Optimization of exopolysaccharide production by pleurotus ostreatus using diffrent cultivation strategies

Pleurotus ostreatus or known as oyster mushroom was regarded as one of the most cultivated mushroom around the world. One of the qualities it has is it able to produced exopolysaccharide called pleuran which secreted into the medium during submerged fermentation. The polysaccharide composed mainly of ß-(1/3)-D glucose and ß-(1/6)-D glucose linked by glycosidic bond. It has molecular weight of 2.4 X 104 Da with molecular formula of (C6H10O5)x The importance of pleuran is that it has the immunomodulatory properties that associated in triggering our immune system response. Nowadays, submerged fermentation is considered as the best method in cultivation this kind of mushroom. However, the production process of this kind of mushroom and its exopolysaccharide production especially in term of medium component is still unclear. In this research, the objectives were to optimize the medium composition and to find the optimum carbon to nitrogen (C: N) ratio for high exopolysaccharide production. Eight different media was screened and followed by factor by factor optimization of the medium component. The factors that been studied were ideal concentration of glucose, yeast extract, ammonium sulfate and dipotassium phosphate. Media number six which contain glucose 60.0 g L-1, yeast extract 2.0 g L-1, (NH4)2SO4 5.0 g L-1, MgSO4.7H2O 0.2 g L-1, K2HPO4 1.0 g L-1 was selected as best media production for P. ostreatus cultivation . The experiment then was further with different concentration of each component in the medium six excluding magnesium sulfate heptahydrate which maintained at 0.2 g L-1 throughout all the experiment stage. The range concentration for glucose, yeast extract, ammonium sulfate and dipotassium phosphate was setup between 0 – 120 g L-1, 0 – 4 g L-1, 0 – 5 g L-1 and 0 – 2 g L-1 respectively. In order to get the best C: N ratio for highest exopolysaccharide production, eleven ratio of carbon to nitrogen was experimented ranging from 15:1 to 65:1.Result shown that the optimum concentration for glucose, yeast extract, ammonium sulfate and dipotassium phosphate was 80.0, 4.0, 2.5 and 1.0 g L-1 respectively whiles the optimal C: N ratio recorded was 40: 1. The optimized medium also produced 2.83 g L-1 of exopolysaccharide increasingly up to 49 % when compared with un-optimized medium which only produced 1.9 g L-1 of exopolysaccharide

Assessment of in vitro antimicrobial and anti-breast cancer activities of extracts isolated from desert truffles in Saudi Arabia

Truffles are consumed worldwide as a type of precious food. Desert truffles are characterized by their growth under extreme soil and climate conditions. They have numerous nutritional and medicinal applications. Desert truffles have been shown to exhibit various biological activities. During the present work, we identified two truffle types collected from Riyadh Province, Kingdom of Saudi Arabia, as Tirmania nivea and Terfezia claveryi. Their extracts showed significant antimicrobial activity against Bacillus subtilis, while the activity was less obvious against Escherichia coli. Hexane and ethyl acetate extracts of both types showed a dose-dependent effect against MCF-7 cancer cells, where their highest toxicities ranged from 91-93%. The lowest effective IC 50 values were 378.9±0.96 and 215.8±0.92 μg/mL for T. nivea and T. claveryi, respectively

Assessment of in vitro antimicrobial and anti-breast cancer activities of extracts isolated from desert truffles in Saudi Arabia

Truffles are consumed worldwide as a type of precious food. Desert truffles are characterized by their growth under extreme soil and climate conditions. They have numerous nutritional and medicinal applications. Desert truffles have been shown to exhibit various biological activities. During the present work, we identified two truffle types collected from Riyadh Province, Kingdom of Saudi Arabia, as Tirmania nivea and Terfezia claveryi. Their extracts showed significant antimicrobial activity against Bacillus subtilis, while the activity was less obvious against Escherichia coli. Hexane and ethyl acetate extracts of both types showed a dose-dependent effect against MCF-7 cancer cells, where their highest toxicities ranged from 91-93%. The lowest effective IC 50 values were 378.9±0.96 and 215.8±0.92 μg/mL for T. nivea and T. claveryi, respectively

Peguero Electrocardiographic Left Ventricular Hypertrophy Criteria and Risk of Mortality

Background: Peguero electrocardiographic left ventricular hypertrophy (ECG-LVH) criteria are newly developed criteria that have shown better diagnostic performance than the traditional Cornell-voltage and Sokolow-Lyon criteria. However, prediction of poor outcomes rather than detection of increased left ventricular mass is becoming the primary use for ECG-LVH criteria which requires investigating any new ECG-LVH criteria in terms of prediction.Aims: To examine the prognostic significance of the newly developed Peguero ECG-LVH criteria.Methods: We compared the prognostic significance of Peguero ECG-LVH with Cornell-voltage and Sokolow-Lyon ECG-LVH criteria in 7,825 participants (age 59.8 ± 13.4 years; 52.7% women) from the third National Health and Nutrition Examination Survey who were free of major intraventricular conduction defects. ECG-LVH criteria were derived from digital ECG tracings processed at a central core laboratory.Results: At baseline, ECG-LVH was detected in 11.8% by Peguero; in 4.3% by Cornell voltage and in 6.4% by Sokolow-Lyon. During a median follow up of 13.8 years, 2,796 all-cause mortality events occurred. In multivariable models adjusted for demographics and cardiovascular risk factors, presence of Peguero ECG-LVH was associated with increased risk of all-cause mortality [HR (95% CI): 1.29 (1.16, 1.44)]. This association was not significantly different from the associations of Cornell voltage-LVH or Sokolow-Lyon LVH with all-cause mortality [HR (95%CI): 1.32 (1.12, 1.55) and 1.24 (1.07, 1.43), respectively; p-values for comparisons of these HRs with the HR of Peguero ECG-LVH 0.817 and 0.667, respectively]. Similar patterns of associations were observed with cardiovascular, ischemic heart disease and heart failure mortalities.Conclusion: Peguero ECG-LVH is predictive of increased risk of death similar to the traditional ECG-LVH criteria

Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa

Africa trails the rest of the world in COVID-19 cases and deaths. However, as the pandemic spreads through the continent, we expect increases in community infection in the months ahead. Patients with kidney infection, especially those with end-stage kidney disease and those with kidney transplants, are at high risk for acquiring the disease and dying from it. While there is limited evidence for the benefit of interventions, we have the advantage of learning from the experiences of those in China, Europe and the Americas. This document sets forth guidance for dealing with our patients who have acute and chronic kidney disease, including those on renal replacement therapy and the staff involved in their care. Emphasis is placed on preparedness and prevention strategies. As evidence and experience accumulate, it is likely that updated guidance will be needed.L’Afrique suit le reste du monde en termes de nombre de cas et de décès dus à COVID-19. Cependant, alors que la pandémie se propage à travers le continent, nous prévoyons une augmentation de l’infection communautaire dans les mois à venir. Les patients atteints d’une maladie rénale, en particulier ceux atteints d’une maladie rénale chronique en phase terminale et ceux ayant subi une transplantation rénale, courent un risque élevé de contracter la maladie et d’en mourir. Bien que les preuves d’interventions soient limitées, nous avons l’avantage de tirer des enseignements des expériences de ceux qui se trouvent en Chine, en Europe et dans les Amériques. Ce document présente des conseils pour traiter nos patients atteints d’insuffisance rénale aiguë et chronique, y compris ceux sous thérapie de suppléance rénale et le personnel impliqué dans leurs soins. L’accent est mis sur les stratégies de préparation et de prévention. Au fur et à mesure que les preuves et l’expérience s’accumulent, il est probable que des directives actualisées seront nécessaires

Correction: Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa

The authors of the article ‘Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa’ [1] wish to acknowledge the contribution of Professor Hussein El Fishawy. Our guidelines drew on various sources, including the Egyptian Ministry of Health guidelines, portions of which were adapted and reproduced with permission from the Egyptian Ministry of Health. Two of the authors of those guidelines, Professors Elsayed and Zaki, are also coauthors of our paper. Professor El Fishawy was the third author of the Egyptian guidelines and we would like to acknowledge his contribution to our review through this source, especially with respect to the treatment algorithms for patients with kidney transplants and those with acute kidney injury. Reference1. Elsayed HM, Wadee S, Zaki MS, Were AJO, Ashuntantang GE, Bamgboye EL, et al. Guidelines for the prevention, detection and management of the renal complications of COVID-19 in Africa. Afr J Nephrol. 2020; 23(1):109-126

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe