Background Antimicrobial resistance (AMR) is an emerging threat to public health worldwide. A significant evidence has suggested that the knowledge and attitude trends among the community, pharmacists and physicians can play a critical role in managing the ever increasing threat of AMR. Methods A cross-sectional survey was performed using three specific self-administered questionnaires for community members, pharmacists/pharmacy owners and physicians on a randomly selected sample population of 473, 424 and 308 respectively. Bivariate and multivariate logistic regression and Pearson chi-square tests were performed during data analysis. Result A response rate of 81.2% ( n = 385), 37.7% ( n = 160) and 53.9% ( n = 166) was achieved for general community, pharmacists/pharmacy owners and physicians respectively. More than half of the community participants (55.6%; n = 214) possess poor knowledge of AMR. Furthermore, knowledge and attitude of the community participants were also found to be significantly correlated (r 2 = 0.02) with each other. In 90.6% ( n = 145) of the pharmacies included in the survey, a qualified pharmacist was not present at the time of the operations. Only 36.9% physicians ( n = 60) knew about the environmental route of dissemination of AMR. Majority of the physicians agreed that AMR is a global problem and also recognize the need for initiating AMR stewardship programs. Conclusion Our study will provide effective assessment and potential insights in designing tri-faceted interventions for rationalizing antibiotics consumption thus controlling the development and dissemination of AMR. Electronic supplementary material The online version of this article (10.1186/s13756-019-0517-3) contains supplementary material, which is available to authorized users.

A new strategy to enhance the antifouling potential of polyether sulfone (PES) membrane is presented. Chemically synthesized silver nanoparticles (AgNPs) were used to prepare a mixed-matrix PES membrane by the phase inversion technique. Primarily, AgNPs synthesis was confirmed by surface plasmon resonance at 410-430 nm using UV-Visible spectroscopy. X-ray diffraction analysis revealed that AgNPs were crystalline with a diameter of 21 ± 2 nm. Furthermore, PES membranes were characterized by energy dispersive X-ray spectroscopy to confirm the incorporation of AgNPs in membranes. Hydrophilicity of the membranes was enhanced, whereas roughness, mechanical strength and biofouling were relatively reduced after embedding the AgNPs. Antibacterial potential of AgNPs was evaluated for E. coli in the disc diffusion and colony-forming unit (CFU) count method. All of the membranes were assessed for antifouling activity by filtering a control dilution (10 CFU/ml) of E. coli and by counting CFU. Anti-biofouling activity of the membrane was observed with different concentrations of AgNPs. Maximum reduction (66%) was observed in membrane containing 1.5% of AgNPs. The addition of antibiotic ceftriaxone enhanced the antibacterial effect of AgNPs in PES membranes. Our practicable antifouling strategy may be applied to other polymeric membranes which may pave the new way to achieve sustainable and self-cleaning membrane reactors on large scale.

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Hospital liquid infectious waste is one of the most important aspects of water contamination. The present investigation was undertaken to evolve a cost effective alternate method of waste water treatment by using Oxidized Water as a disinfectant for hospital effluents. Liquid infectious waste coming from diagnostic laboratories of hospitals (Urine, Blood and Mix of both) was treated with electrolyzed Oxidized Water. Different v/v ratios (95:5, 85:15, 75:25, 50:50 and 25:75) of Sample to Electrolyzed Oxidized Water (EOW) were cultured and incubated at 37 o C for 24 hours. EOW showed a direct relationship with the decontamination of inorganic urine but for blood, an unidentified pattern was observed that may be due to change in pH and/or Oxidation Reduction Potential (ORP) of EOW because of organic nature of blood. The most effective ratio of sample to EOW, at which decontamination was found to be maximum for urine, was 25:75 with treatment efficiency of 96.15 % and 85:15 with treatment efficiency of 84.8 % for blood. The study revealed that Electrolyzed Oxidized Water may be used as a better alternative for treatment of liquid infectious waste.

Charsadda to Peshawar road is characterized with diverse surrounding environment of residential settlements,industrial zones, commercial and agricultural sectors along with heavy traffic route which is contributing to heavy metalpollution. This study is focused on heavy metals: Cadmium (Cd), Chromium (Cr) and Lead (Pb) contribution to theatmospheric pollution level. The heavy metals pollution assessment is carried out by sample collection (soil dust samplesand two vegetation species Cyperus esculentus and Cynodon dactylon) from ten sites along the road which were analyzedby using atomic absorption spectrometry (AAS). Average values of pollution index (PI) as well as average value ofpollution load index (PLI) for Cr, Cd and Pb in case of Cyperus esculentus, Cynodon dactylon and dust were calculated.Geo-accumulation index of roadside dust for Cr, Cd and Pb were estimated along with ecological risk due to roadsidedust using potential ecological risk index (RI). The analyses of this study suggest that the indices for the Cd metal foundto be of more concern than Cr or Pb which correspond to middle or low level of pollution. Statistical analysis revealedthat the three metals had a weak to moderate relationship with one another indicating multiple and somewhat similarsources of pollution.

Background: Particulate matter-associated microbes in the workplace are a burning issue in occupational toxicology. Studies have reported on respiratory infections among tannery cohorts. This study uniquely presents measurements of airborne bacterial concentrations associated with varied particulate-matter sizes, their exposure, and consequent severity in occupational respiratory problems, all for different microenvironments within leather tanneries. Methods: Analyses included molecular identification of isolates, computation of mass median aerodynamic diameter of aerosols, tannery process-exposure dose (TPED) to bacterial aerosols, and spirometry and symptom assessment of impaired pulmonary function. Results:The highest bacterial concentrations were for rawhide treatment and finishing units, showing 3.6×10 3 and 3.7×10 3 CFU/m 3 , respectively. Identified bacterial species included Ochrobactrum pseudogrignonense, Neisseria bacilliformis, Enterobacter cloacae, Alcaligenes faecalis, Klebsiella pneumoniae, and Corynebacterium spp. Maximum and minimum values of mass median aerodynamic diameter were 8.3 µm and 0.65 µm for buffing and snuffing and production units, respectively. The highest TPED was 1,516.9 CFU/kg for finishing units. Respiratory symptoms in order of incidence were dyspnea > phlegm > cough > wheezing and tachypnea (equivalent). Bronchodilator measurements of FEV 1 , FVC, and PEF represent decline in lung function. Of 26 patients identified with COPD, most were working in rawhide treatment. Conclusion:We conclude that exposure-infection synergy is also a cause of pulmonary ailments and COPD development, rather than the better-known exposure-smoking synergy.

Charsadda to Peshawar road is characterized with diverse surrounding environment of residential settlements,industrial zones, commercial and agricultural sectors along with heavy traffic route which is contributing to heavy metalpollution. This study is focused on heavy metals: Cadmium (Cd), Chromium (Cr) and Lead (Pb) contribution to theatmospheric pollution level. The heavy metals pollution assessment is carried out by sample collection (soil dust samplesand two vegetation species Cyperus esculentus and Cynodon dactylon) from ten sites along the road which were analyzedby using atomic absorption spectrometry (AAS). Average values of pollution index (PI) as well as average value ofpollution load index (PLI) for Cr, Cd and Pb in case of Cyperus esculentus, Cynodon dactylon and dust were calculated.Geo-accumulation index of roadside dust for Cr, Cd and Pb were estimated along with ecological risk due to roadsidedust using potential ecological risk index (RI). The analyses of this study suggest that the indices for the Cd metal foundto be of more concern than Cr or Pb which correspond to middle or low level of pollution. Statistical analysis revealedthat the three metals had a weak to moderate relationship with one another indicating multiple and somewhat similarsources of pollution.

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