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The agriculture sector is currently facing a decline in plant productivity and yield. Different technologies are being developed to combat these risks. However, innovation in existing technologies is required. Nanotechnology has the potential to solve these difficulties by modifying traditional farming practices and approaches. Nanoparticles (NPs) can bind and transport various substances, such as plant nutrients, and govern their slow release over a longer period, which can reduce the danger of nutrient losses while maintaining environmental safety. In this aspect, the role of zinc oxide nanoparticles (ZnO NPs) and their derivatives in agriculture has recently sparked a lot of interest. ZnO NPs can be coated with different compounds which enhance their biocompatibility within the plant cells. The unique nanostructures and nano-characteristics of ZnO NPs and their derivatives have resulted in the development of a novel approach for boosting plant development and productivity as well as improved stress tolerance via targeted delivery and slow-release mechanism, resulting in enhanced nutrient use efficiency, regulating phytohormone levels, enhancing root morphology, and increasing enzyme activity, leading to their application as nanofertilizers. There are important knowledge gaps regarding the long-term environmental consequences and the specific biochemical pathways influenced by ZnO NPs. This review aims to provide an overview of the most recent advancements in the use of ZnO NPs in agriculture, identify areas where more research is needed, and suggest potential future research directions.

Salinity stress is a major abiotic factor causing destructive impact on plant growth. Therefore, an approach is needed to alleviate the negative effect of salinity stress. Considering the distinct and advantageous effects of proline and zinc oxide nanoparticles (ZnO NPs) on plant growth, ZnO NPs were functionalized by proline (ZnOP NPs) under the concept of nanofertilizer and slow release of molecules. An in vitro study was performed to investigate the effect of nanocomposite on Coriandrum sativum (coriander) exposed to 50 mM NaCl stress. Scanning electron microscopy (SEM) and X-ray diffraction (XRD) revealed 14.73 nm and 20.59 nm size of ZnO NPs and ZnOP NPs, respectively with spherical to hexagonal structures. Vegetative parameters of plants like height and biomass were improved by the application of NPs. ZnOP NPs at 100 mg/L depicted 200% increase in shoot length while 157% increase in root length when applied with NaCl stress. Fresh weight of shoots and roots increased upto 387 mg and 127 mg, respectively at 100 mg/L ZnOP NPs. Antioxidant and phytochemical activities that were increased due to salinity stress, decreased by ZnOP NPs. Radical scavenging activity reduced upto 55%, antioxidant potential upto 35%, and reducing power by 20% in shoots of plants as compared to NaCl stressed plants. A similar trend was also observed in roots. Likewise, phenolic content decreased by 30% in shoots and 43% in roots at 100 mg/L of ZnOP NPs and same for flavonoid contents. Application of ZnOP NPs to salt stressed plants also reduced the concentrations of superoxide dismutase (SOD) and peroxide dismutase (POD). In conclusion, proline functionalized ZnO NPs were proved effective against salinity stress. This nanofertilizer can be promoted as a potential candidate for combating the negative effects of saline condition.

Background: Due to frequent hospitalizations, complex dialysis procedures and immune compromising effects of end stage renal disease (ESRD), patients on dialysis are more prone to healthcare associated infections (HCAIs). Objective: To study the impact of HCAIs on survival and treatment outcomes among ESRD patients on renal replacement therapy (RRT). Methodology: A multicenter, retrospective study was conducted from June to December 2019 at two public hospitals of Malaysia. ESRD patients with minimum of 6 months on RRT were included, while pregnant patients and patients 2 comorbidities, >60 years of age, low hemoglobin concentration and high C-reactive protein levels. The most frequent treatment outcome was cured [113 (64.9%)], followed by death [37 (21.3%)] and treatment failure [17 (9.8%)]. Advancing age, and low hemoglobin concentration were independent risk factors associated with death, while recurrent HCAIs, use of central venous catheters, and low serum sodium levels were risk factors for treatment failure. Conclusion: The high burden of HCAIs is a profound challenge faced by patients on RRT, which not only effects the treatment outcomes but also contributes substantially to the poor survival among these patients.

BackgroundProfound healthcare challenges confront societies with an increase in prevalence of end-stage renal disease (ESRD), which is one of the leading causes of morbidity and mortality worldwide. Due to several facility and patient related factors, ESRD is significantly associated with increased morbidity and mortality attributed to infections.Aims and objectiveThe aim of this study was to assess systematically the characteristics of patients and risk factors associated with nosocomial infections among ESRD patients undergoing hemodialysis.MethodsA systematic literature search was performed to identify eligible studies published during the period from inception to December 2018 pertaining to risk factors associated with nosocomial infections among hemodialysis patients. The relevant studies were generated through a computerized search on five databases (PubMed, EBSCOhost, Google Scholar, ScienceDirect and Scopus) using the Mesh Words: nosocomial infections, hospital acquired infections, healthcare associated infections, end stage renal disease, end stage renal failure, hemodialysis, and risk factors. The complete protocol has been registered under PROSPERO (CRD42019124099).ResultsInitially, 1411 articles were retrieved. Out of these, 24 were duplicates and hence were removed. Out of 1387 remaining articles, 1337 were removed based on irrelevant titles and/or abstracts. Subsequently, the full texts of 50 articles were reviewed and 41 studies were excluded at this stage due to lack of relevant information. Finally, nine articles were selected for this review. Longer hospital stay, longer duration on hemodialysis, multiple catheter sites, longer catheterization, age group, lower white blood cell count, history of blood transfusion, and diabetes were identified as the major risk factors for nosocomial infections among hemodialysis patients.ConclusionThe results of this review indicate an information gap and potential benefits of additional preventive measures to further reduce the risk of infections in hemodialysis population. Moreover, several patient-related and facility-related risk factors were consistently observed in the studies included in this review, which require optimal control measures.

End stage renal disease (ESRD) patients on renal replacement therapy (RRT) have an increased risk of morbidity and mortality due to healthcare associated infections (HCAIs). The aim of this study is to determine the prevalence, microbial etiology, and risk factors associated with HCAIs among ESRD patients on RRT. A multicenter, retrospective study was conducted from June to December 2019. ESRD patients with minimum of 6 months on RRT were included, while pregnant patients and patients <18 years were excluded. To reduce the risk of selection bias, all patients were randomly selected using a simple random sampling technique. The prevalence showing the proportion of patients that acquired HCAI since the initiation of dialysis until 2019 was calculated using the European patients' academy (EUPATI) formula. Risk factors were assessed using univariate and multivariate regression analysis. The prevalence of HCAI among ESRD patients was 174/400 (43.5%). Catheter related bloodstream infection (CRBSI) was the most common infection [64(36.8%)], followed by peritonitis [45(25.8%)] and pneumonia [37(21.2%)]. Out of 382 total pathogens identified, 204 (53.4%) were Gram positive and 162 (42.4%) were Gram negative. Both methicillin sensitive staphylococcus aureus (MSSA) and methicillin resistant staphylococcus aureus (MRSA) showed statistically significant associations (p<0.05) with CRBSI. Use of multiple accesses, increased blood sugar levels, low serum sodium levels and higher CRP concentration increased the occurrence of HCAIs. The burden of HCAIs among the patients undergoing RRT is high. Preventive strategies and optimum empirical therapy of antibiotics should be used to reduce the risk of these infections among ESRD patients. [ABSTRACT FROM AUTHOR]

End stage renal disease (ESRD) patients have an increased risk of morbidity and mortality due to infections, as these patients have multiple comorbidities, may suffer frommalnutrition, and have profound alterations in their immune system. To determine the prevalence of healthcare associated infections (HCAIs) and their microbial etiology among ESRD patients undergoing renal replacement therapy (RRT).A multicenter, retrospective study of patients on RRT was conducted from June 2019 to December 2019 at two hospitals, including university of Malaya medical centre (UMMC) and hospital Serdang. ESRD patients with minimum of 6 months on RRT were included in this study, while pregnant patients and patients below the age of 18 years were excluded. To confirm the diagnosis of HCAI, patient had to fulfil at least one of the following criteria: 1) attended a hospital, received intravenous therapy, wound care or specialized nursing care in 30 days before the infection or 2) was hospitalized in an acute care hospital for 2 or more days in the previous 90 days. A data collection form was used to retrieve all sociodemographic and clinical data. To reduce the risk of selection bias, all patients were randomly selected using an online tool; research randomizer, which utilizes total number of patients and the sample size to generate random numbers. The period prevalence showing the proportion of patients that acquired HCAI since the initiation of dialysis till 2019, was calculated using a formula stated by European patients' academy (EUPATI). Total of 670 records were examined, out of which 400 patients were selected based on the inclusion criteria. There were 174 patientswith at least one episode of HCAI,hencethe period prevalence was found to be 43.5%. Catheter related blood stream infection (CRBSI) was the most common infection and occurred in 64 (36.8%) patients, while peritonitis and pneumonia were identified in 44 (25.8%) and 36 (21.2%) patients, respectively. Out of 382 total pathogens identified through microbial culture, 204 (53.4%) were gram-positive and 162 (42.4%) were gramnegative. Among the gram-positive organisms,Staphylococcus aureuswas identified in 90 (23.5%) patients, while Staphylococcus epidermidis and Streptococcus spp. were seen in 42 (10.9%) and 24 (6.28%) patients, respectively. Klebsiella pneumonia, which was found in 36 (9.42%) patients, was most frequently identified gram-negative organism. Moreover, Candida spp. were the only fungal organisms found in this study. Both methicillin sensitive S. aureus(MSSA) and methicillin resistant S. aureus(MRSA) showed statistically significant associations (p = <0.05) with CRBSI, while MSSA and klebsiella pneumonia showed similar associations (p = <0.05) with pneumonia. High prevalence of HCAIs was found among ESRD patients undergoing RRT, which is quite alarming. Furthermore, broad range of pathogens were also identified to be associated with these infections. [ABSTRACT FROM AUTHOR]