A multi-component spectrophotometric method for simultaneous determination of total bilirubin, oxyhemoglobin, and methemalbumin in human sera

A new multi-component spectrophotometric method was developed experimentally and theoreticallyto determine the accurate serum concentrations of the total bilirubin (TB), oxyhemoglobin (HbO2), andmethemalbumin (Mha) in healthy human adults and neonates with hemolytic jaundice. With respect to theexperimental technique, the method of preparation of serum solution has been developed, like the use ofdistilled water as a solvent and centrifugation of serum solutions to clear the sample turbidity. The resultsof TB were compared to the diazo-assay. Theoretically, the formulas used for the calculation of the majorcomponents (TB, HbO2, and Mha) in human sera have been derived based on the theory of multi-componentspectrophotometric analysis and the mathematical Gaussian elimination method for matrix calculation. Themethod of multi-component spectrophotometry, suggested in this study for determination of TB, showed% error (3.1%–4.9%), indicating the high accuracy of the method. The small coefficients of variation(CV = 3.65%–5.1%) indicate the high precision of the method. The results showed higher values of serum TB(p < 0.00005), HbO2 (p < 0.001), and Mha concentrations (p < 0.00005) in neonates, when compared to adults.The method is highly sensitive and accurate. It is inexpensive, precise, reproducible, and has the advantages ofsimplicity, speed, and can be computerized.

Isolation and properties of lactate dehydrogenase isoenzyme from buffalo liver: Application in AST and ALT assay diagnostic kits

Lactate dehydrogenase (LDH) enzyme is a major component of aspartate aminotransferase (AST) and alanineaminotransferase (ALT) diagnosis kits. In this work, the LDH enzyme was purified and characterized from buffalo liverfor direct application in the preparation of AST and ALT diagnosis kits. One major LDH (BLLDH) isoform and twoother secondary LDH peaks were analyzed for buffalo liver by diethylaminoethyl (DEAE) cellulose chromatography.BLLDH was obtained by ammonium sulfate sedimentation and chromatographically separated on ion exchange andsize-exclusion matrices. The isolated BLLDH has a specific activity of 17.6 units/mg proteins represented 16 foldsand 32% recovery. BLLDH was manifested homogeneous on native and SDS gels with 35 kDa native mass. OptimumpH of BLLDH was displayed at pH 7.6. BLLDH activity was diminished by FeCl2 and SDS. The produced BLLDH isutilized in constructing of AST and ALT diagnosis kits that were sensible and analogous to trade ready kits.

Impact of Professional Nutrition Education on Dietary Behavior and Body Mass Index Status of Senior Clinical Nutrition Students and Dieticians in Saudi Arabia

Background: Dieticians are uniquely qualified to providenutrition education that can promote healthy lifestyles, reducethe burden of diet related chronic diseases, and improve thequality of life among population.Objectives: To evaluate the effectiveness of professionalnutrition education on changing dietary habits and achievementof normal BMI.Methodology: A cross sectional study. Subjects weregraduates from clinical nutrition departments and otherdepartments of Saudi Universities (n=225). Using internetstructured questionnaire focusing on dietary habits before andafter college education, physical activity and weight changes totest the impact of education on food habits both on the subjectand his/her surrounding environment (family and friends).Results: Increase consumption of fruits, vegetables, darkgreen vegetables, whole grain cereals, dairy products, andwater and increase physical activities, in addition to decreaseconsumption of soda, artificial canned juices, energy drinks,solid fat, added sugar, saturated fat and salt were clear amonggraduates of clinical nutrition departments in comparison toother graduates.Conclusion: Professional nutrition education positively impactfood choices and healthy food habits. This impact is extendedto their families and friends.

The Effect of Mesenchymal Stem Cells Derived Microvesicles on the Treatment of Experimental CCL4 Induced Liver Fibrosis in Rats

BACKGROUND AND OBJECTIVES: The release of microvesicles (MVs) from mesenchymal stem cells (MSCs) has been implicated in intercellular communication, and may contribute to beneficial paracrine effects of stem cell-based therapies. We investigated the effect of administration of MSC-MVs on the therapeutic potential of carbon tetrachloride (CCL₄) induced liver fibrosis in rats.METHODS: Our work included: isolation and further identification of bone marrow MSC-MVs by transmission electron microscopy (TEM). Liver fibrosis was induced in rats by CCl4 followed by injection of prepared MSC-MVs in injured rats. The effects of MSC-MVs were evaluated by biochemical analysis of liver functions, RNA gene expression quantitation for collagen-1α, transforming growth factor β (TGF-β), interleukin-1β (IL-1β), vascular endothelial growth factor (VEGF) by real time reverse transcription PCR (RT-PCR) techniques. Finally histopathological examination of the liver tissues was assessed for all studied groups.RESULTS: BM-MSC-MVs treated group showed significant increase in serum albumin levels, VEGF quantitative gene expression (p < 0.05), while it showed a significant decrease in serum alanine transaminase (ALT) enzyme levels, quantitative gene expression of TGF-β, collagen-1α, IL-1β compared to CCL₄ fibrotic group (p < 0.05). Additionally, the histopathological assessment of the liver tissues of BM-MSC-MVs treated group showed marked decrease in the collagen deposition & improvement of histopathological picture in comparison with CCL₄ fibrotic group.CONCLUSIONS: Our study demonstrates that BM-MSC-MVs possess anti-fibrotic, anti-inflammatory, and pro-angiogenic properties which can promote the resolution of CCL₄ induced liver fibrosis in rats.

Child's risk attributes at birth and infant mortality disparities in Nigeria

Births in avoidable high-risk contexts defined by the interplay of sub-optimal childbearing age, short spacing, and first and high birth order incur elevated risks of childhood death. However, the extent of disparities in risks of dying in infancy vis-à-vis the continuum of non-high-risk and (un)avoidable high-risk attributes at birth as determined by mother's age at childbirth, child spacing, and birth order characteristics is yet to be adequately explored in Nigeria as elsewhere. To fill this gap, chi-square association test and Cox's proportional hazards regression were used to analyze data of 31,260 nationally representative children aged 0-59 months drawn from 2013 Nigeria Demographic and Health Survey. Disparities in infant mortality risks were mainly examined across the spectrum of birth-related risk attributes at birth broadly categorized as no extra high-risk, unavoidable firstorder risk and combined avoidable high-risk. The risks of dying in infancy differed significantly by risk attributes to the extentdictated by other confounders. Also, infant mortality risks varied significantly by all moderating factors excluding religion, water source, toilet type and place of delivery. Interventions targeted at reducing avoidable high-risk fertility rate and strengthening health system to provide life-saving care to most-at-risk children would engender rapid improvement in infant survival

Formulation, evaluation and release rate characteristics of medicated jelly of vitamin C

Medicated jelly formulations are patient friendly dosage form for pediatric, geriatric and dysphagic patients. These formulations offer rapid dissolution and absorption of drugs through oral mucosa therefore show the early onset of action. The objective of the study was to develop and evaluate oral jelly formulations of vitamin C. Slurry method was adopted using glucose 103gm, sugar 67gm, gelatin 10gm and sorbitol 6.56gm. Preformulation studies were performed including the organoleptic profile, pH, and solubility of both drugs. The medicated jelly of Vitamin C was prepared and evaluated for physical characteristics, weight variation, syneresis, pH, taste and palatability, drug content, release rate characteristics and stability studies. All the jellies were found to have patient welcoming taste and were palatable. All formulations showed more than 50% drug release within 15 minutes, while 93% drug was released in 30 minutes. The results of release kinetics showed that the formulation followed the zero order release kinetics. Thus the drug was released at constant rate independent of the drug concentration involved in the process. All the medicated jellies were found to remain stable stored for 60 days at different temperatures. The present study revealed that medicated jellies of vitamin C could be employed orally in an effective form as an alternative solid oral dosage form for special population such as pediatrics, geriatrics and patients with dysphagia

Chemical composition and antimicrobial activities of essential oils of some coniferous plants cultivated in Egypt

Family Cupressaceae is the largest coniferous plant family. Essential oils of many species belonging to family Cupressaceae are known to have several biological activities specially antimicrobial activity. The essential oils from aerial parts of Calocedrus decurrens Torr., Cupressus sempervirens stricta L. and Tetraclinis articulata [Vahl] Mast. were prepared by hydrodistillation. The chemical composition of the essential oils has been elucidated by gas chromatography-mass spectroscopy analysis. The prepared essential oils were examined against selected species of Gram-positive, Gram-negative bacteria and Candida species. Broth dilution methods were used to detect minimum inhibitory concentration [MIC], minimum bactericidal concentration [MBC] and minimum fungicidal concentration [MFC]. Sixteen compounds were identified in the essential oils of both Calocedrus decurrens and Cupressus sempervirens L. and fifteen compounds were identified in the essential oil of Tetraclinis articulata. delta-3-Carene [43.10%], [+]-Cedrol [74.03%] and Camphor [21.23%] were the major constituents in the essential oils of Calocedrus decurrens, Cupressus sempervirens L. and Tetraclinis articulata, respectively. The essential oils showed strong antimicrobial activities against the selected microorganisms in concentration range 0.02 3- 3.03 micro L/mL. This study could contribute to the chemotaxonomic characterization of family Cupressaceae. In addition, it proved that the essential oils under investigation possess potential antimicrobial properties

Evaluation of primary repair of common bile duct in common bile duct stones

Background: Despite advancements in gallbladder surgery with the introduction of endoscopic and laparoscopic techniques, many surgeons, especially in the developing world, still perform open cholecystectomy with common bile duct [CBD] exploration for choledocholithiasis

Aim of the study: The purpose of the study was to report the outcomes of open CBD exploration without theuse of Tetubes

Materials and methods: A prospective study of open CBD exploration and primary closure was performed without Tetube drainage. Preoperative investigations, the surgical techniques, and perioperative outcomes were recorded

Results: Fifty patients had CBD exploration. In 45 patients this was performed by means of asupraduodenal choledochotomy, and in five of these patients free passage into the duodenum could not be achieved using catheters, irrigation, and dilators. These were completed with acholedochoduodenostomy

Conclusion: In a limited resource setting, there is still a role for open CBD exploration and primary closure without the necessity of Tetubes and stents as evidenced by a good perioperative patient outcome

prevalence of celiac disease in patients fulfilling Rome III criteria for irritable bowel syndrome

Background and study aims: the clinical presentation of coeliac disease can vary from a classical malabsorption syndrome to more subtle atypical gastrointestinal manifestations similar to irritable bowel syndrome [IBS]. The aim of this study was to investigate the prevalence of coeliac disease in Egyptian patients with clinically diagnosed diarrhoea-predominant IBS [according to Rome III criteria]

Patients and methods: this study was conducted on 100 patients with clinically diagnosed diarrhoea-predominant IBS [fulfilling Rome III criteria]. They were subjected to complete clinical evaluation, routine laboratory investigations, abdominal ultrasonography and serum anti-tissue transglutaminase antibody [anti-tTG] test as a predictor marker for coeliac disease. All patients who tested positive for serum anti-tTG underwent upper gastrointestinal endoscopy with four to eight biopsy sample collected from the second part of the duodenum

Results: all of the studied 100 patients presented with abdominal pain or discomfort, flatulence and diarrhoea. Eight patients [8%] exhibited high levels of serum anti-tTG, and their duodenal biopsy samples satisfied the histopathological criteria of coeliac disease. The studied patients were divided into two group: Group I comprising 92 patients with IBS and negative anti-tTG results and Group II comprising eight patients with IBS and positive anti-tTG results. A non-significant difference was noted between the two groups in age, gender and duration of abdominal pain [p>0.05]. The haemoglobin level was found to be significantly reduced in anti-tTG-positive patients [p<0.01], as was the Na level in anti-tTG-negative patients [p<0.05]. A highly statistically significant inverse correlation was noted between anti-tTG and both serum total protien and serum albumin

Conclusion: some symptoms overlap between coeliac disease and IBS. A lack of awareness may lead to a diagnostic delay in these patients

audit evaluating anticoagulation clinic managed by clinical pharmacists in Jordan

Background and Objectives: Warfarin is the most widely prescribed oral anticoagulant; it is highly effective for the treatment and prevention of venous and arterial thrombosis. The beneficial outcomes of warfarin therapy are dependent upon achieving and maintaining an optimal international normalized ratio [INR] therapeutic range. The aim of this study was to evaluate the impact of our newly established clinic at Queen Alia Heart Institute [QAHI] in the Royal Medical Services [RMS], Jordan

Patients and Methods: An observational prospective study was carried out in a newly established anticoagulation clinic managed by two clinical pharmacists and one nutritionist in QAHI since September 2013 until June 2014. The patients [no= 250] who were on warfarin for at least two months referred to the clinic were included in our study. All patients or their care givers received a 45 minutes educational session and a warfarin booklet. Then they were followed up regularly for achieving and maintaining the target INR and developing any adverse events related either too high or low INR [>4.5 or <1.5, respectively]

Results: The age range of this group of the patients who were referred to t he clinic was wide, 5-81 years. 65% of them were males, with the most common indications for Warfarin were aortic and mitral valves replacement, and atrial fibrillation.72% of the patients were not achieving therapeutic [T] INR 43% of them achieve the TINR within the first week, 28% within the second week, 17% within the third, 4% within the fourth and 8% exceeded 4 weeks. The proportion of time within TINR for all the patients during the whole period was 75%. Only 7% of the patients had low INR, <1.5 and 5% had high INR, >4.5 for one visit. No major thromboembolic or hemorrhagic events were reported

Conclusion: The newly established clinic had achieved a considerable encouraging results and feedbacks in the short period of time since it had been established

pathophysiologic basis of anaemia in patients with malignant diseases

Cancer patients frequently present with anaemia that may result from the direct or indirect effects of the tumor or its treatment. Anaemia is an independent adverse prognostic factor that exerts negative influence on quality of life and survival of cancer patients. Anaemia in malignant disorders often arises from an interplay of multiple aetiological and pathophysiologic mechanisms. Understanding these mechanisms will help the oncologist identify and treat specific causes of the anaemia thereby minimizing the use of blood transfusion, which is associated with many adverse effects. This paper reviewed the various aetiological and pathophysiologic mechanisms of anaemia in cancer patients including direct and indirect tumour effects that lead to reduced red cell production or increased red cell destruction via a myriad of mechanisms ranging from marrow infiltration and cancer-associated acute myelonecrosis to chronic inflammation, blood loss, iron, folate, vitamin B12 and other nutrients deficiencies, malignancy related renal injury, pure red cell aplasia, hypersplenism, haemophagocytic syndrome, red cell autoantibody production, non-immune red cell fragmentation and cytotoxic therapy-induced erythroid cell apoptosis and eryptosis. Hence anaemia in cancer patients is attributable to a wide spectrum of aetiological factors with multiple and sometimes overlapping pathophysiologic mechanisms. It is therefore necessary for the oncologists to thoroughly investigate all cases of anaemia with the aim of identifying the actual causative factors in order to offer more sustainable cause-specific treatment modalities that will minimize the use of blood transfusion with its attendant adverse effects

Toxicological effects of generated radiations on the eye among computer users

Background: Nowadays computers being used in every aspect of life in both developed and developing countries. These electronic devices generate a form of non-ionizing electromagnetic radiation which exerts negative influence on human health. Eyes are particularly vulnerable; thus computer vision syndrome or dry eye disease is the most frequent health problems among computer users. This study aims to assess toxic effects of computer generated radiation on eyes among a sample of Egyptian computer users

Subjects and Methods: this is a cross-sectional study conducted on 100 volunteers from both sexes who worked daily on a computer. All participants were subjected to a self-filling questionnaire including questions about personal information, work and workplace related information as well as, Ocular Surface Disease Index [OSDI] with 12 questions about symptoms of eye and vision problems

Results: this study revealed that more than three fourths [79.0%] of the studied computer workers suffered from symptoms of dry eye disease, 40.5% of them had severe eye affection, 26.6 % had moderate and 32.9 % had mild eye affection. Those with severe eye affection of participants with dry eye disease were using the computer for a mean duration of 10.3 +/- 2.4 hour/day and 70.9 % of them not taking regular rest during computer work. Wearing visual aids showed a significant association with dry eye disease [P = 0.002]

Conclusion: the majority of participants had symptoms of dry eye disease. The most vulnerable persons were those who wearing medical glasses or lenses and use the computer for around 10 h / day without regular rest. Occurrence of eye dryness was relevant to the presence of fan and air conditioner in the workplace. These results indicated the valuable role and the essential need for visual assessment of computer workers for early and proper diagnosis of dry eye disease in order to minimize its impact on their productivity and quality of life

Cognutuve and neurological complications of bacterial meningitis in adult patients: a hospital based study

Bacterial meningitis is associated with disabling sequelae in a significant proportion of patients. It is associated with high mortality, risk of neuropsychological sequelae and risk of cognitive impairment the purpose of this study is to assess cognitive and neurological complications in adult patients with bacterial meningitis. A total of 45 patients with bacterial meningitis and 16 patients with tuberculous meningitis were enrolled. They were subjected to full medical history taking and clinical examination, full neurological examination on admission and discharge. Mini mental state examination [MMSE] and Wechsler memory scale [WMS] were used to assess cognitive function. The results showed that the ischemic brain insult [87.88%] followed by cranial nerves affection [32.42%] were the commonest neurological complication detected on discharge. Cognitive impairment was detected in 53.66% of patients using MMSE.WMS showed that orientation, information and logical memory were the most common affected. Cognitive and neurological complications were not statistically related to age or etiology [P>0.05]. Longer duration until diagnosis [Beta = -.18, p <0.001], presence of intracranial complications [Beta = -.12, p <0.005], need for mechanical ventilation [Beta = -.79, p <0.001] and drug abuse [Beta = -0.11, p < 0.05] were significant predictors of worse outcome assessed by Glasgow outcome score

Are Pneumococci resistant to microlides?

Background: Streptococcus pneumoniae is the most common cause of acute community - acquired pneumonia and accounts for 30-40% of lower respiratory tract infections. It accounts also for about 50% of hospital-acquired pneumonia. Macrolides remain the primary antibiotic of choice for physicians treating such infections. Macrolide resistance in Strept. pneumoniae is primarily due to two mechanisms; target site modification [encoded by the erm [B] gene] and efflux pump expulsion [encoded by the mef gene]

Objectives: The aim of this study was to identify the incidence of Strept. pneumoniae among acute and chronic otitis media cases; to perform the antimicrobial sensitivity tests for such isolates, to determine the percentage of Strept. pneumoniae resistant to erythromycin, clarithromycin and azithromycin, to assess the antibiotic susceptibility profile of macrolide-resistant Strept. pneumoniae and lastly to detect the frequency of common macrolide resistant genes [The mefE and ermB genes] among erythromycin resistant Strept. pneumoniae by PCR technique

Methodology: 317 patients suffering from acute or chronic otitis media, attended to pediatric and ENT- Outpatient Clinics at Al- Azhar University Hospital of Assiut, were isolated and tested for Strept. pneumoniae and for antibiotics sensitivity pattern. Resistant strains for erythromycin, clarithromycin and azithromycin were assayed for MIC using E test. PCR for erm[B] and mef[E] resistant determinant genes by multiplex PCR was applied

Results: 78 [24.6%] isolates of Strept. pneumoniae were isolated. Of them 66 and 12 isolates from acute and chronic otitis media respectively. Cefoperazone was the most sensitive drug, followed by Cefotaxime, Azithromycin and Amoxacillin-clavulanate. Tetracyclin was the most resistant drug followed by Clindamycin and Apramycin. The E- test confirmed the results of disc diffusion test. By PCR, 10 [41.7%] isolates have both erm B and mef E genes, while 8 [33.3%] isolates have mef E gene only and 2 [8.3%] isolates showed erm B gene only

Conclusion: There is a high prevalence of erythromycin resistant Strept. pneumoniae. So macrolides cannot be recommended for the treatment of pneumococcal infections without susceptibility testing. Results point to the importance of detection of erm B and mef E genes for epidemiological aspects and to track possible presence of macrolide resistance

Comparison between accuracy of different scoring systems in prediction of liver cirrhosis-related complications

Background: Many scoring systems have been widely applied in recent years for assessing and predicting the mortality across a broad spectrum of liver diseases. The two most commonly used prognostic models are the Child-Turcotte-Pugh score and the more recently described the model of end-stage liver disease [MELD] score and its derivatives

Aim of the work: The main objective of this work was to evaluate and compare the accuracy of the Child-Pugh score, the MELD score, and the new scores, MELD-Na, the integrated MELD [iMELD], and the MELD-to-sodium [MESO] index in the prediction of liver cirrhosis complications

Patients and methods: This study was conducted on 60 patients with chronic liver disease. They were divided into two groups: group I consisted of 17 [28.3%] patients with uncomplicated liver cirrhosis. They were 10 [58.8%] male and seven [41.1%] female patients. Their mean age was 58.7 +/- 10.7 years. Group II consisted of 43 [71.7%] patients with liver cirrhosis-related complications. They were 37 [86%] male and six [13.9%] female patients. Their mean age was 55.1 +/- 6.38 years. All were recruited from the Internal Medicine and Hepatology Department in Ain Shams University Hospitals. They were subjected to full medical history, clinical examination, lab investigations, upper gastrointestinal endoscopy, and imaging studies to assess the state of the liver disease and its complications. The MELD, its derivatives, and the Child-Turcotte-Pugh score were calculated for assessing their prognostic accuracy in relation to complications of chronic liver disease

Results: In this study, the most common complication was portal hypertension [70%], which is the leading cause for ascites and hematemesis due to esophageal varices. In this study, there was a highly significant statistical difference between group I and group II regarding albumin and International normalization ratio and a significant statistical difference between group I and group II regarding total bilirubin, platelets, and the sodium level [Na]. In this study, there was also a highly significant statistical difference between group I and group II regarding Child, MELD, MELD-Na, MESO index, and iMELD scores. Regarding the comparison between Child, MELD, MELD-Na, MESO index, and iMELD scores as predictors for liver cirrhosis complications, our study showed that the Child-Pugh score was the most sensitive score with the highest predictive accuracy. The Child score at a cutoff greater than 7.5 has a sensitivity of 97.7%, a specificity of 70.6%, and an accuracy of 0.95 in predicting the occurrence of complications. MELD at a cutoff greater than 12.5 has a sensitivity of 93%, a specificity of 70.6%, and an accuracy of 0.913 in predicting the occurrence of complications. MELD-Na at a cutoff greater than 16 has a sensitivity of 90.7%, a specificity of 70.6%, and an accuracy of 0.867 in predicting the occurrence of complications. The MESO index at a cutoff greater than 0.95 has a sensitivity of 90.7%, a specificity of 70.6%, and an accuracy of 0.919 in predicting the occurrence of complications. iMELD at a cutoff greater than 30.6 has a sensitivity of 95.3%, a specificity of 41.2%, and an accuracy of 0.841 in predicting the occurrence of complications. For the detection of the most common complication, that is, esophageal varices, the MELD score was found to be the most specific, with a specificity of 100% and a sensitivity of 43% and the cutoff point greater than 18. This was followed by the MESO index, with a specificity of 100% and a sensitivity of 39.2% and the cutoff point greater than 1.4, whereas other scores could not be significantly related to the prediction of such complications

Conclusion: This study concluded the superiority of the Child score over MELD, MELD-Na, MESO index, and iMELD scores in the prediction of liver cirrhosis-related complications, whereas the MELD score and the MESO index were the best for predicting the occurrence of esophageal varices

Cytokeratin 18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients

A simple noninvasive test that accurately distinguishes NASH from NAFL as well as determines the disease severity is urgently needed. Recently, it was found that determination of Cytokeratin-18 [CK-18] fragments in the blood, predicts and correlates with histological NASH in which there is development of lobular inflammation, cell ballooning and fibrosis, supporting its usefulness in clinical practice To evaluate the role of CK-18 as a non invasive marker in diagnosis of NASH and its usefulness in correlation with disease severity in Egyptian patients. 90 subjects were divided into 3 groups: group I: including 30 patients with NASH, group II: including 30 patients with NAFL, and group III: including 30 healthy subjects as control. Diagnosis of NASH and its discrimination from NAFL was done by liver biopsy. CK-18 level in plasma was measured for all subjects using ELISA. CK-18 was significantly elevated in patients of group I in comparison to group II and III patients, with mean +/- SD: 460 +/- 279, 167 +/- 56 and 149 +/- 57, respectively, and/3 value: 0.001. The [ROC] curve diagnostic performance of CK18 in diagnosis of NASH shows: cutoff value of >240U/L, with sensitivity 76.7%, specificity 95.0%. Ck-18 was found to correlate with disease severity assessed by NAS scoring system with P value: 0.001. Measurement of CK18 in NASH is a useful screening, diagnostic and staging bio-marker

Effect of Obesity on Hormonal Profile and Semen Parameters of Male Partners of Infertile Couples in Kwara State Nigeria.

Background: Infertility is a global and a public health concern in many parts of sub- Saharan Africa and obesity is gradually becoming an epidemic disease that is rapidly spreading among Africans. Male obesity has been associated with increased incidence of low sperm concentration and progressively low motile sperm count. Methods: The study was a multicenter prospective comparative analytical study conducted at the University of Ilorin Teaching Hospital (UITH), Anchor Medical Centre, Royal Medical Centre, Surulere Medical Centre and Mid-land Fertility Centre all in Ilorin, Kwara State, Nigeria over a period of six months (February to July 2011). Our aim was to identify the effect of male obesity on measures of reproductive potentials among male partners of infertile couples. Serum levels of testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH) and estrogen of 42 obese and 42 non obese male partners of infertile couples were assayed in addition to seminal fluid analysis. Results: There was a statistically significant association between obesity, class of obesity with sperm count and sperm motility (All P< 0.05) and low serum levels of FSH and testosterone (All p <0.05) levels. There was however no significant association between LH and estrogen levels in this study. (All P > 0.05). Conclusion: This study has demonstrated an inverse but significant relationship between male obesity and semen parameters (sperm count and motility), serum testosterone and FSH amongst the study population. This suggests that male obesity has an adverse effect on the quality of semen amongst male partners of infertile couples

Prevalence of extended-spectrum beta-lactamase producing klebsiella pneumoniae by phenotypic and genotypic methods in Assiut University Hospital

This study investigated the urinary tract infection in Assiut university hospitals to evaluate the rate of infection, and the prevalence of extended spectrum ?-lactamase producing Klebsiella pneumoniae to define the magnitude of the problem and may help to implement appropriate infection control measures. This study was conducted from January 2014 to June 2014. Urine samples were collected from urinary tract infected patients to detect the causative organisms. After antimicrobial susceptibility testing, resistant strains to ?-lactam antibiotics were selected for detection of ESBLs. In addition PCR was done to determine the most common group of beta-lactamase genes responsible for resistance. The study included 340 patients presented to urology department at Assiut University Hospitals. The rate of community and hospital acquired UTI were 41% [140/340] and 59% [200/340] respectively. For community patients the commonest isolate was E. coli [54.28%] followed by Klebsiella pneumonia [29.28%] then Staphylococcus aureus [7.14%], Pseudomonas aeruginosa [1.42%], Coagulase-negative Staphylococcus [3.57%], and Candida species [4.28%].While the pattern of nosocomial isolates was Klebsiella pneumoniae [51%] followed by E. coli [30%] whereas, Staphylococcus aureus [4%], Pseudomonas aeruginosa [11%], Coagulase-negative Staphylococcus [3%], Candida species [1%] Antibiotics sensitivity of K. pneumoniae isolates showed that these organisms were mostly sensitive to meropenem [100%]. Phenotypic confirmatory tests [combined disc method, double disc method and ESBL-E-Test] were done to test K. pneumoniae isolates for ESBL production. It was concluded that 60.97% [25/41] of community isolates and 81.37% [83/102] of nosocomial isolates were ESBLs producers. PCR was done to determine the responsible ESBL gene; it revealed that the common ESBL gene was CTX-M followed by TEM then SHV. Further analysis of CTX-M positive isolates showed that CTX-M-group-1 was the predominant type. ESBLs is a neglected healthcare crisis in Egypt that needs strategies to treat, prevent and control the rising rate. In addition, rapid and clinically relevant antibiotic testing service is always required to provide services. Besides, the controlled use of 3[rd] generation cephalosporin along with implementation of infection control measures are the most effective means of controlling and decreasing the spread of ESBL isolates

Enterobacteriaceae in some marine fish fillet

A total of 100 random samples of marine fish fillet represented by Epinephelus alexandrinus fillet, Dicentrachus labrax fillet, Stingray fish fillet and Scomberomorus commerson fillet [25 of each] were collected from different fish markets in Alexandria city. The sample weight was 100 grams. Each sample was kept in a separate sterile plastic bag and transferred in an ice box to the laboratory under complete aseptic conditions without undue delay. All collected samples were subjected to bacteriological examination for isolation and identification of Enterobacteriaceae. The results revealed that the total Enterobacteriaceae count in the examined samples of marine fish fillet were varied from 1.6 x 10[2] to 6.3 x 10[4] with an average of 2.1 x 10[4] + 3.1 x 10[3] cfu/g for Epinephelus alexandrinus fillet, 2.1 x 10[2] to 4.3 x 10[4] with an average of 9.1 x 10[3] + 1.1 x 10[3] cfu/g for Dicentrachus labrax fillet, 3.1 x 10[2] to 6.7 x 10[4] with an average of 1.3 x 10[4] + 7.3 x 10[3] cfu/g for Stingray fish fillet and 2.3 x 10[2] to 1.1 x 10[5] with an average of 6.3 x 10[4] + 5.2 x 10[3] cfu/g for Scomberomorus commerson fillet, respectively. Accurately, all examined samples [100%] out of Epinephelus alexandrinus fillet, Dicentrachus labrax fillet, Stingray fish fillet and Scomberomorus commerson fillet were contaminated with Enterobacteriaceae. Also, the total coliform count in the examined samples of marine fish fillet were ranged from 1.3 x 10 to 2.1 x 10[3] with a mean value of 9 x 10[2] + 7.5 x 10 cfu/g for Epinephelus alexandrinus fillet, 3.1 x 10 to 3.2 x 10[3] with a mean value of 1.1 x 10[3] + 2.3 x 10[2] cfu/g for Dicentrachus labrax fillet, 1.9 x 10 to 7 x 10[3] with a mean value of 2.6 x 10[3] + 1.6 x 10[2] cfu/g for Stingray fish fillet and 6 x 10 to 1.3 x 10[4] with a mean value of 6.4 x 10[3] + 7.1 x 10[2] cfu/g for Scomberomorus commerson fillet. The enteric bacteria isolated were Enterobacter aerogenes [44%] was the most frequent bacterial species isolated from Epinephelus alexandrinus fillet samples, followed by Proteus vulgaris [28%], Citrobacter diversus and Shigella species [20% of each] then Klebsiella ozanae and Provedencia spp [16% of each]. In regard to Dicentrachus labrax fillet samples, the most frequent bacterial species isolated was Enterobacter aerogens [40%], followed by Klebsiella peumoniae [32%], Citrobacter diversus[28%], Proteus vulgaris and Provedencia species [20% of each], Citrobacter freundii [16%] then Enterobacter cloacae, Klebsiella ozanae and Shigella species [12% of each]. Concerning Stingray fish fillet samples, Serratia liquifaciens [44%] represented the highest rate of isolation followed by Enterobacter aerogens and Enterobacter cloacae [36% of each], Citrobacter freundii [28%], Citrobacter diversus and Enterobacter cloacae [24% of each], Shigella species [20%] and Proteus vulgaris [16%]. On the other hand, Citrobacter freundii [28%], Enterobacter aerogens [24%], Proteus vulgaris [20%] then Klebsiella ozanae, Proteus rettgeri and Shigella species [12% of each] were isolated from the examined samples of Scomberomorus commerson fillet The Enteropathogenic Escherichia coli was isolated from 8%, 16%, 20% and 28% of the examined samples of Epinephelus alexandrinus fillet, Dicentrachus labrax fillet, Stingray fish fillet and Scomberomorus commerson fillet, respectively. Also, Salmonella species were recovered from 8%, 12% and 8% of the examined samples of Dicentrachus labrax fillet, Stingray fish fillet and Scomberomorus commerson fillet, respectively. The serotypes of Salmonella organisms isolated from Dicentrachus labrax fillet, Stingray fish fillet and Scomberomorus commerson fillet were S. enteritidis [4% for each] and S. Haifa [4% for each]. However, only one strain [4%] isolated from Stingray fish fillet were serologically identified as S. typhimurium. Enterobacteriaceae count, Coliform count, the isolated enteric bacteria, the isolated enteropathogenic E.coli and the isolated Salmonella organisms as well as the public health significance were discussed and the prophylactic measures to reduce the counts and the isolates in marine fish fillet were recommended

Enterobacteriaceae in beef products from retail outlets in Alexandria

This study aimed to determine the presence of Enterobacteriaceae in beef products as luncheon, pasterma, frankfurter and minced meat as these microbes are considered as major cause of foodborne illness.A total of 100 samples [25 of each beef product] were collected from different retail outlets. Each sample was kept in a separate sterile plastic bag and transferred in an ice box to the laboratory under complete aseptic conditions with a minimum of delay. All collected samples were bacteriologically examined for isolation and identification of Enterobacteriaceae. We found that the most important bacteria that isolated from minced meat were E. coli [44%], Enterobacter spp. Especially Enterobacter aerogenes [12%], Enterobacter intermedium [4] and Enterobacter gergoviae [4%], Citrobacter spp. that includes Citrobacter amalonaticus [4%], Citrobacter diversus [4%] and Citrobacter freundii [4%], serratia spp especially Serratia marcescens 8%], Serratia ficaria [8%], Serratia fonticola [12%], Serratia liquefaciens [4%] and Serratia rubidaea [8%], Edwardsiella spp. Especially Edwardsiella ictalori [8%] and Edwardsiella hoshinae [12%], Povidencia spp. [8%] especially Providencia alcalifciens [4%], Klebsiella pneumoniae especially Subsp. Ozanae [4%] and Proteus spp. especially Proteus mirabilis [16%]. The most important bacteria that isolated from luncheon were E. coli [32%], Enterobacter spp. Especially Enterobacter aerogenes [8%], Enterobacter intermedium [4%] and Enterobacter gergoviae [8%], Citrobacter spp. that includes Citrobacter amalonaticus [12%], Citrobacter diversus [4%] and Citrobacter freundii [16%], Serratia spp. Especially Serratia marcescens [8%], Serratia ficaria [12%], Serratia fonticola [4%], Srratia liquefaciens [4%] and Serratia rubidaea [8%], Edwardsiella spp. especially Edwardsiella ictalori [8%] and Edwardsiella hoshinae [16%], Providencia spp. especially Providencia alcalifciens [4%], Klebsiella pneumoniae especially Subsp. Ozanae [12%] and Proteus spp. especially Proteus mirabilis [8%]. Also, the most important bacteria that isolated from pasterma were E. coli [40%], Enterobacter spp. Especially Enterobacter aerogenes [8%], Enterobacter intermedium [4%] and Enterobacter gergoviae [12%], Citrobacter spp. that includes Citrobacter amalonaticus [4%], Citrobacter diversus [12%] and Citrobacter freundii [4%], Serratia spp. Especially Srratia marcescens [4%], Serratia ficaria [8%], Serratia fonticola [4%], Serratia liquefaciens [4%] and Serratia rubidaea [8%], Edwardsiella spp. especially Edwardsiella ictalori [12%] and Edwardsiella hoshinae [8%], providencia spp. especially providencia alcalifciens [8%], Klebsiella pneumoniae especially subsp. Ozanae [8%] and Proteus spp. especially Poteus mirabilis [12%]. Eventually, the most important bacteria that isolated from frankfurter were E. coli [36%], Enterobacter spp. Especially enterobacter aerogenes [4%], enterobacter intermedium [4%] and enterobacter gergoviae [8%], Citrobacter spp. that includes Citrobacter amalonaticus [8%], Citrobacter diversus [4%] and Citrobacter freundii [4%], Serratia spp. Especially Serratia marcescens [4%], Serratia ficaria [12%], Serratia fonticola [4%], Serratia liquefaciens [4%] and Serratia rubidaea [4%], Edwardsiella spp. especially edwardsiella ictalori [8%] and Edwardsiella hoshinae [12%], providencia spp. especially Providencia alcalifciens [4%], Klebsiella pneumoniae especially subsp. Ozanae [8%] and Proteus spp. especially Proteus mirabilis [8%]