Evaluation of the in-vitro synergistic potential of vancomycin combined with other antimicrobial agents against methicillin-resistant Staphylococcus aureus isolates

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a major public health problem, causing a wide range of infections including bacteremia. Infections caused by MRSA are associated with significant morbidity, mortality, and costs. The present study aimed to determine the frequency of MRSA isolates among bacteremic patients, to determine their antimicrobial susceptibility patterns and to evaluate the in-vitro synergy combinations of vancomycin plus imipenem, cefepime, cefazoline and piperacillin-tazobactam against these isolates. Methods: Fifty confirmed MRSA strains isolated from blood cultures constituted the material of this study. The BD Phoenix was used to determine the susceptibility of these isolates to different antimicrobials. The Two-agent Broth Microdilution checkerboard test was used to evaluate the effect of combinations of two antimicrobial agents on the studied isolates. Results: In the current study the prevalence of MRSA among bacteremic patients was 15.68%, resistance rate was as follow: Gentamicin (80%), erythromycin (68%), ciprofloxacin (64%), norfloxacin (52%), moxifloxacin (36%), trimethoprim-sulfamethoxazole (46%), doxycycline (38%), rifampin (34%), clindamycin (24%), chloramphenicol (8%), linezolid (6%), teicoplanin (2%). All isolates were fully susceptible to daptomycin and vancomycin. Synergy was seen in varying proportions of the MRSA isolates when vancomycin was combined with imipenem, piperacillin-tazobactam, cefepime and cefazolin that was 76%, 66%, 54% and 52% respectively. No antagonism was observed. The mean FIC indices for combination of Vancomycin with Imipenem were significantly inversely correlated with the vancomycin MICs of the isolates using linear regression analysis. Conclusions: The synergistic activity of vancomycin in combination with β- lactam antibiotics offers new insights in treatment options of serious MRSA infections

The Influence of Season on the Gonad Index and Biochemical Composition of the Sea Urchin Paracentrotus lividus from the Golf of Tunis

Seasonal variation in the gonad weight and biochemical composition of the sea urchin Paracentrotus lividus from the Golf of Tunis (Tunisia) were studied between September 2003 and August 2004. The highest gonad indices occurred in March (16.71%). The spawning period occurred between April and July and resulted in a fall in gonad indices to low level (7.12 ± 0.12%). Protein constituted the main component of the gonad, and lipid and carbohydrate were found at appreciable amounts. Consistent with the gonad cycle, sea urchin biochemical components showed clear seasonal variation with a significant decrease during the spawning period. The polyunsaturated fatty acid (PUFA) group was found at high level (40% of the total fatty acids). Of the PUFA group, eicosapentaenoic (C20:5 n − 3) and eicosatetraenoic (C20:4 n − 3) were the most abundant gonadal lipids. The level of PUFA was significantly affected by temperature variation showing an increase during the cold months and a decrease in the hot months

Prevalence and clinical significance of anti-C1q antibodies in cutaneous and systemic lupus erythematosus

Autoantibodies against C1q are strongly linked to immune-complex disorders like systemic lupus erythematosus (SLE). Although anti-C1q antibodies have received much interest in the recent years, their biological functions remain unclear. Anti-C1q antibodies are strongly associated with lupus nephritis. The aim of this study was to determine the prevalence of anti-C1q antibodies in Egyptian lupus patients as well as to evaluate the associations between anti C1q antibodies and clinical and serologic parameters of patients with cutaneous and systemic lupus erythematosus. Fifty-eight patients of lupus erythematosus were recruited in the study, and they were divided into 3 groups according to their clinical presentations and laboratory investigations; group (1) consists of 20 patients with musculoskeletal manifestations, mainly arthritis (34.5%), group (2) consists of 12 patients with lupus nephritis (20%), and group (3) consists of 26 patients with cutaneous lupus (44.8%). Fourteen age and sex matched healthy subjects served as controls. Complete blood picture, kidney function tests, liver function tests and anti-double stranded DNA were done for all the studied patients. Anti-C1q antibodies were determined by immunometric enzyme immunoassay for all the studied subjects. Anti-C1q antibodies were positive in (63.8%) of lupus erythematosus (LE) patients and (0%) of controls. Moreover, the serum anti-C1q antibodies titers were significantly higher (P < 0.001) in all lupus erythematosus patients (both systemic and cutaneous) when compared to healthy controls. Surprisingly, serum anti-C1q antibodies were significantly higher in patients with cutaneous lupus than those with lupus nephritis (P <0.001). Anti-C1q titers were significantly correlated with levels of anti–double stranded DNA (P <0.001), as well as with proteinuria (<0.05) in lupus nephritis patients. It was concluded that anti C1q antibodies might play a pathogenic role in the pathogenesis of cutaneous lupus and could positively be associated with evolution to SLE. Moreover, it could predict patients who subsequently develop nephritis, thus early use of immune modulators in cutaneous lupus could improve patients’ prognosis by decreasing the possibility of evolution to systemic lupus complications, mainly nephritis.Keywords: Anti-C1q; Systemic lupus erythematosus; Cutaneous lupus erythematosus; Lupus nephritis; Complement; Proteinuri

Screening of Dyslipidemia and Obesity among Children in Zagazig University Hospitals

Background: Westerners are well aware of plasma lipid problems, which are becoming increasingly important in the Middle East. The European Expert Panel has advocated universal screening as a preferable approach of hypercholesterolemia screening as a part of the primary preventive effort. Objective: To assess the relation between dyslipidemia and its risk factors; age and body mass index. Patients and Methods: A cross-sectional study that included 357 of children who visited the Pediatrics General Outpatient Clinic at Zagazig University Hospitals. All subjects were subjected to full history taking, general examination, anthropometric measurements, blood pressure, and laboratory investigations including: non-fasting and fasting lipid profiles. Results: Non-fasting total cholesterol (TC) of ≥ 200 was (14.3%) and < 200 was (85.7%). Non-fasting (LDL) of ≥ 130 was (16.8%) and <130 was (83.2%). HDL category of < 40 was (61.3%) and ≥ 40 was (38.7%). There was no statistically significant difference between age, sex and lipid profiles. There was statistically significant positive correlation between non-fasting triglycerides (TG) and non-fasting HDL and non-fasting non-HDL-C. Conclusion: Obesity was associated with the prevalence of at least one abnormal lipid level. This highlights the importance of paying greater attention to the prevention of cardiovascular disease and obesity in children from an early age

Value of dobutamine stress tissue Doppler in evaluation of LV functional improvement after elective PCI

Aim: To clarify the value of dobutamine stress tissue Doppler in the evaluation of LV functional improvement after elective PCI.Methods: The study included 60 patients with hibernating viable myocardium proved by DSE referred for an evaluation of myocardial viability prior to revascularization. Hemodynamic and echocardiographic variables (LVEF, WMSI and TDI Sm) were assessed at rest and during stress. 1 month after PCI follow up echocardiography and TDI were done. Patients were divided into 2 groups: (Group I): 18 patients (30%) with no global functional recovery and (Group II): 42 patients (70%) with global functional recovery.Results: SBP, DPB, HR, EF, WMSI and (Sm) increased significantly at stress P = 0.001. After 1 month patients were divided into 2 groups according to functional recovery. There were no statistically  significant differences between two groups neither as regards age, sex, risk factors (P >0.05) nor as  regards SBP, DBP, HR, rate/pressure product, EF and WMSI during stress but Sm increased during stress and after1 month follow up in Group II (P = 0.001). Univariate regression showed that (Sm) is the only predictor for global functional recovery. ROC curve statistical analysis shows that (Sm) is more sensitive and accurate than (WMSI) in the detection of viable myocardium which predicts improvement after revascularization (sensitivity 100%, 50% and accuracy 93.3%, 83.3% respectively).Conclusion: Stress TDI provides a feasible and quantitative technique that improves reproducibility of DSE. Sm during stress showed better accuracy than WMSI for the prediction of functional recovery following revascularization and was simple, sensitive and accurate for the detection of subtle myocardial systolic velocity changes

Ultrastructure of the anterior adhesive apparatus of the gill parasite Macrogyrodactylus clarii and skin parasite M. congolensis (Monogenea; Gyrodactylidae) from the catfish Clarias gariepinus

Transmission electron microscopy (TEM) was used for the first time to study the anterior adhesive apparatus of the monogeneans Macrogyrodactylus clarii Gussev, 1961 and M. congolensis (Prudhoe, 1957) Yamaguti, 1963 inhabiting gills and skin respectively of the same catfish Clarias gariepinus. Despite the different microhabitats occupied by these parasites, the present study revealed that they have a similar anterior adhesive system. In both parasites, the anterior adhesive apparatus consists of three types of gland cells: G1 cells that produce rod-shaped bodies (S1), G2 cells manufacture irregularly shaped bodies (S2) and G3 cells form mucoid-like secretions (S3). In the cytoplasm of G1 cells, a single layer of microtubules encloses each developing rod-shaped body. A unique feature of S1 secretory bodies is that some fully developed S1 bodies are attached to each other, forming large condensed globules in the cytoplasm of G1 gland cells and terminal portion of the G1 ducts, but none were detected in the adhesive sacs outside the ducts. In the adhesive sacs, G1 ducts open with multiple apertures whereas each of the G2 and G3 ducts have a single opening. The adhesive sacs are lined with two types of tegument (st1 and st2). A third tegument type (st3) connects the st2 tegument with the general body tegument. Only st1 has microvilli. Each adhesive sac is provided with a spike-like sensillum and single uniciliated sense organ. The possible functions of microvilli in increasing the surface area and assistance in spreading and mixing of the adhesive secretion, and the role of sense organs associated with the adhesive sacs are discussed

Symposium: Can intellectual history be done otherwise?

Using Shahzad Bashir’s open-access publication A New Vision for Islamic Pasts and Futures as a baseline, this symposium debates whether and how intellectual history can be done otherwise. Mohamed ‘Arafa follows Bashir’s invitation to explore the potential of open-ended historiographies when he thinks about the viability of a flexible method to interpret Sharī͑a. Nader El-Bizri interrogates whether the assemblage of personal experiential accounts offered by Bashir can be framed within the discourse of intellectual history at all. Nauman Faizi reads Bashir’s approach as a radical attempt to open up hermeneutical possibilities. Lena Salaymeh suggests that modern aesthetics can contribute to neo-colonial distortions of the Islamic tradition, rather than offering alternatives to positivist historiography. Bashir proposes in his response that academics adopt generosity as an analytical gesture in their academic writing, a generosity that would enable different ways of being human in the world

COVID-19 associated mucormycosis and diabetes mellitus: An exploratory study

Background:Mucormycosis has abruptly increased in Egypt during the third wave of COVID-19 especially in patients with diabetes mellitus (DM). The aim of this study was to investigate the risk factors, clinical presentation and outcome of mucormycosis in COVID-19 patients with diabetes. Methods: Prospective cohort study was conducted on 72 COVID-19 patients with DM presented with mucormycosis at intensive care units and Ear, Nose, and Throat Department of Zagazig University Hospitals over a period of three months from May 2021 to August 2021. All participants were submitted to history taking, examination, laboratory investigation, radiological and histopathology and culture testing. Results: Post COVID-19 new-onset diabetes mellitus (NOD) was detected in 40% of studied patients. 72.2% of patients had poorly controlled diabetes. Majority of studied patients presented by rhino-orbital mucormycosis (90.3%) and about 86% of them were operated. Hundred percent of patients gave history of antibiotic use and also nearly 99.0% of them received corticosteroids, while only 1.4% of them received tocilizumab. There was statistically significant association between operated patients, hemoglobin (HB) level, lymphocyte count, neutrophil-lymphocyte ratio (NLR), and CRP level with disease prognosis. Conclusions: Poorly controlled DM and steroid use are the most important risk for post COVID-19 mucormycosis. Early surgical intervention carried better disease outcome

PERFORMANCE ANALYSIS OF MODIFIED SURFACE IRRIGATION SYSTEM BASED ON A DEVELOPED EXPERT SYSTEM

It is very difficult to find an expert at the desired time and place to give guidance about irrigation scheduling or good management of water and irrigation system. In this study, this problem was tried to be solved by designing and evaluating an expert system for a modified surface irrigation system. A rule-based program named as MSISES (Modified Surface Irrigation System by Expert System) was coded and complied using C#.net programing language. The expert system was designed to support users with information about irrigation scheduling (irrigation operating time and irrigation interval) and the gated pipes as one of the surface irrigation modification tools (gates opening ratio). Two different experiments were held to evaluate the performance of the developed expert system. The first one is to evaluate the irrigation scheduling part by cultivating a field crop (Sweet maize) to make a comparison between the crop yield and water productivity after applying the program’s scheduling and the farmer’s scheduling. The second one is to make a comparison between the fully opened gates situation and when the resulted gates opening ratio is applied. The results indicated that an increase at crop yield and crop water productivity by 9.49% and 32.37% respectively for sweet maize using the developed expert system, and also, there was a slight variation between gates discharges after using the expert system except the last four gates discharge were different because of the superimposed pressure near the closed end