The possible association between the types of soft palate and gag reflex: a preliminary study / A possível associação entre os tipos de palato mole e o reflexo de vômito: um estudo preliminar

Objective: whether gag reflex, a common problem encountered during dental procedures, is associated with the different types of the soft palate has not been addressed so far. This preliminary study sought to assess the potential association between the different types of soft palate and gag reflex. Material and Methods: one hundred dental patients were recruited. The type of soft palate was determined. Subjective (self-reported) gag reflex was recorded based on many questions and past experience and on a 0-6 VAS. Objective assessment of gag reflex was done using different maneuvers where the posterior part of the tongue and the soft palate were touched by dental mirror, and by taking impression for the upper arch. The association between the types of soft palate and the subjective and objective recorded gag reflex were statistically tested. Results: there were 53 (53%), 33 (33%) and 14 (14%) of the participants with class I, class II and class III soft palate, respectively. A significant association was found between the type of the soft palate and gag reflex in response to one of the subjective items (P= 0.039), more prominent among females (P= 0.009). Concerning the objective assessment, no significant associations were found among males. Meanwhile more females with class II and class III suffered gag reflex and/or actual gagging upon taking the impression (P = 0.001). Conclusion: this study illustrated an association between the type of soft palate and gag reflex, and its severity in females (more specifically soft palate types II and III) more than in males (AU)

Objetivo: o reflexo de vômito, um problema comum encontrado durante procedimentos odontológicos, está ou não associado aos diferentes tipos de palato mole, não foi ainda abordado até o momento. Este estudo preliminar procurou avaliar a possível associação entre os diferentes tipos de palato mole e o reflexo de vômito. Material e Métodos:cem pacientes odontológicos foram recrutados. O tipo de palato mole foi determinado. O reflexo de vômito subjetivo (auto-relatado) foi registrado com base em muitas perguntas e experiências anteriores e em um VAS de 0-6. A avaliação objetiva do reflexo de vômito foi feita por meio de diferentes manobras onde a parte posterior da língua e o palato mole foram tocados por espelho dental e por meio de moldagem da arcada superior. A associação entre os tipos de palato mole e o reflexo de vômito subjetivo e objetivo registrado foi testada estatisticamente. Resultados: houve 53 (53%), 33 (33%) e 14 (14%) participantes com palato mole classe I, classe II e classe III, respectivamente. Foi encontrada associação significativa entre o tipo de palato mole e o reflexo de vômito em resposta a um dos itens subjetivos (P= 0,039), mais proeminente no sexo feminino (P= 0,009). Em relação à avaliação objetiva, não foram encontradas associações significativas entre os homens. Enquanto isso, mais mulheres com classe II e classe III sofreram reflexo de vômito e/ou engasgo real ao receber a impressão (P = 0,001). Conclusão: este estudo ilustrou uma associação entre o tipo de palato mole e reflexo de vômito e sua gravidade em mulheres (mais especificamente palato mole tipos II e III) mais do que em homens. (AU)

Association Between the Prevalence of Schistosomiasis in Elementary School Students and Their Parental Occupation in Sudan

Global efforts to identify groups at high risk for schistosomiasis have mainly concentrated on identifying their geographical distribution. Investigations on the socioeconomic characteristics of high-risk groups are relatively scarce. This study aimed to explore the associations between schistosomiasis among students and their parents’ occupations. A nationwide cross-sectional survey was conducted targeting 105,167 students in 1,772 primary schools across Sudan in 2017. From these students, 100,726 urine and 96,634 stool samples were collected to test for Schistosoma haematobium and S. mansoni infection. A multi-level mixed effect analysis was used with age and sex as fixed factors, and school as a random factor. The odd ratios (ORs) of practicing open defecation among farmers’ children were almost 5 times higher than their counterparts whose parents were government officials (OR=4.97, 95% confidence intervals (CIs): 4.57-5.42, P<0.001). The ORs of contacting water bodies for watering livestock among farmers’ children were more than 4 times higher than those of children whose parents were government officials (OR=4.59, 95% CIs: 4.02-5.24, P<0.001). This study shows that schistosomiasis represents a disease of poverty and that farmers’ children constituted a high-risk group.

Chronic intestinal pseudo-obstruction in newborn: a case report

Chronic intestinal pseudo-obstruction (CIPO) is a rare and serious disorder of the gastrointestinal tract motility with the primary defect of impaired peristalsis. Symptoms are consistent with a bowel obstruction, although mechanical obstruction cannot be identified. It is a rare differential diagnosis for neonatal intestinal obstruction. Herein we report a case of neonate with non-resolving intestinal pseudo-obstruction, presenting since birth as progressive abdominal distention. The diagnosis was made by exclusion of mechanical causes of intestinal obstruction via thorough imaging studies.

Comparison of the Change in the Prevalence and Intensity of Schistosoma haematobium Infection Between High and Low Prevalence Areas of White Nile State, Sudan

This study aimed to investigate whether mass drug administration (MDA) intervention has an equivalent effect on reducing the prevalence and intensity of Schistosoma haematobium infection regardless of the baseline values. A repeated cross-sectional survey was performed targeting students of 12 primary schools in Al Jabalain and El Salam districts of White Nile State, Sudan, at both 1 week before and 8 months after the MDA. Prior to the baseline survey, school-aged children in Al Jabalain had received MDA interventions twice in 4 years, while those in El Salam had not. The baseline prevalence was 9.1% in Al Jabalain and 35.2% in El Salam, which were reduced to 1.8% and 5.5% at 8 months after the MDA, respectively. The corresponding reduction rates were 80.3% and 84.4%, not significant difference between both districts. However, changes in the geometric mean intensity (GMI) of egg counts were significantly different between both districts. The baseline GMIs were 14.5 eggs per 10 ml of urine (EP10) in Al Jabalain and 18.5 EP10 in El Salam, which were reduced to 7.1 and 11.2 EP10 after treatment, respectively. The corresponding reduction rates were 51.0% and 39.5%. In conclusion, MDA interventions were found to bring about similar relative reduction in prevalence regardless of the baseline value; however, the relative reduction in infection intensity was more salient in the district with a low baseline value for both prevalence and intensity. This clearly points to the importance of repeated MDA interventions in endemic areas, which will eventually contribute to schistosomiasis elimination.

Surgical outcomes of 14 consecutive bilateral cleft lip patients treated with a modified version of the Millard and Manchester methods

BACKGROUND: Bilateral cleft lip deformity is much more difficult to correct than unilateral cleft lip deformity. The complexity of the deformity and the sensitive relationships between the arrangement of the muscles and the characteristics of the external lip necessitate a comprehensive preoperative plan for management. The purpose of this study was to evaluate the repair of bilateral cleft lip using the Byrd modification of the traditional Millard and Manchester methods. A key component of this repair technique is focused on reconstruction of the central tubercle. METHODS: Fourteen patients with mean age of 5.7 months presented with bilateral cleft lip deformity and were operated on using a modification of the Millard and Manchester techniques. Patients with a very wide cleft lip and protruded or rotated premaxilla were excluded from this study. We analyzed 30 normal children for a comparison with our patients in terms of anthropometric measurements. RESULTS: By the end of the follow-up period (between 9 and 19 months), all our patients had obtained a full central segment with adequate white roll in the central segment and a deep gingivolabial sulcus, and we obtained nearly normal anthropometric measurements in comparison with age-matched normal children. CONCLUSIONS: We recommend this modified technique for the treatment of bilateral cleft lip deformity.

Are there differences in risk factors, microbial aspects, and prognosis of cellulitis between compensated and decompensated hepatitis C virus-related cirrhosis?

BACKGROUND/AIMS: Cellulitis is a common infection in patients with liver cirrhosis. We aimed to compare risk factors, microbial aspects, and outcomes of cellulitis in compensated and decompensated hepatitis C virus (HCV)-related cirrhosis. METHODS: Six hundred twenty consecutive HCV-related cirrhotic patients were evaluated for cellulitis. Demographic and clinical data were evaluated, along with blood and skin cultures. Severity of cirrhosis was assessed using Child-Pugh score. In-hospital mortality was assessed. RESULTS: Seventy-seven (12.4%) cirrhotic patients had cellulitis (25 with compensated and 52 with decompensated disease). Smoking and venous insufficiency were risk factors of cellulitis in compensated cirrhosis. Leg edema, ascites, hyperbilrubinemia and hypoalbuminemia were risk factors in decompensated cirrhosis. Gram-positive bacteria (Staphylococcus spp. and Streptococcus pyogenes) were the infective organisms in compensated patients, while gram negative bacteria (Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa) were the predominant organisms in decompensated cirrhosis. Fungi (Candida albicans and Aspergillus niger) were detected in 3 decompensated cases. In-hospital mortality in patients with cellulitis was 27.3%, approaching 100% in decompensated patients with gram-negative cellulitis. Prolonged hospitalization, higher model for end-stage liver disease (MELD)-Na score, septic shock, local complication, and recurrent cellulitis were predictors of mortality. CONCLUSIONS: Cellulitis in compensated cirrhosis is different from that of decompensated patients regarding microorganisms, pathogenesis, and prognosis. Cellulitis has a poor prognosis, with mortality rates approaching 100% in decompensated patients with gram-negative cellulitis. Stratifying patients according to severity of cirrhosis is important to identify the proper empirical antibiotic and to decide the proper means of care.

Two-dimensional and three-dimensional echocardiographic assessment of aorticroot diameter in patients with coronary ectasia

Background: Coronary artery ectasia (CAE) is a well-recognized but relatively uncommon finding encountered during diagnostic coronary angiography. It is commonly defined as in appropriate dilation of the coronary arteries exceeding the largest diameter of an adjacent normal vessel more than 1.5-fold. CAE is not an isolated and benign disease but a reflection of a generalized vascular media defect. Objective: The aim of this study was to compare 2D-TTEand 3D-TTE measurements of the aortic root diameter in patients with coronary artery ectasia to assess the presence of aortic root dilatation. Patients and methods: This prospective observational study included 50 consecutive patients came to the Department of Cardiology, Al-Azhar University Hospital, New Damietta for coronary angiography. The study was carried out from November 2017 until December 2018. Injection aortography was used as a gold standard and to assess the presence of ascending aorta dilatation in those patients. Results: The present study shows that there was a good correlation between 3D-TTE and aortography at the levels of aortic annulus, sinuses of Valsalva, sinotubular junction (r =0.98,0.95,0.98) but a rough correlation between 2D-TTE and aortography at these levels (r =0.49,0.48,0.46). The present study shows that there was increase prevalence of aortic root dilatation 13 patients (26%) and ascending aorta dilatation 9patients(18%) in patients with CAE. Conclusions: Accuracy of aortic root measurement by 3DTTE was superior to that by 2DTTE, because the values by 2DTTE were underestimated compared to those measured by 3DTTE and aortography. Increase prevalence of aortic root dilatation and ascending aorta dilatation in patients with coronary artery ectasia. Dilated Ascending aorta was associated with a higher prevalence of aortic root dilatation

Madurella mycetomatis causing multiple mycetoma lesions: a rareclinical presentation

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Influence of Functional Clinical Temperature over Compressive Strength and Diametral Tensile Strength of Various Luting Cements

Objective: To estimate the effect of temperature over the physical properties of commonly used luting cements. Material and Methods: The two set of cylindrical shaped cement samples measuring 12mm X 6mm and 4mm X 8mm were fabricated from non-eugenol zinc oxide, glass ionomer, zinc phosphate, Zinc polycarboxylate, resin cements. These two sets of samples were utilized to test compressive and diametral tensile strength respectively. Forty cement samples from each mold were fabricated and distributed between 14, 22, 37 and 550C (N=10). The samples were tested under universal testing machine, and data subsequently analyzed using One-way ANOVA and Tukey multiple comparison's statistical methods at p > 0.05. Results: The higher temperature resulted in noticeable reduction in the compressive strength of non-eugenol -zinc oxide, Zinc-phosphate, Zinc poly carboxylate cements. The highest compressive strength was recorded for non-eugenol zinc oxide (8.08 Mpa) at 370C, Zinc phosphate (91.01Mpa) at 140C, and for zinc polycarboxylate (83.06 Mpa) at 370C. The comparative values for respective cements at 550C were 6.40Mpa, 59.80Mpa, and 52.88 Mpa. The higher temperature had insignificant effect on the compressive strength of glass ionomer cement, while composite resin cement indicated minor deterioration. Conclusion: The relative mouth temperature influences the physical properties of the luting cements.

Relationship between liver iron concentration determined by R2-MRI, serum ferritin, and liver enzymes in patients with thalassemia intermedia

BACKGROUND: Iron overload is a risk factor affecting all patients with thalassemia intermedia (TI). We aimed to determine whether there is a relationship of serum ferritin (SF) and alanine aminotransferase (ALT) with liver iron concentration (LIC) determined by R2 magnetic resonance imaging (R2-MRI), to estimate the most relevant degree of iron overload and best time to chelate in patients with TI. METHODS: In this cross-sectional study, 119 patients with TI (mean age years) were randomly selected and compared with 120 patients who had a diagnosis of thalassemia major (TM). Correlations of LIC, as determined by R2-MRI, with SF and ALT levels, were assessed in all participants. A P-value 5 mg Fe/g dry weight (P < 0.0001). A significant relationship was also found for patients with TI who had elevated ALT level (63.5 U/L), of 3.15 times the upper normal laboratory limit, using a cut-off for LIC ≥5 mg Fe/g dry weight. CONCLUSION: We determined the cut-off values for ALT and SF indicating the best time to start iron chelation therapy in patients with TI, and found significant correlations among iron overload, SF, and ALT.

Modulated Gene Expression of Toxoplasma gondii Infected Retinal Pigment Epithelial Cell Line (ARPE-19) via PI3K/Akt or mTOR Signal Pathway

Due to the critical location and physiological activities of the retinal pigment epithelial (RPE) cell, it is constantly subjected to contact with various infectious agents and inflammatory mediators. However, little is known about the signaling events in RPE involved in Toxoplasma gondii infection and development. The aim of the study is to screen the host mRNA transcriptional change of 3 inflammation-related gene categories, PI3K/Akt pathway regulatory components, blood vessel development factors and ROS regulators, to prove that PI3K/Akt or mTOR signaling pathway play an essential role in regulating the selected inflammation-related genes. The selected genes include PH domain and leucine- rich-repeat protein phosphatases (PHLPP), casein kinase2 (CK2), vascular endothelial growth factor (VEGF), pigment epithelium-derived factor (PEDF), glutamate-cysteine ligase (GCL), glutathione S-transferase (GST), and NAD(P)H: quinone oxidoreductase (NQO1). Using reverse transcription polymerase chain reaction (RT-PCR) and quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR), we found that T. gondii up-regulates PHLPP2, CK2β, VEGF, GCL, GST, and NQO1 gene expression levels, but down-regulates PHLPP1 and PEDF mRNA transcription levels. PI3K inhibition and mTOR inhibition by specific inhibitors showed that most of these host gene expression patterns were due to activation of PI3K/Akt or mTOR pathways with some exceptional cases. Taken together, our results reveal a new molecular mechanism of these gene expression change dependent on PI3K/Akt or mTOR pathways and highlight more systematical insight of how an intracellular T. gondii can manipulate host genes to avoid host defense.

Non-microsurgical skin flaps for reconstruction of difficult wounds in distal leg and foot / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To express the versatility of a variety of non-microsurgical skin flaps used for coverage of difficult wounds in the lower third of the leg and the foot over 4 years period. Five kinds of flaps were used. Each flap was presented with detailed information regarding indication, blood supply, skin territory and technique.</p><p><b>METHODS</b>Altogether 26 patients underwent lower leg reconstruction were included in this study. The reconstructive procedures applied five flaps, respectively distally based posterior tibial artery perforator flap (n = 8), distally based peroneal artery perforator flap (n = 4), distally based sural flap (n = 6), medial planter artery flap (n = 2) and cross leg flaps (n = 6).</p><p><b>RESULTS</b>In all cases, there were no signs of osteomyelitis of underlying bones or discharge from the undersurface of the flaps. Fat necrosis occurred at the distal end of posterior tibial artery perforator flap in one female patient. The two cases of medial planter artery flap showed excellent healing with closure of donor site primarily. One cross leg flap had distal necrosis.</p><p><b>CONCLUSION</b>Would at lower third of leg can be efficiently covered by posterior tibial, peroneal artery and sural flaps. Heel can be best covered by nearby tissues such as medial planter flap. In presence of vascular compromise of the affected limb or exposure of dorsum of foot, cross leg flap can be used.</p>

Dose response effect of nitroglycerin on cardiac hemodynamic functions and myocardial infarction in a rat model of ischemia reperfusion

Background: Millions of people suffer from acute coronary syndrome, angina, acute myocardial infarction [MI], or related illnesses. These patients are prescribed nitroglycerin [NG] for the management of these diseases. Accordingly, any risk associated with the use of nitroglycerin can potentially affect those people despite of the undeniable benefit in relieving acute angina

Aim of the present work: was to study the potential of treatment with 3 different doses of NG [25, 50, 100 mg/kg] to develop nitrate tolerance

Materials and Methods: 50 Male Albino rats were randomly divided into 2 main groups: sham group and ischemia/reperfusion [I/R] groups, which was further subdivided into 4 groups, Untreated group; NG 25, 50 and 100 mg groups; rats received nitroglycerin three times daily for 3 days before induction of ischemia reperfusion. The effect of NG on cardiac functions and infarction size and severity score were assessed

Results: Rats exposed to I/R exhibited a significant decrease in their cardiac hemodynamic functions [[upwards arrow] left ventricular end diastolic pressure; LVEDP and [downwards arrow]dp/dt[max]] and development of a measurable cardiac infarction area. Regarding pretreatment with NG; NG 25 mg/kg improved cardiac functions and myocardial infarction size and severity score. NG 50 mg/kg significantly decreased myocardial contractility and increased myocardial infarction size. Meanwhile NG 100 mg/kg produced significant decrease in cardiac functions and significant increase in myocardial infarction size and severity score

Conclusion: NG pretreatment dose dependently decreased cardiac hemodynamic functions and increased myocardial infarction size and severity score in a rat model of ischemia reperfusion

Evaluation of rhomboidal flap in recurrent pilonidal sinus

Background: A pilonidal sinus [PNS] is a small cyst or abscess that occurs in the cleft at the top of the buttocks. A PNS usually contains hair, dirt, and debris. It can cause severe pain and can often become infected. If it becomes infected, it may ooze pus and blood and have a foul odor. The exact cause of pilonidal sinuses is unclear. It is generally thought they are caused by loose hairs pushing into the skin. They could also be caused by deep layers of skin being stretched and moved, leading to a hair follicle rupturing

Aim of the Work: The prospective study aimed at evaluating the outcomes of management of recurrent pilonidal sinuses by rhomboid flap

Patients and Methods: A prospective study of cases with recurrent pilonidal sinus, was done at the department of general surgery at In Al-Azhar University hospitals over the period from July 2017 with medium follow up period of three months

Results: Age: ranged between 17 to 36 years with mean = 24.7+/-5.57. Sex: included 12 male and 8 female

Conclusion: Based on this study, it seems to us that the rhomboid flap is a good alternative for recurrent sacrococcygeal pilonidal sinus, especially for complex sinuses, and it could be appropriate for cases where simpler techniques have failed. It permits early return to complete activity, does not require prolonged postoperative attention, and has very low recurrence rate and postoperative morbidity which may compensate the inconveniences related to an unfavorable cosmetic look

Effect of deferred cord clamping on respiratory function in neonates

Background: the optimal timing of clamping of the umbilical cord after birth have been a subject of controversy and debate, However, there is insufficient evidence to date to support a recommendation as regards the impact of DCC on respiratory function in preterm neonates to delay cord clamping

Aim of the work: this study aimed to evaluate the effect of deferred cord clamping on respiratory function in preterm neonates born vaginal

Methods: The study was randomized controlled trial, including 100 Pregnant women [age 20-35 years old] had spontaneous preterm birth vaginal from 34-36[+6] weeks, 50 subjected to ECC and 50 subjected to DCC

Results: neonates in the two-randomization group differed significantly in requirement of O2 and ventilatory support, and neonates in the ECC group had a mean that was higher than neonates in the DCC group in both CPAP and nasal O2 [ECC 6 [12.0%] vs. DCC 1 [2.0%] - ECC 27 [54.0%] vs. DCC 18 [36.0%] in CPAP and O2 requirement respectively. Apgar scores at 1 and 5 min were significantly different in the two groups, and in general higher in DCC than ECC, reflecting better respiratory symptoms in group DCC

Conclusion: the existing literature on delayed cord clamping has consistently demonstrated benefit especially for preterm neonates in facilitating placental transfusion. Improved physiologic stability in transition [blood pressure], better respiratory outcome, reduced need for transfusion is valuable improvements in outcome

Flexible ureteroscopy with laser lithotripsy versus extracorporeal shock wave lithotripsy in management of ureteric stones in pediatric age group

Background: pediatric stone disease is one of the most common urological issues in pediatric urology practice. The incidence of urinary stone disease is increasing in children in last decades

Aim of the Work: determination of the efficacy and outcome of flexible ureteroscopy using holmium Yttrium aluminium garne laser lithotripsy and compare its results with that of Extracorporeal shock wave lithotripsy EWSL in management of ureteric stones in pediatric age group

Patients and Methods: this study included 40 patients in pediatric age group. Complaining of upper ureteric stones less than [1cm]. Patients underwent either ESWL or Flexible Ureteroscopy randomly according to 1: 1 ratio. The procedures were done at Eldemerdash hospital and National Institute of Urology and Nephrology. The patients were divided into two groups. Group A: Patients undergone extracorporeal shock wave lithotripsy [ESWL]. Group B: Patients received flexible ureteroscopy and laser lithotripsy

Results: there was no statistically significant difference found between the two studied groups regarding age, sex, size and BMI, and stone free rate. Also there was highly statistically significant difference as regard hospital stay. The SWL group required a shorter period of hospitalization and there was highly statistically significant difference between the two groups regarding duration of the procedure which is more prolonged in flexible group

Conclusion: flexible URS lithotripsy and laser are considered a safe, highly efficient, minimally invasive, and reproducible surgery technique -with a higher stone free rates and less postoperative complications, after a single procedure, when compared to ESWL- for management of upper ureteric calculi in children after failure of ESWL

Flexible ureteroscopy with laser lithotripsy versus extracorporeal shock wave lithotripsy in management of ureteric stones in pediatric age group

Background: pediatric stone disease is one of the most common urological issues in pediatric urology practice. The incidence of urinary stone disease is increasing in children in last decades. Aim of the Work: determination of the efficacy and outcome of flexible ureteroscopy using holmium Yttrium aluminium garne laser lithotripsy and compare its results with that of Extracorporeal shock wave lithotripsy EWSL in management of ureteric stones in pediatric age group

Patients and Methods: this study included 40 patients in pediatric age group. Complaining of upper ureteric stones less than [1cm]. Patients underwent either ESWL or Flexible Ureteroscopy randomly according to 1: 1 ratio. The procedures were done at Eldemerdash hospital and National Institute of Urology and Nephrology. The patients were divided into two groups. Group A: Patients undergone extracorporeal shock wave lithotripsy [ESWL]. Group B: Patients received flexible ureteroscopy and laser lithotripsy

Results: there was no statistically significant difference found between the two studied groups regarding age, sex, size and BMI, and stone free rate. Also there was highly statistically significant difference as regard hospital stay. The SWL group required a shorter period of hospitalization and there was highly statistically significant difference between the two groups regarding duration of the procedure which is more prolonged in flexible group

Conclusion: flexible URS lithotripsy and laser are considered a safe, highly efficient, minimally invasive, and reproducible surgery technique -with a higher stone free rates and less postoperative complications, after a single procedure, when compared to ESWL- for management of upper ureteric calculi in children after failure of ESWL

Nosocomial infections: Epidemiology, prevention, control and surveillance

Nosocomial infections or healthcare associated infections occur in patients under medical care.These infections occur worldwide both in developed and developing countries.Nosocomial infections accounts for 7％ in developed and 10％ in developing countries,As these infections occur during hospital stay,they cause prolonged stay,disability,and economic burden.Frequently prevalent infections include central line-associated bloodstream infections,catheter-associated urinary tract infections,surgical site infections and ventilator-associated pneumonia.Nosocomial pathogens include bacteria,viruses and fungal parasites.According to WHO estimates,approximately 15％ of all hospitalized patients suffer from these infections.During hospitalization,patient is exposed to pathogens through different sources environment,healthcare staff,and other infected patients.Transmission of these infections should be restricted for prevention.Hospital waste serves as potential source of pathogens and about 20％-25％ of hospital waste is termed as hazardous.Nosocomial infections can be controlled by practicing infection control programs,keep check on antimicrobial use and its resistance,adopting antibiotic control policy.Efficient surveillance system can play its part at national and international level.Efforts are required by all stakeholders to prevent and control nosocomial infections.

IL-12 and IL-23 Production in Toxoplasma gondii- or LPS-Treated Jurkat T Cells via PI3K and MAPK Signaling Pathways

IL-12 and IL-23 are closely related in structure, and have been shown to play crucial roles in regulation of immune responses. However, little is known about the regulation of these cytokines in T cells. Here, we investigated the roles of PI3K and MAPK pathways in IL-12 and IL-23 production in human Jurkat T cells in response to Toxoplasma gondii and LPS. IL-12 and IL-23 production was significantly increased in T cells after stimulation with T. gondii or LPS. T. gondii and LPS increased the phosphorylation of AKT, ERK1/2, p38 MAPK, and JNK1/2 in T cells from 10 min post-stimulation, and peaked at 30–60 min. Inhibition of the PI3K pathway reduced IL-12 and IL-23 production in T. gondii-infected cells, but increased in LPS-stimulated cells. IL-12 and IL-23 production was significantly reduced by ERK1/2 and p38 MAPK inhibitors in T. gondii- and LPS-stimulated cells, but not in cells treated with a JNK1/2 inhibitor. Collectively, IL-12 and IL-23 production was positively regulated by PI3K and JNK1/2 in T. gondii-infected Jurkat cells, but negatively regulated in LPS-stimulated cells. And ERK1/2 and p38 MAPK positively regulated IL-12 and IL-23 production in Jurkat T cells. These data indicate that T. gondii and LPS induced IL-12 and IL-23 production in Jurkat T cells through the regulation of the PI3K and MAPK pathways; however, the mechanism underlying the stimulation of IL-12 and IL-23 production by T. gondii in Jurkat T cells is different from that of LPS.

Negative pressure wound therapy: An update / 中华创伤杂志(英文版)

<p><b>PURPOSE</b>To get the maximum benefit of vacuum-assisted closure (VAC) in the management of acute and chronic wounds without abuse or misuse.</p><p><b>METHODS</b>Fourty one patients were included in the study. Among them, 9 patients had chronic wounds and the rest 32 patients had acute wounds. In acute wounds, 19 patients had co-morbid conditions. Seven patients had gaped wounds, 4 patients had necrotizing fasciitis and 2 patients had enterocutaneous fistula.</p><p><b>RESULTS</b>The hospitalization period varied from 1 to 6 weeks. The follow-up period was up to 6 months. No mortality was recorded during this study. All skin grafts showed complete healing. Necrotizing fasciitis was managed with good outcome. Wounds with enterocutaneous fistula have improved. In chronic wounds, good healing and excellent outcome were obtained.</p><p><b>CONCLUSION</b>The VAC therapy is an essential element for the management of problematic acute and chronic wounds.</p>