MICROBIOLOGICAL INDUCTION OF ACANTHOCYTOSIS

Acantocytosis is associated with various diseases among which are a β-lipoproteinemia, a genetic disease, following splenectomy, following exposure to toxic chemical, and massive carcinoid tumor. No previous studies have, up to the best knowledge of the author, reported acanthocytosis to be induced by pathogens. The aim of the present study was to explore the potential of β-hemolytic Streptococcus group A to induce acanthocytosis. The methodology of the present study involved incubation of β-hemolytic Streptococcus group A with blood samples, examining blood films of patients diagnosed with β-hemolytic Streptococcus group A and examining urine samples showing acanthocytosis for β-hemolytic Streptococcus group A. Study findings confirmed that acanthocytosis was induced by β-hemolytic Streptococcus group A, and patients diagnosed with β-hemolytic Streptococcus group A showed acanthocytosis in their blood smears. Urine samples showing acnathocytes in microscopic examination were positive for β-hemolytic Streptococcus group A. Taken together, Acanthocytosis is a diagnostic feature of β-lipoproteinemia, a genetic disease. Our data pointed to a new causative agent in which β- hemolytic Streptococcus group A induces acanthocytosis with high potential to play a new etiological agent in pathogenesis of diseases. Our data are preliminary findings that need to be further investigations since pathogens seem to have non-classical roles and new pathological studies are required to explore such roles

MOLECULAR AND CHEMICAL THERAPEUTIC FEATURES OF URTICA SPECIES

The present review study was conducted to review the current understanding of molecular aspects of Urtica species. We refer to the most recent published articles addressing the therapeutic potential of this plant. A wide spectrum of diseases has been associated with Urtica species including cancer, arthritis, autoimmune diseases, diabetes, and fatigue. Some molecular mechanisms and chemical properties have been discussed. Taken together, studies have confirmed the beneficial effects of Urtica all over the world and understanding of the molecular mechanisms underlying the beneficial effects opens new horizon to understand new therapeutic options. The extracts of Urtica should be prepared based on separating effective ingredients for optimal therapeutic benefits

THE PREVALENCE OF HELICBACTER PYLORI AMONG PATIENTS COMPLAINING FROM ABDOMINAL PAIN

Helicobacter pylori has been associated with a number of gastrointestinal disorders including gastritis, peptic ulcer disease, gastric adenocarcinoma and gastric mucosa-associated lymphoid tissue (MALT) lymphoma. The present study was conducted to determine the prevalence of Helicobacter pylori infection among patients complaining from abdominal pain and visiting internal medicine clinics. It was also purposed to investigate the relationship between both age and sex with Helicobacter pylori infection. A retrospective study was conducted and included 101patients with abdominal pain. The results showed that the prevalence of IgG against Helicobacter pylori infection is 85%, while about 38.6% of cases were positive for IgA against Helicobacter pylori. No significant relationships were found for IgG, IgA with age and sex (p value >0.05). Taken together, the study showed high prevalence of H. pylori infection among patients complaining of abdominal pain. H.pylori infection is not associated significantly with age and sex

LEADERSHIP STYLE AMONG MIDDLE MANAGERS IN SAUDI MINISTRY OF HEALTH

Background: Middle managers within ministry of health act under continuous pressure from board level to be successful leaders of today's and tomorrow's healthcare service. Leadership styles are important factors among middle managers to retain employees in organizations and to ensure a high quality of practice.Aims: Two main aims: to examine the leadership style(s) of middle managers as perceived by them as leader from different departments of the Saudi Ministry of Health, and to examine the leadership style(s) of the middle managers as perceived by their subordinates as raters from different departments of the Saudi Ministry of Health.Materials and methods: A cross-sectional descriptive design was used to answer the research questions. A convenience sample of 121 participants, 30 middle managers and 91 subordinates, who were recruited through different departments at Saudi Ministry of Health during the period of June 2010 through September 2010.Participants were subjected to Univariate and Multivariate analysis. The Multifactor Leadership Questionnaire (MLQ) was used to collect data.Results: the mean ratings of all four components of transformational leadership for the subordinates and middle managers were between 2.90 to 3.29 .The mean ratings for contingent reward and management by exception active were 3.30 and 2.50 respectively and this was well within the optimum range as suggested by Bass. Management by exception passive and laissez-faire showed mean ratings of 1.67 and 1.25 respectively. The correlation coefficients among transformational leadership style and each variable of, satisfaction, effectiveness and extra effort for raters and leaders sample was high positively reached (r = .72, p< 0.05) , (r = .81, p< 0.05) , (r = .80, p< 0.05) respectively, The correlation coefficients among transactional leadership style and each variable of, satisfaction, effectiveness and extra effort for raters and leaders sample was high positively reached (r = .20, p<0.05) , (r = .44, p< 0.05) , (r = .35, p< 0.05) respectively, and The correlation coefficients among laissez -Faire leadership style and each variable of, satisfaction, effectiveness and extra effort for raters and leaders sample was high negatively reached (r = -.48, p< 0.05) , (r = -.46, p< 0.05) , (r = -.43, p< 0.05) respectively. There are agreement between leaders and raters on transformational, transactional and laissez-faire as distributive in Saudi Ministry of Health in kingdom of Saudi Arabia. The result showed there was no significant difference on the MLQ factors for raters and Leader due to gender, marital status, and age. Also , the analysis showed significant differences among raters’ opinions due to work experiences as contingent reward and extra effort in favor of raters who experience of them more than ˃ 6 Month, and finally, the analysis showed there significant differences among raters’ opinions due to period working with leaders as transformational, idealized Influence attributed, inspirational motivation, intellectual stimulation, contingent reward, and effectiveness in favor of raters who working with leaders for a period between 6 months - ˂ 1 year, but significant differences among raters’ opinions due to period working with leaders as Laissez –Faire in favor of raters who working with leaders for a period between 1 year - 2 years.Conclusions: transformational leadership can contribute a lot to the effectiveness of organizations and that there is a need for further investigation of leadership at different levels

INVESTIGATION OF ALUMINUM TOXICITY AMONG WORKERS IN ALUMINUM INDUSTRY SECTOR

The study was conducted to evaluate urine aluminum concentration among a total of 150 participants (80 aluminum technicians and 70 non- aluminum technicians as a control). Data were collected through a previously prepared questionnaire which consists of two parts. The first part concerned with demographic data such as age and nationality. The second part concerned with occupational data such as working hours, working years, smoking, and diseases. The mean concentration of aluminum is 51.62+ 29.59 μg/l and the mean concentration of group control 16.32 + 12.49 μg/l. The following variables were associated significantly with aluminum concentration: age, weekly working hours, smoking and daily smoking packets.According to our study, aluminum workers have high concentrations of urine aluminum compared with other studies, in addition to that the incidence of diseases in relation to exposure is low, simply because: 1-Self reported questionnaires may be not a proper way to collect data about diseases. 2- Traditional surveillance approaches used in public health practice are difficult to apply to metals poisoning because adverse health effects related to metal exposure may not be clinically diagnosed, except at very high exposure levels, and are not usually listed as reportable diseases.Finally Special safety precautions and educational programs are also needed to limit the aluminum exposure in this industrial group

HEMATOLOGICAL CHANGES IN PRISONERS WITH HIGHER BLOOD LEAD LEVELS COMPARED WITH GENERAL POPULATION

Lead (Pb) is one of the major environmental health hazards. From a biological point of view, lead is considered as anon-essential trace element and has no any biological function. The aims of the present study were to study blood lead levels among prisoners in the Northern of Jordan. Two prisons in the northern of Jordan were visited. Blood samples were collected and evaluated for hematological parameters and blood lead level. The study included 73 participants (46 prisoners and 27 participants as control). Study findings revealed low exposure of lead among study participants. The mean blood lead level among prisoners was 0.924 μg/dl, and 0.57μg/dl among control group. Hematological parameters under study were less in prisoners compared control group. Study findings revealed significant relationships between blood lead level and hematological parameters among prisoners. Taken together, the present study evaluated the effects of lead exposure on prisoners through studying these effects on some hematological parameters. The findings of the present study indicated that even prisoners had more blood lead levels compared with control group; the exposure variations were not statistically significant, but able to induce changes on studied hematological parameters

THE APPROACH TO THE ANALYSIS OF ELECTRICAL FIELD DISTRIBUTION IN THE SETUP OF PAPER INSULATED ELECTRODES IN OIL

Article presents the problem of the approach to the analysis of electrical field distribution in the model insulating system, which, in the author's experimental research, was used to the assessment of the influence of paper insulation on the mechanism of electrical discharge initiation in mineral oil. The main assumptions of the planned numerical works based on the finite element method were described and scientific aim of the numerical analysis were characterized in this paper. Both the assumptions and the scientific aim were related to the conclusions from the experimental works, especially to the measured times to initiation of the discharges developing in mineral transformer oil, indicating on the important role of the oil quality in the process of discharge initiation in the system of the insulated by paper electrodes immersed in oil

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

MOLECULAR MECHANISMS ASSOCIATED WITH ACUTE MYELOID LEUKEMIA: REVIEW ARTICLE

The present review article purposes to introduce the molecular mechanisms underlying acute myeloid leukemia (AML). An overview of AML was introduced including its classification, therapeutic options and the roles of mutations in p53 and WT1 genes. The possibility of molecular targeting therapies was also discussed. The efforts of many researchers concerning AML were taken into consideration during this review. We also pointed to the various roles of WT1 gene as suppressor or oncogene. The important relationship between p53 gene and WT1 gene was highlighted so that when WT1 gene stabilizes p53, the pathological picture concerning p53 if being mutated or not should be reconsidered again