Molecular characterization of clinical carbapenem-resistant Enterobacterales from Qatar.

One hundred forty-nine carbapenem-resistant Enterobacterales from clinical samples obtained between April 2014 and November 2017 were subjected to whole genome sequencing and multi-locus sequence typing. Klebsiella pneumoniae (81, 54.4%) and Escherichia coli (38, 25.5%) were the most common species. Genes encoding metallo-ß-lactamases were detected in 68 (45.8%) isolates, and OXA-48-like enzymes in 60 (40.3%). blaNDM-1 (45; 30.2%) and blaOXA-48 (29; 19.5%) were the most frequent. KPC-encoding genes were identified in 5 (3.6%) isolates. Most common sequence types were E. coli ST410 (8; 21.1%) and ST38 (7; 18.4%), and K. pneumoniae ST147 (13; 16%) and ST231 (7; 8.6%).

Potential effect of the medicinal plants Calotropis procera, Ficus elastica and Zingiber officinale against Schistosoma mansoni in mice.

CONTEXT: Calotropis procera (Ait.) R. Br. (Asclepiadaceae), Ficus elastica Roxb. (Moraceae) and Zingiber officinale Roscoe (Zingiberaceae) have been traditionally used to treat many diseases. OBJECTIVE: The antischistosomal activity of these plant extracts was evaluated against Schistosoma mansoni. MATERIALS AND METHODS: Male mice exposed to 80 ± 10 cercariae per mouse were divided into two batches. The first was divided into five groups: (I) infected untreated, while groups from (II-V) were treated orally (500 mg/kg for three consecutive days) by aqueous stem latex and flowers of C. procera, latex of F. elastica and ether extract of Z. officinale, respectively. The second batch was divided into four comparable groups (except Z. officinale-treated group) similarly treated as the first batch in addition to the antacid ranitidine (30 mg/kg) 1 h before extract administration. Safety, worm recovery, tissues egg load and oogram pattern were assessed. RESULTS: Calotropis procera latex and flower extracts are toxic (50-70% mortality) even in a small dose (250 mg/kg) before washing off their toxic rubber. Zingiber officinale extract insignificantly decrease (7.26%) S. mansoni worms. When toxic rubber was washed off and ranitidine was used, C. procera (stem latex and flowers) and F. elastica extracts revealed significant S. mansoni worm reductions by 45.31, 53.7 and 16.71%, respectively. Moreover, C. procera extracts produced significant reductions in tissue egg load (∼34-38.5%) and positively affected oogram pattern. CONCLUSION: The present study may be useful to supplement information with regard to C. procera and F. elastica antischistosomal activity and provide a basis for further experimental trials.

Antioxidant and cytotoxic flavonols from Calotropis procera.

Phytochemical investigations of Calotropis procera leaves have led to the isolation of two new compounds: quercetagetin-6-methyl ether 3-O-beta-D-4C1-galacturonopyranoside (3) and (E)-3-(4-methoxyphenyl-2-O-beta-D-4C1 -glucopyranoside)-methyl propenoate (4), along with eleven known metabolites: nine flavonol and two cinnamic acid derivatives. All metabolites were isolated for the first time from the genus Calotropis, except for 1 isolated previously from Calotropis gigantea. The structures were determined by spectroscopic methods (UV, ESI-MS, 1H, 13C NMR, 1H-1H COSY, HSQC, and HMBC). The radical scavenging activity of the aqueous methanol extract and compounds 8-13 was measured by the 1,1-diphenyl-2-picrylhydrazyl (DPPH) method. Cytotoxic screening of the same compounds was carried out on brine shrimps as well.

Obscure pathology of pulled elbow: dynamic high-resolution ultrasound-assisted classification.

AIM: Pulled elbow or nursemaid's elbow is a radial head subluxation caused by a sudden pull on the extended pronated forearm. Children with pulled elbow usually respond dramatically for reduction, yet others show delayed improvement with no clear pathologic explanation. The aim of our study is to propose an explanation for the varying clinical response after the reduction of pulled elbow aided by ultrasound classification of the underlying pathology and its impact on management. PATIENTS AND METHODS: Fifty children with a mean age of 3.8 ± 1.1 (standard deviation [SD]) years with pulled elbow were scanned by static and dynamic ultrasound utilizing the other elbow as the standard. The radial annular ligament (RAL) was examined for integrity and interposition, with measurement of the radiocapitellar distance. Reduction was performed following the hyperpronation technique, and postreduction splinting was guided by ultrasound findings. Postreduction scans and 1-year follow up were performed. RESULTS: Of the 50 included children, 39 (78%) had intact, yet interposed annular ligament (classified as type I) and 11 (22%) had torn annular ligament (classified as type II). The latter underwent splinting for 7 days. Three out of the 50 children had recurrent subluxation and constituted false-negative cases for the detection of torn ligament and represented the reoccurrence rate of 6%. The sensitivity, specificity, and accuracy for the ultrasound diagnosis of torn RAL were 76.9, 92.3, and 92%, respectively. CONCLUSION: PULLED ELBOW IS CLASSIFIED AS FOLLOWS: type I, with an interposed RAL, and type II, with torn ligament.

New triterpene saponins from Duranta repens Linn. and their cytotoxic activity.

From the leaves of Duranta repens (Verbenaceae) two new triterpene saponins, named durantanin IV (1) and V (2)were isolated.In addition, ten known compounds were isolated, namely a bidesmosidic saponin, oleanolic acid, three phenylethanoids and five flavonoids. All metabolites were isolated for the first time from this genus except for 3 (oleanolic acid) and 7 (E/Z acteoside). The structures were determined mainly by spectroscopic methods (UV, IR, HRESI-MS, (1)H-, (13)C-NMR, (1)H-(1)H COSY, HSQC and HMBC). Cytotoxic screening of the chloroform, ethyl acetate and methanol extracts was carried out on brine shrimps. In addition, the investigated methanol extract and compounds 1, 2 and 7 showed significant cytotoxic activity against a HepG2 cell line.