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Background: The quinolone group, a synthetic antimicrobial, is widely used worldwide to treat many diseases, including those caused by Gram-negative bacteria. Escherichia coli and others are among the bacteria that produce quinolone resistance genes (qnr) such as qnrA and aac(6?)-Ib-cr. Objective: The present study aimed to the isolate Escherichia coli from patients attending some Hospitals in Wad Medani city, identification of drug resistance patterns and detection of the frequency of quinolones resistance genes; qnrA and aac(6?)-Ib-cr among isolated strains. Methods: A cross-sectional descriptive, hospital-based study included 119 Escherichia coli strains was conducted. A designed questionnaire used for demographic data collection and the attitude toward antimicrobials usage. Clinical specimens were processed for aerobic bacterial isolation and identification. Antimicrobial sensitivity performed by Kirby Bauer disc diffusion technique according to the CLSI guidelines. Presence of qnrA and aac(6?)-Ib-cr genes was assessed by multiplex PCR. Results: Most strains of Escherichia coli originated from urine 53.8% (64/119) and wounds 42.9% (51/119) specimens. Meropenem had the best effect against tested strains with susceptibility of 85% (101/119). Multiplex PCR assay, using specific primers, demonstrated that 41.2% (49/119) and 37.8% (45/119) of isolated Escherichia coli possessed qnrA and aac(6?)-Ib-cr genes respectively. Conclusion: The high rate of qnrA and aac (6)-Ib-cr genes among Escherichia coli necessitate the usage of molecular tools in detecting the genetic determinants of drug resistance microorganisms in countries such as Sudan.
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Purpose@#This study aims to investigate the safety, efficacy and feasibility of sutureless trabeculectomy using a porous collagen matrix that contains a connected porous structure (Ologen) in the control of intraocular pressure (IOP) in glaucoma patients . @*Methods@#The study includes 25 eyes from 24 patients that met the inclusion criteria. All eyes underwent trabeculectomy with the Ologen implant that provides a space with a dynamic and physiological aqueous reservoir system. The operation was considered successful if IOP is <15 mmHg without need of IOP-lowering drops at 18 months of follow-up. @*Results@#The target IOP was achieved in 21 out of the 25 eyes (84%), the remaining four eyes all had an IOP of 16 mmHg at 18 months. Short-term complications consisted of seven cases of bleb leakage treated with bandage contact lens and one case of mild choroidal effusion which resolved after observation alone. @*Conclusions@#We can conclude that this technique can provide safety, effectiveness and short learning curve for ophthalmology trainees with lower incidence of perioperative and postoperative complications. Further studies may be required to prove stability and long-term efficacy in management of glaucoma patients.
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Purpose@#This study aims to investigate the safety, efficacy and feasibility of sutureless trabeculectomy using a porous collagen matrix that contains a connected porous structure (Ologen) in the control of intraocular pressure (IOP) in glaucoma patients . @*Methods@#The study includes 25 eyes from 24 patients that met the inclusion criteria. All eyes underwent trabeculectomy with the Ologen implant that provides a space with a dynamic and physiological aqueous reservoir system. The operation was considered successful if IOP is <15 mmHg without need of IOP-lowering drops at 18 months of follow-up. @*Results@#The target IOP was achieved in 21 out of the 25 eyes (84%), the remaining four eyes all had an IOP of 16 mmHg at 18 months. Short-term complications consisted of seven cases of bleb leakage treated with bandage contact lens and one case of mild choroidal effusion which resolved after observation alone. @*Conclusions@#We can conclude that this technique can provide safety, effectiveness and short learning curve for ophthalmology trainees with lower incidence of perioperative and postoperative complications. Further studies may be required to prove stability and long-term efficacy in management of glaucoma patients.
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There is need for simple, cheap and highly predctive test for spontaneous preterm labor (SPL). The "zone of endocervical crypts (ZEC)" is a well-defined sonographic landmark corresponding to enfolding of the endocervical mucosa. Early loss of ZEC might be considered as indicative of "premature effacement". We tested the efficacy of a "composite" parameter of cervical length plus ZEC loss for the prediction SPL.MATERIAL/METHODS The study included singleton pregnant women attending Asyout Clinic for Gynecology andObstetrics between 20 and <24 weeks' gestation. Transvaginal ultrasonography was used for:a) measuring the cervical length, and, b) detecting the existence/non-existance of ZEC.* Cervical lengthwas measured as the distance between the internal os of the cervix and theexternal os.* The Zone of Endocervical Crypts (ZEC) was defined as the heteroechoic area around thecervical canal (CC). Monoechoic appearance of the cervix was described as loss of the ZEC.The sensitivity, specificity, positive and negative predictive values (PPV,NPV) were calculated. RESULTS: Two thousand and one pregnancies were evaluated for the incidence and sonographic prediction of SPL (24 - <32 weeks, and 32-36 weeks).The overall SPL rate was 9%.Loss of ZEC, and, the combined ZEC loss with shortened cervix were found to have better specificity and better PPV than the cervical shortening alone. ZEC loss had better PPV for early rather than late PL."Funneling" had poor PPV, but, is still a good "negative". CONCLUSION: The composite parameter of the "lost ZEC" and short cervix is superior to the cervical length alone for the early prediction of SPL. Wider scale study is now being run for: a) ensuring the reproducibility of the parameter testing values, and b) to find any correlation between the ZEC loss and other clinical criteria
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Background : Maternity resembled an important issue in ancient Egyptian life and medicine. Ancient Egyptian papyri contained different prescriptions for care of both pregnant women, birthing moms and their fetus/infant babies. The interventions included both: 1) remedies of different origins, and, 2) incantations. Material/Methods:Different Egyptian papyri and temple representation were studied for the variable remedies for specific cases of maternal/ perinatal problems in relation to pregnancy, birth, breast milk and babycare.Incantation approach was also analyzed. We tried to define the specific material used, and the possible "psychogenic influence of the incantation. Results 1. Some of the remedies could be identified and correlated to current time agents. Practical extrapolation of some of these agents proved of value in modern obstetric practice andtherapeutics. 2. Other remedies could not be characterized, and, up-till now, it was not possible to detect whether they could be corresponding to existing material, 3. The incantation approach could be, in some way, correlated to the "deep psychoanalysis" of modern psychiatry. 4. Many of the "non-medical" ancient Egyptian approaches for maternity/baby care are still resembled in some way of use by current time Egyptian women. Conclusion Ancient Egyptian maternal/infant care is a composite approach. Some of the recognized remedies used proved of value in modern clinical application Identification of further remedies seems to open further promise of extra-benefit. Modification of the of the "non-remedy" line might provide a form of "psychotherapy" better tailored for our societies' concepts
Subject(s)
Egypt , Egypt, Ancient , Infant Care , Perinatal CareABSTRACT
Obesity among population has increased dramatically and has received considerable recent public health attention. The impact of obesity on lung health has become a recognized problem worldwide and an area of intense research. Obese people are at greater risk for asthma, impaired lung mechanics, sleep-disordered breathing, and obesity hypoventilation syndrome. Complete pulmonary function testing [measuring spirometry, lung volumes, and diffusion] often shows a restrictive disease pattern with decreased expiratory reserve volume [ERV] and functional residual capacity [FRC]. For more information on pulmonary function testing, see http:/www.nlm.nih.gov/ medlineplus/ency/article/003853.htm. [Also see Guide to respiratory abbreviations]
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Humans , Male , Female , Respiratory Function Tests , Asthma , Leptin , Risk FactorsABSTRACT
We used the PCR technique based on the abovementioned primer pair and sequencing to demonstrate the Theileria infection in the sheep samples collected from Sultanate of Oman. According to the frame work of "integrated control of ticks and tick borne diseases in globalized world managed by EU-ICTTD-3 project, the samples from blood, liver, spleen, lymph node and lung were sent to the laboratory of Iranian Research Center for Ticks and Tick-borne Diseases [IRCTTD]. Samples from blood smear and impression smears from liver, spleen, lymph node, and lung were analyzed by Geimsa staining. The DNA was extracted from the abovementioned samples and analyzed by PCR technique using specific primers derived from the nucleotide sequences of 18S rRNA gene of T. lestoquardi, which can amplify the common region in other Theileria and Babesia spp. Subsequently the amplified DNA was sequenced. The analysis of blood smears of the sheep was negative for piroplasmosis performed through the Giemsa staining. The impression smears prepared from liver, spleen, lymph node, and lung showed suspicious structures mimicking Theileria schizonts in some cells. The results showed an expected PCR product of 428 bp in length, which is specific for Theileria spp. The PCR products were subsequently sequenced. The corresponding nucleotide sequence is registered under accession number JF309152 in GenBank. The sequence alignment in Gen Bank showed that the PCR products had 99% homology to the known T. lestoquardi registered under accession number AF081135 in the GenBank. Oman sheep are highly susceptible for Theileria infection and the infected sheep mostly die before the microschizonts or erythrocytic form of Theileria appears in the nucleated or erytrocytic cells respectively
Subject(s)
Animals , Molecular Biology , Sheep , Polymerase Chain Reaction , DNA , Theileria , Tick-Borne DiseasesABSTRACT
Childhood asthma is a major health problem in Egypt and worldwide. Barriers to reducing the burden of asthma include symptom-based rather than disease-based approaches, tendency of care to be [acute] rather than [regular] and cultural attitudes towards drugs and drug delivery systems. To measure the disease effect on school performance and to map asthma medications with respect to types, routes and course of use. This cross sectional study involved 206 Cairene asthmatic school children, enrolled from the school students' health insurance facility of El-Matareya Teaching Hospital and the pediatric outpatient clinic of Saint Mark Charity Hospital representing different social classes and residential locations. Their ages ranged between 5 and 15 years and they comprised 100 males and 106 females. They were assessed clinically and by peak expiratory flowmetry. Parents or caregivers were interviewed about disease symptoms, school achievement and attendance and medications used including relievers and controllers, route and course of use, whether continuously, intermittently and/or during attacks. Asthma had a strong impact on school achievement and school absence; 77.3% of study population reported school absence due to asthma and 41.3% reported weak to average school achievement. School performance was associated with asthma severity; the majority of moderate asthmatics [64.6%] had average and weak school performance. Number of days of school absence demonstrated highly significant relation with asthma seventy; 43.6% of moderate asthmatics had 5-6 absent days/month and 33.4% had 3-4 absent days/month. Combined beta 2-agonists andxanthines was the most commonly used [54.8%] reliever therapy followed by beta 2-agonists alone [44.2%] while corticosteroids were the most common controllers used [97.6%]. Therapy was taken mainly by oral than inhalation route. Other medications like cromolyns, anti-histamines, anti-leukotrienes and anti-cholinergics were rarely used. Both rectal and injection routes were rarely used also. Asthma has a social burden on asthmatic children as it affects both school achievement and school attendance. Medical management of asthma in Egyptian children still lags behind available medical knowledge. Patients' and health care givers' education is a cornerstone in improving the current status of asthma management in Egypt
Subject(s)
Child , Schools , Cross-Sectional Studies , Severity of Illness Index , Epidemiologic Studies , Asthma/therapyABSTRACT
Childhood asthma is a major public health problem in Egypt and worldwide. Epidemiologic, physiologic, and social factors appear to be associated with an increased risk of asthma. The aim of the study was to determine the most frequent risk factors of childhood asthma exacerbation and severity in our community. This cross sectional study involved 206 asthmatic children. 5 to 15 years old. They were enrolled from the School Students Health Insurance facility of El-Matareya Teaching Hospital and from the Pediatric Outpatient Clinic of Saint Mark Charity Hospital representing several social and residential classes. They were assessed clinically and by peak expiratory flow rate [PEFR]. Parents of children were interviewed for symptoms and some demographic, social, environmental, housing and familial data as well as asthma triggers through a comprehensive detailed questionnaire. Residential distribution and social status were significantly associated with asthma .severity as most moderate persistent asthmatics lived in semi-urban areas [70.8%] and belonged to the low-level segment of social classification [47. 9%]. In the majority of the study population [69.9%], a family member or more had a positive history of bronchial asthma, and this was especially evident in moderate persistent cases [70.8%]. Passive smoking and dust triggered exacerbations in 48.6% and 65% of the studied sample respectively and in most moderate persistent asthmatics [83.4% and 93.7%]. Most houses of moderate asthmatics were infested with cockroaches [91.7%] and domestic animals were present in 56.2%. Recurrent chest infections and cold/flu attacks were strongly associated with asthma exacerbation and severity [93.8% and 93.7% of moderate persistent cases respectively]. Most moderate persistent asthmatics [91. 7%] reported exercise-induced asthma while 64.6% stated that emotional stress triggered their symptoms. Indoor pollutants such as insecticides, household chemicals and odors were strongly associated with asthma severity and exacerbation especially in moderate persistent cases [triggered symptoms in 66.7%, 52.1% and 58.3% of cases respectively]. Smoking, emotional stress and dust were the most significant triggers of asthma exacerbation and severity in our series. Identification and avoidance of risk factors for persistent asthma, combined with early institution of pharmacologic and other intervention strategies, may lead to a better outcome
Subject(s)
Humans , Male , Female , Child , Risk Factors , Environmental Pollution , Tobacco Smoke Pollution , Socioeconomic Factors , Air Pollution, Indoor , Animals, DomesticABSTRACT
Forty three patients of both sexes were enrolled in this study. They were 28 males and 15 females. Their ages ranged between 18 and 63 years with a mean age of 39.7 years. They suffered from different acute lower respiratory tract infections including acute bronchitis, acute tracheobronchitis, pneumonia and bronchiectasis. They were given azithromycin 500 mg [2 capsules X 250 mg] orally as a single daily dose for 3 successive days. There was complete cure of 39 patients [90.69 percent], improvement in 3 patients [6.97 percent] and failure in one patient [2.33 percent]. Bacteriological evaluation showed that the causative organisms were, streptococcus pneumoniae, haemophilus influenzae and staphylococcus aureus. Causative organisms were eradicated in 42 patients [97.67 percent] and persistence occured in one patient [2.33 percent]. Adverse events were reported in 5 cases [11.62 percent] and were mild and tolerated by the patients. They included loose stools in 3 patients, gastric upset in one patient and nausea in one patient. Therapy did not induce any significant changes in the mean values of blood count, liver and renal function tests. The study showed that azithromycin is an effective, safe and well tolerated therapy for adult patients suffering from acute lower respiratory tract infections
Subject(s)
Anti-Bacterial Agents , Erythromycin/analogs & derivativesABSTRACT
Sulbactam is a beta-lactamase inhibitor, which by itself, has a little antibiotic activity but it extends the therapeutic range of ampicillin when combined with it. The combination is active against ampicillin resistant staphylococcus aureus, haemophilus influenzae, and organisms which are secretor of beta-lactamase enzyme including many other organisms. Thirty adult patients suffering from lower respiratory tract bacterial infections were treated with intramuscular sulbactam-ampicillin combination. Good to excellent clinical responses were achieved in all cases with eradication of 97.87% of causative organisms. The combination was well tolerated and neither local nor systemic side effects were observed. Follow up of haemobiochemical studies revealed absence of significant changes. Sulbactam-ampicillin combination being an effective, safe, and well tolerated antibiotic is welcomed addition to combat lower respiratory tract bacterial infections