Prevalence And Antibiotic Resistance Pattern Of Linezolid And Vancomycin Resistant Gram-Positve Cocci Isolated From Surgical Site Infections

The aim of this study was to determine the prevalence and antimicrobial resistance profiles of Gram-positive cocci isolated from surgical site infections. Out of 320 bacterial isolates, 268 (83.75%) were identified as Staphylococcus spp. and 52 (16.25%) were identified as Enterococcus spp. Among staphylococci, 71.64% were coagulase-positive and 28.36% were coagulase-negative. The antimicrobial resistance of all isolates was tested with a disc diffusion method. The majority (69%) of coagulase-positive staphylococci were methicillin-resistant Staphylococcus aureus (MRSA) while 31% were methicillin-sensitive Staphylococcus aureus (MSSA). All staphylococci were found to be susceptible to vancomycin and only two isolates were found to be resistant to linezolid. On the other hand, high level (28%) of resistance to vancomycin was observed in enterococci and no enterococcal isolates exhibited resistance towards linezolid. Results revealed that all investigated isolates were resistant to ampicillin and tetracycline. High prevalence of erythromycin and ciprofloxacin resistance was observed in 91 and 77% of isolates, respectively, while only 18 and 28% of the isolates were resistant to amikacin and clindamycin, respectively

Effect of Prefeeding Oral Stimulation Program on Preterm Infants' Feeding Performance

One of the most common feeding problems of preterm infants in the neonatal intensive care units (NICUs) is difficulty reaching full oral feeding. The use of an individualized, evidence-based approach is strongly recommended to assist preterm infants in transitioning from gavage to full oral feeding. Hence, this study evaluates the effect of a 5-min. prefeeding oral stimulation program on oral feeding duration, total oral intake rate and net- leakage of preterm infants who were defined as inefficient feeders. A quasi- experimental design was used on a purposive sample composed of fifty five preterm infants selected from two NICUs of Cairo University Hospitals. Twenty eight as a control group who were left to hospital routine care, and twenty seven as intervention group. Three minutes of manual perioral and intraoral stimulation followed by two minutes of sucking on a pacifier was applied to the intervention group for two consecutive days twice per day. Results revealed that the intervention group demonstrated a significant increase in total oral intake rate, less net leakage and shorter oral feeding duration than the control group. In conclusion, prefeeding oral stimulation program improved the preterm infants' feeding performance. Such an intervention should be implemented for inefficient preterm infants in the NICUs because it is safe, simple and inexpensive. Key words: Prefeeding oral stimulation program - Feeding performance -Preterm infants.

A new potentiometric sensor based on molecularly imprinted polymer for analysis of a veterinary drug imidocarb dipropionate

A new potentiometric sensor based on molecularly imprinted polymer (MIP) was fabricated for the recognition and determination of imidocarb dipropionate. The MIP was synthesized using imidocarb as the template material, methacrylic acid as a functional monomer, and ethylene glycol dimethacrylate as a cross linking agent. The sensor showed a high selectivity and a sensitive response to the template molecule in aqueous solution. The MIP-electrode exhibited a near-Nernstian response in a wide concentration range 10-5 - 10-2 M with a lower detection limit of 2×10-6 M. The potentiometric conditions were carefully studied and all measuring parameters were optimized including pH, buffer type, plasticizer type, response time and stability. The applicability of the sensor was tested through potentiometric determination of imidocarb dipropionate in pure drug as well as in pharmaceutical formulation. The proposed method was statistically compared with a reported one showing no significant difference regarding accuracy and precision, which assured a good reliable novel sensor for imidocarb estimation

Neonatal Auditory Screening is a Necessity in The Neonatal Intensive Care Unit: Single Center Study

Background: Hearing impairment early in life interferes with normal healthy psychosocial, linguistic and educational development. Neonatal morbidities might be complicated by increased hearing impairment. Aim of the Work: To study the frequency of hearing loss among neonates with morbidities necessitating admission to neonatal intensive care units. Materials and Methods: This cross-sectional study involved screening of 250 neonate on day of discharge from Neonatal Intensive Care Unit (NICU), Children Hospital, Cairo University Hospitals, Egypt during 2020 using evoked otoacoustic emission (EOAE). Automated auditory brain stem response (AABR) was used as a confirmatory test for those who failed EOAE. Results: among the 250 neonates, 70 (28%) failed the screening by EOAE, and hearing loss was confirmed by AABR among 35(14%). Morbidity risk factors that contributed to hearing impairment was prematurity (p = 0.001), low birth weight (p = 0.003), low APGAR score at 1 and 5 minutes (p = 0.004), long NICU stay duration (p = 0.001), complications of pregnancy and delivery (p = 0.001 and p = 0.006 respectively), hypoxic ischemic encephalopathy (p = 0.001), intracranial hemorrhage (p = 0.001), meningitis (p = 0.003), mechanical ventilation for more than 5 days (p = 0.005), ototoxic drug use (p = 0.007) and hyperbilirubinemia at level of exchange transfusion (p = 0.001). Conclusion: EOAE and confirmatory AABR non- invasively and objectively detected 14% hearing loss among neonates admitted to NICU. Implementation of screening for hearing impairment among those with morbidity risk factors is a necessity to allow prompt diagnosis and early management of hearing loss

العوامل المؤثرة في التوافق بين مخرجات التعليم و سوق العمل

تزايد الاهتمام برأس المال البشري باعتباره أحد القوى المحركة للتنمية الاقتصادية وتزايد معه الاهتمام بدراسة  كيفية سد الفجوة بين مخرجات التعليم العالي ومدخلات سوق العمل. ومن هنا تبرز أهمية البحث في تحليل مشكلة عدم التوافق بين مخرجات التعليم العالي واحتياجات سوق العمل في سورية ، تم  تحليل مشكلة عدم التوافق بين مخرجات التعليم العالي  في "جامعة تشرين" (عينة البحث)  واحتياجات سوق العمل للتعرف على متطلبات سوق العمل وتحليل العوامل التي تحكم العلاقة بين عرض العمل والطلب عليه وذلك لتقديم آلية تمكن من التوفيق بين التخصصات الجامعية المتاحة ومتطلبات سوق العمل من حيث نوعية التخصصات الجامعية، والمهارات المكتسبة للخريج ومدى مواءمتها مع متطلبات سوق العمل.  تم تصميم استبانتين بهدف جمع البيانات، الاستبانة الأولى لقياس رأي أصحاب العمل بشقيه (العام والخاص) و الاستبانة الثانية لقياس رأي الخريجين الجامعيين وتوصلت الدراسة إلى مجموعة من النتائج من أهمها : يتمتع الخريجون الجامعيون بقدرة جيدة على الالتزام بالعمل ومتطلباته وتعلّم المهارات التي يحتاجها، ويعانون من ضعف تأهيلهم من ناحية المهارات العملية المتممة لشهاداتهم العلمية التي يطلبها سوق العمل، و ذلك لضعف التنسيق بين المؤسسات التعليمية ومنظمات سوق العمل. ويركز القطاع العام بشكل كبير على تأمين فرص عمل لمختلف شرائح المجتمع، كما أنه يميل لتوظيف أعداد تفوق حاجته، عكس القطاع الخاص الذي يعمل على توظيف عدد محدد وفق حاجته دون زيادة أو نقصان وأوصى فريق البحث  بضرورة التركيز على الجانب العملي لتحقيق التكامل مع الجانب النظري في التعليم (الجامعي والتقاني) واستحداث وحدات تدريبية خاصة بكل كلية ومعهد تقاني. إدخال الجامعات كبيوت خبرة واستشارة وخاصة فيما يتعلق بتوطين المشروعات ذات الطابع الاقتصادي. وإعادة النظر في الاستثمارات الموظِفة لليد العاملة في الساحل خاصة بعد التغير الديموغرافي الحاصل بسبب الحرب على سورية من خلال: التشجيع على إقامة (المشاريع الصغيرة - المشاريع الانتاجية التكاملية (زراعية – صناعية) المولِدة لفرص العمل وخاصة للخريجين.

Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Benign prostatic hyperplasia: clinical assessment and evaluation

Contains fulltext : mmubn000001_222421924.pdf (publisher's version ) (Open Access)Promotores : F. Debruyne en J. de la Rosette127 p

Patogenicidade de duas variedades de Bacillus thuringiensis Berliner para lavras de lepidoptera e diptera

Acompanha memorialTese (livre-docencia) - Universidade Estadual de Campinas, Instituto de BiologiaResumo: A patogenicidade de duas variedades de Bacillus tnuringiensis Berliner foi investigada em larvas de Lepi-doptera e Diptera. Através do enfoque patológico no estudo, tentou-se esclarecer alguns aspectos importantes nas áreas de pesquisa, industrialização de patógenos e aplicação de produtos à base de B. thuringiensis no campo. Os sintomas externos pré-mortais foram descritos em larvas de Lepidoptera infectadas por B. thuringiensis var. kurstaki e em larvas de Diptera infectadas por B. thuringien-sis var. israelensis. Algumas alterações histológicas foram detectadas em alguns tecidos de tais larvas, principalmente , no intestino médio, sistema nervoso e musculatura. As alterações observadas nesses tecidos foram relacionadas com o desencadeamento dos sintomas externos da bacteriose. A variedade kurstaki teve ação fatal lenta (2 a 3 dias) nas larvas de Lepidoptera, quando comparada com a ação da variedade israelensis nas larvas aquáticas de Diptera,onde a morte ocorre em poucas horas após a infecção. Nenhum dos lepidópteros estudados pertence o tipo I da classicificação de Heimpel & Angus (1959); pois não ocorreu paralisia geral ou aumento no pH da hemolinfa nas larvas doentes. Entre as larvas dessas espécies, as de Brasso-lis sophorae revelaram-se mais susceptiveis em relação às demais. Por outro lado, as larvas de Spodoptera latifascia e-ram as mais resistentes à mesma variedade kurstaki ( sorotipo H-3a:3b). A origem do patógeno, o hospedeiro do qual este foi isolado e o processamento da produção comercial, além da variedade do bacilo e da espécie do inseto infectado, eram fatores responsáveis pela variação nas respostas das larvas infectadas. A expressão da quantidade do patógeno em termos de Unidades Internacionais de virulência / unidade de peso do inseto tratado revelou-se altamente precisa para comparações de susceptibilidade de insetos e virulência de produtos. 0 uso de critérios de DL50 e CL50 _ mostrou-se muito adequado, e até pode ser recomendado, para estudos com populações de insetos geneticamente menos variáveis. A resposta dos indivíduos, no caso, seria diretamente relacionada com e em função da dose ou a concentração aplicada. 0 uso de TL50 , por outro lado, revelou-se mais funcional e, também, pode ser recomendado para investigações com populações de maior variabilidade genética. Os níveis de susceptibilidade revelados para cada uma das espécies estudadas, indicaram a alta possibilidade de obter resultados satisfatórios no campo, quando produtos comerciais à base da variedade kurstaki forem aplicados contra larvas de B. sophorae , Alabama argillacea e Plodia inter-punctella em jardins e áreas urbanas, lavoura e armazéns respectivamente. A morte iniciou-se, nas larvas aquáticas dos dípteros estudados, apenas poucas horas após a infecção pela variedade israelensis. As larvas de Culex declarator (Culicidae) mostraram-se mais susceptíveis a essa variedade do que as lar vas de simulídeos, quando infectadas com este patógeno. Entre as duas espécies de simulídeos, as larvas de Simulium goeldii eram 4 vezes mais susceptíveis do que as de S. rorotaense. As larvas do último estádio de C. declarator revelaram-se mais susceptíveis ao patógeno do que as dos estádios iniciais. No mesmo tempo, as larvas no início do último estádio (42) eram mais susceptíveis do que no final do mesmo estádio. Este último aspecto, juntamente com a morte rápida causada pelo patógeno ( 2 a 3 horas), devem ser considerados nas recomendações de alguns órgãos oficiais no exterior. Tais órgãos, exigem que o 42 estádio larval de Aedes aegypti seja usado nos bioensaios de padronização de produtos à base da variedade israelensis ; porém, sem estabelecer uma fase desse estádio. A especificidade e a alta virulência da variedade israelensis para larvas aquáticas de Diptera, revelam o seu grande valor como agente promissor no controle microbiano de larvas de Culicidae e Simuliidae. Os sintomas externos observados nas larvas de. C. declarator, as alterações nistológicas e a morte rápida foram suficientemente convenientes para mostrar a ação da S-endo toxina produzida pelo patógeno. Tal toxina deve ter afetado drasticamente o sistema nervoso e a musculatura da larva, dificultando assim a manutenção desta na superfície da água e conseqüentemente a sua respiração do ar atmosférico. Assim , a larva afundada morreu por asfixia. Esses estudos revelaram a presença de um novo campo para investigações de patologia de insetos e controle microbiano para os dípteros aquáticos neotropicais e subtropicais . Tais investigações terão o seu alto valor do ponto de vista humano, desde que várias dessas espécies tem a sua importância como insetos vetores de doenças humanasAbstract: The pathogenicity of two varieties of Bacillus thuringiensis Berliner was investigated using some lepi-dopterous and dipterous larvae. The aim of the present study was to clarify certain aspects related to the application of insect pathology, such as susceptibility and virulence évalua tions, standardisation criteria, and field applications of microbial products to the control of some harmful insects. The sequence of external symptoms was described in lepidopterous larvae infected with the B. thuringiensis var. kurstaki (syrotype K-3a:3b) and in dipterous larvae infected with the variety israelensis (syrotype H-14)-The histological alterations, in these infected larvae, were described, principally those in the mid-gut, nervous system, and musculature These alterations were found to be directly associated with the different external symptoms of the disease. The progress of the disease up to the death in the lepidopterous larvae lasted longer time (2-3 days) than in dipterous ones (2-3 hours). Type I of Heimpel & Angus (1959) classification did not occur among the lepidopterous species studied, since nei_ ther general paralysis nor pH alterations in the hemolymph were detected. Brassolis sophorae larvae were found to "be the most susceptible to syrotype H-3a:3b, when compared with the other lepidopterous species. On the other hand, Spodoptera lati-fascia larvae were the most resistant. Origin, natural host, and mass production criteria of the pathogen, in addition to its variety and the tested insect species, were the most important factors responsible for the variation in responses of the infected larvae. Therefore, these aspects should be considered to choice the more adequate product for each insect species to be combatted. The quantity of the pathogen expressed in International Units of toxicity per unit of body weight, showed to be highly precise for the comparison of insect susceptibility and pathogen virulence. The LD^Q and LC^0 criteria were found to be suitable and, therefore, can be recommended for investigations where the populations of insects are of low genetic variability. On the other hand, for genetically variable populations, the LT^q was found to be more adequate. B. sophorae, Alabama argillacea and Flodia inter-punctella were found to be highly susceptible to the syrotype H-3a:3b. Therefore, this pathogen can be recommended for their control. The aquatic dipteran larvae, studied in the present work, died some hours after infection with syrotype H-14.Culex declarator (Culicidae) larvae were more susceptible than those .132 . of the simulid species. Within Simuliidae, Simulium goeldii larvae were 4 times more susceptible than the S_. rorotaense ones. The last instar (4th.) larvae of C. declarator were more susceptible than those of the first instars. Moreover, within the same instar, these larvae showed different levels of susceptibility. In the initial phase of the last instar they were more susceptible than in the final phase. These informations, in addition to the rapid fatal action of the toxin in dipteran aquatic larvae, should be considered by the governamental agencies, in establishing standardization criteria for future commercial products based on this variety.At the present, these agencies establish the 4th instar larvae of Aedes aegypti as a test insect for stadardization bio-assays, ignoring the difference in susceptibility within the same instar. Because of the high specificity and virulence of B. thuringiensis var. israelensis for dipteran aquatic larvae, it can be considered as a promissing agent for microbial control of mosquitos and black flies larvae. Considering the mode of action of syrotype H-14 in mosquito larvae, the results led us to beleive that the £-endotoxin liberated in the high alkaline mid-gut affected the ventral nervous system and consequently the musculature , provoking disfunction of the latter.The effect on the muscles made the larva lose its capacity to maintain itself at the water surface. Consequently, the larva submerged and died by asphixiation. The observed sequence of the external symptoms, as well as the histological alterations sustained this hypothesis. The results obtained in the present study reveal the possibility to utilize the syrotype H-14 in the control of vectors of some human diseases, such as malaria and filaria This application, however, requires additional extensive research work to complete urgently needed informationsLivre DocênciaLivre-Docente em Ciencias Biologica