The Bactericidal Effect of CO2 Laser on Pseudomonas aeruginosa Isolated from Wound and Burn Infections, In-Vitro

A total of 60 cotton swabs are collected from patients suffering from burn wound and surgical site infections admitted to Baghdad Teaching Hospital and Burn Specialist Hospital in Baghdad city during 9/2013 to 11/2013. All cotton swabs are cultured initially on blood agar and MacConkey agar and subjected for standard bacteriological procedures for bacteriological diagnosis. Twenty samples out of sixty are identified as Pseudomonas aeruginosa by conventional methods. The results of antibiotic susceptibility test illustrate that the antibiotics resistance rate of Pseudomonas aeruginosa isolates is as follows:100% (2020) for ceftriaxone, cefepime and carbencillin, 70% (14/20) for amikacin, 65%(13/20) for tobramycin, ceftazidim and gentamycin, 55% (11/20) for ciprofloxacin and norfloxacin, 50% (10/20) for piperacillin and impeneme, 30% (6/20) for aztreonam. All Pseudomonas aeruginosa isolates are investigated for detection of some virulence factors (haemolysin, protease, lipase enzymes, and extracellular pigments) and biofilm formation. The results of virulence factors reveal that all the isolates are haemolysin, protease, lipase enzymes and extracellular pigments producer, while 95% of the isolates are biofilm producer. Six isolates are selected to irradiation by using CO2 laser according to the results of antibiotic susceptibility and virulence factors at power densities (2000, 2500, and 3000) W/cm2 with exposure time (60 and 90) second. The results of CO2 laser irradiation illustrate that CO2 laser irradiation lead to a reduction in the mean value of the viable number CFU/ml of Pseudomonas aeruginosa isolates with the increase of the power density and exposure time. The results of the statistical analysis by using analysis of variance (ANOVA) one way and least significant differences-LSD show that there are statistical significant differences in the mean of the viable number CFU/ml between different power densities and different exposure times. After irradiation, antibiotic susceptibility and virulence factors tests of the irradiated strains are performed. The current study concludes that CO2 laser has bactericidal effect on P. aeruginosa isolates without any effect on its antibiotics susceptibility and virulence factors

Optimization of Water Treatment Parameters using Processed Moringa oleifera As a Natural Coagulant for Low Turbidity Water

Moringa oleifera is a natural coagulant which can be used for water treatment in tropical developing countries. This study presents the results of production of natural coagulant from processed Moringa oleifera with simple technique (oil extraction, salt extraction, and microfiltration with 0.2 μm). The optimization study on physical factors was carried out for coagulation-flocculation process. Low initial turbidity water samples (synthetic and river water) were used with turbidity less than 50 Nephelometric Turbidity Units (NTU). The response surface methodology (RSM) was used, and the analysis of variance (ANOVA) was performed to validate the developed regression model. The residual turbidity obtained was 4.514 NTU for synthetic water and 1.598 NTU for river water by applying the optimum conditions of 40 rpm (low speed), mixing time of 41 minutes, and Moringa oleifera dosage of 0.75 mg/L

Moringa oleifera seeds as natural coagulant for water treatment

Developing countries and third world countries are facing potable water supply problems because of inadequate financial resources. The cost of water treatment is increasing and the quality of river water is not stable due to suspended and colloidal particle load caused by land development and high storm runoff during the rainy seasons especially in a country like Malaysia. During the rainy seasons the turbidity level increases and the need for water treatment chemicals increase as well, which leads to high cost of treatment which the water treatment cannot sustain. As a result, the drinking water that reaches the consumer is not properly treated. Therefore, it is of great importance to find a natural alternative for water coagulant to treat the turbidity. It has been found that Moringa oleifera is the best natural coagulant discovered yet, that can replace aluminium sulphate (Alum) which is used widely all around the world. The study is focusing in Moringa oleifera seeds to find the active constituents which are responsible about the coagulation mechanism and improving the coagulation property. This will help in producing this alternative locally as Moringa oleifera is grown in Malaysia and other tropical countries and can be of great benefit for water treatment

Production of natural coagulant from Moringa oleifera seed for drinking water treatment

Water treatment industry worldwide including South East Asia IS facing high demand for synthetic coagulants for water treatment process. Research is continuously being done to find the best treatment methods and lower cost alternatives. Moringa oleifera seed could be a suitable natural alternative to synthetic coagulants. This paper investigates processing Moringa oleifera seed in order to concentrate the bio-active constituents which have coagulation activity. The proposed method to isolate and purify the bio-active constituents is the cross flow filtration method, which produced the natural coagulant with very cost effective processing technique (oil extraction; salt extraction; and microfiltratlon through 0.20 ~Im). Coagulation activity was determined using conventional jar test procedures, and the major water quality control parameters monitored was the residual turbidity for river water with low initial turbidity. Results showed residual turbidity of less than 5 NTU which is recommended by the World Health Organization (WHO). The turbidity removal was 94.82% for river water of low initial turbidity of 44.2 NTU, without any chemicals added. The microfiitration method is considered to be a practical method which needs no chemicals added. The product is commercially valuable and can contribute to the economic development of South East Asian countries

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

Angiographic correlations of patients with small vessel disease diagnosed by adenosine-stress cardiac magnetic resonance imaging

Cardiac magnetic resonance imaging (CMR) with adenosine-stress myocardial perfusion is gaining importance for the detection and quantification of coronary artery disease (CAD). However, there is little knowledge about patients with CMR-detected ischemia, but having no relevant stenosis as seen on coronary angiography (CA). The aims of our study were to characterize these patients by CMR and CA and evaluate correlations and potential reasons for the ischemic findings. 73 patients with an indication for CA were first scanned on a 1.5T whole-body CMR-scanner including adenosine-stress first-pass perfusion. The images were analyzed by two independent investigators for myocardial perfusion which was classified as subendocardial ischemia (n = 22), no perfusion deficit (n = 27, control 1), or more than subendocardial ischemia (n = 24, control 2). All patients underwent CA, and a highly significant correlation between the classification of CMR perfusion deficit and the degree of coronary luminal narrowing was found. For quantification of coronary blood flow, corrected Thrombolysis in Myocardial Infarction (TIMI) frame count (TFC) was evaluated for the left anterior descending (LAD), circumflex (LCX) and right coronary artery (RCA). The main result was that corrected TFC in all coronaries was significantly increased in study patients compared to both control 1 and to control 2 patients. Study patients had hypertension or diabetes more often than control 1 patients. In conclusion, patients with CMR detected subendocardial ischemia have prolonged coronary blood flow. In connection with normal resting flow values in CAD, this supports the hypothesis of underlying coronary microvascular impairment. CMR stress perfusion differentiates non-invasively between this entity and relevant CAD

Age-sex differences in the global burden of lower respiratory infections and risk factors, 1990-2019 : results from the Global Burden of Disease Study 2019

BACKGROUND: The global burden of lower respiratory infections (LRIs) and corresponding risk factors in children older than 5 years and adults has not been studied as comprehensively as it has been in children younger than 5 years. We assessed the burden and trends of LRIs and risk factors across all age groups by sex, for 204 countries and territories. METHODS: In this analysis of data for the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019, we used clinician-diagnosed pneumonia or bronchiolitis as our case definition for LRIs. We included International Classification of Diseases 9th edition codes 079.6, 466-469, 470.0, 480-482.8, 483.0-483.9, 484.1-484.2, 484.6-484.7, and 487-489 and International Classification of Diseases 10th edition codes A48.1, A70, B97.4-B97.6, J09-J15.8, J16-J16.9, J20-J21.9, J91.0, P23.0-P23.4, and U04-U04.9. We used the Cause of Death Ensemble modelling strategy to analyse 23 109 site-years of vital registration data, 825 site-years of sample vital registration data, 1766 site-years of verbal autopsy data, and 681 site-years of mortality surveillance data. We used DisMod-MR 2.1, a Bayesian meta-regression tool, to analyse age-sex-specific incidence and prevalence data identified via systematic reviews of the literature, population-based survey data, and claims and inpatient data. Additionally, we estimated age-sex-specific LRI mortality that is attributable to the independent effects of 14 risk factors. FINDINGS: Globally, in 2019, we estimated that there were 257 million (95% uncertainty interval [UI] 240-275) LRI incident episodes in males and 232 million (217-248) in females. In the same year, LRIs accounted for 1·30 million (95% UI 1·18-1·42) male deaths and 1·20 million (1·07-1·33) female deaths. Age-standardised incidence and mortality rates were 1·17 times (95% UI 1·16-1·18) and 1·31 times (95% UI 1·23-1·41) greater in males than in females in 2019. Between 1990 and 2019, LRI incidence and mortality rates declined at different rates across age groups and an increase in LRI episodes and deaths was estimated among all adult age groups, with males aged 70 years and older having the highest increase in LRI episodes (126·0% [95% UI 121·4-131·1]) and deaths (100·0% [83·4-115·9]). During the same period, LRI episodes and deaths in children younger than 15 years were estimated to have decreased, and the greatest decline was observed for LRI deaths in males younger than 5 years (-70·7% [-77·2 to -61·8]). The leading risk factors for LRI mortality varied across age groups and sex. More than half of global LRI deaths in children younger than 5 years were attributable to child wasting (population attributable fraction [PAF] 53·0% [95% UI 37·7-61·8] in males and 56·4% [40·7-65·1] in females), and more than a quarter of LRI deaths among those aged 5-14 years were attributable to household air pollution (PAF 26·0% [95% UI 16·6-35·5] for males and PAF 25·8% [16·3-35·4] for females). PAFs of male LRI deaths attributed to smoking were 20·4% (95% UI 15·4-25·2) in those aged 15-49 years, 30·5% (24·1-36·9) in those aged 50-69 years, and 21·9% (16·8-27·3) in those aged 70 years and older. PAFs of female LRI deaths attributed to household air pollution were 21·1% (95% UI 14·5-27·9) in those aged 15-49 years and 18·2% (12·5-24·5) in those aged 50-69 years. For females aged 70 years and older, the leading risk factor, ambient particulate matter, was responsible for 11·7% (95% UI 8·2-15·8) of LRI deaths. INTERPRETATION: The patterns and progress in reducing the burden of LRIs and key risk factors for mortality varied across age groups and sexes. The progress seen in children younger than 5 years was clearly a result of targeted interventions, such as vaccination and reduction of exposure to risk factors. Similar interventions for other age groups could contribute to the achievement of multiple Sustainable Development Goals targets, including promoting wellbeing at all ages and reducing health inequalities. Interventions, including addressing risk factors such as child wasting, smoking, ambient particulate matter pollution, and household air pollution, would prevent deaths and reduce health disparities. FUNDING: Bill & Melinda Gates Foundation