Bacterial etiology of pneumonia and acute cerbations of chronic obstructive pulmonary disease at Assiut Unversity Hospital with special refern to carbapenemase

To assess the bacterial etiology of patients hospitalized for pneumonia and acute exacerbations of chronic obstructive pulmonary disease [AECOPD] and for screening and detection of carbapenemases in Enterobacteriaceae. From November 2006 to February 2008, this study was carried out in Assiut University Hospitals. A total of 29lpatients diagnosed as pneumonia and AECOPD [189 pneumonic patients and 102 AECOPD patients] were included in this study. Blood for serology and sputum for culture were obtained from all patients. Serological examination was carried out for detection of atypical bacterial pathogens, using Pneumobact kits [VERCELL Co., Ltd., GRANADA, SPAIN]. Antimicrobial susceptibility testing performed by using the disc diffusion method. Carbapenemase production in Enterobacteriaceae was determined using: disc diffusion method, MICs were determined by an agar dilution technique, imipenem EDTA double discs synergy test and Modfled-Hodge test [confirmatory test]. One hundred and eighty six microorganisms were identified in 165 of pneumonic patients and 98 microorganisms were identified in 93 of AECOPD patients. No organisms could be detected in 24 patients suffering from pneumonia and 9 patients suffering from AECOPD by different cultures or serological techniques. Kiebsiella Pneumoniae was the most common implicated pathogen in patients with pneumonia [34.9% of isolates] and in AECOPD [37.8% of isolates]. In the present study; 55.6% of S. aureus isolates were resistant to methicillin in CAP patients and 61.5% of S. aureus isolates were resistant to methicillin in nosocomial pneumonia [NP] patients. Carbapenemases were detected in 23.86% and 28.5 7% of Enterobacteriaceae of patients with pneumonia and AECOPD respectively. Pneumonia and AECOPD represents a current problem in Assiut University Hospitals. Carbapenemases are among the most important emerging groups of enzymes responsible for antimicrobial resistance. Modified-Hodge test is easy, simple and specific tests for detection of Carbapenemases production

Evaluation of the genotoxicity and pathological changes induced by the prolonged bromuconazole triazole fungicide exposure in rats

Bromuconazole, is a triazole fungicide used in enclosed commercial greenhouses was evaluated for its potential toxic effects in rat liver. Sprague-Dawley male rats were treated orally at daily doses of 36.5 and 18.25 mg/kg b. wt [1/10 and 1/20 LD[50], respectively] Bromuconazole for 3 months. Measurements include potential DNA fingerprinting using random amplified polymorphic DNA [RAPD-PCR] analysis, total nucleic acids content, total protein as well as histopathological alteration in the liver were performed. The results revealed that, Bromuconazole fungicide had genotoxic and toxicopathological effects in rat liver. The genotoxic effects were indicated by appearance of some changes in polymorphism band patterns including deletion of stable bands or insertion of new bands. The effects on the liver were also manifested by different histopathological lesions including severe necrobiotic and proliferative changes with the appearance of hepatoma at high dose. In addition, the liver tissue DNA, RNA and protein contents were significantly increased with increasing the dose of Bromuconazole. Using of Bromuconazole fungicide should be reconsidered due to its possible cytotoxic. clastogenic and mutagenic effects

Thermal stability of Ni [II] and cu [II] mixed ligand complexes derived from biologically important schiff bases, azoles and morpholine

Thermogravimetry [TG] and differential thermogravimefty [DTG] have been applied to the investigation of the thermal behavior of six mixed ligand complexes of Ni[II] and Cu[II] comprising the Schiff bases: o-hydroxyacetophenoneethanolimine [OHAE], N-salicylidene-o-iminophenol [SOP] and N-salicylidene-o-toluidine [SOT] as well as morpholine [Morph] and certain azotes. The azoles used are: 2-amino-thiazole [2-Atz], benzothiazole [Btz], 2-methylbenzothiazole [2-Mbtz], 3-methyl-2-selenoxobenzothiazole [3-Msbtz] and thiabendazole [Tbdz]. Heating the compounds first results in a release of the morpholine or the azoles. Kinetics of the decomposition reactions were studied using non-mechanistic equations

Immunotoxic effects of lambda-cyhalothrin in rabbits

The effect of Lambda-cyhalothrin on the immune response was studied in rabbits exposed to the insecticide via food at concentrations of 1373.23, 686.76 or 343.38 ppm [equivalent to 1/10[th], 1/20[th] and 1/40[th] oral LD50, respectively] for 8 weeks. The humoral immune response was measured by determination of the antibody titre against sheep red blood cells [SRBC], a T - cell dependent antigen. Moreover, the cell-mediated immune response was evaluated by the delayed - type hypersensitivity reaction to tuberculin. The chemical treatment resulted in a dose - dependent suppression of both humoral and cellmediated immune responses as evidenced by decreased serum hemolysin titres and inhibition of the delayed-type hypersensitivity reaction to tubercluin, respectively. In addition, leucopenia, lymphopenia, depletion of lymphoid cells in the white pulps of spleen, mesentric lymph nodes and Peyer's patches and severe atrophy of thymus cortex were recorded. The serum total protein, albumin, globulin [specially gamma globulin], albumin/globulin [A/G] ratio and the organ to body weight ratios for spleen and thymus were significantly decreased with increasing the insecticide dosage. Moreover, different pathological alterations in liver, and brain were also observed. In conclusion, Lambdacyhalothrin exposure suppressed both humoral and cell-meditated immune responses in rabbits at the tested concentrations in a dose - dependent manner

Reactivity of certain biologically important azoles and morpholine towards Ni [II] and Cu [II] complexes of O-hydroxyacetophenoneethanolimine and N-salicylidene derivatives

A number of mixed ligand complexes of Ni [II] and Cu [II] containing the Schiff bases: o-hydroxyacetophenoneethanolimine [OHAE], N-sallicylidene-o-iminophenol [SOP] and N-salicylidene-o-toluidine [SOT] as well as morpholine or the azoles: 2-aminothiazole, benzothiazole and 2-methylbenzothiazole has been prepared and characterized. The IR, UV-VIS spectra and magnetic moment measurements of the complexes were discussed

Differential diagnostic value of sialic acid and L-fructose in pleural effusion

In order to discriminate between malignant, tuberculous pleural effusions and that due to cardiac failure,Sialic acid and L- fucose were determined in pleural fluid and serum in 44 patients; 16 with malignant, 21 with tuberculous effusion and 7 with effusion due to cardiac failure. Serum and pleural fluid levels of Sialic acid were significantly higher in malignant and tuberculous effusions than in those with effusions due to cardiac failure and insignificantly higher in malignant than in tuberculous effusions The levels of L-fucose were significantly higher in malignant effusions than in the other two types of effusion.Pleural fluid concentration of sialic acid showed the highest sensitivty and diagnostic accuracy in differentiating tuberculous effusion from that due to cardiac failure while pleural fluid concentration of L-fucose showed the highest sensitivity and diagnostic accuracy in differentiating malignant effusion from that due to cardiac failure. An obvious overlap in evaluating each of the two markers was observed on comparing malignant and tuberculous effusions. However, it was less marked on comparing either of them with that due to cardiac failure. Because serum and pleural fluid levels of the two markers were highest in malignant effusions, they seem promising in the differential diagnosis of pleural effusion in spite of the overlap with tuberculous effusion

Diagnostic value of adenosine deaminase and glutamine in tuberculous pleural effusions

Two biochemiccal markers related to lymphocyte functions are adenosine deaminase [ADA] enzyme and glutamine [Glu.]. The discriminating value of both of these indices in differentiating tuberculous from other types of pleural effusions was studied. The present work included 23 patients with tuberculous pleural effusions, 14 patients with malignant effusions as well as 5 patients with post-pneumonic effusions. Pleural fluids and sera were obtained from each participant and used for determination of pleural and serum ADA activity as well as pleural glutamine. It was found that tuberculous pleural effusions had signficantly higher ADA than other types of effusions, while malignant effusions had significantly higher glutamine levels. When ADA activity of more than 30.2 U/L is considered, diagnostic tests of tuberculous effusions showed a sensitivity of 100%, specificity of 79%. A pleural fluid, serum ADA ratio above 2.1 was found in 100% of tuberculous and in 7% of carcinomatous effusions [sensitivity 100%, specificity 93%, diagnostic accuracy 97%]. All postpneumonic effusions had a ratio below 2.1 A pleural fluid glutamine level above 2.2 mg/dl, selected as the discriminating level, was found in 100% of malignant, 4% tuberculous and 20% of postpneumonic effusions. The combined assay of pleural ADA pleural/serum ADA and pleural glutamine provide in-formation in the deferential diagnosis of pleural effusions, especially differentiating tuberculous from malignant ones. These are easy, cheap and could be performed in any hospital lab, as a routine to help diagnosis of pleural effusions

pattern of bacterial isolates and its sensitivity to antibiotics in chronic obstructive airway disease with exacerbation of infection in upper Egypt

This study was carried out on 150 patients having chronic obstructive airway disease. Ninety-six males [64%] and 54 females [36%] with age groups ranged from 20-70 years old. Seventy-six of 96 male patients [79.1%] were smokers either cigarettes or [Goza], most of them [44.6%] consumed 10-20 cigarettes per day, they were classified into 15 patients [10%] having chronic bronchitis, 86 patients [57.3%] having bronchial asthma and 49 patients [32.7%] having emphysema. A sputum sample [purulent or mucopurulent] from each patient was collected in dried and sterilized Petridishes and subjected for various bacteriological investigations [films, cultures and biochemical reactions]. Tuberculous patients were not included in our study. The pneumococci constituted the highest frequency 66 cases 3 [44%], next in frequency the Staphylococcus aureus 53 [35.3%] followed by Branhamella catarrhalis 21 [14%], Klebsiella pneumoniae 13 [8.7%]. Haemophilus influenzae 11 [7.3%], Pseudomonas aeruginosa 5 [3.3%], Microccus tetragenous 4 [2.7%], Streptococcus pyogenes 3 [2%], Acinetobacter pneumoniae 3 [2%] E. coli 2 [1.3%] and yeast 8 [5.3%]. Many of the isolated organisms were present in mixed form. The antibiogram of 100 pure isolates was done. It showed that most of these isolates are sensitive to cefadroxil [duricef], clindamycin [dalacine], cephaloridine [cephalexine], amoxycillin [hiconcil] and cefotoxime [claforan]. On the other hand most of the bacterial isolates were resistant to trimethoprim [bactrim], ampiciliin and chloramphenicol

role of leukotrienes B4 and C4 in bronchial asthma

This study was carried out on 35 asthmatic patients and ten normal control subjects. They were 25 males [71.4%] and 10 females [28.6%]. Their ages ranged between 15-48 years old. Fifteen out of 25 asthmatic males were cigarette smokers [60%], their smoking index ranged, from 50-1000 cigarette with mean 358 cigarette. The asthmatic patients were classified into 3 groups thirteen patients with acute recurrent asthma received salbutamol, eleven patients with chronic asthma received salbutamol, and eleven patients with acute severe asthma received salbutamol and corticosteroid. Control subjects were classified into 2 groups: 5 control smokers and 5 non smokers. Serum LTB[4] and LTC[4] were measured in each patient before and after control of asthma. There was a significant increase in these parameters in asthmatic patients during acute attack than control subjects. Moreover, there was a significant increase in serum LTB[4] in asthmatic patients during remission than control subjects. On the other hand, there was no significant difference in serum LTC[4] in asthmatic patients during remission and control subjects. There was a significant difference in serum LTC[4] in control smokers than in control non smokers. However, there was no significant difference in asthmatic smokers and non smokers in serum LTB[4] and LTC[4]. Furthermore, clinical and ventilatory improvement in asthmatic patients during remission were associated with decreased levels of serum LTB[4] and LTC[4]. However, there was no significant difference in serum LTB[4] and LTC[4] levels in asthmatics patients who received corticosteroid and those who did not receive corticosteroid. These findings suggest that the leukotrienes have a role in the development of acute asthmatic attack and are associated with the pathogenesis of bronchial asthma. The leukotrienes play a definitive role as mediators in bronchial asthma, as they present at serum levels consistent with the severity of acute asthma, and decreased with the improvement of the disease. The beneficial effects of corticosteroid in asthmatic patients appear to be mediated by mechanisms other than reduction of leukotrienes. The development of selective leukotriene antagonist may help in the treatment of asthmatic patients