Bipolar sealing devices versus endoscopic vascular staplers during laparoscopic splenectomy in children with benign hematological diseases

Background: Splenectomy, whether open or laparoscopic, is considered a step of management in many children with benign hematological diseases such as immune thrombocytopenia, thalassemia, autoimmune hemolytic anemia, and spherocytosis. The major challenge during laparoscopic splenectomy (LS) is the rich blood supply of the spleen. Many techniques were considered to control the vascular supply of the spleen. Staplers, clips, either titanium or hemoclips, a bipolar sealing device (BSD), or ultrasonic shears were all used to complete LS. We aimed to compare the results of using BSD versus endoscopic staplers for vascular control of the pedicle during LS.Patients and methods: The study was carried out on 30 children with benign hematological diseases who presented to the Pediatric Surgical Unit. They were grouped randomly into two groups: group A and group B. Group A included 15 patients who were subjected to LS in which BSD was used for vascular control, whereas group B included 15 patients subjected to LS in which endoscopic staplers were used for vascular control of the pedicle.Results: The mean age of the children in group A was 9.60 years, whereas the mean age of the children in group B was 10.40 years. In group A, the mean estimated amount of blood loss was 72.27 ml. However, this was 80.67ml in group B. In group A, the mean operative time required was 39.00 min, whereas it was 56.27 min in group B. The indications for splenectomy were thalassemia in 15 cases (seven for group A and eight for group B), idiopathic thrombocytopenic purpura in 13 cases (seven for group A and six for group B), and spherocytosis in two cases (one for each group). The mean splenic size in group A was 10.43 cm, whereas it was 11.73 cm in group B.Conclusion: LS has evolved over the last decade because of the advancements of BSDs and endoscopic staplers. According to our data the use of LigaSure reduces the overall operative time, operative blood loss, and associated complications compared with the use of staplers.Keywords: children, laparoscopic, splenectom

Ecological Distribution of Virulent Multidrug-Resistant Staphylococcus aureus in Livestock, Environment, and Dairy Products

Staphylococcus aureus is one of the most common causes of mastitis, leading to severe economic losses in the dairy industry. It is also zoonotic, with potential risks to public health. This study aimed to detect the occurrence of S. aureus-resistant strains isolated from cattle, buffalo, their environment, milk and dairy products; and to investigate the extent of animal, ecological, and food contamination by methicillin-resistant (MRSA) or enterotoxigenic S. aureus. Samples (n = 350) were collected from four animal (two cattle and two buffalo) farms, i.e., their environment. Thirty Karish cheese samples were collected from 10 markets in Mansoura, Egypt. S. aureus was detected in 17.9%, 17.6%, and 16.7% of samples collected from cattle, buffalo and Karish cheese, respectively. About 19% of isolated S. aureus strains carried the mecA gene. The distribution of the mecA gene was high in isolates from Karish cheese (60%), followed by samples collected from buffalo (16.2%) and cattle (16%). More than 34% of isolated S. aureus strains were enterotoxigenic, and the presence of enterotoxin genes was higher in isolates from Karish cheese (80%) than those from cattle (48%) and buffalo (18.9%). The most predominant enterotoxin gene among isolated S. aureus strains was the sea gene (26.9%), followed by sec (4.5%) and sed (3%) genes. Isolated strains were resistant to clindamycin (100%), kanamycin (97%), nalidixic acid (86.6%), cefotaxime (73.1%) sulphamethazole—trimethoprim (65.6%). Meanwhile, 95.5%, 94%, 86.6% and 77.7% of S. aureus strains were sensitive to ciprofloxacin, amikacin, imipenem and both cefoxitin and gentamycin, respectively. In conclusion, the presence of enterotoxigenic- and methicillin-resistant S. aureus strains in animals, their environment, and dairy products represents a public health concern, particularly in small-scale dairy farms in Egypt. To reduce the risk of infection of livestock and humans with resistant strains, strict regulations and guidelines for antimicrobial use in such a system are urgently required

Prevalence and molecular characterization of enteropathogenic Escherichia coli isolated from table eggs in Mansoura, Egypt

Objectives: This study was designed to assess the contamination of enterovirulent Escherichia coli with table eggs at Mansoura, Egypt. Materials and methods: A total of 100 commercially available table eggs were randomly collected from various groceries and supermarkets at Mansoura, Egypt. The samples were screened for the presence of E. coli through conventional bacteriological and biochemical analyses followed by confirmation by polymerase chain reaction. Results: Overall, 18% (n=18/100) samples were found to be contaminated with one or more E. coli isolates. All possible E. coli colonies (n=52) appeared on MacConkey agar plates during the screening process were picked for further analysis. Among the 52 suspected isolates, 24 were confirmed as E. coli, which were further serotyped using polyvalent E. coli antisera. In this study, 9 different E. coli serotypes namely O78, O114, O2, O44, O1, O125, O128, O124 and O26 were identified. Out of these 9 serological strains, 5 (O78, O2, O44, O125, O124 and O26) were positive for eae gene, and 3 (O44, O1 and O128) were positive for stx2 gene. Two serological strains (O44 and O1) were positive for both stx1 and eae genes, while O125 and O114 were positive for stx2 and eae genes. Two strains (O78 and O128) were found to be positive for all three genes (stx1, stx2 and eae). Conclusion: Ensuring hygienic measures can effectively reduce the microbial load from table eggs. [J Adv Vet Anim Res 2016; 3(1.000): 1-7

Occurrence and D-Tryptophan Application for Controlling the Growth of Multidrug-Resistant Non-O157 Shiga Toxin-Producing <i>Escherichia coli</i> in Dairy Products

The objectives of the current study were first to determine the prevalence of non O157:H7E. coli, especially Shiga toxin-producing Escherichia coli (STEC) in retailed milk and dairy products in Egypt. Second, the antimicrobial resistance profiling and virulence genes of the isolated E. coli strains were screened. Third, evaluation of the inhibitory effects of D-tryptophan against E. coli O26:H11 was further performed. The results revealed that 20% (30/150) of the samples were STEC positive, with 64 isolates harboring some virulent genes, such as Stx1, Stx2, eaeA, and hylA. Serological identification revealed four different pathotypes belonging to EPEC, ETEC, EHEC, and EIEC. Antimicrobial susceptibility testing revealed that 100%, 98.44%, 92.19%, 71.87%, 65.63% and 64.06% of the isolates had a resistance against tetracycline, oxacillin, erythromycin, nalidixic acid, sulphamethoxazol, and ampicillin, respectively. D-tryptophan addition (40 mM) to E. coli O26:H11-inoculated soft cheese and ice cream revealed a significant reduction (p < 0.05) in bacterial growth, especially when accompanied with other food stressors. D-Tryptophan is considered as an effective food preservative and as a promising alternative candidate in the dairy industry

Heavy metal residues in milk and some dairy products with insight into their health risk assessment and the role of Lactobacillus rhamnosus in reducing the lead and cadmium load in cheese

Heavy metals were analyzed in buffalo's milk and some dairy products assembled from different dairy farms, supermarkets, and vendors in Mansoura, Egypt. The mean concentrations (mg/kg wet weight) of the heavy metals detected in raw milk, Kareish cheese, processed cheese, and milk powder were 0.0014, 0.0378, 0.0022, and 0.0204, respectively for mercury; 0.012, 0.0764, 0.052, and 0.120, respectively for arsenic; 0.1016, 0.2924, 0.1256, and 0.3352, respectively for lead; 0.07, 0.1172, 0.0576, and 0.1252, respectively for cadmium; 0.1044, 0.174, 0.1016, and 0.208, respectively for chromium; and 0.0656, 0.188, 0.1272, and 0.2496, respectively for copper. The probiotic Lactobacillus rhamnosus was incorporated into soft cheese as an attempt for reducing lead and cadmium whose concentrations were diminished by 81.5% and 74.5%, respectively within 48 h at 4 °C. The study concluded that although the maximum limit of Pb and Cd has been exceeded in 44% to 68% of the dairy products tested, the health risk assessment indices comprising Estimated Daily Intakes, Provisional Tolerable Daily Intakes, Target Hazard Quotient, and Hazard Index indicated no potential health risk upon consumption of such dairy products analyzed. The study also suggested the use of Lactobacillus rhamnosus probiotic for minimizing lead and cadmium levels in dairy food