Hemophagocytic syndrome and acute pancreatitis in acute systemic lupus erythematosus

AbstractHemophagocytic syndrome (HPS) is characterized by the activation of histiocytes with prominent hemophagocytosis in bone marrow and other reticuloendothelial systems. It has two forms: primary and secondary. The precise pathogenesis of HPS is unclear but a dysregulation of macrophage–lymphocyte interactions with subsequent increases in the levels of both T-cell-derived and macrophage-derived cytokines has been suggested. Cardinal symptoms of HPS are prolonged high fever, hepatosplenomegaly, cytopenias, lymphadenopathy and neurological symptoms. In this report, we present a case Systemic Lupus Erythematosus associated with HPS and acute pancreatitis

Formant analysis in dysphonic patients and automatic Arabic digit speech recognition

<p>Abstract</p> <p>Background and objective</p> <p>There has been a growing interest in objective assessment of speech in dysphonic patients for the classification of the type and severity of voice pathologies using automatic speech recognition (ASR). The aim of this work was to study the accuracy of the conventional ASR system (with Mel frequency cepstral coefficients (MFCCs) based front end and hidden Markov model (HMM) based back end) in recognizing the speech characteristics of people with pathological voice.</p> <p>Materials and methods</p> <p>The speech samples of 62 dysphonic patients with six different types of voice disorders and 50 normal subjects were analyzed. The Arabic spoken digits were taken as an input. The distribution of the first four formants of the vowel /a/ was extracted to examine deviation of the formants from normal.</p> <p>Results</p> <p>There was 100% recognition accuracy obtained for Arabic digits spoken by normal speakers. However, there was a significant loss of accuracy in the classifications while spoken by voice disordered subjects. Moreover, no significant improvement in ASR performance was achieved after assessing a subset of the individuals with disordered voices who underwent treatment.</p> <p>Conclusion</p> <p>The results of this study revealed that the current ASR technique is not a reliable tool in recognizing the speech of dysphonic patients.</p

Systemic steroids for the management of obstructive subglottic hemangioma

From the department of Otolaryngoloy Head and Neck Surgery . King Abdulaziz University hospital. King Saud University, Riyadh , Saudi ArabiaObjectives; to evaluate the effect of systemic corticosteroids on the management of congenital subglottic hemangioma (CSH). Patients and methods; seven consecutive infants with the diagnosis of CSH were managed at King Abdulaziz University Hospital (KAUH), Riyadh, Saudi Arabia, between September1999 and December 2007. All of the cases were treated with an oral prednisone (dose of about 1mg/kg every other day for a variable period of time, after starting a daily high dose of 3 mg/kg for 10 days). The outcome of the treatment was evaluated as well as the possible complications. Results; all of the cases were successfully treated with the systemic steroids except for one case, which is currently under treatment. Only one of the cases developed cushingoid face. Conclusion; Systemic corticosteroids can be one of the treatment options that may result in overcoming the distressing airway presentation of CSH. Careful monitoring and small dose with an alternating day course of systemic corticosteroids may reduce the possibility of complications as well as avoid growth retardation

Characteristics of antrochoanal polyps in the pediatric age group

<b>Objectives:</b> To evaluate and compare the clinical and the pathological characteristics of antrochoanal polyps (ACPS) in adults and children. <b> Materials and methods: </b> Medical records of 35 patients (19 children, 16 adults) operated upon for ACPS between 1995 and 2005 at an academic tertiary center were reviewed retrospectively. Demographic characteristics, clinical presentation, surgical management, histological findings and recurrence rate were compared. <b> Results: </b> Of the 35 patients, 19 (54&#x0025;) were children (mean age, 12.6 years) and 16 (46&#x0025;) were adults (mean age, 31.4 years). Nasal obstruction was the most common presenting symptom in both groups.<b> </b> The incidence of<b> </b> snoring and/or obstructive sleep apnea was statistically significant, more common among the pediatric age group as compared to the adult group (<i> P </i> =.001). Epistaxis was also found to be more common among the pediatric age group (<i> P </i> =.027), while sinusitis was noted to be significantly more common among the adult group (<i> P </i> =.019).Transnasal endoscopic removal of ACPS was performed in 12 (63.1&#x0025;) children and 11 (68.7&#x0025;) adults. A combined open/endoscopic approach was required in 36.9&#x0025; of children and 31.3&#x0025; of adults. On histologic examination, allergic ACPS (the mucosal surface is respiratory epithelium, no mucus glands, abundant eosinophils) was more common than inflammatory ACPS (the mucosal surface is respiratory epithelium, no mucus glands, abundant neutrophils) in children (2.8:1) as compared to adults (0.8:1) (<i> P </i> =.045). All of our patients were followed with endoscopic examination for a period ranging from 9 to 42 months (mean, 24 months). Recurrence of ACPS was identified in 2 children and 1 adult. <b> Conclusion:</b> Antrochoanal polyps are a rare clinical entity. Children have unique clinical and pathological features as compared to adults. Endoscopic excision is safe and effective in the pediatric age group and has the capability to ensure complete removal and lower recurrence rate

Proposed Mechanism for Emodin as Agent for Methicillin Resistant Staphylococcus Aureus: In Vitro Testing and In Silico Study

In the search for a new anti-MRSA lead compound, emodin was identified as a good lead against methicillin-resistant Staphylococcus aureus (MRSA). Emodin serves as a new scaffold to design novel and effective anti-MRSA agents. Because rational drug discovery is limited by the knowledge of the drug target, &alpha;-hemolysin of Staphylococcus aureus was used in this study because it has an essential role in Staphylococcus infections and because emodin shares structural features with compounds that target this enzyme. In order to explore emodin&rsquo;s interactions with &alpha;-hemolysin, all possible ligand binding pockets were identified and investigated. Two ligand pockets were detected based on bound ligands and other reports. The third pocket was identified as a cryptic site after molecular dynamics (MD) simulations. MD simulations were conducted for emodin in each pocket to identify the most plausible ligand site and to aid in the design of potent anti-MRSA agents. Binding of emodin to site 1 was most stable (RMSD changes within 1 &Aring;), while in site 2, the binding pose of emodin fluctuated, and it left after 20 ns. In site 3, it was stable during the first 50 ns, and then it started to move out of the binding site. Site 1 is a possible ligand binding pocket, and this study sheds more light on interaction types, binding mode, and key amino acids involved in ligand binding essential for better lead design. Emodin showed an IC50 value of 6.3 &mu;g/mL, while 1, 6, and 8 triacetyl emodin showed no activity against MRSA. A molecular modeling study was pursued to better understand effective binding requirements for a lead

Impact of the International Nosocomial Infection Control Consortium (INICC)’s multidimensional approach on rates of ventilator-associated pneumonia in intensive care units in 22 hospitals of 14 cities of the Kingdom of Saudi Arabia

To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and use of INICC Surveillance Online System (ISOS) on ventilator-associated pneumonia (VAP) rates in Saudi Arabia from September 2013 to February 2017. A multicenter, prospective, before–after surveillance study on 14,961 patients in 37 intensive care units (ICUs) of 22 hospitals. During baseline, we performed outcome surveillance of VAP applying the definitions of the CDC/NHSN. During intervention, we implemented the IMA and the ISOS, which included: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on VAP rates and consequences and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using generalized linear mixed models to estimate the effect of intervention. The baseline rate of 7.84 VAPs per 1000 mechanical-ventilator (MV)-days―with 20,927 MV-days and 164 VAPs―, was reduced to 4.74 VAPs per 1000 MV-days―with 118,929 MV-days and 771 VAPs―, accounting for a 39% rate reduction (IDR 0.61; 95% CI 0.5–0.7; P 0.001). Implementing the IMA was associated with significant reductions in VAP rates in ICUs of Saudi Arabia