Evaluation of Extended-Spectrum Beta-Lactamase Resistance in Uropathogenic Escherichia coli Isolates from Urinary Tract Infection Patients in Al-Baha, Saudi Arabia.

Urinary tract infections (UTIs) caused by extended-spectrum beta-lactamase (ESBL)-producing organisms are prevalent in both outpatient and inpatient settings, representing the most often encountered forms of infection. This research aimed to estimate the prevalence of ESBL-UTIs along with other uropathogens in the adult population and to assess the antibiotic activity against Escherichia coli extended-spectrum beta-lactamase (E. coli ESBL) isolates from patient samples in Al-Baha. A retrospective cross-sectional study included patients who presented to King Fahad Hospital in Al-Baha with clinical suspicion of UTI between 1 January 2019 and 30 September 2022. A total of 4406 urine samples with significant microbial growth were included in the scope of this investigation. A collective count of 1644 incidents of Escherichia coli (E. coli) was observed, wherein E. coli constituted 85% of the cases, while the remaining 15% comprised E. coli ESBL producers. The prevalence of E. coli ESBL was observed to be 64.7% in females and 35.3% in males, with a majority (67%) of the affected individuals being over the age of 50. The incidence of E. coli infections in the outpatient setting was found to be greater than that observed in the inpatient setting. E. coli ESBL were sensitive to colistin, tigecycline, amikacin, meropenem, imipenem, and nitrofurantoin by 100% and 93.3-100%, 95-99.6%, 95-99.06%, and 81-91%, respectively. On the other hand, the most resistant agents for E. coli ESBL were the group of cephalosporins, aztreonam, and ampicillin with 100% resistance, ciprofloxacin with 56-74% resistance, and cotrimoxazole with a 45-53% resistance level. ESBL-resistant E. coli strains are moderately prevalent in community- and hospital-acquired UTIs, especially in females and elderly patients (>50 years).

Valorization of bio-colorants extracted from Hypercium scabrum L. plant for sustainable and ecological coloration of wool yarns.

Recently, natural dyes are being explored all over the world as safer and highly sustainable bio-based alternatives to synthetic dyes. Agricultural wastes and plant by-products are the most commonly explored alternatives with dual benefits of waste reclamation and sustainable dye production with extra value-adds. Hypercium scabrum plant contains interesting bio-dye molecules with high flavonoids and tannin contents. The present study aims at exploring the potential of H. scabrum plant extract to color wool textiles with a focus on sustainable bio-dye production and fastness properties. The extracted bio-dye was quantitatively (for total phenolic (2.733 mg per CE/g) and total flavonoid (1.140 mg per GAE/g) content using the Folin-Ciocalteu method) and qualitatively (UV-Vis, FT-IR, and EDX) characterized. The effect of dyeing parameters like pH (2-8), temperature (60-90 °C), dry-weight content of plant material as a dye (25-150% o.w.f.), and dyeing time (15-120 min) on color strength (K/S) values were assessed. Color fastness assays showed good resistance to light, washing, and rubbing. The effect of artificial aging (Xenon arc lamp) on the color strength of dyed wool yarns under different exposure times (0-48 h) was explored. The highest color fading occurred in control dyed samples with a first-order rate constant of 131.57 h-1 and a half-life period of 5.26 x 10-3 h. Color difference (ΔE) values suggested that mordanted samples showed less fading compared to control dyed samples at equal times of Xenon exposure. Additionally, the dyed samples were washed in double distilled water, tap water, and 4 g/L NaCl solution to check their effects on the corresponding K/S values while 4 g/L NaCl solution mimics the real conditions of perspiration. Maximum color leaching occurred in 4 g/L NaCl washing with a first-order rate constant of 11.57 min-1. Cost analysis of the dye extraction and dyeing procedure revealed that the process is sustainable and economical. Thus, the use of H. scabrum whole plant can provide a clean, economical, and sustainable source of alternative natural dyes that can be used to substitute synthetic analogs.

Fewer re-admissions and bed days following an intensive transitional post-discharge aftercare programme for a mixed diagnostic group of patients.

BACKGROUND: The organization of aftercare is important for a successful outcome; still the optimal organization has not been fully explored. An intensive transitional post-discharge aftercare (TA) programme, for a mixed group of non-psychotic patients, was recently developed. Patients with non-psychotic diagnoses are often discharged with low well-being while still symptomatic, placing high demands on aftercare. AIMS: To evaluate retrospectively the short and long-term mental healthcare service use during and after the TA programme compared with the service use of a retrospective comparison group (RC), receiving less intensive outpatient aftercare. METHODS: Number of re-admissions, bed days and emergency visits after 10 weeks, 6 months and 1 year was retrospectively collected from electronic patient registers. Descriptive statistics, independent samples T-tests and repeated-measures analysis of variance was used to compare the groups. RESULTS: The majority of patients in both groups suffered from affective disorders, followed by personality disorders and a small number of other psychiatric diagnoses. Service use in the TA group was lower than in the RC group with fewer bed days after 10 weeks (P = 0.01) and after 6 months (P = 0.003), and fewer re-admissions after 6-12 months (P = 0.04). Emergency contacts did not differ significantly between the two groups at any point. CONCLUSIONS: The present study indicates beneficial effects of intensive TA, for a mixed group of non-psychotic patients. The lower service use in the TA programme group is in line with day treatment programme research for patients with affective disorders.

Nucleic acid amplification tests (NAATs) for gonorrhoea diagnosis in women: experience of a tertiary care hospital in north India.

BACKGROUND & OBJECTIVES: Gonorrhoea is among the most frequent of the estimated bacterial sexually transmitted infections (STIs) and has significant health implications in women. The use of nucleic acid amplification tests (NAATs) has been shown to provide enhanced diagnosis of gonorrhoea in female patients. However, it is recommended that an on-going assessment of the test assays should be performed to check for any probable sequence variation occurring in the targeted region. In this study, an in-house PCR targeting opa-gene of Neisseria gonorrhoeae was used in conjunction with 16S ribosomal PCR to determine the presence of gonorrhoea in female patients attending the tertiary care hospitals. METHODS: Endocervical samples collected from 250 female patients with complaints of vaginal or cervical discharge or pain in lower abdomen were tested using opa and 16S ribosomal assay. The samples were also processed by conventional methods. RESULTS: Of the 250 female patients included in the study, only one was positive by conventional methods (microscopy and culture) whereas 17 patients were found to be positive based on PCR results. INTERPRETATION & CONCLUSIONS: The clinical sensitivity of conventional methods for the detection of N. gonorrhoeae in female patients was low. The gonococcal detection rates increased when molecular method was used giving 16 additional positives. Studies should be done to find out other gene targets that may be used in the screening assays to detect the presence of gonorrhoea.

Midline segmental odontomaxillary dysplasia.

Segmental odontomaxillary dysplasia (SOD) is a rare developmental disorder of the maxilla, characterized by variability of its clinical and radiological features and may mimic other fibro-osseous lesions. Clinically, the disorder is often diagnosed in early childhood due to a unilateral buccolingual expansion of the posterior alveolar process, gingival enlargement, absence of one or both premolars in the affected region, delayed eruption of the adjacent teeth, and malformations of the primary molars. We describe a rare case of a SOD in a 19-year-old female comprising findings similar to earlier reports, but for the first time SOD is reported along midline. She presented with pre-maxillary enlargement and abnormal pattern of eruption of anterior maxillary permanent teeth. Radiographic imaging showed abnormal bony trabeculation. Histopathologic findings showed characteristic features of SOD. We herein report a case of this rare unusual anomaly and review the literature. Clinicians should be aware of its presence when encountering patients presenting with facial asymmetry unresponsive to treatment.