Sultan Ayaz

Prevalence of HBV and HBV vaccination coverage in health care workers of tertiary hospitals of Peshawar, Pakistan

BackgroundHepatitis B Virus (HBV) may progress to serious consequences and increase dramatically beyond endemic dimensions that transmits to or from health care workers (HCWs) during routine investigation in their work places. Basic aim of this study was to canvass the safety of HCWs and determine the prevalence of HBV and its possible association with occupational and non-occupational risk factors. Hepatitis B vaccination coverage level and main barriers to vaccination were also taken in account.ResultsA total of 824 health care workers were randomly selected from three major hospitals of Peshawar, Khyber Pakhtunkhwa. Blood samples were analyzed in Department of Zoology, Kohat University of Science and Technology Kohat, and relevant information was obtained by means of preset questionnaire. HCWs in the studied hospitals showed 2.18% prevalence of positive HBV. Nurses and technicians were more prone to occupational exposure and to HBV infection. There was significant difference between vaccinated and non-vaccinated HCWs as well as between the doctors and all other categories. Barriers to complete vaccination, in spite of good knowledge of subjects in this regard were work pressure (39.8%), negligence (38.8%) un-affordability (20.9%), and unavailability (0.5%).ConclusionsSpecial preventive measures (universal precaution and vaccination), which are fundamental way to protect HCW against HBV infection should be adopted.

Molecular epidemiology of hcv among health care workers of khyber pakhtunkhwa

BackgroundStudies of the molecular epidemiology and risk factors for hepatitis C virus (HCV) in health care workers (HCWs) of Peshawar, Khyber Pakhtunkhwa region are scarce. Lack of awareness about the transmission of HCV and regular blood screening is contributing a great deal towards the spread of hepatitis C. This study is an attempt to investigate the prevalence of HCV and its possible association with both occupational and non-occupational risk factors among the HCWs of Peshawar.ResultsBlood samples of 824 HCWs, aged between 20-59 years were analysed for anti-HCV antibodies, HCV RNA and HCV genotypes by Immunochromatographic tests and PCR. All relevant information was obtained from the HCWs with the help of a questionnaire. The study revealed that 4.13% of the HCWs were positive for HCV antibodies, while HCV RNA was detected in 2.79% of the individuals. The most predominant HCV genotype was 3a and 2a.ConclusionA program for education about occupational risk factors and regular blood screening must be implemented in all healthcare setups of Khyber Pakhtunkhwa province in order to help reduce the burden of HCV infection.

Rising burden of Hepatitis C Virus in hemodialysis patients

AimHigh prevalence of Hepatitis C virus (HCV) has been reported among the dialysis patients throughout the world. No serious efforts were taken to investigate HCV in patients undergoing hemodialysis (HD) treatment who are at great increased risk to HCV. HCV genotypes are important in the study of epidemiology, pathogenesis and reaction to antiviral therapy. This study was performed to investigate the prevalence of active HCV infection, HCV genotypes and to assess risk factors associated with HCV genotype infection in HD patients of Khyber Pakhtunkhwa as well as comparing this prevalence data with past studies in Pakistan.MethodsPolymerase chain reaction was performed for HCV RNA detection and genotyping in 384 HD patients. The data obtained was compared with available past studies from Pakistan.ResultsAnti HCV antibodies were observed in 112 (29.2%), of whom 90 (80.4%) were HCV RNA positive. In rest of the anti HCV negative patients, HCV RNA was detected in 16 (5.9%) patients. The dominant HCV genotypes in HCV infected HD patients were found to be 3a (n = 36), 3b (n = 20), 1a (n = 16), 2a (n = 10), 2b (n = 2), 1b (n = 4), 4a (n = 2), untypeable (n = 10) and mixed (n = 12) genotype.ConclusionThis study suggesting that i) the prevalence of HCV does not differentiate between past and present infection and continued to be elevated ii) HD patients may be a risk for HCV due to the involvement of multiple routes of infections especially poor blood screening of transfused blood and low standard of dialysis procedures in Pakistan and iii) need to apply infection control practice.

Heavy metals content, phytochemical composition, antimicrobial and insecticidal evaluation of Elaeagnus angustifolia

Elaeagnus angustifolia was analyzed for determination of metals, phytoconstituents, bactericidal, fungicidal and insecticidal effects and to explore its chemical and biological potential. The root, branches, leaves, stem bark and root bark parts of E. angustifolia were found to contain iron, lead, copper, cadmium, zinc, chromium, nickel and cobalt in different concentrations. Crude extract of Elaeagnus angustifolia (Ea.Cr) was tested positive for the presence of alkaloids, flavonoids, saponins and tannins. Ea.Cr and its fractions, n-hexane (Ea.Hex), ethyl acetate (Ea.EtAc) and aqueous (Ea.Aq) showed bactericidal activity against Escherichia coli and Staphylococcus aureus, while against Pseudomonas aeruginosa only Ea.Hex and Ea.EtAc were effective. When tested for antifungal effect, Ea.Cr exhibited fungicidal action against Aspergillus fumagatus, Ea.EtAc and Ea.Aq against Aspergillus flavis and Ea.EtAc against Aspergillus niger. Ea.Hex was active against all three fungal strains. The chloroform fraction (Ea.CHCl3) was found inactive against the used microbes. Ea.Cr, Ea.Hex, Ea.CHCl3, Ea.EtAc and Ea.Aq caused mortality of Tribolium castaneum and Ephestia cautella insects observed after 24 and 48 h of treatment. These data indicate that E. angustifolia exhibits different heavy metals and compound groups. Methanolic extract of E. angustifolia and its various fractions possess antibacterial, antifungal and insecticidal activities, which elucidate medicinal application of the plant.

Bacteriological quality assessment of drinking water available at the flood affected areas of Peshawar

Monsoon flooding occurred in the main areas of the Khyber Pakhtunkhwa, Punjab, and Balochistan as well as parts of Gilgit Baltistan of Pakistan and Azad Jammu Kashmir in July 2010. Water-borne diseases such as cholera, enteric fever, and dysentery were common among the inhabitants of flood-affected areas which were selected for sample collection. In the present study, 10 sites in District Peshawar were selected and drinking water samples collected. These samples were analyzed for the total plate count (TPC), total coliform bacteria (TCB), total fecal coliform bacteria (TFCB), Escherichia coli (EC), Pseudomonas aeruginosa (PA), Vibrio cholerae (VB), Salmonella Shigella, and Staphylococcus aureus. The TPC ranged from 8 × 101 to 7 × 104 CFU/ml. The TCB ranged from <1.1 to 280 MPN/100 ml. Twenty percent of the samples were contaminated with TFCB, EC, Salmonella, Shigella, and Staphylococcus aureus, while only one sample contaminated with PA. Forty percent of the samples were contaminated with VB. The surface and well water was greatly contaminated by flooding and major improvements on priority basis are essential.

Cutaneous leishmaniasis in Karak, Pakistan: Report of an outbreak and comparison of diagnostic techniques

A total of 339 patients with clinically suspected cutaneous leishmaniasis (CL) were studied from March to April, 2010 in three villages of Karak, Khyber Pakhtunkhwa, Pakistan where an epidemic of the disease was in question. Using polymerase chain reaction (PCR), 78.17% (265/339) were observed having CL. Microscopically, however, only 43.06% (146/339) were diagnosed with the disease. This study reports and confirms epidemic of CL in both gender of all ages in the area. Females (70.94%) were noted to be predominantly affected as compared to males (29%). Clinically, 12.38% of patients had more than three lesions, 29.20% had two lesions, while 58.40% had only single lesion. Most lesions were found on exposed surfaces of the body (predominantly hands, face and feet). The present study confirms that PCR was more sensitive than microscopic examination. Key words: Epidemic, cutaneous leishmaniasis, polymerase chain reaction (PCR), microscopy, Pakistan.

PCR and Microscopic Identification of Isolated Leishmania tropica from Clinical Samples of Cutaneous Leishmaniasis in Human Population of Kohat Region in Khyber Pakhtunkhwa

Leishmania tropica was isolated from the clinical patients of cutaneous leishmaniasis in rural community of Kohat district in Khyber Pakhtunkhwa province and was identified through PCR, microscopy, and culture techniques. A total of 113 samples from the clinical patients were examined through PCR, microscopy, and culture which showed 87.61% (99/113), 53.98% (61/113), and 46.90% (53/113) prevalence. During the study, 186 bp Leishmania tropica was identified through PCR. Thus the sensitivity of PCR is very high as compared to the conventional techniques.

Quantification of antibodies against poultry haemagglutinating viruses by haemagglutination inhibition test in Lahore

A study was conducted for quantification of antibodies to haemagglutinating viruses such as AIV (H9N2 and H7N3), NDV and IBV in vaccinated poultry flocks. A total of 198 serum samples from different commercial broiler and layer farms in Lahore, Pakistan, were checked for their serological statuses. Haemagglutination inhibition (HI) test was performed to determine the titer of serum antibodies against the above mentioned viruses. It was observed that 25 and 44% samples were positive for H7N3 and H9N2 in broilers, respectively. The seropositivity of H7N3 and H9N2 in serum samples of commercial layers were 66 and 94%, respectively. It was recorded that 96% of the samples in broilers and 100% of those in layers, were found seropositive for antibodies against NDV. Moreover, 69 and 86% were seropositive for IBV in broilers and layers, respectively. Calculated geometric mean titers for groups of 0-2, 2-4 and 4-6 weeks of age were found to be 36.8, 78.8, and 111.4 for H9N2; 48.5, 157.6, 222.9 for NDV; and 97, 84.4, 111.4 for IBV, respectively. It was concluded that the samples were not having protective antibody titers indicating unsuccessful vaccination practiced in these poultry farms which may lead to significant economic losses.

Seropositivity and Coinfection of Hepatitis B and C among Patients Seeking Hospital Care in Islamabad, Pakistan

The undertaken study was conducted to find out the seroprevalence and coinfection of HBV and HCV infection among patients seeking hospital care. A total of 845 samples were received at tertiary care hospital of Islamabad and were screened for hepatitis B and C. The ELISA was used to detect antigen for HBV and antibodies for HCV in patient serum. Among 845 collected samples, 255 (30.1%) were seropositive for HBV and HCV. Out of 255 seropositive samples, 45 (5.3%) were positive for HBsAg while 199 (23.5%) were positive for anti-HCV. Among 255, 11 (1.3%) were seropositive for both HBsAg and anti-HCV (coinfection). Among the seropositive male, HBV was more prevalent (23.8%) while female patients had a high incidence of HCV (52.2%). Among the age group variable, HBV, HCV, and coinfection were found to be more common in the age groups of 21–30 (29%) and 30–40 (24%) years. The seropositivity for HBsAg was higher in unmarried individuals (31.2%) while anti-HCV was more prevalent in married individuals (84%). The present study provides the preliminary information about high HCV and HBV prevalence. Findings from the current study will be helpful for the better management and control of viral hepatitis among patients seeking hospital care.

Fasciola hepatica in some Buffaloes and cattle by PCR and microscopy.

Fasciolosis is the burning problem of the livestock rearing community having huge morbidity, mortality, and economic losses to livestock industries in our country Pakistan. The faecal and liver biopsy samplings were examined by polymerase chain reaction (PCR) and microscopy technique during the entire study. A total of 307 samples including 149 samples from Karak and 158 samples from Kohat abattoirs were examined by PCR method and overall prevalence of fasciolosis was 5.86% (18/307), amongst theses 8.05% (12/149) in liver biopsy and 3.79% (6/158) in feacal samples of cattle and Buffaloes were recorded. Similarly the microscopy based detection was 3.58% (11/307) including 4.61% (7/149) in liver biopsy and 2.5% (4/158) in faecal samples accordingly. Furthermore the areawise prevalence of fasciolosis in abattoirs by PCR method was found to be 7.59% (12/158) in Kohat and 4.02% (6/149) in Karak. A 618 pb DNA was amplified in 2% agarose gel electrophoreses. It is concluded from the study that prevalence of fasciolosis was higher in abattoir of district Kohat and PCR was a more sensitive method of diagnosis than microscopy.