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Aims@#Mobile phones are used extensively by healthcare workers (HCWs) who are unaware of the amount of contamination these phones carry and act as reservoirs for organisms causing hospital-acquired infections. This investigation was aimed to find the prevalence of methicillin-resistant Staphylococcus aureus (MRSA) contamination and antimicrobial resistance patterns of isolates from HCW’s cellphones.@*Methodology and results@#This study was a hospital-based cross-sectional study. A total of 120 samples were isolated from HCWs’ cellphones and subjected to culture and sensitivity as per the standard guidelines. Five (18.1%) out of 120 collected samples were from 11 lab technicians’ phones and were positive for S. aureus and 6.25% were obtained from 48 nurses’ cellphone swabs. @*Conclusion, significance and impact of study@#The findings of this study reveal that HCWs’ cellphones could be apossible source of infection since a high prevalence of MRSA was found on lab technicians and nurse cellphone sample swabs. On the other hand, all S. aureus isolates were resistant to methicillin and ceftazidime. Also, no significant relationship between the prevalence of MRSA was detected.
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OBJECTIVES@#The objective of this study was to evaluate the present status of amoebiasis in Thi-Qar Province in southern Iraq, and to determine the presence of Entamoeba histolytica and Entamoeba dispar with nested and real-time polymerase chain reaction (PCR). @*METHODS@#Epidemiological data were obtained from the public health department of the Thi-Qar Health Office (2015-2020). Eighty stool samples were also randomly collected from patients ≤12 year of age with diarrhea at 2 hospitals between the beginning of February 2020 and the end of October 2020. These samples were selected after microscopy to identify the 18S rRNA gene in Entamoeba DNA. @*RESULTS@#Of the 341,554 cases of intestinal parasitic infections, 38,004 (11.1%) individuals were recorded as having amoebiasis, which accounted for the highest proportion of infections in 2015 (26.1%) and the lowest in 2020 (8.1%). Amoebiasis was distributed among all age groups, with the age group of 5-14 years accounting for the highest proportion (27.3%). In molecular testing, 42 (52.5%) out of 80 samples were positive for the 18S rRNA gene (888 bp). Using nested PCR, E. histolytica (439 bp) was detected in 25 (31.3%) samples and E. dispar (174 bp) in 14 (17.5%), while using real-time PCR, E. histolytica and E. dispar were detected in 28 (35.0%) and 15 (18.8%) samples, respectively. @*CONCLUSIONS@#Epidemiological data confirmed that amoebiasis is endemic in this province, and is not limited to certain months. Our study confirms the applicability of molecular identification to detect pathogenic and non-pathogenic Entamoeba to prescribe the appropriate drug.
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OBJECTIVES@#The objective of this study was to evaluate the present status of amoebiasis in Thi-Qar Province in southern Iraq, and to determine the presence of Entamoeba histolytica and Entamoeba dispar with nested and real-time polymerase chain reaction (PCR). @*METHODS@#Epidemiological data were obtained from the public health department of the Thi-Qar Health Office (2015-2020). Eighty stool samples were also randomly collected from patients ≤12 year of age with diarrhea at 2 hospitals between the beginning of February 2020 and the end of October 2020. These samples were selected after microscopy to identify the 18S rRNA gene in Entamoeba DNA. @*RESULTS@#Of the 341,554 cases of intestinal parasitic infections, 38,004 (11.1%) individuals were recorded as having amoebiasis, which accounted for the highest proportion of infections in 2015 (26.1%) and the lowest in 2020 (8.1%). Amoebiasis was distributed among all age groups, with the age group of 5-14 years accounting for the highest proportion (27.3%). In molecular testing, 42 (52.5%) out of 80 samples were positive for the 18S rRNA gene (888 bp). Using nested PCR, E. histolytica (439 bp) was detected in 25 (31.3%) samples and E. dispar (174 bp) in 14 (17.5%), while using real-time PCR, E. histolytica and E. dispar were detected in 28 (35.0%) and 15 (18.8%) samples, respectively. @*CONCLUSIONS@#Epidemiological data confirmed that amoebiasis is endemic in this province, and is not limited to certain months. Our study confirms the applicability of molecular identification to detect pathogenic and non-pathogenic Entamoeba to prescribe the appropriate drug.
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ntroduction: Vitiligo is an apparent skin condition that has a psychological impact on the affected individuals and their families. Its prevalence is estimated to be about (0.5-2%) globally. Misunderstandings, and negative attitudes toward vitiligo patients are the most important factors affecting the quality of life of vitiligo patients. Objective:The objective of this study was to identify the common misconceptions and attitudes about the nature, causes and prognosis of vitiligoin Al-Baha region, Saudi Arabia. Methods:A cross sectional study collected data from the general population in the public malls in Al-Baha region, Saudi Arabia. We used a questionnaire which was developed by the authors, the questionnaire included questions regarding vitiligo cause, nature, prognosis and the attitude toward vitiligo Results:A total of (453) responses were analysed, of which (53%) were females, and (90.9%) were Saudis. Theparticipants’ ages ranged from (16 -64) with a mean of (28.3). The majority of our sample had a high level of education; university (65.1%), High school (26%) and less than high school (6%). Our population believed that gecko and its saliva were the commonest cause (38.1%). Most of the respondents (44.4%) thought that the condition is exaggerated by stress and anxiety. Regarding attitude; (31.5%) are unwilling to marry a vitiligo patient. Conclusion:The results of the present study show that the misconceptions and attitudes toward vitiligo are prevalent. Health awareness campaigns should be implanted to educate the people and improve the quality of life of the affected individuals
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Epigenetics involved in multiple normal cellular processes. Previous research have revealed the role of hepatitis C virus infection in accelerating methylation process and affecting response to treatment in chronic hepatitis patients. This work aimed to elucidate the role of promoter methylation (PM) in response to antiviral therapy, and its contribution to the development of fibrosis through hepatocarcinogenesis-related genes. A total of 159 chronic hepatitis Egyptian patients versus 100 healthy control group were included. The methylation profile of a panel 9 genes (SFRP1, p14, p73, APC, DAPK, RASSF1A, LINE1, O6MGMT, and p16) was detected in patients’ plasma using methylation-specific polymerase chain reaction (MSP). Clinical and laboratory findings were gathered for patients with combined pegylated interferon and ribavirin antiviral therapy. Regarding the patients’ response to antiviral therapy, the percentage of non-responders for APC, O6MGMT, RASSF1A, SFRP1, and p16 methylated genes were significantly higher versus responders (P<0.05). Of the 159 included patients, the most frequent methylated genes were SFRP1 (102/159), followed by p16 (100/159), RASSF1A (98/159), then LINE1 (81/159), P73 (81/159), APC (78/159), DAPK (66/159), O6MGMT (66/159), and p14 (54/159). A total of 67/98 (68.4%) cases of RASSF1A methylated gene (P=0.0.024), and 62/100 (62%) cases of P16 methylated gene (P=0.03) were associated with mild-degree fibrosis. To recapitulate, the PM of SFRP1, APC, RASSF1A, O6MGMT, and p16 genes increases in chronic hepatitis C patients, and can affect patients’ response to antiviral therapy. The RASSF1A and P16 genes might have a role in the distinction between mild and marked fibrosis.
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In this review we supply information on medical methods for thoraco-lumbar spine fracture management, their efficiency and complication rates, based on previously published researches and also give background information on epidemiology and classification of thoraco-lumbar fractures. We conducted a narrative review over the literature using electronic databases as; MEDLINE, and EMBASE for studies involving data on Dorso-lumbar Spine traumatic injuries, published in September 2019. Spine fractures account for a large portion of musculoskeletal injuries worldwide. A classification of back cracks is essential in order to establish a typical language for therapy indicators and results. Clinical exam, mechanism of injury, and imaging are heavily trusted to choose regarding medical versus non-surgical management.
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Background: Honey bee venom is an important toxin which has various useful properties. Bee venom possesses various peptides including melittin, apamin, adolapamin and mast cell degranulating peptide. It appears to stimulate cortisone secretion, enhances antibody production, and affects cytokine production
Aim: The aim of the work is to study changes in levels of complement system proteins, C3 and C4, together with C-reactive proteins and rheumatoid factors [CRP and RF] in response to bee venom in subjects exposed naturally to sting with honey bee workers
Subjects and Methods: Subjects [12] were randomly selected from patients visiting El-Mostafa bee house, Elmarg, Cairo, Egypt; to get natural bee venom therapy for various diseases. Blood samples [24] were collected from these volunteers, before and after honey bee sting, at the laboratory of Egypt Air Hospital, Cairo, Egypt following the standard protocol. Serum levels of C3 and C4 were measured by radial immunodiffusion technique. CRP was quantitatively measured by in vitro diagnostic test using auto analyzer [Dimension® EXEL] clinical chemistry system. Serum RF was measured by Rapid latex agglutination test for qualitative screening
Result: After exposure of patients to bee sting: all abnormal levels of C3 returned to normal values while abnormal C4 levels did not change; Half of cases that were showing abnormal high CRP levels have dropped to normal levels and All RF positive cases have become negative
Conclusion: The complement system has been activated, in patients, by both classical and alternative pathways before treatment with bee venom where it became only classically activated after treatment. Improved values of both CRP and RF indicate reduction in the inflammatory immune response after exposure of patients to honey bee venom
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Background: area strain [AS] has become a parameter of increasing concern. AS is a parameter that combines both the longitudinal and the circumferential deformations and it is acquired using three dimensional speckle tracking echocardiography [3D STE]. This parameter should be used to detect pathological changes as it is more sensitive than the conventional parameters in evaluating left ventricular [LV] systolic function
Aim: the present study aimed to estimate the maximum normal systolic reference value of Area Strain in a sample of healthy subjects
Subjects and Methods: the study conducted 180 healthy subjects [33.4+/-9.7yrs, 94.4% males, 5.6% females]. The subjects were volunteers without heart-related diseases or other diseases .They were classified into three different age groups : Group I is between the ages of 20-30, Group II is between the ages of 30-40 and Group III is between the ages of 40-50
Results: the study showed that the mean global area strain at group I , group II and group III were -28.40 +/- 2.48% , -28.57 +/- 2.73% and -28.53 +/- 2.81% respectively. The mean maximum systolic global area strain of all the studied subjects was -28.50 +/- 2.66%. The difference between the three groups was statistically insignificant
Conclusion: the study concluded that global area strain obtained from 3D STE may be used clinically as an additional diagnostic method since Area Strain can provide a more global and comprehensive assessment of LV systolic function than traditional parameters
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Background: Trigeminal neuralgia [TN] is a unique disease. The first line of management in TN is medical treatment using antiepileptic drugs, when drugs failed to control the pain or when there is intolerability to them, surgical interventions are then indicated. Percutaneous Trigeminal rhizotomy [PTR] is recommended for elderly patients with higher operative risk factors
Objective: The aim of this work is to review the literature regarding the pathology, methods of investigations, operative techniques, complications of management of trigeminal neuralgia and eventually prognosis, also evaluation of the effectiveness of the radiofrequency percutaneous radiofrequency rhizotomy - for management of trigeminal neuralgia
Patients and Methods: This study included a total of 15 patients with trigeminal neuralgia presented predominantly in females. Female: male 1.7:1 and the mean age was 53 years. They were admitted and managed at the Neurosurgical Department of at Al-Azhar University Hospitals and other private centers between June 2017 and October 2018. Clinical follow-up was obtained in 15 [100%] patients
Results: follow up revealed that 11 patient [73.4 %] had favorable outcome and 4 patient [26.6%] had unfavorable outcome. The mean preoperative visual analogue scale[VAS] was 7.83 [range 7-10]. It dropped immediately postoperative to 2.33 [range 1- 4].], intraoperative complication was noted in 3 cases [18%]
Conclusion: Radiofrequency rhizotomy is the procedure of choice for most patients undergoing first surgical treatments and patients at high risk from general anesthesia [although not necessarily the elderly]
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Background: fractures of the lateral malleolus are the most common type of fracture. Various methods of lateral malleolar fixation have been utilized, all with acceptable results
Aim of the Work: to focus light on important modalities in management of isolated lateral malleolar fracture considering the advantages, the disadvantages and determine different protocol of management regarding the most recent guidelines for this group of patients
Patients and Methods: this study was conducted on twenty patients with fresh isolated lateral malleolar fracture. No or only minimal pain on the medial side was also a prerequisite, safeguarding against a ligamentous SE IV injury of the deltoid ligament. The patients were 4 men and 16 women with a mean age of 36 [22-50] years old
Results: all fractures united within an average time to union of 8.2 weeks. in all patients the average time to full weight bearing was 7.2 weeks. Most of complications were minor and resolved within 21 days
Conclusion: good anatomical reduction is essential for good clinical outcome irrespective of the type of fracture. Nevertheless, if an acceptable reduction cannot be achieved using closed techniques, one should proceed with open reduction and internal fixation without hesitation
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Background: diabetes is well studied in Saudi Arabia; however, there seems to be little research in the area of awareness, education and health care delivery
Objectives: to assess the awareness about diabetes mellitus among attendees of primary health care centers, Makkah, Saudi Arabia
Subjects and Methods: a cross-sectional study was conducted among a representative random sample of adult attendees of primary health care centers [diabetic and non-diabetics], Makkah Al-Mokkaramah, the kingdom of Saudi Arabia during the study period [1-31 November, 2016]. An Arabic self-administered questionnaire was used for data collection. It includes 31 questions with sections of demographic data, community awareness regarding diabetes definition, risk factors, signs and symptoms, and complications community awareness regarding diabetes prevention
Results: the study included 662 adult patients. Approximately one-third of them [32.2%] aged 60 years or more. Females represent 51.1% of them. More than one-fifth of them [21%] were university graduated whereas 6.3% were illiterates. Prevalence of diabetes among the participants was 33.7% and majority of them [97.9%] had family history of diabetes. The most frequent sources were mass media [57.4%], health sector [29.9%] and educational sector [10.6%]. Overall sufficient awareness regarding diabetes mellitus was reported among majority of the participants [91.2%]. Among studied factors, only marital status and income were significantly associated with sufficient awareness
Conclusion: population in Makkah AL-Mokkaramah has enough knowledge of the general knowledge of diabetes regarding risk factors, symptoms, etc. However, they are not very well aware of the diabetes associated secondary complications
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Objectives: It is suggested that a minimum of eight hours of sleep per night is needed for metabolism to work normally. The aim of the study was to determine the association of habitual sleep deprivation and type 2 diabetes mellitus [T2DM]
Methods: We conducted a case-control study comparing patients with T2DM with age and sex matched healthy controls. Standard sleep questionnaires [the Berlin and Epworth Sleepiness Scale] and a weekly diary were used by patients to self-report habitual sleep
Results: A total of 172 diabetics and 188 healthy controls were enrolled in the study. There was a significant difference between T2DM and healthy controls in nocturnal sleep duration [p = 0.033]. There was a significant association between nocturnal sleep duration of fewer than six hours and T2DM [X[2] = 14.0; p = 0.0001]. There was no significant difference in daytime sleepiness and daytime naps between the T2DM and control groups [p = 0.452; p = 0.581, respectively]
Conclusions: A nocturnal sleep duration < 6 hours is associated with T2DM
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Heat shock proteins [HSPs] are molecular chaperones involved in protein folding, stability and turnover, and due to their role in cancer progression, the effect of low power laser irradiation [LPLI] on the expression of HSP70 and HSP90 in Jurkat E6.1 T-lymphocyte leukemia [JELT] cell line was investigated in vitro. JETL cells were irradiated with LPLI at 635nm and 780m wavelengths [energy density 9.174 J/cm[2], and assessed for the expression of HSP70 and HSP90 by flow cytometry after 24, 48 and 72 incubation time periods [ITPs]. At 24 hours ITP post-irradiation, control cultures showed that 10.7% of cells expressed HSP70, while LPLI cultures at 635nm and 780nm manifested a higher expression [32.1and 21.3%, respectively], and the difference was significant [P = 0.05]. However, at 48 hours ITP, the three means were decreased but approximated [5.6, 4.9 and 6.2%, respectively], while at 72 hours ITP, they were markedly increased [45.2, 76.5 and 66.7%, respectively]. In contrast, HSP90 responded differently to LPLI. At 24 hours ITP, control cultures and 780nm cultures showed a similar expression [55.9 and 55.9%, respectively], but both means were significantly higher than that of 635nm cultures [24.0%]. No such difference was observed at 48 hours ITP, and at 72 hours ITP, control cultures and 635nm cultures shared approximated means [31.7 and 35.6%, respectively]; but both means were significantly higher than the observed mean in 780nm cultures [15.2%]. The results highlighted that HSP70 and HSP90 expression responded differently to LPLI in JETL cells; an observation that may pave the way for further investigations in malignant cells
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Humains , Mâle , Protéines du choc thermique HSP70/effets des radiations , Protéines du choc thermique HSP90/effets des radiations , Photothérapie de faible intensité , Cellules Jurkat , Leucémie lymphoïde , Leucémies , Lymphocytes T , Lignée cellulaireRÉSUMÉ
Assessment of left ventricular function and volumes provides valuable information in patients with heart disease. It is also considered a prognostic marker in coronary artery disease. Two- dimensional transthoracic echocardiography is the most widely used method for Left Ventricular function assessment, but this modality is operator dependent and can be impaired by a poor acoustic window. To validate a single tertiary center experience in Multi Detector Computed Tomography for the evaluation of cardiac function in patients undergoing coronary CT angiography. A cross sectional study, conducted at Ibn Albitar center from September 2012 till May 2013. Patients included are those who already underwent 64-slice CT coronary angiography to evaluate known or suspected coronary artery disease, CT coronary angiography is performed using a 64- slice Multi Detector CT-scanner. Transthoracic Echocardiography was done by a single operator served as the reference standard. Eighty patients [66.3% male] were included in the study, the mean age was 53.19 +/- 10.6 years. The mean Left ventricular End Diastolic Volume by Cardiac CT and Echocardiography were 125.31 +/- 41.92, 126.75 +/- 41.894 ml respectively, with excellent correlation [r =0.912; P< 0.001]. Average Left ventricular End Systolic Volume [LVESV] by Cardiac CT and Echocardiography were 58.08 +/- 34.18, 53.74 +/- 33.15 mL respectively
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Humains , Mâle , Femelle , Études transversales , Tests de la fonction cardiaque , Coronarographie , Échocardiographie , Tomodensitométrie multidétecteursRÉSUMÉ
To assess the clinical care of type 2 diabetes mellitus [T2D] patients at Sultan Qaboos University Hospital [SQUH], a countrywide tertiary referral center in Muscat, Oman. We performed a retrospective, observational, cross-sectional study using a total of 673 Omani T2D patients from the Diabetes and Family Medicine Clinics at SQUH. We collected patient data from June 2010 to February 2012 from the Hospital Information System [HIS]. Patients had to be Omani, aged more than 18 years old, and have T2D with active follow-up and at least three visits within one year to be included in the study. Ninety-three percent of the patients [n=622] were on oral hypoglycemic drugs and/or insulin, and 70% were on statins. Patients' anthropometric data, biochemical investigations, blood pressure, and duration of diabetes were recorded from the HIS. Using the recommended standards and guidelines of medical care in diabetes [American Diabetes Association and the American National Cholesterol Education Program III NCDP NIII standards], we observed that 22% of the patients achieved a HbA1C goal of <7%, 47% achieved blood pressure goal of <140/80 mm Hg, 48% achieved serum low density lipoprotein cholesterol goal of <2.6 mmol/L, 67% achieved serum triglycerides goal of <1.7 mmol/L, 59% of males and 43% of females achieved high density lipoprotein cholesterol goals [males>1.0; females >1.3 mmol/L]. Almost 60% of the patients had urinary microalbumin/creatinine ratio within the normal range. The clinical outcomes of the care that T2D patients get at SQUH were lower than those reported in Europe and North America. However, it is similar to those reported in other countries in the Arabian Gulf
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Humains , Mâle , Femelle , Qualité des soins de santé , Établissements de soins ambulatoires , Hôpitaux universitaires , Études rétrospectives , Études transversalesRÉSUMÉ
The aim of this study was to screen Omani individuals for the familial aggregation of type 2 diabetes mellitus. A random cohort of 1182 Omani individuals visiting the Family Medicine Clinic at Sultan Qaboos University Hospital [SQUH], Muscat, Oman, for regular medical checkup, aged >/= 40 years, were sampled. Patients were categorized into three groups: [1] individuals who claim not to have diabetes and had no family history of diabetes; [2] individuals who claim not to have diabetes but had family history of diabetes; [3] individuals with diabetes. Only 16% of these Omani individuals had no diabetes and no family history of diabetes. Another separate random cohort of 234 Omani type 2 diabetes mellitus patients, from the Diabetes Clinic at SQUH, were interviewed and questioned about their family history of type 2 diabetes mellitus. Ninety five percent of the patients had a family history of diabetes. Eighty percent had first degree relatives with diabetes and 46% had second degree relatives with diabetes. At least one parent with diabetes was reported among 55% of these diabetics, while maternal diabetes [55%] was found to be higher than paternal diabetes [47%]. However, only 15% had both parents with diabetes. Furthermore, almost half of the 234 diabetics were having at least one of the following relatives with diabetes: brother, sister, aunt or an uncle. The findings of this study confirm familial aggregation of diabetes among the Omani population. Compared to other populations, familial aggregation of type 2 diabetes mellitus among Omanis is relatively very high, and is perhaps due to the very high degree of consanguinity among Omanis. Since almost everyone seems to have a genetic predisposition to diabetes, the dramatic lifestyle changes over the past 25 years, could tip the population into an epidemic of type 2 diabetes mellitus
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Humains , Femelle , Mâle , Famille , Analyse de regroupementsRÉSUMÉ
Carpal tunnel syndrome [CTS] is a disorder of the hand which results from compression of the median nerve within its fibro-osseous tunnel at the wrist. The slowing in the forearm motor conduction velocity suggests the presence of retrograde degeneration. Existing studies conflict regarding a correlation between the seventies of the entrapment neuropathy in CTS and slowing of median motor nerve conduction velocity in the forearm. The objective of this work was to study retrograde degeneration [RGD] of the median nerve forearm segment in patients with CTS and its relation to variable severity of CTS in Egyptian patients. Twenty-four patients with CTS were included in this study. The Forearm mixed nerve conduction is presumed to be indicative of the conduction of the median nerve over the forearm and is used widely to assess causes of slowing forearm conduction velocity in CTS. In addition to conventional nerve conduction studies of the upper limb, forearm median mixed conduction studies were performed Median motor forearm amplitudes and nerve
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Sacrococcygeal teratoma is one of the most common tumours affecting newborns and infants. Currently, a diagnosis is most likely to be made in the prenatal period during routine ultrasonography examination. Delay in diagnosis and treatment may lead to the development of complications, fetal loss and increased perinatal mortality. This case report investigates rupture of the tumour at birth, one of the complications of Sacrococcygeal teratoma. The baby in this case survived and showed a good postoperative recovery
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The goal of this study was to determine the association of complete left bundle branch block [LBBB], site, severity and risk factors of coronary artery disease [CAD]. Complete Left bundle branch block increases the risk of cardiac mortality, and prognosis is primarily determined by the underlying CAD. Because the presence of complete LBBB makes the noninvasive identification of CAD less informative, patients with complete LBBB often are referred for coronary angiography to assess the presence and severity of CAD. A total of 150 consecutive patients with complete LBBB admitted to the coronary care unit were enrolled from the age of 27 to 81 years with the mean age of 59.32 +/- 10.5. Male 84 [56%], Female [44%]. History, basal investigations echocardiography and virology screen were performed. Coronary angiography has been done for all patients for different reasons of presentation. Critical CAD 70 [46.7%], Left ventricular systolic dysfunction [LVSD] 50 [33.3%]. Hypertension found in 83 [55.3%], diabetes mellitus [DM] in 44 [30%], DMand left ventricular systolic dysfunction[LVSD] were more associated with critical CAD. In our study complete LBBB was more common among hypertensive patients. In DM patients was associated with severe CAD. With Left anterior descending artery being the most common artery involved