Synthesis, characterization and antimicrobial studies of transition metal complexes of imidazole derivative

A series of new biologically active complexes of Zn(II), Cu(II), Co(II) and Ni(II) with imidazole derivative have been synthesized. The synthesized chelating agent and metal(II) complexes were screened for antibacterial activities against four pathogenic species of bacteria namely; Eschereschi coli, Pseudomonas aeruginosa, Klesbiella pneumonia and Staphylococcus aureus by agar well diffusion method. The results show that most of the metal complexes were more active than the neat ligand, against these bacterial species as expected. KEY WORDS: 1,3-Di(1H-imidazol-1-yl)-2-propanol, Coordination compounds, Antimicrobial study  Bull. Chem. Soc. Ethiop. 2010, 24(2), 201-207

Post-Traumatic Syringomyelia: A Case Series

It is relatively common to occur in a Tertiary Care Neurosurgical setup to get a case of Syringomyelia proximal or distal to a space-occupying lesion (SOL) or site of spinal cord compression. In this case series, we are presenting two cases in which syringomyelia developed after traumatic spinal cord injury. On initial radiological investigations, the first case presented as an old D12 fracture with Post-traumatic syrinx formation but on complete workup for the extent of the syrinx, another lesion was found incidentally in the form of an intradural extramedullary SOL at the level of cervicomedullary junction. The SOL turned out histologically as WHO Grade I Meningioma. The second case presented as syrinx formation after gunshot (fire-arm) penetrating spinal cord injury to the D11-12 vertebrae. Treatment plans of both these patients are presented here in detail along with the literature review

Cancer in Faisalabad and Nankana Sahib, Pakistan: 2017-2019; an Observational study

Introduction: The Punjab Cancer Registry's catchment area includes the districts of Faisalabad and Nankana Sahib. It is an observational, descriptive study that covers the three years from 2017 to 2019, evaluating the distribution of cancer in these two districts. Material and Methods: Data on incident cancer cases diagnosed between 2017 and 2019 among residents of Faisalabad and Nankana Sahib in Pakistan, reported by the participating centers of the Registry, were reviewed retrospectively. Figures and proportions for adults, children, and adolescents were computed. Results: During 2017 and 2019, 5,678 cases were reported from Faisalabad and 390 from Nankana Sahib, with over 50% seen in females. In both districts combined, among adult females, cancers of the breast, reproductive system, and hepatobiliary system were commonly diagnosed, while cancer of the lip/oral cavity/pharynx, hepatobiliary system, and non-Hodgkin lymphoma were the leading diagnoses among adult males. In children and young adults (0-19 years), acute lymphoblastic leukemia, Hodgkin lymphoma, and non-Hodgkin lymphoma were the most common diagnoses. Conclusion: The cancer distribution reported from Faisalabad and Nankana Sahib is of utmost importance. However, the underreporting of cancer cases cannot be ruled out. More input from the collaborators is needed to ensure the completeness of cancer surveillance in the region

F-Classify: Fuzzy Rule Based Classification Method for Privacy Preservation of Multiple Sensitive Attributes

With the advent of smart health, smart cities, and smart grids, the amount of data has grown swiftly. When the collected data is published for valuable information mining, privacy turns out to be a key matter due to the presence of sensitive information. Such sensitive information comprises either a single sensitive attribute (an individual has only one sensitive attribute) or multiple sensitive attributes (an individual can have multiple sensitive attributes). Anonymization of data sets with multiple sensitive attributes presents some unique problems due to the correlation among these attributes. Artificial intelligence techniques can help the data publishers in anonymizing such data. To the best of our knowledge, no fuzzy logic-based privacy model has been proposed until now for privacy preservation of multiple sensitive attributes. In this paper, we propose a novel privacy preserving model F-Classify that uses fuzzy logic for the classification of quasi-identifier and multiple sensitive attributes. Classes are defined based on defined rules, and every tuple is assigned to its class according to attribute value. The working of the F-Classify Algorithm is also verified using HLPN. A wide range of experiments on healthcare data sets acknowledged that F-Classify surpasses its counterparts in terms of privacy and utility. Being based on artificial intelligence, it has a lower execution time than other approaches

Newcastle disease virus induces testicular damage and disrupts steroidogenesis in specific pathogen free roosters

Newcastle disease (ND), which is caused by Newcastle disease virus (NDV), can cause heavy economic losses to the poultry industry worldwide. It is characterised by extensive pathologies of the digestive, respiratory, and nervous systems and can cause severe damage to the reproductive system of egg-laying hens. However, it is unknown whether NDV replicates in the male reproductive system of chickens and induces any pathologies. In this study, we selected a representative strain (i.e. ZJ1) of the most common genotype (i.e. VII) of NDV to investigate whether NDV can induce histological, hormonal, and inflammatory responses in the testes of specific pathogen free (SPF) roosters. NDV infection increased the expression of toll like receptor TLR3, TLR7, MDA5, IFN-α, IFN-β, IFN-γ, IL-8, and CXCLi1 in the testes of NDV-infected roosters at 5 days post-infection (dpi). Severe histological changes, including decrease in the number of Sertoli cells and individualized, shrunken spermatogonia with pyknotic nuclei, were observed at 3 dpi. At 5 dpi, the spermatogenic columns were disorganized, and there were fewer cells, which were replaced by necrotic cells, lipid vacuoles, and proteinaceous homogenous material. A significant decrease in the plasma concentrations of testosterone and luteinizing hormone (LH) and the mRNA expression of their receptors in the testes, steroidogenic acute regulatory protein, cytochrome P450 side-chain cleavage enzyme, and 3β-hydroxysteroid dehydrogenase in the NDV-infected group was observed relative to those in the control group (P < 0.05). Collectively, these results indicate that NDV infection induces a severe inflammatory response and histological changes, which decrease the steroidogenesis. © 2020 The Author(s)

Can trained field community workers identify stroke using a stroke symptom questionnaire as well as neurologists? Adaptation and validation of a community worker administered stroke symptom questionnaire in a peri-urban Pakistani community.

Background: Stroke is a leading cause of morbidity and mortality worldwide. There is a paucity of data from South Asia where stroke is highly prevalent. Validated tools administrable by Community Health Workers (CHWs) are required to identify stroke in the community in a resource strapped region such as this. Methods: The study was conducted in a transitional slum in Karachi, Pakistan. Questionnaire for Verifying Stroke-Free Status (QVSFS) was adapted and translated into Urdu. Two CHWs, trained by a neurologist, selected 322 community dwelling subjects using purposive sampling. Each CHW collected data independently which was validated by a vascular neurologist who directly examined each participant. To assess the effect of audit and feedback, data from the final 10% of the subjects was collected following a second training session for the CHWs. Sensitivity, specificity and Cohen’s kappa was determined for the CHW administered questionnaire against neurovascular assessment. Results: Mean age of participants was 56.5 years with 71% of participants being women. The sensitivity and specificity of the questionnaire of detecting stroke was 77.1% (CI: 64.1%–86.9%) and 85.8% (CI: 83.5%–87.5%). The chance corrected agreement using the Cohen’s Kappa statistic was 0.51 (CI: 0.38–0.60). Kappa ranged from 0.37 to 0.58 for each of the seven stroke symptoms. Hemianesthesia (72.9%) and hemiplegia (64.6%) were the most sensitive symptoms. The performance and agreement improved from moderate to substantial after audit and feedback. Conclusion: We found a reasonable sensitivity and specificity and moderate agreement between CHW administered QVSFS and assessment by a vascular neurologist

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

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely