Synergistic effect of 2% chlorhexidine combined with proteolytic enzymes on biofilm disruption and killing.

AIM: To investigate the dynamics of a disinfection regimen using 1% trypsin and 1% proteinase K in combination with 2% chlorhexidine (with or without ultrasonics) using a nutrient-stressed endodontic multispecies model biofilm. METHODOLOGY: Nutrient-stressed biofilms (Propionibacterium acnes, Staphylococcus epidermidis, Actinomyces radicidentis, Streptococcus mitis and Enterococcus faecalis OMGS 3202) were grown in prepared root canals of single-rooted teeth. The treatment groups included 1% trypsin and 2% chlorhexidine (CHX), 1% proteinase K and 2% CHX (with and without ultrasonics). 2% CHX was the positive control and untreated group, and sterile saline (with and without ultrasonics) was the negative control. The biofilms were investigated using confocal laser scanning microscopy (CLSM) with live/dead staining and quantitative microbial culture. RESULTS: The trypsin and CHX group with ultrasonics was significantly more effective in reducing viable counts and the substratum coverage than those of all other groups (P < 0.05). The viable counts of the proteinase K and CHX group used with (4.26 ± 0.58 log10  cfu mL(-1) ) or without ultrasonics (5.05 ± 1.36 log10  cfu mL(-1) ) were significantly reduced (P < 0.05) as compared with the untreated control (7.67 ± 0.84 log10  cfu mL(-1) ) and saline groups used with (6.57 ± 0.73 log10  cfu mL(-1) ) and without ultrasonics (6.74 ± 0.10 log10  cfu mL(-1) ). The CHX group was less effective in biofilm disruption compared to when used in combination with trypsin and proteinase K. CONCLUSION: The trypsin and CHX group with ultrasonics was significantly more effective at reducing bacterial viable counts and disrupting biofilm.

In-hospital complications and 1-year outcome of acute coronary syndrome in patients with hypertension: findings from the 2nd Gulf Registry of Acute Cardiac Events.

Using data from the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE-2) in 2008-09 we investigated the in-hospital complications and 1-year outcome of acute coronary syndrome (ACS) in patients with systemic hypertension from 6 Gulf countries. Of 7847 consecutive patients admitted with ACS, 3746 (47.7%) had hypertension. Hypertension was more prevalent in women, in Arabs than non-Arabs and in older age groups. Patients with hypertension were more likely than those without hypertension to present with dyspnoea and advanced Killip class. Among hypertensive patients, the mortality rate was higher only among those admitted with ST-elevation myocardial infarction. After adjustment for baseline variables, hypertension was an independent predictive factor for heart failure (OR = 1.31) and stroke (OR = 2.47). here were no significant differences in mortality in hypertensive ACS patients when stratified by sex, age or ethnicity.

In-hospital complications and 1-year outcome of acute coronary syndrome in patients with hypertension: findings from the 2nd Gulf registry of acute cardiac events

Using data from the 2nd Gulf Registry of Acute Coronary Events [Gulf RACE-2] in 2008-09 we investigated the in-hospital complications and 1-year outcome of acute coronary syndrome [ACS] in patients with systemic hypertension from 6 Gulf countries. Of 7847 consecutive patients admitted with ACS, 3746 [47.7%] had hypertension. Hypertension was more prevalent in women, in Arabs than non-Arabs and in older age groups. Patients with hypertension were more likely than those without hypertension to present with dyspnoea and advanced Killip class. Among hypertensive patients, the mortality rate was higher only among those admitted with ST-elevation myocardial infarction. After adjustment for baseline variables, hypertension was an independent predictive factor for heart failure [OR = 1.31] and stroke [OR = 2.47]. There were no significant differences in mortality in hypertensive ACS patients when stratified by sex, age or ethnicity

Composition of Casuarina leaf litter and its influence on Frankia-Casuarina symbiosis in soil.

Plant needles of Casuarina equisetifolia were collected and analyzed in parallel with soil analysis. In three strains of Frankia--symbionts of Casuarina--their infectivity and plant performance was determined in vitro after soil amendment with different leaf litter concentrations. Only one strain was able to nodulate the plant at all litter concentrations (0.5, 3 and 5%) although the nodules were very small. However, all treated plants grew poorly; their growth was reduced by approximately 90% (for 5% litter concentration) compared to plants grown on untreated soil, on the basis of total dry mass. Inhibition of nodulation can be attributed to high concentrations of some elements and compounds that were either found in C. equisetifolia litter or originally found in soil (i.e. chloride, cyanide, copper, manganese and phenols). In general, plant growth decreased as more litter was added. Plant total nitrogen content was also reduced after increasing the litter concentration. The inhibitory effect of high litter concentrations was mainly on plant growth and to a lesser extent on plant nodulation by Frankia strains.

The establishment and practice of forensic medicine in Iraq.

The development of a legal curriculum in Iraq included the subject of forensic medicine. In 1972 the College of Medicine in Baghdad included teaching in forensic medicine, and this has continued as the six current medical schools were established in the country. A central Medical Laboratory was established in 1918 and in 1919 a medicolegal department was included. An autopsy service was added to this department in 1920. After several changes the current activities are under the direction of the Ministry of the Interior. Professor A. I. Kayssi was the first active practitioner of forensic medicine in Iraq and he has been succeeded by Dr. W. M. Ali, who was a student and colleague. Each Province of Iraq has Medicolegal Centers whose Directors confer with the Central Institute of Baghdad. This Institute has responsibility for investigation of deaths and the examination of the living involved in sexual attacks or identification problems. The autopsy rate is 2784 per year in this institute. Iraq has 10.5 million people in an area smaller than the state of Texas. Baghdad, the largest city has less than 2 million.