Epidemiology of antibiotic resistance in culture-positive hospitalized patients in selected hospitals in Khartoum, Sudan

Objective: To study the prevelence of antibiotic resistance and the prevalent bacterial isolates in hospitalized patients in Khartoum hospitals. Materials & Methods: A cross-sectional prevalence study was carried out during the period of April–November 2015 in Khartoum; 226 bacterial cultures were included. Identification of isolates using standard biochemical tests and antibiotic susceptibilities were determined using disc diffusion method. Results were interpreted according to the standards of the British society of antimicrobial chemotherapy. Results: Eight bacterial species were isolated: Staphylococcus aureus, Enterococcus faecalis, Streptococcus spp., Klebsiella pneumoniae, Pseudomonas spp., Escherichia coli, Proteus spp., and Acinetobacter spp. S. aureus was the most prevalent, the majority of which were resistant to methicillin/oxacillin (MRSA). Cultures in our study were mainly from urine (36.7%), blood samples (37.2%), and wound cultures (19%). More than 90% of the tested isolates were resistant to cefuroxime; 54% and 73.8% of Gram-positive and Gram-negative isolates, respectively, were resistant to ceftazidime. Furthermore, there was a high meropenem resistance among Gram-negative isolates tested. Multi-resistant Acinetobacter spp. as well as vancomycin-resistant S. aureus was isolated. Gram-negative isolates showed good susceptibilities to aminoglycosides as well as ciprofloxacin. However, the high resistance rate to these antibiotics was observed in Gram-positive isolates in these hospitals. Conclusion: Methicillin-resistant S. aureus was the most prevalent organism. Gramnegative isolates showed good susceptibilities to aminoglycosides and ciprofloxacin. There were high resistance rates to cefuroxime, ceftazidime, and meropenem. Five vancomycin-resistant S. aureus were identified

Tako-Tsubo Cardiomyopathy in a Patient with Advanced Colorectal Adenocarcinoma

Transient left ventricular dysfunction syndrome (TLVDS), or Tako-Tsubo cardiomyopathy (TC), is a clinical entity in which patients present with features of acute coronary syndrome, electrocardiogram abnormalities, and transient left ventricular (apical or mid-ventricular) dysfunction. Patients usually recover from this condition four to six weeks after the event. The etiology or triggering factors of TC remains unknown. Various triggering factors have been associated with this syndrome, with one of the most recent being malignancies. In this case report we present a postmenopausal female with underlying advanced malignancy who presented with TC. This is consistent with a recent hypothesis that in addition to currently known triggering factors, malignancies might well trigger TC in the context of a stressor or paraneoplastic phenomenon

Theoretical Study of the Effect of Fibre Porosity on the Heat Conductivity of Reinforced Gypsum Composite Material

In recent years, there has been an increasing demand for engineering materials that possess good mechanical and thermal properties and are cheap and environmentally friendly. From an industrial and academic point of view, there is a need to study the heat conductivity of newly developed polymer composites and the influence of porosity on the insulation performance of polymer composites. Experimental and theoretical studies were conducted on mainly sisal/glass fibre gypsum composites with different fibre volumes (0, 20, 25, 30, and 35 wt.%). The outcomes from the theoretical model in ANSYS have shown that there is a high possibility to simulate the experimental work and high accuracy for reflecting the experimental findings. Moreover, the results show that natural fibre polymer composites with a high-volume fraction of natural fibres have higher insulation performance than synthetic polymer composites with the same volume fraction of synthetic fibres. Furthermore, the results suggest and support that the improved performance of natural fibre-based composites was due at least in part to the internal porosity of the fibres

Anisotropic diffusion of water molecules in hydroxyapatite nanopores

Funded by EPSRC Grant EP/K000128/1

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Theoretical Study of the Effect of Fibre Porosity on the Heat Conductivity of Reinforced Gypsum Composite Material

In recent years, there has been an increasing demand for engineering materials that possess good mechanical and thermal properties and are cheap an d environmentally friendly. From an industrial and academic point of view, there is a need to study the heat conductivity of newly developed polymer composites and the influence of porosity on the insulation performance of polymer composites. Experimental and theoretical studies were conducted on mainly sisal/glass fibre gypsum composites with different fibre volumes (0, 20, 25, 30, and 35 wt.%). The outcomes from the theoretical model in ANSYS have shown that there is a high possibility to simulate the experimental work and high accuracy for reflecting the experimental findings. Moreover, the results show that natural fibre polymer composites with a high-volume fraction of natural fibres have higher insulation performance than synthetic polymer composites with the same volume fraction of synthetic fibres. Furthermore, the results suggest and support that the improved performance of natural fibre-based composites was due at least in part to the internal porosity of the fibres

Trends in hospital admissions for Varicella and Zoster viruses in England, 2001/2002-2010/2011: time trend study

OBJECTIVES: Varicella and Herpes Zoster are common infectious diseases. Various studies have estimated rates of infection for both manifestations of these infections; however rates of hospital admissions across the country have not previously been described. This paper presents data on hospital admissions in England for Varicella and Herpes Zoster from 2001/2002 to 2010/2011. DESIGN: Time trends study of all hospital admissions for Varicella and Herpes Zoster from 2001/2002 to 2010/2011 in England. SETTING: Hospital admissions across England from 2001/2002 to 2010/2011. PARTICIPANTS: We included all patients admitted to hospital from 2001/2002 to 2010/2011 diagnosed with Varicella and Zoster according to the International Classification of Diseases version 10 (ICD-10). MAIN OUTCOME MEASURES: The main outcome measures were admission rates by year and diagnosis and age-specific admission rates for Varicella and Zoster from 2001/2002 to 2010/2011. METHODS: We analysed data from Hospital Episode Statistics which include patient characteristics such as age which was used here in order to standardise rates to the relevant population. We also used mid-year population estimates from the Office for National Statistics for standardisation purposes. All analyses were conducted using Stata v12.0. RESULTS: The hospital admission rate for Varicella cases has risen by 1.8% over the 10-year study period. While the overall admission rates for Herpes Zoster have decreased by 4% from 2001/2002 levels. The vast majority of Varicella and Zoster admissions were not associated with any complications. CONCLUSION: The introduction of Herpes Zoster vaccine is anticipated to decrease hospital admissions in older age groups further. A repeat of this study after a further period of time would help to evaluate the impact of the introduction of Herpes Zoster vaccine in England on hospital admissions