Assessment of Microbiological Characteristics of the Desalinated Water Used in Household Facilities in Gaza Strip

Access to safe water represents one of the most important basic human needs of the people of Palestine and is vital to a growing economy and a healthy population. Groundwater is the major source of water to the Palestinians. Nowadays, the water crisis in the Strip is multiplying. The objective of this research is to make an assessment of the desalination plants for the microbiological quality for both the inlet (groundwater) and the outlet water (product water) in the desalination plants. Samples from both the inlet and outlet water from 88 desalination plants have been collected by the researchers have been tested in the Palestinian Ministry of Health-The Public Health Laboratory for both Total Coliform and Fecal Coliform. The study proved that the current private desalination monitoring program by the concerned authorities should be developed, enhanced and intensified. The study also revealed that the current private desalination plants were established randomly and for commercial purposes without any previous planning. The results indicated that there is a high percentage of microbiological contamination in the outlet water (21.6%) and the inlet water (16.6%), which exceeded the WHO guidelines. The study concluded that large scale sea water desalination plants should be established to overcome the current water quality problems and the quantity shortage. Keywords: Groundwater, contamination, reverse osmosis (RO), brackish water, desalination plants, Gaza Strip, Total Coliform (TC), Fecal Coliform (FC

A Proposed Model for Predicting Employee Turnover of Information Technology Specialists Using Data Mining Techniques

This article proposes a data mining framework to predict the significant explanations of employee turn-over problems. Using Support vector machine, decision tree, deep learning, random forest, and other classification algorithms, the authors propose features prediction framework to determine the influencing factors of employee turn-over problem. The proposed framework categorizes a set of historical behavior such as years at company, over time, performance rating, years since last promotion, and total working years. The proposed framework also classifies demographics features such as Age, Monthly Income, and Distance from Home, Marital Status, Education, and Gender. It also uses attitudinal employee characteristics to determine the reasons for employee turnover in the information technology sector. It has been found that the monthly rate, overtime, and employee age are the most significant factors which cause employee turnover

Semiocclusive Therapy Versus Full Thickness Skin Grafts Versus Reverse Flow Homodigital Island Flaps in Reconstruction of Volar Oblique Fingertip Injuries

Background: Fingertip amputations are among the most common injuries seen in the hand. The mechanism, level, and direction of amputation are important factors in choosing the appropriate reconstructive option. Optimal management is a much-debated topic with advocates for operative and non-oper¬ative treatment. Aim of the Work: To compare the outcome of healing by secondary intention, full thickness skin grafts from the ulnar border of the hand, and reverse flow homodigital island flaps in the management of volar oblique fingertip amputations in the hand according to time of complete healing, aesthetic outcome, return to work timing and according to complications rate. Patients and Methods: This study was conducted on 75 patients who were presented to ER department, with volar oblique fingertip injury. Patients are classified into three equal groups, each group contain 25 patients. First group was managed conservatively with semiocclusive dressing. Second group was reconstructed with full thickness skin grafts. Third group was reconstructed with reverse flow homodigital island flaps. Results: In this study, we can confirm that surgical intervention with either technique, reconstruction with full thickness skin graft or reconstruction with reverse flow homodigital island flap is too much better than healing with secondary intention. With better results with full thickness skin grafts over homodigital island flaps specially in small defects with no exposed bones, a lesion represent most of fingertip cases in surgery. On the other hand homodigital island flaps are better in big defects and in cases with exposed bones.            Conclusion: Fingertip injuries are the most common injuries in hand trauma patients. The major cause for adult patients is occupational accidents etiology. There are several classifications for fingertip injuries. Treatment options vary depending on the injury mechanism, defect’s size and plane, surgeon’s intention, patient’s needs, condition of the stump and the amputated part. Despite ongoing publication of new flaps for fingertip reconstruction, there is a paucity of evidence to support improved healing and function in a surgically reconstructed fingertip compared to conservative wound management. Controlled trials are sorely needed to distill the truth as to whether surgery is superior to secondary healing or no

A continuous murmur following a nonpenetrating chest trauma

AbstractWe reported a rare case of non-penetrating chest trauma-induced fistula from the right sinus of Valsalva to the right heart chambers. The ruptured sinus of Valsalva aneurysm was diagnosed preoperatively and operated on successfully. The rarity of this case highlights the need for a precise preoperative diagnosis, the role of transthoracic echocardiography, and the importance of a prompt surgical management

Impact of perioperative transesophageal echocardiography on tetralogy of fallot total repair

IntroductionPrevious studies have suggested that in cardiac surgical patients, TEE provides essential information before and after cardiopulmonary bypass regarding cardiac performance, valve function, and congenital anomalies. Significant residual abnormalities may be missed during TOF surgical repair. The result is often post-operative morbidity and mortality and sometimes the need for reoperation.ObjectivesTo determine impact and accuracy of perioperative TEE in assessment of patients undergoing TOF total repair.MethodsThe study included 50 patients with TOF referred to Cardiothoracic Surgery Department Ain Shams University Hospitals for total repair. Each patient was subjected to history taking, clinical examination, routine preoperative investigations, preoperative TTE, perioperative TEE and Post recovery TTE.ResultsOur study population included 45 (90%) pediatric patients and 5(10%) adults. Youngest was 1year 2 months old and oldest was 25 years old. Their weight ranged from 8 to 85Kg. TEE was feasible in 49 cases (98%) while the pediatric probe failed to be introduced in only one patient. TEE was able to visualize LM coronary artery in 96% of cases, and visualized RCA in 70% of cases. TEE newly detected a case with separate ostea of LAD and LCX. Only one patient developed non sustained runs of SVTThere was significant difference between TEE and TTE as regard IAS visualization (P value <0.0001). All our patients had only subaortic VSD except 4 patients. Three had doubly commited subarterial VSD seen by both TTE and TEE, while one patient had subaortic VSD with inlet extension, which was visualized only by TEE. Postoperative TEE detected residual small VSD in 29 cases of whom 14 cases had the VSD closed spontaneously by the time of TTE. TEE missed small residual VSD in 3 cases. In one case postoperative TEE showed a serpignous mid muscular VSD which was not detected preoperatively.There was moderate agreement between TEE and TTE regarding overriding of aortic valve (weighted Kappa 0.580). There was strong agreement between TTE and TEE in assessment of postoperative PR (r o.8594, P<0.0001).Preoperative TEE showed major impact in 2 cases (4%). In one case total repair was decided instead of shunt operation. While in the other TEE newly detected TV chordae attached to IVS crest with inlet extension of VSD. Preoperative TEE had minor impact in 29 cases (59%) by adding new information which did not alter surgical plan, as visualization of coronaries and IAS.TEE showed major postoperative impact in 2 cases (4%) in the form of second run of CPB and RVOT reconstruction. Minor impact in the form of detection of relieved RVOT obstruction, absence of residual shunts, preserved biventricular function in 47 cases (94%).ConclusionTEE imaging is a safe, feasible, and accurate tool for anatomical, hemodynamic, and functional assessment in patients with TOF during surgical repair. TEE offers the advantage of permitting visualization of the operative procedure in real time and provides guidance for the surgeon in making decisions inside the operating room

Impact of plastic surgery medical training on medical students' knowledge, attitudes, preferences, and perceived benefits: Comparative study

Introduction: Misconceptions surrounding the discipline of plastic surgery are widespread among not only the public, but medical students and professionals, as well. The purpose of this study was to explore how the inclusion of plastic surgery rotation into the medical curriculum affects medical students’ knowledge, attitudes and preferences regarding plastic surgery specialization and referral. &nbsp;Design and Methods: A descriptive-correlational design was utilized to collect data from 200 medical students in the final two years of education from two separate six-year medical programs in Jordan. Data was collected using self-reported questionnaires regarding knowledge of surgical procedures allocation, attitude towards plastic surgery, preference of specialization, and benefits of plastic surgery to physicians and patients.Results: Analysis showed that medical students of plastic surgery integrate rotation (program A) had a higher average score of correct procedure-allocation (M = 12.57, SD = 3.14), compared to non-integrated plastic survey rotation program (program B) (M = 8.29, SD = 3.05) 8.29. About 83% of students in program A had their knowledge on plastic surgery from direct exposure to a plastic surgeon, compared to 43% of program B, and 24% of students in program A reported that their perception of plastic surgery influenced by media compared to 62% of those in program B.Conclusions: medical students who have been exposed to plastic surgery education are more confident about procedures of plastic surgery specialty and had more reliable sources of knowledge about plastic surgery than those who were not exposed to plastic surgery rotation

Characterization and comprehensive genome analysis of novel bacteriophage, vB_Kpn_ZCKp20p, with lytic and anti-biofilm potential against clinical multidrug-resistant Klebsiella pneumoniae

IntroductionThe rise of infections by antibiotic-resistant bacterial pathogens is alarming. Among these, Klebsiella pneumoniae is a leading cause of death by hospital-acquired infections, and its multidrug-resistant strains are flagged as a global threat to human health, which necessitates finding novel antibiotics or alternative therapies. One promising therapeutic alternative is the use of virulent bacteriophages, which specifically target bacteria and coevolve with them to overcome potential resistance. Here, we aimed to discover specific bacteriophages with therapeutic potential against multiresistant K. pneumoniae clinical isolates.Methods and ResultsOut of six bacteriophages that we isolated from urban and medical sewage, phage vB_Kpn_ZCKp20p had the broadest host range and was thus characterized in detail. Transmission electron microscopy suggests vB_Kpn_ZCKp20p to be a tailed phage of the siphoviral morphotype. In vitro evaluation indicated a high lytic efficiency (30 min latent period and burst size of ∼100 PFU/cell), and extended stability at temperatures up to 70°C and a wide range of (2-12) pH. Additionally, phage vB_Kpn_ZCKp20p possesses antibiofilm activity that was evaluated by the crystal violet assay and was not cytotoxic to human skin fibroblasts. The whole genome was sequenced and annotated, uncovering one tRNA gene and 33 genes encoding proteins with assigned functions out of 85 predicted genes. Furthermore, comparative genomics and phylogenetic analysis suggest that vB_Kpn_ZCKp20p most likely represents a new species, but belongs to the same genus as Klebsiella phages ZCKP8 and 6691. Comprehensive genomic and bioinformatics analyses substantiate the safety of the phage and its strictly lytic lifestyle.ConclusionPhage vB_Kpn_ZCKp20p is a novel phage with potential to be used against biofilm-forming K. pneumoniae and could be a promising source for antibacterial and antibiofilm products, which will be individually studied experimentally in future studies

Analyzing the Relationship between Smoking and Drinking Patterns Using Neural Networks: A Comprehensive Feature-Based Approach

This study employs a neural network to analyze the connection between smoking, drinking, and various health-related factors using a dataset of 5148 samples. Achieving an impressive 99.94% accuracy and an average training error of 0.0016, the model identifies influential factors such as serum aminotransferases, serum creatinine, sex, weight, and triglyceride levels. These findings enhance our understanding of lifestyle choices and their impact on health. This research underscores the potential of machine learning in studying complex health phenomena