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Viral and Bacterial Coinfection in Patients with Neurological Disorders: An Analytical Cross-Sectional Study from Karachi
Received Date: May 15, 2018 / Accepted Date: May 21, 2018 / Published Date: May 30, 2018
To study the existence of coinfection of the meninges caused by Neisseria meningitidis, Herpes simplex virus-1 (HSV-1) and Herpes simplex virus-2 (HSV-2) in the CSF of patients admitted with neurological disorders. 92 CSF samples collected from patients having neurological ailments were subjected to the microbiological analysis for the detection of possible bacterial etiology. In order to screen the viral coinfection, DNA was extracted from the samples found positive for bacterial presence. Extracted DNA was amplified for the presence of glycoprotein G gene of HSV-1 and HSV-2. Of the 92 samples, 20 samples (21.7%) found infected with Neisseria meningitidis (Nm). PCR results highlighted that of this 20, 8 samples (40%) were found coinfected with both HSV-1 and HSV-2 in addition to the Nm. Whereas, 12 samples (60%) were found negative for the viral etiology. Moreover, out of 8 samples showed viral and bacterial conifection, 5 (62.5%) were from female patients. Whereas 3 (37.5%) were from male patients. Findings from present study provide a considerable evidence of existence of bacterial and viral i.e. Nm and HSVs coinfection in CSF of the patients with neurological disorders. Nonetheless, use of microbiological and molecular testing methods in medical diagnostic laboratories and hospitals are pivotal to differentiate between bacterial and viral meningitis and even detect coinfection of both etiologies.
Keywords: Coinfection; Viral meningitis; Bacterial meningitis; N. meningitidis; Herpes simplex virus; Central nervous system; Cerebrospinal fluid; Diagnosis
Meningitis is established to be the most severe and potentially fatal infection of central nervous system (CNS) involving the risk for permanent disability among survivors [1,2]. This infection is mainly attributed to different bacterial and viral etiologies thus, referred as bacterial meningitis (BM) and viral meningitis (VM) respectively [1, 3,4]. Neisseria meningitidis is commonly responsible for BM [5-9] whereas herpes simplex viruses (HSVs) are the main cause of VM [10- 12].
Extensive literature review has suggested several studies reporting individual infections of both type of aforementioned meningitis [6- 12]. Although, coifections of CNS with microorganisms of quite different texa are extremely rare [13] Nonetheless, evidences suggested that infections have been described with two bacterial species [14] Furthermore, simultaneous infection of CNS caused by bacterial i.e. Streptococcus pneumoniae and viral etiology i.e. HSVs has been reported as well [2,13].
CNS pathogen may adopt various mechanisms to cause dual infections. This may include a well-documented fact that viral infections of the CNS surpass bacterial infections [15,16]. Furthermore, HSVs becomes latent in dorsal root ganglia subsequent to the primary infection. Reactivation of these viruses may occur by several stimuli including febrile illnesses, stress and immunosupperation [13] and other diseases where these viruses might not constitute the aetiopathogenic agents [17] In addition, another important mechanism of viral and bacterial coinfection was studied by Wang et al. mentioning that significant damage to nasal mucosa caused by bacteria favours the establishment of viral infection [18]. Although clinical relevance of these coinfections may not be clear; however, it is tempting to speculate about the interplay between viral and bacterial CNS infections, for example by facilitating the entry of one or the other into the CNS compartment.
Since the detection of viral and bacterial coinfection of the meninges is not routine in many medical laboratories and hospitals in Karachi. Consequently, the diagnosis of this fatal infection with varied etiology may be missed. Therefore keeping in view, present study was aimed out to determine the existence of coinfection of the meninges caused by Neisseria meningitidis, Herpes simplex virus-1 (HSV-1) and Herpes simplex virus-2 (HSV-2) in the CSF of patients admitted with neurological disorders.
Materials and Methods
Unless otherwise stated, all the analytical grade chemicals and formulated bacteriological media were purchased from Merck, Frankfurter, Darmstadt, Germany. Polymerase chain reaction (PCR) reaction mix was purchased from Promega, Madison, Wisconsin, USA.
Study design
Present study is a sub-analysis of cerebrospinal fluid (CSF) samples collected randomly from the patients admitted with neurological ailments in the two major government hospitals of Karachi, Pakistan [9]. Sample collection was carried out subsequent to the consent and approval of lab authorities. All informed patients were given a questionnaire for their consent prior to inclusion in the study. All procedures performed in this study involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments.
All the collected CSF samples were aliquotted and stored at -80°C immediately. CSF samples proven the presence of meningitis bacteria i.e. Neisseria meningitidis (Nm) subsequent to the microbiological processing as previously described [9] were included in the present study. An analytical cross-sectional study design was used to conduct the study reported herein.
Isolation of Neisseria meningitidis
Isolation and identification of bacterial etiological agent was carried out according to the previously described study conducted in our lab [9]. Briefly, different culture media i.e. nutrient agar, blood agar and chocolate agar were separately streaked with 10 μL of CSF samples. The experiment was run in duplicate and all plates were incubated overnight at 37°C. Bacteria were identified on the basis of visual colonial characteristics, cellular morphology, and standard biochemical reactions.
Total 20 Nm positive CSF samples were additionally checked for the presence of Herpes simplex virus 1 (HSV1) and Herpes simplex virus 2 (HSV2) and for the occurrence of their coinfection.
Total DNA extraction
For total cellular DNA extraction, 150 μL of CSF was mixed with 150 μL of cell lysis buffer (containing 2 mg/mL proteinase K in 1 M Tris-HCl (pH 8.0), 0.1 mM ethylenediamine tetraacetic acid, and 5% (w/v) sodium dodecyl phosphate) and incubated at 37°C for 1 hour. The lysed samples were extracted twice with equal volume of phenol and chloroform-isoamyl alcohol (24:1), both steps followed by a centrifugation step at 5000 rpm for 2 min. DNA was precipitated by adding 2.5 volumes of chilled absolute ethanol and placed overnight at -20°C. The DNA was centrifuged at 13,000 rpm for 20 minutes at 4°C. The DNA pellet was washed with 70% ethanol. After air-drying, the DNA was dissolved in 25 μL of sterile distilled water (D/W). Extracted DNA was quantified spectrophotometrically at 260 nm.
PCR reaction
PCR amplification was carried out using GoTaq® Green Master Mix (Promega). For each PCR reaction, the 25 μL reaction mixture contained 12.5 μL of Master Mix, 6.5 μL of the D/W, 2 μL of each forward and reverse primer and 1.7-194 μg of the template. Furthermore, two different sets of viral specific primers targeting glycoprotein G genes reported elsewhere [19] were selected to carry out PCR. The temperature profile used for the PCR is summarized in (Table 1). Amplified PCR products were detected by agarose gel (2%) electrophoresis and gels were visualuzed using GelDoc (BioRed, USA) after staining with ethidium bromide.
|S. No
|Primer name
|Herpes Simplex Virus- 1
|Herpes Simplex Virus- 2
Table 1: Primers used for Herpes Simplex Virus amplification.
Total ninety-two cerebrospinal fluid (CSF) samples were screened for the presence of bacterial neuropathogens, out of which, 20 samples (21.7%) found infected with Neisseria meningitidis (Nm). Cellular DNA quantification profile of these Nm positive CSF samples showed that 8 samples (40%) high yield of DNA i.e. 60.931 μg/mL, whereas the amount of quantified DNA in 12 samples (60%) was found to be of moderate concentration i.e. 24.18 μg/mL (Figure 1).
Furthermore, the results of PCR (Figure 2) highlighted that out of this 20 samples, 8 (40%) revealed the presence of viral coinfection of both HSV-1 and HSV-2 in addition to the Nm. Whereas, 12 samples (60%) were found to be infected with Neisseria meningitidis exclusively. In contrast, (Figure 3) describes the frequency of the coinfection in the CSF samples of patients.
Moreover, the results of the present study indicated out of 8 samples showed viral and bacterial conifection, 5 (62.5%) were from female patients. Whereas 3 (37.5%) were from male patients (Figure 4).
The study herein reported is the first study to provide a better overview of the bacterial and viral coinfection in the cerebrospinal fluid (CSF) of patients suspected different neurological disorders.
Existence of the coinfection was evaluated initially by screening of bacterial etiology. Therefore 92 CSF samples were analyzed for the presence of bacterial neuropathogen. The results of the present study indicated that 20 samples (21.7%) showed infection with Neisseria meningitidis (Nm) subsequent to the standard microbiological and biochemical examination. These results are in line with the findings of other authors [6-9] who reported Nm as the principle pathogen of bacterial meningitis (BM).
Since the detection of viral and bacterial coinfection of the meninges is pivotal from the standpoint of both diagnosis and to better manage the infection. Consequently, reflecting the local epidemiological trend of the microbial agents associated with neurological disorders. Therefore, Nm positive CSF samples were additionally screened for the presence of Herpes simplex virus-1 (HSV-1) and Herpes simplex virus-2 (HSV-2). Our results showed a considerable rate (40%) of coinfection of HSV-1 and HSV-2 in CSF samples that have already showed the infection of Nm (Figures 2 and 3). Since the lifelong latency of HSVs in neuronal cells is the characteristic feature of these viruses [17] therefore, the results of current study can be explained by the fact that the host complex immune response triggered by severe BM can have a phase of decreased immunity i.e. immune paralysis, [20] allowing latent HSVs to reactivate. Our findings can be further supported by the fact that many patients of HSV infection may shed low levels of viruses continuously without demonstrated reactivation [21] In current scenario it can be hypothesized that these viruses were present latently in the cells of CNS. They may get activated after the occurrence of meningococcal infection where this bacterium served as strong stimulus for the viral reactivation.
Interestingly, all the CSF samples showed bacterial and viral coinfection, were collected from the local government hospitals of Karachi. People living in shanty towns belonging to the low socioeconomic status were the common visitors of these hospitals. Therefore, despite of the aforementioned possible clinical causes of coinfection, stressful conditions due to compromised socioeconomic status may also be another cause of viral reactivation. The results of the present study are in accordance with the findings of Padgett et al. [22] who reported that physcological and social stress significantly contribute in the reactivation of the HSV-1.
DNA quantification profile of CSF samples revealed coinfection rendered the high yield of the DNA concentration i.e. 60.931 μg/mL (Figure 1). This result may be explained by the fact that HSVs may stimulate the apoptosis in the infected cells which may lead to either loss or dysfunctioning of the cells of CNS. Neuronal and/or glial cell breakdown during viral infection yields end products which seem to be deleterious for the healthy cells and may facilitate the secondary infection. Our results are consistent with the study of other researcher [23] who concluded that HSVs induced neural cell oxidative tissue damage and cytotoxicity by activating microglial cell reactive oxygen species through a toll like receptor-2 (TLR2) dependent mechanisms. This may contribute to the neurodegeneration both in peripheral and central nervous system that may leads to the permanent disabilities in the survivors of these infections.
Present study provides a considerable evidence of existence of bacterial and viral i.e. Nm and HSVs coinfection in CSF of the patients with neurological disorders. It is noteworthy to state hererein that coinfection of varied aetiologies greatly enhances the sensitivity of host immune, peripheral and central nervous system to subsequent exposure to microbial bioactive molecules. Therefore, patients suspected for BM, VM and even coinfection of both may be kept under strict observation even after convalescence. Furthermore, use of microbiological and molecular testing methods should be required in medical diagnostic laboratories since they can differentiate between bacterial and viral meningitis and even detect coinfection of both etiologies. This would be immensely helpful to shorten hospital stays for patients and avoid unnecessary use of antibiotics. Since antibiotics would not effectively cure the infection if the cause is of viral origin therefore correct diagnosis is pivotal. Nevertheless, present study constitutes a small number of CSF samples which was mainly due to difficulty of CSF sample acquisition from the aforementioned hospitals. This can be explained by the fact that very small number of CSF samples is being considered by the clinicians to be checked for the presence of BM. However, it is suggested that such study must be carried out continuously to establish the surveillance department in the hospitals to acquire the information about the modality of epidemic, pandemic, prevailing and existing disease programme.
Conflict of Interest
The authors of this manuscript declare that they have no conflict of interest.
Authors' Contributions
Conceived and designed the experiments: NJ. Collection of the samples: AT. Experimental work: AT. Analysis of the data and Conclusion: AT, NJ. Writing of the manuscript: AT. All authors read and approved the final manuscript.
Financial Support
Indigenous scholarship provided by Higher Education Commission, Islamabad (HEC).
We would like to thank Higher Education Commission, Islamabad (HEC) for providing the financial assistance in the form of Indigenous scholarship that enabled us to complete this work feasibly in conducive manner.
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Citation: Taj A, Jamil N (2018) Viral and Bacterial Coinfection in Patients with Neurological Disorders: An Analytical Cross-Sectional Study from Karachi. Clin Infect Dis 2: 108.
Copyright: © 2018 Taj A, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Stone Pier – Personal Illustration By Anders Sundstedt 2011
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WEISSMAN PC, Atlanta, GA September 2017 – November 2017
Help Desk Technician
Troubleshot and handled a lot of different issues including Windows, Active Directory, Vmware virtual desktops, Microsoft Office, Printers, Right Fax and Contact Ease. Also especially extensive experience and expertise with Caseaware and Imanage.
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IT Manager
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BP FISHER LAW GROUP Maryland February 2014 – February 2017
IT Support Technician/Caseaware Database Administrator
•Worked remotely using terminal server on Database Administration in Caseaware database/case
management system including the integration of various other applications and systems with Caseaware
including Word, Open Office, Aacer, BKFS and Walz.
•Created and modified complex merge documents, reports and sequences.
MCCURDY & CANDLER, Atlanta, Georgia December 2004 – September 2013
Database, Software and Integration Administrator
•Database Administration in Caseaware database/case management system and the integration of various
other systems with the database including Banko, Imanage, Quandis and Walz.
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and the Caseaware database
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Imanage and the Caseaware database.
Network Administrator
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MORRIS, SCHNEIDER, & PRIOR, Atlanta, Georgia August 1997 – November 2004
Network Support,
•Handled all printer and printer related issues, document management software, and backups for a firm of
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DAVIDSON COLLEGE, Davidson, North Carolina Bachelor of Arts in Psychology
THE NATIONAL CENTER FOR PARALEGAL TRAINING, Atlanta, Georgia
ABA Approved Certificate
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After commenting on my blog 23 moves in 18 seconds due to Marshall's greek gift, GM-Joker, or Wesley Walsh, played the Ruy Lopez with me in live games, 5/0 blitz. GM-Joker currently runs the JoKeR's Death Match!? Tournament in online chess with 96 participating players.
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About this item
- Plastic material
- Dishwasher-safe
- Set of 8
The bubble inspired design of this 8pc Bubble Tumbler from Room Essentials is perfect to give your table top a fresh vibe. The set of 8 includes 4 tall & short tumblers, that are perfect for all your gatherings and everyday use. Made from plastic material, it is dishwasher-safe.
Number of Pieces: 8
Material: Plastic
Piece 1 Capacity: 20.0 ounces
Piece 1 Dimensions: 6.62 inches (H) x 3.25 inches (W)
Piece 2 Capacity: 16.0 ounces
Includes Dining: 4 Tall Tumblers, 4 Short Tumblers
Service For: 4
Care and Cleaning: Do Not Microwave, Dishwasher-safe
Item Number (DPCI): 200-01-1963
If the item details above aren't accurate or complete, we want to know about it. Report incorrect product info.
Reg: $13.99 Save $9.80 (70% off)
only at target
no longer available
Not in stores
Ratings & reviews3
overall: 5 out of 5 stars, see all reviews
Most recent reviews
Love these glasses. Thy stack very well in my cupboard. They have flat bottom so water doesn't collect in the dihaher. I got 24 so now I have enough to match for large group. Tanks TARGET!
(would recommend)
5 out of 5 stars
Carolyn — 2 years ago
These glasses are awesome. Durable plastic. They look so good as part of my everyday dinnerware and so nice to have two sizes.see moreof the reviewer's review
Likable Everyday Tumblers
(would recommend)
5 out of 5 stars
BabyO — 2 years ago
Great value, great stylesee moreof the reviewer's review
we use everyday
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5 out of 5 stars
rj — 2 years ago
We use these for our everyday glasses. The feel and size are very nice. We like the look of the bubbles. We have washed them on the top shelf, as recommended, of the dish washer and they have come out great.see moreof the reviewer's review
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Connecticut (CT), USA
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Hutchinson county hispanic single women
Carson county tx demographics data with population from census shown with charts, graphs and text includes hispanic, race, citizenship, births and singles hutchinson county and potter county. Texas 10 most wanted the texas department of public safety, in partnership with the office of the governor, texas crime stoppers program, identifies select fugitives and wanted sex offenders who pose the most significant threat to public safety in the state. Texas scholarships established by wendy and stanley marsh 3 in 1997 to benefit hispanic and african american students enrolled at hutchinson county (0. Crews are working a grass fire just north of borger near the hutchinson county airport (photo courtesy: abc 7 amarillo borger skycam.
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Hutchinson county officials are searching for a man who is wanted for indecency woman in critical condition after single-vehicle wreck at amarillo blvd and north. Hutchinson county is a county in the us state of texas and 221% from two or more races 1470% of the population were hispanic or latino of any race. Hutchinson county, texas quickfacts provides statistics for all states and counties race and hispanic origin white alone women-owned firms.
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Hutchinson county, south dakota (111% for white non-hispanic residents 235 women) 951% of residents of hutchinson speak english at home. This page shows a google map with an overlay of hutchinson county in the state of texas. Wwwfairdata2000com 7-may-03 selected socio-economic data hutchinson county, texas african american and white, not hispanic data set: census 2000 summary file 3 (sf 3) - sample data. This page shows a google map with an overlay of hutchinson county in the state of south dakota.
Hutchinson county republican women, borger, texas 213 likes welcome to hutchinson county republican women we invite you to attend our meetings the. Hutchinson county historical museum preserves the history of hutchinson county, texas borger texas. It's always free to search our indexed real property records there is a charge to view or print the documents on-line you'll be able to view and print or download to you computer any document available. Ratio of single men to single women, by county county: single men per 100 single women: hutchinson county, tx: 84.


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Searching for really good drinking water could possibly be as simple as turning on your own kitchen faucet. Should you want that, a reverse osmosis system in Hillsboro WV can absolutely provide that for you. Good drinking water is merely that good! It not only tastes much better than municipality administered water, it's also a lot better for you. The advantages of having reverse osmosis drinking water goes on and on. Continue reading the material if you're looking for an at home reverse osmosis system in Hillsboro WV.
It is an effective mechanical water treatment process for minimizing 95 % to 99 % of the dissolved mineral salts, organics and particles by forcing the water, under pressure, through a semi-permeable membrane layer. TDS (Total Dissolved Solids) is the common usage for reverse osmosis in addition to pre-treatment for Deionization.
Reverse osmosis systems make use of pressure to press water through small pores, to create "distilled water." In the process, chemicals, bacteria, and minerals are filtered through different membranes and carbon filters.
The procedure gets rid of many contaminants from water, consisting of dissolved solids, lead, nitrate, sodium and sulfate. Based on customer details from the UNITED STATES Environmental Protection Agency, a reverse osmosis water filter eliminates disease-causing organisms and also most chemical impurities. According to North Dakota State University, it could be used in conjunction with other filtering system stages, such as activated carbon, to lower the level of chemicals, dioxins and volatile organic compounds.
A reverse osmosis water system will get rid of various water quality issues. The system helps with water contaminants, cloudy water, bad tastes or odors, in addition to minimize the costs connected with acquiring bottled water.
Reverse osmosis (RO) is a proven innovation with brand-new applications for various sectors. US Water Services' reps pride themselves on having substantial knowledge of RO water system unit installment, operations, repairing and also cleansing procedures.
The system creates energy, gets rid of waste-water and reuses fluids. This system is made use of in domestic and industrial filtration. The process desalinates water and transforms salt water right into drinking water. For example, the pressure pushes water particles through the membrane layer, however the salt fragments are too big to fit through the filtration, and this causes drinkable water on the other side.
Reverse Osmosis drinking water treatment commonly have pre-filters, which you may intend to change before flushing the RO System. However the actual Reverse Osmosis membrane module should not need replacement. If the manufacturer of the membrane recommends that you change this component of the system you need to ask them to give you the detailed reasons why.
It does produce a lot of waste water. 1 gallon of filtered water to 5 gallons of waste water is not good at all. However if you run your waste water to a storage container and utilize it to water the yard and garden and utilize it to wash your car and your home it doesn't have to all go directly to the drain. Some people even might drink the waste water as it actually has been through many phases of filtration and is a lot better then faucet water. Nonetheless the mineral content will certainly be higher then faucet water. Minerals aren't all bad. Your body can utilize a few of the minerals in the waste water. Yet understand that the waste water is not recommended for drinking as it can cause some digestive system problems.
A reverse osmosis system will need replacement of its membrane. Additionally, it might have pre- and post-filters in the system to eliminate debris and also other undesirable contaminants. These filters will have to be replaced depending exactly how much water flows through the system.
A great reverse osmosis water filter system guarantees that you have accessibility to clean, clear and wonderful tasting drinking water at all times. However exactly what makes an excellent reverse osmosis water filter system and just what does the very best reverse osmosis system have in common? It basically boils down to water purity level, excellent taste and also fast access.
Install a whole house reverse osmosis system to purify your faucet water into healthy water. A great home water filtration system will certainly remove heavy metals like lead and mercury in addition to herbicides, pesticides and also commercial solvents (yikes) that make their way into your drinking water. This is one of the most expensive thing to do, however is so worth it. I was a little doubtful when I installed ours and also was unconvinced that it was substantially much better compared to our Brita filter (it is). We installed it ourselves, it was really easy to install and a year later, I do not know just how I have actually lived without one for as long!
Clearly, the systems differ. Talk to the supplier to see exactly what filters it has and just what is eliminated during the procedure. Likewise examine just how much water is gotten rid of as "waste" for each gallon that is generated for you to drink.
A system with fewer phases like 3 or 4 phases is less trustworthy and steady. It needs constant filter changes (every 4 to 5 months), giving you more problems. A good-quality 5-stage reverse system has filters that last up to 9 to 12 months. It additionally gives better-quality and also better-tasting water. A 5-stage system conserves you time and also money in the long run. Pick a system that has three pre-filters, two carbon blocks and also a sediment filter.
Select a system that is made from exceptional high quality components, particularly certified made in the United States Try to find good workmanship, such as clean neat line connections and the system fits completely on a durable structure. Superb quality materials and workmanship are the tricks of an effective and resilient reverse osmosis water drinking system. Keep in mind pick a 5-stage reverse osmosis system.
The process leads to two streams – permeate and concentrate. For safe and clean water production, permeate is the water that is made use of for drinking, and the concentrate is disposed. Reverse osmosis treatment systems can be found in a variety of sizes from the 25 million-gallon-per-day facility in Gibsonton, Fla., to small house units that can produce 12 to 15 gallons each day.
Below are some of the much better reverse osmosis water filltration systems we have found:
Home Master TMAFC Artesian Full Contact Reverse Osmosis Under Counter Water Filter System, White
Pureness You Need with the Minerals You Want – restores all-natural calcium and magnesium minerals removed during the reverse osmosis procedure to create clean, pure Mineral Water on Tap Remarkable Filtration – gets rid of up to 98-percent of chemicals, heavy metals, sediment, and other contaminants then includes great minerals Filter element and the filter housing are all-in-one modular assembly for quick and easy annual modifications – No wrenches necessary Advanced long lasting filters – 2,500-Gallon or 1 year in between filter changes Included Fast Flow RO Package – Double the flow from your tap fills your mug twice as quick as common RO systems
A far better RO System – cutting-edge design addresses most usual problems associated with traditional RO systems.
Highly Pure Water – its seven stages of filtration and enhancement get rid of around 98 percent of chemicals, including chloramine, and various other pollutants.
Added minerals for fantastic taste – trademarked Full Contact innovation adds calcium and magnesium minerals two times throughout the purification procedure.
Durable and easy change filters – change only once a year or every 2000 gallons; no wrenches required.
Faster flow rate – water moves twice as fast as compared to typical RO systems. Made in USA.
APEC Water – Top Tier – Built in USA – Certified Ultra Safe, High-Flow 90 GPD Reverse Osmosis Drinking Water Filter System (90)
Enjoy limitless ultra-fresh, healthy, terrific tasting drinking water straight from your kitchen tap for cooking and making tasty coffee, tea & ice. Save cash, time, and hassle of purchasing costly, bottled water and live much healthier with ultra-safe water that is 99 % pollutant totally free. The premium-grade ULTIMATE RO-90 system has actually been examined and accredited to the highest possible standard in the market- WQA GOLD Seal, to assure the highest possible contaminant elimination rates and produce the purest water possible. This fast-production RO can cleanse water as much as 2X faster compared to average RO systems while getting rid of the widest array of pollutants consisting of chlorine, taste, odor, fluoride, arsenic, lead, chromium and much more.
Top tier brand of authentic US created, high efficiency drinking water system provides refreshing crisp taste, superior to bottled water.
Highest quality 5-Stage ultra-pure system with 100% US Made, NSF accredited filters to assure water safety and your health.
WQA Gold Seal certified to remove as much as 99 % of impurities consisting of arsenic, chlorine, lead, fluoride, heavy metals, microorganisms, virus as well as 1000+ contaminants.
Equipped with Super capacity filters that last two times as long as compared to others.
1 year satisfaction guarantee
The original, first-class JG Quick Connect fittings, requires no additional lock clips or actions to close leak. Super safe and secure and hassle-free.
System comes with 100% Lead-Free chrome faucet, plus NSF & FDA approved JG food grade tubes to provide safe, contamination-free, pure water.
APEC Water Systems ROES-PH75 Top Tier, Built in USA ,Ultra Safe, pH Alkaline Calcium Mineral Reverse Osmosis Drinking Water System
The ROES-PH75 is a 6-stage 75GPD RO system that includes calcium minerals to enhance the water taste for people that favor mineral water. This system's mineral cartridge includes only 100% US-made high-purity calcium carbonate to efficiently increase pH in the water for those that want alkaline water. Other re-mineralization RO systems will certainly claim to include different valuable minerals back into the water; however, their mineral solutions are typically from unknown and uncertified sources that could result in prospective health concerns. With the ROES-PH75, customers will certainly delight in endless great tasting healthy water right at home for drinking and also cooking. Save money, time, and from buying pricey, bottled water and live much healthier with ultra-safe pure mineral water that is contaminant; worry free.
Take pleasure in ultra-pure drinking water with added calcium minerals for enhanced alkalinity as well as terrific taste
US Made cartridge uses food-grade calcium from trusted source for safe, proven water pH enhancement
Premium long lasting filters utilized to get rid of tap/well water Provide limitless clean drinking water.
75 GPD 6-stage system removes up to 99 % of germs, viruses, cysts, organics, chemicals and more
Top rated brand name of US-Made, high performance, trouble-free system with finest support and guarantee
Home Master TMAFC-ERP Artesian Full Contact Undersink RO System with Permeate Pump
The Home Master Artesian Full Contact with Permeate Pump Undersink Reverse Osmosis System provides exceptional water pureness while additionally adding advantageous minerals that create clean, great-tasting mineral water on tap. The built-in non-electric permeate pump will decrease water waste while increasing water manufacturing. Home Master's innovative style eliminates the most typical issues found in traditional RO systems– container filter housing leaks, slow-moving flow rate, high water waste, service difficulties, and slightly acidic water. Its remarkable performance has actually made it one of the very best RO systems on the market and also it's all backed by a five-year limited warranty.
A far better RO system– Home Master Artesian Full Contact's innovative style resolves the most common troubles connected with standard RO systems.
Highly pure water– its 7 stages of purification and enhancement eliminate approximately 98 percent of chemicals, consisting of chloramine, and other contaminants.
Added minerals for terrific taste — patented Full Contact technology adds calcium as well as magnesium minerals two times during the filtration process.
Integrated non-electric permeate pump– minimises water waste up to 80 percent and raises water production as much as 50%. Made in USA.
Long lasting and easy-to-change filters– quick and painless filter changes requires no wrenches; change just once a year or every 2000 gallons.
iSpring RCC7AK-UV – WQA Gold Seal – Most Comprehensive 7-Stage 75GPD Reverse Osmosis Water Filter with Flow Sensor Switch 11W UV & Alkaline Mineral Stage
Based on their legendary Best Seller #RCC 7 and featuring 11W UV Sterilization Lamp with Smart Flow Sensor Switch and Alkaline pH+ and mineral balls, this design is the most conprehensive Reverse Osmosis water filter system out there. They have created a brand-new design of transformer that includes an inline Flow Sensor. Whenever you turn on the drinking faucet and water starts flowing, the UV is powered on automatically to eliminate 99 % of microorganisms and also viruses. It switches off instantly when water is off. It avoids a possible heat risk and expands the life of the UV light bulb substantially. You will certainly appreciate the cleanest excellent tasting water with healthy minerals right from your tap at just 3 cents per bottle!
Based upon famous #RCC 7, showcasing UV phase for virus and also germs, and Alkaline PH+ to restore ideal amount of minerals and elevates PH to 7-8.
Powerful 11W Ultravalet light functions Flow Sensor Switch that powers on and off with water flow – simultanously managed by drinking faucet.
Alkaline phase adds back appropriate amount of minerals and also boosts PH – limitless wonderful tasting Home-Made Mineral Water at just 3 cents a bottle.
WQA GOLD SEAL Accredited Product – Independentely checked and approved against NSF requirement for RO and Use of FDA food-grade material in ALL PARTS.
Manufacturer Direct Sale – United States Famous brand, authentic high quality RO system that ensures water safety, your wellness and low price
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Who doesn't love Chinese food? Come on now, at least once a week, Chinese food is a part of what I stuff in my face! I don't rarely take food porn shots unless it is the best I have ever tasted, and so when I do post food shots it will already have been half consumed along with my comment. Guess what I ate today for lunch?
Too easy of course - Chinese. The lunch special was ok, but what caught my attention was written on this fortune cookie paper. Correct me if I am wrong, but I can't think of any other type of restaurant that gives these little nuggets of goodness and advice away after the meal is done. Where else can a little piece of paper make you pause for a second or two to wonder if the fortune is accurate or if it will come true? Most will simply smile, throw the paper back down the table and walk away without giving it any further thought. Some, like me, will keep the good ones! ... just in case it *might* come true. What would life be if there were no hopes or dreams! Even a $1 lotto can kick start a dream - the old saying, "everything starts with a dream" right?
The fortune I got today was not about financial fortune, or "That I will be hungry again in 1 hour", but more profound in meaning. My fortune today should have been taken for granted in life and not just applied "these next few days" (Like a fortune that says, "You like Chinese food!"). Listening and understanding, without judgment, during a conversation is awfully important in any relationship, marriage, corporate setting, and 1:1 interaction. Listening and understanding are critical to finding that next business opportunity, hiring that new employee, and dealing with a potential challenge around the corner and how to deal with it. I have learned the hard way and failed on so many levels because of this listening issue.
Listening with our ears is one thing, but body language communicates even louder. By being focused and absorbing all that you can from the speaker, you can learn a lot from that person. This takes being present and turning up the awareness level – what is said, body position, facial movement and so on. There are a lot of materials on how to speak and how to give great presentations; I would also encourage you to read-up on how to be a better listener – all day, every day!
It took me a while to realize this in my life. I did listen in the past, but it was so one-dimensional. I was clueless to the other forms of subtle communications which is even more important to pick-up and be aware of. Many times when I am interacting with a customer and I try to convince them why this feature is good and why that feature has faster performance… I talk, and talk and forget to simply listen to the customer's true needs. Perhaps he didn't really care about all those features, and that if had listened closely all he wanted was to simply use the easiest technology possible – everything else was of no value to him, wasting both our times. The answers were there all along, you have to speak less and listen more to receive the answers! Sounds obvious but hard for most people.
Miki is a renowned motivational speaker and author. He appeared in the 2015 Oscar nominated film "The Last Days in Vietnam" directed and produced by Rory Kennedy, the youngest daughter of Robert F. Kennedy. He often speaks to others on the ways in which they can better their lives. His history is well documented in the documentary that shares the amazing story of his father Ba Van Nguyen and his bravery during the last few days in the Fall of Saigon. His message is one of enlightenment and courage. Miki has overcome many obstacles as he and his family worked hard to create a life in the United States while their homeland was being torn apart. Through his father's example of courage and commitment to a better life for his family Miki is inspired to be the best he can be and be of service to others by sharing his and his family's experiences in an effort to give hope to all refugees who take the enormous risks of leaving everything behind in hopes of a better life.
Miki is available for speaking engagements on a number of topics and also has a new book to be published soon that will offer instruction and inspiration through the recanting of his life and his experiences in this extraordinary world we all call home. For more information visit http://www.mikinguyen.com
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Who can register to vote in California?
Generally, to register to vote in the next election, you must be a U.S. citizen, a California resident, and at least age 18 years old by election day. But even if you meet those requirements, you may lose your right to vote depending on your custody or supervision status. See the next question.


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United Arab Emirates
The luxurious Mina A' Salam hotel is a majestic mansion in a Palace-style building overlooking the picturesque Discover Dubai's past and go back in the days when sailing was the main activity on the coast of the Persian Gulf.
The Mina A' Salam hotel, whose name in Arabic means "haven of peace", as if the gateway to the luxurious resort Madinat Jumeirah. It is from here started winding paths amidst landscaped gardens and numerous water channels, like a delicate spider's web which stretches across the resort. Thus the water taxi "Abra" can take guests to every corner of the vast territory from numerous world-class restaurants, bars and cafes, Spa-center Talise Spa and a shopping centre Souk Madinat Jumeirah, designed in the style of a traditional Arab market and bringing together dozens of fashion boutiques, shops and galleries.
Filled with Oriental hospitality, Mina A' Salam hotel is happy to welcome both discerning business travellers and guests travelling with family or friends. Continue reading
Tours and prices
Unusual hotels in Switzerland
The departure city: Moscow
In Switzerland like wildfire fashion on hotels in unusual places. The tourist in Switzerland to choose from – you can stay in the castle where once lived the bride of Napoleon, or to spend the night in a house without electricity or running water, as well as to speak to the Church in the monastery, you can spend the night in the trees, in the Mongolian yurts and even in a former prison or a bunker. Stay in such unusual places are unlikely to forget!
Alternative to a hotel, for example, can become a glass house-the nest in the trees. Each room unusual hotel has its own kitchen, shower, toilet, and a wood oven, it can fit two to four people. Guests who are afraid of heights, will have to overcome your fear – the cottages are located at a height of 5 to 8 meters.
In Switzerland you can spend a few days there, where once lived the knights, in this castle of dreams. Rotberg fortress proudly rising above the trees some time ago turned into a youth hostel and is now open to all comers.
The decor in the castle is fully consistent with the style of that time – 150 steps lead to the courtyard, behind the thick walls of which are spacious rooms; a spiral staircase rises to the top of the tower where the beloved was Napoleonically his hero. Continue reading
Welcome to Hotel de Rome
In the building of the Hotel De Rome was once the historic headquarters of the Dresdner Bank. Today, the office Manager of the Bank was converted into a Suite, store jewelry in a converted 20-metre indoor swimming pool and hall with offices located Grand ballroom. The building is steeped in history.
Hotel De Rome places you in the heart of Berlin on Bebelplatz, the historic square with views of the trendy district of Mitte, near Museum island. All the most famous sights of Berlin are located nearby.
All rooms are equipped with free Wi-Fi, interactive entertainment, and bathrooms with separate showers and heated floors.
107 rooms ranging from 36 sqm
39 suites, with complimentary Breakfast (from classic suites), VIP services. Continue reading


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8 (3452) 403-434
email@example.com Skype: kg_lex
Motorola razr2 v9 торрент, сериал корабль 2 сезон 9 серия торрент
Keep your Motorola phone up to date with the latest device-specific software upgrade on T-mobile. Upgrading Motorola firmware improves device performance. Motorola RAZR V3 - Cherry Blossom. Find great deals on eBay for Motorola RAZR V9 in Cell Phones and Smartphones. Shop with confidence. Motorola RAZR2 V9x reviews written by Phone Arena users. You can read the opinion of each user and how they rate the phone in 11 categories.
Find great deals for Motorola RAZR2 V9x - Black (AT&T) Cellular Phone . Shop with confidence All the newest Models we can Unlock by Motorola Unlock Code. This includes Motorola Moto G, Razr i, Atrix, Defy, Backflip, V3, Razr, V9, K1, Krzr and all other. Received my second Motorola RAZR 2 V9 from Motorola yesterday, so far so good, com/files/123493762/manual_discrepencies.txt.html.


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Thursday, November 4, 2010
My 1st day in SG
I woke up at 10AM and set myself to go to my uncle's agency around 10:30AM. My 2nd degree cousin Leilani went with us since we don't know how to go there. When we finally arrived there, we met our handsome Uncle Nono who is the younger brother of Tito Noel. He helped us changed our peso money to sing dollar only to find out that the equivalent is really small. He also helped us in printing our resume so we were able to submit a resume to my uncle's agency, we are set to take the exam tomorrow and pay S$28.00. After the short orientation, we went to get ezlink cards for our ride and we had a hard time finding our way to the subway. We went around Lucky Plaza only to find out that the subway is on the other building. It was then easy going back our way home. When we reached home, we went for a dip in the pool at my uncle's place. We did some exercise in the water, since of course trimming down is one of the objectives in our stay in Singapore. We were amazed on the sunrise-sunset event here in SG. Sun rises at around 7AM and sets around 7PM. We ate dinner at 10PM and 12MN still seems like 9PM in the Phils.
Posted by Turquoise Thespian at 11:00 PM
1 comment:
wow, you there for leisure or business?ReplyDelete
Your newest follower here via PMB, dropping by to spread some sweets. Ciao :)
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Food and Passion
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