Sensitizing multi drug resistant Staphylococcus aureus isolated from surgical site infections to antimicrobials by efflux pump inhibitors

Background: Staphylococcus aureus is a common hospital acquired infections pathogen. Multidrug-resistant Methicillin-resistant Staphylococcus aureus represents a major problem in Egyptian hospitals. The over-expression of efflux pumps is a main cause of multidrug resistance. The discovery of efflux pump inhibitors may help fight multidrug resistance by sensitizing bacteria to antibiotics. This study aimed to investigate the role of efflux pumps in multidrug resistance. Methods: Twenty multidrug resistant S. aureus isolates were selected. Efflux pumps were screened by ethidium bromide agar cartwheel method and polymerase chain reaction. The efflux pump inhibition by seven agents was tested by ethidium bromide agar cartwheel method and the effect on sensitivity to selected antimicrobials was investigated by broth microdilution method. Results: Seventy percent of isolates showed strong efflux activity, while 30% showed intermediate activity. The efflux genes mdeA, norB, norC, norA and sepA were found to play the major role in efflux, while genes mepA, smr and qacA/B had a minor role. Verapamil and metformin showed significant efflux inhibition and increased the sensitivity to tested antimicrobials, while vildagliptin, atorvastatin, domperidone, mebeverine and nifuroxazide showed no effect. Conclusion: Efflux pumps are involved in multidrug resistance in Staphylococcus aureus. Efflux pump inhibitors could increase the sensitivity to antimicrobials

Vitamin D status, receptor gene BsmI (A/G) polymorphism and breast cancer in a group of Egyptian females

Background: Vitamin D is involved in a wide variety of biological processes including bone metabolism, modulation of the immune response, and regulation of cell proliferation and differentiation. The present study aimed to investigate vitamin D status and the genetic polymorphism BsmI (A/G) of vitamin D receptor (VDR) among a group of Egyptian female patients with breast cancer.Methods: The current study included 60 female patients diagnosed as breast cancer (BC) attending Mansoura Oncology Center, Mansoura University, and 60 age-matched healthy control females. Serum 25(OH) vitamin D level was measured using Enzyme-linked immunosorbent assay (ELISA) kit. A polymerase chain reaction-based restriction fragment length polymorphism (PCR-RFLP) method and fragment analysis were performed to determine the VDR BsmI (A/G) polymorphism.Results: 25(OH) vitamin D levels were significantly lower in the patients with BC (22.1 ± 10.9 ng/ml) compared to controls (41.2 ± 11.22 ng/ml) (p 6 0.001). Vitamin D deficiency- insufficiency was reported in 76.7% of BC patients and 20% of the controls (P 6 0.001, OR = 13.1, 95%CI = 5.5 31.4). Bb genotype was statistically higher in the BC patients than in the healthy controls (P 6 0.001). 81.2% of BC patients were of Bb genotype, 10.9% of BB genotype and 4.3% of bb genotype, while in controls, 33.3% for each genotype. No statistically significant difference in allele frequency was observed between the two studied groups. Carriers of Bb genotype had 4.6 times increased risk of developing breast cancer (95% confidence interval of 2.0–10.3) when compared to other genotypes.Conclusion: A significant association exists between vitamin D deficiency and the risk of breast cancer. B allele or Bb genotype of VDR may be a susceptibility risk factor for BC development

MODIFICATION AND PERFORMANCE OF DEVICE FOR TESTING THE DIESEL ENGINE INJECTOR

iesel engine, but most of it is operating manually, maintenance and repair centers mostly have used the manually device which depended on the hand of operator to operate it therefore there are inaccuracies in tests. The injector tester device was modified from manual operation to mechanical operation to achieve the uniformity of the injection pressure during the injector test, install of reading, save time and accuracy of testing. Injector tester before the modification was consisted of small fuel tank, pump, pressure gauge, handle pumping and connecting tube. The injector tester device after the modification was consisted of main frame, fuel tank, injection unit, power transmission and measuring table.  From the experiments the fuel consumption was increased with injector tester device before modification than device after modification that with three different injectors due to the regularity of the motion in the mechanical device, but the manual device that is dependent on operator and the irregularity of motion which cause irregularity of pressure. Also, the fuel consumption was decreased with injectors' faults. This is indicating of accuracy reading pressure with the modified devices compared with the device before modified. The results indicated for the important factors which effect on the regularity of injection pressure during the injector testing. The injection pressure for modifying tester device was 175 bar and fuel consumption was 0.73 L/h. The injection pressure  and fuel consumption for tester device before modification were 210 bar and 4.73 L/h respectively. The rate of reducing can be concluded by using the modified tester device for the injection pressure was 1:0.83 and for fuel consumption was 1:0.155 as compared with the manual tester

PROTECTIVE EFFECT OF SOME CHELATING AGENTS AND ANTIOXIDANTS ON THE BIOHAZARDS PRODUCED FROM WATER POLLUTION BY HEAVY METALS IN WISTAR RATS: BIOLOGICAL, GENETIC AND HISTOPATHOLOGICAL STUDY

Background: Heavy metals that normally cause problems are mercury (HgCl2) and lead acetate (LA). Chelating and inhibitor agents are the target to treat and overcome metal toxicity. The current study has been carried out to evaluate the protective effects of N-acetyl cysteine (NAC) and meso 2,3 dimercaptosuccinic acid (DMSA) against HgCl2 and LA toxicity. Materials and Methods: Ninety male Wistar rats were divided into nine equal groups. The groups were administered NAC and/or DMSA in presence or absence of LA (LA; 0.2% in drinking water) or HgCl2 (2 mg/kg BW) for 2 consecutive months. Serum and organs were collected for biochemical, genetic and histopathological changes. Results: Biochemical results revealed that LA and HgCl2 significantly increased the levels of liver and kidney biomarkers. Administration of NAC and DMSA considerably improved these altered changes. LA and HgCl2 decreased serum levels of antioxidants and were ameliorated in NAC and DMSA administered rats. LA and HgCl2 administration upregulated expression of IL-1β and IL-8 that were normalized by NAC and DMSA. Kidneys of LA and HgCl2 groups showed intraluminal hyaline casts. Kidneys of DMSA-administrated rats showed mild hydropic degeneration of renal tubular epithelium in LA and HgCl2 groups. Kidneys of NAC administrated rats showed atrophy of capillary tufts. Kidneys of LA and HgCl2 administered rats which received DMSA and NAC showed normal glomerular structure. Liver histopathology showed sever changes that were ameliorated by NAC and DMSA. Conclusion: Taken together, usage of NAC and DMSA provide significant protection against LA and HgCl2-induced hepatotoxicity and nephrotoxicity in male Wistar rats

Helicobacter pylori infection might be responsible for the interconnection between type 1 diabetes and autoimmune thyroiditis

<p>Abstract</p> <p>Background</p> <p>Higher serological prevalence rates of helicobacter pylori (H. pylori) infection have been reported in patients with type 1 diabetes (T1DM) and autoimmune thyroiditis (AT). Patients with T1DM are at increased risk for developing other autoimmune diseases, most commonly AT. It is unknown whether H. pylori infection could explain the high prevalence of thyroid autoantibodies and AT in T1DM. The aim of the current study was to evaluate anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-Tg) autoantibodies in correlation with anti-H. pylori IgG and IgA in young patients with T1DM.</p> <p>Methods</p> <p>Anti-H. Pylori IgG, IgA, anti-TPO and anti-Tg antibodies titers were measured in 162 euthyroid patients with T1DM and 80 healthy controls matched for age, sex and socioeconomic status.</p> <p>Results</p> <p>Seroprevalence of H. pylori was significantly higher in patients with T1DM than in healthy controls; 79% vs. 51.2%, p < 0.001. Anti H. pylori IgG was positive in 61.1% of patients with T1DM and 30% of controls, p < 0.001, anti H. pylori IgA was positive in 74% of patients with T1DM and 32.5% of controls, p < 0.001. Thyroid autoimmunity was also significantly higher in patients with T1DM than in controls; 56.7% vs. 6.2%, p < 0.001. Anti-TPO was positive in 25.3% of patients with T1DM and 3.7% of controls, p < 0.001, anti-Tg was positive in 47.5% of patients with T1DM and 6.2% of controls, p < 0.001. With simple and multiple regression analysis anti-H. pylori IgG and IgA titers were positively and significantly correlated with Anti-TPO and anti-Tg titers in patients with T1DM.</p> <p>Conclusion</p> <p>our results support the idea of a connection between H. pylori infection and the occurrence of anti-TPO, anti-Tg autoantibodies and AT in young patients with T1DM. So, H. pylori infection could be considered as an environmental trigger for development of AT in T1DM. Young patients with T1DM should be screened for H. pylori infection.</p

Elevated serum neutrophil elastase is related to prehypertension and airflow limitation in obese women

<p>Abstract</p> <p>Background</p> <p>Neutrophil elastase level/activity is elevated in a variety of diseases such as atherosclerosis, systolic hypertension and obstructive pulmonary disease. It is unknown whether obese individuals with prehypertension also have elevated neutrophil elastase, and if so, whether it has a deleterious effect on pulmonary function. Objectives: To determine neutrophil elastase levels in obese prehypertensive women and investigate correlations with pulmonary function tests.</p> <p>Methods</p> <p>Thirty obese prehypertensive women were compared with 30 obese normotensive subjects and 30 healthy controls. The study groups were matched for age. Measurements: The following were determined: body mass index, waist circumference, blood pressure, lipid profile, high sensitivity C-reactive protein, serum neutrophil elastase, and pulmonary function tests including forced expiratory volume in one second (FEV₁), forced vital capacity (FVC) and FEV₁/FVC ratio.</p> <p>Results</p> <p>Serum neutrophil elastase concentration was significantly higher in both prehypertensive (405.8 ± 111.6 ng/ml) and normotensive (336.5 ± 81.5 ng/ml) obese women than in control non-obese women (243.9 ± 23.9 ng/ml); the level was significantly higher in the prehypertensive than the normotensive obese women. FEV1, FVC and FEV1/FVC ratio in both prehypertensive and normotensive obese women were significantly lower than in normal controls, but there was no statistically significant difference between the prehypertensive and normotensive obese women. In prehypertensive obese women, there were significant positive correlations between neutrophil elastase and body mass index, waist circumference, systolic blood pressure, diastolic blood pressure, total cholesterol, triglyceride, low density lipoprotein cholesterol, high sensitivity C-reactive protein and negative correlations with high density lipoprotein cholesterol, FEV1, FVC and FEV1/FVC.</p> <p>Conclusion</p> <p>Neutrophil elastase concentration is elevated in obese prehypertensive women along with an increase in high sensitivity C-reactive protein which may account for dyslipidemia and airflow dysfunction in the present study population.</p

PREVALENCE OF INTESTINAL PARASITISM AND ASSOCIATED SYMPTOMATOLOGY AMONG HEMODIALYSIS PATIENTS

Intestinal parasites are an important cause of morbidity and mortality. Immunocompromised individuals may develop more severe forms of these infections. Taking into account the immunity impairment in patients suffering from chronic renal failure (CRF), we will determine the prevalence and associated symptoms of intestinal parasites in these patients. Controls without CRF were used for comparison. Stool samples were collected and processed for microscopic identification of parasites using the Formalin-ether concentration method. For Cryptosporidium diagnosis, the ELISA technique was used. One hundred and ten fecal samples from hemodialysis patients were analyzed, as well as 86 from a community group used as control group. A result of 51.6% of intestinal parasites was observed in hemodialysis patients and 61.6% in the control group. Cryptosporidium and Blastocystis were the most common infections in patients with CRF (26.4% and 24.5%, respectively). Blastocystis was the most common infection in the control group (41.9%), however no individual was found positive for Cryptosporidium. Among the CRF patients, 73.6% were symptomatic, 54.3% of these tested positive for at least one parasite, in contrast to 44.8% in asymptomatic patients (p = 0.38). The most common symptoms in this group were flatulence (36.4%), asthenia (30.0%) and weight loss (30.0%). In the control group, 91.9% were symptomatic, 60.8% of these tested positive for at least one parasite, in contrast to 71.4% in asymptomatic patients (p = 0.703). A significant difference between the two groups was observed with regard to symptoms, with bloating, postprandial fullness, and abdominal pain being more frequent in the control group than in the hemodialysis group (all p < 0.05). Comparing symptomatic with asymptomatic, there was no association in either group between symptoms or the prevalence of parasitic infection, nor with the type of parasite or with multiple parasitic infections. Patients with chronic renal failure are frequent targets for renal transplantation, which as well as the inherent immunological impairment of the disease itself, results in immunosuppression by medication. For this reason, carriers of intestinal parasites with pathogenic potential can develop serious clinical complications influencing the success of transplantation. This fact, coupled with the high prevalence of intestinal parasites and the dissociation between symptoms and infection in CRF patients, suggests that the stool test should be incorporated in routine propedeutics. Furthermore, preventive measures for the acquisition of parasites through the fecal-oral contamination route should be introduced

Clinical and radiological comparison of a dynamic implant valve vs a hydraulic maxillary sinus lift augmentation technique with simultaneous implant insertion

The study aimed to compare between dynamic implant valve (DIVA) and the crestal ballooning techniques in elevating the maxillary sinus membrane (MSM) in conjunction with simultaneous implantation. Patients and methods: 20-patient prospective clinical cohort study. Ages ranged from 42 to 53 years, and had atrophic edentulous maxillae in the posterior region. To determine maxillary sinus status, patients were investigated utilizing intraoral clinical photographs and CBCT series. &nbsp;Closed Sinus Lifting done and compared between DIVA and ballooning techniques on patients who were randomly separated into two equal groups. The predicted research variables were intraoperative primary stability and level of sinus membrane lift. The main outcome factors were secondary implant Osseointegration stability (ISQ) and the amount of bone height gain. Results: Before surgery, the DIVA and Balloon groups had mean bone heights of 5.8 ± 0.67mm and 6.8 ± 0.86mm , which increased significantly to 12.8± 0.53 and 10.8± 0.67 after 6 months postoperatively. ISQ for DIVA and Balloon groups were 39.0± 2.16 and 40.0±2.16 preoperatively, respectively, and increased to 71.7±1.60 and 70.4±1.27 nine months postoperatively which was significantly higher at 3 months in DIVA group.&nbsp;&nbsp

Synchronous occurrence of primary mucinous carcinoma of recto-sigmoid colon and primary breast Carcinoma: A case report and review of literature

Background: Multiple primary malignant tumors (MPMTs) is simultaneous occurrence of two or more malignancies in different sites with different histopathological type and origin.Diagnosis and management of those patients are challenging due to uncertain guidelines. Case Presentation: A 63-year-old postmenopausal female patient of synchronous MPMTs in which the patient was diagnosed with a malignant mass in recto-sigmoid colon and a synchronous breast cancer was incidentally discovered during clinical and radiological patient evaluation. Treatment: Both colon procedure and breast procedure were performed together in one setting. The anterior resection of the reco-sigmoid mass and colocolonic anastomosis were done. Conclusion: Synchronous colon and breast cancer treatment plan should be individualized for each patient through a complete preoperative evaluation and MDT meeting to provide the best possible treatment for the patient

The Transgene Expression of the Immature Form of the HCV Core Protein (C191) and the LncRNA MEG3 Increases Apoptosis in HepG2 Cells

Long non-coding RNAs (lncRNAs) are regulated in cancer cells, including lncRNA MEG3, which is downregulated in Hepatocellular Carcinoma (HCC). In addition, hepatitis C virus (HCV) core proteins are known to dysregulate important cellular pathways that are linked to HCC development. In this study, we were interested in evaluating the overexpression of lncRNA MEG3, either alone or in combination with two forms of HCV core protein (C173 and C191) in HepG2 cells. Cell viability was assessed by MTT assay. Transcripts&rsquo; levels of key genes known to be regulated in HCC, such as p53, DNMT1, miRNA152, TGF-b, and BCL-2, were measured by qRT-PCR. Protein expression levels of caspase-3 and MKI67 were determined by immunocytochemistry and apoptosis assays. The co-expression of lncRNA MEG3 and C191 resulted in a marked increase and accumulation of dead cells and a reduction in cell viability. In addition, a marked increase in the expression of tumor suppressor genes (p53 and miRNA152), as well as a marked decrease in the expression of oncogenes (DNMT1, BCL2, and TGF-b), were detected. Moreover, apoptosis assay results revealed a significant increase in total apoptosis (early and late). Finally, immunocytochemistry results detected a significant increase in apoptotic marker caspase-3 and a decrease in tumor marker MKI67. In this study, transgene expression of C191 and lncRNA MEG3 showed induction in apoptosis in HepG2 cells greater than the expression of each one alone. These results suggest potential anticancer characteristics