanolic plant extract was tested against three different developmental stages using an egg hatch assay, infective larvae and adult worm motility assay. Different concentrations were used for the bioassays and post exposure mortality was recorded after 8 hr for adult worms and infective larvae, while egg inhibition percentage was observed after 27 hr. A highly significant ability to inhibit the egg hatching (100 %) was recorded for both plant extracts while, the highest activity for adult worm assay and larvicidal assay was 90 % for A. sieversiana. The highest activity for adult motility and larvicidal assay for A. parviflora was 89 % and 86.6 % respectively. For in vivo trials maximum parentage reduction was 77.0 % for A. sieversiana and 73.6 % for A. parviflora. It is concluded that selected plant extracts were effective in reducing worm burden in animals.

Anthelmintic properties of extracts from Artemisia plants against nematodes

Artemisia plant genus, natural inhabitant of northern Punjab Pakistan, is well known for its anthelmintic properties; many Artemisia species have not been so far scientifically proved. The aim of this study was to assess in vitro anthelmintic activity of Artemisia indica and Artemisia roxburghiana against mixed infection of gastrointestinal nematodes in small ruminants. This study is first scientifically proven study on anthelmintic activity of A. indica and A. roxburghiana. Five different concentrations (50, 25, 12.5, 6.25 and 3.75 mg/mL) accompanied by negative control (PBS) and positive control (albendazole, 10%) were used to carry out the egg hatch inhibition assay, larval mortality assay and adult worm mortality assay. The Baermann technique was used first time in larval mortality assay and proved to be effective. The results revealed that methanolic extracts of both A. indica and A. roxburghiana, showed maximum anthelmintic activity at concentration of 50 mg/ml by egg hatch inhibition (85±21.2; 80±28.3), larvae mortality (18±2.8; 17±4.2) and adult worm mortality (8.5±2.1; 8±2.8) assays. However, at concentration of 50 mg/ml both plant extracts in comparison to albendazole showed statistically insignificant (p≤0.05) results. The A. indica showed higher anthelmintic activity at all concentrations as compared to A. roburghiana. It has been concluded both plants exhibit anthelmintic activity and further evaluation of these plants should be carried out to purify the active ingredients for anthelmintic activity. Moreover, the decoctions of these plants could be used to GINs after confirming anthelmintic properties through in vivo.

Seroprevalence of IgG and IgM antibodies and associated risk factors for toxoplasmosis in cats and dogs from sub-tropical arid parts of Pakistan

Pet cats and dogs are an important source of human toxoplasmosis because of their intimate relationship with humans. Present study was designed to determine the prevalence and risk factors of toxoplasmosis in cats and dogs in northern sub-tropical arid region of Pakistan where no such work has been previously conducted. For this study 420 cats and 408 dogs visiting different pet clinics and veterinary hospitals were screened for the presence of anti-Toxoplasma IgG and IgM antibodies using ELISA technique. Epidemiological information regarding age, sex, area, outdoor access and hunting practice was obtained from the owners by questionnaire interview. Overall seroprevalence in cats and dogs was 26.43% (111/420) and 28.43% (116/408) respectively. IgG antibodies were found in 23.33% (98) cats and 25.49% (104) dogs while IgM antibodies were found in 3.57% (15) cats and 3.92% (16) dogs. Seroprevalence was significantly high in cats and dogs older than one year. No significant difference was recorded between males and females. Cats and dogs from rural areas showed higher prevalence. Dogs which had access to outside also showed high seroprevalence. The present study indicates that Toxoplasma gondii is widespread in pet animals in Pakistan which may have important implication for public health.

Chronic orchidectomy does not influence the sensitivity of the pituitary somatotropes to varying doses of GHRH administered intravenously to the adult male rhesus monkey

In the present study, the pituitary growth hormone (GH) response to graded doses of GH-releasing hormone (GHRH) was determined in intact (n = 3) and chronically orchidectomized (n = 3) adult rhesus monkeys (Mucaca mulatta). GHRH in doses of 0, 6.25, 12.5 and 25 microg/kg BW was infused through a teflon cannula implanted in the saphenous vein. Blood samples were collected 60 min before and 90 min after the injection of the neurohormone at 15 min intervals. All bleedings were carried out under ketamine hydrochloride anesthesia. The plasma levels of GH were determined by using AutoDELFIA time-resolved flouroimmunoassay, whereas plasma levels of testosterone and estradiol were determined using specific radioimmunoassay systems. The GH responses to GHRH were not significantly different between intact and chronically orchidectomized monkeys at any of the dose levels tested (p > 0.05). The administration of GHRH resulted in a significant (p < 0.05) stimulation of GH secretion at all the doses tested and in both the groups studied. In both intact and orchidectomized animals, the greatest response was observed at 6.25 microg/kg and no further increase was noted with the higher doses of GHRH. In conclusion, the present study suggests that chronic orchidectomy does not influence the sensitivity of the pituitary somatotropes to GHRH stimulation implying that the responsiveness of the pituitary somatotropes to GHRH is independent of testicular steroid modulation.

The effect of ketamine hydrochloride anesthesia on basal and N-methyl-D,L-aspartate induced plasma prolactin secretion in the adult male rhesus monkey

The excitatory amino acids (EAAs), glutamate and aspartate, acting predominantly on N-methyl-D-aspartate (NMDA) receptor, have been shown to be involved in the central regulation of the secretion of several anterior pituitary hormones including prolactin (PRL), whereas ketamine hydrochloride (KH), a widely used anesthetic, has been reported to antagonize a variety of NMDA receptor mediated actions of these EAAs. In the present study, the effect of KH on basal PRL levels as well as on N-methyl-D,L-aspartate (NMA), an agonist of NMDA receptor, induced plasma PRL secretion was investigated in the adult male rhesus monkey. The values were compared to those obtained from the same animals restrained in primate chairs. The plasma PRL concentrations were higher in animals receiving KH administered either intramuscularly (2.5 mg/kg BW at 30 min intervals) or intravenously (10 mg/kg BW) as compared to those observed in the unanesthetized chair-restrained monkeys. NMA induced an unequivocal increase in plasma PRL concentrations in both conscious chair-restrained and KH anesthetized monkeys, but the response was greater in anesthetized animals than the conscious monkeys. The present findings suggest that KH has stimulatory effects on both basal and NMA induced plasma PRL secretion.

Computerized monitoring of valproate and physician responsiveness to laboratory studies as a quality indicator

Using computerized pharmacy, laboratory, and hospitalization data from a large state psychiatric hospital system, this study examined physician responses to laboratory studies obtained in the course of therapeutic drug monitoring. Computerized monitoring modules based on physician-developed guidelines identified out-of-range laboratory values and searched for appropriate corresponding physician responses within clinically driven, mathematically adjusted time frames. Valproate monitoring in four metropolitan hospitals showed that appropriate physician responses were associated with shorter hospital stays for patients and were predictive of length of stay in a multiple regression analysis (p<.001). After physicians received didactic feedback, the percentage of appropriate responses to low serum valproate levels increased.

Seroprevalence of antibodies to Toxoplasma gondii, with particular reference to obstetric history of patients in Rawalpindi-Islamabad, Pakistan

Six hundred and forty blood samples were obtained from Rawalpindi-Islamabad to determine the frequency of Toxoplasma gondii antibodies using indirect immunofluorescent antibody (IFA) test. Two hundred and forty samples were from suspected cases of Toxoplasmosis. Forty (17%) cases were positive for IgG antibody. Seven (3%) of these cases showed antibody titre greater than 1:320. Of 65 children tested, 8 (12.30%) were positive. Four (6%) children had a rising titre from 1:160 to 1:1025. Prevalence of Toxoplasma antibodies was correlated to mode of living, maternal obstetric history, their animal contact and age of the children.