Staphylococcus aureus Nasal Carriage among Surgical personnel in National Ribat University Teaching Hospital-Khartoum-Sudan

Introduction: Staphylococcus aureus (S. aureus) is one of the most common causes of both community and hospital acquired bacterial infection. There is strong correlation between S aureus nasal carriage and disease progress. Nasal carriage is high among health care workers. Inappropriate usage of antibiotic may lead to emergence of resistant strains which has serious consequences. Objective: The objective of this study is to reveal the frequency of S aureus nasal carriage and its drug resistance among surgical personnel in National Ribat Teaching Hospital Khartoum Sudan. Methods: This is a hospital-based case study. Nasal smears were taken from medical workers in the surgical department and operational theater at National Ribat Teaching Hospital in Khartoum State, Sudan. Samples were processed, cultured, then susceptibility tests were performed using Bauer-Kirby disc diffusion methods following recommendations of National Committee for Laboratory Standards (NCCLS). Results were analyzed and discussed. Results: Sixty three samples were taken. Thirty were males. Growth was achieved in only eight (12.6%). Majority showed resistance to penicillin. However, alls strain were sensitive to amoxicillin/calvunalic acid, vancomycin and oxacillin. Conclusion: this study gives an early alarm on the problems related to S. aureus colonization rate and its drug resistance. Nevertheless, the small number of our study group is a bit fall. Keywords: drug resistance, hospital acquired bacterial infection Sudan Journal of Medical Science Vol. 3 (4) 2008: pp. 281-28

A Quantile Variant of the EM Algorithm and Its Applications to Parameter Estimation with Interval Data

The expectation-maximization (EM) algorithm is a powerful computational technique for finding the maximum likelihood estimates for parametric models when the data are not fully observed. The EM is best suited for situations where the expectation in each E-step and the maximization in each M-step are straightforward. A difficulty with the implementation of the EM algorithm is that each E-step requires the integration of the log-likelihood function in closed form. The explicit integration can be avoided by using what is known as the Monte Carlo EM (MCEM) algorithm. The MCEM uses a random sample to estimate the integral at each E-step. However, the problem with the MCEM is that it often converges to the integral quite slowly and the convergence behavior can also be unstable, which causes a computational burden. In this paper, we propose what we refer to as the quantile variant of the EM (QEM) algorithm. We prove that the proposed QEM method has an accuracy of $O(1/K^2)$ while the MCEM method has an accuracy of $O_p(1/\sqrt{K})$. Thus, the proposed QEM method possesses faster and more stable convergence properties when compared with the MCEM algorithm. The improved performance is illustrated through the numerical studies. Several practical examples illustrating its use in interval-censored data problems are also provided

Medium Optimization using Response Surface Methodology for High Cell Mass Production of Lactobacillus acidophilus

608-614Lactobacillus acidophilus belongs to probiotic microflora inhabiting human gut that provide beneficially enhances human health. Besides balancing the intestinal flora and inhibiting pathogenic microorganisms, the existence of L. acidophilus inside the intestine can restore gut flora following antibiotics treatments. However, usually microorganisms from lactic acid bacteria group are known as fastidious microorganism and naturally required complex nutrients to promote their cellular growth. Therefore, twelve reported cultivation media were screened for their capability to support cell growth of L. acidophilus. The most suitable medium was further optimized using response surface methodology (RSM) and Box-Behnken design to maximize cell growth of L.acidophilus. Using this statistical approach, about 2.5-fold increase in maximal cell dry weight was achieved (5.14 g L-1) compared to the original medium (2.05 g L-1).This increase was accompanied by a significant increase in cell growth rates as well. The new medium formulation composed of (g L-1): glucose, 50; yeast extract, 20.91; ammonium citrate, 3.42; citric acid, 0.5; KH2PO4, 1.5; MgSO4.7H2O, 0.4; MnSO4.7H2O, 0.05; sodium acetate, 1; tween 80, 1

Kefiran biopolymer: Evaluation of its physicochemical and biological properties

Kefiran, an exopolysaccharide produced by lactic acid bacteria, has received a great interest due to a variety of health claims. In this study, we aim to investigate the physicochemical and biological properties of Kefiran polysaccharide extracted from Portuguese kefir grains. The kefir growth rate was about 56% (w/w) at room temperature and the kefir pH after 24 h was about 4.6. The obtained yield of Kefiran polysaccharide extracted from the kefir grains was about 4.26% (w/w). The Kefiran structural features were showed in the 1H nuclear magnetic resonance spectrum. The bands observed in the infrared spectrum confirmed that the Kefiran had a β-configuration; and the X-ray photoelectron spectroscopy analysis confirmed the structure and composition of Kefiran and revealed a C/O atomic ratio of 1.46. Moreover, Kefiran showed an average molecular weight (Mw) of 534 kDa and a number-average molecular weight (Mn) of 357 kDa. Regarding the rheological data obtained, Kefiran showed an interesting adhesive performance accompanied by a pseudoplastic behavior, and the extrusion force of Kefiran was 1 N. Furthermore, Kefiran exhibited a higher resistance to hyaluronidase degradation than hyaluronic acid. Finally, Kefiran showed a lack of cytotoxic response through its ability to support metabolic activity and proliferation of L929 cells, and had no effect on these cells’ morphology. Our research suggested that Kefiran polymer has attractive and interesting properties for a wide range of biomedical applications, such as tissue engineering and regenerative medicine.H.R., C.G., and F.R.M. were supported by grants with reference SFRH/BPD/100957/2014, SFRH/ BPD/94277/2013, and SFRH/BPD/117492/2016, respectively, of Fundação para a Ciência e a Tecnologia (FCT) from Portugal. J.M.O. thanks the FCT for the funds provided under the program Investigador 2015 (IF/01285/2015).info:eu-repo/semantics/publishedVersio

Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy

Background A reliable system for grading operative difficulty of laparoscopic cholecystectomy would standardise description of findings and reporting of outcomes. The aim of this study was to validate a difficulty grading system (Nassar scale), testing its applicability and consistency in two large prospective datasets. Methods Patient and disease-related variables and 30-day outcomes were identified in two prospective cholecystectomy databases: the multi-centre prospective cohort of 8820 patients from the recent CholeS Study and the single-surgeon series containing 4089 patients. Operative data and patient outcomes were correlated with Nassar operative difficultly scale, using Kendall’s tau for dichotomous variables, or Jonckheere–Terpstra tests for continuous variables. A ROC curve analysis was performed, to quantify the predictive accuracy of the scale for each outcome, with continuous outcomes dichotomised, prior to analysis. Results A higher operative difficulty grade was consistently associated with worse outcomes for the patients in both the reference and CholeS cohorts. The median length of stay increased from 0 to 4 days, and the 30-day complication rate from 7.6 to 24.4% as the difficulty grade increased from 1 to 4/5 (both p < 0.001). In the CholeS cohort, a higher difficulty grade was found to be most strongly associated with conversion to open and 30-day mortality (AUROC = 0.903, 0.822, respectively). On multivariable analysis, the Nassar operative difficultly scale was found to be a significant independent predictor of operative duration, conversion to open surgery, 30-day complications and 30-day reintervention (all p < 0.001). Conclusion We have shown that an operative difficulty scale can standardise the description of operative findings by multiple grades of surgeons to facilitate audit, training assessment and research. It provides a tool for reporting operative findings, disease severity and technical difficulty and can be utilised in future research to reliably compare outcomes according to case mix and intra-operative difficulty

High-Dose Testosterone Propionate Treatment Reverses the Effects of Endurance Training on Myocardial Antioxidant Defenses in Adolescent Male Rats

This study was aimed at evaluation of changes in activities of selected antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase, and glutathione reductase) and contents of key nonenzymatic antioxidants (glutathione, protein thiol groups, and α- and γ-tocopherols) in the left heart ventricle of young male Wistar rats subjected to endurance training (treadmill running, 1 h daily, 5 days a week, for 6 weeks) or/and testosterone propionate treatment (8 or 80 mg/kg body weight, intramuscularly, once a week, for 6 weeks) during adolescence. The training alone increased the activities of key antioxidant enzymes, but lowered the pool of nonenzymatic antioxidants and enhanced myocardial oxidative stress as evidenced by elevation of the lipid peroxidation biomarker malondialdehyde. The lower-dose testosterone treatment showed mixed effects on the individual components of the antioxidant defense system, but markedly enhanced lipid peroxidation. The higher-dose testosterone treatment decreased the activities of the antioxidant enzymes, lowered the contents of the nonenzymatic antioxidants, except for that of γ-tocopherol, reversed the effect of endurance training on the antioxidant enzymes activities, and enhanced lipid peroxidation more than the lower-dose treatment. These data demonstrate the potential risk to cardiac health from exogenous androgen use, either alone or in combination with endurance training, in adolescents