Antibacterial Effect of Azadirachta Indica (Neem Extract) and Chlorhexidine as Cavity Disinfectants in Primary Teeth in a Group of Egyptian Children (A Randomized Clinical Trial)

Introduction: The prevention and control of caries requires the eradication of cariogenic microorganisms that produce acids responsible for reducing the pH and starting the demineralization process. With the increasing incidence of drug resistance in the prevalent pathogens and an associated risk with chemotherapeutic agents, it is essential to find an alternative to existing drugs. Aim: The aim of this study was to investigate the effect of neem extract and 2% chlorhexidine (CHX) as cavity disinfectants in the reduction of total viable count in Atraumatic Restorative Treatment (ART) in children. Subjects and Methods: The study included two test groups, Group I (2% chlorhexidine) and Group II (neem extract). Nine patients with at least one tooth with a carious lesion suitable for ART were selected for each group; samples of dentin were collected using sterile spoon excavators at three stages from each tooth: pre-excavation, post-excavation and post-disinfection of the cavities. These dentinal samples were subjected to microbiological analysis for Total Viable Count (TVC). The data collected were statistically analysed using ANOVA and Shapiro-Wilk tests. Results: The results of present study showed that there was a statistically significant reduction in TVC when compared between pre and post excavation in both groups (p Conclusion: Natural antibacterial agents like neem could be effectively used as cavity disinfectant which will help in minimizing secondary caries and rendering a long term restorative success

Correlation of serum soluble endoglin to the severity of pre-eclampsia and its effect on the pregnancy outcome

Background: Preeclampsia is a major obstetric problem and a significant source of maternal and neonatal morbidity and mortality. Preeclampsia  is associated with  increased  risks of  placental  abruption,  acute renal  failure,  cerebrovascular and  cardiovascular complications, disseminated intravascular  coagulation,  and  maternal death. Consequently, early diagnosis of preeclampsia and  close  observation are imperative. In these cases of preeclampsia, combination of Doppler flowmetry and circulating angiogenic factors levels are recorded. Stepan et al examined endoglin, a cell-surface co-receptor for transforming growth factor in patients with Doppler flow patterns of preeclampsia at 19-24 weeks. Soluble endoglin levels were elevated in second trimester pregnancies with abnormal uterine perfusion in women who experienced preeclampsia. The aim of this study was to test if there is correlation between the level of serum endoglin in pregnant women with severe preeclampsia to the maternal and fetal outcome.Methods: This study was conducted on a group of 90 pregnant women attended to the Antenatal clinic and selected from the preeclampsia unit of EL- Shatby Maternity University Hospital, The selected patients were subdivided in two groups. Group A (control group): 30 cases of normotensive pregnant ladies. Group B (case group): 60 cases of severe preeclamptic pregnant ladies. Routine investigations, maternal serum soluble endoglin and ultrasound results were analysed and compared for both groups.Results: Significant correlation was found between severe preeclampsia and high level soluble endoglin. Significant correlation was found between high level of soluble endoglin and the occurrence of IUGR among the severe preeclamptic patients. Positive correlation was found between serum level of soluble endoglin and uterine artery PI and uterine artery RI, the higher the serum level of soluble endoglin the higher the uterine artery pulsatility and resistance index. Significant correlation was found between high level of soluble endoglin and the occurrence of specific complications, the higher the level of soluble endoglin the higher the risk of exposure to preeclampsia complications as the occurrence of eclamptic fits, the development of HELLP syndrome, the admission to the ICU, the admission of the baby to the NICU, and the fetal death.Conclusions: From our study, it is evident that serum endoglin rises during  normal  as  well  as  preeclamptic  pregnancy  and that  the  rise  in  preeclampsia  is  much  higher, the rise in endoglin levels may  occur  as  early  as  the  first  trimester  in  pregnancies  which  later  develop  preeclampsia.   Hence, used alone or in combination with uterine artery Doppler flowmetry, the measurement of soluble serum endoglin has the potential for use as a predictive clinical test for preeclampsia risk assessment and could potentially improve the outcome of pregnancy

Assessment of patient safety culture perception among healthcare workers in intensive care units of Alexandria Main University Hospital, Egypt

Background: Patient safety culture (PSC) is a vital feature to assess the ability of any healthcare setting in addressing and reducing patients harm. This study attempted to assess the PSC in Intensive Care Units (ICUs) at Alexandria Main University Hospital (AMUH) from the point of view of physicians and nurses. Methods: A cross-sectional study was implemented in two ICUs at AMUH over period of six months. Seventy-two participants were interviewed using the Hospital Patient Safety Scale, customized by the Agency for Healthcare Research and Quality (AHRQ). Results: The average positive response to individual items in the patient safety scale ranged from 2.7% to 79.2%. The “Teamwork within Units” dimension had the utmost average percentage positive score (63.5%) amongst all participants, on the other hand, the “Non-Punitive Response to Errors” dimension had the lowest one (12.0%). Less than half (45.8%) of the interviewed participants rated patient’s safety at the hospital as accepted. Conclusions: PSC is friable in targeted ICUs, much of work is needed to raise the responsiveness of health care givers regarding this issue. Executives and supervisors need to encourage the practices of PS through a blame free culture

Long-term spatiotemporal stability and dynamic changes in the haemoparasite community of spiny mice (Acomys dimidiatus) in four montane wadis in the St. Katherine Protectorate, Sinai, Egypt

Background: Long-term field studies of parasite communities are rare but provide a powerful insight into the ecological processes shaping host-parasite interactions. The aim of our study was to monitor long-term trends in the haemoparasite communities of spiny mice (Acomys dimidiatus) and to identify the principal factors responsible for changes over a 12 year period. Methods: To this end we sampled four semi-isolated populations of mice (n= 835) in 2000, 2004, 2008 and 2012 in four dry montane valleys (wadis) located in the Sinai Massif, Egypt. Results: Overall 76.2 % of spiny mice carried at least one of the five haemoparasite genera (Babesia, Bartonella, Haemobartonella, Hepatozoon, Trypanosoma) recorded in the study. Prevalence of haemoparasites varied significantly between the sites with the highest overall prevalence in Wadi Tlah and the lowest in W. El Arbaein, and this changed significantly with time. In the first two surveys there was little change in prevalence, but by 2008, when the first signs of a deepening drought in the region had become apparent, prevalence began to drift downwards, and by 2012 prevalence had fallen to the lowest values recorded from all four sites over the entire 12-year period. The overall mean species richness was 1.2 ± 0.03, which peaked in 2004 and then dropped by more than 50 % by 2012. Species richness was highest among mice from Wadi Tlah and peaked in age class 2 mice (young adults). Site was the most significant factor affecting the prevalence of individual parasite species, with Trypanosoma acomys and Hepatozoon sp. occurring mainly in two wadis (W. Tlah & W. Gharaba). In four of the five genera recorded in the study we observed a significant drop in prevalence or/and abundance since 2004, the exception being Hepatozoon sp. Conclusions: During the 12-year-long period of study in the Sinai, we observed dynamic changes and possibly even cycles of prevalence and abundance of infections which differed depending on parasite species. Although the exact reasons cannot be identified at this time, we hypothesize that the effects of a 15-year-long scarcity of rainfall in the local environment and a fall in host densities over the period of study may have been responsible for a drop in transmission rates, possibly by a negative impact on vector survival

Long-term spatiotemporal stability and dynamic changes in helminth infracommunities of spiny mice (Acomys dimidiatus) in St. Katherine’s Protectorate, Sinai, Egypt

The importance of parasites as a selective force in host evolution is a topic of current interest. However, short-term ecological studies of host-parasite systems, on which such studies are usually based, provide only snap-shots of what may be dynamic systems. We report here on four surveys, carried out over a period of 12 years, of helminths of spiny mice (Acomys dimidiatus), the numerically dominant rodents inhabiting the dry montane wadis in the Sinai Peninsula. With host age (age-dependent effects on prevalence and abundance were prominent) and sex (female bias in abundance in helminth diversity and in several taxa including Cestoda) taken into consideration, we focus on the relative importance of temporal and spatial effects on helminth infracommunities. We show that site of capture is the major determinant of prevalence and abundance of species (and higher taxa) contributing to helminth community structure, the only exceptions being Streptopharaus spp. and Dentostomella kuntzi. We provide evidence that most (notably the Spiruroidea, Protospirura muricola, Mastophorus muris and Gongylonema aegypti, but with exceptions among the Oxyuroidae e.g. Syphacia minuta), show elements of temporal-site stability, with rank order of measures among sites remaining similar over successive surveys and hence some elements of predictability in these systems

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

Poly(Glycerol Adipate-co-ω-Pentadecalactone) Spray-Dried Microparticles as Sustained Release Carriers for Pulmonary Delivery

Purpose The aim of this work was to optimize biodegradable polyester poly(glycerol adipate-co-ω-pentadecalactone), PGA-co-PDL, microparticles as sustained release (SR) carriers for pulmonary drug delivery. Methods Microparticles were produced by spray drying directly from double emulsion with and without dispersibility enhancers ( L -arginine and L -leucine) (0.5–1.5%w/w) using sodium fluorescein (SF) as a model hydrophilic drug. Results Spray-dried microparticles without dispersibility enhancers exhibited aggregated powders leading to low fine particle fraction (%FPF) (28.79 ± 3.24), fine particle dose (FPD) (14.42 ± 1.57 μg), with a mass median aerodynamic diameter (MMAD) 2.86 ± 0.24 μm. However, L -leucine was significantly superior in enhancing the aerosolization performance ( L- arginine:%FPF 27.61 ± 4.49–26.57 ± 1.85; FPD 12.40 ± 0.99–19.54 ± 0.16 μg and MMAD 2.18 ± 0.35–2.98 ± 0.25 μm, L -leucine:%FPF 36.90 ± 3.6–43.38 ± 5.6; FPD 18.66 ± 2.90–21.58 ± 2.46 μg and MMAD 2.55 ± 0.03–3.68 ± 0.12 μm). Incorporating L -leucine (1.5%w/w) reduced the burst release (24.04 ± 3.87%) of SF compared to unmodified formulations (41.87 ± 2.46%), with both undergoing a square root of time (Higuchi’s pattern) dependent release. Comparing the toxicity profiles of PGA-co-PDL with L -leucine (1.5%w/w) (5 mg/ml) and poly(lactide-co-glycolide), (5 mg/ml) spray-dried microparticles in human bronchial epithelial 16HBE14o- cell lines, resulted in cell viability of 85.57 ± 5.44 and 60.66 ± 6.75%, respectively, after 72 h treatment. Conclusion The above data suggest that PGA-co-PDL may be a useful polymer for preparing SR microparticle carriers, together with dispersibility enhancers, for pulmonary delivery

BM-MSCs alleviate diabetic nephropathy in male rats by regulating ER stress, oxidative stress, inflammation, and apoptotic pathways

Introduction: Diabetic nephropathy (DN), a chronic kidney disease, is a major cause of end-stage kidney disease worldwide. Mesenchymal stem cells (MSCs) have become a promising option to mitigate several diabetic complications.Methods: In this study, we evaluated the therapeutic potential of bone marrow-derived mesenchymal stem cells (BM-MSCs) in a rat model of STZ-induced DN. After the confirmation of diabetes, rats were treated with BM-MSCs and sacrificed at week 12 after treatment.Results: Our results showed that STZ-induced DN rats had extensive histopathological changes, significant upregulation in mRNA expression of renal apoptotic markers, ER stress markers, inflammatory markers, fibronectin, and intermediate filament proteins, and reduction of positive immunostaining of PCNA and elevated P53 in kidney tissue compared to the control group. BM-MSC therapy significantly improved renal histopathological changes, reduced renal apoptosis, ER stress, inflammation, and intermediate filament proteins, as well as increased positive immunostaining of PCNA and reduced P53 in renal tissue compared to the STZ-induced DN group.Conclusion: In conclusion, our study indicates that BM-MSCs may have therapeutic potential for the treatment of DN and provide important insights into their potential use as a novel therapeutic approach for DN